Treatment of a Boy with Idiopathic Mental Retardation: From Uneducable to Educable.

Background: Mental retardation has been recently called by the American Psychiatric Association “Intellectual disability”, despite that the World Health Organization is still using the term “Mental retardation” in its ICD-10 publication. It is a heterogeneous condition marked by generalized neurodevelopmental abnormalities associated with significant impairment in mental or intellectual functioning and adaptive behaviors that affect every day general living. Patients and methods: A comprehensive multi-factorial treatment approach was used to treat a boy with idiopathic (Moderate to severe) mental retardation who was uneducable with the main aim of making him more educable. Treatment courses included intramuscular citicoline, piracetam, cerebrolysin and oral pyritinol. Results: Treatment was successful in advancing the mental and cognitive functions of the patient and making the child perfectly educable. Conclusion: There is no single agent that is known to convert an educable mentally retarded child to perfectly educable. Idiopathic mental retardation is a heterogeneous condition and the use of multi-factorial therapeutic agents is suggested for its treatment.

Chronic Cutaneous Disorders in Down syndrome Patients

Background: Down syndrome is an extensively studied chromosomal disorder characterized by mental retardation and distinct physical manifestations, and it is the second most common cause of mental retardation in Iraqi children after idiopathic mental retardation. However, the chronic cutaneous conditions associated with the syndrome have received relatively inadequate attention. This paper aims to determine chronic cutaneous disorders persisting more than six months or reoccurring over six months in Down syndrome patients. Patients and Methods: Twenty-seven patients (17 males and 10 females) with Down syndrome were observed at the Children Teaching Hospital of Baghdad medical City and the Medical Consultation Clinic of Iraq headquarter of Copernicus Scientists international panel in Baghdad during 2018 and 2019. Their ages when they were first seen ranged from 4 months to 30 years. Results: Chronic cutaneous disorders were observed in four patients of the twenty-seven patients observed. Three patients including a thirteen-year-old girl and two boys had alopecia areata, and a man aged thirty years had familial baldness and Tinea corporis of the dorsum of the right hand. Conclusions: This paper highlights the association between Down syndrome and Tinea corporis which has not been noticeably emphasized in the medical literature.

The Etiology of Mental Retardation in Iraqi Children.

Background: Mental retardation is a group of heterogeneous disorders associated with generalized developmental delay during infancy and early childhood, while impairment in cognitive functions and adaptive behaviors became generally apparent during pre-school and early school years depending on the severity of the condition. Little is known about the etiology of mental retardation in Iraq. The aim of this paper is to describe the etiology of mental retardation in a sample of Iraqi children. Patients and methods: During one-year period (February 2018 to February 2019), thirty-six patients with mental retardation (25 males and 11 females) were observed at the neuropsychiatry clinic at the Children Teaching hospital of Baghdad Medical City. Their ages ranged from two to seventeen years. Patients with cerebral palsy, atypical autism with mental retardation and Rett syndrome were not included in this series. Results: Eighteen patients (50%) had idiopathic mental retardation (11 males and 7 females). Seven patients (19%) had Down syndrome (5 males and 2 females). Two male patients had Beckwith Wiedemann syndrome, one of them had an affected brother. Three males had inborn errors of metabolism, each one had phenylketonuria, homocystinuria and Lesch Nyhan syndrome. The patient with Lesch Nyhan syndrome had an older brother who died from the same condition. Six patients each one had Prader-Labhart-Willi syndrome, Sanjad Sakati Richardson Kirk syndrome, Coffin Siris syndrome, kernicterus, Bartter syndrome, Pediatric Huntington disease. Nonspecific abnormalities were present in three patients and included bilateral optic atrophy in one boy, squint and obesity in one girl and a second girl had large ears. Brain CT-scan was available for two patients with idiopathic mental retardation and one patient with kernicterus and showed normal findings. Conclusion: The causes of mental retardation in about two thirds of Iraqi patients with mental retardation were idiopathic mental retardation and Down syndrome.