الفهرس 
Attention deficit hyperactivity disorderOnly 14 pages are availabe for public view
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Abstract
Attention deficit hyperactivity disorder (ADHD) is a developmental condition of inattention and distractibility, with or without accompanying hyperactivity. There are 3 basic forms of ADHD described in the Diagnostic and Statistical Manual, Fifth Edition (DSM-5) of the American Psychiatric Association: inattentive; hyperactive-impulsive; and combined.
learning disorder (LD) is the umbrella term for mathematics, reading, and written expression disorders. It is now a single, overall diagnosis, incorporating deficits that impact academic achievement. Rather than limiting learning disorders to diagnoses particular to reading, mathematics and written expression, the criteria describe shortcomings in general academic skills and provide detailed specifiers for the areas of reading, mathematics, and written expression. The diagnosis requires persistent difficulties in reading, writing, arithmetic, or mathematical reasoning skills during formal years of schooling
the present study was composed of two groups:
The case group: including 40 children attended the Pediatric Clinic in the military production hospital and Faculty of Postgraduate Childhood during a period of one year complaining of ADHD .they were 40%boys and 60%girls and another 40 children with poor scholastic achievement they were 45%boys and 55%girls. All children were subjected to DSM V criteria.A second group including 40 control children at school age were identified from the community as healthy and not been diagnosed as ADHD and learning disability. there were 50% boys and 50% girls . the two groups were subjected to history taking, clinical examination and laboratory investigation including complete blood count and serum ferritin to all children.
In our study ADHD patients of had statistically significant lower serum ferritin level with mean 15.72 as compared to control group with mean 30.43.Also, LD group had statistically significant lower serum ferritin level with mean 25.27 when compared to control group
Also in current study,Results of conner test in ADHD group were inversely proportional to serum ferritin level
Also in our study ADHD patients had statistically significant lower RBCs parameters as compared to control groupe, as regards LD group they had statistically significant lower RBCs parameters when compared to control group
There was no statistically significant difference between ADHD and control group regard . BMI, sex ,consanguinity ,age ,drugs during pregnancy.
Regards Last IQ In ADHD group mean was 83.58 (± 3.75) There was a statistically significant deffrence between them and control group .in LD group mean was 91.62(±11.55 )There was a no statistically significant difference between them and control group .
As regards current school function in ADHD group 24 (60%) bad,4 (10%) good and 12 (30%) moderate .in LD group bad 22 59.5% 0 good and 13 (35.1%) moderate. with statistically difference between them and control group
In current study Vital signs as blood pressure, HR, RR and temperature were normal in both groups with no statistically difference between them and control group
Also , general signs of iron deficiency as fatigue, weakness, headache, short breath, dizziness, tachycardia and short stature were normal in both groups with no statistically difference between them and control group
and local signs of iron deficiency in group a there were 10 (25%) had pale skin, 5 (12.5%) had cold skin and 5 12.5% had brittle nails.in group b there were 5(12.5) %had pale skin ,4 (11%) had cold skin and 4 (11%) had brittle nails with no statistically difference between them and control group
4- audiological examination was normal of all patients in both groups
from this study we concluded that serum ferritin level as an indicator of iron store was law in ADHD and LD children. This study suggested an association between low serum ferritin levels among Egyptian children with ADHD and LD.
Overall, these results suggested that lower ferritin level was associated with higher behavioral problems reported by parents. However, when other factors, such as age, gender, MCV, hemoglobin, RDW, and comorbidity were taken into consideration ferritin seemed to be a significant factor for behavior problems reported by the parents. Subjects with comorbid ADHD had lower hemoglobin and MCV, which may contribute to behavioral problems. Presence of comorbid conditions might increase the effect of lower iron stores on behavioral measures. These results suggested that ferritin level must be evaluated in subjects with ADHD, particularly when comorbid conditions exists.
In current study conner test in ADHD was inversely proportional to serum ferritin level
iron has a role in neurotransmission, neurofunctional maturation, and overall efficacy of the central nervous system. Assays for serum ferritin and hemoglobin. We hypothesized that lower iron status would accompany lower academic performance and that a significant correlation between iron status and all measures of academic performance would reveal a difference between iron deficient and iron sufficient individuals regarding school grades. Following data analysis, a significant positive relationship was found between iron status and academic performance. The relationship (correlation) between serum ferritin and academic performance was in the positive direction, achieving significance with Grade Average.
It was found that Vital signs as blood pressure, HR, RR and temperature were normal in both groups with no statistically difference between them and control group
Also, general signs of iron deficiency as fatigue, weakness, headache, short breath, dizziness, tachycardia and short stature were normal in both groups with no statistically difference between them and control group
The most frequent local signs of iron deficiency in both ADHD and LD groups pale skin.
Recommendation
• Early detection and assessment of iron stores in children and accurate management and follow up is a mandatory for infants and toddlers.
• Update the assessment profile of ADHD and LD to include serum ferritin level and RBCs parameters. It may act as severity indicator
• iron supplementation programs among those with ADHA and LD
• for anemic patients screening of ADHD and LDs and screeninig for anemia among ADHD and LD