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AL-Azhar Journal of Pediatrics
Number of Followers: 1  

  This is an Open Access Journal Open Access journal
ISSN (Online) 1110-7774
Published by Al-Azhar University Homepage  [6 journals]
  • ASSESSMENT OF PHOSPHOLIPASE A2 ACTIVITY IN PLASMA FOR DIAGNOSIS OF LATE
           ONSET NEONATAL SEPSIS

    • Abstract: Background: Neonatal sepsis is a life-threatening disease. Early diagnosis is essential, but no single marker of infection has been identified. sPLA2 is an acute phase reactant which plays a major role in inflammatory diseases by controlling extracellular eicosanoid production. sPLA2 can destroy bacteria through hydrolysis of their membrane lipids, and disturb surfactant function through hydrolysis of their phospholipid bilayer. Aim and objectives: The aim of this study is to assess the diagnostic value of serum Phospholipase A2 (sPLA2) in cases of late onset neonatal sepsis. Subjects and methods: This prospective study was conducted on 60 neonates, admitted in NICU of Bab El-sheria, hospitals Al-Azhar University. From March 2022 to August 2022 and followed up in the neonatal intensive care unit in the same hospital. Neonates were divided into 2 groups, Group I (septic group):30 neonates with late onset neonatal sepsis, divided into two subgroups, subgroups I A→ 15 preterm neonates and subgroups I B→15 full-term neonates. Group II (nonseptic group):30 neonates with no clinical signs or laboratory evidence of sepsis, divided into two subgroups, subgroups Group II A→ 15 preterm neonates and subgroups II B→15 full-term neonates. Result: There was increase in concentration of sPLA2 in patient groups of preterm and full term (p < 0.001) and There was high positive significant correlation between sPLA2 and I/T ratio and CRP, while there was high negative significant correlation between sPLA2 and PLT. Conclusion: serum phospholipase A2 activity is increased in late onset neonatal sepsis and had a higher sensitivity and specificity than CRP& I/T ratio.
      PubDate: Fri, 30 Sep 2022 22:00:00 +010
       
  • A STUDY OF BLOOD LIPID PROFILE IN CHILDREN WITH DOWN SYNDROME COMPARED TO
           OTHER CHILDREN

    • Abstract: Background: Down syndrome (DS) is one of the most common causes of developmental disability in the world with a prevalence of 1:800 live births. Persons born with DS are at increased risk for various health conditions, including thyroid disease, leukemia, congenital heart defects, gastrointestinal tract abnormalities, obesity, and diabetes mellitus. Despite this increased risk of chronic disease, life expectancy for individuals with DS has continued to improve with an estimated mean survival approaching 60 years of age. Aim and objectives: To study lipid profile in patients with Down syndrome compared to normal children. Subjects and methods: This is a cross sectional analytic study that was carried out on a total of 100 children; 50 children previously diagnosed as Down syndrome by karyotyping and attending Bab Al sharia University Hospital and Alexandria University Hospital, and 50 healthy children as a control group during the period from February 2021 to January 2022, they were selected by simple random method. All studied children were subjected medical history (with special emphasis on age, sex and family history of ischemic heart disease or cerebrovascular accidents), clinical examination (with special emphasis on weight, height, body mass index and blood pressure) and laboratory investigations (TC, HDL, TG and LDL). Results: Down syndrome cases had values of triglyceride statistically higher than healthy children. DS had values of cholesterol and low-density lipoprotein statistically higher than healthy children. Healthy children had values of high-density lipoprotein statistically higher than DS. We found no correlation between sex and different elements of lipid profile within Down syndrome group and no correlation between age and different elements of lipid profile within the two groups. Conclusion: Down syndrome cases had values of triglyceride, cholesterol, and low density lipoprotein statistically higher than healthy children. Healthy children had values of high density lipoprotein statistically higher than DS.
      PubDate: Fri, 30 Sep 2022 22:00:00 +010
       
  • HIGHER VERSUS LOWER PROTEIN PARENTERAL NUTRITION EFFECT ON SERUM CYSTATIN
           C IN PRETERM ...

    • Abstract: Background: Nutritional interventions are crucial to optimal outcomes in preterm neonates. The effect of early high protein administration for preterm neonates on glomerular function remains controversial. Objectives: The primary objective is to study the effect of protein parenteral nutrition on serum cystatin C as a marker for renal function in preterm neonates. Secondary objectives are to compare the sensitivity of serum cystatin to serum creatinine in acute kidney injury in preterm neonates and to study the effect of protein parenteral nutrition on weight gain. Subjects and Methods: A case-control study was conducted at the neonatal intensive care units of Ain Shams University Hospital and Manshet El Bakery Hospital. Eighty four preterm neonates 36 weeks gestation or less were enrolled during the period from March 2016 to March 2017; 28 neonates who received enteral feeding and did not receive PPN comprised the control group, 28 neonates received low PPN at Manshet EL Bakery Hospital and 28 neonates received high PPN at Ain Shams University Hospital. Complete blood count, serum creatinine and blood urea nitrogen, serum Na, serum K, pH were measured on day 3 and 7 of life.  Serum cystatin C was measured by ELISA on day 7. Results: On day 7 there were no significant differences regarding serum cystatin C between the high and low PPN groups (P=0.289,). There were no significant differences between the high and low PPN regarding weight gain till day 7. Conclusion: Neither high nor low protein parenteral nutrition has significant effect on s. Cystatin C consequently high protein parenteral nutrition can be used to minimize weight loss without increasing the risk of metabolic acidosis or renal impairment in preterm neonates.  
      PubDate: Fri, 30 Sep 2022 22:00:00 +010
       
  • ATTENTION DEFICIT HYPERACTIVITY DISORDER AND VITAMIN D IN CHILDREN…IS
           THERE A RELATIONSHIP'

    • Abstract: Background: A frequent, early-onset, chronic developmental problem in children and adolescents is attention-deficit/hyperactivity disorder (ADHD). ADHD's etiopathogenesis is unknown. Low vitamin D levels have been linked in several studies to a variety of illnesses and neuropsychiatric conditions. Therefore, this study aimed to investigate the association between serum vitamin D levels in paediatrics and ADHD. Methods: This is a case-control study conducted in a child psychiatry clinic, Ain shams children’s hospital involving a total number of thirty ADHD patients diagnosed according to DSM-V criteria and thirty apparently healthy controls were included in the study during the period from June 2016 to January 2017, they were selected by simple random method. The age of both groups ranged from 6-16-year-old. Serum 25-OH-vitamin D level was evaluated in both groups. Results: Serum 25-OH-vitamin D was significantly lower in children with ADHD than in healthy controls. Conclusion: This study has evidenced a significantly low serum vitamin D level in children with ADHD. There is an association between lower 25-OH-vitamin D concentration and ADHD in childhood. Therefore there is a need for the treatment of patients with vitamin D deficiencies.
      PubDate: Fri, 30 Sep 2022 22:00:00 +010
       
  • ENVIRONMENTAL CO-EXPOSURE TO LEAD AND MANGANESE AND NEURODEVELOPMENTAL
           DISORDERS IN EGYPTIAN ...

    • Abstract: Background: Environmental pollutants are byproducts of our industrialized society. Exposure to Lead and Manganese resulting in elevated levels in the human body is becoming increasingly highlighted as findings, in Attention Deficit Hyperactivity Disorder (ADHD) and Autism which are of complex aetiology and showing increasing prevalence. Objective: This study aimed to investigate the association between ADHD, Autism and environmental exposure to Lead and Manganese. Methods: This case-control study included 100 children aged (2 – 13) years, 70 children previously diagnosed with psychiatric disorders (37 ADHD and 33Autism), diagnosed according to DSM-V criteria coming for follow-up in the Child Psychiatry clinic, Children’s hospital Ain Shams University, and 30 apparently healthy children comparable for age, sex, education and socioeconomic levels as control during the period from July 2018 to August 2020, they were selected by simple random method. Venous blood samples were taken from the studied population to determine the level of Lead and Manganese in the blood along with an interview questionnaire including personal, environmental, medical, psychiatric and social factors which was completed by parents. Results: Blood Lead levels ranged between 2-24 µg/dl among cases and 2-9 µg/dl among controls while Manganese levels were between 5-36 µg/dl among cases and 4-15 µg/dl among controls. Statistical analysis revealed a significantly elevated mean blood Lead level and mean blood Manganese level in children with ADHD and Autism versus the control group ( P<0.01). Conclusion: It was found that there is a statistically significant higher blood level of Lead and Manganese In patients with ADHD and Autism versus the control group. Environmental pollution is an important factor to be considered when handling psychiatric illnesses.
      PubDate: Fri, 30 Sep 2022 22:00:00 +010
       
  • ROLE OF URINARY CALCIUM/CREATININE RATIO IN DIAGNOSIS OF HYPERCALCIURIA IN
           CHILDREN WITH ...

    • Abstract: ABSTRACT Background: Early detection of pediatric urolithiasis is important to avoid the associated morbidities that can affect renal function. Hypercalciuria is a common contributing factor to urinary stone formation in children. Aim of the work: To assess the diagnostic performance of urinary calcium/creatinine (UCa/UCr) ratio as a screening test for cases of hypercalciuria with urolithiasis. Subjects and Methods: One hundred children with urolithiasis who attended the Nephrology and Urology Outpatient Clinics in Fayoum University Hospitals, Fayoum Insurance Hospital, and Fayoum General Hospital, during the period from June 2019 to June 2020 selected by simple random method an subjected to history taking, clinical examination, and investigations including blood chemistry, urine analysis, spot urine sample analysis for UCa/UCr ratio, calcium, and creatinine. Thirty age- and sex-matched, healthy children were included as control. Results: The UCa/UCr ratio was significantly higher among the cases (Median: 0.08 vs. 0.04, p-value = 0.019). Twenty-two percent of cases had a high UCa/UCr ratio above 0.2. The UCa/UCr ratio had the highest area under the curve (AUC = 0.641, p = 0.018) compared to urinary calcium (AUC = 0.575, p = 0.216) and creatinine (AUC = 0.625, p = 0.038). The optimal cut-off point for UCa/UCr ratio was 0.06, with 59% sensitivity and 62.3% specificity. Conclusions: UCa/UCr ratio is a potentially early, useful, practical, and non-invasive screening tool for the early detection of urolithiasis in children. We recommend urine microscopy and strict metabolic work-up for all patients who present with symptoms suggestive of urolithiasis
      PubDate: Fri, 30 Sep 2022 22:00:00 +010
       
  • EFFICACY AND SAFETY OF INTRAVENOUS PARACETAMOL VERSUS INDOMETHACIN FOR
           CLOSURE OF ...

    • Abstract: Background: Hemodynamically significant patent ductus arteriosus (hs-PDA) is a common cause of morbidity and mortality among preterm infants, affecting more than 40% of preterm infants. A persistent hs-PDA can cause significant problems, especially in premature infants. Thus, the early closure of hs-PDA is important to prevent several comorbidities such as necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH), pulmonary edema/hemorrhage, and development of chronic lung disease (CLD). Aim of the study: This study aimed at comparing the efficacy and safety of intravenous (IV) paracetamol compared with IV indomethacin for the pharmacological closure of PDA in preterm infants. Study design: This prospective, randomized study enrolled 100 preterm infants admitted at Bab-elsheria neonatal intensive care unit between August 2020 and August 2022. with gestational age ≤ 35 weeks and postnatal age within first two weeks of life who had hemodynamically significant PDA confirmed by 2 D transthoracic echocardiography. They were randomized into 2 groups, group I (paracetamol group) 50 preterm neonates received 15 mg/kg/6 h IV paracetamol infusion for 3 days, and group II (indomethacin group) 50 preterm neonates received 0.2 mg/kg/12 h indomethacin IV infusion for three doses. Results: The ductus was closed in 38 (76%) infants of the paracetamol group compared with 40 (80%) of the indomethacin group. The reopening rate was higher in the paracetamol group than in the indomethacin group, but the reopening rates were not statistically different (21% [8 of 38] vs 15% [6 of 40]; P =0 .695). The cumulative closure rates after the second course of drugs were high in both groups. Only 2 patient (4%) in the paracetamol group and also 2 patients (4%) in the indomethacin group required surgical ligation. Conclusion: Our study showed that use of IV paracetamol is effective as IV indomethacin in medical closure of hs-PDA in premature infants, and has no side effects mainly on renal function, platelet count, and gastrointestinal bleeding.
      PubDate: Fri, 30 Sep 2022 22:00:00 +010
       
  • THE EFFECT OF SHORT-TERM PROBIOTIC ADMINISTRATION IN NEWLY DIAGNOSED
           CHILDREN WITH TYPE 1 ...

    • Abstract: Background: Type 1 diabetes mellitus (T1DM) is among the most well studied organ-specific autoimmune diseases, it is associated with a lot of life long complications and comorbidities. A number of studies revealed that adolescents with antibody positivity which later progressed to T1DM had reduced diversity of intestinal bacteria. Short chain fatty acids (SCFAs) producing bacteria such as Lactobacillus and bifidobacteria have a documented beneficial effect in autoimmune suppression.Purpose: The main objective of the study is to assess the alterations of gut microbiota among young patients with newly diagnosed T1DM, and to identify if modulation of gut microbiota could partly explain the aetiology of the disease and if this intervention could help in diabetic patients’ management.Subjects and Methods: This is a pilot study which involved 30 newly diagnosed patients with T1DM. The study was done during the period of April 2022 till September 2022. Patients were recruited from outpatient diabetes clinic, Ain shams University pediatric Hospitals, and they were selected by simple random method. Subjects were divided into 2 groups; Control group [A] and intervention group [B].  Patients in group [B] received probiotic enriched yogurt intake (200 g, 10 × 109 colony forming unit (CFU) of both Bifidobacteria spp. and Lactobacillus spp.) daily for 12 weeks duration. All patients were subjected for full history, clinical examination, and laboratory measurements; HbA1C, fasting C peptide, and fecal microbiota assessment by PCR analysis for Log count of Lactobacillus and Bifidobacteria at the onset of the study and after 12 weeks.Results: Comparing the two samples' log counts of the examined bacteria revealed that sample [B] had a substantially greater log count of Lactobacillus than sample [A] (p=0.034). The log count of Bifidobacteria did not vary significantly between the two groups, though. Both groups had significant improvement in glycemic control, lipid profile and BMI Z score. However, No significant variation was detected between the two groups as regard data concerned with glycemic control and/or pancreatic function.Conclusion: Probiotics use alone or in combination with other multi-strains of probiotics, are potentially the useful in improving the intestinal bacterial diversity of useful SCFAs producing bacteria in T1DM patients, further studies with larger number of patients, studying multi-strains probiotic effect and with longer follow up period is highly recommended to emphasize our current study results.
      PubDate: Fri, 30 Sep 2022 22:00:00 +010
       
  • ASSOCIATION OF LOW-DENSITY LIPOPROTEIN RECEPTOR-RELATED PROTEIN-5
           4037C>T VARIANT WITH ...

    • Abstract: Background: In people who have uncontrolled T1DM, microvascular problems such diabetic nephropathy (DN) occur. The co-receptor ligands of the Wnt signalling pathway is lower density lipoprotein receptors-related protein 5 (LRP5). The human LRP5 genes have several single nucleotide variations that have been linked to metabolic diseases. It has been suggested that the Wnt/-catenin pathway is crucial in a number of metabolic diseases, particularly diabetic nephropathy. Unfortunately, there are few research investigating the function of the LRP5 genes variation in T1DM.Purpose: The progression of diabetes sequelae, including diabetic nephropathy and dyslipidemia, in addition to the relationship between the LRP5 variation 4037C>T and indicators of glycemic and metabolic control were examined in this cross-sectional case-control research of adolescents with T1DM.  Methods: Twenty age- and sex-matched control subjects and 40 juvenile T1DM participants participated in this study. All trial subjects underwent thorough history-taking, clinical evaluations, and lab tests to determine their glucose control and risk of diabetic microvascular complications. Employing real-time PCR, the LRP5 gene (rs3736228) variation assay was carried out.Results: The current investigation found no statistically significant change in the LRP5 rs3736228 gene variant between identical control subjects and adolescents with T1DM. A lack of a statistically relevant correlation between the LRP5 gene variation and the onset of diabetic nephropathy was found. Furthermore, there was a statistically significant correlation between obesity and hypercholesterolemia in T1DM individuals with the CT genotypes. Teenagers with DN had HbA1c levels that were considerably greater than those without DN (p=0.018).Conclusion:  According to the research, there is no connection between the LRP5 4037C>T variation and diabetic nephropathy in hospitalized children. Furthermore, there is a statistically significant correlation between the genotype CT and elevated BMI and hypercholesterolemia. Additional research is required to examine numerous gene variations associated with glycemic management and the emergence of diabetic complications.
      PubDate: Fri, 30 Sep 2022 22:00:00 +010
       
  • PERSISTENT FATIGUE POST COVID-19 INFECTION: A GROWING DILEMMA IN EGYPTIAN
           CHILDREN

    • Abstract: Background: Fatigue represents high incidence among the children with long Covid illness, multiple consequences are associated with disease including deteriorated school performance and social family burden, in this study we aimed to detect the pattern of chronic fatigue in children post COVID -19 infection and the possible risk factors. Patients and methods: A cross section study included 140 patients with confirmed COVID-19 infection recruited from Cairo university pediatric hospital during the period from September 2020 to September 2021, they were selected by simple random method. All patients were interviewed with the fatigue scale (CFQ-11) to assess the degree of fatigue and relate it to multiple predisposing factors. Results: The study included 140 patients 3-18 years old, they were 86 (61.4%) males, and 54 (38.6%) females, the incidence of fatigue was 67.9% according to the fatigue scale, the severity of the fatigue increased with the severity of the symptoms, hospital admission, and the presence of underlying diseases. Conclusion: chronic fatigue post Covid-19 infection is a growing dilemma in Egyptian children. It is related to different clinical and radiological factors. Proper history taking with specified scales and regular follow up are important to reduce the hazards of this growing problem.
      PubDate: Fri, 30 Sep 2022 22:00:00 +010
       
 
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