The Gazette of the Egyptian Paediatric Association (Gaz Egypt Paediatr Assoc )

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    1110-6638

Publications in this journal

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    ABSTRACT: Background Although the antioxidant property of vitamin C as well as its endothelial function promotion are well documented, its role in fetal growth during pregnancy is still not conclusive in previous studies. Objectives This study aimed to estimate maternal and cord blood vitamin C level and to detect its influence on neonatal growth as well as placental weight and placental apoptosis. Methods The study was conducted on 60 healthy singleton pregnant women and their full term neonates at Ain Shams University Hospital in Egypt. Maternal and cord blood vitamin C plasma level estimation as well as quantitative analysis of placental apoptotic index were done in addition to full anthropometric assessment for delivered neonates. Results There was a positive significant correlation between maternal and neonatal vitamin C levels (r = 0.838, P < 0.001). Positive significant correlations between maternal vitamin C levels and neonatal weight (r = 0.448 , P < 0.001), length (r = 0.67, P < 0.001), BMI (r = 0.52, P = 0.003), OFC (r = 0.60, P < 0.001) and placental weight (r = 0.373, P < 0.001) while a significant negative correlation with placental apoptotic index (r = −0.817, P < 0.001) were detected. Multiple regression analysis showed that placental weight was the most sensitive predictor of neonatal weight (t = 4.132, P < 0.001) followed by maternal vitamin C (t = 3.034, P = 0.006). Conclusion Maternal vitamin C level has a significant positive impact on neonatal anthropometry and placental weight while negatively correlating with placental apoptosis. This denotes an important role of vitamin C in fetal and placental growth during pregnancy.
    The Gazette of the Egyptian Paediatric Association 07/2014;
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    ABSTRACT: Objective Acute lower respiratory tract infection (ALRTI) is an important cause of morbidity in the developed world, and both morbidity and mortality in the developing world. Vitamin D has a major role in both acquired and innate immunity. Anemic children have less oxygen carrying capacity of blood. This study was done to determine the relation between vitamin D deficiency, anemia and the severity of ALRTIs in hospitalized children. Methods This study included 96 hospitalized infants with ALRTI, 48 diagnosed with pneumonia and 48 with bronchiolitis. Mean age was 10.67 ± 3.143 months. Matched age and sex infants with no respiratory illness were included. Serum 25 hydroxy vitamin D was measured in all cases and controls by Radio-immune assay. Hemoglobin level was measured by Coulter. Results Vitamin D deficiency and low hemoglobin level were positively correlated with the severity of ALRTIs (r = 0.798 and P = 0.001) and (r = 0.708, P = 0.028), respectively. Low vitamin D level was significantly correlated with low hemoglobin level (r = 0.708, P = 0.028). Conclusion Vitamin D deficiency was associated with severity of ALRTIs. Low hemoglobin level was more prevalent in those children. Improving the nutritional status in children by preventing vitamin D deficiency and low hemoglobin might influence the outcome of children with ALRTI.
    The Gazette of the Egyptian Paediatric Association 03/2014; 62(1):1–7.
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    ABSTRACT: Introduction Oxidative stress is the imbalance between pro-oxidants and antioxidants resulting in irreversible cell damage. Objective To assess the oxidative stress status in a sample of Egyptian malnourished stunted children and investigate the relations between oxidative stress markers and anthropometric measurements. Patients and methods This cross sectional descriptive analytical study was carried out on 50 malnourished stunted children (28 males and 22 females), aged from 6–9 years and 50 healthy age and sex-matched controls. Blood oxidative stress biomarkers including catalase (CAT), superoxide dismutase (SOD) malondialdehyde (MDA), plasma glutathione (GSH), total plasma proteins, total anti-oxidant capacity (TAC), copper (Cu), zinc (Zn), and vitamin C were measured in patients and controls. Socio-economic status was assessed for patients. Body weight and height were measured and body mass index (BMI) was calculated. Patients were classified according to their height for age Z-scores (HAZ) into moderate and severe stunted. Results Nutritionally stunted children showed significantly lower levels of the blood oxidative stress biomarkers including, CAT, SOD, plasma GSH, total plasma proteins, Cu, Zn and vitamin C and significantly higher levels of MDA compared with controls (p < 0.001). There was significant difference in plasma levels of Vitamin C and Zn between patients with different social levels. No significant relationships were found between the degree of stunting and oxidative markers. Conclusions Nutritionally stunted children had an increased oxidative stress and decreased antioxidant defense system compared with healthy controls. Oxidative stress, malnutrition and low social level might play an important role in the pathogenesis of stunting.
    The Gazette of the Egyptian Paediatric Association 03/2014; 62(1):28–33.
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    ABSTRACT: Background More patients survive the operations for univentricular repair and the duration of follow up increases, the physicians are becoming increasingly aware of the late failure and the late complications of the surgery. Objective To evaluate the overall outcome of studied patients and to assess their functional status, and the occurrence of complications. Patients and methods This is a retrospective study; patients who underwent univentricular repair operations either Glenn or Fontan were included in the study. The following data were collected: age, sex, type of the operation, and presence of early post operative complications. The outcome was assessed by evaluating clinical status and growth of the patients during the follow-up visits. Medical and surgical complications were retrieved. Results Thirty-nine patients who underwent univentricular repair operations either Glenn or Fontan were included from the pediatric post operative cardiac outpatient clinic. Their age ranged from 2–18 years. 38 patients (97.4%) underwent Glenn operation followed by Fontan in 11 (27%) patients, 1 (2.6%) patient underwent Fontan without any previous operation and 4 (10.2%) patients underwent multistage palliation (prior operation to Glenn). 8 (20.5%) patients had early complications in the form of arrhythmia, bleeding, convulsions, and infection. The general functional status of patients is good; growth curves are within the normal range in 30 (76.9%), and NYHA class I in 24 (61.5%) patients. No late complications during follow-up and no mortality were documented. Conclusion Adequate post operative follow up is essential to improve midterm outcome of the patients.
    The Gazette of the Egyptian Paediatric Association 03/2014; 62(1):14–17.
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    The Gazette of the Egyptian Paediatric Association 10/2013; 61(s 3–4):85–87.
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    The Gazette of the Egyptian Paediatric Association 10/2013; 61(s 3–4):96–99.
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    ABSTRACT: Background It has been suggested that overtreatment of infants with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency might affect their growth and final height. Objective To assess the axiological parameters of infants with CAH due to 21-hydroxylase deficiency from their first presentation in neonatal period and during infancy, in an attempt to decide the optimum doses of glucocorticoid, mineralocorticoid and salt therapy that can achieve androgen suppression, prevent life-threatening salt-wasting crises, and allow normal growth velocity for age. Materials and methods Retrospective study conducted in the Diabetes Endocrine and Metabolism Pediatric Unit at Children’s Hospital, Cairo University included baseline and follow-up data of 28 infants with 21-hydroxylase deficiency. Results Median age at presentation was 34 days. Lower doses of hydrocortisone (<20 mg/m2/day) were associated with better growth, not reaching a statistical significance. Delta change in length standard deviation score (SDS) was significantly higher in males (p = 0.01). Delta change in length and weight SDS of cases with mean basal length SDS below −2 were significantly higher than those with mean basal length SDS above −2 (p = 0.02 and 0.04 respectively). No correlations were found between delta height-SDS and age at diagnosis, duration of follow-up, glucocrticoid or mineralocorticoid dosing. Conclusion Poor growth in infants with salt wasting CAH was not related to age at diagnosis and start of therapy, doses of glucocorticoid, fludrocortisones, or saline therapy. Male sex and mean basal length SDS below −2 were associated with a more favorable growth catch up. Further prospective studies with inclusion of intercurrent illnesses and nutritional status are needed.
    The Gazette of the Egyptian Paediatric Association 04/2013; 61(2):57–62.
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    ABSTRACT: Background Cesarean delivery per se is a risk factor of respiratory morbidity in term neonates and its timing is an adding factor of increased rates of respiratory complications. Objective We aimed to identify the association between elective cesarean delivery at 38 versus 39 week gestation and neonatal respiratory morbidity. Materials and methods We selected 200 pregnant women who underwent elective cesarean delivery at 38 or 39 week gestation at the Kasr El-Aini hospital. Mothers were subjected to ultrasound examination. Neonates with respiratory distress were subjected to laboratory investigations and chest X-ray. Results We found no association between the development of any type of respiratory distress and maternal age or parity. The prevalence of respiratory morbidity was 25% in group A compared to 11% in group B (p = 0.01) and risk estimation showed that delivery at 38 weeks carries 2.7 time risk of having a newborn suffering from respiratory morbidity (95% CI: 1.2–5.8). TTN was observed in 11% of group A compared to 7% of newborns of group B (p = 0.6). RDS developed in 3 cases of group A, while none of group B developed RDS (p = 0.1). The rate of NICU admission, mechanical ventilation in the 1st 24 h and long hospital stay were insignificantly higher in group A (p>0.05). There were no neonatal deaths in both groups. Conclusion Elective cesarean delivery at 39 week gestation is associated with a better neonatal respiratory outcome. Further studies are recommended to identify the best time of elective cesarean delivery associated with the least neonatal and maternal morbidity.
    The Gazette of the Egyptian Paediatric Association 04/2013; 61(2):78–82.
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    ABSTRACT: Background Increased prevalence of antinuclear antibodies (ANA) and auto glutamic acid decarboxylase antibodies (GADA) ratio have been reported in patients with epilepsy. Anti-GAD antibodies (GADA) were first implicated in the pathogenesis of some neurological diseases including epilepsy. The aim of the study To determine the occurrence of GADA and ANA in the serum of children with refractory epilepsy. Patients and methods Forty children with refractory epilepsy 25 males and 15 females, mean age 9.17 ± 3.4 years were selected for this study. Patients with refractory epilepsy had recurrent seizures for more than 18 months with no more than a 3-month seizure free period during those 18 months and failure of at least two appropriate AEDs with proper doses, good compliance and within normal therapeutic range. Twenty children with controlled idiopathic epilepsy 15 males and 5 females newly diagnosed as suffering from various types of seizures generalized and partial types, mean age 10.1 ± 3.1 years were also included in this study. These children with idiopathic epilepsy were included in this study for comparison with children with refractory epilepsy as regard to the serum ANA and GADA. Results Children with refractory epilepsy had high-serum levels of GADA and ANA in comparison to children with idiopathic epilepsy (P < 0.001), also there was a significant correlation between the duration of seizures and the serum levels of ANA and GADA in children with refractory epilepsy. Conclusion Children with refractory epilepsy had high-titer of GADA and ANA. The finding confirmed the association between high GADA, ANA and refractory epilepsy suggesting an immunologic origin of refractory epilepsy.
    The Gazette of the Egyptian Paediatric Association 01/2013; 61(1):46–51.
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    ABSTRACT: Background As survival rates of pediatric acute lymphoblastic leukemia (ALL) improve, attention is turning to side and late effects of therapy including glucose metabolism abnormalities. Objective To asses the presence of abnormal glucose metabolism in pediatric ALL survivors and its possible relation to body mass index (BMI), waist to hip ratio and treatment related factors. Subjects and methods Retrospective study with a prospective follow-up of 12 ALL survivors who had been off chemotherapy for >9 months was done. Fifteen healthy sex and age matched children were involved as controls. Body mass index (BMI) waist to hip ratio (WHR), and Oral glucose tolerance test (OGTT) were performed with assessment of glycated hemoglobin (Hb A1C) and insulin sensitivity indices. Results At study time the mean BMI, WHR, all components of the OGTT (except the 2 h post load glucose), all indices of insulin sensitivity and the mean Hb A1C% were significantly higher compared to those of the controls. Two survivors (16.6%) developed transient hyperglycemia during therapy, one (8.3%) had pre-diabetes, seven (58.3%) had a risk level of Hb A1C but no one had diabetes mellitus (DM) or insulin resistance (IR). At study time the two survivors with transient hyperglycemia during therapy had a significantly high WHR compared to the remainders. WHR of the survivors at study time correlated significantly with fasting plasma glucose and area of insulin under the curve (AUC). The 2 h post-prandial plasma glucose correlated with the duration after therapy completion. Conclusions WHR may play a better role than BMI in the prediction of insulin resistance in those patients. Hb A1C may increase earlier than other indices of glucose tolerance.
    The Gazette of the Egyptian Paediatric Association 01/2013; 61(1):7–14.
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    ABSTRACT: Background In the new era of medical curriculum development, the undergraduate medical students are expected to perform certain practical skills competently. Our aim is to evaluate the extent to which skills lab can achieve required learning outcomes. Methods After an establishment of practical skills lab (PSL), training of staff members, preparation of guidelines and checklists, and running of the first training course; an anonymous questionnaire was distributed to the students in order to evaluate students’ responses to skills teaching. Results Our results showed that the undergraduate medical students had high expectations to skills training, and that students’ expectations were nearly met, 90.4% thought that skills can be taught in PSL, 78% found PSL allows students to achieve an adequate level of competence, 53.2% found that skills acquired in PCSL can be transferred directly to patients, 80.7% found that PCSL build up students’ self confidence. Evaluation of training characteristics showed that 85.5% found that teachers of skills lab are committed to teaching, and 82.7% found that educational materials offered to them were helpful in skills learning. Conclusion The PSL was positively evaluated by undergraduate students and there is a need for extra hours for independent training to increase students’ self confidence.
    The Gazette of the Egyptian Paediatric Association 01/2013; 61(1):1–6.
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    ABSTRACT: Introduction Jaundice is a clinical condition that is often present in pediatric practice and constitutes one of the major issues within the neonatal period. It occurs in both the physiological and pathological processes in newborns.1 Although most newborns with jaundice are otherwise healthy, they need to be monitored because bilirubin is potentially toxic to the central nervous system.2 The American Academy of Pediatrics (AAP) in 2004 recommended that newborns discharged within 48 h should have follow up visits after 2–3 days to detect significant jaundice.3 Aim of the work This study was done to evaluate the predictive value of umbilical cord bilirubin in identifying infants for subsequent hyperbilirubinemia, in full-term (FT) and late pre-term (PT) newborns. Subjects and methods This study is a prospective clinical study which was carried out on 94 newborns taken from the delivery room (DR) and neonatal intensive care unit (NICU) of Ismailia General Hospital at Ismailia Governorate. The study population was followed up clinically and by laboratory investigations from birth and daily during the first week of life. Results The study population consisted of 50 males and 44 females with the mean gestational age of 38.70 ± 1.38 weeks in FT compared to 35.62 ± 0.64 in late PT. It was shown that 40.4% of PT needed treatment in the form of phototherapy compared to 29.8% of FT, and no one of both groups needed exchange transfusion. The mean total cord bilirubin was higher among males, preterm, cesarean deliveries, and ABO and RH incompatibility positive newborns. It was found that when cord blood in late PT newborns was ⩾1.75 mg/dl and ⩾1.85 mg/dl in FT newborns, there was a probability that those newborns may need phototherapy and when the levels of total cord bilirubin were ⩾2.05 mg/dl in PT newborns and ⩾2.15 mg/dl in FT it means that those babies are in actual need of phototherapy. Thus the cut-off points for total cord bilirubin level in PT and FT groups were 2.05 and 2.15 mg/dl respectively. Conclusion It was concluded that total serum bilirubin in cord blood was indicative of the jaundice severity developed by healthy FT and late PT newborns without complications, during the first week of life. Recommendations Cord blood bilirubin could be a useful indicator of developing jaundice in newborns and the use of cut off cord bilirubin levels could be a useful predictor of significant hyperbilirubinemia.
    The Gazette of the Egyptian Paediatric Association 01/2013; 61(1):23–30.
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    ABSTRACT: Background: Pleural effusion sometimes complicates community-acquired pneumonia (CAP); it is thought that it is due to increased vascular permeability. Vascular endothelial growth factor (VEGF) is an endothelial cytokine with an important role in angiogenesis and vascular permeability. A suggested active role for VEGF development of pleural effusion has been postulated. Aim of the work: This study investigated serum levels of VEGF in hospitalized pediatric patients with CAP with and without pleural effusion. PATIENTS AND METHODS: Forty -one cases with CAP were enrolled in the study against 40 age- and sex- matched normal controls. The following investigations were performed: complete blood counts, chest x- ray, quantitative C - reactive protein, erythrocytic sedimentation rate and assay of serum VEGF. RESULTS: Patients with effusion were significantly older (p = 0.001), and their ESR, CRP and total leukocytic levels were significantly higher (p = 0.006, 0.007 and 0.004, respectively). Serum VEGF was significantly higher in cases when compared to controls (1060.29 ± 67 vs. 686.11 ± 50 pg/ml respectively, 95% CI: [111; 638], p = 0.006). Serum VEGF was significantly higher in cases with effusion when compared to cases without effusion (1329 ± 66 vs. 829 ± 60 pg/ml respectively, 95% CI: [95; 905], p = 0.017). There was a significant direct correlation between serum VEGF and pleural effusion (Spearman’s rho = 0.0492, p = 0.001). CONCLUSIONS: Elevated serum VEGF levels in children with pneumonia especially those with pleural effusion, and the significant positive correlation between serum VEGF and amount of effusion postulate that VEGF, a potent inducer of vascular permeability, plays a causal role in pleural fluid formation.
    The Gazette of the Egyptian Paediatric Association 07/2012; 60.
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    ABSTRACT: Pleural effusion complicates community-acquired pneumonia (CAP). It is thought that it is due to increased vascular permeability. Vascular endothelial growth factor (VEGF) is a cytokine with an important role in angiogenesis and vascular permeability. A suggested active role for VEGF in development of pleural effusion has been postulated. This study investigated serum levels of VEGF in hospitalized pediatric patients with CAP with and without pleural effusion. Forty-one cases with CAP were enrolled in the study against 40 age- and sex- matched healthy controls. The following investigations were performed: complete blood counts, chest x- ray, quantitative C-reactive protein, erythrocytic sedimentation rate and assay of serum VEGF. Patients with effusion were significantly older (p = 0.001), and their ESR, CRP and total leucocytic levels were significantly higher (p = 0.006, 0.007 and 0.004, respectively). Serum VEGF was significantly higher in cases when compared to controls (1060.29 ± 67 vs. 686.11 ± 50 pg/ml respectively, 95% CI= [111; 638], p = 0.006). Serum VEGF was significantly higher in cases with effusion when compared to cases without effusion (1329 ± 66 vs. 829 ± 60 pg/ml respectively, 95% CI= [95; 905], p = 0.017). There was a significant direct correlation between serum VEGF and pleural effusion (Spearman’s rho = 0.492, p = 0.001). The study concluded that there were elevated serum VEGF levels in children with CAP especially when associated with pleural effusion, and that the significant positive correlation between serum VEGF and amount of effusion postulate that VEGF, a potent inducer of vascular permeability, plays a causal role in pleural fluid formation.
    The Gazette of the Egyptian Paediatric Association 01/2012; 60(3).
  • The Gazette of the Egyptian Paediatric Association 04/2011; vol 59(issue 5).
  • The Gazette of the Egyptian Paediatric Association 10/2010; vol 58(issue 4):49-55.
  • The Gazette of the Egyptian Paediatric Association 01/2001; 49:4-7.