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: The purpose of this work is to evaluate the effect of sex on the outcome of congenital heart diseases (CHDs) in children. The frequency of occurrence of each outcome within the disease is also detected. Methods 312 patients (171 males and 141 females) with CHDs aged less than 12 years were included in this study. For them complete history taking, physical examination, chest X-ray, electrocardiography and echocardiography were done. The following aspects were recorded: mortality, surgical repair, development of pulmonary hypertension, diagnosis of heart failure, hospitalization due to chest infection and growth parameters (weight and height). Results Of 312 patients the most frequent two diagnoses were atrial septal defect (28.8%), and ventricular septal defect (28.2%). Death occurred in 4.8% of patients with no significant gender difference. 11.9% of patients were treated surgically with no sex disparity. 23.1% developed heart failure and 34.9% of the patients developed pulmonary hypertension with no significant sex difference. 35.6% and 34.6% of the patients were below 10th percentile for weight for age and height for age, respectively with no sex difference. Hospitalization due to chest infection occurred in 42.9% of the patients; females had significantly higher risk than males. Conclusion Females are more vulnerable to hospitalization due to chest infection than males in children with congenital heart diseases while as regards mortality, access to surgery, occurrence of heart failure, development of pulmonary hypertension and affection of growth, no significant gender differences were detected.
    The Gazette of the Egyptian Paediatric Association 06/2014;
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    ABSTRACT: Objective Juvenile dermatomyositis (JDM) is the most common inflammatory myopathy of childhood and is characterized by proximal muscle weakness and pathognomonic skin rashes. In this study, we performed a descriptive cross sectional study to assess the clinical manifestations and outcomes of 39 patients with JDM from the northeast of Iran during 12 years and compared our findings with other studies. Design 39 patients (16 boys and 23 girls) with juvenile dermatomyositis were studied retrospectively between 2001 and 2013. Gender, age at disease onset and diagnosis, clinical manifestations, laboratory data at onset, treatment and outcome of these patients were reviewed. Measurements and results The mean age of onset was 9.42 ± 3.85 years. At the time of presentation, muscle weakness occurred in 100%; heliotrope rash in 51.2%; gottron’s papules in 46.1%, calcinosis in 12.8%, and 87.1% had at least one abnormal muscle enzyme result. Muscle biopsy was performed in 15.3% and was abnormal in all. All patients received corticosteroids; but methotrexate, hydroxychloroquine, intravenous immunoglobulin, or azathioprine was added to corticosteroid in some patients. The mean follow-up period was 22.66 ± 23.53 months. Conclusions This study was in parallel with other reviews except for calcinosis which was observed with lower frequency. It is suggested that delay in diagnosis and treatment may be associated with calcinosis.
    The Gazette of the Egyptian Paediatric Association 06/2014;
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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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    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: 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: Objective and aim Residual PR after repair of tetralogy of Fallot is an important determinant of the outcome of patients. Patients and methods We aim to assess severity of PR by PR index and diastolic/systolic time velocity integrals (DSTVI) and to correlate both of them to RVMPI, to detect which is more likely to reflect RV global function. This is a cross sectional study in which 33 patients with repaired TOF, and 46 controls were enrolled. For each patient full medical history and examination were obtained, conventional and tissue Doppler echocardiography were done, to measure pulmonary regurgitation by two indices: PR index and diastolic systolic time velocity integrals (DSTVI), to measure myocardial tissue velocities at the tricuspid annulus, to determine RVMPI, and to correlate it to the PR indices. Results our study included 33 patients with totally corrected TOF, and 46 controls, there were statistically significant differences in S′,E′,A′ velocities, and RVMPI between cases and controls, no statistically significant correlation between PR index, DSTVI and the RVMPI of the patients. Conclusion Tissue Doppler RVMPI in patients after surgical repair of Fallot tetralogy is not correlated to the degree of PR measured by two indices: PR index and DSTVI, a new index that can assess severity of PR and correlate to RV functions is required.
    The Gazette of the Egyptian Paediatric Association 03/2014; 62(1):24–27.
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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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    The Gazette of the Egyptian Paediatric Association 10/2013; 61(s 3–4):91.
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    The Gazette of the Egyptian Paediatric Association 10/2013; 61(s 3–4):88–89.
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    The Gazette of the Egyptian Paediatric Association 04/2013; 61(2):53–56.
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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: Objective Community acquired pneumonia (CAP) accounts for more than two million deaths per year in children less than 5 years of age, mostly in developing countries. Viruses causing CAP have been identified in up to 50% of patients in studies using the real-time polymerase chain reaction (PCR). This study aimed at screening of viral etiology among hospitalized children with severe pneumonia. Methods In this prospective study conducted at Cairo University Children’s Hospital from 31st March 2010 to 1st April 2011 on 733 children admitted with a clinical and radiological diagnosis of pneumonia, nasopharyngeal or throat swabs were analyzed for common respiratory viruses, including respiratory syncytial virus (RSV), human metapneumovirus (hMPV), influenza B (Flu B), human parainfluenza virus (hPIV), influenza A (H1N1) and adenovirus (ADV) using the real time PCR technique. Results One or more respiratory viruses were detected in 311 patients. RSV was the most commonly detected virus isolated in 197(63.3%) followed by hPIV in 38(12.2%), hMPV in 34(10.9%) and ADV in 26(8.4%) patients. Six cases were positive for H1N1 making the virus the second least common, after Flu B, identified in a single patient in our study. Mixed infection with more than one respiratory virus was detected in 156(45%) cases. Conclusion RSV was the most predominantly isolated virus from all patients in addition to being the most common single virus to cause pneumonia in children with chronic diseases. Although the most commonly isolated virus in our study, RSV came third in causing complications following hPIV & H1N1, but this observation cannot be applied to the community.
    The Gazette of the Egyptian Paediatric Association 04/2013; 61(2):73–77.
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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.