role of hepcidin in iron overload in children with beta-thalassemia

Thalassemias are a group of inherited blood disorders with defective production of hemoglobin. Patients with beta-thalassemia develop iron overload due to increased iron absorption and transfusion therapy. Hepcidin is a hepatic hormone released in case of iron overload to regulate systemic iron homeostasis by inhibiting iron absorption from diet and recycling of iron by macrophages. To determine role of hepcidin in the pathogenesis of iron overload in 13-thalassemia. Setting: Departments of Clinical Pathology, and Pediatrics, Faculty of Medicine, Tanta University, Egypt. 20 patients with beta thalassemia major [TM] included 10 males and 10 females, 20 patients with beta thalassemia intermedia [TI] included 10 males and 10 females and twenty healthy children of matched age and sex were included in this study. We assessed iron overload by measuring serum ferritin, assessed erythropoietic activity by measuring serum erythropoietin levels, and correlated these with urinary hepcidin measurements. We found severe urinary hepcidin deficiency in TI with strong inverse relationship between urinary hepcidin and serum erythropoietin levels in comparison with control group. In contrast, urinary hepcidin levels were elevated in TM with decrease of erythropoietin levels. In addition, serum ferritin level was significantly higher in TM than TI and significantly higher in TM and TI compared with normal control. Hepcidin deficiency may be the key factor allowing excessive iron absorption and iron overload in TI while in TM, chronic hemolysis and frequent blood transfusions may be the main factors that increase iron load

effect of mode of delivery and types of anaesthesia on fetal welfare

This study was carried out on 60 non complicated healthy full term pregnant females and their neonates to study the effect of the mode of delivery and types of anaesthesia [general or epidural] on fetal welfare. The were divided into 4 equal groups, group I [natural vaginal delivery], group II [vaginal delivery under epidural anaesthesia, group III [elective cesarean section under general anaesthesia] and group IV [elective cesarean section under epidural anaesthesia]. For all of them, the plasma catecholamines and cortisol levels were measured. In groups I and II, the first sample was taken at 4-6 cm cervical dilatation and the second at the time of delivery of the head, while in groups III and IV, the first sample was taken just before induction of anaesthesia and the second sample at the time of uterine incision. Arterial blood gases for all parturients were done at the time of delivery of the head in groups I and II and at the time of uterin incision in groups III and IV. Fetal arterial samples were taken from the umbilical cord for all neonates for measurement of plasma catecholamines, cortisol and blood gases. Also, APGAR score at 1 and 5 min, was recorded. The of this study showed that the maternal catecholamines and cortisol levels increased significantly in group 1 and III while they decreased significantly in group II and group IV. The fetal catecholamines and cortisol increased significantly in groups I and II when compared with groups III and IV, also it increased significantly in group IV when compared with group III. The results of this study showed that the fetal outcome were similar in the 4 studied groups as judged by APGAR score and blood gases analysis. So, the conclusion of this study is that epidural anaesthesia during vaginal delivery or cesarean section may be of value for fetal welfare