Effect of phototherapy on cytokines in neonatal jaundice

Jaundice is a common problem in the neonatal period. Phototherapy is, so far, the most effective and safe management of neonatal jaundice. Cytokines are proteins synthesized and secreted by T, B, and NK cells, and by the cells with which they interact. They have the ability to promote and facilitate differentiation and proliferation of the cells of the immune system. The aim of this work is to highlight the effect of phototherapy, if any, on certain types of Cytokines [IL - 1B, IL - 2r, IL- 6, IL - 8 and TNF -] in cases of neonatal jaundice. The results of this case controlled study revealed that the level of IL- 1B was below 5 pg/ml in all the studied sample, whereas, the level of IL- 2r was higher in infant exposed to phototherapy than the other group. The levels of IL - 6 and IL - 8 did not vary between the two groups. The level of TNF - was high in both groups compared to the start studied sample. We concluded that, phototherapy although it is a safe tool of management, yet, it has an effect on the immune system of the neonates through the impact on certain types of cytokines. So it is recommended that phototherapy should be applied to indicated cases only and for limited period to avoid known and unknown hazards untoward effects

Assessment of thyroid status in children with type 1 diabetes mellitus in Ismailia

Diabetes mellitus is defined as a syndrome of disturbed energy homeostasis caused by deficiency of insulin or its action and resulting in abnormal metabolism of carbohydrate, protein and fat. It is the most common endocrine disorder in childhood and adolescence with important consequence on emotional development. Type I diabetes is frequently associated with autoimmune diseases, such as hyperthyroidism, Hashimoto thyroiditis, pernicious anemia, Addison disease, vitiligo, hypoparathyroidism, and myasthenia gravis, thyroid autoimmunity is a remarkably frequent concomitant of type 1 diabetes in childhood. Genetic susceptibility to autoantibody formation in association with autoimmune thyroid diseases [AITD] and type 1 diabetes mellitus has been described with varying frequencies. So the present study is designed to assess thyroid autoimmunity and dysfunction in children with type 1 diabetes mellitus and recognition of possible risk factors. This study is a descriptive study carried out on 64 children with type 1 diabetes mellitus aged 2-18 yr. complete history, physical examination and laboratory testing were done for diabetic children as follows: age and sex, history of diabetes mellitus: duration, complications, and therapy, history suggestive of autoimmune disease: vitiligo, Addison's disease, pernicious anemia, celiac disease and others, family history :paternal consanguinity, history of diabetes mellitus and other endocrinopathy, history of autoimmune diseases, history of thyroid dysfunction and symptoms of hypothyroidism or symptoms of hyperthyroidism. Assessment of thyroid autoantibodies by indirect fluorescent antibody technique [IFA], free T4 and TSH assay were done. Thyroid autoimmunity was detected in 10.9% of diabetic patients [7 patients]. In seven diabetic children, thyroid antibodies levels were elevated on one occasion, whereas 57 patients were antibodies-negative during observation period. In conclusion, these data support and extend the previous findings documenting the high prevalence of thyroid autoimmunity in children and adolescent screened for autoimmune with type 1 diabetes. Also these data support the recommendation for regular testing of thyroid auto antibodies and thyroid hormones

Validity of red blood indices in screening for iron deficiency anemia in exclusively breast fed infants

Iron deficiency anemia [IDA] is a public health problem of widespread prevalence in developing countries. The rapidly growing infants are the most vulnerable to iron deficiency if they are not supplemented with sufficient iron during weaning. The aim of this work is to study the importance of red cell distribution width [RDW] and RDW-MCV [mean corpuscular volume] combination in the diagnosis of iron deficiency anemia. Infants within the age group 6-12 months who were exclusively breast fed for the first six months attending the pediatric outpatient clinic of Suez Canal University Hospital, Ismailia, were assessed for full nutritional history, general examination, hemoglobin level, MCV, mean corpuscular hemoglobin concentration [MCHC], RDW, serum ferritin [SF], serum iron [SI], transferrin saturation [Trns.S%] and total iron binding capacity [TIBC]. The study revealed that in the anemic blood group [based on a hemoglobin level less than 10 g/dL]. RDW had a high sensitivity, specificity and efficiency as a diagnostic test for IDA [83.3%, 67.2% and 86.6% respectively] and that RDW-MCV in combination were 95% sensitive, 83.3% specific and 92% efficient for the diagnosis of IDA. In conclusion, diagnosis of iron deficiency anemia can be made more accurately and with less expense by combining hemoglobin level measurement with MCV and RDW

Factors affecting the state of nutrition in children suffering from malignant tumours

Two hundred children suffering from cancer together with 29 normal Children were assessed nutritionally in a trial to determine the factors that may influence the state of nutrition in such patients. All children were subjected to anthropometric and laboratory tests as well as full clinical examination. The main attention was made to the effects of the disease and the treatment given whether radiotherapy, chemotherapy or combinations of these modalities. Children having malignant diseases showed a definite evidence of malnutrition, that improved with establishment of treatment. Patients that attained complete remission had a better nutritional status than those who were still on treatment. Both groups still had an inferior state of nutrition compared to normal children. This was evident by the ratio weight/height 2 x 100, arm muscle circumference, arm muscle area, arm fat area and serum albumin level. Radiotherapy did not add much to the malnutrition inflicted by chemotherapy. Moreover, children with cancer showed different degrees of vitamin deficiencies in addition to the proved protein energy malnutrition that need attention especially in those who attained complete remission