ABSTRACT
Background: Infectobesity' is a new term to describe obesity of infectious origin, such as infection by human adenovirus-36 [Adv36]. It appears to be a new concept, evolved over the past 20 years. Visceral obesity is associated with a higher risk of cardiovascular disease. Increased carotid intima-media thickness [CIMT], a marker of early-onset atherosclerosis, has been observed in obese children and adolescents. The present study aims to investigate the relationship between visceral obesity, CIMT, and Adv36 in female Egyptian adolescents
Patients and methods: The present study included 90 women aged 12-15 years. It was conducted at the Medical Excellence Research Center of the National Research Centre, Cairo, Egypt, during the period between September 2016 and November 2017. Anthropometric assessment was done. Fasting blood samples were withdrawn for the measurement of Qualitative Human Adv36 antibody using a sandwich enzyme-linked immunosorbent assay. Fasting plasma glucose was determined calorimetrically, by the glucose oxidase method and insulin level using the solid-phase enzyme-linked immunosorbent assay and lipid profile. Visceral obesity was measured by an abdominal ultrasound. CIMT for both carotid arteries were measured by high-resolution echo Doppler
Results: Girls with visceral obesity [n=26] had higher frequency of increased CIMT at left [96.2 vs. 75%], right carotid artery [84.6 vs. 73.4%] and Adv36 sero-positive antibody [69.2 vs. 56.2%] than among those without visceral obesity [n=64]. Among the total samples, visceral obesity had significant positive correlations with BMI, waist and hip circumference, while it had insignificant correlations with age, blood pressure [BP], CIMT at right and left carotid arteries, adenovirus and laboratory findings. CIMT had a significant positive correlation with each other, insulin resistance and total cholesterol, and significant negative correlations with high-density lipoprotein and waist circumference. Adv36 had significant negative correlations with BP [both systolic and diastolic] and significant positive correlation with insulin level. Adv36 and CIMT had insignificant correlations with each other and with the anthropometric measurements, BP, visceral obesity, triglycerides, and low density lipoprotein
Conclusion: The frequency of Adv36 and increased CIMT at left carotid artery were higher among girls with visceral obesity than among those without visceral obesity. However, visceral obesity, CIMT at both right and left carotid arteries, and Adv36 had insignificant correlations with each other
ABSTRACT
Background: Community acquired pneumonia [CAP] is a serious illness with significant costs to the society. Clinical decisions based on evidence based medicine [EBM] improve the outcome of management in an approach for appropriate treatment and prompt referral for care
Objective: Observing cases managed on EBM and comparing the outcomes with cases managed without EBM in a community hospital, providing approach for the clinician in evaluating and treating children
Methodology: A descriptive study on 56 children divided into 28 children EBM group and 28 children Non-EBM group, from June 2015 to May 2016 at Abo El Resh hospital, reviewing demographic, clinical data, observing therapies and outcomes
Results: EBM group showed statistically significant short days [6.8 +/- 2.1 days] for antimicrobial therapy than NEBM group [P=0.001]. outcomes of Non-EBM group who needed admission to ICU for 4.2 +/- 2.6 days, while no children of EBM group need admission [P=0.001]
Conclusion: Effective case management is strategy to reduce pneumonia- related morbidity. Guidelines based on sound evidence are available but used variable
Recommendation: Unifying clinical practice and scientific evidence could rationalize the use of health resources, improving health care quality
ABSTRACT
Objective: to describe the pattern of sleep disturbances among children with CP [the age > 3 years] and to evaluate the relationship between sleep disturbances and neurological state
Methodology: This descriptive study included 124 children with CP; [80 males and 44 females] with an age ranging from 4 to 10 years. Children were randomly recruited from Pediatric Outpatient Clinic [1PGCS ]throughout the period from June 2015 till the end of January 2016. All participants were subjected to IQ test [Stanford- Binet Scale V5], EEG, the CSHQ and hemoglobin measurement
Results: Out of 124 children, 92.7% had spastic CP, 6.5% had dyskmetic CP andO.8% had hypotonic CP. Topographically spastic CPs were; 55.6% diplegic, while quadriplegia and hemiplegia were found in 28.2% and 8.9% of studied cases, respectively. Degree of intellectual disability among cases wasO.8% low average [89- 80], 8.1% were borderline [79- 70], 56.5% were mildly impaired, 14.5% were moderately impaired [54-40], 12.1% were severely impaired [39- 25] and 8.1% were profound. Hemoglobin estimation revealed that 8.1% were anemic. Abnormal EEG was found in 70.2% of cases, 81.36% of the epileptic CP children and 60% of the non- epileptics had abnormal EEG findings, 27.4% had focal epileptiform, 18.5% had generalized slow wave, 16.9% had generalized epileptiform and 7.3% had multi- focal epileptiform. Among the epileptic CP children; 52.54% experienced partial seizures and 47.46% experienced generalized seizures. Out of all studied children, 48.38% showed abnormal total CSHQ score indicating a clinically distinct sleep disturbance. There were significant correlation between sleep disturbance score and the degree of intellectual disability and also presence of epilepsy
Conclusion: sleep disturbance was significantly correlated to several co- morbid conditions including the degree of intellectual disability and the presence of epilepsy
ABSTRACT
Objective: To evaluate inflammatory markers in full term neonates with unconjugated hyper-bilinibinemia. Design: Prospective case control study. This study was done in the department of pediatrics screening clinic, Al-Galaa Teaching Hospital, in Cairo, Egypt from October 2012 to June 2014
Subjects and Methods: The study was done on seventy five full term neonates their age ranged from 3 to 6 days after birth, fifty with unconjugated hyperbilirubinemia compaired to twintyfive normal neonates as control group with matched age and sex. All neonates were subjected to history taking [including gestational age, postnatal age] and clinical examination, anthropometric data, and laboratory investigations including complete blood count, CRP and inflammatory markers TNF-a and ILIp concentration by ELISA
Results: Regarding total bilirubin level in unconjugated hyperbilirubinemia neonates, there was statistically significant to inflammatory markers TNF-a and IL-Ip[p-value was <0.001]. The same finding were also it was found that both inflammatory markers IL-lp and TNF-a showed statistically significant positive correlation with breast feeding p-value was 0.021 for IL-lp and 0.003 for TNF-a respectively. Inflammatory markers IL-lp and TNF-a increasing levels showed positive correlation with neurological examination [Lethargy or irritability, p-value were 0.01 1 for IL-p and 0.046 for TNF-a respectively
Conclusion: Inflammatory markers IL-lp and TNF-a levels increased in neonatal unconjugated hyperbilirubinemia. Inflammatory markers IL-lp and TNF-a was found correlation between neurological examination. Recommendations: Further studies on larger sample size [are advised to verify the diagnostic and prognostic value of inflammatory markers in neonatal unconjugated hyperbilirubinemia which may help also in treatment. Key words: Inflammatory markers, IL-lp and TNF-a, neonatal unconjugated hyperbilirubinemia, Bilirubin and neurological dysfunction
ABSTRACT
Improved quality of care is an increasingly important goal of international family planning programs, for a variety of compelling reasons. From a human welfare perspective, all clients, no matter how poor, deserve courteous treatment, correct information, safe medical conditions and reliable products. It also has been argued that providing such quality services will lead to increased services utilization by more committed users, eventually resulting in higher contraceptive prevalence and lower fertility. This study aims at assessing the quality of family planning services. 760 women of child bearing period using family planning method either from the family planning service or discontinued using the primary care service of family planning were simply random selected. They were chosen by simple random sample, 355 discontinuers clients, 405 continuous service users. Discontinuers were interviewed through a house hold survey, while an interview questionnaire was used for continuous users after receiving their service at the primary health care unit. Before the CQI program the discontinuation rate was 32.35% then changed to 9.62% after implementing the CQI program. The most cited causes of discontinuation were; absence of a female doctor, long waiting time, complications of method, insufficient information, unsuitable clinic working hours, inappropriate staff attitude, doctor's care and finally doctor incompetence. Positive changes in continuation rate of women using family planning method either from the family planning service or from another family planning services could be achieved by quality improvement activities, also raised clients expectations, changed needs, raised awareness about quality, and towards their rights'. So family planning services should have continuous quality improvement policy to gain new clients and decrease discontinuation rate