ABSTRACT
Background: Neonatal sepsis is the single most important cause of neonatal deaths in the community. It remains a major cause of mortality in newborn and life- threatening disorder in infants
Aim: To assess the validity of using diagnostic markers in predicting neonatal sepsis
Methodology: This was a systematic review and meta- analysis. More than 200 potentially relevant studies were collected in 2 years standing from 2012 to 2014 but only 42 of them met the inclusion criteria. A standard method for meta- analysis of diagnostic markers evaluation was performed using Biostat, Comprehensive Meta- analysis version 3.0.
Results: Meta- analysis was performed on 2722 neonates divided into 2 groups according to their clinical manifestations of neonatal sepsis and laboratory findings. PROM was the commonest risk factor predisposing to sepsis. Klebsiella and staphylococcus aureus were the most common isolated organism. Based on the results from included studies in this review, 6 predominant markers were used to evaluate early diagnosis of neonatal sepsis, PCT, IL- 6, TNF- alpha, CD64, slCAM and Eselectm. Procalcitonin was highly significantly elevated with sensitivity [0.93] whereas specificity was [0.87] and it had the most diagnostic accuracy [0.95]. SICAM was the most sensitive marker [0.95] its diagnostic accuracy and specificity were [0.93] and [0.90], TNF- alpha had diagnostic accuracy [0.92] sensitivity and specificity were [0.86], the sensitivity of Eselectin was [0.92], its diagnostic accuracy and specificity were [0.91] and [0.82]. IL6 had diagnostic accuracy [0.93]; the specificity and sensitivity were [0.90] and [0.88]. CD64 was the most specific biomarker for predicting neonatal sepsis [0.91]. sensitivity [0.87] accuracy [0.92]
Conclusion: Based on results from the studies included in this review, it was dear that serum slCAM had a high sensitivity for diagnosis of neonatal sepsis; CD64 had a high specificity and serum procalcitonin had the most diagnostic accuracy
ABSTRACT
Objective: Assess immunological relation between atopic disease and Type 1 diabetes mellitus
Subject and Method: Across sectional study was done by written questionnaire adopted from American Academy of Dermatology Journal, [March 2008], from 200 children with Type 1 diabetes mellitus attending pediatric clinic, National Institute of Diabetes, and 200 non diabetic children attending pediatric clinic, New Cairo hospital
Results: Cases had lower frequency of asthma compared to controls with statistically significant difference between both groups, no allergic conjunctivitis among cases was found but was 2% among controls, cases had lower frequency of allergic rhinitis compared to controls with statistically significant difference both groups, and cases had lower frequency of atopic dermatitis compared to controls with no of statistically significant difference between both groups
This study shows no statistically significant difference between both groups as regard type of lactation, effect of food in presence of atopical symptoms, exposure to tobacco smoke. This study shows that cases had lower frequency of interference with daily activities; lower frequency of family history of atopy. This study indicates that positive atopical cases had higher frequency of positive family of atopy compared to negative group with statistically significant difference In between. This study shows that insulin dose among positive atopy cases was lower compared to negative atopy cases group with no significant difference
Conclusion: Patients with Type 1 diabetes have a lower prevalence of atopic symptoms, mainly asthma and allergic rhinitis which is consistent with the Th1/Th2 polarization concept
Additional studies are needed to evaluate the effect of atopy and allergic diseases on glycemic control and long term complications I patients with Type1 diabetes ad to understand why allergic symptoms among children with Type 1 diabetes have decreased
ABSTRACT
Introduction: Autoimmune disease are frequently associated with growth impairment
This may be a consequence of the inflammatory process associated with disease activity and it also caused by the high-dose corticosteroids that are often used for treatment
Aim: Screening of growth impairment in juvenile rheumatoid arthritis, systemic lupus erythematosus and autoimmune chronic liver disorders
Subject and methods: One thousand cases of school age children of both sexes of juvenile rheumatoid arthritis, systemic lupus erythematosus and autoimmune chronic liver disorders, the study will be conducted in the 4 main pediatric hospitals in Alexandria, to detect growth impairment in those children as indicated by auxological parameters from June 2010 to August 2015
Results: in the studied juvenile rheumatoid arthritis[No. 593] group of school male [No. 118] and female [No. 475] children <3[rd]-<10[th] height for age percentile category [short stature] the percentage in males and females were 51.7 and 46.5 respectively, which the highest percentages are statistically significant and in the studied autoimmune chronic liver disorders [ACLD] group of school age female [N. 69] children and adolescents in the short stature category [<3[rd]-<10[th] height for age percentile] a high percentage was observed which was 45.5 that is statistically significant
Pubertal assessment [Tanner staging] of the studied systemic lupus erythematosus[SLE] group of school age male children and adolescents [No. 69] shows that 48% of cases were in the Tanner stage 1 category is statistically significant which means delayed puberty was in a large number of this cases
Conclusion: Juvenile rheumatoid arthritis, systemic lupus eryth-ematosus and autoimmune chronic liver disorders are frequently associated with growth impairment and delayed puberty. It is important to regularly monitor physical development and control inflammation associated with disease activity
ABSTRACT
Background: Meningitis is defined as an inflammation of the membranes and cerebrospinal fluid that cover completely and bathes the brain and spinal cord. It is a serious disease and may result in permanent complications if not diagnosed and treated early. The initial treatment approach to the patient with suspected acute bacterial meningitis depends on early recognition of the meningitis syndrome, rapid diagnostic evaluation, and emergent antimicrobial and adjunctive therapy
Objectives: To compare the short course antimicrobial treatment of acute bacterial meningitis versus long course; wheather the organism identified or not in Abbassia Fever Hospital
Methodology: Prospective study; in Abbassia Fever Hospital from June 2013 till December 2014
Results: N. meninigitidis were only three cases [three from 84cases]; mean 14.33 and SD +/- 6.03. All these cases received R, V as line of treatment while other organisms as enterococci most of them received the same line [i. e. R, V] 45.8% and only two cases [2.8%] received R, U, and E. The patients whom fully recovered most of them used the treatment plan R, V [38, 63.3%] followed by R, V, E [9, 15%] and to a lesser extent R, U [7, 11.7%]. There was statistical highly significance between the treatment plan chose and the outcomes of the patients and the p value was 0.010. R, V is the most common treatment plan used [44 cases] followed by R, V, E [17 cases] and the least common plan used was R, U, E [2 cases]. The absence of hydrocephalus or shunt operation was the most prevalent [81 cases] where the mean was 11.63 and SD +/- 3.93
Conclusions: The most commonly used treatment plan was ceftriaxone and vancomydn. Only 10 patients received short duration of therapy. Recommendations: Further studies should be conducted on more national level to discuss the importance of short course therapy and which cases can receive it