Comparative study of visual assessment of neonatal jaundice and laboratory estimation of total serum bilirubin in full-term newborn infants

Neonatal hyperbilirubinemia is the most common condition that requires medical attention in newborns. The assessment of jaundice can be carried out using several methods. The aim of this work is to compare visual assessment and laboratory estimation of TSB in full term newborn infants and to evaluate the accuracy of visual assessment of neonatal jaundice in guiding management decisions in the out-patient settings. The study was conducted in the out-patient clinic of Alexandria University Children's Hospital for a period of eight months. 57.2% of babies were male infants while 42.8% were females with a mean gestational age of 38.5 +/- 1.58 weeks and mean weight of 2.98 +/- 0.62 kg. The total agreement between the lab-based management decision and the clinically based decision was 84.2% out of 500 cases involved in the study. Sensitivity of visual assessment was 95.8% while specificity was 80.5%. The false positive rate was 39.2% and positive predictive value was 60.8%. False negative rate and negative predictive value were 1.6% and 94.8% respectively. Also, the Spearman correlation of dermal zones determined by visual assessment and lab TSB in the whole sample was 0.76 [p = 0.000]. It was highest in Infants < 3 days [0.94] and lowest in infants > 14 days [0.69]. In conclusion, visual assessment of neonatal hyperbilirubinemia is a useful clinical tool, if used correctly and by trained medical personnel in resource-poor countries, where there is little or no access to reliable laboratory-based diagnostic services

Frequency of Arg[972]-IRS-1 variant among type I diabetic patients in El-Shatby pediatric Hospital, Alexandria, Egypt

Several polymorphisms have been identified in the amino acid sequence of human insulin receptor substrate-1 [IRS-1]. The most prevalent one is glycine change to arginine at the codon 972 that was hypothesized to play a role in pancreatic beta-cell stimulus-coupled-insulin secretion and survival. The frequency of this variant among type I diabetic patients, their available normal sibs, and control subjects recruited from EI-Shatby Pediatric Hospital, Alexandria University were studied. The results showed that the frequency of Arg[972] IRS-1 variant was 14% in diabetic patients, 9.1% in normal sibs, and 4% in normal control subjects. Data revealed that Odds ratio showed that carriers of Arg[972] IRS-1 variant had four times increased risk for developing the disease. In sibs, the risk is increased by three fold in carriers of this variant as compared to sibs with the wild allele. In spite being non-significant, the results of the present work suggest that Arg[972] IRS-1 variant could be considered as a potential risk factor for developing type I diabetes although it was statistically non-significant, which may be attributed to the small sample size or methods of selection of cases

study on cell-mediated immunity in children with ascariasis

Dinitrochlorobenzene [DNCB] sensitization was evaluated in 25 children with ascariasis. The results showed some impairment in cell-mediated immunity in these children as shown by the failure of 48% of them to respond to DNCB. The study also demonstrated a correlation between the ascaris load and the degree of immune aberration. The possible causal relationship of these findings is discussed