Serum level of ghrelin in umbilical cord in small and appropriate for gestational age newborn infants and its relationship to anthropometric measures

Ghrelin natural growth hormone secratogogue originating from the stomach, is characterized by non endocrine activities such as orexigenic effects and modulation of the endocrine and metabolic response to variation in energy balance. However it nor not known whether it plays a role in energy homeostasis during fetal life or not. The study aims to determine cord blood ghrelin level in small for gestational age [SGA] infants compared with appropriate for gestational age [AGA] infants and its relationship to anthropometric measurements at delivery. Fifty newborn infants, 30 SGA, their gestational age ranged from 36 to 39 weeks and their weight ranged from 1 to 2.2 Kg and 20 AGA infants, their gestational age ranged from 38 to 41 weeks and their weight ranged from 3 to 3.6 Kg were included in the study and were subjected to complete clinical examination, anthropometric measurements and ghrelin assay. The study showed that the cord blood ghrelin level in SGA infants [mean :t SD.; 8.18 :t 1.00 pg/ml] was Significantly greater than that in AGA infants [4.37 :t 0.50 pg/ml]. [p-value 0.0001]. Cord ghrelin level was correlated negatively with gestational age, weight, length and body mass index in SGA group[r=-0.55;p =0.002, r=-0.63,p =0.0001,r=-0.61, p=0.07 and r=0.56, p=0.001] and in AGA group [r=-0.48 ;p =0.05, r=-0.59,p =0.6, r=-0.37, p=0.7 and r=--0.47, p=0.7]. The study showed that the most important factor affecting ghrelin level in both SGA and AGA neonates was their weight, while the least factor is their mid arm circumference. Cord ghrelin concentration increased in small for gestational age infants due to state of prolonged under nutrition. The source of ghrelin remain unknown, it may be either from the placenta or fetal tissues origin

Evaluation of interleukin -8 [IL-8] and granulocyte colony -stimulating factor [G-CSF] for early diagnosis of neonatal sepsis

The objective of this work was to evaluate the role of IL-8 and G-CSF in early diagnosis of neonatal sepsis and to determine if they are helpful in planning strategies to safely reduce the use of antimicrobials in neonates with clkinical signs of sepsis. IL-8 and G-CSF were measured in serum by ELISA technique, along with blood cultures, CRP, CBC including immature-to-total neutrophil [I/T] ratio for 36 neonates [22 term and 14 preterm] with suspected sepsis and 15 healthy neonates as controls. Sensitivity, specificity, positive and negative predictive values were calculated for IL-8, G-CSF, CRP and I/T ratio. Serum levels of IL-8 and G-CSF were significantly higher in infected group as compared to the control group, but there were no significant differences of serum levels of both markers between full term and preterm neonates, and also between cases with positive blood cultures and those with negative blood cultures. There were positive correlations between both markers with band cells%, I/T ratio and CRP, but no correlations were found with gestational age, Hb%, platelet count and total leucocytic count. The best sensitivity was observed with combined IL-8 and CRP [94.6%], followed by IL-8 [90%], G-CSF combined with CRP [89%] and IL-8 with G-CSF [88.3%]