Cord blood ghrelin, leptin, and IGF-1: their inter-relations and relationships to gestational age, gender and anthropometrics

The main purposes of this study was to: 1] compare cord blood ghrelin, leptin and IGF-1 concentrations in PT-AGA and FT-SGA infants to that of FT-AGA. 2] determine the independent contributions of these metabolic hormones to intrauterine fetal growth and infant birth size. 3] investigate their inter-relations and relationships to anthropometric parameters. 4] determine the effect of gender on cord blood hormone concentrations. We studied 75 newborns [45 males, 30 females], classified into 3 sub-groups: Group A: included 45 infants [25 males, 20 females], FT-AGA as controls. Their gestational ages ranged from 37-42 weeks and birth weights ranged from 2575-3930 gm. Group B: included 19 infants [12 males, 7 females], PT-AGA. Their gestational ages ranged from 28-36 weeks and birth weights ranged from 1855-2350 gm. Group C: included 11 infants [7 males, 4 females], FT-SGA. Their gestational ages ranged from 37-41 weeks and birth weights ranged from 2080-2650 gm. All studied newborns were subjected to a detailed history and clinical evaluation. Demographic and anthropometric characteristics, including body weight, length, HC and BMI were registered immediately after birth. At delivery, cord blood sample was collected from all studied newborns for hormonal assay of ghrelin, leptin and IGF-1. A comparative statistical analysis and correlation studies were done for anthropometric and laboratory data within and between studied groups. Ghrelin, leptin and IGF1 were detectable in cord blood of all newborns. Cord blood ghrelin concentration of group A was significantly lower than that of group B and C, while that of group B was significantly lower than that of group C. Cord blood leptin concentration of group A was significantly higher than that of group B and C, while that of group B was significantly higher than that of group C. Cord blood IGF-1 concentration of group A was significantly higher than that of group B and C, while that of group B was significantly higher than that of group C. Cord blood ghrelin, leptin and IGF-1 were significantly higher in female than in male infants. Cord blood leptin correlated positively with gestational age, birth weight, BMI and cord blood IGF-1. Cord blood ghrelin correlated negatively with birth weight, BMI and cord blood IGF-1. IGF-1 correlated positively with birth weight and BMI. Metabolic hormones, ghreiln, leptin and IGF-1 were detectable in cord blood of all newborns, even at early gestation [as early as 28 weeks gestation] Their interrelations and correlations with gestational age and anthropometric parameters suggest that these hormones are gestation related and may play an important role in energy balance and homeostasis and regulating growth in utero

frequency of celiac disease, TB enteritis and giardiasis among children with chronic diarrhea

Chronic diarrhea is one of the most common causes of referral to a gastroenterology clinic. Chronic diarrhea may result from many different causes; celiac disease is one of them. Other important causes in our locality are infections such as TB and Giardiasis. This work was planned to determine the frequency of celiac disease, TB enteritis and Giardiasis among children referred to the gastroenterology unit with the complaint of chronic diarrhea and to evaluate the different methods used in the diagnosis of each disease. The study included 92 patients with chronic diarrhea. Their ages ranged from 6 months to 15 years. They were 56 males and 36 females, admitted to the Pediatric gastroenterology unit, Assiut University Hospital during the period from January 2005 to December 2006. Besides full history and thorough clinical examination, the following investigations were done for all cases: stool analysis for three consecutive days, CBC, ESR, total proteins and serum albumin, tuberculin test, accelerated BCG test [in tuberculin negative cases], serum antiendomysial antibodies. Upper GIT endoscopy with duodenal biopsy and aspiration and tissue staining by H and E and by immuno-histochemistry [anti-tTG moAbs] to detect tTG antigens in biopsy specimens. Lower GIT endoscopy with biopsy sampling and histopathological examination of biopsy specimens was also done. Out of the total patients, 18 cases [19.5%] were positive for celiac disease by AEM antibodies while 16 were positive by tTG immunostaining of biopsy specimens. Fourteen patients [15.2%] had tuberculous enterocolitis while 12 [13%] had biopsy proven Giardiasis. On the other hand 48 patients [52.1%] had other undiagnosed causes of chronic diarrhea. A very high index of suspicion for celiac disease should be maintained for patients who present with chronic diarrhea or iron deficiency anemia. The best method for diagnosis of celiac disease in such patients is serological testing followed by a small-bowel biopsy. The diagnosis of intestinal tuberculosis is difficult due to the lack of specific symptoms and signs. Colonoscopy with ileoscopy is a useful method for diagnosis of intestinal TB. Gastrointestinal endoscopy with biopsy examination is an important method of diagnosis and follows up of children with Giardiasis

Biochemical markers of hypoxic myocardial injury in asphyxiated term neonates with hypoxic ischemic encephalopathy

Perinatal asphyxia is a common cause of neonatal morbidity and mortality and neurologic disabilities among survivors. However, no clear-cut physiologic parameters exist which enable an early identification of neonatal infants who are either at risk to develop brain damage or post-hypoxic heart failure. The main problem related to outcome is cerebral damage. 1] Assess the effect of perinatal asphyxia on the cardiac muscle function as reflected by changes in serum levels of CK, CK-MB, cTnl and cTnT. 2] Investigate the diagnostic value of these markers, their sensitivity, specificity, PPV and NPV as early predictors of the severity of cerebral damage and mortality in infants with HIE. 3] Correlate serum levels of CK, CK-MB, cTnl and cTnT in asphyxiated infants to the other markers of perinatal asphyxia. The study included 68 term newborns, 33 were asphyxiated [group I] and 35 were healthy non-asphyxiated as controls [group II]. Group I infants were considered eligible for the study when their Apgar score was

Celiac disease, TB enterocolitis and giardiasis among children with chronic diarrhea: the accuracy of ANT-EMA and tTG expression in the diagnosis of celiac disease

Chronic diarrhea is one of the most common causes of referral to a gastroenterology clinic. Chronic diarrhea may result from many different causes; celiac disease is one of them. Other important causes in our locality are infections such as TB and Giardiasis. This work was planned to: 1-Determine the frequency of celiac disease, TB enteritis and Giardiasis among children referred to the gastroenterology unit with the complaint of chronic diarrhea and to evaluate the different methods used in the diagnosis of each disease. 2- Verifying the diagnostic accuracy of immunohistochemical tTG expression versus serum anti-endomysial antibodies [EMA] in celiac disease [CD] diagnosis. The study included 92 patients with chronic diarrhea. Their ages ranged from 6 months to 15 years. They were 56 males and 36 females, admitted to the Pediatric Gastroenterology Unit, Assiut University Hospital during the period from January 2005 to December 2006. Besides full history and thorough clinical examination, the following investigations were done for all cases: stool analysis for three consecutive days, CBC, ESR, total proteins and serum albumin, tuberculin test, accelerated BCG test [in tuberculin negative cases], serum anti-EMA. Upper GIT endoscopy with duodenal biopsy and aspiration and tissue staining by H and E and by Immunohistochemical [anti-tTG moAbs] to detect tTG antigens in biopsy specimens. Lower GIT endoscopy with biopsy sampling and histopathological examination of biopsy specimens was also done. Out of the total patients, 18 cases [19.5%] were positive for celiac disease AEM antibodies while 16 were positive by tTG immunostaining of biopsy specimens. Fourteen patients [15.2%] had tuberculous enterocolitis while 12 [13%] had biopsy proven Giardiasis. On the other hand 48 patients [52.1%] had other undiagnosed causes of chronic diarrhea. A very high index of suspicion for CD should be maintained for patients who present with chronic diarrhea or iron deficiency anemia. The best method for diagnosis of celiac disease in such patients is serological testing followed by a small-bowel biopsy. The diagnosis of intestinal tuberculosis is difficult due to the lack of specific symptoms and signs. Colonoscopy with ileoscopy is a useful method for diagnosis of intestinal TB. Gastrointestinal endoscopy with biopsy examination is an important method of diagnosis and follows up of children with Giardiasis