ABSTRACT
Copper is an essential trace element that is vital to the health of all living cells. However, like all essential elements, its serum level must be kept within normal values; otherwise, conditions of toxicity or deficiency can result, each of which has its own unique set of adverse health effects. Wilson's disease [WD] is an inherited disease of copper accumulation that can cause liver and neurological affection. Its management depends on removal of excess copper using copper chelators such as D-penicillamine or trientine, which increase the urinary excretion of copper. In a more recent approach, zinc has been used to decrease copper accumulation. We present two WD cases that developed copper deficiency as a result of their treatment. These cases improve our understanding and management of copper deficiency in WD and highlight the importance of copper-level monitoring in WD
ABSTRACT
Background: Superadded infection with hepatitis B virus [HBV] or hepatitis A virus [HAV] may cause serious consequences for patients with chronic liver disease [CLD]. Therefore, immunization of these patients can reduce the morbidity and mortality associated with cirrhosis. Vaccines against HBV and HAV are available; these vaccines are safe and immunogenic in healthy individuals [and in patients with CLD]
Aim: The aim of the present study was to assess long-term efficacy of HAV and HBV vaccinations in children with CLDs
Patients and methods: Our study included 200 children with CLDs. They were studied both prospectively and retrospectively to evaluate the immunogenicity and longevity of HAV and HBV vaccination during a follow-up period of 5 years. They were divided into two groups according to presence [n=77] or absence [n=123] of cirrhosis
Results: All patients did not lose their immunity against HAV through 5-year follow-up. During the first check up, 65.8% of children were immune against HBV. After 1 year, 14% of cases required booster dose and 7.8% were vaccinated by three doses. At 5 years after vaccination, 66.7% were immune, 18.3% required booster dose, and 12.5% were vaccinated by three doses. Three cases received a course of three double doses because of repeatedly low hepatitis B surface antibody [HBsAb] titer during our follow-up
Conclusion: HAV and HBV vaccines are safe and well tolerated in children with CLD, whether cirrhotic or not. HAV vaccine induces a satisfactory immune response. More frequent doses of HBV vaccine may achieve better results especially with long-term follow-up. There was no statistical difference between cirrhotic and noncirrhotic patients as regards vaccination response
Recommendation: Immunizations against HAV and HBV are recommended in CLD. Postvaccinal HBsAb titer should be checked
ABSTRACT
Urinary tract infection [UTI] is a common problem in infants and children. This infection is mostly ascending Recurrent U.T.I. is mainly caused by bad hygiene and poor health education, and its incidence increased with enuretic children. Cases with episodes of U.T.I. must be followed up by urine culture monthly because may have a new episode without symptoms. The aim of this work it to identify the possible risk factors that may lead to acute and recurrent U.T.I. among children. This study included 100 children suffered from U.T.I. aged from 2-14 years and attended our pediatric clinic. No 29 cases of them had urinary symptoms, 28 cases were a symptomatic and proved to have infections during routine urine investigations, and 43 cases had one episode of U.T.I. and came for follow up which was monthly based on urine culture and during follow up they had recurrent U.T.I. These patients subjected to urine analysis and culture, stool analysis, renal function test, complete blood picture, erythrocyte sedimentation rate, C-reactive protein and ultra sonography for abdomen and pelvis to detect any abnormality, stones and to measure post voided bladder capacity. Our study showed no sex difference in U.T.I. 18% of boys were uncircumcised;. 21% with postponement of the start of potty-training, 61% had pinworm infection, 2% had bladder stones, 3% had bilharzial ova and 16% had enuresis. Urine cultures were positive for E-coli, Klebsiella, Staph. Aureus and Staph. Epidermidis. No, mixed infection was found. With measurement of post-voided bladder volume, we found 11% had voiding dysfuctions. These results proved the presence of multi-factorial risk factors for occurrence of U.T.I. U.T.I. is mainly affected by had hygiene, poor health education and negligence from doctors to follow up patients if they have no symptoms. We recommend routine follow up for U.T.I. cases based on urine culture to enhance early detection of recurrence and early proper treatment. Pediatricians should take urinary symptoms very seriously into account and should do routine wine workup to detect asymptomatic U.T.I