Study of some risk factors of premature atherosclerosis and coronary heart disease in some Egyptian children

Coronary heart disease is a major health problem and one of the most important leading causes of adult deaths although it starts since childhood. Genetic predisposition of coronary heart diseases have been well established, so children of parents or grandparents with premature coronary heart diseases are more susceptible to develop the disease than others. Those with positive family history of premature coronary heart disease are more susceptible to lipid and lipoprotein abnormalities. Lipoprotein [a] is a strong predictor for premature coronary heart disease, together with total cholesterol, high density lipoprotein cholesterol and low density lipoprotein cholesterol. Lipoprotein [a] is genetically determined and if it is elevated in a child, it predicts premature coronary heart disease. The effect of a high lipoprotein [a] increases if associated with high serum low density lipoprotein cholesterol or low serum high density lipoprotein cholesterol. This study was done on two groups of children: The First Group: Included 50 children [age ranging from 5-15 years] of parents with a history of premature coronary heart disease or cerberovascular disease diagnosed clinically and through investigations. The Second Group: Included 25 children [age ranging from 5-15 years] of parents without coronary heart disease or cerberovascular disease. All these children were examined clinically and the following parameters were done and recorded: Anthropometric measurements [Height [Ht], Weight [Wt], Skin fold]. Body mass index [BMI]. Blood pressure [SBP, DBP]. Fasting blood glucose [FBG]. Uric acid level [UA]. C-reactive protein [CRP]. Lipid profile: Cholesterol [TC], Triglyerides [TG], High density lipoprotein [HDL], Low density lipoprotein [LDL], Lipoprotein [a] [LP[a]]. Anti hepatitis A virus [HAV] and anti Helicobacter pylori [H.P] antibodies. The Study Showed that: There was no significant difference between cases and controls in age, HT, WT, BMI, skin fold, SBP and DBP. There was no significant difference between cases and controls in TG. FBG and UA. There was a significant increase in cases than controls in TC and LDL. Also there was a high significant increases in cases than controls in LP[a], while there was a high significant increase in controls than cases in HDL. There was no significant difference between cases and controls in sex, HAV, HP or CRP. There was insignificant correlation between LP[a] and age, BMI, skin fold, SBP, BDP, LDL, FBG and UA. There was a significant correlation between LP[a] and TC. Also there was a high significant correlation between LP[a] and TG, HDL. We concluded that high serum TC is not enough for determination of the risk of atherosclerosis and CHD and that high TG alone is not a risk factor except if associated with low serum HDL and high serum LDL. We recommend screening of all children with a positive family history of premature CHD and/or hypercholesterolemia for lipids and lipoprotein abnormalities especially LP[a] which is a strong predictor for premature CHD and this enables early diagnosis and early successful management by following special dietetic measures with avoidance of excess saturated fatty acids, avoidance of obesity and smoking and practicing physical activities. Prevention and treatment of infections especially HAV and HP is encouraged. Genetic counseling and discouraging against marriage for heterozygotes for CHD and/or hypercholestrolemia as their children may be homozygotes for the disease

Mitral valve prolapse in children: a comparative study between cases with and without frank history of rheumatic fever

A comparative study between cases of MVP with and without frank history of rheumatic fever was done. Fifty cases of MVP were randomly recruited from school health insurance clinics in Cairo Governorate with ages ranged between 7-15 years. MPV was diagnosed by M mode and 2 dimensional echocardiography. All cases were subjected to full medical history and clinical examination. History of rheumatic fever [RF] was diagnosed on the basis of modified Jones Criteria. Out of the 50 cases of MVP, 32 patients proved to have frank history of RF. The study showed that children with frank history of rheumatic fever had significantly higher incidence of anterior leaflet prolapse, higher incidence of thickening of MV leaflets and more prone to mitral regurgitation was significantly higher in rheumatic group; while clicks were significant higher in non-rheumatic group. It was concluded that children suffering from MVP associated with ALP and/or thickened valve leaflets with mitral regurgitation especially of moderate to severe degree must be considered having a rheumatic heart disease even if frank rheumatic history was lacking. Those children may benefit from prophylactic long acting penicillin

Effect of diarrhea on serum zinc and copper concentration in infants and children

Zinc and copper status was evaluated in forty children suffering from diarrhea and twenty healthy controls. Clinical history and examination, hemogram, stool analysis, ad culture, and X-Ray were done for analysis purpose. Serum zinc was depressed in the acute diarrhea group [107.8 +/- 22.19 micro g/dl] and more decrease occurred in the chronic diarrhea [85.2 +/- 3.84 micro g/*dl] when compared with both the acute [P< 0.01] and control group [P< 0.001]. Serum copper was similar I both acute and control groups, but it was diminished in the chronic diarrhea group when compared with acute diarrhea and control group [P< 0.001]. Thus, it can be concluded that chronic diarrhea in infants and children is associated with lower levels of serum zinc and copper

Variation in levels of immunoglobulins in breast milk

In this longitudinal study, we aimed to determine the concentrations of the major immunoglobulins, namely IgA, IgM and IgG in colostrum [2-4 days] and in mature milk at 4-8 weeks and at 5-6 months of lactating mothers. In this regard sixteen lactating mothers were recruited from a poor urban district in Giza and 3 milk samples were collected from each mother over a period of 6 months. The analysis was performed by single radial immunodiffusion technique. The data revealed that immunoglobulin concentrations were higher in colostrum compared to mature milk [P<0.001]. Also IgA was the predominant immunoglobulin throughout the stages of lactation while IgG was present in the least concentration. No significant correlation was found between the age of the mother and immunoglobulin concentrations, while weak significant correlation was found between the parity of the mother and IgM in colostrum [P<0.05]. We concluded that passive immunity provided to the infants by immunoglobulins [especially IgA] in breast milk is particularly important during the early neonatal period