Plasma fibronectin, transferrin and prealbumin in children with bacterial pneumonia with and without protein supplementation

The study included 100 patients with bacterial pneumonia, as well as 20 apparently healthy controls. Their ages ranged from 2-36 months. Any disease that could affect the plasma proteins, e.g. hepatic, renal and/or nutritional were excluded from the patients and controls. Patients were classified according to Downe's score for respiratory distress into mild [score <2], moderate [score 2-5] and severe [score >5]. The patients were subjected to full clinical examination, chest x-ray, tuberculin test, full blood picture and early morning fasting stomach aspirate for bacteriological studies. All patients and controls had fibronectin [Fn], transferrin [Tn] and Prealbumin [PA] measured initially and on follow up after 10 days for the patients. On systematic random basis, to every other case a high protein supplementation was given. Cases with bacterial pneumonia showed significantly lower values of mean +/- S.D. plasma Fn, Tn and PA than controls. Severe and moderate pneumonia, cases showed significantly lower values of plasma. Fn, Tn and PA than mild ones. Patients with non pneumococcal pneumonia showed significantly lower values of plasma Fn, Tn and PA than those with pneumococcal pneumonia. There was a strong positive significant correlation, between the 3 protein markers studied, i.e. Fn, Tn and PA, and estimation of one of them could save estimation of the others. Cases with mild pneumonia initially [as measured by Downe's score] that became either moderate or severe during the course of the disease, showed significantly lower values of Fn, Tn and PA than cases with wild pneumonia that became neither moderate nor severe. With recovery [with or without protein supplementation] follow up levels of Fn, Tn and PA were significantly higher than initially. These data, suggest that early estimation of protein markers may have a predictive value in forecasting the outcome of bacterial pneumonia. They are more accurate than using Downe's score only. The old myth of avoiding excessive intake of proteins during pneumonia is now obsolete. It is recommended, that high intake of proteins during the course of bacterial pneumonia speeds recovery

Clinical features and host and environmental characteristics of newborns with lower respiratory tract infection-Assiut University Hospital

Fifty two newborns with lower respiratory tract infection together with 31 apparently normal controls were studied. Newborns with respiratory infection were significantly different from controls in the following aspects: lower body weight, higher rate of being small for gestational age [SGA], lower rate of breast feeding and a higher rate of artificial feeding predominantly nasogastric [NG] and a higher maternal parity. Among newborns with respiratory infection severely affected cases [respiratory distress 5] differed significantly from less severely affected cases regarding the following aspects: lower body weight, a higher rate of being SGA, lower rate of breast feeding and higher rate of artificial feeding [predominantly nasogastric], a higher rate of low socioeconomic level, a higher rate of birth attendance by Daya and a higher rate of maternal fever during pregnancy or labour. The seasonal proportionate distribution of cases showed a higher rate in winter. The highest predictive values of radiologic pneumonia can be linked to a combination of diminished breath sounds and bronchial breathing [positive predictive value 100% and negative predictive value 65%]. Tachypnea as a simple respiratory sign has the highest sensitivity rates and the highest negative predictive value [100% each] for severe respiratory affection indicated by respiratory distress score [5] while cyanosis has the highest specificity rate [88%] and the highest positive predictive value [87%]. These data were interpreted in light of available previous data

Clinical trial on the efficacy of an instant rice based ORS on the outcome of acute diarrhea with dehydration

The study included sixty male infants with acute diarrhea either exclusively breast or exclusively formula fed with weight for height 70% or more of median NCHS reference and without severe dehydration, bloody diarrhea or fever more than 38.5oC. They were randomly allocated either into WHO-ORS or Rice-Based-ORS intake. Beside clinical history and clinical examination including the weight of bare child, data were recorded for body weight, stools output and amount of the ORS intake every 3 hours. The amount of cereal based diet intake [one meal] and 0 and 24 hours serum levels of sodium and potassium were also recorded. Rice Baed-ORS intake was associated with shorter duration of diarrhea after admission and higher weight gain. The shorter duration of diarrhea was true both for breast fed and formula fed cases. The better gain in weight was significantly evident in formula fed cases. It is noteworthy that breast fed cases showed significantly better weight gain and significantly lower stool output and purging rate than formula fed cases, irrespective of the type of ORS used. During the study 47 cases showed successful rehydration and 13 cases showed failure of rehydration. It is noteworthy that cases with successful rehydration showed significantly lower stools output and purging rate in the first 6 hour and in the first 24 hours, and significantly higher amount of ORS intake in the first 24 hours than cases with failure of rehydreation. Serum sodium and potassium levels at 0 and 24 were within normal limits and no significant changes were observed on follow up which further support that ORS with sodium 90 mmol/litre is safe

Prevalence of rickets in rural Aswan

The study was conducted in El-Sheikh Ibrahim village- Aswan Governorate. All the village children aged 0-5 years [469] were included in this work. Clinical rickets was found in 14.7% of the studied children. Of the rachitic children 79.7% were aged 2 years or less. Prevalence of rickets was significantly higher in boys [18.2%] than in girls [10.9%], in children with birth rank four or more - [24.6%] than in those with birth rank three or less [11.5%], in children with birth interval less than two years [21%] than in those with birth interval 2 years or more [8.6%] and in children with a history of more than four diarrheal episodes per year [50%] than in those with less than 4 diarrheal episodes per year [9%]. Wasting was found in 28.2% and stunting was found in 31.4% of the examined children. The prevalence of rickets was significantly higher in children with wasting [18.6%] than in those without [11.1%]. No significant differences in the prevalence of rickets was found in relation to stunting or in relation to the pattern of feeding. On radiological basis rachitic cases were described as active, healing or heald in 10.1%, 43.9% and 16% respectively. There was a good correlation between the activity of rickets assessed radiologically and the levels of both serum phosphorus and serum alkaline phosphatase. Hypocalcemia was found in all cases of active rickets and in 73.4% of healing rickets. Hypercalcemia was found in 3 cases of healed rickets