Endothelin-1 in plasma and airways of preterms with respiratory distress syndrome

The objective of the study was to characterize the relationship between endothelin 1 [ET-1] concentration in plasma and airway of the preterm and the severity of respiratory distress syndrome [RDS] in early postnatal period. 44 preterm neonates were enrolled in two groups. Group I comprised 29 preterm with RDS requiring mechanical ventilation. They were further discriminated into 3 subgroups according to severity of RDS [mild, moderate and severe RDS]. Group II comprised 15 preterms on mechanical ventilation for repeated attacks of apnea of prematurity, matched for gestational and postnatal age with group I and served a reference group. Laboratory investigations included plain chest radiographs, sepsis work -up to rule out infection, arterial blood gas analysis with calculation of arterial alveolar oxygen ratio [a/A O2]. ET-1 concentration was measured in plasma and tracheal aspirates within the first 48 hours of life. Mean plasma ET-1 concentrations were significantly elevated in preterms with moderate and severe RDS as compared to reference preterms [P <0.01 and P <0.001, respectively]. Significant negative correlation existed between plasma ET-1 and each of gestational age and 1 and 5 minutes Apgar scores, whereas significant positive correlation-existed between plasma ET-1 and each of fraction of inspired oxygen [Fi02], mean airway pressure [MAP] and radiographic grading of severity of RDS. On the contrary, mean concentration of ET-1 in tracheal aspirate was significantly lower in preterms with severe RDS as compared to reference preterms [P <0.01]. A significant positive correlation was found between tracheal aspirate ET- 1 levels and 5 minutes Apgar score, while a significant negative correlation existed between tracheal aspirate ET-1 and MAP. Finally, a significant negative correlation was found between plasma and tracheal aspirate levels of ET-1 [P <0.001] in preterms with RDS, as well as in reference preterms. High plasma ET-1 level is associated with more severe RDS and could be a specific marker for pulmonary endothelial injury that may contribute to the development of elevated pulmonary vascular resistance in this setting. Meanwhile, the association of low ET-1 level in the airway with severe RDS may be attributable to limitation of its stimulant effect on surfaetant secretion and /or the development of airway epithelium; hence, rise in airway ET-1 is indicative of improved pulmonary status in the early course of the disease

Nutritional assessment of failure to thrive

Failure to thrive is a common problem that is met by pediatricians all over the world. 40 cases of children with FTT aged 1-5 years and 10 normal children of the same age as a conttrol group were studied. All were subjected to comperhensive history taking, through physical examination including anthroprometric assessment [weight, height, head and mid-arm circumferences] and laboratory investigations with particular to estimation of nutritional markers [plasma prealbumin, fibronectin and retinal binding protein]. Our results showed a statistically, significant difference with [P<0.001] in the weight and mid-arm circumference between cases of FTT and control group.Statistical non significan't difference between control group and cases in respect to supine length or height and head circumference [All parameters as a percentage of 50[th] percentile of normal Egyptian growth curves] there was statistical difference in the control levels and our cases of FTT in all nutritional markers. The mean prealbumin level in the control group was 25.4 +/- 9.2 mg/dL compared to the organic group 9.57 mg/dL with P value <0.0001 and in non-organic cases was 12.1 mg/dL with P -value [< 0.005] which is highly significant. The mean plasma fibronectin level in the control group was 21.5 +/- 6.8 mg/dL compared to the mean level in FTT cases 11.7 +/- 4.18 mg/dL with P-value [<0.05]. In the organic group mean level was 10. 15 +/- 3.2 mg/dL with P value [< 0.0005] and in non-organic group the mean fibronectin level was 12.68 +/- 2.3 mg/dL with P-value [< 0.05] compared to control group. Retinol binding protein mean level in control group was 3.82 +/- 1.1 mg/dL while in FTT cases was 1.81 +/- 0.69 mg/dL with statstically non-stignificant difference P-value [< 0.25]. We concluded that the incidence of non-organic failure to thrive cases was higher than the organic causes, most likely in children < 5 years. Ignorance, poverty, frequent infections, cultural customs or unstable families are the main causes in our developing countries

Biochemical and physiological aspects of soybean seeds under the effect of benzyl adenine

Two pot experiments were performed in two successive years [1990, 1991] to study the effect of foliar application of benzyl adenine [at 50, 100 and 200 ppm] at flowering and fruiting stages on carbohydrate, protein, oil of the soybean seeds yielded. The results revealed that benzyl adenine at the lowest concentration [50 ppm] induced a marked increase in the carbohydrate content whereas the relatively high concentrations [100 and 200 ppm] induced a marked decrease in the carbohydrate content. The protein content of soybean seeds was increased significantly in response to all doses of benzyl adenine. Also, the results showed that benzyl adenine induced marked changes in amino acid composition of soybean seed protein were dependent upon the concentration of benzyl adenine. Treatment with benzyl adenine at different concentrations induced an appreciable increase in the total saturated fatty acids of soybean oil relative to unsaturated ones and to the control values

Relation between weaning and gastroenteritis

Acute infantile diarrhea is the leading cause of death among Egyptian children, accounting for more than 50 percent of the death in children under 2 years of age [NCDDP, 1988]. In Egypt, most health experts agree that the best time to introduce foods is at four to six months of age. This is the time when breast milk starts to become inadequate to meet all the infant's nutritional needs [Aref et al., 1984] and the rest of the nutritional requirements become obtained through supplementary foods [Millard, 1985]. In this study, we aim to evaluate the relationship between the weaning period and the possible incidence of diarrheal attacks and to spot light on some parameters namely stool examination for different parasites, culture of the specimen and methylene blue preparations to detect faecal leucocytes. Hematocrit value, Hb percent, R.B.Cs and W.L.Cs and differential leucocytic count then estimation of band/total neutrophil ratio. Serum albumin and serum Na+. 60 cases presented with diarrhea after early introduction of foods during the weaning period, aged from 6 - 24 months were taken in addition to one hundred normal children as a control. The results of this work shows that infants below one year of age were the more affected with attacks of diarrhea. Artificial feeding prior to the period of weaning was more affected than breast feeding. Hb, red cell count and serum albumin were decreased. Hematocrit value was low or normal. Isonatremic dehydration is the most common type of dehydration [75 percent]. As regards the causative organisms, E. Coli [28.30 percent] was the most common followed by E. histolytica [21.6 percent] and giardia lamblia [16 percent]. In this work, the presence of polymorph nuclear leucocytes in the stool was found to be a predictive test for bacterial etiology of diarrhea with positive predictive value of 87 percent. The band/neutrophil ratio of bacterial group had a highly significant difference when compared to the control group, but the parasitic diarrheal group had non-significant statistical difference when compared to the control group