Study of some minerals, trace elements and antioxidants in refractory childhood epilepsy

The aim of this study is to evaluate the role of some minerals, trace elements and anti-oxidants in children with intractable epilepsy compared to healthy children. In a case control study, 45 epileptic patients [24 male and 21 female] with age range between 3 to 14.5 years presented to Assiut pediatric university hospital, suffering from various types of refractory epileptic seizures compared with 20 healthy sex- and age-matched children served as controls. Serum Se, Zn, Cu, Mg, Glutathione peroxidase [GSH-PX] and Superoxide dismutase [SOD] were measured. The mean age of the patients +/- SD was 8.4 +/- 3.1y. The serum levels of Zn, Mg and Se are significant lower in patients in comparison with control, p value < 0.001 for each, with no significant difference between both groups in serum Cu. Glutathione peroxidase [GSH-PX] was significantly lower in patients in comparison with control group [p value < 0.001] with no significant difference between both groups in SOD. Some minerals [Mg], trace elements [Zn, Se] and antioxidants [GSHúPX] may play an important role in the pathogenesis of intractable epilepsy

Helicobacter pylori infection in children with refractory iron deficiency anemia [RIDA]

The prevalence of iron deficiency anemia [IDA] varies widely between developed and developing countries and is related to many factors. If iron therapy does not produce the expected results, patient compliance with the prescribed medication should be insured, and if confirmed, the diagnosis of IDA should be reevaluated. Continued iron therapy in the absence of iron deficiency can produce iron overload. Refractory Iron Deficiency Anemia accounts for about 15% of all IDA. Previous reports by many authors suggested that there was a relation between Helicobacter pylori [H. pylori] infection and IDA. The aim of the present work is to determine the prevalence of H. pylori infection among patients with RIDA, to describe the clinical presentation of H. pylori infection among these patients and to determine the value of serum immunoglobulin G, and immunohistochemistery in diagnosing H. pylori infection and finally to describe the histopathological changes in gasrtic biopsy of these patients. The study included 40 cases with RIDA [Hb < 10gm/dl, not responding to oral iron therapy for three months]. They were attending the Hematology unit and children hospital, Assuit University during the period June 2003 to May 2004. They were 31 males and 9 females and their ages ranged from 4 to 13 years. The study also included 10 apparently healthy children of matched age and sex as a control group. Children with positive Tuberculin test, PEM, malabsorption particularly Celiac disease, myeloproliferative, connective tissue disease and those with repeated overt blood loss were excluded from the study. In addition to careful history taking and thorough clinical examination, the following investigations were done: complete blood picture, urine analysis, stool analysis for three consecutive days, stool analysis for occult blood, serum iron, TIBC, serum ferritin, Hb electrophoresis and serum IgG for H. pylori. Patients were subjected to upper gastrointestinal endoscopy and gastric biopsies were taken for Monoclonal antibody against H. pylori [1HC], and for pathological changes by H and E stain. Identification of H. pylori using other stains namely Giemsa and Leung was also done. Triple therapy was given to eradicate H pylori infection and follow up by hem atological profile and iron status was done. Out of the cases with RIDA, 40% were 4 times during the study period. Serum IgG for H. pylori was positive in 32.5% of cases and in 20% of the control. IHC staining for H. pylori was positive in 50%. Sensitivity of IgG for H. pylori was 60%, specificity was 95%, positive predictive value was 92%, negative predictive value was 70% and accuracy was 76%. There was significantly higher frequency of RAP among cases positive for H. pylori IgG than among negative ones. There was also a significantly higher frequency of anemic heart failure and repeated blood transfusion among positive cases for IgG than the negative ones. H. pylori organisms were detected in 50% of the cases by IHC staining. There was significantly higher frequency of positive IHC for H. pylori among cases > 6 years and among males. There was significantly higher frequency of RAP in the positive cases for H. pylori by IHC than in the negative cases. In addition, the frequency of cases with Hb