Accelerated BCG as a diagnostic test of tuberculosis in children

This study included 800 children with some common pediatric problems with increased risk for tuberculosis infection [chronic cough, chronic diarrhea, PEM, nephrotic syndrome receiving steroids, malignancy] and 100 apparently healthy children as controls. Patients and controls aged 3 months to 5 years. All studied children were subjected to tuberculin test. Those with negative tuberculin test were subjected to BCG vaccination. Tuberculin test was significantly positive in 6% of the [diseased group] and 1% of the controls, [X[2] = 4.28, p. 0.05]. Acclerated BCG was found in 3% of the diseased group and in none of the controls. According to the result of tuberclin and BCG tests tuberculosis was found in 11.6%, 10%, 8% and 2% of children with chronic cough, PEM, chronic diarrhea and nephrotic syndrome receiving steroids respectivley. The clinical diagnosis was: pulmonary TB [56%] TB enteritis [20.5%]. TB peritonitis [9. 6%], combined pulmonary and abdominal tuberculosis [13.7%]. This study shows that BCG is an important, reliable and inexpensive tool for supporting the diagnosis of tuberculosis in tuberculin negative children with medical conditions with increased risk of tuberculosis

Lipid peroxides and some antioxidants as indices of oxidant stress in children with non Hodgkin's lymphoma

Oxygen free radicals have been recently suggested to be implicated in the pathogenesis of malignant disorders. Therefore, lipid peroxides as an indicator of oxygen free radical induced damage, together with the enzymatic antioxidants namely ceruloplasmin, superoxide dismutase and the nonenzymatic antioxidant total thiols were determined in sera of 30 children with non Hodgkin 's lymphoma, before any therapeutic intervention. The same bioindices were studied in 20 of these children after completion of their therapeutic regimen together with 10 healthy children representing control group. Lipid peroxides were significantly increased while ceruloplasmin, superoxide dismutase and plasma thiols were significantly decreased in patients compared with healthy children. A significant negative correlation was observed between lipid peroxide levels and ceruloplasmin, superoxide dismutase and total thiols levels. Chemotherapy has no significant effect on the serum levels of the previous bioindices. These results clearly indicates that children with non Hodgkin's lymphoma are under oxidant stress which is manifested by increased lipid peroxides and decreased ceruloplasmin, superoxide dismutase and thiols. This change may contribute to propagation of the malignant process by interfering in the pateint's antitumorous immune surveillance

Some biochemical indices of lead and cadmium exposure in healthy and protein-energy malnutrition [PEM] children in Assiut locality

Due to the recent interest in childhood trace metal intoxication, lead, cadmium and iron plasma concentrations together with zeta-aminolevulinic acid dehydrase [ALA-dehydrate] activity levels were determined in a total of 183 children [144 healthy aged 6 months to 12 years and 39 PEM aged 6 to 36 months]. Taking 3 micro g/dL as the cut-off level, about 24% of the healthy and about 26% of the PEM children had plasma levels above this value. Such increment in lead level was accompanied by significantly decreased hemoglobin concentrations. Plasma lead levels were significantly higher in children who are residing in urban than in those who are residing in rural areas. In the group of healthy children with plasma, lead levels above 3 micro g/dL the significant risk factors were residence in urban areas and history of pica [71.4% for each]. ALA-dehydrase activity was significantly lower and its activation ratio was significantly higher in children with plasma lead, level > 3 ug/dL than in those with lower levels. A significant negative correlation and a significant positive one were found between plasma lead level on one hand and both ALA-dehydrase activity and its activation ratio respectively on the other hand. ALA-dehydrase activity was significantly lower whereas its activation ratio was significantly higher in children who are residing in urban than in those residing in rural areas. Plasma, cadmium levels were increased significantly with age. Significant risk factors for increasing cadmium levels include: urban residence, indoor parents smoking and protein energy malnutrition. It was concluded that children in urban areas are at great risk for lead and cadmium exposure than those in rural areas. Also, ALA-dehydrase activities and its activation ratio can serve as good indicators for early detection of ill health due to lead exposure

Changes in Ige, histamine and esinophils in laryngotracheobronchitis

The present study included 45 children aged 1.5-5 years with laryngotracheobronchitis [the most common form of croup] 15 of them suffered from a single attack and the remaining 30 suffered from recurrent attacks of the disease. The study also included 20 children with bronchial asthma aged 3-6 years and 20 apparently healthy children aged 1-6 years as controls. Plasma IgE and histamine levels and blood esinophil count were significantly higher in laryngotracheobronchitis and asthma children than in controls. Asthma children showed a significantly higher plasma IgE, plasma histamine and blood esinophil count than those with laryngotracheobronchitis. No significant difference could be found in the levels of plasma IgE, plasma histamine and blood esinophil count between children with a single attack and those with recurrent attacks of laryngotracheobronchitis. Changes of plasma IgE, plasma histamine and blood esinophil count in children with laryngotracheobronchitis appear to be related to the basic underlying pathology rather than to allergy

Some risk factors for protein-energy malnutrition in preschool children in Assiut city

The study included 560 children aged 12-60 months recruited from 12 day care centers representing the new and the old districts of Assiut City. Beside the history and clinical examination, the weight for height and the height for age ratios were calculated for each child. Stool examination for intestinal parasites was done for all of the examined children. Wasting, stunting, concurrent wasting and stunting were found in 9.1%, 13.1% and 2.1% respectively among the studied children. Intestinal parasites were found in 29.3% of children included in this study. Both wasting and stunting were more prevalent in children from the old district than those from the new one. The highest prevalences for wasting was found in the second and that for stunting was found in the third years of life. There was no significant difference as well as for stunting include: low level of maternal educations, high crowding index per bed room and the presence of parasitic infestations. Risk factors for wasting [but not for stunting] include: birth order more than the third, maternal age more than 35 years, and unskilled manual maternal job

Plasma histamine in asthmatic children in relation to plasma IgE level

This study included 35 asthmatic children and 10 controls. Ages of patients and controls ranged from 4-8 years. They were recruited from the out-patients clinic of the pediatric Departement, Assiut University Hospital. The following investigations were done for both patients and controls: Plasma IgE level, plasma histamine level, total and differential white blood cell count, urine and stool examination. Plasma histamine level was significantly elevated in asthmatic than in control children. At the same time plasma histamine level was significantly elevated in asthmatic children with normal plasma IgE than in asthmatics with raised plasma IgE. Absolute blood esinophil count was significantly elevated in asthmatic children with elevated plasma IgE than both controls and asthmatics with normal plasma IgE. No significant difference could be found in the absolute blood basophil count could be found between asthmatics children and controls. It appears from this study that histamine may be an important mediator of bronchial asthma in children irrespective of the plasma IgE level

Thyroid hormones in relation to feeding practices and iron status in children

The study included 80 apparently normal children aged 6-24 months, half of these children were breast fed and the other half cow's milk fed. T3 was significantly higher in the breast fed than in the cow's milk fed children. T3 in the cow's milk fed children was significantly higher with than without the addition of sold foods. T4 did not differ significantly between the breast fed and the cow's milk fed children, but significant increase occurred with the addition of solid foods in both groups of children. No significant differences could be found in the mean values of hemoglobin, serum iron, total iron binding capacity,% of transferrin saturation, serum transferrin and serum ferritin between breast fed and cow's milk fed children whether supplemented or not with solid foods. Iron deficiency was found in 25% of the breast fed children whether supplemented or not with solid foods. In the cow's milk fed children iron deficiency was found in 45% in cases not supplemented and 40% in cases supplemented with solid foods. No significant difference could be found in the thyroid hormone levels in relation to the iron status of the studied children

Identification of cardiovascular abnormalities in children with empyema thoracis by two-Dimensional and doppler echocardiography

Echocardiographic assessment of children with empyema has not previously been reported in the literature. Two-dimensional and Doppler echocardiography were performed in 47 children with acute [n=23] and chronic [n=24] empyema and 34 control subjects. Echocardiography demonstrated pericardial effusion in 11/47 patients [23%]. Those with acute empyema had significantly thicker pericardium [p < 0.009] than control subjects. tricuspid regurgitation was present in 21/47 patients [45%]. The mean right ventricular internal dimension in diastole [RVID] was significantly larger in acute [p < 0.006] empyema than that of control subjects. the mean tricuspid pressure gradients indicated on elevated mean right ventricular systolic pressure with increased calculated mean pulmonary arterial systolic pressures of children with acute empyema [38.5 +/- 6.4 mmHg] and chronic [39.8 +/- 5.6 mmHg] empyema than the normal mean [20 +/- 4 mmHg] reported by Krovetz and Goldblom. Children with chronic empyema had significantly less mean left ventricular internal dimension in diastole [LVID] [p < 0.005] and in systole [LVIS] [p < 0.02] than control subjects. strikingly, their mean left ventricular mass was also significantly less [p < 0.05] than that of either acute empyema or control subjects. these results provide base line data for follow up of children with acute and chonic empyema

Serum cadmium, manganese and magnesium levels in low birth wieght newborns and their mothers

The study included 54 neonates [20 preterm, 19 full term small for date and 15 full term with appropriate weight] and their mothers. They were taken from newborns deliverd at Assiut University Hospital. There were no significant differences in the serum levels of cadmium, manganese and magnesium between neonates at birth and their mothers. Serum cadmium level was significantly higher in small for date neonates and their mothers than both preterm and full terms with appropriate weight and their mothers at birth. Serum manganese and magnesium levels in neonates at birth did not differ significantly in relation to gestational age or birth weight. Serum cadmium increased significantly in small for date newborns at the age of 28 days compared to levels at birth. No change in serum levels of both manganese and magnesium could be found at the age of 28 days in all the studied newborns in comparison to levels at birth

state of serum iron and proteins in infantile rickets

Forty children with rickets aged 10-24 months and 10 controls of comparable age, sex and socioeconomic status were included in the present study. Serum iron, iron binding capacity, serum albumin, serum calcium, serum phosphorus and serum alkaline phosphatase were measured. A roentgenogram to the lower end of radius and ulna was done for all rachitic children. Iron deficiency anemia was found in 40% of the rachitic children. In the rachitic group a significantly positive correlation was found between serum iron and each of serum calcium and serum phosphorus. A significantly negative correlation was found between serum iron and serum alkaline phosphatae in rachitic in rachitic cases. Iron status was poorer in cases with active rickets than in both controls and cases with healing rickets. Hypoalbuminumia-was found in 25% of rachitic children. A significantly positive correlation was found between serum iron and serum albumin level in cases with rickets. Rachitic children with either hypocalcemia olr hypoalbuminemia showed a significantly lower serum iron and percent of transferrin saturation and a significantly higher iron binding capacity than rachitic children with normal serum calcium and serum albumin levels

Arm muscle and arm fat areas in infantile rickets

This study included 60 children with rickets aged 6-24 months and 20 controls of the same age and sex. Weight, height, mid arm circumference and triceps skinfold thickness were measured for patients and - controls. Arm muscle area, arm fat area, weight for height and height for age were calculated for each child. The arm muscle and arm fat areas were significantly lower in the rachitic than in the control children. Arm muscle and arm fat areas were significantly lower in advanced than in early rickets. Bottle fed rachitic infants had significantly lower arm muscle area than the breast fed ones. Arm muscle and arm fat areas are more sensitine than the weight for height and the height for age ratios in the assessment of the nutritional status of rachitic children