Plasma procalcitonin concentrations in uremic children undergoing haemodialysis, a new parameter for diagnosis of bacterial infection

Background: bacterial infections are Life-threatening complications in uremic children. Early diagnosis is mandatory but very difficult because currently applied laboratory parameters may be affected by the underlying, the uremia or the haemodialysis [HD]

Objectives: evaluation of the value of serum procalcitonin [PCT] as an indicator of systemic bacterial infection in HD children

Study Design: this cross-sectional short-tern study was conducted on 33 children aged from 7-15 [mean = 9.1 4 1.8 years]. 23 were males and 10 were females. they undergo intermittent HD. Also 30 apparently healthy controls of same age group were recruited into the study. Cases are classified into 2 groups. Group I: [infection +ve]: include 15 patients with evidence of systemic bacterial infection. Group II: [infection -ve]: include 18 patients without evidence of systemic bacterial infection. For all cases blood samples before HD for determining CRP, CBC. IL-6. PCT, albumin and renal function testes

Results: PCT and CRP in-group I are significantly higher than group II while IL-6 and WBCs were elevated in both groups. PCT demonstrated higher sensitivity, specialty, positive and negative prediction values than CRP, IL-6 and WBCs. Furthermore, PCT serum levels were positively correlated with CRP. IL-6 and WBCs values. where it was negatively correlated with albumin and hemoglobin values

Conclusion: procalcitonin [FCT] seems to be a novel diagnostic indicator of systemic bacterial infection in haemodialysis children. Additional investigations are needed to understand its synthesis and prognostic value

Diagnosis and differentiation between E. histolytica and E. dispar by PCR technique

Amoebiasis caused by the enteric protozoan E. histolytica, is one of the major parasitic diseases in the world, it is responsible for up to 100,000 deaths per year. It is common in developing countries with poor socioeconomic conditions and malnutrition. It is well established recently the clear distinction of two separate species which are morphologically indistinguishable E. histolytica and E. dispar the later species is proved to be non- pathogenic and does not require any treatment. This work was done to evaluate PCR technique as a method for diagnosis and discrimination between the two species, and to assess the incidince of this parasite in Qualiubia Province. The study included 200 cases from out patient clinic. History front the patient was taken, the samples were subjected to macroscopical and microscopical stool examination, formol-ether concentration of samples, and PCR of the DNA extracted from stool samples. All the results obtained were analysed statistically

study of some nontraditional risk factors for the development of coronary heart disease in patients with insulin dependent diabetes mellitus

Megjor risk factors explain much of the excess risk for coronary heart disease produced by diabetes, but nontraditional factors may also relate to incident coronary heart disease. This study was conducted on 35 patients with IDDM and coronary heart disease [CHD] [10 females and 25 males, aged 45-70 years], 35 patients with IDDM and without CHD [17 females and 18 males, aged 35-65 years] as well as 20 age and sex matched apparently healthy individuals as a control group. Every individual was subjected to clinical evaluation including history taking and clinical examination with special stress on the presence of risk factors as well as measurement of: fasting and postprandial blood glucose levels, lipid profile, serum albumin level glycosylated hemoglobin [HbA[1]], C-reactive protein [CRP], fibrinogen level von Willebrand factor antigen level [vWF Ag], total leucocyte count and albumin excretion rate [AER] in urine. Insulin dependent diabetics with CHD had higher levels of total cholesterol LDL-c and triglycerides and had lower levels of HDL-c when compared with diabetics without CHD and with controls. They also showed higher levels of fibrinogen, vWFAg level, CRP and total leucocyte count and lower levels of serum albumin. Microalbuminuria was present in 71.4% of diabetics who developed CHD while it was present in 31.4% of diabetics without CHD. In diabetics with CHD, fibrinogen was correlated with vWF at r=0.52 and P< 0.05. vWF Ag level is weakly correlated to lipid parameters, being significantly correlated to triglycerides. It was also positively correlated toAER [microalbwninuria] [r=0.84, P< 0.003], while it was negatively correlated to serum albumin [r = -0.4, P< 0.05]. In the type I diabetic group with CHD C-reactive protein correlated significantly with vWF [r=0.43, P< 0.005] and with fibrinogen [r=0.60, P< 0.001]. In conclusion levels of fibrinogen, von Willebrand factor, CRP, albumin and leucocyte count were predictors of coronary heart disease among patients with IDDM. These associations may reflect the underlying inflammatory reaction or microvascular injury related to atherosclerosis and a tendency toward thrombosis