study of some oxidant products and antioxidants in children with acute respiratory distress

The present study included sixty pediatric patients with acute respiratory distress, their age ranged from 2 months to 13 years. They were 42 males and 18 females, in addition to twenty apparently healthy children of matchable age, sex and socioeconomic status as control group. All patients were selected from the Intensive care and emergency unit of pediatric department, Assiut University Hospitals. Patients with sepsis or suspected metabolic disease were excluded. Thorough clinical history, examination and chest x-ray were conducted. Laboratory assessments included a peripheral hemogram, serum electrolytes, urea, creatinine, arterial blood gases and estimation of some products of oxidant stress and antioxidants including nitric oxide [s. nitrite], lipid peroxides [LPER], total thiols [glutathione], ceruloplasmin and vitamin E. Out of the 60 patients, 5 cases had viral croup [8.33%], 11 cases had acute viral bronchiolitis [18.33%], 14 children had bronchial asthma [23.33%], 26 cases were diagnosed as bronchopneumonia [43.33%] and 4 cases had lobar pneumonia [6.67%]. No significant difference in arterial blood gases was found between the 5 groups except for PaO[2] which was significantly lower in asthmatic children than in those with bronchopneumonia [P<0.01]. Hemoglobin value was significantly lower and total WBC count was significantly higher in all patients with respiratory distress than controls [P<0.001 for each]. Regarding serum electrolytes, only serum calcium was significantly lower in patients with respiratory distress than controls [P<0.001]. The levels of serum nitrite, lipid peroxides and ceruloplasmin were significantly higher in patients than in controls [P<0.001 for each]. However, serum SOD, total thiols and vitamin E were significantly lower in patients than in controls [P<0.001 for each]. Patients with bronchial asthma showed significantly higher serum nitrite, lipid peroxides and ceruloplasmin and significantly lower total thiols and vitamin E than those with viral croup. Significant positive correlations were noticed between arterial oxygen pressure [PaO[2]] and serum nitrite level and between lipid peroxides and respiratory distress score [P<0.001 for each]. Significant negative correlations were observed between SOD levels fraction of inspired oxygen, between total thiols and either respiratory distress score or Fio2 and between serum vitamin E levels and either respiratory distress score or Fio2 [P<0.001 for each]. Imbalance between endogenous antioxidant systems and oxidant stress with shifting toward oxidant stress may be an underlying pathophysiologic mechanism leading to or aggravating the severity of respiratory distress in airway diseases. Further studies are recommended to delineate the effect of exogenous therapeutic augmentation of antioxidant defenses

Real time three dimensional [RT3-D] and two dimensional echocardiography evaluation of atrioventricular septal defect [AVSD]

This study included 60 patients with repaired AVSD that were scanned by 2-D echocardiography to detect and evaluate the degree of residual mitral regurge [MR] and to assess the cardiac function. The preoperative data including age, weight, associated anomalies or Down's syndrome and two-dimensional echocardiography were reviewed. Using real time 3-D echocardiography, the three components of mitral valve [superior, inferior and lateral or mural leaflets] surface areas were measured in 20 out of these 60 patients. A common AVV orifice was present in 73.3% [first group] and the rest had separate AVV orifice [second group]. The prevalence of associated cardiac anomalies was significantly higher in the first group. Down's syndrome was present in 22 cases, 12 of them in the first group and 10 in the second group. It was also observed that late repair [<1 year] was a risk factor for postoperative MR. So, the first year of life is the golden time for definitive repair of AVSD. It can be concluded that late [>12 months] repair of AVSD and associated cardiac anomalies were identified to be significant risk factors for the persistence of MR postoperatively. To improve the surgical results of AVSD repair, operation should be best done before the first year of life. Real time 3-D echocardiography preoperative scanning of the surface areas of the mitral valve leaflets may give a guide to the best procedure of repair. Real time 3-D echocardiography avoids deficiencies encountered with reconstructive 3-D techniques by acquiring volumetric data at a rate sufficient to show real time movements of the heart and intracardiac structures in a very short time

Effects of zinc supplementation on growth and immune function in children with protein-energy malnutrition

The study included 56 malnourished children [32 marsmus and 24 K washirkor] aged 9-24 months, in addition to 16 well nourished healthy children, of comparable age and sex, taken as control. Beside full clinical examination, the study entailed measurements of body weight and height and determinations of hemoglobin concentration, serum albumin, serum zinc, serum immunoglobulions [IgM, IgG, IgA], B and T cells rosette, Lymphoblast transformation index and tuberculin test. In addition to the usual management of protein energy malnutrition, zinc acetate was given orally to every other case in a dose of 2 mg/kg/day of elemental zinc. Anthropometric and laboratory reassessment were done after 60 days of nutritional therapy. Both the zinc supplemented and non supplemented groups showed statistically significant improvement in all the anthropomeric and biochemical studied parameters except for serum zinc after the 60 days of follow up. The improvement of weight and weight/height were significantly better in zinc supplemented than in non supplemented cases. Significant improvement in mean value of T-cell rosette and percentage positive tuberculin reaction was observed only in zinc supplemented cases. Significantly higher frequency of infections especially oral thrush, diarrhea and skin infection were observed in non zinc supplemented group [46.4%, 50% and 39.3% respectively] than in supplemented group [10.7% P < 0.01, 17.8% P < 0.02 and 14.3% P < 0.05 respectively]. In conclusion zinc supplementation of malnourished children proved to be beneficial as it had a significant positive effect on weight gain and improvement of host defense mechanism. Zinc supplementation is recommended for optimal recovery of cases with protein energy malnutrition

Value of some tumor markers in monitoring childhood acute leukemia and lymphoma in relation to therapy

Plasma fibronectin, fibrinogen; serum copper, zinc and copper to zinc [Cu/Zn] ratio were determined in 17 cases with acute lymphoblastic teukemia [ALL], 10 cases with acute non- lymphoblastic leukemia [ANLL], 23 cases with Non-Hodgkin's lymphoma [NHL] and 5 cases with Hodgkin's lymphoma [HL] as well as 20 controls. The patients were followed up for 128 weeks through which the above mentioned parameters were determined after each stage of therapy. Significantly higher plasma fibronectin, fibrinogen serum copper and CU/Zn ratio values and significantly lower serum zinc values were observed in all groups studied before the start of therapy than controls. After induction of remission and during subsequent stages of therapy plasma fibrinogen, serum copper and Cu/Zn ratio showed significantly lower values, while serum zinc showed significantly higher values than pretherapy levels in cases of NHL. However, plasma fibronectin levels raised significantly after induction of remission than before therapy. This was followed by gradual decrease after each subsequent stage of therapy. In cases with acute leukemias significantly lower plasma fibronectin, fibrinogen; serum copper and Cu/Zn ratio values, while significantly higher serum zinc values were observed after induction of remission and during subsequent stages of therapy than pretherapy levels. During stage of maintenance of remission these parameters were normalized and were comparable to that of controls in all groups studied. Plasma fibronectin, fibrinogen; serum copper and Cu/Zn ratio showed significantly higher levels while serum zinc showed significantly lower levels than controls by a period that ranged from 16 to 40 weeks before clinical and/or hematological relapse in various groups studied. This may be considered as a stage of biochemical relapse. These data suggest the use of plasma fibronectin, fibrinogen; serum copper, zinc and Cu/Zn ratio as useful markers in monitoring acute childhood leukemias and lymphomas therapy. They may be of value in detection of disease activity and early relapse

Growth and development patterns of rural preschool children in Assiut governorate

The study was carried on 1070 rural preschool children aged 1-71 months. Every child was subjected to full history, clinical examination and anthropometric measurements. The mean values of studied anthropometric measurement [weight, height, head and chest circumferences, midarm circumference and skinfold thickness] of our children were noticed to be lower than the corresponding values reported in lower Egypt and some Arabic Countries as well as developed countries for children of similar ages. The weight, height and head circumference in males were significantly higher than in females in most age groups. The achievement of developmental milestones was found to be delayed in our children

Physical growth of prepubertal and pubertal Assiut school girls

Physical growth was assessed in 1111 apparently healthy girls 8-18 years of age from both urban and rural Assiut schools. Height, weight, skinfold thickness, midarm and calf circumferences, biacromial and bicrestal diameters were measured. The weight/height, and biacromial diameter/bicrestal diameter ratios were calculated. A steady increase in height and weight were observed with increasing age, with marked rise at 9 years. In this study, girls were taller and heavier in most age groups than their counter parts studied in Assiut at 1962 and 1973. the percentage increment in skinfold thickness with age was higher in he suprailiac region [230.5%] than in the triceps region [96.3%]. A decrease in shoulder/hip width ratio was observed with increasing age

Sexual maturation in healthy school girls in Assiut

A total of 1111 Assiut school girls aged 8-18 years were examined in a cross sectional study for the age of attainment of successive puberty stages of the breast, pubic hair, axillary hair and of menarche. The age of onset of puberty was 9 years and all girls were pubscent at 15 years. The mean ages of attainment for the initial stages of breast, pubic hair and axillary hair development were [11.8 +/- 0.9, 12.0 +/- 1.01, 12.78 +/- 0.82 years respectively]. The mean menarcheal age was 13.17 +/- 0.01 years which was earlier than that recorded in 1970's in Assiut girls