RESUMEN
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
RESUMEN
In this study, 107 patients with common bile duct stone[s] were selected for endoscopic management. The success rate of cannulation of the common bile duct was 97.1%. Endoscopic sphincterotomy was done in 104 patients, stone[s] extraction after endoscopic sphincterotomy was achieved in 73 patients using different endoscopic approaches, basket extraction in 38 cases, balloon extraction in 35 cases and mechanical manual lithotripsy, which was used successfully in 22 patients. The mechanical manual lithotripsy increased the ability to clear CBD stone[s] from 70.19% to 91.3% at the initial endoscopic session. The early complications of ERCP and its therapeutic applications were bleeding in three cases, pancreatitis in four cases and cholangitis in two cases. Late complications included cholecystitis in four cases and recurrent CBD stones in three cases. The overall success rate for CBD stone[s] clearance was 92.5%, while the overall morbidity after ERCP and its therapeutic applications was 16.3%. There was no recorded mortality