Serum sFas, TNF-alpha and BcI2 expression following Traumatic Brain Injury

Background: Traumatic brain injury [TBI] still represents a leading cause of high morbidity and mortality

Objective: This study aims to determine serum level of s Fas and TNF-alpha and its relation to primary outcome [survival/death] of patients following Severe TBI and to show variation in Be 1-2 expression and apoptosis percentage after TBI

Patients and Methods: In this Prospective case control study, twenty five patients who were victims of severe isolated TBI [GCS 3-8] with no indication for surgical intervention were included in this study. Six healthy volunteers without history of TBI were included as control group. All of them were subjected to ELISA detection of serum sFas and TNF-alpha level. Flow cytometric analysis of Bcl2 expression upon PBMNC and apoptotic percentage was detected

Results: Serum sFas, TNF-alpha levels and Bcl2 expression level were significantly higher in TBI patients and in non-survivors than in control group and survivors respectively. Apoptotic cells percentage was significantly lower in TBI patients and non-survivors than in control group and survivors respectively

Conclusion: serum sFas, TNF-alpha levels can be used as prognostic markers for early selection of patients at risk of deterioration after severe traumatic brain injury

Risk Factors of catheter related blood stream infection in neonatal intensive care unit: experience from a developing country

Objective: The aim of this study was to detect the rate of catheter-related bloodstream infection [CRBSI] in NICU of Mansoura University Children's Hospital and to focus on possible predictors of infection. Study

Design: A cross sectional comparative study to detect rate of CRBSI among neonates with central vascular catheters during the period between January 2009 and April 2012. Then, a nested case control study done among CRBSI cases and central vascular catheters none infected as a control group to detect predictors associated with their occurrence

Patients and Methods: Blood samples were collected from III neonates clinically suspected ofsepticemia and had inserted venous line. Central, peripheral blood and catheter tip cultures were done for each case

Results: CRBSI was confirmed in 69 cases as central blood culture count was > 3 folds of peripheral blood culture count. Catheter tip culture showed > 103 CFV/ ml per catheter of the same organisms. Low birth weight, age below 7 days, prematurity, mechanical ventilation, TPN administration and prolonged hospital stay were predictors of CRBSI. Logistic regression of the studied predictors showed that birth weight, TPN administration and length of central venous catheter stay were significant predictors of CRBSI

Conclusion: CRBSI is a common problem in NICU. Predictors of CRBSI included low birth weight, prematurity and mechanical ventilation. Potential use of TPN, prolonged catheter stay and low birth weight are independent predictors for CRBSI