Diagnostic value of umbilical cord blood procalcitonin level as an early marker of neonatal sepsis

Septicemia is a systemic disease associated with the presence and persistence of bacteria and their toxins in the blood. It is one of the major causes of morbidity and mortality in the neonatal period. Early diagnosis and proper manag-ement of neonatal septicemia can bring down the morbidity and mortality rates. Procalcitonin [PCT] has recently become of interest and proposed as a possible marker of the systemic inflammatory response to infection in critically ill patients. The aim of this study was to clarify the diagnostic value of serum Procalcitonin [PCT] level as an early marker for diagnosis of neonatal sepsis. Twenty neonates with maternal risk factors for sepsis were included in this study. They included 8 males, 12 females with a mean gestational age of 38.2 +/- 1.76 weeks and mean birth weight of 3.25 +/- 0.34 kg. Twenty healthy children of matched age and sex with no maternal risk factors for sepsis were included in the study as a control group. Serum PCT concentrations were measured at umbilical cord blood samples, taken at time of delivery and peripheral blood samples taken 48 hours later using an immunochromatographic semi quantitative test [PCT-Q; Brahms, Hennigsdorf, Germany] and C- reactive protein [CRP] concentration was measured using an immune-oreactive quantitative method. Serum PCT concentrations were significantly higher in neonates with confirmed sepsis than both control group and neonates with clinically suspected but not confirmed sepsis. PCT is a more sensitive and specific early marker of neonatal sepsis compared with other laboratory parameters of sepsis

Serum leptin level among malnourished children with and without pneumonia

Protein-energy malnutrition [PEM] is a significant problem among paediatric population, the most severe forms of PEM were marasmus and kwashiorkor. Infectious complications are important cause of death among children with PEM. PEM is a common cause of secondary immune deficiency and susceptibility to infection in humans. Malnutrition impairs the immunity through a variety of mechanisms. The aim of this study is to evaluate the serum leptin level in children with PEM with and without pneumonia. 60 children were included in the study; 20 were used as a control, 20 child had PEM with out infection and 20 child had PEM associated with pneumonia. All included children were subjected to nutritional assessments. Haematological tests [haemoglobin concentration, white blood cell [WBC] count and differentials including CD4 count and ratio, serum albumin, blood glucose, white blood cell count, urine nitrogen, and serum ferritin], and chest x-ray reports were done. The serum leptin level and CD4 ratio were significantly lower in both groups with PEM when compared to the control group [p < 0.001]. Also, serum leptin level and CD4 ratio were significantly lower in the groups with PEM and pneumonia one compared to the group with PEM without pneumonia [p<0.001]. The leptin hormone has an important role in immune system and its deficiency in PEM together with reduction of CD4 ratio are important factors for contracting infections