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

Can we predict the occurrence of mitral regurgitation during percutaneous balloon mitral valvuloplasty?

Mitral regurgitation is a frequent complication of percutaneous balloon mitral valvuloplasty. The creation of a new or an increase in preexisting one has been reported in 19 to 85% of patients undergoing percutaneous balloon mitral valvuloplasty. The aim of this work is to evaluate whether we can predict the occurrence of significant mitral regurgitation during percutaneous balloon mitral valvuloplasty with the use of C-reactive protein [CRP], erythrocytic sedimentation rate [ESR] and leucocytic count or not. 20 patients who developed significant mitral regurgitation during percutaneous balloon mitral valvuloplasty [group A] were retrospectively compared to another 20 age- and sex-matched control group [group B] who did not develop mitral regurgitation as regard CRP, ESR and leucocytic count. ESR, CRP and leucocytic count were found to be significantly higher in group A than in group B. Higher levels of ESR, CRP and leucocytosis can predict the occurrence of significant mitral regurgitation in patients undergoing percutaneous balloon mitral valvuloplasty