role of urinary secretory immunoglobulin [A] in diagnosis of pediatric urinary tract infection

Secretory immunoglobulin A [SIgA], an immunoglobulin synthetized locally in, mucosal surfaces, plays a vital role in preventing mucosal localization by pathogenic bacteria. Its protective effect in urinary tract is still less well documented. This study was done to elucidate the role of SIgA in children with urinary tract infection. The work was carried out in Pediatric Department Zagazig University Hospitals in association with Clinical Pathology and Radiological Departments. 115 children [54 males-61 females] their age ranged between 1.5-14 years with a mean age of 5.4 years. They were classified into 4 clinical groups: Control Group: 40 healthy children who denied any history of urinary tract infection [UTI] and urine culture free. Group I: 30 cases subjects studied at the time of the first symptomatic [UTI]. Group II: 30 cases subjects who had a history of at least 2 documented episodes of UTI but had normal urinary tract and had negative bacterial culture at the time of the study.Group III: 15 cases subjects with symptomatic UTI and had an abnormal urinary tract .All subjects were age matched and subjected to full history taking-complete physical examination and laboratory aids and various radiological investigations. Urinary SIg A excretion rate was determined by immunodiffusion plates [L.C.partigen immunodiffusion plates from Behring AG Marburg, Germany]. Our results showed that: Urinary SIg A excretion rate was high among group I [1.74 +/- 0.13 mg/gm creatinine]-very high among group III [2.247 +/- .22 mg/gm creatinine] and low among group II [0.446 +/- 0.05 mg/gm creatinine]. The variation of SlgA urinary excretion among manifested our cases [group I, group Ill] was related to type of urinary pathogens involved. There was no correlation between urinary SIgA and number of bacterial colonies on urine culture.In localizing the site of UTI using SlgA excretion rate versus scintigraphy urinary SlgA was significant in localizing UTI in cases of group I and has no significance in cases of group Ill. Reflux, stricture urethra and stone Kidney were the commonest urinary abnormalities in our studied cases of group III and there were accompanied by high urinary SlgA excretion

Echocardiographic assessment of cardiac dimensions in normal infants and preschool children

Echocardiography is routinely perfomed for non invasive evaluation of patients with known or suspected heart diseases. It defines anatomical relations and provides numerous measurements of intracardiac dimensions.As with all clinical measurements, it is important to have accurate definition of nomral limits to guide interpretation. Our study aimed to determine the normal limit in cardiac dimensions in a group of normal infants and preschool children from birth up to 5 years and to define the ideal means of indexing cardiac dimensions during this period of time.Our work was carried out in Pediatric department in association with Cardiology department Zaggazig University Hospitals.A total of 160 healthy infants and preschool children were examined by Echocardiography 99 were males - 71 were females. The dimensions examined included the aortic annulus, left atrium and left ventricular end-diastolic diameter, each measured in the parasternal long-axis plane and left-ventricular length measured from the apical two chamber view. Our result showed that age, body surface area [BSA], weight and height are consistently highly correlated with all measured cardiac dimensions left ventricular length [LVL], left ventricular diameter [LVD], Aortic annulus [Ao. an.] and left atrial diameter [LAD] as their correlation coefficient [r] was significant. There is no sex difference in the given myocardial parameters in this age group