Vitamin D status and scholastic achievement in middle age childhood.

Non-classical effects of vitamin D are not surprising in that many tissues, including neurons, possess vitamin D receptors. Thirty school aged children with delayed scholastic achievement and 15 normal ones were enrolled in the current study to identify the serum 25-hydroxy vitamin D [25(OH) D] status in school aged children in relation to their scholastic achievement. Besides estimation of serum 25(OH) D levels, neuro-developmental assessment was done using the Wechsler Intelligence Scale for Children (WISC) and the Benton's Visual Retention Test (BVRT). Serum 25(OH) D was significantly lower in children with delayed scholastic achievement. Picture completion scores were significantly lower in children with deficient and inadequate serum 25(OH) D. There were positive correlations between serum 25(OH) D level and values of WISC. Regarding BVRT results, good memory was associated with adequate serum 25(OH) D. In conclusion, serum 25(OH) D is deficient in children with delayed scholastic achievement causing affection of memory and learning process. Larger scale studies using learning assessment tools are thus recommended to further prove this point and search the impact of vitamin D supplementation on the school achievement in this age group.

Language skills and intelligence quotient of protein energy malnutrition survivors.

The study was conducted on 33 children aged 3-6 years who suffered from protein energy malnutrition (PEM) during infancy in comparison to 30 matching children to assess the long-term deficits in cognition and language skills. The patients' files were revised to record their admission and follow-up data and history, clinical examination, intelligence quotient and language assessment were done. The study revealed that 2-5 years from the acute attack the PEM patients were still shorter than the controls and their cognitive abilities were poorer. Their mental ages and language skills were mostly determined by their height and the duration of follow-up during their acute illness. Additionally their diet after the 3-5 years is still defective and does not meet their recommended daily allowance. These observations urge us to continue following these patients for longer durations to make sure no permanent damage occurs due to the PEM insult to the growing brain.

Neurokinin A level in hypoxic-ischemic encephalopathy.

BACKGROUND: The present study was performed to investigate the effect of neonatal hypoxic-ischemic encephalopathy (HIE) on the neurotransmitter neurokinin A (NKA) and determine its relation to the severity of neonatal hypoxia. METHODS: Eighteen neonates suffering from HIE were compared to 10 clinically healthy full-term neonates acting as the control group. Maternal history of each neonate was collected, then deliveries were attended, resuscitation details including the Apgar score and thorough clinical examination of the neonates were performed. Routine laboratory work-up was done for the enrolled neonates, including complete blood count and C-reactive protein as well as estimation of NKA by enzyme-linked immunosorbent assay in the cord blood and after clinical stabilization. RESULTS: NKA was significantly lower in HIE patients compared to the controls at delivery with improvement in the follow-up sample. Additionally, the maximum decrease was detected in the neonates who suffered severe hypoxia compared to those who suffered mild hypoxia. Significant positive correlations were demonstrated between NKA at birth and Apgar scores at the 10th and 15th min. Regression showed that stage of HIE was the strongest determinant factor for the level of NKA at birth. CONCLUSION: NKA levels are decreased in HIE and this is more profound in the severe degrees of hypoxia compared to the mild ones. This emphasizes its role in pathogenesis of HIE and further proves that an imbalance in the central neuropeptide system results from HIE in the neonatal period.

Early detection of protein energy malnutrition in Sharkia Governorate.

UNLABELLED: The objective of this cross-sectional study was to assess the nutritional status of children, aged 6 to 36 months, in Sharkia Governorate aiming for early detection of malnourished cases. METHODS: the present study was carried out on 1000 children aged 6 to 36 months, selected by a multistage random sample from 6 villages in two districts in Sharkia Governorate. Data were gathered by an interview questionnaire to the child's mother or care giver at their homes. Anthropometric measurements as height, weight, mid-arm, head circumference and skin fold thickness were assessed. Body mass index was calculated. Dietary evaluation was done by a 24 hours recall for amounts and frequencies of food and was transferred to their recommended daily allowance (RDA). The studied children were classified into three groups according to their weight for age percentiles, underweight children, borderline malnourished children and normal weight children. Serum hemoglobin, pre-albumin and albumin were assessed for a randomly selected number of the studied group. RESULTS: the study showed that all anthropometric measurements were lower than normal in underweight and borderline subjects. The prevalence rates of wasting, stunting and underweight were 15%, 24.4% and 15.4% in the studied infants in Sharkia Governorate, respectively. The study revealed that nutrient intake of the study subjects was lower than the RDA for the energy intake from carbohydrates, vitamin D, and iron, while it was higher than the RDA for the energy intake from lipids and vitamin A and equal to the lower level of the normal range of RDA for the energy intake from proteins. Most of the protein intake was of plant origin. Caloric intake was less than RDA in underweight and border line children, but more than RDA in normal children (86%, 90% and 102%). The ratios of caloric intake to the required calories according to weight were 90%, 98% and 108% in the three groups respectively. Chronic cough and chronic and recurrent diarrhea were more complained by underweight and borderline children. Underweight children were more infested with oxyurius and entamoeba histolitica than the other 2 groups. Serum hemoglobin, albumin and plasma pre-albumin levels were within normal range with significantly lower values in underweight and borderline infants compared to normal children. By multiple linear regression analysis, the most important factors affecting BMI were carbohydrate, lipid and caloric intake, serum albumin, plasma pre-albumin, vitamin A and D intake and protein intake. CONCLUSION: There is a high prevalence of wasting ,stunting and underweight among infants and children of the studied sample in Sharkia governorate explained by the low socioeconomic status, unbalanced diet. Early changes of protein energy malnutrition were detected, in spite of the fact that serum hemoglobin, albumin and plasma pre-albumin levels were within normal range, they were significantly lower in underweight and borderline infants compared to normal children.