Dietary intervention with edible film-coated multistrain probiotic Lacticaseibacilli in nondairy food matrices significantly increased the recovery of fecal viable Lacticaseibacilli and improved the performance of several colonic biomarkers among slightly malnourished preschool children.

Probiotic enriched dairy products are widely consumed in Western countries for their beneficial effects on the gastrointestinal tract and overall health. The present study aims to investigate the beneficial effects of probiotic Lacticaseibacilli (LAB) strains in non-dairy food matrices. A blend of edible film-coated probiotic LAB, L. plantarum, L. paracasei, and L. rhamnosus, were incorporated into plain biscuits and dry dates. Design of the randomized controlled study: Children of both sexes (mean age 55.7 ± 14.5 months) attending kindergarten in Tersa, a poor urban Giza district, were recruited and randomized into 5 groups of equal numbers. Treatment groups: (1) placebo biscuits, (2) functional probiotic biscuits (0.18 billion colony forming units (cfu) of LAB) (3) functional probiotic + inulin biscuits (0.2 billion cfu of LAB + 2 g of chicory inulin); (4) placebo dates and (5) functional probiotic dates (0.3 billion cfu of viable multistrain LAB). The supplements were served 5 days a week and each child had to consume 21 servings of the supplement. The primary outcome was an increase in the fecal recovery of viable LAB after the intake of 21 servings (T1) compared to the respective baseline counts (T0). The secondary outcomes include the determination of fecal short-chain fatty acids (SCFA) and secretory immunoglobulin A (s-Ig A) using ELISA and fecal ammonia excretion. Results: Statistically significant % increases in the recoveries of fecal viable LAB were found among the children consuming 21 servings of supplements 2, 3, and 5 compared to the respective count at T0. Similar significant increases were found in the fecal concentrations of SCFA and s-Ig A among the children consuming 21 servings of supplements 2, 3 and 5 compared to the respective counts at T0. On the other hand, the concentration of toxic ammonia excretion decreased significantly in the feces of all children consuming probiotic-containing supplements (groups 2, 3, and 5) at T1 compared to the respective concentrations obtained at T0. Conclusion: Multistrain microencapsulated probiotic Lacticaseibacilli in functional biscuits and dry dates successfully tolerated the acidic gastric transit and exerted their bioactive action on the colonic microbiome. The synbiotic supplement exhibited a higher production rate of colonic SCFA. Probiotic-enriched products that confer definitive health benefits are convenient and do not need to be kept under refrigeration. Manipulating the composition and function of the microbiome in childhood through probiotic/+ prebiotic interventions is cost-effective with long-term beneficial health outcomes. This study was approved by the Medical Research Ethics Committee, National Research Center and registered as Clinical Trial 16/422. Written informed consent was obtained from the mothers of all participating children.

Hearing assessment in Egyptian children with chronic renal failure on regular hemodialysis and renal transplantation children.

INTRODUCTION: Hearing impairment is frequent in patients with end-stage renal disease (ESRD). We aimed to assess the prevalence of hearing impairment in children on regular hemodialysis and renal transplantation. MATERIALS AND METHODS: Transient-evoked otoacoustic emissions (TEOAEs) has been done for 80 children on regular hemodialysis and 40 with renal transplant. RESULTS: In hemodialysis group, TEOAEs showed that 53.8% children had hearing affection, it was significantly related to dialysis duration, dialysis adequacy, vascular access infection, hepatitis C virus (HCV) infection, and ototoxic drugs (p = 0.001, 0.037, 0.011, 0.004, 0.030, 0.007, and 0.044, respectively). In renal transplant group hearing impairment was 25%. There was significant relation with period of dialysis before transplantation and biopsy proved rejection (p = 0.008, <0.001, respectively). CONCLUSION: Hearing impairment is a common finding in ESRD patients. Thus audiological assessment must be done in these patients.

Academic Achievement and Psychosocial Profile of Egyptian Primary School Children in South Sinai.

BACKGROUND: Population of South Sinai has suffered from negligence for many years. Solving educational problems of this population is the main concern nowadays. AIM: To assess academic achievement in primary school children in South Sinai in relation to intelligence and psychosocial profile. SUBJECTS AND METHODS: A descriptive cross-sectional survey was conducted on 407 Bedouin and urban students randomly selected from twelve public primary schools in six cities in South Sinai. Intelligence was assessed using Goodenough-Harris test. The midyear Arabic language and Arithmetic scores were used to assess academic achievement. The teachers completed a Pediatric-Symptom Checklist for evaluation of children behaviour. RESULTS: A statistically significant difference in academic achievement (P < 0.001), total psychosocial scores, (P < 0.05), and externalization (P < 0.05) was found between urban and Bedouin students with significant gender differences (P < 0.05). Highly significant positive correlations were observed between IQ percentile and mid-year Arabic language scores and Arithmetic scores (P < 0.001), and significant negative correlations with the total score of PSCL and its subscale scores (externalising, inattention, and internalising behaviour) (P < 0.001) among the students. CONCLUSION: Comorbid academic and psychosocial dysfunction in primary school children were observed in South Sinai. A national strategy to minimise the educational gap between Bedouin and urban areas should be implemented.

Prevalence of Visual Impairment and Refractive Errors in Children of South Sinai, Egypt.

PURPOSE: To assess the prevalence and causes of visual impairment in children of South Sinai, and to evaluate outcomes of rehabilitation programs. METHODS: Population-based, cross-sectional analysis of 2070 healthy school children screened for visual impairment from 2009 through 2010 in cities of South Sinai and their surrounding Bedouin settlements. Visual acuity (VA) was tested using Snellen charts followed by cycloplegic autorefractometry for cases with presenting VA ≤ 6/9. Appropriate eyeglasses were prescribed and VA re-evaluated. RESULTS: This study included 1047 boys and 1023 girls, mean age 10.7 ± 3.1 years. Visual impairment (uncorrected VA ≤ 6/9) was detected in 29.4% of children, while 2.0% had moderate-severe visual impairment (uncorrected VA ≤ 6/24). There were statistically significant differences in prevalence of visual impairment between the studied cities (p < 0.05), with the highest prevalence in Abu Redis. Prevalence of visual impairment was significantly higher among girls (p < 0.05) and those with positive consanguinity (p < 0.05). Bedouin children showed significantly lower prevalences of visual impairment. Only age was a reliable predictor of visual impairment (odds ratio 0.94, p < 0.0001). Ophthalmic examination revealed other disorders, e.g. dry eye (4.74%), squint (2.37%), exophthalmos (1.58%) and ptosis (0.79%). VA significantly improved in children who received spectacles (p < 0.001). CONCLUSION: A total of 29.4% of South Sinai children had some form of visual impairment, 90.32% of which comprised refractive errors (mainly astigmatism) which were significantly corrected with eyeglasses. VA screening and correction of refractive errors are of the utmost importance for ensuring better visual outcomes and improved school performance.

Nesfatin-1 in childhood and adolescent obesity and its association with food intake, body composition and insulin resistance.

Nesfatin-1 is an anorexigenic peptide that controls feeding behavior and glucose homeostasis. However, there is little data that exists regarding nesfatin-1 secretion in obese children and young adolescents. The aim of this study is to investigate serum nesfatin-1 in childhood and adolescent obesity and to study potential correlations with food intake, anthropometric indices, body composition and insulin resistance. Forty obese children and adolescents and 40 healthy control subjects were studied. Anthropometric measurements were assessed, dietary food intake was evaluated based on 3-days food record and body composition indices were evaluated using bioelectrical impedance analysis. Lipid profile, fasting blood sugar, fasting insulin and HOMA-IR were measured. Fasting serum nesfatin-1 was quantitatively assayed by ELISA. Serum nesfatin-1 was significantly higher in obese group (2.49±1.96 ng/ml) than in control group (0.70±0.81 ng/ml), P=0.001. Positive correlations with serum insulin (P=0.001), HOMA-IR (P=0.000), BMI-SDS (P=0.04), body fat % (P=0.000), fat mass (P=0.000), fat free mass (P=0.03), CHO % (P=0.000), and saturated fat % (P=0.01) were found. While significant negative correlation with protein % (P=0.000) was observed. In conclusion, our results denote that nesfatin-1 might have an important role in regulation of food intake and pathogenesis of insulin resistance in obese children and young adolescents.

Thyroid volumes and iodine status in Egyptian South Sinai schoolchildren.

INTRODUCTION: The determination of goitre prevalence in children by ultrasonography is an important tool for considering iodine deficiency disorders. Our objective was to describe measurements of thyroid volumes by ultrasonography in Egyptian South Sinai schoolchildren and compare these with the WHO/International Council for the Control of Iodine Deficiency Disorders normative thyroid volume criteria (WHO/ICCIDD). MATERIAL AND METHODS: Cross-sectional thyroid ultrasonographic data of 719 schoolchildren (339 boys and 380 girls), aged 6-12 years from five cities in South Sinai (El Tur (T), Abu Redis (R), Ras Sudr (S), Saint Katherine (SK), and Nwebaa (N)). Age/sex and body surface area/sex specific upper limits (97(th) percentile) of normal thyroid volume were derived and urinary iodine (UI) was measured. RESULTS: The median value of urinary iodine was 150 µg/l. Comparing WHO/ICCIDD thyroid volume references to Egyptian South Sinai schoolchildren resulted in goitre prevalence of 10.6% using age/sex specific and 13.48% using body surface area/sex specific cut-off values. The prevalence of goitre was 20.0% in S, 16.3% in R, 10.8% in N, 9.9% in T, and 10.5% in SC. Upper limits of normal (97(th) percentile) thyroid volume from South Sinai schoolchildren calculated using BSA, sex, and age were higher than the corresponding WHO/ICCIDD. CONCLUSIONS: Prevalence of goitre is high in South Sinai schoolchildren. The body surface area reference should be preferred to the reference based on age. South Sinai schoolchildren had larger thyroids than WHO/ICCIDD thyroid volumes, perhaps due to hard polluted water with a high fluorine level.

Epidemiologic study of dermatologic disorders among children in South Sinai, Egypt.

BACKGROUND: Few epidemiologic surveys have been carried out to determine the prevalence of skin diseases in the population of Egypt, particularly in the Sinai Peninsula. Thus, the necessity of such research in South Sinai is pressing. This study aimed to determine the prevalence of various skin diseases among children in South Sinai. METHODS: A community-based protocol was followed. The study included 2194 children of both genders, 18 years of age and younger, and in six different localities within South Sinai. Data were collected by taking a full history and by systemic and dermatologic clinical examination that included the site, severity, distribution, and extent of skin lesions if present. Subjects were surveyed at general morbidity consultations and campaign field visits. The study was conducted from August 2008 to August 2009. Data were tabulated and analyzed statistically using Pearson's chi-squared test. Differences were considered significant at a P-value of < 0.05. RESULTS: Findings revealed that 71.4% of the studied population had one or more skin diseases. The highest rate of prevalence applied to parasitic skin infestations (pediculosis capitis, 37.6%). Eczema or dermatitis were found in 25.8% of participants. Pityriasis alba occurred at a rate of 18.3% and seborrheic dermatitis at a rate of 6.7%. Xerosis was found in 11.8% of subjects, viral warts in 4.1%, photosensitivity in 4.1%, acne vulgaris in 2.6%, and fungal skin infections in 1.0%. Other skin diseases diagnosed in low numbers in the study children included impetigo, freckles, and scabies. Prevalences of vitiligo and psoriasis were very low (0.18% and 0.05%, respectively). CONCLUSIONS: Infective parasitic diseases are a major health problem, particularly among younger children and in subjects of low socioeconomic status.

Effect of different monotherapies on serum nitric oxide and pulmonary functions in children with mild persistent asthma.

INTRODUCTION: Common medications used to treat mild persistent asthma are glucocorticoids, leukotriene receptor antagonists and theophylline. The aim of the study was to evaluate monotherapy with either inhaled steroids, oral leukotriene receptor antagonist or theophylline in Egyptian children with mild persistent asthma by determining their clinical, laboratory and spirometric responses to treatment. MATERIAL AND METHODS: Thirty-nine mild asthmatic children between 8 and 13 years of age were included in the study. Patients were classified according to therapy received into four groups: oral leukotriene receptor antagonist (montelukast), inhaled corticosteroid (fluticasone propionate), sustained-release (SR) theophylline, and no treatment. Pulmonary function testing was performed at the start of therapy and 8 weeks later using spirometry. Eosinophil count and serum nitric oxide were estimated in the blood. Minitab statistical package was used for analysis of data. RESULTS: Follow-up after 8 weeks revealed significant improvement in FEV1% in groups 1 (p < 0.01) and 3 (p < 0.05), significant improvement in PEFR in groups 1 (p < 0.05) and 2 (p < 0.01), significant decline in serum NO levels in groups 1 (p < 0.05) and 2 (p < 0.05), as well as significant improvement in eosinophil count in groups 1, 2 and 3 (p < 0.01, < 0.001, < 0.01 respectively). There was a statistically significant positive correlation between the decline in serum NO and the decline in blood eosinophil % in group 2 (p < 0.05). CONCLUSIONS: Inhaled corticosteroids and montelukast have a significant role in controlling the pulmonary functions and the inflammatory process in children with mild persistent asthma, although inhaled corticosteroids seem to yield a better response. Children with mild persistent asthma should receive a controller medication, and SR theophylline may be a good cost-benefit alternative for low socio-economic groups of patients.