Respiratory diseases in newborns are considered major causes of neonatal morbidity and mortality especially in developing countries. Its causes are diverse and require early detection and management. ...This study aimed for detection of the prevalence and risk factors of respiratory diseases in addition to outcome among neonates admitted in neonatal intensive care unit.
Our study was a prospective observational study that was undertaken at the neonatal intensive care unit of Qena University Hospital, Egypt from July 2017 to July 2018. Demographic and clinical data of newborns and their mothers were evaluated and tabulated.
In this period, 312 neonates were admitted to the neonatal intensive care unit, out of them 145 suffered respiratory diseases giving a prevalence of (46.5%), and (55.9%) were males. The mean neonatal age at admission was 4.33 ± 7.19 days and mean gestational age was 34.49 ± 3.31 weeks. The most common detected respiratory diseases were respiratory distress syndrome (RDS; 49.6%), transient tachypnea of newborn (TTN; 22%), neonatal pneumonia (17.2%) and meconium aspiration syndrome (MAS; 6.21%). Premature rupture of membrane (PROM), maternal diabetes and fetal prematurity had the highest risk factors for respiratory diseases occurrence in neonates. Neonatal mortality rate was 26.2%, mainly due to hyaline membrane disease and pneumonia.
Respiratory diseases constitute major part of total admission in neonatal intensive care unit especially RDS, TTN, pneumonia and MAS. Prematurity and maternal diabetes were the most important risk factors associated with respiratory diseases. Respiratory distress syndrome carried the highest risk of mortality and TTN carried the highest survival rate.
To determine the bacteriological pattern and antibiotic susceptibility of bacterial isolates causing neonatal sepsis in Qena University Hospitals and compare polymerase chain reaction (PCR) and blood ...culture results in a trial for rapid diagnosis.
Blood samples from 75 clinically suspected cases of neonatal sepsis were subjected to identification of bacteria and determination of their antibiotic sensitivity through blood culture, and rapid detection of 16S rRNA and the uidA gene (to confirm the presence of
) by PCR from extracted bacterial DNA.
Most patients were preterm (64%) and low birth weight (LBW) (68%). In total, 42.7% presented with early onset sepsis (EOS). LBW was significantly associated with EOS (
-value=0.03). Although the blood culture and PCR results were similar in EOS, the PCR results were significantly higher than those of blood culture in detecting bacteria (85.3% vs 68%, respectively,
-value=0.001). Blood culture showed 100% specificity. The most common pathogen was
(86.2%) in EOS and
. (45.5%) in late-onset sepsis (LOS) (
-value=0.001 and 0.02, respectively). The most effective antibiotics against Gram-negative bacteria were ofloxacin, ciprofloxacin, imipenem, and amikacin, while vancomycin, oxacillin, and imipenem were the most effective antibiotics against Gram-positive bacteria.
EOS was mainly caused by
, while LOS was mainly caused by
. The 16S rRNA PCR showed higher sensitivity with rapid and accurate diagnosis. Blood culture is the most suitable method for antimicrobial sensitivity testing.
Role of Procalcitonin in Pediatric Patients with Pneumonia Khaled Abdalla Abdelbaseer; Abdelrahman A. Elsaied; Fatma Saber Abdelraheem ...
SVU - International Journal of Medical Sciences (Online),
01/2024, Letnik:
7, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Background: The alveoli, the tiniest air sacs in the lungs, are particularly vulnerable to damage from the inflammation caused by pneumonia. For young children in the poor world, childhood ...community-acquired pneumonia (CAP) is the leading cause of death. CAP is an infection of the lower respiratory tract that spreads easily from person to person. The 116-amino-acid peptide procalcitonin (PCT) is the calcitonin precursor and has no known hormonal property. The levels of PCT in the serum of healthy people are either very low or undetectable. The inflammatory biomarker procalcitonin is of great importance. The CALC-I gene on chromosome 11 codes for a protein that serves as a precursor to calcitonin, a hormone that controls calcium levels in the body. Serum PCT levels may rise by a factor of 1000 due to induction by inflammatory cytokines and bacterial endotoxin in lung, liver, kidney, and adipose tissue during bacterial infections. In 2005, the FDA of the United States authorized PCT for use as a diagnostic tool for sepsis. Objectives: Assessing the use of serum procalcitonin as a diagnostic and prognostic marker in children with pneumonia. Conclusion: procalcitonin should be considered as a useful diagnostic and prognostic biomarker in pediatric patients with pneumonia. It may have some utility in predicting the most severe outcomes.
Scorpion envenomation is a life-threatening emergency and causes serious health problems in tropical and subtropical regions. The aim of this study was to correlate the serum levels of biochemical ...parameters at admission in children with scorpion envenomation with subsequent morbidity and mortality. It was a prospective, observational, and descriptive study conducted for scorpion-envenomed children who presented to emergency and intensive care units between April 2019 and September 2019. Demographic, clinical, and laboratory findings of patients were recorded and tabulated. Routine investigations were done for all patients in addition to blood levels of lactate, free fatty acids (FFA), and insulin. All patients were compared according to outcome as survivors and nonsurvivors and according to glucose level as normoglycemic and hyperglycemic groups. There were 62 scorpion sting cases; their mean age was 8.6 ± 3.2 years. Patients aged more than 6 years (74.2%), and males (66.1%) were more affected than others. As regards severity, 25.8% were suffering organ dysfunction, 40.3% suffered systemic manifestations without organ dysfunction, and (33.9%) with only local manifestations. Serum glucose and FFA were significantly higher in nonsurvivors compared with survivors. Shock, convulsion, coma, heart failure, and pulmonary edema were significantly more common in hyperglycemic than normoglycemic group. Hyperglycemia, and raised FFA were associated with severe scorpion envenomation. Raised FFA was well correlated with presence of heart failure, leucocytosis, and hyperglycemia. Adding serum glucose and FFA to monitoring parameters of scorpionism severity can help the prediction of high-risk patients.
Background: One of the greatest prevalent chronic illnesses, Helicobacter pylori (H. pylori), affects around 50% of people globally. Early infancy is when this virus is most often contracted, ...particularly in developing nations. The frequency of H. pylori varies greatly across nations; in underdeveloped nations, 50% of children are infected by the time they become 10 years old. The beginning of several Gastro intestinal tract pathologies, including active persistent gastritis, peptic ulcers, gastric carcinoma, extra-gastric symptoms, thrombocytopenic purpura, and anemia owing to inadequate iron reserves iron deficiency anemia (IDA), is discovered to be related with H. Pylori infections. A link between anemia and H. pylori infections is supported by a variety of data from epidemiological and clinical research. Objectives: To highlight connection between Helicobacter pylori infections and IDA in children, and to explore the mechanism of this association. Conclusion: Infection with Helicobacter pylori is substantially linked with iron deficiency anemia in children.
Background: The human body contains trace levels of minerals and other micronutrients. Particularly advantageous for physiologic processes, a wide range of biochemical processes, stabilizing proteins ...and enzymes, and serving as cofactors for different enzymes. These essential micronutrients have a major physiological effect and are significantly associated with diabetes. Cobalt, boron, chromium, copper, Sulphur, iodine, fluoride, selenium, manganese, zinc, and molybdenum are examples of trace elements. Sodium, potassium, calcium, phosphorus, magnesium, and iron related to macro elements. The main focus of this review is the effect of particular minerals and trace elements on childhood insulin-dependent diabetes. Objective: Our understanding of how minerals and trace elements affect insulin-dependent diabetes in children will be improved as a result of this review, which is its main goal. Conclusion: The interaction, development, and outcomes of insulin-dependent diabetes in children are significantly influenced by minerals and trace elements.
Information about oxidative stress in preterms with Respiratory Distress Syndrome (RDS) is defective, so various researches in this area are required, which may open new roads in understanding the ...pathogenesis of the disease, hence provide additional helpful therapeutic approaches.
To assess and compare the plasma level of protein carbonyls as a marker for oxidant status and the antioxidant enzymes; Superoxide Dismutase (SOD) and Glutathione Peroxidase (GPx) and the related trace minerals in the form of Copper (Cu), Zinc (Zn) and Selenium (Se) as markers for antioxidant status, in preterms with and without RDS.
A hospital-based case-control study was conducted on fifty-seven preterm neonates (37 preterms with RDS and 20 preterms without RDS) admitted to neonatal intensive care unit of Qena University Hospitals after approval of the University Hospital Ethical Committee. Plasma protein carbonyls assay was done using commercially available ELISA assay kit. Plasma Cu, Zn, Se, erythrocyte SOD and GPx activities assays were done using commercially available colorimetric assay kits.
Significant higher plasma levels of protein carbonyls and oxidant/antioxidants ratio (protein carbonyls/{SOD+GPx}) with significant lower plasma levels of Zn, Cu, Se, erythrocyte SOD and GPx activities were found in the preterms with RDS when compared with the preterms without RDS (p<0.001 for all measured markers for both groups). In terms of birth weights and gestational ages, they were negatively correlated with both plasma protein carbonyls and oxidant/antioxidants ratio and positively correlated with plasma copper, zinc, selenium, erythrocyte SOD and GPx activities in a statistically significant manner. Non-significant correlations were found between the measured oxidative stress markers and the severity of RDS.
Oxidative stress may have a contributory role in the development of RDS among preterms. Lower birth weight and prematurity may increase the susceptibity to oxidative stress among such patients.
Background:Childhood asthma and obesity are significant public health problems. The prevalence of asthma and obesity in children have increased significantly during the past decades. The basis for ...the relationship between pediatric asthma and obesity is not well established. Objective: our study aimed to find the relation between obesity and bronchial asthma and whether obesity may contribute to more severe asthma symptoms in asthmatic children at Qena University Hospital. Patients and method(s): This was a cross-sectionalstudy of asthmatic school aged children who were admitted at pediatric department or attendedemergency department or the outpatient clinic of Qena University Hospital through the period from MAY 2018 to April 2019.They classified according to BMI to two groups, asthmatic obese and asthmatic non-obese. The included asthmatic children are subjected to full through history, clinical examination and pulmonary function tests. Result(s):This was a cross-sectional study which was carried out in Pediatric department of Qena university hospitaland included 60 asthmatic children with intermittent to severe persistent asthma with age range 6-12 years through the period from MAY 2018 to April 2019 and classified to two groups, 30cases asthmatic obese and 30 cases asthmatic non-obese, based on calculated BMI in both groups. The patients were diagnosed according to the global strategy for asthma management and prevention classification. The mean age in asthmatic obese patients was (8.94±1.99)versus (9.13±1.97) in asthmatic non-obese group with no significant difference between them (p-value =0.707). The percentage of moderate persistent asthma was statistically significantly higher in asthmatic obese than asthmatic non-obese group (53.3% versus 26.7%, p-value= 0.035), respectively. 13.3% of asthmatic obese had severe persistent asthma versus 0% in asthmatic non-obese group (p-value=0.038).46.7%of the asthmatic obese children received high dose of steroids versus 10%of asthmatic non-obese with statistically significant difference (p value =0.001). The mean numbers of emergency visits in asthmatic obese were significantly higher than that in asthmatic non-obese (5.9±2.66versus 3.93±1.6), (p-value= 0.001), respectively. FEV1, FVC, FEV1/FVC, were not significantly different in asthmatic obese patients compared with asthmatic non-obese (p-value =0.742, 0.849, 0.751, respectively). Conclusion:obesity was associated with significantly more severe asthma symptoms together with poor asthma control. Pulmonary function tests were not affected by increased BMI.
Background: Neonatal hyperbilirubinemia is a common problem in neonates with an incidence of about 60% in term babies and 80% in preterm babies. It is the commonest cause of admission to the ...hospitals in the newborn period. We should assess all babies for jaundice at every opportunity. Methods include visual assessment, transcutaneous bilirubinometer (TcB) or total serum bilirubin (TSB). Objective: This is a descriptive study aimed to evaluating the protocol of management of unconjugated hyperbilirubinemia in neonatal intensive care unit at Qena University Hospital. Patients and method(s): This descriptive study included neonates admitted to neonatology unit at Qena university hospital from (April to October 2019), Total number of admitted neonates in our NICU through this period were 1274, from which 517 neonates had jaundice as a primary cause of admission or developed during the course of NICU stay. Result(s): In this period the total number of NICU admission was 1274 cases, out of 517 jaundiced neonates, 100 (19.3%) were diagnosed to have unconjugated jaundice on admission without any associated other diseases and 417 (80.7%) of them were admitted due to other causes and developed jaundice during the course of the disease. The other 417 neonates were admitted to our NICU due to RD in 409 (79.1%) cases, 4 (0.8%) cases due to sepsis, two (0.4%) cases due to CHD and two (0.4%) cases due to surgical causes. The unconjugated neonatal jaundice represented (7.8%) (100 cases out of 1274 neonates admitted during the period of the study). Physiological jaundice represented 89.4% while pathological jaundice represented 10.6% of causes of neonatal jaundice. Regarding treatment of studied neonates 12% of cases need only follow up with no need for Phototherapy, 62.8% of cases needed single or double Phototherapy, 12.4% needed extensive Phototherapy (triple phototherapy), 12.8% of cases needed capsule Phototherapy and no cases needed neither exchange transfusion nor drug therapy. Only 0.4% of jaundiced neonates developed prolonged hyperbilirubinemia, while no complications were detected in 99.6% of cases. We started treatment based on measuring bilirubin by TSB in 62.3% of jaundiced neonates and 37.7% by TCB. The mean values of TSB in jaundiced neonates (11.46 ± 4.92) were significantly higher than the TCB (10.31 ± 4.61), P =0.0005. There was significant positive correlation between mean TSB and mean TCB (R= 0.946, P < 0.001). There was no significant difference regarding mean TSB between different gestational age groups p= 0.242). Conclusions: Hyperbilirubinemia is one of the most common causes of hospital admission in our nursery. Among the causes of hyperbilirubinemia, physiologic jaundice was the most common. Intensive phototherapy is effective in lowering TSB in unconjugated jaundice at / or near levels of exchange transfusion, and this may be helpful in decreasing needs for and risks of exchange transfusions. TcB measurements may underestimate the TSB values, so it should be considered only as a screen and samples should be sent to the laboratory for confirmation especially at high risk groups and high levels of TCB.
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