SERUM BRAIN DERIVED NEUROTROPHIC FACTOR AS BIOMARKER FOR EPILEPSY DIAGNOSIS IN EGYPTIAN CHILDREN WITH EPILEPSY; RELATIONSHIP TO DISEASE SEVERITY AND COGNITIVE FUNCTION.

 Objectives: This study was designed to estimate serum brain-derived neurotrophic factor (BDNF) concentration in a group of Egyptian children with epilepsy to clarify its utility as a biomarker for epilepsy diagnosis and to evaluate its relationship with their cognitive function and disease severity. Methods: Intelligence was assessed using Arabic version of the WISC-R test. Serum concentration of BDNF was assessed using enzyme-linked immunosorbent assay in 40 children with epilepsy and 40 apparently healthy children of matched age and sex controls. Results: Of total 40 epileptic patients aged 6–12 years, the mean age was 8.32 ± 0.7 years and male to female ratio was 1.5:1. The mean serum BDNF concentration and cognitive IQ scores were statistically significantly reduced in the studied patient's group versus to controls (p<0.001). There were highly significant differences in serum BDNF concentration as regards epileptic severity. Serum concentration of BDNF showed significantly positive correlation with cognitive, verbal, performance, and totals IQ scores and negative correlation with the age at the onset of seizures, and duration of therapy. The linear regression analysis showed a statistically significant association between age at the onset of seizures, duration of therapy, cognitive function, and serum BDNF concentrations among the studied patients. Conclusions: Concentration of BDNF in serum is involved in the mechanism of epileptogenesis in children with epilepsy. It should be used as a helpful marker for epilepsy diagnosis and detection of severity

RELATIONSHIP OF SERUM DIPEPTIDYL PEPTIDASE-IV ACTIVITY AND ANTI-CASEIN ANTIBODIES TO GASTROINTESTINAL SYMPTOMS AMONG CHILDREN WITH AUTISM SPECTRUM DISORDER: AN EGYPTIAN STUDY

 Objectives: The objectives of the study were to assess serum dipeptidyl peptidase-IV (DPP-IV) activity in autistic children suffering from severe gastrointestinal (GI) disorder and to examine the hypothesis that there is a link between DPP-IV activity in serum and GI disorder in a subgroup of children with autism spectrum disorder (ASD).Subjects and Methods: Serum levels of casein antibodies and DPP-IV enzyme activity from 40 autistic children with chronic GI symptoms, and 40 of age-matched children without autism or gastrointestinal (GI) symptoms were assayed using enzyme-linked immunosorbent assay kits.Results: In comparison with controls, developmental milestones were delayed among autistic children. The serum DPP-IV activity was significantly lower in the studied patients (p<0.05), while the mean serum levels of casein antibodies were statistically significantly higher in the studied patients (p<0.01). Multiple logistic regression analysis recorded significant association between the high serum level of antibodies to casein, food selectivity and recurrent attacks of abdominal pain (p<0.05), while the low serum DPP-IV enzyme activity was associated with recurrent attacks of abdominal pain in the studied patients with a prediction of 95% (p<0.05).Conclusions: Serum levels of casein antibodies were higher in children with ASD, and maybe contributes to their abdominal pain, and food selectivity. Serum DPP-IV enzyme activity was lower and associated with recurrent attacks of abdominal pain in the studied patients. They may benefit from a supplemental digestive enzyme formula

Serum Asymmetric Dimethylarginine, and Adiponectin as Predictors of Atherosclerotic Risk among Obese Egyptian Children

BACKGROUND: Obesity is associated with an increased risk of developing hyperinsulinemia, dyslipidemia, hypertension, premature atherosclerosis, and coronary artery disease in the future.AIM: This study is designed to assess the relationship between serum adiponectin, asymmetric dimethylarginine (ADMA), and lipid profile among Egyptian overweight and obese children.METHODS: This cross sectional case control study included 40 selected pre-pubertal overweight and obese children, 24 girls (60%) and 16 boys (40%) aged between 5 to 13 years (8.85 ± 2.7 years), from new cases attending the National nutrition institute clinic during 2013. Forty apparently healthy children of matched age and sex were recruited as a control group.RESULTS: Obese group showed highly significant higher levels of serum ADMA, triglycerides, and total cholesterol compared with healthy controls (P <0.000 in all). However, serum adiponectin levels were highly significant lower in obese children compared to healthy controls (P < 0.000). Serum ADMA showed significant positive correlations with height, serum total cholesterol and serum triglycerides levels and significant negative correlation with the body mass index and weight for age z score.  Serum adiponectin showed significant negative correlations with BMI, weight, and weight for age z score and significant positive correlation with serum triglycerides. By linear regression analysis; serum adiponectin, and serum triglycerides levels were significant predictors of high serum ADMA level (p =0.045 and 0.015 respectively). BMI, weight, height and serum triglycerides were significant predictors of low serum adiponectin levels (p = 0.005, 0.022, 0.026 and 0.015 respectively).CONCLUSIONS: Our results revealed that ADMA, Adiponectin and lipid profile can be considered as predictive biomarkers in prediction and prevention of atherosclerotic risk in the future among overweight and obese Egyptian children

Adaptive Functioning and Psychosocial Problems in Children with Beta Thalassemia Major

BACKGROUND: Beta thalassemia major is considered one of the serious health problems and the commonest hemoglobinopathy in Egypt that creates a burden not only on health system but also on the affected families and children who become vulnerable to emotional, social, psychological and behavioural problems. AIM: This study was designed to assess the psychosocial burden and the adaptive functioning in children with beta-thalassemia major. SUBJECTS AND METHODS: A group of 50 children with thalassemia major and 50 normal children matched for age and sex were included in a case-control study. Vineland Adaptive Functioning Scale was used to assess the adaptive functions; while the Pediatric Symptom Checklist (PSCL) was used to assess psychosocial morbidity. RESULTS: A group of 50 children aged 5-17 years old with thalassemia major, their mean age was 11.05 ± 3.8, showed a statistically significant lower total adaptive behaviour score and communication subscale score. All the mean values of adaptive behaviour for cases and controls were within the average values. Results from the PSCL revealed no significant difference between mean scores of children with thalassemia and controls. A score of attention domain was markedly higher in children with thalassemia. Internalising behaviour was the most dominant as it was detected in 10% of the patient group. CONCLUSION: Thalassemic patients had a relatively mild affection for adaptive and psychosocial functioning that can be explained by social and medical support they receive, which may increase their competence and psychological wellbeing

Neurocognitive Function and Its Related Potentials in Children with Beta Thalassemia Major: An Egyptian Study

BACKGROUND: Repeated blood transfusions and hemolysis in β-Thalassemia major children lead to iron overload in various organs, including the brain which may cause neurodegeneration. AIM: To evaluate intelligence quotient in children with β-thalassemia major and healthy counterparts and to assess risk factors that cause cognitive problems. SUBJECTS AND METHODS: This case-control study was performed on 50 children aged 6-16 years old with β-thalassemia major as patients group and compared with 50 healthy children as a control group of matched age, sex, and social class. Cognitive functions were evaluated by using the Wechsler Intelligence Scale for Children. Serum ferritin and iron were measured by ELISA. RESULTS: There were significantly lower mean performance and full-scale IQ scores of patients group in comparison with controls, whereas no significant differences between both groups as regards to a verbal IQ score. In thalassemic children, block design, comprehension and arithmetic were negatively correlated with age of disease onset, duration of illness and onset of chelation therapy. Serum iron and ferritin were negatively correlated with similarities and digit span. Serum iron levels were negatively correlated with performance IQ score. CONCLUSION: Children with β-thalassemia major need to receive more academic attention and cognitive assessment to improve their IQ

Relationship of Oxidant and Antioxidant Markers to Asthma Severity in Egyptian Asthmatic Children

BACKGROUND: Asthma is a chronic airway disease which is characterized by oxidant antioxidant imbalance with the generation of oxidative stress related mediators.AIM: The study aimed to evaluate the role of asymmetric dimethylarginine, and malondialdehyde as oxidant markers and serum paraoxonase activity as an antioxidant marker in asthma, and to determine their relationship to the asthma severity and lung function among asthmatic children in Egypt.PATIENTS AND METHODS: This case control study was conducted on sixty patients with asthma compared with sixty apparently healthy children of matched age and sex.RESULTS: Serum concentrations of oxidant markers as asymmetric dimethylarginine and malondialdehyde were significantly increased in asthmatic patients while anti-oxidant marker as paraoxonase activity was significantly decreased compared to healthy controls (P < 0.05). ANOVA test revealed highly significant elevation of the serum concentrations of oxidant markers while anti-oxidant marker was significantly decreased in severe asthmatic patients (P < 0.001) compared to the patients with moderate and mild asthma respectively. Serum malondialdehyde concentration was a strong predictor of asthma severity by multiple regression analysis (P < 0.05).CONCLUSION: The study revealed an imbalance between oxidative and antioxidant defence systems in asthmatic children. Serum concentration of malondialdehyde was the most predictive biomarker having a significant association with asthma severity

Dietary Behaviour Pattern and Physical Activity in Overweight and Obese Egyptian Mothers: Relationships with Their Children's Body Mass Index

BACKGROUND: Obesity and related morbidity increase in Egyptian women and their children. A better understanding of dietary and activity patterns is needed to reduce obesity prevalence.AIM: The present study aimed to assess dietary patterns and physical activity in Egyptian overweight and obese mothers and to explore its relationships with their children's body mass index (BMI).SUBJECTS AND METHODS: This descriptive case-control study was conducted at the National Research Center. The study included a sample of 64 overweight and obese mothers and 75 children, compared with apparently healthy non-obese mothers and their children of matched age and social class. Tested questionnaires were used to collect information of the studied subjects.RESULTS: A statistically significantly higher incidence of unemployment, large family size was observed in overweight & obese women compared to controls (P < 0.05). Those women who consumed vegetables more than 3 times a week were less likely to be overweight or obese (P < 0.05). No significant association were detected between mothers' physical activity, dietary behaviour variables and children’s BMI except for consuming beverages with added sugar (95%CI = 0.074-0.985, P<0.05).CONCLUSION: Improper dietary patterns, nonworking mothers and big family size are associated with obesity among Egyptian women. Emphasis should be given to increasing physical activity and encourage healthier diets among Egyptian mothers and their children

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

Prediction of Gut Wall Integrity Loss in Viral Gastroenteritis by Non-Invasive Marker

BACKGROUND: Intestinal fatty acid binding proteins (I-FABPs) are mainly expressed in the intestinal villi, which are the initial site of destruction in viral gastroenteritis.AIM: This study was designed to assess serum I-FABPs as a predictor of gut wall integrity loss in viral gastroenteritis.PATIENTS AND METHODS: This case-control cross-sectional study was conducted on 93 cases of acute viral gastroenteritis. Twenty-eight healthy children matching in age were recruited as control group. Serum I-FABPs were measured using ELISA technique. Viral detection and typing were done by PCR for adenovirus, and by Reverse transcriptase PCR for rotavirus, astrovirus and norovirus.RESULTS: Serum I-FABPs level was significantly higher in the cases compared to the controls and was also higher in the 46 rotavirus gastroenteritis cases compared to other viral gastroenteritis cases. Serum I- FABPs level was significantly higher in severely dehydrated cases as compared to mildly dehydrated ones (P=0.037).CONCLUSION: Serum I-FABPs could be used as an early and sensitive predictor marker of gut wall integrity loss in children with viral gastroenteritis and its level can indicate case severity

Influence of Interleukin-6 (174G/C) Gene Polymorphism on Obesity in Egyptian Children

BACKGROUND: Obesity is a multi-factorial chronic disorder. A considerable number of studies have been performed to figure out whether there is an association between obesity and polymorphisms of gene IL-6 (174G/C), but the results are equivocal.AIM: This study aimed to find out whether the IL-6 (174G/C) gene was associated with the risk of developing obesity in Egyptian children.SUBJECTS AND METHODS: The study included 149 children and adolescents with age ranged between 9.5 – 18 years. Eighty-five of them were obese which BMIZ-score is > 2, and sixty-four children with BMIZ-score ≤ 2 served as control group. Serum level of IL-6 and genetic analysis for IL-6 (174G/C) gene polymorphism were done.RESULTS: Obese children had significantly higher serum levels of IL-6 as compared to those of control children (P = 0.003). A high percentage of IL-6 polymorphism GC was found in obese subjects (93.7%), while the control group had a higher percentage of IL-6 polymorphism GG (70.6 %).CONCLUSION: Our study showed that carriers of the C allele for the IL-6 (174G/C) polymorphism have higher BMI. As the G174C polymorphism is likely to affect IL-6 expression and its physiological regulation; consequently this polymorphism may affect adiposity