Comparison of Serum IgG Antibody Test with Gastric Biopsy for the Detection of Helicobacter Pylori Infection among Egyptian Children

BACKGROUND: In developing countries, Helicobacter pylori (H. pylori) infection is mainly acquired during childhood and may be a predisposing factor for peptic ulcer or gastric cancer later in life. Noninvasive diagnostic tools are particularly useful in children for screening tests and epidemiological studies. Data on serologic testing of children are lacking. Accurate noninvasive tests for diagnosing Helicobacter pylori infection in children are strongly required.AIM: The aim of this study was to evaluate the performance of a serological test (serum IgG antibody for H. pylori) in Egyptian children with recurrent abdominal pain necessitating endoscopy.SUBJECTS AND METHODS: One hundred children, referred to the endoscopy unit at Mansoura University. Upper endoscopy was done for each with rapid urease test (RUT) and histological examination as the gold standard test for detection of H. pylori infection. Serum samples were collected for detecting IgG for H. pylori infection.RESULTS: The mean age of the subjects included in the study was 7.23 ± 1.94 year. Serological test (IgG to H. pylori) was positive in 60% of all cases. A highly significant association between the standard test and the serological test at a cutoff > 10 U/ml at p = 0.001 were detected for the diagnosis of H. pylori infection. The sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio for the IgG antibody a cutoff > 10 U/ml, were 96.5%, 93%, 13.83, 0.038 respectively.CONCLUSION: Serum IgG antibody to H. pylori infection has a high diagnostic value and can be considered as a suitable and reliable noninvasive test for detection of H. pylori infection

Allergen-Vaccine Immunotherapy And Its Effect On Immunological Markers In Asthmatic Children

Abstract: Allergen immunotherapy is the administration of gradually increasing quantities of an allergen vaccine to an allergic subject, reaching a dose which is effective in ameliorating the symptoms associated with subsequent exposure to the causative allergen. So allergy vaccine immunotherapy is a treatment that can modify allergic disease. In the present study we evaluated a period of one and half year of house dust mite immunotherapy on the concentrations of two immunologic markers: Eosinophil cationic protein (ECR) and nitric oxide (NO). We also compared the effect on asthma symptoms, allergen specific bronchial challenge test and the skin prick test. The immunotherapy was performed on 36 mite allergic, asthmatic children (age range from 6-15 years) were included in our study. Twenty of the cases were treated with sublingual immunotherapy (55.5%) and 17 cases were controls as they refused to receive the medication. Efficacy was evaluated clinically on asthma symptoms and by measuring the serum NO and ECP, allergen specific bronchial challenge test and the skin prick test. Results: The sublingual immunotherapy (SLIT) group detected a significant improvement in asthma symptoms (P=0.001) and skin reactivity to dermatophagoides ptronyssinus (P=0.020) whereas the control group did not. The result of bronchial challenge to D pteronyssinus showed a similar pattern at baseline and after 2 years of treatment in both groups. The serum levels of NO and ECP were significantly reduced in the SLIT group (P=0.01 and P=0.018) compared to baseline, whereas the values remained the same in the control group. The result of bronchial challenge to D pteronyssinus showed similar results at baseline after 2 years of treatment in both groups. The tolerated allergen concentration increased in both groups (p<0.05). Lung function tests, total immunoglobulin (IgE) and specific IgE to D pteronyssinus and Dermatophagoides farinae did not change after 2 years of treatment in either group. Conclusion: The SLIT with D pteronyssinus improves the clinical parameters and the immunological parameters in mite allergic asthmatic children after one and half year of treatment. The skin prick test may be used as a marker of efficacy of therapy

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

Effect of Early Breast Milk Nutrition on Serum Insulin-Like Growth Factor-1 in Preterm Infants

BACKGROUND: Insulin-like growth factor 1 (IGF-1) is one of the essential intrauterine hormonal mediators of growth, and its serum values are often low after preterm delivery. AIM: To evaluate the influence of immediate breast milk feeding on serum IGF-1 in preterm newborns. SUBJECTS AND METHODS: This prospective, observational cohort study included 60 premature infants born < 32 weeks of gestation, divided into group A and B regarding breastfeeding or formula feeding. Growth measurements were taken at birth. The standard deviation of each measurement was calculated. Serum IGF-I was measured one day postnatal and at a time equivalent to 40 weeks of gestation. RESULTS: Significant higher level of mean serum IGF-1 was detected in group A than B at postnatal age equivalent to 40 weeks of gestation. In group A, the higher significant level was detected in mean serum IGF-1 at an age equivalent to 40 weeks of gestation than at birth (25.21 ± 6.69 and 20.13 ± 5.46 p < 0.05). Multiple linear regression analysis showed that high birth weight, increased age of gestation and breastfeeding were correlated to the elevated serum level of IGF-1 at a postnatal age corresponding to 40 weeks gestational age. CONCLUSION: Immediate breast milk feeding was accompanied by elevated IGF-1 in the serum of preterm infants

Association of neopterin as a marker of immune system activation and juvenile rheumatoid arthritis activity

OBJECTIVE: To evaluate neopterin plasma concentrations in patients with active juvenile idiopathic arthritis (JIA) and correlate them with disease activity.METHODS: Sixty patients diagnosed as active JIA, as well as another 60 apparently healthy age- and gender-matched children as controls, were recruited from the Pediatrics Allergy and Immunology Clinic, Ain Shams University. Disease activity was assessed by the Juvenile Arthritis Disease Activity Score 27 (JADAS-27). Laboratory investigations were performed for all patients, including determination of hemoglobin concentration (Hgb), erythrocyte sedimentation rate (ESR), and C-reactive protein. Serum concentrations of tumor necrosis factor-alpha (TNF-a), interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), and neopterin were measured.RESULTS: Significant differences were found between JIA patients and controls with regard to the mean levels of Hgb, ESR, TNF-a, IL-6, and MCP-1 (p < 0.05). A statistically significant higher mean level serum neopterin concentration (p < 0.05) was found in JIA patients (20.43 ± 8.73 nmol/L) than in controls (6.88 ± 2.87 nmol/L) (p < 0.05). Positive significant correlations were detected between serum neopterin and ESR, TNF-a, IL-6, MCP-1, and JADAS-27 (p < 0.05). No correlation was found between serum neopterin and CRP (p > 0.05). Multiple linear regression analysis showed that JADAS- 27 and ESR were the main variables associated with serum neopterin in JIA patients (p < 0.05).CONCLUSION: The elevation of plasma neopterin concentrations in early JIA patients may indicate stimulation of immune response. Serum neopterin can be used as a sensitive marker for assaying background inflammation and disease activity score in JIA patients

Blood lead levels in a group of children: the potential risk factors and health problems

Objective: To investigate blood lead levels (BLLs) in schoolchildren in two areas of Egypt to understand the current lead pollution exposure and its risk factors, aiming to improve prevention politicies. Subjects and method: This was a cross‐sectional study in children (n = 400) aged 6–12 years recruited from two areas in Egypt (industrial and urban). BLLs were measured using an atomic absorption method. Detailed questionnaires on sources of lead exposure and history of school performance and any behavioral changes were obtained. Results: The mean BLL in the urban area of Egypt (Dokki) was 5.45 ± 3.90 μg/dL, while that in the industrial area (Helwan) was 10.37 ± 7.94 μg/dL, with a statistically significant difference between both areas (p < 0.05). In Dokki, 20% of the studied group had BLLs ≥ 10 μg/dL, versus 42% of those in Helwan. A significant association was found between children with abnormal behavior and those with pallor with BLL ≥ 10 μg/dL, when compared with those with BLL < 10 μg/dL (p < 0.05). Those living in Helwan area, those with bad health habits, and those living in housing with increased exposure were at a statistically significantly higher risk of having BLL ≥ 10 μg/dL. Conclusion: Lead remains a public health problem in Egypt. High BLLs were significantly associated with bad health habits and housing with increased exposure, as well as abnormal behavior and pallor

Blood lead levels in a group of children: the potential risk factors and health problems

Abstract Objective: To investigate blood lead levels in schoolchildren in two areas of Egypt to understand the current lead pollution exposure and its risk factors, aiming to improve prevention politicies. Subjects and method: This was a cross-sectional study in children (n = 400) aged 6-12 years recruited from two areas in Egypt (industrial and urban). Blood lead levels were measured using an atomic absorption method. Detailed questionnaires on sources of lead exposure and history of school performance and any behavioral changes were obtained. Results: The mean blood lead level in the urban area of Egypt (Dokki) was 5.45 ± 3.90 µg/dL, while that in the industrial area (Helwan) was 10.37 ± 7.94 µg/dL, with a statistically significant difference between both areas (p < 0.05). In Dokki, 20% of the studied group had blood lead levels ≥ 10 µg/dL, versus 42% of those in Helwan. A significant association was found between children with abnormal behavior and those with pallor with blood lead level ≥ 10 µg/dL, when compared with those with blood lead level < 10 µg/dL (p < 0.05). Those living in Helwan area, those with bad health habits, and those living in housing with increased exposure were at a statistically significantly higher risk of having blood lead level ≥ 10 µg/dL. Conclusion: Lead remains a public health problem in Egypt. High blood lead levels were significantly associated with bad health habits and housing with increased exposure, as well as abnormal behavior and pallor

Urinary liver-type fatty acid-binding protein as a Marker for Early Diagnosis of Diabetic Nephropathy in Type 1 Diabetic Children.

 Objectives: Renal failure and premature mortality are fatal prognosis of diabetic nephropathy. To improve patient outcome, early diagnosis of diabetic nephropathy is necessary. The study was designed to evaluate urinary liver-type fatty acid binding protein (L-FABP), as an early biomarker of tubulointerstitial injury, and its association with the clinical characteristics of type 1 diabetic children.Methods: Fifty randomly selected patients with type 1 diabetes mellitus (DM) attending the diabetes outpatient clinic of Ain Shams University Children's Hospital were included in the study. 50 age and sex-matched healthy subjects were enrolled as controls. Urinary L-FABP, 24 h urine albumin, hemoglobin A1c (HbA1c), serum creatinine, and lipid profile were measured.Results: Diabetic subjects had higher mean urinary L-FABP than controls (p&lt;0.05). In microalbuminuric diabetic subjects, the mean urinary L-FABP was detected to be significantly higher than that in normoalbuminuric diabetic subjects, and significantly higher values of the mean urinary L-FABP were detected in the microalbuminuric and the normoalbuminuric subjects than the controls (p&lt;0.05). Multiple linear regression analysis showed that duration of DM and HbA1c was the main predictors of urinary L-FABP in diabetic subjects.Conclusion: In patients with childhood-onset T1D, urinary L-FABP may be used as an indicator of renal injury in early stages of nephropathy, even in the normoalbuminuric state