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.

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.

AIM: To evaluate hearing in β-thalassemia major patients on iron chelation therapy by using pure-tone audiometry (PTA) and distortion product otoacoustic emissions (DPOAE). SUBJECTS AND METHODS: This cross-sectional, descriptive study was done on (48) diagnosed, 6-18 years old, β-thalassemia major patients who had received at least 3 years iron chelating agent deferoxamine (DFO). We performed PTA, DPOAE testing, and tympanometry for all participants. SPSS was used to analyse data. P < 0.05 was accepted as statistically significant. RESULTS: No significant difference was found between PTA and DPOAE testing in their capability to detect ototoxicity. PTA and DPOAE testing for the detection of ototoxicity in BTM and BTI, kappa values (κ) were found to be 0.516 and 0.459, respectively. The whole mean serum ferritin level was 2,251.3 ng/ml. The mean level was 1,603 ± 1,380 ng/ml in the patients with SNHL and 2,405 ± 1,908 ng/ml in the patients with normal hearing with the statistically significant difference among both groups (p = 0.015). The occurrence of ototoxicity was statistically significant with increasing age (p < 0.001). There was no marked difference as regards gender (p = 0.72). CONCLUSION: Hearing loss is prevailing in patients with β-thalassemia major on iron chelating agents. Therefore, regular hearing evaluations and periodic check-ups after the initiation of chelation therapy are mandatory.

AIM: The study aimed to evaluate serum vitamin D concentrations among neonates with pneumonia. METHODS: This case-control study enrolled 33 neonates with pneumonia in addition to 30 healthy controls. CBC, CRP, Serum vitamin D and Pentraxin 3 levels were measured for all participants. RESULTS: There was significant difference between patients and controls regarding Hemoglobin levels, TLC and CRP (p value < 0.01, = 0.002, < 0.01 respectively). Patients with pneumonia showed significant lower levels of Vit. D (9 ± 2.1) compared to controls (14.1 ± 2.8), P value < 0.01. However, patient group had significant higher levels of Pentraxin 3 (29.1 ± 4.8) compared with controls (12.6 ± 3), P value < 0.01. Moreover, mechanically ventilated patients revealed significant lower vit D (7.7 ± 1.8) and higher pentraxin 3 (32.2 ± 2.6) compared to patients on free oxygen (9.1 ± 2.1, 26.4 ± 3.7 respectively), P value = 0.05, 0.02 respectively. Regarding hospital stay, it had significant positive correlation with serum pentraxin 3 (r = 0.6, P value < 0.01) and significant negative correlation with serum vit D (r = -0.4, P value = 0.04). Finally a significant negative correlation between serum levels of vitamin D and Pentraxin 3 was found (r = -0.4, P value = 0.01). CONCLUSION: Lower concentration of serum vitamin D may be significantly associated with neonatal pneumonia. It also can predict the need for mechanical ventilation and duration of hospital stay in neonatal pneumonia. Similarly, higher levels of Pentraxin 3 may be used as an indicator for mechanical ventilation need and a longer hospital stay in neonates with pneumonia.

Background COVID-19 (Corona Virus Disease 2019) is showing a wide global spread, and urgent joint international efforts is required to the control of this pandemic, the awareness of people towards infectious viruses still the main factor to limit the widespread of disease. The aim of this study is to assess the level of awareness and attitude towards COVID-19 among a sample of Egyptian school children, using a web-based questionnaire. Results A total of 708 participants were involved in this online survey study, representing different areas in Egypt, 378 males (53.4%), 330 females (46.5%); their age range between 6 and 18 years. Regarding the residence, 576 (81.4%) were from urban areas, the remaining 132 (18.6%) were from non-urban areas. Internet and media were more frequent used as a source of information in urban students. The knowledge level score of risk and prevention of the disease were significantly higher in urban students than in non-urban students. Healthy practice score ≥ 50 were significantly more frequent in urban students. Healthy practice score was non-significantly higher in urban students. Conclusions Most of the study participants of school students are knowledgeable about basic information, and have cautious preventive practices towards COVID-19, denoting the efficacy of the public health efforts. However, the lower level of awareness in non-urbans, indicating a need to address alternative channels to communicate with these populations