ObjectiveTo define nomograms for blood pressure in Egyptian children and adolescents.Methods and study designA total of 60 025 Egyptian children from birth to 19 years were enrolled in this cross-sectional randomised study from December 2015 to March 2017. They were selected from diverse geographical districts in Egypt. Healthy children who fulfilled the inclusion criteria, which included good nutritional history, absence of fever or documented underlying disease at the time of examination, no evidence of haemodynamically significant illness, and no antihypertensive drugs or other chronic drug administration, were included in the study. Body weight, recumbent length (for less than 24 months) and height (from 2 years to 19 years), and blood pressure were measured using standard mercury sphygmomanometers.ResultsBlood pressure increases with age in both boys and girls. The 90th percentile of systolic and diastolic blood pressure among Egyptian children was different from other ethnic populations (American and Turkish children) in both sexes. Systolic and diastolic blood pressure showed a positive correlation with weight and height in both sexes (p<0.001).ConclusionWe assumed that normal blood pressure curves should be used cautiously during childhood, and it is recommended that every population have its own normal standard curve to define measured blood pressure levels in children. These centiles increased our knowledge and awareness of normal blood pressure among Egyptian children and adolescents. The percentiles will distinguish children and young adolescents with increased blood pressure and will be of value to both medical practice and scientific research.

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Background: Group-A streptococcal serology is used for post-streptococcal disease diagnoses, such as acute rheumatic fever, and occasionally for diagnosis of streptococcal pharyngitis. The prevalence of rheumatic fever in school children aged 6 to 15 years ranges between 0.2 to 0.75 per 1000 children per year. The prevalence of rheumatic heart disease in 1000 children ranges from 1 to 5.4. Aim of the work: To determine upper limit of the normal range of Antistreptolysin O titre in healthy school children, aged 6-15 years old in El Behira governorate. Patients and Methods: A cross-sectional study had been performed in EL Behira Governorate and the collected sample were tested in clinical pathology Lab [Al-Azhar University Hospital, Damietta]. A total of 3000 [1609 Males, 1391 Females] serum samples had been collected from children aged 6-15 years, had been tested for Anti-streptolysin O titer [ASO] by turbidimetry. Results: Normal value for the ASO titer rose sharply during early childhood and then declined gradually with age. The estimated titer that was 80% of the upper limit or normal at age 10 years was 287 IU/ml for ASO. Conclusion: This study provides the upper limit of normal value for ASO titre of school children. The "more than 400" rating should instruct clinicians in the treatment of post-streptococcal diseases in patients and provide valuable longitudinal evidence for potential intervention trials against streptococcal diseases in group A.

Introduction and Aim: Acute lymphoblastic leukemia (ALL) is the commonest form of childhood leukemia. Molecular studies can provide diagnostic and prognostic information with direct impact on the patient. Recent micro RNAs (miRNAs) studies showed that aberrant expression can be used as signatures of ALL with different subtypes and predict drug resistance. The present work aimed to evaluate the expression of Plasmacytoma Variant Translocation-1 (PVT1) in Childhood ALL patients. Methodology: The study included 55 children from 2 months to 15 years old; 45 patients with ALL before receiving any treatment, and 10 control children. Long non-coding RNA PVT1 expression in plasma cells was detected by reverse transcription quantitative polymerase chain reaction. Results: Lnc_PVT1 expression is upregulated by twelve-folds in ALL patients. At optimum cut-off value of 22.0, the biomarker has a sensitivity of 72% and 82% specificity to discriminate ALL patients from controls. Correlating the mean values of miR_1204gene fold expression with different subgroups concerning prognostic criteria, there was no statistical differences between age groups, gender, ALL phenotypes, cytogenetic abnormality, total leukocytes count, hemoglobin concentrations and platelet count. In contrast, statistical significance was detected with bone marrow blasts percentage, clinical response, and minimal residual disease. Conclusion: A higher expression of lnc-PVT1 was observed in ALL patients, and it had a diagnostic and prognostic potential. In addition, miR-1204 was down-regulated in pediatric ALL and associated with higher risk.

Background: Iron deficiency anemia [IDA] is a very common medical condition affecting primary school-age children, with several unfavorable consequences. There are some reports pointing to a possible effect of IDA on thyroid gland function. Aim of the work:To assess thyroid function in primary school age children in Damietta Governorate, Egypt with iron deficiency anemia and to investigate potential related risk factors. Patients and Methods: A controlled cross-sectional study included 100 primary school age children [age: 6-12 years]; 50 children with iron deficiency anemia [case group], and 50 healthy age-and sex-matched children [control group]. Complete blood count, serum iron, serum ferritin and thyroid hormone profile [thyroid stimulating hormone [TSH], free triiodothyronine [FT3] and free thyroxine [FT4] were analyzed for all children. Results: In the case group, compared to the control group, there was a significantly higher TSH level [2.77±1.30 vs. 2.10±1.11; P=0.006] and lower FT3 [3.22±0.82 vs. 3.61±0.69; P=0.011]. The frequency of hypothyroid status [both overt and subclinical] was elevated in the case group [24% vs. 6%; P=0.02]. There was a significant negative correlation between TSH with both serum iron [P=0.019] and ferritin [P=0.009]. Conclusion:Iron deficiency anemia, especially when serum ferritin and iron are very low, in primary school children is associated with liability to get subclinical hypothyroidism.

Article informationBackground: Carnitine is one of hydrophilic amino acid derivatives participating in pulmonary surfactant production in infants. The deficiency of Carnitine might lead to the incidence and severity of respiratory distress syndrome [RDS] in preterm infants. Aim of the work:The aim of this work is the assessment and evaluation of L-carnitine therapy effect on the prognosis of respiratory distress syndrome. Patients and Methods: The study included a total number of 90 preterm infants with RDS, categorized into two groups; group I [40 cases] with sufficient level of lcarnitine and group II [50 cases] with deficient l-carnitine. Both groups are subdivided into two subgroups; intervention group [received carnitine] and control group. Patients with sufficient carnitine levels received Carnitine supplementation at a dose of 10 mg/kg/day. Patients with deficient carnitine levels received Carnitine therapy at a dose of 30 mg/kg/day Follow-up was carried out to assess the need of respiratory support, oxygenation, hospital stay and mortality. Results: The mean gestational age was 31.62 ± 2.18 wks. The mean birth weight was 1.58 ± 0.41 Kg. Newborns with deficient carnitine level were had lower birth weight [1.68 ± 0.42 Kg vs. 1.50 ± 0.39 Kg; P=0.046] and exhibited more frequency of mechanical ventilation [P=0.021]. In the sufficient Carnitine group, carnitine supplementation was associated with improvement of weight [P=<0.001] and early onset of enteral feeding [P=0.013]. In the deficient carnitine group, carnitine supplementation was associated with lower need [P=0.031] and short duration [P=0.006] of mechanical ventilation. Conclusion:The supplementation of Carnitine for infants with sufficient carnitine has a significant positive effect on their growth and weight gain. Carnitine therapy for infants with deficient carnitine significantly reduces mechanical ventilation requirement and duration, improved chest X-ray, shortened duration to reach full enteral feeding and the duration of neonatal intensive care unit [NICU] stay.

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