Background. Children with congenital heart diseases (CHDs) may have a risk of developing myocardial injury caused by volume and pressure overload. Objective. To evaluate the incidence of myocardial injury in children with cyanotic and acyanotic CHDs using cTnI assay and to correlate it with different hemodynamic parameters. Methods. This study included 80 children with CHDs (40 acyanotic and 40 cyanotic) as well as 40 healthy children (control group). Serum cTnI levels were measured for patients and control. Pulmonary to systemic blood flow (Qp/Qs) and pulmonary to systemic arterial pressure (Pp/Ps) ratios were measured for children with CHDs during cardiac catheterization. Results. Sixty-four out of 80 patients with CHDs had myocardial injury as evidenced by increased cTnI. Serum cTnI was significantly higher in both cyanotic and acyanotic groups compared to control group (p < 0.05). Serum cTnI level significantly correlated with oxygen saturation (SpO2), ejection fraction (EF), Qp/Qs, and Pp/Ps ratios. Conclusion. The incidence of myocardial injury was high in children with CHDs. The use of cTnI for follow-up of children with CHDs may help early detection of myocardial injury and help early management of these cases.
Background: Ochratoxin A (OTA) is a well-known widely-spread mycotoxin all over the world that constitutes a real human threat. Its presence in human milk has previously been reported in different countries.Objective: This study aimed to detect the presence of OTA in both mothers' milk, sera, and infants' sera and compare the results with a previous study done in Egypt. Patients and Methods: Forty-eight healthy breast-lactating mothers and their infants who were exclusively breast-fed for at least 4 months were included. All of them were subjected to a thorough laboratory evaluation including determination of OTA concentration by (ELISA) Enzyme-Linked Immunosorbent Assay. Results: Fifteen mothers (31.3%) and their infants had been contaminated with OTA. The analysis showed that all infants of affected mothers had OTA in their sera. Conclusion: Multivariate logistic regression analysis showed that there was a significant correlation between OTA levels in mothers' sera, milk, and their infants' sera.
Background: Pulmonary hypertension is defined as a resting mean pulmonary artery pressure (mPAP) of 25 mmHg or above. PAH is a frequent complication of congenital heart disease (CHD), particularly in patients with left-to-right (systemic-to-pulmonary) shunts. Objective: The present study aimed to investigate changes in the blood level of endothelin-1 (ET-1) in patients of PAH complicated by acyanotic CHD and to detect possible correlation with different hemodynamic parameters. Patient and methods: 48 children were recruited in Pediatric Cardiology Unit, Pediatrics Department in Zagazig University Hospitals after obtaining the required permissions and informed consent from the their caregivers. They were divided into Group (A), which included 24 children with acyanotic CHD with left to right shunt with PAH and Group B included 24 children with acyanotic CHD with left to right shunt but no PAH. All children were subjected to clinical and radiological examination, echocardiography and measurement of endothelin-1 level as well as correlation between the studied parameters were performed. Results: the present results showed that Group A was significantly associated with previous need of hospital admission and insignificantly associated with ICU need. Endothelin-1 was significantly negatively correlated with weight and oxygen saturation (SPO2) but significantly positively correlated with systolic blood pressure (SBP), heart rate (HR), respiratory rate (RR) and pulmonary blood pressure. Significant area under the curve (AUC) with cutoff value >1.55 with sensitivity 85.05 and specificity 91.1%. Conclusion: Pulmonary hypertension (PAH) complicated by CHD can be predicted by estimation of endothelin-1 (ET-1) as an indicator of endothelial injury.
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