ObjectiveTo evaluate the role of serum apelin as a diagnostic tool in retinopathy of prematurity (ROP) disease.Patients and methodsThirty-eight preterm infants (60% male) with gestational age ranging from 30 to 36 weeks admitted to the neonatal intensive care unit, KJO Hospital, Saudi Arabia with proven diagnosis of ROP were included in the study. In addition, 27 preterm infants without ROP served as controls. All newborn infants in the study were subjected to adequate history taking, full clinical examination, and fundus examination by indirect ophthalmoscope (at 4–6 weeks) as well as determination of serum apelin at birth and at 4–6 weeks of age.ResultsThe study revealed that oxygen therapy longer than 7 days’ duration, cesarean section (as a mode of delivery), sepsis, mechanical ventilation, blood transfusion, premature rupture of membranes, pneumothorax, perinatal asphyxia, cardiac problems, and neonatal jaundice were considered as risk factors related to development of ROP. Serum apelin levels were significantly lower in patients than controls (P<0.001) at time of diagnosis of the disease (4–6 weeks) while no significant differences were observed in levels at birth.ConclusionSerum apelin was found to be of significant diagnostic value in the occurrence of ROP.
Mycobacterium tuberculosis is endemic to many parts of the world. It may have variable clinical presentations, especially in the pediatric age group. Presented here is the case of a 9-month old infant who was referred for infectious disease opinion when his thigh induration failed to improve after surgical drainage and a course of oral antibiotic therapy. Mycobacterial PCR on the operative sample fluid was found to be positive; and mycobacterial culture grew M. tuberculosis. He received 9 months of treatment with anti-TB medications, with excellent results and complete recovery. This is the first report of TB pyomyositis in an infant; and highlights the need to have a high index of suspicion for unusual organisms when conventional therapy fails to demonstrate expected results.
Purpose:The aim of this study is to evaluate the role of ureteric stents in relieving obstruction and improvement of kidney function in patients with obstructive uropathy.Materials and Methods:This study involved 138 patients with obstructive uropathy with age ranged from 2 months to 73 years. Patients classified into two groups: Group (I): Includes 57 patients (41.3%), ureteric stents fixed to them; and Group (II): Includes 81 patients (58.6%) managed by other treatment modalities. All patients underwent clinical assessment, Laboratory and radiologic investigations: At presentation and postoperative. These included: Complete urine analysis, urine culture and sensitivity, serum creatinine, serum urea nitrogen, serum uric acid, serum sodium (Na), serum potassium (K), Fasting blood glucose level and blood picture and plain X-ray (KUB), abdominal ultrasonography (US), diuretic renography and retrograde pyelography.Results:Renal glomerular filtration rate (GFR) was used as an indicator for improvement of renal function after fixation of ureteric stent. In group I: 56 (71.8%) kidneys showed significant recovery compared to 61 kidneys (66.3%). In group II, there is statistically significant relation between renal perfusion and renal recovery (P < 0.004), statistically significant relation between parenchymal thickness and recovery in both groups (P < 0.0002), statistically significant relation between degree of corticomedullary differentiation and recovery (P < 0.0003) and statistically significant relationship between hemoglobin levels at presentation and the recoverability (P < 0.002).Conclusion:The predictors of renal recoverability revealed that ureteral stents alone can help in regaining renal function and significant improvement of clinical condition in patients with obstructive uropathy.
Background: Birth asphyxia is a leading cause of neonatal mortality. Ischemia-modified albumin (IMA) levels may have a predictive role in the identification and prevention of hypoxic disorders, as they increase in cases of ischemia of the liver, heart, brain, bowel, and kidney.Purpose: This study aimed to assess the value of IMA levels as a diagnostic marker for neonatal hypoxic-ischemic encephalopathy (HIE).Methods: Sixty newborns who fulfilled 3 or more of the clinical and biochemical criteria and developed HIE as defined by Levene staging were included in our study as the asphyxia group. Neonates with congenital malformation, systemic infection, intrauterine growth retardation, low-birth weight, cardiac or hemolytic disease, family history of neurological diseases, congenital or perinatal infections, preeclampsia, diabetes, and renal diseases were excluded from the study. Sixty healthy neonates matched for gestational age and with no maternal history of illness, established respiration at birth, and an Apgar score ≥7 at 1 and 5 minutes were included as the control group. IMA was determined by double-antibody enzymelinked immunosorbent assay of a cord blood sample collected within 30 minutes after birth.Results: Cord blood IMA levels were higher in asphyxiated newborns than in controls (250.83±36.07 pmol/mL vs. 120.24±38.9 pmol/mL). Comparison of IMA levels by HIE stage revealed a highly significant difference among them (207.3±26.65, 259.28±11.68, 294.99±4.41 pmol/mL for mild, moderate, and severe, respectively). At a cutoff of 197.6 pmol/mL, the sensitivity was 84.5%, specificity was 86%, positive predictive value was 82.8%, negative predictive value was 88.3%, and area under the curve was 0.963 (<i>P</i><0.001).Conclusion: IMA levels can be a reliable marker for the early diagnosis of neonatal HIE and can be a predictor of injury severity.
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