Low 25(OH)D level is far frequent among Egyptian preterm neonates. Vitamin D deficiency is an independent risk factor for development of RDS in preterm neonates.

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Preterm neonates with respiratory distress syndrome (RDS) are at increased risk of acute kidney injury (AKI). Our study aimed at determining whether serum cystatin C (sCysC) on day 3 of life (D3) can early predict AKI in preterm neonates with RDS. This prospective study was conducted on 75 preterm neonates; 50 with RDS and 25 without RDS. On D3, sCysC, serum creatinine (sCr) and blood urea nitrogen (BUN) were measured and estimated glomerular filtration rate (eGFR) was calculated. sCr and BUN levels were measured again on days 5 and 7. Neonates were evaluated for development of AKI during first week of life according to the modified pediatric RIFLE (pRIFLE) criteria. Thirteen neonates with RDS developed AKI (26%).There was no significant difference between RDS and control groups with respect to sCysC. RDS neonates with AKI had significantly higher sCysC than those without AKI (1.62 ± 0.12 versus 1.16 ± 0.09 mg/l; p < .001). RDS grade III-IV neonates had significantly higher sCysC than RDS grade I-II. There was a significant positive correlation between D3 sCysC and (D5 and D7 sCr and BUN). Receiver operating characteristic (ROC) curve showed that D3 sCysC can predict AKI in preterm neonates with RDS at a cutoff point of >1.3 mg/l with sensitivity of 92.30% and specificity of 96%. We conclude that neonates with RDS are at increased risk of AKI. sCysC on day 3 of life can predict AKI earlier than Cr and eGFR.

Background: Hepatocellular carcinoma (HCC) is the sixth most common cancer and the third leading cause of cancer related death overall. The role of insulin resistance in the development of HCC associated with chronic HCV infection has not been established. Resistin is a polypeptide hormone belonging to the adipokine family which could contribute to tumorigenesis and angiogenesis. Our aim was to study serum resistin and insulin resistance as risk factors for HCC in HCV cirrhotic patients. Materials and Methods: This prospective case controlled study included 100 patients with HCV related liver cirrhosis and HCC, 100 patients with HCV related liver cirrhosis without HCC and 50 apparently healthy participants as controls. For all subjects, liver profile, serologic markers for viral hepatitis, lipid profile, alpha-fetoprotein level (AFP), homeostasis model assessment (HOMA) were examined along with resistin. Results: HCC patients had higher mean values of HOMA-IR and resistin than cirrhotic patients and the control subjects (p<0.01). HOMA and resistin were considered independent risk factors in development of HCC, those patients with resistin › 12 ng/ml and HOMA ›4 being 1.6 times more likely to have HCC. Conclusions: HOMA and serum resistin allow for early identification of patients with cirrhosiswho are at substantially increased risk of HCC. Recommendation: HOMA and serum resistin could represent novel markers to identify HCV cirrhotic patients at greater risk of development of HCC.

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Phytochemical investigation of the methylenechloride/methanol extract of the aerial parts of Stachys aegyptiaca afforded a new neoclerodane-type diterpene with a new side chain 1, in addition to two known diterpenes 2 and 3 and a known flavonoid glycoside 4. The structures of the compounds were determined by comprehensive NMR studies including DEPT, COSY, NOESY, HMQC, HMBC and HR-MS.

Background: Limited data are available about renal involvement in thalassemia patients. Renal dysfunction in these patients seems to be multifactorial attributed mainly to long standing anemia, chronic hypoxia, iron overload and toxicity of iron chelators.Objective: To assess the frequency of subclinical glomerular and tubular dysfunctions in children and adolescents with b-thalassemia major and intermedia, and to correlate these findings with the degree of iron overload and type of chelation therapy.Methods: The study included 40 thalassemia major and 20 thalassemia intermedia pediatric patients recruited from the Pediatric hematology clinic, Ain Shams University. Serum sodium, potassium, phosphorous and creatinine, and urinary sodium, potassium, phosphorous, protein/creatinine ratio and urinary b2 microglobulin were measured. Fractional excretion of sodium and potassium was calculated.Results: The mean level of serum creatinine in all patients was within the normal range and comparable in both TM and TI groups (0.17 ± 0.06 and 0.18 ± 0.07 mg/dl, respectively, P > 0.05). The mean eGFR was higher than normal range in both TM and TI groups (552.65 ± 231.73 and 472.15 ± 272.99 ml/min, respectively). Mean level of urinary b2 microglobulin was within the normal range (0.13 ± 0.05 and 0.10 ± 0.03 lg/ml) in TM and TI patients, however, it was significantly higher in TM patients (P = 0.009). Urinary b2 microglobulin was positively correlated to Abbreviations: A/C, albumin/creatinine ratio; b2MG, urinary b2 microglobulin; CBC, complete blood count; FENa, fractional excretion of sodium; FEK, fractional excretion of potassium; Hb, hemoglobin; HPLC, high-performance liquid chromatography; NAG, N-acetyl-b-dglucosaminidase; TM, thalassemia major; TI, thalassemia intermedia; U pr/Cr ratio, urinary protein/creatinine ratio * Corresponding author. E-mail addresses: amiradiabetes@yahoo.com (A.A.M. Adly), dtoaima@yahoo.com (D.N. Toaima). Production and hosting by Elsevier B.V. on behalf of Ain Shams University. both transfusion index and serum ferritin level (P < 0.05). Tubular reabsorption of phosphorus (TRP) was significantly higher among TM patients (P = 0.037). The mean height and height percentile were lower in the poorly chelated group (serum ferritin P2500 ng/ml) than the well chelated group. In addition, the mean serum sodium and urinary protein/creatinine ratio were significantly higher in the poorly chelated group (P < 0.05).Conclusion: Subclinical renal affection can start earlier in TM patients compared to TI. Poor chelation is associated with early signs of renal affection. Periodic renal assessment of those patients is mandatory as they may be affected by hidden renal dysfunction.Ó 2014 Production and hosting by Elsevier B.V. on behalf of Ain Shams University.