Penile and Testicular Measurements in Male Neonates and Infants: Single Center Egyptian Study.

BACKGROUND: Universal reference values of penile length, circumferences and testicular volume in newborns and infants are inappropriate to be used in variable ethnic backgrounds. OBJECTIVE: The aim of this prospective study was to establish normal reference values for stretched penile length, penile circumference and testicular volume for Egyptian newborn and infants. SUBJECTS AND METHODS: This observational cross-sectional study included 1850 healthy male full term newborn and infants applied for routine check-up, aged 0 -24 months, the newborn and infants were recruited from Tanta University Hospital in the period from July 2015 to January 2017. Penile length, penile circumference, testicular volume, weight, length and occipito-frontal circumference were measured. RESULTS: The studied infants were divided into five groups. Group I: 1-4 weeks, the mean penile length was 3.51 ± 0.49 cm, penile circumference was 3.95 ± 0.48 cm, and testicular size was (right 1.81 ± 0.44 cm and left 1.67 ± 0.47 cm). Group II: > 1-6 months age, the mean penile length was 3.99 ± 0.46 cm, penile circumference was 4.10 ± 0.38 cm, and testicular size was (right 2.10 ± 0.33 cm and left 2.04 ± 0.27 cm). Group III: >6-12 months age, the mean penile length was 4.45 ± 0.48 cm, penile circumference was 4.21 ± 0.33 cm, and testicular size was (right 2.13 ± 0.33 cm and left 2.06 ± 0.28 cm). Group IV: >12-18 months age, the mean penile length was 4.55 ± 0.54 cm, penile circumference was 4.28 ± 0.32 cm, and testicular size was (right 2.12 ± 0.33 cm and left 2.09 ± 0.32 cm). Group V: >18-24 months age, the mean penile length was 4.89 ± 0.63 cm, penile circumference was 4.45 ± 0.33 cm, and testicular size was (right 2.28 ± 0.45 cm and left 2.25 ± 0.45 cm). There were significant positive correlations between penile length, penile circumference, left and right testicular volumes with each other and also with all other anthropometric measures including: weight, height and head circumference. CONCLUSION AND RECOMMENDATION: The age-related values of penile and testicular measurements must be known to be able to determine the abnormal sizes and to monitor treatment of underlying diseases. Our study is a step to achieve accurate reference values of penile and testicular measurements for Egyptian male newborns and infants. Therefore multicenter studies are recommended to establish Egyptian norms.

New diagnostic biomarker in acute diarrhea due to bacterial infection in children.

BACKGROUND AND OBJECTIVES: Diarrhea is a major cause of morbidity and mortality in children, and diarrhea may be due to infection that is bacterial or non-bacterial. Differentiation between diarrhea from a bacterial or non-bacterial infection is not a simple task, and no single method is present to differentiate between these causes of diarrhea.To evaluate the diagnostic accuracy of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) and procalcitonin (PCT) in the diagnosis of acute diarrhea due to bacterial infection. PATIENTS AND METHODS: Case control study of forty children with bacterial infection diarrhea diagnosed by stool culture and CRP, 40 children with acute non-bacterial infection diarrhea and 30 age- and sex-matched healthy controls. Stool cultures, serum CRP, PCT and serum sTREM-1 were measured in all children on admission. RESULTS: Children with acute bacterial infection diarrhea had a significant increase in the serum sTREM-1 and PCT levels on admission compared to patients with nonbacterial infection diarrhea and controls (26.3667 ± 16.8184 ng/ml vs 7.2267 ± 6.4174 ng/ml vs 6.7367 ± 5.6479 ng/ml and 39.9933 ± 22.5260 ng/ml vs 1.8533 ± 1.7123 vs 0.2840 ± 0.1208 ng/ml, respectively; P < 0.05). sTREM-1 demonstrated significantly higher sensitivity (93.7%) and specificity (94.3%) in the prediction of bacterial infection as a cause of acute diarrhea in children with an area under the receiver operator characteristic (ROC) curve (95% CI) of 0.94 (0.84-0.99) at a cutoff value of 12.4 ng/ml. CONCLUSIONS: Both serum PCT and sTREM-1 are valuable in the early diagnosis of acute bacterial infection-induced diarrhea in children, and there was markedly higher diagnostic discriminatory power for sTREM-1.

Immune Status 'in Children with Beta Thalassemia' in Correlation 'with Iron Overload': Single Center Egyptian Study.

BACKGROUND: 'Beta thalassemia is inherited hemoglobin disorder resulting in chronic hemolytic anemia that requires lifelong transfusion therapy'. 'Repeated blood transfusions and RBCs hemolysis are the main causes of iron overload', which in addition to immune abnormalities, are common predisposing factors to infections in patients with thalassemia. The Aim of this Work: The aim of this work was to study immune status including T lymphocyte subsets and serum immunoglobulin levels 'in children with beta- thalassemia in correlation with iron overload'. PATIENTS AND METHODS: The present 'study was conducted on 40 children with beta thalassemia major under follow up at Hematology Unit, Pediatric Department, Tanta University' 'including 24 males and 16 females with mean' age value of 9. 22 ± 3.9 years and 20 'healthy children of matched age and sex as a control group'. All children included in the study were subjected to; 'complete blood count, Hb electrophoresis, serum iron status', T cell subsets including CD3, CD4 and CD8 and serum immunoglobulin levels including IgM, IgA and IgG. RESULTS: 'Pallor and jaundice were the most common presenting' clinical manifestations. Infective episodes 'were significantly higher in patients' compared with controls. There were significantly lower Hb, MCV and MCH levels and significantly higher WBCs and platelets counts, reticulocytes and lymphocytes percentage in patients than controls and no significant differences in MCHC between patients and controls. Serum ferritin and iron were 'significantly higher but TIBC was significantly lower in' patients than controls. CD3, CD4 and IgM were significantly lower but CD8, IgG, and IgA 'were significantly higher in patients than controls' with negative correlation between CD3, CD4, IgM and ferritin and positive correlation between CD8, IgG, IgA and ferritin. CONCLUSION: Iron overload can affect humeral and cell mediated immunity in patients with beta thalassemia with reduction of IgM, CD3 and CD4 and elevation of CD8, IgG, and IgA. RECOMMENDATIONS: Regular follow up of patients with beta thalassemia for detection of iron overload as it affects humeral and cell mediated immunity.