Development and evaluating the biopotency of ready to eat liver meat balls in fighting anaemia and vitamin A deficiency, improving selected nutritional biochemical indicators and promoting the cognitive function among mildly anaemic Egyptian children aged 3-9 years.

OBJECTIVE: Ready to eat fried liver meat balls (LMB) were developed to fight anaemia and vitamin A deficiency and promote cognitive function. DESIGN: Randomised controlled trial consisting of two arms: control group with no supplement and LMB group receiving LMB supplement three times a week for 90 d. Criteria of evaluations included dietary assessment, anthropometric measurements, laboratory investigations and cognitive function by Wechsler test. SETTING: Kinder Garten and primary school in Urban Giza. PARTICIPANTS: Sixty boys and girls aging 3-9 years. RESULTS: The LMB supplement contributed to significant increases in the intakes of high bioavailable Fe and vitamin A in the diets of all children. Initial overall prevalence of mild and moderate anaemia was 43 %, which disappeared completely from all children aging < 72 months and from 88 % of children ≥ 72 months after the 90 d dietary intervention with the LMB. Faecal systemic immune globulin A, urinary hydroxyproline index and urinary iodine excretion increased significantly (P < 0·05) only after the dietary intervention with the LMB supplement for 90 d. The standard scores of verbal and non-verbal cognitive function tests (Δ day 90-day 0) increased significantly (P < 0·05) among the LMB group compared with the respective changes observed among the control group. The increase in height-for-age Z score and blood Hb were good predictors for improvement in cognitive function. CONCLUSION: LMB supplement is effective sustainable nutritious biotherapeutic food in fighting hidden hunger and promoting the cognitive function.

Tumor necrosis factor receptor II and PTPN22 genes polymorphisms and the risk of systemic lupus erythematosus in Egyptian children.

BACKGROUND: Many genes have been implicated in the pathogenesis of systemic lupus erythematosus (SLE). Tumor necrosis factor (TNF) is a potent cytokine stimulator acting through 2 cell surface receptors (TNFR I and II). TNFRII gene which controls expression of these receptors has been linked to SLE susceptibility through promoting apoptosis. Also; Protein tyrosine phosphatase non receptor 22 (PTPN22) gene enhances intrinsic phosphatase activity of T lymphocytes leading to their dysregulation and stimulates autoimmune process of lupus and its rs2476601 has been linked to susceptibility to thyroiditis in SLE patients in few studies. OBJECTIVES: (i) to investigate the correlation between 2 SNPs of TNFR II and PTPN22 genes and SLE susceptibility in a cohort of Egyptian children compared to controls (ii) and to investigate their possible association with different clinical presentations of the disease in children. SUBJECTS AND METHODS: Typing of TNFR II rs1061622 and PTPN22 rs2476601 SNPs were done using polymerase chain reaction-restriction fragment length polymorphism for 74 children with SLE and 100 matched healthy controls. RESULTS: Children with SLE had more frequent G allele and GG genotype of TNFR II rs1061622 (p < 0.001) and more T allele and TT genotype of PTPN22 rs2476601 (p = 0.012 and <0.001, respectively) compared to controls. Only 6 patients (8%) had thyroiditis (hypothyroidism) with T allele and TT genotype of PTPN22 1858 T more prevalent in those patients versus those without thyroiditis (p ≤ 0.001). Apart from, thyroiditis, no significant association was found between genotypes and alleles frequencies of the 2 studied SNPs and other clinical manifestations of the disease. CONCLUSION: The G allele and GG genotype of TNFR II rs1061622 and T allele and TT genotype of PTPN22 rs2476601 genes polymorphism can be considered as risk factors for the development of SLE. The presence of the T allele of PTPN22 rs2476601 may increase the risk of concomitant thyroiditis in Egyptian children with SLE but further studies are required to confirm this finding as thyroiditis was reported only in few cases in this study.

Temperament Styles of Children from Egypt and the United States: A Cross-Cultural Examination.

Age, gender, and cross-national differences of children ages 9 through 15 in Egypt (N = 800) and the United States (U.S., N = 800) are examined on four bipolar temperament styles: extroversion-introversion, practical-imaginative, thinking-feeling, and organized-flexible using the Student Styles Questionnaire (SSQ). Egyptian children generally prefer extroverted over introverted, practical over imaginative, and organized over flexible styles. Their general preference for feeling over thinking styles is gender related; although both males and females generally prefer feeling styles, males are less likely than females to prefer this style. Age differences are found on extroverted-introverted and practical-imaginative styles. Cross-national differences are found on four temperament styles. In contrast to children in the U.S., children in Egypt are more likely to prefer extroverted, practical, feeling, and organized styles.

Angiotensin II type 2 receptor gene polymorphisms and serum angiotensin-converting enzyme level in Egyptian children with systemic lupus erythematosus.

BACKGROUND: There are no reports about the association of angiotensin II type 2 receptor ( AT2R) gene polymorphisms and susceptibility to systemic lupus erythematosus (SLE) in children. OBJECTIVE: The objective of this research is to study AT2R gene polymorphisms in exon 3 (C1593A) and intron 1 (A1675G) in Egyptian children with SLE and its correlation with disease manifestations and serum angiotensin-converting enzyme (ACE) level. METHODS: Typing of AT2R gene polymorphisms was conducted in 123 children with SLE in comparison with 100 healthy controls using the restriction fragment length polymorphism method. RESULTS: Significant differences were found between SLE patients and controls for A-containing genotypes (CA + AA) and A-allele frequencies of AT2R in exon 3 (C1593A) ( p = 0.01, odds ratio (OR) = 2.5, 95% confidence interval (CI) = 1.3-5.05; p = 0.01, OR = 2.2, 95% CI = 1.2-4.1, respectively). G-containing genotypes (AG + GG) and G allele of AT2R in intron 1 (A1675G) were more frequent in SLE patients compared to controls ( p = 0.01, OR = 2.3, 95% CI = 1.2-4.5; p = 0.02, OR = 2.1, 95% CI = 1.2-3.7, respectively). Serum ACE level was significantly higher in SLE patients than in controls ( p < 0.001). There was no association between AT2R gene polymorphisms and ACE level in serum. Moreover, there was no association between AT2R gene polymorphisms and SLE clinical manifestations. CONCLUSION: AT2R gene polymorphisms can be considered risk factors for SLE development in Egyptian children.

Genetic mutation in Egyptian children with steroid-resistant nephrotic syndrome.

BACKGROUND/PURPOSE: Nephrotic syndrome is the commonest etiology of proteinuria in children. Steroid-resistant nephrotic syndrome (SRNS) is defined by resistance to standard steroid therapy, and it continues to be one of the most intractable etiologies of renal failure. Molecular studies discovered specialized molecules in podocytes that play a role in proteinuria. Mutations in NPHS2 that encodes for podocin constitute a frequent cause of SRNS worldwide. This study aimed to screen for podocin mutations in SRNS Egyptian children and their parents. METHODS: Our study included patients from 10 unrelated Egyptian families diagnosed with SRNS. Mutational analysis of the NPHS2 gene was performed by polymerase chain reaction amplification of the whole coding region of the gene and direct sequencing. RESULTS: Positive consanguinity was detected in five cases, and four of them had a positive family history of SRNS in a family member. Mutational analysis of NPHS2 revealed pathogenic mutations in four cases (40%) including a novel missense in one patient (c.1A>T; p.M1L). CONCLUSION: Our study concludes that mutations of NPHS2 gene are common among Egyptian children with SRNS. We support a model where ethnicity plays an important role in specific NPHS2 mutations, since a novel mutation was found in one patient in this study. Future study on a large number of Egyptian patients with SRNS is warranted to identify the actual genetic contribution of this gene in the development of SRNS in our population, which might help in patients' prognosis and management.

Angiotensin-converting enzyme insertion/deletion gene polymorphism in Egyptian children with systemic lupus erythematosus: a possible relation to proliferative nephritis.

Introduction Angiotensin-converting enzyme (ACE) is crucial in the pathogenesis of systemic lupus erythematosus through angiotensin II which regulates vascular tone and endothelial functions. Objectives To study the frequency of ACE insertion/deletion (I/D) gene polymorphism in Egyptian children with systemic lupus erythematosus and its possible relation to the renal pathology in cases with lupus nephritis. Subjects and methods The frequency of ACE gene insertion/deletion polymorphism genotypes was determined in 78 Egyptian children with systemic lupus erythematosus and compared to a matched group of 140 healthy controls using polymerase chain reaction. Results The DD genotype of the ACE gene was higher in systemic lupus erythematosus patients when compared to controls ( P<0.0001; odds ratio (OR) 2.4; 95% confidence interval (CI) 1.7-3.3) and the D allele was more frequent than the I allele in systemic lupus erythematosus patients in comparison to controls ( P < 0.0001; OR = 2.2; 95% CI = (1.6-3.1). In the lupus nephritis group, the DD genotype was significantly higher in those with proliferative lupus nephritis when compared to those with non-proliferative lupus nephritis ( P = 0.02; OR = 1.45; 95% CI = 1.4-1.6). Also, patients with proliferative lupus nephritis showed a higher frequency of the D allele ( P < 0.001; OR = 1.98; 95% CI = 1.3-2.9). Conclusion The D allele and DD genotype of the ACE gene appear to be a risk factor for the susceptibility of systemic lupus erythematosus and occurrence of proliferative nephritis in Egyptian children.

Evaluation of the coronary circulation and calcification in children on regular hemodialysis.

BACKGROUND: The objective of this study was to evaluate the coronary circulation and calcification in children with end-stage renal disease (ESRD) on hemodialysis. METHODS: A total of 50 children with ESRD and 50 healthy controls were enrolled in the study. Cardiac functions and coronary blood flow were evaluated with conventional and tissue Doppler echocardiography. Coronary artery calcification (CAC) was evaluated using high-resolution multidetector computed tomography (CT). RESULTS: The hyperemic coronary flow volume (CFV) and coronary flow reserve were significantly lower in the patient group than in the controls, while there was no significant difference in the baseline CFV between the two groups. Hypertension was present in 60% and CAC was observed in 20% of the children in the patient group. CAC was present in 30% of the children in the hypertensive subgroup. The left ventricle myocardial performance index (LV MPI), CAC score, duration of hypertension and level of diastolic blood pressure were independent predictors of the coronary blood flow, and LV MPI, serum parathyroid hormone, duration of dialysis and E'/A' mitral valve were independent predictors of coronary calcification. CONCLUSION: High diastolic blood pressure, long duration of hypertension, high LV MPI and increased CAC scores are independent risk factors for impaired coronary blood flow in children with ESRD.

The Effects of a School-Based Physical Activity Program on Physical Fitness in Egyptian Children: A Pilot Study from the DELICIOUS Project.

BACKGROUND: Ensuring the physical fitness of Egyptian children is of paramount importance to their overall well-being, given the unique socio-cultural and educational barriers they face that may hinder their active participation. As part of the DELICIOUS project, the "Be Fit Program" aims to increase the level of physical fitness among Egyptian school-aged children. This study explores the effectiveness of a structured, six-week physical activity (PA) program in improving various facets of physical fitness in children, including body composition, speed, coordination, muscular strength, and cardiovascular endurance. With the increasing prevalence of sedentary lifestyles, such efforts are imperative to improve overall health outcomes. METHODS: A cohort of 125 children, aged 8.50 to 12.25 y (mean age 10.19 ± 1.03 y), participated in the study. Their body composition, speed, coordination, strength, and aerobic fitness were assessed before and after the Be Fit Program using the revised International Physical Performance Test Profile. Paired t-tests were used to detect changes between the pre- and post-tests. RESULTS: Following the six-week intervention, statistical analyses revealed significant improvements in coordination and lower body strength (p < 0.01). Aerobic endurance showed marginal improvements, approaching statistical significance (p = 0.06). Conversely, there were no statistically significant changes in body composition, speed, or upper body strength (p > 0.05). CONCLUSIONS: The study confirms that tailored, non-competitive physical activities can positively influence specific fitness components in Egyptian children. However, achieving holistic improvements across all targeted fitness domains may require further strategic adjustments or a longer program duration. This pilot study underscores the importance of culturally tailored, school-based PA programs and highlights the continued need for research and program refinement to comprehensively improve children's fitness in the Egyptian context.

Effect of a Nurses' Training Program on Early Detection of Egyptian Children With Developmental Disabilities in Assiut Governorate.

This study aimed to determine the effectiveness of a designed training program for nurses toward early detection of developmental disabilities among children aged 0-3 years. A group of 21 licensed nurses with professional experience ranging from 5-11 years participated in the study. The participants completed the measurements to evaluate their current knowledge, practice, and perception pre- and post-training program, as well as during a follow-up, in relation to early detection of disabilities. The results showed highly statistically significant difference between the studied nurses' total knowledge, perception, and practice in pre- and post-program application (p = 0.01). However, there was no statistically significant difference between the post-program and follow-up application (p = 0.180).

Recurrent Fever with Oral Lesions in Egyptian Children: A Familial Mediterranean Fever Diagnosis Not to Be Missed.

OBJECTIVES: the aim of this study was to describe the genetic and clinical features of familial Mediterranean fever (FMF) in a group of Egyptian children. MATERIALS AND METHODS: This cross-sectional observational study included 65 children diagnosed with FMF according to the (Eurofever/PRINTO) classification criteria. The complete blood count (CBC), and acute phase reactants such as Serum amyloid A (SAA), and C-reactive protein (CRP) were all measured during the febrile episode. Mutation analysis for the MEFV gene was carried out for all subjects. RESULTS: A total of 65 patients with FMF were included in the study. The first clinical manifestation was recurrent fever in all patients. Recurrent oral lesions accompanied fever in 63% of cases, abdominal pain in 31%, and musculoskeletal pain in 6%. The mean SAA level was 162.5 ± 85.78 mg/L. MEFV mutations were detected in 56 patients (86%). Among these patients, 6 (10.7%) were homozygous, while 44 (78.6%) were heterozygous. The most frequently observed mutation was E148Q 24 (37.5%), followed by M694I 18 (32.1%), and V726A 13 (20.3%). Half of the patients with oral lesions were E148Q positive, however abdominal pain was found to be higher in the patients with the M694I mutation. CONCLUSION: Recurrent fever with oral lesions could be an important atypical presentation of FMF in Egyptian children that should not be ignored and/or missed.

Prevalence of viral pathogens in a sample of hospitalized Egyptian children with acute lower respiratory tract infections: a two-year prospective study.

Background: Viral pneumonias are a major cause of childhood mortality. Proper management needs early and accurate diagnosis. This study objective is to investigate the viral etiologies of pneumonia in children. Results: This prospective study enrolled 158 and 101 patients in the first and second year, respectively, and their mean age was 4.72 ± 2.89. Nasopharyngeal swabs were collected and subjected to virus diagnosis by reverse transcription polymerase chain reaction (RT-PCR). Viral etiologies of pneumonia were evidenced in 59.5% of the samples in the first year, all of them were affirmative for influenza A, 2 samples were affirmative for Human coronavirus NL63, and one for Human coronavirus HKU1. In the second year, 87% of patients had a viral illness. The most prevalent agents are human metapneumovirus which was detected in 44 patients (43.6%) followed by human rhinovirus in 35 patients (34.7%) and then parainfluenza-3 viruses in 33 patients (32.7%), while 14 patients had a confirmed diagnosis for both Pan coronavirus and Flu-B virus. Conclusions: Viral infection is prevalent in the childhood period; however, the real magnitude of viral pneumonia in children is underestimated. The reverse transcriptase polymerase chain reaction has to be a vital tool for epidemiological research and is able to clear the gaps in-between clinical pictures and final diagnoses.

Hearing assessment in Egyptian children with chronic renal failure on regular hemodialysis and renal transplantation children.

INTRODUCTION: Hearing impairment is frequent in patients with end-stage renal disease (ESRD). We aimed to assess the prevalence of hearing impairment in children on regular hemodialysis and renal transplantation. MATERIALS AND METHODS: Transient-evoked otoacoustic emissions (TEOAEs) has been done for 80 children on regular hemodialysis and 40 with renal transplant. RESULTS: In hemodialysis group, TEOAEs showed that 53.8% children had hearing affection, it was significantly related to dialysis duration, dialysis adequacy, vascular access infection, hepatitis C virus (HCV) infection, and ototoxic drugs (p = 0.001, 0.037, 0.011, 0.004, 0.030, 0.007, and 0.044, respectively). In renal transplant group hearing impairment was 25%. There was significant relation with period of dialysis before transplantation and biopsy proved rejection (p = 0.008, <0.001, respectively). CONCLUSION: Hearing impairment is a common finding in ESRD patients. Thus audiological assessment must be done in these patients.

Association of the Gelatinase B/Metalloproteinase 9 (MMP-9) Gene Haplotype in Systemic Lupus Erythematosus (SLE) in the Pediatric Egyptian Population.

Permanent systemic inflammation is a defining feature of systemic lupus erythematosus (SLE), which affects multiple organs. Gelatinase B/matrix metalloproteinase-9 (MMP-9) is an essential protease investigated in inflammation that has been linked to SLE. The study's objective was to investigate the relationship between the rs3918249 T/C and rs17576 A/G SNPs in the MMP-9 gene with SLE. The study was conducted with 100 SLE cases and 100 age/sex-matched healthy individuals. TaqManTM SNP was used for genotyping by real time PCR on the Artus Rotor-Gene Qiagen equipment. Haplotypes (TG: OR = 0.226, 95% CI = 0.119−0.429) and (CA: OR = 0.36, 95% CI = 0.2206−0.631), both with a p-value < 0.001 were substantially linked to a lower incidence of SLE. Conversely, the risk of SLE was not associated with the individual SNPs studied. The haplotype analysis was more significant than the SNP analysis and may correlate with the decreased risk of SLE in children and adolescents in Egypt.

Effect of iron deficiency anemia on language development in preschool Egyptian children.

BACKGROUND: Iron deficiency anemia (IDA) is the most common nutritional deficiency primarily in developing countries. OBJECTIVE: This study evaluates the effect of IDA on language development in preschool children. METHODOLOGY: The study is a multicenter, comparative cross-sectional study included 226 children between ages 4-6 years. The children were classified into two groups' anemic (patients) and non anemic (controls) according to the hemoglobin level. All anemic children subjected to complete iron study including; Serum iron, total iron binding capacity (TIBC), Serum ferritin level, to confirm the diagnosis of iron deficiency anemia. Cognitive assessment was done using the Arabic translation Stanford Binet intelligence scale, version four which comprised of four cognitive area scores; visual reasoning, verbal reasoning, quantitative reasoning and short-term memory. Measurement of IQ and mental age were calculated for each child. Language evaluation was done using the Arabic Language test. Receptive language quotient, expressive language quotient and total language quotient were calculated for each child. RESULTS: 122 children were anemic and 90 were non-anemic with hemoglobin level 10.65 and 11.96 g/dL, respectively (P < 0.000). Anemic children had significantly lower serum ferritin (p < 0.0001), and serum iron (p < 0.0001) compared to the controls. Both groups were matched as regards age, sex, socioeconomic levels and parental educational level. No significant differences observed regarding IQ, mental age, receptive, expressive and total language quotients between anemic and non-anemic children. CONCLUSIONS: IDA does not seem to have an effect on language development in preschool Egyptian Children. Future large controlled studies with long follow-up time for the younger age group are needed to determine whether there are existent associations between IDA with language development.

Prevalence of short stature and malnutrition among Egyptian primary school children and their coexistence with Anemia.

BACKGROUND: Under nutrition and overweight typically occur during nutritional transition periods in developing countries including Egypt. Short stature and anemia are public health concern due to its strong link with malnutrition which is a preventable risk factor. OBJECTIVES: to estimate the prevalence of overweight, obesity, underweight and short stature and its concurrence with anemia, also to determine the etiological profile of short stature among primary school children in Egypt. METHODS: A cross-sectional study was carried out on 33,150 Egyptian children aged 6-11 years old from January 2018 to January 2020, allocated in 59 primary schools from diverse geographical districts in Egypt. Complete anthropometric measurements were conducted and applied according to WHO growth charts. Hemoglobin level was measured. Systematic approach to detect the etiology of short stature was applied randomly to a sample of 380 stunted children. RESULTS: The prevalence of underweight was 8.2%, while obesity and overweight represented 21.8% (9.6 and 12.2% respectively). Overall short stature constituted 17%. The main etiologies of short stature were familial (40.8%) and constitutional (24.2%). Anemia was diagnosed in 26% of children; while concurrent anemia and stunting was reported in 9.9%. Regarding anemia and anemia with stunting were more common among girls (30.0% (OR = 1.50, CI95%: 1.43-1.58) and 11.4% (OR = 1.39, CI95%:1.29-1.49) respectively), who were living in rural areas (33.4% (OR = 1.96, CI 95%:1.87-2.06) &12.7% (OR = 1.72, CI 95%:1.60-1.85)) and those who had low socioeconomic status)34.6% (OR = 2.54, CI 95%:2.29-2.82) & 17.2% (OR = 3.32, CI 95%:2.85-3.88() respectively. Anemia with stunting was significantly higher among children aged ≥9 years old representing 12% (OR = 1.40, CI 95%:1.30-1.51). CONCLUSION: Prevalence of short stature, obesity and anemia was high among primary school children in Egypt with a strong concurrence between anemia and stunting. Intensive parental health education and in-depth nutritional assessment are required.

Assessments of Amino Acids, Ammonia and Oxidative Stress Among Cohort of Egyptian Autistic Children: Correlations with Electroencephalogram and Disease Severity.

OBJECTIVE: The current study aimed to assess the profiles of plasma amino acids, serum ammonia and oxidative stress status among autistic children in terms of electroencephalogram findings and clinical severity among the cohort of autistic Egyptian children. PATIENTS AND METHODS: The present study included 118 Egyptian children categorized into 54 children with autism who were comparable with 64 healthy controls. Clinical assessments of cases were performed using CARS in addition to EEG records. Plasma amino acids were measured using high-performance liquid chromatography (HPLC), while, serum ammonia and oxidative stress markers were measured using colorimetric methods for all included children. RESULTS: The overall results revealed that 37.04% of cases had abnormal EEG findings. Amino acid profile in autistic children showed statistically significant lower levels of aspartic acid, glycine, ß-alanine, tryptophan, lysine and proline amino acids with significantly higher asparagine amino acid derivative levels among autistic patients versus the control group (p˂0.05). There were significantly higher serum ammonia levels with significantly higher total oxidant status (TOS) and oxidative stress index (OSI) values among the included autistic children vs controls (p˂0.05). There were significantly negative correlations between CARS with aspartic acid (r=-0.269, P=0.049), arginine (r= - 0.286, p= 0.036), and TAS (r= -0.341, p= 0.012), and significantly positive correlations between CARS with TOS (r=0.360, p= 0.007) and OSI (r= 0.338, p= 0.013). CONCLUSION: Dysregulated amino acid metabolism, high ammonia and oxidative stress were prevalent among autistic children and should be considered in autism management. Still EEG records were inconclusive among autistic children, although may be helpful in assessment autism severity.

Analysis of 25-hydroxy cholecalciferol, immunoglobulin E, and vitamin D receptor single nucleotide polymorphisms (Apa1, Taq1, and Bsm1), among sample of Egyptian children with bronchial asthma: A case-control study.

PURPOSE: The current study aimed to assess the serum levels of vitamin D and immunoglobulin E (IgE) among asthmatic Egyptian children and to find out the possible associations of vitamin D receptor (VDR) polymorphisms with bronchial asthma development. METHODS: The study included 100 Egyptian children, 50 asthmatic children who were comparable with 50 age, sex, and body mass index-matched, unrelated healthy controls (HCs) clinical assessments of asthmatic children were done using global initiative of asthma. Pulmonary function tests (forced expiratory volume in 1 second [FEV1], forced vital capacity [FVC], FEV1/FVC ratio) were performed. Enzyme-linked immunosorbent assays of serum vitamin D3 and total IgE were done. VDR-single nucleotide polymorphisms (SNPs) (ApaI, TaqI, and BsmI) detection has performed using polymerase chain reaction through restriction fragment length polymorphism technique. Data analysis was performed using SPSS version 20.0. The studied SNPs were followed the Hardy Weinberg equation. RESULTS: The mean serum level of 25(OH) D3 was significantly lower among asthmatic children (13.46 ng/mL ± 10.50 SD) in comparison to HCs (37.53 ng/mL ± 13. 0.40 SD), P < .05. Vitamin D deficiency was detected in 72% of cases with no significant difference in its level regarding asthma control. There was significantly higher IgE level among asthmatic children (99.83 ku/L ± 233.81 SD) versus HCs (7.52 ku/L ± 3.32 SD), P < .05. Asthmatic children were presented more commonly with TaqI t allele (odds ratio [OR], 2.25; 95% confidence interval [CI], 1.28-3.96; P < .05) and BsmI b allele (OR, 1.83; 95% CI, 1.05-3.21; P < .05). ApaI a allele was not significantly different among patients versus controls (P > .05). TT + Tt and Bb + bb genotypes were significantly higher among cases versus the controls, P < .05 for all. CONCLUSIONS: TaqI and BsmI were associated with risk of bronchial asthma development among Egyptian children. High IgE and Low vitamin D status were frequently occurring among asthmatic children.

New Advances in Evaluation of Hearing in a Sample of Egyptian Children with ß-Thalassemia Major.

AIM: To evaluate hearing in ß-thalassemia major patients on iron chelation therapy by using pure-tone audiometry (PTA) and distortion product otoacoustic emissions (DPOAE). SUBJECTS AND METHODS: This cross-sectional, descriptive study was done on (48) diagnosed, 6-18 years old, ß-thalassemia major patients who had received at least 3 years iron chelating agent deferoxamine (DFO). We performed PTA, DPOAE testing, and tympanometry for all participants. SPSS was used to analyse data. P < 0.05 was accepted as statistically significant. RESULTS: No significant difference was found between PTA and DPOAE testing in their capability to detect ototoxicity. PTA and DPOAE testing for the detection of ototoxicity in BTM and BTI, kappa values (κ) were found to be 0.516 and 0.459, respectively. The whole mean serum ferritin level was 2,251.3 ng/ml. The mean level was 1,603 ± 1,380 ng/ml in the patients with SNHL and 2,405 ± 1,908 ng/ml in the patients with normal hearing with the statistically significant difference among both groups (p = 0.015). The occurrence of ototoxicity was statistically significant with increasing age (p < 0.001). There was no marked difference as regards gender (p = 0.72). CONCLUSION: Hearing loss is prevailing in patients with ß-thalassemia major on iron chelating agents. Therefore, regular hearing evaluations and periodic check-ups after the initiation of chelation therapy are mandatory.

Vitamin D receptor rs7975232, rs731236 and rs1544410 single nucleotide polymorphisms, and 25-hydroxyvitamin D levels in Egyptian children with type 1 diabetes mellitus: effect of vitamin D co-therapy.

Purpose: We aimed to examine the possible association role of vitamin D and vitamin D receptor (VDR) single nucleotide polymorphisms (SNPs) in type 1 diabetes mellitus (T1DM) development, glycemic control and complications among a cohort of Egyptian children. Subjects and methods: A prospective case-control study has been conducted on 50 Egyptian children with T1DM who were comparable with 50 controls. Vitamin D and HbA1c were measured. VDR-SNPs [ApaI (rs7975232), TaqI (rs731236) and BsmI (rs1544410)] detection was done by polymerase chain reaction through restriction fragment length polymorphism (PCR-RFLP) technique. Vitamin D supplements were given to the included T1DM children with low vitamin D and reassessments of both HbA1c% and 25(OH)D serum levels were performed in those children three months later. Results: Eighty percent of the included diabetic patients have poor glycemic control. Vitamin D was deficient in 68% and insufficient in 16% of diabetic patients. Significant improvements in both vitamin D and glycemic status among T1DM children, who have low vitamin D and received vitamin D supplementations. There were significantly negative correlations between serum levels of vitamin D with both HbA1c % (r= -0.358, P˂0.05) and daily insulin dose (r=-0.473, P˂0.05). Compared with controls, T1DM children presented more commonly with ApaI a allele (OR: 2.87; 95%CI: 1.39-5.91, P˂0.05) and BsmI b allele (OR: 4.38; 95%CI: 2.30-8.33, P˂0.05). TaqI t allele wasn't significantly differing among patients and controls (P˃0.05). Aa+aa and Bb+bb genotypes were significantly higher among T1DM vs the controls (OR: 3.08;, 95%CI: 1.33-7.15, P˂0.05 and OR: 9.33; 95%CI: 3.61-24.17, P˂0.05respectively). Conclusion: ApaI and BsmI were associated with risk of T1DM development among Egyptian children. Low vitamin D status was frequently occurring among T1DM with significant improvement in the glycemic control of such children when adding vitamin D supplements to the standard insulin therapy.

Role of Procalcitonin As an Inflammatory Marker in a Sample of Egyptian Children with Simple Obesity.

BACKGROUND: Obesity is a multifactorial disease, associated with metabolic disorders and chronic low-grade inflammation. Procalcitonin (PCT) is well known as a biomarker of infection, and systemic inflammation. Recently, it has potential as a marker for chronic low-grade inflammation. AIM: This study aims to evaluate the role of serum PCT as an inflammatory biomarker in the diagnosis of obesity-related low-grade inflammation. METHOD: In this case-control study, 50 obese and 35 normal weight children and adolescents aged 5-15 years were enrolled. Anthropometric parameters were measured in all subjects. Blood samples were collected for measurement of lipid profile, blood glucose, insulin, high sensitivity-CRP (Hs-CRP) and serum procalcitonin. Serum (PCT) levels were assessed using enzyme-linked immunosorbent assay. RESULTS: Obese participants had higher concentrations of serum PCT, total cholesterol, triglycerides, LDL-c, glucose and Hs-CRP than control group. On correlation analysis, procalcitonin had significant positive correlation with (BMI) z-score (P = 0.02), insulin (P = 0.00), insulin resistance (HOMA-IR) (P = 0.006), Hs-CRP (P = 0.02), total cholesterol (P = 0.04) and triglycerides (P = 0.00) in obese group. CONCLUSION: The increased serum procalcitonin concentrations were closely related to measures of adiposity, Hs-CRP and insulin resistance, suggesting that PCT may be an excellent biomarker for obesity-related chronic low-grade inflammation in children and adolescents.