Effect of honey supplementation on clostridium difficile infection in childhood cancer

Background: the treatment of cancer is associated with nausea and vomiting, oral mucositis, constipation, xerostomia and diarrhea and weight loss, additionally; chemotherapeutic agents promote inflammatory changes in the gut, intestinal necrosis, and anaerobic conditions, allowing proliferation of Clostridium Difficile. Honey, as a natural honeybee product, has antioxidant, antimicrobial, immunomodulatory and anticancer effects. Honey can fight microbial infection by its immuno-activating, anti-inflammatory and prebiotic activity

Objectives: the aim of this study was to evaluate the effect of honey supplementation on frequency of Clostridium Difficile infection [CDI] and gastrointestinal complications in pediatric patients undergoing chemotherapy

Design: a cross sectional study conducted on 40 patients with malignancy recruited from Children's Hospital, Ain Shams University, Oncology Unit and Clinic, Cairo, Egypt in the period from December 2015 to December 2016. Patients were divided into two groups; group I [25 patients] received honey in the dose of 2gm/kg 3 times dailyfor 1month] while group II [15 patients] did not receive honey. All the studied patients were subjected to medical history and clinical examination, with special emphasis on gastrointestinal complication including oral mucositis, vomiting, diarrhea, constipation, and abdominal pain. Follow up was done for weight, height z score, gastrointestinal complications and any adverse events. Stool analysis, culture, C difficle toxin A, B by ELISA was done to all patients at baseline and repeated to patients receiving honey at week 4 of supplementation. Main outcome measure frequency of CDI, gastrointestinal complication, febrile neutropenia

Results: the frequency of C difficle was 8% [2], the first case was 9 years old patient with ALL [50%] and the other 11 years old patient with Burkitts lymphoma both were diagnosed by positive stool culture and positive stool ELISA for toxin A, B. gastrointestinal complications were significantly less and improved in the supplemented group and mean of hemoglobin significant increase in group 1

Conclusion: the frequency of CDI in children with cancer 8% diagnosed by stool culture and toxin A, B study in stool. Honey improved the oral mucositis and different GIT complications associated with chemotherapy

Certain tumour markers in long standing chronic hepatitis B and C in Egyptian beta thalassemia

B-thalassemia major is the most Common haemolytic disease in Egypt and is transfusion dependent disease. Thalassemic patients have high prevalence of HCV and HBV. A study involving 135 polytransf used thalassemic Egyptian children was conducted from haematologic clinic Faculty of Medicine, Ain Shams Univesity and Ahmed Maher Teaching Hospital to determine the prevalence of HCV and HBV and the rule of blood transfusion in the spread of the virus and also to determine the levels of tumor markers AFPand CA 19.9 in the sera of the patients for early detection of HCC in polytransfused thalassemic patients with long standing chronic HCV and HBV. Also 25 healthy children considered as control group. Serum specimens were assayed for hepatitis markers [HBsAg, HBsAb, HBcAb [IgG, IgM] and HCV antibodies]. The result of this study showed that the prevalence of combined HCV and HBV was the highest one 79.2% then HBV only 10.4% then HCV antibodies 8.9% and lastly 1.5% had no any markers for HBV and HCV. Positive hepatitis cases were associated with increased duration of illness, and volume and number of transfusion when compared with negative cases. The high prevalence of HCV antibody [87.4%] among multitransfused children suggests that blood and blood products supplies should be regularly screened for HCV antibody. AFP and CA 19.9 measurements in cases showed that there is slight non significant increase in the level of both compared with control. Measuring of AFP and CA 19.9, liver sonography, isotope liver scan for selected cases showed no evidence of HCC in these patients