Evaluation of the efficacy and safety of radiofrequency ablation in treatment of supraventricular tachycardias in pediatric age group

The present study aimed to assess the efficacy and safety of radiofrequency [RF] catheter ablation in treatment of Supraventricular tachycardia [SVT] in children. A total of 60 pediatric patients with clinically documented SVT underwent an electrophysiologic study and RF catheter ablation at Mansoura University Children Hospital. The arrhythmias included alrioventricular reentrant tachycardia [AVRT; n = 45, 75%], atrioventricular nodal reentrant tachycardia [AVNRT; n = 6, 10%], and atrial tachycardia [AT; n = 9, 15%]. The success rate of the RF catheter ablation was 93.3% for AVRT, 66.7% for AVNRT, and 77.8% for AT, respectively. Procedure-related complications were infrequent [7/60, 11.7%], [atrial flutter during RF catheter ablation [4/60, 6.6%]; ventricular fibrillation during RF catheter ablation [1/60,1.6%]; transient complete heart block during anesthesia or during RF catheter ablation [2/60, 3.3%]]. The recurrence rate was 8.3% [5/60] during a follow-up period of 24 months. RF catheter ablation is an effective and safe method to manage children with SVT

Detection of bordetella pertussis by PCR in infants with respiratory failure

Despite being under-reported, Bordetella pertussis injection remains a severe disease of high incidence world-wide. No cases were reported in Egypt since 2001. Different immunization protocols exist in different countries with variable vaccination coverage ratios. This prospective investigation study was conducted in the PICU of Mansoura University Children Hospital. Mansoura, Egypt identifying cases of B. pertussis infection among mechanically ventilated infants presenting with respiratory failure and features compatible with pertussis [bronchopneumonia, apnoea, acute life threatening event]. Infants less than one year of age were enrolled over a period of 12 months. Sixty one specimens of endotracheal secretions were examined by PCR for the presence of a 262-bp target sequence from IS481 specific for B. pertussis. Nine specimens were positive for B. pertussis, five infants in this group did not survive. All non survivors were younger than 6 months of age. Infants in the PCR-positive group had a younger age [p = 0.038], a longer duration of illness prior to PICU admission [p < 0.01] and a higher mortality rate [p = 0.045] compared to the PCR - negative infants. It is crucial to raise awareness, among medical professionals, of clinical picture, complications and treatment of pertussis, If immunization program of Egypt was to be reviewed, there may be a need for a more accelerated primary immunization program against pertussis with booster doses for young adults

Lymphocyte apoptosis and proliferation related gene products in childhood acute lymphoblastic leukemia

The aim of the study is to characterize markers of apoptosis in children with ALL in relation to treatment outcome of the disease. The study was performed on 34 children with ALL and 60 healthy children as a control group. Apoptosis was assessed by cell morphology; DNA fragmentation; ELISA and RT-PCR for CD95, CD95L, BcL2 and NF-KB; and flowcytometry for CD95, CD40, CD49d, and CD11a. Apoptosis was significantly lower in cases than controls. Apoptosis detected by CD95 ligand was significantly lower in cases with no remission after treatment than those with remission. Antiapoptotic factors: CD40, BcL2, and NF-KB were all found to be higher in cases than controls and in cases with no remission than those with remission, CD49d was significantly lower in cases than controls, and significantly lower in cases with no remission. CD11a levels were not different among various groups. Delayed apoptosis of ALL cells is genetically controlled either directly or indirectly by a network of oncogenes and tumor suppressor genes. CD40 appeared to stimulate both T and lineage and is considered the most potent influencer and predictor to resistance to therapy. Inhibitors for the activity of CD40, 8c/2 and NF-kB as well as stimulants to CD95 could have a potential therapeutic benefit

Growth in infants and children with congenital cyanotic and acyanotic heart disease: impact of serum leptin and hemodynamic abnormalities

This work was carried out to study growth parameters, serum leptin and different hemodynamic data in infants and children with cyanotic and acyanotic congenital heart disease [CHD] to delineate any abnormality and the correlation between different studied parameters. The study included 44 patients with CHD divided into 2 groups cyanotic CHD/acyanotic CHD [23/21], the cyanotic group was further subdivided according to pulmonary blood flow [PBF] into patients with decreased PBF/patients with increased PBF [15/8] based on echocardiographic study and cardiac catheterization in some patients. Another 12 healthy children of matched age and sex served as a control group. Patients were subjected to clinical examination, anthropometric measurements according to Roles of Tanner. Laboratory investigations were performed for all the studied groups including arterial oxygen saturation, hemoglobin level, arterial oxygen content and serum leptin level using immunoenzymometric assay. The results showed that patients with CHD had growth retardation compared to healthy Egyptian infants and children of matched age and sex. Height was affected more that weight in both groups while weight and mid arm circumference [MAC] were affected more in the cyanotic group. Body mass index [BMI] was not so affected in both groups. On the other hand, serum leptin level showed no significant difference between both groups and between patients and control group, In addition, arterial oxygen contents showed no significant difference between all the studied groups. The degree of left to right shunt [QP/QS] in patients with acyanotic CHD was negatively correlated with weight standard deviation score [SDs], MAC SDs, BMI SDs and serum leptin level. CHD is associated with reduction in weight, height and MAC. The increased QP/QS ratio in acyanotic CHD is correlated with the degree of retardation in weight, MAC and BMI. Serum leptin levels show no significant difference between groups which exclude the role of leptin in the pathogenesis of weight loss in patients with CHD