Brain Volume and Doppler Velocimetry in Growth-Restricted, Small-for-Gestational-Age, and Appropriate-for-Gestational-Age Fetuses.

Objective This study aims to detect possible differences in fetal brain volumes between growth-restricted fetuses (FGR), small-for-gestational-age (SGA) fetuses with normal Doppler indices, and appropriate-for-gestational-age fetuses (AGA). Study Design Three-dimensional measurements of fetal brain volume and umbilical artery and middle cerebral artery (MCA) pulsatility index (PI) and resistance index (RI) were made in 80 AGA fetuses, 68 SGA fetuses with normal Doppler indices, and 68 FGR with brain-sparing effect between 32 and 36 weeks of gestation. Results MCA-PI and MCA-RI were significantly lower in FGR group compared with the other two groups (p < 0.001). Brain volume was significantly lower in SGA and FGR groups compared with AGA group (p < 0.001). Conclusion Brain volume is significantly lower in SGA and FGR groups compared with AGA group.

Health problems among street children seeking care in the Center for Social and Preventive Medicine in Egypt.

BACKGROUND: In Egypt, around 1 million children are on the streets. Street children's health is an issue that is not well researched. The objective of the current study was to determine the health problems of a targeted group of street children seeking medical care and to generate a hypothesis about the positive/negative role of street children care organizations. METHODS: A cross-sectional study was done on 2169 street children who sought medical care at El-Basma clinic at the Center for Social and Preventive Medicine in Cairo University Children Hospital from January 2011 to July 2014. RESULTS: Respiratory illnesses and skin problems were the most prevalent conditions, affecting 485 (22.4%) and 359 (16.6%) of the patients, respectively. Psychological issues and trauma were significantly higher among the adolescent group. Respiratory and gastrointestinal problems were significantly higher among children aged less than 2 years. Genital and cardiac problems were significantly higher among those referred from organizations whereas trauma was significantly higher among those coming directly from the streets. A significant proportion of children at the extremes of the studied age spectrum were coming directly from the streets. Sexually transmitted infections were rare problems. CONCLUSIONS: Respiratory and skin diseases were the major morbidity problems among street children, especially adolescent males. Organizations afforded opportunities for access to different health care services.

Vitamin D deficiency in Egyptian mothers and their neonates and possible related factors.

OBJECTIVE: To correlate vitamin D level in Egyptian mothers with that of their newborns, and examine risk factors related to maternal vitamin D deficiency. METHODS: A cross-sectional study was carried out at the university teaching hospital in Cairo, Egypt. Serum 25(OH) D levels were measured by enzyme-linked immunosorbent assay in 135 pregnant women at ≥37 weeks' gestation immediately before delivery and in cord blood of their newborns. RESULTS: The levels of serum 25(OH) D were 32.6 ± 21.4 ng/ml in mothers and 16.7 ± 10 ng/ml in their newborns. Maternal vitamin D level was strongly correlated with that of the newborns (r = 0.7, p < 0.0001). Maternal vitamin D deficiency/insufficiency and neonatal vitamin D deficiency/insufficiency were encountered in (40%, 28.9% and 60%, 32.6% respectively). Maternal vitamin D levels showed significant correlations with maternal body mass index (BMI; r = -0.201, p = 0.021), gestational age at delivery (r = 0.315, p ≤ 0.0001), fish consumption (r = 0.185, p = 0.032), educational level (r = 0.29, p = 0.001), and skin exposure (r = 0.247, p = 0.004). CONCLUSION: Maternal vitamin D levels strongly correlate with neonatal levels. Maternal vitamin D deficiency is a real problem in Egypt; this is generally related to high BMI, low fish consumption, low educational level, and limited skin exposure.

The expanded clinical profile and the efficacy of colchicine therapy in Egyptian children suffering from familial Mediterranean fever: a descriptive study.

BACKGROUND: Familial Mediterranean fever (FMF) is an autosomal recessive disease characterized by self-limiting recurrent attacks of fever and serosal inflammation, leading to abdominal, thoracic or articular pain. OBJECTIVE: To detect variable clinical presentations and genotypic distribution of different groups of FMF patients and the efficacy of colchicine therapy in treatment of these groups of FMF after one year. METHODS: A cross-sectional study was conducted on 70 patients already diagnosed with FMF and following-up at the Rheumatology Clinic, Children's Hospital - Cairo University. Diagnosis of FMF was determined according to Tel Hashomer criteria for FMF. All patients were subjected to a questionnaire including detailed history with emphasis on clinical manifestations and colchicine dose to control attacks. Mutational analysis was performed for all study subjects covering 12 mutations in the MEFV gene: E148Q, P369S, F479L, M680I (G/C), M680I (G/A), I692del, M694V, M694I, K695R, V726A, A744S and R761H. Response to colchicine treatment was evaluated as complete, incomplete and unresponsive. RESULTS: Out of the 70 patients- 40 males and 30 females- fever was the most common presenting feature, followed by abdominal pain, and arthritis; documented in 95.7%, 94.3%, and 77.1% of cases respectively. Mutational analysis detected gene mutation on both alleles in 20 patients (homozygotes), on only 1 allele in 40 patients (heterozygotes), and on none of the alleles (uncharacterized cases). Mild to moderate disease severity score (according to Tel Hashomer key to severity score) was detected in a significant proportion of heterozygotes and the uncharacterized group than the homozygotes. All patients received colchicine therapy; 22.9% of them showed complete response, 74.3% showed incomplete response and 2.9% showed no response to therapy. The colchicine dose needed to control attacks was significantly lower in heterozygotes than the homozygotes(P=0.04). Also patients' response to colchicine therapy was significantly better in the heterozygous group(P=0.023). CONCLUSION: Fever, abdominal pain and arthritis are the most common presenting features for homozygous, Heterozygous and uncharacterized patients. E148Q, V726A, and M680I were the most common mutations detected in the heterozygous group. Homozygosity were found for M680I, M694V, and M694I mutations in 13 patients (65% of homozygotes). Heterozygotes presenting with severe phenotype should be further analyzed for less common second MEFV mutation using gene sequencing. The colchicine dose required to control the attacks was significantly lower and patients' response to colchicine therapy was significantly better in the heterozygous group than homozygous group.