Calcitonin gene-related peptide and its correlation with prognosis in severe pneumonia among children below 6 years at PICU of Al Zahraa university hospital.

Pneumonia is known to be the biggest cause of death in children younger than five years old. In pulmonary diseases such as pulmonary arterial hypertension, asthma, acute lung injury, and pulmonary fibrosis, calcitonin gene related peptide (CGRP) has been linked to the regulation of inflammation, proliferation, and fibrosis. However, its ability to foretell the emergence of severe pneumonia is questionable. We aimed to determine whether blood levels of CGRP correlate with the outcome of critically ill children. This case-control study included 45 children with severe pneumonia admitted to the pediatric intensive care unit and 45 children with matched age and sex as controls. We investigated the serum level of CGRP as well as routine laboratory investigations of both groups. The CGRP level was lower in the patient group with median of 77 ng/L ranged from 55 to 183 as compared to control group with median of 230 ng/L ranged from 133 to 664 (p≤0.001). Also, CGRP level was significantly higher in the survived group with median of 96.1 ng/L ranged from 55 to 183 than the non-survived group with median of 63.4 ng/L ranged from 55.5 to 120.9 (p=0.022). In conclusion, we found that serum level of CGRP was extremely low in critical and extremely critically ill patients, and thus can be used as a predictor of mortality in children with severe pneumonia.

The relationship between serum homocysteine and highly sensitive C- reactive protein levels in children on regular hemodialysis.

Hyperhomocysteinemia has attracted a lot of attention in renal patients, not only because of its close relationship with renal function but also because it has been implicated as an independent cardiovascular risk factor in these patients. An increased level of C-reactive protein (CRP) has been reported to be a strong predictor of cardiovascular mortality in hemodialysis (HD) patients. The aim of this study was to assess the association between homocysteine (Hcy) and highly sensitive CRP (hsCRP) in cardiovascular risk prediction in children with chronic kidney disease (CKD) on HD. This case-control study was conducted on 40 children with CKD on regular HD and 20 age- and sex-matched healthy children as controls. Their ages ranged from 4 to 18 years, and they were selected from the pediatric nephrology and HD unit at Al-Azhar University Hospital, during the period from May 2015 to April 2016. Complete blood count, serum ferritin, cholesterol, triglycerides, calcium, phosphorus, parathormone (PTH), Hcy, and hsCRP levels were measured in both groups. Measurements of anthropometry and blood pressure (BP) were performed. There was a significant increase in serum Hcy levels in cases than controls; it was 17.22 ± 9.66 pmol/L and 6.32 ± 1.47 pmol/L, respectively (P <0.01). Furthermore, there was a significant increase in hsCRP in patients than controls; 2.73 ± 2.65 and 0.9 ± 0.85, respectively (P <0.01). There was a significant positive correlation between hsCRP and Hcy with BP, cholesterol, triglyceride, PTH, and ferritin levels. Our data highlighted the important correlation between serum Hcy and hsCRP to detect high-risk patients for subsequent cardiovascular disease and utility of preventive strategies that attenuate inflammatory risk.

Leptin and Lipid Profile in Overweight Patient with Type 1 Diabetes.

AIM: To evaluate leptin and lipid profile in overweight patients with type 1 diabetes. PATIENTS AND METHODS: The study included 50 overweight patients with type 1 diabetes and 50 age and sex matched healthy controls. Blood samples were taken for evaluation of glycosylated haemoglobin, lipid profile and leptin. Also, urine samples were taken for evaluation of albumin/creatinine ratio. RESULTS: Leptin level was significantly lower in overweight with type 1 diabetes and showed a significant positive correlation with hip circumference and body mass index and negative correlation with glycosylated haemoglobin (HbA1c). Leptin level was significantly lower in overweight diabetic patients with HbA1c > 7.5 %. The best cut-off point between overweight diabetic group and control group regarding leptin levels was found at 16.9 (ng/ml) with a sensitivity of 68% and specificity of 56%, area under the curve 0.623. CONCLUSION: Leptin levels were found to be low in overweight patients with type 1 diabetes and showed correlation with the body mass index and hip circumference. LDL was significantly higher while HDL was significantly lower in the diabetic, overweight group indicating increased risk of cardiovascular disease. Leptin level in overweight diabetic patients might be related to the metabolic control.