Pediatric Sciences Journal最新文献

{"title":"Fluid responsiveness in children with Septic shock is not a Reliable Predictor of outcome: Single Center Experience","authors":"S. Ishak, R. Mandour, Ahmed Behairy, Doha El Shirbeny, E. Ahmed","doi":"10.21608/cupsj.2022.175796.1085","DOIUrl":"https://doi.org/10.21608/cupsj.2022.175796.1085","url":null,"abstract":"Background: Fluids are an integral line of management of septic shock as circulatory instability and myocardial dysfunction are the major causes of death in septic shock. Several indicators of fluid responsiveness (FR) have been proposed. Aim of the Work: to assess predictive value of assessment of fluid responsiveness on outcome of children with sepsis. Methods: This study was a prospective observational cohort study which was conducted on 25 children who were admitted to Pediatric Intensive Care Unit with septic shock at Children Hospital, Cairo University from February 2020 to May 2020. All underwent bedside echocardiography assessment of fluid responsiveness (FR) using inferior vena cava’s (IVC) diameter: distensibility, collapsibility, variability indices and time velocity integral across aortic valve before and after fluid resuscitation. Results: The mean age ± SD of the studied cohort was 33.72 ± 39.65 months, 17 (68%) were males and 8 (32%) were females. All patients presented by septic shock, of them 13 (52%) were fluid responsive and 12(48%) were fluid nonresponsive (p=0.118). FR was different between ventilated patients and non-ventilated patients as regards IVC variability % before and after IV fluids (p= 0.001) and (p=0.001) respectively, stroke volume and cardiac output after IV fluids (p =0.033) and (p=0.001) respectively. FR correlated with central venous pressure measurements (p=0.000017) and inotropic support (p=0.0074) but not with main diagnosis of septic shock, mechanical ventilation of patients or not and not with number of system failure. Ten (40%) of them were on mechanical ventilation and inotropes. Nineteen (76%) improved and 6 (24%) died. There was no correlation between FR and outcome (p= 0.316). Conclusion: Bedside echocardiography may be a useful non-invasive method for follow up, evaluation of fluid responsiveness in children septic shock and to assess CI which helps in assessment of fluid response, make decision on medication, and help evaluate the different forms of shock, but it has no significant relation to the outcome of these children. Outcome of septic shock is multifactorial, depends on timing of diagnosis, fluid administration, inotropic support, and cardiac condition not fluid responsiveness only. Level of Evidence of Study: IV (1).","PeriodicalId":153483,"journal":{"name":"Pediatric Sciences Journal","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117142702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular Complications and Indoxyl Sulfate Are Related to Longer Duration of End Stage Renal Disease in Children","authors":"Fatina I. Fadel, N. El-Anwar, Fatma Abdel Maksoud, N. Mohamed, Yasmin Ramadan","doi":"10.21608/cupsj.2022.170954.1076","DOIUrl":"https://doi.org/10.21608/cupsj.2022.170954.1076","url":null,"abstract":"Background: Indoxyl sulfate (IS) is a non-dialyzable gut-derived uremic toxin that is reported to be cardiotoxic in patients with advanced chronic kidney disease stages. Aim of the Work: The aim of this study was to investigate the role of IS as a risk factor for cardiovascular complications in children with end stage kidney disease (ESKD) on regular HD. Patients and Methods: This is a cross-sectional analytical study that included children with ESKD on regular hemodialysis (HD) for at least 6 months following at Nephrology Unit of Cairo University Pediatric Hospitals. Serum IS level was measured for all patients by the enzymelinked immunosorbent assay (ELISA). Cardiac complications was assessed using the M mode and 2D transthoracic echocardiography. Results: The study comprised 88 children with ESKD on regular HD for a mean ± SD of 31.94 ± 26.05 months, with a mean age ± SD of 9 ± 3.2 years (range 3.314 years). Of them 52 (59.1%) were males. Obstructive uropathy (28.4%), and focal segmental glomerulosclerosis (20.5%), were the main causes of ESKD in the study group. Cardiovascular complications were identified in 48 (54.5%) patients in the form of dilated cardiomyopathy in 44 (50%) children with decreased fractional shortening <30% and moderate to severe left ventricular hypertrophy above 95th for age and gender in 10 (11.4%). Cardiovascular affection correlated with duration of HD, hypertension, and IS serum level (p=<0.001 for each). Hypertension was reported in 55 (62.5%) of patients, and vascular access related complications were evident in 40 (45.4%) patients with thrombosis being the commonest complication in 16 (18.1%). The mean IS was 29.14 ± 17.43 μg/ml in ESKD patients with normal cardiac function, and 77 ± 15.18 μg/ml among those with cardiac compromise (p < 0.001). The IS level correlated with longer duration of HD (p= 0.002), and older age (p= 0.043). IS level and duration of HD did not predict cardiomyopathy, (p=0.192), and (p=0.760) respectively. Conclusion: Cardiac complications are common among children on HD. Both cardiovascular complications and IS accumulation correlated positively with longer duration of HD, and age of children with ESKD. IS is non-dialysable and there is a need to control its production from the gut. Level of Evidence of Study: IV (1).","PeriodicalId":153483,"journal":{"name":"Pediatric Sciences Journal","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129925062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency and Risk Factors of Early Complete Heart Block Post Cardiac Surgery in Children: A Multicenter Prospective Study","authors":"L. A. Ibrahim, Mohammed Soliman, Asmaa Gad Elkarim, Amira Esmat El Tantawy","doi":"10.21608/cupsj.2022.175068.1081","DOIUrl":"https://doi.org/10.21608/cupsj.2022.175068.1081","url":null,"abstract":"Background: Complete heart block (CHB) remains a foremost complication post cardiac surgery with subsequent medical, social, and financial burden. Aim of work: To evaluate the frequency of early permanent CHB in children and assess the contributing risk factors among children with congenital heart disease (CHD) who underwent surgical correction. Material and Methods: A prospective descriptive study included 1668 patients post cardiac surgery, they were enrolled from two tertiary centers; Cairo University Children Hospitals and Atfal Misr Insurance Hospital, from February 2019 to February 2020. Medical history, examination, perioperative data as aortic clamp time and cardio bypass times and electrocardiogram were recorded. Results: from a total of 1668 patients, 50 (3%) developed early permanent CHB. Their mean age at the time of the operation was 59.37 ± 41.91months (median:19 months, range: 5-144 months), 62% were males and 38% females. They underwent total surgical repair for Fallot tetralogy in 25 (50%) patients, ventricular septal defect in 14 (28%), atrial septal defect in 3 (6%) and common atrioventricular canal in 6 (12%). All 50 patients had undergone clamping of the aorta for a mean ± SD of 42.6 ±16.05 min, (median: 42 min, range: 5-105 min) and cardio bypass with a mean ± SD of 65.4±20.34 min, (median:60, range:10-145min). Prolonged aortic clamp (p=0.001) and cardio bypass times (p=0.003) were important risk factors of CHB. Thirty-eight (76%) patients were scheduled for pacemaker implantation, 12 (24%) died from complications of prolonged surgery. Mortality was related to younger age (p=0.027), and prolonged ICU stay (p=0.001). Conclusion: The frequency of CHB post open cardiac surgery was 3%. Early permanent CHB is related to perioperative parameters as aortic clamp time and cardio bypass time. Mortality in patients with CHB is linked to younger age, and prolonged ICU stay. Level of Evidence of Study: IV (1).","PeriodicalId":153483,"journal":{"name":"Pediatric Sciences Journal","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133708039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hair coil strangulation of the penis in children: Single center experience in a decade.","authors":"A. Shouman, M. Abd El Wahab, M. Elgharably, A. Mostafa","doi":"10.21608/cupsj.2022.175457.1084","DOIUrl":"https://doi.org/10.21608/cupsj.2022.175457.1084","url":null,"abstract":": Background : Penile hair coil strangulation is a rare condition that might culminate in penile gangrene and amputation. Aim of work : To report clinical presentation, management, complications and outcomes of hair coil strangulation of the penis in the pediatric age. Material and Methods : We reviewed the data of 31 patients who presented with penile hair coil strangulation between January 2010 and December 2020 to the Urology Department at Cairo University Specialized Pediatric Hospital. Injury was graded as proposed by Bashir and El Barbary. Data regarding presentation, surgical intervention, complications and the outcomes were recorded. Results : Mean age at presentation was 4.43 ±2.5 years. Thirty (97%) patients presented in the strangulation phase. Onset of symptoms was estimated to be 1-4 weeks earlier. All boys were circumcised. None had any neurological disease. Hair coil removal and medical management (antiseptic, antibiotics, anti-inflammatory) was done for all patients on the day of presentation. Examination under anesthesia and hair removal was done for 7 (22.5%) boys. Urinary diversion was not done on day of presentation. Mean follow up period was 22.5±8.65months (6 - 36). Five (16%) boys had superficial skin injury grade (0) and were managed conservatively, 19 (61%) had partial transection of the urethra grade (1), 6 (19%) had complete transection of the urethra grade (2) and 1 (3%) had transection of the spongiosum and the cavernosum with amputated glans grade (3). Surgical intervention was delayed for 3 months after hair coil removal. Twenty six boys (84%) needed surgical intervention. Mean duration until catheter removal was 7.65±3.05 days (5-14). Twenty four boys (92%) had satisfactory cosmetic outcome (normal looking glans, no constriction ring), 2 (8%) had persistent constriction ring which was surgically corrected later and 4 (15.38%) had small urethrocutaneous fistula which was repaired after 6 months. None of our boys developed anastomotic strictures. Success rate was 77% after primary surgery. Conclusion : Penile hair coil strangulation is a rare condition that can be easily misdiagnosed as balanitis, proper diagnosis requires high index of suspicion. Delayed single stage surgical intervention gives chance for inflammation to subside with satisfactory functional and cosmetic outcome.","PeriodicalId":153483,"journal":{"name":"Pediatric Sciences Journal","volume":"99 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123279335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Predictors for Outcome of Continuous Positive Airway Pressure in Respiratory Distress Syndrome in Preterms: Single Center Study","authors":"Amira M Sabry, R. Saber, D. Khairy, A. Edris, M. El-Baz","doi":"10.21608/cupsj.2022.169956.1074","DOIUrl":"https://doi.org/10.21608/cupsj.2022.169956.1074","url":null,"abstract":"Background: Applying mechanical ventilation (MV) to premature lungs carries many risks, up to lung injury and bronchopulmonary dysplasia. Stabilization with continuous positive airway pressure (CPAP) avoids intubation and invasiveness. Aim of work: To evaluate the predictors of outcome of nasal CPAP on preterms with respiratory distress syndrome (RDS). Material and Methods: This prospective observational study included all preterms with RDS that necessitated CPAP introduction (according to the European Consensus Guidelines on the Management of RDS), who were admitted to the Neonatal Intensive Care Unit (NICU) of Department of Pediatrics, Cairo University Hospitals, from February to July 2019. CPAP was initiated in the first 2 hours of life. Respiratory compromise was assessed using Silverman score. Hematological scoring system (HSS) was studied as a predictor of outcome. Those who did not need subsequent intubation were labeled CPAP success group and were compared to the group where CPAP failed. Results: Over 6-months, 508 preterm with gestational age (GA) 27-33 weeks with RDS were admitted to our NICU, of them 61 (mean GA± SD of 32.08 ± 1.98 weeks) were included in the study. Of them 35 (57.4%) were males and 26 (42.6 %) females. CPAP was successful in 37 (60.7%) and Silverman score improved 2 hours after CPAP. Their initial median (IQR) of Silverman score was 5 (range 3-6) and improved to 1 (range 1-2) 2 hours after CPAP, while in the failure group, it was 6 (range 5-7) initially and worsened to 8 (range 7.5-9) (p=0.026). Antenatal steroids administration was highly protective (p= 0.000) but not GA p=0.086) or gender (p=0.521). Initial severe RDS in chest X-ray at birth was present in 1 (2.7 %) preterm in the CPAP success group and 10 (41.7 %) in the failure group (p=0.000). The systolic blood pressure ≤ 66, HSS, chest X-ray before CPAP, non-improvement of chest X-ray after CPAP and apnea were the important predictors for CPAP failure (p= 0.023), (p= 0.090), (p= 0.025), (p= 0.011) and (p= 0.049) respectively. Conclusion: Trials of CPAP for preterms with severe RDS with hemodynamic stability are effective in obviating the need for more invasive MV. Factors including hypercarbia, apnea, poor respiratory efforts, systemic hypotension, higher Silverman score and HSS ≥5 were the most significant associations of failed CPAP. Level of Evidence of Study: IIA (1).","PeriodicalId":153483,"journal":{"name":"Pediatric Sciences Journal","volume":"97 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133317236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depression and Anxiety in Children with Congenital Adrenal Hyperplasia","authors":"S. Hassanein, N. Badawi, Dina Afifi, R. Gamal, A. Ibrahim","doi":"10.21608/cupsj.2022.143452.1065","DOIUrl":"https://doi.org/10.21608/cupsj.2022.143452.1065","url":null,"abstract":": Background : Congenital adrenal hyperplasia (CAH) is a genetic chronic disease in which both adrenal insufficiency and adrenal androgen excess coexist associated with life-long therapy, supraphysiological dose of glucocorticoid and demanding psychological aspects. Patients and methods : This cross sectional study included 33 children with CAH who were following up at Endocrinology outpatient clinic, Specialized Pediatric Hospitals, Cairo University Hospitals, Egypt, and apparently age and gender- matched healthy 33 normal children as controls. Depression severity was assessed using the Children’s Depression Inventory (CDI) and the Spence Children’s anxiety Scale was used to assess six areas of anxiety in both studied groups. Results : The CAH comprised 16 (48.5%) girls and 17 (51.5%) boys with mean ±SD age of 9.63years ± 2.5 and 9years ± 2.82 respectively. According to Spence score none of the cases and controls had abnormal anxiety level of more than 60 which is considered the highest level of normal. The mean ±SD of total anxiety score in the cases (36.27±8.55) was higher mean ±SD of total anxiety score in the control group (30.15±3.52) (p=0.005). The mean ±SD of the CDI score of the cases was 13.79±5.16, while that of the control group was 11.115±2.7, which was not statistically significant (p=0.080). But mild depression was found in 12 (36.4 %) of CAH cases and moderate depression in 3 (9.1%). The total score of CDI and Spence anxiety scale correlated positively with current age of the cases (p=0.006) and (p= 0.028) respectively, androstenedione level (p= 0.001) and (p= 0.0001) respectively, 17 hydroxyprogesterone level (p=0.001) and (p= 0.0001) respectively, age at genitoplasty surgery (p= 0.006) and (p= 0.006) respectively, dose of hydrocortisone (p=0.0001) and (p= 0.002 respectively), and negatively with age at diagnosis (p=0.036) and (p= 0.008 respectively. Conclusion : Not all cases of CAH had depression and none of them had abnormal anxiety level. Early genitoplasty surgery was a protecting factor for CAH cases against development of depression and anxiety, while disease chronicity with high glucocorticoid dose therapy was a precipitating factor for depression in those children.","PeriodicalId":153483,"journal":{"name":"Pediatric Sciences Journal","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116679520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neonatal Biliary Obstruction Caused by Pancreatic Kaposi Hemangioendothelioma","authors":"M. Kotb, S. Kaddah, S. E. El Sorogy, Reham Mahmoud, Naglaa El Kinaaiee, Sayed Khedr, M. Gad","doi":"10.21608/cupsj.2022.141453.1056","DOIUrl":"https://doi.org/10.21608/cupsj.2022.141453.1056","url":null,"abstract":": Kaposiform hemangioendothelioma (KHE), is a rare benign locally invasive proliferation of blood vessels that forms a mass. Besides the mass effect of KHE, it infiltrates adjacent tissues, it can be associated with severe thrombocytopenia, consumptive coagulopathy with high mortality rate. The manifestations of KHE are variable and range from cutaneous lesions with wide varieties of appearances to deep masses without cutaneous signs. We report a case of 3 month old male who presented as extrahepatic biliary atresia in the form of jaundice, hepatomegaly, clay colored stool and elevated liver enzymes. Dynamic Magnetic Resonance Imaging revealed pancreatic head solid mass. Operative findings and biopsy of the highly vascular lesion confirmed that it was KHE of head of pancreas. The mass was excised and hepato-portoenterostomy was successfully performed. One year later the boy is disease free with no organomegaly or any other complication. KHE of head of pancreas is a very rare cause of extrahepatic biliary obstruction early in life. It is amenable to successful surgical intervention. of )","PeriodicalId":153483,"journal":{"name":"Pediatric Sciences Journal","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115138491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Care Bundle Application Decreases The Frequency and Severity of Intraventricular Hemorrhage in Preterm Neonates: Single Center Study","authors":"Sara S. Eltatawy, A. Gad, T. Eissa, Salma Z. El Houchi, Amira M Sabry","doi":"10.21608/cupsj.2022.142531.1061","DOIUrl":"https://doi.org/10.21608/cupsj.2022.142531.1061","url":null,"abstract":": Background: Intraventricular hemorrhage (IVH) is a severe complication in preterm babies admitted to Neonatal Intensive Care Units (NICU). Advanced stages of IVH predispose to neurological deficits such as cerebral palsy and hydrocephalus. There are numerous strategies and policies implemented in NICUs around the world to decrease the incidence of IVH in preterm babies and prevent its ensuing neurodevelopmental complications. Aim of the Work: To study the effect of implementing a bundle of care on incidence and severity of IVH among preterm neonates. Materials and Methods: Retrospective analysis of patient records for incidence and severity of IVH between May and August 2018 was done. This was followed by an educational interim period where NICU staff received training of pre-natal, natal, and postnatal care bundle guidelines to reduce IVH. The guidelines were then implemented on all preterm babies (28-34 weeks gestational age (GA)) born and admitted to Kasr Al Ainy Teaching Hospital NICU, Cairo University between October 2018 and January 2019 (n=58). Cranial ultrasonography was performed at week 1 and week 2-3 of life. Frequency and severity of IVH were compared among studied groups. Risk factors for IVH were analyzed and recorded. Results: The frequency of IVH was significantly lower in the post-bundle group (44-46% pre-bundle, and 27% post-bundle) especially evidenced by the ultrasonography in week two of life. Severity of IVH also improved post bundle since there were no grade III IVH patients in that group. Exposure to hypocapnia, blood pressure fluctuations, IV fluid boluses and administration of sodium bicarbonate were significantly correlated with development of IVH in preterm babies (p = 0.001). Conclusion: Implementation of an IVH care bundle that includes perinatal measures can positively affect the neurological outcome by decreasing incidence and severity of IVH in preterm babies.","PeriodicalId":153483,"journal":{"name":"Pediatric Sciences Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130977756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Activin A is Not a Reliable Prognostic Biomarker For Bilirubin Induced Neurotoxicity in Neonates","authors":"E. Elmazzahy, I. Iskander, Hazem S. Abou-Youssef, H. Madani, Sara S. Eltatawy","doi":"10.21608/cupsj.2022.245869","DOIUrl":"https://doi.org/10.21608/cupsj.2022.245869","url":null,"abstract":": Background: Bilirubin induced neurological dysfunction (BIND) remains an important cause of disability in developing countries. Although high total serum bilirubin (TSB) is the main instigator for BIND, different babies may have different neurological outcomes at the same TSB level. This reflects the need for a more specific predictive factor for the neurological outcome, which would allow prompt intervention and prevention of kernicterus. Aim of the Work: To assess the value of serum activin A as a predictor for acute bilirubin neurotoxicity and adverse neurodevelopmental outcomes at one year of life. Materials and Methods: The study enrolled 84 term/near-term infants admitted with indirect hyperbilirubinemia requiring intervention to the Neonatal Intensive Care Unit of Cairo University Children’s Hospital. Clinical examination, BIND score and laboratory tests including activin A were performed. Neurodevelopmental outcome was assessed at 3, 6 and 12 months using the Bayley scale of Infant Development II. Correlations between serum activin A, TSB, BIND scores and Bayley scores were studied. Results: Mean TSB level at admission was 25.92±7.14 mg/dL. BIND score at admission ranged from 0-7, and mean serum activin A level was 109.92±55 pg/ml. Activin A did not show significant correlations with TSB or BIND scores. A negative correlation between activin A level and psychomotor developmental index (PDI) at 3 months was detected however all other neurodevelopmental outcomes showed no significant correlation with activin A. Conclusion: In cases of neonatal hyperbilirubinemia, activin A is not a reliable biomarker for predicting acute or chronic bilirubin induced neurotoxicity. of Normal developmental indices of PDI MDI are ≥ Mild delay is defined at scores of and severe delay is defined at scores of ≤","PeriodicalId":153483,"journal":{"name":"Pediatric Sciences Journal","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126265770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thrombocytopenia is more Frequent in Gram negative Neonatal Septicemia","authors":"Eman Abobakr Abd Alazem, E. A. Abdel Ghany, S. Zaky, M. Abd Elhady","doi":"10.21608/cupsj.2022.115388.1043","DOIUrl":"https://doi.org/10.21608/cupsj.2022.115388.1043","url":null,"abstract":": Background : Sepsis is one of the major causes of neonatal thrombocytopenia. Aim of the work: To identify the frequency, severity, and clinical outcome of thrombocytopenia associated with culture-proven neonatal septicemia in the Neonatal Intensive Care Units (NICUs) of Cairo University Children's Hospitals. Methods: We conducted a retrospective cohort study that included all neonates with culture-proven sepsis and thrombocytopenia who were admitted to the NICUs over a one-year period (from January 2017 to December 2017). Thrombocytopenia was defined as platelet count less than 150x10 3 / µ L. The thrombocytopenic neonates were divided into two groups according to the type of cultured bacteria (gram-positive and gram-negative). Both groups were compared regarding maternal and neonatal risk factors, onset and severity of thrombocytopenia, complications, and patient survival. Results: A total of 316 out of 2172 (total number of NICU admissions) newborns were found to have culture proven-sepsis (14.5%). The frequency of thrombocytopenia in neonates with culture proven-sepsis was 30.3% (n = 96/316). Prematurity is a risk factor for early onset sepsis with thrombocytopenia (p= 0.001). The frequency of severe thrombocytopenia is more in gram-negative sepsis than that in gram-positive sepsis at the onset of sepsis and at the lowest platelet count (p= 0.014, 0.015) respectively. The frequency of hemorrhage in neonates with sepsis and thrombocytopenia was 20.8 % (n = 20/96) and it was mainly pulmonary hemorrhage 10.4 % (n=10). The overall mortality among the study group was 40.6% (n=39/96), with a higher mortality rate (46.3%) in gram-negative sepsis with thrombocytopenia (OR 2.65, p= 0.042). Conclusion: Neonatal thrombocytopenia is a common finding in neonatal sepsis, and the frequency of severe thrombocytopenia is more in gram negative sepsis. Pulmonary hemorrhage is a common type of bleeding in thrombocytopenic neonates with sepsis. Gram-positive sepsis associated thrombocytopenia has a better prognosis than gram-negative sepsis. resistant; MRSA: Methicillin-resistant staphylococcus aureus; MV: Mechanical ventilation; NICUs: Neonatal Intensive Care Units; PEEP: Positive end-expiratory pressure; PROM: Premature rupture of membrane; PT: Pre-term; RDS: Respiratory distress syndrome; SD: Standard deviation; SGA: Small for gestational age; TLC: Total leukocyte count; VD: Vaginal delivery.","PeriodicalId":153483,"journal":{"name":"Pediatric Sciences Journal","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128632500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}