This study aimed to assess the impact of high-fat diet (HFD) and vitamin D3 supplementation on cardiac apoptosis, inflammation, oxidative stress, and cardiac uncoupling proteins (UCPs) 2&3 expression. Forty rats were fed either (45%) or (10%) fat diet with or without vitamin D3 (500 U/kg/day) for 6 months, then cardiac tissue expression of Bax, Bcl2, Fas, Fas-L (markers for apoptotic pathways), TNF-α, MDA7, GPX1 (inflammatory and oxidative markers) and UCP 2&3 were assessed. Results revealed the enhancement of intrinsic and extrinsic cardiomyocyte apoptosis cascades and increased inflammatory and oxidative burdens on the heart in HFD rats. Downregulation of UCP2 and upregulation of UCP3 gene expression at 6 months. After vitamin D3 supplementation with HFD, cardiac apoptotic, inflammatory and oxidative markers were mitigated and expression of UCP3 was downregulated and UCP2 was upregulated. This work highlights the novel cardioprotective effect of vitamin D3 in the experimental model of HFD feeding through the downregulation of UCP3.

Aim

This prospective randomized case control study aimed to investigate effect of oral agar administration in reducing total serum bilirubin (TSB) levels in full-term neonates with jaundice in comparison with control.

Materials and methods

One hundred sixty full-term neonates were enrolled with TSB 10–19 mg/dl at first week of age from Assiut University Children’s Hospital. Neonates were divided according to TSB into outpatient group (n = 100) (TSB 10–15 mg/dl) and admitted group (n = 60) (TSB > 15–19 mg/dl). Outpatients group were subdivided into agar group received oral agar and control group received placebo. Admitted group were subdivided into agar group received oral agar plus phototherapy combination and control group received phototherapy alone. Neonates in the agar supplementation received oral agar 600 mg/kg/day dissolved in 10 ml distilled water twice daily till TSB decreased to 7 mg/dl. Daily weight, stool frequency and side effects of treatment were observed for each group. TSB was determined pretreatment then serially every 48 h until TSB level reaching ≤7 mg/dl.

Results

Agar fed was effective in lowering TSB in neonates with TSB 10–15 mg/dl. TSB percentage changes were not significantly lower in agar-fed newborn with TSB >15–19 mg/dl compared with control groups after 24 h and 7 days. Age fed shortened the time required to decrease TSB and increased stooling frequency.

Conclusions

Oral agar supplemented feeding at 600 mg/kg/day is safe for full-term neonates and useful in decreasing TSB and phototherapy duration. The efficacy of phototherapy in decreasing TSB level in neonatal hyperbilirubinemia can be augmented with oral agar usage.

Background and objectives

Primary monosymptomatic nocturnal enuresis (PMNE) is a common distressing condition to children and parents. This study aimed to determine frequencies, severities and characteristics of behavioral problems with PMNE.

Methods

This cross-sectional study included 80 children with PMNE (age: 12.58 ± 1.24 yrs.; boys = 58, girls = 22) and 60 healthy children. Behavioral symptoms were assessed by Strength and Difficulties Questionnaire (SDQ).

Results

This study included 80 children (boys/girls ratio = 2.64:1) with PMNE. They had mean age of 12.58 ± 1.24 yrs. The majority (70%) had good response to medical treatment. Compared to controls, children with enuresis had higher frequencies of emotional, conduct and hyperactivity-inattention symptoms and peer relationship and prosocial problems and higher total (P = 0.001) and different subscales' scores of SDQ. There was an overlap of behavioral problems in 52.2% of children with nocturnal enuresis. Compared to children without behavioral symptoms, children with behavioral symptoms were significantly older at age at presentation (P = 0.046) regardless of gender, residence and type or response to medications. Multiple regression analysis showed that emotional [β = 0.053 (95%CI = 0.037–0.084), P = 0.024] and hyperactivity-inattention symptoms [β = 0.063 (95%CI = 0.028–0.097), P = 0.001] were significantly associated with enuresis independent to other problems.

Conclusion

PMNE is associated with higher risk of behavioral problems particularly emotional and hyperactivity-inattention symptoms indicating externalizing and internalizing problems, therefore, the importance of early non-pharmacological or/and drug interventions. The comorbid behavioral disorders should be treated separately according to evidence-based recommendations to prevent persistence of enuresis and the development of psychiatric disorders in the future.

Objectives: Iron deficiency (ID) and its anemia (IDA) are the most prevalent nutritional deficiency worldwide. Dysfunction of the autonomic nervous system (ANS) is a consequence of anemia regardless to its type. Many studies found ANS dysfunction in adults with ID/IDA. This study evaluated ANS function in children and adolescents with IDA as related studies are scare. Patients and Methods: This prospective study included 60 children with IDA (boys = 20; girls = 40; age: 14.50 ± 2.04 yrs.). Blood concentrations of hemoglobin, ferritin and iron were determined. ANS function testing were carried twice (at baseline and 3 months after iron therapy). They included measuring of heart rate at rest and its variation (HRV) in response to standing and breathing and blood pressure (BP) changes in response to standing, sustained handgrip and cold. Results: Manifestations of IDA included excessive fatigue, dizziness, palpitation at rest and headache. Children with IDA had significant changes in resting heart rate, blood pressure and HRV parameters compared to healthy mates indicating sympathetic hyperactivity and reduction in parasympathetic activity. Early, definite and severe ANS dysfunctions were found in 20%, 36.67% and 3.33%, respectively. For children with IDA, significant correlations were found between ferritin levels and HB and iron levels (P = 0.001), HRV to active standing, deep breathing and Valsalva maneuver (P = 0.001) and systolic and diastolic (P = 0.001) and diastolic BPs in response to sustained handgrip and cold (P = 0.001). Ferrous sulfate therapy (6 mg/kg/day) for 3 months resulted in improvement of ANS manifestations with IDA. Conclusion: ANS dysfunctions are common consequences of IDA in children and can be attributed to the increased need of tissues for oxygen, resulting in sympathetic hyperactivity. Optimal iron therapy can improve ANS consequences of IDA.

Neonatal morbidity and mortality rates indicate a country's socioeconomic status and the quality, and effectiveness of its health care system. This research aimed to identify the clinical pattern and causes of neonatal admission for inborn and outborn babies in a tertiary care university hospital and their outcomes. Over a year, this prospective hospital-based research was conducted in the neonatal intensive care unit (NICU) of Assiut Children's Hospital in Upper Egypt (January 1st to December 31^st, 2020). Gender, birth weight, gestational age, postnatal age, delivery mode, delivery place, admission cause, hospital stay period, and neonatal outcomes were collected. A total of 1,638 newborns were admitted; 930 (56.8%) were preterm and 708 (43.2%) full-term. Inborn admissions were 1,056 (64.5%) and outborn 582 (35.5%). The majority of inborn admissions were preterm 726 (68.8%), and outborn were full-term 378 (64.9%). The commonest admission causes among inborn and outborn preterm infants were respiratory distress syndrome (84.3%) and congenital intestinal obstruction (22.5%), respectively, while multiple congenital anomalies were the commonest cause for admission among both inborn and outborn full-term babies. The mortality rate was 708 (43.2%), higher among inborn (50%) versus outborn (30.9%). The leading cause of death was respiratory distress syndrome among premature inborn with case fatality rate of (56.9%) and multiple congenital anomalies among premature outborn (60%), as well as inborn (67.4%), and outborn (42.6%) full-term neonates. In conclusion, the neonatal mortality rate was high among studied cases. Morbidity and mortality of respiratory distress syndrome and congenital anomalies were alarmingly high. Therefore, all health care providers must devote a considerable effort to improve health care delivered to these neonates.