Background

Tissue injury due to hypoxia and/or free radicals is common in a variety of disease processes. This cross-sectional study aimed to investigate effect of chronic kidney diseases (CKD) and hemodialysis (HD) on hypoxia and oxidative stress biomarkers.

Methods

Forty pediatric patients with CKD on HD and 20 healthy children were recruited. Plasma hypoxia induced factor-1α (HIF-1α), vascular endothelial growth factor (VEGF) were measured by specific ELISA kits while, total antioxidant capacity (TAC), total peroxide (TPX), pyruvate and lactate by enzymatic/chemical colorimetric methods. Oxidative stress index (OSI) and lactate/pyruvate (L/P) ratio were calculated.

Results

TAC was significantly lower while TPX, OSI and VEGF were higher in patients at before- and after-dialysis session than controls. Lactate and HIF-1α levels were significantly higher at before-dialysis session than controls. Before dialysis, TAC and L/P ratio were lower than after-dialysis. In before-dialysis session, VEGF correlated positively with pyruvate, HIF-1α and OSI correlated positively with TPX, but, negatively with TAC. In after-dialysis session, HIF-1α correlated negatively with TPX and OSI; while, OSI correlated positively with TPX.

Conclusions

CKD patients succumb considerable tissue hypoxia with oxidative stress. Hemodialysis ameliorated hypoxia but lowered antioxidants as evidenced by decreased levels of HIF-1α and TAC at before- compared to after-dialysis levels.

The aim was to assess the effects of different routes of chronic nicotine administration on gastric morphology and hormonal secretion; mainly gastrin, ghrelin, histamine and prostaglandin E₂ (PGE₂). Forty adult male albino rats were randomly assigned into four groups (10 rats per group), treated for 21 days as follows: control group (given standard rat pellets and water only); oral nicotine-treated group [50 μg (ml drinking water)⁻¹]; intraperitoneal nicotine-treated group [0.5 mg (kg body weight)⁻¹]; and inhaled nicotine-treated group [0.5 mg (kg body weight)⁻¹]. Concentrations of gastrin, ghrelin, PGE₂ and histamine in serum and gastric tissue homogenates were assessed using ELISA kits. Stomach fundus was processed for histopathology and immunohistochemistry using light and electron microscopy. Different routes of chronic nicotine administration resulted in a significant increase in serum and gastric homogenate gastrin and ghrelin concentrations and a significant decrease in serum and homogenate PGE₂ concentrations compared with the control group. Moreover, nicotine administration via oral and inhalation routes caused gastric erosion, transformation of peptic cells into the mucous variety, a significant increase in parietal cell numbers and an increase in expression of gastrin. In conclusion, the negative impact of nicotine administration on gastric structure that is associated with an increased concentration of gastrin and decreased concentration PGE₂ might be the leading cause of gastric/peptic ulcers in heavy smokers. The increased ghrelin concentration and its effect following nicotine chronic administration needs further investigation. Based on these findings, we suggest that the alteration in gastric structure following chronic administration of nicotine can be prevented by reducing gastrin secretion and/or targeting its receptors.
 

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.