BackgroundMost studies of Campylobacter infection triggering Guillain-Barré Syndrome (GBS) are conducted in western nations were Campylobacter infection and immunity is relatively rare. In this study, we explored Campylobacter infections, Campylobacter serotypes, autoantibodies to gangliosides, and GBS in Egypt, a country where Campylobacter exposure is common.MethodsGBS cases (n = 133) were compared to age- and hospital-matched patient controls (n = 374). A nerve conduction study was performed on cases and a clinical history, serum sample, and stool specimen obtained for all subjects.ResultsMost (63.3%) cases were demyelinating type; median age four years. Cases were more likely than controls to have diarrhea (29.5% vs. 22.5%, Adjusted Odds Ratio (ORa) = 1.69, P = 0.03), to have higher geometric mean IgM anti-Campylobacter antibody titers (8.18 vs. 7.25 P<0.001), and to produce antiganglioside antibodies (e.g., anti-Gd1a, 35.3 vs. 11.5, ORa = 4.39, P<0.0001). Of 26 Penner:Lior Campylobacter serotypes isolated, only one (41:27, C. jejuni, P = 0.02) was associated with GBS.ConclusionsUnlike results from western nations, data suggested that GBS cases were primarily in the young and cases and many controls had a history of infection to a variety of Campylobacter serotypes. Still, the higher rates of diarrhea and greater antibody production against Campylobacter and gangliosides in GBS patients were consistent with findings from western countries.
Glutaric acidemia type 1 (GA1) is an inherited metabolic autosomal recessive disorder that is caused by a deficiency in glutaryl-CoA dehydrogenase (GCDH). Untreated patients suffer primarily from severe striatal damage. More than 250 variants in the GCDH gene have been reported with a variable frequency among different ethnic groups. In this study, we aimed to characterize 89 Egyptian patients with GA1 and identify the variants in the 41 patients who were available for genotyping. All of our patients demonstrated clinical, neuroradiological, and biochemical characteristics that are consistent with a diagnosis of GA1. All patients presented with variable degrees of developmental delay ranging from mild to severe. Most of the 89 patients presented with acute onset type (71.9%), followed by insidious (19%) and asymptomatic (9%). A delay in diagnosis was inversely associated with macrocephaly. The prevalence rate ratio (PR) for macrocephaly that was associated with each 6-month delay was 0.95 (95%CI 0.91–0.99). However, high body weight was associated with a higher likelihood of having macrocephaly (PR 1.16, 95%CI 1.06–1.26 per 1 SD increment of Z score weight). However, body weight was inversely associated with the morbidity score. Consanguinity level was 64% among our patient’s cohort and was positively associated with the C5DC level (β (95%CI) 1.06 (0.12–1.99)). Forty-one patients were available for genotyping and were sequenced for the GCDH gene. We identified a total of 25 variants, of which the following six novel variants were identified: three missense variants, c.320G > T (p.Gly107Val), c.481C > T (p.Arg161Trp) and c.572 T > G (p.Met191Arg); two deletions, c.78delG (p.Ala27Argfs34) and c.1035delG (p.Gly346Alafs*11); and one indel, c.272_331del (p.Val91_Lys111delinsGlu). All of the novel variants were absent in the 300 normal chromosomes. The most common variant, c.*165A > G, was detected in 42 alleles, and the most commonly detected missense variant, c.1204C > T (p.Arg402Trp), was identified in 29 mutated alleles in 15/41 (34.2%) of patients. Our findings suggest that GA1 is not uncommon organic acidemia disease in Egypt; therefore, there is a need for supporting neonatal screening programs in Egypt. Electronic supplementary material The online version of this article (10.1007/s11011-019-00422-3) contains supplementary material, which is available to authorized users.
Purpose This study aims to assess the relationship between sleep habits and obesity in children. Design/methodology/approach This is an observational cross-sectional case–control study conducted on 100 children aged 6–12 years, selected randomly from the OPC of the Pediatric Hospital, Ain-Shams University. The subjects were subdivided into two groups: the control group of 50 and the target group of children who are classed overweight or obese. Subjects were excluded where the obesity could be explained owing to an endocrinal and/or any identified disease, those who have a medical or psychiatric illness, and those whose parents refused to give consent. All patients had a full history taken, and each child’s parent fulfilled one questionnaire on sleep behaviors. Findings This study found that 72% with bedtime resistance compared to only 14% among the control subjects, 68% of children experienced a delay with sleep onset compared to 14% among controls, 68% experienced sleep duration abnormalities compared to 12% in the control group, 60% of children stated they needed their parents while going to sleep, compared to 12% among controls, 64% of cases suffered from walking during the night compared to 12% among controls, 64% of cases had a Parasomnia compared to 12% among controls, 66% of cases snoring loudly compared to 12% among controls, and 66% suffering from Apnea, compared to 6% in the control group, and 50% of cases had daytime sleepiness compared to 14% among controls. Research limitations/implications It is hoped that this research will be remedied through the adoption of a child-centered approach inspired by the rights to health and play, and the general principles of the Convention on the Rights of the Child (CRC). Practical implications The results showed a strong association between excessive weight and increased risk of sleep problems, which were broadly diffused in the population childhood. Originality/value This current study has given us a base for the overwhelming fact that these children are directly affected by obesity. A chronic medical condition has enormous implications on health and can lead to many associated disease processes.
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