Background: The pathological state of insulin resistance (IR) is closely related to obesity. Insulin sensitivity, therefore, could be permanently impacted by genetic disorders, steroids, or growth hormonal treatment. Objective: Measuring the specificity and sensitivity of several cutoff points in order to determine insulin resistance in pediatric community depending on anthropometric and metabolic characteristics. Methods: 107 children between the ages of seven to eleven years participated in this cross-sectional survey, of whom 53 had obesity, 22 had overweight, and 32 had adequate nutrition as determined by body mass index (BMI) for age. BMI, hip and waist circumference measurements, the conicity index, and the percent of body fat were all measured. Fasting samples of blood had been used to assess the levels of triglyceridemia, glycemia, and insulinemia. Using the 90 th percentage as the cutoff point, the glycemic homeostatic approach was used to assess insulin resistance. Results: For such entire sample, the values were: insulinemia = 0.97 (0.97-0.98), 18.5 μUmL -1 ; fat mass proportion = 0.86 (0.79-0.93), 41.1%; BMI = 0.88 (0.81-0.95), 23.67 kgm 2-1 ; waist circumference = 0.86 (0.77-0.94), 76.0 cm; glycemia = 0.69 (0.52-0.86), 86.0 mgdL -1 ; triglyceridemia = 0.76 (0.64-0.88). For the entire sample, triglyceridemia was 114.0 mg/dL -1 and conicity index was 0.67 (0.48-0.85), 1.21; for the obese subgroup, these values were insulinemia of 0.97 (0.96-0.98), 19.52 μUmL -1 , body fat percentage of 0.74 (0.62-0.87), 42.0%, BMI of 0.76 (0.62-0.90), 24.51 kg/m 2-1 , waist circumference of 0.75 (0.59-0.90). Conclusions: Utilizing the cutoff points with the optimal specificity and sensitivity for the prediction method, anthropometric and metabolic markers seem to have strong predictive potential for insulin resistance in children aged between seven to eleven years old.

Background: In newborns, persistent pulmonary hypertension (PPHN) poses a serious hazard to life. The principal treatment, inhaled nitric oxide, is believed to be unavailable in developing nations, where mortality is predicted to be between 10% and 20% higher. Objectives: This study aimed to assess the effectiveness, safety, and potential adverse reactions of bosentan and sildenafil when used in newborns with PPHN. Patients and Methods: Between July 2021 and August 2022, a double-blind clinical experiment was carried out at Damietta General Hospital's Neonatal Intensive Care Unit. In newborns with PPHN, the effectiveness, safety, and potential adverse reactions of bosentan and sildenafil were assessed. Comparisons were done between the two groups' echocardiographic results, length of oxygen reliance, need for invasive ventilator assistance, duration of medication, and short-term results such as: blood pressure, white blood cell, and haemoglobin counts. Results: Bosentan has comparable PAP-lowering and cardiac output-improving effects to sildenafil. Bosentan had a considerably shorter treatment period than sildenafil (P = 0.003). During 15 and 17 days, the oxygen need time was comparable between the two groups (P = 0.175). Both groups required invasive breathing support, which was equivalent (P = 0.867). The third echocardiographic research results, including pulmonic inadequacies (P = 0.183), tricuspid regurgitations (P = 0.357), and ejection fractions (P = 0.159), were comparable in the bosentan and sildenafil groups, despite pulmonary artery pressure (PAP) and the intensity of tricuspid valve inadequacy being higher before therapies. Conclusion: Neonatal PPHN is successfully treated with bosentan, which decreased it more quickly. Comparing to sildenafil, it is more effective at lowering PAP and lessens the degree of tricuspid valve dysfunction in a shorter period of time.

Introduction and Aim: Acute Kidney Injury (AKI) is a common medical problem, especially in neonatal intensive care unit. However, the reported incidences and associated risk factors are widely heterogenous and sometimes absent for developing countries. Thus, the current work designed to explore the incidence and potential risk factors of AKI for critically ill neonates. Patients and methods: The current work was an observational prospective study, completed between March 2019 and March 2022.  It included 459 newborns admitted to the NICUs at Al-Azhar University Hospital (New Damietta) and Damietta General Hospital (Ministry of Health, Damietta, Egypt). For all neonates, careful history and clinical examination were done and data was documented. Then, repeated creatinine measurements and arterial blood gas analysis were performed. Discharge or death was the primary end point of the study. Other comorbid conditions were the secondary outcome. Results: The incidence of AKI was 92.2% and there was no significant difference between AKI and non-AKI regarding neonatal age, sex and mode of delivery. Patients with AKI had significantly lower gestational age, reduced birth weight, pH and HCO3. The serum creatinine showed significant increase during the first week of NICU admission in AKI than non-AKI groups, while basal values did not. Sepsis, nephrotoxic medications, hypoxic ischemic encephalopathy, umbilical catheter, duration of admission and mortality, all were significantly higher in AKI than non-AKI groups. Sepsis was reported among 44.8% and 27.7%, while mortality was reported for 20.9% and 4.9% of AKI and non-AKI groups, respectively. The duration of admission was 15.25±3.19 vs 9.50±2.21 days respectively. Conclusion: AKI was relatively higher (29.2% of admitted neonates) and associated with prematurity and lower birth weight. Neonatal sepsis and exposure to nephrotoxic drugs were among the commonest predisposing factors for AKI.

Introduction and aim: Iron deficiency can negatively affect thyroid function. This research was done to find out whether children's thyroid levels and iron status are related. Methodology: A cross-sectional research of 300 children attending the outpatient clinic of Pediatric Department at Damietta General Hospital, was carried out., Their ages were between 6 and 12 years. Hemoglobin (Hb), serum irons, overall iron binding capacities, triiodothyronine (t3), thyroxine (t4), thyroid releasing hormones, free thyroxine, free triiodothyronine, and percent transferrin saturation were measured in blood samples. Results: In the group, there were 235 children who were euthyroid (78.3%), overtly hypothyroid (1.7%), subclinically hypothyroid (17.7%), as well as subclinically hyperthyroid (2.3%). Children who were anemic and iron-deficient frequently had hypothyroidisms, both overt and subclinical. When compared to non-anemic and iron-sufficient children, Hb levels and transferrin saturation showed a strong positive association (r = 0.322, p< 0.001), although fT3 and fT4 showed only modest correlations (r = 0.069, p = 0.358, and r = -0.022, p = 0.676, respectively). In comparison to non-anemic and iron-sufficient kids, the likelihood of hypothyroidisms (overt and subclinical) in anemic and iron-deficient kids was 6.624 (95% CI: 3.233-11.796, p< 0.001) and 1.828 (95% CI: 1.182-3.338, p = 0.034), accordingly. Conclusion: Children frequently have anemia, iron insufficiency, and thyroid dysfunctions. Children in this group who were iron-deficient and anemic showed impaired thyroid functions.