Early administration of melatonin to asphyxiated term neonates is feasible and may ameliorate brain injury.

The aim of this study was to evaluate the myocardial changes in infants of diabetic mother either with gestational or pregestational diabetes and its relation to maternal diabetic control. The study included 45 infants of diabetic mother (IDMs) and 45 healthy newborn as a control group. IDMs were then categorized into 2 subgroups: twenty infants of mother with pregestational diabetes and twenty-five infants of mothers with gestational diabetes. The studied groups underwent measurement of the maternal and neonatal glycated Hb % (HbA1c), conventional echocardiography, tissue Doppler imaging (TDI) and two-dimensional speckle tracking imaging (STI). The weight, the rate of complications, and the rate of cesarean section were significantly higher in the IDMs group than in the control group. Significant positive correlation was present between the levels of HbA1c of IDMs and HbA1c of their mothers (P < 0.05). A significant deterioration of both systolic and diastolic functions measured by both conventional echocardiography and TDI was present in IDMs with both pre-gestational and gestational diabetes compared with the control group. Also, the septal/posterior wall ratio (SW/PW) was significantly higher in pregestational (1.86 ± 0.3) and gestational (2 ± 0.4) groups than in the control group (1 ± 0.06). Two-dimensional STI showed that the cardiac torsion was significantly impaired in pre-gestational (9.66 ± 2.5) and gestational (8.66 ± 3.9) groups when compared with the control group (5.4 ± 2.4) [P < 0.0001]. It also showed that the global strain was significantly impaired in pre-gestational (-10.4 ± 3.2) and gestational (-13.1 ± 4.7) groups when compared with the control group (-19 ± 2) [P < 0.0001]. However, no significant differences were present among the two patients' subgroups in echocardiographic data except for a significant decrease of E'/A' ratio and S wave at tricuspid annulus derived by TDI and impaired global strain derived by STI in infants of mothers with pre-gestational DM than those with gestational DM [P = 0.02]. SW/PW and cardiac torsion were significantly higher in infant of diabetic mother than the normal newborn and on the contrary systolic function and global strain were significantly lower in IDMs especially in infants of mother with pre-gestational diabetes. All the previous TDI findings did not show any significant correlation to neither maternal nor fetal HbA1c. Also, there was no significant correlation between cardiac torsion and the rest of TDI data neither in IDMs group nor in the control group. TDI and two-dimensional STI were efficient and sensitive tools able to early detect cardiac dysfunction in IDMs even in the absence of morphologic cardiac changes.

Background: Obesity in adolescents has quadrupled in the past 30 y. Markers for cardiovascular risks are needed in this population. We hypothesized that soluble receptor for advanced glycation end products (sRAGE) and asymmetric dimethyl arginine (ADMA) can correlate with carotid intimamedia thickness (cIMT), a known index of subclinical atherosclerosis. We also aimed to evaluate the frequency of (Gly82Ser) RAGE gene polymorphism in obese adolescents. Methods: Obese and nonobese adolescents were evaluated in a cross-sectional study for lipid profile, insulin resistance, ADMA, sRAGE, and RAGE gene (Gly 82 Ser) polymorphism. We measured cIMT in all subjects and performed correlation analyses with all markers. results: The study included 50 obese and 40 healthy control adolescents. Compared to controls, obese subjects had less sRAGE (P = 0.02) and greater cIMT (P = 0.006), insulin resistance (P < 0.0001), and ADMA (P < 0.0001). In a multivariate linear regression model, sRAGE was associated with cIMT (β = 0.28, P = 0.04). Both GS and SS genotypes of RAGE were more frequent in obese than controls (P = 0.04). conclusion: Increased ADMA and decreased sRAGE are associated with cardiovascular risks in obese adolescents. The S allele in RAGE gene is more frequently detected with obesity. The role of RAGE gene and mechanisms leading to cardiovascular risks need further studying. c hildhood obesity is an emerging public health challenge with an estimated prevalence of around 20% in western countries (1). Exposure to cardiovascular risk factors in early life, including obesity, may induce changes in the arteries that are associated with the diagnosis of atherosclerosis in adults (2). The measurement of carotid intimamedia thickness (cIMT) is a noninvasive test to detect early alterations in arterial wall and can be a useful screening tool to early assess subclinical manifestations of cardiovascular and metabolic diseases (3). However, there is a desperate need to discover novel biomarkers that can help understand the exact pathophysiology and improve clinical management of cardiovascular diseases associated with obesity in children (4).Asymmetric dimethyl arginine (ADMA) is a competitive inhibitor of endothelial nitric oxide (NO) synthase that reduces the production of NO and therefore might cause endothelial dysfunction. Serum ADMA concentrations are increased in individuals with hypercholesterolemia, atherosclerosis, hypertension, chronic heart failure, diabetes mellitus, and chronic renal failure. It has been suggested as a potential risk predictor for cardiovascular events and all-cause cardiovascular mortality in patients with coronary artery disease (5). The relationship between ADMA and cardiovascular complications in children remains unclear.The advanced glycation end products (AGE) and its receptor (RAGE) system is a newly discovered pathway implicated in the pathogenesis of several cardio-metabolic diseases (6). The RAGE is a multiligand receptor of the immunoglobulin superfamily of cell surface molecules and enga...

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Background: The achievement of optimal number of CD34 + umbilical cord stem cells is essential for successful umbilical cord stem cell transplantation. So the aim of this study was to assess the potential effect of both maternal and neonatal factors on the umbilical cord blood CD34 + cell count. Methods:The study was done on umbilical cord blood samples obtained from 20 mothers during labor.Their ages ranged from 22 to 34 years and were subjected to history taking, physical examination of the baby and assessment of the CD34 + cells count in umbilical cord blood.Results: Number of previous live births and weight of the baby had a significant effect on CD34 + cells count while the sex of the baby, delivery route, maternal age and gestation period had no significant effect on CD34 + cells count.Conclusions: Umbilical cord blood-derived CD34 + cell count is better with good weight and first babies and decreased with subsequent babies.