Objective of the studyTo evaluate the value of serum creatine phosphokinase-brain specific (CK-BB) and urinary lactate/creatinine (L/C) ratio as early indicators of brain damage in full-term newborns with hypoxic ischemic encephalopathy (HIE).Patients and methodsA case–control study including 25 full-term new-born infants with perinatal asphyxia who were admitted to neonatal intensive care unit (NICU) with a proven diagnosis of HIE, compared to 20 healthy age- and sex-matched full-term newborns. All newborn infants were subjected to full history taking, clinical examination, routine investigations (cord blood gases and complete blood picture), and assessment of serum CK-BB (cord blood, 6 and 24 hours after birth) and urinary L/C ratio (collected within the first 6 hours, on the 2nd and 3rd day after birth).ResultsThe serum CK-BB and urinary L/C ratio in infants with HIE were significantly higher in samples collected throughout the monitoring period when compared with the control group (all P<0.001). The cord CK-BB and urinary L/C ratio within the first 6 hours were significantly higher in infants with severe HIE than in infants with mild and moderate HIE (P<0.001). Cord CK-BB level at 12.5 U/L had 100% sensitivity and 84% specificity in the detection of severe HIE infants. Urinary L/C ratio of more than 10.5 collected within the first 6 hours after birth had 100% sensitivity and 78% specificity for the detection of severe HIE infants.ConclusionThe serum CK-BB and urinary L/C ratio in HIE infants were significantly increased early in the course of the disease, which can be used as useful indicators for predicting the development of HIE.

Elevated vascular endothelial growth factor serum level is associated with pulmonary artery hypertension in children with β-thalassemia.

Background Acute lower respiratory infection (ALRI) is the leading cause of child mortality, especially in the developing world. Polymorphisms in the interleukin 4 (IL‐4) gene have been linked to a variety of human diseases. Objectives To investigate whether the IL‐4 ‐590C/T (rs2243250) polymorphism could be a genetic marker for susceptibility to ALRIs in young Egyptian children. Methods This was a multicenter study conducted on 480 children diagnosed with pneumonia or bronchiolitis, and 480 well‐matched healthy control children. Using PCR‐RFLP analysis, we genotyped a ‐590C/T (rs2243250) single nucleotide polymorphism of the IL‐4 gene promoter, meanwhile the serum IL‐4concentration was measured by ELISA. Results The frequency of the IL‐4 ‐590 T/T genotype and T allele were overrepresented in patients with ALRIs in comparison to the control group (OR = 2.0; [95% confidence interval [CI]: 1.38‐2.96]; for the T/T genotype) and (OR: 1.3; [95%CI: 1.07‐1.56]; for the T allele; P < 0.01). The IL‐4 ‐590 T/T genotype was associated with significantly higher mean serum IL‐4 concentration (58.7 ± 13.4 pg/mL) compared to the C/T genotype (47.6 ± 11 pg/mL) and the C/C genotype (34.8 ± 9.6 pg/mL); P < 0.01. Conclusion The IL‐4 −590C/T (rs2243250) polymorphism may contribute to susceptibility to ALRIs in young Egyptian children.

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