Background: Myocardial infarction is a critical complication frequently occurs with type 2 diabetes mellitus (T2DM). Sitagliptin is antidiabetic drug inhibits DPP-4,which augments endogenous level of glucagon like peptide 1(GLP-1).Metformin is an FDA-approved antidiabetic drug, which is commonly prescribed for management of T2DM. Objectives: Is to investigate the possible beneficial effects of sitagliptin, metformin, and their combination on myocardial ischemic and vascular changes in T2D rats and possible mechanisms underlying these effects. Methods: Adult male albino rats were used in this study and were randomly divided into control normal group, control diabetic group , sham diabetic group and diabetic with induction of MI group. Diabetic rats with myocardial infarction(MI) were divided into the following treated subgroups: Oral Sitagliptin (300 mg/kg/day), Metformin(120mg/kg/day) and Combined metformin sitagliptin treated subgroups for 6 weeks. blood glucose (bl gl) level, serum Triglycerides (TG) and Low-density lipoprotein (LDL) levels, markers of oxidative stress(vascular Malondialdehyde (MDA) and cardiac Superoxide dismutase(SOD)levels),inflammation marker(plasma Interleukin-6( IL6),and plasma Creatin kinase-MB (CK-MB) were measured. Hematoxylin and Eosin stained sections of cardiac tissue were examined. vascular reactivity of thoracic aortas were measured. Results:DMT2 with induction of MI evoked oxidative stress, inflammation, as well as histopathological derangements in cardiac tissue and decreased vascular reactivity. Treatment with sitagliptin , metformin and their combination improved the cardiac histopathological changes and vascular reactivity as well as attenuating the oxidative stress and inflammatory processes. Conclusion: Sitagliptin has beneficial protective effects against myocardial ischemic changes induced in T2D rats but combined administration of metformin sitagliptin was superior to each drug alone in cardiovascular protection effects. This protective effect of sitagliptin may be due to its anti-inflammatory and antioxidant potentials.

A pertinent issue in the administration of pneumonic contaminations is the low explicitness of clinical side effects for the specific determination and the need of anti-infection treatment. A perfect biomarker for bacterial pneumonic diseases ought to permit a quick conclusion, have a prognostic esteem and encourage restorative dynamic.. The mix of a few biomarkers reflecting distinctive pathophysiological pathways can possibly improve the administration of network gained pneumonia later on. I-Inclusion criteriaAll enrolled patients were:  Admitted in pediatric ward and PICU aged between 1 month and18 years old (both males and females).  Children with diagnosis of pneumonia. II-Exclusion criteriaAny patient was excluded from this study if:  Children with any chronic chest illness other than pneumonia .  patients with renal impairment.  Patients with liver impairment.  patients below one month and above 18 years. Study50 children aged from 2 months to 18 years with mean age (54.32± 39.53 (4-120) They were 28 males (56%) and 22 females(44%).Parental consent was granted in all cases and two children died after examination.Their diagnosis based on clinical, laboratory, radiological evaluation. MethodsAll studied patients have been subjected to the following: Demographic data including: I-Full history taking in the form of applied questionnaire includin Sample  Personal history: age, sex, residence.  Onset, duration of illness.  Presenting symptoms: fever, cough, tachypnea, cyanosis, recurrent attacks and congenital anomalies .  Medication received  Outcome 142 Copeptin as an Inflammatory Marker in Diagnosis and Prognosis of Community Acquired Benha Journal Of Applied Sciences, Vol.(5) Issue(5) Part (1) (2020) II -Full clinical examination in the form of:- General examination  General look Vital signs Temperature, heart rate, respiratory rate, blood pressure, capillary refill Oxygen saturation Anthropometric measurements (Head circumference, weight, height)  Systemic examination for  Cardiac systemInspection and palpation to detect the presence of pericardial bulge, pulsations and to examine apex.Auscultation: for heart sounds and audible murmur. Respiratory system Inspection: to detect retractions, chest movements and signs of respiratory distress.  palpation: for tracheal shift and palpable ronchi.  Auscultation: for air entry , breath sounds and advential sound(fine crepitations and wheez) Neurological examination  Assessment of conscious level by Galscow coma scale.  Examination of muscle power, tone and reflexes. Abdominal examination  Inspection: for abdominal distention  Palpation: for organomegaly (hepatomegaly and/ or splenomegaly)  Percussion: for ascites.  Auscultation: for intestinal sound III -Investigations Biochemical and hematological investigations: Measurement of  Complete blood count.  C-reactive protein.  Serum copeptin. 1. Complete blood count (CBC) was done for all samples using sysmex KX-21N (Sysmex Corporation, New York, USA) for red blood cell (RBC) count, hemoglob...