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Objective The aim was to detect serum levels of oxidative stress (OS) biomarkers [malondialdehyde (MDA) and total antioxidant capacity (TAC)] in children suffering from urinary tract infection (UTI). Background Reactive oxygen species (ROS) are normally produced in low levels during tissue metabolism and are necessary for several biological processes. However, higher levels of ROS might cause damage to cells. Cellular damage by ROS could be prevented by different types of either endogenous or exogenous antioxidant. UTI is the most common bacterial infection in children and a major cause of hospitalization resulting in bad affection of the pediatric kidney. Patients and methods This case–control study was conducted on 100 children (75 patients: 25 controls) from 3 to 15 years old. From 100 children, 59 were women while 41 were men. They were selected from the outpatient clinic of nephrology of Menoufia University Hospital and Outpatient Clinic of Shebin El-Kom Fever Hospital from January 2018 to January 2019. Oxidant–antioxidant balance biomarkers (MDA and TAC) were quantified in serum samples and urine culture was performed to identify the causative organism of UTI. Results There was significant increase in serum MDA while a decrease in TAC in UT-infected children. Escherichia coli was the most responsible microorganism for UTI in children. Conclusion UTI in children badly affect their health causing an increase in MDA and a decrease in TAC serum levels resulting in decreasing the protecting effects of antioxidants on the body of children.

Methionine synthase reductase (MTRR) is one of the main regulatory enzymes in the homocysteine/folate pathway. Genes involved in this pathway may play an important role in the development of congenital heart diseases (CHDs). C524T and A66G polymorphisms of MTRR gene may play an imperative role in the development of acyanotic CHDs. This study carried out on 200 children equally divided into 2 groups: group I: 100 children with acyanotic CHDs; and group II: 100 healthy children served as controls. PCR-RFLP method carried out to amplify the A66G and C524T polymorphisms of MTRR gene digested with Xho1and NdeI enzymes. A significant difference(P=0.015) in genotype frequencies of C524T polymorphism between cases and controls, where CC, CT, and TT were 14.0%, 40.0% and 46.0% in patients compared to 38.0,36.0% and 26.0% in controls. Again, a significant difference (P=0.010) in genotype frequencies of A66G polymorphism between the two groups as AA, AG and GG were 26.0%, 32.0% and42.0% in patients compared to 48.0, 36.0% and 16.0% in controls. Also, MTRR A66G and C524T polymorphisms were associated with a higher CHD risk in the homozygote comparison of wild and mutant genotypes and also in heterozygote and mutant comparison. So A66G and C524T polymorphisms of MTRR gene are associated with increased risk of acyanotic CHDs.

Objective The aim of this study was to measure serum leptin levels in children with cyanotic and acyanotic congenital heart disease and to examine its possible role in growth in these children. Background Leptin has been shown to be an integral component of energy homeostasis and regulation of body weight. Leptin regulates adipose tissue mass and correlates with the fat mass. Research on the physiological function of leptin has primarily focused on its role in the pathogenesis of obesity. Children with congenital heart disease are at increased risk for poor growth. Several factors may play a role in poor growth, including feeding difficulties, increased caloric requirements, and the effects of cardiac lesions on growth regulation. Patients and methods This study was carried out over 1 year on 35 patients with congenital heart disease [20 patients were acyanotic (12 boys, 8 girls) and 15 patients were cyanotic (9 boys, 6 girls)] in the Pediatric Cardiology Department in Menoufia University Hospital and 35 apparently healthy children of the same age (range: 3 months–12 years), sex, and socioeconomic status. All patients and controls were subjected to a complete assessment of history, a thorough clinical examination, chest radiograph, ECG, echocardiography, and measurement of serum leptin level. Results Children with cyanotic congenital heart disease had statistically significant lower weight, length, mid-arm circumference, and BMI. There was no statistically significant difference in serum leptin levels in the cyanotic, acyanotic, and control groups. Serum leptin level was correlated positively with BMI and mid-arm circumference in all groups. Conclusion Serum leptin level did not change in children with acyanotic and cyanotic congenital heart disease, suggesting that other factors may regulate nutrient intake, growth, weight, and energy input and output in these children.

Objective: The aim of this study was to evaluate iron-deficiency anemia (IDA) in infancy in relation to different patterns of feeding (exclusive breast milk, exclusive cow's milk, and milk fortified with iron). Background: Iron is a component of several metalloproteins and plays a crucial role in vital biochemical activities, such as oxygen sensing and transport, electron transfer, and catalysis. The biological functions of iron are based on its chemical properties. Decreased hemoglobin level and decreased serum ferritin level aid the identification of IDA in infants. Patients and methods: This study included 147 infants with different patterns of feeding (exclusive breast fed, exclusive cow's milk fed, and iron-fortified formula). The studied groups were subjected to a full detailed assessment of history, thorough clinical examination, anthropometric measurements, complete blood count, and determination of serum iron, serum ferritin, and total iron-binding capacity. Results: In our study, the results showed that 84 (57.1%) infants of the total group studied (147 infants) were found to have IDA. According to sex, IDA among girls was 51.2%, which is higher than that found among boys (48.8%). IDA was much higher in cow's milk-fed infants 24 (96%) than exclusively breast milk-fed infants 47 (66.2%), and less in infants receiving mixed feeding with a fortified formula, 13 (25.5%), respectively. Conclusion: Our study found that infants aged 6–24 months represent one of the highest risk groups to develop IDA (57.1%) of the total study. The risk factors for IDA include consumption of cow's milk during the first year, delaying the introduction of solid foods, and lack of fortification of food with iron after 6 months of age.

Objective The aim of the study was to determine the incidence and risk factors of fungal infections in patients admitted to pediatric intensive care unit (PICU) in Menoufiya University Hospital. Background Critically ill patients are immunosuppressed, invasively monitored, and exposed to aggressive interventions that put them at increased risk for infectious complications while residing in PICU. Fungal pathogens are an increasing important cause of infection among patients in PICU. Patients and methods This study was conducted on 492 critically ill pediatric patients admitted to PICU from July 2010 to July 2011; each patient was examined and sampled on the day of admission and after 5 and 7 days of admission. Samples were taken from oropharyngeal, axillary, and rectal areas in addition to blood sample. All specimens were cultured on Sabouraud dextrose agar. The analysis of samples included a direct examination, culture, and susceptibility of isolates to antifungal drugs. Results Candida albicans was the most common colonizing organisms, as about 156 (31.7%) patients were colonized by it on the day of admission. The most commonly acquired fungi were: C. glabrata in 71 (25.7%) patients, C. tropicalis in 61 (22.1%) patients, C. albicans in 46 (16.7%) patients, C. krusei in 33 (11.9%) patients, Aspergillus flavus in 20 (7.3%) patients, and mixed infection in 45 (16.3%) patients. Patients on previous antibiotic therapy, parenteral nutrition, and central venous line had an increased risk of acquiring fungal organisms. Conclusion Monitoring for colonization with Candida spp. in children admitted to PICU and children undergoing treatment for severe sepsis or septic shock in PICU for more than 5 days may offer an opportunity for early intervention for prevention of candidemia.