Objective: To study the effect of melatonin as an adjuvant therapy in the treatment of neonatal sepsis. Methods: This study is a prospective nonrandomized nonblind case–control study and was carried on 40 neonates with neonatal sepsis diagnosed by both clinical and laboratory criteria. They were enrolled from the Neonatal Intensive Care Unit, Menoufia University Hospitals. These cases were selected during the study period from November 2015 to May 2016 and were divided into two groups: intervention group (number 20 neonates) received melatonin 20 mg as single dose and antibiotics and control group (number 20 neonates) received antibiotics only and then both groups followed by physical examination, complete blood count (CBC), and high sensitive C-reactive protein (hs-CRP) to evaluate the improvement in both groups. Results: Before melatonin administration, there was no significant difference between intervention group and control group with regard to clinical condition, hs-CRP, and other serum parameters. After 24 and 72 hours of melatonin administration, both groups improved with regard to clinical condition, hs-CRP, and serum parameters with significant improvement in intervention group than control group. Conclusion: Melatonin could be used in the treatment of neonatal sepsis in both preterm and full-term neonates beside the conventional treatment.

Objective/background: To assess the percentage of CD4⁺, CD8⁺, and natural killer cells (CD16⁺, CD56⁺) in children with immune thrombocytopenic purpura (ITP) at presentation and study their impact on disease chronicity. Methods: This case-control study was conducted at the Pediatric Hematology and Oncology Unit, Menoufia University Hospital (tertiary care center in Egypt). The study was held on 30 children presenting with ITP; they were followed-up and classified into two groups: 15 children with acute ITP; and 15 children with chronic ITP. Patients were compared to a group of 15 healthy children of matched age and sex. Measurements of CD4⁺, CD8⁺, and natural killer cells (CD16⁺, CD56⁺) by flow cytometry were assessed and compared in these groups. Results: CD4⁺ and CD4⁺/CD8⁺ were significantly lower in acute and chronic patients than the control group (p <0.05 and p 0.05). However, CD8⁺ was significantly higher in acute and chronic patients than the control group (p < 0.05), with no significant difference between acute and chronic patients (p > 0.05). Natural killer cell percent was significantly lower in acute patients than the control group (p < 0.001), with no significant difference between chronic and control groups (p > 0.05). Conclusion: ITP is associated with immunity dysfunction denoted by the increase in cytotoxic T lymphocytes and the decrease in natural killer cells.

Aim: To estimate the blood level of Erythropoietin(EPO) in neonates with anemia of prematurity (APO) and in late hypo-regenerative anemia and to clarify role of EPO in correction of anemia and reducing the number of blood transfusions. Methods: This study was carried out on 60 neonates divided into; group I (30 preterm neonates) with AOP received EPO (250 IU/kg/dose subcutaneously 3 times weekly for 4 weeks), compared to group II (30 neonates) with AOP treated only with blood transfusion. CBC parameters and transfusion requirements were followed during therapy. Serum level of EPO was measured by ELISA technique. Results: By the end of the 4th week of therapy, there was significant increase in group I post r-Hu EPO compared to group II regarding reticulocyte counts (P < 0.001) leading to rise of the Hb (P < 0.001), Hct levels (P < 0.001) with subsequent reduction in the overall number of blood transfusions (P < 0.001). Conclusion: EPO therapy in conjunction with iron, vitamin E and folic acid, stimulated erythropoiesis and significantly reduced the need for blood transfusion in AOP.