الفهرس 
KETOGENIC DIETOnly 14 pages are availabe for public view
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Abstract
T
he Ketogenic Diet (KD) is a high-fat, low-carbohydrate, and adequate-protein diet well-established as treatment option for drug resistant childhood epilepsies.
The increase in fatty acid oxidation causes an increase in ketones production (Ketosis), mainly beta-hydroxybutyrate and acetoacetate.
Neutrophils are an important component of humans` innate phagocytic defense which usually arrive first at sites of infection and/or inflammation. Within neutrophils, the heme protein myeloperoxidase mediates the production of hypochlorous acid, which is a potent microbicidal compound that is inhibited by acetoacetate.
from this we can conclude that acetoacetate inhibits neutrophil microbicidal activity and thus it might increase susceptibility to infections.
The objectives of this study were to estimate the phagocytic index and correlate it to the level of ketosis in the studied patients, and assess the effect of ketosis induced by KD on neutrophils as regards their number and function.
It was prospective case control study, in Nutrition Clinic, Ain Shams University, Children’s Hospital. The period of the study was from May 2018 till Decemberr 2019 and it involved 21 patients with refractory epilepsy. Nine age and sex matched healthy children was recruited as a control group.
All the included patients were subjected to:
Full history taking, examination including anthropometric measurements (body weight, length or height, BMI and z-scores), neurological examination, investigations as serum lipid profile (cholesterol, triglyceride, LDL, HDL), CBC, Urine organic acids, extended metabolic screen, liver and kidney functions, ammonia and lactate, neuroimaging and EEG.
Neutrophil phagocytic function of the patients was compared initially and after 6 months of KD administration using fluorescence labelled E. coli (supplied by Glycotope).
All the patients had normal liver and kidney organic acids, CBC and lipid profile upon recruitment as demonstrated in their files in the ketoclinic.
There was a significant decrease in lymphocytes after 6 months of KD.
This study showed that there was significant decrease in phagocytic function in the studied patients after 6 months of KD with significantly lower phagocytic function in patients compared to controls after the 6 months KD therapy.