الفهرس 
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Abstract
Calcium ion has long been known as an inotropic substance. It is essential for excitation-contraction coupling in the cardiac muscle.
Calcium has a central role in myocardial contraction coupling, and hypocalcemia reduces myocardial function. Congestive cardiac failure (CCF) due to hypocal- cemia is also reported, though rare. There are scattered reports of hypocalcemia related myocardial dysfunction.
The present study had been performed at the paediatric department , out patient clinic , intermediate care unit , and neonatal intensive care unit (NICU) of Sohag university hospital , Upper Egypt through the period from 30 of December 2012 to the 1st of november 2013.
It included 60 patients, half of them diagnosed to have symptomatic hypocalcemia ,the other half are controls ,Their ages ranged from birth to 12 years , as for gender distribution of our studied cases (23) were males ((76.67%)),while(7) were females(23.33%)with male predominance, male to female ratio (2.7:1) .
We found that most of our cases presented during the period from 6month-1 year (53%) , ittitablity is the main presentation of our studied cases(93%) followed by delayed teething(63%), delayed motor (43%) and tetany (33%), Most of them were breast fed, signs of rickets found in 50% of cases, ECG was normal in all our cases, ECHO findings was normal ,as there was no structural abnormality , normal cardiac functions in all of our studied cases. Chest Xray was normal in(60%) of cases, no cardiomegaly detected.
Cardiac markers including troponin which is a superior cardiac marker was normal in most of our studied cases(97%) , myoglobin was normal in (90%) of our cases, CK-MB was normal in 93% of cases , LDH which is not a specific cardiac marker was elevated in (67%) of cases .
we also found vit D was deficient in (60%) of cases, alkaline phosphates was elevated in (76%) of cases. Vit D deficiency in developing countries is possibly nutritional. In addition, deficiency occur in breast fed infants of mothers unexposed to sunlight.
Concerning therapeutic modalities at time of the study, we found that our studied cases received IV calcium , oral calcium, vit D (oral, drops, injections).
Conclusion:
Based on this study, we recommend informing pediatricians that Decline in total and ionized serum calcium concentration was not associated with impaired cardiac function, and calcium infusion in these hypocalcemic infants neither improved nor impaired cardiac function.