bluuebunny/crossref_metadata_2025 huggingface dataset:
The Association between Parathyroid Hormone and Preterm Labor
Authors: Badwy Hamdi Mohamed , Abou-Gamrah Amgad Alsaid , Ashoush Sherif Ahmed , Mostafa Rania Hassan
Published: July 2024

Background

Preterm labor represents the main cause of both neonatal mortality and the childhood mortality as it accounts for (35% of 2.8 million neonatal deaths) and (17% of 6.3 million childhood deaths) worldwide. Parathyroid hormone regulates feto-placental mineral homeostasis and stimulates placental calcium transfer. Myometrial activity is directly related to cytoplasmic free calcium, and reduced calcium concentrations inhibit contractions.

Aim of the Work

We aim to explore the possible association between PTH, calcium, magnesium, phosphorus & albumin levels and preterm labor. Thus, it might be used as a predictor to help prophylaxis, early diagnosis or add another diagnostic tool for preterm labor and further management.

Patients and Methods

At Ain Shams University Maternity Hospital we conducted a case control on one hundred pregnant women who were recruited from the outpatient clinic and labor ward assessed for eligibility and were enrolled in this study and classified into two groups. Group A: Cases: 50 women who were having established preterm labor and Group B: Controls: 50 matched pregnant women with gestational age (28-36 weeks).

Results

Mean parathyroid hormone in preterm in labor group was 42.13 while in other preterm not in labor was 50.77 and mean albumin in preterm in labor group 4.02 was while it 4.36 was in the other group so the results shows that there is no statistically-significant difference between the two studied groups regarding the laboratory data except a very small variability between the mean of albumin that can't make any difference to our conclusion.

Conclusion

We found that there is no obvious association between parathyroid hormone and preterm labor.
Overexpression of Estrogen Receptor Beta and Its Prognostic Significance among Malignant Pleural Mesothelioma Patients
Authors: Helali Mariam , Abdelmotal Ahmed , Gobran Nagy Samy , El Ghazaly Hesham , Mahdy Manal El , Karim Khaled Abdel
Published: July 2024

Background

The expression of estrogen receptor beta (ER beta) and its correlation with the prognosis of malignant mesothelioma remains controversial. This study aimed at studying ER beta expression in tumour cells in patients with mesothelioma and its association with clinicopathological factors and survival outcomes.

Material and Methods

A prospective study to evaluate prognostic significance of ER beta overexpression by immunohistochemistry (IHC) on paraffin blocks among malignant mesothelioma patients at Ain Shams university hospital and correlate their overexpression with the patients' follow up clinical data, OS, and PFS.

Results

Forty-two mesothelioma cases were enrolled and followed up, High ER beta expression (modified Allred score 7-9) was reported in 9.5% of the patients (4 cases), moderate expression (modified Allred score 4-6) was reported in 28.6% of the patients(12 cases), weak and negative expression ( modified Allred score 0-3) was reported in 61% of the patients(26 cases), percent of ER beta positive cases was 69% of the total patients, there was no statistical difference as regard age (p value:0.8), sex(p value:0.4), stage (p-value: 0.71), ECOG (p-value :0.84), histological subtype(p value:0.17) and response to first-line treatment (p value:0.5) across the 3 groups of patients (high, moderate, weak and negative ER beta on tumour cells).there was no statistically significant difference in OS and PFS for ER beta overexpression.

Conclusion

ER beta overexpression was not associated with improved OS or PFS in mesothelioma patients, larger sample size would be recommended for more solid conclusions.
Screening for Retinopathy of Prematurity in Neonatal Intensive Care Unit in Ain Shams University Hospital
Authors: Noor Mohamed Salaheldeen , Ali Elbarbary Magdy Mohamed , Embabi Sherif Nabil , Zaki Mohamed Abdelhakim , Awad Hihsam Abdelsamie , Al-feky Mariam Ahmad
Published: July 2024

Purpose

to evaluate the Retinopathy of prematurity prevalence and screening outcome in a tertiary hospital in Cairo, Egypt. Also, to assess the risk factors for its development and to suggest modifications to the international guidelines for screening for Retinopathy of prematurity to fit the Egyptian population.

Methods

A prospective observational study was carried out in Neonatal Intensive Care Unit (NICU) in Ain Shams University Hospital. In this study 159 premature infants born in the period between 1 September 2018 to 1 September 2021 were screened for Retinopathy of Prematurity (ROP). Screening was based on the most inclusive criteria reported to date. All premature infants with gestational age (GA) of ≤ 34 weeks or birth weight (BW) of ≤ 2000 grams were included. Infants were also included if GA > 34 weeks or BW > 2000 grams, but multiple co-morbidities existed. The prevalence of retinopathy of prematurity and plus disease and their correlation with risk factors of interest were studied.

Results

The gestational age of the included infants ranged from 27 to 36 weeks, with a mean (SD) of 31.87 (± 1.81) weeks. Infants had birth weight ranging from 640 to 3900 grams, with a mean (SD) of 1784.71 (± 560.30) grams. The prevalence of ROP changes more than stage 0 in the screened infants was 25.8% (41 infants) with 7.3% of cases (11 infants) showing plus disease and 6.3% of cases (10 infants) showing severe changes that needed treatment. Of those, 2 cases (20%) fell outside the British Guideline’s criteria for Screening. there was a highly significant (p < 0.0001) correlation between appearance of Retinopathy of prematurity changes more than stage 0 and low gestational age, low birth weight of the screened infants, receiving mechanical ventilation, respiratory distress syndrome stage, presence of Necrotizing enterocolitis, Intraventricular haemorrhage and blood transfusion. On the other hand, no significant correlation was found between appearance of Retinopathy of prematurity changes more than stage 0 and gender (p = 0.911), presence of PDA (p = 0.187), or sepsis (p = 0.998).

Conclusion

Retinopathy of prematurity is a significant problem in the premature infants in Cairo, Egypt. Extremely premature infants with lower birth weight are more prone to develop this disease. However, cases with higher gestational age and birth weight than mentioned in the British guidelines screening criteria especially with multiple comorbidities showed severe Retinopathy of prematurity changes that needed intervention, which implies the need to develop a screening guideline for the Egyptian population.
Arthroscopic Scaphoid Bone Graft Combined with Percutaneous Fixation versus Open Scaphoid Fixation with Non Vascularized Graft in Scaphoid Non-Union
Authors: Hamdy Alnaggar Hamdy Essam , El-Mahy Mohammed Mostafa , Atiyya Ahmed Naeem , Diab Ramy Ahmed , Mohamed Aly Amr Mostafa
Published: July 2024

Background

Consensus about Management of scaphoid nonunion is controversial, many procedures have been described. This study compares between 2 modalities for management of scaphoid nonunion either arthroscopic scaphoid bone grafting from iliac bone combined with percutaneous fixation versus open scaphoid fixation and non-vascularized bone graft from iliac bone in management of scaphoid nonunion to identify if one technique is better as regards union rate, time to union and functional outcome.

Patients and Methods

A prospective randomized control trial held to recruit the patients between September 2019 and December 2020 between open grafting group (group O) for scaphoid non union (15 patient) and arthroscopic group (group A) ( 15 patients), randomization was done by using computerized random allocation. The mean follow up was 17.2 months(12- 24 months). We evaluated the results as regards union rate, time to union, complications, grip strength functional outcome according to disability of arm, shoulder and hand questionnaire (DASH) score and modified mayo wrist score (MMWS). We analyzed the results by using Statistical Package for the Social Sciences software (SPSS) version 25.

Results

union rate for group A was 100 % with time to union mean of 9.73 weeks (±2.4 weeks), union rate for group O was 93.33% with time to union mean of11.64 weeks(±1.82 weeks) which was significantly faster to union for group A(p value<0.05) . The open group showed significantly less operative time, the mean operative time was59.2 min±11.01, 90.6min±11.77 for group O and group A respectively. Grip strength, range of motion, VAS, MMWS and DASH score improved post operative for both groups with no statistical difference between them with comparable complication rate.

Conclusion

arthroscopic grafting technique for scaphoid non unions showed comparable results as regard union rate, complications, range of motion and functional outcomes with significantly faster time to union however, significantly longer operative time.
Clinical Outcomes Following Treatment of Ramp Lesion during Anterior Cruciate Ligament Reconstruction (Systematic Review and Meta-Analysis)
Authors: Sobhy Mohamed Hassan , Fakhery Ebied Wessam Eldin , Abd Elhakeem Ismail Mohamed Hesham
Published: July 2024

Background

Ramp lesion is defined as a vertical longitudinal detatchment of PHMM due to meniscocapsular ligament tears that is not greater than 2 cm in medio-lateral length resulting in separation of meniscocapsular or meniscotibial ligament.

Aim of the Work

The study aims to perform a systemic review and meta analysis concerning outcomes of ramp lesion repair during ACL reconstruction.

Methodology

Systematic review and Meta-analysis on Patients with ramp lesion undergoing ACL reconstruction and ramp lesion treatment with total of 387 studies matched our search terms. After exclusion of duplicates, 37 studies were initially included based on their Abstract. 27 studies were finally included. The average MINORS score of all non-randomised studies was 8.7/16 for non- comparative studies and 16.9/24 for comparative studies, respectively.

Results

Our results suggest that medial meniscus repair associated with ACL reconstruction may restore meniscal function by adjusting the anteroposterior length of the torn medial meniscus. Our data demonstrate that more than 75% of medial meniscal tears in the ACL-deficient knee occur in the peripheral posterior horn. If we assume that the anatomy as described by Hughston and Eilers is correct, then care should be taken when addressing these tears, because a strong repair is needed to preserve the stability of the knee.

Conclusion

MRI demonstrated moderate sensitivity and excellent specificity in the diagnosis of ramp lesion in patients with ACL tear. According to the current systematic review, ramp lesions are common in ACL-deficient knees and are often missed through standard anterior portals. Exploration of the meniscocapsular complex via an additional posteromedial portal is recommended, if MRI suggests a lesion in this area or if instability is present at probing. If the posteromedial view still does not reveal any lesion despite significant instability, soft-tissue debridement might uncover hidden lesions (meniscotibial ligament disruptions). Ramp lesion repair leads to a significant improvement of subjective knee scores, regardless of the specific fixation technique. For stable ramp lesions, trephination and abrasion might be equivalent to ramp lesion repair in terms of postoperative stability.
Management of Unstable Intertrochanteric Fracture Femur using Long Stem Cementless Arthroplasty Single Armed Clinical Trial
Authors: Fahmy Ebrahim Mohammad Khalil , EL-Aziz Bassiony Ayman Abd , Mansour Saleh Gameel , Mehasseb Ahmad Mohammad , EL-Aleem Elshabrawy Waleed Elsayed Abd
Published: July 2024

Background

fractures of trochanteric region of femur are common in elderly. Internal fixation of these fractures is a standard practice. But, Nowadays we encounter failures require reoperation. In fresh comminuted fracture through porotic bone in elderly with medical comorbidities or symptomatic ipsilateral degenerative hip disease, replacement preferred to allow early full weight bearing mobilization. arthroplasty using long-stem is a surgical method that helps patients relieve pain, facilitate early rehabilitation, limit long-term complications, and improve quality of life for patients. Hip fracture treatment in elderly patients remains challenging.

Aim

The aim of our study is to detect functional outcomes and complications after usage of cementless hip arthroplasty with long femoral stem for management of intertrochanteric femur fractures.

Materials and Methods

We followed 20 patients were treated with long-stem cementless arthroplasty due to intertrochanteric femur fractures. The mean age was 72.9±5.79 years and the mean follow-up period was 12.8 months. The patients underwent either bipolar or total hip arthroplasty. Outcomes were evaluated with the Harris hip score (HHS).

Results

At the last follow-up, the mean Harris hip score was 81.2points. There were no cases of osteolysis. All stems were stable without significant changes in alignment or progressive subsidence. Superficial Infection was observed in one patient and was treated medically. Implant loosening and periprosthetic fractures were not noted.

Conclusion

Primary cementless long stem arthroplasty is one of good choices in treatment unstable ITF in elderly patients, helped patients improve the quality of life.
Oblique Lateral Versus Extreme Lateral as Approaches for Lumbar Disc Inter-Body Fusion
Authors: Gomaa abo-warda Mohamed , Elsayed Mohamed Nabil , Mahmoud Abderady
Published: July 2024

Background

In the current surgical therapeutic regimen for the degenerative lumbar disease, both oblique lateral interbody fusion (OLIF) and extreme lateral lumbar interbody fusion (LLIF) are gradually accepted.

Aim of the Work

In this research, we aimed to compare the radiographic and clinical outcomes of OLIF and XLIF for the degenerative lumbar disease.

Subjects and Methods

This was a Meta-analysis study, The review considered case-control studies, case report studies, and retrospective case follow-up comparing radiographic and clinical outcomes of OLIF and XLIF for the degenerative lumbar disease.

Results

Change in Oswestry disability index (ODI) was reported in 9 studies. The effect estimate is - 28.247 with Random model applied. There is heterogeneity p = 0.001.Moreover, it was noted that change in visual analog scale (VAS) was reported in all 10 studies. The effect estimate is -3.796 with Random model applied. There is heterogeneity p < 0.001.

Conclusion

The two groups are similar in terms of radiographic outcomes, operative blood loss, operative time and the length of hospital stay. The OLIF group shows advantages in VAS and ODI scores improvement. Though the incidence of perioperative complications of OLIF and LLIF is similar, the incidence of main complications is significantly different.
Tri-Ponderal Mass Index versus Body Mass Index: Correlation to Body Fat and Metabolic Profile
Authors: Ebrahim Wessam A , Mahmoud Rana A A , Abd El Moniam Manar S
Published: July 2024

Background

Obesity is a worldwide health problem. Obese individuals are at a high risk of developing dyslipidemia, hypertension, impaired glucose tolerance and insulin resistance. Recently, tri-ponderal mass index (TMI) has been reported as an alternative to body mass index (BMI) because it may estimate body fat levels more accurately than BMI, especially in adolescents. TMI is nearly stable throughout adolescence .

Aim of the Study

To compare (BMI) and (TMI) as predictors of fat mass percentage (FM %) as detected by DXA scan and to compare the efficacy of TMI and BMI in predicting insulin resistance (IR), hyperlipidaemia.

Methods

This study was conducted on sixty Egyptian healthy male and female with simple obesity with age range between 5-18 years. Patients were interviewed for data including, socio- economic status, dietetic history, physical activity, family history of obesity, cardiovascular disease, diabetes and hypertension. Clinical examination included complete physical examination, Tanner stage, anthropometric measurements, their standard deviation scores (SDSs ). Lab investigations included fasting lipid profile, insulin, glucose and Insulin resistance by (HOMA-IR) index. Assessment of body composition including fat mass percentage (FM %) and bone density was done by (DXA) scanner .

Results

We found that BMI and TMI were significantly positively correlated with blood pressure. They were also positively correlated with the presence of acanthosis nigricans indicating IR. They were both negatively correlated with cholesterol levels, while fat percentage was positively correlated with insulin levels and HbA1c. BMI was significantly correlated with glucose levels. We found a lower prevalence of obesity was obtained when we used TMI classifications rather than BMI. There was a positive correlation between BMI and each of TMI and fat percentage. Furthermore, only BMI correlated with percentage of body fat (BF%) measured by DXA.

Conclusion

BMI seems to predict adiposity better than TMI in children and adolescents. In addition, TMI seemed to perform similarly as BMI for identifying metabolic syndrome.
Health Related Quality of Life and Psychosocial Profile of Patients with Sickle Cell Disease and Their Caregivers
Authors: Mokhtar Galila Mohamed , Zaky Eman Ahmed , Ebeid Fatma S E , Abdelmageed Reham Ibrahim , Elkamel Nermeen Mohamed , Ali Heba G A
Published: July 2024

Background

Sickle cell disease (SCD) is a chronic, debilitating disorder can negatively affect health-related quality-of-life (HRQoL) outcomes in SCD.

Aim of the Study

Primary objective was to assess the prevalence of impaired psychosocial profile and poor HRQoL among SCD patients and their caregivers in comparison to age and sex matched controls, while secondary objective was to determine the association of such impairment if any with parameters of disease severity.

Methods

An observational, case control study recruited sixty-five children and adolescent with confirmed SCD, conducted at Paediatric Haematology Oncology clinic, Ain Shams University, Egyptfrom1st of August 2020 to 28th of February 2021. Demographic and clinical data were collected, and thorough clinical and psychiatric assessments were conducted. Quality-of-life (QoL) of both children and their caregivers were performed compared to 65 matched healthy control.

Results

sixty five children and adolescents with confirmed SCD were included; there were 34 (52.3%) boys and 31 (47.7%) girls and their mean age was 11.40 ± 3.55. Most patients 44(67.7%) had sickle HbSβ+-thalassemia, the most frequent manifestations were vasoooclusive crises in 24 (36.9%) patients, The most common causes for hospital admission were pain crisis in 14 (33.3%) patients and vasoocclusive crisis in 14 (33.3%). Results indicated that patients with SCD and their caregivers had depression and anxiety symptoms scores more than reported in control group.Sickle children had significantly less self-esteem and quality of life than control children, least scores in s ick le c hild re n Q O L wer e in co mmunica t io n do ma in. These were s ignific a nt ne ga t ive consequences, advanced age, duration of illness, number and duration of hospitalizations, disease severity score and occurrence of complications were associated with psychological disorders.

Conclusion

The QOoL of children suffered from SCD and their caregivers is adversely affected necessitate implementation of interventions which focus on reducing depressive symptoms, enhancing self-esteem and QoL.
Psychometric Assessment and Health Related Quality of Life of Children and adolescents With Cystic Fibrosis
Authors: Zaky Eman Ahmed , Fouda Eman Mahmoud , Abdelaziz Asmaa Wafeeq , Mohammed Hassan Yasser Hassan , Saber Ibrahim Ayman Ahmed
Published: July 2024

Background

Cystic fibrosis (CF) is an exhausting and time-consuming disease that can interfere or impair typical daily life activities and social interactions.

Aim and Objectives

Evaluation of psychological aspects and Quality of life in cystic fibrosis patients.

Subjects and Methods

This was a cross sectional study, conducted at the Paediatric Chest Clinic, Children's Hospital, Ain Shams University on 31 patients with verified diagnosis of CF compared to 31 healthy children. Psychological assessment was done using Children depression Inventory (CDI) Scale, Spence Children’s Anxiety Scale, and The Pediatric Quality of Life (PedsQLTM) Scales. Result: CF patients experienced statistically significant higher levels of depression and anxiety than their healthy peers (p < 0.001; p = 0.001, respectively). There were no significant differences in PedsQLTM Scales between the CF patients and the healthy controls (p > 0.05).

Conclusion

This study is significantly important for revealing that psychiatric symptoms are prevalent among children with CF, which implies that annual symptom screening is justified.
Study of Mortality Rate and its Causes among Egyptian Children and Adolescents with Cancer
Authors: El Sherif Nayera H , Ebeid Fatma S , Sayed Safa M , Akl Asmaa M
Published: July 2024

Background

There is little evidence about the burden of childhood cancers in Egypt. Knowledge about the current disease burden of childhood cancers is crucial to priorities cancer control plans and improve survival.

Objective

To describe the frequency of deaths among children diagnosed with cancer in the last 10 years.

Patients and Methods

This retrospective descriptive study was conducted in Pediatric Hematology /Oncology Unit, Children's Hospital, Ain Shams University. The data of 500 patients was collected from the database in the period from 1st September 2011 to 30th September 2021. The study included 500 Children less than 18 years diagnosed as solid and hematological malignancies.

Results

The median age of the included patients was 4.25 years, males represented 54.4%. The most common etiology of malignancies among the included patients were: acute lymphoblastic leukemia (31.8%) and acute myeloid leukemia (714.6%). Death was evident in 71.4% of the included patients. Among the dead cases 106 (74.12%) had late death; that occurred 5 years or more after diagnosis and 37(25.4%) had early death; that occurred within 30 days after diagnosis of the first neoplasm. The higher mortality was reported among acute lymphoblastic leukemia (52; 36.4%), acute myeloid leukemia (28; 19.6%), neuroblastoma (13; 9.1%) and brain tumors (10; 7.0%). Comparison between living and dead childhood cancer patients as regards the demographic and clinical data showed no significant difference regarding; age, gender, and residence (P-value= 0.591, 0.122 & 0.077, respectively). Relapse was significantly increased among dead cases representing 32.9% (P-value= 0.000).

Conclusion

In our institute, childhood cancer patients’ mortality rate was 28.5% in the last 10 years. Early death occurred in (25.8%) among them; infection was the leading cause of death, while primary malignancy was the main cause of death among those who died late, which is almost comparable with international studies. Furthermore, the overall survival of our childhood with cancer was (67.30%) at 5 years from diagnosis. This is relatively better than the previous published Egyptian data and reaching international figures.
Diagnostic Yield of Same Setting Oesophago-Gastro-Duodenoscopy (OGD)and Colonoscopy for Pediatric Patients with Chronic Diarrhea
Authors: El-Hodhod Mostafa Abdel-Aziz , Aziz Ghazal Faten Abdel , Hamdy Ahmed Mohamed , Mohsen Yosra Mohamed , Abbas Saleh Ghada Saleh
Published: July 2024

Background

In patients with unexplained chronic diarrhea colonoscopy and upper GI endoscopy are helpful in the diagnosis. It is the routine practice in Ain Shams University pediatric endoscopy unit to perform both procedures at same setting for patients with unexplained chronic diarrhea.

Aim of the Work

To find out whether doing Oesophago-gastro-duodenoscopy (OGD) and colonoscopy in patients with chronic diarrhea in one setting is essential for the diagnosis of all cases.

Patients and Methods

Fifty patients presenting with chronic unexplained diarrhea (>4 weeks duration) in Paediatric Gastroenterology Unit, Children’s Hospital, Ain-Shams University were enrolled. After full history taking, physical examination, both endoscopies were performed biopsy taken and histopathological recording for each sample.

Results

Of 50 patients with chronic diarrhea included in our study; 23 (46%) had positive endoscopic findings in the OGD. Most common findings in esophagus and stomach were inflammation and erythema. while most common findings in duodenum were edema and flattened mucosa. Colonoscopy findings were positive in 50% of patients including inflammation, nodularity, and edema mostly in the ileum. 50% of endoscopied patients reached final diagnosis based on endoscopy and histopathology. Definitive diagnosis reached through EGD alone in (12%) of cases, through colonoscopy alone in (28%) and through both techniques in (60%). There was no statistical significant agreement between endoscopy findings and predominant gastrointestinal manifestations including different types of diarrhea, fecal calprotectin with p-value =0.150, and 0.833 respectively. There was no statistical significant agreement between final diagnosis and suspected GIT part involvement on initial clinical evaluation with p- value=0.805.

Conclusion

Endoscopy for upper gastrointestinal tract and colonoscopy at same day may be helpful in diagnosis of cases with chronic diarrhea as we can't decide which one to perform based on clinical presentation.
Developmental Outcomes of Traumatic Brain Injury in Infants and Children: A Prospective Study
Authors: Deif-Allah Shaymaa A , Abdel Ghany Walid A , Abdelaziz Esmail K , Elmikaty Hani A , Abdel Raouf Batoul M
Published: July 2024

Background

Traumatic brain injury (TBI) in children is a significant health burden worldwide. Children aged 0 to 4 years have the highest incidence of TBI among the non-elderly. These children suffer from long term neurological deficits that compromise their quality of life and daily living activities.

Objective

To determine the developmental outcomes of infants and children with TBI.

Subjects and Methods

A prospective descriptive study on infants and children with TBI was conducted. Developmental outcomes by Age and Stage Questionnaire 3rd edition (ASQ-3) was assessed twice; once at hospital discharge and another time 3 months later. Further, Bayley scales of infants and toddlers’ development III was assessed only once in the second visit. Results at discharge and follow up were compared and correlated.

Results

Eighty -five patients were included in the study with 63.5% were males and the median age was 24(12-34) months, range (1- 42 months). There were statistically significant difference between ASQ-3 at discharge and follow up which was higher at follow up than at discharge indicating better developmental outcomes(P < 0.001 for all aspects). Comparison between ASQ-3 (problem solving) and Bayley Scale (cognitive) at follow up shows that there was no statistically significant difference between them with kappa agreement and 95% CI of 0.527 (0.218–0.837). Also, comparison between ASQ-3 (motor) at follow-up and Bayley Scale (motor)at follow up shows that there was no statistically significant difference between them with kappa agreement and 95% CI of 0.285 (0.001 - 0.569). Also, comparison between ASQ-3 (communication) and Bayley Scale (language) at follow up shows that there was no statistically significant difference between them with kappa agreement and 95% CI 0.501 (0.235 - 0.766). this means that both tests were comparable

Conclusions

ASQ-3 can be used as a screening tool for infants and children after TBI before referral to Bayley scale. Developmental milestones improved at follow up in most infants and children after TBI.
Bee Honey as an Adjuvant Therapeutic Modality for Children with Functional Dyspepsia
Authors: Abdulrhman Mamdouh Abdulmaksoud , Mohsen Awad Yosra Mohamed , Eid Sayed Amna Ali
Published: July 2024

Background

Functional dyspepsia (FD) is a constellation of diverse gastrointestinal disturbing symptoms with multifactorial feature, that are not attributable to organic causes after proper medical assessment. Treatment options are unsatisfactory due to the lack of identifiable pathophysiology as well as the pharmacological therapy are less effective, so using an additional reliable non- pharmacological therapy would be promising. Bee honey has been used as a complementary and alternative medicine for its several benefits in different health aspects.

Objective

To assess the effect of bee honey as an adjuvant therapy among children with functional dyspepsia.

Patients and Methods

In this randomized controlled clinical trial (RCT) 30 patients aged (8-18) years old according to Rome IV criteria from Gastroenterology Clinic in Children’s Hospital, Ain Shams University, Egypt. Patients were randomly allocated into 2 groups; both groups received proton pump inhibitor (PPI) for 4 weeks and the intervention group received honey in addition. Both groups were re-assessed after this period. All patients were subjected to thorough history taking, physical examination and follow-up assessment which was done every week during the study period. Assessment of the severity of dyspepsia was done by using "Modified Glasgow Dyspepsia Severity Score" (MGDS) score.

Results

There were no significant differences in the baseline sociodemographic characteristics and total scores at the beginning of the study among both groups(p > 0.05). A significant beneficial effect of honey combined with PPI in improvement of FD and decrease severity of symptoms in intervention group which was evident from significant decreases in total score interpretation (P < 0.05). There was statistically significant difference between both groups as regards to the percentage of improvement, where the patients who received honey showed a higher percentage of cure rate (P < 0.05).

Conclusion

Honey supplementation combined with PPI could be used as a novel therapeutic modality in children with functional dyspepsia with high cure rate.
Efficacy and Safety of Resveratrol in Patients with Type 1 Diabetes Mellitus
Authors: El-Asrar Mohamed Abo , Rahman Ismail Eman Abdel , Salah Nouran Yousef , Abd Elhamid Noha Mahmoud
Published: July 2024

Background

Resveratrol is a food component found in grapes, peanuts, cranberries.. It has a wide range of effects including antimicrobial, anti-inflammatory and anti-apoptotic effects. Resveratrol could ameliorate diabetes in diabetic animals and it showed beneficial effects in adults with type 1 diabetes mellitus (T1DM).

Objectives

This randomized-controlled trial assessed the efficacy and safety of oral resveratrol supplementation on glycemic control and lipid profile in pediatric patients with T1DM.

Methods

This study included 60 children and adolescents with T1DM. Enrolled patients aged 12- 18 years with disease duration > 5 years. Patients were randomly assigned into two groups; intervention group who received oral resveratrol tablets 250 mg twice daily. The other group (did not receive any supplementation and served as a control group. Both groups were followed-up for 6 months with assessment of fasting blood glucose (FBG), HbA1c% and fasting lipid profile.

Results

After 6 months, resveratrol therapy resulted in a significant decrease of FBG, HbA1c, triglycerides and total cholesterol compared with baseline levels and compared with the control group (p < 0.001). No significant difference was found between Patients with T1DM without resveratrol adjuvant therapy at baseline and at 6 months as regards any of the studied variables except for triglycerides and total cholesterol which were significantly increased at study end.

Conclusions

Resveratrol as an adjuvant therapy to insulin improved blood glucose levels, glycemic control and dyslipidemia without adverse effects in pediatric patients with T1DM.
Non-Invasive High Frequency Oscillatory Ventilation versus Continuous Positive Airway Pressure in Preterm Neonates With Respiratory Distress Syndrome
Authors: Gad Ghada Ibrahim , Salama Asmaa Ahmed , Amin Ibrahim Mariam John
Published: July 2024

Background

Respiratory distress syndrome (RDS) is the main cause of respiratory failure in preterm neonates, its incidence varies from 80% to 25% depending on gestational age. When optimal prenatal care is provided, the best approach to treat RDS, according to several recent trials, consists of providing continuous positive airway pressure (CPAP) from the first minutes of life using short binasal prongs or masks, followed by early selective surfactant administration for babies with worsening oxygenation and/or increasing work of breathing. Any effort must be done to minimize the time under invasive mechanical ventilation (IMV). Non-invasive high-frequency oscillatory ventilation (nHFOV) is a new mode of non-invasive ventilation that connects non-invasive circuits to high-frequency ventilators, through which gas exchange is achieved by the superposition of high-frequency oscillation over continuous positive flow. Compared with other non-invasive ventilation modes, nHFOV combines the advantages of nCPAP and high-frequency ventilation, making it more effective at maintaining alveolar stability, eliminating CO2, and limiting barotrauma.

Objective

To investigate the effectiveness of nasal high frequency oscillatory ventilation in comparison to nCPAP as a primary mode of respiratory support in preterm neonates with respiratory distress syndrome.

Methods

This randomized controlled trial that was conducted on 90 neonates diagnosed with RDS at the Neonatal Intensive Care Units (NICUs), Ain Shams University Hospitals throughout six months.

Results

In the current study, there was a significant decrease in FiO2 needs in nHFOV group vs. nCPAP group, the median (IQR) (30% (21 to 37) vs. 31% (30 to 40) respectively, P-value=0.030), but non significant difference in RDS according to total Silverman score in nHFOV group vs. nCPAP group with median (IQR) total Silverman score (4 (4 to 5)vs. 4 (3 to 6) respectively, P-value= 0.474).

Conclusion

Using nHFOV is better than nCPAP in decreasing the need of FiO2.
Frequency of Wheezing Among Preschool Children Presenting to the Emergency Department: Single Centre Study
Authors: El-Owaidy Rasha H , Ali Ahmed A , Shousha Ghada A , El-Sayed Zeinab A
Published: July 2024

Background

Preschool wheeze (PSW) is a serious clinical problem which, while typically mild, can present within a wide spectrum of severity and is associated with considerable healthcare costs. Therefore, we were motivated to investigate the frequency rate of PSW among the children presenting to emergency department (ED) of a primary care General Pediatric Hospital, ni Suez, Egypt, over a period of one year.

Patients and Methods

A Cross sectional study was conducted from May 2019 to April 2020 in the ED of Suez General Hospital. Patients aged from 1 to 5 years, presenting with preschool wheezes were recruited with detailed description of the episodes concerning severity on presentation, seasonal variations and response to treatment.

Results

Out of 3720 infants and children presenting to the ER over the study period, 302 (8.1%) patients had SW, 187(61.9%) males and 115 (38.1%) females with mean age of 2.65 ‡ 1.21 years. Over the study period, frequency of PSW presentation was more during winter (38.5%) and fall (28.1%). Around 33 % of PSW patients had associated allergic rhinitis (32.8%), while family history of allergy was positive in 29.1%. Flare ups severity was determined at time of enrollment and showed that 60.9% were mild, 30.5% moderate, 7% severe and 1.7% were life threatening exacerbations.

Conclusion

PSW is common among Egyptian children with frequency approaching international numbers. Wider scale longitudinal studies are needed to estimate the frequency and severity of PSW and the risk of future asthma.
Comparison of Oral Vitamin D2 and Vitamin D3 Supplementation in Raising Serum 25-Hydroxy Vitamin D Status in Pediatric Patients
Authors: Elsedfy Heba Hassan , Hassan Nawar Marwa Magdy , Ali Sohair Abdelbaset , Ahmed Mahmoud Rana Abd Elhakim
Published: July 2024

Background

there is a controversy regarding the effect of vitamin D2 and D3 in elevating and sustaining 25-hydroxyvitamin D (25(OH)D) levels in pediatric patients. It has been suggested that vitamin D3 may be superior to vitamin D2 in raising and sustaining adequate 25(OH)D values. Aim: To study the difference between the effect of enteral vitamin D2 and vitamin D3 administration in raising and maintaining serum 25(OH)D in pediatric patients.

Methods

Randomized controlled clinical trial, conducted in Pediatric Endocrinology Unit, Ain Shams University, Cairo, Egypt, where 60 participants who had vitamin D deficiency were recruited. Subjects were divided into two groups, 30 patients per group (group A received 2400 IU of oral vitamin D2 daily and group B received 2400 IU of oral vitamin D3 daily). History of sun exposure and dietary intake of calcium, assessment of anthropometric measures and Tanner staging, laboratory investigations were documented. Follow up of serum level of 25(OH)D was done every month for three consecutive months.

Results

Oral vitamin D3 supplementation in group B patients resulted in significantly higher increments in 25(OH)D levels than that achieved by oral vitamin D2 supplementation in group A after 2nd, and 3rd months of the supplementation (P=0.000). Vitamin D3 supplementation resulted in a significantly greater increment in serum 25(OH)D levels from 1st to 2nd month and from 1st to 3rd month than Vitamin D2 supplementation (P=0.000). All participants in group B (100%) who received vitamin D3 reached sufficient levels (≥ 30 ng/ml) after 2 months while 76.7% of participants in group A who received vitamin D2 reached sufficient levels after 2 months and 23.3% of participants after 3 months (P= 0.017).

Conclusion

Oral vitamin D3 supplementation was more effective in raising serum 25(OH)D status in pediatric patients than oral vitamin D2 supplementation.
COVID-19 Infection in a Group of Egyptian Children with Bronchial Asthma: A Single Center Study
Authors: Harb Waleed N , Shousha Ghada A , El-Owaidy Rasha H , El-Sayed Zeineb A
Published: July 2024

Background

Impact of asthma on COVID-19 severity and outcome in infants is not well investigated. Therefore, we sought to assess the presentation, severity and outcome of COVID-19 infection in a group of Egyptian asthmatic children.

Patients and Methods

We conducted an observational follow up study on 30 asthmatic children with probable/confirmed COVID-19, aged 6-10 years, who were enrolled consecutively from the Emergency department and Isolation Ward, Children`s Hospital, Ain Shams University, Egypt. COVID-19 clinical manifestations, severity and outcome were studied.

Results

The median age of the children was 9 years (IQR: 6-18 years). Out of the 30 studied patients, we had 9 boys and 21 girls. COVID-19 was asymptomatic in 2/30 (6.7%), mild in 20/30 (66.7%), and severe in 8/30 (26.7%). Clinical manifestations of COVID-19 included constitutional (22,73.3%), respiratory (21, 70%), gastrointestinal (7, 23%), cardio- vascular (5, 16.7%), and dermatological (1, 3.3%) manifestations. Multisystem inflammatory syndrome (MIS-c) was diagnosed in only one patient. Chest X-ray abnormalities were found in (36.7%). The median duration of hospital stay was 10 days, Complete resolution was the final outcome of all patients.

Conclusion

Asthma does not represent a risk of severe COVID-19 or poor outcome and COVID-19 course, and the outcome in asthmatic children is similar to the general pediatric population. However, our study is limited by the small sample size and short duration of follow-up. Further longitudinal studies are needed to investigate the exact impact of different SARS-CoV-2 variants with respect to asthma phenotypes and asthma biological treatments and allergen immunotherapies in children.
Effects of Memantine on Cognitive Flexibility in a Valproic Acid Rat Model of Autism
Authors: Zohny Sohir M , Habib Mohamed Z , Mohamad Magda I , Elayat Wael M , Elhossiny Reham M , Abd El-salam Mohamed F , Hassan Ghada A M , Aboul-Fotouh Sawsan
Published: July 2024

Autistic children frequently struggle with cognitive flexibility. The potential molecular mechanism underlying cognitive inflexibility remains unclear. Decreased level of brain-derived neurotrophic factor (BDNF), which plays a vital role in neural development and synaptic plasticity may have a role. This study aimed to investigate the effects of memantine on (BDNF) expression in hippocampus of prenatal VPA exposed rats, and its consequent effects on cognitive flexibility.

Pregnant female rats received a single intraperitoneal injection of VPA (600 mg/kg) on gestational day 12.5 to induce autistic-like behaviors in their offspring. Afterwards, the 23-day-old male Wistar rat pups received daily intraperitoneal injections of memantine (20 mg/kg) for 4 weeks. The prenatal VPA-exposed rats exhibited reduced cognitive flexibility in the attentional set- shifting task (ASST) reflecting ASD-associated cognitive flexibility deficits, a common ASD- associated problem with accompanied reduction in hippocampal BDNF. The defective performance in ASST was more prominent in the reversal stages. Memantine associated increased hippocampal BDNF could alleviate cognitive inflexibility in ASD. This study draws attention to the potential favorable effect of memantine on cognitive performance in autistic subjects.
Evaluation of Serum Procalcitonin as a Diagnostic and Prognostic Biomarker for Sepsis in Major Burn Patients: A Prospective Study
Authors: Mohammed Salah Nasser , Ghanem Mohamed Abdel-Mohsen , Abd ElHalim Mohamed Mamdouh , Fekry Mohamed Fathy
Published: July 2024

Background

Sepsis in burns worsens the patient’s prognosis and increases the risk of organ failure and death. Multiple organ dysfunction syndrome (MODS), which is a direct response to sepsis is the main reason for death in burn patients. Identifying early sepsis is very important, given that every 6 h delay in the diagnosis of sepsis reduces survival by 10%. Complexity in diagnosing sepsis in the burn is due to the systemic response to the burn itself clinically simulating sepsis.

Aim of the Work

The aim of this study is: To investigate the diagnostic validity of PCT in burn sepsis as an early diagnostic tool and to identify its prognostic value in major burn patients with sepsis.

Patients and Methods

The study was a prospective study carried out in the Burn Intensive Care Unit (ICU) of Ain Shams University Hospitals on 30 patients that were admitted from October 2021 to April 2022 with major burn (more than 20% of TBSA) were included and the Local Ethics Committee approved the study, and informed consent was obtained from all participants or their guardians.

Results

It had been revealed that the first 3 samples have no significant increase in PCT levels in relation to sepsis. However, the following 2 samples which had been withdrawn on day 5 show a significant increase in PCT levels, and these on day 7 on admission are highly significant with a median (IQR) range of 9 ng/dl and median (IQR) range of 13.2 ng/dl respectively. Moreover, it had been noted that the PCT level on admission was significant for the prognosis of death with a median (IQR) range of 1.65 ng/dl while in survivor patients the median was 0.45 ng/dl.

Conclusion

Our study demonstrated that PCT level in major burn patients is a promising diagnostic biomarker in detecting sepsis that could facilitate ideal management and initiate proper antimicrobial therapy and good prognostic value as an early predictor of mortality.
Satisfaction and Comfortability of the International Non-Arab Students at Faculty of Medicine, Ain Shams University in Their Accommodation Place: A Cross Sectional Study
Authors: Ali Yomna Ayman Ali , Hussein Abdullah Rasha Saad , Manzour Ayat Farouk , Mustafa Nayera Samy
Published: July 2024

Background

The growing international educational marketplace attracts students from all over the world. These students bring economic benefits to the host countries and their cultures and languages. However, international students face challenges and have needs and expectations when studying abroad. Comfortability in their accommodation whether it is in official dorms or private places among one of the most concerning challenges.

Objectives

To measure international non-Arab students’ satisfaction and comfortability level in their accommodation place, and to identify the effect of gender and place of accommodation on the satisfaction and comfortability level of students.

Methods

A cross sectional study with a total of 119 international non-Arab students were included in the study (42% males, and 58% females), Data was collected using a self-administered questionnaire including questions about age, gender, place of accommodation, satisfaction, and comfortability in the accommodation place.

Results

The mean age of the sample was (19.46 ± 2.02), and 58% of them were females. Most of the study participants lived in rented apartments (53.80%). The mean of the comfortability in the accommodation place was (32.08 ± 6.80). 46 % of the study participants had moderate comfortability in their accommodation. Satisfaction and comfortability in the accommodation place was associated with the gender of the students and the accommodation group (official dorms and private places), P values were 0.032, and 0.002, respectively.

Conclusion and Recommendation

The satisfaction and comfortability of the international students in the official dorms are lower than in the private places, and this needs more institutional support to improve the students’ experience.
The Role of CT in Differentiating the Non Pediatric Renal and Adrenal Region Fatty Masses
Authors: Elgaafary Sahar Mohamed , Naguib Elaassar Maha Mahmoud , Shoukry Amir Elham , Bedair Elbastawesy Mai Mohamed
Published: July 2024

Background

CT is indicated in many abdominal conditions because of its excellent morphological resolution and its ability to image many different structures, such as abdominal viscera, pelvic organs, lungs and bones, with a single examination.

Aim of the Work

The aim of this study is to highlight the accuracy of multi-detector computed tomography scan in diagnosing the different fatty lesions of the renal and adrenal regions by comparing the CT study of the benign lesions with their follow up CT scan and comparing the CT study of the malignant cases with their histo-pathological results.

Patients and Methods

The study was conducted on 34 patients most of them had unrelated complaints(incidental findings) and were referred to Radiology department, Theodor Bilharz Research Institute. Their age ranged from 20 years to 81 years old (mean age 56.35 years±13.61). Most of the patients were males 21cases while female were 13 cases. The patients were referred from oncology, general surgery, and urology departments of Theodor Bilharz Research Institute hospital as well as the outpatient clinics to perform MDCT in the period from September 2021 to June 2022.

Results

MDCT examinations were done for 34 patients and concluded that MDCT should be used in the first place in the course of diagnostic procedures of patients with renal and adrenal region fatty lesions and this was justified by an overall diagnostic accuracy of 100% for benign lesions and 82% for malignant lesions, where MDCT could correctly diagnose (33/34) cases and only 1 case was misdiagnosed, confirming the ability of MDCT to show up the accurate diagnosis, the exact location, extent of tumor, along with involvement of adjacent organs and vessels.

Conclusion

It also has a high accuracy in differentiation of malignant from benign lesions and detection of lymph node involvement & metastasis. There by improving the prognosis.