bluuebunny/crossref_metadata_2025 huggingface dataset:
CXCL13 Level in Children with Acute and Relapsing Demyelinating Disorders of the Nervous system
Authors: Elagouza Iman Ali , Soliman Dina Ahmed , Zaitoun Raghda Mohamed Hesham , Habib Habib Lahzi
Published: August 2023

Background

The chemokine, C-X-C motif ligand 13 (CXCL13) plays an important role in B cell recruitment within the central nervous system (CNS). CXCL13 has been implicated as key regulatory factor in inflammatory CNS disorders including autoimmune CNS diseases.

Aim of the Work

To compare between the serum level of CXCL13 in patients diagnosed with acute central or peripheral demyelination and in healthy age and gender matched controls.

Patients and Methods

Twenty patients (patients’ group) diagnosed with acute demyelinating diseases (acute disseminated encephalomyelitis (ADEM; n = 7), acute necrotizing encephalopathy of childhood (ANEC; n = 3), autoimmune encephalitis (AE; n = 3), transverse myelitis (TM; n = 3), Guillain-Barré syndrome (GBS; n = 4) and 40 healthy age and gender matched children (control group), were enrolled in the study. All patients were subject to full history, examination and measurement of serum levels of CXCL13 in both cases and controls.

Results

Serum CXCL13 level status was significantly higher in cases compared to controls (p < 0.001). The mean serum CXCL13 level in cases was (341.75 ± 164.71 pg/ml) and in control was (51.5 ± 18.99 pg/ml).

Conclusion

Serum CXCL13 levels are significantly increased in pediatric patients with acute acquired central and peripheral demyelinating diseases of the nervous system.
Assessment of Probiotics (Lactobacillus) Supplementation in the Management of Attention Deficit Hyperactivity Disorder (ADHD)
Authors: Abdelbasir Reham Mohammed Elhossiny , Elshahawy Heba Hamed , ElSerwy HananMohey Eldin Mohamed , Abdelmageed Reham Ibrahim
Published: August 2023

Background

Studies suggest that the bidirectional relationship existent between the gut microbiome (GM) and the central nervous system (CNS), or so-called the microbiome–gut–brain axis (MGBA), is involved in diverse neuropsychiatric diseases in children and adults.

Aim and objectives

The aim of the study was to assess the effect of probiotics supplementation as an adjunctive therapy in the treatment of Attention Deficit Hyperactivity Disorder (ADHD) cases.

Subjects and methods

This was a randomized controlled study included 80 patients with ADHD diagnosed according to DSM-5 diagnostic criteria for ADHD with age ranging from 6 to 16 years old who are following up at the Child Psychiatry Clinics of both Children`s Hospital and Psychiatry Institute Faculty of medicine, Ain-Shams University, All patients randomly distributed into two equal groups, Group1:ADHD cases received probotic in addtion to atomoxetine and Group2: ADHD cases received atomoxetine without probiotic, all cases subjected to Conner’s Parent Rating Scales-Revised (CRS-R) and The Continuous Performance Test (CPT) before and after intervention.

Results

In group 1, there was significant decrease in mean differences between before and after intervention as regards Oppositional, inattentive, Hyperactive/impulsive and total scores after intervention in comparison with before intervention (p < 0.001). In group 2, the mean differences between before and after showed non-significant differences regarding Oppositional, inattentive and Hyperactive/impulsive scores (p > 0.05). There was statistically significant elevation (improvement) in the mean Correct trials, Correct targets, Correct foils, Target Accuracy Rate and foil Accuracy Rate scores of CPT among the group 1 compared with the group 2 (p < 0.05). On the other hand, group 1 had significant lower (improvement) scores of Commission errors, Omission errors, Correct Real Time Standard Deviation, Error real time mean Score and Error Real Time SD compared to group 2 (p < 0.05). In group 2, the mean differences between before and after showed non-significant differences regarding all sub items of CPT (p > 0.05).

Conclusion

Results of This study suggests that Probiotic supplementation could be beneficial as an adjunctive therapy in the treatment of ADHD cases.. This is a relatively new area of research and the number of included studies is limited.
Screening of Strawberry Allergy in Egyptian Atopic Children
Authors: El-Sayed Zeinab A , Sakr Heba A , Shousha Ghada A
Published: August 2023

Background

Strawberries are included in the list of allergenic foods. However, definite figures in many countries including Egypt are lacking. Children with food allergy are 2 to 4 times more likely to have asthma, eczema, and allergic rhinitis than their non-allergic peers. We therefore sought to investigate IgE-mediated strawberry sensitization among a group of atopic children and correlate it to their clinical and laboratory parameters.

Patients and Methods

This study comprised 256 children, 1 to 18 years old, with physician-diagnosed bronchial asthma (98 patients), allergic rhinitis (28 patients), atopic dermatitis (53 patients), food allergy (10 patients) and combined allergies (67 patients). They were enrolled consecutively from the Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo. Sensitization to strawberry was assessed using prick-prick test (PPT).

Results

Strawberry sensitization was observed in 7.8% of the studied children. Confirmed strawberry allergy was elicited in 2% of them. Strawberry sensitization was more prevalent in patients with food allergy followed by those with atopic dermatitis. Severity of allergic disease, frequency of flare ups and response to treatment did not influence the rate of strawberry sensitization in our series.

Conclusion

Strawberry allergy is not as common as claimed to be among Egyptian children with allergic disorders. Sensitization to strawberry did not impact the severity of allergy or response to treatment. The findings are limited by the sample size.
A Neonatal Sequential Organ Failure Assessment Score as a Predictor of Mortality in Neonates with Late-Onset Sepsis
Authors: Mohamed Maha H , AbdElreheem FatmaT , Shinkar Dina M
Published: August 2023

Background

Late onset neonatal sepsis (LOS) is an important problem in neonatal intensive care units (NICUs).The occurrence of multi-organ dysfunction can result in mortality in neonates with LOS. Many scores are being developed to predict mortality in neonates with LOS.

Aim

Our aim was to test the validity of neonatal sequential organ failure assessment score (nSOFA) to identify NICU patients at a high risk of mortality among those with LOS dependent on routinely collected data .

Patients and Methods

This prospective observational study was conducted on neonates with late onset sepsis. Full history taking and complete clinical examination was undertaken. Complete blood count (CBC) including total leukocytic count (TLC), C- reactive protein (CRP) and blood culture were withdrawn from included neonates. nSOFA score was calculated for all included neonates using data from patients records. nSOFA score is a noval objective score that detect organ dysfunction in neonates with late onset sepsis, and used to identify the risk of mortality using data from patients records.

Results

The obtained results showed that, neonates who did not survive had significantly higher CRP and TLC significantly lower platelet count than those who survived. Also, neonates who did not survive had significantly higher median nSOFA score than survivors. In the current study, the sensitivity of nSOFA score on presentation to predict mortality in LOS neonates was 84.21% and its specificity was 80.39% with area under the curve (AUC) was 0.890%.Also positive predictive value PPV was 61.5% and negative predictive value NPV was 93.2%.

Conclusion

The nSOFA can be useful in predicting mortality in neonates with LOS. Further studies are needed to assess its utility in different gestational age groups.
Electrophysiological Changes in Patients with Pediatric Mental Disorders
Authors: Zaky Eman A , Ramadam Mohammed Maha Z , Ali Mahmoud Y , Mageed Reham I Abdel
Published: August 2023

Background

Electroencephalography (EEG) measures represent an important data source for a new quantitative science of macroscopic and microscopic cortical brain dynamics.

Objective

To record the central neuro- electrophysiological pattern in children with different types of pediatric mental disorders.

Methods

In this cross-sectional observational study, 100 children with different types of pediatric mental disorders [Autism (n = 30), ADHD (n = 30) and nocturnal enuresis (n = 40)] were evaluated from those under regular follow up at the Child Psychiatry Clinic, Children’s hospital, Ain Shams University. Full history, detailed psychiatric interview, psychometric assessment using specific scales according to the disorder, IQ assessment, EEG and Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria for definitive diagnose of each disorder were assessed.

Results

The enrolled children age ranged between 5-16 years with a mean value of 9.09 ±2.49 years, and 74 were males. Eleven children had history of Neonatal Intensive Care Unit (NICU) admission.IQ ranged from 27 to 101 with a mean value of 78.92 ± 16.29 SD. Childhood Autism Rating Scale (CARS) for children with Autism ranged from 30 to 47 with a mean value of 35.53 ± 3.42 SD. The Conners Comprehensive Behavior Rating Scale for children with ADHD ranged from 61 to 78 with a mean value of 68.63 ± 4.66 SD. Only 5 children had epileptogenic activity in the EEG [autism (n = 3), ADHD(n = 1), nocturnal enuresis(n = 1)] with a (P-value= 0.362). In addition, history of NICU admission showed association with subsequent development of pediatric mental disorders (P-value =0.015). Furthermore, developmental history had association with pediatric mental disorder (Pvalue =0.00).

Conclusion

We observed a non-significant association between EEG changes and pediatric mental disorders. However, this study showed a significant association between NICU admission and subsequent development of pediatric mental disorders.
Should We Monitor Renal Functions in Congenital Heart Disease Infants Using High Energy Infant Formula? A Case Report
Authors: Kotby Alyaa A , Ahmed Mohammed M , Nasef Marwa A
Published: August 2023

Background

High Energy Infant Formula (HEIF) promotes adequate catch-up growth in infants with faltering growth. Of concern, is the potential increased risk of HEIF as a high protein diet on renal function.

Case Presentation

This four month old female presented with ventricular septal defect, pulmonary hypertension and heart failure that was controlled with treatment. She suffered from faltering growth where her weight and length were < -2 z-score for age thus HEIF was prescribed. Serum creatinine was high normal. Two weeks after HEIF intake, growth was still faltering and mild dyspnea reappeared inspite cardiac medications. Investigations showed a rising high serum creatinine. Abdominal ultrasound revealed the presence of a single kidney. The exact contribution of predisposing factors to renal dysfunction can’t be measured since the patient had an already borderline renal functions.

Conclusion

Renal functions should be monitored before HEIF and during its use to avoid renal dysfunction in susceptible patients.
Diagnostic Yield of Endoscopy in Upper Gastrointestinal Bleeding in Pediatrics
Authors: Hamdy Ahmad Mohamed , Awad Yosra Mohamed Mohsen , Fahmy Passant Osama
Published: August 2023

Introduction

Esophagogastroduodenoscopy is currently considered the first-line diagnostic procedure of choice for upper gastrointestinal (GI) bleeding; however, the etiology of bleeding remains unknown in a subset of patients. This study aims to evaluate the diagnostic yield of upper gastrointestinal endoscopy in upper gastrointestinal bleeding in pediatrics and determine the clinical predictors for unreached diagnosis during endoscopy.

Methods

Cross sectional study, conducted at pediatric endoscopy unit, Ain Shams University, Cairo, Egypt, where 100 patients were recruited, as they were referred for diagnostic upper GI endoscopy due to overt upper GI bleeding in the form of hematemesis and/or melena. Full medical history, examination, laboratory investigations, endoscopic and histopathologic findings were documented.

Results

:100 patients with ages ranging from 3 months to 15 years, median age 4 years, 47% males and 53% females, 65% presented by hematemesis only, 7% with melena only, and 28 % presented with both hematemesis and melena. In 38 % of cases no endoscopic diagnosis was reached. While patients with a positive diagnostic yield 62%, had variable diagnosis, the most common of which was H pylori gastritis and reflux oesophagitis in 23% and 11% of cases respectively. Followed by nonspecific gastritis (8%), oesophageal varices (4%), and others (16%).. Melena was a negative predictor to reach a diagnosis by upper GI endoscopy.

Conclusion

Diagnostic yield of upper GI endoscopy in pediatric patients with upper GI bleeding was only 62%. Combining upper GI endoscopy with other tools in cases presenting with melena alone is highly recommended since bleeding from a source in the small bowel or right colon may also be the cause.
Trace Elements Status (Zinc & Copper) in Pediatric Patients on Regular Hemodialysis
Authors: Wastawy Hoda L , Attwa Ramy G , Saleh Waleed S , Abdel Halim Bassma A , Sallam Dina E
Published: August 2023

Background

Hemodialysis patients are at risk for deficiency of essential trace elements and excess of toxic trace elements, both of which can affect health.

Objectives

Up to our knowledge, there is no previous data about the normal values of trace elements in pediatric hemodialysis patient, so our aim was to evaluate the status of both serum zinc & copper in our pediatric hemodialysis patients in order to evaluate the need for supplementation.

Methodology

This is a case control study which involved 2 groups: Patients’ group included 60 children with end stage kidney disease on regular hemodialysis following up at Pediatric Dialysis Unit, Ain Shams University Hospitals and 60 healthy children served as a control group. Measurements of serum copper and zinc were performed by atomic absorption spectrophotometry, complete blood count (CBC), iron and lipid profiles were done and correlated to serum copper and zinc level.

Results

Patients’ group were 32 males (53.3%) and 28 females (46.6%) with an average age of 13.06 ± 2.08, 8-17 years, BMI of (15.07 ± 3.30, 8.38-21.14 Kg/m2) and duration of hemodialysis was (3.28 ± 2.33, 1-10 years). The control group were 39 males (65%) and 21 females (35%) with age of (8 ± 2.14, 5-12 years) and BMI was (16.36 ± 1.30, 14.6-18.5 Kg/m2).

Six patients (10%) had low serum zinc level with values between 58 to 59 mcg% (normal:60-120 mcg%), while only two patients (3.3%) had low serum copper level with values of 66 mcg% (normal:70140 mcg%). All control group had normal serum zinc and copper levels with a significant difference between patients and control groups as regards serum copper level (Patients’ group 78.06 ± 7.5 mcg%, control group 82.46 ± 8.13 mcg%, P = 0.03). We found a negative correlation between blood copper and ferritin level (r = 0.334, P value = 0.009). We also found a positive correlation between blood copper and cholesterol level (r = 0.276, P value = 0.033).

Conclusion

Hemodialysis could lead to depletion of biologically essential trace elements, thus routine monitoring of trace element blood levels is important for proper nutritional support of patients on hemodialysis.
Characteristics of Autism Spectrum Disorder among a Sample of Egyptian Children
Authors: Zahra Sally S , Hassan Batoul M , AMahmoud Rana A , Abdel Lateef Rania K
Published: August 2023

Background

Autism spectrum disorder (ASD) is a biologically based neurodevelopmental disorder characterized by impairments in two major domains; deficits in social communication and social interaction and restricted repetitive patterns of behavior, interests and activities.

Aim of the Work

Understanding and correlating the socioeconomic status (SES), clinical characteristics and the severity of ASD.

Patients and Methods

100 autistic patients were assessed using DSM-V criteria, intelligence quotient (IQ) assessment using Stanford Binnet intelligence scale, assessment of severity of autistic symptoms using childhood autism rating scale (CARS), and psychometric evaluation for comorbid psychiatric conditions by using Pediatric Symptoms Checklist (PSCL), Full clinical examination, neurological examination, Electroencephalography (EEG) for some patient & socioeconomic status (SES) assessment were also done.

Results

Severity of ASD was correlated with each of motor & social delay (p = 0.007) (p = 0.000) respectively, impairment in Sphincter control (p = 0.012), imitation impairment (p = 0.010) and stereotypic behavior (p = 0.015. Our patients had comorbidities in the form of; gastrointestinal tract (GIT) symptoms, eating disorders and EEG findings (p = 0.004) (p = 0.005) (p = 0.038) respectively. Our patients mainly belonged to middle SES (57%) and severity of ASD was correlated with family possessions domain of SES (p = 0.001). Children who belonged to high SES were more likely to be diagnosed earlier (p = 0.016) with better IQ (p = 0.003) than those from lower SES.

Conclusion

It is important for developing countries to have their own research and to increase public awareness in all socioeconomic strata and establish integrated services for autism.
Neurocognitive, Psychosocial Outcomes and Quality of Life in Pediatric Brain Tumors and Their Caregivers
Authors: Ebeid Fatma S E , Aziz Asmaa W Abdel , Ali Sara G M , Ali Heba G A
Published: August 2023

Background

Treatment Modalities included surgical management and the use of cranial irradiation (CI) and/or chemotherapy have significantly increased the survival rate of pediatric brain tumour.

Aim of the Study

Primary objective was to determine neurocognitive and psychosocial outcomes in pediatric brain tumour as well as to assess quality of life in pediatric patients with brain tumours and their caregivers. While the secondary objective was to determine risk factors that might affect these outcomes.

Methods

A cross sectional study including children and adolescent with confirmed diagnosis of Pediatric Brain Tumour (PBT) conducted in Pediatric Haematology Oncology clinic, Ain Shams University Hospital, Egypt from the period June 2019 to June 2021.Demographic and clinical data were collected, a thorough clinical and psychiatric assessments were conducted. Qualityof-life (QoL) of the children were performed using Arabic validated version of PedsQL 4.0 and pediatric symptom checklist. Quality-of-life (QoL) of the caregivers were performed using the short version of the WHO Quality of Life Instrument (WHOQOL-Bref)

Results

Forty-five patients with confirmed diagnosis of pediatric brain tumour who regularly followed up at the study site were included. Patients were 27 (60%) boys and 18 (40%) girls, and their mean age was 7.22 ± 3.23 years. Thirty four patients (75.6%) had primary brain tumour and eleven patient (24,4%) had secondary brain tumour. There was overall decrease in all domains of quality-of-life of patients with brain tumour assessed using PedsQL 4.0. Using pediatric symptom checklist revealed that 37.8% had psychological abnormalities.

Conclusion

The quality of patients' life and their caregivers after brain tumors diagnosis is affected, the disease, its treatment and its course had significant negative impact on the multiple domains of their daily life. Consequently, it is vital for healthcare professionals to develop and implement interventions which target on reducing depressive symptoms, enhancing self-esteem and QoL.
Interleukin-18, Interleukin-18 Gene Polymorphisms and Interleukin18 Binding Protein in Children and Adolescents with Immune Thrombocytopenia
Authors: Mokhtar Galila Mohamed , Altawil Mohamad Mostafa , Kamal Tarek Mostafa , Andrawes Nevine Gamal , Elfatah Mona Fathy Abd , El-Wahab Fayed Waleed Abd , Eltonbary Khadiga Yehia
Published: August 2023

Background

Immune thrombocytopenia (ITP) is an autoimmune illness characterized by an aberrant T cell response, which is supported by autoreactive B cell growth and differentiation. IL-18 expression has been linked to a number of autoimmune and inflammatory illnesses. IL18BP is a protein that binds IL-18 with high affinity, suggesting a potential mechanism for regulating IL-18 activity. Corticosteroids may play a significant role in reversing the IL-18- IL18BP ratio by upregulating IL18BP.

Objective

The aim was to study associations between IL-18 and two associated gene polymorphism sites -607 & -137 with incidence and response to therapy in patients with ITP.

Patients and Methods

It is a case control study conducted on children and adolescents with ITP.A total of 55 patients with different stages of ITP (25 acute, 18 persistent & 12 chronic patients) were recruited with 30 age matched healthy controls. All patients were subjected to full history and physical examination. Laboratory investigations included serial blood counts, IL-18 and IL-18BP serum levels using enzyme linked immunosorbent assay (ELISA) and IL-18 gene polymorphisms using polymerase chain reaction (PCR).

Results

At diagnosis the median platelet count was 16× 109/L (range 2-79) & eventually increased to a median of 90× 109/L after treatment. IL-18 level was significantly higher than that of control (P < 0.001) & even after treatment. There was no significant difference between patient and control groups regarding the studied gene polymorphism sites -607 & -137. The mean IL-18 was still significantly elevated in all stages of ITP compared to control group & as well the drop after treatment. This was also observed in IL-18 BP which increased significantly after response to steroid therapy. However, it was observed that the decline in level of IL-18 as well as increment in IL-18 BP was the least in the patients tested during the acute phase. Mean IL-18 & IL-18 BP levels show no significant relation with gender, family history of ITP, mode of treatment or genotype.

Conclusion

Among the studied IL-18 gene polymorphisms, no significant difference was detected among ITP patients or had a significant correlation with clinical or laboratory markers. Reversed IL-18/IL-18BP ratio is an important modulator in pathogenesis of ITP. Increasing levels of IL-18BP could have a significant role in treatment.
Transcranial Doppler Sonography in Children with Congenital Heart Disease Undergoing Cardiac Catheterization
Authors: Hassanein Sahar Mohamed Ahmed , Hameed Abeer Maghawry Abdel , Nasef Marwa Waheed Abdel Hady , Sattar Yomna Mohsen Abdel
Published: August 2023

Background

Children with congenital heart disease (CHD) are at high risk for neurodevelopmental disabilities. Acute neurologic complications, such as seizures, transient ischemic attack, intracranial hemorrhage, and ischemic stroke might occur in the setting of cardiac surgery and cardiac catheterization. Cardiac catheterization is important in the diagnosis and assessment of hemodynamic function in children with congenital heart disease. The incidence of neurologic complications (occurring within 48 hours) in interventional cardiac catheterization is significantly higher than those in diagnostic.

Objective

The Aim of this study is to evaluate the effect of cardiac catheterization on TCD Commented [RM1]: transcranial doppler (TCD) in children with congenital heart disease.

Methods

This is a prospective study. 40 children were enrolled; at Children’s hospital, Ain Shams University over 6 months. TCD parameters, clinical data, neurologic examination were done before and after cardiac catheterization.

Results

In the present study, 33 patients (82.5%) had interventional catheter and 7 (17.5%) had diagnostic catheter. Middle cerebral artery TCD parameters of the patients in the diagnostic group showed lower peak systolic (PS), and time average mean of the maximal velocities (TAMX), also called mean velocity, before catheterization and lower PS, end diastolic (ED), and TAMX post catheterization. All patients showed statistically significant lower TAMX post catheterization.

Conclusion

Cardiac catheterization lower middle cerebral artery time average mean of the maximal velocities in children with congenital heart disease. This impairment in blood flow might be a risk for cerebrovascular diseases in this population.
Validating Rat Model of Polycystic Ovary Syndrome Induced Non-Alcoholic Fatty Liver Disease: Role of Hyperandrogenism and Insulin Resistance
Authors: Hashem Maha H , Mohamed Doaa I , El-Kharashi Omnyah A , El-Waseef Dalia A , Bassyouni Lobna A , Elmelegy Ahmed Abdel-Salam M
Published: August 2023

Background

Polycystic ovary syndrome (PCOS) is a highly prevalent endocrinemetabolic disorder. PCOS is frequently associated with abdominal adiposity, insulin resistance, and cardiovascular risk factors. Increased prevalence of NAFLD has been reported in patients with PCOS.

Aim

to validate a model of PCO induced NAFLD and determine the role of androgen and insulin resistance in the model pathogenesis.

Material and Method

Testosterone Enanthate (TE) was used to induce PCOS in female wistar rats by receiving TE subcutaneously at a dose of 7.5 mg dissolved in sesame oil by S.C. injection daily from embryonic day 16 (E16) to E19, female offsprings are divided into; control group, model group.

Results

PCO produced significant increase in body weight, liver weight, ALT/AST ratio, testosterone (T), Luteinizing hormone (LH), fasting glucose, serum insulin, HOMA-IR and serum c-peptide with dyslipidemia and decrease in serum estradiol (E2) level. The picture of PCOS and NAFLD was clearly seen biochemically and histologically.

Conclusion

our study validated the model of PCO induced NAFLD as manifested by the biochemical and histological analysis. .
Injection of Hyaluronic Acid versus Steroid Guided by Ultrasound in Management of Rotator Cuff Tendinopathy
Authors: Haider Alaa I , Abd El-Hakim Mervat M , ElShishtawy Heba F , El-Mallah Reem M
Published: August 2023

Aim of the Work

To compare effect of injection of sodium hyaluronate versus steroid guided by ultrasound in treatment of rotator cuff tendinopathy.

Aim of the Work

To compare effect of injection of sodium hyaluronate versus steroid guided by ultrasound in treatment of rotator cuff tendinopathy.

Patient and Methods

This study was conducted on 30 patients with shoulder pain. All patients were subjected to history taking, clinical examination and laboratory investigations together with diagnostic musculoskeletal ultrasound. Pain and function scores were assessed using the visual analog scale(VAS), Oxford shoulder score (OSS), and Constant shoulder score (CSS). All patients were randomly assigned into one of two groups; Group I received single steroid injection, Group II received single hyaluronic acid injection. Patients were re-assessed after 2 months of injections.

Results

After 2 months of injection, both groups showed improvement regarding CSS, OSS and VAS and the difference between pre-injection and post-injection was highly significant regarding all three parameters (p < 0.001). On comparison between groups; Group II showed highly significant improvement regarding CSS and VAS compared to group I (P < 0.001). However, there was no difference in OSS between two groups (p > 0.05).

Conclusion

Hyaluronic acid injection offers better therapeutic advantages over a corticosteroid injection in the treatment of rotator cuff tendinopathy especially in the short term follow up.
Comparison between Total Contact Custom-Made Insole versus Over the Counter Insole in Rehabilitation of Rheumatoid Arthritis Patients
Authors: Eweis Noha A , El-Kadery Nadia Abd-El Salam , Ahmed El-Hilaly Rana , ElBadawy Mohja Ahmed
Published: August 2023

Objective

To compare the effect of total contact custom-made foot insoles versus over-thecounter flat silicone insoles on pain and foot function in rheumatoid arthritis patients.

Patients and Methods

This study included 30 patients diagnosed with rheumatoid arthritis according to the 2010ACR/EULAR classification criteria. All underwent history, clinical examination of foot, plantar pressure assessment, pain assessment by visual analog scale (VAS), foot functionality, assessed by Lower Extremity Functional Scale (LEFS). Patients were randomly assigned to group (A) 15 patients which received total contact custom made insoles. And group B, 15 patients received a flat over the counter insole made of silicone, follow up was done after two weeks using VAS and LEFS scores.

Results

A total of 30 patients, aged 46.07 ± 10.78 years, with disease duration ranged from 2 – 18 years with Median (IQR) of 5.50, body mass index (BMI) ranged from 19.5 to 37 kg/m2 with mean ±SD of 29.01 ± 4.00. In both groups, significant difference in the VAS after using insoles, observed more in -group A with mean ± SD 22.67 ± 11.47, while mean ± SD of group B was 39.00 ± 14.04. Regarding LEFS score: significant improvement of the score ―improved lower limb functionality‖ in both groups after using the insoles, slightly higher in group B more than group A. No significant differences in functionality between the two groups (LEFS score after intervention for group A with Mean ± SD 40.13 ± 9.88, group B with Mean ± SD 43.20 ± 6.82).

Conclusion

The custom-made foot orthoses significantly reduced the patients’ foot pain, although they did not have significantly positive effects on disability and foot functionality compared with only cushioning.
Serum Galectin-1 Level in Egyptian Patients with Rheumatoid Arthritis: A Pilot Study
Authors: Zaki Salwa A , ElGanzoury Amal M , Fouda Neven M , Elbably’ Mona M
Published: August 2023

Background

Rheumatoid arthritis (RA) is an autoimmune disease that primarily affects the small joints of the hand, wrist, and feet. If left untreated, it can lead to extensive impacts on quality of life, with loss of productivity due to damaged and deformed joints. It is also associated with significant extra-articular manifestations and mortality. The cause of developing the disease is still unknown which leads to ongoing studies to further understand the pathogenesis and find new treatment targets and new classes of therapeutics. One of the studied markers is Galectin-1 (Gal-1). Gal-1 is a part of Galectin family and is their prototype. It could be found in a large number of tissues with pro-inflammatory and antiinflammatory effects depending on the cellular microenvironment.

Objectives

To evaluate the serum level of Galectin-1 in Egyptian rheumatoid arthritis patients and controls.

Patient and methods

This case-control study included 20 Egyptian patients with rheumatoid arthritis diagnosed according to 2010 ACR\EULAR criteria and 20 Egyptian healthy controls. Every patient is subjected to full clinical examination; swollen joints, tender joints, deformity, laboratory investigations; serum Galectin-1 level, ESR, CRP, CBC, SGPT, SGOT, creatinine, urea, Anti-CCP, RF.

Results

Comparing serum Galectin-1 levels between Egyptian RA cases and controls, there was a highly statistically significant increase in the serum Galectin-1 level in RA Cases group than the control group with a p-value <0.001 with a cut-off point between the control group and Cases group > 15 (ng/ml). There was a non-significant change in serum Galectin-1 level between different disease activity categories according to DAS28-ESR and DAS28-CRP.

Conclusion

Our study demonstrated the usefulness of measuring serum Galectin-1 in Egyptian patients with RA with high validity. This proves the role of Galectin-1 in RA pathogenesis.
Adipose-Derived Stromal Vascular Fraction in Treatment of Osteoarthritis: Experimental Study
Authors: El Din Mohamed Moussa Sherine Alaa , El Din Zaki M Gamal , Mohamed Manal Osman , Zeid Asmaa A Abo , Farrag Dina A
Published: August 2023

Background

Osteoarthritis OA is the commonest musculoskeletal disabling disease in adults. Most of the current available treatments provide only symptomatic relief. Adipose derivedstromal vascular fraction SVF has been recently introduced as potential regenerative therapy for OA.

Objective

We aimed to study the therapeutic role of adipose – derived SVF in OA.

Materials and Methods

This work included 42 female Wister rats for induction of osteoarthritis and 6 male Wistar rats acting as donors for the extraction of SVF from adipose tissue which yielded 106 cells/ml. Osteoarthritis was induced by intra-articular injection of collagenase type II in the right knee joint of all female rats and the left knee was considered as healthy controls. Rats were divided into three groups, healthy control Group (group I), induced osteoarthritis control group (Group II) which received no treatment and SVF treatment group (Group III). Group II and III were subdivided into 2 subgroups; IIa, IIb and IIIa, IIIb which were euthanized after 1 and 2 months of OA induction respectively. Modified Manikin score (MS) was used to assess cartilage degeneration. Image Analysis was used to assess chondrocyte count, articular cartilage thickness and optical density in slides stained with Hematoxylin and Eosin and Safranin-O-stain.

Results

It was observed that MS scored highest in Group II compared to Group III and Group I (P < 0.001). After 1 month, MS in Group IIa and Group IIIa was (10.75 ± 0.50 and 2.50 ± 0.53, P < 0.001). Similarly at 2 months MS was (8.50 ± 0.58, 0.50 ± 0.53, P < 0.001). Also, morphometric analysis revealed Group II contained least chondrocyte cellular count compared to Group III and Group I (P < 0.001). After 2 months, articular cartilage thickness was least in Group II compared to Group IIIb and highest in Group I (P < 0.001). Also, optical density OD measurement using imaging in slides stained with Safranin revealed OD was highest in Group I, followed by Group III and least in Group II (P < 0.001).

Conclusion

Adipose derived SVF represents potential regenerative therapy for OA. It decreased development of degenerative changes at early stages of induced osteoarthritis in rats and promoted regeneration with increased cartilage thickness and proteoglycan content at later stage.
Effect of Apelin on Hepatic Dysfunction in a Rat Model of Heart Failure
Authors: Yassin Naema Gomaa , Aly Seif Ansam , Abd el Hamid Manal Said , Nassef Noha Abdel- Aziz
Published: August 2023

Background

Severe heart failure can be accompanied with liver dysfunction. The role of apelin in liver disease is still a matter of debate. The aim of this study is to examine the effect of apelin on liver dysfunction in heart failure rat model and the underlying mechanisms of this effect.

Materials and Methods

39 female Wistar rats were divided into three groups 13 each; control (Intraperitoneal saline for 2 weeks, daily), Isoprenaline (ISO) (Intraperitoneal saline for 2 weeks, ISO in the last 2 days (100 mg/kg, subcutaneous) and Apelin group (apelin, 15 µg/kg/day Intraperitoneal for 2 weeks and ISO in the last 2 days). Body weights, heart and liver weights, ECG record, isolated heart study and histopathological examination for both heart and liver were carried out. Serum cardiac troponin T (cTnT), liver enzymes (alanine transaminase (ALT), aspartate transaminase (AST), lactate dehydrogenase (LDH) and apelin and liver APJ receptors, malondialdehyde (MDA), reactive oxygen species (ROS) and cytochrome C were measured.

Results

Apelin decreased heart weights, shortened QRS complex as well as observed and corrected Q-T intervals, increased R voltage, peak developed tension, peak developed tension per left ventricular weights and mean coronary flow rate compared to ISO treated rats. It decreased serum levels of cTnT, ALT, AST& LDH and improved serum apelin level. Also, it enhanced the hepatic expression of APJ receptor and decreased MDA & ROS and cytochrome C in liver tissue.

Conclusion

Apelin had a protective role against hepatic dysfunction that accompanied heart failure through its antioxidant and anti-apoptotic effects.
Evaluation of Blood Lactate Concentrations as a Marker for Resuscitation and Prognosis in Patients with Major Burns
Authors: Mohammed Salah Nasser , Amin Mohamed Ahmed , ElHalim Mohamed Mamdouh Abd , Nawar Kamal Ibrahim Kamal
Published: August 2023

Background

Severe burns require appropriate fluid management in the acute phase. A massive volume of intravenous fluid is usually required to ensure adequate end-organ perfusion. Lactate is a product of anaerobic metabolism. A high level of lactate in tissue is direct indication of tissue hypoxia. The correlation between serum lactate and clinical outcome has been well accepted in hemorrhagic and septic shock. However, studies on its use in predicting mortality and morbidity of major burn patients in particular is sparse. Early prediction of outcome in patients with major burn is very likely to aid suitable modification of management strategies.

Objective

To assess the role of serum lactate measurement as the predictor burn patient's outcome (survivors and non-survivors).

Patients and Methods

30 patients with major burn (more than 20% of TBSA) were included. This includes operated/ non-operated patients. Of the 30 patients, 20 were males and 10 were females. All adult burned patients admitted within the first 24h post burn were included in the study. Patients admitted after 24h from the thermal injury, or those who were discharged or died 48h after admission were excluded.

Results

Serial blood lactate measures were better as a prognostic tool than isolated measure. Reduction or normalization of lactate levels 24 hours after admission was significantly associated with a higher probability of survival. This study confirms the prognostic value of serum lactate for mortality in patients with major burns as serial blood lactate measurements predict mortality in these patients.

Conclusion

Although many studies reiterate the importance of blood lactate and lactate clearance in predicting mortality in burn patients, the role of these markers in therapy titration is ambiguous. Overzealous fluid resuscitation can cause fluid overload and acute respiratory distress syndrome. little regional data are available to establish the importance of blood lactate. We have demonstrated the association of blood lactate in the first 36 hours of the burn injury with mortality. Further large multicenter prospective studies are required.
Assessment of Health Services Provided by Women's Health Centre, Nasser Institute for Research and Treatment, Cairo
Authors: Shaheen Alaa Ahmed , Manzour Ayat F , Mostafa Nayera Samy , Fotouh Aisha Aboul
Published: August 2023

Background

Healthcare quality has become an important topic for practitioners, researchers and managers as it has great effect on cost reduction and services improvement. Recently, the role of individuals working in health institutions is very important for reaching the institutions’ goals. The satisfaction of the healthcare workers and the consequences of their satisfaction are good indicators of the quality and well-being of workers’ life. Patient satisfaction is a subjective evaluation of the health service received against client’s expectations. It is principally based on evaluating seven health service dimensions: general satisfaction, technical quality, interpersonal aspects, communication, financial aspects, time spent with doctor, and the ease of contact or availability.

Objective

To assess health services in women health centre in Nasser Institute and to analyze the customers’ opinions at women’s health centre.

Methods

This cross-sectional study was conducted at women’s health centre in Nasser institute for research and treatment. Evaluation of services in the women's health centre was done according to Well-Woman recommendations. The healthcare workers in the centre were 10 and all of them were given self-administered job satisfaction questionnaire adapted from a questionnaire of a previous study in Nigeria. Sample of client women included 210 women visiting the centre who were interviewed using SERVQUAL (questionnaire.

Results

Immunization services were missing at the centre according to Well-Woman recommendations.

Regarding, health care workers, mean age of participating healthcare workers (Mean ± SD) was 45 ± 9.6 years. The majority of healthcare workers were female (80%). Sixty percent of healthcare workers think that there is a need to improve the service packages. Regarding women seeking the services in the centre, the mean age of study participants (Mean ± SD) was 53.7 ± 11.4 years. Most of participating women were between 45 to less than 65 years (62.9%). Most of them (82.4%) were highly educated, 69.5 % were married and 78.1% knew the services from friends and relatives. Average gap score of total SERVQUAL dimensions was (Mean ± SD) 0.6 ± 0.3.

Conclusions and recommendations

According to Well-Woman recommendation, there is a defect in the comprehensive medical services in women health centre at Nasser Institute and immunization is absent. Total satisfaction rate was high for healthcare workers and women receiving the service. It is recommended to introduce more services in the centre such as immunization as well as more investigations such as Hepatitis C and B testing. Periodic professional development and training programs for healthcare workers are also recommended.
Epidemiology of Occupational Injuries and Workplace Assessment in Turnery Industries at an Industrial District, Eastern Cairo, Egypt
Authors: Mansour Asmaa Gamal , EL-Aal Abdel Hamid Mona Abd , Hakim Sally Adel , Wahdan Maha Magdy
Published: August 2023

Background

Occupational injury could be fatal or non-fatal with lost work time. Turneries are workplaces in which multiple simultaneous health hazards occur and the most common hazards are mechanical hazards.

Objective

To measure the frequency and types of injuries among a sample of turnery workers, to identify risk factors of occupational injuries among them, and to describe the environmental conditions at some of these turneries as a part of occupational safety prospective.

Methods

A cross-sectional survey was conducted on 75 workers in three Industrial areas in Eastern Cairo El-herafeen, Madinat Al-salam and El-Abour. Data were collected using a structured interview questionnaire with both close and open-ended questions, and an observational environmental checklists were filled by the researcher.

Results

Seventy-five turnery workers were interviewed, (76%) of them reporting injury during the last 12 months. About (46.7%) of operators believing that their work is extremely dangerous. The most significant determinants for occupational injuries (p value < 0.05) were lack of safety training, non-use of personal protective devices and work hazard perception. In environmental assessment, all work stations had non-covered traditional machines, only 2 work stations out of 10 assessed had natural ventilation with open windows; not any of the work stations had regular noise survey neither did any of the workers use hearing protection equipment even though it was available in 2 work stations; only 4 work stations had floors free from protruding nails, splinters, holes and loose boards, goggles were available in 4 stations while gloves and rubber boots were available in 6 stations.

Conclusion

Most of workers in small scale work stations specialized in turnery industry had occupational injury during the last 12 months. Most of the observed workstations did not comply with advised safety checklist.
Epidemiology of Age-Related Macular Degeneration in Elderly in Geriatric Homes
Authors: Edarous Dina Hussien , Fahim Hoda Ibrahim , El Maguid Tolba Momen Mohamed Abd , Manzour Ayat Farouk Mohamed , El-salam Shaat Ashraf Abd
Published: August 2023

Background

Age-related macular degeneration (AMD) is a leading cause of visual impairment and blindness in elderly population. It can cause irreversible loss of vision.

Objective

To measure the prevalence of AMD among a sample of elderly persons residing in geriatric homes, and to measure the effect of AMD on falls frequency in these elderly persons.

Methods

A cross-sectional study was conducted on 283 elderly persons in thirty geriatric homes in different geographical areas in Cairo. Data were collected using a structured questionnaire, Amsler Grid as a screening test for AMD and fundus examination.

Results

The study included 283 elderly persons with a mean age of 73.18±7.09 (60–96) years. The overall prevalence of AMD among the participants was 12.7%. The prevalence of early AMD was 58.4% while the prevalence of late dry and late wet AMD was 8.3% and 33.3% respectively. About 61.1% of the participants had unilateral AMD and only 38.9% were bilaterally affected. There was a significantly higher prevalence of AMD among those aged at least 80 years as compared with other age groups. The frequency of falls during the last year in the study participants was 53.7%, out of them 17.8% had AMD.

Conclusion

Prevalence of AMD was relatively high especially with increasing age. Among our participants, AMD was significantly associated with an increased risk of falls compared to nonAMD peers.
Relationship between Frailty and Malnutrition among Elderly Attending Two Primary Health Care Centers in Cairo
Authors: Mohamed Ghada Saad , Manzour Ayat Farouk , Momen Mohamed Abdel Maguid Tolba , Hamza Sarah Ahmed , Bakr Iman Mohammed Ahmed
Published: August 2023

Background

Frailty and malnutrition are interrelated common events associated with aging. They share similar symptoms. Many studies reported that those who are malnourished or who are at risk of malnutrition have an increased risk of frailty and loss of independence. An adequate energy intake may promote elderly`s quality of life (QOL) and prevent frailty in long-term care. Knowing dynamic between these two syndromes can assist in preventing their development and improving elderly QOL.

Objective

To determine the prevalence of frailty and malnutrition and to investigate the relationship between them.

Patients and Methods

This study was conducted in two Primary Health care centers (PHCs) in Cairo. It included 264 elderly ≥ 60 years old. Participants underwent an interview questionnaire which included socio-demographic data, medical history, frailty assessment using fried phenotype and nutritional assessment using Mininutritional assessment (MNA). Basic anthropometric measurements including weight and knee height were also done.

Results

Prevalence of frailty was 62.1% using fried phenotype criteria whereas 29.9% were considered as prefrail. Weakness and exhaustion were the most frequent reported phenotypes. Using MNA, the prevalence of malnutrition was 28% while 50.8% of the participants were at risk of malnutrition. Frailty was highly prevalent in older age, low educational level, retired elderly, in participants with chronic diseases e.g.: hypertension and diabetes. Older age, females or having chronic diseases especially hypertension, diabetes or heart diseases, were either malnourished or at risk of malnutrition. The relationship between frailty and malnutrition was significant.

Conclusion and recommendation

Frailty and malnutrition are highly prevalent among elderly and they are interrelated. It’s recommended to screen elderly individuals for frailty and malnutrition to target older persons to early intervene before their consequences become clinically evident and irreversible.