bluuebunny/crossref_metadata_2025 huggingface dataset:
Cardiorespiratory Assessment of Preterm and Near Term Neonates on Nasal Continuous Positive Airway Pressure (CPAP) in Different Body Positions
Authors: Hassan Maha Hassan Mohammed , El-sakka Abeer Salah Eldin , Ahmed Doaa abdel-Hamid Mohammed , Alhassanin Arwa Hamdy Al sharabasy
Published: November 2024

Background

The use of continuous positive airway pressure (CPAP) is one of the recommended interventions to reduce morbidity and mortality in preterm infants. The effect of body position is directly associated with clinical conditions and factors related to respiratory assistance.

Aim and Objectives

To evaluate the effect of different body positions on different cardiac, respiratory parameters for preterm and near term neonates with respiratory distress treated with CPAP.

Patients and Methods

This one arm clinical observational study was conducted on 81 preterm and near term neonates who had respiratory distress, placed on nasal CPAP. They were placed in prone, supine, left lateral and right lateral position, each for 90 minutes. The neonate was kept in each position for 30 minutes (washout period), then was observed clinically and monitored for respiratory rate, heart rate, oxygen saturation. Also, using electrical cardiometry cardiac output, stroke volume and index of contractility (ICON) level were monitored for 60 minutes, recorded at intervals of 10 minutes then the average was taken.

Results

Respiratory rate was significantly decreased (p-value < 0.001) in prone position 42.65 ±5.03(breath/min), compared to 45.41±7.73(breath/min)in supine position, 45.2±5.39(breath/min) in left lateral position, 45.23±5.32(breath/min) in right lateral position. Oxygen saturation was significantly increased (p-value <0.001) in prone position 97.3%±1.6% compared to 95.8±1.5% in supine position, 94.9%±1.6% in left lateral position, 95±1.5% in right lateral position, while there was no statistically significant difference as regard heart rate (p-value 0.64). As regards cardiometry parameters, cardiac output and stroke volume were highly significantly increased(p- value 0.019, <0.001 respectively) in prone position; that cardiac output was 0.41 ± 0.13 (l/min) in prone position versus0.38± 0.14 (l/min) in supine and right lateral positions, 38± 0.13 (l/min) in left lateral position, stroke volume was 3.02 ± 1.03(ml) in prone position versus 2.67 ± 0.87(ml) in supine position, 2.72 ± 0.94 (ml) in left lateral position, 2.74 ± 1.07(ml) in right lateral position.

Conclusion

Neonates on nasal CPAP in prone position had the highest oxygen saturation, lowest respiratory rate, highest stroke volume and cardiac output, further researches are needed on a greater scale.
Electrocardiographic Changes in Pediatric Patients with COVID-19
Authors: Mostafa El-Ganzory Mona , Elguindy Waleed Mohamed Mohamed , El-Gendy Yasmen Gamal Abdo , Elsamman Nora , Sadek Hadeel Yasser Mohamed
Published: November 2024

Background

COVID-19 may present with cardiac involvement such as shock, elevated troponin or, pro- brain natriuretic peptide level, coronary artery involvement, ventricular dysfunction, and arrhythmia. The most frequent electrocardiographic findings are low QRS amplitude, nonspecific ST segment changes and T-wave abnormalities. PR interval prolongation and first-degree AV block are also common in patients with MIS-C.

Aim of the Study

To evaluate the electrocardiogram changes in pediatric patients with COVID-19.

Patients and Methods

The present study is a cross sectional study which included 75 patients with definite, probable or evidence of previous COVID-19 infection (based on positive PCR, IgM or IgG), who were admitted at El Demerdash Pediatrics Hospital. Each child had two electrocardiogram done (on presentation and on third day of admission).

Results

The median age of our population was five years. Thirty five were females and fourty were males. On presentation, our patients had regular rythm, bradycardia was found among 9 patients (12%) and tachycardia was found among 17 patients (22.7%). Four patients (5.3%) showed prolonged PR interval, one patient (1.3%)showed prolonged QRS complex, one patient showed Right axis deviation and four patients (5.3%) showed left axis deviation, prolonged QT interval was found among four patients(5.3%). Regarding T wave, there was inversion in V1 in 27 patients(37.5%) and inversion in v4 in 24 patients(32.9%). All these findings disappeared with follow up on day three of admission.

Conclusion

Electrocardiogram may represent a crucial test in the diagnosis of myocardial injury or heart rythm disturbances in patients with SARS-COV-2.
Caveolin-1 Level in Children and Adolescents with Type 1 Diabetes
Authors: Mohamed Elbyoumi Afify Mohamed Abo-Elasrar , Elhenawy Yasmine Ibrahim , Kamel Salem Hanaa Ragab , ElSamman Nora
Published: November 2024

Background

Diabetic nephropathy is a major vascular related complication of diabetes and the most common cause of end-stage renal disease. Caveolin-1 is a significant regulator of cellular adhesion and migration, playing a key role in signal transduction.

Aim

Assess caveolin level among children and adolescents with type 1 diabetes and highlight the relation between caveolin level and urinary albumin excretion rate (UAER).

Methodology

A comparative cross-sectional study recruiting a total of 50 participants with type1 diabetes and 25 age and gender matched controls. Participants with type1 diabetes were equally divided into a normoalbuminuric and a microalbuminuric group according to (UAER). Caveolin level was measured by enzyme-linked immunoassay.

Results

Caveolin levels were higher in patients with diabetes compared to healthy controls (p < 0.01). Among patients with type 1 diabetes, caveolin levels were significantly higher in patients with diabetic nephropathy compared to patients without diabetic nephropathy (p < 0.001). ROC curve analysis showed that a cut off value of caveolin more than 6 ng/ml best differentiated patients with diabetic nephropathy from those without nephropathy with a specificity of 96%. Additionally, data from the current showed that caveolin levels positively correlated with (UAER) and HbA1c.

Conclusion

Caveolin levels are significantly associated with UAE in patients with type 1 diabetes. These findings may support the concept that elevated caveolin may be associated with diabetic angiopathy and could serve as a potential therapeutic target.
Socio-Demographic, Epidemiological and Clinical Pattern of the Egyptian Children with Cystic Fibrosis
Authors: Hasan Hossam Adel Gouda , Khalak Karima Ahmed Abdel , Fouda Eman Mahmoud , El Gaafary Maha Mohamed , Ahmed Ali Heba Allah
Published: November 2024

Background

Cystic fibrosis (CF) is a genetic disease; most definitely serious, transmitted in am autosomal recessive mode, that mainly affects the respiratory and gastrointestinal system. However, little is known about the characteristics of CF among the Egyptian children.

Aim of the Work

To record the demographic, clinical characteristics, diagnostic tools, the most frequent mutations and the outcome of the Egyptian cystic fibrosis children attending our center, paving the way for having national survey of CF children.

Patients and Methods

This was a cross-sectional studywhich was conducted at Pediatric Pulmonology Unit, Ain Shams University, Children’s Hospital for a period of 12 month recruiting CF patients attending Pediatric Pulmonology Clinic during their routine visits.

Results

Ninety-six CF patients were included whose ages was 6.44(±4.33) years, and ranged between 0.5 to 17.7 years. Gender distribution was fairly even, with 52.1% males and 47.9% females. Most lived in rural areas (56.3%), while 43.8% were in urban areas. 75% of the patients were of average socioeconomic status. A significant portion had a family history of cystic fibrosis (74%). Diverse initial complaints among participants were reported where the most common was failure to thrive in 30.22% of patients, followed by steatorrheain 29.17%. Recurrent chest infections affected 25% of patients, while delayed passage of meconium was reported in 7.3%. The most common presenting symptoms were cough (96.9%) followed by steatorrhea(92.7%) followed by expectoration(84.4%) and wheezes 81.3%. The most common genetic mutations wasF508del (30.2%) No mortality has been reported among the studied cystic fibrosis patients

Conclusion

the comprehensive data presented in this study provide a thorough understanding of the clinical profile, most common mutations and outcomes of the 96 pediatric patients with CF in a single center which is recommended to be done in all centers caring for CF patients to allow establishment of CF registry in Egypt
Oxidative Stress Status in Gaucher Disease under Enzyme Replacement Therapy
Authors: Adly Amira Abdel Moneam , Ismail Eman Abdel Rahman , Ibrahim Fatma A , Sayed Khaled Anwar El , Aly Nihal Hussien
Published: November 2024

Background

Enzymatic deficiency in patients with Gaucher disease (GD) may induce a cascade of events that results in production of reactive oxygen species that can then generate oxidative stress.

Objectives

This study assessed the oxidant-antioxidant status in Egyptian patients with GD under enzyme replacement therapy (ERT) and its relation to disease severity.

Methods

This study included 40 patients with GD with median age 10 years (11 had type 1 GD and 29 had type 3 GD). All patients were on stable dose of enzyme replacement therapy (ERT). All included patients were subjected to detailed medical history with special emphasis on hepatic, skeletal, hematological and skeletal manifestations as well as history of splenectomy and ERT (dose, type and duration. Abdominal ultrasonography was performed. Severity score index was assessed. Complete blood count, liver enzymes, lyso GL1, malondialdehyde (MDA) as an index for lipid peroxidation was measured and antioxidant enzymes (reduced glutathione [GSH], superoxide dismutase [SOD], glutathione peroxidase [GPx] and peroxiredoxin 2 [PRDX2] levels) were assessed. Oxidant-antioxidant status was compared with levels of 40 age and sex-matched healthy controls.

Results

Patients with GD had significantly higher levels of MDA compared with healthy controls (median, 19.6 versus 7.19 mg/dL; p < 0.001). GSH was significantly lower in GD patients with a median 0.95 versus healthy controls 8.92 mg/dL (p < 0.001). Mean levels of SOD, GPX and PRDX2 were significantly decreased in GD patients (p < 0.001 for all). Severity score index was positively correlated to MDA (r = - 0.511, p = 0.023) while negatively correlated to PRDX2 (r = - 0.562, p = 0.01). PRDX2 was negatively correlated to lyso GL1 (r = -0.569, p = 0.009).

Conclusions

Oxidative stress is prevalent in pediatric patients with GD and related to disease severity. This helps to understand GD pathophysiology ad allow the use of antioxidants as an adjuvant therapy to decrease disease burden.
Assessment of Psychological Impact among Hospitalized Children; Single Centre Study
Authors: Abdelaziz Eman Amin , Youssef Azza Mohamed , Abdel Raouf Batoul Mohamed , Elhamid Salwa Amin Abd , Zakaria Mahmoud Mennat Allah
Published: November 2024

Background

The modern hospital environment is geared towards providing a safe and healing environment for those afflicted with a variety of illnesses. Staying in the hospital may affect patient's behavior and emotions, which may have an impact on patient's health and development.

Aim of Work

The aim of the work was Psychosocial and mental health assessment among the hospitalized children between 7 to 12 years of age via clinical psychosocial structured interview for patients using Pediatric symptom checklist (PSCL) and assessment of pain using VAS (visual analogue scale for pain).

Subjects and Methods

This was a Cross Sectional Study curried out at Children’s Hospital Faculty of Medicine for 1 year duration on hospitalized children; the studied populations were divided into cases group and control group. Cases group were further divided according to the presence of acute or chronic illness. Children aging from 7 years to 12 years, children diagnosed with medical illness or surgical cause or both were included to this study in the cases group. While in control group matched healthy children were added. Children in pediatric intensive care unit or with known psychiatric illness were excluded. Detailed medical history through direct interview with the patients & their legal guardian was done. Psychosocial assessment & interview: The following questionnaires were being applied: Clinical psychosocial structured interview for patients using Pediatric symptom checklist (PSCL) to facilitate recognition of emotional and behavioral problems (Arabic version). Assessment of pain using VAS (visual analogue scale for pain).

Results

Higher results were found between the 3 groups in all subscales of PSC-17 being higher in chronic illness then acute illness then control group with P value (0.000) in total score, internalizing subscale, attention subscale except for externalizing subscale result where no significant difference found between the 3 groups with P value (0.059). There is a highly significant difference between cases group and control group as regard VAS scale for pain with P value (0.000) while no significant difference found between both acute illness and chronic illness group with P value (0.299).

Conclusion

Hospitalized Children due to chronic or acute conditions are at a higher risk for Psychosocial and mental health disorders as; depression, ADHD and pain in comparison with healthy children.
Effects of L-Carnitine Supplementation on Gastric Emptying in Children with Drug Resistant Epilepsy on Ketogenic Diet
Authors: Nassar May F , Shata Mennatallah O , Ibrahim Haya E , Awadallah Shrouk M , Youssef Mennatullah A
Published: November 2024

Background

The ketogenic diet (KD) is a high fat, low carbohydrate, and adequate protein (1 g/kg) diet with a demonstrated efficacy in the treatment of drug-resistant epilepsy (DRE) in infants and children. Gastrointestinal (GI) disturbances are often related to scarce tolerance of the diet that results in a significant resistance to the ketogenic diet and even blunting its efficacy. In addition, ketogenic diet’s high-fat content prolongs the gastric emptying time thus favoring gastro-esophageal reflux disease, nausea and vomiting.

Objectives

The objective of the study was to assess the effect KD on Chalfont seizure severity scale and the effect of L-carnitine supplementation on gastric emptying in children with drug resistant epilepsy (DRE) on ketogenic diet (KD).

Patients and Methods

This was a randomized controlled clinical trial that was conducted on thirty children newly diagnosed with DRE. The patients were divided randomly into 2 groups (15 patients received KD with L-carnitine supplementation and the rest received KD only). Patients were assessed at baseline and 3 months of starting KD. Assessments of children included Chalfont Seizures Severity Scale and the antral length by ultrasound.

Results

The mean age of the studied children was 4.5 years in KD with L-carnitine supplementation group and 3.5 years in KD only group, 33.35% of the children were females and 66.65% were males. Our study showed that there was a highly significant increase in weight and height/length for age z-scores in all patients after intervention with p-value=0.002. Our results also showed marked improvement of seizures activity for epileptic children in both groups after 3 months of intervention. Our study proved that the patients who received KD with L-carnitine supplementation showed highly significant increase in HDL level after intervention. A comparison between the two studied groups regarding the antral length by ultrasound showed that there was no statistically significant difference between both groups at time of enrolment and after intervention.

Conclusion

KD is an effective, safe, and tolerable therapy for children with DRE. Although antral length didn’t reach statistically significant difference between both groups initially and after KD therapy, L- carnitine supplementation had a positive effect on fasting lipid profile.
Assessment of Blood Products Transfusion in Tertiary Neonatal Intensive Care Units Ain Shams University
Authors: Awad H , Ramzi Mira M A , Hussein Mohamed H M
Published: November 2024

Background

Preterm Neonates, especially very low birth weight infants, remain a category of patients with high transfusion needs. Appropriate transfusion of neonates is vital when the potential clinical benefit outweighs the risk. However, the association between transfusion and adverse outcomes remains inconclusive.

Aim Of The Work

To evaluate transfusion practices in Tertiary Neonatal Intensive Care Units at Ain Shams University.

Patients and Methods

A cross sectional observational study was conducted on patients selected from Tertiary Neonatal Intensive Care Units at Ain Shams University- Children’s hospital. There were 703 neonates (29.64%) who received at least one type of blood products (packed red blood cells, platelets, fresh frozen plasma or cryoprecipitate) transfusion or underwent exchange transfusion during their hospital stay. All neonates receiving blood products transfusions were assessed for full history taking, clinical parameters i.e. gestational age, birth weight and general examination, indications for admission whether medical or surgical indications. Co-morbid illness such as bronchopulmonary dysplasia, necrotizing enterocolitis, retinopathy of prematurity, sepsis and patent ductus arteriosus were also noted. In addition, the indications for each of blood products transfusion i.e. anemia, exchange transfusion, thrombocytopenia, sepsis or other indications. Then, the requisition was assessed for pre- and post-transfusion laboratory parameters.

Results

Packed red blood cell was the most frequent blood component transfused (82.4%) and the main indication was anemia of prematurity (34.8%). There was a highly statistically significant increase in each of hemoglobin and hematocrit (HCT) post transfusion (with P value <0.0001) and a highly statistically decrease in the required median fraction of inspired oxygen (FiO2) (with P value <0.0001). 681 neonates (96.9%) presented with comorbidities; the most common comorbidity was neonatal sepsis in 81.2%. Packed red blood cells (PRBCs) transfusions were highly statistically significant related to comorbidity development.

Conclusion

Majority of blood transfusions occur during the first 2 weeks of life. Gestational age, birth weight, underlying disease of neonates, the need for oxygen support and blood collection within first two weeks of birth influence their transfusion needs. Sepsis remains the foremost etiological factor for blood component transfusion.
Diagnostic Outcome of Rome IV Criteria in Diagnosis of Functional Constipation among Infants and Children
Authors: Talaat El-Deeb Marwa , Awad Yosra Mohamed Mohsen , El-Ghafar Mohamed Ahmed Abd
Published: November 2024

Background

Functional Constipation is one of the most prevalent functional gastrointestinal disorders (FGIDs) among children worldwide. Rome IV criteria is used to diagnose functional constipation. The use of Rome questionnaire for screening also reveals other associated FGIDs.

Objective

To assess the outcome of Rome IV criteria in diagnosis of functional constipation among infants and children and follow up of cases to uncover any organic causes among them.

Methods

Cross-sectional, controlled study on 121 patients diagnosed as constipation with no red flags, selected from Pediatric Gastroenterology & General Clinics in Ain Shams University, Egypt. Patients were divided into 2 groups, below 4 years old (21 patients) and above 4 years old (100 patients) based upon the age stratification of the Rome criteria which was applied to all patients.

Results

There was nearly equal gender affection with a median age of 10 months among patients younger than 4 years, and a median age of 7 years old among patients older than 4 years. It was found that 38.1% of infants had a mixed diagnosis, where infant colic and regurgitation occurred in 9.5% and 33.3% of cases respectively. While among the group above 4 years old, Functional Dyspepsia represented the most common associated FGID (64%), followed by Aerophagia (8%), then Functional Vomiting (5%), while Abdominal Migraine and Functional Nausea represented 3% and 1% of all cases respectively. Upon follow up none of the patients developed any organic disease.

Conclusion

We concluded that diagnosis and follow up of patients using Rome IV is efficient in excluding organic diseases and diagnosing functional constipation (FC) and it avoids the need for further investigations. Moreover, Rome questionnaire was able to detect other FGIDs associated with constipation.
Effect of Ketogenic Diet on Sleep Quality of Children with Drug Resistant Epilepsy and Their Mothers
Authors: Fathy El-Rashidy Omnia , Nassar May Fouad , Shata Mennatallah Osama , AbdelMageed Reham Ibrahim , El-haggar Mohamed Ahmed
Published: November 2024

Background

Children with drug-resistant epilepsy (DRE) often suffer from sleep disorders and psychosocial dysfunction. Their mothers also complain of sleep difficulties in relation to poorly controlled of seizure activity of their children. Recently, several studies confirmed the positive effects of the ketogenic diet (KD) on DRE both in adult and in pediatric populations.

Objectives

The objective of the study was to assess the effect of using KD as an adjuvant treatment on the sleep quality of children with DRE and their mothers.

Patients and Methods

The current prospective observational study was conducted on forty epileptic children on KD who followed up at Pediatric Neurology and Clinical Nutrition Outpatient clinics or were admitted due to drug resistant seizures at the Pediatric Neurology Department. Patients and their mothers were assessed at baseline and after 3 months of starting KD. Measures for children included children’s sleep habits questionnaire (CSHQ) and measures for mothers included Pittsburgh Sleep Quality Index (PSQI).

Results

The mean age of the studied children was 5.19 years (±3.22). About 52.5% of the children’s parents were relatives and 20% of the children had a perinatal history of neonatal asphyxia, 87.5% gave a history of delayed development and 5% had a family history of similar cases. For children the mean score of CSHQ showed a statistically significant difference between baseline and after 3 months of starting KD with p value (<0.001). Regarding the mothers, the results showed that there was a statistically significant difference in PSQI between baseline and after 3 months of their children starting KD with p value (<0.001).

Conclusion

The results of this study showed an improvement of sleep quality for children with drug resistant epilepsy and their mothers over the course of 3 months of KD therapy.
Diabetes Self-Management Smartphone Application: Patient Satisfaction Survey for Rightest app Using the Short Version User Experience Questionnaire (UEQ-S) : A Single Center Pilot Study
Authors: Elbarbary Nancy S , Fereig Yasmeen A , Mohamed Mohamed O
Published: November 2024

Background

The ability of people with type 1 diabetes mellitus (T1DM) to improve glycemic control depends on their ability to interpret and act on blood glucose results. We investigated applicants satisfaction when switching to blood glucose meters (BGMs) featuring rightest app via Bluetooth using their smartphones.

Objective

This study aimed to assess the feasibility of the app (rightest) and the participants satisfaction after using the app in 3 months interval by using UEQ -S score.

Methods

This is an observational study, conducted at the Pediatric and Adolescent Diabetes Unit, Children’s Hospital, Faculty of Medicine, Ain Shams University (PADU), on participants with T1DM(13-18 years old). The recruited participants (n = 20) with T1DM started using the “Rightest” app for 3 months. UEQ-S was used at the end of the study to asses the participants satisfaction. It consists of the two dimensions pragmatic quality (item 1–4) and hedonic quality (item 5–8). Each item is measured on a 7-point Likert scale with two opposite meanings ranging.

Results

20 participants with T1DM, following up at PADU, used BGM with rightest app for 3 months. UEQ-S results revealed pragmatic total score (1.425) was above average while the hedonic total score was good(1.250) and the overall score was good(1.338) where -3 indicates extremely bad score while +3 indicates extremely good score. This indicates that they showed overall good satisfaction for mobile app using UEQ-S score.

Conclusion

This study demonstrated that switching to BGMs with mobile app showed good satisfaction after 3 month interval.
Knowledge, Attitude and Practice Survey towards Antibiotic Misuse among Egyptian Parents
Authors: Ramadan Mohammed Maha Zakariya , Anis Omnia Atta , El-Ganzoury Mona Mostafa , Wassif Ghada Ossama Mohamed , Sallam Dina Ebrahem Darweish
Published: November 2024

Background

The burden of antimicrobial resistance (AMR) is significantly high in low- and middle-income countries. A multitude of factors contributes to the development of AMR such as antibiotic misuse and overuse through self-medication combined with lack of awareness. Therefore, evaluation of patients' knowledge, attitude, and practice are indicators for antibiotic misuse.

Objectives

To assess knowledge, attitude, and practice (KAP) of antimicrobial self- medication among Egyptian parents and

Methods

This cross-sectional study used a 55-item questionnaire that was previously developed in English language. An Arabic validated version was used after ensuring its accuracy by translating the questionnaire to Arabic and then back translating it to English version by 2 bilingual experts in Faculty of Al-Alsun (Languages), Ain Shams University. The questionnaire was also face-validated by four experts, two in the field of Pediatrics, one in the field of Pediatric Neurology and one in in the field of Public Health. The questionnaire included: demographic data, knowledge and attitudes on antibiotic use, experiences of interactions with physicians, and practices of purchasing antibiotics.

Results

We have included 210 parents from the General outpatients’ clinic, where 49.52% of them showed inadequate knowledge, 52.38% of parents exhibited negative attitude and 53.81% of parents had poor practice. This was significantly influenced by sociodemographic characteristics including age, sex, educational level, medical insurance, and monthly income. We also found a significant positive correlation between the total knowledge score and total scores of attitudes and practice (r = 0.174, 0.264 and p = 0.011, 0.0001, respectively).

Conclusion

Lack of knowledge and misconceptions exist about the use and indications of antibiotics. Efforts is required to improve parents’ knowledge about antibiotics and promote healthier attitudes.
Microbiological Causes of Relapses in Pediatric Onset Inflammatory Bowel Disease
Authors: Ebaid Peter Atif Ghally , Saber Ahmed Mohamed Hamdy , Awad Yosra Mohamed Mohsen , Mahmoud Basma Sherif Fahmy
Published: November 2024

Background

A bidirectional relationship exists between infections and the development of inflammatory bowel disease (IBD). Early diagnosis of infection in a relapse may reduce a patient’s unnecessary exposure to corticosteroids and/or immunosuppressive drugs and it may also hasten their time to recovery.

Aim of the Work

The aim of the present study is to assess the microbiological causes of relapses in IBD patients including clostridium difficile infection.

Patients and Methods

This was a cross sectional study included 50 known children with IBD who were following up at Pediatric Gastroenterology Unit, Children’s Hospital, Ain Shams University, and presented with acute relapse. All patients were subjected to history taking including socio- demographic data, symptoms and signs of IBD during relapse, and medications including IBD therapy and recent antibiotics, laboratory investigations including blood tests, stool analysis and culture and sensitivity. Clostridium difficile toxin A and B test was done via rapid chromatographic immunoassay in fecal specimens.

Results

The mean age (SD) of the studied patients were 12.45 (±3.2469) years. They were 30 males and 20 females. Stool culture and sensitivity showed no growth in 86% of the patients, E.coli, Salmonella and entamoeba histolytica were isolated in 10%, 2% and 2% respectively, but the serotype testing was not available. Clostridium difficile infection (CDI) was positive in 40% of included children. Children who were tested positive for CDI had high frequency of recent antibiotic use (P = 0.036), associated diabetes mellitus (DM) (p = 0.004) and presence of RBCs in stool (P = 0.038).

Conclusion

Clostridium difficile infection is an important infection in cases of relapsed IBD, which is often overlooked in pediatrics. This risk might be increased with previous intake of antibiotics and associated immunological diseases (DM).
Prevalence of Nocturnal Enuresis among Egyptian Children Presenting at the Pediatric Outpatient Department of Ain Shams University Hospital
Authors: Abdeen Reem Ramadan Hussien , Youssef Azza Mohamed , Mageed Reham Ibrahim Abdel , Elhamid Salwa Amin Abd
Published: November 2024

Background

Enuresis is a common problem among children and adolescents, and can lead to important social and psychological disturbances to them and their caregivers.

Objectives

To determine the prevalence of primary and secondary enuresis in the children and adolescent presenting at outpatient clinic. Furthermore, we aimed to determine associated risk factors of nocturnal enuresis among enuretic children.

Patients and Methods

A cross- sectional study was done among 1587 Arabic fluent mothers or caregivers of children aging 6-16 years recruited from outpatient clinic, Ain Shams University, Children’s Hospital from November 2022 to July 2023. Structured questionnaires were used to assess socio-demographic characteristics, risk factors of enuretic childrens, the association between enuresis and sleep disorders by using Children Sleep Habit Questionnaire (CSHQ) and the impact of enuresis on quality of their life by using Pediatric incontinence Questionnaire (PinQ).

Results

This study included 1587 children in Egypt, the overall prevalence of enuresis among children age group 6 to 16 years was 21%, that consisted of 209 (62.8%) boys and 124 (37.2%) girls. This study focused on risk factors that had significant difference between enuretic and non enuretic children as family history of nocturnal enuresis (p value <0.001), change living place (p value = 0.001) and habitual use of caffeinated drinks 9.9%and sweaty drinks 22.8% were significant risk factors (p value<0.001). There was a significant difference in sleep disorder grades between two groups (p value= 0.016), Enuretic participants exhibited a slightly higher prevalence of high sleep disorder grades compared to non- enuretic individuals. There was a positive significant correlation between age and PinQ score (parents’ report) (rho= 0.177, p value<0.001).

Conclusion

this study conducted among 1587 children in Egypt sheds light on the prevalence of enuresis, risk factors, and impact of nocturnal enuresis on children's quality of life. Revealed that nocturnal enuresis is a significant concern, affecting 21% of the studied children, with risk factors including gender, birth order, socioeconomic status, and family history. Furthermore, there was a significant association between sleep disorders and enuresis. Notably, nocturnal enuresis was found to negatively impact children’s quality of life.
Acute Cerebrovascular Diseases in Children: Single Center Experience
Authors: Fathallah Samah Khalaf , Hassanein Sahar Mohamed Ahmed , AlaaEl-Din Habib Mohamed , Mohammad Shaimaa Abdelsattar , Zaitoun Raghda Mohamed Hesham , Mesbah Mostafa Mohamed Farid
Published: November 2024

Background

In children, cerebrovascular events are classified into acute ischemic or hemorrhagic stroke. Ischemic stroke includes both arterial ischemic stroke (AIS) and cerebral sino-venous thrombosis (CSVT). Compared to adults, pediatric cerebrovascular events have a heterogeneous etiology and various clinical presentations. Both factors lead to a delay in diagnosis and proper management.

Aim

Our aim is to study risk factors for the occurrence of cerebrovascular events in children.

Patients and Methods

A retrospective medical record review for all children admitted to Children's Hospital, Ain Shams University from 2010-2021. All records with radiological diagnosis of a cerebrovascular event AIS, CSVT or Hemorrhagic stroke were included. Full history, family history of stroke, known risk factor of stroke like (genetic factors, cardiac, hematological, thrombophilia, collagen diseases…etc), precipitating factors for stroke before the onset or conditions like (acute illness, dehydration, head or neck trauma…etc) were reviewed. Records of full detailed neurological examination and full general and systemic examination at ER arrival were all included.

Results

sixty- two children were diagnosed as acute cerebrovascular events, 42 (71%) as AIS, 13(21%) CVST, and 7(11.3%) Hemorrhagic Stroke (HS). The age at diagnosis was 74.2% (2-6 years), 11.3% (6-10 years), 11.3% (10-14 years), and 3.2% (14-18 years). Acute illness preceded acute stroke in (31) 50%, dehydration in (2) 3.2%, head or neck trauma in (3) 4.8%, cardiac catheterization in (7) 11.3%, and chemotherapy in (1) 1.6%. There were no stroke risk factors in (30) 48.4%, cardiac (8)12.9%, hematological (2) 3.2%, thrombophilia (5) 8.1%, genetic (7) 11.3%, infection (3) 4.8%, collagen or vascular diseases (4) 6.5%, family history (2) 3.2%, and cardiac and genetic (1) 1.6%.

Conclusion

While there were not risk factors in half of the admitted children for acute stroke, acute illness was the commonest precipitating factor for acute stroke. The most common risk factor was cardiac diseases and cardiac catheterization.
Role of Fetal Cardiac Screening in Fetuses of Diabetic Mothers and its Impact on Postnatal Outcome
Authors: Ahmed Sara Mahfouz Mohamed , Ganzory Mona Mosatafa E L , Habeeb Nevin Mohamed Mamdouh , Ali Hend Galal Eldeen Mohammed , Elaal Mohamed Omar Abd , El sayed Eman Mohamed
Published: November 2024

Background

Maternal diabetes mellitus (DM) is known to affect fetal growth and development. Fetuses of diabetic mothers may have functional cardiac abnormalities, which have recently gained importance and may be found despite good glycemic control. Analysis of fetal cardiac function might provide important information on the hemodynamic status and cardiovascular adaptation to different perinatal complications.

Objectives

To study the role of fetal echocardiography and fetal cardiac MRI in screening of fetuses of diabetic mother and to study the impact of early diagnosis on postnatal outcome.

Subjects and Methods

Our study included 60 pregnant diabetic females divided into two groups according to HbA1c cut off value which is related to adverse pregnancy outcomes 7% (Group a): 30 pregnant diabetic females with HbA1c level below 7% were examined by fetal echocardiography and also assessed by postnatal echocardiography (Group b): 30 pregnant diabetic females with HbA1c level more than 7% were examined with fetal echocardiography with further assessment with fetal cardiac MRIand also assessed by postnatal echocardiography

Results

As regard type of maternal diabetes 32.5% of our patients were diagnosed with gestational diabetes and 67.5% were diagnosed with pregestational diabetes. Maternal diabetes affects left ventricle (LV) diastolic function and global cardiac function but does not affect LV systolic function. Diastolic dysfunction was detected through assessment of myocardial performance index(MPI)which ranges form (0.42_0.64)in group (b) compared to (0.4_0.48) in group (a) with p value 0.000. Diastolic dysfunction was detected in 10% of infants of diabetic mothers (IDM) of our patients with pregestational maternal diabetes compared to 0% affection of systolic function in IDM of our patients (p-value=0.000). Interventricular septum (IVS) thickness showed significant values in IDM with 72% in pregestational maternal diabetes with range of (2.3_5 mm) compared to 45% in gestational maternal diabetes with range of (0.28_4.9mm) with (p- value=0.001). IVS showed positive correlation with myocardial performance index (MPI) and indices of DM such as HbA1c. HbA1c is the most significant predictor for IVS thickness in fetuses of diabetic mothers especially with long duration of DM with p value of 0.026.

Conclusion

Fetal echocardiography in diabetic mothers is highly important for evaluation of cardiac function of the fetuses. Fetal cardiac MRI can provide additional information about fetal cardiac function that may improve post-natal follow up and management.
Fetal Echocardiography Vs. Pulse Oximetry Screening for Early Detection of Critical Congenital Heart Diseases and Neonatal Outcome
Authors: Habeeb Nevin Mamdouh , Emam Safaa Shafik , Aref Miral Adel , Gafar El Feky Wessam Abd El
Published: November 2024

Background

Delayed diagnosis of critical congenital heart disease (CCHD) in neonates increases morbidity and mortality. Prenatal diagnosis by fetal echocardiography (FE) allows preparing an appropriate perinatal and postnatal care, while postnatal pulse oximetry screening (POS) is recommended to increase detection of these conditions as well.

Objective

This study aimed at comparing outcome in neonates with congenital heart diseases diagnosed either by fetal echocardiography versus those screened by pulse oximeter.

Patient and Methods

This is an observational study conducted on 30 neonates admitted to Neonatal intensive care unit of Ain Shams University Maternity Hospital with CHD in the period from December 2019 to June 2021. Neonates were divided into 2 groups; Group1of neonates with CHD identified by FE and Group 2 included those detected by POS.

Results

Fifteen neonate diagnosed by fetal echocardiography were compared to another 15 newborns with congenital heart disease detected by pulse oximeter screening. There was no significant difference between both groups regarding demographic and maternal history. Clinical examination between the two groups did not differ either except for oxygen saturation, which was lower in the group diagnosed by pulse oximeter (p = 0.035). Fetal echocardiography could diagnose all types of cardiac abnormalities, unlike Pulse oximeter that detected only those with desaturation. Neither management nor outcome of patients differed based on the mode of diagnosis.

Conclusions

Fetal echocardiography can diagnose all types of structural cardiac anomalies antenatal, unlike postnatal pulse oximeter, which detects congenital cardiac defects with evidence of desaturation only.
Predictive Factors for Seizure Recurrence in Pediatric Patients Following an Unprovoked Seizure
Authors: Saleh Dina Amin , Hassan Abeera
Published: November 2024

Background

We studied the predictive factors related to seizure recurrence in children who presented with an unprovoked seizure at our pediatric neurology clinic over 4 years period.

Aim

To explore the predictive factors underlying seizure recurrence following an unprovoked seizure and the diagnostic yield of performing an initial EEG in pediatric patients.

Methods

We retrospectively reviewed the charts of patients who had an unprovoked seizure and were followed up for at least one year from February 2016 until February 2020. Relevant demographic and clinical data, electroencephalogram (EEG), and brain magnetic resonance imaging (MRI) findings were recorded and analyzed at annual intervals. Patients with acute neurological insult and those who were diagnosed with an epilepsy syndrome or who were already receiving antiseizure medications were excluded from the study.

Results

The predictive factors for seizure recurrence were focal seizures, symptomatic seizures due to a remote static lesion such as “perinatal insult, infection, stroke, or cerebral malformation”, abnormal initial EEG results and abnormal brain MRI findings. The recurrence rate was 96.2% in our cohort, of which 68.8% occurred within six months of the first seizure. On using the Kaplan-Meyer survival analysis curve, the probable risk of having a second unprovoked seizure among all patients was 91.8, 94.7 and 98.4% at 1, 2 and 3 years respectively but it was significantly higher among children with symptomatic seizure etiology at each interval.

Conclusion

Our cohort of patients showed an increased risk of seizure recurrence with several risk factors implicated, among those was having an abnormal initial EEG. This indicates the importance of having a baseline EEG study in predicting the risk of seizure recurrence, especially in children with symptomatic seizure etiology. The highest risk of recurrence was observed in the first six months warranting close monitoring of children during this period.
Amisulpride Ameliorates 5-Fluorouracil-Induced Memory Deficits in Wistar Rats
Authors: Raafat Radwa S , Habib Mohamed Z , Hendawy Nevein , Kamal Khaled A , Nawishy Salwa A , Aboul-Fotouh Sawsan
Published: November 2024

Mounting evidence reports chemotherapy-induced cognitive impairments in a significant number of cancer survivors which is known as “chemo-brain”. 5-fluorouracil (5-FU) is a widely used chemotherapeutic agent that crosses the blood–brain barrier readily and may have a direct brain neurotoxic effect. Moreover, 5 FU has been reported to affect cognition and hippocampal neurogenesis. In contrast, studies reveal the enhancement of cognition and hippocampal neurogenesis by atypical antipsychotics such as amisulpride. In this study the behavioural effects of chronic amisulpride therapy have been investigated in 5-FU-exposed adult Wistar rats. Behavioural effects were tested using the novel object recognition test (NORT) and the object location test (OLT). 5-FU-exposed rats exhibited significant deficits in object recognition and object location tasks. Moreover, 5-FU chemotherapy induced a significant reduction in hippocampal brain derived neurotrophic factor compared to control group. These deficits were alleviated following chronic amisulpride treatment. These findings suggest that 5-FU therapy can negatively affect both neurogenesis and hippocampal dependent working memory and that these deficits can be reversed by the simultaneous administration of the atypical antipsychotic amisulpride.
Evaluation of the Use of free Anterolateral Thigh Flap in Lower Leg and Foot Defects in Pediatric Population
Authors: Mahmoud Amr Magdy Sayed , Gad Ahmed Mohamed , Tallal Raghda Elsayed , Mehany Marian Wagih
Published: November 2024

Background

Trauma is one of the main mechanisms of complex wound formation affecting pediatric population. The goal of lower extremity reconstruction is the coverage of defects with open wounds of the leg and foot to give patients a healed wound and to let them resume their life while preventing amputation.

Objective

To clinically evaluate the reliability of free anterolateral thigh flap for reconstruction of distal leg and foot defects in pediatric patients.

Patients and Methods

This prospective study included 20 patients; 6 patients (30%) were female and 14 patients (70%) were males who had soft tissue defects in lower leg, ankle and foot which were reconstructed by free anterolateral thigh flap.

Results

the survival rate of the flap was 95% with the ability to cover defects size ranging from 12 × 5 cm to 15× 22 cm without any functional affection on the donor site. Regarding the donor site closure, 60% of the cases’ donor sites were directly closed while 40 % needed STSG. There were (100%) matching skin color between the skin of the flaps and the recipient site. 5 patients (25%) required flap debulking in secondary procedures and (75%) didn’t need debulking.

Conclusion

Anterolateral thigh flap is reliable option for reconstruction of massive soft tissue defects at the distal leg, ankle and foot in children. It provides good donor and recipient site functional and aesthetic outcomes with additional advantage of minimal donor site morbidity and a high level of patient satisfaction among pediatric population.
Assessment of Sensory Function of the First Dorsal Metacarpal Artery Flap Used in Coverage of Post Traumatic Distal Thumb Defects; A Systematic Review and Meta-Analysis
Authors: Abdelrahman Nouran Mohamed , Sayed Adel Hussein , Ali Hassan Ahmad ,   Mohamed Osama Saad el deen
Published: November 2024

Background

Reconstruction of complex soft tissue defects of the thumb, with exposure of the underlying structures, is challenging to hand surgeons, due to limited local soft tissue availability, The aim of thumb reconstruction is to create a thumb that is pliable, durable, and sensate (Prabhu et al., 2013) our study aims to assess the sensory function of one of the most commonly used sensate flaps which is the first dorsal metacarpal artery flap. The innerved first dorsal metacarpal artery flap harvested from the dorsum of the index finger was first described by Hilgenfeldt and refined by Holevich (1963). An island flap carried on a neurovascular pedicle consisting of the first dorsal metacarpal artery was first demonstrated by Foucher and Braun (1979).

Methods

we performed a systematic review of all studies that assessed the sensation of the first dorsal metacarpal artery flap that was used in coverage of post traumatic thumb defects from the year 1992 to 2022.

Results

Total of 580 papers were identified and screened, 109 full texts were reviewed and 25 studies met our criteria and reported static 2 point discrimination test of 491 patient with post traumatic thumb defects underwent coverage by first dorsal metacarpal artery flap with mean 2 point discrimination 9.394

Conclusion

First dorsal metacarpal artery flap is a good option as a sensate flap for post-traumatic thumb reconstruction
Health-Related Quality of Life among COVID-19 Patients Discharged from Ain Shams University Isolation Hospitals, 2021
Authors: El-remaily Amira Ayman Fouad , Sabbour Sahar Mohamed , Mostafa Aya , Kandil Sahar Khalil , Basyoni Nashwa Ismail
Published: November 2024

Background

A significant proportion of individuals, including those who were hospitalized, through the global pandemic of the novel 2019 coronavirus disease (COVID-19), experienced residual symptoms following acute COVID-19 infection. Accordingly, it has impacted the patient's Health-Related Quality of Life (HRQoL) resulting in negative effects on one or more domains of their quality of life.

Objective

To assess the HRQoL of COVID-19 patients discharged from Ain Shams University Isolation Hospitals, 2021.

Methods

We conducted a cross-sectional study including a total of 550 adults discharged from Ain Shams University Isolation Hospitals. Data was collected using a phone-based interview questionnaire including questions about socio-demographic characteristics, clinical information, and Short-form 8 (SF- 8) to assess the 8 domains of HRQoL; general health, physical functioning, Role physical, bodily pain, vitality, social functioning, mental health, and role emotional. Univariate analysis was done to investigate the relationship between the study variables and the total mean score of HRQoL.

Results

Participants' mean age was 53.71 ± 13.17, and 53.1% of them were females. We found that 63.5% had co-morbidities. The mean of the total days of hospital stay was 12.37 ± 7.22 and about fifth was admitted to the intensive care unit (ICU) (22.2%). The mean of the total score of the 8 items of SF-8 in discharged patients was 69.96 ± 23.31. The Role physical domain was more affected among the other domains (51.55±40.03). The following variables were significantly associated with lower mean of the total score of HRQoL as: age≥50, female gender, having co-morbidities, length of hospital stay and ICU admission.

Conclusion and Recommendation

COVID-19 is associated with negative effect on HRQoL of hospitalized COVID-19 patients especially the physical domain. Follow up service after COVID infection is recommended, especially for people with existing comorbid conditions.