bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Dipeptidyl Peptidase-4 Inhibitors Supplementation on Non-Alcoholic Steatohepatitis in Adolescents with Type 1 Diabetes Mellitus
Authors: ElKabbany Zeinab Anwar , Elbarbary Nancy Samir , Ismail Eman Abdel Rahman , Hamed Eman Tawfik
Published: November 2024

Background

Many patients with type 1 diabetes mellitus (T1DM) had histological evidence of steatosis and met the histological criteria for non-alcoholic steatohepatitis (NASH). Accumulating data suggested that dipeptidyl peptidase-4 (DDP-4) enzyme is involved in the development of various chronic liver diseases. Some studies showed the beneficial effect of DDP-4 inhibitors in liver injury for their ability in modulating fatty acid oxidation, decreasing lipogenesis and improving hepatic glucose metabolism.

Objectives

Therefore, we performed a randomized-controlled trial to assess the effect of the oral DPP- 4 inhibitor vildagliptin as an add-on therapy on NASH in adolescents with T1DM as well as its effect on glycemic control, lipid profile.

Methods

This study included 60 adolescents with T1DM and NASH. Patients were randomly assigned into two groups; intervention group who received oral vildagliptin (50 mg daily). The other group did not receive any supplementation and served as a control group. Both groups were followed- up for six months with assessment of fasting and 2 hours post-prandial blood glucose levels, HbA1c, liver function tests, fasting lipid profile and hepatic steatosis index.

Results

Supplementation with oral DPP-4 inhibitor vildagliptin was safe and well-tolerated. After six months, Vildagliptin adjuvant therapy for the intervention group resulted in a significant decrease of systolic and diastolic blood pressure as well as insulin dose (p < 0.001). Blood glucose levels, HbA1c, liver enzymes, triglycerides, total cholesterol and hepatic steatosis index were significantly lower after vildagliptin therapy compared with baseline levels and compared with the control group (p < 0.001).

Conclusions

The DDP-4 inhibitor vildagliptin in a once daily dose of 50 mg orally for six months as an add-on therapy for adolescents with T1DM and NASH was safe and improved glycemic control and dyslipidemia while decreasing steatosis; hence, preventing disease progression.
The Frequency of Beef Allergy in Children with Cow Milk Allergy
Authors: Zaky Ghobrial Engy Melik , El-Deeb Marwa Talaat , Awad Yosra Mohamed Mohsen , Radwan Nesrine Mohamed
Published: November 2024

Background

Children with cow’s milk allergy may be instructed to avoid beef since it is recognized that there is cross-reactivity of bovine serum albumin and bovine γ-globulin which are present in both milk and beef. The true prevalence of beef allergy has been studied only in few researches.

Aim

The primary objective was to determine the frequency of allergy to beef meat in children with cow’s milk protein allergy by serum measurement. The Secondary objective was to assess the sensitivity and specificity of beef IgE in relation to the gold standard of challenge test through introduction of cooked beef.

Methods

Cross sectional study conducted on 96 children from seven months to three years old newly diagnosed with cow milk allergy at Gastroenterology Unit and Allergy, Rheumatology and Immunology Unit, Ain Shams University. Then, serum specific IgE for beef and oral food challenge test have been done.

Results

In this study, 96 children diagnosed with cow’s milk allergy have been included. Specific IgE for beef showed that 78 patients (81.25%) were positive while 18 patients (18.75%) were negative. Then, all patients were suspected to oral challenge test where they were asked to eat well cooked beef with gradual doses. 22.3% of patients suffered from gastrointestinal symptoms while 18.1%, 10.6% and 5.3% of patients suffered from skin symptoms, napkin dermatitis and respiratory symptoms, respectively.

Conclusion

Children allergic to milk protein are not necessarily to be allergic to cooked beef. Thus, elimination of beef from the diet of children with cow’s milk allergy should not be done except after oral challenge test to not lose its nutritional value without benefit.
Tissue Inhibitor of Metalloproteinase 2 and Insulin-Like Growth Factor-Binding Protein 7 in Pediatric Diabetic Ketoacidosis
Authors: Shahin Hadeer Helmy Abd Elhamied , Sallam Dina Ebrahem Darweish , El-Din Nouran Youssef Salah , Taha Sara Ibrahim Abdelfattah , Awadallah Shrouk Mohamed , Matter Randa Mahmoud
Published: November 2024

Background

Diabetic ketoacidosis (DKA) is one of the main causes of end-stage kidney disease (ESKD). Urinary concentration of tissue inhibitor of metalloproteinase 2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) are well known urinary acute kidney injury (AKI) biomarkers.

Objectives

to determine the level of urinary TIMP-2 and IGFBP7 as markers of acute kidney injury (AKI) in children with T1DM during and after the resolution of diabetic ketoacidosis.

Patients and Methods

A prospective longitudinal study was conducted over 1 year, where we have included children with T1DM presented to Emergency Department (ED) at Children’ s Hospital, Faculty of Medicine, Ain Shams University, with moderate and severe DKA, where we followed them at presentation and day 14, and determined those who developed AKI and measured urinary TIMP-2 and IGFBP7 to detect it AKI.

Results

We have included 40 pediatric patients with T1DM with mean (±SD) age of 10.59 ± 2.17 years, with a female predominance (90%). Among our patients, 18 patients (45%) had AKI at presentation, where they had a significantly elevated urinary level of both TIMP-2 and IGFBP7 than without AKI (TIMP-2 (ng/ml):112.58(13.76 - 190.1) versus 33.53 (17.27 - 149.65), IGFBP7(ng/ml) :77.42(0.57 - 164.3) versus 1.41(0.67 - 82.63) (p < 0.001). Follow up at day 14, after recovery from DKA, we had no patients with AKI, with significant decrease in the same urinary biomarkers (TIMP-2(ng/ml) :11.35 (8.13 - 25.03) versus 9.62 (7.67 - 17.02), IGFBP7(ng/ml) :0.94(0.51 - 2.34) versus 0.78 (0.43 - 1.34) (p < 0.005).

Conclusion

The level of urinary TIMP-2 and IGFBP7 increased in children and adolescent with T1DM who developed AKI at the time of presentation of DKA, and normalized after the resolution of DKA and the recovery from AKI.
Two Different Regimens of Oral Vitamin D in Treatment of Early Onset Neonatal Sepsis
Authors: Toaima Nadin N , Ali Mona R , Abdelsattar Hoda A , Mohamed Mayada A , Abdelaal NourElDin M
Published: November 2024

Background

Newborns are more susceptible to infections as both innate and adaptive immune systems are not entirely developed. Associations have been shown between vitamin D deficiency and respiratory tract infections and sepsis. Vitamin D also has immunomodulatory effects on immune function.

Objectives

To compare (lower dose of oral Vitamin D 400 IU versus doubling of it) in full term neonates with early-onset sepsis (EOS).

Methods

A randomized controlled trial (RCT) comprised sixty six (66) full term neonates with EOS, admitted to the Neonatal Intensive Care Unit of Children's Hospital, Ain Shams University and the NICU of El Ahrar Teaching Hospital in Zagazig. We excluded preterm newborns, neonates on NPO (nothing per os), neonates with maternal risk factors, such as chorioamnionitis, neonates delivered at home and those with major congenital abnormalities. All patients were assessed according to Newborn Scale of Sepsis. The cases were randomly assigned into 3 groups; group A (who received lower dose of oral Vitamin D 400 IU and group B, who received 800 IU/day of vitamin D3 and group C who didn’t receive any vitamin D supplementation. Serum concentrations of 25(OH)D were measured at enrollment and on recovery.

Results

The mean serum level of 25 (OH) vitamin D in all 66 newborns with early onset sepsis included in the study was 18.12 ± 3.6 ng/ml and it was low and considered insufficient. 78.8% of enrolled infants were vitamin D- insufficient at enrollment in the three groups. The study shows significant relation between the mean of serum vitamin D on recovery and regimen of vitamin D supplemented to the newborns; where 55 % of the patients in group A became sufficient on recovery, 75 % of the patients of group B became sufficient on recovery and 25% of group C became sufficient on recovery. Mean age of recovery of group A, B and C were 10.4±3.6, 8.7±3.2 and 11.3±3.8 respectively with significant difference between group B and group C (mean±SD) being 8.7±3.2 versus 11.3±3.8 respectively with p- value= 0.024. None of the infants enrolled in the study had signs of vitamin D toxicity or serum levels exceeding 80-100 ng/ml upon recovery.

Conclusions

Vitamin D supplementation has a role in recovery of full term neonates suffering from sepsis.
Frequency of Anicteric Hepatitis A Virus Infection in a Group of Pre-School Egyptian Children Presenting with Gastroenteritis like Manifestations
Authors: Ahmed Larine Bahy Eldin , Talaat Eman Mohamed , Aboelwafa Menna Allah Zakaria Mohammad , Abdelrahman Mohamed Samir
Published: November 2024

Background

Hepatitis A virus (HAV) infection is one of the most frequent communicable diseases with an estimated 1.5 million cases diagnosed each year globally. Most infections in children under the age of six are asymptomatic and if infection occurs, it is usually anicteric. Therefore, the disease is underreported.

Aim

To determine the prevalence of HAV infection in a group of Pre-School Egyptian children presenting with gastroenteritis like manifestations and anicteric-hepatitis and to correlate that with social and demographic risk factors.

Patients and Methods

This was a cross sectional study conducted at Ain Shams University Children’s hospital emergency room and outpatient clinic, Cairo, Egypt during the period from February 2023 to July 2023 and performed on 385 preschool Egyptian child presented with acute gastroenteritis like manifestations; who were jaundice free, with no past history of HAV infection, HAV vaccination or chronic liver disease. To all enrolled cases, history was taken, clinical examination done, socioeconomic status and liver enzymes assessed, HAV IgM antibody was evaluated only in group with elevated liver enzymes double upper limit of normal for age and sex and for cases with positive HAV IgM, complete blood count and international normalized ratio (INR) withdrawn to assess severity of the disease.

Results

Among the enrolled cases, only 32 cases had elevated liver enzymes (8.3%), 4 cases had positive HAV IgM (1%) with no stastical difference between males and females. Poor hand hygiene was significantly higher in group with elevated liver enzymes compared to other studied cases. Lower score in family possessions in socioeconomic evaluation was significant in the group with positive HAV IgM in comparison to the remained studied population.

Conclusion

Frequency of anicteric HAV infection is not uncommon in preschool age group with gastroenteritis like manifestations. Hand hygiene and family possessions can influence its prevalence. Hepatomegaly, right hypochondrial tenderness and certain cut values of transaminases may be used as good NPV values in diagnosis of HAV infection.
Reticulocyte-Hemoglobin Content as Marker for Iron Status in Preterm Neonates
Authors: Abdel-Rahman Mona Ali Ahmed , El-Laboudy Mohammed Abdel-Mohsen , Khafagy Soha Mohamed , Zakaria Abou Elwafa Menna Allah , Eltonbary Khadiga Yehia
Published: November 2024

Background

Reticulocyte indices and reticulocyte hemoglobin provide a direct real time measure of hemoglobinization in newly produced erythrocytes, without perturbation by inflammation. It has been a reliable indicator of iron availability for Hb synthesis in children and adults.

Aim of the Work

To assess the average RET-Hb values in premature neonates soon after birth, to assess its value as marker of iron deficiency (ID) and to correlate these levels with the need for early iron supplement and/or blood transfusion.

Patients and Methods

This is a prospective observational study conducted at Neonatal Intensive Care Unit (NICU), Ain Shams University Children Hospital from March 2022 till September 2022.

Results

The study included 22 females (44.0%) and 28 males (56.0%) with mean gestational age of 31.84±1.60 weeks. The mean HGB level on admission was 16.76 ± 2.16 mg/dL, with 24.0% of neonates having an HGB level <15 mg/dL and the mean Ret-HB level for preterm neonates was 31.70 ± 2.68 pg/cell. The median serum ferritin level was 168 (IQR: 125 – 225) ng/mL and ferritin was positively correlated with Ret-Hb. Almost 58% (n = 29) required iron supplements in the first 2-4 weeks of life and 64% of neonates required packed red cell transfusion during their hospitalization. Ret-Hb at a cut off level of ≤ 30.4 pg/cell can predict early enteral iron supplement among the studied group at the cut off level with sensitivity of 52.4%, specificity of 75.9% and with a cut off level < 30.8pg/cell can predict the need for blood transfusion among the studied group with sensitivity of 56.25% and specificity of 83.33%.

Conclusion

Ret-Hb levels in preterm neonates was significantly correlated with ferritin levels. Ret-Hb could be a reliable marker of iron deficiency and helps in early enteral iron supplement for this age group but normal reference ranges should be standardized.
Helicobacter pylori Infection in Children with Portal Hypertension and its Correlation with Serum Ammonia
Authors: Kamel Ibrahim Nour Hassan Hassan , Ahmed Lerine Bahy Eldin , ElAdawy Mohamed Saaed Eldin , Awad Yosra Mohamed Mohsen , Abouelkhair Mariam B , Farid Laila M
Published: November 2024

Background

Helicobacter pylori (H. pylori) infection is the most common bacterial infection worldwide, but it is even more common in developing countries. Through its urease enzyme, H. pylori converts urea into ammonia. Therefore, theoretically, H. pylori infection can augment the increase in plasma levels of ammonia in patients with portal hypertension.

Aim

To assess the prevalence of H. pylori infection among pediatric patients with portal hypertension and to assess the relationship between H. pylori infection and plasma ammonia.

Patients and Methods

This study was conducted on patients following up at Hepatology unit, children’s Hospital, Ain Shams University during the period from January to August 2023. Patients who had documented portal hypertension regardless of its grade and the status of their liver function were included. Patients who had active bleeding, sepsis, or who received antibiotics or proton pump inhibitors in the four weeks before enrollment were excluded. All patients were subjected to clinical evaluation, routine laboratory investigations and plasma ammonia level. They all underwent upper GIT endoscopy for gastric biopsy, and biopsies were subjected to rapid urease test and histopathological assessment was done for H. pylori infection using the Housten updated Sydney scoring system.

Results

Biopsies revealed that H. pylori infection was evident in 87% of the studied patients. 4 patients had grade-3 H. pylori infection, 15 had grade-2, 16 had grade-1, and 5 had no H. pylori infection. Patients with grade-3 H. pylori infection have significantly higher plasma ammonia as compared to grade 1 and 2 (p 0.007). None of the patients reached the critical plasma ammonia level, level of dialysis, of 400 ug/dl. There was no significant relationship between the patients’ diagnoses, liver function tests (PT, PTT, INR, Albumin, ALT, AST), result of rapid urease test, and plasma ammonia levels.

Conclusion

H. pylori infection is common among hepatic patients and is associated with significantly higher plasma ammonia level with more severe grades of infection. Further longitudinal studies are warranted to evaluate the real risk of H. pylori infection among patients with portal hypertension.
Value of 2D Speckle Tracking Echocardiography in Assessment of Pediatric Patients with History of Carditis at Children's Hospital
Authors: El-Ganzory Mona Mostafa , El Guindy Waleed Mohamed , Elmaged Omaima Eltaher Abo , Samman Nora El
Published: November 2024

Background

Primary myocarditis in pediatrics is presumed to be due to either an acute viral infection or a post-viral autoimmune response. Secondary myocarditis occurs due to chemotherapy, renal disease, systemic lupus erythematosus, or association with Kawasski disease. Two-dimensional (2D) speckle-tracking echocardiography allows an objective and quantitative evaluation of regional and longitudinal cardiac function.

Aim

To assess the echocardiographic changes in pediatric patients presented with carditis at their presentation and at follow-up after four weeks to detect any residual cardiac affection.

Methods

This study was a prospective controlled-cohort study that studied the two- dimensional speckle-tracking echocardiography changes in 30 pediatric patients with the diagnosis of carditis and 30 healthy age- and sex-matched controls. The study was conducted at the children's hospital, Ain Shams University, Egypt. It was done in the period from August 2021 until July 2023. A full medical history and clinical examination were done. Cardiac enzymes and two-dimensional (2D) speckle tracking echocardiography were done at admission and four weeks post-treatment.

Results

The median age of patients in the study was 9.5 years (IQR 3–11). They were 60% females and 40% males. The leading cause of carditis in our patients was viral infection, being seen in 46.7% of patients. The most common symptoms and signs at presentation were tachycardia and tachypnea. Creatinin Kinase MB was elevated in 30%, while serum troponin was high in 40%. Intravenous immunoglobulin (IVIG) was given for 60% of the patients, while steroids were given to 40%. Four patients (13.3%) needed inotropic support with PICU admission. Echocardiography showed that the left ventricle was dilated in 30% of patients. Three patients (10%) had impaired cardiac function and had abnormal global longitudinal strain (GLS) as determined by a two-dimensional speckle tracking echo (hypokinesia) with a GLS of -15%. At follow-up after four weeks, the clinical examination and investigations were unremarkable. Two-dimensional speckle echo was normal in all patients. GLS was within normal value in all patients (-19.13±1.45)% but lower than the control group (-20.36 ± 1.17)% (p-value 0.001). We found a positive relationship between global longitudinal strain at presentation with aspartate aminotransferase and cardiac enzymes (creatine kinase total and creatine kinase MB (p-values 0.000, 0.012, and 0.001), respectively.

Conclusion

Monitoring cardiac function with two-dimensional speckle tracking echo is an important tool in detecting critically ill patients with carditis, and follow-up is recommended to detect further subtle cardiac affection.
Effect of Treatment with Bisphosphonates on Bone Turnover Markers in Osteogenesis Imperfecta
Authors: Shrief Osama Elsaied Sobhy , Mahmoud Rana Abdelhakim Ahmed , El-Ashry Marwa Abd ElRasoul , Elsedfy Heba Hassan , Amr Nermine Hussein
Published: November 2024

Background

Bisphosphonates are used as standard treatment in patients with osteogenesis imperfecta (OI) in childhood and adolescence. N-terminal collagen type I extension propeptide (PINP) has been identified as the most promising marker of bone formation.

Aim and Objectives

Our study aimed to use PINP as a marker of bone formation in patients with OI receiving bisphosphonates treatment.

Patients and Methods

This observational study included 28 with OI patients (12 boys & 16 girls) on bisphosphonates treatment following up at Pediatric Endocrinology Clinic, Ain Shams University Children's Hospital during the period from March 2021 till April 2022. PINP was measured at baseline and one year after treatment. Clinical severity score was evaluated.

Results

(53.6%) of patients were classified as moderate degree of clinical severity score. Clinical severity score domains were as follows: (67.9%) of patients were classified as grade I regarding number of fractures per year (0-1), (50.0%) of patients were classified as grade II regarding motor milestones (delayed with catch up), (46.4%) of patients were classified as grade III regarding long bone deformities (noticed by both clinical examination and X-rays affecting isolated long bones) and regarding height SDS (-3.1 to -5.0), while (46.4%) of patients were classified as grade I regarding DXA Z-score (< -1.5 SD). PINP decreased <20% in 6 patients (21.4%) and increased <20% in 5 patients (17.9%). There was no change in 17 patients (60.7%). Furthermore, there was no significant relation between PINP and clinical severity score.

Conclusion

PINP change in patients with OI on bisphosphonates treatment might not be pronounced or sustained after treatment, thus might not reflect the clinical status of the patients on short term basis.
Bone Mineral Density among Egyptian Adolescents
Authors: Bashandi Rasha Omar Mohammed , Mahmoud Rana Abdelhakim Ahmed , Amr Nermine Hussein
Published: November 2024

Background

Adolescent bone mineral density is affected by several endogenous and exogenous factors. Failure to maintain optimal bone health during adolescence carries a great risk for low bone mass later on with increase liability for fractures.

Aim of the Study

To determine the level of bone mineral density (BMD)in Egyptian adolescents and to evaluate the impact of, weight, height, body mass index (BMI), physical activity, sun exposure, pubertal stage and socio-economic status on bone mass.

Methods

Forty healthy Egyptian adolescents aged 12-13years were subjected to comprehensive medical history, dietary history to assess daily calcium intake, sunlight exposure, physical activity and socio-economic status. Complete physical examination was done including anthropometric measurements and identification of Tanner stage. Serum levels of calcium, phosphorus, and alkaline phosphatase were measured. Assessment of BMD of whole body, lumbar spine (LS), femoral neck (FN) and body composition was done using Hologic dual energy X-ray absorptiometry (DEXA) scanner.

Results

The mean values of total, subtotal, lumbar and, femoral BMD of our subjects were 0.86± 0.08,80± 0.080, 0.65±0.10, 0.77±0.1 respectively. Males had significant higher values regarding each of total, subtotal and femoral BMD (p value = 0.003, 0.004,< 0.001respectively) while females had significant higher values regarding lumbar spine BMD, total body fat and fat %(p value = 0.023,< 0.001,< 0.001respectively). No difference of significance was found in lean mass or total bone mineral content. Most of DEXA parameters correlated positively with each of exercise, sun exposure as well as anthropometric measurements. (p value < 0.05). No relation of significance was found with each of social status, Tanner stage and biochemical bone markers.

Conclusion

Peak bone mass in our patients has many influencing factors, for example gender, weight, height, exercise and sun exposure. Further interventions should be done to modify the exogenous factors aiming to decrease risk of fracture later on throughout adulthood.
Effect of Health Education on Knowledge and Attitude of Parents towards Paediatric Epilepsy in Egyptian Children
Authors: Mohammed Maha Zakariya Ramadan , El Shafie Abd El Aziz Salma Mahmoud , Tomoum Hoda Yahya , Elhamid Salwa Amin Abd
Published: November 2024

Background

Epilepsy remains one of the most common neurological diseases in the world but seems to be widely misunderstood, especially in low-income countries. Patients with epilepsy can face considerable stigma in society, Parents’ knowledge on care of children greatly influences the health status of a child by reducing the mortality and morbidity rate.

Aim of the Work

Assess the attitude and knowledge toward paediatric epilepsy amongst parents of paediatric patients with epilepsy and other parents seeking advice in the out-patient clinic, Assess the effect of educational program of home management of seizures on knowledge and practice of parents.

Patients and Methods

This comparative cross-sectional study included 100 parents of children with epilepsy who follow up in Paediatric neurology clinic, Ain Shams University (Group A) and 300 parents of normal children who sought advice in Paediatric outpatient clinic, Ain Shams University (Group B) in which sociodemographic characteristics were collected and a validated questionnaire was distributed before and after an educational session about epilepsy facts and its first aid.

Results

The study revealed significant difference between study and control groups in their baseline knowledge about epilepsy, in terms of “epilepsy being an organic disease, rather than a psychiatric illness or an evil spirit” (67.0% vs. 39.8%, P < 0.001) respectively, and management of a child experiencing a seizure where 6% of group A answered “do not know” vs 74.6% of group B, P < 0.001). Regarding attitude towards epilepsy, both groups showed negative attitude towards epilepsy; 78% of group A and 66% of group B agreed that epilepsy is a factor that strongly impair child learning. Similarly, 81% of group A and 65% of group B reported that epilepsy can strongly limit sports and leisure activities. In terms of effect of educational effect, group A showed significant difference in number of correct answers regarding manifestation and first aid measures for a child with seizure before and after education (12% vs 51% P < 0.001 & 45% vs 75% P = 0.009) respectively. Moreover, group B showed significant difference in correct answers for both topics after education (0% vs. 49.2 % P, 0.001 & 0% vs 71.2% P < 0.001).

Conclusion

Our results highlight the need for educational programs and targeted awareness campaigns, to reduce misconceptions and promote a more supportive environment for individuals with epilepsy.
Behavioral and Sexual problems in Children with Mild Intellectual Disability: An Observational Study
Authors: Ahmed Samar , Youssef Azza Mohamed , Abdelmageed Reham Ibrahim , Abdelaziz Asmaa Wafeeq
Published: November 2024

Background

The cognitive and adaptive functioning deficits are the intellectual disability (ID) hallmark. Children with Intellectual Disability (ID) often display distinct behavioral and sexual problems.

Objective

To investigate behavioral and sexual problems in children with mild ID (IQ score 50-70) as compared to an age-and sex-matched control group.

Patients and Methods

A cross-sectional study was conducted on 200 children (100 with mild ID (IQ score 50-70) and 100 controls) aged 6-12 years at Ain Shams University's Developmental and Behavioral Pediatrics Clinic. Sociodemographic data were collected using an Arabic-validated Socioeconomic Status Scale. Intellectual ability was assessed with the Stanford-Binet Intelligence Scale and Adaptive behaviors were measured using the Vineland Adaptive Behavior Scale (VABS). Behavioral competency and problems were assessed using the Child Behavior Checklist (CBCL). Sexual behaviors were evaluated using the Child Sexual Behavior Inventory (CSBI).

Results

A higher percentage of children with ID (54%) had working mothers compared to controls (40%, p = 0.047). Fathers of children with ID exhibited higher education levels (p = 0.020). CSBI scores were markedly higher in children with ID (all p-values < 0.001) and CBCL scores were also markedly higher in children with ID (all p-values <0.001). Similarly more ID children were in clinical range for internalizing (p-value <0.001) and externalizing problems (p-value <0.001) of CBCL broadband syndrome.

Conclusion

Children with mild ID display significant differences in behavioral and sexual problems compared to their controls Identified risk factors offer insight into potential interventions and underline the need for tailored education and support for this demographic.
Oxidative Stress in Children and Adolescents with Diabetic Nephropathy
Authors: Elhenawy Yasmine Ibrahim , Thabet Rasha Adel , Fereig Yasmeen AbdelAziz , Hegazy Marwa G A , El-Morsy Shymaa Ayed Mohammed
Published: November 2024

Background

The pathogenesis of diabetic nephropathy (DN) involves multiple factors, and the exact mechanisms remain uncertain. Thus, the aim of the current study is to assess the oxidant/ antioxidant status among children and adolescents with type 1 diabetes(T1D) and diabetic nephropathy (DN).

Methods

A comparative cross-sectional study including 100 patients with T1D; equally divided into 2 groups according to urinary albumin excretion rate (UAER). Both groups of T1D were compared with age and gender matched healthy controls. To assess oxidant/ antioxidant status, malondialdehyde (MDA) and total antioxidant capacity (TAC) were assessed using colorimetric method.

Results

The MDA levels were significantly higher in patients with DN (9.24 nmol/ml) compared with patients with normoalbuminuria (1.99 nmol/ml) and healthy controls (0.78 nmol/ml) (P < 0.001). Unlike MDA, TAC levels were significantly lower in patients with T1D compared to healthy subjects. Among participants with T1D, TAC levels were significantly higher among patients with DN (P < 0.001). A significant negative correlation was found between MDA and TAC levels (r=-0.655, P < 0.01). Furthermore, a significant positive correlation was elicited between MDA and both HbA1C (r = 0.5, P < 0.001) and UAER (r = 0.7, P < 0.001).

Conclusion

T1D is associated with heightened levels of oxidative stress compared to those without the condition, with higher level of oxidant/antioxidant imbalance in DN. This suggests that oxidative stress could potentially serve as a significant factor in the development DN.
Effect of Oropharyngeal Dysphagia and Quality of Life in Children with Cerebral Palsy
Authors: Hassanein Sahar M A , Saleh Hala A , Bassiouny Samia E , Shata Mennatallah O , Swilem Dina A N , Mohamed Shymaa I A
Published: November 2024

Background

Cerebral palsy (CP) is a common neuromotor disorder causing physical and developmental disability varying in severity but with common developmental features. Dysphagia is a common comorbidity, it compromises airway safety during swallowing, efficiency, or adequacy of nutritional intake. Untreated dysphagia can lead to achalasia, aspiration, dehydration, malnutrition and pneumonia. The aim of the present study was to determine the quality of life among children with CP and co-morbid dysphagia. Patient and method: This was a cross sectional study included pediatric patients with cerebral palsy and dysphagia who attended children's hospital, Faculty of Medicine, Ain Shams University, Cairo, Egypt. Between January 2020 to 0ctober 2023.

Inclusion Criteria

Children with cerebral palsy associated with oromotor dysfunction and Mild to moderate dysphagia according to ASHA scale. Exclusion criteria: patients with congenital anomalies of other systems (respiratory, cardiac systems). All patients were subjected to full medical history, and assessment of cerebral palsy severity using Gross Motor Function Classification System (GMFCS), Oropharyngeal examination: oral structures and functions, drooling, presence of abnormal reflexes, oral preparatory phase, oral phase, feeding intervention assessment according to functional oral intake scale (FOIS), assessment of dysphagia severity by The American Speech, Language and Hearing Association (ASHA`s) Scale. Standard CP quality of life questionnaire and adult carer QoL questionnaire, (Generic version III-Arabic language copy).

Results

Twenty-two CP children with dysphagia included 6 females (27.3%) and 16 males (72.7%). Their age was 33.90±12.63 months, their weight 10.18±2.14 kg, all children were with oropharyngeal dysphagia of ASHA score 4), 11children with FOIS 5 and 11was of 4 FOIS score. GMFCS 12 children had GMFCS score 5 and 10 had 4 GMFCS score. The quality of life of CP children with dysphagia is low due to disability and nutritional deficiency. The way they get along with people generally, with caregivers, with brothers and sisters, other children, children ability to play with toys, with other children was defective, and how they were accepted by others was poor. Their ability to participate in recreational activities, in sporting activities, in social events and in their communities, they had low score in communication. The caregivers were worried about their children's future, and their opportunities in life.

Conclusion

The quality of life is poor in families having children with cerebral palsy and co-morbid dysphagia and oromotor dysfunction.
Chronic Restraint Stress Induced Ovarian Dysfunction in Wistar Rats
Authors: Helal Nourhan Hosni Othman , Ali Gaber Abd El Sabour , Soliman El Bakly Wesam Mostafa , El Ezz Sally Abdallah Abu , Abdalla Hendawy Nevien Fekry
Published: November 2024

Background

Chronic stress has become a common problem that cannot be ignored and has become an important risk factor for the onset of many diseases. Responses to chronic stress are systemic reactions involving multiple organs and can induce symptoms such as depression, impaired reproductive ability, cognitive impairment, cardiovascular disease, immune dysfunctions, bone loss, and reduced life expectancy.

Aim

The present study was designed to investigate the effect of chronic restraint stress on the ovarian function on female wistar rats, further to demonstrate its relation to hormonal disturbance on reproductive hormones.

Methods

24 female wistar rats were divided into 2 groups as Control group and Chronic restraint stress (CRS) subjected group (done by restraining rats for 3 hours daily for 4 weeks). Body weight, forced swimming test and ovarian hormones levels follicular stimulating hormone (FSH), leutinizing hormone (LH), Anti mulleurian hormone (AMH) and estradiol (E2) were investigated.

Results

Chronic restraint stress decreased body weight significantly starting from week 3, and increased immobility time and decreased struggling time as observed in forced swimming test compared to control group. Additionally, significantly increased FSH and LH levels and decreased AMH and Estradiol levels in CRS group.

Conclusion

chronic restraint stress can induce ovarian changes similar to ovarian failure. which could be indicated by changes in hormonal levels as, elevated FSH and LH and decrease AMH and E2 levels in females.
Non Contrast MRA and Ankle Peak Systolic Velocity for Assessment of Lower Limb Arterial Disease in Diabetic Patients
Authors: Shaheen Esraa , Shalaby Menatallah , Foda Haitham , Nabil Sameh
Published: November 2024

INTRODUCTION

Noninvasive techniques such as duplex ultrasound (DU) and non-contrast-enhanced magnetic resonance angiography (CE-MRA) are valid alternatives in the preoperative evaluation of lower limb ischemia diabetic patients.

AIM OF THE Study

Our aim is to assess the diagnostic accuracy of NCE-MRA and DU in diabetic patients with peripheral arterial disease (PAD) and either if we can depend on NCE-MRA in patients with renal impairment.

THE CONTEXT

53 diabetic patients with unilateral or bilateral chronic lower limb ischemic disease - who have come to the department of radiology at Kafr El Sheik University Hospital for Doppler US. Out of the 53 patients 4 had intermittent claudication when walking more than 200 m (Rutherford II), 9 had sever claudication when walking more than 200 m (Rutherford stage III), 10 had rest pain (Rutherford stage IV), 11 had trophic changes (Rutherford stage V), ulcers and 19 has gangrene and major tissue loss (Rutherford stage VI)

RESULT

The study involved 53 patients, 28 men (52.8 %) and 25women (47.2 %). They were between 33 and 75.0 years with mean 59.56 years and standard deviation ±10.3. There was 26 patients chronic smokers 49.1%, 16 had renal failure 30.2 %, 30 had hypertension 56.6%. There was a good reliability and agreement between NCMRA & Doppler techniques with significant Kappa agreement in all measurements K = 0.91 P value was significant <0.001.

Conclusion

Both Non contrast enhanced angiography and duplex US have good predictive value of chronic lower limb ischemia but the combination between them has better diagnostic accuracy and we can depend on them in the patient with chronic renal disease.
The Role of Susceptibility Weighted Imaging as a Substitute to Post-Contrast Tl-Weighted Images in Detection of Active Multiple Sclerosis Lesions
Authors: Darwish Eman Ahmed Fouad , El-Sayed Fatma Rashad Ali , Teiba Mohamed Kamal Ahmed
Published: November 2024

Background And Purpose

Multiple sclerosis (MS) is a progressive inflammatory, demyelinating, autoimmune disease of the central nervous system (CNS). Its inflammatory process is thought to be initiated and maintained by an autoimmune cascade, leading to the accumulation of focal perivascular infiltrates of mononuclear inflammatory cells, microglia activation, demyelination, and axonal degeneration. Acute inflammatory activity of MS lesions is traditionally assessed through contrast-enhanced Tl- weighted MR images. Yet, the use of contrast is contraindicated in some patients. However, SWI may represent a viable alternative to contrast agents for this purpose.

Aim

The aim of this study is to determine whether a qualitative evaluation of SWI can be used to distinguish active and inactive MS lesions and whether it could be considered as a feasible alternative to gadolinium-based contrast agents for fulfilling this objective.

Materials And Methods

our study was carried out on 76 Adult patients of either sex with a known diagnosis of MS based on the 2010 revision of the McDonald criteria. SWI &post contrast Tl weighted imaging were recorded and compared.

Results

The presence of hypointense rings or marked hypointensity showed a strong association with the absence of gadolinium enhancement (P, .001), with a sensitivity of 93.0% and a specificity of 82.9%. The presence of mild hypointensity or isohyperintensity showed a strong association with the presence of gadolinium enhancement (P, .001), with a sensitivity of 68.3% and a specificity of 99.2%.

Conclusions

A qualitative analysis of the signal pattern on SWI of T2-hyperintense MS lesions allows determining the likelihood that the lesions will enhance after administration of a gadolinium contrast agent, with high specificity albeit with a moderate sensitivity. While it cannot substitute for the use of contrast agent, it can be useful in some clinical settings in which the contrast agent cannot be administered.
Long Term Efficacy of Peripherally Inserted Central Catheter in Oncology Patients with Non Feasible or Complicated Port A Cath
Authors: Abd El Hameed Haitham Mohamed , Elmaaty Mohamed Elgharib Abo , Taha Noha Mohamed , Soliman Ahmed Hassan
Published: November 2024

Introduction

Peripherally Inserted Central Catheter (PICC) is a safe and efficient method of long-term intravenous access, particularly in oncology patients. They are inserted via a non surgical procedure by interventional radiologists in the radiology suite. They offer advantages over other central venous access methods due to their less invasive insertion and avoidance of surgical implantation.

Methods

one-arm clinical trial, aimed to evaluate the effectiveness of Peripherally Inserted Central Catheters in oncology patients where port-a-cath was not feasible or complicated. This trial assessed their patency and complications in 20 patients for 1 and 3-month

Results

18 patients maintained patency throughout the study, while occlusion occurred in one patient after a month and another after three months. Complications encompassed infection of insertion site, pain, catheter-related deep vein thrombosis, catheter damage. Revealed that 35% of Peripherally Inserted Central Catheters encountered complications, prompting removal in some instances. However, 65% of them were removed without complications after completing their treatment regimens.

Conclusion

the insertion of Peripherally Inserted Central Catheter was mostly successful, displaying a favorable maintenance rate. Patients expressed enhanced comfort with parenteral access following Peripherally Inserted Central Catheter insertion. Considering the unique circumstances of terminally ill cancer patients, who often have compromised general health and limited life expectancy, Peripherally Inserted Central Catheteremerges as a secure and effective intravenous access method.
Resistive Index as a Predictor of Acute Kidney Injury in Patients Undergoing Coronary Angiography
Authors: Elshahat Hamsa , Mohamed Marwa Sayed , Eissa Ahmed Hanan Mohamed
Published: November 2024

Background

Contrast induced Acute kidney injury (CI-AKI) is a common and serious complication of contrast agents used in imaging studies, and is the third leading cause of acute kidney injury in hospitalized patients. Clinical markers useful for early detection of CI-AKI and prediction of outcome are needed in order to speed diagnosis and implementation of measures to preserve renal function. In septic shock, postoperative setting of cardiac surgery and TAVI subjects, an increased Doppler renal resistive index (RRI) is a predictor of AKI. This study aims to test the hypothesis that Doppler-based renal resistive index would similarly predict contrast induced acute kidney injury in patients undergoing cardiac catheterization.

Methods

We enrolled 100 patients undergoing cardiac catheterization and at risk of CI-AKI. All presented with at least two CI- AKI risk factors and were free of other identifiable causes of acute kidney injury or arrhythmia. Doppler RRI was measured before and at first day after catheterization. CI-AKI was assessed, defined by serum creatinine increase 25% above the pre- procedural baseline or rise in serum creatinine of > 0.5 mg/dl from baseline value or a > 25% decrease in eGFR within 5 days after cardiac catheterization.

Results

Nineteen subjects developed CI- AKI in the first five days post-procedure, with two requiring dialysis. Post procedural RRI value was higher in CI-AKI subjects [RRI: 0.77±0.02 with CI- AKI vs 0.67±0.03 without CI-AKI, (P < 0.001)]. In addition, the RRI increased significantly in the first day after the procedure [from RRI 0.7±0.38 preprocedural to 0.77±0.02 in patients developing CI-AKI (p < 0.001)]. Post procedural RRI >0.744 predicted CI- AKI with a sensitivity of 94% and specificity of 92%.

Conclusions

Measurement of the Doppler-based RRI early post-catheterization in high risk patients enabled early prediction of contrast induced acute kidney injury.
Evaluation of an AI-Driven Deep Learning Model in Predicting Mammographic Breast Density
Authors: Tawfik El Khamy Israa Reda Hashem , Tantawy Salma Hassan , Keriakos Nermeen Nasry Halim
Published: November 2024

Background

Increased mammographic breast density is an established risk factor for breast cancer. Given the high workload of mammography screening programs, Mounting attention is being directed at establishing and fine- tunning AI algorithms capable of improving the performance of human readers.

Aim of the Work

To emphasize the role of AI-driven deep learning algorithms in accurate prediction of breast density on digital mammograms.

Patients and Methods

The study was performed on 62 digital mammography films of women undergoing breast cancer screening. Mammograms were assessed by three human readers of different levels of experience in comparison to a commercially available AI algorithm (Lunit INSIGHT MMG, version 1.1.7.2; Lunit Inc).

Results

This clinical investigation demonstrated that AI softwares (namely LUNIT INSIGHT in our study) can predict mammographic breast density with about 67.7%, 69.4 % and 75.81 % accuracy for HR1(least experienced), HR2 and HR3 (most experienced) respectively, and reliability (Cronbach's Alpha) 0.887, 0.892 and 0.906 for HR1(least experienced), HR2 and HR3 (most experienced) respectively. This result offers a robust way to overcome the variability of human visual assessment and improve the overall performance of less experienced radiologists allowing them to reach expert like levels.

Conclusion

Application of AI softwares on screening mammograms can overcome the variability of human visual assessment and improve the overall performance of less experienced radiologists allowing them to reach expert like levels.
Comparison between Carotid Artery Doppler Ultrasound and Coronary Calcium Score as Predictors of Significant Coronary Artery Disease in Patients Undergoing Computed Tomography Coronary Angiography
Authors: Mohamed Ahmed Mostafa , Osman Ahmed Mohamed , Haiba Mohamed Mohamed Ali Kelany
Published: November 2024

Background

Cardiovascular illnesses are the leading cause of mortality in the industrialized western world, and they will most likely be the leading cause of death worldwide in the near future.

Objective

To compare the capability of carotid artery Doppler US and CCS to predict the presence of significant CAD in patients without known cardiovascular disease.

Methods

This prospective cross sectional study was carried out at Ain Shams University Hospital-Radiology Department within a period of six months on 40 patients the mean age was 48.28 (32-60) with 80% (32) males and only 8 (20%) females.

Results

HTN and hypercholesterolemia were the commonest morbidities among the patients under study. The most frequent indication for CT angiography was doubtful provocative test in asymptomatic patient (40%). Of the included patients, the percent for presence of carotid artery disease was 30 % with no significant difference (p-value > 0.05) in correlation to demographic data, risk factors and CTCA indications among the studied patients. Presence of carotid artery disease in correlation to IMT, plaque mass, plaque volume among the studied patients revealed highly significant (P-value < 0.01) and there was significant difference (p-value < 0.05) in correlation to CACS and presence of coronary artery disease among the studied patients. Of the included patients, the percent of coronary artery disease was 42.5% with significant difference (p- value < 0.05) in correlation to smoking as a risk factor, yet no significant difference (p-value > 0.05) in correlation to CTCA indications, demographic data, other risk factors among the studied patients. Presence of coronary artery disease in correlation to CACS, plaque mass and plaque volume among the studied patients revealed highly significant difference (p-value < 0.01) and there was significant difference (p-value < 0.05) in correlation to carotid IMT and presence of carotid artery disease among the studied patients.

Conclusion

Within a period of six months on 40 patients included in our sample, there was a highly significant correlation between diagnosis of coronary artery disease and CACS, plaque mass besides plaque volume and there was a significant correlation with carotid IMT. Also there was a highly significant correlation between diagnosis of carotid artery disease and IMT, plaque mass besides plaque volume and there was a significant correlation with CACS.