bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Axial Length on Full-Field and Multifocal Electroretinogram
Authors: Hamzawy Noura S , El-Zarakany Tarek A , El-Shazly Amany A , Mohamed Sameh H
Published: October 2021

Background

The Electroretinogram is a mass potential, which reflects the summed electrical activity of the retina. Full-field ERG measures the electrical signals from the whole retina in response to a light stimulus. The weakness of the full-field ERG is that it cannot provide topographical information regarding the functional integrity of the retina and cannot detect subtle functional defects. The response is dominated by the peripheral retina due to its predominance of retinal cells.

Aim of the Work

to investigate the effect of axial length on fullfield (ffERG)and multifocal ERG (mfERG).

Subjects and Methods

Forty-four eyes of 44 healthy subjects were included in this case series study which has been conducted at Ain shams university hospitals after the approval of the research ethical committee in the faculty of medicine, Ain Shams University between July 2018 and September 2019. Full ophthalmologic examination was performed for all participants, including visual acuity assessment (Best corrected visual acuity) using Snellen chart, calculation of spherical equivalent (SE), slit Lamp biomicroscopy examination with IOP measurement via Goldmann applanation tonometry (GAT), and fundus examination by indirect ophthalmoscope or via 90 D VOLK lens to assess macular area. Axial length measurement, ffERG & mf-ERG.

Results;

We found that in the absence of fundus changes, mfERG parameters showed decreased amplitudes with increase in axial length. The Six- Rings Response Densities showed negative correlation with AL while there is no significant correlation between Six- Rings Response Densities and SE. The Six- Rings P1 Amplitude showed negative correlation with AL while there is no significant correlation between P1 Amplitude and SE. The Six- Rings N1 Amplitude showed negative correlation with AL while there is no significant correlation between P1 Amplitude and SE. The four- quadrant Response Densities showed negative correlation with AL while there is no significant correlation between four- quadrant Response Densities and SE. The four- quadrant P1 Amplitude showed negative correlation with AL while there is no significant correlation between P1 Amplitude and SE. The four- quadrant N1 Amplitude showed negative correlation with AL while there is no significant correlation between P1 Amplitude and SE. There is no significant correlation between full-field clinical ERG parameters and both AL and SE.

Conclusion

In the absence of fundus changes, mfERG parameters showed decreased amplitudes with increase in axial length. For correct interpretation of ERG responses in clinical practice, we recommend consideration of axial length measurement when evaluating mfERG responses.
Efficacy of Hounsfield Unit of CT in Prediction of the Chemical Composition of Urinary Stones
Authors: Ahmed Shehata Ahmed Salah Mahmoud , El-Halaby Mohamed Rafik , Saafan Ahmed Mohamed
Published: October 2021

Objectives

to make a reliable correlation between the chemical composition of the urinary calculi and its Hounsfield unit on CT scan, upon which we can depend on it for prediction of the type of the urinary calculi. The prediction of the chemical structure of the stone would help us to reach a more efficient therapeutic and prophylactic plan.

Methods

A retrospective study was performed by interpretation of the preoperative CT scans for patients who were presented by urinary stones.

Identification of the chemical structure of the calculi was implemented using Fourier Transform Infrared Spectroscopy (FT-IR spectroscopy). The laboratory report revealed multiple types of stones either of pure or mixed composition. Afterwards, a comparison was done between Hounsfield units of the stones and the chemical structure.

Results

The chemical structure of the urinary stones revealed four pure types of stones (Uric acid, Calcium Oxalate, Struvite and Cystine) and two types of mixed stones (mixed calcium oxalate+ Uric, and mixed calcium oxalate+ calcium phosphate).

Uric acid stone had a mean Hounsfield Unit (HU) density of428 ± 81, which was quite less than the other stones, followed by struvite stones with density ranging about 714 ± 38.

Mixed calcium oxalate stones could be differentiated from other types of stones like uric acid, pure calcium oxalate and struvite stones by the Hounsfield unit of Computed Tomography (the mean Hounsfield Unit was 886 ± 139 and 1427 ± 152 for mixed calcium oxalate + uric stone and mixed calcium oxalate + calcium phosphate stones respectively). Moreover, pure calcium oxalate stones were easily differentiated from all other stones using the mean Hounsfield density as it was 1158 ± 83. It was challenging only when it was compared to cystine stones, as they were quiet similar to HU value (997 ± 14).

The variation of Hounsfield values among the previously mentioned stones, was statistically significant (p < 0.001).

Conclusion

The study proved that the Hounsfield Unit of CT scanning is a convenient measure to predict the chemical structure of urinary calculi.
Comparative Study between Pneumatic and Holmium Laser Lithotripsy in Treatment of Ureteric Stones
Authors: Esmat Mohamed , Elsaeed Karim Omar , Mohamed Adel Moataz Bellah
Published: October 2021

Objective

The aim of this study was to compare the efficacy & safety of holmium laser and pneumatic lithotripsy used in the ureteroscopic treatment of ureteral stones.

Materials and Methods

A prospective randomized clinical study was done using the data of patients to whom ureteroscopic lithotripsy (URL) was applied for ureter stones in our clinic. Then these patients were separated into 2 groups according to the type of lithotriptor used in stone fragmentation as laser lithotripsy (Group 1) and pneumatic lithotripsy (Group 2).

Results

Statistically, the two groups were similar in respect of the number of stones, stone burden and the number of double J stents applied intra-operatively. Mean operating time was calculated as 62.9 (±7.69) minutes in Group 1 and 50.98 (±6.63) minutes in Group 2. The mean operating time was found to be higher in group 1 than group 2 (P = 0.000). On postoperative day 1 after the URL, the SFR of Group 1 79.0% found to be significantly high compared to the SFR of Group 2 (64.0%) (P = 0.019), while at postoperative month 1, the SFR of both groups (Group 1 84%, Group 2 80%) was found to be similar (P = 0.462).

Conclusions

Compared to the pneumatic lithotripter, the Ho: YAG laser seems to have a statistically significant higher SFR in the early postoperative period (1 day), even though there are statistically insignificant success rate (after 1 month) and complications (hematuria, mucosa injury, stone migration, stricture and perforation avulsion).
Evaluation of Holmium Laser versus Cold Knife in Optical Internal Urethrotomy for the Management of Urethral Stricture
Authors: Ali Maged Wael , Gamal Mohamed Ahmed , Tawfeles Samuel Fayek
Published: October 2021

Background : urethral stricture is one of the most difficult urological problems to cure adequately and is know to mankind since ages as it has been documented in ancient literature of Egyptians and Greeks.

Aim of the work: the aim of our study is to evaluate and compare the outcomes of Ho:YAG laser urethrotomy with the conventional cold knife technique as regards treatment outcome, efficacy and complications

Patients and methods: A total of 20 male patients presented to the urology department at El Maadi military hospital and Ain shams university hospitals diagnosed as urethral stricture requiring optical internal urethrotomy were included in this study. Patients were randomized into two groups : In group A (holmium group): 10 patients underwent internal urethrotomy with Holmium laser. In group B (cold knife group) 10 patients underwent internal urethrotomy with cold knife.

Results: based upon uroflowmetry, assessment of treatment effectiveness and complications were made at 3 months follow-up. Post operative fall in the peak flow rate was noted during the follow up in both groups, but was highter fall in the holmium group than the cold knife group at the end of the third month.
The Role of Bcl-2 in Pediatric Functional Bowel Obstruction Cases with Ganglionated Specimens
Authors: Hegazy Nedal Ahmed , Ghazal Faten Abd El Aziz , Zaki Ahmed Mohy El Din , Hakim Sarah Adel , Arafa Ahmed Bassiouny , Mohamed Lobna Abd El Fattah
Published: October 2021

Background

Functional disturbances of the gastrointestinal tract is caused by a number of neurodysplastic conditions including other diseases, rarer than the Hirschsprung’s disease dysganglionosis, such as ganglion cells immaturity including Intestinal Neuronal Dysplasia (IND). Bcl-2 shows positive immunoreactivity in the degenerative and immature ganglion cells .

Aim

This work evaluates the role of immunohistochemical expression of Bcl-2 in pediatric functional bowel obstruction cases with ganglionated specimens.

Material and Methods

Twenty one cases of functional bowel obstruction were enrolled in our study including the Hirschsprung Allied Disorders (HAD) and operated cases of Hirschsprung’s Disease (HD) with adequate ganglionated resection margins and presented by obstructive symptoms following surgery. All cases underwent histologic examination of ganglion cells and nerve bundles as well as evaluation for Bcl-2 immunohistochemical expression.

Results

57.1% of the cases were strongly positive for Bcl-2 protein, 19% were weakly positive and 23.8 % were negative. A highly significant correlation was demonstrated between Bcl-2 expression and ganglion cell number ( P < 0.001 ) where all hyperganglionic specimens showed strong positivity in contrast to the hypoganglionic and adequately ganglionic ones. A positive association was also found between Bcl-2 expression and IND in comparison to other disorders of dysganglionsis (P = 0.04) and recurrent HD cases (P = 0.002). A significant correlation was also detected between ganglion cell number and nerve bundle hypertrophy (P = 0.02).

Conclusion

Bcl-2 immunohistochemistry can be used as a valuable tool in the diagnosis of Hirschsprung’s disease allied disorders through its expression in the immature ganglion cells which are difficult to be identified by conventional H & E staining.
Histopathological study of gastrointestinal endoscopic biopsies in pediatric patients
Authors: Ghazal Faten A , Osman Wesam M , Hakim Sarah A , Tamem Nada N
Published: October 2021

Background

Non neoplastic GI lesions in pediatrics are variable and differ in types and prevalence among each pediatric age group. Helicobacter pylori is an important pathogen that can cause gastritis and peptic ulcers in adults as well as in children. Celiac disease is a gluten-dependent autoimmune disorder which affects individuals having genetic susceptibility. Eosinophilic gastrointestinal diseases are disorders that primarily affect the gastrointestinal tract with eosinophil-rich inflammation in the absence of known causes for eosinophilia. Inflammatory bowel disease (IBD) is a chronic inflammatory disorder, mainly affecting the gastrointestinal tract with extraintestinal manifestations and associated immune disorders. It seems that it is one of the most common gastrointestinal diseases affecting children in the developed countries.

Aim of the work

To study different types of paediatric non neoplastic gastrointestinal lesions from gastrointestinal endoscopic biopsies received at the Pathology Department in Ain Shams University hospital during a period of 2 years (2017-2018), and to correlate them with the clinicopathological presentations and endoscopic findings.

Patients and Methods

A cross sectional study was conducted on all pediatric gastrointestinal biopsies received at Pathology Department in Ain Shams University Hospital during the period of two years (2017- 2018). Only cases with information for all the covariates (n = 580) were selected and the results were statistically analyzed.

Results

Total 580 pediatric cases were enrolled according to inclusion criteria. Nonspecific gastrointestinal inflammation represented (47.1%), Helicobacter pylori associated gastrointestinal inflammation represented (43.5%), Eosinophilic gastrointestinal disease represented (3.8%), Inflammatory bowel disease (IBD) represented (3.7%), Celiac disease represented (1.9%).

Conclusion

This is the first study conducted in Ain Shams University Hospitals to assess the different types of pediatric non neoplastic gastrointestinal lesions received with clinicopathological and endoscopic correlation. The most common pediatric non neoplastic GI lesion is Helicobacter pylori infection. The diagnosis of pediatric non neoplastic GI disorder necessitates interdepartmental teamwork between GI pediatricians and pathologists.
Portal Vein Thrombosis in Neonates with Umbilical Vein Catheterization: Incidence and Risk Factors
Authors: Abd El Gawad Tarek A , El Din Lerine Bahy , El Faramawy Amel A.M , Wafeeq Asmaa , Shaaban Hebatallah A , Amin Abdullah A
Published: October 2021

Background and aim of the work

Umbilical venous catheter(UVC) placement is thought to be a cause of portal vein thrombosis(PVT).Our study aimed to identify the incidence of PVT and potential risk factors predisposing neonates with UVC to develop PVT and the prevalence of hereditary prothrombotic mutations among the affected group.

Methods

A prospective observational study was conducted in the Neonatal intensive care unit (NICU) of Ain Shams university(ASU) Children's Hospital on 100 neonates.They were subjected to abdominal X-ray initially and duplex on their portal veins initially and at 1,6 and 12 months post insertion.We studied the correlation between length of NICU stay, UVC duration, technique, birth weight(BW),gestational age (GA) and the development of PVT.

Results

There was 46 males and 54 females.The mean BW was 1.87±0.72 Kg, the mean GA was

33.71±2.41weeks.Mean stay in NICU was 18.22±9.78 days, with mean UVC insertion duration 6.88 ±2.55 days,75%of inserted UVC were central in position,77% of the studied neonates were premature,1 patient had NEC(Necrotizing EnteroColitis),18% had sepsis,4% had blood products transfusion through the UVC.The one year follow up of the study group showed no incidence of UVC related PVT.

Conclusion

Although PVT is related to UVC in the literature and in our experience in the ASU Children's Hospital Hepatology Clinic as a tertiary referral centre, yet in this study, the sole placement of UVC does not appear to increase risk of PVT if properly inserted and cared.
Occult hemorrhage in Egyptian children with Immune thrombocytopenia
Authors: Gawad AzzaA , El Sherif Nayera H , Kenny Mahmoud A , El. Hassan Ahmed
Published: October 2021

Background

Occult hemorrhage can occur in any internal organ in ITP patients. Four sites of occult hemorrhage deserve special attention including microscopic hematuria, fecal occult blood, retinal hemorrhage, and silent intracranial hemorrhage.

Aim

The aim of this study was to investigate for the frequency of subclinical bleeding in Egyptian children with ITP and its relation to different clinical and laboratory parameters of the disease.

Methods

This cross-sectional study included 40 ITP patients recruited from the Pediatric Hematology& Oncology unit, Children Hospital, Ain Shams University. Occult blood in stools and urine analysis, fundus examination, and non-contrast brain MRI, for brain microbleed, were done.

Results

The total number of patients with occult bleeds was eleven. Two patients had occult blood in stool, five had microscopic hematuria, one had retinal bleeds and three patients had brain microbleeds. Nine patients with occult bleeding were chronic, one persistent and one acute ITP patients. Their mean age was 10.23 ± 4.18 and their mean initial bleeding score was 2.55 ± 0.82.There were no significant differences between patients with occult bleeding and those without as regards the platelet counts & hemoglobin level, as well as the mean platelet counts & mean hemoglobin level over the disease duration.

Conclusion

Our results suggest that subclinical bleeding is a potential risk in children with ITP, more commonly chronic ITP patients. We could not demonstrate a significant relation of occult bleeding to the laboratory findings; nevertheless, the significance of the routine assessment of occult bleeding in ITP and the identification of high-risk patients require additional studies.
Hair Magnesium content and its relation to Serum Magnesium level in children with Idiopathic Epilepsy
Authors: Shatla Hamed Mahmoud , Maksoud Mariam Fathy Abdel , Zaitoun Raghda Mohamed Hesham , Mahmoud Alaa Rabie Abdel Baset
Published: October 2021

Objective

To measure the level of hair Mg, as well as its level in serum, in patients with epilepsy and compare them to the levels found in non-epileptic age and gender matched children, and to explore any potential correlation between either serum or hair level of magnesium and seizure characteristics in children with idiopathic epilepsy.

Methods

An observational cross-sectional study including 50 children with idiopathic epilepsy and 100 non-epileptic age and gender matched control subjects. Cases were subjected to full history taking, examination and measurements of serum and hair levels of magnesium, control subjects only had their serum and hair level of magnesium measured as for the cases.

Results

The mean serum magnesium was 29.11 ± 13.42 ug/ml for cases and 27.67 ± 7.24 ug/ml for controls and the median hair level of magnesium was 42.22 ug/g with IQR of 25.9 - 56.82 for cases and 38.6 ug/g with IQR of 25.21 - 61.25 for controls. No statistically significant difference was observed between both groups as regards either serum or hair magnesium levels. No statistically significant correlation was observed between either hair or serum levels of magnesium and seizure characteristics though the correlations were nearing statistical significance for the hair magnesium content.

Conclusion

Hair magnesium level may be better correlated to seizure characteristics and control than serum levels in patients with epilepsy.
Screening for Depression in Adolescents with Type 1 Diabetes Mellitus
Authors: Mohamed Elbyoumi Afify Mohamed Abo Elasrar , Adel Thabet Rasha , Hany Elrasas Hanan , Elazab Alaaeldeen Nouby Mohamed
Published: October 2021

Introduction

Type 1 diabetes (T1DM) is one of the most frequent chronic metabolic diseases in childhood and adolescence. Depression is common among adolescents and its occurrence is higher in people with diabetes mellitus.

Objectives

The aim of the study is to detect depression disorder among adolescents with type 1 Diabetes Mellitus and determine the risk factors and relation to the glycemic control.

Patients and Methods

This cross-sectional study was carried out on 100 adolescents with type 1 diabetes. Patients were recruited from the outpatient diabetes specialized clinic, pediatric hospital at Ain Shams University. Patients were subjected to: (1) an interview Pre structured questionnaire which included the following: Personal history, socio economic level, medical history: Duration of diabetes, frequency of hospital admission, presence of diabetic complication, BMI and HbA1C measurement at time of study. (2) Psychiatric screening for the major depressive disorders by using the Arabic version of PHQ-A "modified PHQ-9 for adolescents". (3) Essential examination & investigations to detect presence of diabetic complications.

Results

The current study reveals that 89% of the patients have depression, while 11% of them don't have. Additionally; there is a statistically significant relationship between the depression score and age, sex, socioeconomic level, HbA1c as well as obesity.

Conclusions

Adolescents with type 1 diabetes mellitus are at increased risk for depression specially those with poor diabetic control.
Normotensive or Hypertensive: Adolescent Female with Headache; A Case Report
Authors: Kotby Alyaa A , Wahab Asmaa R. Abdel , Nasef Marwa A
Published: October 2021

Background

Ambulatory blood pressure (ABP) monitoring became a method of choice for the diagnosis and therapeutic monitoring of arterial hypertension in adult and pediatric patients. BP load is defined as the percentage of valid BP readings above the ambulatory 95th percentile for both SBP and DBP during the entire 24-hour awake and sleep periods. BP loads in excess of 25% are generally considered abnormal, with increased loads associated with LVH). Masked hypertension (MH) is defined as normal OBP(<95th percentile) but elevated ambulatory BP levels (>95th percentile).

Case Presentation

This case report describes a case of an obese adolescent female complaining of chronic headache, referred for evaluation of possible hypertension, after exclusion of other organic causes of her symptom. Her office blood pressure (OBP) was normal so ABP monitoring was suggested for possible masked hypertension.

Results

The BPLab ABP was provided for the patient from 8 AM to 8 AM in the next day. It revealed that The 24 systolic ABP was 119Hg (75th percentile), The 24 diastolic ABP was 64 (50th percentile), daytime systolic ABP was 124 (75th percentile), nighttime systolic ABP was110(75th percentile), daytime diastolic ABP was 67(50th percentile), nighttime diastolic ABP was 58 (75th percentile). BP load was 53%. Nocturnal BP dipping was normal for both systolic and diastolic BP (16% and 19%, respectively).

Conclusion

High blood pressure load detected by ABP monitoring could be a sign of masked hypertension especially if associated with cardiovascular risk factors like obesity.
Egyptian Mother’s Breast Milk: Protein and Lipid Content in Correlation with Growth of Their Newborns
Authors: Shaaban Sanaa Y , Hameed Enas Abd El , El Gendy Yasmin G Abdo , Abd Elazim Athar FM
Published: October 2021

Background

Infant growth is a big concern among the community, mothers and the pediatricians, this study focused on what can affect newborns growth in Egyptian community.

Objective

Primary objective to detect the relationships between protein and lipid content of the breast milk of Egyptian women with their infant’s growth. Secondary objective is to correlate protein and lipid content in the mother’s milk and their diet.

Patients and Methods

This is a cohort study done on 30 infant in Ain Shams University for a period of six months.history was taken by questionnaire about infant’s Gestational age. parity. Dietetic history of infant (breast fed, frequency of feeds),Mother’s age, education, address, body weight, height, BMI and maternal illness. Mother’s dietetic history by 24 hour recall.breast milk samples was collected by hand expression between 4 and 8 weeks of lactation, kept frozen at20 °C. Triglyceride (fat) concentrations were measured in homogenized HM samples using H-Nuclear magnetic resonance (NMR) spectra. For protein, total nitrogen was measured by the Dumas method.

Results

The growth rate range of infants under study was (18gm/day _ 28gm/day). Protein content of mother’s milk lowest value was 0.7gm, and highest value was 1.9gm. Lipid content of mother’s milk lowest value was 3.1gm, and highest value was 5.6gm. Lactose content of mother’s milk lowest value was 5.9gm, and highest value was 7.4gm.Caloric content of maternal diet lowest value was 1013kcal/day and highest value was 2818kcal/day. the protein of breast milk has a direct positive effect on Infant’s growthrate(r = 0.735,p=0.000)weight(r = 0.689,p=0.000)and z score(r = 0.573, p = 0.001).lipid content of breast milk has a positive effect on Infant’s growthrate(r = 0.677,p=0.000)weight(r = 0.742,p=0.000)and zscore(r = 0.592,p=0.001). Protein of maternal diet has an impact on the protein content of her breast milk(r = 0.719,p=0.000)and lipid content of breast milk(r = 0.712, p = 0.000).lipid of maternal diet has no effect on lipid content of breast milk(r = 0.127,p=0.52)and protein of breast milk (r = 0.118,p=0.536).caloric intake of mothers has positive effect on protein of breast milk(r = 0.599,p=0.000),and lipid of breast milk(r = 0.496,p=0.005).

Conclusion

Protein content of breast milk of mothers positively affects growth rate weight and height of their infants. (P value 0.000, 0.001,0.005 respectively). As protein content of breast milk exceeds 1.1gm/dl infant kept same or higher weight/height centile and z score. As lipid content of breast milk exceeds 4mg/dl infant kept same or higher weight/height centile and z score. Protein content of breast milk is positively affected by protein in maternal diet(r = 0.747,P 0.000) and her total caloric intake(r = 0.519,p 0.005).lipid content of breast milk is positively affected by protein content of maternal diet (r = 0.719,P 0.000)and her total caloric intake(r = 0.496,p 0.005).
Outcome of Lactoferrin Supplementation In Critically Ill Septic Children With Acute Gut Failure
Authors: Ibrahim Hanan M , Sabery Eriny E , Magdy Sondos M
Published: October 2021

Background

Sepsis is a clinical syndrome caused by many infections. Septic patients may suffer from Gut failure resulting in severe complications. To improve Gut function, the effect of lactofferin supplementation has been studied.

Objective

To test the effect of lactoferrin supplementation on improving gut barrier function by using plasma citrulline level as a marker of functional enterocytic mass.

Patients and Methods

This double armed single blinded therapeutic clinical trial study was conducted on 40 children admitted to (PICUs) of Ain Shams University Hospitals. By diagnosis sepsis and gut failure, twenty of them weren't supplemented with LF (group 1) and the other twenty were supplemented (group 2). All critically ill septic patients diagnosed with acute gut failure admitted from October 2018 to 2019 were subjected to citrulline level measurement by (ELISA).

Results

We found that citrulline concentration was significantly lower in patients (9.52 nmol/L) than control group (122 nmol/L) and lowered in non survivors (5.13 nmol/L) than survivors (30.68 nmol/L) with p value of 0.027 and 0.034 respectively and a cut off value ≤ 7.82 mmol/L. There was no significant difference between the groups 1 and 2 in treatment of sepsis with gut failure.

Conclusion

(1) Citrulline level can be used as a predictor of intestinal failure severity and mortality. (2) Lactoferrin supplementation was not beneficial in pediatric septic patient with gut failure and did not improve outcome or prognosis of patients.
Evaluation Of Some Blood Biomarkers As Predictors Of Neonatal Necrotizing Enterocolitis
Authors: El-Raggal Nehal M , Darweesh Yasser W , Hassan Azza M , Zaki Esraa R , Rabie Dina E
Published: October 2021

Background

Necrotizing enterocolitis is a leading cause of mortality and morbidity in preterm neonates; however the lack of a reliable biomarker makes definite diagnosis difficult. Therefore, its early suspicion and proper management are important.

Objective

To evaluate the value of NLR, serum levels GGT, total serum bilirubin and serum Ca2+ concentrations for early diagnosis and prediction of NEC severity; and to make a predictive score for early diagnosis of NEC.

Patients and methods

A case control study which was conducted on neonates admitted to NICU, Children Hospital, Ain Shams University over a period of 6 months, fifty neonates were classified into two groups: the patients group included 25 neonates with NEC with a gestational age 28-36 weeks regardless of birth weight matched with control group which included 25 healthy preterm neonates, however we excluded neonates with congenital infectious diseases, perinatal asphyxia, severe birth defects, congenital digestive tract malformations, inherited metabolic diseases or parental refusal of enrollment.

Results

ROC curve of NEC diagnosis by NLR, serum GGT, total serum bilirubin and serum Ca2+ showed cut off: > 1.13, > 40 U/L, > 0.95 mg/dl, < 8.85 mg/dl respectively, Sensitivity 84, 92%, 84%, 84% respectively and Specificity 80%, 92%, 92%, 84% respectively; also beta-weighted score for prediction of NEC disease showed that NLR (Best cut off > 1.13) or GGT (Best cut off > 40 U/L could be helpful with sensitivity 92% and specificity 92%.

Conclusion

NLR, GGT, T.Bil and calcium levels could be good non-invasive markers for NEC disease prediction and also for its diagnosis.
The Frequency of Obstructive Sleep Apnea in Asthmatic Patients, and Impact of OSA on Asthma Control
Authors: Abdel Ghaffar Hegazy Laila M , Allam Ahmad Mostafa , Helmy Marwa Salah
Published: October 2021

Background

Obstructive sleep apnea (OSA) and asthma are common inflammatory respiratory diseases of childhood. The similarities between and the parallel rise of both diseases raise the question of whether OSA is indeed more common in asthmatic children.

Objectives

The present study is cross section study conducted on fifty children with bronchial asthma the aim of study was to evaluate the frequency of obstructive sleep apnea in asthmatic patients, and impact of OSA on asthma control.

Patients and Methods

The present work is a Cross-sectional study conducted on fifty Children (27 females and 23 males) aging 5 to 18 years diagnosed as bronchial asthma following up in pulmonology clinic or admitted to pulmonology department in Pediatric Hospital- Ain Shams University. Patients were excluded from presence of any other chronic chest diseases, any congenital malformation in upper respiratory, any genetic disease or inborn error of metabolism, morbid obesity and other medical co morbidities that might interfere with sleep quality. All patients were subjected to full history taking, meticulous general and local chest examination, pulmonary function tests and exposed questionnaire: Asthma control questionnaire (ACQ) and OSA-18 quality of life questionnaire. Children were positive OSA with OSA-18 quality of life questionnaire referred to sleep study.

Results

54 % of cases were females and 46% were males. There mean age=10.1, mean of OSA score =75.6. 20% diagnosed OSA according to questionnaire. OSA score increased in patients with history of PICU and hospital admission. OSA score was highly correlated with severity and degree of control of bronchial asthma. 10% of children were positive OSA with OSA-18 quality of life questionnaire suggestive have obstructive sleep apnea according to polysomnogram.

Conclusion

OSA has a direct and significant impact on asthma severity and control. Asthma and OSA are common disorders, and the concomitant presence of both conditions can be detrimental. Due to the bidirectional association of both conditions, we as clinicians should be aware of it.
The Etiology of Portal Hypertension in Egyptian Children and Adolescents
Authors: El-Din Ahmed Lerine B , Abd Elaziz Asmaa W , Abdelmegeed Reham I , Battah Mayada Abd El-Rahman F
Published: October 2021

Background

Portal hypertension is a clinical syndrome in which the portal venous pressure gradient between portal vein and inferior vena cava exceeding 5mmHg. Clinically significant portal hypertension is diagnosed when clinical manifestations of the disease appear or the portal pressure gradient exceeding 10 mmHg. For better management, it is important to determine the underlying cause.

Objective

To evaluate the aetiology of portal hypertension in pediatric who attending the hepatology clinic at El-Demerdash hospital, Ain Shams University.

Materials and Methods

This cross sectional study was done in the department of pediatric hepatology clinic at El-Demerdash hospital, Ain Shams University on 91 consecutive cases of portal hypertension enrolled from 2016 to 2019. All pediatric patients were subjected to full history, clinical examination, investigations and questionnaire about effect of portal hypertension and its complications on QOL.

Results

Age of children and adolescent was 5 months to 16 years with mean age of 5.55±4.30y and male to female ration was 1.5:1. Out of 91 children (51, 56.1%) developed portal hypertension due to extrahepatic causes and (39, 42.9%) due to hepatic causes. In extrahepatic causes (portal vein thrombosis was found 36, (39.6%) and Budd Chiari syndrome 15(16.5%)). On the other hand, hepatic causes (cong. hepatic fibrosis (CHF) was found in 21(23.1%), cases, hepatic cirrhosis 12(13.2%), extrahepatic biliary atresia 3(3.3%) and autoimmune hepatitis with secondary hepatic fibrosis 3(3.3%)). In extrahepatic cases first variant bleed much earlier than hepatic cases.

Conclusion

Extrahepatic disease were the most common aetiology of portal hypertension in studied cases. Portal vein thrombosis in extrahepatic cases and congenital hepatic fibrosis in intrahepatic cases were the most common causes.
Psychological Assessment of a Sample of Egyptian Children and Adolescents with type 1 diabetes
Authors: AbdelAziz Eman Amin , Ali Hanan Hassan , AbdelRaouf Batoul M , Mousa Mohamed Abdullah
Published: October 2021

Background

Type 1 Diabetes Mellitus (T1DM) is the most common type of diabetes in children. Besides the damaging effects of diabetes on various organs, cognitive changes are also very common. Changes in memory, executive function, attention and academic performance are among the most important impairments seen in children with diabetes.

Objectives

The aim of this work is to do psychological assessment of children and adolescents with type 1 diabetes at Ain Shams University paediatrics hospital including Health Related Quality of life assessment and DSM-5 criteria for diagnosing ADHD.

Patients and methods

This study is cross sectional case-control study included 140 cases divided into two groups group (A) includes seventy diabetic children recruited from the Paediatric Diabetes Clinic, paediatric hospital, Ain Shams University 35 males (50%) and 35 females(50%) age ranges from 6 to 14 years old with Mean±SD (9.56±2.25), group (B) includes seventy normal children 32 males(45.7%) and 38 females(54.3%) age ranges from 5 to 15.5 years old with Mean±SD (10.32 ± 2.93). Both groups were subjected to full history taking, clinical examination including Anthropometric measures i.e. weight, height, Body Mass Index (BMI), laboratory investigations includes HbA1C, CBC, Metabolic Profile, psychometric assessment includes DSM-5 criteria for attention deficit hyperactivity disorder (ADHD), Conners rating scale, health related quality of life ( HRQL) questionnaire, Pediatric Check List (PCL).

Results

Cases fulfilling criteria of ADHD (predominantly hyperactive type, predominantly inattentive type, mixed type) more than control group and difference was statistically significant, HRQOL of diabetic children shows lower score than those of the control group and difference was statistically highly significant.

Conclusion

Diabetes has an important impact on the psychosocial development of the children as they grow up.
Study of the Outcome of Pediatric Patients with Aplastic Anemia treated with Immunosuppressive Therapy at Ain Shams University Pediatric Hospital
Authors: Mohamed W , Matboly S , Morcy N
Published: October 2021

Background

Aplastic anemia (AA) is life threatening disorder in pediatric age group with an increasing incidence nowadays. Hematopoietic stem cell transplant being the 1st line therapy; immunosuppressive therapy (IST) is the alternative therapy and is the most commonly used modality of treatment especially in the developing countries.

Aim of the Work

to assess the outcome of IST in children with severe and very severe AA.

Patients and Methods

Data for 23 children treated with IST from January 201 0 to January 201 9 (10 years) were retrieved from clinic records. IST included rabbit anti thymocyte globulin (ATG) along with cyclosporine A and another group were treated by sandimmune alone.

Results

Patient characteristics included median age (9) with 73.9% male and 26.1% female.

With median interval between diagnosis and start of IST 2(1 -5) months and around 30.4% with hepatitis A associated aplastic anemia. Complete response, and no response were seen in 4 (50%) patients and 4(50%) patients, respectively in patients received ATG and sandimune. While in patients received sandimune alone complete response, partial response and no response were seen in 7(46.7%) patients, 5 (33.3%) patients, and 3 (20%) patients respectively. The median time to best response in the whole cohort was 2 months. There was no difference in outcome related to severity of AA, or higher Hb or platelet level. There was a significantly better rate of response in both groups of patients with higher initial TLC count (p = 0.001) initial ANC (p = 0.002), initial ALC (p = 0.001), and initial ARC (p = 0.014) before start of IST. An overall response rate in both groups around of 43.47% reported a 5-year OS. With 45.5 of patients with complete response had HAAA. A delayed time to complete response with prolonged requirement of cyclosporine therapy was detected in the study.

Conclusion

In a developing country setting, IST with ATG and cyclosporine seems to be an alternative treatment for children with aplastic anemia lacking MRD.
Impact of PICU Admission on Neurocognitive Function in Children
Authors: Aly Rasha Hussein , Ahmed Ahmed Rezk , Zaitoun Raghda , Ai-Saeed Sarah Mohamed Nabil
Published: October 2021

Objective

To study the impact of admission to a pediatric intensive care unit (PICU) on children's neurocognitive performance.

Methods

A case–control observational study including 50 children & adolescents and 75 age and gender matched children and adolescents.The study subjects underwent formative IQ testing using the Stanford Binet IQ test 3 months after discharge from the PICU.

Results

27 males and 23 females with a mean age of 6.98 years were included in the study. Almost two thirds of the cases were admitted to the PICU post operatively (surgical causes). More than half of the cases needed sedation, 38% needed mechanical ventilation and 12% needed inotropic support. There was no statistically significant difference between cases and controls are regard IQ scores (total, verbal and performance IQ scores), neither was there a difference between medical and surgical cases. Data from similar pediatric cohorts is conflicting.

Conclusion

PICU does not seem to affect cognitive outcome in pediatric survivors. Further long term studies using standard scoring systems and time points of assessment are required.
Outcome of Cyclophosphamide versus Mycophenolate Mofetil in Induction of remission in Pediatrics Lupus Nephritis
Authors: Salama Ashraf Abdel Baki , Mohamed Shimaa Sobhy , Radwan Nesrine
Published: October 2021

Background

Systemic lupus Erythematous (SLE) is an autoimmune inflammatory disease characterized by antibodies directed against self-antigens, resulting in multi-organ damage. Up to 20% of cases are diagnosed during childhood with 55% of these patients are expected to develop lupus nephritis (LN).

Objective

At comparing the efficacy of mycophenolate mofetil versus pulse intravenous cyclophosphamide in induction of remission in pediatric patients with lupus nephritis.

Subjects and Methods

This is a retrospective study that was conducted in Pediatric Allergy and Immunology Unit, Children’s Hospital, Ain-Shams University from the period of December 2007 to January 2017 on 65 pediatric patients with lupus nephritis taking either cyclophosphamide or Mycophenolate Mofetil as an induction therapy. Patients’ data was gathered from their medical records in the Pediatric Allergy and Immunology Unit, Children’s Hospital, Ain-Shams University. Patients enrolled in the study after consideration of inclusion and exclusion criteria.

Results

Our studied patients were 65 patients divided into 58(89%) female and 7(11%) male with female: male ratio (8: 1) and their age ranged between (5- 18) years. There was no statistically significant difference between different laboratory parmaters used to compare between both groups (C3, 24 hour urinary protein, anti-DNA). However, the rate of change in SLEADI score was higher in patient receiving Cyclophosphamide and Mycophenolate mofetil, but with no significant difference.

Conclusions

No significant difference between group taking cyclophosphamide and mycophenolate mofetil.
The Effect of Fluoxetine and Ibuprofen on BCG-Induced Alteration in Pain Sensitivity in Mice
Authors: El-Morsy Heba H , El-Bakly Wesam , Hasanin Amany H , Hamza May , Abdel-Bary M
Published: October 2021

Clinical observations recognized the co-existence and interactions of pain and depression a long time, ago. The aim of this work was to study the effect of ibuprofen and fluoxetine on BCGinduced depressive-like behaviour, on formalin-induced pain, as well as on mechanical allodynia after planter incision in mice. BCG induced a depressive behaviour that was seen in the forced swim test (FST) and the tail suspension test (TST). It also induced a decrease in pain-related behaviour in the formalin test, and an increase in the baseline in mechanical allodynia test compared to the control group. Fluoxetine (80 mg/L of drinking water) showed a significant decrease in the immobility time in the FST and TST and enhanced pain related behaviour in formalin test in the BCG-inoculated group. However, it did not affect the increase in the pain threshold in the planter incision allodynia model. Adding ibuprofen to drinking water (0.2 g/L of drinking water), reversed the depressive like behaviour induced by BCG and enhanced pain-related behaviour in formalin test, in both the total pain-related behaviour and phase 2. It also prevented the increase in the base line induced by BCG. On the other hand, the incisional pain model was not affected by BCG inoculation except at the 2-hour time point, where it showed hypoalgesia, as well.
Possible Protective Role of Deferoxamine in Ameliorating Osteoporosis in a Rat Model of Liver Cirrhosis via Iron Metabolism Regulation
Authors: Helmy Shereen , Mohamed Doaa I , Elbakly Wesam , Elaziz Lobna F Abd , Khairy Eman , Atalla Suzi Sobhy
Published: October 2021

Background

Liver cirrhosis is considered the terminal stage of many hepatic diseases of different etiologies. Liver cirrhosis was associated with increased incidence rates of some extrahepatic manifestations such as osteoporosis. Regardless of the liver disease etiology, the presence of cirrhosis implies a twofold risk of bone fractures higher than non-cirrhotic patients. The liver is the main storage depot for iron and is the primary organ that is responsible for clearing excess iron in conditions of iron overload. When the iron storage and antioxidant capacity of the liver is overwhelmed, iron overload can lead to marked oxidantmediated liver and bone injury and iron overload was a risk factor for osteoporosis via affecting osteoblast survival.

Aim of the work

to examine the possible protective effect of Deferoxamine (DFO) on liver cirrhosis rat model induced osteoporosis.

Material and Method

rats was divided into 4 groups Animal Groups: Naïve control, DFO-treated group, TAA-treated group received Thioacetamide (TAA) ip (200 mg/kg/rat) twice weekly for 12 weeks, TAA+DFO treated group received TAA intra-peritoneal in addition to DFO intraperitoneal injections (300 mg/kg/3 times/week, for the last 4 weeks of TAA injections.

Results and Conclusion

Deferoxamine produced significant improvement in bone mineralization alongside its significant effect on liver function test in a rat model of liver cirrhosis induced osteoporosis.
Association of serum progesterone level and endometrial estradiol & progesterone receptors in women with unexplained recurrent miscarriage
Authors: Alam Ihab Found , Ashoush Sherif Ahmed , Gomaa Ihab Adel , AbdEl-Hafeez Ahmed Sabry
Published: October 2021

This study investigated the endometrial tissue to study the fluctuation of estrogen receptors (ERs) and progesterone receptors (PRs) in women with recurrent miscarriage compared with normal endometrium of fertile women. Forty women were divided into two groups: 20 non-pregnant women with history of recurrent miscarriage (who had three or more first- trimester miscarriages) and 20 controls. Both groups had regular ovulatory menses and proven fertility. Endometrial biopsy was taken in the two groups during the luteal phase of the menstrual cycle, between the 8th and the 10th postovulatory days using an endometrial biopsy curette for determination of estrogen (E2) and progesterone (P4) hormones levels and their receptors. On the same day as the biopsy, a blood sample was taken for determination of estradiol (E2) and progesterone (P4) levels. The obtained results showed no significant differences between both groups regarding age, BMI, menarche, menstrual cycle & menstruation, significant decrease in E2 and P4 levels in the serum and endometrial biopsy of recurrent miscarriage women versus control. In control and recurrent miscarriage; ER levels in cytoplasm and salt extracted nucleus were higher than PR levels. ER and PR values were higher in the nuclear compartment than in the cytoplasmic compartment. The women with early recurrent miscarriage showed lower levels of both ER and PR significantly. All types of endometrial receptors (ER &PR) and hormones (E2 &P4) in serum and endometrium showed correlation relating to number of previous miscarriages.
Induction of Abortion in the Second Trimester by Misoprostol or Misoprostol with Letrozole
Authors: Kortam Mohamed Ashraf Mohamed Farouk , Raafat Tarek Aly , Rahman Rehab Mohamed Abd El , Mahfouz Amir Hamdy Abd El Hady
Published: October 2021

Background

Abortion is the termination of pregnancy by any means (surgical or medical) before the age of viability. The definition varies in duration of gestational age according to the countries and available facilities. Estrogen is important in the maintenance of pregnancy. Aromatase inhibitors such as letrozole, suppress the peripheral conversion of androgen to estrogen, the use of letrozole combined with vaginal misoprostol was more effective than misoprostol alone in termination of pregnancy.

Objective

Assessing the efficacy of addition of letrozole to Misoprostol in medically induced abortion in the second trimester of pregnancy in the Maternity hospital of Ain Shams University.

Methods

This clinical trial was conducted at Ain Shams University Maternity hospital in the period between December 2018 and May 2019. Patients that seem to be fulfilling the inclusion criteria were recruited, then informed written consent was taken from every patient before starting the examination That was followed by detailed history and examination of all patients to confirm fulfilling the inclusion and exclusion criteria.

Results

This study demonstrated that 10 mg letrozole for three days followed by 800 mcg of vaginal misoprostol is more effective than misoprostol alone for second trimester abortion. In the total of 72 women were recruited the complete abortion rate of the letrozole group was significantly higher than that of the control group (61,1% in the letrozole group compared with 33,3% in the control group).

Conclusion

s: The use of letrozole in addition to misoprostol was associated with a higher complete abortion rate, shorter induction to abortion interval and shorter curettage rates compared to a placebo followed by misoprostol in patients undergoing induction of abortion between 12 & 24 weeks gestation.