bluuebunny/crossref_metadata_2025 huggingface dataset:
Praziquantel - chitosan nanoformulation against murine Schistosoma mansoni infection
Authors: Tawfeek G M , Abdelbaki M H , Ibrahim A N , Hanafy M A , Fathy M M , Diab M S M
Published: May 2020

The aim of the present work was to design praziquantel (PZQ) loaded chitosan nanoparticles (PZQ-Cs) to improve the oral bioavailability and overcome the drawbacks of conventional PZQ therapy. The synthesized chitosan nanoparticles (CsNPs) were physico-chemically characterized by TEM and dynamic light scattering (DLS) with the calculation of the encapsulation efficiency (EE). PZQ was loaded into CsNPs in three different doses; reduced dose (250 mg/kg), high dose (500 mg/kg) and fully effective dose (1000 mg/ kg). Infected treated groups received either oral PZQ-Cs or oral PZQ alone 42 days post-infection and were sacrificed 2 weeks post-treatment. The current study revealed that PZQ-Cs induced a significant anti-schistosomal effect, compared to the infected non-treated control. However, on comparison with conventional PZQ treatment at the corresponding doses, oral PZQ-Cs showed a lower anti-schistosomal potential as reflected by the total worm burden, tissue ova count and oogram pattern. PZQ-Cs was significantly effective in attenuating the oxidative insult associated with S. mansoni infection, compared to the infected non-treated and PZQ treated groups. Genotoxicity assessment proved the safety of CsNPs, as they did not induce a significant DNA fragmentation in non-infected mice treated with blank CsNPs. The present work highlights CsNPs as safe, effective anti-inflammatory and antioxidant agents that could find a clinical use in the treatment of schistosomiasis induced oxidative stress and hepatic dysfunction. Further studies are recommended, however, to investigate how PZQ-Cs could be further modified to increase its anti-schistosomal potential.
Vector-borne disease problems in rapid urbanization
Authors: Zayed A
Published: May 2020

Habitat change of disease vectors has a great impact on their effectiveness to transmit vector borne diseases (VBD). This may result from man-made or natural factors. Urbanization, though it reflects development, is one crucial factor affecting the competence of existing vectors in certain geographic area, or allow for introducing and/or increasing the vectorial capacity of subsidiary vectors. Developing countries, challenging areas with political constrains and those affected by natural disasters are the most threatened areas in terms of VBD continuous change. Vector control strategies are mainly based on having an up-to-date complete knowledge of the spatial and temporal composition of disease vectors. Flexible control and planning decisions, and evidence-based interventions may help containing changes in VBD status due to the rapid urbanization.
The potential diagnostic value of immunohistochemical expression of trop2 in papillary thyroid carcinoma
Authors: Zaki S S , Farid R M , Abugabal H H , Khalil R M
Published: May 2020

Background

The diagnosis of the papillary thyroid carcinoma depends upon the characteristic histopathological features, however there may be borderline cases with controversial features necessitating the use of immunohistochemical studies.Trophoblastic cell surface antigen 2 (TROP-2) is a promising marker that is used recently in the diagnosis of PTC.

Aim of the Work

To highlight the diagnostic value of TROP-2 marker in PTC in comparison with other benign and borderline thyroid lesions on tissue specimens.

Materials and Methods

This retrospective cohort study included 55 cases of PTC, its histopathological variants, benign and borderline thyroid lesions received at pathology department, Faculty of medicine, Ain Shams university between 2011 and 2016. Immunohistochemical evaluation of TROP-2 was applied on. Membranous staining without cytoplasm in > 5% of cells was considered positive. TROP-2 expression in various thyroid lesions were determined by immunohistochemical staining and results were statistically analyzed.

Results

Among the studied cases, 85.1% of PTC demonstrated TROP-2 staining. Most of the cases revealed diffuse staining. No significant staining difference was reported between studied classic and non classic variants. TROP-2 sensitivity and specificity were 85.1% and 94.4%.

Conclusion

In view of present study we concluded the use of TROP-2 as a novel promising marker in the diagnosis of PTC as its positivity was significantly higher in PTC compared to all other non PTC lesion .
Study of Serum Levels of Cyclophilin A in Patients with Coronary Artery Disease
Authors: Zaki M M , Mohsen M , Shaaban M A , Sedky R M
Published: May 2020

Background

Coronary artery disease is a complex chronic inflammatory disease, characterized by remodeling and narrowing of the coronary arteries supplying oxygen to the heart. It is the leading cause of death worldwide being responsible for approximately onethird of all deaths in individuals older than 35 years. Cyclophilin A (CyPA) is a protein secreted from vascular smooth muscle cells (VSMCs) in response to reactive oxygen species (ROS). It is suggested that CyPA plays an important role in later stages of atherosclerosis and plaque rupture. However, little information had addressed the potential relationship between CyPA and CAD.

Objective

Aim of the present study was to assess the role of CyPA in early diagnosis and prediction of severity in CAD patients.

Subjects and Methods

This study was conducted on eighty- nine (89) adult patients undergoing coronary angiography for suspected CAD. They were selected from the Cardiology Department of Ain Shams University Hospitals. According to the angiography findings, 68 patients had CAD and twenty-one age-and-sex matched subjects had normal coronaries and thus were considered as control group. The patients’ group was further classified according to number of occluded vessels into four subgroups; zero-, one-, two- and three-vessel disease subgroups. Blood samples were collected for determination of HbA1c, serum creatinine, cardiac troponin, as well as assay of CyPA. The latter was carried out using double antibody sandwich ELISA technique.

Results

Our study revealed a significantly higher levels of CyPA among patients with CAD than the control group (p < 0.01). Also a significantly higher CyPA levels were detected in zero-vessel group patients when compared with control group (p < 0.05). In addition, significant difference was revealed in CyPA levels between patients with zero-vessel disease when compared to those with one-vessel disease, two-vessel disease and three-vessel disease, being lower in former group than other groups (p < 0.05, respectively). The diagnostic sensitivity and specificity of CyPA were 91.2% and 61.9% respectively at a cutoff value of 7ng/mL for discrimination between patients and control groups. Moreover, the diagnostic sensitivity and specificity of CyPA were 58.3% and 90.5%, respectively at a cutoff value of 13ng/mL in discrimination between zero-vessel disease and control groups. It was shown that 2 by adding hypertension as a risk factor in patient’s group with CyPA > 7ng/mL, sensitivity and specificity were elevated to 95.6% and 76.2% respectively. By applying the same on the zero vessel disease group with CyPA>7ng/mL, sensitivity and specificity were noticeably enhanced to 91.7 and 95.2, respectively.

Conclusion

Cyclophilin A can be used as an early predictor of CAD and in discrimination between zero-vessel disease and healthy individuals. The association of hypertension as a risk factor together with elevated CyPA levels enhances its diagnostic sensitivity and specificity.
Diagnostic Role of Aldoketoreductase family 1B10 (AKR1B10) in Hepatocellular Carcinoma and Benign Hepatic Lesions
Authors: Farid L M , Abdelrahman M H , Sammour S A , Hegazy N A , Ibrahim E , Abougabal H H
Published: May 2020

Background

Hepatocellular carcinoma is the most common primary liver cancer. It is the second most common cause of cancer deaths. The majority of HCCs arise in chronically diseased livers with cirrhotic background. Several benign lesions might be found in a cirrhotic liver along with hepatocellular carcinoma (HCC), and may exhibit typical or atypical imaging features. Distinction between benign hepatocellular nodular lesions, such as hepatic adenoma, and focal nodular hyperplasia, from HCC is of crucial clinical importance in determining appropriate therapy and assessing the prognosis.AKR1B10 is a promising marker that is recently used in the HCC diagnosis.

Aim of the Work

is to study the immuno-histochemical expression of Aldoketoreductase family 1B10 (AKR1B10) in hepatocellular carcinoma and benign hepatic lesions, to assess its role in the diagnosis of hepatocellular carcinoma and in differentiating it from different benign hepatic lesions.

Materials and Methods Hepatocellular carcinoma (HCC(T)):(109), corresponding non tumor tissue with and without cirrhosis (NT):(80), benign hepatic lesions (Focal Nodular Hyperplasia(FNH):(6) and Hepatic Adenoma(HCA)) (6) and Hepatic Cirrhosis (Cs) without HCC (16).

Results

AKR1B10 was over expressed in 82.6% (90/109) of studied HCC cases, negative expression in studied corresponding non-tumor hepatic tissue (NT) in 92.5% (74/80), complete negativity of AKR1B10 was observed in studied benign hepatic lesions 100% (0/12) and also negative expression in 81.3% (13/16) of included hepatic cirrhosis without HCC.

Conclusion

AKR1B10 is a promising marker in the diagnosis of HCC and distinguishing it from other benign hepatic lesions.
Screening for Primary immunodeficiency in Egyptian children with repeated infections
Authors: Elsayed Z A , Elowaidy R H , Sobh A , Aleitewy N S
Published: May 2020

Introduction

Despite efforts, primary immunodeficiency disorders (PIDs) are still under estimated. Predominantly antibody deficiencies (PADs) account for approximately two-thirds of all PIDs. We sought to screen for immunoglobulin deficiency among Egyptian infants and children presenting with unusually recurrent, severe and/ or persistent infections.

Methods

We conducted a cross sectional study that included 75 children presenting with clinical history and/or features suggestive of immunodeficiency. They were enrolled from Children’s Hospitals of Ain Shams and Mansoura Universities. They were subjected to clinical evaluation and measurement of serum immunoglobulin (Ig) levels: IgA, IgG and IgM (by nephelometry) and IgE (by ELISA).

Results

Patients’ ages ranged between 0.5-14 years (median (IQR): 2(0.83-3) with male to female ratio 2:1. Pneumonia was the most common infection (84%) followed by gastroenteritis (64%). Eleven patients (14.7%) had allergic manifestations and three (4%) had suppurative lung disease. Duration of infections per year ranged 3-150 days (median (IQR): 65(60-90), with average of 5 times hospitalization per year. Eighteen (24%) patients had failure to thrive and 21 patients (28%) had absent BCG scar. According to immunological evaluation, 7 patients (9.3%) had combined immunodeficiency, 4 (5%) had agammaglobulinemia, 2 (2.5%) had hypogammaglobulinemia, 2 (2.5%) had Hyper-immunoglobulin E syndrome and one had HIV infection. Patients without B cell defects had significantly higher frequency infection and hospitalization per year compared to those with B cell defects (p = 0.017 and 0.019 respectively). Conclusion: Primary immunodeficiency disorders are not rare. The awareness of families and primary health care physicians is crucial in the establishment of early diagnosis and initiation of appropriate therapy.
Effect of Assisted Exercise on Musculoskeletal System and Growth in Preterm Infants
Authors: Awad H A , Elganzoury M M , Emam S S , Gad G I , Elfarrash R A H , Ibrahim B A
Published: May 2020

Background

osteopenia of prematurity, also known as bone metabolic disorder, is one of the common diseases in very low birth weight (VLBW) prematurity.

Aim of the Work

the primary aim of this study was to assess whether physical activity programs in preterm infants improve bone mineralization as well as growth and reduce the risk of fractures. The secondary aim was to include other potential benefits in terms of length of hospital stay, weaning from mechanical ventilation, feeding tolerance and adverse events.

Patients and Methods

this study was conducted on 36 neonate, Preterm infants (gestational age <33 completed weeks), body size appropriate for gestational age according to the growth curve, Postnatal age of ≥ 1 week with medically stable condition and favorable evolution that is presenting no associated diseases besides prematurity, tolerating enteral feeds of preterm formula at or above 100 kcal/kg/d.

Methods

the studied neonates were randomized into the physical exercise (n = 18) and control (n = 18) groups. Randomization was made by birth order. The studied neonates were subjected to full history taking, complete clinical assessment together with complete blood picture, C-reactive protein, serum Ca, Serum phosphorous concentration, Serum magnesium concentration. Serum alkaline phosphatase concentration, Serum Alanine Aminotransferase (ALT), Urinary calcium/phosphorous ratio. Babies admitted to NICU bathed, placed in incubator, attached to monitor. Infants in treatment and control groups received well defined interventions for the exercise group, systematic physical activity programs consisting of range-of-motion exercises with gentle compression, extension and flexion of all joints of both bilateral upper extremities; including the shoulder, elbow, and wrist and lower extremities; including the hip, knee and ankle, with a total of 12 joints Each activity was about 10 min a day and was carried out 5 times per week for 4 weeks. This program was started after 1 week of birth. Physical activity continued until discharge from hospital.

Results

the study demonstrated non significant difference in weight at enrollment (p = 0.516) which was turned into significant difference at end of the study as being higher among exercise group (p < 0.001). In our study although there was increase in the length and head circumference (p < 0.001) in the 2 groups no significant difference detected comparing them together. The control group had significantly lower serum phosphorus (p < 0.001), higher urinary Ca/Po4 ratio (p < 0.035) and higher ALP (p < 0.005) compared to excerise group at the end of the exercising protocol.

Conclusion

our study has demonstrated that regular physical activity programs (range-of-motion exercises), after an initial period of stabilization, might provide a simple intervention for improving musculoskeletal system and skeletal growth in preterm infants. They may also promote general growth in preterm infants.
Assessment of Hemodynamic Status and Perfusion Markers in Critically Ill Children with Septic Shock
Authors: Abdelgawad T , Mansour M G , Elguindy W M , Khallaf M K
Published: May 2020

Background

Severe sepsis causes release of inflammatory mediators and an associated redistribution of intravascular volume together with depression of myocardial function which manifests as hemodynamic pattern of low cardiac output, low systemic vascular resistance, hypotension, hyperlactatemia and signs of altered tissue perfusion such as oliguria and prolonged capillary refill time.

Aim of the Work

To assess hemodynamic status together with the perfusion markers (lactate) in critically ill children with septic shock.

Patients and Methods

This single cohort study was conducted on 40 patients recruited from the pediatric intensive care units (PICU) at: Ain Shams university hospital, Al-Galaa Military medical complex and Ghamra Military hospital From December 2017 to August 2018.

Results

Only four cases of cases with septic shock developed ejection fraction below 55% denoting myocardial dysfunction during the duration of assessment (first 24 hours of diagnosis). There was negative correlation between cardiac functions represented by hemodynamic measures on one side and SOFA score, PIM 2 score and serum lactate levels on the other side. However, by studying the performance of the parameters included in our study in predicting death; only lactate-24 ≥2.0 (mmoL/L) had statistically significant moderate diagnostic performance, other studied measurements had weak diagnostic performance.

Conclusion

Myocardial dysfunction was found to be common in children having septic shock. Close monitoring and hemodynamic assessment is important to avoid missing these cases. In addition, serum blood lactate level is an important biomarker that should be carefully monitored as it is a good prognostic tool that can predict outcome in pediatric sepsis and septic shock.
Glucose metabolism in liver disease in children Retrospective study
Authors: Elkabbany Z A , Abdelaziz A W , Abdelmageed R I , Fahim M A
Published: May 2020

Background

Diabetes developed as a complication of cirrhosis is known as hepatogenous diabetes (HD). Around 30% to 60% of cirrhotic patients suffer from this metabolic disorder. Insulin resistance in muscular, hepatic and adipose tissues as well as hyperinsulinemia, seem to be pathophysiologic bases for HD.

Objectives

to determine the frequency of diabetes mellitus and impaired glucose tolerance in cirrhotic patients in Ain Shams university hospital of pediatrics and identify risk factors.

Patients and methods

The study included 50 patients, their age is ranging from 6 months to 17 years with chronic liver disease following in the hepatology outpatient clinic (Ain Shams University). These patients were compared according to their fasting plasma glucose, fasting C-peptide, fasting plasma insulin and glycosylated hemoglobin.

Results

28% of the patients included in the study were diagnosed as Wilson’s Disease and 24% were diagnosed as extrahepatic biliary system atresia. Thirty patients (60%) showed impaired glucose tolerance, these patients showed hepatomegaly clinically and by ultrasound, also their liver biopsy showed periportal fibrosis and mild to moderate degree of chronic hepatic fibrosis, decreased level of Hemogolbin, high level of liver enzymes especially alanine aminotranferase, and finally high level of Hemoglobin A1C (glycosylated hemoglobin), fasting plasma insulin and fasting C-peptide.

Conclusion

Most patients with chronic liver disease complicated with liver cirrhosis are liable to develop impaired glucose tolerance and on the long run, they may develop hepatogenous diabetes.
Frequency and Etiology of Nosebleeds among Children in Pediatric Out-Patient Clinic of Ain Shams University Hospitals
Authors: Elalfy M S , Tantawy A A , Badreldin B M , Ebeid F S E , Mekawy M A , Mohammad Y A
Published: May 2020

Aims

Measure frequency, severity, and etiology of epistaxis in a tertiary center pediatric out-patient clinic.

Population

Pediatric patients presented with epistaxis of an unknown cause.

Methods

Thorough clinical assessment, ENT examination CBC and coagulation profile and confirmatory tests when needed.

Results

100 patients with epistaxis (53 females and 47 males) were recruited out of 30043 visits to pediatric OPC throughout one year (1 in 300). Most of them were younger than 12 and nearly half of them were younger than 6 years. 43 patients had epistaxis only, most probably local bleeding (37 had idiopathic epistaxis, 6 had local ENT cause). 57 had other bleeding manifestations, most probably systemic bleeding (47 had a definite bleeding disorder and 10 had undiagnosed bleeding tendency). There was a statistically significant higher number of patients with a positive family history for epistaxis and being referred from a primary care physician in those with probably systemic cause.

Conclusion

Epistaxis is not uncommon, it is not always idiopathic and can be the presenting symptom for an underlying bleeding tendency.
Tic Disorders in Children with Epilepsy: Effect on Behavior and Quality of Life
Authors: ELagouza I A , Deifalla S M , Hossameldin A
Published: May 2020

Idiopathic Epilepsy in children is associated with several comorbidities. Tics and other deviant behaviors are some of them which could negatively impact the family quality of life. The current study aimed at comparing quality of life and behavioral test results in children with epilepsy and tics versus those with epilepsy only.

Patients and Methods

Sixty patients with idiopathic epilepsy aged from 4 to 18 years participated in the current study. Group I included 30 patients with idiopathic epilepsy and tic disorders aged 10.1+/-3.2 years and group II 30 with epilepsy only aged 10.1+/-3.1 years. The Arabic version of the Pediatric quality of life inventory 4.0 (PedsQLTM 4.0), the Arabic translation of the Child Behavior Checklist (CBCL) scores were used and Conner’s parent rating scale were used. The results were compared between the 2 participating groups.

Results

Group I patients had worse total quality of life scores for both the child’s and parent’s scores compared to group II patients (p<0.05). CBCL scores were significantly higher in group I regarding most of the internalizing and externalizing domains yet the total score was non-significantly higher in group I compared to group II (p=0.05). Group I patients had higher total Conner’s score compared to group II; (p=0.045). Furthermore, those with ADHD in group I was 70% compared to 50% in group II.

Conclusion

Tic disorders in the context of idiopathic epilepsy should be addressed seriously as they are associated with other behavioral defects that require intervention to achieve better quality of life.
Health related quality of life of children with chronic liver diseases
Authors: Hassan B M A M , Zaky E A
Published: May 2020

Introduction

Chronic liver disease encompasses a wide spectrum of disorders, including infectious, metabolic, genetic, druginduced, idiopathic, structural, and autoimmune diseases. The clinical presentation and initial laboratory data in many of these diseases are similar, and a definitive diagnosis often relies on specialized laboratory investigation and histologic examinationof liver tissue. End-stage liver disease in children presents a challenging array of medical and psychosocial problems for the health care delivery team.

Health-related quality of life (HRQOL) is a marker of disease severity.Influence of the liver disease, active medical and psychiatric comorbidities, and socio-demographic variables in the determination of health-related quality of life (HRQOL) measured by a generic and a liver-specific instrument in unselected patients with chronic liver disease revealed that Psychiatric comorbidity and active medical comorbidity, and not severity of the liver disease according to Child-Pugh score,determine reduced HRQOL in patients with chronic liver diseases (Häuser et al., 2004).

Aim

The aim of this study was to assess the influence of chronic liver discease on health-related quality of life (HRQL) of the patients.

Methods

This study was conducted on 32 children with chronic liver disease (17 males ; 15 females) with ages ranging from 6-14 years, following up at the Pediatric Hepatology Clinic,The Children`s Hospital, Ain Shams university.

Cohorts of 15 apparently healthy children (8 males; 7 females) with ages ranging from 5-14 years were also studied as a control group.

All children included in the study were subjected to thorough clinical history and examination and Assessment of Pediatric Quality of Life using PedsQLTM Inventory both Child Self Report and Parent Proxy Report.The PedsQLTM scales comprised of parallel child selfreport and parent-proxy formats.

Results

Statistical comparison between studied groups as regards Health Related Quality of Life assessment among parents shows that the parents` perception of qualityof life total summary score as well as physical, emotional, and school sub-scores were significantly lower among parents of CLD children compared to controls and also showed that the child perception of quality of life total summary score as well as physical, and school subscores were significantly lower among CLD children compared to controls.
Serum Transforming Growth Factor Beta2 and Feeding Intolerance in Premature Formula -Fed versus Breast Milk-fed Neonates
Authors: Ismail R I H , Othman W O A , Abouwarda M A
Published: May 2020

Serum Transforming Growth Factor Beta2 and Feeding Intolerance in Premature Formula -Fed versus Breast Milk-fed Neonates

Objectives

to assess occurance of feeding intolerance and NEC in relation to serum level of TGF-β2 in breast milk versus preterm formula fed neonates.

Subjects and Methods

a prospective observational study on 80 preterm neonates(≤36weeks gestational age). They were divided to two groups; breast milk fed group(n = 40) and preterm formula fed group(n = 40). They were assessed clinically for feeding intolerance and NEC and laboratory by measurement of TGF-β2 using ELISA technique.

Results

TGF-β2 serum level was significantly lower in preterm formula fed group than breast fed group;median(interquartile) 500(250-3000) pg/ml vs 7750(6500-11250) pg/ml (p < 0.0001). Both primary outcome(feeding intolerance and NEC) and secondary outcome(respiratory support and sepsis) were negatively correlated to TGF-β2 serum level. TGF-β2 serum level below 1250 pg/ml was found to be a good diagnostic test for feeding intolerance with sensitivity of 75.86% and specificity of 96.08%.

Conclusion

low serumTGF-β2 level is a specific marker for feeding intolerance in preterm neonate. Using premature formula in premature neonates is not recommended as it is associated with lower serum TGF-β2 and higher incidence of feeding intolerance compared to breast feeding.
Effect of Vitamin D level on growth velocity of RHGH treated children
Authors: Mouharam W A , Saab A A , Soliman D A
Published: May 2020

Objective

Recent studies have shown a relationship between vitamin D status, growth hormone and insulin-like growth factor 1 axis. Aims of the study are: 1- To evaluate the vitamin-D blood level in children on substitution treatment with rhGH. 2. To find out correlation between the vitamin D level and growth velocity with rhGH therapy, height, height SDS, height/height SDS after 1 year of treatment

Methods

The study included 173 prepubertal children, with short stature on treatment with rhGH (90 girls and 81 boys), aged between 2 and 10.3 years. To determine vitamin D status we measured serum 1,25-OH vitamin D by taking a single blood sample in the morning, in a fasting stage. Growth velocity over the year of observation, starting height, height SDS, height at the end of the year and its SDS all were calculated and correlated to vitamin D level.

Results

In the present study: 56 patients had vitamin D deficiency (<10 ng/ml); 54 had vitamin D insufficiency (10–20 ng/ml) and 63 had vitamin D sufficiency (>20 ng/ml). No statistical significance correlation was found between vitamin D level and height, height SDS, follow up height, and follow up height SDS (P.09, .066, .455, .927 respectively) Significant positive correlation was found between vitamin D and growth velocity (r .445 and P.0001).

Conclusions

Optimizing vitamin D level in patients with short stature under growth hormone therapy may improve growth velocity and response to growth hormone.
Voice analysis and vocal cord assessment in asthmatic children
Authors: Zaky E A , Fouda E M , Eldesouky H A , Abdhakeem A S
Published: May 2020

Aim of work

This is a cross sectional case control study to asses vocal folds abnormalities and voice analysis in asthmatic children to detect subclinical changes and to correlate them with their various clinical and functional grading and level of control.

Methods

the study included 48 asthmatic children (34 males and 14 females ) regularly attending Pediatric chest Clinic, Ain Shams university for follow up.Their median age was 7.8 years ± 2.15 IQR. A 12 age and sex matched healthy children were chosen as control group. For all patients and control the following were done: history taking,General and chest examination, Spirometry Pulmonary functions(FEV1,FVC,), videolaryngoscopy (VLS)and Multidimensional voice analysis (MDVA) .

Results

VideoLaryngoscopy (VLS) of asthmatic patients showed different abnormalities in 26 cases ( 54.2% ).eg Phonatory west 1mm from the middle line(4 cases), Bilateral vocal folds nodules (4 cases), Bilateral thickening of both vocal folds(3 cases), Vocal fold cyst.(4 cases). Asthmatic children with abnormal finding in (VLS) had a statistical significant lower values of FEV1 and MMEF with higher percentage of poor asthma control. Voice analysis showed impairment of voice acoustics in asthmatic children with significant difference between asthmatic and control as regards voice analysis data with significant higher jitter and shimmer dB (measure of voice amplitude and detector of early hoarseness of voice) .

Conclusion

Asthmatic patients may have an associated Laryngeal or vocal folds abnormalities which are considered a comorbid condition and one of the causes of poor asthma control. Voice analysis may help in detection of subclinical hoarseness of voice which may be sequelae of chronic cough or side effects of inhaled steroids.
Glycated Albumin, a Marker for RA associated Coronary Artery Athelosclerosis
Authors: Eskander M R Y , ELsebaie H , Assaf N , Elgharbawy N , Allam L
Published: May 2020

Objectives

to detect the value of serum Glycated Albumin measurement as a marker for RA associated coronary artery atherosclerosis and also a marker for RA disease activity.

Patients and Methods

serum GA using enzyme-linked immunosorbent assay (ELISA), chemical and immunological markers of RA were measured in 30 RA patients and 15 age and sex matched controls known to have established coronary artery disease. Disease activity was assessed using the DAS-28 score. Carotid ultrasound was done to both groups to measure the carotid IMT.

Results

A significantly higher serum GA level on comparing RA patients and controls (T = 5.096, P < 0.001). Serum GA had a significant positive correlation with ESR (r = 0.546, P < 0.002) and CRP (r = 0.768, P < 0.001), a significant positive correlation with DAS-28 (r = 0.532 , P < 0.002), a significant positive correlation with mean carotid IMT (r = 0.471, P = 0.019). The mean carotid IMT showed a highly significant positive correlation with the disease duration (r = 0.645, P < 0.001), a positive correlation with severe disease activity (r = 0.771, P = 0.015), but negative correlation with mild and moderate disease activity (r = 0.500, P = 0.667) and ( r = 0.452, P = 0.059) respectively. Another significant positive correlation was found between the mean carotid IMT and the LDL (r = 0.408, P = 0.025) but negative correlation with total cholesterol and HDL (r = 0.120, P = 0.527) and (r = -0.250, P = 0.183). On comparing the mean carotid IMT with the presence of soft atheromatous plaque it gave negative results with positive correlation (T = -3.273, P = 0.003)

Conclusion

Serum GA is a specific and sensitive biomarker for detection of subclinical atherosclerosis and disease activity in RA.
Assessment of the Efficacy of Insoles in Treatment of Foot pain in Rheumatoid Arthritis Patients
Authors: Elwy M A , Elhilaly R A , Abaza N M , Alubaidy A K
Published: May 2020

Background

Customized toot insoles. Were commonly used as a conservative treatment for the foot pain in rheumatoid arthritis (RA) to prevent and control joint damage, and to improve foot function.

Objective

to assess the efficacy of total contact soft foot insoles in treatment of foot pain in RA patients.

Methods

20 RA patients with foot pain were randomized into 10 patient as foot insole group plus physiotherapy and foot exercise and other 10 patients without insole, with only physiotherapy and foot exercise. Foot pain and disability were assessed by visual analogue scale (VAS) and foot function index (FFI%). other parameters to assess foot involvement such as conventional radiography and diagnostic ultrasound and power Doppler ultrasound to assess joint involvement in addition to pedobarography (planter pressure assessment) to measure the static planter peak pressure (SPPP) and dynamic planter peak pressure (DPPP) of both feet.

Results

At the end of the study period analyses were performed on data collected at baseline and after 2 months of randomized clinical trial. Twenty women (mean age, 39.20±5.35years; mean disease duration, 7.68 ± 3.71y-ears) were evaluated, before and after clinical trial. We found highly significant reduced in pain, disability scales and joint inflammation in the insole group more than in non-insole group.

Conclusion

customized total contact foot insole with physiotherapy and foot exercise have a significant positive effect on the pain, disability, joint and soft tissue inflammation and planter pressure distribution.
Study of immediate changes in blood coagulation in an experimental model of ischemia/reperfusion injury of the kidney
Authors: Gamil N M B , Abdelrahman A M , Darwish D A A , Ahmed E
Published: May 2020

Introduction

Ischemia- reperfusion injury (IRI) in the kidney triggers multifaceted network of plasma cascades including the complement, coagulation, kinins, and fibrinolytic system, which play major role in the reperfusion-triggered inflammatory process.

Aim of the work

The aim of the present study was to investigate changes in blood coagulation parameters immediately after ischemia and after ischemia/reperfusion of the kidney in adult rats of both sexes.

Materials and Methods

The study was carried out on 56 adult albino rats of both sexes weighing 160-220 gm. Rats were randomly allocated into 5 experimental groups as follows: Control rat group (C; n = 10). Sham1- operated rat group (SH1; n = 10) subjected to all the procedures of the I rat group except for renal ischemia and were sacrificed after 45 minutes. Ischemic rat group (I; n = 10) subjected to renal ischemia for 45 min, then were sacrificed. Sham 2 operated rat group 2 (SH2; n = 10) subjected to all the procedures of IR – rat group except for renal ischemia and reperfusion and were sacrificed after 1½ hour. Ischemic/reperfusion rat group (IR; n = 10) subjected to renal ischemia for 45 min, then reperfusion for 45 minutes, then were immediately sacrificed. All rats were subjected to estimation of body weight (BW), absolute and relative kidney weights (AKW and RKW), hemoglobin (Hb) and hematocrit (Ht.) values, clotting time, prothrombin time (PT), activated partial thromboplastin time (PTT), thrombin time (TT) and serum levels of urea (Ur.) and creatinine (Cr.).

Results

I rat group showed insignificant changes in AKW and RKW, CT, APTT, PT and TT compared to SH1 and C rat groups. However they showed significant elevation in Hb content, Ht. value and serum levels of Ur. and Cr. compared to C rat group. IR rat group showed significant increase in AKW and RKW compared to SH2, I and C rat groups. Also they showed significant increase in Hb. content, Ht. value and serum levels of Ur. and Cr. compared to C rat group. However they showed no significant change in their CT, APTT, PT and TT compared to SH2, I and C rat groups

Conclusion

Coagulation parameters are not changed immediately after kidney ischemic/reperfusion and may not contribute to the immediate pathophysiological changes of ischemic reperfusion injury.
The potential hepatoprotective effect of quercetin on cholestatic liver injury in rats
Authors: Abushady E A , Elagaty S M , Nassef N A , Abdelhamid G S
Published: May 2020

Background

cholestasis is a prevalent health problem associated with liver oxidative stress, inflammation, and fibrosis. Quercetin has been shown to afford a beneficial effect in a variety of liver diseases.

Aim

This study was designed to investigate the potential protective effect of quercetin on liver cholestasis and the possible underlying mechanisms in a rat model of bile duct ligation (BDL).

Design

Experimental study

Methods

This study was carried out on adult male Wister rats which were randomly divided into: Sham, BDL and BDL- quercetin treated (BDL- Q) groups. Quercetin was given by gavage in a dose of 50 mg/kg/day.

Results

Bile duct ligation resulted in a significant increase in serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), and liver levels of myeloperoxidase (MPO), tumor necrosis factor alpha (TNF-α),and transforming growth factor beta 1(TGF-β1), along with a significant decrease in serum levels of total proteins (TP) and liver glutathione peroxidase(GPX) in BDL group versus sham group. Quercetin treatment significantly lowered serum levels of AST, ALT, ALP, and MPO, TNF-α, and TGF-β1 in liver tissues associated with a significant increase in serum TP and liver GPX in BDL-Q group versus BDL rats. Histological studies revealed enhancement of inflammation and a significant increase in the percentage area of collagen deposition in BDL versus sham group. These changes were attenuated in BDL-Q group compared to BDL rats.

Conclusions

Quercetin alleviated cholestasis induced liver injury and improved liver function possibly via attenuating liver oxidative stress, inflammation and fibrosis.
Possible Protective Effect of Onion Supplementation on Hepatic Functional and Structural Alterations Induced by Cholestasis
Authors: Mohamed A A , Saad D A , Francis M M , Mohamed F A
Published: May 2020

Background

Cholestasis is the obstruction or the reduction in bile flow that results in intrahepatic accumulation of bile constituents, which progresses to develop liver pathology. Common bile duct ligation (BDL) in rodents is an experimental model of cholestasis that has been carried out in research for many years. BDL model of cholestatic liver injury involves other mechanisms, including oxidative stress, inflammation, and fibrogenesis. Antioxidant, antiinflammatory or antiapoptotic properties gained much interest for the amelioration of liver dysfunction.

Aim

the aim of this study is to assess the possible protective effects of onion supplementation on hepatic structural and functional alterations induced by BDL in rats, which reflect the effects of cholestasis resulting from intrahepatic accumulation of bile.

Methods

Thirty adult female Wistar rats were randomly and equally allocated into three groups: (1) control group, (2) BDL group; subjected to ligation of the common bile duct and (3) Onion-supplemented BDL groups (O-BDL). Both control and BDL groups received distilled water (solvent for onion powder) daily by gavage for 4 weeks. Onion-supplemented BDL group (O-BDL); subjected to ligation of the common bile duct and then received 500 mg/kg of onion powder dissolved in distilled water, daily by gavage for 4 weeks. At the end of the experimental period, plasma levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), direct bilirubin, total proteins, total antioxidant capacity (TAC), tumor necrosis factor-α (TNF-α), and hepatic tissue level of malondialdehyde (MDA) and transforming growth factor-β (TGF-β) were measured for all groups. In addition, histopathological examination of liver tissue samples was performed for the three groups.

Results

Plasma levels of ALT, AST, ALP, direct bilirubin, TNF-α and hepatic tissue levels of MDA and TGF-β were significantly increased and TAC was significantly decreased in the BDL group compared to the control group. In addition, altered architecture was detected in hepatic tissue samples of BDL group. Onion supplementation significantly decreased the plasma levels of ALT, AST, ALP, direct bilirubin, TNF-α and hepatic tissue levels of MDA and TGF-β in the O-BDL group when compared to the BDL group. Total proteins level was not significantly different among all the studied groups. In addition in O-BDL group, histopathological examination of liver revealed near normal structure of hepatic tissue.

Conclusion

BDL induces hepatic structural alterations and functional disturbances. Onion supplementation inhibits inflammation and oxidative insults that associate BDL, and subsequently protects against BDL-induced liver injury.
Aortae of Young Rats with Metabolic Syndrome Exhibit Enhanced Vasoconstrictor Activity Than Older Rats
Authors: Ali R H , Gamil N M B , Abdelrahman A M , Ahmed M A , Megahed G K , Abdelwahed D M
Published: May 2020

Background

Metabolic syndrome (MetS) causes pathological remodeling of the heart and adjacent vessels. The functional changes in the big vessels in different age groups had not been fully delineated.

Aim of the work

The present study was planned to investigate aortic vasodilator and vasoconstrictor reactivity in young, adult and old female rats with MetS.

Design: The experimental study was performed on 90 female albino rats randomized into 6 groups: young, adult and old rats with MetS and their respective control groups.

Methods

MetS was induced by feeding rats 41% fructose -containing diet and giving fructose solution (5 g fructose in 4 ml distilled water/day) by gavage in two sessions (2 ml/session). On the 8th week, all rats were sacrificed and were subjected to determination of body weight (BW), body mass index (BMI), absolute and relative visceral fat weight (VF), fasting blood glucose (FBG), plasma insulin (PI), homeostasis model of insulin resistance (HOMA-IR) and plasma lipid profile. All rats’ aortae were subjected to study of vascular reactivity to Potassium chloride (KCL), phenylephrine (PE) and acetyl choline (A.Ch) as well as estimation of nitrite content.

Results

On the 8th week of the study, all MetS groups developed criteria of metabolic syndrome as evidenced by the significant increase in final BW, BMI, absolute and relative VF weights, FBG, PI and HOMA-IR compared to their control group values. Also, MetS rat groups exhibited evident dyslipidemia in the form of significant increase in plasma levels of triglycerides, total cholesterol and significant decrease in HDL-cholesterol compared to their control group values. Aortae of young and adult MetS rat groups showed significant increase in their vasoconstrictor response to KCl and PE and decrease in A.Ch/KCL% and A.Ch/PE % compared to their controls, while old MetS rat group showed significantly increased vasoconstrictor response only to KCL compared to their controls. When compared to each other, young age MetS group had significantly higher vasoconstrictor response to PE compared to old MetS group despite comparable nitrite content.

Conclusion

Met.S causes functional vascular changes in all age groups with unexpectedly enhanced vasoconstrictor response in the young group compared to old.
Effect of Insulin Sensitizers and Sodium Glucose Cotransporter 2 Inhibitor on Glycemic State and Cardiovascular Performance in Type II Diabetic Rats
Authors: Ewida S F , Shabaan A M H , Eldomiaty H F , Hanna G S Y , Hassabelnabi S E , Saleh S A
Published: May 2020

Background

Cardiovascular disease is the most life-threatening diabetic complication. Type II diabetes may lead to damage of the heart muscle. Sodium glucose cotransporter 2 (SGL2) inhibitors are a new class of diabetic medications indicated only for the treatment of type II diabetes.

Aim

This investigation was assigned to compare the effect of metformin and SGL2 inhibitors (dapaglifilizone) in type II diabetic rats.

Design and methods: Eighty rats divided into four groups were used: non diabetic; diabetic; diabetic metformin -treated; diabetic dapagliflizoline- treated. At the end, arterial blood pressure and cardiac performance (cardiac contractility and heart rate) were assessed. Serum glucose, glycosylated hemoglobin (HbA1c), insulin, lipid profile, total antioxidant capacity, malondialdehyde, tumor necrosis factor α were measured. HOMA-IR index was calculated. DNA changes were assessed from hearts and aortea. Aortic endothelial changes recorded using H&E and masson trichome techniques.

Results

Glycemic index, lipid profile, oxidative stress and inflammatory parameters were significantly improved in both metformin and dapagliflizoline treated groups with also significant improvement in blood pressure, Cardiac performance and reduction in collagen deposition in aortic tissue and DNA fragmentation. Dapagliflizoline treatment results were significantly improved in all parameters compared to metformin treatment.

Conclusion

SGL2 inhibitors (dapaglifilizone) successfully restored glycemic state, cardiac performance, DNA and endothelial changes in type II diabetic rats compared to metformin.
A Possible Cardio-Protective Role of Early Remote Ischemia Preconditioning Against Ischemia Reperfusion Injury I’m Isolated Hearts of Adult Albino Rats: Possible Involvement of Hypoxia Inducible Factor
Authors: Abdelhamid M S , Mansour R S , Ebrahim A T , Elkafoury B M
Published: May 2020

Background

Inspite of the claimed cardio-protective effects of ischemic preconditioning (IPC), it is invasive and so using remote ischemic preconditioning (RIPC) may offer an alternative. Meanwhile, RIPC cardioprotective role is controversial, with an equivocal underlying mechanism. The hypoxia inducible factor 1 alpha (HIF-1-alpha) which is increased following ischemic insults is claimed as a humoral mediator for RIPC.

Objective

To investigate the effect of remote ischemic pre-conditioning on myocardial ischemia/reperfusion injury in rats, and to elucidate the possible role of hypoxia inducible factor in this protection.

Materials and Methods

The present study was performed on 28 adult female albino rats in the same estrus cycle evaluated by vaginal smear, and they were allocated into 3 groups: Group I: control rats subjected to ischemic/reperfusion injury (I/R) only, group II: early RIPC rats (RIPC 2 hours prior to I/R), group III: acriflavine-treated early RIPC rats. Acriflavine is a drug that binds directly to HIF-1 alpha and HIF-2 alpha subunits, thus inhibiting its dimerization and transcriptional activity, and it was injected IP 10 days prior to RIPC. On sacrifice day, ECG was recorded and isolated heart studies were performed. Later, cardiac chambers weight, serum HIF-1-alpha, myocardial perfusate lactate dehydrogenase, and cardiac oxidative markers: Malonaldehyde and glutathione perioxidase were measured.

Results

Compared to the control group, the early RIPC group showed significant increase in the heart rate (HR), QTc interval in the ECG recording, glutathione peroxidase and the HIF 1α levels together with reduction in the percent of decrease in PT and PT/LV, in the percent of prolongation in time to peak tension (TPT), perfusate lactate dehydrogenase and MDA levels, while no significant changes were recorded in the heart chronotropic activity, in the percent of half relaxation time (HRT) prolongation, or in the percent of decrease of MFR. Following acriflavine treatment, the effects of RIPC were abolished highlighting the role of HIF-1-alpha in mediating RIPC protective effects.

Conclusion

The non-invasive and non-pharmological remote ischemic preconditioning technique can ameliorate the cardiac ischemic reperfusion injury with an obvious role of HIF-1α in mediating these protective effects.