bluuebunny/crossref_metadata_2025 huggingface dataset:
Internal and External Rotators Muscle Strength Ratio and Acromio-Humeral Distance as Predictors of Shoulder Injuries in Volleyball Players
Authors: El Sebaie Mona Abdullah , Elsaid Ahmed Mohamed , Kotb Ahmed Mostafa , El- Mallah Reem , Mohamed Hassan Amr Mohamed Taha
Published: July 2024

Purpose

We aimed to investigate the ratio between strength of internal and external rotators of shoulder using handheld dynamometer and acromio-humeral distance actively and passively using musculoskeletal ultrasound to identify a relation between strength imbalance and shoulder joint injuries in Egyptian volleyball players.

Methods

A case control study, carried out on 60 volleyball players, subdivided into 2 subgroups, 30 with shoulder pain (injured group) and 30 apparently healthy players as a control group. The internal and external rotator muscles were measured with and held dynamometer, and acromio- humeral distance was measured using musculoskeletal ultrasound.

Results

injured group included 10 female players (33.3%) and 20 male players (66.7%), age ranged between 16-30 years old, while control group included 4 females (13.3%) and 26 males (86.7%). Internal and external rotation strength ratio was less than 0.9 in injured group in the dominant arm, in favor of the normal group with statistical difference between them (p < 0.004). Acromio-humeral distance actively in injured group ranged from 0.45 to 0.87cm with mean ±SD of (0.64±0.07), less than normal group which ranged from 0.7 to 1cm with a mean ±SD of (0.79±0.08) (p < 0.000)

Conclusion

Weakness of external rotators muscles strength will decrease ratio between external rotator/internal rotator muscles, reducing the acromio-humeral distance especially during abduction, leading to shoulder injuries among volleyball players.
Study of the Effect of Tumor Necrosis Factor Alpha (TNF-α) Antagonist (Adalimumab) on Giardiasis in Mice
Authors: Habib Faiza S M , Badawy Abeer F , Abd Elhafiz Hala E , Thabet Engy E
Published: July 2024

Giardia lamblia (G. lamblia) is the most common worldwide intestinal protozoal. Serum TNF-α contributes to the recovery from Giardia lamblia infection especially in the first and second week of infection. TNF-α antagonists are biologics used to treat many inflammatory diseases as rheumatoid arthritis. The present study aimed to study the effect of TNF-α antagonist (Adalimumab) on experimental giardiasis in mice by parasitological and histopathological examination. A total of 45 parasite-free laboratory-bred Swiss albino mice included into 2 main groups: test group and control group were used. Test group included mice infected with G. lamblia and receiving three intraperitoneal Adalimumab injections from days 9 till 15 post infection (pi). This group was further subdivided into 3 subgroups (Ia, Ib, Ic) according to Adalimumab doses which were 1.5, 3 and 6 mg/kg BW, received, respectively. Control group (non-Adalimumab-treated group) included a non-infected healthy group and Giardia -infected group. Monitoring the serum TNF-α level in all mice was done on two occasions (day 16 and 28 pi) by ELISA to follow variation in its level with and without administration of the drug. Infection outcome was assessed by following cyst shedding in stools of infected mice on intermittent days, counting trophozoites in intestinal wash, registering weight of animals, and recording pathological changes occurring in histopathological sections from small intestine. Highly significant increase in serum TNF-α was recorded in infected control mice on day 16 post-infection than in normal control group. Similarly, a significant increase in TNF-α level in the 3 test subgroups but attaining significant lower levels. On day 28 post infection, serum TNF- α level decreased in all infected mice with no significant differences being higher in infected control group than in non-infected control group. On assessing the effect of decreased serum TNF-α by the drug on infection outcome, highly significant increases in cyst shedding were recorded in the test group specifically group receiving 3 mg/kg BW than in control infected group on day 16 pi, and in trophozoite counts on day 28 pi. Mice weight gain was highly significant being more in control non-infected group than in control infected group. It was significantly lower in test group than normal infection control. The intestinal sections of test subgroups showed moderate to severe inflammatory reaction with more inflammatory cellular infiltration in the lamina propria causing villous shortening and blunting more than that observed in infection control group. Furthermore, lymphoid follicles and sloughing of the epithelium were only observed in test subgroups on day 16 p.i. It was concluded that TNF-α antagonist (Adalimumab) led to increased parasitic load as evidenced by cyst shedding, trophozoite count, less weight gains with moderate to severe histopathological damage in test subgroups.
Serum Angiotensin II Level in Pediatric Patients with COVID-19 and its Correlation with the Disease Severity
Authors: Fouda Eman Mahmoud , Wahba Nancy Samir , Abdel Fattah Samah Ibrahim , Hamza Heba Moustafa
Published: July 2024

Background

Coronavirus disease 2019 (COVID-19) is a newly discovered RNA betacoronavirus infection. It has been caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Angiotensin II (Ang-II) is a mitochondrial toxin that under normal circumstances is rapidly removed by angiotensin converting enzyme 2 (ACE-2). SARS-CoV-2 uses the receptor ACE-2 for host cell entry and viral replication. ACE-2 proteins are occupied and downregulated by SARS-CoV-2. ACE-2 downregulation has been directly linked to toxic over accumulation of Ang-II. Accumulating Ang-II triggers many severe and fatal conditions such as acute respiratory distress syndrome (ARDS).

Aim of the Work

To assess the serum level of Ang-II and correlate it with the severity of COVID-19 infection in pediatric patients.

Patients and Methods

This case control study was conducted on 45 positive COVID-19 RT-PCR children who were compared to age and sex matched 45 healthy controls. Clinical examination, laboratory assays and imaging studies were done for the patients group to assess the severity of COVID–19 infection. Serum Ang-II was measured by ELISA for both groups and correlated with clinical (heart rate, blood pressure, respiratory rate and oxygen saturation), laboratory (total leucocytic count, lymphocytes, neutrophils, serum ferritin, ESR and CRP) and radiological (chest x-ray and CORAD score of CT chest ) parameters of the patients.

Results

The median “IQR” of serum Ang-II was significantly higher in the COVID-19 patients than in the controls (100 (88-137) ng/L) versus 20 (15-25) ng/L) (p-value= 0.001). There were statistically significant positive correlations between serum Ang-II levels and different grades of clinical severity classification (rs = 0.92, p-value=0.001) and CORAD score of CT chest. On the other hand, no statistically significant correlations were found between serum levels of Ang-II and total leucocytic count, lymphocytes, neutrophils, ESR and CRP.

Conclusion

Serum Ang-II could be used as a biomarker in predicting the severity of COVID-19 infection in pediatrics.
Clinical and Biochemical Profile of Patients with 46, XY Disorders of Sex Development
Authors: Hassan Ali Nagwa Mosaed , Elsedfy Heba Hassan , Mohamed Ebrahim Salah Mahmoud , Ahmed Mahmoud Rana Abdelhakim
Published: July 2024

Background

Disorders of sex development (DSD) comprise a wide range of conditions with varying features and pathophysiology that most often present in the newborn or the adolescent. Affected newborns are born with ambiguous genitalia, whereas adolescents present with atypical sexual development during the pubertal years.

Aim of the Work

To study the clinical and biochemical profile of patients with 46, XY disorders of sex development.

Patients and Methods

This was a descriptive study, conducted on 50 patients with 46, XY DSD attending the Pediatric Endocrinology clinic, Children's Hospital, Ain Shams University were recruited from April 2019 till April 2020.

Results

In our study 88% of cases were reared as males, while 12% were reared as females. The mean age at diagnosis was 2.48 ± 1.33 years with a range of 1-7 years. Parental consanguinity was present in 28 (56.0%) patients and a positive family history in 10 (20.0%). Mean external masculinization score (EMS) in our study was 3.30 ± 1.81 and ranged from 0 to 9 with a median of 3. The mean of stimulated Testosterone / Dihydrotestosterone (T/DHT) ratio was 17.5 (7.8-26) and ranged between 1.5 and 66.6. The median of Anti Mullerian Hormone (AMH) was 56 ng/ml and ranged between 19.08 and 105 ng/ml. There was correlation between EMS final score and stimulated DHT (r = 0.54, P = 0.000). Of note 6 (12.0%) patients had reconstruction of scrotum, 7 (14%) had undergone inguinal hernia repair, 12 (24%) had undergone correction of hypospadias, 6 (12.0%) bilateral gonadectomy,6 (12.0%) left orchiopexy, 3 (6.0%) right orchiopexy and 10 (20%) bilateral orchiopexy.

Conclusion

Due to the overlapping clinical and biochemical parameters in various subsets of DSD, only a preliminary etiological diagnosis can be made in some cases. Genetic examination with long-term follow-up are needed for a precise diagnosis. Management of these patients is multidisciplinary which needs an endocrinologist, gynecologist, psychologist, pediatrician, and clinical geneticist.
Detection of Subclinical Cardiomyopathy in Patients with Hashimoto Thyroiditis
Authors: Elsedfy Heba Hassan , Ahmed Mahmoud Rana Abd Elhakim , Hassan Nawar Marwa Magdy , Mahmoud El-Samman Nora Hussein , Hassan Ali Mohamed Sayed
Published: July 2024

Background

Hashimoto thyroiditis (HT) is the most common cause of thyroid diseases in children and adolescents. Ventricular myocardial dysfunction associated with HT has been suggested to be related to the chronic inflammatory state associated with autoimmunity as well as to the endocrine effects.

Objective

To evaluate using speckle tracking echocardiography (STE) and estimation of carotid intima-media thickness (CIMT) in early detection of myocardial dysfunction in children with Hashimoto thyroiditis.

Patients and Methods

A cross-sectional case-control study was performed that included 15 patients with HT recruited from the pediatric endocrinology clinic, at Ain Shams University Hospital from October 2020 to July 2021. The patients were compared to 15 age and sex-matched healthy controls. Data were collected from patients’ files including age at initial diagnosis, initial level of thyroid hormones, antithyroglobulin antibodies, and antithyroid peroxidase antibodies.

Results

Mean age of enrolled patients was 13.20 ± 3.05 years. Cardiac functions in HT patients by using conventional Echocardiography and STE, both were correlated to thyroid hormones, auto- antibodies, lipid profile, and duration of disease (P < 0.05 for all). There were no statistically significant differences in conventional Echocardiographic parameters between patients and controls(P > 0.05 for all). Left ventricular global longitudinal strain (LVGLS) was within the normal range for both groups and showed no statistically significant differences between them (P > 0.05). Known HT patients had lower LVGLS mean (19.72 ± 1.22 %) than newly diagnosed patients (21.52 ± 0.99%, P = 0.014). There was no correlation between cardiac functions and the level of thyroid auto-antibodies (P > 0.05 for all). There was no statistically significant difference between patients and controls in CIMT (0.33 ± 0.05 vs 0.35± 0.05, P = 0.473). There was a positive correlation between the duration of disease and CIMT among patients (P-value= 0.025)

Conclusion

Patients with HT may have subclinical myocardial dysfunction which could be attributed to the chronic inflammatory state even with normal thyroid functions. STE can early detect the myocardial dysfunction on initial examination and follow up.
Sonographic Evaluation of Visceral Fat and its Correlation with Metabolic and Liver Profiles in Obese Children
Authors: Salem Ashraf M , Emam Ehab K , Yacoub George E , Abdelhaleem Bassma A
Published: July 2024

Background

Abdominal obesity plays a major role in development of metabolic syndrome. Computed tomography and dual-energy X-ray absorptiometry were used to assess abdominal fat in children but carry risk of radiation and are expensive. Assessing abdominal fat using ultrasound in obese children could be a reasonable alternative with evaluating its relationship to obesity indicators especially insulin resistance.

Methods

We conducted a cross sectional study on 46 obese children and adolescents aged between 6-16 years to evaluate abdominal adiposity by using ultrasound. Subcutaneous fat thickness (SFT) and visceral fat thickness (VFT) were measured and correlated to anthropometric measures, fasting lipid profile, HOMA-IR and liver function tests.

Results

VFT was strongly correlated with the BMI (r = 0.397, p=0.006) and HOMA- IR (r = 0.413, P = 0.004) with AUC for VFT as a predictor of insulin resistance of 0.858 and cut of point of > 2.98 cm . VFT also correlated positively with serum triglycerides (r = 0.421, p=0.004) and serum ALT (r = 0.370, P=0.011). VFT correlated negatively with HDL (r= -0.313, P= 0.034 ).

Conclusions

Ultrasound could be a useful tool for measuring abdominal fat thickness in children and adolescents. Ultrasound measured VFT could be an appropriate prognostic factor for insulin resistance, hypertriglyceridemia, and elevated liver enzymes.
Early Prediction of Hemodynamically Significant Patent Ductus Arteriosus in Preterm Infants using Non-invasive Electrical Cardiometry
Authors: El Tahry Adham Mohamed , El- Farrash Rania Ali , Farag Mariam Nagy , Shinkar Dina Mohamed
Published: July 2024

Background

Prematurity is a term for the broad category of neonates born at less than 37 weeks' gestation following onset of the last menstrual period. Different degrees of prematurity are defined by gestational age (GA) or birth weight (BW). Prematurity is associated with approximately one- third of all infant deaths. Complications of prematurity are the underlying cause of the higher rate of infant mortality and morbidity in preterm infants compared to full term infants.

Objective

To identify hemodynamic changes during the first 48hrs in life using non-invasive cardiometry and how these changes can predict which infants would develop clinical and echocardiographic criteria for PDA treatment.

Patients and Methods

This Prospective cohort study was conducted at tertiary care hospital at the neonatal intensive care units of Ain Shams University, Children’s Hospital from October 2021 till April 2022 and performed on preterm neonates who are less than 35 weeks gestational age and admitted to the NICU of pediatric hospital.

Results

Hemodynamically-significant PDA group had significantly lower systolic, diastolic blood pressure and mean arterial blood pressure than hemodynamically not significant PDA group at each time of follow up and significantly higher heart rate at (12, 15, 18, 21, 24, 27, 30, 33, 36, 39, 45, 48) hours in patients with hemodynamically-significant PDA. There was statistically significant difference between the two studied groups as regards vital data of Oxygen saturation (SpO2) and UOP which were significantly lower in hemodynamically-significant PDA.

Conclusion

in our prospective cohort study increased heart rate, decreased mean arterial blood pressure predict a clinically significant PDA requiring treatment. Furthermore, vital data seem to be a good non invasive tools to monitor hemodynamic changes in preterms with hemodynamically significant PDA. However, further studies with a higher number of patients are necessary to ground the outcomes of these preliminary considerations.
Pattern of Monthly Percentage of Hemodialysis Children Achieving the KDIGO Recommended Hemoglobin Targets: A Twelve-Month Prospective Study to Assess the Trend of Anemia
Authors: Khalil Mariam A , Said Ragia M , El-Hakim Ihab Z , Abd Elhafez Amany M , El Farsy Mohamed S , Kasem Mohammed F
Published: July 2024

Background

Anemia is one of the common problems in children on maintenance hemodialysis (HD). It leads to poor quality of life and when severe, it is associated with cardiovascular dysfunction, cardiomyopathy, and death. Proper treatment of anemia in these patients results in better physical and mental performance. So, our study aimed to assess the trend of anemia among HD children by following the monthly percentage of patients capable of achieving Hb level between 11-12g/dl.

Methods

For optimum treatment of anemia, the Kidney Disease Improving Global Outcomes (KDIGO) guidelines (2012) recommended to measure Hb every month in HD children targeting monthly Hb concentration of 11-12 g/dl. So, we conducted this 12-months prospective study to assess the trend of anemia among HD children at Pediatric Dialysis Unit of Ain Shams University by following the monthly percentage of patients capable of achieving Hb level between 11-12g/dl.

Results

This study was done over 12 month-period from April 1st, 2020, till March 31st, 2021. A total of 78 patients were included with a mean age at the time of enrollment in the study of 12.16 ± 3.3 years. They were 45 (57.7%) males and 33 (42.3%) females. All patients were receiving 3 hours every other day HD session for 3 sessions a week with a HD duration range of 3.0 - 140.88 months and a median of 16.51 months. All patients were receiving proper doses of recombinant human erythropoietin (rHuEPO) and intravenous iron therapy. Our study showed that the monthly reported percentages of patients achieved Hb level between 11-12g/dl ranged from 14.7% to 40.8% and that of patients with Hb level <11g/dl ranged between 51.4 – 73.5%. It also revealed statistical evidence of significant association between the presence of anemia in our patients at the time of enrollment in the study and HD durations < 6 months (p < 0.05).

Conclusion

Despite proper HD treatment and proper doses of recombinant human erythropoietin (rHuEPO) and intravenous iron therapy, anemia is still a prevalent problem among our HD children.
Assessment of 8-Hydroxy-2’-Deoxyguanosine (8-OH-dG) Level in Urine as a Urinary Marker of Oxidative Stress in Children with Autism Spectrum Disorder
Authors: Zaky Eman Ahmed , Abdelhameed Salwa Amin , Eldamer Nourhan Moustafa , Abdelaziz Asmaa Wafeek
Published: July 2024

Background

Autism spectrum disorder (ASD) is a developmental disorder characterized by deficits in social interaction, restricted interest and repetitive behavior. Oxidative stress in response to environmental exposure plays a role in virtually every human disease and represents a significant avenue of research into the etiology of ASD.

Objective

The aim of this study was to asses 8-hydroxy-2’-deoxyguanosine (8-OH-dG) level in urine as a urinary marker of oxidative stress in children with autism spectrum disorder in comparison to sex and age matched healthy control group.

Patients and Methods

We included 51 children with autism (43 males and 8 females whose age ranged from 2 to 16 years). They were compared to 51 children of the same age as a control group. The diagnosis of autism was made based on the criteria of autistic disorders as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSMV). In the patients group, detailed medical history included sociodemographic form and family history was taken for autistic group also Intelligence Quotient test IQ test and Childhood Autism Rating Scale (CARS) used to measure the severity of autism. In the study, 8-OHdG values in urine were investigated using the enzyme-linked immunosorbent assay (ELISA) method and Urinary creatinine was determined with the Beckham Coulter analyzer and was used to normalize all biochemical measurements then the urinary 8-OHdG/creatinine levels were corrected to the urinary concentration of creatinine.

Results

The median age was 9.9 in the ASD group and 9.1 in the control group (P = 0.256). In the ASD group, (8-OH-dG)/creatinine ratio values were found to be significantly higher than those of the controls (P < 0.001). but also No statistically significant correlation between (8-OH- dG)/creatinie ratio and CARS score or IQ score (P = 0,7).

Conclusion

The data from this study supported the hypothesis of the oxidant/antioxidant balance as a key piece that may contribute to the autistic pathology
Detection of the Association between Osteocalcin Level and Insulin Resistance in Obese Children
Authors: Nassar May Fouad , Abd-Alhamid Enas Mokhtar , Elghoroury Eman Ahmed , Elsayed Shaimaa Adel , Elkholy Heba E
Published: July 2024

Background

There is an increasing incidence of obesity among children which is associated with increasing occurrence of diseases which were originally adult diseases. Among these diseases is insulin resistance which was recently found to be related to osteocalcin level.

Aim of Work

Detect the association between osteocalcin level and insulin resistance among obese children.

Subjects and Methods

The study included 40 obese children and 20 age and sex matched controls who were recruited from the Clinical Nutrition Clinic, Children`s Hospital, Ain Shams University. All children were subjected to full history taking, dietary history and anthropometric measurements including weight, height, waist circumference, and hip circumference with calculation of body mass index (BMI), waist hip ratio (WHR) and waist height ratio (WHtR). Laboratory tests included fasting glucose, fasting insulin, HOMA-IR and osteocalcin level.

Results

Obesity was more prevalent among boys (57.5%) in the study population.. Insulin, fasting glucose and HOMA-IR were significantly higher in the obese children compared to the controls with p- values 0.000, 0.007 and 0.000 respectively.Serum insulin ranged between 7.8-37.55 mIU/L, with mean±SD 17.11±7.22 mIU/L in patients, compared to 3.03-9.21 mIU/L, with mean±SD 6.47±1.89 mIU/L in the controls. Fasting glucose ranged between 73-127 mg/dl with mean±SD 96.90±14.41 mg/dl in patients compared to 75-105 mg/dl with mean±SD 87.15±8.79 mg/dl in the controls. HOMA IR in patients ranged between 1.85-11.35 with mean±SD 4.19±2.12 compared to 0.6-1.85 with mean±SD 1.38±0.39 in the controls. Osteocalcin levels were lower ranging between 1.2-94.5 ng/ml with mean±SD of 57.66±28.43 ng/ml in patients compared to a range of 7.2-91 ng/ml with mean±SD of 66.21±19.71 ng/ml in controls, the difference was distinct, but not statistically significant with P-value of 0.233. There were non significant negative correlations between osteocalcin level and each of BMI, WHR and WHtR with r-values -0.136, -0.171 and -0.085 and p-values 0.404, 0.291 and 0.601 respectively. Additionally, there were negative correlations with no statistically significant difference between osteocalcin level and each of fasting glucose, insulin level and HOMA-IR as P-values were 0.687,0.977 and 0.790 respectively; and r - values were -0.066, -0.005 and -0.043 respectively.

Conclusion

Insulin resistance is demonstrated in pediatric obesity and correlated with osteocalcin levels. Additionally, osteocalcin was distinctly lower in patients and although it didn’t reach statistical significance further larger scale studies are recommended to highlight its possible role as a marker of comorbidities especially insulin resistance in paediatric obesity.
Neuroglobin as a Novel Biomarker in Egyptian Children with Epilepsy
Authors: Temraz Basma Y , El-khayat Hamed A , Tomoum Hoda Y , Ramadan Maha Z , Elwakad Amany S
Published: July 2024

Background

Neuroglobin (Ngb) is the fourth member of globin family which was found to be highly expressed in central and peripheral nervous system of humans. Overexpression of neuroglobin is strongly related to a neuroprotective function.

Aim of the Study

Primary aim: to detect the levels of neuroglobin in children with Epilepsy Compared to Normal healthy Controls. Secondary aim: To compare the level of neuroglobin in controlled and uncontrolled epilepsy.

Subject and Method

The study is controlled cross sectional study which was conducted on 85 children divided into three groups: group (I) included 30 children with controlled epilepsy, group (II) included 30 children with uncontrolled epilepsy, and group (III) included 25 healthy children selected as controls of matched gender and age. Serum Ngb assay, complete blood count (CBC) were performed to all children.

Results

The overall results show that serum neuroglobin levels were significantly increased in patients’ groups than in controls. Neuroglobin levels showed no significant difference between controlled epilepsy group and uncontrolled epilepsy one.

Conclusion

Higher serum neuroglobin levels among children with epilepsy whether controlled or uncontrolled, reflecting its role as a neuroprotective marker. This study may help to discovernewer antiepileptic therapy through acting on neuroglobin levels.
Noninvasive High Frequency Ventilation as a Post-extubation Respiratory Support in Preterm Neonates
Authors: Hassan Abo-seif Ibrahim Saad , Salaheldin Sondos Ahmed , Shinkar Dina Mohammed , Ahmed Wafaa Osman , Abdelrahman Ibrahim Marwa Elsayed , El-Razek Mohammed Suzan Abd
Published: July 2024

Background

Noninvasive mechanical ventilation aims to provide respiratory support without the pulmonary and non-pulmonary complications associated with invasivemechanical ventilation including infection, subglottic stenosis, air leak syndrome and bronchopulmonary dysplasia (BPD). There is a notable increase in use of various types of noninvasive respiratory support post extubation to ensure the sucesss of extubation and avoid re-intubation. Noninvasive high frequency ventilation (NHFOV) is a new mode of noninvasive ventilation which is achieved through the use of noninvasive continuous flow with superimposed oscillations combining the benefits of high frequency oscillatory ventilaltion and noninvasive ventilation.

Aim of Work

The primary aim of the study is to compare re-ventilation rate between noninvasive positive pressure ventilation (NIPPV) and NHFOV when used as post extubation respiratory support. Secondary aim was to compare workof breathing, chest X-ray grade, incidence of pneumothorax and duration to reach full enteral intake between the 2 groups.

Methodology

Sixty preterm neonates with respiratory distress syndrome (RDS) who received invasive mechanical ventilation for more than 48 hours were included in this randomized controlled trial. Patients were randomly allocated post-extubation toNIPPV or NHFOV. The 2 groups were matched regarding weight, gestational age and comorbidities during invasive ventilation. Patients were compared regarding re-ventilation rate, work of breathing assessed by Downes score, chest X-ray grade, incidence of pneumothorax and duration to reach full enteral intake.

Results

Lower re-ventilation rate was found in NHFOV group (23.3%) compared to NIPPV group (30.0%). Median duration to reach full intake was shorter in NHFOV group (8 days) compared to NIPPV group (9.5 days) however, theseresults didn’t reach statistically significant difference (P value = 0.559 value and0.299 respectively). No difference was found between studied groups regarding work of breathing assessed by Downes’ score (P value = 0.634) nor regarding chest X-ray grades (p value= 0.902). Incidence of pneumothorax was equal in NHFOV group compared to NIPPV group with p value of 0.313.

Conclusion

NHFOV is a promising safe noninvasive mode for neonates post-extubation.
Comparison between the effect of Steroid Injection, Prolotherapy Local Injection and Extracorporal Shock Wave Therapy in Treatment of Symptomatic Calcaneal Spur
Authors: El-helw Mohamed Ragaei , Fathallah Mahmoud Mohammed , El Zohiery Abeer Kadry , Mostafa Nourhan Hussien
Published: July 2024

Background

Calcaneal spurs are common cause of heel pain occurring anywhere along the calcaneal tuberosity and most frequently found at the insertion of the plantar fascia. They are usually asymptomatic, but when they are painful, the condition is generally the result of inflammation of the insertional fibers of the plantar fascia at the medial tuberosity. Symptomatic calcaneal spurs are often found in association with plantar fasciitis. Like plantar fasciitis, calcaneal spurs can occur alone or may be part of a systemic inflammatory condition such as rheumatoid arthritis or gout. In some patients, the cause seems to be entirely mechanical, and such patients often exhibit an abnormal gait with excessive heel strike.

Objective

To compare the effectiveness of dextrose prolotherapy injection, corticosteroid injection and extracorporal shockwave in symptomatic calcaneal spur, based on clinical and functional outcome measures.

Patients and Methods

This study was conducted on forty-five patients diagnosed with symptomatic calcaneal spur (plantar fasciitis) for more than 6 months. The patients were recruited from Physical Medicine, Rheumatology and Rehabilitation department at Ain Shams University Hospitals. Diagnosis was based on detailed history taking, full clinical examination, pain and functional assessments of the foot using visual analogue scale (VAS score) and foot function index (FFI).

Results

Eight weeks after treatment, the pain score by VAS was significantly improved at ESWT group mostly, less extent at prolotherapy group and least at corticosteroid group. Also the percentage of improvement in ESWT group was found higher than the other groups indicating the long term analgesic effect of ESWT. Eight weeks after treatment, the FFI subscales (pain, disability and activity limitation)and total FFI score significantly improved mostly at ESWT group, less extent at prolotherapy group and least at corticosteroid group indicating the long term beneficial effect of ESWT on the function in patients with chronic PF.

Conclusion

Although ESWT, dextrose prolotherapy injection, and local corticosteroid injection were all effective in the treatment of symptomatic calcaneal spur during 8weeks of follow-up but, ESWT was superior to all other modalities in its effect on pain intensity and function during daily life activities at long term follow up.
The Role of Intra-Articular Injection of Autologous Platelet Rich Plasma versus Corticosteroids in Treatment of Synovitis in Lumbar Facet Joint Disease
Authors: Kotb Shahdan Y , Sherif Nahed M , Saleh Hala Abdulhady , Ahmed Sahar Fathi , Sakr Hossam M , Taeimah Mohamed O
Published: July 2024

Background

Low back pain (LBP) is an extremely common health problem and lumbar facet joint (FJ) disease is one of its main causes. Intra-articular injection of FJ is one of the vital therapeutic methods for FJ disease. Corticosteroids (CS) are the most commonly used injected drugs; however, previous studies have indicated that it has limited ability in long-term relief of LBP.

Aim of the Work

to compare the efficacy of intra-articular injection of platelet rich plasma (PRP) versus CS in improving MRI detected synovitis in correlation to clinical complaints of the patients with lumbar FJ syndrome.

Patients and Methods

Thirty patients with lumbar FJ syndrome divided into two equal groups: Group ‘I’ injected with PRP and Group ‘II’ with CS. The patients were comparatively assessed pre and post the intervention according to; number of tender lumbar FJs on palpation, maximum active lumbar extension range of motion, LBP visual analogue score (VAS), functional disability questionnaires - Roland Morris disability questionnaire (RMQ) and Oswestry disability index (ODI) - and MRI lumbar FJ detected synovitis and their grading.

Results

Both study groups showed statistical significant improvement in all mentioned parameters at 3 month follow up, there was no statistically significant difference between the results of both groups, however, PRP injected joints showed better performance regarding MRI synovitis grade in all lumbar FJ levels as compared to those injected with CS.

Conclusion

Both PRP and CS injections were determined to be effective in improvement of MRI detected FJ synovitis concurrently with improving clinical parameters, pain and functional activities of the patients at 3 months follow-up. However, PRP showed superior effect in improving MRI detected synovitis grade, therefore may be a better treatment option for longer duration efficacy and fewer side effects.

TRN

NCT04860531- 1/3/2021
Effect of Orchidectomy on Hepatic Ischemia/Reperfusion Injury
Authors: Khaled Amin Yasmin Mohammed , ElSayed Mohamed Hassan , Abdel-Wahed Doaa Mohamed , Elkhateb Lobna Abdelrazek , Ahmed Mona A
Published: July 2024

Background

Little attention has been paid to investigate the effect of orchidectomy on hepatic ischemia/reperfusion (I/R) injury, which is lacking.

The Aim of This Study

is to evaluate the possible impact of orchidectomy and/or testosterone treatment on the function and structure of liver in rat model of hepatic I/R injury and, also, to explore the possible underlying mechanism(s).

Materials and Methods

65 male Wistar albino-rats were divided into 5 groups; sham- operated control group (Sham), hepatic ischemia/reperfusion group (hepatic I/R), orchidectomized hepatic ischemia/reperfusion group (Orch+I/R), Testosterone- treated hepatic ischemia/reperfusion group (T+I/R) and Orchidectomized testosterone-treated hepatic ischemia/reperfusion group (Orch+T+I/R). All rats were subjected to determination of serum levels of alanine transaminase (ALT), aspartate transaminase (AST), testosterone and estradiol, and hepatic tissue level of malondialdehyde (MDA), superoxide dismutase (SOD), tumor necrosis factor- alpha (TNF-α) and gene expression of nuclear factor-kappa B (NF-κB) and nuclear factor erythroid 2-related factor 2 (Nrf2). Also, hepatic tissues were histopathologically assessed.

Results

Hepatic I/R was associated with significant rise of serum ALT and AST, and hepatic tissue TNF-α, NF-κB and MDA, and significant reduction of serum testosterone and estradiol, and hepatic tissue SOD and Nrf2. Histopathological analysis showed vacuolization of the cytoplasm, dilated sinusoids, inflammatory cells infiltration, increased collagen fibers and significantly increased caspase-3. Hepatic I/R -mediated effects were aggravated following orchidectomy, however preischemic treatment with testosterone protected the liver as shown by the significant decline in ALT and AST, and hepatic tissue MDA, TNF-α and NF-κB, and significant enhancement of serum testosterone and estradiol, and hepatic tissue SOD and Nrf2, and restoration of hepatic architecture.

Conclusion

Orchidectomy hypersensitizes the liver to ischemic injury, due to exaggeration of oxidative and inflammatory states and apoptosis, while testosterone treatment improved the hepatic I/R detrimental effects on liver function and morphology due to its suppressive effect on oxidative and inflammatory states and apoptosis.
Role of Adenosine Receptor Agonist in a Rat Model of Diabetic-Induced Osteoporosis
Authors: Abd-El Hamid Manal S , Abou Shady Ebtessam A , Elyazed Mohamed Nourhan Abo , Morsy Wessam E
Published: July 2024

Background

Diabetic osteoporosis is caused by chronic hyperglycemia, oxidative stress, advanced glycation end products accumulation and microvascular changes. All these alter signaling pathways involved in bone metabolism. Adenosine receptors (ARs) are expressed in the bone and might play a role in bone homeostasis. Recent data reveal that A2AAR plays a key role in bone homeostasis and regeneration. However, whether it has a role in treatment of osteoporosis induced by diabetes has not been reported.

Objective

The aim of the present study was to evaluate the effect of CGS-21680, an A2A adenosine receptor agonist, in ameliorating osteoporosis induced by diabetes in a rat model.

Materials and Methods

Forty adult male Albino-rats were allocated into four groups: Group I: control group; Group II: untreated diabetic induced osteoporosis group; Group III: insulin treated diabetic-induced osteoporosis group; Group IV: adenosine receptor agonist treated diabetic-induced osteoporosis group. Diabetes was induced by a single intraperitoneal injection of STZ at a dose of 40 mg/Kg body weight. At the end of the study the bone marker osteocalcin, serum glucose, insulin, tumor necrosis factor-α, malondialdehyde, glutathione peroxidase, calcium and phosphorus were measured, and bone histopathological analysis was done.

Results

Compared with the untreated diabetic groups, the A2A adenosine receptor agonist treated group showed less bone loss, which was revealed by the increased cortical bone thickness and trabecular thickness. In addition to decreased oxidative damage and inflammation.

Conclusion

The decreased oxidative stress and inflammation in the A2A adenosine receptor agonist treated group supports a beneficial effect of A2AAR stimulation in treatment of diabetic induced osteoporosis, which was demonstrated by the improvement in bone microarchitecture.
Evaluation of the Use of Negative Pressure Wound Therapy for Securing Split-Thickness Skin Grafts for Coverage of Chronic Wounds
Authors: El Badawi Ahmed Mohamed , Nagy Eman , Abdelhalim Mohamed M , Youssef Ramy Atef
Published: July 2024

Background

Split-thickness skin grafting (STSG) is a versatile reconstructive option that has passed the test of time. However, many factors can cause poor graft take. Negative pressure wound therapy (NPWT) has transformed the management of complicated wounds and has been used as a means for securing split-thickness skin grafts (STSG). The role of NPWT in the fixation of grafts was compared to conventional Tie over bolster dressing.

Aim of the Work

To assess whether NPWT would result in a better graft take especially in wounds with large surface area.

Patients and Methods

This is a parallel group randomized control study. conducted from November 2021 to June 2022 in the Plastic, burns, and maxillofacial Surgery Department, Ain Shams University Hospitals. Block randomization of 52 patients into one of the two groups (NPWT vs. non-NPWT; 26 patients each) was done. Graft take/loss and length of hospital stay post-grafting were assessed.

Results

Mean graft take in the NPWT group was quantitatively and qualitatively better than that in the non-NPWT group. None of the patients in the NPWT group required a second coverage procedure. No major complication was encountered with the use of NPWT.

Conclusion

Compared with conventional tie over bolster dressing, NPWT is a simple, yet powerful and effective alternative in the integration of STSG. It significantly increases the rate of graft take especially in large wounds, while reducing rates of complications and hence re-operation.
Effect of Hydroxyethyl Starch (HES) versus 5% Albumin Solution on Intra-Abdominal Pressure in Severe Burn Patients: A Randomized Clinical Study
Authors: Mabrouk Amr Reda , Abdelsalam Ahmed Mohamed , Desawy Bakry Sameh Adel , Abdel Hafiez Rania Hassan , Abdelmotaal Amr Mahmoud
Published: July 2024

Introduction

Massive burn patients are at high risk of developing intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) as a complication of aggressive resuscitation. This study aimed to evaluate the effect of Hydroxyethyl starch (HES) versus 5% albumin solution on intra-abdominal pressure (IAP) in massive burn patients.

Methods

This was a single-center, prospective randomized clinical trial carried on at Ain Shams University (ASU) burn unit for 2 years. Where adult patients with burns 20 to 60 % of TBSA were equally randomized into HES group or albumin group.

Results

Fifty-two patients were equally randomized into 2 groups. There was no difference in age, sex, weight, type of burn, and TBSA between the two groups. The mean total resuscitation fluid volume in the first 48 hours was 213 ml/kg and 206.2 ml/kg for the HES group and the albumin group respectively (p = 0.674). IAP statistically was non-significantly higher in the HES group. There was no statistical difference between the two groups as regards the renal function tests.

Conclusion

Both HES and 5% albumin solution are effective and safe colloids for burn resuscitation. They partially have an equal effect on intra-abdominal pressure, renal involvement, and vital data stability in massive burn patients.
Value of PET/CT Scanning in Detection of Osseous and Marrow Metastatic Lesions in Cancer Patients
Authors: Hussein Abdelfadil Mostafa Abdelwahab , Aboulwafa Islam M , El-Naggar Heba , Sharara Sherine M
Published: July 2024

Background

Early diagnosis of cancer remains to be of paramount importance to maximize a patient’s long-term survival and reduce various neurological, hematological, and orthopedic complications that may arise. Skeletal metastasis (SM) is a frequently encountered and important complication of cancer which can lead to intolerable pain.

Objectives

The goal of the study was to illustrate the value of combined 18F-FDG PET/CT over isolated CT for detection of osseous metastases in cancer patients.

Patients and Methods

The study included 75 patients. 18F-PET/CT scans were performed. In this study, a lesion-based analysis was performed in detailed retrograde manner. Statistical analysis including specificity, Sensitivity, negative predictive value (NPV) and positive predictive value (PPV) of each of these modalities were calculated. A final diagnosis of metastasis was confirmed by biopsy.

Results

Combined PET-CT examination is highly sensitive imaging modality in detection of early bone marrow metastatic lesions which are not yet evident on conventional CT study.

Conclusion

Combined 18-F FDG PET/CT significantly improves the sensitivity and specificity of isolated CT for the detection of osseous and bone marrow metastases. Thus, it adds a significant value that can detect lesions and consequently start a treatment course and improve the overall outcome of the disease process.
Chest Computed Tomography Severity Score to Predict Outcome of Patients with COVID 19
Authors: Nasr Abd Elwahed Yousra Mohamed , Abdelrhman Ahmed Samy , Youssef Youssef Ahmed , Youssef Ekladious Mena Elerian
Published: July 2024

Background

The coronavirus disease 2019 (COVID-19) is an acute infectious pneumonia caused by a severe acute respiratory syndrome-coronavirus-2. Some studies have suggested that C-reactive protein, lymphocyte count, and features from CT scoring as predictors of severity and prognosis of COVID-19. Non-contrast chest computed tomography (CT) scan was found to be a useful diagnostic instrument for screening COVID-19 pneumonia. This score uses lung opacification as a surrogate for extension of the disease in the lungs.

Aim

To assess the prognostic value of chest CT severity score (CSS) to predict the severity of symptoms and outcomes among patients with typical CT findings.

Subject and Methods

This Prospective Observational study was conducted at Radiology department, faculty of medicine, Ain Shams University on 94 patients.

Results

There is a significant difference between the groups regarding symptoms severity. there is no significant difference between the groups regarding CT findings. left lung severity scores and total severity score were significantly higher among poor prognosis patients compared to good prognosis patients. mortality rate was significantly higher among poor prognosis patients compared to good prognosis patients. severity score was significantly higher among severe symptoms patients compared to mild symptoms patients in good prognosis patients.

Conclusion

The current study showed that CT images and CT-severity scores can predict ICU admission and mortality in patients with COVID-19 pneumonia. Clinicians and radiologists can use the CT-severity score as a measure of disease severity and an indicator of poor prognosis, including the need for mechanical ventilation. Also, our findings showed the superiority of CT findings over other clinical information and co-morbidities in predicting the short-term outcome.
Ultrasound with Elastography versus MRI in Diagnosis of Rotator Cuff Tendinopathy
Authors: Mohamed Shehab Mohamed Hussein , Ibrahim Ayman Mohamed , Ahmed Teiba Mohamed Kamal
Published: July 2024

Background

tendinopathies and tendon injuries that are due to overload, are important and extremely widespread problem in musculoskeletal diseases. Real-time Sonoelastography (SE) is used to evaluate the tissue elasticity.

Aim

This study assessed the role of sonoelastography in evaluation of tendon stiffness in comparison to the magnetic resonance imaging (MRI) in diagnosis of patients with rotator cuff (RC) tendinopathy.

Methods

cross sectional study with 36 adult patients that were clinically suspected to have supraspinatus tendinopathy with no past history of trauma and performed MRI of the shoulder were selected for our study. SE images were taken and assessed for focal soft areas. The supraspinatus (SSP) tendinopathy was graded (Grade 0, normal; Grade I, mild tendinopathy; Grade II, moderate tendinopathy; and Grade III, marked tendinopathy).

Results

the examined population, by MRI examination of supraspinatus tendon findings categorized as 7 patients (19.4%) had grade 0, and 17 patients (47%) had grade 1, 11 (30.6%) had grade 2, and 1 (2.8%) had grade 3. On the other hand, by Sonoelastography, there was 8 patients (22.2%) had grade 0, and 18 patients (50%) had grade 1, 9 (25%) had grade 2, and 1 (2.8%) had grade 3. Perfect positive correlation (r = 0.83) was found between the MRI and Sonoelastography grading. The association between the two modalities was statistically significant (p < 0.01).

Conclusions

SE showed good correlation with MRI in identifying supraspinatus tendon intratendinous alterations.
Role of Thermal Ablation in Management of Pulmonary Tumours
Authors: Elqousy Ahmed M M O , Tantawy Wahid H , Sobhi Mohamed , Nasser Haytham M
Published: July 2024

Background

An effective alternate option for treating primary and metastatic lung cancers that cannot be operated on is image-guided percutaneous thermal ablation. These methods rely on the heating impact of a percutaneous applicator on surrounding tissue to cause coagulative necrosis of the tumor cells.

Aims

The current study is to assess the role of CT guided thermal ablation in management of lung tumors.

Methods

Based on radiological and pathological evaluation, our study involved 40 patients who had CT-guided thermal ablation ("MWA & RFA") treatments at Ain Shams University Hospitals and Misr Radiology Center from February 2020 to February 2022.for 1ry and 2ry lung neoplasms. After thermal ablation there is follow up program at 3, 6 & 12 months post ablation.

Results

Various lung cancers, including primary and secondary metastatic lung deposits, were prospectively treated using CT-guided RF and MW. In our study, there were 64 lung lesions. 38 lesions were ablated in 25 individuals with MWA with overall success about 84.2%, 26 lesions were ablated in 15 individuals with RFA with overall success about 84.6%, there was no statistical significant differences between MW and RF regarding outcome. Regarding complications there was no intraprocedural death and the overall mortality 60 days post ablation was 0%. No major complication encountered during the procedure. All complications were non significantly more common in the MWA group. The MWA group had much larger lesions and more lesions were hilar or para-hilar in comparison to the RFA group.

Conclusion

Percutaneous thermal ablation is a safe and effective minimally invasive treatment alternative is selected patients.