bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of Tobacco Smoking in A Sample of General Secondary School Students in Cairo and Its Correlation to Other Psychiatric Disorders
Authors: Farwiez Mohamed Gamal , ElShahawi Heba Hamed , Amin Ghada Refaat , Khalil Sherien Ahmed , Morsy Mahmoud Hassan , Nawara Mayar Medhat
Published: July 2024

Background

Tobacco smoking is considered currently as a global public health concern among youth especially school student. There is a scarcity of data about the impact of this global phenomenon in Middle Eastern countries. This study assesses the prevalence of tobacco smoking, including conventional cigarettes, E-cigarettes and waterpipe and its sociodemographic and psychiatric correlates among a sample of general secondary school students in Cairo, Egypt.

Results

A convenient sample of 391 Egyptian general secondary students from different areas of Greater Cairo were assessed using the Socioeconomic scale, Fagerstrom Test For Nicotine Dependence, The Lebanon Water pipe Dependence Scale, questionnaire for electronic cigarette using, Barratt impulsivity scale 11, The MINI International Neuropsychiatric Interview for Children and Adolescents. 12.8% (n = 50) were smokers. There is significant relation between family history of smoking and substance use and smoking and significant relation between smoking, impulsivity and mood symptoms.

Conclusions

Prevalence of tobacco smoking in Egyptian adolescents was 12.8% with significant relation between smoking and impulsivity and mood symptoms.
Risk Factors of Cognitive Impairment in Relapsing Remitting Multiple Sclerosis
Authors: Khalil Salma Hamed , Zamzam Dina Abdelgawad , Aboustate Alaa Mohamed , Mohamed Ali Yasmeen Ashraf
Published: July 2024

Background

Multiple sclerosis is an immune-mediated neuro-inflammatory and neurodegenerative disease. It affects mostly young adults between 20 and 40 years of age and women about 2–3 times more often than men. Disease severity and prognosis are hard to predict, different disease courses are observed in patients. It is the second most common cause of disability in young adults, and it is one of the costliest chronic diseases.

Aim of the Study

Our study aims to Asses risk factors affecting cognitive impairment (CI) in MS patients, focusing on risk factors including; Body Mass Index (BMI), Vitamin D level, Smoking and Alcohol and Physical activity.

Patients and Methods

It is a cross-sectional study carried on 50 patients with definite MS from MS unit at Ain-Shams University with inclusion and exclusion criteria was conducted, where the subjects were assessed regarding their basic demographic data, Body Mass Index (BMI), Vitamin D level, Smoking and Alcohol and Physical activity and correlated these data with their cognitive function where patients were classified to cognitive impaired or cognitive preserved using SDMT scale.

Results

Patients’ weight, height and BMI showed no significant correlation with the cognitive impairment assessed by SDMT. There was no significant correlation between cognitive impairment assessed by SDMT and smoking, Alcohol intake, BMI, vitamin D level, caffeine intake past or current physical activity. Our study showed a significant correlation between the cognitive impairment and the type of treatment of MS, where patients on 1st line DMD showed the majority of Cognitively preserved patients; 15 out of 18 patients with a percentage of 83.3 % while patients on 2nd line DMD showed the majority of Cognitively impaired patients, 17 patients with a percentage of 53.1 %. And thus could be related to disease progression not type of treatment itself as patients who are on 2nd line DMD are mostly the most progressive.

Conclusion

Cognitive affection of MS could be part of disease progression itself and not related to risk factors. This exploratory study underscores the complexity of physiopathological mechanisms underlying CI in MS and provides a few clues to further research in this area.
The Clinical and Neuroimaging Differences between Patients with Vascular Parkinsonism and Idiopathic Parkinson’s Disease
Authors: George Peter , Roushdy Tamer , Fathy Mai , Hamid Eman , El-Belkimy Mahmoud , Abdulghani Osama , Shalash Ali
Published: July 2024

Background

Parkinson's disease (PD) and vascular parkinsonism (VP) share multiple features together.

Objectives

The aim of this study was to investigate the differences between VP and PD.

Materials and Methods

A total of 27 patients with VP and 48 PD patients were matched regarding age, sex, and educational level. All patients were assessed using MDS-UPDRS score and MRI brain.

Results

VP showed significantly shorter disease duration, less tremor dominant subtype, more PIGD subtype .Meanwhile Patients with VP showed no significant difference regarding motor part of MDS UPDRS off score from PD patients . MRI brain showed that VP group has significantly higher Fazekas scale compared to PD group.

Conclusion

VP is presented by postural instability and gait dysfunction, less tremor, and associated with more severe white matter ischemic changes.
Intra-Ovarian Platelet-Rich Plasma (PRP) Injection in Management of POSEIDON IV Poor Responders before ICSI: Pilot Study
Authors: Farid Laila Aly , Gomaa Mostafa Fouad , Abd-Raboh Eid Joseph Hozain , Sammour Hazem Mohamed , ElGamal Hatem , Sallam Mohamed T H , Eltaieb E
Published: July 2024

Background

Poseidon IV poor responders are 35 years old or older women with antral follicle count < 5 and anti-Mullerian hormone < 1.2 ng/ml with cumulative live birth rate (CLBR) of 22.34% - 34.46% following ICSI.

Aim of the Work

To assess the effectiveness of intra-ovarian platelet-rich plasma (PRP) injection in POSEIDON IV poor responders before ICSI.

Patients and Methods

This study was conducted on women complaining from infertility at assisted reproductive techniques unit at Ain Shams University Maternity Hospital at the period from March 2021 till January 2022. We got a 55 cases matching the inclusion and exclusion criteria among them 25 cases accepted to participate as the study group (PRP group) and the others 30 cases refused to the participate PRP group and they were enrolled as a control group.

Results

Endometrium thickness at day of HCG trigger was statistically significantly higher among PRP group than among control group. Ovulation statistically was non-significantly more frequent among PRP group than among control group. Fertilization statistically was non- significantly more frequent among PRP group than among control group. biochemical pregnancy, clinical pregnancy, ongoing pregnancy statistically were non-significantly more frequent among PRP group than among control group.

Conclusion

According to the finding in this study intra-ovarian platelet-rich plasma (PRP) injection in POSEIDON IV poor responders before ICSI had a non-significant role regarding the laboratory variables and pregnancy outcomes. Hence, further studies are required.
The Value of First Trimesteric 3D Ultrasound Placental Volume in Prediction of Pre-Eclampsia in High-Risk Pregnant Women
Authors: Hussein Ahmed Mahmoud , Mohamed Ramy Ahmed Ramy , El-Hamid Shahaat Eman Mahmoud Abd
Published: July 2024

Background

Hypertension with pregnancy remains a major health issue for women and neonates worldwide. Pre-eclampsia (PE) complicates 2–5% of all pregnancies and is a leading cause of maternal and neonatal mortality and morbidity. PE and eclampsia are responsible for approximately 14% of maternal mortality. PE is also associated with later-life cardiovascular disease among women and their offspring.

Aim of the Work

To determine the value of first trimesteric placental volume in predicting pre-eclampsia in high-risk pregnant women.

Patients and Methods

This Prospective observational study was conducted at tertiary care hospital at Ain Shams University hospitals from September 2019 till November 2021 and performed on a total of 125 pregnant women with high risk of PE at 12 to 12 + 6 week of gestation attending Fetal care unit, Ain Shams University Maternity Hospital.

Results

DBP statistically had significant moderate diagnostic performance with DBP cut-off value of ≥ 79.0 mmHg in predicting preterm delivery and SGA with significant low diagnostic performance in predicting NICU admission with DBP sensitivity of 83.3%, 67.9%, 64.5% and specificity of 74.8%, 76.3% and 76.6% in predicting preterm delivery, SGA and NICU admission respectively.

Conclusion

Placental volume and diastolic blood pressure (DBP) were significantly lower in cases with preeclampsia and predictive of maternal complications of HELLP syndrome, Renal impairment, ICU admission and predictive of preterm labor, SGA and NICU admission.
Retrospective Study of Clinicopathologic Features and Outcome of Colonic Cancer in Relation to Primary Tumor Location
Authors: Hassan El Wakiel Hesham Mahmoud , Abbas El Lithy Mahmoud Mahmoud , Ali Ezz El Din Mai Mohammed , Mohamed Hassan Ola Essam Mosad
Published: July 2024

Background

Colon cancer is one of the most common cancers worldwide and outcomes of colon cancer are different according to the primary tumor location and could be considered as distinct disease entities of the same organ.

Objectives

Analyzing and comparing clinical, epidemiological, pathologic features and outcome of colon cancer according to primary location whether the patients are right sided colon cancer (RSCC) and left sided colon cancer (LSCC) patients in different situations.

Patients and Methods

This is a retrospective, descriptive and analytical study conducted between January 1st, 2013 and January 1st 2019. One hundred and fifty patients diagnosed with colon cancer were enrolled in GIT unit, Department of Clinical Oncology, Ain Shams University Hospital.

Results

In our study right sided colon cancer patients were more females and clinically presented with higher frequency of anaemia (P value = 0.001) and perforation (P value = 0.02). Left sided colon cancer on the other side were more males (P value = 0.032) and was associated with more constipation (P value <0.001) and intestinal obstruction (P value = 0.085). RSCC was more associated mucinous adenocarcinoma, more advanced T stage (T4), lymphovascular invasion, larger tumor sizes and more poorly differentiated tumor. LSCC was associated with more advanced stage and lymph node positivity. Right side tumor has highest disease-free survival period which is 34.63 months (95% confidence interval [CI] 28.39-40.86) comparing with the left side tumor which was 24.94 months (95% confidence interval [CI] 19.61-30.27). left side tumor has highest progressive free survival period which is 4.77 months (95% confidence interval [CI] 3.33-8.22) comparing with the right-side tumor which was 2.21 months (95% confidence interval [CI] 0.63-3.79).

Conclusion

RSCCs and LSCCs show different characteristics in clinical presentation and prognostic features, so we can consider the side of tumor is helpful in determining the behavior and the outcome of the disease. We can consider RSCC and LSCC as two separate disease entities.
Outcomes of Three Corner Fusion without Triquetrum Excision versus Conventional Four Corner Fusion in SNAC Wrist
Authors: Youssef Khaled Nabil , El-Mahy Mohammed Mostafa , Atiyya Ahmed Naeem , Nabil Amr
Published: July 2024

Background

Four corner fusion (4CF) has long been the preferred treatment for stages II and III of scaphoid nonunion advanced collapse (SNAC) with intact radiolunate articulation. Three corner fusion (3CF) with excision of the triquetrum was then suggested aiming to improve wrist motion . Several concerns had been emerged regarding proprioceptive function of the triquetrum and risk of early progression to radiolunate arthritis following excision . Three corner fusion without triquetrum excision (3CFT) was suggested as a relevant alternative to conventional limited fusion techniques . Since then, there is an on-going debate on the best technique to use for SNAC wrist . The authors evaluated the functional and operative outcomes of 4CF versus 3CFT in SNAC wrist.

Materials and Methods

A total of 34 patients underwent four corner fusion or three corner fusion without triquetrum excision for SNAC grade II and III . The average follow-up period was 1 year .Clinical evaluations were conducted and determined by radiographs, range of motion, grip strength, visual analog scale, and modified Mayo wrist scores.

Results

There were no significant differences between the demographic data, preoperative and postoperative parameters between the two groups. There was a significant difference in the operative time between the two groups (P < 0.001).There was no significant difference between the two groups regarding the complication rate.

Conclusions

The authors concluded that 3CFT offered a comparable functional outcome to 4CF with less operative time with no significant complications or mortality.
Management of Neglected and Malunited Ankle Fractures
Authors: Salem Basem Mohamed , Fahmy Hisham Ahmed , El-Beltagy Atef Mohamed , Goda Ayman Hussin , Abd-Ella Mohamed Mokhtar , Abdel-Hamid Metwaly Radwan Gamal El-Deen
Published: July 2024

Background

Ankle fractures are very frequent and they can present a variety of clinical features. Dislocated or unstable ankle fractures are generally treated with surgical anatomical reduction and internal fixation. Most of these fractures heal very well. However, some of these fractures fail to reduce and become malunited. Early biomechanical studies have demonstrated that lateral talar shift greater than 1mm may cause a loss of over 40% of the tibiotalar contact area.

Aim of the Work

The aim of the treatment is to obtain an ankle with normal alignment and function which exhibits no pain with preventing any degenerative changes that may take place in the future. Surgical options include refixation of non-united medial or lateral malleolus, lengthening of fibula, repair of neglected syndesmotic injury, and repair of other ligamentous injury.

Patients and Methods

Our study included 30 patients with malunited ankle fractures. The outcomes were compared pre and post operatively. The Inclusion criteria were patients with malunited or neglected ankle fractures, both sexes and Age between 20 – 60 years old. While, Exclusion criteria were patients suffering from peripheral vascular insufficiency, advanced ischemia, peripheral neuropathy, advanced tibiotalar osteoarthritis, soft tissue compromise, stiff ankle, infected non-union and skeletally immature patients.

Results

The AOFAS in patient with syndesmotic affection showed improvement from mean±SD 48.35±12.99 preoperatively to 82.71±10.32 postoperatively, while in patients with non syndesmotic affection showed improvement from 60.46±18.91 preoperatively to 86.77±20.79 post operatively. This means that this is significant increase in AOFAS score in both groups but its more obvious among patients with syndesmotic affection. The FAAM score in patient with syndesmotic affection showed improvement from mean±SD 46.47±15.96 preoperatively to 82.41±8.05 postoperatively, while in patients with non syndesmotic affection showed improvement from 54±18.96 preoperatively to 79.77±16.45 post operatively. It means that there is increase in FAAM score in both groups but its more significant among patients with syndesmotic affection. The FADI score among patients was mean±SD 49.87±11.39 preoperatively and 77.07±11.89 two years postoperative, there was statistically significant higher mean value of FADI in follow up compared to pre-operative.

Conclusion

There is statistically significant improvement in functional and radiological outcomes in patients with syndesmotic affections more than patients with non syndesmotic affection.
Systematic Review and Meta-Analysis Comparing Long Head Biceps Tendon Tenotomy versus Tenodesis with Concomitant Repiarable Rotator Cuff Tears
Authors: Abd Ellatif Hussein Ali Ibrahim , Hamed Abeid Wessam Eldin Fakhery , Ebrahim Kubtan Helmy Muhammad
Published: July 2024

Background

Both tenotomy and tenodesis have been widely used for the treatment of long head of biceps tendon (LHBT) lesions, but the optimal strategy remains considerably controversial. In this meta- analysis of published studies, we compared the results of the two procedures.

Methods

A literature search that compared tenotomy with tenodesis was performed using pubmed, MEDLINE, cochrane libaray and researchgate . A total of 6 studies reporting data on 659 subjects were included. Study quality was evaluated using Cochrane collaboration tool for assessing the risk of bias.

Results

Data synthesis showed higher ASES score, constant score, simple shoulder test mean, lower popeye sign and insignificant vas score in patients managed with tenodesis compared to tenotomy (ASES score, P <0.001; constant score, P < 0.001; simple shoulder test mean, P = 0.045, popeye sign, P = 0.010 ; vas score, P = 0.422 respectively).

Conclusion

The current evidence indicates that biceps tenodesis for LHBT lesions with concomitant reparable rotator cuff tears results in decreased rate of Popeye sign and improved Constant score also ASES score compared to biceps tenotomy.
Diagnosis of Human Cystic Echinococcosis by detecting Antigen B in Serum and Urine using Nanomagnetic Beads-Enzyme Linked Immunosorbent Assay
Authors: El-Din Mahmoud Manal Salah , Badawy Abeer Fathy , Khayyal Amira Elsaady , Ibrahim Rehan Barhom
Published: July 2024

Cystic echinococcosis (CE) is a zoonotic parasitic disease caused by the larval stage; hydatid cyst, of E. granulosus. The disease is usually asymptomatic, and mostly presents by pressure symptoms according to its location. The diagnosis of CE is currently based on imaging techniques, which may not be available in some areas and antibody detection in serum, with several known drawbacks. Conversely, antigen detection has proven its efficacy in serodiagnosis of CE. The study aimed to test the diagnostic efficacy of Nanomagnetic beads-enzyme linked immunosorbent assay (NMB-sandwich ELISA) for diagnosis of CE by detection of E. granulosus AgB in serum and urine samples in comparison to conventional sandwich ELISA. The study included 42 individuals classified into 3 groups; CE infection group (Gp I), other parasitic infections group (Gp II) and healthy control group (Gp III). E. granulosus AgB was prepared from human hydatid cysts and used to produce anti- E. granulosus AgB-IgG-pAbs in rabbit which was used to detect AgB level in serum and urine samples by sandwich ELISA and NMB-sandwich ELISA. Using sandwich ELISA, AgB was detected in serum samples of 88.9% of CE patients with sensitivity and specificity of 88.9% and 91.7%, respectively. In urine samples, sandwich ELISA detected AgB in 83.3% of CE patients and the sensitivity and specificity were 83.3% and 87.5%, respectively. NMB-sandwich ELISA detected AgB in serum samples of 94.4% of CE patients with a sensitivity and specificity of 94.4% and 95.8%, respectively, whereas in urine samples it was detected in 88.9% of CE cases and the sensitivity and specificity were 88.9% and 95.8%, respectively. There was no statistically significant difference (p > 0.05) between the use of serum and urine samples for detection of AgB when examined by either sandwich ELISA or NMB- sandwich ELISA. The best test accuracy was obtained with NMB-sandwich ELISA detecting AgB in serum samples (95.2%), whereas, it showed a slightly lower accuracy of 92.9% when using urine samples. It was concluded that NMB-sandwich ELISA is efficient for detection of AgB in serum samples. Moreover, urine samples might be a good alternative to serum samples for the detection of AgB showing reasonable sensitivity, specificity and accuracy.
Diagnosis of Experimental Trichinosis by Nano-Based ELISA and Nano-Based Latex Agglutination Test Compared with Traditional Sandwich ELISA
Authors: Kamel Hanan H , Elleboudy Noha A , Mohammad Omnia S , Ali Ibrahim R , Hasan Aml N
Published: July 2024

Human trichinellosis is a serious foodborne parasitic zoonosis. The main route for contracting the infection is eating raw or undercooked meat, especially pork containing a sufficient load of infective viable larvae. Early diagnosis is crucial before the larval encystation in skeletal muscles, so detection of circulating antigens can be helpful. The objective of the present study was to evaluate the novel Nanomagnetic beads based-ELISA (NMB-ELISA), and Nanomagnetic beads based latex agglutination test (NMB-LAT) for the diagnosis of experimental trichinellosis compared to sandwich ELISA through the detection of Trichinella spiralis adult worm crude extract antigen AW-CEA in serum. The study included thirty-eight (38) mice classified into 3 groups; T. spiralis infection group (GI) which was equally subdivided into 5 subgroups according to the time of sacrifice (6, 8, 10, 12, and 14 dpi), other parasitic infections group (GII) and healthy control group (GIII). T. spiralis AW-CEA was prepared from the adult worms through homogenization and ultra-sonication and then used to produce anti- T. spiralis IgG-pAbs in rabbits which were subsequently utilized to detect AW-CEA in serum samples by sandwich ELISA, NMB-ELISA, and NMB-LAT. Using NMB-ELISA, T. spiralis AW-CEA was detected in sera collected at 6 and 8 dpi, with a sensitivity of 50%, and 75%, respectively, and a specificity of 100%. Meanwhile, sandwich ELISA and NMB-LAT couldn’t detect the antigen at the same time intervals. Both ELISA formats were able to detect the antigen in samples collected at 10, 12, and 14 dpi with a sensitivity of 100% for NMB-ELISA, and 25%, 75%, and 100% respectively, for sandwich-ELISA. On the other hand, NMB-LAT couldn't detect T. spiralis AW-CEA until 12 dpi with a sensitivity of 50% and specificity of 75%. In conclusion, the NMB-ELISA is a promising sensitive technique for early and specific diagnosis of acute trichinellosis in an animal model. Thus, it can be used as a potential alternative to the standard ELISA to obtain confident results. In addition, the use of NMB-LAT for AW-CEA detection could be a valuable screening diagnostic technique in field surveys.
The Role of Serum Lactate Values as a Predictor of Morbidity in Preterm Infants
Authors: Maluil Santino Kuot , Abdel Wahed Mohamed Ashraf , Ahmed Wafaa Osman
Published: July 2024

Background

Early hemodynamic assessment of critically ill newborns requires mostly invasive measurements in neonatal intensive care unit. Base deficit and serum lactate concentrations may be important prognostic indicators in preterm infants.

Aim and Objectives

to investigate the relationship between serum lactate levels and adverse outcome in preterm infants who were admitted to NICU of Ain Shams University Hospital.

Subjects and Methods

This study is prospective cohort study, that included 90 preterm patients that were admitted to neonatal intensive care unit during a period of 6 months, all the neonates had the level of serum lactate been evaluated by ELISA (at 6, 12, 18 and 24 hours of birth) and correlated with the incidence of intracranial hemorrhage as diagnosed by cranial ultrasonography. Result: The initial serum lactate level was compared with the follow up readings at 12, 18 and 24 hours and showed statistically significant reduction of serum lactate in follow up recordings (p-value <0.05), Serum lactate was statistically significant predictors of death with increase serum lactate at 12hrs., at 18hrs. and at 24hrs, with p-value (p < 0.05). Serum lactate had no statistically significant association with intracranial hemorrhage as detected by transcranial ultrasonography.

Conclusion

Serial lactate measurements greater than 5.6 mmol/l predict adverse outcome and may aid the clinician in bedside decision making.
Study of the Efficacy and Safety of Darbepoetin Alfa versus Epoetin Alfa in the Treatment of Anemia in Pediatric Patients on Regular Hemodialysis
Authors: Fouad Elhakim Ihab Zaki , Affifi Maged Elsayed , Ibrahim Nada Essam , Said Ragia Marei Ali
Published: July 2024

Background

Anemia is a common comorbidity in patients with chronic kidney disease (CKD). That affects the vast majority and can have a significant impact on patient morbidity and mortality. Erythropoiesis-stimulating agents (ESAs) are the main lines in management of anemia in hemodialysis patients. Replacement therapy with recombinant human erythropoietin (r- HuEPO) has provided an effective treatment for patients with renal “Epoetin alfa” is a recombinant erythropoietin with the same amino acid sequence as human erythropoietin (EPO). In comparison to epoetin alfa, darbepoetin alfa (DPO) contains an increased amount of sialic acid-containing carbohydrate chains. It shows a much longer elimination half-life than epoetin alfa, with prolonged erythropoietic effect.

Aim of the Work

to evaluate whether darbpoetin and epopoetin alpha can be used interchangeably on the same patient, achieving the same desired effect and to detect any difference in the occurrence of side effects between both ESAs.

Patient and Methods

This was a crossover study that took place in the Pediatrics Dialysis unit, Children’s Hospital, Ain Shams University. The study was conducted on 40 children with end stage renal disease on regular hemodialysis over a period of 6 months. The patients were randomly put into two groups A and B, each group contained 20 patients. Each group received one type of ESA either ( darbpoetin alpha or epopoetin alpha )for 3 months and then shifted to the other type of ESA for another 3 months. The dosage of epoetin alfa used was (200 IU/kg/week) and a conversion rate of EPO: DPO, 300:1. A period of 6 weeks was agreed as a washout period after the first drug given in both groups in which no results were recorded but ESA was not stopped due to its essentiality. Blood tests (hemoglobin (Hb), serum urea, serum creatinine and iron profile; (S. iron, S. ferritin, TIBC, and transferrin saturation)) were withdrawn at the start and the end of the 3 months’ period of each drug.

Results

We found no difference on the Hb level with both drugs. The interchange between them did not yield any significant drop in the Hb levels. Hb target in both EPO and DPO was reached in 22.5% of total cases, and was not reached in 62.5%. This proved that both drugs give the same effect with nearly negligible difference. No serious Sside effect as convulsions, hypertension, and thrombosis were noticed in both groups.

Conclusion

The target Hb was not reached in most patients of both groups of ESRD on regular hemodialysis at the unit and none of both drugs showed superior results or less side effects than the other.
Radiological Assessment of Hand and Wrist Bones in Malnourished Children
Authors: Elkhayat Hamed A , Elsyed Nahla M , Abdelhaleem Bassma A , Madkour Sherihan S
Published: July 2024

Background

Protein energy malnutrition (PEM) is still an important health problem that is responsible for childhood morbidity and mortality leading to permanent impairment of physical and mental growth.

Objective

This study is designed to assess the appearance of ossification centers of lower end of radius and ulna, carpals, metacarpals and phalanges in normal children and malnourished children then comparing between them, to detect early changes in bone growth in malnourished children.

Subjects and Methods

This case-control cross-sectional study included 45 malnourished children and 45 age and sex matched controls whose ages ranged between 6 months and 5 years. The patients were recruited from Pediatric Nutrition Clinic of Ain Shams University. All children (malnourished and control) were examined for anthropometric parameters (weight, height, body mass index (BMI) and mid upper arm circumference (MUAC)), investigated for serum calcium, phosphorus, alkaline phosphates and had a plain X-ray done on left hand and wrist (posteroanterior (P-A) view), the X-ray was analyzed by using A Digital Atlas of Skeletal Maturity.

Results

The plain X-ray hand and wrist showed delayed appearance of ossification centers in malnourished infants and children (97.8% had delayed bone age) when compared to controls (25.5% had delayed bone age) which was statistically highly significant with P-value < 0.01. Signs of vitamin D deficiency rickets together with serum calcium, phosphorus and alkaline phosphatase were statistically significantly lower in the cases when compared to the controls with P-value < 0.01. The statistical measurements of mean ± SD regarding weight of case group and control group was (9.05 ± 2.48, 13.54 ± 3.81) with P-value < 0.01 which is highly significant, regarding length or height was (79.51 ± 12.78, 88.94 ± 15.02) with P-value < 0.01 which is highly significant, regarding MUAC was (11.38 ± 1.91, 16.02 ± 1.26) with P-value < 0.01 which is highly significant.

Conclusion

X-ray hand and wrist for malnourished infants and children showed delayed appearance of ossification centers when compared to matched controls.
The Prevalence of Gonadal Changes in Patients with Congenital Adrenal Hyperplasia
Authors: Eldin EL Kholy Mohamed Salah , Elsedfy Heba Hassan , Ahmed Rana Abdelhakim , Abdelrahman Marwa ElSayed , Mohamed Hasnaa Hassan
Published: July 2024

Background

Adrenal rest tumours can appear in early childhood in patients with congenital adrenal hyperplasia(CAH). The common cause of infertility in males with CAH is testicular adrenal rest tumours (TARTs). Ovarian adrenal rest tumour (OART) and polycystic ovaries (PCO) can impair the ovarian function in female patients with CAH.

Objective

Detect the prevalence of gonadal changes by imaging among patients with CAH andassess the patients' radiological findings in relation to their hormonal profile.

Patients and Methods

This observational, cross sectional study was conducted on 50 patients with CAH. Testicular ultrasonography was done to male patients and magnetic resonanceimaging (MRI) of the pelvis was done to female patients. Data on prescribed glucocorticoid dose and serum levels of 17- hydroxyprogesterone (17-OHP), androstenedione (Andro) and ACTH were obtained from medical records within endocrinology clinic, Children's Hospital, Ain Shams University.

Results

TARTs were detected in 10/20 (50%) of CAH patients. There was significant relationbetween presence of TARTs and each of weight standard deviation score (SDS), body mass index (BMI), BMI SDS and current bone age (p = 0.028, 0.046, 0.017 and 0.023; respectively). There was no significant relation between presence of TARTs and the laboratory parameters or the treatment received (p > 0.05). There was significant correlation between Tanner testicular volume and mean testicular volume by ultrasound (p < 0.001). Only one female patient had bilateral polycystic ovaries (prevalence 3.3%) and none had ovarian adrenal rest tumours.

Conclusion

The prevalence of TARTs in male patients in our study is high (50%), highlighting the importance of TARTs screening in children with CAH. We would suggest that routine ovarian imaging in CAH females is not indicated. However, when ovarian dysfunction is present, ovarian imaging is advised.
Intranasal vs Buccal vs Intramuscular Midazolam for the Home and Emergency Treatment of Acute Seizures in Pediatric Egyptian Patients
Authors: El-Rashidy Omnia Fathy , Elagouza Iman Ali , El Gaafary Maha Mohamed , Ramadan Mohammed Maha Zakaryia , Rashad El-Garhy Rana Ahmed Mohamed
Published: July 2024

Introduction: Acute convulsions in children are a common emergency worldwide. Benzodiazepines are the recommended first line of treatment. We wished to compare the efficacy, ease of administration and overall satisfaction of midazolam by the buccal, intranasal orintramuscular route in the treatment of acute seizures in Egyptian children both at homes and Emergency room (ER)

Methods

A prospective, randomized, trial was performed in children aged 1 months to 17 years with acute seizures lasting longer than 5 min. Children were randomly assigned to receive midazolam, 0.2 mg/kg, by the buccal, intranasal or intramuscular route. The primary endpoint was seizure cessation within 10 min of drug administration and no seizure recurrence within 30 minutes.

Results

There were 196 seizures analysed in home group, 67 patients received midazolam via buccal route, 60 via intranasal, 69 via intramuscular route while 105 patients were recruited from ER 37 patients received buccal midazolam, 34 received intranasal and 34 received intramuscular midazolam. Intramuscular midazolam stopped seizures within 10 min in 94.2 % in home group and 85.3 % in ER group. On the other hand, intranasal midazolam was successful to stop seizures in 93.3% in home group and 88.2 % in ER group within 10 minutes. The buccal route was effective in 91% in home group and 78.4 % in ER group. There were no significant differences in efficacy between all groups. P = 0.763 and P = 0.509 among home and ER groups respectively. Time to seizure cessation was significantly higher in the buccal group 5.11 ± 1.23minutes in home group and 5.91 ± 1.25 in ER group (P = 0.000). Highest overall satisfaction and ease of administration was seen in intranasal group especially among caretakers in home group > 7= 49 (81.7 %) P = 0.002.. Intramuscular midazolam was more preferred by physicians in ERgroup >7=32 (94.1%) (P = 0.001) There were no significant cardio-respiratory events in all groups.

Conclusions

Our results indicate that there is no clinically important difference between buccal, intranasal and IM routes of administration midazolam. Buccal and intranasal midazolam were safe and effective for treatment of acute seizures in children.
Effect of BAL Lipoxin A4 Level in Children with Bronchiectasis on Disease Severity
Authors: Fouda Eman Mahmoud , Ishak Younan Sally Raafat , Nabih Enas Samir , Osman Ahmed Mohamed , Hassan Shehab Yasmine El-Sayed Abd El-Rahman , Hussein Mahitab Morsy
Published: July 2024

Background

A central feature of most cases of bronchiectasis is airway inflammation. The elevated neutrophil count has been strongly correlated with impaired lung function, bronchiectasis severity, and disease duration. There is a failure of resolution of inflammation in bronchiectasis, leading to irreversible damage and dilatation of the bronchial airways with loss of mucociliary function. Lipoxins were the first agents to be identified as anti-inflammatory endogenous lipid mediators involved in the resolution of inflammation.

Aim of the Work

This study aimed to measure Lipoxin A4 level in bronchoalveolar lavage (BAL) of children with Cystic Fibrosis bronchiectasis (CF) and Non-CF bronchiectasis as a prognostic marker for clinical and radiological severity in these children as regard Bronchiectasis severity score.

Methods

A cross-sectional study was conducted at Children’s Hospital, Ain Shams University from December 2020 to December 2021, on children following up at the Pediatric Pulmonology Clinic. The study included 15patients with cystic fibrosis (CF) bronchiectasis, 15 patients with non-CF bronchiectasis, and 30 control cases,without breathing difficulty or signs of RDS. Human Lipoxin A4 was measured in BAL by ELISA.

Results

There was a significant difference between patients and controls as regards Lipoxin A4 level (p = 0.002),being higher in control group, but no significant difference in its level between CF and non-CF bronchiectasischildren(p = 0.663).

Conclusion

Severe bronchiectasis is associated with decreased airway Lipoxin A4 levels as lowest level of lipoxinA4 was found in severe cases by bronchiectasis severity score.
Effect of Omega-3 Fatty Acids Supplementation in Pediatric Patients with Type 1 Diabetes Mellitus
Authors: Elbarbary Nancy Samir , Rahman Ismail Eman Abdel , Mohamed Sarah Abdelaal
Published: July 2024

Background

Omega-3 fatty acids (O3FAs) are polyunsaturated fatty acids derived from fish oil. Beneficial effects of O3FA supplementation in a wide range of disease condition have been well studied. However; the role of O3FA in management of type 1 diabetes mellitus (T1DM) remains unclear and controversial.

Objectives

Therefore, we performed a randomized-controlled trial to assess the effect of oral O3FAssupplementation on glycemic control and lipid profile in pediatric patients with T1DM.

Methods

This study included 70 children and adolescents with T1DM. Patients were randomly assigned into two groups; intervention group and received oral O3FAs capsules (1 gram daily). The other group did not receive any supplementation and served as a control group. Both groups were followed-up for 6 months with assessment of fasting blood glucose (FBG), HbA1c and fasting lipids.

Results

Supplementation with O3FAs was safe and well-tolerated. After 6 months, O3FAs adjuvant therapy for the intervention group resulted in a significant decrease of systolic blood pressure, insulin dose, FBG, HbA1c, triglycerides, total cholesterol and LDL-cholesterol compared with baseline levels and compared with the control group (p < 0.05). On the other hand, T1DM patients without O3FAs adjuvant therapy (control group) had higher blood glucose levels and HbA1c at study end compared with baseline levels (p < 0.001).

Conclusions

O3FAs as an adjuvant therapy to insulin improved blood glucose levels, glycemic control and dyslipidemia leading to reduction in insulin dose in pediatric patients with T1DM.
Ameliorating Effects of Intermittent Fasting on Cardiac Dysfunctions in Experimentally Induced thyrotoxicosis in Adult Rats. Role of Ghrelin Hormone
Authors: ElSayed Mohamed H , Abou Shady Ebtessam A , Francis Marian M , Abd El Hamid Manal S
Published: July 2024

Background

Cardiovascular complications of hyperthyroidism have high morbidity and mortality rates. The cardioprotective effect of intermittent fasting (IF) in addition to the concomitant rise of blood ghrelin hormone level during IF have gained attention, but their effects on thyrotoxic hearts are still unclear. Therefore, we aimed to investigate the impacts of IF on hearts of rats subjected to induced thyrotoxicosis (TH) elucidating the role of ghrelin hormone in the assumed cardio protection.

Methods

Forty-five adult male Wistar Albino rats in 3 groups: control group, thyrotoxic group, injected IP with L-thyroxine100 μg/kg/day, 5 days/week for 4 weeks and intermittent fasting-treated thyrotoxic group, subjected to alternative day fasting regimen for 4 weeks. cardiac functions were assessed by in-vivo studies (ECG recording and arterial blood pressure evaluation) and in-vitro studies (responses to isoproterenol infusion using Langendorff’s preparation).

Results

Compared to the TH rats, intermittent fasting showed significant body weight loss, decreased left ventricular and whole heart absolute weights, with significant decrease of heart rate (HR) and prolongation of P-R interval in ECG. The baseline values of PT/LV, HRT and MFR/LV as well as their maximal responses and their delta changes in response to isoproterenol infusion were increased and were positively correlated to ghrelin hormone. Ghrelin hormone was increased in IF rats reaching the control group value and showed positive correlation with GPx and BCL-2.

Conclusions

IF conferred partial cardioprotective effects against thyrotoxicosis. These effects were attributed – at least partially- to normalization of ghrelin hormone which has anti-inflammatory, antioxidant as well as anti-apoptotic effects.
Studying Provider’s Satisfaction on Video Consultation by Ain Shams University Virtual Hospital
Authors: Mostafa Basma H A , Al Tehewy Mahi M F , Wahba Hoda M F , Basyoni Nashwa I A
Published: July 2024

Background

Video consultations were developed to allow long-distance patient and clinician contact, care, advice and monitoring which has been shown to improve patient health status. When rural settings, lack of transport, a lack of mobility, decreased funding, or a lack of staff restrict access to care, video consultation may bridge the gap.

Objective

To measure satisfaction of physicians involved in video consultations services provided at Ain Shams Virtual Hospitals (AVH). To identify the main factors affecting satisfaction of physicians involved in such video consultations services provided at AVH.

Methods

A descriptive cross-sectional study was conducted to measure satisfaction of a sample of providers of video consultations at AVH from December 2020 to March 2021.

Results

Total 37 physicians were included in the study, 29 physicians responded (78.3%). The mean age ±SD is 37.97 ±6.3 and their main specialties were neuropsychiatry (40.7%), internal medicine subspecialties (40.7%), and surgical specialties (18.5%). About 83% were confident with their diagnoses in video consultations and (13.8%, 75.9%) of the physicians reported that they always/sometimes suffered from bad quality of image/sound respectively. More than half of the physicians (53.5%) thought that lack of physical examination would affect the accuracy of the diagnoses and 53.5% of the physicians thought that video consultation would be suitable for follow-up patients post operatively.

Conclusion

Two thirds of the physicians had a positive experience and were satisfied with using video consultations in their clinical practices.

Recommendations

It is recommended to use video consultations in following-up of patients. It is also recommended to monitor provider`s satisfaction over time.
Imaging Spectrum of COVID-19 Associated Cranio-Facial Mucormycosis
Authors: Mustafa Abo-Gamra Sherif Hamed , Ahmed Teiba Mohamed Kamal , Abdelwahab Elrokh Aya Shaker
Published: July 2024

Background

The post COVID craniofacial mucormycosis was found to emerge since the second wave of the COVID pandemics. It was called black fungus as it was associated with high mortality rate.

Objective

To describe combined computed tomography (CT) and magnetic resonance imaging (MRI) characteristics of post COVID craniofacial mucormycosis for accurate diagnosis and determination of the extent of involvement.

Patients and Methods

The main source of data for this study was the archived CT and MRI imaging of the patients referred to the department of Radiology, Ain Shams University Hospitals.

Results

Our study population presented with craniofacial symptoms within 1-8 weeks from COVID-19 infection. The study revealed strong association between history of ICU admission, high doses of corticosteroids, oxygen administration and sever imaging MRI features of fungal sinusitis. Fungal invasion is not necessary to be through bony destruction.

Conclusion

The severest form of fungal sinusitis was found to be more commonly associated with ICU admission, usage of high doses of corticosteroids as well as patients who needed O2 therapy, the usage of contrast enhanced MRI should be combined with CT for assessment of disease extension as well as bony invasion.
Advanced Myocardial Characterization in Hypertrophic Cardiomyopathy: Feasibility of CMR-based Feature Tracking Strain Analysis
Authors: Abdelrahman Elkassas Lama Samir , Raief Mosaad Basant Mohamed , Ibrahim Ahmed Samir
Published: July 2024

Aim of the Work

This study aimed to evaluate the role of cardiovascular magnetic resonance feature tracking (CMR-FT) using a commercially available software module for analysis of left ventricular strain in hypertrophic cardiomyopathy patients.

Patients and Methods

A total of 20 HCM patients and 10 controls were studied. All patients were subjected to detailed clinical history taking and CMRI. Left ventricular global longitudinal, circumferential and radial strains were analyzed as well as segmental longitudinal and circumferential strains.

Results

LV mass in the HCM group was significantly higher than that in the control group (p < 0.001). No statistical difference was found in ejection fraction (p = 0.074). Global circumferential strain (GCS) global longitudinal strain (GLS), segmental longitudinal strain (SLS) and segmental circumferential strain (SCS) in the HCM group were all significantly lower than the correlated parameters in the control group (p < 0.001, respectively). Global radial strain (GRS) in the HCM group was significantly higher than the control group (p = 0.002). Additionally, SLS & SCS in the HCM group were both significantly lower, before global strain affection (p < 0.001).

Conclusion

CMR-FT is a promising approach in analyzing impairment of global and segmental myocardium deformation in Egyptian patients with hypertrophic cardiomyopathy, non-invasively and quantitatively.
Assessment of Alpha Feto Protein in Patients with Hepatocellular Carcinoma Presenting to HCC Clinic During Era of COVID19 Pandemic
Authors: Ashraf Osama , Hamdy Hisham , Raafat Khaled , Mostafa Sahar Mohamed , ELsadek Azab Khaled Mohamed Abd
Published: July 2024

Background

Hepatocellular carcinoma (HCC), a major health problem worldwide, is one of the most common primary neoplasms of the liver and one of the most common solid tumors in the world. More than 500,000 new cases were diagnosed each year. HCC accounts for between 85% and 90% of primary liver cancer. It is the fifth most common cancer worldwide and the third most common cause of cancer mortality.

Aim of the Work

The aim of this study is to assess of alpha fetoprotein in patients who are diagnosed with hepatocellular carcinoma after COVID-19 infection.

Patients and Methods

This is cross Sectional Study on 60 Egyptian patients with HCC presenting to multidisciplinary clinic during era of Covid 19 pandemic divided into two subgroups: Group I: 30 patients with HCC and COVID 19 infection and group II: 30 patients with HCC who weren’t infected with COVID 19.

Results

In this study we found that there was insignificant difference between both studied groups as regards age and sex (p = 0.92 and p = 0.119, respectively). In this study we demonstrated that there was insignificant difference between both studied groups as regards etiology of HCC (p > 0.05). In this thesis we cleared that there was highly significant difference between both studied groups as regards Liver presentations (P < 0.001). In this thesis we found that there was significant difference between both studied groups as regards CBC (p < 0.05). In this study we demonstrated that there was significant difference between both studied groups as regards liver function tests (p < 0.05). Our results showed that that there was highly significant difference between both studied groups as regards AFP (p = 0.002). In study in our hands, we found that there was highly significant difference between both studied groups as regards tumor size and tumor stage (p < 0.001). In this study we found that there was highly significant difference between both studied groups as regards MELD score (p < 0.001). In this study we illustrated that Child Pugh class, MELD score, AFP and COVID-19 infection were the independent risk factors associated with poor survival among HCC patients

Conclusion

Our study concluded that tumor marker parameters, including AFP, can be used as Prognostic tools for HCC patients with СOVID-19. In which there were higher mortality rate among HCC with COVID-19 with higher levels of AFP.