bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of hepatic progenitor cells in predicting response to therapy in Egyptian patients with chronic hepatitis C, genotype 4
Authors: Helal T E A , Radwan N A , Mahmoud H A , Zaki A M E , Ahmed N S , Wahib A A A 
Published: May 2020

Abstract

Background
Interferon therapy is used as a line of treatment of chronic hepatitis C virus (HCV) in several areas of the world including Egypt.

Objective
Our aim is to investigate the value of hepatic progenitor cells (HPCs) in predicting response of patients with chronic HCV, genotype 4 to pegylated interferon (PEGIFN) plus ribavirin (RBV) therapy.

Methods
Pretreatment liver biopsies obtained from 110 patients with chronic HCV, genotype 4 were examined immunohistochemically for HPCs using cytokeratin 19. The mean number of HPCs as ductular reaction (DR) and as isolated progenitor cells (IPCs) was counted in each case. The patients were classified into: those with sustained virological response (SVR) and those who did not achieve SVR. The results were compared between the two groups. Also, the relationships between HPCs and other clinico-pathologic variables were estimated using multivariate analysis.

Results
The mean number of HPCs was the only independent predictor of therapeutic response, being significantly higher in non-responders (P = 0 for DR and P = 0.03 for IPCs). On the other hand, fibrosis stage and steatosis were the only independent factors which showed a significant direct association with the mean number of HPCs in the form of DR and IPCs (P = 0 for each).

Conclusion
The number of HPCs provides prognostic information in chronic HCV since it is significantly associated with stage of fibrosis. More importantly, it can be used as a marker to predict response of patients with chronic HCV to PEGIFN plus RBV therapy.
Pediatric Surgery Rate of Constipation After Sagittal Anorectoplasty For Rectoperineal Fistula
Authors: Bayoumi M M M , Allam A M , Abouzeid A A 
Published: May 2020

Abstract

Background
Rectoperineal fistula is a congenital low anorectal malformation that is presented with constipation and straining at stool. There is argument as regarding name, diagnosis and surgical treatment.

Objectives
to estimate the incidence of postoperative constipation among patients with rectoperineal fistula treated with anorectoplasty using Krickenbeck classification for postoperative outcomes.

Patients and Methods
The study was conducted between January 2018 and August 2018. The study included patients with rectoperineal fistula who underwent sagittal anorectoplasty (SARP) in the last five years in two tertiary hospitals; Ain Shams University Children Hospital and Banha Specialized Children Hospital. We excluded patients who underwent operations other than SARP and patients having Currarino syndrome and sacral anomaly like hemisacrum and caudal regression. Krickenbeck classification was used for assessment of constipation before and after operation. A simple questionnaire was used for follow up assessment.

Results
The study included 30 patients (19 female and 11 male). Their age at time of repair ranged from 3m to 78 months with a median age of 7.5 months. Rate of constipation in patients with rectoperineal fistula after SARP was 39%, while improvement rate was 65%. 14 patients out of 23 having preoperative constipation (61%) were treated from constipation, and one patient (4%) got improved regarding constipation grade and frequency, while remaining 8 patients (35%) were still having the same degree of constipation. There were 7 children who had no constipation before and after repair. These results were statistically significant as measured using McNemar test. Postoperative soiling was recorded in 7 patients; all of them had pseudo-incontinence (ORSI).

Conclusion
Rectoperineal fistula patients can gain benefit from SARP not just cosmetically, but also functionally (65% of constipated patients got improved).
Early detection of premature atherosclerosis in β-thalassemia patients by measuring carotid intima-media thickness
Authors: Ibrahim W E , Youssef O I , Ali H G A , Alnagar D M A 
Published: May 2020

Abstract

Background
Beta-thalassemia patients still suffer from many complications. Transfused patients may develop complications related to iron overload including growth retardation and failure or delay of sexual maturation, cardiac involvement (dilated cardiomyopathy or rarely arrhythmia), liver (fibrosis and cirrhosis), endocrine glands (diabetes mellitus, hypogonadism, insufficiency of parathyroid, thyroid, pituitary and less commonly, adrenal glands).

Purpose
The present study was undertaken to evaluate the role of Carotid artery intima media thickness (CIMT) measurement as an early detector of premature atherosclerosis in beta-thalassemia children and early adolescents and its relation to biochemical risk factors as iron overload and lipid profile.

Patients and Method
Twenty-two β-thalassemia major (TM), 8 β-thalassemia intermedia (TI) with confirmed diagnosis of beta-thalassemia (major and intermedia) proved by clinical and laboratory investigations, frequent blood transfusion, chelation therapy with their age ranging from 10 to18 years old and 30 age-and sex matched healthy controls were included. Lipid profile (by colorimetric assay), serum ferritin, and CIMT measurements using high-resolution B-mode ultrasonography were estimated.

Results
CIMT of thalassemic patients (major and intermedia) was highly significantly increased compared to controls with no significant difference between β-thalassemia major and β thalassemia intermedia groups could be detected. CIMT was positively correlated with serum ferritin, TG, Total cholesterol level in both diseased groups and LDL level in B-TM group only. This provides a good evidence of the presence of premature atherosclerosis in vascular-free TM and TI patients and its relation to increased body iron and dyslipidemia.

Conclusion
Carotid artery intima media thickness represented a simple, accurate and non-invasive method for early detection of premature atherosclerosis which started early in β- thalassemia patients This study identified a relationship between body iron status, dyslipidemia and increased carotid IMT..
1,3 β-D-Glucan versus blood culture for the diagnosis of invasive fungal infection in formula-fed preterm neonates
Authors: Awad H A , Ismail R I H , Elbadrawy M A 
Published: May 2020

Abstract

Background
1,3 β-D-Glucan is an important marker for diagnosis of invasive fungal infection (IFI).Its value in comparison to blood culture is not yet established in neonates.

Aim
primary aim is to study the value of 1,3 β-D-Glucan in comparison with culture on Sabouraud dextrose agar in diagnosis of IFI, Secondary aim is to study the prevalence of IFI in preterm neonates.

Subjects and methods
a prospective observational study carried on 75 non-exclusively breast fed preterm neonates ≤34 weeks gestational age. Tollner and Rodwell sepsis scores, SNAPII and blood culture were done to all neonates initially and on day 10&17 of life. 1,3 β-D-Glucan was done for all neonates on day 10 of life.

Results
fungal growth was found in 9.3% of included preterm neonates.1,3β-D-Glucan was higher in culture proven fungal sepsis compared to culture proven bacterial sepsis and culture negative preterm neonates (83.28±26.22 pg\ µl, 51.42±16.71 pg\ µl, 43.07±12.87 pg\ µl respectively). 1,3 β-D-Glucan was related to Tollner (r = 0.286,p=0.013), Rodwell (r = 0.317,p=0.006) sepsis scores and to SNAPII score (r = 0.331,p=0.04). Its cut off point for diagnosis of IFI is 79pg\µl with sensitivity of 71% and specificity of 98%.

Conclusion
1,3β-D-Glucan is an easy, rapid and specific marker for diagnosis of IFI in neonates. Further studies are needed to evaluate it as a therapeutic monitoring for IFI.
Neuron-Specific Enolase, Serum-100B, Electroencephalogram as Indicators of Extent of Brain Damage in Post Cardiac Arrest Patients
Authors: Elseify M Y , Ahmed A R , Shattah M O , Salaheldin S A 
Published: May 2020

Abstract

Background
Post cardiac arrest patients have high risk of mortality and morbidity. Brain injury plays an important role in determining patients’ outcome. Aim of the Work: To correlate the levels of Neuron-specific enolase (NSE), Serum-100B (S100B) and Electroencephalogarm patterns in post cardiac arrest pediatric patients with cardiac arrest circumstances and patients’ outcome. Patients and Methods: This prospective observational study was conducted in Pediatric Intensive Care Unit, Ain Shams University. It included 41 post cardiac arrest patients who underwent serum sampling for NSE, Serum 100B and Electroencephalogram. Results: In our study, 19.5% of patients survived to hospital discharge. Convulsions and sepsis were present in 21.9% and 82.9% of the study group respectively. Convulsions and sepsis were associated with higher mortality with relative risk 1.33 and 1.99 respectively. Serum NSE and serum 100B showed no statistically significant relation with outcome. NSE levels were positively correlated with duration of arrest. EEG patterns showed statistically significant differences when related to outcome with p value of 0.01. Conclusion: Post cardiac arrest patients need intense care especially regarding sepsis and convulsions. NSE levels are related to duration of arrest but not survival. S100B levels aren’t related to survival or duration of arrest. Different EEG Patterns are related to patients’ outcome.
Arthralgia in Egyptian children
Authors: Kotby A A , Soliman N M S , Abdelsalam R M 
Published: May 2020

Abstract

Background
Children presenting with joint pains are a very common occurrence in any general pediatric outpatient department. About 15% of general pediatric consultations are for myriad pains of the musculoskeletal system.

Aim of the work
To screen Egyptian children presenting to a tertiary center for different causes of arthralgia.

Subjects and Methods
This is a descriptive study that was conducted on 200 pediatric patients (86 males and 114 females) presenting with arthralgia at the Children’s hospital Ain shams University from August 2017 till April 2018. Patients with chronic illness, skeletal deformity, past history of acute rheumatic fever, and any patient with acute febrile illness were excluded. All patients were subjected to full medical history, examination, laboratory investigation as complete blood picture, erythrocyte sedimentation rate, c reactive protein, electrocardiography and echocardiography.

Results
Around 18% of patients with arthralgia were proved to have post streptococcal arthralgia, 35% had collagen diseases, 10% with malignant conditions. no identifiable cause could be found in 36% of the patients and two patients diagnosed as acute rheumatic fever.

Conclusion
Arthralgia is a common symptom in the pediatric age group. Although it is a benign condition, sometimes it accurs due to serious illness like malignancy or collagen diseases.
Short Term Neurodevelopmental Outcome in Infants and Children Presenting with a Clinical Picture of Central Nervous System Infection
Authors: Deifalla S A M , Abdelhakam D , . Aly R H 
Published: May 2020

Abstract

Background
Morbidity evaluation of patients with acute encephalitis/encephalopathy (AEE) is an important aspect of pediatric outcomes research.

Aim of the Study
Assessment of the neurodevelopmental outcome of infants and children presenting with acute CNS infection 1 month after hospital discharge.

Patients and Methods
Twenty previously healthy infants and children of age range 6-36 months presenting clinically to the Children’s Hospital, Faculty of Medicine, Ain Shams University ER with acute CNS infection. Upon presentation; patients were clinically and functionally assessed. Also, Laboratory investigations including blood tests and lumbar puncture assessment were done. According to the bacterial meningitic score (BMS); patients were classified as having ‘very low risk’ of meningitis or ‘not low risk’. One month after discharge; patients were neurodevelopmentally assessed using the third edition of the Bayley scales of infant and toddler assessment.

Results
Nine patients had ‘very low risk of meningitis’ and 11 had ‘not low risk’ according the BMS. The functional assessment tools used upon admission were comparatively insignificant in the two classified groups p = &lt;0.05. However, all Bayley scales composite scores were lower in the ‘very low risk’ group compared to the ‘not low risk’ group with significant difference regarding the language composite score; 78+/-14 and 94+/-13 for the ‘very low risk’ and the ‘not low risk’ groups respectively p = 0.02. Also, significant negative correlations were found between the functional tests used and all Bayely scales composite scores.

Conclusion and recommendations
Neurodevelopmental evaluation of patients with CNS infection is important to highlight the adverse consequences of the disease.
Thyroid Profile abnormalities of RHGH treated children
Authors: Mouharam W A , Soliman D A 
Published: May 2020

Abstract

Objective
Normal thyroid function is important for optimal growth. Contradictory studies are available on the impact of rhGH treatment on thyroid function. Study aim is to evaluate the effect of rhGH treatment on thyroid function.

Methods
Study involved 102 euthyroid, prepubertal patients with growth hormone deficiency treated with rhGH. For all children, basal thyroid function, height, height velocity after 1 year of treatment, thyroid function every 3 months during the first year of treatment, all were performed.

Results
At 3 months of treatment 12 patients had elevated TSH, with or without low free T4. The remaining patients had normal free T4 (but lower than the basal one in most of the patients), with no TSH difference. The latter results were normalized at 1 year. Growth velocity was significantly lower in patients with hypothyroidism.

Conclusion
Thyroid profile may be affected in patients with short stature on growth hormone treatment which may negatively impact treatment response.
Think renal, think wise
Authors: Sallam D E D 
Published: May 2020

Abstract
A fourteen-years-old male, suffered generalized abdominal pain, vomiting & non-bloody diarrhea, a week later, GTCs occurred
He was diagnosis as encephalitis, but was anuric, edematous & hypertensive.
Investigations were done and showed anemic with NO thrombocytopenia but with impaired KFT. Renal biopsy revealed TMA/TTP.
He received 12 TPE with partial improvement then he developed bleeding/Rectum not responding to medical management, lower GIT endoscopy revealed: Cobble stone appearance in transverse colon & active IBD (Croh’s) so Pentasa & Immuran started
GTCs developed again, MRI brain showed PRESS.
KFT deteriorated again with oliguria, so 10 TPE sessions with infliximab & FDS were given with partial improvement. Two weeks later, more deterioration occurred.
New Investigations:
• Non-microangiopathic Non-hemolytic anemia
• Normal platelet & TLC
• Coomb’s test: negative
• eGFR: 25 ml/min/1.732
• Normal Complements
• ANA, Anti-DNA-Ab, ANCA: negative
• Protein-C, S & Anti-thrombin-III: Normal
• ADMATS13 level: Normal
• Urinalysis: hemaruria & Heavy proteinuria
• MRI: encephalitis vs ischemic areas 2ry to Vasculitis
Revision of biopsies:
§ Colonic: Leukocytoclastic vasculitis
§ Renal: TMA
A diagnosis of MULTI-SYSTEMIC LEUKOCYTOCLASTIC-VASCULITIS was established and started:
1. Pulse steroid 5 doses then oral FDS then withdrawal till reaching the lowest dose
2. MMF 1.2 gm/m2/day
Marked improvement of his renal, GIT and CNS condition had achieved:
Clinically: No GIT bleeding, convulsion
Laboratory: GFR: 75ml/min/1.732, Urinalysis: trace albumin
Radiologically: Normal MRI, A & V.
Knowledge and experience with Sudden Unexpected Death in Epilepsy (SUDEP) among neurologists in the Eastern Mediterranean Region (EMR)
Authors: Saleh D A A , Kassie S , Alsaadi T 
Published: May 2020

Abstract

Objective
SUDEP is one of the causes of mortality in patients with epilepsy. We investigated SUDEP discussion practices among neurologists in the EMR to identify gaps in knowledge and to increase awareness.

Methods
An online survey was sent out to neurologists practicing in the EMR through registered emails and to attendees of local neurology conferences. Results: 132 practitioners completed the survey. 19.7% respondents were from Egypt, 15.2% from Sudan, 8.3% from KSA, and 4.5% from Syria. Only 1.5% of the respondents discussed SUDEP with their patients nearly all of the time, while 46.2% rarely discuss SUDEP. 18% of the respondents had experienced definite or probable SUDEP in the past 24 months of their clinical practice. Top three reactions to SUDEP discussion were distress (74%), anxiety (70.5%), and depression (65.9%). 77.3% of the respondents believe that patients are at minimal risk of SUDEP, 37.9% fear it would affect patients’ mood or quality of life, and 27.3% believe SUDEP is so rare and the risks of discussion outweigh potential benefits. We found no significant association between years of independent practice, number of patients seen annually, number of SUDEP in the past 24 months and how often respondents discussed SUDEP.

Conclusion
Neurologists in the EMR rarely discuss SUDEP with their patients / caregivers. Negative reactions and underestimating the risk of SUDEP may be the reason, suggesting lack of awareness among practitioners, patients, and caregivers. Framing the discussion positively and using different resources to support patients / caregivers around SUDEP may minimize negative reactions.
Prevalence of Functional Gastrointestinal Disorders among School-aged Children and adolescents, A Multicenter Study
Authors: Ibrahim A T A , Hamdy A M , Elhodhod M A 
Published: May 2020

Abstract

Background
The term Functional Gastrointestinal Disorder ‘(FGID)’ defines several and variable combinations of recurrent or chronic gastrointestinal (GI) symptoms that do not have an identified underlying pathophysiology. Without an objective marker, the classification of FGIDs depends on symptoms.
The aim of the Work: To measure the prevalence of FGIDs among a representative sample of school-aged children/adolescents aging 4-18 years, to determine the socio-demographic characteristics of children affected by FGID and to assess the effect of FGIDs on health-related quality of life concerning both the child and the parent/caregiver.

Patients and Methods
The present cross-sectional study included 1082 Egyptian children/adolescents with age varying between 4-18 yrs. They were randomly selected among those attending primary, preparatory and secondary schools at Cairo, El-Gharbya and El-Sharqia governorates in the period from September 2017 to September 2018. Each child was subjected to clinical history taking, assessment of socioeconomic standard of family, assessment for presence of FGIDs using an Arabic translation of “Rome 4 diagnostic Questionnaire for pediatric functional GI disorders” and using Arabic translation of HRQOL score which included social and school functioning to study the effect of FGIDs on quality of life of children and parents.

Results
Mean age for screened children was 8.05 ± 3.03 years. 574 (53.1%) were males. The prevalence of FGIDs among studied children was 30.4%. Irritable bowel syndrome (IBS) was the most common type of FGIDs (11.6%), followed by functional constipation (8.4%), then functional dyspepsia (4.6%). Late order of birth and more members in the family, lower income per capita were all significantly related to positive FGID diagnosis. Children with FGID had lower scores for health-related quality of life (HRQOL).

Conclusion
FGIDs are common in school-aged Egyptian children/adolescents; IBS is the most common. Risk factors associated with having FGID include increased family members and decreased income per capita. FGIDs adversely affect the HRQOL of patients.
Growth hormone and ghrelin status in autistic children
Authors: Abozaid H M , Algohary E A A , Zaky E A , Mahmoud R A A 
Published: May 2020

Abstract

Background
Autism spectrum disorders (ASD) is a neurodevelopmental disorder with multifaceted etiology; with the hormonal imbalance playing an important role. Recent evidence suggests that plasma levels of Growth Hormone (GH) and ghrelin are altered in autistic children. Both hormones play a role in mucosal integrity which is crucial in immune tolerance. Ghrelin also modulates neuroinflammatory and apoptotic processes, thus both may have an impact on pathogenesis of autism.

Aim
To study the GH and ghrelin status in children with ASD and their relation to anthropometry and clinical phenotype.

Patients and Methods
This is a cross-sectional case-controlled study that included 45 children (30 males and 15 females) diagnosed with ASD compared to 30 age, sex and pubertal stage matched clinically normal controls. Psychometric evaluation including DSM 5, IQ, and CARS were done for the patients, while serum Acyl ghrelin, GH levels and anthropometric measurements were done for both the patients and controls.

Results
Compared to controls, patients had significantly higher weight and BMI (19.07 ± 4.56 kg versus 23.66 ± 11.44 kg, p 0.004) and (16.20 ± 0.89 kg/m2versus 17.94 ± 4.22 kg/m2, p 0.003) respectively. Ghrelin levels were significantly lower in our cases (7.04 ± 3.95 versus 1.90 ± 0.82, p 0.000) with significant positive correlation to the age. GH levels were also significantly lower in our cases (5.86 ± 2.21 versus 2.99 ± 1.51, p 0.000) with significant negative correlation to their CARS score.

Conclusion
Children with ASD have lower levels of ghrelin, GH compared to their normal counterparts. These findings support the hypothesis that hormones may modulate pathogenesis of autism, thus may play a key role in diagnosis and treatment response.
Anti-myelin oligodendrocyte glycoprotein antibodies in an Egyptian boy with recurrent paraplegia
Authors: Mohammed M Z R , Kevin R , Tomoum H Y 
Published: May 2020

Abstract

We report a case of NMOSD anti-MOG demyelinating disorder in a 5-year-old male.

Case presentation
A previously healthy 5-year-old male presented due to secondary inability to walk and incontinence. Initial neuroimaging identified demyelinating lesions of both corona radiata and centrum semiovale with intramedullary abnormal signal intensity opposite C5 and a long segment at upper dorsal spinal cord extending from D2 to D4. The patient received oral steroid with complete resolution of his symptoms. 2 years later, the patient presented with quadriparesis and incontinence. MRI brain and cervical spine revealed multiple cerebral demyelinating lesions and intramedullary high signal intensity opposite most of cervical spinal cord. After a course of oral steroid, the patient showed complete resolution of his symptoms except for mild right-hand weakness. CBC, ESR, ANA were normal. Aquaporin- 4 was negative. VEP showed mild bilateral optic nerve affection. CSF revealed no cells with no abnormal oligoclonal bands, but high IgG index was detected. As a result, IV methyl-prednisolone was initiated. Four months later, the patient presented with sudden diminution of vision. MRI brain showed bilateral symmetrical occipital T2 hyperintense signal. Anti-MOG antibody evaluation was positive. The patient received IV methyl-prednisolone and was commenced on mycophenolate mofetil. He showed complete clinical remission with no relapses.

Conclusions
This case outlines the management of anti-MOG demyelinating disorder. Understanding the presentation of this clinical entity may allow for earlier intervention and diagnosis with concomitant reduction of morbidity.