bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bovine Colostrum For Prevention Of Late Onset Sepsis In Preterm Neonates: A Randomized Control Trial
Authors: Awad H A , Imam S S , Aboushady N M , Ismail R I H , Abdou R M , Azzam N T 
Published: May 2020

Abstract

Objective
to determine whether gut priming with bovine colostrum reduces nosocomial sepsis episodes and to determine its effect on sepsis severity and weight increment.

Study Design
In this prospective, placebo-controlled, double-blinded, randomized trial, infants born before 34 weeks were assigned to receive either placebo (n 33) or bovine colostrum (n 32) as gut priming. Episodes of nosocomial sepsis (diagnosed by using Rodwell and Töllner sepsis scores) were recorded. A third comparison was made with standard care group of preterm neonates (n 17).

Results
Fewer sepsis episodes were observed in bovine colostrum-treated infants (3 vs. 6, p-value 0.482) with none developed severe sepsis. There was no significant difference in the weight increment (p-value 0.355)

Conclusion
Gut priming with oral Bovine Colostrum decreases severe sepsis in preterm neonates.
Double Negative Alpha Beta T Cells in Pediatrics Patients with Hemophagocytic Syndromes
Authors: Hossny E M , Elowaidy R H , Afifi H M , Ahmed H R 
Published: May 2020

Abstract

Introduction
Autoimmune lymphoproliferative syndrome (ALPS) and hemophagocytic lymphohistiocytosis (HLH) share clinical and laboratory features including lymphandenpathy, splenomegaly and pancytopenia. We sought to measure αβ double negative T cells (αβ DN T cells) among patients with established diagnosis of HLH and study its relation to disease activity and severity.

Methods
we conducted a follow-up controlled study, comprising 25 patients fulfilling diagnosis of HLH according to criteria set forward by the pediatric HLH study Group of the Histiocyte Society, in addition to 25 healthy matched controls. Patients were subjected to clinical evaluation and flow cytometric measurement of αβ DN T Cells percentages at presentation and 9 weeks after start of HLH induction treatment.

Results
In 17 (68%) patients, infection was the trigger of HLH while the trigger was malignancy in three (12%), and rheumatological disorders in two patients (8%). At enrollment, 15 patients (60%) has elvated αβ DN T cells (&gt;2%), with median (IQR) counts of 1.71 (1.25-2.12) that were significantly higher that the control values (median (IQR): 0.7 (0.4-0.8) (p &lt; 0.001). Initial αβ DN T cells counts of patients were also higher at enrollment as compared to results at the end of week 9 (median (IQR): 0.76 (0.45–1.17), p = 0.018). Survivors (n = 17 [68%] )and non-survivors (n = 8 [32%]) had comparable levels of αβ DN T cells at enrollment (p = 0.861).αβ DN T cells correlated positively with ALT (p = 0.019) and negatively with CD4/CD8 ratio (p = 0.023).

Conclusion
Elevated αβ DN T cell counts may not be specific for ALPS and their mild elevation might be related to the HLH process. Wider scale studies with longer periods of follow up are needed to validate the results and properly anticipate the correlation between both medical conditions.
Levosmindan: A new step up in Management in Neonatal Cardiogenic shock
Authors: Awad H A , Mahmoud M Z , Aboelwafa M S , Shabana A M , Shehata B M , Ahmed W O , Ismail R I H , Imam Safaa S 
Published: May 2020

Abstract
We report the use of Levosimendan, calcium sensitizer, inodilator in a neonate with post-operative refractory cardiogenic shock. Currently, no data are available on the use of levosimendan in newborns outside the cardiosurgical setting. A 38-week neonate -with isolated exomphalos major-presented post-operatively with pulmonary hypertension, refractory cardiogenic shock (inspite of receiving, a bolus of 10ml/kg, Dopamine and Dobutamine 15µg/kg/min, Adrenaline up to 1mg/Kg/min, Noradrenaline 0.5mg/Kg/min, Terlipressin 20µg/Kg/hour, Milrinone 25µg/Kg/min) and arrhythmia (supraventricular tachycardia). Levosimendan was introduced as an intravenous infusion with an initial rate of 0.1 up to 0.2µg/Kg/min in addition to Noradrenaline 1µg/Kg/min, Dopamine 15µg/Kg/min and Furosemide infusion 0.1mg/Kg/hour. The patient improved evidenced by normalization of vital signs and restoration of perfusion with better cardiac functions by echocardiography. Conclusion: Levosimendan has positive inotropic, lusitropic and vasodilating effects for the treatment of heart failure yet further studies in neonates are still required.
Helicobacter pylori Antibiotic resistance patterns among Egyptian children and predictors of resistance
Authors: Awad Y M M M , Eldeeb M T , Fathi M S , Mahmoud N , Morsy R M E 
Published: May 2020

Abstract

Background
Most individuals are infected by Helicobacter pylori during early childhood; in developing countries, 50% of children are infected by the age of 5 years. Successful eradication is important to prevent the development of antibiotic resistance, as well as to reduce the number of treatments and procedures. Among children receiving the standard triple therapy regimen, eradication rates are declining. Thus, national/ regional antibiotic resistance data could be used to guide treatment regimens for H pylori infection

Aim of the work
to evaluate the antibiotic resistance patterns of Helicobacter pylori strains among pediatric patients and the predictors of this resistance.

Patients and Methods
Cross sectional, carried out on 30 pediatric patients who presented to gastroenterology unit Ain Shams University for endoscopic evaluation of their upper GI symptoms including hematemesis, vomiting and abdominal pain. Five gastric biopsies were taken, two from the corpus for histopathology and culture, and 3 from the antrum, where one of them was sent for histopathology, and the second one for rapid urease test, and the third one was sent for culture and sensitivity.

Results
Results of culture and sensitivity has shown that resistance to amoxicillin was 20%, to clarithromycin was 50%, metronidazole resistance was 86.7%, tetracycline resistance showed to be 13.3%, finally levofloxacin resistance was 6.7%. Excess intake of fat was associated with resistance to amoxicillin and clarithromycin. While, duodenal ulcer and duodenal nodularity were associated with resistance to tetracycline and levofloxacin respectively.

Conclusion
The eradication regimen in Egypt should be revised according to our national antibiotic resistance data. Further studies are needed to assess predictors of resistance to antibiotics.
Nutritional and feeding Assessment of neurologically impaired children: a single center study
Authors: Younis N T , Elgendy Y G , Shata M O , Sheha H G 
Published: May 2020

Abstract

Background
Neurologically impaired (NI) children are at increased risk of malnutrition due to several nutritional and non-nutritional factors. Under nutrition, growth failure, overweight, micronutrient deficiencies, and osteopenia are nutritional comorbidities that can affect them.

Patients and Methods
A case control study,302 patients were recruited from Children’s Hospital Ain Shams University with age range from 6 months to 16 years. They were divided into (group 1) 151 neurologically impaired children and (group 2) 151 age and sex matched healthy controls, group 1 was further classified into 4 subgroups according to motor or mental deficit. All patients were subjected to detailed History, dietetic history (3 day food diary), Feeding assessment questionnaire and Complete anthropometric measurements

Results
majority of studied patients (47.6%) had motor and mental affection ,feeding difficulties were high where Gagging occurred in (44.37%) Choking (39.47%)( Vomiting 21%) Limited volume(50%) Limited variety(40.4%) aspiration ( 51.66%) and food retention (41%)
NI patients had significant lower values of recommended dietary allowance of calories, protein ,CHO ,fat ,iron, vitamin B1 and vitamin B2(p &lt; 0.001)

Conclusion
feeding difficulties were significantly high in NI Children they suffered from restricted daily caloric intake required for their energy needs, resulting in a decrease of linear growth and a serious risk of malnutrition. Micronutrients deficiency is common in younger children with neurological disorders.
Liver disease in children and Adolescents with Type1 Diabetes Mellitus
Authors: Elsayed M H , Hamza M T , Elsaeed M M , Thabet R A F 
Published: May 2020

Abstract
Glycogenic hepatopathy (GH) is a very rare complication seen mostly in patients with type 1 diabetes mellitus (T1DM) in whom glycemic control has been poor for a long time. We assessed liver diseases in children and adolescents with type 1 diabetes mellitus by detection of elevated liver transaminases and confirmed by fibro scan and ultrasound. One hundred and seven children and adolescents with T1DM were subjected to detailed history, physical examination, laboratory investigation and radiological investigation. Liver transaminases, mean HbA1c and pelviabdominal ultrasound were done for all patients while fibro scan for those with elevated liver enzymes only. Patients with elevated liver enzymes were reassessed after one year. Only nine of our patients have elevated liver enzymes. HbA1c and fibro scan abnormalities (F stage) were significantly higher in patients with elevated liver enzymes. (p &lt; 0.001) After follow up a significant decrease in liver enzymes, fibro scan abnormalities and HbA1c in the group with elevated liver enzymes initially was detected. (p &lt; 0.001) We concluded that liver disease is not a common complication in patients with long standing uncontrolled diabetes which can be reversed after proper control.
Anti GAD Negative Autoimmune Limbic Encephalitis in Diabetic Ketoacidosis: A Case Report
Authors: Zaitoun R M H , Abdelsalam O A , Aly H H 
Published: May 2020

Abstract
A 4-year-old boy presented to the emergency room with severe abdominal pain, tachypnea and vomiting followed by progressive obtundation. He was found to have hyperglycemia, ketonuria and metabolic acidosis. A diagnosis of Diabetic ketoacidosis was hence made and the boy was managed as such, with improvement in his laboratory parameters as well as in his level of consciousness.
On day 6 after admission, the boy developed a recurrence of altered consciousness and repeated seizures. On examination the boy had spastic quadriparesis lateralizing to the right side. MRI of the brain showed multiple inflammatory lesions involving both temporal lobes. CSF analysis was unremarkable and CSF Herpes Simplex virus PCR was negative. Based on the inflammatory nature of lesions on MRI, with negative PCR for HSV and otherwise unremarkable CSF, together with progressive worsening of level of consciousness and spasticity, the possibility of autoimmune encephalitis was raised and the boy received 2 grams per kilogram of intravenous immunoglobulin with mild improvement in level of consciousness. The boy then received intravenous pulsed methylprednisolone, with a clear improvement in both his motor and mental capabilities. Three months post hospital discharge, the child was back to normal.
This case highlights the importance of considering autoimmune encephalitis in the differential diagnosis of altered level of consciousness in a child with type 1 diabetes, especially in the presence of suggestive MRI findings and a lack of an alternative explanation.
Cardiac Troponin T in very low birthweight preterm infants with patent ductus arteriosus
Authors: Mohamed M H , Aboraya H M , Makawy M A , Elgebaly H H 
Published: May 2020

Abstract

Aim
to assess the role of cardiac troponin C (cTnT) as a marker of cardiac injury in VLBW infants with clinically significant PDA and its relation to echocardiographic findings.

Methods
Seventy-seven VLBW preterm infants, were included, divided according to their diameter of PDA and its hemodynamic significance into patients and control groups. For all neonates, CBC, CRP, cTnT and echocardiography, were done at 48 hours of life and as follow up 5-7 days later.

Results
41 preterm infants with a mean gestational age of 31.7±1.57 weeks and birth weight of (1.38±0.2kg) were included as patients group, 36 preterm infants were included as control group with a mean gestational age of 32.2±0.9 weeks and birth weight of (1.33±0.2kg). At 48 hours, cTnT concentrations in patients group was significantly increased than in control group (0.31±0.06 ng/dl, 0.16±0.03 ng/dl, respectively, P &lt; 0.001) and was positively corelated to PDA diameter in patients group (r:0.313, P:0.046). Mean left ventricular end systolic diameter was significantly decreased in patients than in control groups (9.00±1.94, 14.72±1.56, P:0.023).
On 5th day, cTnT concentrations (0.15 ±0.03 ng/dl) significantly decreased with closure of the duct (p: 0.004) together with increase in ejection fraction and fraction shortening (P &lt; 0.001, P:0.008 respectively)

Conclusion
cTnT may provide the basis for early diagnosis and detection of hemodynamically significant PDA in VLBW neonates for trials of medical treatment.
Effect of Botulinum Toxin Injection in Treatment of Upper Limb Spasticity in Childhood Cerebral Palsy: A Systematic Review
Authors: Alkadery N A , Mohammed M O , Elzohiery A K , Ahmed S M 
Published: May 2020

Abstract
Cerebral palsy (CP) is the most common cause of childhood disability globally. It manifests in restricted functional mobility and impacts the quality of life negatively. Botulinum toxin injections are widely used to manage limb spasticity in children with cerebral palsy. In the upper limbs of CP children intramuscular botulinum toxin-A has been used to manage pre and post-operative pain, facilitate nursing and achieve functional and/or cosmetic improvement of hand position. These goals are achieved primarily through reduction of spasticity.. This review aims at providing the evidence for effect of botulinum toxin-A injections to manage upper limb spasticity in spastic cerebral palsy cases. The literature extraction process yielded 15 articles for inclusion in this review. After reviewing these articles we concluded that botulinum toxin-A had a positive effect on the degree of spasticity, motor functions and cosmetic appearance of the injected upper limb but its effect increased by addition of another regimen as O.T.,P.T, casting or splintage.
Role of Dynamic Subtraction MRI in Assessment of Reactivity of Hepatic Focal Lesions post Trance arterial chemoembolization
Authors: Hassan M G , Abdelrahman A S , Abdu E M H 
Published: May 2020

Abstract
The aim of this work was to assess HCC cases after trans-arterial chemoembolization by subtraction dynamic contrast enhanced MRI to detect its accuracy, sensitivity and specifity in detecting residual tumor and assess the need for further treatment. Patients and methods: This was a retrospective comparative study will be conducted on 35 patients hepatocellular carcinoma (HCC); to assess HCC cases after trans-arterial chemoembolization (TACE) by subtraction dynamic contrast enhanced MRI to detect its accuracy, sensitivity and specificity in detecting residual tumor and assess the need for further treatment. We found that; the mean age of all patients was (62.31 ± 7.14) years. Regarding gender of the patients, the majority (88.6%) of patients were males; while only (11.4%) were females. Regarding residence, the majority (77.1%) of patients live in rural areas, while only (22.9%) live in urban areas. Comparative study between D-MRI and DS-MRI assessments revealed; highly significant increase in disease detection rate, sensitivity, and NPV in favor of DS-MRI in HCC patients; with highly significant difference (p &lt; 0.01 respectively). Comparative study between D-MRI and DS-MRI assessments revealed; non-significant difference in specificity and PPV in HCC patients; with non-significant difference (p &gt; 0.05). We found a moderate agreement between D-MRI and DS-MRI assessments of reactivity among HCC patients (kappa =0.44). Conclusion: Dynamic MRI is valuable in detecting recurrent lesions however, this value is augmented by the addition of subtraction technique especially in lesions having high signal before administration of contrast medium. So we recommend adding the subtraction technique in the protocol of MRI in the follow up after transarterial chemoembolization as it increases the diagnostic confidence. This may help to facilitate the appropriate clinical management of patients including the need for re-treatment sessions.
Assessment of Uterine Cervical Cancer by Means of MR Spectroscopy
Authors: Abdelmawla Y A M , Ali M A A , Ali F H 
Published: May 2020

Abstract

Background
Proton magnetic resonance spectroscopy has been shown to have clinical value in managing cancers of the brain, breast, cervix and prostate, it is useful for diagnosing and monitoring treatment of cervical cancer by analyzing the metabolite composition of cervical tumors, providing details of tumors metabolism that might assist tumor grading and leading to a better understanding of the biochemical pathways found within the lesion, serving as a noninvasive biomarker of metabolism in tumors. 1H-MRS has achieved great strides as a molecular imaging technique since its introduction, and its scope in many clinical scenarios and research settings is rising.

Objective
In this study, MRS was performed in all cases using single voxel spectroscopy (SVS) and patient spectra were interpreted qualitatively by inspection of the peaks of lipid and choline.

Aim and Patients and Methods
This study was carried out during the period between December 2017 and September 2018. Twenty three patients with cancer cervix diagnosed clinically and/or pathologically proved cancer were recruited from (Oncological department) in Ain Shams University Hospitals.

Results
Our study revealed high lipid level in 65% of cervical cancer patients which has 100% sensitivity and 74% specificity in detecting cervical cancer, choline level which considered most consistent difference between majority of normal tissue and tumors shows high level in measured 69.2% of the patients.

Conclusion
Abnormal metabolism is a key tumor hallmark. Proton magnetic resonance spectroscopy (1H-MRS) allows measurement of metabolite concentration that can be utilized to characterize tumor metabolic changes. 1H-MRS measurements of specific metabolites have been implemented in the clinic. This study interpret ate the role of 1H-MRS for cancer evaluation, evaluates its strengths and limitations, and correlates metabolite peaks at 1H-MRS with diagnostic and prognostic parameters of cervical cancer.
Role of Ultrasound Guided Injection of Platelet Rich Plasma (PRP) in Rotator Cuff Tendinopathy
Authors: Niazy G M , Ali A H , Mahmoud M S S 
Published: May 2020

Abstract

Background
Rotator cuff tendinopathy is a leading cause of shoulder pain and a significant source of disability. It is a common disorder, with its prevalence increasing substantially with age and affecting more than 50% of the general population by the age of 60 years

Objectives
Based on these facts, our study efforts seeked assessment of the role of ultrasound guided platelet rich plasma injection (PRP) in cases of rotator cuff tendinopathy.

Patients and Methods
Type of Study is single arm interventional study was conducted in Ain shams university hospitals in the period between October 2018 and March 2019, 15 patients were included in the study ranging from 25 to 60 years old, were referred to the Radiology department at Ain Shams University Hospitals. Study Setting: all US examinations were performed by the same senior musculoskeletal radiologist with a large experience in the musculoskeletal US at the radiology department of Ain Shams University hospitals. Study Period: 6 months for data collection.

Results
Our study showed remarkably noticeable change on comparing the pre-injection and post-injection SPADI Scoring system at 4,8,12 and 24 weeks. There is highly statistically significant pain and disability score and percentage improvement, yet on the other hand the radiological improvement shows no statistically significant difference found between baseline tendon thickness and its follow up at 4, 8 and 12 weeks while only there was statistically significant decrease in tendon thickness found at 24 weeks with p-value = 0.043.

Conclusion
The ultrasound-guided PRP injection for supraspinatus tendinopathy cases is a safe, cheap, and easily prepared outpatient procedure which showed competitive, promising, and well-proved results when compared to other modalities outcomes such as conventional surgeries, arthroscopic procedures, and physiotherapy. It deserves our attention to its value and efficacy for the sake of the patient as a minimally invasive procedure providing better quality of life.
Comparative Study between Diabetic and non- Diabetic Patients Regarding Prevalence of Coronary Artery Disease and Plaque Composition by Multi-detector CT Coronary Angiography
Authors: Morsy H A , Habib L A , Abdeldayem E H , Sayed A I 
Published: May 2020

Abstract

Diabetes is known to be a major cardiovascular risk factor associated with significantly increased morbidity and mortality and particularly increased risk of major cardiac events especially myocardial infarction as a manifestation of highly incident coronary artery disease (CAD).This can lead to decreased life expectation and life quality. Major cause for myocardial infarction is plaque rupture. Prevalence of obstructive and non-obstructive plaques is increased in diabetic patients.

Background and Objectives
The prevalence of coronary heart disease in diabetic patients compared to non- diabetics and evaluating the composition of the plaque in diseased individuals in both groups by usage of multislice computed tomography (MSCT) angiography .

Subjects and Methods
A total of 80 consecutive MSCT angiography examinations were performed between August 2017 and June 2018. Of these, the patients were evaluated for the presence and type of atherosclerotic plaque and severity of luminal narrowing.

Results
Eighty (40 in the diabetic group and 40 in the non-diabetic group) patients underwent MSCT angiography with DM prevalence of 0.212 (95% Cl for AOR 0.056 -1.896). Among them, 20 patients (50 %) in the diabetic group and 14 patients (35 %) in the non-diabetic group had +ve coronary heart disease, 33.3 % had significant and moderately significant coronary narrowing on diabetic group and 31.3 % in non-diabetic group on MSCT angiography. Diabetic patients had more soft plaque compared with non-diabetic patients.

Conclusion
DM is not an independent factor for the disease occurrence in coronary artery disease but is a dependent factor in the association of other risk factors such as smoking ,hypertension and dyslipidemia.
Intraurethral Steroid Injection Following Visual Internal Uerthrotomy in the Management of Anterior Urethral Strictures
Authors: Abdallah H M , Abuelnaga M , Rasmy A G 
Published: May 2020

Abstract

Background
Urethral strictures can occur due to trauma, infection, ischemia, inflammation, or unknown causes. As a result, scar tissue forms in the epithelium, which leads to decrease in caliber of the urethral lumen.

Objective
to evaluate the effect of local intraurethral injection of steroid in treatment of urethral stricture after visual urethrotomy.

Patients and Methods
Our study was done at the Ain Shams University Hospitals and the Urology department of National institute of Nephrology and Urology. Thirty male Patients with anterior urethral strictures were divided into two groups: Group A (IU only) and Group B (IU+ corticosteroids).

Results
Our study revealed that internal urethrotomy for anterior urethral stricture with intrauretheral injection of 40 mg methyl prednisone acetate decrease the recurrence rate of the urethral stricture.

Conclusion
Intraurethral corticosteroids injections at stricture site follows VIU seems to be an effective modality of treatment in decreasing the incidence of recurrent stricture after VIU. However more studies with larger population and long interval follow up are required for better evaluation.