bluuebunny/crossref_metadata_2025_split huggingface dataset:
Joint health state in relation to different clinical, laboratory, and radiological variables of hemophilia A patients
Authors: Tantawy Azza Abdel Gawad , Elsherif Nayera H.K , Safwat Nesma Ahmad , El Seteha Khaled Anwar El Sayed 
Published: October 2021

Abstract

Background
Haemophilic (HF) arthropathy is a major complication in haemophilia. Collagen factors are responsible for maintaining the integrity of the vessel wall in the joint.

Our goal
was to assess the haemophilia joint state and its relation to the clinical, laboratory &radiological data.

Methods
This cross-sectional study included 50 hemophilia A patients recruited from the Pediatric Hematology / Oncology unit, Children’s Hospital, Ain Shams University,Cairo,Egypt. Assessment of joint status clinicallyand radiologically by X-rays& ultrasound was performed.

Results
48% of the studied hemophilia A patients had one, 40 % had two target joints or more. The elbow and knee are the most frequently affected joints (46%,62% respectively).There were no significant differences between inhibitor positive and inhibitor negative patients regarding the number of target joints.However, inhibitor positive patients had significantly lower annual bleeding rate; moreover, none of inhibitor positive patients had surgeries done and none were on celecoxib. There were no significant differences between inhibitor positive hemophilia A patients and inhibitor negative regarding US total score, hem QOL, total HJHS and total FISH score. Patients with 2 target joints had significant higher annual bleeding rate, worse quality of life score, higher total HJHS score compared to those with one or without target joints.

Conclusion
In our study, we argued the lack of significant difference between inhibitor positive and inhibitor negative Hemophilia A patients as regards the occurrence of hemophilic arthropathy. Nevertheless, patients with ≥ 2 target joints had worse annual bleeding rate, quality of life & total HJHS score.
Serum Soluble Cytotoxic T-Lymphocyte-Associated Antigen 4 in Children and Adolescents with Autoimmune Cytopenia
Authors: El-Sherif Nayera H , Hassan Mona .F , Makkeyah Sara M , Ibrahim Marwa G 
Published: October 2021

Abstract

Background
Autoimmune cytopenias are characterized by the production of autoantibodies against differentiated hematopoietic cells because of defects in central and/or peripheral tolerance. It includes autoimmune hemolytic anemia (AIHA), immune thrombocytopenic purpura (ITP), autoimmune proliferative syndrome (ALPS) and Evans syndrome (EV).

Aim of the Work
to compare levels of sCTLA-4 in different types of immune cytopenias and their control.

Patients and Methods
Forty seven children and adolescents who have autoimmune cytopenias were recruited and assessed for eligibility in Pediatric Hematology Clinic, Ain Shams University Children’s Hospital and forming a patients group with age range 8 – 204 months old. An age and sex matched healthy control group were recruited including forty seven healthy participants with age range 6 – 156 months old.

Results
On initial examination in our study, the prevalence of hepatosplenomegaly and lymphadenopathy among the patients group was 27.7% and 2.1% respectively. Autoimmune cytopenic patients group have statistically significant higher serum sCTLA-4 levels (range 1 – 82 ng/ml) than control group (range 0 – 9 ng/ml) (where P &lt; 0.01 HS). On the other hand, there was no significant difference when comparing levels of sCTLA-4 between sera of ITP, AIHA and ALPS patients (P &gt; 0.05). Serum sCTLA-4 was inversely related to the age at diagnosis and positively related to disease duration. Our results demonstrated the presence of correlations between the levels of sCTLA4 and the severity of autoimmune cytopenias (negative correlation with Hemoglobin (R= -0.315; P = 0.031), mean Hemoglobin (last year) (R= -0.471; P = 0.001) and platelet (R= -0.324; P &lt; 0.05)) and (positive correlation between levels of sCTLA-4 and Reticulocyte count (R = 0.413; P = 0.004), Indirect Bilirubin (R = 0.427; P = 0.003) and Lactate dehydrogenase (R = 0.357; P = 0.014)). There was a significant differences in the prevalence of hepatosplenomegaly among ITP, AIHA and ALPS patients (P &lt; 0.05) with higher prevalence among ALPS patients.

Conclusion
Soluble form of CTLA4 (sCTLA4) presents in elevated levels in the sera of children and adolescents who have autoimmune cytopenia including AIHA/Evans, ITP and ALPS compared to healthy control group that suggests sCTLA4 could play a role in the pathogenesis of immune cytopenias.
Pharmacokinetics of Factor VIII Level in Patients Hemophilia A in Relation to Clinical and Radiological Outcomes
Authors: Tantawy Azza Abdel gawad , Ragab Iman Ahmed , Khalil Mohamed Gomaa 
Published: October 2021

Abstract

Background
The benefit of pharmacokinetics (PK) -guided dosing is that both prophylactic and “on demand” dosing will be based on actual FVIII trough and peak levels instead of current FVIII estimates based on body weight and in-vivo recovery based dosing. Knowledge will increase with regards the relationship between FVIII level and bleeding in individual patients. The dose and frequency of factor VIII for patients on prophylaxis should only be reduced if clinically justified and impact should be monitored with regard to bleeding events, bleeding pattern and joint status.

Objective
To assess the trough and peak level of factor VIII in patients with hemophilia A on low dose prophylaxis and its impact on the clinical and radiological joint status.

Patients and Methods
A cross sectional study was performed in Ain-Shams University, Pediatrics Hospital, Hemophilia Clinic. It included 25 children and adolescents with hemophilia A on prophylactic factor VIII during the period from September 2018 to August 2019. Factor VIII used was recombinant 3rd generation with a dose of 45 IU/Kg/week rounded to the nearest 500IU. Trough level of factor VIII was done before prophylactic dose and peak level was done one hour postinfusion through chromogenic assay using STAGO-Immuno-Def VIII reagent. Clinical joint score and Functional Independence Score of Hemophilia (FISH) were done. Radiological joint scores were done using conventional x-ray, ultrasound and MRI. Cut-off level of trough levels was studied at 1% and 1%-5% of factor VIII.

Results
Patients were classified into 3 groups,4 patients (21.1%) had trough level &lt;1%, 13 patients (68.4%) had trough level between 1%-5%, 2 patients (10.5%) had trough level &gt; 5%. No significant difference between trough level of factor VIII and clinical joint scores and FISH scores of patients. Median score of the worst joint of patients with trough level &gt;5% was 5 in comparison to 8 and 7 in patients with trough level 1%-5% and &lt;1% respectively. Mean FISH of patients with trough level &gt;5% was 9.50 ± 2.12 in comparison to 12.92 ± 5.41 and 11.00 ± 3.56 for patients with troughs 1%-5% and &lt;1% that was respectively. Comparison between groups with different trough level of factor VIII according to X-ray scores of patients showed no significant difference

Conclusion
Low trough levels alone did not warrant intensification of the prophylaxis regimen; rather, the dose and dosing frequency should be adjusted based on individual’s bleeding pattern and many other factors as shown in our study the insignificant relation between trough levels of factor VIII and clinical and radiological outcomes.. More frequent factor VIII monitoring and incorporation into population based PK are warranted.
Comparison between Continuous positive Airway Pressure (CPAP) and High Flow Nasal Cannula (HFNC) in Management of Bronchiolitis and community acquired pneumonia in Infants and Young Children
Authors: Gawad Tarek Ahmed Abdel , Allam Ahmad Mostafa , Sayed Sarah Ali El 
Published: October 2021

Abstract

Background
Acute respiratory failure develops in infants with bronchiolitis and Community acquired pneumonia (CAP) because of hypoxemia, due to mismatch between ventilation and perfusion. Nasal continuous airway pressure (nCPAP) and high-flow nasal cannula (HFNC) improve the work of breathing and oxygenation .High flow nasal cannula (HFNC), also called heated humidified high flow nasal cannula (HHHFNC), is a new non-invasive ventilation therapy that seems to be well tolerated in infants with hypoxemic respiratory failure.

Aim
To compare the effectiveness and the outcome of Heated Humidified High Flow Nasal Cannula (HFNC) versus Nasal Continuous Positive Airway Pressure (NCPAP), as a primary mode of respiratory support, in patients with respiratory failure due to pneumonia or bronchiolitis at PICU regarding demographic data, length of admission, increasing of positive pressure and need of intubation.

Patients and Methods
observational study was conducted on 40 patients with acute respiratory failure due to either bronchiolitis or community acquired pneumonia (CAP), admitted to Paediatric ICU, Children Hospital, Ain Shams University, in the time period between February 2018 to July 2019. The patients, aged between 1 month to 5 years, were subjected to detailed clinical history and examination.All patients received continuous monitoring of electrocardiograph ,pulse oximetry and respiratory rate .The patients were treated either with (HFNC) Humidified high flow nasal cannula or continuous positive airway pressure (CPAP). Studied groups were compared regarding demographic data, increasing in respiratory support ,need of intubation, fate and length of admission during PICU stay.

Results
HFNC was as efficient as CPAP in lowering RR(respiratory rate) and HR(heart rate) in infants with bronchiolitis and community acquired pneumonia. Thus HFNC group was as significant as NCPAP group in treatment of bronchiolitis and CAP regarding length of admission ,increasing of positive pressure and need of iintubation in PICU .

Conclusion
This study concluded that HFNC is as efficient as nCPAP for initial respiratory support in young infants, hospitalized in a PICU for moderate to severe acute respiratory failure.
Neuroprotective effect of lacosamide on cognitive dysfunction in Streptozotocin induced Alzheimer disease
Authors: Ibrahim Fatma Sobhy , Abdel-Aziz Lobna Fouad , Elbakly Wesam Mostafa , El Gayar Nesreen Hamdy 
Published: October 2021

Abstract
Alzheimer disease (AD) is a chronic and progressive neurodegenerative disorder characterized by memory loss and cognition impairment. A link has been established between AD and epilepsy sharing multiple mechanisms and pathogenesis. Similar Hippocampal changes have been found between both diseases. Choosing antiepileptic drug in AD patient represent a great a challenge especially with increase seizure risk in AD patients. Lacosamide, antiepileptic drug, was reported to have a neuroprotective effect in animal models and a histone deacetylase inhibition activity. This study was designed to investigate the potential effect of chronic lacosamide treatment in Streptozotocin induced AD in male Wistar rats.

Methods
AD animal model was induced with single bilateral intracerebroventricular injection of STZ (3 mg/kg) on day one. Lacosamide (30 mg/kg orally, once daily) was administrated for 21 days.
Cognitive function assessment was done with Morris Water Maze (MWM) and Y Maze tasks. APP and MAPT mRNA level were measured.

Results
ICV-STZ caused significant prolongation in Escape latency time and reduction in time spent in target quadrant in MWM and reduction in spontaneous alteration ratio in Y Maze compared to control group. STZ induced Up-regulation in Amyloid precursor protein and Microtubule associated protein tau gene expression. Chronic Lacosamide treatment attenuated STZ induced cognitive impairment and mitigated APP and MAPT induced expression with STZ.

Conclusion
Lacosamide has a neuroprotective effect against STZ induced cognitive deficits ameliorating Aβ and Tau pathology.
Hydration therapy in oligohydraminos in Ain Shams University Maternity Hospital: Randomized Controlled Clinical Trial
Authors: Abdel-Hamaid Sherif Mohammad , Mansour Dina Yahia , Bakhat Gehad Sayed Abdel-Rahman 
Published: October 2021

Abstract

Background
Amniotic fluid surrounds the fetus within first gestational weeks. acts physiologically and anatomically in a protective manner preventing fetal and umbilical cord compressive forces, besides have antibacterial features keeping the fetal temperature stable, and avoiding adhesive attachment to developing fetal membrane system. Amniotic fluid volume and constituents continuously change in a dynamic manner as the gestation progresses. Sufficient amniotic fluid volume is crucial for fetal mechanophysiological well-being adding in normal musculoskeletal wellbeing besides aminiotic fluid consituents refelect physiological integrity of fetal systems particularly the renal and gastrointestinal systems.

Objective
The aim of this study is to find out if there is significant increase in amniotic fluid index after acute maternal hydration in pregnant women with oligohydraminos and to evaluate therapeutic effectiveness of two different modalities of hydration therapy.

Methods
We conducted randomized controlled open labeled clinical trial on 300 cases with oligohydraminos admitted to Ain Shams University Maternity Hospital (ASUMH) in the period from September 2019 to March 2020. These patients were classified to three groups, Patients in group A were Oral hydration group: 100 participants while Patients in group B were Intravenous hydration group: 100 participants, patients in Group 3 No hydration group: 100 participants.

Results
The demographic data analysis of the current study have shown that there was no statistical significant difference between the investigated research groups as regards the demographic characteristics (age, BMI, Parity gestational age p values 0.171,0.370,0.840,0.290 consecutively). The study results also showed that oligoydramnios recurrence frequency was highest among control group, followed by intravenous group and least in oral group, the differences were statistically nonsignificant.

Conclusion
Hydration can be considered an effective way of decreasing the chance of oligohydraminos because maternal dehydration increases the chance of the condition. Therefore both serum and oral hydration therapies are hypothesized to be effective treatment for oligohydraminos. Previous studies have supported this hypothesis. Maternal hydration may theoretically increase amniotic fluid volume may by causing fetal diuresis.
Comparison between AFI and DVP in predicting adverse neonatal respiratory outcomes in women with prolonged pregnancy undergoing induction of labour
Authors: Elkady Mohamed Ahmed , Mansour Dina Yahia , Abu zaid Hamada Farag 
Published: October 2021

Abstract

Background
The intrapartum management of prolonged pregnancies is aunique challenge to the obstetricians, as the perinatal outcomes areadverse after completed 40 weeks. In such cases, intrapartumasphyxia and meconium aspiration are associated with almost.

Objective
To comparison between MVP and AFI in predicting neonatal respiratory outcomes in induction of labour in prolonged pregnancies.

Patients and Methods
The study was a prospective comparative study that was conducted on 266 women with prolonged pregnancy undergoing induction of labour. The patients were recruited from Ain Shams university hospitals during the period from February 2019 to August 2019.

Results
Amniotic fluid index and MVP were evaluated in 269 women with pregnancies of 40 or more weeks and intact membranes using a 3.5-MHz linear transducer. Both measurements were obtained for each participant by the same obstetrician in one sitting. Oligohydramnios was defined as an AFI of 5 cm or less or an DVP of 1 cm or less. External cardiotocography was performed during intrapartum period in all cases. Fetal distress was diagnosed when any one of the nonreassuring fetal heart rate pattern occurred or when the Apgar score at birth was 6 or less. The results were analyzed by the chi(2) and the t tests.

Conclusion
The use of the AFI and SDVP is useful in predicting neonatal outcomes in the induction of labor in prolonged pregnancies. The SDVP measurement appears to be the more appropriate method for predicting neonatal outcomes. The same observation was found when AFI and SDVP were combined. It is also logical to recommend that only one method should be used for fetal assessment tests.
Assessment of accuracy of two dimensions ultrasonography of fetal thigh soft tissue versus Hadlock's formula in estimation of fetal weight
Authors: Elsenity Mohamed Abdel Fattah , El Sayed El Zeiny Mohamed Abdel Aziz , Shahin Marwa Radwan Abbass , El-Din Adel Shafik Salah 
Published: October 2021

Abstract

Objective
The current study aims to compare between mid-thigh soft tissue formula and modified mid-thigh soft tissue formula with Hadlock formula in estimation of fetal weight.

Materials and methods
Two hundred full term pregnant women attending Ain Shams Maternity Hospital in the period from April 2018 and April 2019 were included in this comparative study. Whole study group (200 women) had 2D ultrasonography using Hadlock's formula, thigh soft tissue formula and Modified thigh soft tissue formula.

Results
In our current study Hadlock's formula was better than thigh soft tissue and modified thigh soft tissue formula in estimation of fetal weight.

Conclusions
Fetal mid-thigh SST is a simple, useful, and easily applicable parameter for fetal weight estimation.
Prophylactic antibiotics in patients with artificial rupture of membranes during labor: (Randomized controlled clinical trial)
Authors: Swidan Khalid Hassan , Abuelghar Wessam Magdy , Ali Mohamed Adel , Soliman Mohamed Soliman Hussein 
Published: October 2021

Abstract

Background
Amniotomy, also known as artificial rupture of membranes (AROMs) and by the lay description "breaking the water," is the intentional rupture of the amniotic sac by an obstetrical provider. This procedure is common during labor management and has been performed by obstetrical providers for at least a few hundred years. Amniotomy during labor induction is associated with a faster time to delivery, most notably in nulliparous women, without an increase in cesarean delivery or maternal and neonatal morbidity. Shortening time to delivery is associated with decreased hospital costs and increased patient satisfaction, and therefore, early amniotomy, given the safety profile, should be considered when a faster delivery is of importance to patients and providers.

Objective
To determine the efficacy of prophylactic antibiotics in patient during labor on reducing maternal and neonatal morbidities.

Methods
This prospective randomized study was performed from January 2020 to July 2020, at maternity hospital of Ain Shams University. Informed consent was obtained from all participants. Candidates for this study included all patients with singleton gestations between 37 weeks and 41 weeks of gestation underwent artificial rupture of the membranes during active phase of labor. Gestational age was confirmed by a reliable last menstrual period, early sonogram. Amniotomy was confirmed by visualization of pooling fluid in the posterior vaginal fornix through the cervix after artificial rupture of membrane by sterile hook.

Results
There were no statistical significance differences between two groups regarding demographic characteristics, endometritis, cord-prolapse and abruptio placenta. Maternal septicemia was absent in both groups. Chorio-amnionitis, cesarean section rate, episiotomy infection, NICU admission, neonatal sepsis, neonatal hypoxia and intraventricular hemorrhage were significantly less frequent in prophylaxis group.

Conclusion
Using of prophylactic antibiotics with amniotomy in pregnant women during labor reduced maternal and neonatal morbidities as chorio-amnionitis, endometritis, cesarean section rate, episiotomy infection, NICU admission, neonatal sepsis, neonatal hypoxia and intraventricular hemorrhage. On the other side it had no proved protective effect against maternal septicemia, cord-prolapse and abruptio placenta.
The ‘occiput-spine angle’: a new sonographic index of fetal head deflexion during first stage of labor as predictor of course of labor and outcome
Authors: Fathy Hesham Mohammed , El-Din Ahmed Mohammed Bahaa , Mohammed Haitham Fathy , Helmy Mohammed Mahmoud Mohammed 
Published: October 2021

Abstract

Background
Labor is a physiologic process during which the products of conception (i.e. the fetus, membranes, umbilical cord, and placenta) are expelled outside of the uterus. Labor is achieved with changes in the biochemical connective tissue and with gradual effacement and dilatation of the uterine cervix as a result of rhythmic uterine contractions of sufficient frequency, intensity, and duration. Labor is divided into three stages that include cervical dilatation, fetal delivery and delivery of the placenta.

Objective
The aims of this study were to quantify the degree of fetal head deflection via the use of Ultrasound during the first stage of labor and to determine whether a parameter derived from ultrasound examination (the occiput-spine angle) has a relationship with the progress of labor, subsequent effect on maternal, fetal complications and rate of cesarean delivery.

Methods
This is a prospective cohort study which includes a total of 200 women with gestational age 37-42 weeks were assessed in this study in Ain shams Maternity hospital labor ward by 2 dimensional ultra sound. Examinations were performed after a verbal and written consent from the patient with the patient lying in the dorsal supine position. And exclusion of Occiput-posterior position, multigravida, Indication for cesarean, Medical disorder eg hypertension or diabetes, pre labor rupture of membranes to correlate between the Occiput- spine angle (OSA) and the outcome of labor regarding the progress of labor, incidence of cesarean section, maternal and fetal complications.

Results
This study demonstrates that the sonographic measurement of the angle formed by the fetal occiput and the spine (occiput-spine angle) is feasible and reproducible, the occiput-spine angle in the first stage of labor is positively correlated with the clinically established station and the risk of obstructed labor requiring an operative delivery ie, Occiput-spine angle have been statistically significantly lower in cases underwent operative delivery. Occiput-spine angle had a statistically significant low diagnostic performance in predicting operative delivery.

Conclusion
The occiput-spine angle in the first stage of labor correlates significantly with the risk of obstructed labor Compared with spontaneous vaginal deliveries, cases that require obstetric intervention demonstrated a smaller occiput-spine angle at a similar station, suggesting diminished flexion of the fetal head. For occiput anterior fetuses, the greater the degree of fetal head deflexion, the greater risk of operative delivery due to labor arrest.