bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neurodevelopmental Outcomes after Neonatal Mechanical Ventilation
Authors: Zaky Eman Ahmed , Shaaban Hebatallah AM , Dawoud Mohamed OA , Madbouly Kareem SEF , Deifalla Shaymaa M 
Published: October 2021

Abstract

Background
A majority of extremely preterm infants are treated with mechanical ventilation, which is associated with an increased risk for future development of chronic lung disease, neonatal brain damage, and neurodevelopmental impairments.

Objectives
The aim of the current study was to evaluate the current and follow up neurodevelopmental status of an Egyptian sample of newly and previously discharged mechanically ventilated infants following them up for a period of 6 months for the earlier group and a year for the latter.

Patients and Methods
The current study was designed to be a descriptive study with retrospective (50 infants) and prospective (50 infants) domains. It was carried out on 100 neonates who were recruited from the Pediatric Neonatology Clinic, Children's Hospital and Neonatal Intensive Care Unit, Ain Shams University using clinical evaluation, Bayley Scales of Infant Development, and Childhood Autism Rating Scale (CARS)..

Results
There was statistically significant negative correlation between CARS score and Bayley Scale by using Composite Score (Cognitive, Language and Motor) on first assessment and follow up in the Prospective group while no correlation was found in the retrospective group. The study results showed that there was no statistical significant difference between two groups as regards gestational age, gender, residency, consanguinity, maternal disease, maturity, mode of delivery, respiratory distress, duration of stay in NICU, duration on mechanical ventilation, weight on admission, audiometry and fundus examination (P &gt; 0.05).

Conclusion
Using a mechanical ventilator in the neonatal period for a prolonged duration increased the risk for ASD and neurodevelopmental delay. Future studies on large samples are recommended from multicenters to confirm the validity of such findings, Bayley scale is a predicative for neurodevelopmental delay in neonates with long duration stay at NICU especially preterms with low birth weight.
A Study of the Prognostic Value of Initial EEG in Children with Acute Encephalitis
Authors: Hassanein Sahar Mohamed Ahmed , Ahmed Ahmed Rezk , Zaitoun Raghda Mohamed Hesham , El-Kodous Marina Gamal Alfy Abd 
Published: October 2021

Abstract

Objective
to assess the short-term prognostic aid of the initial Electroencephalography (EEG) in patients with acute viral encephalitis.

Methods
An observational follow up study including 30 children with acute non-herpetic viral encephalitis. Cases were subjected to full history taking, examination and an EEG recording obtained during hospital admission. Functional outcome assessment was done using the Liverpool outcome score during admission and repeated again at 3 months post discharge.

Results
The mean age of patients was 2.8 ±3.5 years old, with ages ranging from 6 months to 15 years. 73% of the cases were male. Clinical seizures were observed in 96.7% of the cases and EEG was abnormal in 26.7%. The Liverpool outcome scores were significantly lower at discharge and even more so after 3 months in cases with epileptiform activity on EEG. Abnormalities of EEG background did not significantly impact the Liverpool outcome score of the patients.

Conclusion
The presence of EEG epileptiform discharges is associated with a worse clinical outcome in children with acute encephalitis. The same cannot be said for abnormalities of EEG background.
QTc interval in Acute Severe Asthma
Authors: Kotby A A , El sayed M , Selim M K 
Published: October 2021

Abstract

Background
Prolonged QTc interval in children may be congenital or acquired. It could be fatal if it induces tachyarrhythmias and cardiac arrest.

Objectives
This work studied the QTc interval in acute asthma attacks and its relation to the severity of the attack and the bronchodilators used.

Patients and Methods
This is a descriptive prospective study of 30 children with moderate and severe asthma. Patients were divided according to GINA guidelines 2016: Group 1:10 patients with moderate acute attack, Group Il: 20 patients with severe acute attack. 12 lead ECG was done before start of medication, then repeated daily till discharge. QTc interval measured in lead V5 using Bazett Formula was considered prolonged if &gt; 445msec.

Results
Our study showed that 4 patients (13%) developed prolonged QTc interval; 3 (75%) had severe attack and one (25%) had moderate attack. QTc interval increased with number of bronchodilators used, but not reaching statistical significance. On day2, QTc was 340—435msec in patients on 2 medications and 350—460msec in patients on 3 medications. However, on 3rd day QTc interval was between 348-410msec,346—420msec,350—446msec in patients having 1, 2, 3 medications respectively. Also, there was no relation between theophylline and prolonged QTc interval.

Conclusion
Prolonged QTc interval can occur in 13% of children with moderate and severe asthma. QTc interval increased with number of bronchodilators used yet not reaching statistical significance. Bronchodilators must be used judiciously since they might be potentially arrhythmogenic drugs that induce fatal arrhythmia .
Association between Maternal and Neonatal Vitamin D status and the Development of Congenital Anomalies
Authors: EL Barbay Mohamed N , Abd El Maksoud Sahar S , Mohamed Suzan A 
Published: October 2021

Abstract

Background
Vitamin D (VD) is a remarkable problem during pregnancy. VD plays a crucial role in cellular growth and differentiation during embryogenesis. VD deficiency in pregnancy is associated with various maternal and neonatal comorbidities. In this study, we aimed to evaluate the potential association between maternal and neonatal vitamin D status and the subsequent development of congenital anomalies.

Patients and methods
A case-control study involving 30 mothers and their neonates born with gross structural congenital anomalies as cases and 30 mothers and their healthy neonates as controls recruited from Ain Shams University Children Hospital. Maternal and Neonatal blood samples were obtained to determine serum 25hydroxyvitamin D. The 25-hydroxyvitamin D concentration was stratified into a severe deficient&lt;10ng/ml, deficient &lt;20ng/ml, insufficient 20-29ng/ml and sufficient &gt;30ng/ml. Status above 150ng/ml presents high risk of toxicity.

Results
There were statistically significant differences between the two groups regarding maternal and neonatal vitamin D serum level within 29 days postpartum. Mean maternal vitamin D level in cases was 23.8ng/ml versus 42.13ng/ml in controls (P = 0,000). Mean neonatal vitamin D level in cases was 15.97ng/ml versus 28.9ng/ml in controls (P = 0,000).There was significant positive correlation between both maternal and neonatal vitamin D level with birth weight.

Conclusion
A compromised maternal vitamin D status is associated with an increased prevalence of congenital anomalies in offspring. Therefore, improvement of the periconceptional maternal vitamin D status is recommended.
Effect of Melatonin on Feeding Intolerance and Incidence of Necrotizing Enterocolitis in Preterm Infants
Authors: Awad Hisham A , El-Farghali Ola G , Shaaban Hebatallah A , El-Gammall Mona M 
Published: October 2021

Abstract

Background
Necrotizing enterocolitis (NEC) is one of the most dangerous gastrointestinal diseases that affects neonates especially preterm neonates. It is considered one of the oxygen radical diseases of neonatology as it is attributed to accumulation of reactive oxygen species (ROS) and free radicals leading to cellular oxidative damage. Melatonin proved to be an effective antioxidant and free radical scavenger with no documented side effects.

Objective
We aimed to evaluate the efficacy and safety of melatonin as adjuvant therapy in feeding intolerance and prophylaxis against NEC.

Methods
This was an interventional trial conducted on 90 preterm neonates with feeding intolerance. They were simply randomized to Group I that received melatonin treatment (n = 45) and Group II that received traditional treatment only (n = 45). Melatonin was administered at a total dose of 20 mg enterally in two divided doses of 10 mg each, 1 h apart. Tumor necrosis factor alpha (TNFα) level was assessed in patients 72 hours after starting treatment and both groups were observed for incidence of NEC, clinical improvement of feeding intolerance and time needed to reach full intake.

Results
Group I reported significantly less incidence of NEC in Group I treated with melatonin. Improved tolerance to feeds was observed in Group I resulting in earlier achievement of full enteral intake. Significantly higher levels of TNF alpha were found in Group II that received traditional treatment, indicative of higher level of oxidative stress and free radicals.

Conclusion
Melatonin in an effective and safe antioxidant and free radical scavenger associated with improvement of clinical and laboratory data in preterm infants with feeding intolerance and significantly less incidence of NEC.
Developmental Care Implementation on preterm neonates in Ain Shams University Pediatric Hospitals: An interventional study
Authors: Gad Ghada Ibrahim , El Kholy Nour El Eman Magd El Deen Menchawy , Rabie Dina Essam Abd El Hamid 
Published: October 2021

Abstract

Introduction
Developmental care is an approach to individualize care of infants to maximize neurological development and reduce long term cognitive and behavioral problems which may result from the stressful experience in the neonatal intensive care units like neonatal exposure to loud noise, bright light, heel pricking, orogastric suction and endotracheal intubation. It includes minimizing exposure to noise, light, proper skin to skin contact or kangaroo care, proper positioning, applying clustering of care and non-nutritive suckling.

Objectives
To study developmental care implementation and its relation to time to achieve full feed, length of hospital stay, amount of feeding, incidence of IVH, NEC & ROP, and consequently death in preterm neonates admitted to NICU.

Patients and methods
A Double arm randomized controlled clinical trial, care application, carried out on 60 preterms in the Neonatal Intensive Care Unit, Children's Hospital, Ain Shams university. Inclusion criteria of Developmental care group & controls (conventional care group) was; gestational age 29-36 week, no major congenital anomalies, and no pharmacological analgesics nor sedation were received before enrollment in the study. N-PASS (neonatal pain agitation sedation scale) and NISS (neonatal infant stressor scale) scores were assessed in both groups before and after developmental care implementation on developmental care group and conventional care application in conventional care group.

Results
N-PASS & NISS scores were decreased significantly with developmental care application, developmental care implementation resulted in a significant decrease in time to achieve full feed & length of hospital stay, there was a tendency to a decrease in incidence & grading of IVH, NEC & ROP, and consequently death in developmental care group compared to conventional care group.

Conclusion
Application of developmental care measures to NICU admitted preterm babies minimizes neonatal pain, stress, helps reaching amount of full feeding in a shorter time, with an increase in neonatal weight gain & a decrease in length of hospital stay.
Selection of children with drug resistant epilepsy who are candidates for epilepsy surgery: pre and post-operative evaluation
Authors: El Sharkawy Osama Salah Mohamed , El kabbany Zeinab Anwar , Younis Neveen Tawakol , Ahmad Khaled Aboulfotouh , Mahmoud Ahmed Darwish , Shata Mennatallah Osama 
Published: October 2021

Abstract

Objective
To select patients with drug resistant epilepsy following up in Pediatrics Neurology Outpatient Clinic of Children's Hospital, Ain Shams University who are candidates for epilepsy surgery and to detect outcome of epilepsy surgery in such children as regards seizures control.

Methods
This prospective study was conducted over a period of 36 months and comprises of 3 stages. Stage 1 includes selection of candidates for epilepsy surgery and preoperative evaluation. Evaluation included clinical assessment, video EEG, MRI epilepsy protocol. Stage 2 include surgery phase where decision of surgery was made by a multidisciplinary team. Stage 3 includes post-operative evaluation as regards Seizures frequency, Seizures Severity using Chalfont score, Engel Epilepsy Surgery Outcome Scale and the International League Against Epilepsy (ILAE) outcome classification. Data was tabulated and analyzed with SSPS package for windows.

Results
17 patients underwent epilepsy surgery. Results revealed significant decrease in seizures frequency and severity at 6 and 12 months after surgery. As regards Engel Epilepsy Surgery Outcome Scale 11 (64.7%) patients were class I at 12 months. As regards the ILAE outcome classification 10 (58.8%) patients are class 1 at 12 months.

Conclusions
epilepsy surgery can be a hope for patients with drug resistant epilepsy who are well selected and evaluated preoperatively. New studies on larger number and for longer duration are recommended.
Screening for Celiac Disease in Newly Diagnosed Children with Type I Diabetes
Authors: El Samahy M H , Thabet RA , Ragab DA , Ibrahim SI 
Published: October 2021

Abstract

Background
Type I diabetes (T1D) is an autoimmune disease caused by the immune-mediated destruction of insulin-producing pancreatic β cells.. Celiac disease is 5-7 percent more common in people with T1D than in the general population.

Objectives
The aim of this study was to detect the incidence of coeliac disease among newly diagnosed T1D children by assessment of Anti-tissue Transglutaminase Antibody (anti-tTG), IgA.

Methods
Fifty children with newly diagnosed T1D and another 15 age and sex –matched healthy individuals were subjected to screening for celiac disease by measuring total body IgA and antiTtg(IgA).

Results
the incidence of positive anti tTG(IgA) Ab among our T1D patients was found to be 12%. Upon comparing children with positive anti tTG(IgA) Ab with those with negative anti tTG(IgA) Ab we found that children with +ve anti tTG(IgA) Ab were significantly shorter than those with -ve anti tTG(IgA) Ab(p &lt; 0.05). Also HbA1c among our diabetic children with +ve anti tTG(IgA) Ab was significantly higher than those with -ve anti tTG(IgA) (p &lt; 0.05). Gastrointestinal manifestations were significantly higher among T1D patients with anti tTG (IgA)+ve than those with anti tTG(IgA)- ve.(p &lt; 0.001).

Conclusion
Anti tTG(IgA) Ab levels are elevated in children and adolescents with type 1 diabetes compared with healthy controls with incidence rate of about 12%. Anti tTG(IgA) Ab test can be used as screening test for celiac disease among type1 DM.
Potential Therapeutic Effects of Ursodeoxycholic Acid in Comparison to Ramipril in a Rat model of Diabetic Nephropathy
Authors: Elsheemy Maha Safwat Abd-elrahman , Elmelegy Ahmed Abdel-Salam M , Elaziz Lobna Fouad Abd , El hefnawy Nadia Galal M , El shaer Mohammad Mahmoud , Sedky Amina Ahmed 
Published: October 2021

Abstract

Background & Aim
Diabetic nephrectomy (DN) is a chronic progressive disorder that complicates long standing diabetes. Albuminuria is a prominent clinical feature of DN. Ursodeoxycholic acid (UDCA) is a physiologic hydrodrophillic bile acid that is therapeutically used in the treatment of primary biliary cirrhosis. It is known to alleviate endoplasmic reticulum (ER) stress in podocytes. In comparison to Ramipril as a standard ACEI therapy of DN, the present study was designed to investigate the effect of UDCA treatment on DN in association with renal biomarkers changes.

Method
Four groups of male Wister rats (6 per group) were designed; Normal control group, DN untreated group (High fat diet + STZ injection of 45 mg/kg + uninephrectomy), DN/Ramipril group; (1 mg/kg/d orally for 12 weeks) and DN/UDCA group (40 mg/kg/d orally for 12 weeks).

Results
DN rats treated with UDCA for 12 weeks exhibited significant decrease in ER stress marker, ATF6 with mean percentage value of 73.8% and improvement of podocyte structural deformities that is accompanied by a significant reduction in albuminuria by mean percentage value of 43.8% comparatively to Ramipril that caused reduction in ATF6 level with mean percentage value of 65.5% and reduction in albuminuria by mean percentage value of 50.2%. The remarkable improvement in metabolic profile and the neutral effect on blood pressure in UDCA treated group could explain the renoprotection at histopathological basis rather than the proved hemodynamic effect of ramipril.

Conclusion
Participation of ER stressmediated apoptosis in the pathophysiology of diabetic nephropathy make the UDCA a potential therapeutic option or add-on therapy due to its anti-apoptotic property apart from classic metabolic and hemodynamic aspects.
A Comparative Study of Surgical versus Medical Management of Cases of First Trimesteric Missed Abortion
Authors: Harb Hesham Mahmoud , Mansour Dina Yahia , Sayed AbdelRhman Badawi Lethi 
Published: October 2021

Abstract

Background
Missed abortion is a common obstetric problem constitutes approximately 15% of clinically diagnosed pregnancies and it was reported that about 80% of early pregnancy loss occurs in the first trimester. Missed abortion can be managed expectantly, surgically and medically. Surgical evacuation is the standard treatment for missed abortion with around 95% success rate and it had been widely performed all over the world in the last five decades, there are some complications associated with surgery such as higher cost, infection and bleeding. Medical management might be more suitable instead of surgical evacuation, it may be less costly than surgical treatment and consequently due to its lower complications most patients prefer it.

Objective
To compare the efficacy, safety and patient satisfaction of medical treatment of 1st trimestric missed abortion using misoprostol versus surgical evacuation.

Patients and Methods
Types of study: Randomized controlled open labelled clinical trial. Study setting: Maternity hospital, Ain Shams University. Study period: For six months from 1st of March 2019 to 31st of August 2019.

Results
The study shows no significant differences were found between groups regarding systolic blood pressure, diastolic blood pressure, pulse rate and body temperature before and after treatment. The results also show that occurrence of abdominal pain was frequent in both groups but, with no significant difference between groups but time needed to induce abortion was significantly higher in medical management group compared to surgical management one.

Conclusion
Medical management is found to be as effective as surgical management in the 1st trimesteric missed abortion, by using Misoprostol.
Sildenafil Citrate adjuvant Ovulation Induction Therapy with Clomiphen Citrate in Polycystic Ovarian Syndrome for Successful Ovulation; Cross-Over, Randomized Controlled Trial
Authors: Abbas Mustafa M , Fattah Ihab H. Abdel , Kolaib Magdy H , Mohammed Walid E , Salman Mohammed M 
Published: October 2021

Abstract

Background
Sildenafil Citrate (Respatio® 20 mg) as an adjuvant therapy in induction of ovulation along with Clomiphen Citrate (Clomid ®), is settled to enhance the endometrial receptivity through enhancing endometrial thickness and echogenicity. Yet, the exact role of Sildenafil in ovulation itself is still under study assuming that through increasing ovarian blood flow as a part of pelvic blood flow, will enhance the ovulation measured by the number and diameter of the growing follicles.

Aim of the Work
The aim of this study is to evaluate the efficacy of sildenafil citrate on the ovulation in PCOS women undergoing induction of ovulation using clomiphene citrate.

Patients and Methods
The current study was conducted in Ain Shams University Maternity Hospital- Infertility outpatient clinic during the period between January 2018 and December 2019. It included a total number of 595 patients who either were assessed for eligibility of the study, of which, 141 were excluded due to non-matching inclusion criteria or had exclusion criteria. 22 patients did not consent to participate in the study432 patients were matched, randomized and allocated to the two groups of the study each with 216 and received induction of ovulation according to the protocol of the study with either Clomiphen Citrate and Sildenafil Citrate or Clomiphen Citrate only, then they were followed up for 3 months. Those who didn't get pregnant given 2 months with no induction to wash over the effect and croos over the groups was done and followed up for another 3 months.

Results
Pregnancy test was positive in 39.8% in Clomiphen/Sildenafil group compared to just 30.1% in Clomiphen group. The patients that did not have positive pregnancy test in the first three months, have a rest for 2 months and then cross over of the groups took place. 145 patients shifted to Clomiphen/ Sildenafil protocol while 126 patients shifted to Clomiphen protocol and follow up for 3 months again and positive pregnancy test was 38% and 25% in the two groups in order.

Conclusion
using sildenafil citrate in patients with PCO syndrome undergoing induction of ovulation increases the chemical and clinical pregnancy rates through not only increasing the endometrial thickness and improving the endometrial pattern with improving the endometrial Doppler indices but also improving the ovulation by improving the ovarian arteries Doppler indices as well.
Therapeutic Effect of Vitamin D3 Supplementation to Clomiphene Citrate Resistant PCOS Women: A Randomized Controlled Trial
Authors: Hashaad Ahmed Mohamed Nour El-Din , Ghanem Reda Mokhtar Kamal , Dawoud Sara Abouelfath Abouelasrar Gad 
Published: October 2021

Abstract

Background
Polycystic ovary syndrome (PCOS) is considered one of the most common endocrine disorders affecting females in their reproductive age. In PCOS, an imbalance between androgens, anti-Müllerian hormone (AMH) and follicle stimulating hormone (FSH), cause a halt of follicular growth. Insulin resistance (IR) is another important component of PCOS. There is increasing evidence that vitamin D affects insulin and glucose metabolism, Vitamin D plays a vital role in the regulation of glucose-insulin homeostasis.

Objectives
to assess the efficacy of vitamin D supplementation in improving ovulation induction in PCOS women (1ry outcome) and increasing pregnancy rate (secondary outcome).

Patients and Methods
120 women diagnosed PCOS according to Rotterdam criteria and were resistant to CC treatment were randomly allocated into equal two groups: Group V: number of 60 patients received cholecalciferol + Metformin for 2 months. Group C: 60 patients received Metformin 2 months. After two months from the start:Both study groups started induction with Clomiphene Citrate added every month starting from the 3rd month to the 5th month (3 cycles of ovulation induction) in addition to previous drugs mentioned.

Results
In our study results, regulation of menstrual cycle occured in 63.6% of women who recieved vitamin D + metformin (group V) and ovulation was confirmed in 34.5% of the total number (55 women). Later, 18% of them got pregnant after 3 months of treatment. Added to that 16 women out of 39 (41%) got pregnant by the end of the follow up period with cumulative pregnancy rate (53%). On the other hand menstrual regularity in (group C: metformin) recorded 61% with ovulation percentage of 26.9% (n = 54). Followed by 14.8% pregnancy rate at the 3rd month., which increased to 27.5% by the end of the study out of 47.5% ovulated women (n = 40). Cumulative pregnancy rate 40%.

Conclusion
From the current study we can conclude that there is no significant difference of adding vitamin D to CC resistant PCOS regarding ovulation and pregnancy rates. However, it can augment metformin action and improves its outcome.