bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tissue Inhibitor of Metalloproteinase 2 and Insulin-Like Growth Factor-Binding Protein 7 in Pediatric Diabetic Ketoacidosis
Authors: Shahin Hadeer Helmy Abd Elhamied , Sallam Dina Ebrahem Darweish , El-Din Nouran Youssef Salah , Taha Sara Ibrahim Abdelfattah , Awadallah Shrouk Mohamed , Matter Randa Mahmoud 
Published: November 2024

Abstract

Background
Diabetic ketoacidosis (DKA) is one of the main causes of end-stage kidney disease (ESKD). Urinary concentration of tissue inhibitor of metalloproteinase 2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) are well known urinary acute kidney injury (AKI) biomarkers.

Objectives
to determine the level of urinary TIMP-2 and IGFBP7 as markers of acute kidney injury (AKI) in children with T1DM during and after the resolution of diabetic ketoacidosis.

Patients and Methods
A prospective longitudinal study was conducted over 1 year, where we have included children with T1DM presented to Emergency Department (ED) at Children’ s Hospital, Faculty of Medicine, Ain Shams University, with moderate and severe DKA, where we followed them at presentation and day 14, and determined those who developed AKI and measured urinary TIMP-2 and IGFBP7 to detect it AKI.

Results
We have included 40 pediatric patients with T1DM with mean (±SD) age of 10.59 ± 2.17 years, with a female predominance (90%). Among our patients, 18 patients (45%) had AKI at presentation, where they had a significantly elevated urinary level of both TIMP-2 and IGFBP7 than without AKI (TIMP-2 (ng/ml):112.58(13.76 - 190.1) versus 33.53 (17.27 - 149.65), IGFBP7(ng/ml) :77.42(0.57 - 164.3) versus 1.41(0.67 - 82.63) (p &lt; 0.001). Follow up at day 14, after recovery from DKA, we had no patients with AKI, with significant decrease in the same urinary biomarkers (TIMP-2(ng/ml) :11.35 (8.13 - 25.03) versus 9.62 (7.67 - 17.02), IGFBP7(ng/ml) :0.94(0.51 - 2.34) versus 0.78 (0.43 - 1.34) (p &lt; 0.005).

Conclusion
The level of urinary TIMP-2 and IGFBP7 increased in children and adolescent with T1DM who developed AKI at the time of presentation of DKA, and normalized after the resolution of DKA and the recovery from AKI.
Two Different Regimens of Oral Vitamin D in Treatment of Early Onset Neonatal Sepsis
Authors: Toaima Nadin N , Ali Mona R , Abdelsattar Hoda A , Mohamed Mayada A , Abdelaal NourElDin M 
Published: November 2024

Abstract

Background
Newborns are more susceptible to infections as both innate and adaptive immune systems are not entirely developed. Associations have been shown between vitamin D deficiency and respiratory tract infections and sepsis. Vitamin D also has immunomodulatory effects on immune function.

Objectives
To compare (lower dose of oral Vitamin D 400 IU versus doubling of it) in full term neonates with early-onset sepsis (EOS).

Methods
A randomized controlled trial (RCT) comprised sixty six (66) full term neonates with EOS, admitted to the Neonatal Intensive Care Unit of Children's Hospital, Ain Shams University and the NICU of El Ahrar Teaching Hospital in Zagazig. We excluded preterm newborns, neonates on NPO (nothing per os), neonates with maternal risk factors, such as chorioamnionitis, neonates delivered at home and those with major congenital abnormalities. All patients were assessed according to Newborn Scale of Sepsis. The cases were randomly assigned into 3 groups; group A (who received lower dose of oral Vitamin D 400 IU and group B, who received 800 IU/day of vitamin D3 and group C who didn’t receive any vitamin D supplementation. Serum concentrations of 25(OH)D were measured at enrollment and on recovery.

Results
The mean serum level of 25 (OH) vitamin D in all 66 newborns with early onset sepsis included in the study was 18.12 ± 3.6 ng/ml and it was low and considered insufficient. 78.8% of enrolled infants were vitamin D- insufficient at enrollment in the three groups. The study shows significant relation between the mean of serum vitamin D on recovery and regimen of vitamin D supplemented to the newborns; where 55 % of the patients in group A became sufficient on recovery, 75 % of the patients of group B became sufficient on recovery and 25% of group C became sufficient on recovery. Mean age of recovery of group A, B and C were 10.4±3.6, 8.7±3.2 and 11.3±3.8 respectively with significant difference between group B and group C (mean±SD) being 8.7±3.2 versus 11.3±3.8 respectively with p- value= 0.024. None of the infants enrolled in the study had signs of vitamin D toxicity or serum levels exceeding 80-100 ng/ml upon recovery.

Conclusions
Vitamin D supplementation has a role in recovery of full term neonates suffering from sepsis.
Frequency of Anicteric Hepatitis A Virus Infection in a Group of Pre-School Egyptian Children Presenting with Gastroenteritis like Manifestations
Authors: Ahmed Larine Bahy Eldin , Talaat Eman Mohamed , Aboelwafa Menna Allah Zakaria Mohammad , Abdelrahman Mohamed Samir 
Published: November 2024

Abstract

Background
Hepatitis A virus (HAV) infection is one of the most frequent communicable diseases with an estimated 1.5 million cases diagnosed each year globally. Most infections in children under the age of six are asymptomatic and if infection occurs, it is usually anicteric. Therefore, the disease is underreported.

Aim
To determine the prevalence of HAV infection in a group of Pre-School Egyptian children presenting with gastroenteritis like manifestations and anicteric-hepatitis and to correlate that with social and demographic risk factors.

Patients and Methods
This was a cross sectional study conducted at Ain Shams University Children’s hospital emergency room and outpatient clinic, Cairo, Egypt during the period from February 2023 to July 2023 and performed on 385 preschool Egyptian child presented with acute gastroenteritis like manifestations; who were jaundice free, with no past history of HAV infection, HAV vaccination or chronic liver disease. To all enrolled cases, history was taken, clinical examination done, socioeconomic status and liver enzymes assessed, HAV IgM antibody was evaluated only in group with elevated liver enzymes double upper limit of normal for age and sex and for cases with positive HAV IgM, complete blood count and international normalized ratio (INR) withdrawn to assess severity of the disease.

Results
Among the enrolled cases, only 32 cases had elevated liver enzymes (8.3%), 4 cases had positive HAV IgM (1%) with no stastical difference between males and females. Poor hand hygiene was significantly higher in group with elevated liver enzymes compared to other studied cases. Lower score in family possessions in socioeconomic evaluation was significant in the group with positive HAV IgM in comparison to the remained studied population.

Conclusion
Frequency of anicteric HAV infection is not uncommon in preschool age group with gastroenteritis like manifestations. Hand hygiene and family possessions can influence its prevalence. Hepatomegaly, right hypochondrial tenderness and certain cut values of transaminases may be used as good NPV values in diagnosis of HAV infection.
Reticulocyte-Hemoglobin Content as Marker for Iron Status in Preterm Neonates
Authors: Abdel-Rahman Mona Ali Ahmed , El-Laboudy Mohammed Abdel-Mohsen , Khafagy Soha Mohamed , Zakaria Abou Elwafa Menna Allah , Eltonbary Khadiga Yehia 
Published: November 2024

Abstract

Background
Reticulocyte indices and reticulocyte hemoglobin provide a direct real time measure of hemoglobinization in newly produced erythrocytes, without perturbation by inflammation. It has been a reliable indicator of iron availability for Hb synthesis in children and adults.

Aim of the Work
To assess the average RET-Hb values in premature neonates soon after birth, to assess its value as marker of iron deficiency (ID) and to correlate these levels with the need for early iron supplement and/or blood transfusion.

Patients and Methods
This is a prospective observational study conducted at Neonatal Intensive Care Unit (NICU), Ain Shams University Children Hospital from March 2022 till September 2022.

Results
The study included 22 females (44.0%) and 28 males (56.0%) with mean gestational age of 31.84±1.60 weeks. The mean HGB level on admission was 16.76 ± 2.16 mg/dL, with 24.0% of neonates having an HGB level &lt;15 mg/dL and the mean Ret-HB level for preterm neonates was 31.70 ± 2.68 pg/cell. The median serum ferritin level was 168 (IQR: 125 – 225) ng/mL and ferritin was positively correlated with Ret-Hb. Almost 58% (n = 29) required iron supplements in the first 2-4 weeks of life and 64% of neonates required packed red cell transfusion during their hospitalization. Ret-Hb at a cut off level of ≤ 30.4 pg/cell can predict early enteral iron supplement among the studied group at the cut off level with sensitivity of 52.4%, specificity of 75.9% and with a cut off level &lt; 30.8pg/cell can predict the need for blood transfusion among the studied group with sensitivity of 56.25% and specificity of 83.33%.

Conclusion
Ret-Hb levels in preterm neonates was significantly correlated with ferritin levels. Ret-Hb could be a reliable marker of iron deficiency and helps in early enteral iron supplement for this age group but normal reference ranges should be standardized.
Helicobacter pylori Infection in Children with Portal Hypertension and its Correlation with Serum Ammonia
Authors: Kamel Ibrahim Nour Hassan Hassan , Ahmed Lerine Bahy Eldin , ElAdawy Mohamed Saaed Eldin , Awad Yosra Mohamed Mohsen , Abouelkhair Mariam B , Farid Laila M 
Published: November 2024

Abstract

Background
Helicobacter pylori (H. pylori) infection is the most common bacterial infection worldwide, but it is even more common in developing countries. Through its urease enzyme, H. pylori converts urea into ammonia. Therefore, theoretically, H. pylori infection can augment the increase in plasma levels of ammonia in patients with portal hypertension.

Aim
To assess the prevalence of H. pylori infection among pediatric patients with portal hypertension and to assess the relationship between H. pylori infection and plasma ammonia.

Patients and Methods
This study was conducted on patients following up at Hepatology unit, children’s Hospital, Ain Shams University during the period from January to August 2023. Patients who had documented portal hypertension regardless of its grade and the status of their liver function were included. Patients who had active bleeding, sepsis, or who received antibiotics or proton pump inhibitors in the four weeks before enrollment were excluded. All patients were subjected to clinical evaluation, routine laboratory investigations and plasma ammonia level. They all underwent upper GIT endoscopy for gastric biopsy, and biopsies were subjected to rapid urease test and histopathological assessment was done for H. pylori infection using the Housten updated Sydney scoring system.

Results
Biopsies revealed that H. pylori infection was evident in 87% of the studied patients. 4 patients had grade-3 H. pylori infection, 15 had grade-2, 16 had grade-1, and 5 had no H. pylori infection. Patients with grade-3 H. pylori infection have significantly higher plasma ammonia as compared to grade 1 and 2 (p 0.007). None of the patients reached the critical plasma ammonia level, level of dialysis, of 400 ug/dl. There was no significant relationship between the patients’ diagnoses, liver function tests (PT, PTT, INR, Albumin, ALT, AST), result of rapid urease test, and plasma ammonia levels.

Conclusion
H. pylori infection is common among hepatic patients and is associated with significantly higher plasma ammonia level with more severe grades of infection. Further longitudinal studies are warranted to evaluate the real risk of H. pylori infection among patients with portal hypertension.
Value of 2D Speckle Tracking Echocardiography in Assessment of Pediatric Patients with History of Carditis at Children's Hospital
Authors: El-Ganzory Mona Mostafa , El Guindy Waleed Mohamed , Elmaged Omaima Eltaher Abo , Samman Nora El 
Published: November 2024

Abstract

Background
Primary myocarditis in pediatrics is presumed to be due to either an acute viral infection or a post-viral autoimmune response. Secondary myocarditis occurs due to chemotherapy, renal disease, systemic lupus erythematosus, or association with Kawasski disease. Two-dimensional (2D) speckle-tracking echocardiography allows an objective and quantitative evaluation of regional and longitudinal cardiac function.

Aim
To assess the echocardiographic changes in pediatric patients presented with carditis at their presentation and at follow-up after four weeks to detect any residual cardiac affection.

Methods
This study was a prospective controlled-cohort study that studied the two- dimensional speckle-tracking echocardiography changes in 30 pediatric patients with the diagnosis of carditis and 30 healthy age- and sex-matched controls. The study was conducted at the children's hospital, Ain Shams University, Egypt. It was done in the period from August 2021 until July 2023. A full medical history and clinical examination were done. Cardiac enzymes and two-dimensional (2D) speckle tracking echocardiography were done at admission and four weeks post-treatment.

Results
The median age of patients in the study was 9.5 years (IQR 3–11). They were 60% females and 40% males. The leading cause of carditis in our patients was viral infection, being seen in 46.7% of patients. The most common symptoms and signs at presentation were tachycardia and tachypnea. Creatinin Kinase MB was elevated in 30%, while serum troponin was high in 40%. Intravenous immunoglobulin (IVIG) was given for 60% of the patients, while steroids were given to 40%. Four patients (13.3%) needed inotropic support with PICU admission. Echocardiography showed that the left ventricle was dilated in 30% of patients. Three patients (10%) had impaired cardiac function and had abnormal global longitudinal strain (GLS) as determined by a two-dimensional speckle tracking echo (hypokinesia) with a GLS of -15%. At follow-up after four weeks, the clinical examination and investigations were unremarkable. Two-dimensional speckle echo was normal in all patients. GLS was within normal value in all patients (-19.13±1.45)% but lower than the control group (-20.36 ± 1.17)% (p-value 0.001). We found a positive relationship between global longitudinal strain at presentation with aspartate aminotransferase and cardiac enzymes (creatine kinase total and creatine kinase MB (p-values 0.000, 0.012, and 0.001), respectively.

Conclusion
Monitoring cardiac function with two-dimensional speckle tracking echo is an important tool in detecting critically ill patients with carditis, and follow-up is recommended to detect further subtle cardiac affection.
Effect of Treatment with Bisphosphonates on Bone Turnover Markers in Osteogenesis Imperfecta
Authors: Shrief Osama Elsaied Sobhy , Mahmoud Rana Abdelhakim Ahmed , El-Ashry Marwa Abd ElRasoul , Elsedfy Heba Hassan , Amr Nermine Hussein 
Published: November 2024

Abstract

Background
Bisphosphonates are used as standard treatment in patients with osteogenesis imperfecta (OI) in childhood and adolescence. N-terminal collagen type I extension propeptide (PINP) has been identified as the most promising marker of bone formation.

Aim and Objectives
Our study aimed to use PINP as a marker of bone formation in patients with OI receiving bisphosphonates treatment.

Patients and Methods
This observational study included 28 with OI patients (12 boys & 16 girls) on bisphosphonates treatment following up at Pediatric Endocrinology Clinic, Ain Shams University Children's Hospital during the period from March 2021 till April 2022. PINP was measured at baseline and one year after treatment. Clinical severity score was evaluated.

Results
(53.6%) of patients were classified as moderate degree of clinical severity score. Clinical severity score domains were as follows: (67.9%) of patients were classified as grade I regarding number of fractures per year (0-1), (50.0%) of patients were classified as grade II regarding motor milestones (delayed with catch up), (46.4%) of patients were classified as grade III regarding long bone deformities (noticed by both clinical examination and X-rays affecting isolated long bones) and regarding height SDS (-3.1 to -5.0), while (46.4%) of patients were classified as grade I regarding DXA Z-score (&lt; -1.5 SD). PINP decreased &lt;20% in 6 patients (21.4%) and increased &lt;20% in 5 patients (17.9%). There was no change in 17 patients (60.7%). Furthermore, there was no significant relation between PINP and clinical severity score.

Conclusion
PINP change in patients with OI on bisphosphonates treatment might not be pronounced or sustained after treatment, thus might not reflect the clinical status of the patients on short term basis.
Bone Mineral Density among Egyptian Adolescents
Authors: Bashandi Rasha Omar Mohammed , Mahmoud Rana Abdelhakim Ahmed , Amr Nermine Hussein 
Published: November 2024

Abstract

Background
Adolescent bone mineral density is affected by several endogenous and exogenous factors. Failure to maintain optimal bone health during adolescence carries a great risk for low bone mass later on with increase liability for fractures.

Aim of the Study
To determine the level of bone mineral density (BMD)in Egyptian adolescents and to evaluate the impact of, weight, height, body mass index (BMI), physical activity, sun exposure, pubertal stage and socio-economic status on bone mass.

Methods
Forty healthy Egyptian adolescents aged 12-13years were subjected to comprehensive medical history, dietary history to assess daily calcium intake, sunlight exposure, physical activity and socio-economic status. Complete physical examination was done including anthropometric measurements and identification of Tanner stage. Serum levels of calcium, phosphorus, and alkaline phosphatase were measured. Assessment of BMD of whole body, lumbar spine (LS), femoral neck (FN) and body composition was done using Hologic dual energy X-ray absorptiometry (DEXA) scanner.

Results
The mean values of total, subtotal, lumbar and, femoral BMD of our subjects were 0.86± 0.08,80± 0.080, 0.65±0.10, 0.77±0.1 respectively. Males had significant higher values regarding each of total, subtotal and femoral BMD (p value = 0.003, 0.004,&lt; 0.001respectively) while females had significant higher values regarding lumbar spine BMD, total body fat and fat %(p value = 0.023,&lt; 0.001,&lt; 0.001respectively). No difference of significance was found in lean mass or total bone mineral content. Most of DEXA parameters correlated positively with each of exercise, sun exposure as well as anthropometric measurements. (p value &lt; 0.05). No relation of significance was found with each of social status, Tanner stage and biochemical bone markers.

Conclusion
Peak bone mass in our patients has many influencing factors, for example gender, weight, height, exercise and sun exposure. Further interventions should be done to modify the exogenous factors aiming to decrease risk of fracture later on throughout adulthood.
Effect of Health Education on Knowledge and Attitude of Parents towards Paediatric Epilepsy in Egyptian Children
Authors: Mohammed Maha Zakariya Ramadan , El Shafie Abd El Aziz Salma Mahmoud , Tomoum Hoda Yahya , Elhamid Salwa Amin Abd 
Published: November 2024

Abstract

Background
Epilepsy remains one of the most common neurological diseases in the world but seems to be widely misunderstood, especially in low-income countries. Patients with epilepsy can face considerable stigma in society, Parents’ knowledge on care of children greatly influences the health status of a child by reducing the mortality and morbidity rate.

Aim of the Work
Assess the attitude and knowledge toward paediatric epilepsy amongst parents of paediatric patients with epilepsy and other parents seeking advice in the out-patient clinic, Assess the effect of educational program of home management of seizures on knowledge and practice of parents.

Patients and Methods
This comparative cross-sectional study included 100 parents of children with epilepsy who follow up in Paediatric neurology clinic, Ain Shams University (Group A) and 300 parents of normal children who sought advice in Paediatric outpatient clinic, Ain Shams University (Group B) in which sociodemographic characteristics were collected and a validated questionnaire was distributed before and after an educational session about epilepsy facts and its first aid.

Results
The study revealed significant difference between study and control groups in their baseline knowledge about epilepsy, in terms of “epilepsy being an organic disease, rather than a psychiatric illness or an evil spirit” (67.0% vs. 39.8%, P &lt; 0.001) respectively, and management of a child experiencing a seizure where 6% of group A answered “do not know” vs 74.6% of group B, P &lt; 0.001). Regarding attitude towards epilepsy, both groups showed negative attitude towards epilepsy; 78% of group A and 66% of group B agreed that epilepsy is a factor that strongly impair child learning. Similarly, 81% of group A and 65% of group B reported that epilepsy can strongly limit sports and leisure activities. In terms of effect of educational effect, group A showed significant difference in number of correct answers regarding manifestation and first aid measures for a child with seizure before and after education (12% vs 51% P &lt; 0.001 & 45% vs 75% P = 0.009) respectively. Moreover, group B showed significant difference in correct answers for both topics after education (0% vs. 49.2 % P, 0.001 & 0% vs 71.2% P &lt; 0.001).

Conclusion
Our results highlight the need for educational programs and targeted awareness campaigns, to reduce misconceptions and promote a more supportive environment for individuals with epilepsy.
Behavioral and Sexual problems in Children with Mild Intellectual Disability: An Observational Study
Authors: Ahmed Samar , Youssef Azza Mohamed , Abdelmageed Reham Ibrahim , Abdelaziz Asmaa Wafeeq 
Published: November 2024

Abstract

Background
The cognitive and adaptive functioning deficits are the intellectual disability (ID) hallmark. Children with Intellectual Disability (ID) often display distinct behavioral and sexual problems.

Objective
To investigate behavioral and sexual problems in children with mild ID (IQ score 50-70) as compared to an age-and sex-matched control group.

Patients and Methods
A cross-sectional study was conducted on 200 children (100 with mild ID (IQ score 50-70) and 100 controls) aged 6-12 years at Ain Shams University's Developmental and Behavioral Pediatrics Clinic. Sociodemographic data were collected using an Arabic-validated Socioeconomic Status Scale. Intellectual ability was assessed with the Stanford-Binet Intelligence Scale and Adaptive behaviors were measured using the Vineland Adaptive Behavior Scale (VABS). Behavioral competency and problems were assessed using the Child Behavior Checklist (CBCL). Sexual behaviors were evaluated using the Child Sexual Behavior Inventory (CSBI).

Results
A higher percentage of children with ID (54%) had working mothers compared to controls (40%, p = 0.047). Fathers of children with ID exhibited higher education levels (p = 0.020). CSBI scores were markedly higher in children with ID (all p-values &lt; 0.001) and CBCL scores were also markedly higher in children with ID (all p-values &lt;0.001). Similarly more ID children were in clinical range for internalizing (p-value &lt;0.001) and externalizing problems (p-value &lt;0.001) of CBCL broadband syndrome.

Conclusion
Children with mild ID display significant differences in behavioral and sexual problems compared to their controls Identified risk factors offer insight into potential interventions and underline the need for tailored education and support for this demographic.