bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment and Significance of Pentraxin (PTX3) Plasma Level in Coagulopathy in Children with Covid19
Authors: Adly Amira Abd Elmonem , Eltonbary Khadiga , Salem Lamyaa , Sobhe Ali Elbagory Mennat-allah Sobhe 
Published: November 2024

Abstract

Background
Pentraxin-3 (PTX3), plays an important role in regulation of inflammation and resistance to a lot of pathogens. It has been recently reported to be correlated with coagulopathy and disease severity in patients with COVID-19

Objective
To assess significance of PTX 3 as a serum biomarker in children with COVID 19 infection and associated coagulopathy, multisystem inflammatory syndrome in children (MIS-C) and short-term disease outcome.

Subjects and Methods
This was a cross sectional study, carried out over 6 months duration, from September 1st, 2021, to March 1st, 2022 and it included 62 COVID-19 pediatric patients whose ages ranged between 2 to 18 years admitted through Pediatric Intensive Care Unit or Emergency room and 25 apparently healthy children as a control group. Clinical features, laboratory work up (complete blood picture, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), serum ferritin and D-dimer) and imaging studies (chest x-ray, computed tomography of the chest (CTscan), echocardiography with calculation of coronary artery Z-score were done to all patients in addition to a measurement of serum PTX3 by enzyme linked immunosorbent assay to both patients and controls.

Results
The mean (SD) age of the enrolled patients was 8.4±1.71SD. The number of females was 32 and of males was 30. The main presenting symptoms were malaise, sore throat and headache in all patients followed by dry irritative cough (85.5%) and fever (64%). The mean serum PTX3 level was significantly higher in patients compared to controls (13ng/ml (7 – 16.5) versus 0.8ng/ml (0.5 – 1). Serum PTX3 levels were positively correlated with ESR, CRP and serum ferritin as well as with D-dimer (P value=0.007)and INR (P value=0.001). Out of 62 patients, 11 required intensive care unit admission and mortality was 6.5%. PTX3 cut-off level of 8ng/ml had sensitivity of 68.42% and specificity of 100% in predicting significant CT findings categorized as CORAD IV or V. Also PTX3 level with a cut-off of &gt; 2.1ng/ml, has sensitivity of 96.77% and specificity of 100% in detecting the disease severity.

Conclusion
Our data contribute to the accumulating evidence that PTX3 serum concentrations are significantly elevated in COVID-19 pediatric patients and can serve as an early biomarker of disease severity in children. It can predict significant pulmonary involvement and multi-system inflammatory response. Moreover, PTX3 is likely to participate in COVID-19 associated coagulopathy
Relation between Helicobacter pylori Infection and Autoimmune Thyroid Disease in a Sample of Pediatric Patients
Authors: Attallah Mostafa Mohammed Mabrouk , Amr Nermine Hussein , Khalaf Randa Ismail , Hassan Marwa Magdy 
Published: November 2024

Abstract

Background
Autoimmune thyroid diseases (ATDs) are heterogeneous group of acquired disorders that are characterized by the presence of circulating anti-thyroid antibodies, infiltration of the thyroid gland by reactive B and T lymphocytes in addition to altered thyroid function. This study aimed to explore the thyroid function profile and H. pylori infection in a sample of pediatric patients with autoimmune thyroid disease.

Methods
This case control study included 31 pediatric patients diagnosed with ATDs proven by positive thyroid autoantibodies and 31 healthy age and sex matched children were included as control group. Detailed history including clinical manifestations and treatment modalities were taken. Free T4, free T3, TSH, anti-thyroglobulin and anti-tissue peroxidase, H. Pylori stool antigen and thyroid ultrasound were done. None of our included children have received treatment for H. pylori infection.

Results
Out of the 31 patients, 11 were diagnosed with Graves’ disease (35.48%) while 20 were diagnosed with Hashimoto thyroiditis (64.52%) with mean age of 13.515 ± 3.176 and 14.081 ± 2.715 years respectively. There is no statistically significantly difference in thyroid ultrasound findings in children with GD and HT. H. pylori infection was significantly higher in children with ATDs (51.6%) in comparison to healthy children (25.8%). 17 of the 31 children with ATDs had dyspeptic symptoms with insignificant difference between H. pylori positive and negative children. Regarding treatment modalities, 18 of children with ATDs (58.1%) were controlled on medications while 13 were uncontrolled (41.9%) and needed frequent adjustment of doses or surgical intervention. 19 children with HT (95%) and 7 children with GD (63.6%) received medical treatment only, while 1 patient with HT (5%) and 4 children with GD (36.4%) underwent thyroidectomy after a duration ranged from 3 to 6 years of medical treatment.

In Conclusion
Hashimoto thyroiditis was the most prevalent ATD in pediatric age group. H. Pylori infection is more frequent in children with ATDs. Medications alone may be insufficient to achieve symptoms control in children with AUTs and surgical intervention may be required. Further studies are required to evaluate the impact of H. pylori infection eradication on thyroid function in children with ATDs.
Diagnostic Yield of Gastrointestinal Endoscopies in Children
Authors: Hamdy Ahmed M , Radwan Nehal A , Awad Yosra M , Hafez Nourhan J 
Published: November 2024

Abstract

Background
Endoscopies proved to be an indispensable tool in pediatric gastrointestinal practice. With the surge in the number of endoscopies and healthcare expenses, it is imperative to ascertain the diagnostic yield of endoscopies to improve patient selection and reduce unnecessary costs.

Objective
The aim of this study is to evaluate the diagnostic yield of pediatric gastrointestinal endoscopies.

Methods
Patients undergoing diagnostic endoscopy at one tertiary center in Egypt over the past 5 years, from 2018 to 2023, were included in a retrospective study. Demographic, clinical, endoscopic, and histopathological data were collected and studied.

Results
2125 patients aged one month to 16 years, presenting with different symptoms, were evaluated. School age children represented the most common age group (34.6%). The most common indications for upper gastrointestinal(GI) endoscopies were upper gastrointestinal bleed (27.7%) followed by persistent vomiting (24.0%) and failure to thrive and/or chronic diarrhea (17.2%), whereas 77.5% of colonoscopies were performed due to bleeding per rectum. The diagnostic yield (frequency of positive endoscopies) for all GI endoscopies performed is 66.9%. Colonoscopies depicted a higher diagnostic yield of 72.7%, than upper GI endoscopy, of 66.7%. The diagnostic yield of performing both endoscopies together was 62.8%. The most frequent endoscopic diagnoses with upper GI endoscopies alone were gastroduodenitis (27.7%), foreign body ingestion (12.4%), and celiac disease (11.9%). As for colonoscopies alone, GI polyps (48.5%), non-specific colitis (12.1%), and hemorrhoids (7.9%) were most frequent, and for both procedures, suspected inflammatory bowel disease (19.7%), gastroduodenitis (17.4%) and lymphoid nodular hyperplasia were the most common endoscopic diagnoses. GI polyps were found in 40.1% of patients presenting with lower GI bleeds. Failure to thrive and/or chronic diarrhea represented 44.1% of patients undergoing both procedures.

Conclusion
The diagnostic yield for GI endoscopies is 66.9%, and vary based on age, procedure, and indication. Histologic correlation further increases the diagnostic yield.
E- Selectin as a Predictor for Overt and Subclinical Cardiovascular Riskin Patients with Juvenile Idiopathic Arthritis
Authors: Fatah Ibrahim Magid Ashraf Abdel , Mostafa Gehan Ahmed , Shousha Ghada Abdel Haleem , Fatah Mohamed Roshdy Ola Mohamed Abdel , Hameed Abeer Maghawry Abdel , Ghani Amani Mohamed Abdel , Elsayed Eman Mohamed 
Published: November 2024

Abstract

Background
The risk of cardiovascular disorders (CVD) was described in adult patients with systemic juvenile idiopathic arthritis (SJIA) as a part of the systemic activity of the disease. Subclinical cardiovascular risk and early atherogenesis were not broadly studied in children.

Objectives
This work aims to evaluate soluble E-selectin level as a marker of early endothelial injury, as a predictor for early or subclinical CVD among patients with juvenile idiopathic arthritis (JIA).

Patients and Methods
This cross-sectional study with nested follow up was conducted in the Pediatric Allergy, Immunology and Rheumatology Unit, Children’s Hospital, Ain Shams University on 57 children and adolescents diagnosed as JIA. They were 6 to 16 years old, including 26/57 (45.6%) males and 31/57 (54.4%) females, and 30 matched healthy controls, during the period from September 2021 to September 2022. Patients were enrolled consecutively during activity and remission status of the disease, determined according to juvenile arthritis disease activity score (JADAS). Serum level of endothelium (E)-selectin was measured using ELISA technique. Patients with active JIA were followed till complete remission.

Results
Serum levels of E-selectin showed higher estimates among JIA patients during activity and remission than in the healthy control group (p &lt; 0.001); whereas there was no significant difference in E-selectin level among the studied categories of JIA (P &gt; 0.05).

Conclusion
The observed significantly elevated soluble E-selectin levels among pediatric patients with JIA, denotes the possibility of early atherogenesis or subclinical CVD. Correlation with other cardiac evaluation tools in patients with JIA is recommended.
The Effect of Iron Therapy on Plasma Ghrelin and Leptin Levels in Egyptian Children with Iron Deficiency Anemia
Authors: Mahmoud Gad EL Hak Radwa Gad EL Hak , Emam Ehab K , Abdo El Gendy Yasmin Gamal , Shaaban Menna Allah Ali , Mohammed Basma Abd El Nasser 
Published: November 2024

Abstract

Background
Iron deficiency (ID) is the most common micronutrient deficiency and the most common cause of anemia worldwide. It is known that iron deficiency anemia effects appetite and growth negatively. The aim of this study was to investigate the effect of iron therapy on appetite and plasma ghrelin and leptin levels in children with nutritional iron deficiency anemia.

Methods
A prospective interventional study was done on 40 iron deficient pediatric patients diagnosed by CBC and Iron profile aged between 12 to 60 months. All 40 cases were given oral iron therapy (5mg/kg). Anthropometric measures and appetite score subjectively by mother were done before and after iron therapy. Caloric intake was calculated specially protein, Fat and CHO before and after treatment. Serum Ghrelin and Leptin done by ELISA Kit ;Specimen Collected whether Serum or plasma.

Results
The median rang (IQR) plasma ghrelin level was 1 (0.9 - 1.25) mg/mL before therapy and it increased to 3.6 (2.65 – 4.8) mg/mL (p &lt; 0.001) while the median plasma leptin level decreased from 2.05 (1.4 – 3.2) ng/mL to 0.41 (0.3 – 0.65) ng/mL (p &lt; 0.01) after therapy. The amount of daily caloric intake, carbohydrate and protein intake were significantly increased after therapy (p &lt; 0.001). Body weight was correlated with plasma ghrelin levels before and after therapy significantly. There was a positive correlation for Ghrelin with TIBC and UIBC (r = 0.387, p-value = 0.014) (r = 0.388, p-value = 0.033) respectively.

Conclusions
In conclusion, the findings of our study indicate that plasma ghrelin level increases and leptin level decreases in children with iron deficiency anemia after iron therapy. The increase in appetite and improvement of growth in iron deficiency anemia might result from decreased leptin and increased plasma ghrelin levels after treatment.
Impact of Digital Media on ADHD Patients during COVID 19 Quarantine (Pandemic)
Authors: Youssef Azza Mohammed , Othman Abo AL–Ola Radwa Mohammed , Elhamid Salwa Amin Abd 
Published: November 2024

Abstract

Background
The COVID-19 pandemic & quarantine cause increased media usage along with positive and negative life style changes under lockdown for all children especially those with attention deficit hyperactivity disorder (ADHD) as they are already at higher risk to have more psychological and behavioural problems.

Objectives
To assess the effect of digital media on emotional state and family environment of the children and adolescents with ADHD during pandemic and quarantine.

Patients and Methods
Observational cross-sectional study was conducted on 200 participants recruited from (patients from developmental and behavioral clinic and controls from other pediatrics outpatient clinics). They were divided into; 100 ADHD (43 cases with problematic digital media use (PDMU) and 57 cases without PDMU and control group (n = 100)). Detailed history was taken including sociodemographic data, age, sex, total hours of using media and total hours of activity per week The following scales had been evaluated: Self- rating questionnaire for problematic mobile phone use: which estimate the dependence symptoms of mobile phone use (which used to classify patients to ADHD with and without PDMU and control group according to its score), Revised Child Anxiety and Depression Scales and Difficulties in Emotion Regulation Scale–Short Form.

Results
The study showed that ADHD group with PDMU had significantly increased in total hours of watching media as well as lower activity (p &lt; 0.001) when compared to ADHD without PDMU and control group. Also, ADHD children showed higher Anxiety and depression scores when compared to control group while non-significant differences were observed between ADHD children with PDMU, when compared to ADHD children without PDMU (p &lt; 0.001). ADHD children with PDMU showed significantly less ability to control their emotions followed by ADHD children without PDMU then control group (p &lt; 0.001).

Conclusion
The digital media use during COVID19 pandemic and quarantine, was affecting ADHD children with PDMU negatively more than ADHD without PDMU then those without ADHD as regard their regulation of emotions, total hours of using media, anxiety and depression scores.
Evaluation of Serum Interleukins 17A and 22 Levels in Pediatric Patients with Autism
Authors: Mostafa Gehan Ahmed , Hossiny Reham Mohammed El , Abdelfattah Sara Ibrahim , Sabry Shaker Youstina , Sallam Dina Ebrahem Darweish 
Published: November 2024

Abstract

Background
The etiology of autism has emerged as a topic of serious debate in recent years, where autoantibodies may play a role. IL-17A is a key regulator of Autism spectrum disorder development, while interleukin (IL)-22 is a potent mediator of inflammatory responses promoting leukocyte infiltration in the brain.

Objective
To assess serum levels of IL-17A and IL-22 in children with autism.

Methods
A cross-sectional study, that was carried out at Child Psychiatric Clinic, Ain Shams University, Cairo, Egypt on autistic children and healthy controls.

Results
we had 48 subjects, 24 autistic children; 6 females (25%) 18 males (75%) and 24 age and gender matched controls; 9 females (37.5%) 15 males (62.5). The median (IQR) age was 5.25(5 – 8) and 6(5 – 9) years respectively. The median serum levels of IL-17A and IL-22 were significantly higher in autism patients than controls, where serum level of IL-17 was 262.5 (235 – 320) pg/mL in autistic patients versus 35 (25 – 47.5) pg/mL in controls, meanwhile IL-22 in autistic patient was 800 (680 – 975) pg/mL versus 50 (45 – 65) pg/mL in controls (p = &lt;0.001).

Conclusion
In our cases, a Shaimaa Abdo Elmetwaly Shaimaa Abdo Elmetwaly Shaimaa Abdo Elmetwaly utism was associated with elevated serum levels of IL_17A and IL-22. We can't point out whether it is a cause, an effect or a mere association. Further research is needed for better understanding the role of these cytokines in autism and their potential implications for diagnosis and treatment.
Assessment of Infection Prevention and Control Measures in Pediatric Hematology Oncology Unit, Ain Shams University
Authors: Mohamed Wafaa Ezzat Ibrahim , El-Tonbary Khadiga Yehia , Fahmy Monica Ashraf Samy 
Published: November 2024

Abstract

Background
There are various factors which contribute to the increased susceptibility to infections in Pediatric Hematology/Oncology (PHO) patients, most prominent of them being disruption of cutaneous and mucosal barriers (oral, gastrointestinal, etc.), microbial gastrointestinal translocation, defects in cell-mediated immunity, and insufficient quantities and inadequate function of phagocytes.

Aim of the Work
This study aimed to assess the currently applied infection prevention and control (IPC) measures among Pediatric Oncology and Hematology patients admitted to the inpatient unit and to explore areas of improvement of IPC measures to improve the overall outcome of such patients.

Patients and Methods
This cross-sectional observational study was conducted at the Hematology and Oncology unit, Children's Hospital at Ain Shams University from April 2023 to September 2023. It assessed the IPC measures in the inpatient ward and the measures applied to the 100 admitted, patients in addition to reported infectious complications. The study also assessed the practices and vaccination status of the health care professionals(HCP).

Results
A total of 100 patients were included, hematological (including lymphomas)malignancies dominated with 72%, solid and CNS tumors represented 20% and the aplastic anemia patients represented 8%. The majority were admitted 77% for chemotherapy. Thirty-one febrile neutropenia episodes were reported. As regards the patient care practices, all patients followed a neutropenic diet as per hospital policy, no guidelines were available for drinking water, tap water was supplied through hospital tanks. Oral and dental care was strictly followed in 36% of patients during admission and only 2% had pre-chemotherapy dental assessment. Regarding other IP measures, strict guidelines were followed during central lines, venous access or indwelling catheter application. HCP vaccination status was defective in annual flu vaccine, however all were fully vaccinated with hepatitis B and COVID vaccines. Mucositis was reported in 45 % and was significantly correlated with sepsis-related mortality. Among the laboratory confirmed bloodstream infection (LCBI) staphylococcus aureus and staph coagulase negative dominated while in the reported central line- associated bloodstream infection (CLABSI)(15%), klebsiella was the commonest organism.

Conclusion
Staphylococcal infection and klebsiella were the commonest pathogens in the PHO ward. Though strict sterile measures were followed, still Staph coagulase was a common pathogen in CLABSI. Mucositis andmucosal barrier injury (MBI) is a significant risk for microbial translocation and morbidity. Dental care, water supply and healthcare professionals’ immunizations are important areas to improve in order to improve the PHO ward.
Early Detection of Arteriovenous Fistula Problems among Pediatric Hemodialysis Patients
Authors: Elhakim Ihab Z , Elsayed Reham G , El-Azim Tarek A Adel Abd , Hetta Walid M , Darwish Yasser W , Sallam Dina E 
Published: November 2024

Abstract

Background
End stage Kidney disease (ESKD) is a major problem that is related to development of inflammation. Establishment of vascular access (VA) in the form of arteriovenous fistula (AVF) is mandatory to conduct efficient hemodialysis (HD). VA complications are one of the main causes of increase in morbidity and mortality in ESKD patients, which needs to be monitored regularly.

Objective
to evaluate the value of duplex ultrasound (DUS) and inflammatory markers (high sensitivity (hs) CRP, IL10, TNF) in early detection of vascular access complications in pediatric ESKD patients on regular HD.

Methods
This observational and interventional study was carried on 59 pediatric patients on regular HD at the PediatricDialysis Unit, Children’s Hospital, Ain Shams University, where DUS and serum level of inflammatory markers (hs-CRP, IL10, and TNF) were assessed once at time of enrollment (1) and the second at the time of early clinical suspicion of VA complication (2) which was detected by any abnormalities in physical examination.

Results
The study comprised 59 pediatric patients on regular HD, their mean (± SD) age was 13.97 (±2.65) years, 39 (56.5%) of them were males. The most common etiology of CKD was congenital anomalies of kidney and urinary track (CAKUT). Complications of the VA were reported in 55.9% of our studied patients, which include thrombosis, aneurysm, stenosis, early VA failure, pseudoaneurysm and perivascular hematoma, where thrombosis was the most frequent (28.8%), and was confirmed by DUS. AVF diameter (2), and flow volume (2) were significantly lower among patients with AVF thrombosis. The mean serum level of hs CRP was significantly elevated at the time of early clinical suspicion of AVF stenosis, and was confirmed by DUS, in comparison to its baseline level at time of enrollment of the study (0.08±0.08, 0.16±0.28 ng/mL, respectively, p = 0.04), serum IL10(1&2) and TNF (2) were higher in this group. Early VA failure were reported in patients who had lower AVF diameter (1), PSV (1), EDV(1&2),flow volume (1&2), and higher AVF diameter (2), PSV (2).

Conclusion
DUS and hs-CRP are useful tools for early detection and, hence the management of AVF complications.
Melatonin Attenuates Diclofenac Induced Renal Injury in Aged Rats via Modulating mRNA Expression of miR-34a, Nrf2/HO-1, ENaC and Suppressing NLRP3 Inflammasome Activation
Authors: Agaty Sahar M El , Darwish Doaa A , Diaa Sherif M , Metwally Doaa K , Wanis Nardine A 
Published: November 2024

Abstract

Background
High doses of diclofenac (DF) might induce acute kidney injury (AKI), particularly in elderly, a known vulnerable population. Melatonin was found to afford a beneficial effect in various kidney diseases.

Aim
To investigate the possible nephroprotective effect of melatonin in aged rats subjected to AKI by DF, and to highlight the implicated mechanisms.

Design
Experimental study

Methods
Thirty male Wister rats, aged 22-24 month, were equally divided into: control group, DF treated group (DF-group), and melatonin and DF treated group (Mel-DF-group).

Results
Melatonin significantly attenuated plasma creatinine, and urea along with decreased renal malondialdehyde and NADPH-oxidase-4 in Mel-DF-group versus DF-group. This was associated with a significant decrease in renal levels NLRP3 (NLR family-pyrin domain containing-3) inflammasome, Toll-like receptor-4, nuclear factor kappa (NF-κB), caspase-1, renal mRNA expression of microRNA-34a (miR-34a), and renal expression of tumor necrosis factor-alpha. The renal reduced glutathione (GSH), nuclear factor erythroid-2-related factor-2 (Nrf2), and hemoxygenase-1 (HO-1) were significantly increased in Mel-DF-group versus DF- group. Also, melatonin significantly reduced DF-induced hypernatremia together with significant decrease in renal epithelial sodium channels (ENaC) expression. Histopathological examination showed a significant decrease in vascular congestion, mononuclear cells infiltration, glomerular and tubular damage scores in Mel-DF-group-versus DF-group, besides a significant decrease in area % of collagen fibers deposition.

Conclusions
Melatonin provides a nephroprotective effect against DF-induced AKI in aged rats via attenuating renal oxidative stress, miR-34a, and NLRP3 inflammasome activation, which further increased renal Nrf2/HO-1 and GSH and inhibited fibrosis. Also, melatonin alleviated DF-induced hypernatremia via decreasing the ENaC renal expression.