bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Ultrasonographic Changes of Intercostal Muscles and Diaphragm in Mechanically Ventilated Preterm Neonates
Authors: Abu-Saif Ibrahim Saad , Shabana Ayah Mohamed , Ashraf Okba Ahmed , Mohamed Noha Saied Ibrahim 
Published: November 2024

Abstract

Background
Although mechanical ventilation is a lifesaving treatment, abundant evidence indicates that its prolonged use (one week or more) promotes respiratory muscle weakness due to both contractile dysfunction and atrophy. Along with the diaphragm, the intercostal muscles are one of the most important groups of respiratory muscles. In recent years, muscular ultrasound has become a useful bedside tool for the clinician to identify patients with respiratory muscle dysfunction related to critical illness and/or invasive mechanical ventilation.

Objective
To assess the impact of mechanical ventilation on diaphragm and intercostal muscles using ultrasonography in preterm neonates.

Patients and Methods
This observational prospective study was conducted at Neonatal Intensive Care Unit (NICU), Children's Hospital Ain Shams University over 6 months from October 2022 to April 2023, It included 60 preterm neonates, divided into two groups; 30 cases of respiratory distress syndrome (RDS) who were on mechanical ventilation for one week or less and 30 preterm infants of matched age and gender who didn’t require respiratory support.

Results
A total of 60 premature neonates participated in the study. Among them, 30 neonates required mechanical ventilation, whereas the other group consisted of 30 spontaneously breathing neonates of matched age and gender. The mean gestational age of both groups was 33 weeks, there was no statistical significant difference between our two groups as regards weight and gestational age. The relation between the right and left diaphragmatic thickness fraction (DTF) and parasternal intercostals muscle thickness fraction (TFiC) in the ventilated group in day 1 and day 3 was of non significance (p-value = 0.089 in left TFiC, p-value = 0.554 in right DTF), while the relation between them from day 1 to day 5 was significantly decreasing (p-value = 0.019 in left TFiC, p-value = 0.008 in left DTF), demonstrating the relation between the duration of ventilation and muscle function and that prolonged ventilation has a great impact on diaphragmatic effort and amplitude, on the other hand the control group measurements were significantly increasing at both right and left diaphragmatic and intercostals muscle fraction from day 1 to day 5 (p-value = 0.001 in left TFiC, p-value = 0.020 in left DTF).

Conclusion
Musculoskeletal ultrasound can detect early diaphragm and intercostals muscle atrophy that was observed in most of the patients treated by invasive mechanical ventilation.
Breast Milk for Treatment of Adhesive Related Skin Injury in Neonates: A Randomised Controlled Trial
Authors: Ismail Rania Ibrahim Hossni , El-Gendy Salma Mohamed Yahia , Elwareth Amira Mohammed Attya Abd , Michael Hany Wifky Gendy , Azzam Nesmahar Tarek Abdelhamed 
Published: November 2024

Abstract
Breast milk is an extremely complex, dynamic and highly variable biofluid. The healing effect of human breast milk has led researchers to increase interest in human breast milk as a natural medicine. Adhesive-related skin injury (ARSI) has a significant negative impact on patient safety.

Aim
to assess the efficacy of breast milk in treatment of ARSI.

Subject and Method
This study is a randomized controlled trial that conducted on neonates admitted to neonatal intensive care units of Ain Shams university Hospitals and El-Galaa Teaching Hospital.

Results
The study included 39 lesions of ARSI from 29 neonates (12 males and 17 females), they divided to breast milk group that enrolled 14 neonates with 20 lesions and routine care group that enrolled 15 neonates with 19 lesions, their gestational age ranged between 36 and 40 weeks and their age were from 5 to 28 days old. When we compared the skin sore score of ARSI before and after treatment between breast milk group and control group it showed that before treatment the breast milk group included 18 lesions with score 2 and 2 lesions with score 1 and the control group included 18 lesions with score 2 and 1 lesion with score 3 and there were no statistical significant difference between both groups with P-value 0.226. Also after treatment the breast milk group included 18 lesions with score 0, 1 lesion with score 1 and 1 lesion with score 2 and the control group included 14 lesions with score 0, 3 lesions with score 1 and 2 lesions with score 2 and there were no statistically significant difference between bothgroups with P-value 0.405. In breast milk group, when compared the skin sore score after treatment with before treatment, we found the skin sore score before treatment included 18 lesions with score 2 and 2 lesions with score 1 which improved significant statistically to 18 lesions with score 0, 1 lesion with score 1 and 1 lesion with score 2 With p value 0.000. this reduction was comparable to the reduction of skin sore score in the control group with no statistical significant difference between both groups as the median number regarding breast milk group was 2 (2 – 2) and the median number regarding routine care group was 2 (1 – 2) and the P-value in comparison between both groups were 0.660.

Conclusion
breast milk was as effective as routine care in treatment of ARSI and showed non inferiority in treatment of ARSI.
Practice for Patent Ductus Arteriosus in Late Preterm and Full Term Infants; A Single Center Experience
Authors: El-samman Nora Hussein , Ibrahim Safaa Shafik Emam , Tahrany Reham Hassan Hassan El , Alhassanin Arwa Hamdy Al sharabasy 
Published: November 2024

Abstract

Background
The arterial ductus is a major communicative pathway which is naturally patent in the fetus. Although usually closing on its own, it may remain open in the second postnatal week due to a lack of prompt diagnosis or absence of prompt treatment.

Methodology
In this observational study, 40 full term and late preterm neonates who have been diagnosed with patent ductus arteriosus (PDA) were recruited from the Neonatal Intensive Care Unit, Ain Shams University over a period of 6 months. The diagnosis of PDA was established both clinically (hemodynamic state) and by echocardiography. The enrolled neonates were observed to evaluate PDA treatment decisions (either ibuprofen, paracetamol or conservative management).

Results
We found significant increased PDA size before treatment in patients who had taken either ibuprofen or paracetamol (2.59 ± 0.59) for treatment of PDA when compared with those who had received no treatment (1.75 ± 0.16) (p = 0.001). In addition, we found significantly longer capillary refill time before treatment in patients treated by ibuprofen (2.2 ± 0.4) when compared to those who were treated by intravenous paracetamol infusion and the third group who received only conservative management (2.7 ± 0.7) (p = 0.026). However, we found no significant difference between the three groups as regard the final outcome (PDA closure, complications, survival and duration of NICU stay) (p- &gt; 0.05).

Conclusions
Our findings showed that choosing certain treatment for closing PDA in our NICU depended mainly on clinical assessment of the baby and PDA size. And, that conservative management of PDA did not compromise survival and is not associated with increased morbidities in near term and full term neonates.
Vascular Endothelial Growth Factor as a Predictor Marker of Progression in Childhood Interstitial Lung Disease
Authors: Ahmed Shaimaa Abdo Elmetwaly , Shaheen Malak Ali , Hassan Safeya Hamdy Zakaria , Abdelkarim Maha Ahmed Sayed , Ahmed Ali Heba Allah 
Published: November 2024

Abstract

Background
Childhood interstitial lung disease (chILD) encompasses a group of heterogeneous diseases characterized by varying degrees of aberrant inflammation and fibrosis of the lung parenchyma. Vascular endothelial growth factor (VEGF) is a signal protein produced by cells that stimulates the formation of blood vessels and might be implicated in the abnormal signaling in the pathogenesis of chILD.

Objectives
To measure the level of VEGF in serum among patients with chILD and determine its relation to the clinical severity.

Patients and Methods
This cross sectional study has been conducted at Pediatric Pulmonology clinic; Ain Shams University Children’s Hospital located in Cairo during the period from January 2023 to June 2023. The study included 35 children compared to 35 sex- and age-matched healthy controls. All patients were assessed in terms of demographic, clinical data and laboratory investigations including serum VGEF using enzyme-linked immunosorbent assay (ELISA) technique along with radiological findings.

Results
The most common clinical finding was cough (93.3%) while the most common systemic symptom was anorexia and weight loss (46.7%). Serum VGEF level was significantly elevated among chILD patients 120 (80 - 200) pg/ml compared to controls 13 (9-16) pg/ml. Moreover, serum VEGF was significantly elevated among severe cases of chILD compared to non severe ones, p-value&lt;0.001.

Conclusion
Serum VGEF was significantly higher among chILD patients especially severe cases.
Evaluation of sRAGE as a New Diagnostic and Prognostic Marker of Sepsis and Septic Shock Cases on Critically Ill Pediatric Patients
Authors: El-Gawad Tarek Ahmed Abd , Abdelhamid Dalia Hosni , Khairy Wafaa Salah , Magdy Sondos Mohammed 
Published: November 2024

Abstract

Background
Serum sRAGE is a soluble isoform of a receptor for advanced glycation end products in different stages of sepsis. The present study will investigate the possible use of sRAGE as a diagnostic and prognostic marker of sepsis and septic shock in pediatric patients.

Objective
To study the role of sRAGE as a potential diagnostic and prognostic marker in sepsis and septic shock in pediatric intensive care unit.

Patients and Methods
This was a case control study that was conducted at Pediatric ICU, Ain Shams University Hospitals. This Studied were divided into 3 groups: 1/ Sepsis group (20 patients). 2/ Septic shock group (20 patients). 3/ healthy control group (40 child).

Results
In Sepsis cases, ROC curve analysis proved good discriminating power of the Serum RAGE between Non Survivor group and Survivor group where Area under the ROC curve (AUC) = 0.760 with (95% Confidence interval 0.52–0.92); p &lt; 0.001. Cutoff point &gt;270 with sensitivity= 80% and specificity=73.3%. In Septic Shock Cases, ROC curve analysis proved good discriminating power of the Serum RAGE between Non Survivor group and Survivor group where Area under the ROC curve (AUC) = 0.955 with (95% Confidence interval 0.76–0.99); p &lt; 0.001. Cutoff point &gt;310.9 with sensitivity= 90% and specificity=91%.

Conclusion
Our study suggests that sRAGE may serve as a valuable biomarker for assessing the severity and prognosis of sepsis and septic shock in pediatric patients, although further research with a larger sample size is warranted to validate these findings.
Assessment of the Presence of Predominantly Antibody Deficiency among Pediatric Patients with Interstitial Lung Disease
Authors: Salama Ashraf Abdel Baky , Radwan Nesrine Mohamed , Hussein Mahitab Morsy , Hamza Mohamed Tarif , Abdelsalam Walaa Eid 
Published: November 2024

Abstract

Background
Predominantly antibody deficiencies (PADs) are frequent primary immunodeficiency diseases (PIDs) that have different etiologies. PAD patients present with various clinical manifestations, including infections and non-infectious disorders such as interstitial lung disease (ILD). The determination of serum Igs (IgG, IgM, IgA) is the first step in the evaluation of humoral immunity, and will help diagnose or at least point to a suspicion of quantitative Ig deficiencies. Lung disease is a frequent clinical manifestation in people living with primary immunodeficiency diseases, the most prevalent of which are common variable immunodeficiency disorders (CVID).

Aim of Work
Screening for Predominantly Antibody Deficiency (PAD) among pediatric patients diagnosed with primary interstitial lung disease.

Patients and Methods
This was a pilot study that was conducted on 30 children diagnosed with primary interstitial lung disease (ILD) following up in the Pediatric chest clinic, Children’s hospital, Ain Shams University in the period from September 2022 to February 2023, their ages ranged between 9-180 months and They were 16 (53.3%) males and 14 (46.7%) females. Tools of assessment included detailed clinical history with stress on history of respiratory symptoms, history of ten warning signs of immunedeficiency, general and chest examination and immunoglobulins (IgA, IgM, IgG) level by ELISA.

Results
There were 2 (6.7%) children with low levels of IgG, As regard IgM 2(6.7%) children had low levels, and 1(3.3%) child had high level. While 5 (16.7%) children had low levels of IgA. based on the criteria of Europian Society For Immunodeficiencies (ESID) 2 children were probable to be Commom Variable Immundeficiency (CVID) and 3 children were possible to be CVID.

Conclusion
Predominantly antibody deficiencies (PADs) may be presented as ILD and ILD may be the first presentation even before PID diagnosis.
Seroprevalence and Parents’ Knowledge about Hepatitis E among a Sample of Egyptian Children and Adolescents
Authors: Elfaramawy Amel Abdel Magied , Mohamed Yasmine Hussein , Salah HebatAllah Mohammed , Taha Sara Ibrahim Abdelfattah 
Published: November 2024

Abstract

Background
Hepatitis E virus is one of the causes of waterborne outbreaks of hepatitis in areas of poor sanitation where it is transmitted predominately by the feco-oral route. HEV is an underdiagnosed self-limiting disease that lasts few weeks following an incubation period of 2 to 6 weeks, hepatitis E infection can be chronic in immunocompromised patients, in rare cases acute hepatitis E can be severe and result in fulminant hepatitis or acute liver failure.

Objectives
To assess the prevalence of anti-HEV IgG antibodies as an indicator of past hepatitis E infection among a group of Egyptian children and adolescents and to evaluate the parents' knowledge about the mode of transmission, symptoms and prevention of Hepatitis E.

Methods
This cross sectional study involved 188 subjects and was conducted in the General Pediatric clinic, Children’s Hospital, Ain Shams University. Sociodemographic characteristics along with socio-economic status classification and medical history were evaluated among participants. Serum anti-HEV IgG of HEV were assessed using enzyme-linked immunosorbent assay (ELISA). Then parents' knowledge about modes of transmission and symptoms combined with preventive practices related to HEV were assessed by a questionnaire.

Results
The included participants were 188, among them 102 male, 86 female with a mean age of 6.56±3.77 years. The Seroprevalence of HEV IgG was 7.4% among the participants, HEV IgG seropositive patients aged more than 6years old and both genders were equally affected the majority of them are living in rural areas and belong to middle social class, animal contact was significantly found in IgG seropositive patients. Parents’ knowledge about acute hepatitis was very low (3.2%) compared to knowledge of chronic hepatitis (33.5%). Parents’ practice was the significant protective factor against infection.

Conclusion
Hepatitis E virus infection is not uncommon in the studied group of children, living in rural areas, animal contact and middle socioeconomic status are risk factors while adequate parents hygienic practice is a protective factor against the infection, general knowledge about acute hepatitis is poor among included parents.
Comparative Study of Pulmonary Artery Pressure Assessment by Both Pre-Operative Echocardiography and Direct Intra-Operative Catheterization with its Impact on Surgical and Postoperative Outcome
Authors: Mansour Mervat Gamal Elden , Abdelshahid Youstina Wagdy Gerges , Elgendy Waleed Mohamed Mohamed , Kamel Ibraheam Waleed Ismail , Sheehata Beshoy Attaallah Ebrahim 
Published: November 2024

Abstract

Background
Pulmonary arterial hypertension (PAH) is defined as an increase in mean pulmonary arterial pressure ≥ 25 mmHg at rest as assessed by right heart catheterization. PAH is a relatively common complication of congenital heart disease (CHD). While invasive assessment of hemodynamics in the catheterization is the gold standard for diagnosing PAH in children, transthoracic echocardiography (TTE) serves as the initial diagnostic tool as misinterpretation of TTE variables can lead to delayed diagnosis and therapy.

Aim and Objectives
To compare the directly measured intra-operative PAP to preoperative measurement of PAP by transthoracic echocardiography. To assess the impact of pre-operative echocardiographic findings of PAH on surgical decision and post-operative outcome.

Subjects and Methods
This was an observational cross-sectional study that was conducted on 22 infants and children aged from 1 month to 5 years old diagnosed with congenital heart disease with left to right shunt: {atrial septal defect (ASD) or ventricular septal defect (VSD)} referred for surgical intervention in Cardiothoracic Academy, Ain Shams University. Patients were needed to detect pre-operative and post-operative assessment of pulmonary artery pressure using trans- thoracic echocardiography and intra-operative direct assessment of pulmonary artery pressure using direct catheterization.

Result
In this study, before repair, the mean pulmonary artery pressure measured by TTE was (34.27 ± 5.64) mmHg, significantly lower than the corresponding direct catheterization measurement (53.09 ± 10.93) mmHg (p &lt; 0.001, highly significant). After repair, the mean pulmonary artery pressure decreased substantially to (15.77 ± 4.69) mmHg, signifying a successful intervention (p &lt; 0.001, highly significant). There was statically significant positive correlation between hospital length of stay and pulmonary artery pressure before repair by direct catheterization.

Conclusion
pre-operative echocardiography may be a useful tool for assessing pulmonary artery pressure, but that it may under-estimate pulmonary artery pressure compared to intraoperative assessment by direct catheterization. Elevated pre-operative pulmonary artery pressure, as assessed by echocardiography, may be associated with certain postoperative outcomes. Echocardiography alone may be insufficient to obtain the anatomic and functional information needed for surgical repair in CHD and may require preoperative catheterization. In conclusion, cardiac catheterization is necessary to delineate pulmonary artery anatomy, origin and hemodynamic assessment for operability in CHD with severe PAH
Role of Folic Acid on Ischemia-Reperfusion-Induced Renal Injury in Rats: Folic Acid Prophylactic Effect Revisited
Authors: Hamed Aya E H , Khedr Sherif , Mahros Elsayed Ghonamy , Mahmoud Faten A , Ahmed Mona A 
Published: November 2024

Abstract

Background
Acute kidney injury (AKI) is a medical condition that has been associated with high morbidity and mortality rates all over the world. Ischemia-reperfusion (IR) has been claimed for AKI incidence especially among hospitalized patients. Unfortunately, there are no definitive preventive measurements or treatment for such a condition stemming from the underpinning complicated pathophysiologic mechanisms. Folic acid has been used for decades as a supplementary nutrient with many positive effects in different pathologies.

Aim
Our study aims for characterizing the impact of folic acid supplementation on acute kidney injury induced by IR, understanding the molecular mechanisms involved.

Materials and Methods
The study was conducted on 50 male Wister rats. Experiments were assigned randomly into 4 experimental groups. Group I; Sham-operated control, Group II; FA- treated, Group III; subjected to IR injury, and Group IV: FA- treated and subjected to IR injury. The kidney function was assessed by serum urea and creatinine level, hand in hand with the histopathological analysis. Moreover, plasma total homocysteine (Hcy) level was measured as an independent marker for renal injury. In addition, we measured oxidative stress parameters, inflammatory indicators and apoptotic/ antiapoptotic markers.

Results
FA pretreatment in renal IR group resulted in a statistically significant reduction in serum creatinine and urea levels, plasma total homocysteine levels and renal tissue levels of malondialdehyde, (MDA), nitrite, high mobility group box-1 (HMGB1), nuclear factor kappa-B (NF-κB) and caspase-3. Meanwhile, FA pretreatment in IR group caused a marked and statistically significant increase in the renal tissue superoxide dismutase (SOD) activity and mitochondrial membrane potential (MMP), when compared to the untreated IR group. The histopathological analysis confirmed the biochemical results underscoring the renoprotective effect of FA.

Conclusion
Our data show, and for the first time, the beneficial protective impact of FA treatment against renal IR injury, that is associated with subsequent lowering of the renal inflammatory, oxidative stress and apoptotic status. This valuable renoprotective effect of FA could have a positive influence on the trajectory renal function.
Potential Effect of Nigella Sativa on the Development of Type 2 Diabetic Nephropathy in Rats: Possible Role of Hypoxia Inducible Factor
Authors: Hussien Nahla , Khedr Sherif , Sabry Yasmine Gamal , Seif Ansam , Nassef Noha 
Published: November 2024

Abstract

Objective
This study was conducted to delineate the beneficial effect of Nigella Sativa (NS) on the development and progression of diabetic kidney disease.

Methods
Rats were allocated into 3 groups: control, T2D (type 2 diabetes), and T2D-NS-treated group. Animals were assessed for renal function, lipid profile, fasting glucose, insulin resistance, RT-qPCR was used to detect mRNA of AMPK, PI3K, AKT, mTOR, HIF-1α, and VEGF, and histopathological analysis was conducted using H&E staining.

Results
T2D group showed a significant elevation in the blood glucose, insulin, HbA1C, renal function tests, microalbuminuria as well as marked dyslipidemia compared to the control. Moreover, there were an increase in the expressional level of PI3K, AKT, mTOR, HIF-1α, and VEGF and downward regulation of AMPK associated with histopathological deleterious changes. NS treatment ameliorated the biochemical, and histopathological changes to comparable levels with the control.

Conclusion
NS exerted a clear antidiabetic, antihyperlipidemic, and renoprotective effect in T2D.