bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge, Attitude and Practice Survey towards Antibiotic Misuse among Egyptian Parents
Authors: Ramadan Mohammed Maha Zakariya , Anis Omnia Atta , El-Ganzoury Mona Mostafa , Wassif Ghada Ossama Mohamed , Sallam Dina Ebrahem Darweish 
Published: November 2024

Abstract

Background
The burden of antimicrobial resistance (AMR) is significantly high in low- and middle-income countries. A multitude of factors contributes to the development of AMR such as antibiotic misuse and overuse through self-medication combined with lack of awareness. Therefore, evaluation of patients' knowledge, attitude, and practice are indicators for antibiotic misuse.

Objectives
To assess knowledge, attitude, and practice (KAP) of antimicrobial self- medication among Egyptian parents and

Methods
This cross-sectional study used a 55-item questionnaire that was previously developed in English language. An Arabic validated version was used after ensuring its accuracy by translating the questionnaire to Arabic and then back translating it to English version by 2 bilingual experts in Faculty of Al-Alsun (Languages), Ain Shams University. The questionnaire was also face-validated by four experts, two in the field of Pediatrics, one in the field of Pediatric Neurology and one in in the field of Public Health. The questionnaire included: demographic data, knowledge and attitudes on antibiotic use, experiences of interactions with physicians, and practices of purchasing antibiotics.

Results
We have included 210 parents from the General outpatients’ clinic, where 49.52% of them showed inadequate knowledge, 52.38% of parents exhibited negative attitude and 53.81% of parents had poor practice. This was significantly influenced by sociodemographic characteristics including age, sex, educational level, medical insurance, and monthly income. We also found a significant positive correlation between the total knowledge score and total scores of attitudes and practice (r = 0.174, 0.264 and p = 0.011, 0.0001, respectively).

Conclusion
Lack of knowledge and misconceptions exist about the use and indications of antibiotics. Efforts is required to improve parents’ knowledge about antibiotics and promote healthier attitudes.
Microbiological Causes of Relapses in Pediatric Onset Inflammatory Bowel Disease
Authors: Ebaid Peter Atif Ghally , Saber Ahmed Mohamed Hamdy , Awad Yosra Mohamed Mohsen , Mahmoud Basma Sherif Fahmy 
Published: November 2024

Abstract

Background
A bidirectional relationship exists between infections and the development of inflammatory bowel disease (IBD). Early diagnosis of infection in a relapse may reduce a patient’s unnecessary exposure to corticosteroids and/or immunosuppressive drugs and it may also hasten their time to recovery.

Aim of the Work
The aim of the present study is to assess the microbiological causes of relapses in IBD patients including clostridium difficile infection.

Patients and Methods
This was a cross sectional study included 50 known children with IBD who were following up at Pediatric Gastroenterology Unit, Children’s Hospital, Ain Shams University, and presented with acute relapse. All patients were subjected to history taking including socio- demographic data, symptoms and signs of IBD during relapse, and medications including IBD therapy and recent antibiotics, laboratory investigations including blood tests, stool analysis and culture and sensitivity. Clostridium difficile toxin A and B test was done via rapid chromatographic immunoassay in fecal specimens.

Results
The mean age (SD) of the studied patients were 12.45 (±3.2469) years. They were 30 males and 20 females. Stool culture and sensitivity showed no growth in 86% of the patients, E.coli, Salmonella and entamoeba histolytica were isolated in 10%, 2% and 2% respectively, but the serotype testing was not available. Clostridium difficile infection (CDI) was positive in 40% of included children. Children who were tested positive for CDI had high frequency of recent antibiotic use (P = 0.036), associated diabetes mellitus (DM) (p = 0.004) and presence of RBCs in stool (P = 0.038).

Conclusion
Clostridium difficile infection is an important infection in cases of relapsed IBD, which is often overlooked in pediatrics. This risk might be increased with previous intake of antibiotics and associated immunological diseases (DM).
Prevalence of Nocturnal Enuresis among Egyptian Children Presenting at the Pediatric Outpatient Department of Ain Shams University Hospital
Authors: Abdeen Reem Ramadan Hussien , Youssef Azza Mohamed , Mageed Reham Ibrahim Abdel , Elhamid Salwa Amin Abd 
Published: November 2024

Abstract

Background
Enuresis is a common problem among children and adolescents, and can lead to important social and psychological disturbances to them and their caregivers.

Objectives
To determine the prevalence of primary and secondary enuresis in the children and adolescent presenting at outpatient clinic. Furthermore, we aimed to determine associated risk factors of nocturnal enuresis among enuretic children.

Patients and Methods
A cross- sectional study was done among 1587 Arabic fluent mothers or caregivers of children aging 6-16 years recruited from outpatient clinic, Ain Shams University, Children’s Hospital from November 2022 to July 2023. Structured questionnaires were used to assess socio-demographic characteristics, risk factors of enuretic childrens, the association between enuresis and sleep disorders by using Children Sleep Habit Questionnaire (CSHQ) and the impact of enuresis on quality of their life by using Pediatric incontinence Questionnaire (PinQ).

Results
This study included 1587 children in Egypt, the overall prevalence of enuresis among children age group 6 to 16 years was 21%, that consisted of 209 (62.8%) boys and 124 (37.2%) girls. This study focused on risk factors that had significant difference between enuretic and non enuretic children as family history of nocturnal enuresis (p value &lt;0.001), change living place (p value = 0.001) and habitual use of caffeinated drinks 9.9%and sweaty drinks 22.8% were significant risk factors (p value&lt;0.001). There was a significant difference in sleep disorder grades between two groups (p value= 0.016), Enuretic participants exhibited a slightly higher prevalence of high sleep disorder grades compared to non- enuretic individuals. There was a positive significant correlation between age and PinQ score (parents’ report) (rho= 0.177, p value&lt;0.001).

Conclusion
this study conducted among 1587 children in Egypt sheds light on the prevalence of enuresis, risk factors, and impact of nocturnal enuresis on children's quality of life. Revealed that nocturnal enuresis is a significant concern, affecting 21% of the studied children, with risk factors including gender, birth order, socioeconomic status, and family history. Furthermore, there was a significant association between sleep disorders and enuresis. Notably, nocturnal enuresis was found to negatively impact children’s quality of life.
Acute Cerebrovascular Diseases in Children: Single Center Experience
Authors: Fathallah Samah Khalaf , Hassanein Sahar Mohamed Ahmed , AlaaEl-Din Habib Mohamed , Mohammad Shaimaa Abdelsattar , Zaitoun Raghda Mohamed Hesham , Mesbah Mostafa Mohamed Farid 
Published: November 2024

Abstract

Background
In children, cerebrovascular events are classified into acute ischemic or hemorrhagic stroke. Ischemic stroke includes both arterial ischemic stroke (AIS) and cerebral sino-venous thrombosis (CSVT). Compared to adults, pediatric cerebrovascular events have a heterogeneous etiology and various clinical presentations. Both factors lead to a delay in diagnosis and proper management.

Aim
Our aim is to study risk factors for the occurrence of cerebrovascular events in children.

Patients and Methods
A retrospective medical record review for all children admitted to Children's Hospital, Ain Shams University from 2010-2021. All records with radiological diagnosis of a cerebrovascular event AIS, CSVT or Hemorrhagic stroke were included. Full history, family history of stroke, known risk factor of stroke like (genetic factors, cardiac, hematological, thrombophilia, collagen diseases…etc), precipitating factors for stroke before the onset or conditions like (acute illness, dehydration, head or neck trauma…etc) were reviewed. Records of full detailed neurological examination and full general and systemic examination at ER arrival were all included.

Results
sixty- two children were diagnosed as acute cerebrovascular events, 42 (71%) as AIS, 13(21%) CVST, and 7(11.3%) Hemorrhagic Stroke (HS). The age at diagnosis was 74.2% (2-6 years), 11.3% (6-10 years), 11.3% (10-14 years), and 3.2% (14-18 years). Acute illness preceded acute stroke in (31) 50%, dehydration in (2) 3.2%, head or neck trauma in (3) 4.8%, cardiac catheterization in (7) 11.3%, and chemotherapy in (1) 1.6%. There were no stroke risk factors in (30) 48.4%, cardiac (8)12.9%, hematological (2) 3.2%, thrombophilia (5) 8.1%, genetic (7) 11.3%, infection (3) 4.8%, collagen or vascular diseases (4) 6.5%, family history (2) 3.2%, and cardiac and genetic (1) 1.6%.

Conclusion
While there were not risk factors in half of the admitted children for acute stroke, acute illness was the commonest precipitating factor for acute stroke. The most common risk factor was cardiac diseases and cardiac catheterization.
Role of Fetal Cardiac Screening in Fetuses of Diabetic Mothers and its Impact on Postnatal Outcome
Authors: Ahmed Sara Mahfouz Mohamed , Ganzory Mona Mosatafa E L , Habeeb Nevin Mohamed Mamdouh , Ali Hend Galal Eldeen Mohammed , Elaal Mohamed Omar Abd , El sayed Eman Mohamed 
Published: November 2024

Abstract

Background
Maternal diabetes mellitus (DM) is known to affect fetal growth and development. Fetuses of diabetic mothers may have functional cardiac abnormalities, which have recently gained importance and may be found despite good glycemic control. Analysis of fetal cardiac function might provide important information on the hemodynamic status and cardiovascular adaptation to different perinatal complications.

Objectives
To study the role of fetal echocardiography and fetal cardiac MRI in screening of fetuses of diabetic mother and to study the impact of early diagnosis on postnatal outcome.

Subjects and Methods
Our study included 60 pregnant diabetic females divided into two groups according to HbA1c cut off value which is related to adverse pregnancy outcomes 7% (Group a): 30 pregnant diabetic females with HbA1c level below 7% were examined by fetal echocardiography and also assessed by postnatal echocardiography (Group b): 30 pregnant diabetic females with HbA1c level more than 7% were examined with fetal echocardiography with further assessment with fetal cardiac MRIand also assessed by postnatal echocardiography

Results
As regard type of maternal diabetes 32.5% of our patients were diagnosed with gestational diabetes and 67.5% were diagnosed with pregestational diabetes. Maternal diabetes affects left ventricle (LV) diastolic function and global cardiac function but does not affect LV systolic function. Diastolic dysfunction was detected through assessment of myocardial performance index(MPI)which ranges form (0.42_0.64)in group (b) compared to (0.4_0.48) in group (a) with p value 0.000. Diastolic dysfunction was detected in 10% of infants of diabetic mothers (IDM) of our patients with pregestational maternal diabetes compared to 0% affection of systolic function in IDM of our patients (p-value=0.000). Interventricular septum (IVS) thickness showed significant values in IDM with 72% in pregestational maternal diabetes with range of (2.3_5 mm) compared to 45% in gestational maternal diabetes with range of (0.28_4.9mm) with (p- value=0.001). IVS showed positive correlation with myocardial performance index (MPI) and indices of DM such as HbA1c. HbA1c is the most significant predictor for IVS thickness in fetuses of diabetic mothers especially with long duration of DM with p value of 0.026.

Conclusion
Fetal echocardiography in diabetic mothers is highly important for evaluation of cardiac function of the fetuses. Fetal cardiac MRI can provide additional information about fetal cardiac function that may improve post-natal follow up and management.
Fetal Echocardiography Vs. Pulse Oximetry Screening for Early Detection of Critical Congenital Heart Diseases and Neonatal Outcome
Authors: Habeeb Nevin Mamdouh , Emam Safaa Shafik , Aref Miral Adel , Gafar El Feky Wessam Abd El 
Published: November 2024

Abstract

Background
Delayed diagnosis of critical congenital heart disease (CCHD) in neonates increases morbidity and mortality. Prenatal diagnosis by fetal echocardiography (FE) allows preparing an appropriate perinatal and postnatal care, while postnatal pulse oximetry screening (POS) is recommended to increase detection of these conditions as well.

Objective
This study aimed at comparing outcome in neonates with congenital heart diseases diagnosed either by fetal echocardiography versus those screened by pulse oximeter.

Patient and Methods
This is an observational study conducted on 30 neonates admitted to Neonatal intensive care unit of Ain Shams University Maternity Hospital with CHD in the period from December 2019 to June 2021. Neonates were divided into 2 groups; Group1of neonates with CHD identified by FE and Group 2 included those detected by POS.

Results
Fifteen neonate diagnosed by fetal echocardiography were compared to another 15 newborns with congenital heart disease detected by pulse oximeter screening. There was no significant difference between both groups regarding demographic and maternal history. Clinical examination between the two groups did not differ either except for oxygen saturation, which was lower in the group diagnosed by pulse oximeter (p = 0.035). Fetal echocardiography could diagnose all types of cardiac abnormalities, unlike Pulse oximeter that detected only those with desaturation. Neither management nor outcome of patients differed based on the mode of diagnosis.

Conclusions
Fetal echocardiography can diagnose all types of structural cardiac anomalies antenatal, unlike postnatal pulse oximeter, which detects congenital cardiac defects with evidence of desaturation only.
Predictive Factors for Seizure Recurrence in Pediatric Patients Following an Unprovoked Seizure
Authors: Saleh Dina Amin , Hassan Abeera 
Published: November 2024

Abstract

Background
We studied the predictive factors related to seizure recurrence in children who presented with an unprovoked seizure at our pediatric neurology clinic over 4 years period.

Aim
To explore the predictive factors underlying seizure recurrence following an unprovoked seizure and the diagnostic yield of performing an initial EEG in pediatric patients.

Methods
We retrospectively reviewed the charts of patients who had an unprovoked seizure and were followed up for at least one year from February 2016 until February 2020. Relevant demographic and clinical data, electroencephalogram (EEG), and brain magnetic resonance imaging (MRI) findings were recorded and analyzed at annual intervals. Patients with acute neurological insult and those who were diagnosed with an epilepsy syndrome or who were already receiving antiseizure medications were excluded from the study.

Results
The predictive factors for seizure recurrence were focal seizures, symptomatic seizures due to a remote static lesion such as “perinatal insult, infection, stroke, or cerebral malformation”, abnormal initial EEG results and abnormal brain MRI findings. The recurrence rate was 96.2% in our cohort, of which 68.8% occurred within six months of the first seizure. On using the Kaplan-Meyer survival analysis curve, the probable risk of having a second unprovoked seizure among all patients was 91.8, 94.7 and 98.4% at 1, 2 and 3 years respectively but it was significantly higher among children with symptomatic seizure etiology at each interval.

Conclusion
Our cohort of patients showed an increased risk of seizure recurrence with several risk factors implicated, among those was having an abnormal initial EEG. This indicates the importance of having a baseline EEG study in predicting the risk of seizure recurrence, especially in children with symptomatic seizure etiology. The highest risk of recurrence was observed in the first six months warranting close monitoring of children during this period.
Amisulpride Ameliorates 5-Fluorouracil-Induced Memory Deficits in Wistar Rats
Authors: Raafat Radwa S , Habib Mohamed Z , Hendawy Nevein , Kamal Khaled A , Nawishy Salwa A , Aboul-Fotouh Sawsan 
Published: November 2024

Abstract
Mounting evidence reports chemotherapy-induced cognitive impairments in a significant number of cancer survivors which is known as “chemo-brain”. 5-fluorouracil (5-FU) is a widely used chemotherapeutic agent that crosses the blood–brain barrier readily and may have a direct brain neurotoxic effect. Moreover, 5 FU has been reported to affect cognition and hippocampal neurogenesis. In contrast, studies reveal the enhancement of cognition and hippocampal neurogenesis by atypical antipsychotics such as amisulpride. In this study the behavioural effects of chronic amisulpride therapy have been investigated in 5-FU-exposed adult Wistar rats. Behavioural effects were tested using the novel object recognition test (NORT) and the object location test (OLT). 5-FU-exposed rats exhibited significant deficits in object recognition and object location tasks. Moreover, 5-FU chemotherapy induced a significant reduction in hippocampal brain derived neurotrophic factor compared to control group. These deficits were alleviated following chronic amisulpride treatment. These findings suggest that 5-FU therapy can negatively affect both neurogenesis and hippocampal dependent working memory and that these deficits can be reversed by the simultaneous administration of the atypical antipsychotic amisulpride.
Evaluation of the Use of free Anterolateral Thigh Flap in Lower Leg and Foot Defects in Pediatric Population
Authors: Mahmoud Amr Magdy Sayed , Gad Ahmed Mohamed , Tallal Raghda Elsayed , Mehany Marian Wagih 
Published: November 2024

Abstract

Background
Trauma is one of the main mechanisms of complex wound formation affecting pediatric population. The goal of lower extremity reconstruction is the coverage of defects with open wounds of the leg and foot to give patients a healed wound and to let them resume their life while preventing amputation.

Objective
To clinically evaluate the reliability of free anterolateral thigh flap for reconstruction of distal leg and foot defects in pediatric patients.

Patients and Methods
This prospective study included 20 patients; 6 patients (30%) were female and 14 patients (70%) were males who had soft tissue defects in lower leg, ankle and foot which were reconstructed by free anterolateral thigh flap.

Results
the survival rate of the flap was 95% with the ability to cover defects size ranging from 12 × 5 cm to 15× 22 cm without any functional affection on the donor site. Regarding the donor site closure, 60% of the cases’ donor sites were directly closed while 40 % needed STSG. There were (100%) matching skin color between the skin of the flaps and the recipient site. 5 patients (25%) required flap debulking in secondary procedures and (75%) didn’t need debulking.

Conclusion
Anterolateral thigh flap is reliable option for reconstruction of massive soft tissue defects at the distal leg, ankle and foot in children. It provides good donor and recipient site functional and aesthetic outcomes with additional advantage of minimal donor site morbidity and a high level of patient satisfaction among pediatric population.
Assessment of Sensory Function of the First Dorsal Metacarpal Artery Flap Used in Coverage of Post Traumatic Distal Thumb Defects; A Systematic Review and Meta-Analysis
Authors: Abdelrahman Nouran Mohamed , Sayed Adel Hussein , Ali Hassan Ahmad ,   Mohamed Osama Saad el deen
Published: November 2024

Abstract

Background
Reconstruction of complex soft tissue defects of the thumb, with exposure of the underlying structures, is challenging to hand surgeons, due to limited local soft tissue availability, The aim of thumb reconstruction is to create a thumb that is pliable, durable, and sensate (Prabhu et al., 2013) our study aims to assess the sensory function of one of the most commonly used sensate flaps which is the first dorsal metacarpal artery flap. The innerved first dorsal metacarpal artery flap harvested from the dorsum of the index finger was first described by Hilgenfeldt and refined by Holevich (1963). An island flap carried on a neurovascular pedicle consisting of the first dorsal metacarpal artery was first demonstrated by Foucher and Braun (1979).

Methods
we performed a systematic review of all studies that assessed the sensation of the first dorsal metacarpal artery flap that was used in coverage of post traumatic thumb defects from the year 1992 to 2022.

Results
Total of 580 papers were identified and screened, 109 full texts were reviewed and 25 studies met our criteria and reported static 2 point discrimination test of 491 patient with post traumatic thumb defects underwent coverage by first dorsal metacarpal artery flap with mean 2 point discrimination 9.394

Conclusion
First dorsal metacarpal artery flap is a good option as a sensate flap for post-traumatic thumb reconstruction
Health-Related Quality of Life among COVID-19 Patients Discharged from Ain Shams University Isolation Hospitals, 2021
Authors: El-remaily Amira Ayman Fouad , Sabbour Sahar Mohamed , Mostafa Aya , Kandil Sahar Khalil , Basyoni Nashwa Ismail 
Published: November 2024

Abstract

Background
A significant proportion of individuals, including those who were hospitalized, through the global pandemic of the novel 2019 coronavirus disease (COVID-19), experienced residual symptoms following acute COVID-19 infection. Accordingly, it has impacted the patient's Health-Related Quality of Life (HRQoL) resulting in negative effects on one or more domains of their quality of life.

Objective
To assess the HRQoL of COVID-19 patients discharged from Ain Shams University Isolation Hospitals, 2021.

Methods
We conducted a cross-sectional study including a total of 550 adults discharged from Ain Shams University Isolation Hospitals. Data was collected using a phone-based interview questionnaire including questions about socio-demographic characteristics, clinical information, and Short-form 8 (SF- 8) to assess the 8 domains of HRQoL; general health, physical functioning, Role physical, bodily pain, vitality, social functioning, mental health, and role emotional. Univariate analysis was done to investigate the relationship between the study variables and the total mean score of HRQoL.

Results
Participants' mean age was 53.71 ± 13.17, and 53.1% of them were females. We found that 63.5% had co-morbidities. The mean of the total days of hospital stay was 12.37 ± 7.22 and about fifth was admitted to the intensive care unit (ICU) (22.2%). The mean of the total score of the 8 items of SF-8 in discharged patients was 69.96 ± 23.31. The Role physical domain was more affected among the other domains (51.55±40.03). The following variables were significantly associated with lower mean of the total score of HRQoL as: age≥50, female gender, having co-morbidities, length of hospital stay and ICU admission.

Conclusion and Recommendation
COVID-19 is associated with negative effect on HRQoL of hospitalized COVID-19 patients especially the physical domain. Follow up service after COVID infection is recommended, especially for people with existing comorbid conditions.