bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Diagnostic Value of Progranulin in Early Onset Sepsis in Preterm Neonates
Authors: Seif Ibrahim Saad Hassan Abu , Alhassanin Arwa Hamdy Alsharabasy , Elmihi Nouran Mahmoud Bahig , Emam El Bahnasawy Abdelhay Youssef Ali 
Published: November 2024

Abstract

Background
Neonatal sepsis is a leading cause of morbidity and mortality, especially in preterm Infants. It represents a deregulated host response to an infectious agent, resulting in multiple organ failure and long-term neurodevelopment delay. There is growing evidence that Progranulin is a promising biomarker in the early diagnosis of sepsis in neonates.

Aim of the Work
To assess the use of Progranulin as an early biomarker for detection of early onset sepsis in Preterm neonates and to detect whether Progranulin will provide us with earlier detection of EOS Than the usual used septic screen.

Patients and Methods
This was a case control study that was conducted in neonatal intensive care unit Department, Faculty of Medicine, Ain Shams university on 60 Neonates with early onset neonatal sepsis. Study groups were classified according to the blood culture into two groups: Group 1 (cases): 30 preterm neonates proved to have early onset sepsis with positive blood culture. Group 2 (control): 30 preterm neonates with negative blood culture. The study period was 6 months.

Results
PGRN levels were significantly elevated in the EARLY ONSET SEPSIS neonates compared with the levels in the non-EOS neonates (301.33 vs. 29.5 ng/ml (median), P &lt; 0.001). Also, the receiver operating characteristic curve (ROC) showed that the best cut off point of PGRN (ng/mL) to detect Cases group was found to be &gt; 50 with sensitivity of 100.0% and specificity of 100.0%.

Conclusion
Progranulin may can be used as a promising biomarker for the diagnosis of Early Onset Sepsis.
Psychological Outcomes in Children Following Pediatric Intensive Care Unit Hospitalization
Authors: Nasr Ahmed N , Youssef Azza M , Magdy Sondos M , Abdel Aziz Asmaa W , Abdelmageed Reham I 
Published: November 2024

Abstract

Background
Critically ill children may be at risk for developing negative psychological sequel following pediatric intensive care unit (PICU) hospitalization. The highly invasive technological interventions, lack of control over events, the severity of the child’s illness, and high levels of parental distress have been identified as particularly salient factors

Aim of the Work
To assess the psychological impact of admission to PICU among children and their parents

Methods
In this cross-sectional study, 100 children admitted to the PICU or ward and their parents completed the Strength and Difficulties Questionnaire (SDQ) and Hospital Anxiety and Depression Scale (HADS) at admission, 6 weeks, and 6 months after discharge.

Results
The PICU group (n = 50) had significantly higher disease severity scores than the ward group (n = 50) based on mean PRISM (9.5 vs 3.0, p &lt; 0.001) and mean TISS scores (14.98 vs 6.7, p &lt; 0.001). PICU children had a longer mean length of stay (9.8 vs 4.6 days, p &lt; 0.001). At 6 weeks, 38% of PICU children scored in the high or very high risk range on the SDQ total difficulties score compared to 8% of ward children. At 6 months, 28% of PICU children remained at high or very high risk versus 4% of ward children. The SDQ emotional symptoms subscale was most affected. Regarding parental stress, at 6 weeks 12% of PICU parents had abnormal depression scores on the HADS versus 2% of ward parents, while 14% of PICU parents had abnormal anxiety scores versus 4% of ward parents. Multivariate regression found number of previous admissions, severity scores, and invasive procedures predicted SDQ scores at follow-up.

Conclusion
PICU admission has a significant psychological impact on children and parents lasting at least 6 months. Screening for those at high risk is recommended.
Clinical Characteristics and Outcomes of Young Patients with Thrombotic Microangiopathy at Ain Shams University Children’s Hospital
Authors: Makkeyah Sara Mostafa Mohammad , Andrawes Nevine Gamal , Wasel Asmaa El Saied Hassan , Sallam Dina Ebrahem Darweish 
Published: November 2024

Abstract

Introduction
Thrombotic microangiopathies (TMA) is a life-threatening condition that requires urgent management. Survival of patients has improved greatly over the past two decades with improved supportive care and other therapeutic options.
Objectives: to describe the clinical features and outcomes of patients with TMA at Ain Shams University Children’s Hospital.

Methods
In a retro-prospective study, we included patients diagnosed with TMA in the Pediatric Hematology and Pediatric Nephrology Units at Ain Shams University Children’s Hospital from 2009 through 2023.

Results
Thirty-three patients were enrolled, they were 15 females and 18 males with age ranges from 0.31 to 13.9 years and median (IQR) of 4.3 (1.4 – 9.0) years. Almost half of our patients had infection related hemolytic uremic syndrome (HUS) (51.5%), 30.3% had atypical HUS (aHUS), 9.1% had congenital thrombotic thrombocytopenic purpura (cTTP), while 9.1% were diagnosed with immune-mediated TTP (iTTP). Renal manifestations were the most common presenting symptoms (90.9%), hematological manifestations were present in (66.7%), while neurological manifestation were evident in (36.4%) of patients. Conservative management was the most commonly used approach (87.9%),while (75.8%) received plasma infusion and (69.7%) needed renal replacement therapy. On studying the outcome of our TMA cases, 33.3% had residual hematological manifestations, meanwhile 60.6% left with chronic kidney disease. Mortality was reported in 18.2% during the whole follow-up period.

Conclusion
infection-related HUS was the most common type of TMA in our cohort, and most patients were managed conservatively with disease resolution at 3 and 6 months follow up.
Neurological Complications and Cognitive Function after Pediatric Living Related Liver Transplantation
Authors: Yassin Tawhida , Elhakim Athar Abd , Rahim Suzan Abdel , Wafeeq Asmaa , Mohammed Maha Z 
Published: November 2024

Abstract

Background
Neurological complications in the post liver transplantation period increase morbidity and mortality, with most of them occurring within the first 1– 3 months. Many studies have found that long-term neurocognitive development in children after liver transplantation is not ideal.

Aim and Objectives
The aim of the study was to assess the frequency, types and risk factors for neurological complications among children who underwent liver transplantation and to determine the cognitive functions of those children after liver transplantation.

Subjects and Methods
fifty patients who underwent living related liver transplantation as well as fifty controls of same age and sex were recruited to the study, medical records were revised including history of any symptoms suggestive of neurological affection in the post-operative period (type, timing, imaging, prognosis). Neurological examination was done as well as cognitive assessment by Wechsler intelligence scale.

Result
Twenty percent of the studied cases with mean age11.58 ± 3.07 years (male 62%) (females 38%) had neurological complications; most common presentation was seizures 18%. All complications occurred in first fifty days after liver transplantation. Neurological examination at time of study showed that all patents resolved completely except one patient who is still on treatment) mean duration post liver transplantation was 3.5 years). Cognitive assessment revealed a potential decrease in verbal comprehension and significant decreases in perceptual reasoning, working memory, and full-scale IQ in the cases group compared to controls p value = 0.01

Conclusion
current research suggests that neurological complications in liver transplanted children is not uncommon. Those children are at higher risk for developing cognitive deficits compared to the age-matched normal population.
Effect of “Egyptian Acute Seizure Management Guidelines” Education on Emergency Room Pediatricians
Authors: Hassanein Sahar Mohamed Ahmed , Amin Ghada Essam Aldin , Mohamed Aya Abdelnaby Darweesh , Elmasry Ahmed Mostafa Ahmed , Shata Mennatallah Osama 
Published: November 2024

Abstract

Background
Acute convulsive seizure in children is the most terrifying experience to parents. Status epilepticus can be life threatening in children if not early and properly managed. There are no unified management guidelines for childhood acute seizure management in Egypt. The Egyptian acute seizure management in children's guidelines provides a framework for diagnosing and caring for children experiencing an acute convulsion, which is intended to assist health care providers

Aim of the Work
To assess pediatricians’ knowledge about acute seizure management in emergency department, and to evaluate the effect of education on their knowledge.

Methods
The current study is an interventional study, on physicians treating children with acute seizures in emergency departments, from August 2022 to May 2023, an online survey was prepared by the authors according to the “Egyptian acute seizure management in children’s guidelines”, then 3 electronic forms were designed online using Research Data Capture Software (REDCap). In the first form (pre-intervention phase) The public link is one link sent through whatsApp groups for pediatricians or general practitioner; containing their personal data and questions assessing their knowledge about acute seizure management in children, two hundred and twenty three pediatrician responded to it. The second form (intervention phase) educational materials (a PDF file contains the guidelines and educational video) sent automatically after the participant finished and submitted the pretest. One week later (post intervention phase) unique link was sent for each participant to his e-mail. Each participant initial (pre-test) and final (post-test) answers were analyzed for the level of knowledge and stratified into Poor ≤50%, 50-75% Fair and ≥ 75% good according to his/her correct answers.

Results
In the pre-intervention phase, the majority of the participants (66.8%) had poor knowledge about pediatric acute seizure management. Females were found to have lower knowledge levels than males. In the post-intervention phase of the study, the majority of participants (70%) who completed the post-intervention phase had good knowledge level (75%) and the rest (25%) had fair knowledge level.

Conclusion
We concluded that education to enhance healthcare providers' knowledge about acute pediatric seizure management is mandatory. The study's findings imply that focused education can significantly raise knowledge levels aiming at raising the standard of care given to children with acute seizures in the ER.
The Effect of Ketogenic Diet on Platelet Function in Children with Drug-Resistant Epilepsy
Authors: Nassar May F , Shata Mennatallah O , Ibrahim Haya E , Abou Elwafa Menna Allah Z , Ibrahem Dina M 
Published: November 2024

Abstract

Background
The ketogenic diet (KD) is a high-fat, adequate-protein, low-carbohydrate diet. As a special diet, the KD provides daily nutritional needs for children while controlling seizure and thus decreases the use of antiepileptic drugs. Several studies have reported pathological coagulation parameters and platelet abnormalities in patients treated with various antiseizure drugs (ASDs), especially for Valproic acid (VPA). The KD is frequently used in combination with antiepileptic drugs (AEDs), which may increase the risk of bleeding tendency, particularly with concomitant use of VPA or Topiramate.

Objective
To assess platelet count and function at baseline and six months after starting the KD in children with drug resistant epilepsy (DRE).

Methods
This prospective cohort study was conducted on 25 DRE children treated with KD for 6 months with age range of 4 months -14 years in the Children ‘s Hospital, Ain Shams University, Cairo, Egypt. They were assessed for anthropometric measurements, detailed medical history, history of bleeding symptoms, complete physical examination, neurological examination, and laboratory assessments as Complete Blood Count (CBC) and platelet function by ADP level at start and after 6 months of ketogenic diet treatment.

Results
There is no statistically significant change between platelet count and function initially and after 6 months of KD treatment, most of the patients (44%) were maintained on combination of Valproic acid and Levetiracetam and (40%) were maintained on triple therapy Valproic acid, Levetiracetam and Topiramate.

Conclusion
KD is an effective, safe, and tolerable therapy for children with DRE. No excessive bruising or other bleeding events were observed in any studied patient on KD.
Association between Serum 25 OH Vitamin D Level and Pediatric Complicated Community Aquired Pneumonia
Authors: Ezzat Deraz Tharwat , Hussien Mahitab Morsy , Kamal Tarek Mostafa , Mohamed Enas Maher Mahmoud 
Published: November 2024

Abstract

Background
The most common infectious killer of children under 5 years old worldwide is pneumonia. The frequency of vitamin D deficiency in children and teenagers has been found to be very high all over the world. It has been suggested that vitamin D deficiency may be a risk factor in the epidemic of acute lower respiratory tract infection (ALRTI), especially community acquired pneumonia (CAP).

Objectives
to investigate serum vitamin D level in pediatric patients hospitalized with complicated pneumonia (CP).

Patients and Methods
This was a case control study that was held in Children’s Hospital, Ain Shams University, where 100 children admitted to the hospital with complicated pneumonia, 100 children with uncomplicated pneumonia and 120 apparently healthy control children were enrolled in this study. The serum 25-hydroxy vitamin D (25D) level was assessed using ELISA method.

Results
In comparison to controls, 25-OH vitamin D serum level was significantly lower in patients with CP and uncomplicated pneumonia (p 0.001). Also compared to controls (19%), CP (60%) and uncomplicated pneumonia (40%) had higher rates of vitamin D deficiency. Also individuals with vitamin D deficiency are 1.7 times more likely to develop complicated pneumonia (CP) than individuals with uncomplicated pneumonia (OR = 1.69; (95% CI: 0.91-3.14), p = 0.001).

Conclusion
Vitamin D deficiency is a risk factor for the development of pediatric pneumonia and progression to complicated pneumonia.
Serum Levels of Soluble Vascular Endothelial Cadherin among COVID-19 Children
Authors: Mostafa El-Ganzoury Mona , El-Farrash Rania Ali , Magdy Sondos Mohammed , Nasef Marwa Waheed Abd Elhady , Rahman Eman Ismail Abdel , Ahmed Hadeer Youssry Gameel 
Published: November 2024

Abstract

Background
COVID-19 is an endothelial disease, and the consequent endotheliopathy is responsible for inflammation, cytokine storm, oxidative stress, and coagulopathy. Vascular endothelial cadherin (VE- cadherin) is a strictly endothelial specific adhesion molecule located at junctions between endothelial cells. Aim: serum levels of VE-cadherin was assessed as a marker of endothelial dysfunction among COVID-19 patients compared with healthy controls.

Methods
Thirty patients with COVID-19 with median age 5.6 (3.3-7.0) years old were enrolled. They were compared with 30 healthy controls. Covid-19 polymerase chain reaction, Covid-19 antibodies, complete blood count, blood gases, C-reactive protein, D-dimer, lactate dehydrogenase, serum ferritin and VE-cadherin levels were assessed.

Results
VE-cadherin levels were significantly higher in COVID-19 patients compared with healthy controls. There was a significant negative correlation between VE-cadherin and platelet count while VE-cadherin was positively correlated to creatinine level.

Conclusion
VE-cadherin levels are elevated in children and adolescents with COVID- 19 suggesting the presence of endothelial dysfunction. VE-cadherin levels are mainly related to lung and kidney injury in COVID-19 patients.
Clinico-Epidmological Study and Outcome of COVID 19 Infection in Children with Hemato-Oncological Disorders
Authors: Ebeid Fatma Soliman Elsayed , El-Din Aya Mostafa Kamal , Magdi Sondos Mohamed , Abd El Kader Haidy Mohamed , Aly Nihal Hussien 
Published: November 2024

Abstract

Background
Severe acute respiratory syndrome Coronavirus 2 (SARS-Cov2) outbreak has caused a pandemic rapidly impacting on the way of life of the entire world. Several studies reported the specific role of an immunocompromised status as a possible risk factor for CoV-related pneumonia. The detrimental impacts of COVID-19 pandemic on childhood cancer are multiple including a delay in diagnosis and starting treatment, the impact of infection, and the uncertainty about the decision for chemotherapy in polymerase chain reaction–positive asymptomatic patients.

Aim of the Work
The study aimed to Measure the frequency of COVID-19 infection among children with hemato-oncological disorder in a period from 27 February 2022 till 27 March 2023 and to develop a registry dataset which can be used as a template for national registry for children with hemato-oncological disorder with proven COVID19 infection.

Patients and Methods
This is a retrospective cohort non-interventional study in which we recruited 620 child and adolescents patients who attended the pediatric hematology oncology unit, Ain Shams University, Children’s hospital in a period from 27 February 2022 till 27 March 2023.

Results
This is a cohort study included 620 immunocompromised children including 319 patients with hematological malignancies, 30 patients with solid malignancy, 271 patients with benign hematology. Our findings showed that 620 patients, 87 of them were found to be COVID-19 positive. The median age of COVID-19 the patients was 5 years (range: 0.75–16 years). The median duration of COVID-19 positivity of the patients was 12 days (range: 3–38 days). There was significant increase in the percentage of patients with positive chest X-ray, abnormal echo, patients with organomegaly in abdominal US in COVID-19 group than non COVID-19 group.

Conclusion
The percentage of patients with COVID-19 were higher among patients with hematological malignancies and benign hematological diseases especially acute lymphoplastic leukemia and aplastic anemia respectively. COVID-19 was tolerable among immunocompromised patients. Mortality was associated with abnormal neurological examination in patients with COVID-19 disease.
Myostatin as a Marker of Reduced Muscle Mass in Children and Adolescents with Chronic Liver Disease
Authors: Abass Heba Abd Elkader , Elfaramawy Amel Abdel Magied , Mahmoud Fatma AbdEllah Abdullah , Elkholy Heba Essam 
Published: November 2024

Abstract

Background
Sarcopenia is defined as a decrease in muscle mass, and is a reliable marker of nutritional status of patients with chronic diseases. Multiple factors contribute to malnutrition in chronic liver disease (CLD), such as impaired absorption and/or digestion, increased metabolic demands, anorexia, and decreased oral intake. Changes due to liver cirrhosis are considered potential disruptors of the balance of protein anabolism and catabolism which is a characteristic feature of Sarcopenia.

Aim of the Work
to assess the muscle mass in CLD pediatric patients and evaluate myostatin as a biomarker of sarcopenia in CLD pediatric patients and its association with muscle mass.

Patients and Methods
The study was conducted at the hepatology and nutrition clinics, of Ain Shams Children`s Hospital. It included 42 (20 male and 22 female) CLD patients and 45(26 male and 19 female) healthy controls aging between 2 and 18 years during the period from August 2021 to January 2022. They were subjected to full history taking, clinical evaluation, anthropometric measurements including weight, height, mid upper arm circumference(MUAC) and body mass index(BMI), assessment of body composition and measurement of serum myostatin.

Results
The prevalence of malnutrition in the CLD patients was significantly higher than the controls with p value&lt;0.001 and it was as follow: 50% had abnormal weight, 42.85%were stunted and 42.85% had abnormal BMI. Although the prevalence of malnutrition in the cases detected by MUAC (in age group 2-5years) was 33.33%, yet this was not statistically significant compared to healthy control with p value 0.329. As regards the lean muscle mass measured by body composition scale, we found that the prevalence of decreased lean muscle mass was 57.58% in the cases which was significantly higher than the controls with p value&lt;0.001. Our study showed that CLD patients had significantly higher serum myostatin level with median of 757ng/mL and range of (450-825ng/mL) in comparison to median of 120ng/mL and range of (100-140ng/mL) in healthy controls. There was a negative but non-significant correlation between the serum myostatin and decreased lean muscle mass in the cases with p value 0.253 and r -0.205.

Conclusion
Malnutrition is prevalent in children with CLD and decreased lean muscle mass is significantly evident. Serum myostatin level is significantly higher in patients with CLD compared to healthy controls.
Complications of Central Venous Lines in Egyptian Children and Adolescents with Malignancy
Authors: Ahmed Heba Hussain Mohamed , Elhabashy Safinaz Adel , Ellaboudy Mohamed Abdel-Mohsen , Elraheem Heba Gomaa Abd , Elsayed Eman Mohamed , Fahim Noha Alaa Eldin Mohamed 
Published: November 2024

Abstract

Background
Central venous catheters (CVCs) are currently an important component in pediatric oncohematological care, with a direct influence on outcome. Several types of CVC are available; however, CVCs are often associated with several complications which may affect patients’ morbidity and mortality.

Aim
The aim of this study was to prospectively evaluate the CVC-related complications in pediatric patients with Hematooncologic malignancy in terms of frequency, types, and outcome, and possible risk factors.

Methods
Between January 2020 and January 2023, 384 CVCs were inserted in 142 patients and prospectively evaluated till end of study period. Regarding each catheter, data were recorded on type, date of positioning, age and underlying disease of the patient, date and type of any complication, date of the last examination, and cause of catheter removal, if applicable.

Results
A total of 142 patients with a median age (IQR) at time of insertion of CVCs of 4.512 (7.5) years were evaluated. Patients with hematological malignancy constituted 71.1% (n = 101) and the rest were being treated for solid malignant tumors (n = 41). Complications developed in 98 (25.5%) CVCs. A total of 6357catheter days were screened. Median (range) CVC in-dwelling time was 15 (7- 22) days. In total, 129 complications developed of which 68(52.7%) were infectious complications, 42 (32.5%) were vascular, 16(12.4%) were mechanical and 3 (2.3%) were malfunction. The overall complication rate was 20.29 per 1000 catheter days. Subjects with hematological malignancies had significantly more complications than those with solid tumors (p = 0.040). The most significant risk factors for having a CVC complication were hematological malignancy, neutrophil count, platelet count before insertion and a D-Dimer in excess of 0.83mg/L. At end of study period one patient passed away because of catheter complications.

Conclusion
Appropriate knowledgeable and skilled teams are mandatory in order to address issues regarding indications, placement and removal techniques, choice of the devices, catheter care and possible complications in such a peculiar population. All health care professionals should receive regular and continued education on CVC usage, and complications.