bluuebunny/crossref_metadata_2025_split huggingface dataset:
Frequency of CD4+CD25 + (High) Foxp3+ Regulatory T cells (Tregs) in Peripheral Blood of Pediatric Patients with Autism
Authors: Mostafa Gehan Ahmed , Elhossiny AbdelBasir Reham Mohammed , Haleem Shousha Ghada Abdel , Shehab Abeer Al Sayed , Mohamed Hala Khalid 
Published: July 2024

Abstract

Background
Immune system dysfunctions have been observed in autistic spectrum of disorders (ASD). Autoimmunity may have a role in ASD. In addition, skewed cytokine responses, differences in total numbers and frequencies of immune cells and their subsets, neuroinflammation, both adaptive and innate immune dysfunction, altered levels of immunoglobulins and the presence of autoantibodies in some autistic children were reported.

Objective
To measure the frequency of CD4+CD25 + (High) Foxp3+ Tregs in peripheral blood of children with autism in relation to the disease severity.

Patients and Methods
This cross-sectional study involved 30 ASD patients were enrolled from the Psychiatry and Development clinic, Children’s Hospital, Ain Shams University, after excluding children with concomitant allergic diseases or infections. Another 30 healthy children were included as a control group. Severity of ASD and associated convulsions or impaired intelligence were demonstrated. The frequency of CD4+CD25 + (High) Foxp3+ Tregs was assessed using flow cytometry. Data collected were coded, tabulated and analyzed using Microsoft Excel software Statistical analysis (SPSS) (version 21, Chicago, IL, USA).

Results
Thirty patients with primary ASD were recruited, including 24 males (80%) and 6 females (20%) with mean age of 6.62 ± 2.11 years. Mild illness was diagnosed in 20 patients (66.7%) and severe illness was defined in 10 patients (33.3%)%). CD4+CD25 + (High) Foxp3+ Tregs were significantly lower among autistic children compared to healthy control (mean percentage in patients 15.41 ± 32.1%, mean percentage in control 49.2 ± 42.6%, P-value &lt;0.001). The markers were not correlated with disease severity, epilepsy status or IQ level (P = 0.716, 0.729, 0.472, respectively). However,CD4+CD25 + (High) Foxp3+ Tregs were significantly lower among male patients compared to females(Median in males 1.25 (0-96), Median in females 2.25 (1.5-84.2). CD4+CD25 + (High) lymphocytes less than 3.15 cells were found to be 80% sensitive and 73.5% specific for ASD probability (AUC was 0.816). Whereas percentage of FOXP3 less than 2.55% showed 73.3% and 76.7% sensitivity and specificity, respectively (AUC was 0.753).

Conclusion
CD4+CD25 + (High) FOXP3, the master promotor of Tregs, was detected in lower levels in ASD Egyptian children. A level of expression lower than 2.5% is both sensitive and specific for ASD diagnosis. We recommend considering CD4+CD25 + (High) FOXP3 as a future therapeutic target in children with ASD to achieve early, efficient management.
Follow Up of Cardiovascular Affection in Covid-19 Pediatrics Survivors
Authors: Abdel-Baset Ahmed Amira Mohamed , Mostafa El-Ganzoury Mona , Mamdouh Nevin Mohamed , Ibrahim Ahmed Samir , El-Samman Nora 
Published: July 2024

Abstract

Background
Multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19 is a rare complication of (SARS-CoV-2) infection. Presenting (4–6) weeks after infection as high fever, organ dysfunction, and strongly elevated markers of inflammation which is mostly due to post infection immune reaction.

Aim of the Work
to evaluate cardiac outcomes 6 months after initial presentation with MIS-C associated with cardiac affection.

Patients and Methods
This was a retrospective cohort study on 28 patients (19 boys & 9 girls) who were diagnosed as multi system inflammatory syndrome in children (MIS-C) related to COVID19 six months ago at children`s hospital, Ain shams university from January 2021 to October 2021. All patients were subjected to the following: (demographic data, clinical signs and symptoms, laboratory investigations) in the acute phase (obtained from patient’s medical records) and at follow up after 6- months.

Results
in our study all patients fulfilled criteria of MIS-C presented with fever, shock or cardiac dysfunction and gastrointestinal symptoms in addition to conjunctivitis and skin rash. Our patients were presented with hypotension with mean systolic blood pressure (87) mmHg & mean diastolic blood pressure (48) mmHg. Regarding symptoms: vomiting was seen in (60.7%), diarrhea in (32.1%), conjunctivitis in (82.1%) and cardiovascular abnormalities were seen in (100%) in the form of (myocardial dysfunction in (50%), coronary dilatation in (28.8%), valvular regurgitation in (100%) and pericardial effusion in (7.2%)). After 6 months there was significant improvement regarding vital signs. Regarding laboratory findings: at time of presentation most of the patients had high CRP, high troponin, and high CK-MB. On follow up after 6 months, all patients had normal values.

Conclusion
Our follow up study suggests that functional recovery and coronary outcomes are good in multisystem inflammatory syndrome in children.
Analysis of Risk Factors of Difficult Weaning from Mechanical Ventilation after Pediatric Cardiac Surgery: A Single Center Prospective Study
Authors: Eldeen Mansour Mervat Gamal , Youssef Moftah Hassan Mohamed El_Nabawy , Abdel Kareem Maha Ahmed Sayed , Azeem Khafaga Sabah Nasr Eldin Abdel , Magdy Sondos Mohamed 
Published: July 2024

Abstract

Background
Weaning from mechanical ventilation (MV( and timing of extubation are crucial components in the postoperative management of cardiac surgery as altered respiratory mechanics and positive pressure ventilation may have significant influence on hemodynamics. Aim: To evaluate risk factors for failure of weaning from mechanical ventilation after pediatric cardiac surgery and to assess the frequency of phrenic nerve injury.

Methodology
This Cohort study included medical records of 101 children admitted consecutively to Pediatric post-cardiac surgery ICU in Academy of Cardiovascular surgery in Ain Shams university Hospitals between April, 2020 and April, 2021, who had undergone heart surgery. The patients were divided into two groups : - successefully weaned group. - Difficult to wean group.
Diaphragmatic ultrasound was done for every difficult weaning patient to assess diaphragmatic paralysis. Result: Age (P &lt; 0.001), Weight (P &lt; 0.001), volum intake (P &lt; 0.001), systolic blood pressure (P = 0.017), Diastolic blood pressure (P = 0.004), were significantly lower in patients who showed difficult weaning compared to patients with successful weaning. Furthermore operation time (P &lt; 0.001), use of noradrenaline (P = 0.019), use of adrenaline ( P = 0.017), use of Milirinon ( P = 0.003), respiratory rate ( P = 0.003), inotropic support (P = 0.001), positive fluid balance (P &lt; 0.001), heart failure, renal failure, Pulmonary complications, need of pace maker, sepsis ( P &lt; 0.001), diaphragmatic paralysis ( P &lt; 0.001), transposition of great arteries operations ( P = 0.009), were significantly higher in patients who showed difficult weaning compared to patients with successful weaning. While use of dobutamine, discharge with open chest, reoperation, transfusion &gt; 50 ml / kg, urine output, reoperation bleeding and any operation other than atrial septal defect, transposition of great arteries all did not affect weaning difficulty.

Conclusion
younger age, operation time, as well as sepsis were the best predictors for difficulty of weaning.
The Effect of Chronic Restraint Stress Induced Alzheimer Like Changes In Male Adult Rats
Authors: Soliman El Bakly Wesam Mostafa , Magdy Yosra Mohamed , Tawfiq Sherin Shafik , Abdelazeem El Shal Amal Saaed 
Published: July 2024

Abstract

Chronic stress has become a common problem that cannot be ignored and has become an important risk factor for the onset of many diseases. Responses to chronic stress are systemic reactions involving multiple organs and can induce symptoms such as depression, cognitive impairment, cardiovascular disease, immune dysfunctions, impaired reproductive ability, bone loss, and reduced life expectancy.

Aim
The present study was designed to investigate the effect of chronic restraint stress on the cognitive function in male albino rats, further to demonstrate its relation to amyloid and tau protein accumulation.

Methods
24-albino male wistar rats were divided into 2 groups as Control group and Chronic restraint stress (CRS) subjected group (done by restraining rats for 3 hours daily for 4 weeks). Body weight, morris water maze test (MWM) and brain levels of p tau and amyloid beta were investigated

Results
CRS increased body weight significantly in week 4 and increased latency time as observed in MWM test compared to control group. Additionally, p tau and amyloid beta levels in CRS group were significantly increased.

Conclusion
chronic stress is able to accelerate the appearance of Alzheimer’s disease (AD) Changes upon chronic stress in the brain were related to accumulation of β-amyloid, TAU hyperphosphorylation in males.
Serum Levels of CXCL10 in Patients with Lupus Nephritis and its Relation with Disease Activity
Authors: El shirbiny Nourhan A , El Ganzoury Amal M , Abaza Nouran M , Azab Manar A 
Published: July 2024

Abstract

Objective
To evaluate the levels of CXCL10 in lupus nephritis (LN) patients and its relation with the activity of lupus nephritis.

Patients and Methods
Thirty four lupus patients were enrolled in our study, 17patients had lupus nephritis (LN) and 17 patients were without evidence of had lupus nephritis (LWN). Seventeen healthy subjects were also participated as a control group. Complete biochemical and serological parameters were measured and their correlation with serum levels of CXCL10 were assessed in the studied groups.

Results
The mean age of the LN patients was 31.94 ± 6.37,the mean age of LWN patient was 31.11± 6.42 and the mean age of the controls was 30.471± 4.705, Serum levels of CXCL10 were significantly elevated in LN patients group than LWN and control group with p-value &lt;0.001,While serum CXCL10 in LWN was statistically increased than control group with p-value&lt;0.001. Based on the receiver operator characteristic (ROC) curve analysis the efficacy of Serum CXCL10 levels in LN in a sample of Egyptian SLE patient This biomarker may be useful due to its high accuracy, with a sensitivity 94.12% and specificity of 76.47% as a biomarker of nephritis in SLE. There were statistically significant positive correlations between CXCL10 and 24 urinary protein (p-value = 0.031) (r = 0.524), creatinine (p-value = 0.003) (r = 0.682), renal activity (RSLEDAI) (p-value = 0.013) (r = 0.590) and Activity index (p-value = 0.003) (r = 0.669), whereas there was negative correlations between them and C3 (p-value = 0.021) (r=-0.554).

Conclusion
Being higher in patients with LN, CXCL10 might play a role in the pathogenesis of the disease. In addition to its excellent diagnostic performance for discriminating patients with lupus nephritis from other SLE patients, it might be helpful to predict the onset and progression of lupus nephritis in SLE patients and to detect renal flares.
Neuromuscular Phrenic Nerve Ultrasound versus Nerve Conduction Study of Phrenic Nerve in Amyotrophic Lateral Sclerosis
Authors: El Helow Mohamed Ragaai , Ahmed Sahar Fathi , El Bably Mona Mohamed , ElHadba Dina Maamoun 
Published: July 2024

Abstract

Background
Amyotrophic lateral sclerosis (ALS) is a fatal motor neuron disorder that is, characterized by progressive loss of the upper (UMNs) and lower motor neurons (LMNs) at the spinal or bulbar level. In the most advanced stages, ALS patients will develop symptoms of dyspnea due to weakness of respiratory muscles and subsequently death in ALS.

Objective
To compare between neuromuscular ultrasound and nerve conduction study of phrenic nerve in the assessment of pulmonary function in Amyotrophic lateral sclerosis patients.

Patients and Methods
This was a case control study performed in Ain Shams University Hospitals in the period from 2/2022 to 8/2022. The study included 15 patients diagnosed with Amyotrophic lateral sclerosis according to El Escorial revised criteria and 15 healthy people served as controls. Patients were randomized by a simple computer generated method into two groups: A study group (n = 15) and a control group (n = 15).

Results
This study showed that PNCS is more sensitive than CSA in the assessment of respiratory affection in ALS. PNCS is simple and easy to do and doesn’t need a highly equipped device. Also PN amplitude has a normal value and many studies were done about it. To our knowledge no research studies this correlation between PN CSA and PN amplitude in the assessment of respiratory affection among ALS patients.

Conclusion
Electrodiagnosis and Neuromuscular ultrasound have a valuable role in the diagnosis and monitoring ALS patients. This study showed that PNCS is more sensitive than PN CSA by NMUS in the assessment of respiratory affection in ALS. PNCS is simple and easy to do and doesn’t need a highly equipped device. Also there were well established reference values as many researches studied electrophysiology of phrenic nerve.
Biparametric versus Multiparametric MRI in Cancer Prostate Detection
Authors: Mahmoud Ali Ayah Tarek , Sheha Aliaa Sayed , Ahmed Tolba Mohammed Kotb , Mohammed Zedan Nehal Sayed 
Published: July 2024

Abstract

Background
Prostate cancer is the most frequently diagnosed cancer among men in over one-half of the countries of the world. Multi-parametric MRI is currently recognized as the best imaging method for assessment of cancer prostate.

Aim of the Work
comparing the diagnostic accuracy of mpMRI and bpMRI, according to PI- RADS V2.1 using the histopathological results as the standard of reference.

Patients and Methods
41 suspected prostate cancer patients were enrolled in our study based on elevated PSA levels or abnormal digital rectal examination, underwent prostate MRI. Images were interpreted first without DCE-MRI sequence then DCE-MRI was included, and scores were recorded, once for bpMRI and once for mpMRI.

Results
ROC curve analysis revealed that the AUC for the bpMRI and mpMRI protocols in diagnosing cancer prostate were 0.953 and 0.950 respectively and the difference was not statistically significant (P-value=0.875). Sensitivity, specificity and accuracy were calculated to reveal that when using PI-RADS score of ≥ 3 as a cut-off, bpMRI and mpMRI had exactly the same sensitivity, specificity, accuracy, PPV and NPV (100, 62.5, 85% respectively). When increasing the cut-off point of PI-RADS score to ≥ 4, the sensitivity of bpMRI decreased from 100 to 80, specificity increased from 62.5 to 93.75 yet, accuracy remained the same (85.4%). Whereas the sensitivity of mpMRI remained 100, specificity increased from 62.5 to 68.75 and accuracy increased from 85.4% to 87.8%.

Conclusion
bpMRI without DCE-MRI sequence did not lead to significant differences in diagnostic accuracy when using PI-RADS V2.1.
The Value of Magnetic Resonance Enterography Activity Indices in Evaluation of Crohn’s Disease Clinical Activity
Authors: AbdelWahed Waly Dalia Emad , Ahmed Aya Yassin , Abdulhafiz Essam Mohamed 
Published: July 2024

Abstract

Background
Crohn’s disease is a chronic inflammatory segmental bowel disorder characterized by attacks of remission and exacerbation that can significantly affect the patients’ quality of life. Hence monitoring the disease activity is crucial to achieve longer symptom free intervals which may result either from active inflammation and its complications as deep ulceration, fistulae formation and abscesses or sequelae from longstanding inflammatory process as fibrotic scarring and strictures.

Aim of the Work
to compare the performance of the currently available scoring systems Maria, Clermont, CDMI and MEGS to the clinical disease activity index and endoscopic indices

Patients and Methods
the study was conducted at the Diagnostic Radiology Unit; Radiology Department, Ain Shams University Hospitals. Over a period of 9 months. Convenience sample of proven cases of Crohn’s disease based on clinical suspicion, biomarkers, endoscopy and histopathological specimens who were referred for MRE enterography at our institution.

Results
We studied the relevance of 18 different single MR parameters and 5 indices in conjunction with clinical and endoscopic based scores. Our aim was to identify if any of the MR parameters can be used solely or in combination with others (indices) as predictors of disease activity. In our study, we identified that the presence of ulcers reflected the clinical rather than the endoscopic severity. Other individual MR parameters couldn’t predict either the clinical or endoscopic severity. The MaRIA score showed significant correlation with the clinical but not endoscopic score. The simplified MaRIA score reflected both the endoscopic and clinical severity scores regarding their absolute values and severity grade. Neither Diffusion- MaRIA/Clermont nor the CDMI scores could predict the degree of clinical and endoscopic disease severity. MEGS score was the most reliable score in determining the endoscopic activity despite being a consuming score with relative subjectivity in comparison to the forementioned scores.

Conclusion
MR indices provide an adjunct tool for evaluation of disease activity and identifying the severe disease evidenced by MaRIA, simplified MaRIA and MEGS scores. However, the use of a single MR parameter doesn’t provide a true reflection of the ongoing disease process, even the presence of ulcers and haustral loss may be associated with chronic disease.
Role of Ultrasound Imaging in Detection and Diagnosis of Different Types of Inflammatory Breast Diseases
Authors: Amin Khedr Heba Salah Tawfik , Amin Sherine Kadry , Louka Amir Louis 
Published: July 2024

Abstract

Background
Mastitis refers to inflammation of the breast parenchyma, often presenting with pain, heat and redness that may be a debilitating illness with prolonged morbidity. It may also present with a wide array of other nonspecific symptoms, which may lead to delayed diagnosis and inappropriate treatment.

Aim of the Work
The study aims to discuss different types of inflammatory breast diseases encountered by ultrasound and to distinguish their diverse radiological findings aiding in the early diagnosis to establish good prognosis.

Patients and Methods
This was a cross-sectional study which was carried out at Ain Shams University Hospitals; the study was conducted on 75 women with inflammatory breast diseases referred to the Radiology Department and Surgical outpatient ‘s clinics.

Results
Follow up by u/s and histopathology of the studied group revealed that 72(96.0%) were resolved and 3(4.0%) were IDC by histopathology. Final results regarding our statistical findings for our cases in differentiation between inflammatory lesions of the breast with sensitivity about 85.98 and Specificity about 85.46, the AUC was 0.898.

Conclusion
Ultrasound plays a fundamental role in the diagnostic work up of mastitis patients. An ideal ultrasound should ensure an accurate diagnosis, guide for interventional procedures whenever necessary and should be used to monitor adequate management by short term follow up studies along the course of therapy.
MRI Imaging Appearance in Mullerian Duct Anomalies
Authors: Shebreya Naglaa Hussein , Elsaed Elsaed Yasmin Tharwat , Ragheb Samar Ramzy 
Published: July 2024

Abstract

Background
Müllerian duct anomalies include a complex spectrum of anatomical anomalies that arise from deviations during the normal development of the Müllerian ducts. In paediatrics, such defects cannot present with any clinical symptoms before puberty, yet, they can also have obstructive symptoms or a mass effect due to presence of a non communicating rudimentary horn or transverse vaginal septum. At the beginning of puberty, girls with these anomalies might have primary amenorrhea, pelvic pain or endometriosis. Müllerian duct anomalies have also associated with a variety of other congenital abnormalities.

Aim of the Work
To review MRI features of Mullerian Duct Anomalies and classify them according to ASRM and ESHRE-ESGE classifications.

Patients and Methods
The study was a case series study that included 37 patients who underwent pelvic MRI at Radiology Department “Ain Shams University hospitals” in Cairo, Egypt.

Results
In our study, Hypoplastic, Agenesis and Didelphysis found to have the same ratio of (21.6%), while Bicornuate uterus was (13.5%), septate (8.1%), unicornuate and transverse vaginal septum all were of (5.4%) incidence and the least common was arcuate uterus with (2.7%) incidence.

Conclusion
MRI is a highly helpful technique for evaluating female genital abnormalities and is able to consistently provide the essential imaging characteristics for the accurate identification of Mullerian malformations. Additionally, incidental pelvic disease and any related renal abnormalities may be thoroughly evaluated by MRI in a single scan, removing the need for additional diagnostic procedures.
Chest CT Features of Coronavirus Disease-19 (COVID-19) Pneumonia: Which Findings on Initial CT can Predict an Adverse Short-term Outcome?
Authors: Sharara Sherine Ibrahim , Naguib Alaasar Maha Mahmoud , Mohamed Abeer Maher Ali 
Published: July 2024

Abstract

Background
COVID-19 is a highly contagious viral disease that caused daunting challenges to the health care system; early diagnosis plays a pivotal role in management and prognosis of the disease.

Aim of the Work
To study the spectrum of chest CT features in coronavirus disease-19 (COVID- 19) pneumonia and to identify the initial CT findings that may have the potential to predict a poor short-term outcome.

Patients and Methods
This was a retrospective study that included 60 patients (30 clinically improved and 30 clinically deteriorated patients) with RT-PCR confirmed COVID-19 infection who referred to the Radiodiagnosis Department at Ain Shams University Hospitals for chest HRCT examination. An acceptance from the ethical committee of the Radiology Department and the ethical committee of Faculty of Medicine - Ain Shams University was obtained to use the data stored on PACs system with the patient’s consent waived being a retrospective study.

Results
Shortness of breath, fatigue and presence of other comorbidities were more common in unstable group, seen in 93%, 86% and 66% respectively. CT severity score was higher in unstable group ranging from 12 to 26 together with anteroposterior distribution, central and peripheral distribution, crazy paving and consolidation with air bronchogram.

Conclusion
Comparison between clinically stable and unstable COVID-19 patients regarding clinical data at admission and initial CT chest findings revealed that higher percentage of total lung affection, central and peripheral involvement, anteroposterior distribution, crazy paving, consolidation with air bronchogram and vessel enlargement were the harbingers of poor prognosis especially in patients of old age, having other comorbidities and presented with shortness of breath.