bluuebunny/crossref_metadata_2025_split huggingface dataset:
Study of the Efficacy and Safety of Darbepoetin Alfa versus Epoetin Alfa in the Treatment of Anemia in Pediatric Patients on Regular Hemodialysis
Authors: Fouad Elhakim Ihab Zaki , Affifi Maged Elsayed , Ibrahim Nada Essam , Said Ragia Marei Ali 
Published: July 2024

Abstract

Background
Anemia is a common comorbidity in patients with chronic kidney disease (CKD). That affects the vast majority and can have a significant impact on patient morbidity and mortality. Erythropoiesis-stimulating agents (ESAs) are the main lines in management of anemia in hemodialysis patients. Replacement therapy with recombinant human erythropoietin (r- HuEPO) has provided an effective treatment for patients with renal “Epoetin alfa” is a recombinant erythropoietin with the same amino acid sequence as human erythropoietin (EPO). In comparison to epoetin alfa, darbepoetin alfa (DPO) contains an increased amount of sialic acid-containing carbohydrate chains. It shows a much longer elimination half-life than epoetin alfa, with prolonged erythropoietic effect.

Aim of the Work
to evaluate whether darbpoetin and epopoetin alpha can be used interchangeably on the same patient, achieving the same desired effect and to detect any difference in the occurrence of side effects between both ESAs.

Patient and Methods
This was a crossover study that took place in the Pediatrics Dialysis unit, Children’s Hospital, Ain Shams University. The study was conducted on 40 children with end stage renal disease on regular hemodialysis over a period of 6 months. The patients were randomly put into two groups A and B, each group contained 20 patients. Each group received one type of ESA either ( darbpoetin alpha or epopoetin alpha )for 3 months and then shifted to the other type of ESA for another 3 months. The dosage of epoetin alfa used was (200 IU/kg/week) and a conversion rate of EPO: DPO, 300:1. A period of 6 weeks was agreed as a washout period after the first drug given in both groups in which no results were recorded but ESA was not stopped due to its essentiality. Blood tests (hemoglobin (Hb), serum urea, serum creatinine and iron profile; (S. iron, S. ferritin, TIBC, and transferrin saturation)) were withdrawn at the start and the end of the 3 months’ period of each drug.

Results
We found no difference on the Hb level with both drugs. The interchange between them did not yield any significant drop in the Hb levels. Hb target in both EPO and DPO was reached in 22.5% of total cases, and was not reached in 62.5%. This proved that both drugs give the same effect with nearly negligible difference. No serious Sside effect as convulsions, hypertension, and thrombosis were noticed in both groups.

Conclusion
The target Hb was not reached in most patients of both groups of ESRD on regular hemodialysis at the unit and none of both drugs showed superior results or less side effects than the other.
Radiological Assessment of Hand and Wrist Bones in Malnourished Children
Authors: Elkhayat Hamed A , Elsyed Nahla M , Abdelhaleem Bassma A , Madkour Sherihan S 
Published: July 2024

Abstract

Background
Protein energy malnutrition (PEM) is still an important health problem that is responsible for childhood morbidity and mortality leading to permanent impairment of physical and mental growth.

Objective
This study is designed to assess the appearance of ossification centers of lower end of radius and ulna, carpals, metacarpals and phalanges in normal children and malnourished children then comparing between them, to detect early changes in bone growth in malnourished children.

Subjects and Methods
This case-control cross-sectional study included 45 malnourished children and 45 age and sex matched controls whose ages ranged between 6 months and 5 years. The patients were recruited from Pediatric Nutrition Clinic of Ain Shams University. All children (malnourished and control) were examined for anthropometric parameters (weight, height, body mass index (BMI) and mid upper arm circumference (MUAC)), investigated for serum calcium, phosphorus, alkaline phosphates and had a plain X-ray done on left hand and wrist (posteroanterior (P-A) view), the X-ray was analyzed by using A Digital Atlas of Skeletal Maturity.

Results
The plain X-ray hand and wrist showed delayed appearance of ossification centers in malnourished infants and children (97.8% had delayed bone age) when compared to controls (25.5% had delayed bone age) which was statistically highly significant with P-value &lt; 0.01. Signs of vitamin D deficiency rickets together with serum calcium, phosphorus and alkaline phosphatase were statistically significantly lower in the cases when compared to the controls with P-value &lt; 0.01. The statistical measurements of mean ± SD regarding weight of case group and control group was (9.05 ± 2.48, 13.54 ± 3.81) with P-value &lt; 0.01 which is highly significant, regarding length or height was (79.51 ± 12.78, 88.94 ± 15.02) with P-value &lt; 0.01 which is highly significant, regarding MUAC was (11.38 ± 1.91, 16.02 ± 1.26) with P-value &lt; 0.01 which is highly significant.

Conclusion
X-ray hand and wrist for malnourished infants and children showed delayed appearance of ossification centers when compared to matched controls.
The Prevalence of Gonadal Changes in Patients with Congenital Adrenal Hyperplasia
Authors: Eldin EL Kholy Mohamed Salah , Elsedfy Heba Hassan , Ahmed Rana Abdelhakim , Abdelrahman Marwa ElSayed , Mohamed Hasnaa Hassan 
Published: July 2024

Abstract

Background
Adrenal rest tumours can appear in early childhood in patients with congenital adrenal hyperplasia(CAH). The common cause of infertility in males with CAH is testicular adrenal rest tumours (TARTs). Ovarian adrenal rest tumour (OART) and polycystic ovaries (PCO) can impair the ovarian function in female patients with CAH.

Objective
Detect the prevalence of gonadal changes by imaging among patients with CAH andassess the patients' radiological findings in relation to their hormonal profile.

Patients and Methods
This observational, cross sectional study was conducted on 50 patients with CAH. Testicular ultrasonography was done to male patients and magnetic resonanceimaging (MRI) of the pelvis was done to female patients. Data on prescribed glucocorticoid dose and serum levels of 17- hydroxyprogesterone (17-OHP), androstenedione (Andro) and ACTH were obtained from medical records within endocrinology clinic, Children's Hospital, Ain Shams University.

Results
TARTs were detected in 10/20 (50%) of CAH patients. There was significant relationbetween presence of TARTs and each of weight standard deviation score (SDS), body mass index (BMI), BMI SDS and current bone age (p = 0.028, 0.046, 0.017 and 0.023; respectively). There was no significant relation between presence of TARTs and the laboratory parameters or the treatment received (p &gt; 0.05). There was significant correlation between Tanner testicular volume and mean testicular volume by ultrasound (p &lt; 0.001). Only one female patient had bilateral polycystic ovaries (prevalence 3.3%) and none had ovarian adrenal rest tumours.

Conclusion
The prevalence of TARTs in male patients in our study is high (50%), highlighting the importance of TARTs screening in children with CAH. We would suggest that routine ovarian imaging in CAH females is not indicated. However, when ovarian dysfunction is present, ovarian imaging is advised.
Intranasal vs Buccal vs Intramuscular Midazolam for the Home and Emergency Treatment of Acute Seizures in Pediatric Egyptian Patients
Authors: El-Rashidy Omnia Fathy , Elagouza Iman Ali , El Gaafary Maha Mohamed , Ramadan Mohammed Maha Zakaryia , Rashad El-Garhy Rana Ahmed Mohamed 
Published: July 2024

Abstract

Introduction: Acute convulsions in children are a common emergency worldwide. Benzodiazepines are the recommended first line of treatment. We wished to compare the efficacy, ease of administration and overall satisfaction of midazolam by the buccal, intranasal orintramuscular route in the treatment of acute seizures in Egyptian children both at homes and Emergency room (ER)

Methods
A prospective, randomized, trial was performed in children aged 1 months to 17 years with acute seizures lasting longer than 5 min. Children were randomly assigned to receive midazolam, 0.2 mg/kg, by the buccal, intranasal or intramuscular route. The primary endpoint was seizure cessation within 10 min of drug administration and no seizure recurrence within 30 minutes.

Results
There were 196 seizures analysed in home group, 67 patients received midazolam via buccal route, 60 via intranasal, 69 via intramuscular route while 105 patients were recruited from ER 37 patients received buccal midazolam, 34 received intranasal and 34 received intramuscular midazolam. Intramuscular midazolam stopped seizures within 10 min in 94.2 % in home group and 85.3 % in ER group. On the other hand, intranasal midazolam was successful to stop seizures in 93.3% in home group and 88.2 % in ER group within 10 minutes. The buccal route was effective in 91% in home group and 78.4 % in ER group. There were no significant differences in efficacy between all groups. P = 0.763 and P = 0.509 among home and ER groups respectively. Time to seizure cessation was significantly higher in the buccal group 5.11 ± 1.23minutes in home group and 5.91 ± 1.25 in ER group (P = 0.000). Highest overall satisfaction and ease of administration was seen in intranasal group especially among caretakers in home group &gt; 7= 49 (81.7 %) P = 0.002.. Intramuscular midazolam was more preferred by physicians in ERgroup &gt;7=32 (94.1%) (P = 0.001) There were no significant cardio-respiratory events in all groups.

Conclusions
Our results indicate that there is no clinically important difference between buccal, intranasal and IM routes of administration midazolam. Buccal and intranasal midazolam were safe and effective for treatment of acute seizures in children.
Effect of BAL Lipoxin A4 Level in Children with Bronchiectasis on Disease Severity
Authors: Fouda Eman Mahmoud , Ishak Younan Sally Raafat , Nabih Enas Samir , Osman Ahmed Mohamed , Hassan Shehab Yasmine El-Sayed Abd El-Rahman , Hussein Mahitab Morsy 
Published: July 2024

Abstract

Background
A central feature of most cases of bronchiectasis is airway inflammation. The elevated neutrophil count has been strongly correlated with impaired lung function, bronchiectasis severity, and disease duration. There is a failure of resolution of inflammation in bronchiectasis, leading to irreversible damage and dilatation of the bronchial airways with loss of mucociliary function. Lipoxins were the first agents to be identified as anti-inflammatory endogenous lipid mediators involved in the resolution of inflammation.

Aim of the Work
This study aimed to measure Lipoxin A4 level in bronchoalveolar lavage (BAL) of children with Cystic Fibrosis bronchiectasis (CF) and Non-CF bronchiectasis as a prognostic marker for clinical and radiological severity in these children as regard Bronchiectasis severity score.

Methods
A cross-sectional study was conducted at Children’s Hospital, Ain Shams University from December 2020 to December 2021, on children following up at the Pediatric Pulmonology Clinic. The study included 15patients with cystic fibrosis (CF) bronchiectasis, 15 patients with non-CF bronchiectasis, and 30 control cases,without breathing difficulty or signs of RDS. Human Lipoxin A4 was measured in BAL by ELISA.

Results
There was a significant difference between patients and controls as regards Lipoxin A4 level (p = 0.002),being higher in control group, but no significant difference in its level between CF and non-CF bronchiectasischildren(p = 0.663).

Conclusion
Severe bronchiectasis is associated with decreased airway Lipoxin A4 levels as lowest level of lipoxinA4 was found in severe cases by bronchiectasis severity score.
Effect of Omega-3 Fatty Acids Supplementation in Pediatric Patients with Type 1 Diabetes Mellitus
Authors: Elbarbary Nancy Samir , Rahman Ismail Eman Abdel , Mohamed Sarah Abdelaal 
Published: July 2024

Abstract

Background
Omega-3 fatty acids (O3FAs) are polyunsaturated fatty acids derived from fish oil. Beneficial effects of O3FA supplementation in a wide range of disease condition have been well studied. However; the role of O3FA in management of type 1 diabetes mellitus (T1DM) remains unclear and controversial.

Objectives
Therefore, we performed a randomized-controlled trial to assess the effect of oral O3FAssupplementation on glycemic control and lipid profile in pediatric patients with T1DM.

Methods
This study included 70 children and adolescents with T1DM. Patients were randomly assigned into two groups; intervention group and received oral O3FAs capsules (1 gram daily). The other group did not receive any supplementation and served as a control group. Both groups were followed-up for 6 months with assessment of fasting blood glucose (FBG), HbA1c and fasting lipids.

Results
Supplementation with O3FAs was safe and well-tolerated. After 6 months, O3FAs adjuvant therapy for the intervention group resulted in a significant decrease of systolic blood pressure, insulin dose, FBG, HbA1c, triglycerides, total cholesterol and LDL-cholesterol compared with baseline levels and compared with the control group (p &lt; 0.05). On the other hand, T1DM patients without O3FAs adjuvant therapy (control group) had higher blood glucose levels and HbA1c at study end compared with baseline levels (p &lt; 0.001).

Conclusions
O3FAs as an adjuvant therapy to insulin improved blood glucose levels, glycemic control and dyslipidemia leading to reduction in insulin dose in pediatric patients with T1DM.
Ameliorating Effects of Intermittent Fasting on Cardiac Dysfunctions in Experimentally Induced thyrotoxicosis in Adult Rats. Role of Ghrelin Hormone
Authors: ElSayed Mohamed H , Abou Shady Ebtessam A , Francis Marian M , Abd El Hamid Manal S 
Published: July 2024

Abstract

Background
Cardiovascular complications of hyperthyroidism have high morbidity and mortality rates. The cardioprotective effect of intermittent fasting (IF) in addition to the concomitant rise of blood ghrelin hormone level during IF have gained attention, but their effects on thyrotoxic hearts are still unclear. Therefore, we aimed to investigate the impacts of IF on hearts of rats subjected to induced thyrotoxicosis (TH) elucidating the role of ghrelin hormone in the assumed cardio protection.

Methods
Forty-five adult male Wistar Albino rats in 3 groups: control group, thyrotoxic group, injected IP with L-thyroxine100 μg/kg/day, 5 days/week for 4 weeks and intermittent fasting-treated thyrotoxic group, subjected to alternative day fasting regimen for 4 weeks. cardiac functions were assessed by in-vivo studies (ECG recording and arterial blood pressure evaluation) and in-vitro studies (responses to isoproterenol infusion using Langendorff’s preparation).

Results
Compared to the TH rats, intermittent fasting showed significant body weight loss, decreased left ventricular and whole heart absolute weights, with significant decrease of heart rate (HR) and prolongation of P-R interval in ECG. The baseline values of PT/LV, HRT and MFR/LV as well as their maximal responses and their delta changes in response to isoproterenol infusion were increased and were positively correlated to ghrelin hormone. Ghrelin hormone was increased in IF rats reaching the control group value and showed positive correlation with GPx and BCL-2.

Conclusions
IF conferred partial cardioprotective effects against thyrotoxicosis. These effects were attributed – at least partially- to normalization of ghrelin hormone which has anti-inflammatory, antioxidant as well as anti-apoptotic effects.
Studying Provider’s Satisfaction on Video Consultation by Ain Shams University Virtual Hospital
Authors: Mostafa Basma H A , Al Tehewy Mahi M F , Wahba Hoda M F , Basyoni Nashwa I A 
Published: July 2024

Abstract

Background
Video consultations were developed to allow long-distance patient and clinician contact, care, advice and monitoring which has been shown to improve patient health status. When rural settings, lack of transport, a lack of mobility, decreased funding, or a lack of staff restrict access to care, video consultation may bridge the gap.

Objective
To measure satisfaction of physicians involved in video consultations services provided at Ain Shams Virtual Hospitals (AVH). To identify the main factors affecting satisfaction of physicians involved in such video consultations services provided at AVH.

Methods
A descriptive cross-sectional study was conducted to measure satisfaction of a sample of providers of video consultations at AVH from December 2020 to March 2021.

Results
Total 37 physicians were included in the study, 29 physicians responded (78.3%). The mean age ±SD is 37.97 ±6.3 and their main specialties were neuropsychiatry (40.7%), internal medicine subspecialties (40.7%), and surgical specialties (18.5%). About 83% were confident with their diagnoses in video consultations and (13.8%, 75.9%) of the physicians reported that they always/sometimes suffered from bad quality of image/sound respectively. More than half of the physicians (53.5%) thought that lack of physical examination would affect the accuracy of the diagnoses and 53.5% of the physicians thought that video consultation would be suitable for follow-up patients post operatively.

Conclusion
Two thirds of the physicians had a positive experience and were satisfied with using video consultations in their clinical practices.

Recommendations
It is recommended to use video consultations in following-up of patients. It is also recommended to monitor provider`s satisfaction over time.
Imaging Spectrum of COVID-19 Associated Cranio-Facial Mucormycosis
Authors: Mustafa Abo-Gamra Sherif Hamed , Ahmed Teiba Mohamed Kamal , Abdelwahab Elrokh Aya Shaker 
Published: July 2024

Abstract

Background
The post COVID craniofacial mucormycosis was found to emerge since the second wave of the COVID pandemics. It was called black fungus as it was associated with high mortality rate.

Objective
To describe combined computed tomography (CT) and magnetic resonance imaging (MRI) characteristics of post COVID craniofacial mucormycosis for accurate diagnosis and determination of the extent of involvement.

Patients and Methods
The main source of data for this study was the archived CT and MRI imaging of the patients referred to the department of Radiology, Ain Shams University Hospitals.

Results
Our study population presented with craniofacial symptoms within 1-8 weeks from COVID-19 infection. The study revealed strong association between history of ICU admission, high doses of corticosteroids, oxygen administration and sever imaging MRI features of fungal sinusitis. Fungal invasion is not necessary to be through bony destruction.

Conclusion
The severest form of fungal sinusitis was found to be more commonly associated with ICU admission, usage of high doses of corticosteroids as well as patients who needed O2 therapy, the usage of contrast enhanced MRI should be combined with CT for assessment of disease extension as well as bony invasion.
Advanced Myocardial Characterization in Hypertrophic Cardiomyopathy: Feasibility of CMR-based Feature Tracking Strain Analysis
Authors: Abdelrahman Elkassas Lama Samir , Raief Mosaad Basant Mohamed , Ibrahim Ahmed Samir 
Published: July 2024

Abstract

Aim of the Work
This study aimed to evaluate the role of cardiovascular magnetic resonance feature tracking (CMR-FT) using a commercially available software module for analysis of left ventricular strain in hypertrophic cardiomyopathy patients.

Patients and Methods
A total of 20 HCM patients and 10 controls were studied. All patients were subjected to detailed clinical history taking and CMRI. Left ventricular global longitudinal, circumferential and radial strains were analyzed as well as segmental longitudinal and circumferential strains.

Results
LV mass in the HCM group was significantly higher than that in the control group (p &lt; 0.001). No statistical difference was found in ejection fraction (p = 0.074). Global circumferential strain (GCS) global longitudinal strain (GLS), segmental longitudinal strain (SLS) and segmental circumferential strain (SCS) in the HCM group were all significantly lower than the correlated parameters in the control group (p &lt; 0.001, respectively). Global radial strain (GRS) in the HCM group was significantly higher than the control group (p = 0.002). Additionally, SLS & SCS in the HCM group were both significantly lower, before global strain affection (p &lt; 0.001).

Conclusion
CMR-FT is a promising approach in analyzing impairment of global and segmental myocardium deformation in Egyptian patients with hypertrophic cardiomyopathy, non-invasively and quantitatively.
Assessment of Alpha Feto Protein in Patients with Hepatocellular Carcinoma Presenting to HCC Clinic During Era of COVID19 Pandemic
Authors: Ashraf Osama , Hamdy Hisham , Raafat Khaled , Mostafa Sahar Mohamed , ELsadek Azab Khaled Mohamed Abd 
Published: July 2024

Abstract

Background
Hepatocellular carcinoma (HCC), a major health problem worldwide, is one of the most common primary neoplasms of the liver and one of the most common solid tumors in the world. More than 500,000 new cases were diagnosed each year. HCC accounts for between 85% and 90% of primary liver cancer. It is the fifth most common cancer worldwide and the third most common cause of cancer mortality.

Aim of the Work
The aim of this study is to assess of alpha fetoprotein in patients who are diagnosed with hepatocellular carcinoma after COVID-19 infection.

Patients and Methods
This is cross Sectional Study on 60 Egyptian patients with HCC presenting to multidisciplinary clinic during era of Covid 19 pandemic divided into two subgroups: Group I: 30 patients with HCC and COVID 19 infection and group II: 30 patients with HCC who weren’t infected with COVID 19.

Results
In this study we found that there was insignificant difference between both studied groups as regards age and sex (p = 0.92 and p = 0.119, respectively). In this study we demonstrated that there was insignificant difference between both studied groups as regards etiology of HCC (p &gt; 0.05). In this thesis we cleared that there was highly significant difference between both studied groups as regards Liver presentations (P &lt; 0.001). In this thesis we found that there was significant difference between both studied groups as regards CBC (p &lt; 0.05). In this study we demonstrated that there was significant difference between both studied groups as regards liver function tests (p &lt; 0.05). Our results showed that that there was highly significant difference between both studied groups as regards AFP (p = 0.002). In study in our hands, we found that there was highly significant difference between both studied groups as regards tumor size and tumor stage (p &lt; 0.001). In this study we found that there was highly significant difference between both studied groups as regards MELD score (p &lt; 0.001). In this study we illustrated that Child Pugh class, MELD score, AFP and COVID-19 infection were the independent risk factors associated with poor survival among HCC patients

Conclusion
Our study concluded that tumor marker parameters, including AFP, can be used as Prognostic tools for HCC patients with СOVID-19. In which there were higher mortality rate among HCC with COVID-19 with higher levels of AFP.