bluuebunny/crossref_metadata_2025_split huggingface dataset:
Non-Invasive Electrical Cardiometry versus Echocardiography for Assessment of Patent Ductus Arteriosus Hemodynamic Response to Medical Treatment in Preterm Neonates
Authors: Gad Ghada Ibrahim , Abd–El-Aziz Eman Mahmoud , El-Samman Nora Hussein , Saleh Ghada Ahmad 
Published: July 2024

Abstract

Background
Patent ductus arteriosus (PDA) poses a diagnostic and a therapeutic dilemma for neonatologists. Although echocardiography (Echo) has been the gold standard diagnostic tool for PDA, it requires a trained cardiologist or neonatologist to perform and it is usually not available around the clock. Echo provides also a single rather than continuous assessment of the sick neonates, whose hemodynamic status changes quickly. Electrocardiometry (EC) is a new device for continuous hemodynamic monitoring of neonates.

Aim of the Work
To evaluate the accuracy and precision of EC in comparison to ECHO in assessment of PDA response to treatment in preterm neonates.

Patients and Methods
This diagnostic accuracy study was conducted in the neonatal intensive care units (NICUs) of Children’s Hospital of Ain Shams University, Cairo, between (1/5/2021 and 31/3/2022). The study was approved by the ethical committee of Ain Shams University. Preterm neonates&lt;35weeks gestational age admitted during the study period were eligible for enrollment. Neonates with hemodynamically non-significant PDA and those with other congenital anomalies were excluded. A baseline echo and electrical cardiometry were done at the time of enrollment and on day 5.

Results
Forty neonates were enrolled (27 females, 13 males). Closure rate of oral ibuprofen was 100% (39/39) while paracetamol failed to close the PDA in one patient (closure success 0%). Echo and EC didn’t agree upon the tested parameters (stroke volume (SV), cardiac index (CI), ejection fraction (EF), cardiac output (CO) but agreed in measuring heart rate (HR). In patients with inotropes, Echo detected significant changes in CO (p = 0.044) and CI (p = 0.047) but no changes in SV, EF and HR (p = 0.41, 0.506 & 0.105 respectively). In patients who needed mechanical ventilation, Echo detected significant changes in CI (p = 0.008), CO (0.006) and SV (0.042). No changes were detected in any parameter by EC in patients who needed either inotropes or mechanical ventilation (p &gt; 0.05 in all parameters).

Conclusion
While EC is safe and an easy to apply device, our results show that electrocardiometry is not as accurate as the echocardiography in predicting the hemodynamic changes that might correspond to the closure of PDA in preterm neonates with hemodynamically significant PDA.
Cord Blood Hemoglobin Levels in Full Term Neonates of Mothers with Iron Deficiency Anemia
Authors: El-Deen El-Farghali Ola Galal Bader , Ahmed Mortada El-Sayed , Abdel Hamed Azzam Nesmahar Tark , El-Mohamdy Hasb El-Nabi Marwa Adham , AbdElaziz Rezk Sara Helmy 
Published: July 2024

Abstract

Background
Iron is a critical micronutrient for tissue oxygenation, cellular metabolism, energy generation, and the metabolism of toxins. Iron transfer from mother to fetus is a regulated process involving iron status in the maternal circulation, its transport across the placenta and subsequent transfer into the fetal circulation.

Objective
To evaluate cord blood Hemoglobin (Hb) levels in neonates of mothers with iron deficiency anemia (IDA).

Patients and Methods
This prospective case-control study was conducted at Ain Shams University Hospitals. It included 60 full terms newborn who were born at Obstetrics and Gynecology Hospital. The study population included full term neonates delivered at ≥ completed 37 weeks of gestation which was divided into two groups according to maternal risk factor: Case: full term neonates with maternal risk factor. Control: full term neonates without maternal risk factor. Thorough clinical examination and investigations were performed including cord blood samples collected for measurement of the level of complete blood count (CBC; (Hb, MCV and MCH). For the mothers, venous blood samples were withdrawn with standard precautions and strict sterile conditions for CBC, transferrin saturation and serum ferritin.

Results
In comparison between cases and controls as regard RBCS parameter, there was no significant difference between cases and controls regarding neonatal hemoglobin( 14.93±1.14 vs 15.44 ±1.35(g/dL), p = 0.12) and MCH (32.51±2.9 vs33.57 ±1.9 (pg), p = 0.10), but there was significantly lower MCV in cases compared to controls (104.07± 7.36 vs 109.60±4.93 (fL), p = 0.001). There was no significant difference between cases and controls as regard maternal clinical characteristics including (age, weight, height, maternal diseases, gravidity, consanguinity and mode of delivery, p &gt; 0.05 for all). Also, there was no significant difference between cases and controls regarding neonatal weight, Z score for weight, length (cm), head circumference (cm) and gestational age by Ballord Score and Apgar Score in 1-minute and 5-minute score p &gt; 0.05 for all).

Conclusion
There was no relation between the maternal Hb deficient levels and neonatal Hb. The first sign of iron deficiency in neonates reflected in lower MCV in cases, but not reached to decrease Hb levels in neonates.
Evaluation of Vitamin (A) Deficiency among Critically Ill Children with Sepsis
Authors: Ibrahim Hanan M , Abd El Aziz Manal M , Magdy Sondos M , Essam Haya M , Gad Ebthal E 
Published: July 2024

Abstract

Background
Vitamin A is an immunomodulatory, and its deficiency may cause impaired immune function, which are found in sepsis. There is a biological rationale that vitamin A deficiency (VAD) may be a contributing factor related to poor clinical outcomes in patients with sepsis.

Aim of the Work
to assess the prevalence of vitamin A deficiency in critically ill children with sepsis and its association with clinical outcomes.

Patients and Methods
This cross-sectional study included 40 critically ill children with sepsis who were admitted to the paediatric intensive care unit. The control group consisted of 40 age- and sex-matched approximate-health children from outpatient clinic. For the measurement of serum vitamin A status, blood samples were taken from all patients within the first 24 hours of admission. The vitamin A status of the sepsis and control groups were compared. Univariate and multivariate approaches were used to assess the link between vitamin A deficiency and sepsis.

Results
The study enrolled 40 children with sepsis and 40 matched healthy children so there was no statistically significant difference between controls and patients among age and sex, with median age 4 (2 – 12) months for both groups with male predominance (60.0%). Regarding body measures there was a high statistically significant lower values among patients group than controls group for z score of weight, height/length, body mass index (BMI) and mid arm circumference (MAC) of the studied subjects, that indicated increased malnutrition prevalence among septic children than control group. In the present study, by comparing VAD between patients and controls, there was high statistically significant difference as all septic patients (100%) had VAD and the VAD among healthy control was found in 30% of them. We also found that patients with septic shock, patients who were nothing per os (NPO), patients on ventilators and died patients were more deficient in vitamin A level than other patients compared with them (high statistically significant difference), illustrated that VAD may be had a role in sepsis related morbidity and mortality. There was a positive correlation between vitamin A and BMI z score and MAC while there was a negative correlation with prism 3 and prism 4.ROC curve for assessment of vitamin A as a predictor of sepsis, found that at cut off value ≤9 μg/dl, the Sensitivity, Specificity, positive predictive value (PPV) and negative predictive value (NPV) were 100% for each.

Conclusion
low level of vitamin A, lower than or equal to 9 μg/dl was associated with sepsis, septic shock, and higher PRISM score. Vitamin A deficiency may be a marker of morbidity and mortality in critically ill children with sepsis.
Assessment of the Validity and Reliability of an Arabic Version of Autism Behavior Checklist: One Center Study
Authors: Rihan Lamiaa Safwat , Youssef Azza Mohamed , Abdelaziz Asmaa Wafeeq , Abdelmageed Reham Ibrahim 
Published: July 2024

Abstract

Background
Autism behavior checklist (ABC) is a list of questions concerning a child's behaviors as a part of a broader tool, the Autism screening instrument for educational planning (ASIEP). To date, this checklist has not been translated into Arabic, and therefore, it cannot be used with Arabic speaking patients.

Objective
To translate the Autism Behavior Checklist from English to Arabic and to assess the psychometric properties of the Arabic version.

Patients and Methods
A total of 400 Arabic fluent mothers or caregivers of autistic and typically developed children aging 2-14 years recruited from Developmental and behavioral clinic and outpatient clinic-pediatrics hospital, Faculty of Medicine, Ain Shams University participated in the study. The Arabic version of Autism behavior checklist was checked for its structural validity and reliability.

Results
Of 400 children included in the study, the autism group consisted of 114 boys (76%) and 36 girls (24%), mean age was 7 years ± 1.8 years, and the typical development group consisted of 145 boys (58%) and 105 girls (42%),mean age was 7.4 years ±1.6 years. The Autism behavior checklist was translated following the international guidelines. Autism behavior checklist yielded a five factors model by exploratory factor analysis (EFA). Kaiser-Meyer-Olkin (KMO) statistic was (0.671), Bartlett's Test of Sphericity was statistically significant (P-value&lt; 0.05) with chi square test value of (χ2 = 22231.064, df = 1596). Overall, the 75 items revealed good internal consistency, Cronbach's alpha was (0.972), the intra- class correlation coefficients (ICC) of the five subscales ranged from 0.423 to 0.677 (P &lt; 0.01). At two weeks interval the ICC of the five subscales ranged from 0.335 to 0.856 and the total score was 0.869 (P &lt; 0.01).

Conclusion
The Arabic version of Autism Behavior Checklist (AV-ABC) is a valid and reliable tool to screen and assess cases with autism spectrum disorder.
Possible Protective Effect of Trimetazidine Alone and in Combination with Methotrexate in Attenuating Joint Inflammation in Freund’s Adjuvants Induced Rheumatoid Arthritis in Rats
Authors: Omran Enas , Mohamed Doaa I , Ezzat Samar F , El Lithy Ghada , Tarek Marwa 
Published: July 2024

Abstract
Rheumatoid Arthritis is a complex chronic auto-immune systemic illness. It is primarily characterized by synovial hyperplasia and localized pro-inflammatory cytokine production that causes chronic synovitis and a long-lasting inflammation of the joints and bones. The study's goal was to look into the potential anti-arthritic effects of trimetazidine in a rat model of Freund’s complete adjuvant (FCA)-induced arthritis, which has many clinical and biochemical similarities to rheumatoid arthritis (RA). The underlying antirheumatoid arthritis mechanism, as well as its impact on TLR4/NFKB pathway were investigated to understand and confirm its potential efficacy in RA treatment. Our study was based on 4 groups, control group received saline injections, trimetazidine (7.2 mg/kg/day) treated group, methotrexate (0.75 mg/kg/week) treated group and combination group that received both medications in the same doses for 21 days. The degree of ipsilateral paw swelling, ankle diameter, body weight, tissue expression levels of TLR4(toll like receptor) and NFKB (nuclear factor kappa b) in paw, and serum ACPA (anticitrullinated protein antibodies) were all measured. With a slight but not statistically significant impact on ankle diameter, trimetazidine and methotrexate considerably reduced the arthritic symptoms as indicated by ipsilateral paw volume. It had no discernible impact on body weight. Together with the overall improved synovial hyperplasia and cartilage disarrangements, TLR4 and NFKB expression in synovial tissue were reduced. In a rat model of CFA-induced arthritis, trimetazidine displays a considerable anti- inflammatory impact that is even better than methotrexate and has the potential to be anti-arthritic. Additionally, there is a large additive effect between the two medications.
Role of Vascular Endothelial Growth Factor A in Pediatric Hemophilic Arthropathy
Authors: Mohamed Saboony Omar Ahmed , El Sebaie Mona Abdullah , Mohamed Ragab Iman Ahmed , El Din El Mikkawy Dalia Mohamed Ezz , Abdelmohsen Labib Hossam Salaheldin 
Published: July 2024

Abstract

Background
Hemophilia A is a hereditary bleeding disorder caused by the lack of blood clotting factor VIII. The incidence is about 1 in 5000. Although some progresses have been made in the treatment of the disease, arthropathy caused by joint bleeding is still a challenge to prevent and treat, which often results in joint deformity and disability, Biomarkers may give us the chance to early predict the joint arthropathy.

Objective
assess the level of serum VEGF-A as a vascular biomarker in children with hemophilia A to identify its possible role in hemophilic arthropathy and its severity.

Methods
This study included thirty child patients with clinical evidence of hemophilic arthropathy and thirty healthy matched age and sex as controls. All underwent history taking, clinical examination, Laboratory investigations including Vascular endothelial growth factor A.

Results
serum VEGF-A levels were significantly higher in patients than control group (p &gt; 0,001) with sensitivity of 83.33% and specificity of 70.0%.it showed significant positive correlation with hemophilia severity (r=-0.734)(p &lt; 0.001).

Conclusion
serum VEGF-A level was higher in Hemophilic patients which serve as a diagnostic marker for HA, also its significant correlation with severity may serve as a marker for disease progression and severity.
Aesthetic and Functional Evaluation of Abdominal Contouring Using Lipo-Abdominoplasty versus Lipo-Abdominoplasty with TULUA Procedure: A Comparative Clinical Study
Authors: Fahmy Hany Fouad A , Helal Hesham A , Afifi Salah Nasser M , Elsherbeny Khaled M , Mohamed Eman Nagy 
Published: July 2024

Abstract

Background
Lipoabdominoplasty techniques may be followed by a wide range of complications as flap necrosis, wounddehiscence, surgical site infection, epigastric bulging, malpositioned umbilicus, high transverse scar and seroma formation. Villegas in 2014 introduced the TULUA abdominoplasty to improve the aesthetic outcome and to avoid the many associated complications mentioned. The objective of this study is to compare the aesthetic and functional outcomes between the traditional lipoabdominoplasty and TULUA abdominoplasty.

Methods
in this prospective comparative clinical study, sixty adult women with excess subcutaneous abdominal fat and skin laxity after repeated pregnancies with mild to moderate degree of diastasis of recti were included. The patients’ ages ranged between 28-55 years, their BMI scores were 25-35 kg/m2. Group A (30 patients) underwent lipoabdominoplasty while group B (30 patients) underwent TULUA abdominoplasty. The patients were followed up for a minimum of 6 months where the comparative study included aesthetic results as regards the abdominal contouring using clinical outcome scaling systemin addition to functional aspects assessing anatomical features, changes in anterior abdominal wall and finally the complication rate between both techniques.

Results
The average total liposuction aspirate volume of the abdomen was 2400 ml in group A, while in group B, the average volume was 3500 ml. The mean surface area of vertical plicature measured intraoperatively was 211.93 (±54.66) cm2 in group A, while in group (B) transverse plicature surface area was 369.47(±84.22) cm2. The increase in intra-abdominal pressure IAP after plication and skin closure in group A was 7.93±1.26 cmH2O; while for group B there was a highly significant increase by 9.87±1.01 cmH2O. Flap sloughing was seen in 4 cases(13.3%), wound dehiscence 2 cases (6.6%) seroma in 3 cases(10%) for group A,conversely no cases reported flap necrosis, wound dehiscence or seroma that need to be aspired in group B. The aesthetic outcomes were evaluated using a 5 points likert scale system through three indicators, f or group A,an overall result that was 4.50 ± 0.87, umbilical appearance 4.61±0.73, and scar quality 4.35 ± 0.82; On the other hand group B showed overall result 4.53 ± 0.71, umbilical appearance 4.52 ± 0.82, and scar quality 4.43 ± 0.87.

Conclusions
TULUA procedure is a safe, reproducible shift in abdominoplasty, with fewer complications to occur.
Assessment of Patients’ Satisfaction after Reconstruction of Unilateral Microtia Using Modified Questionnaire Form
Authors: Shafik Fady Rezk , Abdelhalim Mohamed M , Gad Ahmed M , Elshahat Ahmed 
Published: July 2024

Abstract

Background
Microtia is a rare and severe craniofacial abnormality that impairs newborns' appearance. The most favored treatment for microtia is regarded as autologous ear reconstruction. Patient satisfaction is paramount element in improvement of surgical outcomes. Most studies depended on medical stuff reviews for reconstruction.

Aim of the Work
Thus, this study aims to help define items that individual’s own satisfaction is based on.

Patients and Methods
In this cross sectional study, 44 patients, 28 females and 16 males ; with unilateral microtia underwent autologous ear reconstruction using costal cartilage graft were selected. Bilateral cases and Anotia types were excluded.6th to 8th costal cartilage were harvested in the 1st stage to shape the framework. Elevation was done in the 2nd stage. Satisfaction was recorded using a questionnaire form 4 months postoperatively.

Results
All patient were satisfied with their surgery and never regret doing it. Helix and lobule get higher satisfaction rates than those for antihelix and concha.

Conclusion
Helix and lobule of reconstructed auricle get the highest level of satisfaction while antihelix and concha still need more continuous work and follow up to enhance their aesthetic outcome.
Chest Computerized Tomography Findings in COVID-19 Patients Presenting to the ER with Gastrointestinal Symptoms
Authors: Ali Noreldien Ali hagag , Ali El Hefnawy Suzan Baheeg , Yousef Yousef Ahmed , Mohamed Said Nariman Hussein 
Published: July 2024

Abstract

Background
The world continues to face a life-threatening viral pandemic. SARS-CoV-2 has caused over 98 million cases and 2.2 million deaths since January 2020. Chest Computerized tomography is one of the main modalities in the screening and diagnosis of corona virus disease; yet it must correlate with the clinical and laboratory findings. Among available modalities for detecting COVID19, Chest Computerized tomography was done mainly in symptomatic and in high risk patients showing a sensitivity of 94.6% and specificity of 46.0%.

Purpose of the Study
Detecting COVID19 patients presenting initially or mainly with Gastrointestinal manifestations and to help preventing misdiagnosis and overlooking these patients. In addition to estimating the prevalence of these COVID19 patients presenting with gastrointestinal symptoms only versus those presenting with combined gastrointestinal and respiratory manifestations.

Results
This study included 95 patients recruited from the Ain-shams and Souad Kafafi University Hospitals from August 2021 till March 2022. These patients presented with gastrointestinal symptoms as their initial or main symptoms with positive PCR test. They were investigated by Chest CT and were interpreted by experienced radiologists in reading CT chest. From such patients, (32%) presented with gastrointestinal manifestations only. The rest of the patients were presenting mainly with gastrointestinal symptoms and associated with chest symptoms. A recurrently observed pattern of bilateral peripheral Ground glass opacities with basal predominance was found in gastrointestinal only group CT scans. Bilateral involvement, consolidation, crazy paving and multi lobar affection were statistically significantly higher in combined group in comparison to GIT only group.

Conclusions
Commonest Chest CT pattern was bilateral, peripheral GGO with basal predominance among Gastrointestinal only group. These findings indicate high possibility of COVID 19 even in the absence of chest symptoms. Consequently, a rapid diagnosis and earlier quarantine will assist in better treatment and prognosis.
Validation of LI-RADS Treatment Response Algorithm after Loco-Regional Therapy of Hepatocellular Carcinoma
Authors: Mohamed Ezzat Sarah Mohamed , El Gaafary Sahar Mohamed , Kamel Abdelmaksoud Mohamed Hosni , Mohamed Mohamed Yosry 
Published: July 2024

Abstract

Background
Hepatocellular carcinoma (HCC) is the third cause of cancer related death worldwide and liver cirrhosis is the most common predisposing factor for HCC. Loco-regional therapy as radiofrequency ablation (RFA) or trans-arterial chemoembolization (TACE) have very important role as potentially curative or palliative methods for treatment of HCC.

Objective
To investigate the potential application of LI-RADS Treatment Response [LRTR] algorithm in terminology and diagnostic performance after local- regional treatment of hepatic lesions.

Methods
During the period from September 2021 to March 2022, the present study included 31 patients: 26 were males and 5 were females with hepatocellular carcinoma treated by loco-regional therapy including 21 conventional TACE and 10 RF. Their ages ranged between 51 - 80 years with mean age of 70 years old.

Results
There were excellent inter-observer agreements between both reader radiologists regarding the classification of treated HCC: LR-TR viable, LR-TR non- viable and LR-TR equivocal according to major features of LIRADS. DWI and ADC as well as T1 and T2 pre-contrast signal are considered good ancillary features in evaluating post treatment response of treated HCC.

Conclusion
Our study demonstrates that LIRADS treatment response algorithm is a good reporting system for explaining the outcome of the treated HCC with loco-regional therapy as it doesn’t depend only on APHE and mentions that there is expected post-treatment enhancement pattern that does not denote viability. This isn’t found in modified RECIST criteria.