bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcome of Neonatal Registry Through Electronic Medical Registry at Neonatal Intensive Care Units, Children's Hospital of Ain Shams University
Authors: El-Farrash Rania Ali , Mohamed Ammar Alaa Ragab , Farid Yasmin A 
Published: July 2024

Abstract

Background
The neonatal mortality rate is 19 deaths per 1000 live births worldwide. Studies have shown that neonatal registry network systems can provide the necessary data for establishing evidence- based strategies to decrease the complications in high-risk neonates and consequently reduce neonatal mortality rate.

Aim of the Work
To determine the frequency and distribution of neonatal critical illnesses in Neonatal Intensive Care Unit (NICU) of Ain Shams University.

Patients and Methods
This descriptive study was conducted in NICU, Children's Hospital, Ain Shams University. The data collected from initiated neonatal registry through electronic medical record to reach sample size number (381) patients. The current study was conducted after approval by the Department of Pediatrics, and the local Ethics and Research Committee, Faculty of Medicine, Ain Shams University.

Results
The mean ± (SD) age at admission was 5.52 ± 6.9 days, gestational age was 36.19 ± 2.47 weeks, more than half of our patients were males (55.6%) and females represented in (44.4%). Two- thirds (64.2%) of our participants were full term, and preterm were only (35.7%). The main etiology of NICU admission was respiratory disease (35.7%), followed by neonatal sepsis (25.2%), neonatal jaundice (21%), congenital anomalies (12.3%), CNS diseases (6.8%), inborn errors of metabolism (1%) and mortality rate was 10.5%. Four cases had inborn errors of metabolism in the form of: Maple syrup urine disease (one case), organic academia (one cases) and 2 cases referred to genetic clinic for further assessment. Congenital heart diseases in our study was reported in (7.9%) of neonates. The main etiology among them was reported in following order: PDA / pulmonary hypertension (26.7%), VSD (13.3%), Fallot tetralogy (10%), transposition of great arteries (10%), supraventricular tachycardia (6.7%) then many etiologies represented in 3.3% as Ebstein anomaly, right single ventricle, heart block, pulmonary artery stenosis, arrhythmia, tricuspid atresia and left hypoplastic heart disease.

Conclusion
This study showed the ability of the electronic medical record to store large amounts of data which creates a potential for information overload in the intensive care (ICU) setting. This will stimulate and facilitate research on neonatal critical illness and its management, mortality and morbidity outcomes of neonates admitted to NICUs in Children's Hospital, Ain Shams University, Egypt.
Screening of Palatopharyngeal Incoordination in Mechanically Ventilated Critically Ill Infants
Authors: Ibrahim Youssef Hanan M , Rezk Ahmed R , Abdel Hameed Mohamed Abeer Maghawry , Refaat Salem Ahmed Mohamed , Ahmed Mohamed Ahmed Elsayed 
Published: July 2024

Abstract

Background
Palatopharyngeal incoordination is a common phenomenon in patients requiring endotracheal intubation for mechanical ventilation. Understanding the underlying mechanism of palatopharyngeal incoordination may help as a screening tool that improves rates of early recognition and diagnosis and the ability to take preventive measures essential to alleviate related morbidity and complications.

Objective
The aim of this study is to screen palatopharyngeal incoordination in infants who needed mechanical ventilation and to elicit palatopharyngeal incoordination secondary to mechanical ventilation.

Material and Methods
This study included 51 patients at the Pediatric Intensive Care Unit, Faculty of Medicine, Ain Shams University, The study was conducted during the period from February 2021 to February 2022. patients were classified according to a Fiberoptic Flexible Endoscopic Evaluation of Swallowing (FEES) early post intubation, FEES early post extubation, Videofluoroscopic Swallow Study (VFSS) post extubation and dye study into five groups: group (1) the not affected group, group (2) the palatopharyngeal incoordination group, group (3) The palatopharyngeal incoordination with gastro esophageal reflux group, group (4) The reflux group, group (5) The congenital upper air way anomalies group in which patients were ventilated due to respiratory distress. Follow up FEES and VFSS were done after three months for palatopharyngeal incoordination patients.

Results
Palatopharyngeal incoordination was detected in 16 patients (31.3%), congenital upper airway anomalies were found in 12 patients (23.5%), and gastroesophageal reflux was only detected in 10 patients (19.6%). Performing VFSS and FEES after three months showed 92.3 % of palatopharyngeal incoordination patients had resolved palatopharyngeal incoordination and 7.7 % of palatopharyngeal incoordination patients had silent aspiration.

Conclusion
The prevalence of palatopharyngeal incoordination is 31.3 % and there was no palatopharyngeal incoordination secondary to mechanical ventilation.
Lung Ultrasound Evaluation of Pulmonary Abnormalities in Children with Congenital Heart Diseases
Authors: Elsayed Eman Mohamed , Elguindy Waleed Mohamed , Ahmed Farag Amina Mohamed , Ahmed Ali Esraa Ibrahim , Hussein Mahitab Morsy 
Published: July 2024

Abstract

Background and Aims
Congenital heart disease (CHD) can cause several abnormalities of the lungs, such as pulmonary overflow (PO), pulmonary hypertension and chest infection like pneumonia. We aimed to assess pulmonary abnormalities using lung ultrasound (LUS) in children with congenital heart diseases.

Patients and Methods
This is a cross-sectional study, which included (33) CHD patients aged between 0.5 to 3.5 years who were admitted to the Cardiology Unit,Ain Shams University, Children’s Hospital. The patients were subjected to detecting any consolidation and measuring B vertical lines in all lung zones. LUS score was recorded at baseline and after course of management.

Results
There was statistically reduction in the after management group compared to the before management group according to LUS score with p-value (p &lt; 0.001). There was a difference between types of management according to LUS score and its severity in the before management group, with p-value (p &lt; 0.001) whereas, surgical type of management had the highest mean value of the LUS score compared to other types of management among our studied patients before management with a highly statistically significant difference, with p-value (p &lt; 0.001).

Conclusion
Lung ultrasound is an ideal tool for the diagnosis and follow-up of pulmonary complications such as lung congestion, pulmonary edema and pneumonia. Also, there was improvement in pulmonary congestion after management among CHD children.
Spinal Cord Involvement in Children with Acquired Demyelinating Syndromes: A Single Centre Study
Authors: El-Agouza Iman Ali , Ahmed Khaled Aboulfotouh , Ahmed Abualwafa Sarah Tarek Abdelsamie , Hesham Zaitoun Raghda Mohamed 
Published: July 2024

Abstract

Background
Myelitis may be the first presentation of relapsing acquired demyelinating syndromes (ADS) such as neuromyelitis optica (NMO) or multiple sclerosis (MS) and in association with connective tissue diseases. It may also occur in the context of acute disseminated encephalomyelitis (ADEM). Early recognition of myelitis in these disorders will allow better management plan including theprognosis.

Objective
To evaluate the frequency of myelitis among children with acquired demyelinating neurological diseases, and the variability of clinical features, neuroimaging findings and treatments given.

Methods
A pilot observational study with both retrospective and prospective components was conducted on children and adolescents fulfilling the diagnostic criteria for any of the acquired demyelination syndromes admitted inChildren’s Hospital, Ain Shams University whose ages were below 18 years during the period from July 2020 to February 2022.

Results
Forty-three children were included in our study with mean (SD)age of onset 7.63 (4.28) years. The most common diagnosis was ADEM (n (%) =20 (46.5%), followed by transverse myelitis (TM) (n (%) =11 (25.6%) and NMO (n (%) =7(16.3%). Progression to develop encephalopathy was recorded in 55.8%of cases (100% of ADEM and autoimmune encephalitis (AE) cases). Seizures developed in 23.3% of cases (35% of ADEM, 50% of AE and 14.29% of NMO cases). MRI brain abnormalities were observed in 76.7% of cases (100% of ADEM, NMO, AE and MS cases), and abnormalities of MRI spine were seen in 59% of cases (100% of TM and MS cases, 85.7% of NMO, 33.3% of AE and 23.5% of ADEM cases). Spinal cord affection was most commonly cervical(86.9%) and mostly short segment. All cases received pulsed methylprednisolone therapy, while intravenous immunoglobulins (IVIG) were used in 32.5% of cases and plasmapheresis in 13.9% of cases as a stepwise approach. Nearly half of the cases (53.5%) had monophasic illnesses without the need for long term therapy.

Conclusion
Spinal cord involvement is frequently observed in childhood acute demyelinating syndromes, and is most commonly cervical and short-segment. MRI spine should be regarded as a sensitive tool for diagnosis of myelitis in the context of ADEM and MS. MRI Brain is a sensitive tool accounting forfindings in 100% of ADEM, NMO, AE and MS cases. Patients with ADEM and AE has higher risk to develop encephalopathy and seizures unlike TM, NMO and MS patients.
Hypertrophic Cardiomyopathy Risk Factors in Infants of diabetic mothers
Authors: Abou Shady Nancy Mohamed , Azzam Nesmahar Tarek , Atef Alaa Mohamed , Atia Abdelmaksoud Eman Abdelmaksoud 
Published: July 2024

Abstract

Background
Diabetes mellitus (DM) is a systemic chronic metabolic disorder characterized by increased insulin resistance and/or β- cell defects. Maternal DM significantly affects the fetal heart and fetal–placental circulation in both structure and function. Cardiac defects, myocardial hypertrophy are three times more prevalent in infants of diabetic mothers (IDMs).

Objective
Assess the frequency of hypertrophic cardiomyopathy (HCM) among infants of diabetic mothers and its relationship to the maternal glycemic control and the birth weight for the gestational age.

Patients and Methods
This was a cross-sectional study conducted on (50) neonates with gestational age ≥ 35 weeks born to diabetic mothers recruited from the delivery room and Neonatal Observation Unit, Obstetrics and Gynecology Hospital, Ain shams university. Detailed history was taken for the duration of maternal diabetes, glycemic control and any associated complications and the level of hemoglobin A1C (HbA1C) was assessed for all the enrolled mothers. Neonates were subjected to full clinical examination and echocardiographic evaluation in the first week of life.

Results
Forty % of mothers had gestational diabetes mellitus (GDM), (20%) were pre-gestational diabetes type 1 and 40% were pre-GDM type 2. There were 18 infants (36%) had HCM. HCM was highly statistically significant (p-value &lt; 0.001) more in cases with high maternal HbA1C (8.3 ± 0.9). The frequency of HCM among infants of pre-GDM mothers (15 patients, 50%) was significantly higher (p-value = 0.012) when compared to infants of GDM mothers (3 patients, 15%). But the frequency of HCM was equal in infants of pre-GDM type I mothers and those of pre-GDM type 2 mothers. HCM was more common with large for gestational age (LGA) infants (10 cases 55.6% of infants with HCM were LGA).

Conclusion
HCM is more frequent among infants of mothers with pre-GDM type 1 than infants of GDM. Poor maternal glycemic control and large for gestational age are associated with higher frequency of HCM among those infants.
Epidemiology of Household Transmission of COVID-19 among Patients Attending Outpatient Clinics of Teaching Hospital in Cairo, Egypt
Authors: Ali Dalia F , Abozaid Dena A , Elbagoury Lamyaa S , Abd Elaziz Khaled M 
Published: July 2024

Abstract

Background
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). People in closed settings with COVID-19 patients, such as household contacts, were more likely to become infected. Household studies can provide informative data for COVID-19 prevention and control.

Aim
to identify the epidemiological features of household transmission in a sample of patients attending the family medicine clinic of a tertiary hospital in Egypt, and to calculate the household COVID19 secondary clinical attack rate for the recruited patients.

Materials and Methods
An observational follow-up study was conducted among a sample of 180 primary probable COVID-19 cases attending a tertiary hospital in Cairo, Egypt and their 395 household contacts. The modified WHO case reporting form was used for follow-up of primary probable COVID-19 cases, and the modified WHO contact reporting form was used for their household contacts follow-up. Follow-up phone calls were conducted after 7, 10, and 14 days after attending to the hospital.

Results
The mean household Secondary clinical attack rate is 65.3 ± 29.9 (95 CI: 60.5% - 70.1%). There was a significant statistical association between reporting symptoms consistent with COVID-19 and sharing a room with the primary case, being not vaccinated, not using Personal protective equipment (PPE) as well as taking care of a primary case (p &lt; 0.001).

Conclusion and Recommendations
Secondary clinical attack rate among the household contacts was high; more than the average reported rates globally. Vaccination and using PPE had important roles in lowering the risk of reporting symptoms consistent with COVID-19 among household contacts, yet the overall rate of using PPE was low and vaccination coverage was low compared to the rates reported globally. which necessitates more efforts to increase awareness of household transmission and how to safely care for a home-isolated COVID-19 case. The presence of co-morbidities increased the risk of hospitalization among symptomatic contacts This gives an alert to increase the awareness of cases with comorbidities about warning signs that necessitate early hospitalization for a better prognosis. about using PPE among household contacts with a COVID-19 case and also about the importance of vaccination against COVID- 19.
15 Years Survival of Budd-Chiari Patients in a Single Center Study
Authors: Zaki Helmy Ali Ahmed , Salem Hossam Mohamed , Elsayed Enaam Ali , Khalil Dabbous Ahmed Hesham 
Published: July 2024

Abstract

Background
Budd–Chiari syndrome (BCS) is a heterogeneous group of clinical conditions ranging from acute liver failure to completely asymptomatic patient. It is caused by hepatic venous outflow obstruction at any level from the small hepatic veins (HVs) to the junction of inferior vena cava (IVC) with the right atrium.
Aim of the Work: The idea of this work was to report the result so favast clinical experience over 15 years presented by Tropical medicine department Ain Shams University through analysing the patient and disease characteristics, outcome, complications and innovations in therapeutic intervention. Ultimately this should throw lights on the understanding of the pathophysiology causes and clinical consequences of BCS among Egyptian patients.

Patients and Methods
199 Egyptian patients with confirmed diagnoses of primary BCS were evaluated regarding their socio-demographic features, etiology, risk factors for BCS, clinical manifestations, management modalities and outcomes. The studied patients were enrolled from patients presented to Budd chiari study group clinic, Tropical Medicine Department ward, Ain Shams University hospitals, from January 2006 till December 2021.

Results
The commonest complaints in Budd Chiari patients were abdominal enlargement in 79.9% (159 patients) and abdominal pain in 77.9% (155 patients), Ascites was present in 75.4% (150), Hepatomegaly in 75.4% (150), Splenomegaly 61.8% (123). More than Seventy Seven percent (77.9%) of the enrolled patients were Chronic BCS patients, 12.6% were subacute BCS and 9.5% were acute BCS. In this study the leading cause of Budd-Chiari was FVLM 76 patients (38.2%). Several papers concluded that FVLM is the main or leading etiology to BCS but regarding the other papers that showed different results, these differences might possibly be due to the difference in sample size. In the current study the outcomes varied from one etiological factor to the other as in FVLM 78.7% of the BCS FVLM patients were compensated, 14.7% were decompensated and 6.7% died and these results were highly significant.

Conclusion
It seems that TIPS creation is an effective treatment for eligible BCS patients and has long-term survival benefit with satisfactory shunt patency and patient survival. The outcome of TIPS has improved over the years due to the increase in the operator experience and the availability of PTFE-covered stents.
Evaluation of a Rapid PSA Test for Prostate Cancer Screening
Authors: Mohamed Ali Ali Khaled , Elsaid Mohamed Hasan , Gad Hany Hamed 
Published: July 2024

Abstract

Background
Prostate-specific antigen (PSA) is a protein produced by normal prostate cells. This enzyme participates in the dissolution of the seminal fluid coagulum and plays an important role in fertility. The highest amounts of PSA are found in the seminal fluid; some PSA escapes the prostate and can be found in the serum.

Aim of the Work
to detemine accuracy, sensitivity, specificity of one-step PSA test (Fortel Test®) “FDA approved” for screening for prostate cancer in comparison to a conventional quantitative assay.

Patients and Methods
This Prospective cohort clinical study was conducted at tertiary care hospital at Urology Department, Outpatient clinic, Faculty of Medicine, Ain Shams University from January 2022 till June 2022 and performed on a total of 150 patients who were above 50 years old or above 40 years old with family history of prostate cancer.

Results
Our study results revealed that Fortel PSA test had high Sensitivity (97.2%), specificity (96.2%), positive predictive value (95.9%) and negative predictive value (97.4%) in accuracy of screening of prostatic cancer.

Conclusion
The Fortel PSA test is a simple, feasible, and reproducible tool for PC screening. The lower cost, ease of handling, and rapid procedure could make this test useful in the general practitioner or urologist office setting as well as for mass primary PC screening.
Evaluation of the Efficacy of Mini Percutaneous Nephrolithotomy in Comparison with Standard Percutaneous Nephrolithotomy for the Management of Large Renal Stones, a Randomized Controlled Clinical Trial
Authors: Osman Tarek , ElSaeed Karim Omar , Sadeq Mohammed Metwally 
Published: July 2024

Abstract

Background
Management of renal calculi targets complete clearance without any residual fragments, along with pain relief and eradication of the causative micro- organisms. Percutaneous nephrolithotomy (PNL) is currently the standard treatment option for patients with complex and large renal stones. However, innovations in instruments and techniques have resulted in “miniperc”, which was found to be safe and effective.

Aim and Objectives
to compare between mini PNL and the standard PNL in management of renal stones (20-40 mm) regarding operative time, fluoroscopy time, blood loss, stone free rate, and postoperative complications according to modified Clavein system.

Subjects and Methods
This prospective randomized comparative study was carried out at Urology department Ain Shams University hospitals, from 2019 to 2022 on 93 patients coming for renal stone management. Patients were divided into 2 groups: Group A included 44 patients who underwent standard PNL, whereas Group B included 49 patients who underwent mini PNL. Result The standard PNL yielded shorter operating time 70.1 ± 13.9 min vs 96.4 ±14.3 min,p &lt;0.001) Patients in the standard PNL group also had longer hospitalization time, nephrostomy time and catheterization time(4 vs 3 days, 36 vs 24 hours and 5 vs 4 days respectively, p &lt; 0.001). The mean drop in hemoglobin level that necessitated blood transfusion was significantly lower in the mini PNL group (0.7 vs 1.6 gm/dl, p &lt; 0.0001). Although the stone-free rate was higher in the standard PNL group, but this was statistically insignificant (79.5 vs 61.2%, p = 0.054) According to modified Clavien–Dindo classification, no statistical difference was detected between the 2 groups in terms of complication rates The postoperative pain and the need for postoperative analgesia were significantly more in standard PNL patients. Visual Analogue Score (VAS) was 7.4 and 5.2 in standard PNL and mini PNL respectively.

Conclusion
We compared the standard PNL and mini PNL regarding the safety and efficacy in management of large renal stones. Standard PNL achieved higher stone free rate and shorter operative time while mini PNL has the advantage of shorter hospitalization time and low incidence of postoperative complications and pain.
Effect of JJ Stent on Outcomes of Extracorporeal Shockwave Lithotripsy of Renal Stones around 2 cm
Authors: El-Zayat Tarek Mostafa , Ahmed Tolba Mohamed Kotb , El-Said Soliman Mohamed Nabil 
Published: July 2024

Abstract

Background
Urolithiasis is a common problem in Egypt as it lies within the stone belt region extending from Indonesia to Egypt. Economic and dietary factors, dehydration, exposure to heat and possible genetic factors. Urolithiasis is one of the most common problems encountered by urologists. Many factors affect Stone formation like geographical, climatic, ethnic, dietary and genetic factors. The recurrence rate is determined by the primary etiology of stones formation.

Aim of the Work
Evaluation of the role of JJ stent in enhancing the passage of fragments in patients undergoing extracorporeal shockwave lithotripsy (ESWL) for renal stones with size around 2 cm.

Patients and Methods
This randomized controlled clinical trial was conducted on 90 patients in the period from December 2021 to July 2022 with age ranged from 24 – 60 years with mean±SD of 44.21 ± 10.99 years; they were 28 females (31.1%) and 62 males (68.9%) and randomly divided into two groups: Group (I): Patients without JJ stent consists of 45 patients & Group (II): Patients with JJ stent consists of 45 patients.

Results
The analysis of our study results showed no statically significant difference between the two groups regarding SFRs (95.6% in group I & 93.3% in group II), time to SFRs (mean±SD 1.05 ± 0.55 month in group I & 1.20 ± 0.59 month in group II), number of sessions of ESWL (2.11 for group I & 2.37 for group II), auxillary procedures (Two patients in group I (4.4%) 1 patient had PCNL & 1 patient had URS due to steinStrasse 2.2%) & Three patients in group II (6.7%) failed ESWL and had PCNL), number of ER visits (in group I 46.7% & in group II 40 % had attended at least once for the ER, analgesics consumption (In group I 77.8% & In group II 84.4%) & laboratory tests changes like Hb drob between pre & post ESWL in the two groups (-0.02 ± 0.04 & -0.11 ± 0.08 in group I & group II respectively) & the amount of increase in serum creatinine level (post – pre) was found 0.07 ± 0.03 in patients without JJ stent and 0.03 ± 0.04 in patient with JJ stent.

Conclusion
Routine JJ stent fixation before extracorporeal shock wave lithotripsy in management of renal stones around 2cm is unnecessary because it doesn’t improving free stone rate or enhancing the passage of the fragments during ESWL.