bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between Autoimmune Hepatitis and Celiac Disease among Egyptian Children and Adolescents
Authors: El-Din Ahmed Lerine Bahy , Magied Elfaramawy Amel Abdel , Hamdy Saber Ahmed Mohammed , Talaat Iman Mohammed , Abdullah Fatma Abd Ellah , Ahmed Mohammed Ahmed Badawy 
Published: July 2024

Abstract

Background
Celiac disease (CD) is an immune-mediated intolerance to gluten .CD has been recognized as a multisystem disorder which may affect other extra intestinal organs, such as the skin, thyroid, heart, nervous system, pancreas and liver. Individuals with CD are at increased risk of liver disease namely cryptogenic liver disorder and autoimmune liver disorder. However, until now, it remains unknown whether these two forms of liver disease are really different entities or only different severities of the same disorder.

Objective
To evaluate the association of CD with autoimmune hepatitis in pediatrics.

Subjects and Methods
This was a cross-sectional study that was conducted at the Pediatric Hepatology Clinic and Pediatric Gastroenterology Clinic, Children’s Hospital, Ain Shams University. The study included 2 groups of patients each comprised 20 children and adolescents as follow: Group I: Patients with established diagnosis of autoimmune hepatitis (AIH). All patients were receiving corticosteroids and azathioprine Group II: Patients with established diagnosis of CD. In group I patients with AIH, CD was screened for using anti-tissue transglutaminase (tTG) IgA in addition to measuring serum IgA to determine the need to measure anti-tTG IgG. Immunological markers (ANA, anti-smooth muscle antibody (ASMA) and liver and kidney microsomal (LKM) antibodies in addition to protein electrophoresis were done for group II patients with CD to screen for AIH.

Results
All patients in group I with AIH had normal serum IgA levels and were found negative for anti-tTG IgA. Also, group II patients with CD were negative for ANA, ASMA and LKM antibodies with normal protein electrophoresis.

Conclusion
The current study showed that CD does not seem to have significant association with AIH, however, the small sample size is a study limitation. Further wider scale studies are needed to evaluate the risk of AIH in CD.
Evaluation of Sleep EEG Changes in Paediatric Patients with Language Dysfunction: A Follow Up Study
Authors: El-Rashidy Omnia Fathy , Ghandour Hassan Hosny , Mahsoub Abd-Elsalam Omnia Alaa , Hesham Zaitoun Raghda Mohamed 
Published: July 2024

Abstract

Background
Several case reports and studies have described an association between sleep epileptiform discharges and language dysfunctions. This has been partly confirmed in studies that have investigated the effect of this epileptiform discharges on neurocognitive function.

Objectives
To screen for sleep-potentiated epileptiform discharges in children with language dysfunction (language delay or regression) and to evaluate the effect of treatment of these epileptiform discharges on language dysfunction.

Methods
The study was conducted on 93 children with language delay or language regression. Patients were recruited from the pediatric neurology clinic, pediatric outpatient clinic, phoniatrics outpatient clinic and the inpatient neurology ward at the Ain Shams University Children’s hospital, Cairo, Egypt in the period between February 2020 and November 2021. A 90- minute sleep electroencephalography, intelligence quotient level and language age were done for all patients included in the study. Children who had an active electroencephalography with uncontrolled clinical seizures or persistently epileptogenic activity without clinical seizures received treatment according to type of activity then after 6 months they were subjected to follow up electroencephalographyand assessment of intelligence quotient level and language age.

Results
The enrolled patients were divided into two groups: Group (1) including 28 (30%) patients with either or both of epileptogenic activity and clinical seizures and group (2) including 65 (70%) patients without either epileptogenic activity or clinicalseizures. We found 24 (85.7 %) children in group 1 had clinical seizures with median age of onset 2.5 years (range from 1-8 years). Further in the first group, 21 (85.7 %) of children showed presence ofepileptogenic activity with 10 (47.6 %) of children showed spike and slow wave, 6 (28.6 %) showed sharp wave, 3 (14.3 %) showed continuous spike and wave during slow wave sleep (CSWS), 2 (9.5 %) children showed sharp and slow wave. In our study, levetiracetam was given as first line treatment in patients with active seizures. An add-on therapy was given in patients who were not controlled on one antiepileptic drug. A follow up 90 minutes sleep electroencephalography was done and showed a highly significant reduction in epileptogenic activity with a p value of &lt; 0.001. A follow up language test and intelligence quotient level score were done and showed a highly significant improvement with p value of (0.001 and 0.009) respectively.

Conclusion
Epileptiform activities with or without epilepsy in children may alter normal language function. Treatment of these epileptogenic activity affect improvement of this language dysfunction.
Trial registration: ClinicalTrials.gov I.D: NCT05487521.
The Clinical Significance of the Platelet Membrane Glycoproteins in Children with Primary Immune Thrombocytopenia
Authors: Mokhtar Galila Mohamed , Elsayed Ebeid Fatma Soliman , Sayed Safa Matbouly , Abdelmaksoud Mariam Fathy , Fathy Shnouda Sara Adel 
Published: July 2024

Abstract

Background
Primary immune thrombocytopenia (ITP) is an acquired immune-mediated disorder characterized by isolated thrombocytopenia. Although decreased platelet count is believed to be the main cause of hemorrhage in ITP, it is a poor predictor of bleeding risk by itself.

Aim of the Work
to measure CD62p and CD42b level in the pediatric ITP patients by using flow cytometer, measurement of platelet parameters in the pediatric ITP patients and to study its correlations to bleeding score.

Patients and Methods
sixty children with ITP were recruited and assessed for eligibility at the out-patients Hematology clinic – Pediatric Hospital at Ain Shams University, and compared with age and sex matched thirty healthy subjects.

Results
Pediatric ITP patients had a significant increase in the mean platelet volume, platelet distribution width and a significant decrease in plateletcrit among the ITP patient group in comparison with the control group (P value&lt;0.001). The chronic ITP subgroup had significant increase of platelet count and plateletcrit in comparison with the acute ITP subgroup (P value&lt;0.001). Pediatric ITP patients had significant increase in CD42b and a significant decrease in CD62p among the ITP patient group in comparison with the control group (P value&lt;0.001). No statistically significant difference found between the acute, persistent and chronic ITP subgroups regarding CD42b and CD62p (P value&gt;0.05).

Conclusion
Platelet function, platelet parameters and platelet glycoprotein CD62p, CD42b expression can be used as a clinical biomarkers in pediatric ITP.
CD34+ Hematopoietic Stem Cell Count as a Novel Predictor of Vascular Event in Sickle Cell Disease Patients
Authors: Mohsen Ellaboudy Mohamed Abdel , Aly Nihal Hussien , Ismail Mona Ahmed , Ibrahim Badawi Rania Ahmed 
Published: July 2024

Abstract

Background
Sickle cell disease (SCD) is one of the most common genetic disorders, it not only has hematological pathophysiological consequences, but also has systemic pathological manifestations such as vascular events (VEs). Prior studies have described that VEs are associated with poor outcomes in the short term and decreased quality of life in patients over the long term. There is no standardized method for predicting vascular injury in Sickle cell disease patients.

Aim of the Work
Our aim is to evaluate circulating CD34 as a novel predictive marker of occurrence of vascular event in Children with Sickle Cell Disease in their steady state and relate levels to severity of VEs in the following 6 months.

Patient and Methods
This study was an exploratory study, conducted at Pediatrics Hematology- Oncology Unit at Ain Shams University Children’s Hospital, where 50 children with sickle cell disease were enrolled at their steady state (defined as 2 months free from any Vascular Event prior to the study), aged 6 months - 16 years. Flow cytometry was done for quantification of circulating CD34+ at inclusion and compared to age and sex matched control and patients were followed up for 6 months for vascular events.

Results
There is statistically significant higher level of CD34+ among SCD patients compared to age and sex matched control with p value &lt; 0.001.Circulating CD34+ showed significantly higher level in patients who developed systemic vascular events after 6 months of follow up with p value 0.022. There was no statistically significant correlation between circulating CD34+ and severity of peripheral vascular events (or any need for hospitalization) on follow up.

Conclusion
CD34+ cell count at steady state may be a promising biomarker of further vascular event in children with SCD.
Frequency of Non-Thyroidal Illness Syndrome in Pediatric Patients with Sepsis and Septic Shock
Authors: Abdelgawad Tarek Ahmed , Magdy Sondos Mohamed , Ahmed Mahmoud Rana Abdelhakaim , Abdelfatah Taha Sara Ibrahim , Elhameed Ali Safaa yossef Abd 
Published: July 2024

Abstract

Background
Non-Thyroidal Illness Syndrome (NTIS) is considered when patients demonstrate abnormal thyroid functions and levels decrease at onset of infection and keep decreasing with disease progression. Levels usually get normalized after the illness is cured. NTIS is not studied well in pediatric population.

Aim of the Work
Assess the hormonal changes of NTIS in sepsis and septic shock patients. Furthermore, Follow up the severity of NTIS and its effect on outcome.

Patients and Methods
This study (1st phase: Cross-sectional, 2nd phase: Prospective) included 40 critically ill children categorized into two groups: (i) Sepsis group : was defined according to standard international criteria using pediatric Sequential Organ Failure Assessment (p SOFA) score and sepsis was considered when p SOFA score &gt; 2 (ii) Septic shock group: was defined by a vasopressor requirement to maintain a mean arterial pressure ≥ 65 mm Hg and having a serum lactate level &gt; 2 mmol/L despite adequate fluid resuscitation (Singer et al., 2016), with 20 patients in each group. Patients were admitted to the pediatric intensive care unit (PICU). Thyroid hormone levels were assessed and compared in day 1 and day 5 in all patients and subgroups. All patients were followed up until discharge or death. ROC curve and Univariate and multivariate approaches were used to assess the link between thyroid hormones and prediction of mortality.

Results
NTIS was found in 47.5% of patients. NTIS was higher among septic shock group than sepsis 65.5% versus 30% (p value = 0.027). NTIS was associated with each of ventilation, catecholamines infusion and SOFA score (p value =0.044, 0,027 and 0.033) respectively. FT3 (Free triiodothyronine) levels were lower and rT3 (reverse T3) levels were higher in day 5 of illness than day 1 (p value =0.041and 0.000) respectively. Furthermore, FT3 levels in day 5 were lower, and rT3 levels in day 1 and day 5 were higher in non survivors than survivors (p value =.0.002, 0.015 and 0.003) respectively. ROC curve to assess thyroid hormone levels, SOFA score and CRP (C-reactive protein) as predictors of mortality revealed that FT3 levels in day 5 was the best in predicting PICU mortality (sensitivity 100%, and specificity 68.42%), Followed by SOFA score day 5 (sensitivity 100%, and specificity 57.89%). In the multivariate regression analysis, we discovered that high rT3 levels in day1 and CRP in day 5 were independently associated with PICU mortality.

Conclusion
NTIS is common among critically ill children and higher among septic shock group than sepsis. Also, Beside the SOFA score, FT3 measured in day5 of illness and rT3 measured in day1 of illness were the best predictors of PICU mortality.
Oral Ibuprofen versus Placebo for Management of Patent Ductus Arteriosus in Preterm infants: A Double Blinded, Randomized Controlled Trial
Authors: Sherif Dalia El , El-Raggal Nehal M , Mohamed Nada Hussein , Saleh Ghada Ahmad , Abd Elhady Marwa Waheed , Metwally Mohamed Hussein 
Published: July 2024

Abstract

Background
A consensus on the management of patent ductus arteriosus (PDA) in premature neonates remains indefinable. Conservative PDA treatment is based on the premise that in most preterms PDAs spontaneously close before discharge. Ibuprofen has been used for treating PDA, however, no clear guidelines for management have been suggested.

Aim of Work
The aim of this work is to compare the effect of oral ibuprofen versus placebo on PDA closure in preterm infants less than 34 weeks’ gestation.

Methodology
This study was conducted on 80 preterm neonates with gestational age ≤ 34 weeks with a hemodynamically significant PDA. They were randomized into a medical treatment group (n = 40) and a placebo group (n = 40). Both groups received conservative PDA therapy in the form of fluid restriction, positive end-expiratory pressure, and/or diuretics. The medical treatment group received oral ibuprofen (at an initial dose of 10 mg/kg/day, followed by 5 mg/kg/day for the next 2 days) and the placebo group received an oral placebo. The open-label option and an extended oral ibuprofen therapy (an offered or a repeated course with the same dose) were only offered if there are concerns over a poor patient condition that was attributed to persistent PDA and only after meeting certain criteria like signs of pulmonary hyperperfusion and/or systemic hypoperfusion. Echocardiography was done on day 1 of recruitment (48-72 hours of age) and was followed up till discharge. The patients were followed up for adverse effects of ibuprofen by serum creatinine and total serum bilirubin after the first course of treatment.

Results
There was no significant difference in PDA closure rate following the first ibuprofen course (62.5% in the ibuprofen treated group vs 65% in the placebo group, p &gt; 0.05). At discharge time (mean 13.5 days in the ibuprofen group, 14 days in the placebo group), a closure rate of 75% was achieved in both groups, respectively. There was no significant difference in initial serum creatinine levels between the two groups either on day 1 of recruitment or after the first course of the intervention, p &gt; 0.05, respectively. Meanwhile, serum creatinine significantly decreased in both groups after treatment (p-value &lt;0.001, respectively). Also, there was no difference between the two groups in serum bilirubin either on day 1 of recruitment or after the first course of treatment, p &gt; 0.05, respectively.

Conclusion
Conservative treatment is not inferior to oral ibuprofen therapy in the management of PDA. Oral ibuprofen does not elevate serum creatinine levels or cause hyperbilirubinemia.
Comparative Study between Platelet-Rich Plasma, Corticosteroids and Perineural Dextrose local Injections for Treatment of Carpal Tunnel Syndrome
Authors: Magdy Sarah , Mohamed Abbas , El-Sebaie Mona Abdullah , Amin Irene Raouf , Nassif Mary Atef 
Published: July 2024

Abstract

Background
Carpal tunnel syndrome (CTS), one of the most common entrapment neuropathies, is considered as a socio- economic issue that reduces work productivity and increases disability.

Aim of the Work
to compare the effect of Platelet- Rich Plasma (PRP), corticosteroids (CS) and perineural Dextrose 5 % in water (D5W) local injections for the treatment of idiopathic mild and moderate CTS.

Patients and Methods
A prospective study was performed on 60 median nerves of 60 patients. They were diagnosed as idiopathic CTS and classified randomly into 3 groups (each contains 20 patients) according to the treatment program received: group I (ultrasound guided CS injection), group II (ultrasound guided perineural Dextrose 5% injection) and group III (ultrasound guided PRP injection).

Results
Ultrasound guided local injection using single doses of CS, D5W, and PRP were very efficient as regards symptomatic and functional improvement, reducing distal motor latency (DML) and Peak sensory latency ( PSL) of median nerve, as well as decreased Cross Section Area (CSA) of Median nerve (MN) and improving median nerve mobility for idiopathic mild to moderate CTS. For symptom and functional improvement, single injection of CS was more effective than that of PRP and D5W within 3 months post-injection. Moreover, PRP was slightly better than D5W. For reducing DML and PSL, CS was the most effective followed by PRP and then D5W at 3 months post injection. For reducing CSA, CS was the most effective followed by PRP and then D5W at 3 months post injection. For improving mobility of median nerve, D5W was the most effective at 3 months post injection followed by CS and PRP.

Conclusion
Injection of CS, D5W and PRP had resulted in significant Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) score reduction at 3 months post-injection in comparison to the BCTQ score at the baseline evaluation. All of the three studied groups (Corticosteroids, dextrose 5 % and PRP) have shown a great result regarding improving in clinical examination, clinical assessment scales, nerve conduction studies and improving in Neuromuscular Ultrasound results with favorable results of Corticosteroids group over Perineural dextrose 5 % group and PRP group.
Significance of Inflammatory Markers in Primary Fibromyalgia Syndrome and Their Relation in Assessing the Disease Severity
Authors: Mohamed El-sawy Esraa Ayman , Abdul Hakim Mervat Mohamed , Kadry El-Zohiery Abeer Ahmed , Salama Sherihan Mahdy 
Published: July 2024

Abstract

Background
Fibromyalgia syndrome (FMS) is a musculoskeletal disorder characterized by diffuse chronic musculoskeletal pain associated with various other symptoms. Although the etiology and pathogenesis of FMS are still unclear, it was reported to have possible inflammatory basis. No laboratory marker is currently available to diagnose the disease.

Aim of the Work
to assess the serum levels of ESR, CRP, NLR, MPV and PDW in primary Fibromyalgia syndrome patients and their relation with the disease severity and depression scores.

Patients and Methods
The study included 30 FMS patients, diagnosed according to the 2010 ACR (American Colleague of Rheumatology) criteria who presented to Ain Shams University Physical Medicine and Rehabilitation clinic as well as 30 healthy volunteers who served as a control group. The following laboratory tests were assessed among both groups: Erythrocyte Sedimentation Rate (ESR), C-reactive protein (CRP), Neutrophil Lymphocyte Ratio (NLR), Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW). FMS patients filled out The Revised Fibromyalgia Impact Questionnaire (FIQR) and Montgomery Asberg Deprssion Score (MADRS) as well.

Results
MPV, NLR, ESR and CRP values were significantly higher among the patients’ group (p &lt; 0.05). Statistically positive correlation was found between FIQR and each of CRP (p = 0.021) and ESR (p = 0.027) levels. Another statistically significant positive correlation was found between MADRS and CRP (p = 0.01). The NLR showed marginal positive significance with FIQR.

Conclusion
In the light of these previous results, we can state that the serum levels of the tested inflammatory markers being mainly the acute phase reactants, have a positive relation with disease severity and depression scores, which in turn affect the quality of daily living. Accordingly, we arise the possibility of using those markers as good indicators of ongoing inflammatory process among FMS patients reflecting the severity of the disease.
Study of the Influencing Factors and their Predictive Value of Skin Graft Take in Early Excision and Grafting in Severe Burns: A Prospective Study
Authors: Mohamed Mostafa Mohamed , Mohammed Salah Nasser , Abd El Salam Ahmed Mohamed , Amin Abdel Gawad Ebrahim Mohamed 
Published: July 2024

Abstract

Background
Burn injury is one of the most life-threatening traumas worldwide especially in developing countries. After severe burns, the patients suffer from loss of multiple functions of skin, such as fluid loss, and high infection rate with burn sepsis and septic shock.

Objective
To investigate the various factors that affect the survival rate of skin grafts in early excision and grafting procedures (from 3rd to 7th day after burn) in patients with severe burns.

Patients and Methods
This Prospective cohort study was done in Ain Shams University Burn Center attached to Plastic, burn and maxillofacial department during the period from May 2021 to May 2022.

Results
Analysis was performed on 75 individuals who had early burnt skin excised and early skin graft coverage. Two patient groups were analyzed, in the form of good skin graft take &gt;70% in 45 patients, and poor skin graft take &lt; 70% in 30 cases, based on the survival rate of the skin graft post operatively.

Conclusion
The univariate analysis and repeated measurement showed that burn intensity, the post-operative sepsis, the neutrophil lymphocytic ratio on day 3 (NLR3) in the poor skin graft take group were significantly higher than those in the good skin graft take group, while the estimated albumin levels in perioperative period and the estimated pre-albumin levels in perioperative period were higher in the good skin graft take group. Receiver operating characteristic curve showed that NLR3, the estimated albumin levels and pre-albumin levels in perioperative period had a good predictive value for the survival of skin grafts. The estimated albumin levels ≤3.18 gm/dl, estimated pre-albumin ≤23.9 mg/dl, and NLR3 ≥ 12 were independent risk factors for graft take in perioperative period.