bluuebunny/crossref_metadata_2025_split huggingface dataset:
CXCL13 Level in Children with Acute and Relapsing Demyelinating Disorders of the Nervous system
Authors: Elagouza Iman Ali , Soliman Dina Ahmed , Zaitoun Raghda Mohamed Hesham , Habib Habib Lahzi 
Published: August 2023

Background
The chemokine, C-X-C motif ligand 13 (CXCL13) plays an important role in B cell recruitment within the central nervous system (CNS). CXCL13 has been implicated as key regulatory factor in inflammatory CNS disorders including autoimmune CNS diseases.

Aim of the Work
To compare between the serum level of CXCL13 in patients diagnosed with acute central or peripheral demyelination and in healthy age and gender matched controls.

Patients and Methods
Twenty patients (patients’ group) diagnosed with acute demyelinating diseases (acute disseminated encephalomyelitis (ADEM; n = 7), acute necrotizing encephalopathy of childhood (ANEC; n = 3), autoimmune encephalitis (AE; n = 3), transverse myelitis (TM; n = 3), Guillain-Barré syndrome (GBS; n = 4) and 40 healthy age and gender matched children (control group), were enrolled in the study. All patients were subject to full history, examination and measurement of serum levels of CXCL13 in both cases and controls.

Results
Serum CXCL13 level status was significantly higher in cases compared to controls (p &lt; 0.001). The mean serum CXCL13 level in cases was (341.75 ± 164.71 pg/ml) and in control was (51.5 ± 18.99 pg/ml).

Conclusion
Serum CXCL13 levels are significantly increased in pediatric patients with acute acquired central and peripheral demyelinating diseases of the nervous system.
Assessment of Probiotics (Lactobacillus) Supplementation in the Management of Attention Deficit Hyperactivity Disorder (ADHD)
Authors: Abdelbasir Reham Mohammed Elhossiny , Elshahawy Heba Hamed , ElSerwy HananMohey Eldin Mohamed , Abdelmageed Reham Ibrahim 
Published: August 2023

Background
Studies suggest that the bidirectional relationship existent between the gut microbiome (GM) and the central nervous system (CNS), or so-called the microbiome–gut–brain axis (MGBA), is involved in diverse neuropsychiatric diseases in children and adults.

Aim and objectives
The aim of the study was to assess the effect of probiotics supplementation as an adjunctive therapy in the treatment of Attention Deficit Hyperactivity Disorder (ADHD) cases.

Subjects and methods
This was a randomized controlled study included 80 patients with ADHD diagnosed according to DSM-5 diagnostic criteria for ADHD with age ranging from 6 to 16 years old who are following up at the Child Psychiatry Clinics of both Children`s Hospital and Psychiatry Institute Faculty of medicine, Ain-Shams University, All patients randomly distributed into two equal groups, Group1:ADHD cases received probotic in addtion to atomoxetine and Group2: ADHD cases received atomoxetine without probiotic, all cases subjected to Conner’s Parent Rating Scales-Revised (CRS-R) and The Continuous Performance Test (CPT) before and after intervention.

Results
In group 1, there was significant decrease in mean differences between before and after intervention as regards Oppositional, inattentive, Hyperactive/impulsive and total scores after intervention in comparison with before intervention (p &lt; 0.001). In group 2, the mean differences between before and after showed non-significant differences regarding Oppositional, inattentive and Hyperactive/impulsive scores (p &gt; 0.05). There was statistically significant elevation (improvement) in the mean Correct trials, Correct targets, Correct foils, Target Accuracy Rate and foil Accuracy Rate scores of CPT among the group 1 compared with the group 2 (p &lt; 0.05). On the other hand, group 1 had significant lower (improvement) scores of Commission errors, Omission errors, Correct Real Time Standard Deviation, Error real time mean Score and Error Real Time SD compared to group 2 (p &lt; 0.05). In group 2, the mean differences between before and after showed non-significant differences regarding all sub items of CPT (p &gt; 0.05).

Conclusion
Results of This study suggests that Probiotic supplementation could be beneficial as an adjunctive therapy in the treatment of ADHD cases.. This is a relatively new area of research and the number of included studies is limited.
Screening of Strawberry Allergy in Egyptian Atopic Children
Authors: El-Sayed Zeinab A , Sakr Heba A , Shousha Ghada A 
Published: August 2023

Background
Strawberries are included in the list of allergenic foods. However, definite figures in many countries including Egypt are lacking. Children with food allergy are 2 to 4 times more likely to have asthma, eczema, and allergic rhinitis than their non-allergic peers. We therefore sought to investigate IgE-mediated strawberry sensitization among a group of atopic children and correlate it to their clinical and laboratory parameters.

Patients and Methods
This study comprised 256 children, 1 to 18 years old, with physician-diagnosed bronchial asthma (98 patients), allergic rhinitis (28 patients), atopic dermatitis (53 patients), food allergy (10 patients) and combined allergies (67 patients). They were enrolled consecutively from the Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo. Sensitization to strawberry was assessed using prick-prick test (PPT).

Results
Strawberry sensitization was observed in 7.8% of the studied children. Confirmed strawberry allergy was elicited in 2% of them. Strawberry sensitization was more prevalent in patients with food allergy followed by those with atopic dermatitis. Severity of allergic disease, frequency of flare ups and response to treatment did not influence the rate of strawberry sensitization in our series.

Conclusion
Strawberry allergy is not as common as claimed to be among Egyptian children with allergic disorders. Sensitization to strawberry did not impact the severity of allergy or response to treatment. The findings are limited by the sample size.
A Neonatal Sequential Organ Failure Assessment Score as a Predictor of Mortality in Neonates with Late-Onset Sepsis
Authors: Mohamed Maha H , AbdElreheem FatmaT , Shinkar Dina M 
Published: August 2023

Background
Late onset neonatal sepsis (LOS) is an important problem in neonatal intensive care units (NICUs).The occurrence of multi-organ dysfunction can result in mortality in neonates with LOS. Many scores are being developed to predict mortality in neonates with LOS.

Aim
Our aim was to test the validity of neonatal sequential organ failure assessment score (nSOFA) to identify NICU patients at a high risk of mortality among those with LOS dependent on routinely collected data .

Patients and Methods
This prospective observational study was conducted on neonates with late onset sepsis. Full history taking and complete clinical examination was undertaken. Complete blood count (CBC) including total leukocytic count (TLC), C- reactive protein (CRP) and blood culture were withdrawn from included neonates. nSOFA score was calculated for all included neonates using data from patients records. nSOFA score is a noval objective score that detect organ dysfunction in neonates with late onset sepsis, and used to identify the risk of mortality using data from patients records.

Results
The obtained results showed that, neonates who did not survive had significantly higher CRP and TLC significantly lower platelet count than those who survived. Also, neonates who did not survive had significantly higher median nSOFA score than survivors. In the current study, the sensitivity of nSOFA score on presentation to predict mortality in LOS neonates was 84.21% and its specificity was 80.39% with area under the curve (AUC) was 0.890%.Also positive predictive value PPV was 61.5% and negative predictive value NPV was 93.2%.

Conclusion
The nSOFA can be useful in predicting mortality in neonates with LOS. Further studies are needed to assess its utility in different gestational age groups.
Electrophysiological Changes in Patients with Pediatric Mental Disorders
Authors: Zaky Eman A , Ramadam Mohammed Maha Z , Ali Mahmoud Y , Mageed Reham I Abdel 
Published: August 2023

Background
Electroencephalography (EEG) measures represent an important data source for a new quantitative science of macroscopic and microscopic cortical brain dynamics.

Objective
To record the central neuro- electrophysiological pattern in children with different types of pediatric mental disorders.

Methods
In this cross-sectional observational study, 100 children with different types of pediatric mental disorders [Autism (n = 30), ADHD (n = 30) and nocturnal enuresis (n = 40)] were evaluated from those under regular follow up at the Child Psychiatry Clinic, Children’s hospital, Ain Shams University. Full history, detailed psychiatric interview, psychometric assessment using specific scales according to the disorder, IQ assessment, EEG and Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria for definitive diagnose of each disorder were assessed.

Results
The enrolled children age ranged between 5-16 years with a mean value of 9.09 ±2.49 years, and 74 were males. Eleven children had history of Neonatal Intensive Care Unit (NICU) admission.IQ ranged from 27 to 101 with a mean value of 78.92 ± 16.29 SD. Childhood Autism Rating Scale (CARS) for children with Autism ranged from 30 to 47 with a mean value of 35.53 ± 3.42 SD. The Conners Comprehensive Behavior Rating Scale for children with ADHD ranged from 61 to 78 with a mean value of 68.63 ± 4.66 SD. Only 5 children had epileptogenic activity in the EEG [autism (n = 3), ADHD(n = 1), nocturnal enuresis(n = 1)] with a (P-value= 0.362). In addition, history of NICU admission showed association with subsequent development of pediatric mental disorders (P-value =0.015). Furthermore, developmental history had association with pediatric mental disorder (Pvalue =0.00).

Conclusion
We observed a non-significant association between EEG changes and pediatric mental disorders. However, this study showed a significant association between NICU admission and subsequent development of pediatric mental disorders.
Should We Monitor Renal Functions in Congenital Heart Disease Infants Using High Energy Infant Formula? A Case Report
Authors: Kotby Alyaa A , Ahmed Mohammed M , Nasef Marwa A 
Published: August 2023

Background
High Energy Infant Formula (HEIF) promotes adequate catch-up growth in infants with faltering growth. Of concern, is the potential increased risk of HEIF as a high protein diet on renal function.

Case Presentation
This four month old female presented with ventricular septal defect, pulmonary hypertension and heart failure that was controlled with treatment. She suffered from faltering growth where her weight and length were &lt; -2 z-score for age thus HEIF was prescribed. Serum creatinine was high normal. Two weeks after HEIF intake, growth was still faltering and mild dyspnea reappeared inspite cardiac medications. Investigations showed a rising high serum creatinine. Abdominal ultrasound revealed the presence of a single kidney. The exact contribution of predisposing factors to renal dysfunction can’t be measured since the patient had an already borderline renal functions.

Conclusion
Renal functions should be monitored before HEIF and during its use to avoid renal dysfunction in susceptible patients.
Diagnostic Yield of Endoscopy in Upper Gastrointestinal Bleeding in Pediatrics
Authors: Hamdy Ahmad Mohamed , Awad Yosra Mohamed Mohsen , Fahmy Passant Osama 
Published: August 2023

Introduction
Esophagogastroduodenoscopy is currently considered the first-line diagnostic procedure of choice for upper gastrointestinal (GI) bleeding; however, the etiology of bleeding remains unknown in a subset of patients. This study aims to evaluate the diagnostic yield of upper gastrointestinal endoscopy in upper gastrointestinal bleeding in pediatrics and determine the clinical predictors for unreached diagnosis during endoscopy.

Methods
Cross sectional study, conducted at pediatric endoscopy unit, Ain Shams University, Cairo, Egypt, where 100 patients were recruited, as they were referred for diagnostic upper GI endoscopy due to overt upper GI bleeding in the form of hematemesis and/or melena. Full medical history, examination, laboratory investigations, endoscopic and histopathologic findings were documented.

Results
:100 patients with ages ranging from 3 months to 15 years, median age 4 years, 47% males and 53% females, 65% presented by hematemesis only, 7% with melena only, and 28 % presented with both hematemesis and melena. In 38 % of cases no endoscopic diagnosis was reached. While patients with a positive diagnostic yield 62%, had variable diagnosis, the most common of which was H pylori gastritis and reflux oesophagitis in 23% and 11% of cases respectively. Followed by nonspecific gastritis (8%), oesophageal varices (4%), and others (16%).. Melena was a negative predictor to reach a diagnosis by upper GI endoscopy.

Conclusion
Diagnostic yield of upper GI endoscopy in pediatric patients with upper GI bleeding was only 62%. Combining upper GI endoscopy with other tools in cases presenting with melena alone is highly recommended since bleeding from a source in the small bowel or right colon may also be the cause.
Trace Elements Status (Zinc & Copper) in Pediatric Patients on Regular Hemodialysis
Authors: Wastawy Hoda L , Attwa Ramy G , Saleh Waleed S , Abdel Halim Bassma A , Sallam Dina E 
Published: August 2023

Background
Hemodialysis patients are at risk for deficiency of essential trace elements and excess of toxic trace elements, both of which can affect health.

Objectives
Up to our knowledge, there is no previous data about the normal values of trace elements in pediatric hemodialysis patient, so our aim was to evaluate the status of both serum zinc & copper in our pediatric hemodialysis patients in order to evaluate the need for supplementation.

Methodology
This is a case control study which involved 2 groups: Patients’ group included 60 children with end stage kidney disease on regular hemodialysis following up at Pediatric Dialysis Unit, Ain Shams University Hospitals and 60 healthy children served as a control group. Measurements of serum copper and zinc were performed by atomic absorption spectrophotometry, complete blood count (CBC), iron and lipid profiles were done and correlated to serum copper and zinc level.

Results
Patients’ group were 32 males (53.3%) and 28 females (46.6%) with an average age of 13.06 ± 2.08, 8-17 years, BMI of (15.07 ± 3.30, 8.38-21.14 Kg/m2) and duration of hemodialysis was (3.28 ± 2.33, 1-10 years). The control group were 39 males (65%) and 21 females (35%) with age of (8 ± 2.14, 5-12 years) and BMI was (16.36 ± 1.30, 14.6-18.5 Kg/m2).
Six patients (10%) had low serum zinc level with values between 58 to 59 mcg% (normal:60-120 mcg%), while only two patients (3.3%) had low serum copper level with values of 66 mcg% (normal:70140 mcg%). All control group had normal serum zinc and copper levels with a significant difference between patients and control groups as regards serum copper level (Patients’ group 78.06 ± 7.5 mcg%, control group 82.46 ± 8.13 mcg%, P = 0.03). We found a negative correlation between blood copper and ferritin level (r = 0.334, P value = 0.009). We also found a positive correlation between blood copper and cholesterol level (r = 0.276, P value = 0.033).

Conclusion
Hemodialysis could lead to depletion of biologically essential trace elements, thus routine monitoring of trace element blood levels is important for proper nutritional support of patients on hemodialysis.
Characteristics of Autism Spectrum Disorder among a Sample of Egyptian Children
Authors: Zahra Sally S , Hassan Batoul M , AMahmoud Rana A , Abdel Lateef Rania K 
Published: August 2023

Background
Autism spectrum disorder (ASD) is a biologically based neurodevelopmental disorder characterized by impairments in two major domains; deficits in social communication and social interaction and restricted repetitive patterns of behavior, interests and activities.

Aim of the Work
Understanding and correlating the socioeconomic status (SES), clinical characteristics and the severity of ASD.

Patients and Methods
100 autistic patients were assessed using DSM-V criteria, intelligence quotient (IQ) assessment using Stanford Binnet intelligence scale, assessment of severity of autistic symptoms using childhood autism rating scale (CARS), and psychometric evaluation for comorbid psychiatric conditions by using Pediatric Symptoms Checklist (PSCL), Full clinical examination, neurological examination, Electroencephalography (EEG) for some patient & socioeconomic status (SES) assessment were also done.

Results
Severity of ASD was correlated with each of motor & social delay (p = 0.007) (p = 0.000) respectively, impairment in Sphincter control (p = 0.012), imitation impairment (p = 0.010) and stereotypic behavior (p = 0.015. Our patients had comorbidities in the form of; gastrointestinal tract (GIT) symptoms, eating disorders and EEG findings (p = 0.004) (p = 0.005) (p = 0.038) respectively. Our patients mainly belonged to middle SES (57%) and severity of ASD was correlated with family possessions domain of SES (p = 0.001). Children who belonged to high SES were more likely to be diagnosed earlier (p = 0.016) with better IQ (p = 0.003) than those from lower SES.

Conclusion
It is important for developing countries to have their own research and to increase public awareness in all socioeconomic strata and establish integrated services for autism.
Neurocognitive, Psychosocial Outcomes and Quality of Life in Pediatric Brain Tumors and Their Caregivers
Authors: Ebeid Fatma S E , Aziz Asmaa W Abdel , Ali Sara G M , Ali Heba G A 
Published: August 2023

Background
Treatment Modalities included surgical management and the use of cranial irradiation (CI) and/or chemotherapy have significantly increased the survival rate of pediatric brain tumour.

Aim of the Study
Primary objective was to determine neurocognitive and psychosocial outcomes in pediatric brain tumour as well as to assess quality of life in pediatric patients with brain tumours and their caregivers. While the secondary objective was to determine risk factors that might affect these outcomes.

Methods
A cross sectional study including children and adolescent with confirmed diagnosis of Pediatric Brain Tumour (PBT) conducted in Pediatric Haematology Oncology clinic, Ain Shams University Hospital, Egypt from the period June 2019 to June 2021.Demographic and clinical data were collected, a thorough clinical and psychiatric assessments were conducted. Qualityof-life (QoL) of the children were performed using Arabic validated version of PedsQL 4.0 and pediatric symptom checklist. Quality-of-life (QoL) of the caregivers were performed using the short version of the WHO Quality of Life Instrument (WHOQOL-Bref)

Results
Forty-five patients with confirmed diagnosis of pediatric brain tumour who regularly followed up at the study site were included. Patients were 27 (60%) boys and 18 (40%) girls, and their mean age was 7.22 ± 3.23 years. Thirty four patients (75.6%) had primary brain tumour and eleven patient (24,4%) had secondary brain tumour. There was overall decrease in all domains of quality-of-life of patients with brain tumour assessed using PedsQL 4.0. Using pediatric symptom checklist revealed that 37.8% had psychological abnormalities.

Conclusion
The quality of patients' life and their caregivers after brain tumors diagnosis is affected, the disease, its treatment and its course had significant negative impact on the multiple domains of their daily life. Consequently, it is vital for healthcare professionals to develop and implement interventions which target on reducing depressive symptoms, enhancing self-esteem and QoL.
Interleukin-18, Interleukin-18 Gene Polymorphisms and Interleukin18 Binding Protein in Children and Adolescents with Immune Thrombocytopenia
Authors: Mokhtar Galila Mohamed , Altawil Mohamad Mostafa , Kamal Tarek Mostafa , Andrawes Nevine Gamal , Elfatah Mona Fathy Abd , El-Wahab Fayed Waleed Abd , Eltonbary Khadiga Yehia 
Published: August 2023

Background
Immune thrombocytopenia (ITP) is an autoimmune illness characterized by an aberrant T cell response, which is supported by autoreactive B cell growth and differentiation. IL-18 expression has been linked to a number of autoimmune and inflammatory illnesses. IL18BP is a protein that binds IL-18 with high affinity, suggesting a potential mechanism for regulating IL-18 activity. Corticosteroids may play a significant role in reversing the IL-18- IL18BP ratio by upregulating IL18BP.

Objective
The aim was to study associations between IL-18 and two associated gene polymorphism sites -607 & -137 with incidence and response to therapy in patients with ITP.

Patients and Methods
It is a case control study conducted on children and adolescents with ITP.A total of 55 patients with different stages of ITP (25 acute, 18 persistent & 12 chronic patients) were recruited with 30 age matched healthy controls. All patients were subjected to full history and physical examination. Laboratory investigations included serial blood counts, IL-18 and IL-18BP serum levels using enzyme linked immunosorbent assay (ELISA) and IL-18 gene polymorphisms using polymerase chain reaction (PCR).

Results
At diagnosis the median platelet count was 16× 109/L (range 2-79) & eventually increased to a median of 90× 109/L after treatment. IL-18 level was significantly higher than that of control (P &lt; 0.001) & even after treatment. There was no significant difference between patient and control groups regarding the studied gene polymorphism sites -607 & -137. The mean IL-18 was still significantly elevated in all stages of ITP compared to control group & as well the drop after treatment. This was also observed in IL-18 BP which increased significantly after response to steroid therapy. However, it was observed that the decline in level of IL-18 as well as increment in IL-18 BP was the least in the patients tested during the acute phase. Mean IL-18 & IL-18 BP levels show no significant relation with gender, family history of ITP, mode of treatment or genotype.

Conclusion
Among the studied IL-18 gene polymorphisms, no significant difference was detected among ITP patients or had a significant correlation with clinical or laboratory markers. Reversed IL-18/IL-18BP ratio is an important modulator in pathogenesis of ITP. Increasing levels of IL-18BP could have a significant role in treatment.