bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic Delay in Pediatric Cancer; Causes and Effect on Survival Rates
Authors: Elhabashy Safinaz Adel , Wahdan Maha Magdy , Hussein Doha Salama Hassan , Ali Heba G A 
Published: August 2023

Background
Currently, timely diagnosis immediately followed by effective treatment is an essential approach for control of the public health burden due to childhood cancers.
Our aim was to ascertain the median lag time till diagnosis, and treatment of pediatric patients with malignancy and to determine factors influencing the delayed diagnosis and relate delay times to diagnosis with overall and event free survival rates.

Methods
A cross sectional prospective study including children and adolescents with confirmed cancer diagnosis was conducted in Pediatric Hematology –Oncology Unit of Ain Shams University Children's Hospital, Egypt. A predesigned questionnaire was structured to collect data from parents or legal guardians of patients diagnosed with cancer about demographic and cancer characteristics the latter included presenting symptoms, type, site, risk, modalities of diagnosis, time to diagnose, treatment with calculation of event free survival and overall survival times.

Results
The study enrolled 115 children and adolescents with cancer during the period from August 2020 to May 2021. Misdiagnosis was initially recorded in 16 (13.9%) patients. Median total diagnostic delay or Lag Time (LT) for all patients was 53 days. Patients’ gender, age and socioeconomic status did not affect the median total delay, whereas residency, misdiagnosis, presence of health insurance, tumor location and presence of metastasis significantly influenced the total diagnostic delay. There was no significant correlation between overall and event free survival rates and total diagnostic delay.

Conclusion
Delayed diagnosis of solid malignant neoplasms except Wilms tumor, needs more attention to health care providers awareness especially in rural regions.
Vitamin D Level in Children with Acute and Relapsing Demyelinating Disorders of the Nervous System
Authors: Tomoum Hoda Yahya , Solimam Dina Ahmad , Zaitoun Raghda Mohamed Hesham , El-beshbeshy Hany Mohamed Alla 
Published: August 2023

Background
Vitamin D has recently gained increased attention owing to its immunomodulatory role. Epidemiological evidence demonstrates that deficiency of Vitamin D is a relevant risk for acute acquired immune-mediated inflammatory demyelinating diseases in childhood, such as Multiple sclerosis (MS). Exact mechanism remains widely unexplored.

Aim
to measure the serum level vitamin D-25(OH) in pediatric patients diagnosed with acquired central and peripheral demyelinating diseases, and to compare these to levels found in healthy age and gender matched controls.

Patients and Methods
Twenty children (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-Barre 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 25 (OH) vitamin D3 in both cases and control group.

Results
The mean level of vitamin D in cases was 4.4 ± 11.14 ng/ml, and it was deficient in 75% of the cases and insufficient in 15% of cases. The mean vitamin d level in cases was significantly lower than that in controls (27.18 ± 7.8 ng/ml).

Conclusion
Serum levels of 25 (OH) Vitamin D3 in pediatric acute acquired demyelinating diseases of the nervous system are significantly lower than levels in healthy controls, raising a possibility that vitamin D deficiency may be a risk factor for the development of various autoimmune neurological diseases.
Evaluation of Smectite Effect as a Food Thickener in Gastroesophageal Reflux Disease in Neonates Using Combined Esophageal Multichannel Intraluminal Impedance
Authors: Ismail Rania Ibrahim Hossni , Awad Hesham Abdel Samie , Shafik Emam Safaa , Shady Nancy Mohammed Abou , Fayez Ahmed Hend , Rabie Dina 
Published: August 2023

Introduction
Gastroesophageal reflux disease (GERD) occurs when reflux of the gastric contents causes symptoms, MII-pH offer several advantages over the traditional diagnostic measures as it detects reflux regardless of its pH and distinguishes swallows from GER. Thickening of infant formulas has been recommended for the treatment of GERD. Agents that have been used include cereal, rice, bean gum, sodium carboxymethyl cellulose, pectin, cellulose and carobel. We aimed to assess the efficacy of (Smectite) as a food thickener in treating GERD in neonates using MII-pH before and after Smectite.

Patients and Methods
Twenty preterm neonates ≤ 36 weeks of age from maternity hospital, Ain Shams University, enrolled during the period 2018 to 2020, all had signs suggestive of GERD, Feeding intolerance, and repeated chest infections due to frequent apneas, aspiration or associated with bronchopulmonary dysplasia as well as nonspecific behavioral signs including arching, irritability, and apparent discomfort associated with feedings, GERD was confirmed by MII-pH for 24hrs. Diagnosis of reflux was done by total number of liquid and mixed Reflux &gt; 100 as per (1) López-Alonso et al., 2006. patients then were prescribed Smectite (3 g/day for 7 days). On the 8th day, a second 24-hour MII-pH was performed to assess the response.

Results
Preterm infants with more than 100 impedance events were diagnosed with GERD most of these attacks were non acidic and weakly acidic attacks. Using Smectite as a food thickener was followed by a significant decrease in total reflux time and total frequency of reflux episodes (P. value &lt;0.001), there was also a significant decrease in the frequency of impedance events per 24hrs. Total frequency of reflux episodes before and after Smectite decreased in terms of number of signs related to reflux before and after treatment such as vomiting, acute life threatening events like bradycardia, apnea, wheezy chest, desaturations all of which improved significantly after treatment.

Conclusion
MII-pH is one of the most sensitive tools for the diagnosis of reflux and Smectite could be used as a feed thickener to decrease reflux signs and symptoms for more studies on a larger scale to confirm.
Eating Disorders in Adolescents with Type 1 Diabetes
Authors: Elhabashy Safinaz Adel , Thabet Rasha Adel , Elrassas Hanan Hany , Abd ElMalak Mariam William 
Published: August 2023

Background
Diabetes Mellitus is a chronic disease commonly associated with eating disorders especially in adolescents.

Objectives
to assess occurrence of eating disorders, and its nature, associated risk factors, comorbidities, and consequences in a cohort of adolescents with type 1 diabetes.

Methods
In this cross-sectional study, 138 patients were recruited to complete 3 questionnaires;Eating Attitude Test (EAT-26) and Eat Behavior questionnaire (ORTO-15) and Eating Disorder Examination Questionnaire version 6 (EDE-Q6) for assessment of any eating disorder (ED).

Results
Patients were categorized as having an ED according to predetermined cutoff value for each questionnaire. Of the 138 patients, 24 (17.4%) had risk for eating disorders by EAT-26 score, 53 (38.4%) have got Orthorexia nervosa by ORTO-15 and 45 (32.6%) were having a disordered eating behavior by EDE-Q6. Patients with risk of eating disorders had lower mean ORTO-15 score as compared to those without (p = 0.01), and higher mean Global EDE-Q6 (p &lt; 0.001). A significant correlation was found between EAT-26 scores and both ORTO-15 and EDE-Q6 scores, (p &lt; 0.05). As for risk factors, a positive correlation was found between EAT-26 scores and both age (p &lt; 0.0001) and BMI (p &lt; 0.0001). Also, ORTO-15 score correlated with duration of diabetes (p = 0.0418). Diabetic ketoacidosis, peripheral neuropathy and microalbuminuria occurred frequently in patients with any high score of the 3 questionnaires. Hypoglycemic episodes were reported more in those with high EAT-26 or global EDE-Q6 scores.

Conclusion
Subclinical eating disorders and abnormal eating behaviors are common in Egyptian adolescents with type I diabetes.
Study of Pentraxin-3 as an Early Marker of Diabetic Vascular Complications in Children and Adolescents with Type 1 Diabetes Mellitus
Authors: Afify Mohamed Abo El Asrar Mohamed Elbayoumi , Elzoghby Doaa M A , Ibrahim Marwa Elsayed Abd ElRaahman , Thabet Rasha Adel , Fekry Mohammed Diya Eldin Mahmoud 
Published: August 2023

Background
Vascular complications are the major cause of morbidity and mortality in diabetic patients. These can result from interactions between systemic metabolic abnormalities, such as hyperglycemia, dyslipidemia, genetic and epigenetic modulators, and local tissue responses to toxic metabolites.

Aim of the Work
To assess the role of PTX3 as an early marker of vascular complications in children and adolescents with type 1 diabetes mellitus and its correlation with metabolic control and its relation to hsCRP level.

Patients and Methods
Fifty adolescents with type 1 diabetes mellitus and 40 age and sex matched control group, Detailed history taking, full systemic examination were done, Patients also were investigated using HbA1c, lipid profile, ALT, Alb/Cr ratio in urine, PTX3, hsCRP and carotid intima media thickness (CIMT). An informed consent was obtained from patients, controls or their legal guardians before enrollment in the study.

Inclusion criteria
Patients with type 1 diabetes their age ranging from 5 to 18 years old with at least 5 years disease duration and on regular clinic visits and multiple daily insulin therapy .

Exclusion criteria
Patients with proven vascular complications and those with any clinical evidence of infection, hematological diseases, tumors, liver dysfunction, urinary tract disorders, connective tissue disease, or other autoimmune diseases, also patients with morbid obesity were excluded.

Results
PTX3 and hsCRP were significantly higher in patients compared to control group. A significant positive correlation between serum PTX3 and level of HbA1c%, level of Triglycerides (TG), level of Total Cholesterol was observed. Additionally, PTX3 and hsCRP levels were elevated in patients with elevated lipid profile (TG and Cholesterol) and high HbA1c% level in comparison with those with normal lipid profile and those with controlled HbA1c% level (p &lt; 0.001). No significant difference was found between patients and control groups as regard CIMT.

Conclusion
. The increased levels of PTX3 and hsCRP in patients with uncontrolled diabetes even before development of both microvascular and macrovascular complications add a promising tool for their follow up and applying early protective measures.
The Effect of Clover Honey Supplementation on the Anthropometric Measurements and Lipid Profile of Malnourished Infants and Children
Authors: Abdulrhman Mamdouh A , Mohamed Nagwa I , Abdelhaleem Bassma A 
Published: August 2023

Background
Malnutrition in children is an increasing problem worldwide which may result in both short and long term irreversible negative health outcomes.

Objective
This study was to assess the effect of clover honey supplementation on the anthropometric measurements and lipid profile of malnourished infants and children.

Subjects & Methods
This was prospective interventional clinical trial done on 20 malnourished infants and children whose ages ranged between 1-5 years. The patients with primary malnutrition only included in our study and we excluded patients with secondary malnutrition or who had any diseases as (diabetes, GIT diseases, severe systemic illness or inborn error of metabolism).The patients were recruited from the Pediatric Nutrition Clinic Ain Shams University. The children received honey supplementation for 3 months and anthropometric measurements (weight, height, body mass index, head circumference and mid arm circumference) and fasting serum cholesterol level were measured baseline and after 3 months honey supplementation in a dose of 1.75ml/kg/dose twice weekly for 3 months to ensure compliance.

Results
The 3-month honey consumption has statistically highly significant effect on increasing weight, height, and body mass index and lowering fasting serum cholesterol level in primary malnourished infants and children. The statistical measurements of mean ± SD regarding weight, height, body mass index and fasting serum cholesterol level before honey consumption were (9.49 ± 2.03, 81.45 ± 8.31, 14.24 ± 2.15, 178.00 ± 20.91) and after 3 months honey consumption were (10.91 ± 2.11, 84.80 ± 8.23, 15.07 ± 2.05, 162.45 ± 19.73) respectively with P-value&lt; 0.01.

Conclusion
Honey is a natural substance with a lot of benefits for nutrition and health. Our results showed a significant effect of consuming honey on changes in the nutritional status based on weight, height, and body mass index, and has a favorable effect on lowering fasting serum cholesterol level.
The Impact of COVID 19 on Glycemic Control in Children with Type 1 Diabetes on Insulin Pump Therapy: A Single Centre Study
Authors: Abdelmaksoud Abeer Ahmed , Salah Nouran Yousef , Ayoup Safaa Alshraki Alsayed 
Published: August 2023

Background
Children with type 1 diabetes (T1DM) are at risk of glycemic deterioration during the COVID-19 pandemic due to several factors. However, some studies reported glycemic improvement in these children.

Aim
To assess the impact of COVID-19 on children with T1DM on insulin pump in terms of glycemic control and insulin therapy adjustments.

Methodology
Forty-two children with T1DM on insulin pump (Medtronic) for at least 3 months were recruited from the Pediatric and Adolescent Diabetes Unit (PADU), Ain-Shams University, Cairo, Egypt. They were assessed for insulin requirements, frequency of diabetic ketoacidosis and clinically significant hypoglycemia. Auxological parameters, HbA1c and lipid profile were assessed. Continuous glucose monitoring was performed using Medtronic i-pro device for 5 days for each patient. Data were compared to previous patients’ data obtained from their medical records. Study period was performed between 29/6/2020 until 29/12/2020.

Results
This study was carried out on 42 children with T1DM on insulin pump (15 males and 27 females with a male to female ratio of 1: 1.8) with a mean age of 11.31± 3.28 years, mean BMI of 18.80± 3.35 and mean disease duration of 4.40± 2.93 years. The mean insulin requirements of the studied children before the COVID- 19 pandemic was 0.83 ± 0.28 U/kg/d, range 0.5- 1.8 U/Kg/d with a mean basal percentage of 51.19 ± 3.46 %, range 45-60 % .As regards the laboratory data of the studied children with a mean HbA1c of 9.0±1.2%, range: 7-11.8%, mean fasting cholesterol of 184.88 ± 27.03 mg/dl, range: 142-233 mg/dl, mean fasting triglycerides of 89.81 ± 32.69 mg/dl, range: 43-148 mg/dl, mean LDL of 87.77±9.97 mg/dl, range: 68-98 mg/dl, mean HDL of 58.33± 12.28, range: 32-83 and median UACR was 13(10-21.9) mg/g, range: 7.0-94. There was a statistically significant increase in the total daily insulin units(P = 0.001), basal percentage (P = 0.011) and time in range (p = 0.009) with a significant decrease in the frequency of DKA (P = 0.001), hypoglycemia (P = 0.004), HbA1c (p = 0.001) and glycemic variability (p = 0.001) after the COVID-19 pandemic.

Conclusion
Glycemic control improved during the COVID-19 pandemic among children with T1DM on insulin pump therapy reflected by improvement in TIR and decrease in glycemic variability.

Declarations

Conflicts of interest disclosure
The authors declare that they have no conflict of interest.

Funding sources
No funding sources
The Effect of Intermittent Fasting on Isoproterenol-Induced Myocardial Infarction in Aged Rats: A Potential Role of Autophagy
Authors: El Agaty Sahar M , Nassef Noha A , Abou-bakr Doaa A , Hanafy Aya A 
Published: August 2023

Background
Aging is associated with cardiovascular and metabolic changes, increasing the susceptibility to acute myocardial infarction (MI). Intermittent fasting (IF) was found to reduce the age associated cardiovascular diseases.

Aim
To investigate the possible protective effect of IF against acute MI induced by isoproterenol (ISO) in old rats and its underlying mechanisms, including autophagy.

Methods
50 male Wistar rats were equally divided into five groups: Adult; Old; Old-F (rats were subjected to IF for 4 weeks); Old-ISO (rats subjected to MI by ISO) and Old-F-ISO groups.

Results
IF significantly reduced troponin-I and creatine kinase (CK-MB), cardiac malondialdehyde (MDA) and TNF- α in Old-F-ISO compared to Old-ISO group. This was associated with a significant decrease in the age-related overall and visceral obesity; and dyslipidemia in Old-F and Old-F-ISO versus Old and Old-ISO groups. IF increases cardiac Atg-5 in Old-F-ISO versus Old group. Also, IF attenuated the age-related diabetic changes and significantly increased the pancreatic Atg-7 in Old-F-ISO versus Old group. Histological studies revealed attenuation of the local inflammatory response in Old-F-ISO versus Old-ISO group. Pancreatic Atg-7 and heart Atg-5 were significantly increased in Old-ISO versus Old rats.

Conclusion
IF protects against acute MI in old rats, in part, via alleviation of the age-related obesity, diabetic changes, and dyslipidemia. Chronic activation of heart and pancreatic autophagy by IF may possibly afford a cardioprotective effect. Acute activation of both heart and pancreatic autophagy by ISO could have a deleterious effect, augmenting cardiac injury.
Assessment of Pericardial Fat Volume and Carotid Intimal Thickness as Risk Factors for Developing Coronary Atherosclerosis Using Multi Detector Computed Tomography
Authors: Elkordy Mahmoud Moustafa Mahmoud , Mohammed Ahmed Moustafa , El Naggar Heba T-Allah Mohammed 
Published: August 2023

Background
The real visceral fat deposit of the heart is epicardial adipose tissue, which exists directly on the epicardial surface of the myocardium and is totally confined within the pericardial sac. Because the coronary arteries and their major branches are embedded in fat, local contact between a metabolically active epicardial adipose tissue and the coronary vasculature was possible. Carotid artery increased intimal thickness is the initial step within the process of atherosclerosis, which is a major cause of coronary and arterial diseases.

Aim of the Work
To study the relation between pericardial fat volume measurements in Multi and detector computed tomography ‘MDCT’ with carotid intima-media thickness in duplex study for detecting the risk of developing coronary atherosclerosis.

Patients and Methods
This retrospective study was carried out at the Radiodiagnosis department; Ain Shams University Hospitals (ASUH) during the period from January 2021 to June 2021 on 30 patients; their ages ranged from 37 to 78 years old, with a mean age of 60 years. Patients were either self-referred or referred by a physician to follow up or investigate CAD. All patients underwent coronary CT angiography. They were evaluated for: (I) Coronary calcium score. (II) Pericardial fat volume. (III) Degree of atherosclerosis, then a carotid duplex study was performed to determine the carotid intimal thickness.

Results
we demonstrated that pericardial fat volume MDCT has a positive, significant, strong correlation with CAD (P. Value &lt;0.001). In our study, a Post-hoc Bonferroni test was done regarding the obtained data and found a significant difference between (Moderate and Severe) versus all groups. This means a significant difference between the moderate group with minimal or mild, and a significant difference between the severe group with minimal or mild. So it could be considered as a screening test at an early stage for any patient with different degrees of CAD.

Conclusion
Multi-detector CT and Carotid duplex examination were both considered good non-invasive tools for evaluation of PAT volume (mean for unremarkable to minimal degree, volume of about 94 ± 14.73 cm3) and CIMT (mean for unremarkable to minimal degree, thickness of about 0.67 ± 0.06 mm). Both were found to be significant and positively proportionately correlated risk factors for coronary atherosclerosis, so it is suggested that both tests be used as an evaluating/screening tool for any patient with suspected or confirmed CAD to assess risk and severity.
Three to Six-Months Follow-Up Chest CT Findings after COVID-19 Pneumonitis, Incidence of Complications and Correlation to Different Risk Factors
Authors: Hebisha Omar Mostafa Ali Elsayed , Moftah Sherine George , Salama Asmaa Magdy Mohamed 
Published: August 2023

Background
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, or SARS-CoV-2, has become a global pandemic. As of November 19, 2020, World Health Organization stated that this disease has been found in more than 200 countries. Pathology studies have shown that COVID-19 causes injuries in multiple organs and tissues, with extensive pulmonary involvement similar to that found in other coronavirus infections (ie, severe acute respiratory syndrome coronavirus and Middle East respiratory syndrome coronavirus infection).

Aim of the Work
to evaluate pulmonary changes on 3-6 months follow-up chest CT scans and to explore the risk factors for fibrotic-like changes in the lung in patients who recovered from COVID-19 pneumonia.

Patients and Methods
This was a retrospective and prospective study that included 50 patients who had Symptoms of variable degree of fever, cough, and dyspnea with RT-PCR confirmed COVID- 19 infection at Ain Shams University Hospitals referred to the Radiodiagnosis Department for HRCT chest examination. All patients were evaluated for: (I): Incidence of complications (residual fibrotic like changes in their follow up CT chest scans). (Il): Correlation to different risk factors such as (smoking, diabetes mellitus, hypertension, pre-existing pulmonary disease, pre-existing renal disease and steroid therapy).

Results
56% of cases showed residual fibrotic like changes in their follow up chest CT scans while 44% of cases showed total resolution of the disease process. Smoking and old age were significant risk factors while steroid therapy decreased risk of fibrotic like change.

Conclusion
Twenty eight cases (56%) showed residual fibrotic like changes in their 3-6 months follow-up chest CT scan (CO-RADS III to V). Patients with older age and smokers have higher incidence of residual fibrotic like changes in their follow up chest CT scans, while patients on steroid therapy have less liability to develop fibrotic changes.