@article { author = {A. Mustafa, Kamel and A. Khattab⃰, Raafat and F. Ahmed⃰, Mohammed}, title = {Myocardial performance index (Tei index) in neonatal respiratory distress and perinatal asphyxia}, journal = {Al-Azhar Journal of Pediatrics}, volume = {22}, number = {2}, pages = {185-205}, year = {2019}, publisher = {Al-Azhar University, Al-Azhar Pediatric Society}, issn = {1110-7774}, eissn = {3009-7770}, doi = {10.21608/azjp.2019.68420}, abstract = {Objectives: The aim of the study was to evaluate the role of myocardial performance index (Tei index) in the assessment of ischemic cardiac damage in neonates with respiratory distress and perinatal asphyxia. Patients and Methods: This is a descriptive cross-sectional study conducted on 40 neonates in the NICU of Bab-El Shaarya University Hospital in 6 months period from January 2018 to June 2018. They were 22 males and 18 females with post-natal age 1-7 days, 15 with perinatal asphyxia (group1), 15 with respiratory distress(group2) and 10 normal as a control group(group3). Detailed history, thorough clinical examination, chest x-ray, ECG, Two-Dimensional echo, M- mode and Doppler (pulsed &tissue) echocardiographic examinations with the measurement of myocardial performance index ((ICT "isometric contraction time"-IRT "isometric relaxation time”)/ET "ejection time”) of the left and right ventricles. Results: There was statistically significant increase in the-myocardial performance index in group 1&2than group3.      There was inverse relationship between Tei index and each of ejection fraction and fraction shortening and there was statistically significant correlation between LV Tei index and gestational age. Conclusion: Tei index was higher in neonates with respiratory distress and neonates with perinatal asphyxia than in normal neonates despite normal or even increased ejection fraction which indicates that these patients may have subclinical ventricular dysfunction which should be followed up carefully. Recommendation: Tei index is recommended to assess ventricular function in neonates with respiratory distress or perinatal asphyxia as our study revealed that it is not affected by age or heart rate and it doesn't depend on ventricular geometry.}, keywords = {Key words: Tei index,neonatal respiratory distress,perinatal asphyxia,Echocardiography}, url = {https://azjp.journals.ekb.eg/article_68420.html}, eprint = {https://azjp.journals.ekb.eg/article_68420_94014648dc8fb57cd20efc199f046b36.pdf} } @article { author = {Ibrahim Karam, Muhammad abdel-Aziz and Taha Elkeiy, Mohsen and Ahmed Shobair, Ibrahim and Hammad, Kamel Soliman}, title = {SERUM ZINC LEVEL AMONG CHILDREN WITH ATTENTION DEFICIT HYPERACTIVITY DISORDER By}, journal = {Al-Azhar Journal of Pediatrics}, volume = {22}, number = {2}, pages = {206-220}, year = {2019}, publisher = {Al-Azhar University, Al-Azhar Pediatric Society}, issn = {1110-7774}, eissn = {3009-7770}, doi = {10.21608/azjp.2019.68422}, abstract = {Background: Zinc deficiency causes abnormal dopaminergic neurotransmission and may contribute to the physiopathology of attention-deficit/hyperactivity disorder (ADHD). Attention-deficit hyperactivity disorder is an early-onset, clinically heterogenous disorder of inattention, hyperactivity, and impulsiveness. The diagnosis and treatment of attention-deficit hyperactivity disorder continues to raise controversy, and, there is also an increase in treatment options. Therefore, we aim to assess serum zinc level among children with ADHD. Methods: This was a case control cross sectional study, in which 100 ADHD children were recruited from Bab Elsharya outpatient pediatric psychiatry clinic and compared with 40 healthy control children in the period between May 2017 and May 2018. Serum zinc level was assessed with atomic absorption in both groups. Psychometric procedure: The Arabic version of Conners’ Parent Rating Scale-Revised-Long version, and social score were used to calculate social standards of families. Results: The mean serum zinc levels were lower in the children with ADHD (mean ± SD, 75 ± 19 ug/dL) than in the controls (mean ± SD, 112 ± 15 ug/dL; P < .001). Serum zinc levels were less than ( Conclusion: This study brings additional information about the role of zinc in the etiology of ADHD. The study indicated that ADHD patients has significant decrease in serum zinc level in comparison to the controls, however there was no significant correlation between serum zinc level and symptoms of ADHD, mostly due to the multi-factorial nature of its etiology. Recommendations: serum zinc level should become a routine measurement in ADHD children which might benefit from a therapeutic trial with zinc supplementation. Furthur studies are required to assess the effectiveness of zinc administration in the management of ADHD children.}, keywords = {Key words: attention-deficit hyperactivity disorder,socioeconomic standard,serum zinc level}, url = {https://azjp.journals.ekb.eg/article_68422.html}, eprint = {https://azjp.journals.ekb.eg/article_68422_67c5928f33a00f48f65065315f1873e4.pdf} } @article { author = {Ghaffar, Aida and Ghanem, Sabry and Metwally, Mahmoud and Sasy, Ahmed Saleh}, title = {SERUM MANNOSE BINDING LECTEN IN NEONTAL SEPSIS}, journal = {Al-Azhar Journal of Pediatrics}, volume = {22}, number = {2}, pages = {221-240}, year = {2019}, publisher = {Al-Azhar University, Al-Azhar Pediatric Society}, issn = {1110-7774}, eissn = {3009-7770}, doi = {10.21608/azjp.2019.68840}, abstract = {Background: Mannose-binding lectin (MBL) is a component of innate immunity and particularly important in neonates in whom adaptive immunity is not yet completely developed. MBL deficiency and MBL is associated with an opsonization defect and have been associated with recurrent infections. Objectives: The aim of our study was to determine whether serum MBL levels could serve as markers for predicting neonatal sepsis in neonatal intensive care (NICU). Patients and Methods: This case- control study was conducted on 75 neonates classified into 3 groups: The first group (septic) included 30 neonates who had clinical and laboratory signs of neonatal sepsis..  The second group (suspected) included 30 neonates who had clinical not laboratory signs of neonatal sepsis. The third group (control) included 15 healthy neonates who had no clinical nor laboratory signs of neonatal sepsis ELISA technique was used for measuring MBL serum concentration. Results: Serum MBL levels were significantly lower in the neonates with sepsis or suspected than in the control group. MBL had high sensitivity and specificity values to detect sepsis. Conclusion: MBL serum level could be considered a sensitive and specific marker for prediction of neonatal sepsis. Neonates with significant decrease in MBL are at increased risk for developing sepsis and septic shock.}, keywords = {mannose-binding lectin,newborn infants,Sepsis}, url = {https://azjp.journals.ekb.eg/article_68840.html}, eprint = {https://azjp.journals.ekb.eg/article_68840_f646804b7a038fa8b3f347a63282f80e.pdf} } @article { author = {Hassan Abomayla, Mohamed and Elkeiy, Mohsen and Fakher, Osama}, title = {Retrospective Outcome of Pediatric Neurology Outpatient Clinic}, journal = {Al-Azhar Journal of Pediatrics}, volume = {22}, number = {2}, pages = {241-259}, year = {2019}, publisher = {Al-Azhar University, Al-Azhar Pediatric Society}, issn = {1110-7774}, eissn = {3009-7770}, doi = {10.21608/azjp.2019.68843}, abstract = {Background: Neurological disorders in children are common occurrence in clinical practice. The disorders account for more than 20% of the world's disease burden with great majority of people affected living in Africa. The clinical manifestations of neurological disorders may progress and get worst over time. Objectives: We aimed to demonstrate the patterns of pediatric neuropsychiatric disorders in a sample of Egyptian children at the Pediatric Neurology Outpatient Clinic in Bab-AL-Sharyea University Hospital &The management outcome of different neurologic diseases. Patients and Methods: This study composed of  two parts, the first part is a retrospective study included 2944 children with documented neurological diseases, this children were attended Outpatient Clinic of Pediatric Neurology at Bab Al-Sharyea University hospital from 2011 to 2017, and the second part is longitudinal study (follow up study) to follow up outcome of treatment of 50 cases, these cases were selected during the period from July 2017 till January 2018 from Outpatient clinic of Pediatric Neurology at Bab Al-Sharyea University hospital. History taking complete clinical examination, and laboratory investigations were registered. Results: The Results showed that neuropsychiatric disorders in male (63.2%) was higher than in female (36.8%) , the most common age group of the studied patients was among (6 - < 12 years) in 39.4%, epilepsy and other paroxysmal disorders were the commonest neurologic disorders accounting for (21.7%) of cases followed by cerebral palsy representing (16.2%) of cases. The study shows positive relation between epilepsy and CP in which epilepsy was found in (60.5%) of CP children. The study shows that most common psychiatric disorders was autism which occurred in (45%) of cases. The study shows that follow up of 50 cases after 6 months from start of treatment revealed that: 15 cases (30%) were cured, 17 cases (34%) were improved, 12 cases (24%) with partial improvement and 6 cases (12%) with no improvement. Conclusion: Neuropsychiatric disorders was frequent among children. Neuropsychiatric disorders was frequent in males than females. Early diagnosis of neurological disorders was associated with a good prognosis.}, keywords = {Pediatric Neurology,Outpatient Clinic,Outcome}, url = {https://azjp.journals.ekb.eg/article_68843.html}, eprint = {https://azjp.journals.ekb.eg/article_68843_b1f88b25c9eb4d872fc9380d1b664669.pdf} } @article { author = {Abd El-Moneam, Abd El-Moneam and Gabr, Ahmed Mohammed and Afia, Ali Abdellatif}, title = {Evaluation of Left Ventricular Rotational Deformation by Non-Conventional Echocardiography Before and After Transcatheter Closure of Large Secundum Atrial Septal Defects in Children}, journal = {Al-Azhar Journal of Pediatrics}, volume = {22}, number = {2}, pages = {260-278}, year = {2019}, publisher = {Al-Azhar University, Al-Azhar Pediatric Society}, issn = {1110-7774}, eissn = {3009-7770}, doi = {10.21608/azjp.2019.68845}, abstract = {Introduction: Atrial septal defects (ASD) are a common congenital heart disease which causes increased volume overload of the right side of the heart that leads to impairment of LV performance. LV torsion is a three dimensional (3D) performance, so it cannot be assessed accurately by the 2D speckle tracking method. Aim of the work: The purpose of this study was to evaluate left ventricular (LV) rotational & torsional deformation in large ASD patients undergoing transcatheter ASD device closure using 4D speckle tracking Imaging (STI). Methods: All patients who underwent transcatheter device closure of large ostium secundum ASD were included in the study. We assessed LV torsion in large ostium secundum ASD patients pre and post device closure by using 4D speckle tracking echocardiography. Results: A total of 20 patients with large ostium secundum ASD (11 females and 9 males) were included in this study. The mean age was 6.1± 3.5 years and the mean ASD size was 17.95 ± 5.45 mm. LV peak basal clockwise rotation improved significantly in post transcatheter closure (-6.96 ± 2.65˚ before vs. -10.32 ± 4.11˚after closure, P=0.005), and shortened time to peak clockwise rotation (345.15 ± 124.72 ms before vs. 282.25 ± 82.96 ms after closure, P = 0.021). There was no significant difference in apical rotational parameters including peak counterclockwise rotation (4.82 ± 3.44˚ before vs. 6.16 ± 3.38˚ after closure) and time to the peak (250.05 ± 69.17 ms before vs 252.45 ± 60.06 ms after closure (P >0.05 for both). LV twist (11.39 ± 3.81˚ before vs. 17.56 ± 7.18 ˚after closure, P = 0.001) and torsion (2.13 ± 0.79˚/cm before vs. 3.07 ± 1.27 ˚/cm after closer, P = 0.010) were significantly improved in patients with large ASD after the device closure, mainly as the result of improvement of LV basal rotation. Conclusion: After large ASD device closure there is increased peak LV twisting and torsion that were mainly attributed to the improved peak systolic clockwise basal rotation while the apical rotation remained unchanged}, keywords = {}, url = {https://azjp.journals.ekb.eg/article_68845.html}, eprint = {https://azjp.journals.ekb.eg/article_68845_51415fa4c60cd60bd2ade220a7a75348.pdf} } @article { author = {Mohammed, Mahmoud and el-mougi, mahmoud and Abu-Farrage, Ibrahim and Mohamed, Tahseen}, title = {A study of Knowledge, Attitude and Practice of House Officers toward Diarrhea in Children under Five Years in Al-Azhar Cairo and Minia Universities}, journal = {Al-Azhar Journal of Pediatrics}, volume = {22}, number = {2}, pages = {279-300}, year = {2019}, publisher = {Al-Azhar University, Al-Azhar Pediatric Society}, issn = {1110-7774}, eissn = {3009-7770}, doi = {10.21608/azjp.2019.68890}, abstract = {Background: Worldwide, an estimated 2.5 billion cases of acute diarrhea occur annually in children under 5 years. In these children, diarrhea is the second biggest cause of mortality (after acute respiratory illnesses) with the vast majority occurring in low resource settings such as sub-Saharan Africa. A cross-sectional study was conducted to the house officers toward diarrhea and its management in children under five years. Objectives: The aim of this research is to improve quality of the health of children under five years through proper management of diarrhea and to assess the knowledge, attitude and practice of house officers toward diarrhea and its management in children under five years. Subjects and Methods: All patients who underwent transcatheter device closure of large ostium secundum ASD were included in the study. We assessed LV torsion in large ostium secundum ASD patients pre and post device closure by using 4D speckle tracking echocardiography. Results: A total of 100 HOs were interviewed. Undergraduate training in El-Minia HOs was more than that of Al-Azhar HOs regarding attendance of HOs the undergraduate pediatric round and discussion of diarrheal cases in clinical rouds , but the difference did not reach statistical significance. The main source of studying in Al-Azhar HOs was Pediatric department book, but that of El-Minia lecture notes were the main source. Most of HOs of each faculty had good knowledge about dehydration classification and signs but, they had poor knowledge about ORS composition and dose. Al-azhar HOs had good knowledge toward avoided fluids (P 0.003) and NG tube usage indication with diarrhea (P < 0.001) than El-Minia HOs. HOs in both sites had poor awareness toward infant mortality in Egypt Al-azhar Ho (32 %) correct, El-Minia HO (46%) correct. Representation of diarrheal diseases in final written exams in both universities was few not exceeds 3.7 % in Al-azhar but 4.5 % in El-Minia. Conclusion: Non-significant differences between Al-azhar HOs and El-Minia HOs in the knowledge, Attitude and practice toward diarrhea in children and. Non-significant differences between HOs who received training in pediatrics during HO year and who didn't yet receive in both universities. Poor knowledge toward avoided fluids with diarrhea like soft drinks especially El-Minia HOs. Poor awareness toward infant mortality especially Al-azhar HOs. Diarrheal diseases weren't represented adequately in final written exams in both faculties of medicine. Sayed Galal hospital has a rehydration unit while Al-Hussein and El-Minia Hospitals don't have.}, keywords = {}, url = {https://azjp.journals.ekb.eg/article_68890.html}, eprint = {https://azjp.journals.ekb.eg/article_68890_43733c9a3faa21b64441d6d153e4d94e.pdf} }