@article { author = {}, title = {RISK FACTORS OF ACUTE KIDNEY INJURY IN ADMITTED NEWBORNS IN THE NEONATAL INTENSIVE CARE UNIT}, journal = {Al-Azhar Journal of Pediatrics}, volume = {23}, number = {4}, pages = {1246-1258}, year = {2020}, publisher = {Al-Azhar University, Al-Azhar Pediatric Society}, issn = {1110-7774}, eissn = {3009-7770}, doi = {10.21608/azjp.2020.128769}, abstract = {Background: Acute Kidney Injury (AKI) in the newborn is a common problem in the neonatal intensive care unit. The incidence of acute kidney injury ranges from 6-24% (Andreoli, 2016). Aim: This study aimed to study the risk factors for the development of acute kidney injury in admitted newborns in the neonatal intensive care unit. Patients and methods: The study was a simple random study.      The study was carried out on 150 neonates, who were admitted to the neonatal intensive care unit (NICU) of Al-Azhar University Hospitals (Al-Hussien and Sayed Galal hospitals) during the period from November 2018 to August 2019. Results: The study showed that the most common risk factors of neonatal acute kidney injury is sepsis, prematurity, hypoxic ischemic encephalopathy (HIE) and respiratory distress syndrome. Conclusion: The study concluded that the main risk factors for AKI in these neonates were sepsis, prematurity, HIE and respiratory distress.  }, keywords = {}, url = {https://azjp.journals.ekb.eg/article_128769.html}, eprint = {https://azjp.journals.ekb.eg/article_128769_9229e8f131095e2f3d2f22249f794746.pdf} } @article { author = {}, title = {SCREENING OF AUTISM SPECTRUM DISORDER BY USING GILLIAM AUTISM RATING SCALE IN A SAMPLE OF EGYPTIAN CHILDREN ATTENDING BAB AL SHA’REYA UNIVERSITY HOSPITAL}, journal = {Al-Azhar Journal of Pediatrics}, volume = {23}, number = {4}, pages = {1259-1277}, year = {2020}, publisher = {Al-Azhar University, Al-Azhar Pediatric Society}, issn = {1110-7774}, eissn = {3009-7770}, doi = {10.21608/azjp.2020.128770}, abstract = {Background: Autism spectrum disorder is a developmental disability that can cause social, communication, and behavioral challenges (Preece, 2014). The Gilliam Autism Rating Scale is a helpful in diagnosis and grading the severity of ASD. it is a norm-referenced measure designed to assess symptoms of autism in individuals aged three to 22 years (Gilliam, 2006).}, keywords = {}, url = {https://azjp.journals.ekb.eg/article_128770.html}, eprint = {https://azjp.journals.ekb.eg/article_128770_363001dbcd40a93dafad43e018e4da43.pdf} } @article { author = {}, title = {ESTIMATION OF VITAMIN C STATUS IN CHILDREN AND ADOLESCENTS WITH BRONCHIAL ASTHMA}, journal = {Al-Azhar Journal of Pediatrics}, volume = {23}, number = {4}, pages = {1278-1296}, year = {2020}, publisher = {Al-Azhar University, Al-Azhar Pediatric Society}, issn = {1110-7774}, eissn = {3009-7770}, doi = {10.21608/azjp.2020.128771}, abstract = {}, keywords = {}, url = {https://azjp.journals.ekb.eg/article_128771.html}, eprint = {https://azjp.journals.ekb.eg/article_128771_f88990a1d7df68e1e6bf36ee8543ec9a.pdf} } @article { author = {}, title = {AETIOLOGICAL PROFILE AND OUTCOME OF JAUNDICED NEONATES ADMITTED TO BAB ALSHARYIA UNIVERSITY HOSPITAL}, journal = {Al-Azhar Journal of Pediatrics}, volume = {23}, number = {4}, pages = {1297-1314}, year = {2020}, publisher = {Al-Azhar University, Al-Azhar Pediatric Society}, issn = {1110-7774}, eissn = {3009-7770}, doi = {10.21608/azjp.2020.128813}, abstract = {Background: Hyperbilirubinemia is the most common condition requiring evaluation and treatment in newborns. It must be treated early to avoid development of kernicterus. Management of unconjugated hyperbilirubinemia is clearly tied to the etiology. Early identification of known causes of non-physiologic hyperbilirubinemia should prompt appropriate laboratory investigations, and timely intervention. Objectives: to make a survey to all jaundiced baby admitted to NICU to determine the different causes of neonatal hyperbilirubinemia, the different modalities of treatment and the risk factors for developing complications. Patients & Methods: This study was an  analytic observational  study  included all neonates presented by neonatal hyperbilirubinemia admitted to the NICU of  Bab Alsharyia University Hospital over one year period from January 2019 to January 2020, the study included 260 neonates (142 males, and 118 females) with mean gestational age was 37.25 ± 0.91 weeks. Results: neonatal jaundice in admitted cases was 54.6% in males and 45.4% in females. 19.2% of the cases were vaginally delivered and 80.8% were delivered by caesarean section. The mean gestational age was 37.25 ± 0.91 weeks. The mean birth weight was 2.79 ± 0.68 kg. The mean age of onset of neonatal jaundice was 4.01 ± 3.64 day of life. The mean total bilirubin level at presentation was 17.13 ± 3.74 mg/dL. The mean maximum total bilirubin level was 25.76 ± 7.13 mg/dL. ABO incompatibility as a cause found  in (32.7%) of cases, with more neonates having blood group A (45.3%) than those having blood group B (33.1%), Rh incompatibility in (4.6)% of cases , combined ABO and Rh incompatibility in (6.2%) of cases, breast milk in (38.1%), breast feeding (18.1%), biliary atresia (0.4%) of cases. Conclusion: Neonatal hyperbilirubinemia still the most common cause of admission in NICU.Many etiological factors are associated with neonatal hyperbilirubinemia, mostly ABO incombatibility and breast milk jaundice .Early intensive phototherapy may restrict the need for blood exchange and its hazards.}, keywords = {Key words: Neonatal jaundice,risk factors,NICU}, url = {https://azjp.journals.ekb.eg/article_128813.html}, eprint = {https://azjp.journals.ekb.eg/article_128813_d2e475fa66de55889a6c741a08021a77.pdf} } @article { author = {}, title = {SERUM INTERLEUKIN-6 LEVEL IN CHILDREN WITH ATTENTION-DEFICIT HYPERACTIVITY DISORDER}, journal = {Al-Azhar Journal of Pediatrics}, volume = {23}, number = {4}, pages = {1315-1337}, year = {2020}, publisher = {Al-Azhar University, Al-Azhar Pediatric Society}, issn = {1110-7774}, eissn = {3009-7770}, doi = {10.21608/azjp.2020.128814}, abstract = {Introduction: Attention deficit hyperactivity disorder (ADHD) is characterized by pervasive and impairing symptoms of inattention, hyperactivity, and impulsivity according to Diagnostic and Statistical Manual of Mental Diseases (DSM-V). It is estimated that around 60%–100% of children with ADHD also exhibit one or more comorbid disorders that often continue into adulthood 1. Elevated levels of some inflammatory markers have been reported in children with various neuropsychiatric disorders, including ADHD, indicating that inflammation may have a role in the pathogenesis of these disorders 2. Objectives: The aim of this study was to measure the level of serum interleukin-6 (IL-6) as an indicator of inflammatory markers in children with ADHD. Subjects and Methods: This case control study, the participants were consecutively recruited by simple random method from the pediatric neurology clinic in Bab-El Sharyia university hospital in the period from June 2019 to February 2020. Twenty children diagnosed as ADHD (fulfilling the criteria of Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, for ADHD diagnosis) and 20 healthy children as a control .Both groups were subjected to complete history taking, clinical examination, psychometric tests and Serum interleukin-6 was measured by enzyme-linked immunosorbent assay (ELISA). Results: In the patients group, 85% of patients were males while15% were females. Regarding subtypes of ADHD, 55% of ADHD patients were of the combined type, 25% were of the inattentive type while 15% of the hyperactive type. 70% of the studied ADHD patients were from rural areas and 30% were from urban areas.IQ was lower in ADHD patients than controls. There were significant higher Conners’ scores in ADHD patients compared to the control. The mean serum level of IL-6 was 23.35 ± 13.47 pg/ml in ADHD patients, while it was 7.57 ± 3.47 pg/ml in the controls, with highly significant difference. Conclusion: Serum IL-6 values were significantly higher in ADHD patients compared to healthy control children.}, keywords = {}, url = {https://azjp.journals.ekb.eg/article_128814.html}, eprint = {https://azjp.journals.ekb.eg/article_128814_dbf252953e85c2dbf4edc8311d0a7715.pdf} } @article { author = {}, title = {IS REPEATING THYROID SCREENING OF THE HEALTHY NEWBORN IS BENEFICIAL}, journal = {Al-Azhar Journal of Pediatrics}, volume = {23}, number = {4}, pages = {1338-1355}, year = {2020}, publisher = {Al-Azhar University, Al-Azhar Pediatric Society}, issn = {1110-7774}, eissn = {3009-7770}, doi = {10.21608/azjp.2020.128815}, abstract = {Background: Some cases of congenital hypothyroidism may be missed by first neonatal screening. This study aimed to evaluate thyroid stimulating hormone TSH and free T4 of healthy full term at 7th and 28th day for detection of the missed cases of hypothyroidism at 1st neonatal screening. Methods: This prospective study was performed on 100 healthy term neonates born at Zagazig University Hospitals and Al-Azhrar Hospital. The study was done on healthy full term new born at Neonatal Intensive Care Unit of Zagazig University hospital and Al-Azhrar Hospital and was under go follow up for TSH and free T4 at 7th and 28th day of life .Newborns were classified into two groups based on their age at 7th and 28th day of life. The following was done 1. Demographic data of the studied cases. Clinical assessment, Laboratory tests: included TSH and Free T4 concentration. Results: Congenital hypothyroidism among the studied Cases at 7th day was (3%). Congenital hypothyrodism among the studied Cases at 28th day was (9%). Higher prevalence of CH among patients with positive maternal history of thyroid disorders. Higher prevalence of CH among patients delivered by cesarean section (C/S). Our results showed that history of thyroid disorders had a high risk for CH. There were statistically significant increases of maternal age among Cases with Congenital Hypothyroidism than Cases with euthyrodism. There were statistically significant decrease in weight and length among Cases with Congenital hypothyrodism than Cases with euthyrodism. Conclusion: 2nd Neonatal screening of all healthy newborns at 28th day of life is very important, since some cases of congenitl hypothyroidism can be missed in the 1st neonatal screening at the 4th day of life.}, keywords = {}, url = {https://azjp.journals.ekb.eg/article_128815.html}, eprint = {https://azjp.journals.ekb.eg/article_128815_234c8c6aca4a42992734a2655f6ec0c5.pdf} } @article { author = {}, title = {PATTERN OF LIVER DISORDERS IN NEONATAL INTENSIVE CARE UNIT}, journal = {Al-Azhar Journal of Pediatrics}, volume = {23}, number = {4}, pages = {1356-1373}, year = {2020}, publisher = {Al-Azhar University, Al-Azhar Pediatric Society}, issn = {1110-7774}, eissn = {3009-7770}, doi = {10.21608/azjp.2020.128816}, abstract = {Objectives: Our objective is to detect hepatic insult and its potential risk as Co-factor that can be faced by babies admitted to NICU. Background: Liver may affect by many disorders in neonatal period, the most common are neonatal sepsis (mainly due to gram-negative organisms), hypoxic induced encephalopathy (the common neurological complication in perinatal period). Patients and Methods: A prospective observational study carried out in NICU of El-Hussein University Hospital included 100 neonates for diagnosis of liver affection associated with other neonatal disorders  with exclusion of neonates with multiple congenital anomalies and cases with inborn errors of metabolism during the period from March 2019 to September 2019. Results: Our results showed a significant male admission with significant occurrence of liver insult in neonates with very low birth weight, neonatal sepsis, HIE, maternal history of PROM, maternal comorbidities, Low APGAR score, presence of splenomegaly, hepatomegaly, liver enzymes elevation, change in bleeding profile and albumin, rise in CRP and alkaline phosphatase enzyme and positive blood culture results.      The results showed significant relation between liver insult and bad outcomes and the use of CPAP, MV. Conclusion: We conclude that neonates especially with low-birth weight more prone to liver affection if with neonatal sepsis and hypoxic induced encephalopathy. Recommendation: Any baby admitted to NICU especially with critical disorders (HIE, Neonatal sepsis) must be investigated for liver function tests to rule out hepatobiliary dysfunction.}, keywords = {Key words: Neonatal sepsis (NS),Hypoxic induced encephalopathy (HIE),Multi-organ dysfunction (MOD),neonatal intensive care unit (NICU),premature rupture of membranes (PROM)}, url = {https://azjp.journals.ekb.eg/article_128816.html}, eprint = {https://azjp.journals.ekb.eg/article_128816_741903af439b49bac02f357903cf10d6.pdf} } @article { author = {}, title = {EVALUATION OF MELATONIN EFFECT AS ADJUVANT THERAPY IN TREATMENT OF SEPTIC NEWBORNS}, journal = {Al-Azhar Journal of Pediatrics}, volume = {23}, number = {4}, pages = {1374-1391}, year = {2020}, publisher = {Al-Azhar University, Al-Azhar Pediatric Society}, issn = {1110-7774}, eissn = {3009-7770}, doi = {10.21608/azjp.2020.128817}, abstract = {Background: Neonatal sepsis is a clinical syndrome with a systemic sign and symptom of infection in the first 4 weeks of Life, sepsis is an important cause of morbidity and mortality, Free radical and reactive oxygen species ROS play An important role in the pathogenesis of neonatal sepsis, Melatonin is an endogenous substance produced from the pineal gland, Melatonin is a highly effective antioxidant and free radical scavenger. Aim of work: Evaluate the therapeutic efficacy of melatonin in the treatment of neonatal sepsis as adjuvant therapy. Design: A prospective case-control study that was carried out on 40 neonates with neonatal sepsis diagnosed clinically and laboratory, they were Enrolled from NICU of Bab-alsha'reya university hospital in the period from April 2019 to October 2019. Patient and method: The Study included 40 neonates, divided by systemic random method into two groups,(Group 1) 20 neonates with sepsis received a single oral dose of melatonin in a dose of(20mg/day)as a single dose ,(Group2) 20 neonates with sepsis didn’t receive melatonin, both groups received the same protocol of antibiotics of the unit, investigations were done included CBC and CRP before administration of melatonin and 48h after administration of melatonin in group 1, in group 2 CBC, CRP at 48h after administration of antibiotics. Inclusion criteria: Any term or preterm with neonatal sepsis diagnosed clinically and laboratory, their weight less than 4kg. Exclusion criteria: Hypoxic-ischemic encephalopathy (HIE), major congenital anomalies, Persistent vomiting, and septic shock. Results: The study showed that serum parameter including (TLC, ANC, I/T ratio, platelets, and CRP) were similar in both group before administration of melatonin in group 1, while there was a significant difference in serum parameters, after 48h of starting administration of melatonin, so the present study showed that melatonin improves serum parameters and improve the clinical course of septic newborns. Conclusion: The administration of melatonin as adjuvant therapy in the treatment of neonatal sepsis is associated with better prognosis and improves outcomes}, keywords = {: Neonatal sepsis,Evaluation,Melatonin,adjuvant therapy}, url = {https://azjp.journals.ekb.eg/article_128817.html}, eprint = {https://azjp.journals.ekb.eg/article_128817_e44536bfc3c8833b7bc02e16a5c3a24b.pdf} } @article { author = {}, title = {CHANGES OF LIVER SIZE AND ITS FUNCTION IN CRITICALLY ILL PATIENTS AT PEDIATRIC INTENSIVE CARE UNIT}, journal = {Al-Azhar Journal of Pediatrics}, volume = {23}, number = {4}, pages = {1392-1406}, year = {2020}, publisher = {Al-Azhar University, Al-Azhar Pediatric Society}, issn = {1110-7774}, eissn = {3009-7770}, doi = {10.21608/azjp.2020.128819}, abstract = { Introduction: Critical illness may result in hepatic injury due to alterations in hemodynamic and oxygen delivery and metabolic derangements. This may result in alteration of liver size as well as impairment of important liver functions. Aim of the study: to Study liver size changes during the period of admission into PICU and its correlation with AST, ALT and CRP. Patients and Methods: 50 Patients were recruited from PICU at Sayed-Galal-University Hospital in the period from February to July 2020. All patients admitted to PICU were included in our study unless they did not fulfill the inclusion criteria. -    Patients were examined clinically and investigated by AST,ALT and CRP -    Clinical and laboratory Follow up weekly were done including ALT, AST and CRP. -    Pelvi-abdominal ultrasound was done when any changes of its size detected clinically. Results: Total number of studied patients was 50, the most common indication of admission was Respiratory problems which constitute 44% followed by surgical problems about 28% while neurological problems in 16% and 12% were cardiac problems.      15 children (30%) of study patients had hepatomegaly according to age with mean liver span on admission 11.57±1.9 that increased after one week to 13.37±2.3 but did not show significant changes after two weeks as the mean was 13.86 ± 3.39.      The studied patients had elevated ALT, AST and CRP above upper level of normal with percentage 58%, 56 and 62% consequently. Conclusion: Hepatomegaly and abnormalities of liver enzymes is a common finding in PICU especially in patients suffering from pneumonia and heart failure. Patients with hepatomegaly and altered hepatic function admitted to PICU carry a bad prognosis with long hospital stay, requirement of mechanical ventilation, inotropic support and they have a high mortality rate than those without hepatomegaly.}, keywords = {}, url = {https://azjp.journals.ekb.eg/article_128819.html}, eprint = {https://azjp.journals.ekb.eg/article_128819_19baf080e9c91019758c5e49fb6fdc51.pdf} } @article { author = {}, title = {EVALUATION OF SERUM CALPROTECTIN AS A DIAGNOSTIC MARKER IN EARLY DETECTION OF NEONATAL SEPSIS}, journal = {Al-Azhar Journal of Pediatrics}, volume = {23}, number = {4}, pages = {1407-1424}, year = {2020}, publisher = {Al-Azhar University, Al-Azhar Pediatric Society}, issn = {1110-7774}, eissn = {3009-7770}, doi = {10.21608/azjp.2020.128820}, abstract = {ABSTRACT Background: Neonatal sepsis remains one of the main causes of mortality and morbidity despite the progress in hygiene so that the accurate and early diagnosis of neonatal sepsis is a relevant problem. Calprotectin is an antimicrobial, calcium and zinc binding heterocomplex protein that could be used as a nonspecific marker for activation of granulocytes and mononuclear phagocytes. Therefore, calprotectin has been proposed for the diagnosis of inflammatory conditions. Objectives: The aim of this work was to evaluate the diagnostic value of serum Calprotectin in newborns with suspected sepsis. Patients and Methods: After obtaining the approval of the Al-Azhar University Ethical Committee, A case control study was conducted on thirty neonates. The study was carried out in Al-Azhar University Hospitals (AL- Hussein &Sayed Galal Hospitals), during the period from June 2018 to October 2019. All patients gave their written informed consents prior to their inclusion in the study. Thirty children divided into 2 groups (case & control). Serum level of calprotectin was measured for all neonates recruited in this study, by a commercial ELISA assay Results: Serum calprotectin levels were significantly higher in septic group than non- septic and control groups as mean Serum Calprotectin was 5.8 ± 1.4μg/ml and 1.3 ± 0.9μg/ml, respectively. Significant positive correlations were found between calprotectin levels and WBCs and IM ratio, while negative correlations were found between its level and lymphocytes and platelets. In our study, Calprotectin sensitivity and specificity values were 100 % and 97.5%, respectively. Conclusion: Serum calprotectin levels were significantly higher in neonates with sepsis. Its levels correlated well with other laboratory markers of sepsis and neonatal mortality. It is a sensitive diagnostic marker for neonatal sepsis.}, keywords = {: Neonatal sepsis,serumcal protectin}, url = {https://azjp.journals.ekb.eg/article_128820.html}, eprint = {https://azjp.journals.ekb.eg/article_128820_e78a39e251cb97770261af9d3dc7df63.pdf} } @article { author = {}, title = {MISCONCEPTIONS TOWARDS BREASTFEEDING AMONG LACTATING MOTHERS}, journal = {Al-Azhar Journal of Pediatrics}, volume = {23}, number = {4}, pages = {1425-1547}, year = {2020}, publisher = {Al-Azhar University, Al-Azhar Pediatric Society}, issn = {1110-7774}, eissn = {3009-7770}, doi = {10.21608/azjp.2020.128821}, abstract = {Background: Scientific research studies conducted during the last three decades have clearly proved that breastfeeding provides the most suitable nutrition for an infant. However in Egypt, BF is inadequately practiced due to prevailing misconceptions and cultural taboos. Aim of the Work: This study was to assess the socio-cultural beliefs influencing breastfeeding practices among postnatal mothers in urban and rural areas of Cairo and Banha governorates respectively. Subjects and methods: This descriptive comparative study was conducted in Cairo Governorate (represented by Al Hussein University hospital (AHUH)) as urban residents and Qaliubya Governorate represented by Banha University hospital (BUH)) as rural residents (residents of villages of Banha area), comparing the misbelieves regarding breast feeding among lactating mothers. The study population was 200 lactating healthy mothers whose babies are healthy and who were willing to participate and to come back during the study period.100 of them in Cairo at AHUH and the other 100 in Qaliubya Governorate at BUH. They were enrolled by simple random method from outpatient Pediatrics and BF clinics at AHUH (on Sunday& Wednesday weekly) and BUH (on Saturday & Tuesday weekly) during the period between December 2018 and October 2019.The research design selected for the study is descriptive comparative design. The tool used for data collection was an interview questionnaire written in local language consisting of both open and closed ended items. After obtaining the verbal consent from mothers, the validated interview questionnaire was administered to collect their socio-demographic data and to assess their socio-cultural believes on breastfeeding. The questionnaire was answered by all selected mothers individually without any support from the examiner (pre-intervention stage). Supporting correction for each misconception was declared. By the end of each session, the questionnaire was checked by the BF consultant and the professor of psychiatry who did help in counseling the mothers, and a group discussion was conducted to declare the correct answers (intervention stage). Same mothers were asked to come back after two months to assess the effect of correcting their misbelieves towards BF that influenced their knowledge, attitude and practice regarding BF by answering the same questionnaire (post-intervention stage).}, keywords = {}, url = {https://azjp.journals.ekb.eg/article_128821.html}, eprint = {https://azjp.journals.ekb.eg/article_128821_e398ba789544908cfb9ac76618017cea.pdf} }