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SOX9 in biliary atresia: New insight for fibrosis progression

Hepatobiliary & Pancreatic Diseases International 2021年第2期20卷 154-162页

作者： Hanaa Ahmed El-Araby Magdy Anwar Saber Noha mohamed Radwan Doha Maher Taie nermin mohamed adawy Ahmad mohamed Sira Department of Pediatric Hepatology Gastroenterologyand NutritionNational Liver InstituteMenoufia University32511 Shebin El-koomMenoufiaEgypt Department of Pathology National Liver InstituteMenoufia University32511 Shebin El-koomMenoufiaEgypt

Background:Liver fibrosis is a hallmark determinant of morbidity in biliary atresia(BA)even in successfully operated *** factors for this rapid progression of fibrosis are not completely *** expression of the transcription factor SOX9 and hepatic progenitor cells(HPCs)proliferation have roles in fibrogenesis in cholestatic ***,they were not investigated sufficiently in *** aimed to delineate the relation of SOX9 and HPCs to fibrosis and its progression in ***:Forty-eight patients with BA who underwent an initial diagnostic liver biopsy(LB)and consequent intraoperative LB were recruited and compared to 28 cases with non-BA cholestasis that had an LB in their diagnostic *** fibrosis,tissue SOX9 and HPC expressions were studied in both BA and non-BA-cholestasis *** fibrosis,SOX9,and HPCs’dynamic changes in BA cases were *** of fibrosis and its progression to SOX9 and HPCs in BA was ***:SOX9 and HPCs in ductular reaction(DR)form were expressed in 100%of BA and their grades increased significantly in the second *** rapidly progressive fibrosis in BA,represented by fibrosis grade of the intraoperative LB,correlated significantly to SOX9-DR and HPC-DR at the diagnostic(r=0.420,P=0.003 and r=0.405,P=0.004,respectively)and the intraoperative(r=0.460,P=0.001 and r=0.467,P=0.001,respectively)*** the other hand,fibrosis,SOX9-DR,and HPC-DR were significantly lower in non-BA cases at a comparable age(P<0.001,P=0.006,and P=0.014,respectively).Conclusions:Fibrosis in BA is rapidly progressive within a short time and is significantly correlated to SOX9 and *** of targeting SOX9 and HPCs on fibrosis progression is warranted.

关键词： Biliary atresia Fibrosis Hepatic progenitor cells Immunohistochemistry Neonatal cholestasis SOX9

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Serum ferritin in neonatal cholestasis: A specific and active molecule or a non-specific bystander marker?

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Hepatobiliary & Pancreatic Diseases International 2019年第2期18卷 173-180页

作者： Behairy El-Sayed Behairy Hatem Abd-Alsattar Konswa Hanaa Talaat Ahmed Dina Shehata El-Azab nermin mohamed adawy Ahmad mohamed Sira Department of Pediatric Hepatology Gastroenterology and Nutrition National Liver Institute Menofiya University Department of Pathology National Liver Institute Menofiya University

Background: Serum ferritin(SF) and consequently hepatic iron have long been considered important in liver fibrosis progression. They have been studied in different liver diseases with no previous reports in neonatal cholestasis(NC). This study aimed to measure SF in different etiologies of NC and investigate its relation to hepatic iron and fibrosis. Methods: SF was measured in 75 infants, including 50 with NC and 25 with sepsis. SF was compared between these two groups. Biochemical parameters, hepatic iron grades, and liver fibrosis and other histopathological characteristics and correlated with SF were assessed in NC group. Finally, a comparison between intrahepatic cholestasis and obstructive etiology was performed. Results: SF was elevated in NC(1598 ± 2405 ng/mL) with no significant difference from those with sepsis( P = 0.445). NC and sepsis constituted augmenting factors leading to more elevation of SF(2589 ± 3511 ng/mL). SF was significantly correlated with hepatic iron grades( r = 0.536, P < 0.0 0 01) and a cut-off value of 803.5 ng/mL can predict higher grades( ≥ grade 3) of iron deposition with sensitivity of 100%, specificity of 70% and accuracy of 85%. Moreover, SF was significantly higher( P < 0.0 0 01) in those with intrahepatic cholestasis(2602 ± 3154 ng/mL) and their prevalent pathological findings of giant cell transformation( P = 0.009) and hepatocyte swelling( P = 0.023) than those with obstructive etiology(672 ± 566 ng/mL) and their prevalent pathological findings of ductular proliferation( P = 0.003) and bile plugs( P = 0.002). SF was unrelated to the grade of liver fibrosis( P = 0.058). Conclusions: SF is non-specifically elevated in NC, with positive correlation to hepatic iron grades. SF ≥ 803.5 ng/mL can predict higher grades( ≥ grade 3) of hepatic iron. However, an active role of increased SF and hepatic iron in disease progression remains questionable.

关键词： Biliary atresia Liver fibrosis Hepatic iron grade Intrahepatic cholestasis Iron

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Gastrointestinal tolerability of organic infant formula compared to traditional infant formula: A systematic review

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World Journal of Clinical Pediatrics 2024年第1期13卷 125-140页

作者： Mohammed Al-Beltagi nermin Kamal Saeed Adel Salah Bediwy Reem Elbeltagi mohamed Basiony Hamza Department of Pediatric Faculty of MedicineTanta UniversityTanta 31511AlghrabiaEgypt Department of Pediatric University Medical CenterKing Abdulla Medical CityArabian Gulf UniversityDr.Sulaiman Al Habib Medical GroupManama 26671ManamaBahrain Medical Microbiology Section Department of PathologySalmaniya Medical ComplexMinistry of HealthKingdom of BahrainManama 12ManamaBahrain Medical Microbiology Section Department of PathologyIrish Royal College of SurgeonBusaiteen 15503MuharraqBahrain Department of Pulmonology Faculty of MedicineTanta UniversityTanta 31527AlghrabiaEgypt Department of Pulmonology University Medical CenterKing Abdulla Medical CityArabian Gulf UniversityDr.Sulaiman Al Habib Medical GroupManama 26671ManamaBahrain Department of Medicine The Royal College of Surgeons in Ireland-BahrainBusiateen 15503MuharraqBahrain Department of Pediatric Faculty of MedicineTanta UniversityTanta 31511AlgahrbiaEgypt

BACKGROUND Infants'nutrition significantly influences their growth,development,and overall *** the increasing demand for organic infant formula driven by the perception of health benefits and growing awareness of natural feeding options,it is crucial to conduct a comparative analysis of the gastrointestinal tolerability between organic and traditional infant *** To provide a concise and precise analysis of the gastrointestinal tolerability of organic infant formula compared to traditional infant *** to limited direct comparisons,the review synthesizes available literature on each formula type,presenting insights into their potential effects on infants'digestive *** An extensive literature search was conducted,compiling studies on organic and traditional infant formulas,their compositions,and reported effects on gastrointestinal *** searched academic databases such as PubMed and Google Scholar and specialized nutrition,paediatrics,and infant health journals using relevant keywords till October 1,*** Although specific comparative studies are scarce and formula heterogeneity is a significant limitation,this systematic review provides an in-depth understanding of organic infant formulas'composition and potential *** scientific evidence directly comparing gastrointestinal tolerability is limited,organic formulas strive to use carefully selected organic ingredients to imitate breast milk *** benefits include improved lipid profiles,higher methionine content,and decreased antibiotic-resistant bacteria *** the gastrointestinal tolerability of organic and traditional infant formulas is crucial for parents and healthcare providers to make informed *** Despite limitations in direct comparisons,this systematic review provides insights into the composition and potential benefits of organic infant *** emphasizes the need for further research to eluci

关键词： Organic infant formula Traditional infant formula Gastrointestinal tolerability Formula ingredients Digestive health Infant nutrition Organic farming

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Renal calcification in children with renal tubular acidosis:What a paediatrician should know

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World Journal of Clinical Pediatrics 2023年第5期12卷 295-309页

作者： Mohammed Al-Beltagi nermin Kamal Saeed Adel Salah Bediwy Reem Elbeltagi Samir Hasan mohamed Basiony Hamza Department of Pediatrics Faculty of MedicineTanta UniversityTanta 31511AlghrabiaEgypt Department of Pediatrics University Medical CenterKing Abdulla Medical CityDr.Sulaiman Al Habib Medical GroupManamaBahrainManama 26671ManamaBahrain Medical Microbiology Section Department of PathologySalmaniya Medical ComplexMinistry of HealthKingdom of BahrainManama 12ManamaBahrain Medical Microbiology Section Department of PathologyIrish Royal College of SurgeonBahrainBusaiteen 15503MuharraqBahrain Department of Pulmonology Faculty of MedicineTanta UniversityTanta 31527AlghrabiaEgypt Department of Chest Disease University Medical CenterKing Abdulla Medical CityArabian Gulf UniversityDr.Sulaiman Al Habib Medical GroupManamaManama 26671ManamaBahrain Department of Medicine The Royal College of Surgeons in Ireland-BahrainBusiateen 15503MuharraqBahrain Department of Pediatrics Faculty of MedicineTanta University HospitalTanta 31511AlgharbiaEgypt Department of Pediatrics Faculty of MedicineTanta UniversityTanta 31511AlgharbiaEgypt

Renal tubular acidosis(RTA)can lead to renal calcification in children,which can cause various complications and impair renal *** review provides pediatricians with a comprehensive understanding of the relationship between RTA and renal calcification,highlighting essential aspects for clinical *** article analyzed relevant studies to explore the prevalence,risk factors,underlying mechanisms,and clinical implications of renal calcification in children with *** show that distal RTA(type 1)is particularly associated with nephrocalcinosis,which presents a higher risk of renal ***,there are limitations to the existing literature,including a small number of studies,heterogeneity in methodologies,and potential publication *** data and control groups are also lacking,which limits our understanding of longterm outcomes and optimal management strategies for children with RTA and renal *** play a crucial role in the early diagnosis and management of RTA to mitigate the risk of renal calcification and associated *** addition,alkaline therapy remains a cornerstone in the treatment of RTA,aimed at correcting the acid-base imbalance and reducing the formation of kidney ***,early diagnosis and appropriate therapeutic interventions are paramount in preventing and managing renal calcification to preserve renal function and improve long-term outcomes for affected *** research with larger sample sizes and rigorous methodologies is needed to optimize the clinical approach to renal calcification in the context of RTA in the pediatric population.

关键词： Renal tubular acidosis Nephrocalcinosis Renal calcification Hypercalciuria Kidney stones Metabolic acidosis Children

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Improved Bat Algorithm with Deep Learning-Based Biomedical ECG Signal Classification Model

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Computers, Materials & Continua 2023年第2期74卷 3151-3166页

作者： Marwa Obayya Nadhem NEMRI Lubna A.Alharbi mohamed K.Nour Mrim M.Alnfiai Mohammed Abdullah Al-Hagery nermin M.Salem Mesfer Al Duhayyim Department of Biomedical Engineering College of EngineeringPrincess Nourah Bint Abdulrahman UniversityP.O.Box 84428Riyadh11671Saudi Arabia Department of Information Systems College of Science and Art at MahayilKing Khalid UniversitySaudi Arabia Department of Computer Science College of Computers and Information TechnologyTabuk UniversitySaudi Arabia Department of Computer Sciences College of Computing and Information SystemUmm Al-Qura UniversitySaudi Arabia Department of Information Technology College of Computers and Information TechnologyTaif UniversityP.O.Box 11099Taif21944Saudi Arabia Department of Computer Science College of ComputerQassim UniversitySaudi Arabia Department of Electrical Engineering Faculty of Engineering and TechnologyFuture University in EgyptNew Cairo11835Egypt Department of Computer Science College of Sciences and Humanities-AflajPrince Sattam Bin Abdulaziz UniversitySaudi Arabia

With new developments experienced in Internet of Things(IoT),wearable,and sensing technology,the value of healthcare services has *** evolution has brought significant changes from conventional medicine-based healthcare to real-time observation-based *** Electrocardiogram(ECG)signals are generally utilized in examination and diagnosis of Cardiovascular Diseases(CVDs)since it is quick and non-invasive in *** to increasing number of patients in recent years,the classifier efficiency gets reduced due to high variances observed in ECG signal patterns obtained from *** such scenario computer-assisted automated diagnostic tools are important for classification of ECG *** current study devises an Improved Bat Algorithm with Deep Learning Based Biomedical ECGSignal Classification(IBADL-BECGC)*** accomplish this,the proposed IBADL-BECGC model initially pre-processes the input ***,IBADL-BECGC model applies NasNet model to derive the features from test ECG *** addition,Improved Bat Algorithm(IBA)is employed to optimally fine-tune the hyperparameters related to NasNet ***,Extreme Learning Machine(ELM)classification algorithm is executed to perform ECG classification *** presented IBADL-BECGC model was experimentally validated utilizing benchmark *** comparison study outcomes established the improved performance of IBADL-BECGC model over other existing methodologies since the former achieved a maximum accuracy of 97.49%.

关键词： Data science ECG signals improved bat algorithm deep learning biomedical data data classification machine learning

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Causative bacteria of ventilator-associated pneumonia in intensive care unit in Bahrain:Prevalence and antibiotics susceptibility pattern

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World Journal of Critical Care Medicine 2023年第3期12卷 165-175页

作者： mohamed Eliwa Hassan Safaa Abdulaziz Al-Khawaja nermin Kamal Saeed Sana Abdulaziz Al-Khawaja Mahmood Al-Awainati Sara Salah Yusuf Radhi mohamed Hameed Alsaffar Mohammed Al-Beltagi Intensive Care Unit Department of Internal medicineSalmaniya Medical ComplexMinistry of HealthManamaKingdom of BahrainManama 12ManamaBahrain Infectious Disease Unit Department of Internal MedicineSalmaniya Medical ComplexMinistry of HealthKingdom of BahrainManama 12ManamaBahrain Medical Microbiology Section Department of PathologySalmaniya Medical ComplexMinistry of HealthKingdom of BahrainManama 12ManamaBahrain Medical Microbiology Section Department of PathologyIrish Royal College of SurgeonBahrainBusiateen 15503MuharraqBahrain Department of Family Medicine Ministry of HealthManamaKingdom of BahrainManama 12ManamaBahrain Department of Pediatrics Faculty of MedicineTanta UniversityTanta 31511AlghrabiaEgypt Department of Pediatrics University Medical CenterKing Abdulla Medical CityArabian Gulf UniversityDr.Sulaiman Al Habib Medical GroupManama 26671ManamaBahrain

BACKGROUND Ventilator-associated pneumonia(VAP)is defined as pneumonia that occurs two calendar days following endotracheal intubation or after *** is the most common infection encountered among intubated *** incidence showed wide variability between *** To define the VAP incidence in the intensive care unit(ICU)in the central gove-rnment hospital in Bahrain and review the risk factors and the predominant bacterial pathogens with their antimicrobial susceptibility *** The research was a prospective cross-sectional observational study over six months from November 2019 to June *** included adult and adolescent patients(>14 years old)admitted to the ICU and required intubation and mechanical *** was diagnosed when it occurred after 48 h after endotracheal intubation using the clinical pulmonary infection score,which considers the clinical,laboratory,microbiological,and radiographic *** The total number of adult patients admitted to the ICU who required intubation and mechanical ventilation during the study period was ***-six patients developed VAP during their ICU stay(29.7%).The calculated VAP rate was 22.14 events per 1000 ventilator days during the study period,with a mean age of 52 years±*** VAP cases had late-onset VAP with a mean number of ICU days before the development of VAP of 9.96±***-negative contributed to most VAP cases in our unit,with multidrug-resistant Acinetobacter being the most identified *** The reported VAP rate in our ICU was relatively high compared to the international benchmark,which should trigger a vital action plan for reinforcing the implementation of the VAP prevention bundle.

关键词： Ventilator-associated pneumonia Intensive care unit Antibiotics susceptibility pattern Kingdom of Bahrain Adults Bacterial resistance Acinetobacter

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Safety and efficacy of Hansenula-derived PEGylated-interferon alpha-2a and ribavirin combination in chronic hepatitis C Egyptian children

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World Journal of Gastroenterology 2014年第16期20卷 4681-4691页

作者： Suzan El Naghi Tawhida Y Abdel-Ghaffar Hanaa El-Karaksy Elham F Abdel-Aty Mona S El-Raziky Aleef A Allam Heba Helmy Hanaa A El-Araby Behairy E Behairy mohamed A El-Guindi Hatem El-Sebaie Aisha Y Abdel-Ghaffar nermin A Ehsan Ahmed M El-Hennawy Mostafa M Sira Pediatric Department National Hepatology and Tropical Medicine Research Institute11441 CairoEgypt Yassin Abdel Ghaffar Charity Center for Liver Disease and Research 2851 CairoEgypt Pediatric Department Ain Shams University11566 CairoEgypt Department of Pediatrics Cairo University Pediatric Hospital11562 CairoEgypt Pediatric Hepatology Department National Liver InstituteMenofiya UniversityShebin El-koom32511 MenofiyaEgypt Biochemistry Department National Liver Institute32511 MenofiyaEgypt Clinical Pathology Department Ain Shams University11566 CairoEgypt Pathology Department National Liver InstituteMenofiya UniversityShebin El-koom32511 MenofiyaEgypt Pathology Department Cairo UniversityFaculty of MedicineKasr El-Aini11562 CairoEgypt

AIM:To investigate the safety and efficacy of a Hansenula-derived PEGylated(polyethylene glycol)interferon(IFN)-alpha-2a(Reiferon Retard)plus ribavirin customized regimen in treatment-na?ve and previously treated(non-responders and relapsers)Egyptian children with chronic hepatitis C ***:Forty-six children with chronic hepatitis C virus(HCV)infection were selected from three tertiary pediatric hepatology *** and laboratory evaluations were *** polymerase chain reaction(PCR)for HCV-RNA was performed before starting treatment,and again at 4,12,24,48,72wk during treatment and 6 mo after treatment *** patients were assigned to receive a weekly subcutaneous injection of PEG-IFN-alpha-2a plus daily oral ribavirin for 12 ***-four patients were treatment-na?ve and 12 had a previous treatment *** were then divided according to PCR results into two ***Ⅰincluded patients who continued treatment on a weekly basis(7-d schedule),while groupⅡincluded patients who continued treatment on a 5-d *** from either group who were PCR-negative at week 48,but had at least one PCRpositive test during therapy,were assigned to have an extended treatment course up to 72 *** occurrence of adverse effects was assessed during treatment and follow *** study was registered at ***(NCT02027493).RESULTS:Only 11 out of 46(23.9%)patients showed a sustained virological response(SVR),two patients were responders at the end of treatment;however,they were lost to follow up at 6 mo post *** was seen in 18(39.1%)patients,one patient(2.17%)showed relapse and 14(30.4%)were *** gender,short duration of infection,low viral load,mild activity,and mild fibrosis were the factors related to a better *** the other hand,patients with high viral load and absence of fibrosis failed to respond to *** treatment,liver transaminases were ***

关键词： Children Chronic hepatitis C Hansenula polymorpha

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