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Consensus statement on the epidemiology,diagnosis,prevention,and management of cow's milk protein allergy in the Middle East:a modified Delphi-based study

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World Journal of Pediatrics 2021年第6期17卷 576-589页

作者： Moustafa A.el-hodhod mortada h.f.el-shabrawi Ahmed AIBadi Ahmed hussein AM Almehaidib Basil Nasrallah Ebtsam Mohammed AIBassam hala el feghali hasan M.Isa Khaled Al Saraf Maroun Sokhn Mehdi Adeli Najwa Mohammed Mousa Al-Sawi Pierre hage Suleiman Al-hammadi Department of Pediatrics Faculty of MedicineAin Shams UniversityCairoEgypt faculty of Medicine October 6 UniversityGizaEgypt faculty of Medicine Cairo UniversityCairoEgypt International Pediatric Association(IPA) MarengoUSA International Society of Tropical Pediatrics(ISTP) ManilaPhilippines DRC hospital MuscatOman Al Amiri and Al Adan hospitals KuwaitKuwait Pediatric Gastroenterology Department of PediatricsKing Faisal Specialist Hospital and Research Center RiyadhRiyadhSaudi Arabia American hospital Dubai DubaiUnited Arab Emirates Nutrition Service Department King Faisal Specialist and Research Center RiyadhRiyadhSaudi Arabia ChU Notre Dame de Secours ByblosLebanon Pediatric Department Salmaniya Medical ComplexManamaBahrain Pediatric department Arabian Gulf UniversityManamaBahrain Pediatrics Department Dar Al Shifa HospitalKuwaitKuwait Pediatric Gastroenterology Hepatologyand Nutrition DepartmentSaint George University Medical CenterUniversity of BalamandBeirutLebanon Sidra Medicine DohaQatar Department of Pediatrics Doctor Sulaiman Alhabib Medical GroupAlrryan BranchRiyadhSaudi Arabia Pediatric Pulmonology and Allergology University of BalamandBeirutLebanon College of Medicine Mohanuned Bin Rashid University of Medicine and Health SciencesBuilding 14505055 DubaiUnited Arab Emirates

Background This study aimed to develop an expert consensus regarding the epidemiology,diagnosis,and management of cow’s milk protein allergy(CMPA)in the Middle *** A three-step modified Delphi method was utilized to develop the *** specialized pediatricians participated in the development of this *** statement was considered a consensus if it achieved an agreement level of>80%.Results The experts agreed that the double-blind placebo-controlled oral challenge test(OCT)should be performed for 2-A weeks using an amino acid formula(AAf)in formula-fed infants or children with suspected ***-fed infants with confirmed CMPA should be offered a therapeutic *** panel stated that an extensively hydrolyzed formula(ehf)is indicated in the absence of red flag *** the same time,the AAf is offered for infants with red flag signs,such as severe anaphylactic *** panel agreed that infants on an ehf with resolved symptoms within 2-4 weeks should continue the ehf with particular attention to the growth and nutritional *** the other hand,an AAf should be considered for infants with persistent symptoms;the AAf should be continued if the symptoms resolve within 2-4 weeks,with particular attention to the growth and nutritional *** cases with no symptomatic improvements after the introduction of an *** measures should be *** panel developed a management algorithm,which achieved an agreement level of 90.9%.Conclusion This consensus document combined the best available evidence and clinical experience to optimize the management of CMPA in the Middle East.

关键词： Consensus Cow's milk protein allergy Infant formula Middle East Milk hypersensitivity

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Effect of nutrition-related infodemics and social media on maternal experience: A nationwide survey in a low/middle income country

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World Journal of Clinical Pediatrics 2024年第1期13卷 93-106页

作者： Marwa M Zein Noha Arafa mortada h.f.el-shabrawi Nehal Mohammed el-Koofy Department of Public health and Community Medicine Cairo UniversityCairo 515211Egypt Department of Pediatric Endocrinology and Diabetes Children's HospitalKasralainy Medical SchoolCairo UniversityCairo 515211Egypt Department of Pediatrics Cairo UniversityCairo 12411Egypt Department of Pediatrics The Children's HospitalCairo UniversityCairo 12411Egypt

BACKGROUND Undernutrition is a crucial cause of morbidity and mortality among children in low-or middle-income countries(LMICs).A better understanding of maternal general healthy nutrition knowledge,as well as misbeliefs,is highly essential,especially in such *** the current era of infodemics,it is very strenuous for mothers to select not only the right source for maternal nutrition information but the correct information as *** To assess maternal healthy nutritional knowledge and nutrition-related misbeliefs and misinformation in an LMIC,and to determine the sources of such information and their assessment *** This cross-sectional analytical observational study enrolled 5148 randomly selected Egyptian mothers who had one or more children less than 15 years *** data were collected through online questionnaire forms:One was for the general nutrition knowledge assessment,and the other was for the nutritional myth *** of information and ways of evaluating internet sources using the Currency,Relevance,Authority,Accuracy,and Purpose test were additionally *** The mean general nutrition knowledge score was 29±9,with a percent score of 70.8%±12.1%(total score:41).The median myth score was 9(interquartile range:6,12;total score:18).The primary sources of nutrition knowledge for the enrolled mothers were social media platforms(55%).half of the mothers managed information for currency and authority,except for considering the author's contact *** than 60%regularly checked information for accuracy and *** mothers with significant nutrition knowledge checked periodically for the author's contact information(P=0.012).The nutrition myth score was significantly lower among mothers who periodically checked the evidence of the information(P=0.016).Mothers dependent on their healthcare providers as the primary source of their general nutritional knowledge were less likely to hold myths by 13%(P=0.044).however,usi

关键词： Nutrition Infodemics Maternal knowledge Myth Low/middle income country

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Value of duplex doppler ultrasonography in non-invasive assessment of children with chronic liver disease

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World Journal of Gastroenterology 2010年第48期16卷 6139-6144页

作者： mortada hf el-shabrawi Maissa el-Raziky Maha Sheiba hanaa M el-Karaksy Mona el-Raziky fetouh hassanin Abeer Ramadan Department of Pediatrics Cairo University Department of Tropical Medicine Cairo University Department of Clinical Pharmacy Misr International University

AIM:To investigate the value of duplex Doppler ultrasonography (US) in the assessment of the hemodynamics of the portal and hepatic veins in a cohort of children with chronic liver disease (CLD) and to detect any relationship between the US changes,etiology and severity (or stage) of CLD. METhODS:We prospectively enrolled 25 children with biopsy-proven CLD. Thirteen had cirrhosis (aged 8.9 ± 2.0 years) and 12 had chronic hepatitis (aged 9.3 ± 2.3 years). Gray scale and color-coded duplex Doppler US were performed for all,as well as 30 healthy age and sex-matched controls. findings were correlated with clinical,laboratory and histopathological characteristics. RESULTS:Prominent caudate lobe was detected in 100% of cirrhotics,but none of the chronic hepatitis or controls. Thickened lesser omentum and loss of the triphasic waveform of the hepatic vein were present in 69.2% and 53.8% of cirrhotics vs 33.3% and 8.3% of chronic hepatitis respectively. Portal vein flow velocity was significantly lower (P he congestion index was significantly higher (P h patient groups compared to controls. Child-Pugh's staging showed a positive correlation with both abnormal hepatic vein waveform and direction of portal blood flow; and a negative correlation with both hepatic and portal vein flow velocities. No correlation with the etiology of CLD could be detected. CONCLUSION:Duplex Doppler added to grayscale US can detect significant morphologic and portal hemodynamic changes that correlate with the severity (stage) of CLD,but not with etiology.

关键词： Chronic hepatitis Chronic liver disease Cirrhosis Doppler Grayscale Pediatrics Ultrasound

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Applicability and efficacy of a model for prevention of perinatal transmission of hepatitis B virus infection:Single center study in Egypt

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World Journal of Gastroenterology 2014年第45期20卷 17075-17083页

作者： hanaa M el-Karaksy Lamiaa M Mohsen Doa'a A Saleh Mona S hamdy Noha A Yassin Mohamed farouk Mohamed E Salit mortada h el-shabrawi Department of Pediatrics Kasr Al-Ainy School of Medicine Cairo University Department of Community Medicine Kasr AlAiny School of Medicine Cairo University Department of Clinical and Chemical Pathology Kasr Al-Ainy School of Medicine Cairo University Department of Obstetrics and Gynecology Kasr Al-Ainy School of Medicine Cairo University

AIM: To identify possible maternal risk factors for hepatitis B virus (hBV) acquisition and assess the efficacy of immunoprophylaxis given to infants born to hepatitis B virus surface antigen (hBsAg) positive mothers.

关键词： Egypt hepatitis B virus hepatitis B virus surface antigen positive mothers Immunoprophylaxis Perinatal transmission

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histopathological changes in the oesophageal mucosa in Egyptian children with corrosive strictures: A single-centre vast experience

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World Journal of Gastroenterology 2019年第7期25卷 870-879页

作者： Ayman EskANDer Carolyne Ghobrial Nabil A Mohsen Bahaa Mounir Dalia Abd el-Kareem Sara Tarek mortada hf el-shabrawi Department of Paediatrics Kasr Alainy School of Medicine Cairo University Department of Pathology Kasr Alainy School of Medicine Cairo University

BACKGROUND The caustic ingestion continues to be a major problem worldwide especially in developing countries. The long-term complications include stricture and increased life time risk of oesophageal carcinoma. Patients suffered from corrosive induced oesophageal strictures have more than a 1000-fold risk of developing carcinoma of the *** To determine the possibility of oesophageal mucosal dysplasia after prolonged dilatation in post corrosive *** This observational study was conducted at the Paediatric Endoscopy Unit in Cairo University Children's hospital. It included children of both sexes older than 2 years of age who had an established diagnosis of post-corrosive oesophageal stricture and repeated endoscopic dilatation sessions for more than 6 mo. All patients were biopsied at the stricture site after 6 mo of endoscopic dilatation. A histopathological examination of an oesophageal mucosal biopsy was performed for the detection of chronic oesophagitis, inflammatory cellular infiltration and *** The mean age of the enrolled children was 5.9 ± 2.6 years; 90% of the patients had ingested an alkaline corrosive substance(potash). The total number of endoscopic dilatation sessions were ranging from 16 to 100 with mean number of sessionswas 37.2 ± 14.9. histopathological examination of the specimens showed that 85%of patients had evidence of chronic oesophagitis(group A) in the form of basal cell hyperplasia, hyperkeratosis and subepithelial fibrosis. Thirteen percent of the patients had evidence of reactive atypia(group B) in the form of severe neutrophilic intraepithelial inflammatory cellular infiltration, and 2 patients(2%)had mild squamous dysplasia(group C); we rebiopsied these two patients 6 mo after the initial pathological assessment, guided by chromoendoscopy by Lugol's *** The histopathology of oesophageal mucosal biopsies in post-corrosive patients demonstrates evidence of chronic oesophagitis, intraepi

关键词： Children Endoscopic dilatation Dysplasia Oesophageal strictures Postcorrosive

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Serologic, endoscopic and pathologic findings in pediatric celiac disease: A single center experience in a low/middle income country

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World Journal of Clinical Pediatrics 2022年第3期11卷 295-306页

作者： hala h Mansour Nabil A Mohsen mortada hf el-shabrawi Somia M Awad Dalia Abd el-Kareem Department of Pediatrics Faculty of Medicine Kasr Al AinyCairo UniversityCairo 12411Egypt Department of Pathology Cairo UniversityCairo 11562Egypt

BACKGROUND Studies in Africa,Asia,and Latin America are needed to provide a comprehensive picture of the global incidence of celiac disease(CD).AIM To describe the serology,endoscopic and histological findings in typical and atypical presentations of pediatric CD at a tertiary referral hospital in an African low/middle income country(LMIC).METhODS This observational study was conducted on 199 patients with CD from 2010 to *** patients were divided into typical and atypical groups according to the presenting symptoms including 120 and 79 patients ***,upper gastrointestinal endoscopy with duodenal biopsy were performed for patients who had symptoms suggestive of *** severity of the intestinal damage was graded according to the histo-pathologic Marsh-Oberhuber *** Chronic diarrhea was the main intestinal presentation in the typical *** was the most common extraintestinal symptom in both the typical and atypical ***-Oberhuber type 3b and 3c was significantly higher in the seropositive patients with a P value of 0.007.A significant correlation was observed between the histological grade of the biopsied duodenal mucosa and the clinical presentation(Pficantly higher in the atypical group(P valuehough typical CD was observed in 120 patients in this study,the clinical variability of the condition was frequently *** only was a significant predictor for the appearance of atypical ***,CD presentations in LMIC are not different from industrialized countries.

关键词： Typical Atypical celiac disease Celiac serology Marsh-Oberhuber histopathology

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Effects of dual sofosbuvir/daclatasvir therapy on, chronic hepatitis C infected, survivors of childhood malignancy

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World Journal of Clinical Cases 2019年第16期7卷 2247-2255页

作者： mortada hf el-shabrawi Laila M Sherief Mostafa Yakoot Naglaa M Kamal Mohamed A Almalky Manal M Abdelgawad Aml A Mahfouz Sherine helmy Enas M Kamal Dina Attia hisham R el-Khayat Paediatric hepatology Department Cairo Faculty of MedicineCairo 11559Egypt Paediatric hematology-Oncology Department Zagazig Faculty of MedicineZagazig 21121Egypt Internal medicine Pediatrics and HepatologyGreen Clinic and Research CenterAlexandria UniversityAlexandria 21121Egypt Paediatric hepatology Department Alexandria Faculty of medicineAlexandria 21121Egypt Innovations & Research Pharco CorporationAlexandria 21121Egypt Endemic medicine and hepatology Department Minia UniversityMinia 22233Egypt Endemic medicine and hepatology Department Beni-suef UniversityBeni-suef 62511Egypt Gastroenterology and Endemic Medicine Department Theodore Research InstituteCairo 23323Egypt

BACKGROUND Childhood cancer survivors are potentially at a higher risk of infection with hepatitis C virus (hCV).The effects of all-oral direct-acting antiviral therapy (DAA) on both the hCV infection as well as the state of cancer remission have not been well investigated in this *** To test the effects of dual sofosbuvir/daclatasvir (SOf/DCV) therapy in the treatment of chronic hCV in survivors of hematologic malignancy in pediatric age *** We conducted a prospective,uncontrolled,open-label multicenter study.A total of 20 eligible,chronic hCV,genotype-4,infected children who had been in continuous complete remission from hematologic cancer (leukemia/lymphoma) for at least one year were included in the *** patients were treated with combined SOf/DCV for 12 *** were monitored throughout the study till 12 wk after end of treatment for safety and efficacy outcomes including the sustained virologic response 12 (SVR12) rate,hematological indices,liver and kidney *** The intent-to-treat SVR12 rate was 20 of 20 (100%;95%CI: 84%-100%).All patients showed normalized liver enzymes from *** hematological indices,liver and kidney functions were kept normal throughout the *** fatalities or treatment-emergent serious or severe adverse events were reported throughout the *** SOf/DCV combined therapy could be used safely and effectively in the treatment of chronic hCV genotype-4 infection in leukemia/lymphoma treated *** relapses were detected during treatment and throughout the follow up period for either the original malignant disease or the hCV infection.

关键词： Chronic hepatitis C Survivors of childhood cancer Sofosbuvir Daclatasvir Efficacy

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Burden of pediatric hepatitis C

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World Journal of Gastroenterology 2013年第44期19卷 7880-7888页

作者： mortada hassan el-shabrawi Naglaa Mohamed Kamal Alanani Pediatrics and Pediatric hepatology Faculty of MedicineCairo University Giza 12411 Egypt

hepatitis C virus(hCV)is a major health burden infecting 170-210 million people *** 3-4millions are newly-infected *** of pediatric infection varies from 0.05%-0.36%in the United States and Europe;up to 1.8%-5.8%in some developing *** highest prevalence occurs in Egypt,sub-Saharan Africa,Amazon basin and *** has been present in some populations for several centuries,notably genotypes 1 and 2 in West *** anti-schistosomal therapy practiced in the 1960s until the early 1980s had spread hCV infection throughout *** acquisition of hCV remains a major route for infection among Egyptian *** screening of transfusions,unsterilized injection equipment and re-used needles and syringes continue to be major routes of hCV transmission in developing countries,whereas vertical transmission and adolescent high-risk behaviors(e.g.,injection drug abuse)are the major routes in developed *** risk of vertical transmission from an infected mother to her unborn/newborn infant is approximately 5%.Early stages of hCV infection in children do not lead to marked impairment in the quality of life nor to cognitive,behavioral or emotional dysfunction;however,caregiver stress and family system strain may *** slowly progresses to serious complications as cirrhosis(1%-2%)and hepatocellular carcinoma(hCC)especially in the presence of risk factors as hemolytic anemias,obesity,treated malignancy,and concomitant human immune deficiency and/or hepatitis B virus *** vaccine remains elusive to *** the immune mechanisms in patients who successfully cleared the infection is essential for vaccine *** pediatric standard of care treatment consists of pegylated interferon-α2a or b plus ribavirin for 24-48 *** new oral direct acting antivirals,approved for adults,need further evaluation in *** virologic response varies depending on the viral lo

关键词： hepatitis C virus Burden Genotypes Cost Pediatrics

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hepatobiliary manifestations in children with inflammatory bowel disease:A single-center experience in a low/middle income country

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2020年第3期11卷 48-58页

作者： mortada hf el-shabrawi Sara Tarek Maha Abou-Zekri Safa Meshaal Afaf Enayet Engy Adel Mogahed Department of Paediatrics Kasr Alainy School of MedicineCairo UniversityCairo 11562Egypt Department of Clinical Pathology Kasr Alainy School of MedicineCairo UniversityCairo 11562Egypt

BACKGROUNDThere has been a worldwide increase in the reported incidence of inflammatorybowel disease (IBD) in children over the past 2-3 decades. The hepatobiliary (hB)manifestations of IBD have been well-studied in children in industrialized anddeveloped countries but are infrequently reported in low- and middle-incomecountries (LMIC) such as *** determine the prevalence of the hB manifestations in a cohort of Egyptianchildren with *** cross-sectional observational study was carried out over a period of 6 mo(between June 2013 to December 2013, at the Paediatric hepatology andGastroenterology Units of Cairo University Children's hospital, which is thelargest paediatric tertiary care centre in the *** study included 48 patients with confirmed IBD based upon clinical,laboratory, endoscopic and histopathological features, 29 (60.4%) were ***-four patients (50%) had ulcerative colitis (UC), 11 (22.9%) had Crohn'sdisease (CD) and 13 (27.1%) had unclassified-IBD (IBD-U), which was formerlyknown as indeterminate colitis. The mean age of the patients at the time ofpresentation was 8.14 (± SD 4.02) years and the mean age at the time of studyenrolment was 10.16 (± SD 4.19) years. All patients were screened for hBmanifestations by physical examination, liver function tests, imaging and liver biopsy when indicated. hB disorders were confirmed in 13 patients (27.1%).Transaminases were elevated in 3 patients (6.3%). Two patients (4.2%) hadelevated biliary enzymes (one was diagnosed as primary sclerosing cholangitis(PSC) and the other was diagnosed with PSC/autoimmune hepatitis overlapsyndrome and the third patient had hepatitis C virus infection. Ten patients(20.8%) had bright echogenic liver on ultrasound suggesting fatty infiltration as asequel of malnutrition or medication *** commonest hB disorders in Egyptian children with IBD were abnormal liverfunction tests, fatty infiltration and PSC. These hB manifestations i

关键词： Children Crohn's disease Egypt elevated liver enzymes hepatobiliary Inflammatory bowel disease Ulcerative colitis

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Investigation of structural parameters and self-aggregation of Algerian asphaltenes in organic solvents

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Petroleum Science 2015年第3期12卷 509-517页

作者： Asma Larbi mortada Daaou Abassia faraoun Laboratoire de Synthèse organique Physico-chimieBiomolcules et Environnement (LSPBE)Department of Industrial Organic ChemistryFaculty of ChemistryUniversity of Sciences and Technology of Oran Laboratoire de Chimie Physique Macromoléculaire (LCPM) Department of ChemistryFaculty of SciencesUniversity of Oran

elemental analysis, fourier transform infrared （fTIR）, 1h-NMR, fluorescence spectroscopy, and surface tension methods have been used to characterize the molecular structure and the aggregation behaviors of two asphaltenic fractions derived, respectively, from an Alge- rian petroleum well and a corresponding storage tank deposit. elemental analysis, fTIR, ~h-NMR, and fluores- cence spectroscopy were used to investigate the chemical composition and structural parameters of asphaltenes, while the surface tension method was used to measure the critical micelle concentration （CMC） in organic solvents with different solubility parameters and polarities in order to characterize the asphaltenes＇ aggregation behaviors. Results show that the unstable asphaltenes fraction extracted from the storage tank deposit possesses a higher polarity （higher heteroatoms content） and a lower aro- maticity than stable asphaltenes from the petroleum well. The CMC results indicate that asphaltenes with high polarity and low aromaticity have a high solubility in polar solvents such as nitrobenzene, whereas asphaltenes with low polarity and high aromaticity are more soluble in solvents with weak polarity, like toluene. It is concludedthat the difference of structure of asphaltene samples and polarity of solvents can lead to difference of aggregation behaviors.

关键词： Asphaltenes Algerian petroleum Structural parameters - CMC

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