Objectives: To evaluate the efficacy, compliance, safety and economic cost for Fosfomycin trometamol and Nitofurantoin in uncomplicated lower urinary tract infections during pregnancy. Background: Nitofurantoin and Fo...Objectives: To evaluate the efficacy, compliance, safety and economic cost for Fosfomycin trometamol and Nitofurantoin in uncomplicated lower urinary tract infections during pregnancy. Background: Nitofurantoin and Fosfomycin trometamol are recommended as the first-line agents for treatment of urinary tract infections (UTIs) in the latest guidelines endorsed by the Infectious Diseases Society of America (IDSA) and the European Society for Clinical Microbiology and Infectious Diseases (ESCMID). Fosfomycin is bactericidal and inhibits bacterial cell wall biogenesis and reduces bacterial adherence to uroepithelial cells. Fosfomycin has broad antibacterial activity against both Gram-positive and Gram-negative pathogens, as Escherichia coli, Escherichia faecalis, and various Gram-negatives like Citrobacter and Proteus. Both Nitofurantoin and Fosfomycin are category B in pregnancy. Patients and Methods: This study was conducted at Tanta University Hospitals in the period from June, 1, 2015 to January, 1, 2017. Patients were recruited from outpatient clinics of Obstetrics and Gynecology and Urology Departments presenting with asymptomatic bacteruria or cystitis. Patients were allocated randomly into 2 groups: group I (n = 50 cases) received Fosfomycin therapy and group II (n = 50 cases) received Nitofurantoin therapy (n = 50 cases). After treatment, evaluation of patient symptoms, organism count, patient compliance and cost of treatment were done. Results: The enrolled patients were suffering from lower urinary tract infections;asymptomatic bacteruria (17 cases) or cystitis (83 cases). Ten patients were excluded. The demographic data of included patients were not significant for both groups. Complete relief (100%) of symptoms 5 days after start of treatment was noticed in Fosfomycin group while improvement of symptoms after 5 day-treatment was noticed in 86.49% in Nitofurantoin group (p-value = 0.030). The side effects were recorded in 7 cases (18.42%) in Fosfomycin group compared to (35.14%) with significant difference in the reported side effects, (p-value = 0.003). Compliance was 38/38 (100%) in Fosfomycin group compared to 34/37 (91.89%) in Nitrofuantoin group (p-value = 0.001). Resistance was very minimal in Fosfomycin group where 1/38 case (2.63%) reported resistance for treatment compared to 8/37 cases (21.62%) in Nitofurantoin group (p-value = 0.001). Conclusion: Fosfomycin trometamine proved to be safe, effective, and has limited resistance. Moreover higher patient compliance and fewer side effects were recommending Fosfomycin to be a first choice drug for uncomplicated lower urinary tract infections during pregnancy at Tanta University.展开更多
The physico-chemical and biological （algal and bacterial） quality of tap water in Tanta City were elucidated. Samples were collected during December 2011, covering all the water plants and the areal extension of the...The physico-chemical and biological （algal and bacterial） quality of tap water in Tanta City were elucidated. Samples were collected during December 2011, covering all the water plants and the areal extension of the pipe line network in Tanta. Total dissolved solids content classifies water origin into surface water, shallow and deep groundwater. Fe, Mn and hardness in some samples of groundwater origin are obviously exceeding the WHO （World Health Organization） limit. Mostly, green algae are found （31 species）, followed by diatoms （19 species）, then blue-green algae （13 species）. CCA （Canonical Corresponding Analysis） indicates that green algae are strongly correlated with pH, NH4, alkalinity, Mn and Si; diatoms with EC （electric conductivity）, turbidity, Zn and Si and blue green algae with EC and alkalinity. 50% of samples of surface origin, 80% of samples of both deep and shallow groundwater origins crossed WHO and Egyptian guideline in their content of mean TCC （Total Coliform Count）. CCA estimates strong correlations of TCC with temperature, NH4 and PO4; E. coli with EC; heterotrophic bacteria with turbidity and NO3; Salmonella sp. with Si and SO4 and Pseudomonas aeruginosa with Mn. Finally, the water plants treatment may be not effective and pipes serve as a reservoir for pathogenic microorganisms.展开更多
Egypt has a high attitude in construction and demolition waste (CDW) amounts causing a negative impact on the environment. The use of such waste for infrastructures applications can be useful for each environment and ...Egypt has a high attitude in construction and demolition waste (CDW) amounts causing a negative impact on the environment. The use of such waste for infrastructures applications can be useful for each environment and in addition an economic benefit to it in the construction. This study explores the possibility of replacing natural coarse aggregate with recycled concrete construction and demolition waste aggregate for general purpose concrete (i.e. plain concrete and low strength structural concrete). Different samples of CDW were extracted from different demolition sites and landfill locations around Tanta city area for the experimental investigation. CDW was crushed with all its hard constituents (e.g. concrete, brick etc.) found in the landfill. Coarse size crushed CDW was used as a coarse aggregate for concrete. Main characteristics of CDW aggregate determined in addition to the main properties of concrete which was made using this aggregate were measured. The results showed that the CDW could be transformed into recycled concrete aggregate leading to reduction in the concrete compressive strength ranged from 37% to 62% depending on the type of the CDW constituents.展开更多
Inflammatory bowel disease(IBD)is a chronic inflammatory illness of the intes-tine.While the mechanism underlying the pathogenesis of IBD is not fully under-stood,it is believed that a complex combination of host immu...Inflammatory bowel disease(IBD)is a chronic inflammatory illness of the intes-tine.While the mechanism underlying the pathogenesis of IBD is not fully under-stood,it is believed that a complex combination of host immunological response,environmental exposure,particularly the gut microbiota,and genetic suscept-ibility represents the major determinants.The gut virome is a group of viruses found in great frequency in the gastrointestinal tract of humans.The gut virome varies greatly among individuals and is influenced by factors including lifestyle,diet,health and disease conditions,geography,and urbanization.The majority of research has focused on the significance of gut bacteria in the progression of IBD,although viral populations represent an important component of the microbiome.We conducted this review to highlight the viral communities in the gut and their expected roles in the etiopathogenesis of IBD regarding published research to date.展开更多
BACKGROUND Functional gastrointestinal disorders(FGIDs)in children present with chronic symptoms like abdominal pain,diarrhea,and constipation without identifiable structural abnormalities.These disorders are closely ...BACKGROUND Functional gastrointestinal disorders(FGIDs)in children present with chronic symptoms like abdominal pain,diarrhea,and constipation without identifiable structural abnormalities.These disorders are closely linked to gut-brain axis dysfunction,altered gut microbiota,and psychosocial stress,leading to psychia-tric comorbidities such as anxiety,depression,and behavioral issues.Under-standing this bidirectional relationship is crucial for developing effective,holistic management strategies that address physical and mental health.AIM To examine the psychiatric impacts of FGIDs in children,focusing on anxiety and depression and their association with other neurodevelopmental disorders of childhood,such as attention-deficit/hyperactivity disorder,emphasizing the role of the gut-brain axis,emotional dysregulation,and psychosocial stress.Key mechanisms explored include neurotransmitter dysregulation,microbiota imbalance,central sensitization,heightening stress reactivity,emotional dysregulation,and symptom perception.The review also evaluates the role of family dynamics and coping strategies in exacerbating FGID symptoms and contributing to psychiatric conditions.METHODS A narrative review was conducted using 328 studies sourced from PubMed,Scopus,and Google Scholar,covering research published over the past 20 years.Inclusion criteria focused on studies examining FGID diagnosis,gut-brain mechanisms,psychiatric comorbidities,and psychosocial factors in pediatric populations.FGIDs commonly affecting children,including functional constipation,abdominal pain,irritable bowel syndrome,gastroesophageal reflux,and cyclic vomiting syndrome,were analyzed concerning their psychological impacts.RESULTS The review highlights a strong connection between FGIDs and psychiatric symptoms,mediated by gut-brain axis dysfunction,dysregulated microbiota,and central sensitization.These physiological disruptions increase children’s vulnerability to anxiety and depression,while psychosocial factors-such as chronic stress,early-life trauma,maladaptive family dynamics,and ineffective coping strategies-intensify the cycle of gastrointestinal and emotional distress.CONCLUSION Effective management of FGIDs requires a biopsychosocial approach integrating medical,psychological,and dietary interventions.Parental education,early intervention,and multidisciplinary care coordination are critical in mitigating long-term psychological impacts and improving both gastrointestinal and mental health outcomes in children with FGIDs.展开更多
BACKGROUND Managing critical care emergencies in children with autism spectrum disorder(ASD)presents unique challenges due to their distinct sensory sensitivities,communication difficulties,and behavioral issues.Effec...BACKGROUND Managing critical care emergencies in children with autism spectrum disorder(ASD)presents unique challenges due to their distinct sensory sensitivities,communication difficulties,and behavioral issues.Effective strategies and protocols are essential for optimal care in these high-stress situations.AIM To systematically evaluate and synthesize current evidence on best practices for managing critical care emergencies in children with ASD.The review focuses on key areas,including sensory-friendly environments,communication strategies,behavioral management,and the role of multidisciplinary approaches.METHODS A comprehensive search was conducted across major medical databases,including PubMed,Embase,and Cochrane Library,for studies published between 2000 and 2023.Studies were selected based on their relevance to critical care management in children with ASD,encompassing randomized controlled trials,observational studies,qualitative research,and case studies.Data were extracted and analyzed to identify common themes,successful strategies,and areas for improvement.RESULTS The review identified 50 studies that met the inclusion criteria.Findings highlighted the importance of creating sensory-friendly environments,utilizing effective communication strategies,and implementing individualized behavioral management plans.These findings,derived from a comprehensive review of current evidence,provide valuable insights into the best practices for managing critical care emergencies in children with ASD.Sensory modifications,such as reduced lighting and noise,visual aids,and augmentative and alternative communication tools,enhanced patient comfort and cooperation.The involvement of multidisciplinary teams was crucial in delivering holistic care.Case studies provided practical insights and underscored the need for continuous refi-nement of protocols.CONCLUSION The review emphasizes the need for a tailored approach to managing critical care emergencies for children with ASD.Sensory-friendly adjustments,effective communication,and behavioral strategies supported by a mul-tidisciplinary team are integral to improving outcomes.Despite progress,ongoing refinement of care practices and protocols is necessary.This ongoing process addresses remaining challenges and engages healthcare professionals in continuous improvement of care for children with ASD in critical settings.展开更多
BACKGROUND The relationship between diabetes mellitus(DM)and asthma is complex and can impact disease trajectories.AIM To explore the bidirectional influences between the two conditions on clinical outcomes and diseas...BACKGROUND The relationship between diabetes mellitus(DM)and asthma is complex and can impact disease trajectories.AIM To explore the bidirectional influences between the two conditions on clinical outcomes and disease control.METHODS We systematically reviewed the literature on the relationship between DM and asthma,focusing on their impacts,mechanisms,and therapeutic implications.Various studies were assessed,which investigated the effect of glycemic control on asthma outcomes,lung function,and exacerbations.The study highlighted the role of specific diabetes medications in managing asthma.RESULTS The results showed that poor glycemic control in diabetes can exacerbate asthma,increase hospitalizations,and reduce lung function.Conversely,severe asthma,especially in obese individuals,can complicate diabetes management and make glycemic control more difficult.The diabetes-associated mechanisms,such as inflammation,microangiopathy,and oxidative stress,can exacerbate asthma and decrease lung function.Some diabetes medications exhibit anti-inflammatory effects that show promise in mitigating asthma exacerbations.CONCLUSION The complex interrelationship between diabetes and asthma suggests bidirectional influences that affect disease course and outcomes.Inflammation and microvascular complications associated with diabetes may worsen asthma outcomes,while asthma severity,especially in obese individuals,complicates diabetes control.However,the current research has limitations,and more diverse longitudinal studies are required to establish causal relationships and identify effective treatment strategies for individuals with both conditions.展开更多
BACKGROUND Antibiotic resistance is a growing global health threat,and understanding local trends in bacterial isolates and their susceptibility patterns is crucial for effective infection control and antimicrobial st...BACKGROUND Antibiotic resistance is a growing global health threat,and understanding local trends in bacterial isolates and their susceptibility patterns is crucial for effective infection control and antimicrobial stewardship.The coronavirus disease 2019(COVID-19)pandemic has introduced additional complexities,potentially influencing these patterns.AIM To analyze trends in bacterial isolates and their antibiotic susceptibility patterns at Salmaniya Medical Complex from 2018 to 2023,with a specific focus on the impact of the COVID-19 pandemic on these trends.METHODS A retrospective analysis of microbiological data was conducted,covering the period from 2018 to 2023.The study included key bacterial pathogens such as Escherichia coli(E.coli),Klebsiella pneumoniae,Acinetobacter baumannii,Pseudomonas aeruginosa,and Staphylococcus aureus,among others.The antibiotic susceptibility profiles of these isolates were assessed using standard laboratory methods.To contextualize the findings,the findings were compared with similar studies from other regions,including China,India,Romania,Saudi Arabia,the United Arab Emirates,Malaysia,and United States.RESULTS The study revealed fluctuating trends in the prevalence of bacterial isolates,with notable changes during the COVID-19 pandemic.For example,a significant increase in the prevalence of Staphylococcus aureus was observed during the pandemic years,while the prevalence of E.coli showed a more variable pattern.Antibiotic resistance rates varied among the different pathogens,with a concerning rise in resistance to commonly used antibiotics,particularly among Klebsiella pneumoniae and E.coli.Additionally,the study identified an alarming increase in the prevalence of multidrug-resistant(MDR)strains,especially within Klebsiella pneumoniae and E.coli isolates.The impact of the COVID-19 pandemic on these trends was evident,with shifts in the frequency,resistance patterns,and the emergence of MDR bacteria among several key pathogens.CONCLUSION This study highlights the dynamic nature of bacterial isolates and their antibiotic susceptibility patterns at Salmaniya Medical Complex,particularly in the context of the COVID-19 pandemic.The findings underscore the need for continuous monitoring and effective anti-microbial stewardship programs to combat the evolving threat of antibiotic resistance.Further research and policy initiatives are required to address the identified challenges and improve patient outcomes in the face of these ongoing challenges.展开更多
BACKGROUND Familial Mediterranean fever(FMF)is an autosomal recessive autoinflammatory disorder marked by recurrent episodes of fever and serositis.Resistin,a proinflammatory cytokine,may play a role in FMF pathogenes...BACKGROUND Familial Mediterranean fever(FMF)is an autosomal recessive autoinflammatory disorder marked by recurrent episodes of fever and serositis.Resistin,a proinflammatory cytokine,may play a role in FMF pathogenesis by promoting the release of interleukin-1beta,tumour necrosis factor alpha,and interleukin-6.AIM To evaluate serum resistin levels in children with FMF during acute attacks and remission,and to assess its potential as a biomarker for disease activity and progression.METHODS A case-control study was conducted involving 40 pediatric patients with FMF and 40 age-and sex-matched healthy controls.Serum resistin and inflammatory markers—including total leukocyte count(TLC),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),serum amyloid A(SAA),and fibrinogen—were measured using enzyme-linked immunosorbent assay and standard assays.RESULTS No significant differences were found in age or sex between FMF patients and controls.Among FMF patients,fever was the most prevalent symptom(95%),followed by abdominal pain(75%).The most frequently detected genetic mutation was M694I,followed by M694V,E148Q,M680I,and V726A.Compound heterozygous mutations,including M694I/V726A and M694I/M694V,were equally represented.During acute attacks,FMF patients exhibited significantly elevated levels of TLC,ESR,CRP,SAA,and fibrinogen compared to attack-free periods and controls.Serum resistin levels were markedly higher during acute attacks and showed a strong positive correlation with other acute inflammatory markers.Receiver operating characteristic curve analysis demonstrated high sensitivity and specificity of resistin as a potential biomarker for FMF.CONCLUSION Resistin is significantly elevated in children with FMF during acute episodes and correlates with established inflammatory markers.These findings support its potential role as a non-invasive biomarker for disease activity and severity in pediatric FMF.展开更多
Saltwater Intrusion(SI)poses a significant environmental threat to freshwater resources in coastal aquifers globally.The primary objective of this research is to illustrate the variations in the saltwater-freshwater i...Saltwater Intrusion(SI)poses a significant environmental threat to freshwater resources in coastal aquifers globally.The primary objective of this research is to illustrate the variations in the saltwater-freshwater interface using several established analytical solutions,integrated within a user-friendly web-based tool.Three case studies,including a hypothetical unconfined coastal aquifer,an experimental coastal aquifer,and a real-world coastal aquifer in Gaza,were applied to examine the interface dynamics using the developed tool,built with JavaScript.To simulate variable-density flow within the Gaza coastal aquifer,the public domain code SEAWAT was employed.The resulting lengths of seawater intrusion,as simulated by SEAWAT and the observed toe length,were compared with those obtained from the web-based analytical solutions under both constant head and constant flux boundary conditions.This comparison demonstrated a strong correlation between the experimental results,SEAWAT model outputs,and analytical solutions.This research provides valuable insights into SI in coastal aquifers,with a specific focus on the impact of Sea Level Rise(SLR)on the shifting position of the seawater intrusion toe.The outcomes are presented through an accessible web-based interface,thereby promoting broader dissemination and practical application of the research outcomes.展开更多
The rise of the“fishing reviewer”phenomenon presents a significant threat to the integrity of academic publishing,undermining the credibility of the peer review process and eroding trust in scientific journals.This ...The rise of the“fishing reviewer”phenomenon presents a significant threat to the integrity of academic publishing,undermining the credibility of the peer review process and eroding trust in scientific journals.This editorial explores the risk factors contributing to this troubling trend and identifies key indicators to recognize such reviewers.To address this issue,we propose strategies,including enhanced reviewer vetting,comprehensive training,and transparent recognition policies to foster a culture of accountability and ethical conduct in scholarly review.By implementing these measures,we can safeguard the quality and credibility of academic research.展开更多
BACKGROUND Human milk oligosaccharides(HMOs)are bioactive components of breast milk with diverse health benefits,including shaping the gut microbiota,modulating the immune system,and protecting against infections.HMOs...BACKGROUND Human milk oligosaccharides(HMOs)are bioactive components of breast milk with diverse health benefits,including shaping the gut microbiota,modulating the immune system,and protecting against infections.HMOs exhibit dynamic secretion patterns during lactation,influenced by maternal genetics and environ-mental factors.Their direct and indirect antimicrobial properties have garnered significant research interest.However,a comprehensive understanding of the secretion dynamics of HMOs and their correlation with antimicrobial efficacy remains underexplored.AIM To synthesize current evidence on the secretion dynamics of HMOs during lactation and evaluate their antimicrobial roles against bacterial,viral,and protozoal pathogens.METHODS A systematic search of PubMed,Scopus,Web of Science,and Cochrane Library focused on studies investigating natural and synthetic HMOs,their secretion dynamics,and antimicrobial properties.Studies involving human,animal,and in vitro models were included.Data on HMO composition,temporal secretion patterns,and mechanisms of antimicrobial action were extracted.Quality assess-ment was performed using validated tools appropriate for study design.RESULTS A total of 44 studies were included,encompassing human,animal,and in vitro research.HMOs exhibited dynamic secretion patterns,with 2′-fucosyllactose(2′-FL)and lacto-N-tetraose peaking in early lactation and declining over time,while 3-fucosyllactose(3-FL)increased during later stages.HMOs demonstrated significant antimicrobial properties through pathogen adhesion inhibition,biofilm disruption,and enzymatic activity impairment.Synthetic HMOs,including bioengineered 2′-FL and 3-FL,were structurally and functionally comparable to natural HMOs,effectively inhibiting pathogens such as Pseudomonas aeruginosa,Escherichia coli,and Campylobacter jejuni.Additionally,HMOs exhibited synergistic effects with antibiotics,enhancing their efficacy against resistant pathogens.CONCLUSION HMOs are vital in antimicrobial defense,supporting infant health by targeting various pathogens.Both natural and synthetic HMOs hold significant potential for therapeutic applications,particularly in infant nutrition and as adjuncts to antibiotics.Further research,including clinical trials,is essential to address gaps in knowledge,validate findings,and explore the broader applicability of HMOs in improving maternal and neonatal health.展开更多
An integrated study on source rock characterization and hydrocarbon generation potential modeling was conducted for the selected Dingo Claystone,Barrow Sub-basin,Australia.In this study,data were collected solely from...An integrated study on source rock characterization and hydrocarbon generation potential modeling was conducted for the selected Dingo Claystone,Barrow Sub-basin,Australia.In this study,data were collected solely from two wells represented by the Bambra-1 and Bambra-2 wells.The collected data include those from bulk geochemical analyses of cuttings and sidewall cores sampled from the Late Jurassic Dingo Claystone.Geochemical data obtained from Rock-Eval pyrolysis and gas chromatography(GC)of extracted organic matter were integrated for source rock characterization and the construction of burial history and hydrocarbon generation in the Dingo Claystone.To improve the accuracy of thermal maturity estimations,only samples with S2 greater than 1 were considered due to potential issues with peak integration and uncertainties of Tmax determination in samples with lower S2 values.Furthermore,Rock-Eval data from the Bambra wells may be unreliable due to the contamination of cuttings and sidewall core(SWC)samples by drilling mud additives and natural hydrocarbons,which could impact the reliability of the data for determining thermal maturity.This study reveals that the Dingo Claystone Formation has total organic carbon(TOC)contents ranging from 0.66%to 8.31%.A poor to good hydrocarbon generation potential is indicated,with a production yield(PY=S_(1)+S_(2))ranging from 1.37 to 10.44 mg HC/g rock.Hydrogen index values vary between 42 and 226 mg HC/g TOC,confirming that the Dingo Claystone is dominantly kerogen TypeⅢ,with minor contributions from typesⅡ/ⅢandⅣ.Thermal maturity ranges from immature to late mature and is mostly in the oil window.This is indicated by T_(max)values of 398-462℃and vitrinite reflectance(Ro,%)of 0.47-1.99.Some samples show suppressed T_(max)and a higher production index,which is typical for samples affected by drilling fluids during drilling operations.Additionally,gas chromatography(GC)analyses are used to interpret the paleodepositional environment showing mixed input between marine and terrestrial origins of the source rocks.One-dimensional basin modeling for the Bambra-1 and Bambra-2 wells was carried out to evaluate the burial and thermal history of the formation.The transformation ratio suggests that hydrocarbon generation has not reached its peak and is still in an ongoing phase.An indication of hydrocarbon migration can be observed in this formation based on the transformation ratio.The effects of contamination warrant further investigation,as it could significantly impact maturity estimates and data reliability.展开更多
Arsenic,a naturally occurring toxic element,manifests in various chemical forms and is widespread in the environment.Exposure to arsenic is a well-established risk factor for an elevated incidence of various cancers a...Arsenic,a naturally occurring toxic element,manifests in various chemical forms and is widespread in the environment.Exposure to arsenic is a well-established risk factor for an elevated incidence of various cancers and chronic diseases.The crux of arsenic-mediated toxicity lies in its ability to induce oxidative stress,characterized by an unsettling imbalance between oxidants and antioxidants,accompanied by the rampant generation of reactive oxygen species and free radicals.In response to this oxidative turmoil,cells deploy their defensemechanisms,prominently featuring the redox-sensitive transcription factor known as nuclear factor erythroid 2-related factor 2(NRF2).NRF2 stands as a primary guardian against the oxidative harm wrought by arsenic.When oxidative stress activates NRF2,it orchestrates a symphony of downstream antioxidant genes,leading to the activation of pivotal antioxidant enzymes like glutathione-S-transferase,heme oxygenase-1,and NAD(P)H:quinone oxidoreductase 1.This comprehensive review embarks on the intricate and diverse ways by which various arsenicals influence the NRF2 antioxidant pathway and its downstream targets,shedding light on their roles in defending against arsenic exposure toxic effects.It offers valuable insights into targeting NRF2 as a strategy for safeguarding against or treating the harmful and carcinogenic consequences of arsenic exposure.展开更多
BACKGROUND The relationship between exercise and gastrointestinal(GI)health is complex and bidirectional.While moderate exercise generally promotes gut health by enhancing motility,reducing inflammation,and supporting...BACKGROUND The relationship between exercise and gastrointestinal(GI)health is complex and bidirectional.While moderate exercise generally promotes gut health by enhancing motility,reducing inflammation,and supporting microbial balance,intense or prolonged physical activity may exacerbate GI symptoms,particularly in individuals with preexisting digestive disorders.A deeper understanding of this interplay is essential for optimizing both exercise performance and GI well-being.AIM To synthesize current evidence on exercise-related GI disorders,exploring the prevalence,mechanisms,risk factors,and management strategies associated with exercise-induced GI symptoms.METHODS Following PRISMA guidelines,comprehensive searches of databases,including PubMed,Scopus,Web of Science,and EMBASE were conducted.Studies were included if they focused on exercise-induced GI disorders,encompassed randomized controlled trials,cohort studies,case-control studies,and cross-sectional designs,and addressed symptoms across various exercise modalities.Data were extracted and analyzed to identify patterns and implications for clinical and athletic practice.RESULTS A total of 231 studies met the inclusion criteria,highlighting both the benefits and risks of exercise on GI health.Regular moderate-intensity exercise,including activities such as walking,cycling,and yoga has been associated with improved GI function in conditions like gastroesophageal reflux disease,irritable bowel syndrome,inflammatory bowel disease,and constipation.These benefits are attributed to enhanced intestinal motility,reduced systemic inflammation,and improved gut barrier integrity.Additionally,exercise plays a role in regulating the gut-brain axis,with practices like yoga and Tai Chi demonstrating particular effectiveness in alleviating functional GI disorders.Conversely,high-intensity or prolonged exercise may contribute to symptoms such as nausea,diarrhea,and abdominal pain due to mechanisms like splanchnic hypoperfusion and increased intestinal permeability.Individual factors,including fitness level,dietary habits,hydration status,and underlying GI conditions,significantly influence the body’s response to exercise.CONCLUSION Moderate-intensity exercise is a beneficial and well-tolerated intervention for promoting GI health,whereas highintensity activities require careful monitoring,particularly in individuals with pre-existing GI disorders.Personalized exercise and dietary strategies are essential for balancing the benefits of physical activity with the risk of GI distress.Further research is needed to explore the long-term effects of exercise on gut microbiota composition and overall digestive health.展开更多
Attention-deficit/hyperactivity disorder(ADHD)is one of the most common neurodevelopmental disorders of childhood,yet its diagnosis remains complex and fraught with challenges.Pediatricians,often the first point of co...Attention-deficit/hyperactivity disorder(ADHD)is one of the most common neurodevelopmental disorders of childhood,yet its diagnosis remains complex and fraught with challenges.Pediatricians,often the first point of contact for concerned families,play a pivotal role in the diagnostic process.However,they face numerous obstacles that can hinder accurate and timely diagnosis,particularly in resource-limited or culturally diverse settings such as the Middle East and North Africa(MENA)and Arabian Gulf regions.This narrative review explores the key challenges pediatricians face in diagnosing ADHD and highlights practical and emerging solutions.The article offers both a global perspective and a contextualized view relevant to the MENA region.A narrative literature review was conducted using PubMed,Scopus,and Google Scholar,focusing on peer-reviewed studies,clinical guidelines,and epidemiological data from 2010 to 2025 related to pediatric ADHD diagnosis,especially in MENA regions.The review identifies six major diagnostic barriers:(1)Symptom overlap with other conditions[e.g.,autism spectrum disorder(ASD),anxiety,learning disabilities];(2)Reliance on subjective informant reports;(3)Cultural and societal influences including stigma and gender bias;(4)Variability in ADHD training and time constraints in clinical practice;(5)Limited access to multidisciplinary evaluations;and(6)Systemic referral and communication inefficiencies.Comorbidities are highly prevalent and frequently complicate the diagnostic picture.Delayed or inaccurate diagnosis can lead to academic underperformance,family stress,missed interventions,and long-term psychological consequences.Emerging solutions include digital screening tools,artificial intelligence-assisted analysis,structured reporting platforms,and improved training and referral models.Regional data from the Arabian Gulf highlight variable prevalence rates(1.3%-22%)and underscore the need for culturally sensitive diagnostic strategies.To improve diagnostic accuracy and patient outcomes,pediatricians must be supported through better training,interdisciplinary collaboration,validated tools,and policy-level reforms.Tailoring these approaches to local contexts will be key to addressing the growing burden of ADHD,particularly in the MENA region.展开更多
Ulcerative colitis(UC)is an inflammatory condition of the intestine,resulting from an increase in oxidative stress and pro-inflammatory mediators.In this study,the extract of endophytic bacterium Rhizobium aegyptiacum...Ulcerative colitis(UC)is an inflammatory condition of the intestine,resulting from an increase in oxidative stress and pro-inflammatory mediators.In this study,the extract of endophytic bacterium Rhizobium aegyptiacum was prepared for the first time using liquid chromatography-mass spectrometry(LC-MS).In addition,also for the first time,the protective potential of R.aegyptiacum was revealed using an in vivo rat model of UC.The animals were grouped into four categories:normal control(groupⅠ),R.aegyptiacum(groupⅡ),acetic acid(AA)-induced UC(groupⅢ),and R.aegyptiacum-treated AA-induced UC(groupⅣ).In groupⅣ,R.aegyptiacum was administered at 0.2 mg/kg daily for one week before and two weeks after the induction of UC.After sacrificing the rats on the last day of the experiment,colon tissues were collected and subjected to histological,immunohistochemical,and biochemical investigations.There was a remarkable improvement in the histological findings of the colon tissues in groupⅣ,as revealed by hematoxylin and eosin(H&E)staining,Masson's trichrome staining,and periodic acid-Schiff(PAS)staining.Normal mucosal surfaces covered with a straight,intact,and thin brush border were revealed.Goblet cells appeared magenta in color,and there was a significant decrease in the distribution of collagen fibers in the mucosa and submucosal connective tissues.All these findings were comparable to the respective characteristics of the control group.Regarding cyclooxygenase-2(COX-2)immunostaining,a weak immune reaction was shown in most cells.Moreover,the colon tissues were examined using a scanning electron microscope,which confirmed the results of histological assessment.A regular polygonal unit pattern was seen with crypt orifices of different sizes and numerous goblet cells.Furthermore,the levels of catalase(CAT),myeloperoxidase(MPO),nitric oxide(NO),interleukin-6(IL-6),and interlukin-1β(IL-1β)were determined in the colonic tissues of the different groups using colorimetric assay and enzyme-linked immunosorbent assay(ELISA).In comparison with groupⅢ,groupⅣexhibited a significant rise(P<0.05)in the CAT level but a substantial decline(P<0.05)in the NO,MPO,and inflammatory cytokine(IL-6 and IL-1β)levels.Based on reverse transcription-quantitative polymerase chain reaction(RT-qPCR),the tumor necrosis factor-α(TNF-α)gene expression was upregulated in groupⅢ,which was significantly downregulated(P<0.05)by treatment with R.aegyptiacum in groupⅣ.On the contrary,the heme oxygenase-1(HO-1)gene was substantially upregulated in groupⅣ.Our findings imply that the oral consumption of R.aegyptiacum ameliorates AA-induced UC in rats by restoring and reestablishing the mucosal integrity,in addition to its anti-oxidant and anti-inflammatory effects.Accordingly,R.aegyptiacum is potentially effective and beneficial in human UC therapy,which needs to be further investigated in future work.展开更多
Cow milk protein allergy(CMPA)is a prevalent food allergy in infancy.It often presents with symptoms that overlap with other conditions,such as gastroeso-phageal reflux disease,lactose intolerance,food protein-induced...Cow milk protein allergy(CMPA)is a prevalent food allergy in infancy.It often presents with symptoms that overlap with other conditions,such as gastroeso-phageal reflux disease,lactose intolerance,food protein-induced enterocolitis syndrome,and eosinophilic esophagitis.This diagnostic overlap makes distin-guishing CMPA from its mimics difficult,resulting in potential misdiagnoses and unnecessary dietary restrictions.This review aims to comprehensively analyze CMPA and its mimicking conditions,highlighting their clinical presentations,diagnostic approaches,and management strategies to enhance diagnostic accu-racy and optimize patient care.A systematic literature search was conducted using PubMed,Scopus,Web of Science,and Google Scholar,focusing on studies published within the last 20 years.Articles addressing CMPA and its mimicking conditions were selected,with data synthesized into comparative analyses of diagnostic methods and management strategies.Accurate differentiation between CMPA and its mimics requires a thorough clinical evaluation supported by diagnostic tests such as skin prick tests,serum-specific IgE,and oral food challenges.Misdiagnosis can lead to nutritional deficiencies,psychological stress,and increased healthcare costs.Emerging diagnostic technologies,including component-resolved diagnostics and cytokine profiling,offer promising avenues for improving accuracy.A multidisciplinary approach involving pediatricians,allergists,and dietitians is essential for precise diagnosis and effective management.Ongoing research and education are crucial to enhancing clinical outcomes and reducing the burden on families.展开更多
BACKGROUND Functional neurological disorder(FND)in children is a complex and multifaceted condition characterized by neurological symptoms that cannot be explained by organic pathology.Despite its prevalence,FND in pe...BACKGROUND Functional neurological disorder(FND)in children is a complex and multifaceted condition characterized by neurological symptoms that cannot be explained by organic pathology.Despite its prevalence,FND in pediatric populations remains under-researched,with challenges in diagnosis and management AIM To synthesize the current literature on FND in children,focusing on clinical presentation,diagnostic approaches,treatment strategies,and outcomes.METHODS A comprehensive literature search was conducted across multiple databases,including PubMed,Scopus,and Web of Science,for articles published up to August 2024.Studies were included if they addressed FND in pediatric populations,specifically focusing on review articles,research articles,systematic reviews,meta-analyses,case reports,guidelines,expert opinions,and editorials.Data extraction and quality assessment were performed according to PRISMA guidelines.A total of 308 articles were included in the final analysis.RESULTS The analysis included 189 review articles,57 research articles,3 systematic reviews and meta-analyses,5 case reports,2 guidelines,5 expert opinions,and 2 editorials.Key findings revealed a broad spectrum of symptoms,including motor and sensory disturbances and psychological factors contributing to the onset and persistence of FND.Diagnostic challenges were frequently highlighted,emphasizing the need for interdisciplinary approaches.Treatment strategies varied,with cognitive-behavioral therapy(CBT)and multidisciplinary care emerging as the most effective approaches.The outcomes varied,with early intervention being critical for a better prognosis.CONCLUSION Early diagnosis and multidisciplinary care,including CBT,are critical for improving outcomes in pediatric FND.Standardized diagnostic criteria and treatment protocols are needed to enhance clinical management.展开更多
BACKGROUND Malnutrition and epilepsy share a complex bidirectional relationship,with malnutrition serving as a potential risk factor for epilepsy development,while epilepsy,in turn,often exerts profound effects on nut...BACKGROUND Malnutrition and epilepsy share a complex bidirectional relationship,with malnutrition serving as a potential risk factor for epilepsy development,while epilepsy,in turn,often exerts profound effects on nutritional status.Nutritional interventions have emerged as a critical adjunctive approach in epilepsy management.AIM To explore the multifaceted associations between malnutrition and epilepsy,structured into three primary sections:(1)Elucidating the impact of malnutrition as a risk factor for epilepsy onset;(2)Examining the reciprocal influence of epilepsy on nutritional status,and(3)Evaluating diverse nutritional interventions in the management of epilepsy.METHODS A systematic search was conducted across PubMed,Scopus,and Web of Science databases utilizing defined keywords related to malnutrition,epilepsy,and nutritional interventions.Inclusion criteria encompassed various study types,including clinical trials,animal models,cohort studies,case reports,meta-analyses,systematic reviews,guidelines,editorials,and review articles.Four hundred sixteen pertinent references were identified,with 198 review articles,153 research studies,21 case reports,24 meta-analyses,14 systematic reviews,4 guidelines,and 2 editorials meeting the predefined criteria.RESULTS The review revealed the intricate interplay between malnutrition and epilepsy,highlighting malnutrition as a potential risk factor in epilepsy development and elucidating how epilepsy often leads to nutritional deficiencies.Findings underscored the importance of nutritional interventions in managing epilepsy,showing their impact on seizure frequency,neuronal function,and overall brain health.CONCLUSION This systematic review emphasizes the bidirectional relationship between malnutrition and epilepsy while emphasizing the critical role of nutritional management in epilepsy treatment.The multifaceted insights underscore the need for a holistic approach to addressing nutritional aspects alongside conventional epilepsy management strategies.展开更多
文摘Objectives: To evaluate the efficacy, compliance, safety and economic cost for Fosfomycin trometamol and Nitofurantoin in uncomplicated lower urinary tract infections during pregnancy. Background: Nitofurantoin and Fosfomycin trometamol are recommended as the first-line agents for treatment of urinary tract infections (UTIs) in the latest guidelines endorsed by the Infectious Diseases Society of America (IDSA) and the European Society for Clinical Microbiology and Infectious Diseases (ESCMID). Fosfomycin is bactericidal and inhibits bacterial cell wall biogenesis and reduces bacterial adherence to uroepithelial cells. Fosfomycin has broad antibacterial activity against both Gram-positive and Gram-negative pathogens, as Escherichia coli, Escherichia faecalis, and various Gram-negatives like Citrobacter and Proteus. Both Nitofurantoin and Fosfomycin are category B in pregnancy. Patients and Methods: This study was conducted at Tanta University Hospitals in the period from June, 1, 2015 to January, 1, 2017. Patients were recruited from outpatient clinics of Obstetrics and Gynecology and Urology Departments presenting with asymptomatic bacteruria or cystitis. Patients were allocated randomly into 2 groups: group I (n = 50 cases) received Fosfomycin therapy and group II (n = 50 cases) received Nitofurantoin therapy (n = 50 cases). After treatment, evaluation of patient symptoms, organism count, patient compliance and cost of treatment were done. Results: The enrolled patients were suffering from lower urinary tract infections;asymptomatic bacteruria (17 cases) or cystitis (83 cases). Ten patients were excluded. The demographic data of included patients were not significant for both groups. Complete relief (100%) of symptoms 5 days after start of treatment was noticed in Fosfomycin group while improvement of symptoms after 5 day-treatment was noticed in 86.49% in Nitofurantoin group (p-value = 0.030). The side effects were recorded in 7 cases (18.42%) in Fosfomycin group compared to (35.14%) with significant difference in the reported side effects, (p-value = 0.003). Compliance was 38/38 (100%) in Fosfomycin group compared to 34/37 (91.89%) in Nitrofuantoin group (p-value = 0.001). Resistance was very minimal in Fosfomycin group where 1/38 case (2.63%) reported resistance for treatment compared to 8/37 cases (21.62%) in Nitofurantoin group (p-value = 0.001). Conclusion: Fosfomycin trometamine proved to be safe, effective, and has limited resistance. Moreover higher patient compliance and fewer side effects were recommending Fosfomycin to be a first choice drug for uncomplicated lower urinary tract infections during pregnancy at Tanta University.
文摘The physico-chemical and biological （algal and bacterial） quality of tap water in Tanta City were elucidated. Samples were collected during December 2011, covering all the water plants and the areal extension of the pipe line network in Tanta. Total dissolved solids content classifies water origin into surface water, shallow and deep groundwater. Fe, Mn and hardness in some samples of groundwater origin are obviously exceeding the WHO （World Health Organization） limit. Mostly, green algae are found （31 species）, followed by diatoms （19 species）, then blue-green algae （13 species）. CCA （Canonical Corresponding Analysis） indicates that green algae are strongly correlated with pH, NH4, alkalinity, Mn and Si; diatoms with EC （electric conductivity）, turbidity, Zn and Si and blue green algae with EC and alkalinity. 50% of samples of surface origin, 80% of samples of both deep and shallow groundwater origins crossed WHO and Egyptian guideline in their content of mean TCC （Total Coliform Count）. CCA estimates strong correlations of TCC with temperature, NH4 and PO4; E. coli with EC; heterotrophic bacteria with turbidity and NO3; Salmonella sp. with Si and SO4 and Pseudomonas aeruginosa with Mn. Finally, the water plants treatment may be not effective and pipes serve as a reservoir for pathogenic microorganisms.
文摘Egypt has a high attitude in construction and demolition waste (CDW) amounts causing a negative impact on the environment. The use of such waste for infrastructures applications can be useful for each environment and in addition an economic benefit to it in the construction. This study explores the possibility of replacing natural coarse aggregate with recycled concrete construction and demolition waste aggregate for general purpose concrete (i.e. plain concrete and low strength structural concrete). Different samples of CDW were extracted from different demolition sites and landfill locations around Tanta city area for the experimental investigation. CDW was crushed with all its hard constituents (e.g. concrete, brick etc.) found in the landfill. Coarse size crushed CDW was used as a coarse aggregate for concrete. Main characteristics of CDW aggregate determined in addition to the main properties of concrete which was made using this aggregate were measured. The results showed that the CDW could be transformed into recycled concrete aggregate leading to reduction in the concrete compressive strength ranged from 37% to 62% depending on the type of the CDW constituents.
文摘Inflammatory bowel disease(IBD)is a chronic inflammatory illness of the intes-tine.While the mechanism underlying the pathogenesis of IBD is not fully under-stood,it is believed that a complex combination of host immunological response,environmental exposure,particularly the gut microbiota,and genetic suscept-ibility represents the major determinants.The gut virome is a group of viruses found in great frequency in the gastrointestinal tract of humans.The gut virome varies greatly among individuals and is influenced by factors including lifestyle,diet,health and disease conditions,geography,and urbanization.The majority of research has focused on the significance of gut bacteria in the progression of IBD,although viral populations represent an important component of the microbiome.We conducted this review to highlight the viral communities in the gut and their expected roles in the etiopathogenesis of IBD regarding published research to date.
文摘BACKGROUND Functional gastrointestinal disorders(FGIDs)in children present with chronic symptoms like abdominal pain,diarrhea,and constipation without identifiable structural abnormalities.These disorders are closely linked to gut-brain axis dysfunction,altered gut microbiota,and psychosocial stress,leading to psychia-tric comorbidities such as anxiety,depression,and behavioral issues.Under-standing this bidirectional relationship is crucial for developing effective,holistic management strategies that address physical and mental health.AIM To examine the psychiatric impacts of FGIDs in children,focusing on anxiety and depression and their association with other neurodevelopmental disorders of childhood,such as attention-deficit/hyperactivity disorder,emphasizing the role of the gut-brain axis,emotional dysregulation,and psychosocial stress.Key mechanisms explored include neurotransmitter dysregulation,microbiota imbalance,central sensitization,heightening stress reactivity,emotional dysregulation,and symptom perception.The review also evaluates the role of family dynamics and coping strategies in exacerbating FGID symptoms and contributing to psychiatric conditions.METHODS A narrative review was conducted using 328 studies sourced from PubMed,Scopus,and Google Scholar,covering research published over the past 20 years.Inclusion criteria focused on studies examining FGID diagnosis,gut-brain mechanisms,psychiatric comorbidities,and psychosocial factors in pediatric populations.FGIDs commonly affecting children,including functional constipation,abdominal pain,irritable bowel syndrome,gastroesophageal reflux,and cyclic vomiting syndrome,were analyzed concerning their psychological impacts.RESULTS The review highlights a strong connection between FGIDs and psychiatric symptoms,mediated by gut-brain axis dysfunction,dysregulated microbiota,and central sensitization.These physiological disruptions increase children’s vulnerability to anxiety and depression,while psychosocial factors-such as chronic stress,early-life trauma,maladaptive family dynamics,and ineffective coping strategies-intensify the cycle of gastrointestinal and emotional distress.CONCLUSION Effective management of FGIDs requires a biopsychosocial approach integrating medical,psychological,and dietary interventions.Parental education,early intervention,and multidisciplinary care coordination are critical in mitigating long-term psychological impacts and improving both gastrointestinal and mental health outcomes in children with FGIDs.
文摘BACKGROUND Managing critical care emergencies in children with autism spectrum disorder(ASD)presents unique challenges due to their distinct sensory sensitivities,communication difficulties,and behavioral issues.Effective strategies and protocols are essential for optimal care in these high-stress situations.AIM To systematically evaluate and synthesize current evidence on best practices for managing critical care emergencies in children with ASD.The review focuses on key areas,including sensory-friendly environments,communication strategies,behavioral management,and the role of multidisciplinary approaches.METHODS A comprehensive search was conducted across major medical databases,including PubMed,Embase,and Cochrane Library,for studies published between 2000 and 2023.Studies were selected based on their relevance to critical care management in children with ASD,encompassing randomized controlled trials,observational studies,qualitative research,and case studies.Data were extracted and analyzed to identify common themes,successful strategies,and areas for improvement.RESULTS The review identified 50 studies that met the inclusion criteria.Findings highlighted the importance of creating sensory-friendly environments,utilizing effective communication strategies,and implementing individualized behavioral management plans.These findings,derived from a comprehensive review of current evidence,provide valuable insights into the best practices for managing critical care emergencies in children with ASD.Sensory modifications,such as reduced lighting and noise,visual aids,and augmentative and alternative communication tools,enhanced patient comfort and cooperation.The involvement of multidisciplinary teams was crucial in delivering holistic care.Case studies provided practical insights and underscored the need for continuous refi-nement of protocols.CONCLUSION The review emphasizes the need for a tailored approach to managing critical care emergencies for children with ASD.Sensory-friendly adjustments,effective communication,and behavioral strategies supported by a mul-tidisciplinary team are integral to improving outcomes.Despite progress,ongoing refinement of care practices and protocols is necessary.This ongoing process addresses remaining challenges and engages healthcare professionals in continuous improvement of care for children with ASD in critical settings.
文摘BACKGROUND The relationship between diabetes mellitus(DM)and asthma is complex and can impact disease trajectories.AIM To explore the bidirectional influences between the two conditions on clinical outcomes and disease control.METHODS We systematically reviewed the literature on the relationship between DM and asthma,focusing on their impacts,mechanisms,and therapeutic implications.Various studies were assessed,which investigated the effect of glycemic control on asthma outcomes,lung function,and exacerbations.The study highlighted the role of specific diabetes medications in managing asthma.RESULTS The results showed that poor glycemic control in diabetes can exacerbate asthma,increase hospitalizations,and reduce lung function.Conversely,severe asthma,especially in obese individuals,can complicate diabetes management and make glycemic control more difficult.The diabetes-associated mechanisms,such as inflammation,microangiopathy,and oxidative stress,can exacerbate asthma and decrease lung function.Some diabetes medications exhibit anti-inflammatory effects that show promise in mitigating asthma exacerbations.CONCLUSION The complex interrelationship between diabetes and asthma suggests bidirectional influences that affect disease course and outcomes.Inflammation and microvascular complications associated with diabetes may worsen asthma outcomes,while asthma severity,especially in obese individuals,complicates diabetes control.However,the current research has limitations,and more diverse longitudinal studies are required to establish causal relationships and identify effective treatment strategies for individuals with both conditions.
文摘BACKGROUND Antibiotic resistance is a growing global health threat,and understanding local trends in bacterial isolates and their susceptibility patterns is crucial for effective infection control and antimicrobial stewardship.The coronavirus disease 2019(COVID-19)pandemic has introduced additional complexities,potentially influencing these patterns.AIM To analyze trends in bacterial isolates and their antibiotic susceptibility patterns at Salmaniya Medical Complex from 2018 to 2023,with a specific focus on the impact of the COVID-19 pandemic on these trends.METHODS A retrospective analysis of microbiological data was conducted,covering the period from 2018 to 2023.The study included key bacterial pathogens such as Escherichia coli(E.coli),Klebsiella pneumoniae,Acinetobacter baumannii,Pseudomonas aeruginosa,and Staphylococcus aureus,among others.The antibiotic susceptibility profiles of these isolates were assessed using standard laboratory methods.To contextualize the findings,the findings were compared with similar studies from other regions,including China,India,Romania,Saudi Arabia,the United Arab Emirates,Malaysia,and United States.RESULTS The study revealed fluctuating trends in the prevalence of bacterial isolates,with notable changes during the COVID-19 pandemic.For example,a significant increase in the prevalence of Staphylococcus aureus was observed during the pandemic years,while the prevalence of E.coli showed a more variable pattern.Antibiotic resistance rates varied among the different pathogens,with a concerning rise in resistance to commonly used antibiotics,particularly among Klebsiella pneumoniae and E.coli.Additionally,the study identified an alarming increase in the prevalence of multidrug-resistant(MDR)strains,especially within Klebsiella pneumoniae and E.coli isolates.The impact of the COVID-19 pandemic on these trends was evident,with shifts in the frequency,resistance patterns,and the emergence of MDR bacteria among several key pathogens.CONCLUSION This study highlights the dynamic nature of bacterial isolates and their antibiotic susceptibility patterns at Salmaniya Medical Complex,particularly in the context of the COVID-19 pandemic.The findings underscore the need for continuous monitoring and effective anti-microbial stewardship programs to combat the evolving threat of antibiotic resistance.Further research and policy initiatives are required to address the identified challenges and improve patient outcomes in the face of these ongoing challenges.
文摘BACKGROUND Familial Mediterranean fever(FMF)is an autosomal recessive autoinflammatory disorder marked by recurrent episodes of fever and serositis.Resistin,a proinflammatory cytokine,may play a role in FMF pathogenesis by promoting the release of interleukin-1beta,tumour necrosis factor alpha,and interleukin-6.AIM To evaluate serum resistin levels in children with FMF during acute attacks and remission,and to assess its potential as a biomarker for disease activity and progression.METHODS A case-control study was conducted involving 40 pediatric patients with FMF and 40 age-and sex-matched healthy controls.Serum resistin and inflammatory markers—including total leukocyte count(TLC),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),serum amyloid A(SAA),and fibrinogen—were measured using enzyme-linked immunosorbent assay and standard assays.RESULTS No significant differences were found in age or sex between FMF patients and controls.Among FMF patients,fever was the most prevalent symptom(95%),followed by abdominal pain(75%).The most frequently detected genetic mutation was M694I,followed by M694V,E148Q,M680I,and V726A.Compound heterozygous mutations,including M694I/V726A and M694I/M694V,were equally represented.During acute attacks,FMF patients exhibited significantly elevated levels of TLC,ESR,CRP,SAA,and fibrinogen compared to attack-free periods and controls.Serum resistin levels were markedly higher during acute attacks and showed a strong positive correlation with other acute inflammatory markers.Receiver operating characteristic curve analysis demonstrated high sensitivity and specificity of resistin as a potential biomarker for FMF.CONCLUSION Resistin is significantly elevated in children with FMF during acute episodes and correlates with established inflammatory markers.These findings support its potential role as a non-invasive biomarker for disease activity and severity in pediatric FMF.
基金funded by the Science and Technology Development Fund(STDF)-Egypt(Grant number#46278).
文摘Saltwater Intrusion(SI)poses a significant environmental threat to freshwater resources in coastal aquifers globally.The primary objective of this research is to illustrate the variations in the saltwater-freshwater interface using several established analytical solutions,integrated within a user-friendly web-based tool.Three case studies,including a hypothetical unconfined coastal aquifer,an experimental coastal aquifer,and a real-world coastal aquifer in Gaza,were applied to examine the interface dynamics using the developed tool,built with JavaScript.To simulate variable-density flow within the Gaza coastal aquifer,the public domain code SEAWAT was employed.The resulting lengths of seawater intrusion,as simulated by SEAWAT and the observed toe length,were compared with those obtained from the web-based analytical solutions under both constant head and constant flux boundary conditions.This comparison demonstrated a strong correlation between the experimental results,SEAWAT model outputs,and analytical solutions.This research provides valuable insights into SI in coastal aquifers,with a specific focus on the impact of Sea Level Rise(SLR)on the shifting position of the seawater intrusion toe.The outcomes are presented through an accessible web-based interface,thereby promoting broader dissemination and practical application of the research outcomes.
文摘The rise of the“fishing reviewer”phenomenon presents a significant threat to the integrity of academic publishing,undermining the credibility of the peer review process and eroding trust in scientific journals.This editorial explores the risk factors contributing to this troubling trend and identifies key indicators to recognize such reviewers.To address this issue,we propose strategies,including enhanced reviewer vetting,comprehensive training,and transparent recognition policies to foster a culture of accountability and ethical conduct in scholarly review.By implementing these measures,we can safeguard the quality and credibility of academic research.
文摘BACKGROUND Human milk oligosaccharides(HMOs)are bioactive components of breast milk with diverse health benefits,including shaping the gut microbiota,modulating the immune system,and protecting against infections.HMOs exhibit dynamic secretion patterns during lactation,influenced by maternal genetics and environ-mental factors.Their direct and indirect antimicrobial properties have garnered significant research interest.However,a comprehensive understanding of the secretion dynamics of HMOs and their correlation with antimicrobial efficacy remains underexplored.AIM To synthesize current evidence on the secretion dynamics of HMOs during lactation and evaluate their antimicrobial roles against bacterial,viral,and protozoal pathogens.METHODS A systematic search of PubMed,Scopus,Web of Science,and Cochrane Library focused on studies investigating natural and synthetic HMOs,their secretion dynamics,and antimicrobial properties.Studies involving human,animal,and in vitro models were included.Data on HMO composition,temporal secretion patterns,and mechanisms of antimicrobial action were extracted.Quality assess-ment was performed using validated tools appropriate for study design.RESULTS A total of 44 studies were included,encompassing human,animal,and in vitro research.HMOs exhibited dynamic secretion patterns,with 2′-fucosyllactose(2′-FL)and lacto-N-tetraose peaking in early lactation and declining over time,while 3-fucosyllactose(3-FL)increased during later stages.HMOs demonstrated significant antimicrobial properties through pathogen adhesion inhibition,biofilm disruption,and enzymatic activity impairment.Synthetic HMOs,including bioengineered 2′-FL and 3-FL,were structurally and functionally comparable to natural HMOs,effectively inhibiting pathogens such as Pseudomonas aeruginosa,Escherichia coli,and Campylobacter jejuni.Additionally,HMOs exhibited synergistic effects with antibiotics,enhancing their efficacy against resistant pathogens.CONCLUSION HMOs are vital in antimicrobial defense,supporting infant health by targeting various pathogens.Both natural and synthetic HMOs hold significant potential for therapeutic applications,particularly in infant nutrition and as adjuncts to antibiotics.Further research,including clinical trials,is essential to address gaps in knowledge,validate findings,and explore the broader applicability of HMOs in improving maternal and neonatal health.
文摘An integrated study on source rock characterization and hydrocarbon generation potential modeling was conducted for the selected Dingo Claystone,Barrow Sub-basin,Australia.In this study,data were collected solely from two wells represented by the Bambra-1 and Bambra-2 wells.The collected data include those from bulk geochemical analyses of cuttings and sidewall cores sampled from the Late Jurassic Dingo Claystone.Geochemical data obtained from Rock-Eval pyrolysis and gas chromatography(GC)of extracted organic matter were integrated for source rock characterization and the construction of burial history and hydrocarbon generation in the Dingo Claystone.To improve the accuracy of thermal maturity estimations,only samples with S2 greater than 1 were considered due to potential issues with peak integration and uncertainties of Tmax determination in samples with lower S2 values.Furthermore,Rock-Eval data from the Bambra wells may be unreliable due to the contamination of cuttings and sidewall core(SWC)samples by drilling mud additives and natural hydrocarbons,which could impact the reliability of the data for determining thermal maturity.This study reveals that the Dingo Claystone Formation has total organic carbon(TOC)contents ranging from 0.66%to 8.31%.A poor to good hydrocarbon generation potential is indicated,with a production yield(PY=S_(1)+S_(2))ranging from 1.37 to 10.44 mg HC/g rock.Hydrogen index values vary between 42 and 226 mg HC/g TOC,confirming that the Dingo Claystone is dominantly kerogen TypeⅢ,with minor contributions from typesⅡ/ⅢandⅣ.Thermal maturity ranges from immature to late mature and is mostly in the oil window.This is indicated by T_(max)values of 398-462℃and vitrinite reflectance(Ro,%)of 0.47-1.99.Some samples show suppressed T_(max)and a higher production index,which is typical for samples affected by drilling fluids during drilling operations.Additionally,gas chromatography(GC)analyses are used to interpret the paleodepositional environment showing mixed input between marine and terrestrial origins of the source rocks.One-dimensional basin modeling for the Bambra-1 and Bambra-2 wells was carried out to evaluate the burial and thermal history of the formation.The transformation ratio suggests that hydrocarbon generation has not reached its peak and is still in an ongoing phase.An indication of hydrocarbon migration can be observed in this formation based on the transformation ratio.The effects of contamination warrant further investigation,as it could significantly impact maturity estimates and data reliability.
基金supported by the Natural Sciences and Engineering Research Council of Canada(NSERC)Discovery Grant[RGPIN 250139]to A.O.S.E.
文摘Arsenic,a naturally occurring toxic element,manifests in various chemical forms and is widespread in the environment.Exposure to arsenic is a well-established risk factor for an elevated incidence of various cancers and chronic diseases.The crux of arsenic-mediated toxicity lies in its ability to induce oxidative stress,characterized by an unsettling imbalance between oxidants and antioxidants,accompanied by the rampant generation of reactive oxygen species and free radicals.In response to this oxidative turmoil,cells deploy their defensemechanisms,prominently featuring the redox-sensitive transcription factor known as nuclear factor erythroid 2-related factor 2(NRF2).NRF2 stands as a primary guardian against the oxidative harm wrought by arsenic.When oxidative stress activates NRF2,it orchestrates a symphony of downstream antioxidant genes,leading to the activation of pivotal antioxidant enzymes like glutathione-S-transferase,heme oxygenase-1,and NAD(P)H:quinone oxidoreductase 1.This comprehensive review embarks on the intricate and diverse ways by which various arsenicals influence the NRF2 antioxidant pathway and its downstream targets,shedding light on their roles in defending against arsenic exposure toxic effects.It offers valuable insights into targeting NRF2 as a strategy for safeguarding against or treating the harmful and carcinogenic consequences of arsenic exposure.
文摘BACKGROUND The relationship between exercise and gastrointestinal(GI)health is complex and bidirectional.While moderate exercise generally promotes gut health by enhancing motility,reducing inflammation,and supporting microbial balance,intense or prolonged physical activity may exacerbate GI symptoms,particularly in individuals with preexisting digestive disorders.A deeper understanding of this interplay is essential for optimizing both exercise performance and GI well-being.AIM To synthesize current evidence on exercise-related GI disorders,exploring the prevalence,mechanisms,risk factors,and management strategies associated with exercise-induced GI symptoms.METHODS Following PRISMA guidelines,comprehensive searches of databases,including PubMed,Scopus,Web of Science,and EMBASE were conducted.Studies were included if they focused on exercise-induced GI disorders,encompassed randomized controlled trials,cohort studies,case-control studies,and cross-sectional designs,and addressed symptoms across various exercise modalities.Data were extracted and analyzed to identify patterns and implications for clinical and athletic practice.RESULTS A total of 231 studies met the inclusion criteria,highlighting both the benefits and risks of exercise on GI health.Regular moderate-intensity exercise,including activities such as walking,cycling,and yoga has been associated with improved GI function in conditions like gastroesophageal reflux disease,irritable bowel syndrome,inflammatory bowel disease,and constipation.These benefits are attributed to enhanced intestinal motility,reduced systemic inflammation,and improved gut barrier integrity.Additionally,exercise plays a role in regulating the gut-brain axis,with practices like yoga and Tai Chi demonstrating particular effectiveness in alleviating functional GI disorders.Conversely,high-intensity or prolonged exercise may contribute to symptoms such as nausea,diarrhea,and abdominal pain due to mechanisms like splanchnic hypoperfusion and increased intestinal permeability.Individual factors,including fitness level,dietary habits,hydration status,and underlying GI conditions,significantly influence the body’s response to exercise.CONCLUSION Moderate-intensity exercise is a beneficial and well-tolerated intervention for promoting GI health,whereas highintensity activities require careful monitoring,particularly in individuals with pre-existing GI disorders.Personalized exercise and dietary strategies are essential for balancing the benefits of physical activity with the risk of GI distress.Further research is needed to explore the long-term effects of exercise on gut microbiota composition and overall digestive health.
文摘Attention-deficit/hyperactivity disorder(ADHD)is one of the most common neurodevelopmental disorders of childhood,yet its diagnosis remains complex and fraught with challenges.Pediatricians,often the first point of contact for concerned families,play a pivotal role in the diagnostic process.However,they face numerous obstacles that can hinder accurate and timely diagnosis,particularly in resource-limited or culturally diverse settings such as the Middle East and North Africa(MENA)and Arabian Gulf regions.This narrative review explores the key challenges pediatricians face in diagnosing ADHD and highlights practical and emerging solutions.The article offers both a global perspective and a contextualized view relevant to the MENA region.A narrative literature review was conducted using PubMed,Scopus,and Google Scholar,focusing on peer-reviewed studies,clinical guidelines,and epidemiological data from 2010 to 2025 related to pediatric ADHD diagnosis,especially in MENA regions.The review identifies six major diagnostic barriers:(1)Symptom overlap with other conditions[e.g.,autism spectrum disorder(ASD),anxiety,learning disabilities];(2)Reliance on subjective informant reports;(3)Cultural and societal influences including stigma and gender bias;(4)Variability in ADHD training and time constraints in clinical practice;(5)Limited access to multidisciplinary evaluations;and(6)Systemic referral and communication inefficiencies.Comorbidities are highly prevalent and frequently complicate the diagnostic picture.Delayed or inaccurate diagnosis can lead to academic underperformance,family stress,missed interventions,and long-term psychological consequences.Emerging solutions include digital screening tools,artificial intelligence-assisted analysis,structured reporting platforms,and improved training and referral models.Regional data from the Arabian Gulf highlight variable prevalence rates(1.3%-22%)and underscore the need for culturally sensitive diagnostic strategies.To improve diagnostic accuracy and patient outcomes,pediatricians must be supported through better training,interdisciplinary collaboration,validated tools,and policy-level reforms.Tailoring these approaches to local contexts will be key to addressing the growing burden of ADHD,particularly in the MENA region.
基金funding provided by The Science,Technology&Innovation Funding Authority(STDF)in cooperation with The Egyptian Knowledge Bank(EKB).
文摘Ulcerative colitis(UC)is an inflammatory condition of the intestine,resulting from an increase in oxidative stress and pro-inflammatory mediators.In this study,the extract of endophytic bacterium Rhizobium aegyptiacum was prepared for the first time using liquid chromatography-mass spectrometry(LC-MS).In addition,also for the first time,the protective potential of R.aegyptiacum was revealed using an in vivo rat model of UC.The animals were grouped into four categories:normal control(groupⅠ),R.aegyptiacum(groupⅡ),acetic acid(AA)-induced UC(groupⅢ),and R.aegyptiacum-treated AA-induced UC(groupⅣ).In groupⅣ,R.aegyptiacum was administered at 0.2 mg/kg daily for one week before and two weeks after the induction of UC.After sacrificing the rats on the last day of the experiment,colon tissues were collected and subjected to histological,immunohistochemical,and biochemical investigations.There was a remarkable improvement in the histological findings of the colon tissues in groupⅣ,as revealed by hematoxylin and eosin(H&E)staining,Masson's trichrome staining,and periodic acid-Schiff(PAS)staining.Normal mucosal surfaces covered with a straight,intact,and thin brush border were revealed.Goblet cells appeared magenta in color,and there was a significant decrease in the distribution of collagen fibers in the mucosa and submucosal connective tissues.All these findings were comparable to the respective characteristics of the control group.Regarding cyclooxygenase-2(COX-2)immunostaining,a weak immune reaction was shown in most cells.Moreover,the colon tissues were examined using a scanning electron microscope,which confirmed the results of histological assessment.A regular polygonal unit pattern was seen with crypt orifices of different sizes and numerous goblet cells.Furthermore,the levels of catalase(CAT),myeloperoxidase(MPO),nitric oxide(NO),interleukin-6(IL-6),and interlukin-1β(IL-1β)were determined in the colonic tissues of the different groups using colorimetric assay and enzyme-linked immunosorbent assay(ELISA).In comparison with groupⅢ,groupⅣexhibited a significant rise(P<0.05)in the CAT level but a substantial decline(P<0.05)in the NO,MPO,and inflammatory cytokine(IL-6 and IL-1β)levels.Based on reverse transcription-quantitative polymerase chain reaction(RT-qPCR),the tumor necrosis factor-α(TNF-α)gene expression was upregulated in groupⅢ,which was significantly downregulated(P<0.05)by treatment with R.aegyptiacum in groupⅣ.On the contrary,the heme oxygenase-1(HO-1)gene was substantially upregulated in groupⅣ.Our findings imply that the oral consumption of R.aegyptiacum ameliorates AA-induced UC in rats by restoring and reestablishing the mucosal integrity,in addition to its anti-oxidant and anti-inflammatory effects.Accordingly,R.aegyptiacum is potentially effective and beneficial in human UC therapy,which needs to be further investigated in future work.
文摘Cow milk protein allergy(CMPA)is a prevalent food allergy in infancy.It often presents with symptoms that overlap with other conditions,such as gastroeso-phageal reflux disease,lactose intolerance,food protein-induced enterocolitis syndrome,and eosinophilic esophagitis.This diagnostic overlap makes distin-guishing CMPA from its mimics difficult,resulting in potential misdiagnoses and unnecessary dietary restrictions.This review aims to comprehensively analyze CMPA and its mimicking conditions,highlighting their clinical presentations,diagnostic approaches,and management strategies to enhance diagnostic accu-racy and optimize patient care.A systematic literature search was conducted using PubMed,Scopus,Web of Science,and Google Scholar,focusing on studies published within the last 20 years.Articles addressing CMPA and its mimicking conditions were selected,with data synthesized into comparative analyses of diagnostic methods and management strategies.Accurate differentiation between CMPA and its mimics requires a thorough clinical evaluation supported by diagnostic tests such as skin prick tests,serum-specific IgE,and oral food challenges.Misdiagnosis can lead to nutritional deficiencies,psychological stress,and increased healthcare costs.Emerging diagnostic technologies,including component-resolved diagnostics and cytokine profiling,offer promising avenues for improving accuracy.A multidisciplinary approach involving pediatricians,allergists,and dietitians is essential for precise diagnosis and effective management.Ongoing research and education are crucial to enhancing clinical outcomes and reducing the burden on families.
文摘BACKGROUND Functional neurological disorder(FND)in children is a complex and multifaceted condition characterized by neurological symptoms that cannot be explained by organic pathology.Despite its prevalence,FND in pediatric populations remains under-researched,with challenges in diagnosis and management AIM To synthesize the current literature on FND in children,focusing on clinical presentation,diagnostic approaches,treatment strategies,and outcomes.METHODS A comprehensive literature search was conducted across multiple databases,including PubMed,Scopus,and Web of Science,for articles published up to August 2024.Studies were included if they addressed FND in pediatric populations,specifically focusing on review articles,research articles,systematic reviews,meta-analyses,case reports,guidelines,expert opinions,and editorials.Data extraction and quality assessment were performed according to PRISMA guidelines.A total of 308 articles were included in the final analysis.RESULTS The analysis included 189 review articles,57 research articles,3 systematic reviews and meta-analyses,5 case reports,2 guidelines,5 expert opinions,and 2 editorials.Key findings revealed a broad spectrum of symptoms,including motor and sensory disturbances and psychological factors contributing to the onset and persistence of FND.Diagnostic challenges were frequently highlighted,emphasizing the need for interdisciplinary approaches.Treatment strategies varied,with cognitive-behavioral therapy(CBT)and multidisciplinary care emerging as the most effective approaches.The outcomes varied,with early intervention being critical for a better prognosis.CONCLUSION Early diagnosis and multidisciplinary care,including CBT,are critical for improving outcomes in pediatric FND.Standardized diagnostic criteria and treatment protocols are needed to enhance clinical management.
文摘BACKGROUND Malnutrition and epilepsy share a complex bidirectional relationship,with malnutrition serving as a potential risk factor for epilepsy development,while epilepsy,in turn,often exerts profound effects on nutritional status.Nutritional interventions have emerged as a critical adjunctive approach in epilepsy management.AIM To explore the multifaceted associations between malnutrition and epilepsy,structured into three primary sections:(1)Elucidating the impact of malnutrition as a risk factor for epilepsy onset;(2)Examining the reciprocal influence of epilepsy on nutritional status,and(3)Evaluating diverse nutritional interventions in the management of epilepsy.METHODS A systematic search was conducted across PubMed,Scopus,and Web of Science databases utilizing defined keywords related to malnutrition,epilepsy,and nutritional interventions.Inclusion criteria encompassed various study types,including clinical trials,animal models,cohort studies,case reports,meta-analyses,systematic reviews,guidelines,editorials,and review articles.Four hundred sixteen pertinent references were identified,with 198 review articles,153 research studies,21 case reports,24 meta-analyses,14 systematic reviews,4 guidelines,and 2 editorials meeting the predefined criteria.RESULTS The review revealed the intricate interplay between malnutrition and epilepsy,highlighting malnutrition as a potential risk factor in epilepsy development and elucidating how epilepsy often leads to nutritional deficiencies.Findings underscored the importance of nutritional interventions in managing epilepsy,showing their impact on seizure frequency,neuronal function,and overall brain health.CONCLUSION This systematic review emphasizes the bidirectional relationship between malnutrition and epilepsy while emphasizing the critical role of nutritional management in epilepsy treatment.The multifaceted insights underscore the need for a holistic approach to addressing nutritional aspects alongside conventional epilepsy management strategies.
