Fayoum University Research Articles

The assessment of pentraxin 3: a diagnostic and prognostic biomarker in lower respiratory tract infections in children

BackgroundPentraxin 3 (PTX3) is an acute-phase reactant that is elevated in the plasma during inflammatory responses. We aimed to evaluate the utility of PTX3 as a clinical marker in children with lower respiratory tract infections (LRTIs) and the association between PTX3 and LRTIs severity.MethodsWe included 60 patients admitted to Fayoum University Hospital with LRTIs fulfilling the WHO criteria for diagnosing LRTIs. We collected data on peak temperature, respiratory rate, heart rate, oxygen saturation upon admission, and length of hospital stay. The complete blood count (CBC), C-reactive protein (CRP) level, and PTX3 were measured upon admission.ResultsPTX3 levels were significantly correlated with peak temperature, duration of hospital stay, the Pediatric Respiratory Severity Score (PRESS), total leucocytic count (TLC), CRP, and blood cultures.ConclusionPTX-3 represented the severity of the disease and predicted the prognosis. Pentraxin levels demonstrate a statistically significant sensitivity of (93.3%) and a specificity of (70%) at the cut-off value (of 8.84) with an area under the curve (90.7%) in the diagnosis of LRTIs.

Psychological capital educational program and its effect on nurse interns’ innovative behavior

BackgroundNurse interns’ capacity for innovative behavior is a key component of healthcare settings because of increasing demands and complexities. Thus, it is important to find strategies that promote their innovative behavior. The development of psychological capital (PsyCap) improves positive behaviors and attitudes, such as engagement, motivation, and satisfaction, in the work environment. Therefore, this study aimed to assess the effect of a PsyCap educational program on nurse interns’ innovative behavior.MethodsA quasi-experimental design was used in this study. This study was executed at Fayoum University hospitals. The study participants comprised all the available nurse interns (n = 223) registered in the internship year (2022–2023) in the aforementioned settings. The data were gathered using three instruments, namely, the PsyCap Knowledge Questionnaire, the PsyCap Questionnaire, and the Innovative Behavior Inventory.ResultsThe nurse interns’ mean scores regarding total knowledge about PsyCap, total perception of PsyCap, and total perception of innovative behavior significantly improved through the posttest phase (41.27 ± 9.31, 92.22 ± 6.26, 91.31 ± 9.06, respectively) and the follow-up phase (37.83 ± 8.83, 89.96 ± 6.31, 88.89 ± 8.33) in comparison with the pretest phase (14.39 ± 5.83, 69.04 ± 8.13, 60.55 ± 7.15).ConclusionThe PsyCap educational program was effective and beneficial for improving the nurse interns’ perceptions of innovative behavior. Therefore, PsyCap interventions should be implemented in hospitals through professional development programs and orientation programs.

Analysis of clinical management and radiological affection of coronavirus disease 2019 patients under isolation: an experience from a University Hospital

Background During the coronavirus disease 2019 (COVID-19) pandemic, Egypt was among the minor epidemic areas. COVID-19 has wide variations in the clinical presentation manifesting as a heterogeneous disease severity varying from mild, moderate, and severe to critical illness. Objective This study aimed to identify the potential clinical, radiological, and laboratory characteristics and prognosis of the COVID-19 patients obtained during the first peak of this pandemic at a University Hospital in Egypt, and to provide a reference for the pandemic management in the subsequent peaks. Patients and methods A single-center prospective study was done on patients with COVID-19 admitted to Fayoum University Hospital during the period from May to July 2020. All patients had full medical history taking, clinical examination, laboratory assessment, oxygen-saturation monitoring, chest computed tomography (CT), and reverse transcriptase-PCR testing. All the patients were treated with the treatment protocol accredited by the Egyptian Ministry of Health and accordingly disease outcome was determined. Results The study included 162 COVID-19 patients, 80 (49.4%) had mild cases, 40 (24.7%) had moderate cases, and 26 (16.0%) and 16 (9.9%) had severe and critical cases, respectively. The median CT-severity score was 10 (3.75–11.25). Significantly high serum levels of C-reactive protein, D-dimer, lactate dehydrogenase, and ferritin levels were observed in severe cases (P<0.01 for all) in comparison with mild/moderate cases. By comparing died cases with other severe cases, the proportion of cases with CURB 65 score (comorbidity, confusion, urea, respiratory rate, blood pressure, and 65 years of age or older score) more than or equal to 4, PaO2/FiO2 less than 300, hypoxemia less than 85%, higher levels of ferritin, D-dimer, alanine aminotransferase, aspartate aminotransferase, CT severity, and consolidation score were significantly higher in died cases than other severe cases. By regression analysis, among severe cases, predictors of death were the presence of comorbidity and increased consolidation size. Conclusion All healthcare workers should understand the presentation of the disease, workup, and supportive care experienced from the first outbreak and offer an evidence-based management for succeeding outbreaks in our community.

Maternal and Neonatal Outcome of Teenage Pregnancy at El- Fayoum University Hospital

Maternal and Neonatal Outcome of Teenage Pregnancy at El- Fayoum University Hospital

Impact of COVID 19 on neurological manifestations in Fayoum University Hospitals: Systemic Review

Impact of COVID 19 on neurological manifestations in Fayoum University Hospitals: Systemic Review

Impact of covid 19 on neurological manifestations in Fayoum University Hospitals.

Impact of covid 19 on neurological manifestations in Fayoum University Hospitals.

The clinical significance of long non-coding RNAs MALAT1 and CASC2 in the diagnosis of HCV-related hepatocellular carcinoma.

Globally, hepatocellular carcinoma (HCC) is the second most common cause of cancer-related death due to a lack of early predictive and/or diagnostic tools. Thus, research for a new biomarker is important. LncRNAs play a functional role in target gene regulation and their deregulation is associated with several pathological conditions including HCC. This study aimed to explore the diagnostic potential of two LncRNAs MALAT1 and CASC2 in HCC compared to the routinely used diagnostic biomarker. The current study is a case-control study carried out at Fayoum University Hospital and conducted on 89 individuals. The study included three groups of 36 HCC patients on top of HCV(HCC/HCV), 33 HCV patients, and 20 healthy volunteers as a control group. All study subjects were subjected to radiological examinations. The determination of CBC was performed by the automated counter and liver function tests by the enzymatic method were performed. In addition, HCV RNA quantification and the expression level of two LncRNAs (MALAT1 and CASC2) were performed by qRT-PCR. The results revealed a statistically significant difference between study groups regarding liver function tests with a higher mean in HCC/HCV group. Also, serum MALAT1 significantly up-regulated in HCV (11.2±2.8) and HCC/HCV (4.56±1.4) compared to the control group. Besides, serum CASC2 levels in the HCV group were significantly upregulated (14.9±3.6), while, downregulated in the HCC group (0.16± 0.03). Furthermore, The ROC analysis for diagnostic efficacy parameters indicated that CASC2 has higher accuracy (94.6%) and sensitivity (97.2%) for HCC diagnosis than AFP with an accuracy of (90.9%), sensitivity (69.4%), and MALAT1 showed an accuracy of (56.9%), sensitivity (72.2%). Our study results indicated that CASC2 is a promising biomarker and is considered better and could help in HCC diagnosis on top of HCV than MALAT1 and the routine biomarker AFP.

The pattern of neurological disorders requiring hospitalization during the COVID-19 era: an experience from Fayoum University Hospital, Egypt

BackgroundCoronavirus was primarily discovered in December 2019, causing pneumonia and severe acute respiratory syndrome. It was reported several neurological symptoms associated with COVID-19. Both the central and peripheral nervous systems could be affected which might result in a higher mortality rate in hospitalized patients. This study aimed to determine the spectrum of neurological clinical presentations among patients admitted to Fayoum University Hospital before, during, and after the COVID-19 era and to examine the influence of COVID-19 vaccines mandated by the Egyptian government on neurological disorders.MethodsThis is a historical cohort study that was conducted on patients admitted to the Neurology Department at Fayoum University Hospital before, during, and after COVID-19 outbreaks from January 1st, 2018, to July 31, 2022. All participants had undergone thorough history taking and neurological examination and the necessary investigations according to the suspected diagnosis. All hospitalized patients during the COVID-19 pandemic were positive for the virus, as determined by either a positive rapid antigen test or a positive real-time reverse transcription polymerase chain reaction (RT-PCR).ResultsIt was shown that the patients hospitalized during the COVID-19 era were notably older, smokers, and diabetic in comparison to other groups. Cerebrovascular disorders were more prevalent in the COVID-19 pandemic. Surprisingly, compared to prior times, individuals with autoimmune-mediated neurological diseases had higher hospitalization rates than those with other neurological disorders. Patients who were not vaccinated reported more vascular complications than those who got them. However, patients who received vaccination exhibited significantly higher neurological complications as regards, exacerbation of paroxysmal disorders.ConclusionIt was concluded that the frequency of hospitalizations with cerebrovascular disorders and autoimmune-mediated illnesses was significantly influenced during the pandemic era. Although COVID-19 vaccinations have potential adverse effects, they have played a crucial role in preventing serious neurological problems.

Factors associated with peripartum blood loss among women with placenta previa/accreta in Fayoum university hospital

Factors associated with peripartum blood loss among women with placenta previa/accreta in Fayoum university hospital

Risk Scoring System with MRI for Intraoperative Massive Hemorrhage in Placenta Previa and Accreta in Fayoum university hospital

Risk Scoring System with MRI for Intraoperative Massive Hemorrhage in Placenta Previa and Accreta in Fayoum university hospital

Biochar Amendment Alleviates the Combined Effects of Salinity and Drought Stress on Water Productivity, Yield and Quality Traits of Sugar Beet (Beta vulgaris L.)

Salinity and drought are two commonly occurring major threats to agricultural yields worldwide, including sugar beet production. Therefore, this work aimed to determine the effectiveness of biochar amendment in improving soil health and alleviating the combined effects induced by salinity and drought on morphological, physiological and biochemical responses of sugar beet plants. Two field studies were established at the experimental farm of Fayoum University, Egypt over two successive winter seasons (2019/2020 and 2020/2021). The experiments were carried out in a split-split plot design with triplicate including three factors: 1) soil salinity, with two levels of ECe (< 4 dS m−1 as control and 10 dS m−1) as main-plot factor; 2) deficit irrigation regimes (I100, I80, and I60) representing 100%, 80%, and 60% of crop evapotranspiration (ETc), respectively as sub-plot factor; and 3) biochar amendment with three application levels (B0 as control, B10, and B20) corresponding to 0, 10, and 20 t ha−1, respectively as sub-sub plot factor. Drought and salinity stress induced significant reduction in growth attributes, relative water content, membrane stability, relative chlorophyll content (SPAD), yield and yield components of sugar beet plants. Meanwhile, the contents of sucrose, proline, Na, K, α amino-N were substantially increased with increasing stress severity. The application of biochar amendment improved the soil physical and chemical properties, resulting in better morphological, physiological and biochemical responses of saline-drought stressed sugar beet plants. Biochar at level (B20) produced the highest values of root yield (95.02 t ha−1) and sugar yield (20.24 t ha−1) for full irrigated sugar beet plants in non-saline soil. Moreover, the application of biochar enhanced water productivity for drought and saline stressed sugar beet plants. Biochar amendment could be effectively used as a helpful agro-management strategy in alleviating the detrimental impacts of salinity and water stress on sugar beet plants, improving soil quality and enhancing water productivity to ensure water sustainability and food security, especially in areas of limited water supply.

Outcome Predictors for ICU Admitted Critically Ill Covid-19 Patients in Fayoum University Hospitals

Outcome Predictors for ICU Admitted Critically Ill Covid-19 Patients in Fayoum University Hospitals

Epicardial fat thickness among neonates of diabetic mothers attending the neonatal intensive care unit at Fayoum University Hospital: a case control study

BackgroundUsing conventional echocardiography, this study aimed to evaluate the epicardial fat thickness (EFT) and its role in discriminating infants of diabetic mothers (IDMs) from those of non-diabetic mothers (INDMs) and to assess its prognostic role in IDMs. This case control study was conducted at the Neonatology and Cardiology Units of Pediatric Department, Fayoum University Hospital, Egypt, between February and September 2023. A total of 54 neonates were enrolled into three groups: 18 IDMs with well-controlled diabetes mellitus (DM), 18 IDMs with poorly controlled DM, and 18 INDMs.ResultsThe sensitivity, specificity, and cutoff of EFT were 100%, 100%, and 3.950 mm for detecting cases of IDMs and were 66.7%, 72.2%, and 5.100 mm for differentiating controlled from uncontrolled diabetic mothers, respectively. The interventricular septum in diastole (IVSd), interventricular septum in systole (IVSs), estimated pulmonary artery pressure (PAP), left ventricle (LV) Tei index, and isovolumetric relaxation time (IVRT) of LV all showed a positive correlation with EFT (r = 0.35, 0.31, 0.41, 0.34, and 0.39; P = 0.009, 0.025, 0.002, 0.01, and 0.003; respectively). There was a significant negative correlation between EFT and left ventricular internal dimensions in diastole (LVIDd) and left ventricular internal dimensions in systole (LVIDs) (r = − 0.44 and 0.42, P = 0.001 and 0.001). Regarding tissue Doppler, there was a significantly higher Tei index in group I cases compared to control (0.59 ± 0.10 vs. 0.49 ± 0.09, P < 0.001).ConclusionsThe EFT is higher in IDMs than in INDMs, with a positive correlation with birth weight, IVSd, IVSs, Tei index of mitral, IVRT, and ESPAP and a negative correlation with LVIDd and LVIDs. Neonatal EFT can be used as one of the helpful parameters to detect IDMs. Also, it may be used as one of the prognostic factors in IDMs as it is positively correlated with the diastolic function of the LV.

Adaptability of bipedicled scalp advancement flap for coverage of huge scalp defects after tumor resection

BackgroundSeveral reconstructive techniques have been used to reconstruct scalp defects. Numerous researchers have studied the utilization of bipedicled scalp advancement flaps for scalp defect coverage. In this study, we will assess the adaptability of a bipedicled scalp advancement flap for coverage of huge scalp defects after tumor resection. MethodsThis study was performed at the Plastic Surgery Department, Fayoum University Hospital, on 20 patients with huge scalp tumors treated by adequate excision and reconstructed using a bipedicled scalp advancement flap from December 2021 to July 2023. ResultsThe study was conducted on 20 patients: 16 (80%) were men and 4 (20%) were women presenting with large scalp tumors. The mean age was 57.4 years (33–68 years). The sites of the tumors were 10 (50%) occipital, 6 (30%) parietal, and 4 (20%) parieto-occipital. No major complications occurred postoperatively, and the bipedicled flaps survived well in all cases, with no necrosis. ConclusionHuge scalp defects after tumor resection can be safely reconstructed with a large versatile bipedicled advancement scalp flap, either transversely or longitudinally oriented, with favorable functional results and accepted aesthetic results, apart from the alopecic area over the grafted donor site, which can be treated by tissue expansion if desired later.

The impact of the use of digital technology on the job performance of employees in public universities (An applied study at Fayoum University)

The impact of the use of digital technology on the job performance of employees in public universities (An applied study at Fayoum University)

New challenge in double-bore medical thoracoscopy in Fayoum University Hospital

Abstract Background Thoracoscopy is an invasive technique. When other, less intrusive techniques are ineffective at providing a diagnosis in the case of pleural exudates, thoracoscopy should be employed. The diagnostic and therapeutic thoracoscopy methods used by the pulmonologist are divided into two techniques. In the first technique, a single entry site of a thoracoscope together with a working channel for supplementary tools and optical forceps for biopsy is often created. The alternative method employs two entrance points: one is for the examination telescope and the other is for accessory instruments, including the biopsy forceps. Aim The aim of this study is to assess the effect of the use of optical rigid bronchoscopy forceps using one entry site instead of two entry sites in double bore medical thoracoscopy. Results Thirty patients with undiagnosed pleural effusion underwent medical thoracoscopy by single entry site (procedure A) using optical rigid bronchoscopy forceps and another 30 patients undergone medical thoracoscopy with two entry sites (procedure B). all patients were subjected to history, examination, computed tomography (CT) of chest, ultrasound examination, laboratory tests. The two groups were matched regarding age, sex, smoking, and co morbidities. There were matched regarding radiology, thoracoscopic picture, and pathological diagnosis with same outcomes. The procedure A was short in duration with less postprocedure complications compared with procedure B. Conclusion The use of optical rigid bronchoscopy forceps in medical thoracoscopy as a single entry site is valuable in decreasing procedure duration and postprocedure complications in comparison with two entry sites in medical thoracoscopy.

Clinical impact and efficacy of bedside echocardiography on patient management in pediatric intensive care unit: A single center study

BackgroundCritically ill pediatric patients often have multi-system involvement that can overlap different clinical diagnoses, making proper assessment and management challenging. Using echocardiography is increasing as a bedside and noninvasive tool for accurate hemodynamic assessment and guiding treatment. ObjectivesThis study aimed to determine the indication and value of bedside echocardiography in patient management in the pediatric intensive care unit (PICU) at Fayoum University Hospital and the relationship to the Pediatric Risk of Mortality Score III (PRISM). MethodsA total of 200 critically ill pediatric patients admitted to the PICUs of Fayoum University Hospital between January 2020 and January 2021 were prospectively evaluated. Detailed clinical examinations and requested echocardiography were conducted by intensivists and cardiologists. Results200 critically ill pediatric patients had an age range of 0.2–12 years, with 134 patients (67 %) under two years old. The most common admission diagnosis was pulmonary disease in 51 patients (26 %), followed by cardiac disease in 44 (22 %). The most common indication for echocardiography was left ventricle function assessment in 68 patients (34 %). Among the 108 patients (54 %) who underwent echocardiographic assessment, no difference in the management was found, while in the remaining 92 patients (46 %), supplemental information or decision help in management was obtained. There was a positive correlation between the effective value of echocardiography in the management of patients with primary cardiac disease (p-value = 0.001), shock (p-value = 0.001), and hypoxia (p-value = 0.009). Additionally, there was no correlation between the PRISM score and the effectiveness of echocardiographic assessment. ConclusionThe most common clinical indication for bedside echocardiography is assessing cardiac function. Echocardiography is an effective tool in PICU patient management, particularly in cases with primary cardiac disease, hypoxia, and shock, but its effectiveness does not increase according to the severity of the disease.

The effect of iron deficiency anemia on myocardial function in pediatrics

BackgroundIron deficiency is one of the most common types of anemia in children. Anemia leads to tissue hypoxia, which activates compensatory mechanisms such as increased cardiac output. Tissue Doppler imaging (TDI) is a useful echocardiographic technique for evaluation of regional and global myocardial systolic and diastolic function. ObjectivesThis study aimed to determine whether iron deficiency anemia (IDA) affects myocardial function in pediatric patients using conventional echocardiography and TDI. MethodsThis case-control study was conducted at an outpatient general pediatric clinic in cooperation with the Cardiology Unit of the Pediatric Department of Fayoum University Hospital from May 2021 to February 2022. The study included 30 cases with IDA and 30 apparently healthy children. The two study groups were matched for age and sex. ResultsThere was an increase in left ventricular end-diastolic diameter (LVEDD), while the control group showed increased ejection time (ET). There was a statistically significant lower mean E/A ratio among cases. There was a positive correlation between serum iron levels, ET, and isovolumetric contraction time (IVCT) among the cases. Additionally, there was a negative correlation between hemoglobin levels and LVEDD in the entire study group. No significant difference was found between the two study groups regarding the Tei index. ConclusionMinimal alterations in LV function parameters may occur due to IDA. A decrease in serum iron levels was significantly associated with further decreases in ET and IVCT. Additionally, there was a statistically significant lower mean E/A ratio among cases.

Role of Uterocervical Angle, Cervical Length, and Cervicovaginal Fetal Fibronectin in the Prediction of Preterm Birth

BACKGROUND:Cervical length measurement and fetal fibronectin (FFN) are widely used to estimate the risk of preterm birth. Another potential predictor of preterm birth is the uterocervical angle, and this additional measurement may improve the risk assessment. This study aimed to predict the onset of labor in women who present with preterm labor through cervical length, uterocervical angle, and FFN.METHODS:A prospective cohort study was carried out on 90 symptomatic women at high risk of preterm labor attending the Gynecology and Obstetrics department at Fayoum University Hospital. FFN in the cervicovaginal fluid was assessed by ELISA technique. The uterocervical angle and cervical length were measured by transvaginal ultrasound. Maternal history and pregnancy data were recorded. Delivery data were subsequently collected.RESULTS:The average age was 21.79 ± 3.3 years, and the average body mass index (BMI) was 24.6 ± 5.8 kg/m2. The mean gestational age (GA) was 32.83 ± 2.3 weeks. Twelve women in our cohort reported previous preterm labor. The cervical length and FFN showed better sensitivity and specificity compared with the uterocervical angle in predicting preterm birth. Logistic regression analysis demonstrated that preterm birth depended only on the cervical length and quantitative FFN.CONCLUSION:The combination of FFN and cervical length could improve preterm birth prediction accuracy.

Possibility and predictors of surgical salvage of infected mature arteriovenous fistula for hemodialysis

Background Infection in arteriovenous fistula (AVF) is a common complication in patients with end-stage renal disease (ESRD) requiring dialysis. The standard management includes ligation of the AVF to prevent the progression of septicemia. Till now, there is limited evidence on the effectiveness and possibility of salvage of infected AVFs. Aim To evaluate the effectiveness and safety of salvage of infected mature autogenous AVF. Methods This prospective study was conducted at the Fayoum University Hospital from September 2015 to April 2023. We included patients with dysfunctional and functioning infected AVF. Patients with infected synthetic grafts and immature infected AVFs were excluded. We aimed to excise the infected part of the vein wall and surrounding tissues to restore fistula patent and functioning after direct vein repair. We followed-up with all patients for 1 year and examined the repaired AVFs for patency and the possibility of re-infection. Tissue cultures were obtained to identify the commonest responsible organism and the recommended antibiotics. Results A total of 46 patients with infected AVFs were included. At the end of the follow-up period, 11 patients were ligated, and 35 underwent AVF salvage procedures. 19 cases experienced some complications: 5 cases had hematoma required surgical intervention, 2 cases had hematoma managed conservatively, 2 patients had wound dehiscence, 3 patients required hybrid angioplasty for acute failed AVF, and 7 cases required angioplasty for failing AVF. Conclusion When performed correctly and with expert hands, salvage of infected mature AVFs seems possible with excellent efficacy and high patency for up to 1 year.