Menoufia University Hospital Research Articles

The outcomes of neurosurgical procedures/operations among COVID-19 patients: a retrospective case–control study

BackgroundCOVID-19 pandemic has a considerable adverse effect on surgical outcomes and poses various hazards to patients who are undergoing surgeries. We aimed to study the mortality and morbidity rates in Egyptian patients with COVID-19 who underwent urgent neurosurgical procedures and assess factors that determine the outcomes of surgeries in those patients.MethodologyA retrospective cohort study included patients subjected to urgent neurosurgical procedures from Menoufia University hospital. A total of 228 COVID-19 cases (with mild and moderate to severe infection) were identified and compared, and 130 non-COVID-19 controls matched by sex, age, and surgical maneuver were selected. The risk of postsurgical complications, morbidity and mortality rates, were assessed using multivariable conditional logistic regression to calculate the odds ratios (ORs) with 95% confidence intervals (CIs).ResultsThe high risk of postsurgical complications and mortality was associated with cranial surgery (OR 6.56, 3.62,95%; CI 1.28–21.14, 1.07–18.36), diabetes mellitus (OR 1.85, 1.85, 95%; CI 0.91–11.20, 0.91–11.20), hypertension (OR 7.45, 1.32, 95%; CI 1.21–7.97, 0.36–6.33), Severity of COVID-19 (OR 9.1, 5.8, 95%; CI 1.92–12.12, 1.32–9.07) and immunosuppression (OR 8.31, 6.11, 95%; CI2.5–25.6, 2.1–12.6). Prolonged hospitalization and advanced age were the two risk factors that enhanced mortality and morbidity among those patients.ConclusionsThe mortality and morbidity rates among COVID-19 infected patients undergoing urgent neurosurgical procedures was considerably greater in severe COVID-19 cases than in mildly infected or uninfected individuals. Cranial surgeries, advanced age, prolonged hospitalization, and comorbidities were the risk factors that enhanced mortality and morbidity among those patients.

Evaluation of the tear film and meibomian glands before and after cataract surgery by the ocular surface analyzer.

The aim of this study was to assess the tear film and meibomian gland function before and after cataract surgery using the Lacrydiag ocular surface analyzer. This was an observational prospective study including 34 eyes that underwent phacoemulsification at the Ophthalmology Department of Menoufia University Hospital from October 2023 to January 2024. The patients were evaluated pre-operatively as well as 1week, 1month, and 3months postoperatively. Dry eye symptoms were assessed using the Ocular Surface Disease Index (OSDI) questionnaire. Traditional tear break up time (TBUT) was performed as well as Schirmer I test. The Lacrydiag Ocular Surface Analyzer was used for assessment of the tear film and meibomian glands. Ocular surface analyzer evaluations revealed statistically significant changes at 1week, 1month, and 3months after surgery in comparison to the values before surgery. Significant reductions were observed in non-invasive tear break-up time (NITBUT) and tear meniscus height, as well as in Schirmer's test without anesthesia, and fluorescein break-up time at each postoperative interval. Some improvements were observed at 1month and 3months, however, measurements did not return to the initial preoperative levels. Ocular Surface Disease Index (OSDI) scores significantly increased after 1week, 1month, and 3months post-surgery compared to preoperative levels. The proportion of meibomian gland area loss did not significantly increase after surgery (no structural alterations were noted). The study shows that phacoemulsification impacts both tear quantity and quality, affecting overall tear film stability and ocular surface health.

BASNEF behavioral transformation: effect of empowerment program on children’s knowledge, attitude, self-efficacy, and practice of nail biting

BackgroundNail-biting or onychophagia is a common phenomenon affecting children. Excessive nail biting is associated with several adverse consequences beyond mere appearance. The aim of this study is to evaluate the effect of an empowerment program based on the BASNEF model on children’s knowledge, attitude, self-efficacy, and nail-biting practice.MethodA quasi-experimental study was conducted in the pediatric wards of Menoufia University Hospital and Benha University Hospital. A convenience sample of 135 children (6 to 18 years) was randomly assigned to the study or control group who received routine care. To effectively measure the dependent variables, four questionnaires were developed and tested for content validity, stability reliability and internal consistency. Exploratory Factor Analysis (EFA) identified the underlying factors while the findings of the Confirmatory Factor Analysis (CFA) demonstrated a satisfactory fit. The researcher developed the session objectives, learning activities and designed a booklet with relevant content. The participants of the study group were divided into sub-groups (six children and their mothers) who attended four empowerment sessions based on the BASNEF model, emphasizing (a) age-appropriate information, (b) fostering a positive attitude towards quitting nail-biting, (c) discovering the subjective norms, perceived social expectations, and influences of nail-biting behaviors, and (d) equipping children with enabling factors to quit. The comparison between the two groups was done using the Mann-Whitney (U) test, while the Wilcoxon Signed Rank test conducted for the intragroup comparison.ResultsThere was a significant improvement in knowledge about nail-biting among children in both groups and a noticeable decline in the nail-biting habits/practices among children in the study group (22.42 ± 5.69) compared to the control group (42.76 ± 6.75). The attitude scores towards nail-biting significantly improved among children in the study group compared to the control group with appositive impact on children’s self-efficacy in controlling the habit (P < 0.001 for each).ConclusionThe empowerment program based on the BASNEF model effectively improved children’s knowledge, attitude, self-efficacy, and practice of nail biting.Trial registration numberTrial registration number: NCT06471153, ClinicalTrails.gov, Retrospectively registered June 18th, 2024), URL of trial registry record: https://clinicaltrials.gov/ct2/show/NCT06471153.

Mitomycin C augmented canalicular silicone intubation versus external dacryocystorhinostomy in primary acquired nasolacrimal duct obstruction: a retrospective study.

Given the improvement in the instruments and techniques, novel surgical interventions emerged to avoid osteotomy from the gold standard dacryocystorhinostomy (DCR) for treating primary acquired nasolacrimal duct obstruction (NLDO). This study compares external dacryocystorhinostomy versus canalicular silicone intubation using Mitomycin C (MMC) in primary acquired nasolacrimal duct obstruction (NLDO). 60 cases were diagnosed with primary acquired NLDO enrolled in a retrospective study at the Department of Ophthalmology, Menoufia University Hospital, Egypt, from June 2021 to July 2023. Data were collected from patient files, the study was conducted, statistics were conducted and the research was written during the period from May 2024 to August 2024. Patients were randomly allocated into two groups: thirty cases underwent external DCR (Group Ex-DCR), and twenty-six underwent silicone intubation with MMC (Group SIMMC). This study was registered in the clinical trials with Gov ID: NCT037808. At six months, external DCR and SI with MMC had success rates of 90% and 80.7%, respectively, with no statistically significant difference between both groups. Silicon intubation with MMC is comparable to external DCR in terms of safety and efficacy, with the advantage of being a less invasive procedure, more accessible with a shorter learning curve, and shorter operative time in primary acquired NLDO.

Visfatin (rs3801266) and Adiponutrin (rs738409) gene single nucleotide polymorphisms in patients with Hashimoto's thyroiditis.

Hashimoto's thyroiditis (HT) is the most common cause of hypothyroidism and is also associated with an increased risk of thyroid malignancy. Identifying the exact initiators of the disease could aid in its accurate prevention and treatment. This study aims to clarify the role of Visfatin and Adiponutrin genes in the development of HT. This case‒control study was carried out on patients from the Internal Medicine, Endocrinology Department, Menoufia University Hospital. Samples are collected from ninety-six patients with HT and ninety-six controls. The findings of this study indicate that the patient group has a significantly higher Body Mass Index (BMI), lipid dysregulation, and thyroid dysfunction compared to the control group. Additionally, the results suggest that the rs3801266 variant of Visfatin and the rs738409 variant of Adiponutrin are associated with the patient group. Specifically, the CC genotype (16.7% vs. 4.2%) and C allele (40.6% vs. 26.0%) of rs3801266, as well as the GG genotype (11.5% vs. 2.1%) and G allele (35.9% vs. 23.4%) of rs738409, are significantly more frequent in patients, indicating a potential genetic predisposition. Anti-Thyroglobulin (Anti-TG) and Anti-Thyroperoxidase (anti-TPO) levels varied significantly across genotypes. CC and TC carriers of rs3801266 had significantly higher anti-TG levels, while GG carriers of rs738409 showed a marked increase in both anti-TPO and anti-TG levels compared to other genotypes. The involvement of both the Adiponutrin and Visfatin genes is believed to contribute to the pathogenesis of HT, either directly or as a consequence of obesity.

Effect of educational program on nurses’ performance regarding application of liberation bundle in pediatric intensive care unit

BackgroundRecent guidelines in paediatric critical care emphasize the implementation of the evidence-based liberation bundle to improve patient outcomes in paediatric intensive care units (PICUs). However, there is limited information on the application of this bundle in Egyptian hospitals, and the effectiveness of educational programs on nurse performance in this context remains unclear.AimThis study aimed to evaluate the effect of an educational program on nurses’ performance regarding the application of the liberation bundle in paediatric intensive care unit.MethodsA one-group pre/post quasi-experimental design was employed. The study was conducted in the PICUs of Al-Azhar University Hospital and Menoufia University Hospital, involving a convenient sample of 52 paediatric nurses. Data were collected using two tools: a predesigned questionnaire to assess knowledge about the liberation bundle and an observational checklist to evaluate nurse practices before and after the educational program.ResultsThe results demonstrated significant improvements in nurses’ knowledge and practices post-intervention. The studied nurses’ total level of knowledge regarding the liberation bundle increased from 13.7 to 92.3% post-educational program X2 (P. value) = 89.143(0.000). The studied nurses’ total level of practices regarding the liberation bundle increased from 9.6 to 80.8% post-educational program X2 (P. value) = 89.143(0.000).ConclusionThe educational program significantly enhanced the nurses’ knowledge and practices in applying the liberation bundle in PICUs. This improvement in knowledge and practices is expected to lead to better outcomes for paediatric patients, including reduced mortality, shorter PICU stays, and fewer post-intensive care complications. By equipping nurses with the skills to implement the bundle, the program can improve recovery and long-term health outcomes in critically ill children.

The prevalence of methicillin-resistant Staphylococcus aureus by detecting the mecA gene among healthcare workers at Menoufia University Hospitals

The prevalence of methicillin-resistant Staphylococcus aureus by detecting the mecA gene among healthcare workers at Menoufia University Hospitals

Clinical evaluation of 3D PEEK implants for skull bone defects repair: a single center case serious

BackgroundCustom-designed 3D-printed polyetheretherketone (PEEK) implants have emerged as a promising option for skull bone defect repair. This study aimed to evaluate the clinical outcomes, feasibility, and safety of using 3D-printed PEEK implants in patients with skull defects.MethodsA retrospective case series was conducted at Menoufia University Hospital, reviewing the medical records of patients who underwent cranioplasty between January 2022 and December 2023. Patients aged 18–65 years with skull bone defects due to trauma, surgical resection, or congenital anomalies were included. All patients underwent preoperative CT scans for custom implant design using computer-aided design (CAD) software. The 3D-printed PEEK implants were fabricated and implanted during surgery. Primary outcome measures included successful implant integration and structural stability, while secondary outcomes assessed complications and patient satisfaction.ResultsThirteen patients (76.9% male, mean age 45.8 years) were included. The majority of defects were caused by trauma (76.9%). The mean time to cranioplasty was 6 ± 2 months, and the average operative time was 143 ± 34 min. Mean blood loss was 265 ± 97 cc, and the average hospital stay was 2.85 ± 0.9 days. Complications included dural tears in 38.5% of cases, while no immediate postoperative complications were reported. Late complications included one case of convulsions (7.7%) and one superficial infection (7.7%). Radiographic follow-up confirmed successful implant integration in all patients.Conclusion3D-printed PEEK implants provide a feasible and effective solution for skull bone defect repair, with favorable outcomes and manageable complication rates. These custom implants offer a personalized approach to cranioplasty, but larger studies with longer follow-up are needed to validate these findings.

Immunohistochemical expression of parathyroid hormone-related protein and ezrin in invasive breast carcinoma of no special type: a retrospective analysis

BackgroundGlobally, breast cancer ranks among the most common malignancies and has a high mortality rate. Invasive breast carcinoma of no special type (IBC-NST) presents a heterogeneous group with variable prognosis. Identifying reliable biomarkers is crucial for improving treatment strategies and predicting outcomes. This study investigates the immunohistochemical expression of parathyroid hormone-related protein (PTHrP) and ezrin in IBC-NST and their correlation with clinicopathological features and overall survival.MethodsThis retrospective study analyzed 160 paraffin-embedded tissue samples, including 123 IBC-NST and 37 normal breast tissues, collected from patients treated at Menoufia University Hospital during the period from January 2018 to January 2022. Immunohistochemical staining for PTHrP and ezrin was performed, and expression levels were quantified using the H score.ResultsPTHrP expression was significantly higher in IBC-NST than in adjacent DCIS and normal tissues (p < 0.001). High PTHrP percent of expression was associated with metastasis (p = 0.009), bone metastasis (p = 0.012), and lymphovascular invasion (p = 0.037). Ezrin expression was also significantly elevated in IBC-NST, with higher H score values correlating with high tumor grade (p = 0.002), high N stage (p = 0.045), advanced AJCC stage grouping (p = 0.0043) and metastasis (p = 0.001). A significant positive correlation was observed between PTHrP and ezrin expression (rs = 0.341, p < 0.001). Kaplan-Meier analysis showed that high ezrin expression, in terms of intensity (p = 0.007) and H score (p = 0.002), was linked to poorer survival.ConclusionThe study highlights the significant roles of PTHrP and ezrin in breast cancer progression. Elevated levels of these proteins are associated with more aggressive disease, suggesting their capability as prognostic indicators and treatment targets in breast cancer. Additional studies are required to investigate their interaction and collective influence on breast cancer metastasis and treatment.

Effect of negotiation skills training program on head nurses' knowledge and behavior.

Negotiating is a common occurrence and a significant part of everyday tasks for head nurses. The ability of the head nurse to effectively negotiate is a crucial management tool for work management in healthcare facilities. The present study aimed to assess the effect of negotiation skills training program on head nurses' knowledge and behavior. A pretest-posttest, one-group quasi-experimental design was conducted at Menoufia University Hospitals. It is located in Shebeen, Elkom City, Cairo, Egypt. All head nurses and their assistants and their number 64head nurses. The results indicated that a minority of head nurses had satisfactory knowledge regarding negotiation in the pretest phase and obviously increased in the posttest to be more than three quarters and slightly decreased in the follow-up phase. Also, a minority had a high negotiation behavior level in the pretest phase and increased to be more than half in the posttest with a slight decrease in the follow-up stage. There was a highly statistically significant difference between pre-, post-, and follow-up results regarding negotiation knowledge and behavior. The study revealed that the head nurse's knowledge and behavior increased markedly after implementing the negotiation skills training program. Conduct continuous education and training programs for stimulating and developing head nurses' knowledge, behavior regarding negotiation, and hospital administration should support the importance of negotiation skills to both head nurses and organizations. TRIAL REGISTRATION NUMBER [TRN]: The study protocol was approved by the Research Ethics Committee of the Faculty of Nursing, Ain Shams University (code number: NUR 23.10.131).

Clinical Pregnancy and Miscarriage Rates in relation to Vitamin D Supplementation among women with Hyper Androgenic PCOS: A prospective study.

Pregnant mothers frequently have vitamin D deficiency, which has potential consequences for the health of their unborn children. Prenatal vitamin D administration raises maternal and foetal 25(OH)D levels. This study aims to assess the effects of 25(OH)D supplementation on clinical pregnancy and miscarriage rates in women diagnosed with hyperandrogenic polycystic ovarian syndrome (PCOS). This prospective study was conducted on 200 patients with hyperandrogenic PCOS who attended an outpatient infertility clinic at Menoufia University Hospital from March 2021 until March 2022. Participants were divided into two groups-(A) women who received a therapeutic dose of 25(OH)D supplements (n=100) and (B) women who did not receive 25(OH)D supplements (n=100). The duration needed to reach follicles that were ≥18 mm was significantly higher in group B (16.74 ± 2.57) compared with group A (13.40 ± 2.12). Midluteal progesterone was significantly higher in group A (19.63 ± 2.12) compared with group B (17.74 ± 2.36, P<0.001). Our results indicate that women with adequate 25(OH)D levels are far more likely to experience clinical pregnancies than those with 25(OH)D deficiency. More research is necessary to determine whether vitamin D supplementation can be a simple and economical solution to increase pregnancy rates. Our study population had a significant 25(OH)D deficit or insufficiency prevalence. Determining 25(OH)D levels as part of a routine infertility assessment may be advantageous.

The effect of educational programs on parents’ knowledge, behavior, and practices regarding aluminum phosphide poisoning and its first-aid measures

BackgroundAluminum phosphide is an excellent insecticide available as a chalky white or brown tablet. Aluminum phosphide is traded in the Egyptian market as tablets under the brand name celphos. To date, no specific antidotes for aluminum phosphide poisoning have been identified. Management is primarily supportive, to control toxic symptoms and prevent the anticipated consequences. Therefore, educating parents about first aid management is of utmost importance. This study aimed to evaluate the knowledge, behavior, and practices of parents concerning aluminum phosphide poisoning and its first-aid measures.MethodsThis study used a quasi-experimental research design and was conducted in the inpatient clinical toxicology department ward of Menoufia University Hospital between June 2022 and May 2023. Children (n = 98) who met the inclusion criteria (aged between 0 and 18 years and who experienced accidental or suicidal aluminum phosphide poisoning) were recruited from the inpatient clinical toxicology department ward, intensive care unit in the emergency department, and critical care unit of Menoufia University Hospital. Four questionnaires were used to collect data for this study: (1) sociodemographics, poisoning data, physical examination, and laboratory investigations; (2) knowledge of parents; (3) practice of parents; and (4) behavior response scales.ResultsThis study analyzed 98 cases of acute ALP poisoning, predominantly affecting females (67.3%) aged 16–18 years, with most incidents occurring in summer (51.1%) and rural areas (80.6%). Suicidal ingestion accounted for 86.7% of cases, and delays in hospital arrival were noted in 65.3%. Clinical findings included vomiting (76.6%), dyspnea (77.5%), and cardiogenic shock (84.8%). ECG abnormalities were found in 82.7% of patients, and metabolic acidosis was present in 82.3% of patients. An educational program significantly improved the knowledge and first-aid practices of the participants regarding ALP poisoning, highlighting the need for enhanced awareness and intervention strategies.ConclusionsCommunity awareness programs, such as first-aid education initiatives, can positively influence the knowledge, practices, and behaviors of mothers in terms of providing first aid for aluminum phosphide toxicity.

Assessment study of how much Egyptian patients are satisfied following total knee arthroplasty

Background: Advanced stages of Knee OA can be incapacitating as a result of reduced functional range of motion and pain. Joint replacement may be needed for end-stage arthritis. Among the patient-reported outcome measures is patient satisfaction. Objectives: To study patients’ satisfaction one year later of total knee arthroplasty using different outcome measures and scoring systems. Patients &amp; Methods: This was a prospective cohort study that was performed at Menoufia University Hospitals on 132 patients who received primary TKR. All participants were subjected to complete personal and medical history, and general examination including BMI and vital signs (heart, respiratory rate, and blood pressure). Preoperative investigations include CBC, serum creatinine, RBS, Liver function tests), Electrocardiogram, imaging studies such as (knee X-ray, CT, MRI, and bone densitometry). Surgical steps for TKR, postoperative care (hydration, analgesia). Knee joint physiotherapy until discharge. Study tools: Knee Society score, Western Ontario and McMaster Universities Osteoarthritis Index score. Patient satisfaction (The patient is asked if he would recommend total knee replacement for his relatives or not. Visual Analogue Scale). Results: The average age of the study group was 58.47±8.037 years, BMI 28.79±1.364 with 78.7%were females. 72.9% of the study group were satisfied with TKR.

Detection of multidrug-resistant Klebsiella species with overexpressed efflux pumps in neonatal intensive care units at Menoufia University Hospitals

Detection of multidrug-resistant Klebsiella species with overexpressed efflux pumps in neonatal intensive care units at Menoufia University Hospitals

Evaluation of Traditional Liposuction, VASER Liposuction, and VASER Liposuction Combined with J-plasma in Management of Gynecomastia.

Because gynecomastia is one of the most considerable aesthetic procedures for men, we are researching in our article recent management methods for high grades of gynecomastia. This prospective study included 45 individuals with gynecomastia, divided into 3 groups: group A (15 individuals) managed by traditional liposuction, group B (15 individuals) managed by vibration amplification of sound energy at resonance (VASER)-assisted lipoplasty, and group C (15 individuals) managed by VASER and J-plasma. Authors used a skin fold caliper for measurement of subareolar disk size and a Cutometer for assessment of skin pliability and firmness. The study was conducted at the Department of Plastic Surgery, Menoufia University Hospital, Egypt, and Reflect Center for Plastic Surgery in Riyadh, Saudi Arabia. Statistically significant differences were found among the groups in terms of reduction of subareolar disk size (assessed by skinfold caliper), skin redundancy (assessed by Cutometer), the need for a second stage of treatment, and patient satisfaction (by questionnaire). The combination of VASER and J-plasma is effective for managing grade 2 and 3 gynecomastia, resulting in significant reduction in subareolar disk size, minimal skin redundancy with enhanced skin firmness, reduced need for further procedures, and improved patient satisfaction compared with traditional methods.

Up Regulation of ZNF76 rs10947540 and SCUBE3 rs1888822 Single Nucleotide Polymorphisms as a Genetic Risk Factor in Egyptian Patients with Rheumatoid Arthritis

ABSTRACT Introduction The protein SCUBE3 has been observed to exhibit an association with various autoimmune conditions, including psoriasis and rheumatoid arthritis. Genetic experiments have revealed that changes in Zinc finger protein-coding sequences correlate with an increased vulnerability to developing autoimmune diseases, so we aimed to study investigates the involvement of ZNF76 rs10947540 and SCUBE3 rs1888822 gene expression in individuals diagnosed with Rheumatoid Arthritis. Methods In a case-control study conducted from January 2022 to March 2023, 80 adults with RA from Menoufia University Hospital were compared with 80 age- and gender-matched healthy controls. Single nucleotide polymorphisms (SNPs) ZNF76 rs10947540 and SCUBE3 rs1888822 were analysed using real-time polymerase chain reaction (PCR). Results ZNF76 rs10947540 demonstrated a 7.125-fold increased risk for RA in CC genotype individuals and a 2.958-fold risk associated with the C allele. Those with the TC genotype had a 2.523-fold increased risk. Similarly, SCUBE3 rs1888822 showed a 6.364-fold risk for RA in TT genotype individuals and a 3.065-fold risk for T allele carriers. GT genotype individuals had a 2.765-fold risk. Discussion Our study suggests that ZNF76 rs10947540 and SCUBE3 rs1888822 polymorphisms may be risk factors for RA in Egyptian patients. Understanding the genetic variations associated with higher risk underscores the role of genetics in RA progression.

The Relation between Entrepreneurial Leadership and Innovative Work Behavior among Nurses at Menoufia University Hospital

Background: Entrepreneurial leadership is becoming concept in health that can affect and direct performance and achievement of either staff or organizations goals. Entrepreneurial leadership and innovative work behavior are widely regarded as an important basis for competitive advantage in work environment and enhancing capabilities for work growth and the wealth of nations.

Comprehensive analysis of MRSA in ICU settings: Antibiogram, molecular characterization, risk assessment, and infection control strategies in Menoufia University Hospitals

Comprehensive analysis of MRSA in ICU settings: Antibiogram, molecular characterization, risk assessment, and infection control strategies in Menoufia University Hospitals

Laryngo pharyngeal affection of COVID-19 during Delta and Omicron variant (Comparative Study)

BackgroundSince the declaration of COVID-19 as a pandemic in 2020, its main symptoms have primarily affected the respiratory system. However, it also presents other systemic manifestations, including symptoms related to the larynx and pharynx. COVID-19 has evolved into subsequent variants, starting from the alpha variant and currently dominated by the Omicron variant, with the Delta variant being the most severe.The study aimed to elucidate the laryngo pharyngeal manifestations related to Delta and Omicron variants of COVID-19 as well as the associated risk factors.ResultsThis study adopted a case–control design. The data were collected from patients who attended the phoniatric outpatient clinic at Menoufia University Hospital from January to December 2022. Patients were categorized into three groups (50 patients each). Group I consisted of patients who exhibited COVID-19 Laryngo pharyngeal symptoms during the Delta wave (Group 1) and the Omicron wave (Group 2). The control group included non-COVID-19 participants. The symptoms related to the larynx and pharynx were documented. In addition, laryngoscopic and stroboscopic examinations were done. The age of individuals affected by the Delta variant was higher. Delta cases exhibited a higher rate of smoking, diabetes, hypertension, and COPD compared to Omicron cases. Additionally, Delta cases displayed greater severity. Dysphagia, dysphonia, choking attacks related to swallowing, and stridor had significant higher rate in the Delta variant compared to the Omicron variant. The Delta variant primarily exhibited unilateral vocal fold paralysis in 38% of cases, as well as bilateral vocal fold paresis and paralysis in 20% and 22% of cases, respectively. In contrast, Omicron cases predominantly showed vocal fold congestion (80% of cases). Delta cases were more prone to experiencing abnormalities in amplitude, symmetry, and periodicity.ConclusionsThe Delta variant is more prone to neurologic affection of the vocal folds manifesting as paresis and paralysis, whereas the Omicron variant, which has maintained its dominance thus far, experiences milder affection, primarily manifesting as congestion. Consequently, laryngeal affection with various degrees of severity is still suspected.

CELF4 (rs1786814) gene polymorphism and speckle-tracking Echocardiography for cardiovascular complications in childhood cancer survivors.

Despite a well-known dose-dependent association between the risk of cardiac dysfunction and anthracycline, the risk of cardiac dysfunction for any given anthracycline dose varies between patients. So, we assessed CELF4 (rs1786814) gene polymorphism on anthracycline-related cardiotoxicity in childhood cancer survivors (CCS). This comparative cross-sectional study included 53 CCS who had regular follow-up visits at the Pediatric Oncology Unit, Menoufia University Hospital. CELF4 (rs1786814) gene polymorphism and conventional and speckle-tracking Echocardiography were done for all survivors. Regarding CELF4 (rs1786814) genotypes, significant differences existed between the studied groups with a predominance of GG homozygous mutation. For Echocardiographic findings, the ejection fraction and end-systolic diameter compared to the control group, were significantly lower in the survivors group. Speckle- tracking Echocardiography showed a significant difference regarding (GLPS-A4C) and (GLPS-LAX), with no significant difference regarding (GLPS-A2C), (GLPS-Avg) and left atrium between the studied groups. Multivariate logistic regression analysis illustrated a statistically significant relation between cumulative anthracycline dose >300 mg/m2 and CLEF4 (rs1786814) genotypes (GG and GA) and the risk of cardiotoxicity with more significance in GG mutation. Early detection of ventricular dysfunction in CCS with subclinical cardiotoxicity with regular follow-up is promising before the development of life-threatening complications. Early detection of anthracycline-related cardiotoxicity in childhood cancer survivors (CCS) after finishing chemotherapy. CLEF4 (rs1786814) GG variant is more significant in CCS exposed to high-dose anthracycline. GLPS holds promise as an early predictor of late left ventricular dysfunction and subclinical cardiotoxicity in CCS.