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Zein MM, Arafa N, El-Shabrawi MHF, El-Koofy NM. Effect of nutrition-related infodemics and social media on maternal experience: A nationwide survey in a low/middle income country. World J Clin Pediatr 2024; 13:89139. [PMID: 38596445 PMCID: PMC11000056 DOI: 10.5409/wjcp.v13.i1.89139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 12/29/2023] [Accepted: 02/18/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Undernutrition is a crucial cause of morbidity and mortality among children in low- or middle-income countries (LMICs). A better understanding of maternal general healthy nutrition knowledge, as well as misbeliefs, is highly essential, especially in such settings. In the current era of infodemics, it is very strenuous for mothers to select not only the right source for maternal nutrition information but the correct information as well. AIM To assess maternal healthy nutritional knowledge and nutrition-related misbeliefs and misinformation in an LMIC, and to determine the sources of such information and their assessment methods. METHODS This cross-sectional analytical observational study enrolled 5148 randomly selected Egyptian mothers who had one or more children less than 15 years old. The data were collected through online questionnaire forms: One was for the general nutrition knowledge assessment, and the other was for the nutritional myth score. Sources of information and ways of evaluating internet sources using the Currency, Relevance, Authority, Accuracy, and Purpose test were additionally analyzed. RESULTS The mean general nutrition knowledge score was 29 ± 9, with a percent score of 70.8% ± 12.1% (total score: 41). The median myth score was 9 (interquartile range: 6, 12; total score: 18). The primary sources of nutrition knowledge for the enrolled mothers were social media platforms (55%). Half of the mothers managed information for currency and authority, except for considering the author's contact information. More than 60% regularly checked information for accuracy and purpose. The mothers with significant nutrition knowledge checked periodically for the author's contact information (P = 0.012). The nutrition myth score was significantly lower among mothers who periodically checked the evidence of the information (P = 0.016). Mothers dependent on their healthcare providers as the primary source of their general nutritional knowledge were less likely to hold myths by 13% (P = 0.044). However, using social media increased the likelihood of having myths among mothers by approximately 1.2 (P = 0.001). CONCLUSION Social media platforms were found to be the primary source of maternal nutrition information in the current era of infodemics. However, healthcare providers were the only source for decreasing the incidence of maternal myths among the surveyed mothers.
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Affiliation(s)
- Marwa M Zein
- Department of Public Health and Community Medicine, Cairo University, Cairo 515211, Egypt
| | - Noha Arafa
- Department of Pediatric Endocrinology and Diabetes, Children's Hospital, Kasralainy Medical School, Cairo University, Cairo 515211, Egypt
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El-Koofy N, Mahmoud E, El Mougy F, Nasr E, Okasha S, El-Karaksy H, Anwar G, El-Shabrawi MH, Badawi NE, Arafa N. Effect of medium chain triglycerides enriched formula on growth of biliary atresia patients after Kasai portoenterostomy. Arab J Gastroenterol 2024:S1687-1979(24)00015-7. [PMID: 38378358 DOI: 10.1016/j.ajg.2024.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 01/22/2024] [Accepted: 01/27/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND AND STUDY AIMS Biliary atresia (BA) is the most common cause of neonatal cholestasis, negatively affecting nutritional status, growth, and development. It is the most frequent paediatric indication for liver transplantation. The Kasai portoenterostomy (KPE) operation is an effective procedure with favourable outcomes when performed before two months of age. The present study aimed to assess the nutritional status of patients with biliary atresia who underwent the Kasai operation and to evaluate the effectiveness of nutritional counselling using medium-chain triglyceride (MCT) formulas and proper supplementation on their nutritional status, growth, and vitamin D levels. PATIENTS AND METHODS This prospective observational study included 36 infants with biliary atresia who underwent Kasai portoenterostomy. All patients underwent clinical assessment, anthropometric evaluation, nutritional counselling, and an evaluation of vitamin D levels. Only compliant patients (22/36) were followed up after 3 and 6 months of nutritional counselling. RESULTS Z-scores for weight, triceps skinfold thickness, and mid-upper arm circumference improved significantly after three months, and the height velocity Z-score improved after six months of nutritional counselling using an MCT-containing formula and supplementations. Patients who showed an improvement in cholestasis had better responses. The initial assessment revealed low serum levels of 25-hydroxyvitamin D in 77.8 %, which increased significantly (p = 0.012). CONCLUSION Dietary intervention and supplementation with MCT and micronutrients can improve the nutritional status of children with BA following KPE.
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Affiliation(s)
- Nehal El-Koofy
- Department of Pediatrics, Kasr Al-Ainy Medical School, Cairo University, Egypt
| | - Eman Mahmoud
- Department of Pediatrics, Kasr Al-Ainy Medical School, Cairo University, Egypt
| | - Fatma El Mougy
- Department of Clinical and Chemical Pathology, Kasr Al-Ainy Medical School, Cairo University, Egypt.
| | - Engy Nasr
- Department of Pediatrics, Kasr Al-Ainy Medical School, Cairo University, Egypt.
| | - Sawsan Okasha
- Department of Pediatrics, Kasr Al-Ainy Medical School, Cairo University, Egypt
| | - Hanaa El-Karaksy
- Department of Pediatrics, Kasr Al-Ainy Medical School, Cairo University, Egypt
| | - Ghada Anwar
- Department of Pediatrics, Kasr Al-Ainy Medical School, Cairo University, Egypt
| | | | - Nora E Badawi
- Department of Pediatrics, Kasr Al-Ainy Medical School, Cairo University, Egypt
| | - Noha Arafa
- Department of Pediatrics, Kasr Al-Ainy Medical School, Cairo University, Egypt.
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Elsharkawy A, Abd Al-latif K, Farag M, Arafa N. Effect of Swaddle Bathing on Neonatal Thermal Stability and Cardio-Respiratory Parameters. Alexandria Scientific Nursing Journal 2022; 24:79-90. [DOI: 10.21608/asalexu.2022.280356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Musa N, Ramzy T, Hamdy A, Arafa N, Hassan M. Assessment of urinary podocalyxin as a marker of glomerular injury in obesity-related kidney disease in children and adolescents with obesity compared to urinary albumin creatinine ratio. Clin Obes 2021; 11:e12452. [PMID: 33797164 DOI: 10.1111/cob.12452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 02/28/2021] [Accepted: 03/18/2021] [Indexed: 11/29/2022]
Abstract
Obesity increases the risk of chronic kidney disease in children. Our aim was to assess urinary podocalyxin (PCX) in children and adolescents with obesity as a potential marker of obesity-related kidney disease (ORKD). The current case-control study included 128 children with obesity compared to 60 non-obese age and sex matched controls. Study population were subjected to full history taking as well as thorough physical examination. Urine samples for albumin creatinine ratio (uACR) and PCX were collected from the study population as well as blood samples for assessment of serum creatinine and fasting lipid profile. A statistically significant difference was found between cases and controls regarding urinary PCX (P < .001) and uACR (P = .021). A statistically significant positive correlation was found between uACR and weight SD score (SDS), body mass index SDS, waist circumference, estimated glomerular filtration rate, triglycerides (TG) as well as urinary PCX, whilst urinary PCX correlated significantly with obesity duration and uACR. Cases with microalbuminuria had a statistically significant higher waist circumference, waist-hip ratio, fat percentage, TG and urinary PCX compared to those with normal uACR (P = .042, .034, .05, .018 and .036 respectively). Urinary PCX showed 83.3% sensitivity and 74% specificity in detection of albuminuria. Urinary PCX was increased significantly in children with obesity making it a potential sensitive marker of ORKD in children.
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Affiliation(s)
- Noha Musa
- Diabetes, Endocrine and Metabolism Pediatric Unit (DEMPU), Cairo University, Cairo, Egypt
| | - Tarek Ramzy
- Lecturer of Chemical pathology, Cairo University, Cairo, Egypt
| | - Ahmed Hamdy
- Pediatric Resident, Cairo University, Cairo, Egypt
| | - Noha Arafa
- Diabetes, Endocrine and Metabolism Pediatric Unit (DEMPU), Cairo University, Cairo, Egypt
| | - Mona Hassan
- Diabetes, Endocrine and Metabolism Pediatric Unit (DEMPU), Cairo University, Cairo, Egypt
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A Shamma R, Atef S, Arafa N. Etiological classification and clinical spectrum of Egyptian pediatric patients with disorder of sex development, single center experience. Endokrynol Pol 2021; 72:558-565. [PMID: 34010442 DOI: 10.5603/ep.a2021.0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/03/2021] [Accepted: 04/04/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The aim of the current work was to review the clinical profile, etiological classification as well as management of Egyptian paediatric patients with disorder of sex development (DSD) presented at tertiary center in Cairo. MATERIAL AND METHODS The study was a cross sectional observational study included Egyptian patients who were attending the Endocrine clinic during a period of one year from January to December 2019. All patients with overt genital ambiguity aged from 0 to 18 years were recruited in the study. The diagnosis of patients was dependent upon clinical and hormonal profile. RESULTS Out of 100 patients, 71% had 46XY DSD, 24% had 46XXDSD, and sex chromosome DSD was identified in 5%. The median age of presentation was 12 months with 19% presented during infancy. The most common cause of 46XY DSD was due to either defect in androgen synthesis or action (40%) with the majority due to androgen insensitivity syndrome (28%). Most of 46 XX DSD (21/24) group were diagnosed as classic congenital adrenal hyperplasia secondary to deficiency of 21 hydroxylase enzyme with 90% was salt waster. CONCLUSION Our series revealed that 46XY DSD was the most frequent etiological diagnosis with androgen insensitivity syndrome representing the commonest presumed cause. CAH with classic salt wasting type was the second common disorder. Management of children with DSD is a real challenge especially with lack of adequate resources. The crucial issues which stand against proper diagnosis and management are late presentation combined with economic constrains, social and cultural issues.
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Affiliation(s)
- Radwa A Shamma
- Cairo university, Kasr El Aini, Faculty of medicine, Pediatric department, Elsaraya street, Cairo, Egypt, 35221 Cairo, Egypt
| | - Shimaa Atef
- Cairo university, Kasr El Aini, Faculty of medicine, Pediatric department, Elsaraya street, Cairo, Egypt, 35221 Cairo, Egypt
| | - Noha Arafa
- Cairo university, Kasr El Aini, Faculty of medicine, Pediatric department, Elsaraya street, Cairo, Egypt, 35221 Cairo, Egypt.
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Badawi N, Fawaz L, Amin A, Kamel A, Arafa N. The validity of the Bayley-Pinneau method in predicting final adult height at the onset of puberty in patients with classic congenital adrenal hyperplasia. Endokrynol Pol 2021; 72:301-307. [PMID: 34010438 DOI: 10.5603/ep.a2021.0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 03/20/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The final adult height (FAH) of patients with congenital adrenal hyperplasia (CAH) is often lower than the predicted adult height (PAH) using the Bayley-Pinneau (B&P) method. The aim of the current work was to test the validity of B&P in predicting FAH from a bone age (BA) measurement performed at onset of puberty. MATERIAL AND ETHODS This was a retrospective longitudinal observational convenience single-centre study. The study included 54 patients (male and female) with classic CAH, whether salt-wasting (SW) or simple virilising (SV), who had reached FAH. The results of auxological measurements and hormonal data around the time of puberty were retrieved from files. Predicted adult height (PAH) was calculated from a BA taken at onset of puberty and compared with FAH. RESULTS The median PAH SDS at the onset of puberty (-1.5) was significantly greater than the median FAH SDS (-2.2) (p < 0.001). The median target height SDS (-0.8) was significantly higher than the median FAH SDS (-2.2) (p < 0.001). FAH and FAH SDS were significantly worse in females (150.36 ± 7.23; -2.05 ± 1.13) than in their male counterparts (162.86 ± 3.30; -1.53 ± 0.51) (p value < 0.001; 0.048). In patients with good control, there was no difference between PAH SDS (-1.7) and FAH SDS (-1.5) (p value = 0.37). In patients with poor control (over- or under-treated) FAH SDS (-2.1) was significantly lower than PAH SDS (-1.4) (p value < 0.001). CONCLUSION The B&P method was able to accurately predict FAH in children with classic CAH, who were medically well controlled (based on 17-hydroxyprogesterone levels), but overestimated it by a significant 0.7 SD in poorly-controlled patients.
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Affiliation(s)
- Nora Badawi
- The Diabetes Endocrine, Metabolism Paediatric Unit (DEMPU), Children's Hospital, Department of Paediatrics, Faculty of Medicine, Cairo University, Egypt
| | - Lubna Fawaz
- The Diabetes Endocrine, Metabolism Paediatric Unit (DEMPU), Children's Hospital, Department of Paediatrics, Faculty of Medicine, Cairo University, Egypt
| | - Ahmed Amin
- The Diabetes Endocrine, Metabolism Paediatric Unit (DEMPU), Children's Hospital, Department of Paediatrics, Faculty of Medicine, Cairo University, Egypt
| | - Abdelkarim Kamel
- Department of Medical Biochemistry, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Noha Arafa
- The Diabetes Endocrine, Metabolism Paediatric Unit (DEMPU), Children's Hospital, Department of Paediatrics, Faculty of Medicine, Cairo University, Egypt.
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Badawi NES, Hafez M, Eldin HS, Abdelatif HM, Atef S, Ismail MM, Arafa N. Outcome of the use of 0.9% saline versus 0.45% saline for fluid rehydration in moderate and severe diabetic ketoacidosis in children. Egypt Pediatric Association Gaz 2021. [DOI: 10.1186/s43054-021-00057-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The debate for the optimum sodium concentration in the rehydration solution in diabetic ketoacidosis (DKA) persists till the moment. The aim was to compare the outcome of 0.9% saline versus 0.45% saline in children with moderate and severe (DKA) regarding the effect on serum electrolytes, duration of DKA resolution and the incidence of hyperchloremia.
Results
A retrospective analysis of 121 children with moderate or severe DKA was done. After the initial 4 h in which both groups received normal saline, patients were divided into two groups continuing on 0.9% (N=72) or switched to 0.45% saline (N=49). Serum chloride and Cl/Na ratios were significantly higher in 0.9% saline group at 4 and 8 h. The 0.9% saline group had significantly higher proportion of hyperchloremia at 4 and 8 h (P value: 0.002, 0.02). The median duration of correction of DKA (14 h among 0.9% saline versus 10 h among 0.45% saline) without significant difference (P value= 0.43). The change in plasma glucose, effective osmolarity, corrected Na levels were comparable between groups.
Conclusion
There is an unavoidable iatrogenically induced rise in serum chloride with higher incidence of hyperchloremia with the use of normal saline in rehydration of children presenting in DKA and shock. The use of 0.45% saline as post-bolus rehydration fluid is not associated with a decline in the corrected serum sodium concentration and does not affect the rate of correction of acidosis or rate of drop in blood glucose or duration of DKA resolution when compared to normal saline.
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Arafa N, Bazaraa HM, Sharaf ElDin H, Hussein M, Salah DM. Glucose tolerance in a cohort of Egyptian children after kidney transplantation. Diabetes Res Clin Pract 2021; 172:108605. [PMID: 33333203 DOI: 10.1016/j.diabres.2020.108605] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 10/13/2020] [Accepted: 12/01/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Post- transplantation diabetes mellitus (PTDM) in children is a serious metabolic complication that can endanger both graft and patient survival. These complications can be partially reduced by early diagnosis & prompt treatment of impaired glucose tolerance. The aim of this study was to assess glucose tolerance & insulin resistance among a cohort of kidney transplanted children. METHODS Thirty consecutive pediatric kidney transplant recipients were subjected to basal evaluation of plasma glucose and insulin then underwent oral glucose tolerance test (OGTT). RESULTS Abnormal glucose metabolism was detected in 7 (23.3%) patients; 3 (10%) patients with PTDM; 3 (10%) patients with impaired fasting glucose (IFG) and 1 (3.3%) patient with IFG and impaired glucose tolerance (IGT). Four (13.3%) patients had high Homeostatic model assessment of insulin resistance (HOMA-IR). Patients with abnormal glucose metabolism had significantly higher tacrolimus trough levels and higher maintainence steroid doses (p values = 0.003,0.026). Significant positive correlation existed between pre-transplantation glucose level and post-transplantation fasting glucose (p = 0.001, r = 0.69), glucose at 120 min (p = 0.018, r = 0.429) and HOMA-IR (p = 0.008, r = 0.47). CONCLUSION Abnormalities in glucose metabolism (IFG, IGT &PTDM) are frequent in Egyptian pediatric kidney transplant recipients. OGTT is the gold standard for assessment of abnormalities in glucose metabolism.
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Affiliation(s)
- Noha Arafa
- Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Hafez M Bazaraa
- Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Heba Sharaf ElDin
- Department of Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt.
| | | | - Doaa M Salah
- Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt.
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Abdou M, Hafez MH, Anwar GM, Fahmy WA, Abd Alfattah NM, Salem RI, Arafa N. Effect of high protein and fat diet on postprandial blood glucose levels in children and adolescents with type 1 diabetes in Cairo, Egypt. Diabetes Metab Syndr 2021; 15:7-12. [PMID: 33276255 DOI: 10.1016/j.dsx.2020.11.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 11/20/2020] [Accepted: 11/22/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND AIMS To determine the effect of high protein and high fat meals on post prandial glycemia in patients with type 1 diabetes. METHODS This study included 51 children and adolescents with type 1 diabetes who were following up at Diabetes, Endocrine and Metabolism Pediatric Unit (DEMPU), Abo Elrish Children's hospital, Cairo University. Post prandial blood glucose levels were recorded and compared following three breakfast meals with varying protein and fat content (standard carbohydrate meal, high fat meal, and high protein meal) over a period of 5 hours on 3 consecutive days. RESULTS High protein meal resulted in hyperglycemia with the peak level at 3.5 hours and continued for 5 hours post prandial while high fat meal caused early hyperglycemia reached the peak at 2 hours then declined towards 5 hours. Comparison of the three different breakfast meals revealed statistically significant difference regarding the postprandial glycemia at 30, 60, 90,120, 180, 210, 240, 270, 300 min. CONCLUSION Meals high in protein caused sustained increase in postprandial glucose levels over a period of 5 h. However, high fat meals caused early postprandial hyperglycemia. Protein and fat content of meals affect the timing and values of the peak blood glucose as well as the duration of postprandial hyperglycemia. Therefore, fat/protein unit should be taken in consideration while calculating the bolus insulin dose and anticipating the postprandial glucose response.
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Affiliation(s)
- Marise Abdou
- Department of Pediatrics, Member of the Diabetes Endocrine and Metabolism Pediatric Unit (DEMPU), Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Mona Hassan Hafez
- Department of Pediatrics, Faculty of Medicine, Diabetes, Endocrine and Metabolism Pediatric Unit (DEMPU), Children Hospital, Cairo University, Cairo, Egypt.
| | - Ghada Mohammad Anwar
- Department of Pediatrics, Faculty of Medicine, Diabetes, Endocrine and Metabolism Pediatric Unit (DEMPU), Children Hospital, Cairo University, Cairo, Egypt.
| | - Wafaa Ahmed Fahmy
- Head of Growth and Nutrient Requirements Department, National Nutrition Institute, Cairo, Egypt.
| | | | - Rania Ibrahim Salem
- Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Noha Arafa
- Department of Pediatrics, Member of the Diabetes Endocrine and Metabolism Pediatric Unit (DEMPU), Faculty of Medicine, Cairo University, Cairo, Egypt.
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Arafa N, Mamdouh Hassan M, Atef S, Salah Eldin Fathallah A, Ibrahim A. Clinical characteristics and precipitating factor(s) associated with diabetic ketoacidosis presentation in children with newly diagnosed diabetes. Clinical Diabetology 2020. [DOI: 10.5603/dk.2020.0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Ibrahim A, Salah S, Attia M, Madani H, Ahmad S, Arafa N, Soliman H. Serum Dipeptidyl peptidase-4 level is related to adiposity in type 1 diabetic adolescents. Diabetes Metab Syndr 2020; 14:609-614. [PMID: 32422444 DOI: 10.1016/j.dsx.2020.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 05/02/2020] [Accepted: 05/03/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Insulin resistance (IR) plays a great role in type 1 diabetes (T1DM) disease process than is commonly recognized. Dipeptidyl peptidase-4 (DPP-4) is an enzyme that deactivates many bioactive peptides involved in glucose regulation. AIMS This study evaluates DPP-4 level in adolescent patients with T1DM compared to controls and investigates the relationship between DPP-4 level and IR in these patients. MATERIALS AND METHODS We measured serum DPP-4 level in 50 patients with T1DM recruited from the Diabetes Endocrine Metabolism Pediatric Unit, and in 80 healthy controls. IR was assessed by the equation for estimated glucose disposal rate (eGDR). Biochemical evaluation including glycated haemoglobin (HbA1C) and lipid profile were included. RESULTS IR was found in 80% of patients with T1DM. DPP-4 was significantly higher in control group than patients with T1DM. Patients with T1DM were classified into 3 groups according to DPP-4 tertiles showing significant increase in BMI SDS and total cholesterol across the 3 groups. Significant correlation was found between DPP-4 levels and insulin dose. DPP-4 was significantly higher in patients with T1DM with good glycemic control. CONCLUSION In sample of individuals researched by us, serum DPP-4 was related to adiposity and not to the hyperglycemia in patients with T1DM. Larger sample should be researched to make firm conclusions.
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Affiliation(s)
- Amany Ibrahim
- The Diabetes Endocrine and Metabolism Pediatric Unit (DEMPU), Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Shaimaa Salah
- Pediatric Department, Faculty of Medicine, Kafrelsheikh University, Kafr Elsheikh, Egypt
| | - Mona Attia
- The Diabetes Endocrine and Metabolism Pediatric Unit (DEMPU), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hanan Madani
- Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, Egypt
| | - Samah Ahmad
- The Diabetes Endocrine and Metabolism Pediatric Unit (DEMPU), Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Noha Arafa
- The Diabetes Endocrine and Metabolism Pediatric Unit (DEMPU), Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Hend Soliman
- The Diabetes Endocrine and Metabolism Pediatric Unit (DEMPU), Faculty of Medicine, Cairo University, Cairo, Egypt
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12
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Hassan MM, Arafa N, Abdou M, Hussein O. Characteristics of diabetes diagnosis and control in toddlers and preschoolers from families with limited resources: A single center experience. Diabetes Res Clin Pract 2020; 159:107966. [PMID: 31805353 DOI: 10.1016/j.diabres.2019.107966] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 11/03/2019] [Accepted: 11/29/2019] [Indexed: 02/08/2023]
Abstract
AIM To describe the characteristics of diabetes diagnosis, insulin therapy regarding type, dose and frequency also the degree of glycemic control achieved in toddlers and preschoolers coming from families with limited resources. METHODS Over one year, 69 toddlers and preschoolers clinically diagnosed as type 1 diabetes were included. Data related to presentation at diagnosis, insulin therapy and glycemic control was reviewed from patients' care givers and medical records. RESULTS Diabetic ketoacidosis (DKA) was recorded in 71% of the children at initial diagnosis. The mean time since diabetes diagnosis was 2 ± 1 years. Most of children (65/69, 94%) were on basal-bolus regimen while four (6%) were on basal insulin only. NPH and long acting analogues were used as basal insulin in (74%) and (26%). Regular insulin and rapid acting analogues were used as bolus insulin (27%) and (73%).The mean frequency of daily self monitoring of blood glucose was (2.9 ± 1). The arithmetic mean of HbA1c done over past 6 months to one year before inclusion in the study was 8.2 ± 1.5% (66 ± 12 mmol/mol) with 65% having HbA1c ≥ 7.5% (≥58 mmol/mol). CONCLUSION Toddlers and preschoolers with diabetes coming from families with limited resources frequently present with DKA at diagnosis and have suboptimal self-monitoring of blood glucose and glycemic control. NPH is more commonly used in this age group, combined with postprandial rapid analogues and less commonly preprandial regular insulin and that yields more favorable HbA1c but with a greater risk of hypoglycemia. The most common cause of hospital readmission was ketoacidosis and uncontrolled hyperglycemia.
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Affiliation(s)
- Mona Mamdouh Hassan
- The Diabetes Endocrine and Metabolism Pediatric Unit, Children's Hospital, Cairo University, Cairo, Egypt
| | - Noha Arafa
- The Diabetes Endocrine and Metabolism Pediatric Unit, Children's Hospital, Cairo University, Cairo, Egypt.
| | - Marise Abdou
- The Diabetes Endocrine and Metabolism Pediatric Unit, Children's Hospital, Cairo University, Cairo, Egypt
| | - Omar Hussein
- The General Pediatric Department, Children's Hospital, Cairo University, Cairo, Egypt
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13
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Tousson E, Ibrahim W, Arafa N, Akela MA. Monoamine concentrations changes in the PTU-induced hypothyroid rat brain and the ameliorating role of folic acid. Hum Exp Toxicol 2011; 31:282-9. [DOI: 10.1177/0960327111405863] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- E Tousson
- Department of Zoology, Faculty of Science, Tanta University, Tanta, Egypt
| | - W Ibrahim
- Department of Medical Biochemistry, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - N Arafa
- National Authority for Control and Pharmaceutical Research, Giza, Egypt
| | - MA Akela
- Department of Zoology, Faculty of Science, Tanta University, Tanta, Egypt
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14
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Kotb Sultan M, Bakr I, Ahmed Ismail N, Arafa N. Prevalence of unmet contraceptive need among Egyptian women: a community-based study. J Prev Med Hyg 2010; 51:62-66. [PMID: 21155407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
INTRODUCTION An estimated 17% of married women in the developing world still have an unmet need for contraception. This study aimed to measure the prevalence and reasons for unmet contraceptive need among married women in the childbearing period in an underprivileged district in Eastern Cairo. METHODS A cluster survey of 2340 women in the Marg district of Eastern Cairo was performed. Socio-demographic data and data on both past and present contraceptive use were obtained by interview questionnaire. RESULTS The prevalence of unmet need was 7.4%; 53.4% for limiting and 46.6% for spacing. Experience of side effects from contraceptive use, and fear of side effects, was highly prevalent among women with unmet need. In addition, a large proportion of women with unmet need perceived themselves not to be at risk for conceiving. CONCLUSIONS A substantial proportion of women in Cairo have unmet contraceptive need. Efficient counseling of women about contraception may help reduce this high prevalence.
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Affiliation(s)
- M Kotb Sultan
- Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Plancoulaine S, Mohamed MK, Arafa N, Bakr I, Rekacewicz C, Trégouët DA, Obach D, El Daly M, Thiers V, Féray C, Abdel-Hamid M, Abel L, Fontanet A. Dissection of familial correlations in hepatitis C virus (HCV) seroprevalence suggests intrafamilial viral transmission and genetic predisposition to infection. Gut 2008; 57:1268-74. [PMID: 18480169 DOI: 10.1136/gut.2007.140681] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Unsafe injections and transfusions used during treatments are considered to be responsible for many cases of transmission of hepatitis C virus (HCV) in developing countries, but cannot account for a substantial proportion of present infections. The aim of the present work was to investigate familial clustering of HCV infection in a population living in a highly endemic area. DESIGN, SETTING AND PARTICIPANTS A large seroepidemiological survey was conducted on 3994 subjects (age range, 2-88 years) from 475 familial clusters in an Egyptian rural area. Epidemiological methods appropriate for the analysis of correlated data were used to estimate risk factors and familial dependences for HCV infection. A phylogenetic analysis was conducted to investigate HCV strain similarities within and among families. MAIN OUTCOME MEASURES HCV familial correlations adjusted for known risk factors, similarities between viral strains. RESULTS Overall HCV seroprevalence was 12.3%, increasing with age. After adjustment for relevant risk factors, highly significant intrafamilial resemblances in HCV seroprevalence were obtained between father-offspring (odds ratio (OR) = 3.4 (95% confidence interval (CI), 1.8 to 6.2)), mother-offspring (OR = 3.8 (95% CI, 2.5 to 5.8)), and sibling-sibling (OR = 9.3 (95% CI, 4.9 to 17.6)), while a weaker dependence between spouses (OR = 2.2 (95% CI, 1.3 to 3.7)) was observed. Phylogenetic analysis showed greater HCV strain similarity between family members than between unrelated subjects, indicating that correlations can be explained, in part, by familial sources of virus transmission. In addition, refined dissection of correlations between first-degree relatives supported the role of host genes predisposing to HCV infection. CONCLUSIONS Current HCV infection in endemic countries has a strong familial component explained, at least partly, by specific modes of intrafamilial viral transmission and by genetic predisposition to infection.
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Affiliation(s)
- S Plancoulaine
- INSERM U550, Laboratoire de Génétique Humaine des Maladies Infectieuses, Faculté de Médecine Necker, 156 rue de Vaugirard, 75015 Paris, France.
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Mohamed M, Bakr I, El-Houssinie M, Arafa N, Hassan A, Ismail S, Anwar M, Attala M, Rekacewicz C, Zalata K, Abdel Hamid M, Esmat G, Fontanet A. P.226 HCV-related morbidity in a rural community of Egypt. J Clin Virol 2006. [DOI: 10.1016/s1386-6532(06)80406-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Plancoulaine S, Mohamed M, Arafa N, Bakr I, Rekacewicz C, Obach D, Abdel-Hamid M, Abel L, Fontanet A. O.144 Intra-familial transmission of HCV infection in a rural area from Egypt. J Clin Virol 2006. [DOI: 10.1016/s1386-6532(06)80138-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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