1
|
Iqbal W, Iram U, Nisar S, Musa N, Alam A, Khan MR, Ullah B, Ullah M, Ali I. Epidemiology and clinical features of cutaneous leishmaniasis in Khyber Pakhtunkhwa, Pakistan. BRAZ J BIOL 2024; 84:e249124. [DOI: 10.1590/1519-6984.249124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 07/22/2021] [Indexed: 12/23/2022] Open
Abstract
Abstract Current cross-sectional study was carried out between September 2019 to January 2020 at the Department of Pathology, Mardan Medical Complex (MMC), Mardan, and District Headquarter Hospital North Waziristan, Khyber Pakhtunkhwa (KP), Pakistan. The objectives of the current study were to determine the prevalence of leishmaniasis and its associated risk factors in selected districts of KP province, Pakistan. Altogether, three hundred and seventy-four (n=374) leishmaniosis patients were included in the current study. Skin specimen from the ulcer border were collected. The slides were stained by Giemsa stain and examined for the presence of amastigote. The prevalence of leishmania infected patients in different region of KP were as follows: North Waziristan region 53.7 (n=201) District Mardan 34.7% (n=130); District Nowshera 6.7% (n=25), District Swabi 1.1% (n=4) and other Districts i.e. Dir, Malakand, Buner and Bajawarr were 3.7% (n=14). The frequency of leishmaniasis were more in male and majority of the infected patients were in the age group of <10 years. Among n=374 patients 95.7% (n= 358) had cutaneous leishmaniasis while 3% (n= 11) had mucocutaneous type of infection and 1.3% (n= 5) patients had both cutaneous and mucocutaneous infection. Upon treatment by Sodium stibogluconate (SSG) 97% (n=362) showed clinical signs of complete or partial recovery of their skin lesions. Conclusively, highest incidence of leishmania infection occurred during short study period and majority of the cases showed positive response to treatment.
Collapse
Affiliation(s)
- W. Iqbal
- The University of Haripur, Pakistan; Mardan Medical Complex, Pakistan
| | - U. Iram
- Abdul Wali Khan University Mardan, Pakistan
| | - S. Nisar
- Bacha Khan Medical College, Pakistan
| | - N. Musa
- Khyber Medical College, Pakistan
| | - A. Alam
- Khyber Medical College, Pakistan
| | | | - B. Ullah
- Khyber Medical University, Pakistan
| | - M. Ullah
- Khyber Medical University, Pakistan
| | - I. Ali
- Khyber Medical University, Pakistan
| |
Collapse
|
2
|
Shamma RA, Anwar GM, Musa N, Mira MF, Abdou M. Assessment of the Effect of Timing of Insulin Glargine Administration (Bedtime versus Morning) on Glycemic Control in Children with Type 1 Diabetes in Cairo, Egypt: A Single Centre Experience. Curr Diabetes Rev 2023; 19:11-18. [PMID: 35410614 DOI: 10.2174/1573399818666220411123314] [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: 10/15/2021] [Revised: 12/20/2021] [Accepted: 01/27/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Diabetes control without developing hypoglycemia is challenging in Type 1 diabetes (T1D) management, with few studies evaluating the effect of insulin glargine timing on glucoregulation. OBJECTIVES The aim is to compare glycemic control using continuous glucose monitoring (CGM) in children with T1D receiving bedtime versus morning glargine and to assess CGM effect on glycemia. METHODS This cross-sectional observational study was conducted on 30 pediatric patients with T1D receiving glargine (19 at bedtime and 11 in the morning). CGM sensor was applied for 3-5 days using the I-Pro2 blood glucose sensor. RESULTS Total daily dose of glargine showed a significant correlation with HbA1C (p=0.006) and percentage of glucose readings within average (p=0.039). HbA1C correlated significantly with time in range (TIR) (p=0.049). Nocturnal hypoglycemia was significantly higher in the bedtime glargine group than in the morning one (p=0.016). The morning glargine group showed better control in terms of lower HbA1C and higher TIR, but these did not reach statistical significance. Follow- up after 3 months revealed significant improvement in the percentage of hyperglycemia, BG readings within average, as well as HbA1c (p:0.001). CONCLUSIONS Bedtime glargine administration was associated with a higher frequency of occurrence of nocturnal hypoglycemia. No statistically significant difference in glycemic control between both groups was found. CGM use improved glycemic control.
Collapse
Affiliation(s)
- Radwa A Shamma
- The Diabetes Endocrine and Metabolism Pediatric Unit, Children's Hospital, Cairo University, Cairo, Egypt
| | - Ghada M Anwar
- The Diabetes Endocrine and Metabolism Pediatric Unit, Children's Hospital, Cairo University, Cairo, Egypt
| | - Noha Musa
- The Diabetes Endocrine and Metabolism Pediatric Unit, Children's Hospital, Cairo University, Cairo, Egypt
| | - Marwa F Mira
- 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
| |
Collapse
|
3
|
Salah DM, Hafez M, Fadel FI, Selem YAS, Musa N. Monitoring of blood glucose after pediatric kidney transplantation: a longitudinal cohort study. Pediatr Nephrol 2023; 38:847-858. [PMID: 35816203 PMCID: PMC9842551 DOI: 10.1007/s00467-022-05669-0] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 06/12/2022] [Accepted: 06/13/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND Glucose metabolism after kidney transplantation (KT) is highly dynamic with the first post-transplantation year being the most critical period for new-onset diabetes after transplantation (NODAT) occurrence. The present study aimed to analyze dynamics of glucose metabolism and report incidence/risk factors of abnormal glycemic state during the first year after KT in children. METHODS Twenty-one consecutive freshly transplanted pediatric kidney transplant recipients (KTRs) were assessed for fasting plasma glucose (FPG) and oral glucose tolerance test (OGTT) weekly for 4 weeks, then every 3 months for 1 year. RESULTS Interpretation of OGTT test showed normal glucose tolerance (NGT) in 6 patients (28.6%) while 15 (71.4%) experienced impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) at any time point of monitoring. Seven patients had NODAT, for which three needed insulin therapy. Hyperglycemia onset was 7.8 ± 13.12 weeks (median (range) = 1 (0-24) week) after KT. Percent of patients with abnormal OGTT was significantly more than that of IFG (38.1% vs. 71.4%, p = 0.029). Patients with abnormal glycemic state had significantly elevated trough tacrolimus levels at 6 months (p = 0.03). Glucose readings did not correlate with steroid doses nor rejection episodes while positively correlating with tacrolimus doses at 3 months (p = 0.02, CC = 0.73) and 6 months (p = 0.01, CC = 0.63), and negatively correlating with simultaneous GFR at 9 months (p = 0.04, CC = - 0.57). CONCLUSIONS Up to two thirds of pediatric KTRs (71.4%) experienced abnormal glycemic state at some point with peak incidence within the first week up to 6 months after KT. OGTT was a better tool for monitoring of glucose metabolism than FPG. Abnormal glycemic state was induced by tacrolimus and adversely affected graft function. A higher resolution version of the Graphical abstract is available as Supplementary information.
Collapse
Affiliation(s)
- Doaa M Salah
- Pediatric Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
- Pediatric Nephrology & Transplantation Units, Cairo University Children Hospital, Cairo, Egypt.
| | - Mona Hafez
- Pediatric Department, Faculty of Medicine, Cairo University, Cairo, Egypt
- Diabetes, Endocrine & Metabolism Pediatric Unit, Cairo University Children Hospital, Cairo, Egypt
| | - Ftaina I Fadel
- Pediatric Department, Faculty of Medicine, Cairo University, Cairo, Egypt
- Pediatric Nephrology & Transplantation Units, Cairo University Children Hospital, Cairo, Egypt
| | | | - Noha Musa
- Pediatric Department, Faculty of Medicine, Cairo University, Cairo, Egypt
- Diabetes, Endocrine & Metabolism Pediatric Unit, Cairo University Children Hospital, Cairo, Egypt
| |
Collapse
|
4
|
Hassan MM, Sarry Eldin AM, Musa N, El-Wakil KH, Ali M, Ahmed HH. Insights into the implication of obesity in hypogonadism among adolescent boys. J Pediatr Endocrinol Metab 2022; 35:1497-1504. [PMID: 36282972 DOI: 10.1515/jpem-2022-0277] [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: 05/26/2022] [Accepted: 10/03/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES This research aimed at uncovering the mechanisms behind obesity-related hypogonadism in adolescent boys and to investigate the association between anthropometric characteristics and testicular functions of these boys. METHODS This study included 60 adolescent boys (12-18 years) with exogenous obesity (BMI≥95th percentile) and 30 age matched lean controls (BMI=15th-85th percentile). Full clinical examination, anthropometric measurements and pubertal assessment were performed. Laboratory investigations included hemoglobin, hematocrit, lipid panel, LH, FSH, free and total testosterone, inhibin B and estradiol. RESULTS The results indicated the presence of positive family history of obesity in 85% of obese boys vs. 40% of the lean counterparts. Concerning SBP of obese boys, 7% were hypertensive (95th percentile), 25% were prehypertensive (between 90th and 95th percentiles) while, DBP findings showed that 33% are hypertensive and 33% are prehypertensive. Meanwhile, 13.3% of lean controls were prehypertensive. Anthropometric measurements and lipid profile values revealed a significant difference between obese and lean boys. Compared to obese boys the normal weight boys had higher levels of free testosterone (21.15 ± 2.90 pg/mL vs. 11.38 ± 3.96 pg/mL, p<0.001), total testosterone (10.59 ± 6.63 ng/dL vs. 3.23 ± 1.70 ng/dL, p<0.001), FSH (7.33 ± 3.75 mIU/mL vs. 5.63 ± 3.96 mIU/mL, p=0.026) and inhibin B (83.28 ± 27.66 pg/mL vs. 62.90 ± 17.85 pg/mL, p=0.001) and they registered lower level of estradiol (18.48 ± 7.33 pg/mL vs. 40.20 ± 7.91 pg/mL, p<0.001). In obese boys, BMI SDS significantly correlated with lipid profile and estradiol whereas, it showed significant negative correlation with LH, free and total testosterone and inhibin B. Penile length significantly correlated with LH while it revealed significant negative correlation with cholesterol. CONCLUSIONS This study evidenced a close association between obesity and hypogonadism in adolescent boys which could be due to the increased estradiol level and decreased T/E2 ratio.
Collapse
Affiliation(s)
- Mona M Hassan
- Diabetes, Endocrine and Metabolism Pediatric Unit, Pediatrics Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Azza M Sarry Eldin
- Biological Anthropology Department, Medical Research and Clinical Studies Institute, National Research Centre, Giza, Egypt
| | - Noha Musa
- Diabetes, Endocrine and Metabolism Pediatric Unit, Pediatrics Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Khaled H El-Wakil
- Biological Anthropology Department, Medical Research and Clinical Studies Institute, National Research Centre, Giza, Egypt
| | - May Ali
- Biological Anthropology Department, Medical Research and Clinical Studies Institute, National Research Centre, Giza, Egypt
| | - Hanaa H Ahmed
- Hormones Department, Medical Research and Clinical Studies Institute, National Research Centre, Giza, Egypt
| |
Collapse
|
5
|
Hasan Q, Elfakki E, Fahmy K, Mere O, Ghoniem A, Langar H, Musa N, Attia R, Othman MM, Samhouri D, Chaudhri I, Abubakar A, Hajjeh R, Hutin YJ. Inequities in the deployment of COVID-19 vaccine in the WHO Eastern Mediterranean Region, 2020-2021. BMJ Glob Health 2022; 7:bmjgh-2021-008139. [PMID: 35764354 PMCID: PMC9315235 DOI: 10.1136/bmjgh-2021-008139] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 05/30/2022] [Indexed: 11/04/2022] Open
Abstract
The WHO Eastern Mediterranean Region (EMR) is characterised by a large range in routine immunisation coverage. We reviewed progress in access, deployment efforts, and use of COVID-19 vaccines in the EMR to identify bottlenecks and propose recommendations. We compiled and analysed data reported to WHO regarding the number of vaccines provided emergency use authorisation (EUA) in each country, the number of vaccine doses allocated and delivered by COVAX, the number of vaccine doses received bilaterally, the date of initiation of vaccination, vaccine usage rate and overall vaccination coverage. In June-July and October-November 2021, we conducted two rounds of a regional survey to assess vaccine acceptance and calculated the weighted proportion of individuals who would get vaccinated once a vaccine is available and recommended. We stratified the analysis according to four groups based on their participation status in COVAX, from the highest to lowest income, that is, (1) fully self-financing high-income countries (group 1), (2) fully self-financing upper middle-income countries (group 2), (3) Advance Market Commitment (AMC) countries not eligible to receive Gavi support (group 3) and (4) AMC countries eligible for Gavi support (group 4). As of 31 December 2021, the median number of vaccines provided with EUA was 6 for group 1, 11 for group 2, 8 for group 3 and 9 for group 4. On the same date, COVAX had delivered 179 793 310 doses to EMR countries. Vaccination started on 10 December 2020 in group 1, on 13 December 2020 in group 2, on 30 December 2020 in group 3 and on 20 January 2021 in group 4. The regional acceptance survey (first round) pointed to higher vaccine acceptance in group 1 (96%), than in others, including group 2 (73.9%), group 3 (78.8%) and group 4 (79.3%), with identical patterns in the second round (98%, 78%, 84% and 76%), respectively. Usage of vaccine allocated by COVAX to participating countries was 89% in group 1, 75% in group 2, 78% in group 3 and 42% in group 4. The full dose and partial dose coverage decreased with the income groups of countries, from 70% and 6% in group 1, to 43% and 8% in group 2, to 33% and 11% in group 3, and 20% and 8% in group 4. All 22 EMR countries introduced COVID-19 vaccines by 21 April 2021, but with major inequities in coverage. Additional efforts are needed to address the determinants of unequal vaccine coverage at all stages of the result chain to improve vaccine equity.
Collapse
Affiliation(s)
- Q Hasan
- DCD/IVP, WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - E Elfakki
- DCD/IVP, WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - K Fahmy
- DCD/IVP, WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Osama Mere
- DCD/IVP, WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - A Ghoniem
- DCD/IVP, WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - H Langar
- WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - N Musa
- DCD/IVP, WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Rania Attia
- DCD, WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - M M Othman
- DCD/IVP, WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Dahlia Samhouri
- WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Irtaza Chaudhri
- WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | | | - Rana Hajjeh
- WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Y J Hutin
- DCD, WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt
| |
Collapse
|
6
|
Abdelrahman SM, Samir B, Alazem EAA, Musa N. Effect of pre and post-transplant body mass index on pediatric kidney transplant outcomes. BMC Pediatr 2022; 22:299. [PMID: 35597898 PMCID: PMC9123701 DOI: 10.1186/s12887-022-03344-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 05/04/2022] [Indexed: 11/28/2022] Open
Abstract
Introduction Kidney transplantation (KT) has been established as an efficient treatment of end stage renal disease (ESRD) with the advantage of allowing the patient to live a nearly healthy life. We aimed to determine whether pre-transplant body mass index (BMI) affects renal allograft function and survival in pediatric KT recipients. Methods cross sectional cohort study included 50 post KT recipients (more than 3 years) with an age range of 10 to 15 years, regularly following at the Kidney Transplantation Outpatient Clinic, Cairo University Children’s Hospital, were subjected to a detailed history and physical examination, laboratory investigation in the form of fasting blood glucose (FBG),oral glucose tolerance test (OGTT), lipid profile, hemoglobin A1c (HbA1c) and microalbuminuria. Results Pre- post- kidney transplant BMI has significant positive correlation with graft rejection episodes, HbA1c, FBG, BMI post-KT, total cholesterol, triglycerides, and low-density lipoprotein (p < 0.01). There was a statistically significant negative correlation between the mean difference of BMI (post – pre) and graft survival in years (p = 0.036). Obese patients displayed lower survival compared with non-obese subjects at 5 years, but this was statistically not significant (p-value = 0.165). Conclusion obesity is an independent risk factor for graft loss and patient death in kidney transplantation. Careful patient selection with pre-transplantation weight reduction is mandatory to reduce the rate of early post-transplantation complications and to improve long-term outcomes.
Collapse
Affiliation(s)
- Safaa M Abdelrahman
- Department of Pediatrics, Center of Pediatric Nephrology &Transplantation, Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Basma Samir
- Department of Pediatrics, Center of Pediatric Nephrology &Transplantation, Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Eman Abobakr Abd Alazem
- Department of Pediatrics, Center of Pediatric Nephrology &Transplantation, Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt. .,Cairo University Children's Hospital, Cairo University Mounira Pediatric Hospital (Abou El Reeshe), Sayyeda Zeinab, Kasr Al Ainy, PO Box: 11562, Cairo, Egypt.
| | - Noha Musa
- Diabetes, Endocrine and Metabolism Pediatric Unit, Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt
| |
Collapse
|
7
|
Tosson AMS, Abdelrazek AA, Yossif R, Musa N. Impact of phototherapy type and duration on serum electrolytes and blood glucose in neonatal hyperbilirubinemia: a prospective single-center cohort study. Egypt Pediatric Association Gaz 2022. [DOI: 10.1186/s43054-022-00102-5] [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
Neonatal hyperbilirubinemia (NH) is among the common neonatal morbidities. Phototherapy is its most used therapeutic intervention. Different delivering systems and types are currently available. This study aimed to detect and compare the effects of the different phototherapy types on serum electrolytes and blood glucose and to study the effect of phototherapy duration on them.
Results
Five hundred healthy newborns with indirect NH were treated by different phototherapy types (conventional, light emitting diode LED, intensive) according to severity and availability. Serum sodium (Na), potassium (K), calcium (Ca), blood urea nitrogen (BUN), creatinine (Cr), and blood glucose (Glu) were measured repeatedly over 48 h of phototherapy. In this prospective cohort study, 273 (54.6%) neonates were exposed to conventional phototherapy, 145 (29.0%) to LED, and 82 (16.4%) to intensive phototherapy. A highly significant negative correlation was found between phototherapy duration and serum levels of Na, K, Ca, BUN, and Cr (p < 0.001). There was a positive correlation between phototherapy duration and blood glucose level (p = 0.005). Each type of phototherapy individually significantly affected the Na, K, Bun, Cr, and Ca levels after 48 h. Comparing the effects of the 3 different phototherapy types together, no significant differences apart from a decline in potassium level at 48 h (p = 0.043) were recorded.
Conclusions
Serum electrolytes significantly decreased during phototherapy. These changes were affected by the phototherapy duration. The type of phototherapy had only some effect on serum potassium.
Collapse
|
8
|
Tolba A, Mandour I, Musa N, Elmougy F, Hafez M, Abdelatty S, Ibrahim A, Soliman H, Labib B, Elshiwy Y, Ramzy T, Elsharkawy M. Copy Number Variations in Genetic Diagnosis of Congenital Adrenal Hyperplasia Children. Front Genet 2022; 13:785570. [PMID: 35309130 PMCID: PMC8924405 DOI: 10.3389/fgene.2022.785570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 01/31/2022] [Indexed: 11/24/2022] Open
Abstract
Background: Congenital adrenal hyperplasia (CAH) is a monogenic disorder caused by genetic diversity in the CYP21A2 gene, with 21-hydroxylase deficiency (21-OHD) as the most common type. Early sex assignment and early diagnosis of different genetic variations with a proper technique are important to reduce mortality and morbidity. Proper early sex identification reduces emotional, social, and psychological stress. Aim: Detection of a spectrum of aberrations in the CYP21A2 gene, including copy number variations, gene conversion, chimeric genes, and point variations. Methods: The CYP21A2 gene was screened using MLPA assay in 112 unrelated Egyptian children with 21-OHD CAH (33 males and 79 females). Results: In the studied group, 79.5% were diagnosed within the first month of life. 46.8% of the genetic females were misdiagnosed as males. Among the copy number variation results, large deletions in 15.4% and three types of chimeric genes in 9% (CH-1, CH-7, and CAH-X CH-1) were detected. Regarding gene dosage, one copy of CYP21A2 was found in 5 cases (4.5%), three copies were detected in 7 cases (6.3%), and one case (0.9%) showed four copies. Eight common genetic variants were identified, I2G, large deletions, large gene conversion (LGC), I172N, F306 + T, -113 SNP, 8bp Del, and exon 6 cluster (V237E and M239K) with an allelic frequency of 32.62%, 15.45%, 7.30%, 3.00%, 2.58%, 2.15%, 0.86%, and 0.86%, respectively. Conclusion: High prevalence of copy number variations highlights the added value of using MLPA in routine laboratory diagnosis of CAH patients.
Collapse
Affiliation(s)
- Aisha Tolba
- Clinical and Chemical Pathology Department, Cairo University, Giza, Egypt
| | - Iman Mandour
- Clinical and Chemical Pathology Department, Cairo University, Giza, Egypt
| | - Noha Musa
- Diabetes, Endocrine and Metabolism Pediatric Unit, Cairo University, Giza, Egypt
| | - Fatma Elmougy
- Clinical and Chemical Pathology Department, Cairo University, Giza, Egypt
| | - Mona Hafez
- Diabetes, Endocrine and Metabolism Pediatric Unit, Cairo University, Giza, Egypt
| | - Sahar Abdelatty
- Clinical and Chemical Pathology Department, Cairo University, Giza, Egypt
| | - Amany Ibrahim
- Diabetes, Endocrine and Metabolism Pediatric Unit, Cairo University, Giza, Egypt
| | - Hend Soliman
- Diabetes, Endocrine and Metabolism Pediatric Unit, Cairo University, Giza, Egypt
| | - Bahaaeldin Labib
- Royal College of Surgeons in Ireland, Medical University of Bahrain, Giza, Egypt
| | - Yasmine Elshiwy
- Clinical and Chemical Pathology Department, Cairo University, Giza, Egypt
| | - Tarek Ramzy
- Clinical and Chemical Pathology Department, Cairo University, Giza, Egypt
| | - Marwa Elsharkawy
- Clinical and Chemical Pathology Department, Cairo University, Giza, Egypt
- *Correspondence: Marwa Elsharkawy,
| |
Collapse
|
9
|
Musa N, Elmonem MA, Beetz C, Hafez M, Hassan M, Rolfs A, Selim L, Elkhateeb N. A novel POU1F1 pathogenic variant: Two familial case reports with phenotype expansion. Clin Genet 2021; 100:641-642. [PMID: 34378789 DOI: 10.1111/cge.14043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/31/2021] [Accepted: 08/02/2021] [Indexed: 11/28/2022]
Abstract
Up: A schematic-diagram of POU1F1-gene. Down right: an electrophoretogram of the detected novel pathogenic-variant in comparison with wild-type POU1F1 exon-6 sequence. Down left: Family pedigree of the two-siblings reported.
Collapse
Affiliation(s)
- Noha Musa
- Diabetes, Endocrine and Metabolism Pediatric Unit, Pediatrics Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed A Elmonem
- Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | - Mona Hafez
- Diabetes, Endocrine and Metabolism Pediatric Unit, Pediatrics Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mona Hassan
- Diabetes, Endocrine and Metabolism Pediatric Unit, Pediatrics Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | - Laila Selim
- Pediatric Neurology and Inherited Metabolic Diseases Unit, Pediatrics Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Nour Elkhateeb
- Pediatric Neurology and Inherited Metabolic Diseases Unit, Pediatrics Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| |
Collapse
|
10
|
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.
Collapse
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
| |
Collapse
|
11
|
Frandsen E, Kirk C, Law Y, Musa N, Files M. Use of Isosorbide Dinitrate/Hydralazine in the Pediatric Cardiac Population. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.587] [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
|
12
|
Elmougy F, Elsharkawy M, Hafez M, Atty SA, Baz H, Ibrahim A, Soliman H, Ekladious S, Abdullatif M, Thabet G, Rady N, Afif A, Tolba A, Zaki Z, Musa N. Genetic profiling of CAH Egyptian children: rapid guide to clinical interpretation of common mutations. J Endocrinol Invest 2021; 44:83-93. [PMID: 32358738 DOI: 10.1007/s40618-020-01271-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 01/21/2020] [Accepted: 04/21/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES The prevalence of CAH in Egypt is reported to be ten times more than that of the worldwide prevalence. The study aimed at genetic screening of children diagnosed with 21-alpha hydroxylase deficiency congenital adrenal hyperplasia (21OHD-CAH). In addition, the study offers a rapid and easy guide for clinical reporting of common mutations for endocrinologists. METHODS A cohort of 174 unrelated Egyptian children with 21OHD-CAH were screened for 11 common CYP21A2 gene mutations using a strip hybridization assay, and then, bioinformatics analysis was done to report the pathogenicity of the common mutations for clinical classification. RESULTS The most common mutations were I2 splice and p.Q318X. Deletions/conversions comprised 45.9% of the cohort, whereas 7.4% of the cases were negative for all mutations. The least positively detected point mutations were p.P453S, cluster E6, p.R483P, and p.L307FS, which were detected in fewer than 5% of cases. CONCLUSION Strip hybridization assay is a rapid screening tool for the diagnosis of CAH. The authors hypothesized an easy and rapid scheme for clinical interpretation of the strip results to gain the highest value of the strip in diagnosis.
Collapse
Affiliation(s)
- F Elmougy
- Clinical and Chemical Pathology Department, Faculty of Medicine, Kasr Al-Aini Hospital, Cairo University, Cairo, 11562, Egypt
| | - M Elsharkawy
- Clinical and Chemical Pathology Department, Faculty of Medicine, Kasr Al-Aini Hospital, Cairo University, Cairo, 11562, Egypt.
| | - M Hafez
- Diabetes, Endocrine and Metabolism Pediatric Unit, Cairo University, Cairo, Egypt
| | - S A Atty
- Clinical and Chemical Pathology Department, Faculty of Medicine, Kasr Al-Aini Hospital, Cairo University, Cairo, 11562, Egypt
| | - H Baz
- Clinical and Chemical Pathology Department, Faculty of Medicine, Kasr Al-Aini Hospital, Cairo University, Cairo, 11562, Egypt
| | - A Ibrahim
- Diabetes, Endocrine and Metabolism Pediatric Unit, Cairo University, Cairo, Egypt
| | - H Soliman
- Diabetes, Endocrine and Metabolism Pediatric Unit, Cairo University, Cairo, Egypt
| | - S Ekladious
- Clinical and Chemical Pathology Department, Faculty of Medicine, Kasr Al-Aini Hospital, Cairo University, Cairo, 11562, Egypt
| | - M Abdullatif
- Clinical and Chemical Pathology Department, Faculty of Medicine, Kasr Al-Aini Hospital, Cairo University, Cairo, 11562, Egypt
| | - G Thabet
- Clinical and Chemical Pathology Department, Faculty of Medicine, Kasr Al-Aini Hospital, Cairo University, Cairo, 11562, Egypt
| | - N Rady
- Clinical and Chemical Pathology Department, Faculty of Medicine, Kasr Al-Aini Hospital, Cairo University, Cairo, 11562, Egypt
| | - A Afif
- Clinical and Chemical Pathology Department, Faculty of Medicine, Kasr Al-Aini Hospital, Cairo University, Cairo, 11562, Egypt
| | - A Tolba
- Clinical and Chemical Pathology Department, Faculty of Medicine, Kasr Al-Aini Hospital, Cairo University, Cairo, 11562, Egypt
| | - Z Zaki
- Clinical and Chemical Pathology Department, Minia University, El Minya, Egypt
| | - N Musa
- Diabetes, Endocrine and Metabolism Pediatric Unit, Cairo University, Cairo, Egypt
| |
Collapse
|
13
|
Musa N, Asem N, Basyony S, Fawaz L. Assessment of health-related quality of life in Egyptian children and adolescents with congenital adrenal hyperplasia. J Pediatr Endocrinol Metab 2020; 33:295-304. [PMID: 32004147 DOI: 10.1515/jpem-2019-0345] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 07/28/2019] [Accepted: 11/18/2019] [Indexed: 11/15/2022]
Abstract
Background Congenital adrenal hyperplasia (CAH) is a chronic disorder causing adrenal insufficiency and hyperandrogenism affecting the quality of life (QOL). The objective of the study was to assess the health-related QOL (HRQOL) in Egyptian children and adolescents with CAH and to identify factors affecting it. Methods This cross-sectional study included 200 CAH patients (with 21-hydroxylase deficiency [21-OHD]) who were assessed according to their age, sex, clinical phenotype, timing of genitoplasty, hospital admissions within the last year, compliance to treatment, regularity of follow-up, presence of complications and hormonal control. HRQOL was assessed using the World Health Organization (WHO)QOL-BREF questionnaire with four domains analyzed independently including physical, psychological, social and environmental domains, with higher scores indicating better QOL. Results The study included 140 females and 60 males with a mean age of 6.6 ± 4.5 years, and 88% were salt-wasting (SW). Older patients had significantly lower QOL scores (r = - 0.151, p = 0.033). The physical domain correlated significantly with the degree of virilization (r = - 0.491, p = 0.001) and frequency of hospitalization (r = - 0.495, p < 0.001). The psychological domain was affected by age (r = - 0.157, p = 0.026) and timing of genitoplasty (r = - 0.326, p = 0.001), while the social domain was affected by age (r = -0.277, p < 0.005) and pubertal stage (r = - 0.195, p = 0.006). Females had lower scores at the psychological domain (p < 0.001), whereas males had lower scores at the physical domain (p = 0.003). Salt-losing patients had lower scores at the physical domain (p = 0.001). Patients with good hormonal control had higher scores at the physical domain (p = 0.03). Genitoplasty affected both psychological and social domains (p = 0.003 and 0.01, respectively). Patients with hypertension and hirsutism had lower QOL scores (p < 0.05). Conclusions HRQOL was relatively more affected in CAH patients with older age, poor hormonal control, high frequency of hospital admissions and those who developed complications.
Collapse
Affiliation(s)
- Noha Musa
- Assistant Professor of Pediatric Endocrinology, Diabetes Endocrine and Metabolism Pediatric Unit, Pediatric Department, Cairo University, Cairo, Egypt.,home address: 15 Naser El Thawra street, Haram, 12111 Giza, Egypt, Phone: +2 01225304041
| | - Noha Asem
- Department of Public Health, Cairo University, Cairo, Egypt
| | - Shaza Basyony
- Pediatric resident at Diabetes Endocrine and Metabolism Pediatric Unit, Cairo University, Cairo, Egypt
| | - Lubna Fawaz
- Professor of Pediatric Endocrinology, Diabetes Endocrine and Metabolism Pediatric Unit, Cairo University, Cairo, Egypt
| |
Collapse
|
14
|
Hafez M, Musa N, Abdel Atty S, Ibrahem M, Abdel Wahab N. Effect of Vitamin D Supplementation on Lipid Profile in Vitamin D-Deficient Children with Type 1 Diabetes and Dyslipidemia. Horm Res Paediatr 2020; 91:311-318. [PMID: 31266036 DOI: 10.1159/000500829] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 03/10/2019] [Accepted: 05/08/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Vitamin D (VD) was suggested to have both direct and indirect effects on modifying lipid profile in patients with diabetes through its regulatory action that increases the activity of lipoprotein lipase in adiposity. OBJECTIVES To detect the relationship between serum 25-hydroxyvitamin D (25OHD) and lipid profiles in dyslipidemic T1D patients and study the effect of VD supplementation on lipid profiles of VD-deficient T1D patients. METHODS Fifty patients with T1D (for >2 years) and dyslipidemia were included. 25OHD was assessed and patients were divided accordingly into 2 groups: VD sufficiency (>30 ng/mL) and VD deficiency (VDD) or insufficiency (<29 ng/mL) who were allocated to VD3 supplementation for 4 months, then lipid profile was reevaluated in both groups. RESULTS Thirty patients had VDD, while 20 patients had VD sufficiency. There was no significant correlation between 25OHD and different study parameters (p > 0.05). A significant difference was found among both groups in the family history of coronary heart disease (p = 0.036) and free tetraiodothyronine 4 (p = 0.035). After 4 months of VD supplementation in VDD group, the mean difference (at 0 and 4 months) in low-density lipoproteins (LDL) and hemoglobin A1c (HbA1c) was statistically significant (p = 0.02 and 0.04 respectively) between both groups. The mean basal LDL was 126.91 mg/dL in VDD group that improved to 117.13 mg/dL after 4 months of VD therapy with a mean difference of -9.7 mg/dL compared to a mean difference of -2 mg/dL in VD sufficiency group. CONCLUSIONS VDD was highly prevalent in patients with T1D. There was no significant correlation between 25OHD levels and lipid profile in patients with T1D. VD supplementation for 4 months had a significant lowering effect on LDL and HbA1c.
Collapse
Affiliation(s)
- Mona Hafez
- Diabetes, Endocrine and Metabolism Pediatric Unit, Children Hospital, Cairo University, Cairo, Egypt
| | - Noha Musa
- Diabetes, Endocrine and Metabolism Pediatric Unit, Children Hospital, Cairo University, Cairo, Egypt,
| | - Sahar Abdel Atty
- Department of Chemical Pathology, Cairo University, Cairo, Egypt
| | - Mohamed Ibrahem
- Department of Clinical Biochemistry, Cairo University, Cairo, Egypt
| | - Nehal Abdel Wahab
- Diabetes, Endocrine and Metabolism Pediatric Unit, Children Hospital, Cairo University, Cairo, Egypt
| |
Collapse
|
15
|
Samsuddin S, Arumugam PA, Md Amin MS, Yahya A, Musa N, Lim LL, Paramasivam SS, Ratnasingam J, Ibrahim L, Chooi KC, Tan A, Tan PC, Omar SZ, Samingan N, Ahmad Kamar A, Anuar Zaini A, Jalaluddin MY, Vethakkan SR. Maternal lipids are associated with newborn adiposity, independent of GDM status, obesity and insulin resistance: a prospective observational cohort study. BJOG 2019; 127:490-499. [PMID: 31778255 DOI: 10.1111/1471-0528.16031] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To determine the association between maternal lipaemia and neonatal anthropometrics in Malaysian mother-offspring pairs. DESIGN Prospective observational cohort study. SETTING Single tertiary multidisciplinary antenatal clinic in Malaysia. POPULATION A total of 507 mothers: 145 with gestational diabetes mellitus (GDM); 94 who were obese with normal glucose tolerance (NGT) (pre-gravid body mass index, BMI ≥ 27.5 kg/m2 ), and 268 who were not obese with NGT. METHODS Maternal demographic, anthropometric, and clinical data were collected during an interview/examination using a structured questionnaire. Blood was drawn for insulin, C-peptide, triglyceride (Tg), and non-esterified fatty acid (NEFA) during the 75-g 2-hour oral glucose tolerance test (OGTT) screening, and again at 36 weeks of gestation. At birth, neonatal anthropometrics were assessed and data such as gestational weight gain (GWG) were extracted from the records. MAIN OUTCOME MEASURES Macrosomia, large-for-gestational-age (LGA) status, cohort-specific birthweight (BW), neonatal fat mass (NFM), and sum of skinfold thickness (SSFT) > 90th centile. RESULTS Fasting Tg > 95th centile (3.6 mmol/L) at screening for OGTT was independently associated with LGA (adjusted odds ratio, aOR 10.82, 95% CI 1.26-93.37) after adjustment for maternal glucose, pre-gravid BMI, and insulin sensitivity. Fasting glucose was independently associated with a birthweight ratio (BWR) of >90th centile (aOR 2.06, 95% CI 1.17-3.64), but not with LGA status, in this well-treated GDM cohort with pre-delivery HbA1c of 5.27%. In all, 45% of mothers had a pre-gravid BMI of <23 kg/m2 and 61% had a pre-gravid BMI of ≤ 25 kg/m2 , yet a GWG of >10 kg was associated with a 4.25-fold risk (95% CI 1.71-10.53) of BWR > 90th centile. CONCLUSION Maternal lipaemia and GWG at a low threshold (>10 kg) adversely impact neonatal adiposity in Asian offspring, independent of glucose, insulin resistance and pre-gravid BMI. These may therefore be important modifiable metabolic targets in pregnancy. TWEETABLE ABSTRACT Maternal lipids are associated with adiposity in Asian babies independently of pre-gravid BMI, GDM status, and insulin resistance.
Collapse
Affiliation(s)
- S Samsuddin
- Endocrine Unit, Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - P A Arumugam
- Endocrine Unit, Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Md S Md Amin
- Endocrine Unit, Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - A Yahya
- Department of Social and Preventive Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - N Musa
- Endocrine Unit, Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - L-L Lim
- Endocrine Unit, Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - S S Paramasivam
- Endocrine Unit, Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - J Ratnasingam
- Endocrine Unit, Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - L Ibrahim
- Endocrine Unit, Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - K C Chooi
- Endocrine Unit, Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Atb Tan
- Endocrine Unit, Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - P C Tan
- Department of Obstetrics and Gynaecology, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - S Z Omar
- Department of Obstetrics and Gynaecology, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - N Samingan
- Department of Paediatrics, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - A Ahmad Kamar
- Department of Paediatrics, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - A Anuar Zaini
- Department of Paediatrics, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - M Y Jalaluddin
- Department of Paediatrics, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - S R Vethakkan
- Endocrine Unit, Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| |
Collapse
|
16
|
Musa N, Aquilino F, Panzera P, Martines G. Successful conservative treatment of enterocutaneous fistula with cyanoacrylate surgical sealant: case report. G Chir 2019; 38:256-259. [PMID: 29280707 DOI: 10.11138/gchir/2017.38.5.256] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
AIM Enterocutaneous (EC) fistula is an abnormal communication between the gastrointestinal tract and the skin. The majority of EC fistulas result from surgery. Only 15-25% of EC fistulas are spontaneous and they often result from underlying diseases such as Crohn's disease, radiation and chemotherapy. CASE REPORT A 62-year old woman who, in 2012, underwent Pylorus-preserving cephalic pancreaticoduodenectomy (PPPD sec. Traverso-Longmire), due to an advanced pancreatic ductal adenocarcinoma (pT3N1M1). After surgery, the patient underwent chemotherapy with folfirinox regimen. In December 2016, as a result of the appearance of metastatic liver lesions and perianastomotic recurrence, the patient underwent second line treatment with Gemcitabine and pab-paclitaxel. After five months from the beginning of this new second line therapy she presented an EC fistula. The fistula of the patient was successfully treated with total parenteral nutrition and with percutaneous injection of cyanoacrylic sealant. RESULTS The result suggests the advisability of percutaneous injection of sealant devices, such as cyanoacrylate glue; in order to successfully control stable Enterocutaneous fistulas with acceptable morbidity and mortality especially in particular situations, such as, with low output EC fistulas without signs of complications or on patients considered not suitable for surgery, a conservative approach could ensure the control of the fistula. CONCLUSION This approach is easy and safe, viable and useful for future trials on the efficacy in conservative treatment of EC fistula.
Collapse
|
17
|
Hafez M, Musa N, Elbehairy S, Atty SA, Elbarbary M, Amin M. Effect of metformin on clinical and biochemical hyperandrogenism in adolescent girls with type 1 diabetes. J Pediatr Endocrinol Metab 2019; 32:461-470. [PMID: 31005950 DOI: 10.1515/jpem-2018-0430] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 10/04/2018] [Accepted: 03/07/2019] [Indexed: 12/31/2022]
Abstract
Background Hyperandrogenism with or without polycystic ovarian syndrome is seen in adolescents with type 1 diabetes (T1D), especially those with suboptimal control. Objective To assess the effect of metformin on hyperandrogenism and ovarian function in adolescents with T1D. Methods This prospective study included 28 T1D females showing signs of hyperandrogenism. History taking (detailed diabetes history and menstrual history) and anthropometric measurements (weight, height, body mass index [BMI], waist and hip circumference) were initially performed, and then the patients were assessed for the manifestations of hyperandrogenism (acne, hirsutism as well as pelvic ultrasound [U/S] for ovarian morphology). Biochemical evaluation for ovulation (progesterone assessment during the luteal phase), sex steroids (estradiol, testosterone, dehydroepiandrosterone sulfate [DHEAS] and androstenedione), prolactin, glycemic control (hemoglobin A1c [HbA1c]) and gonadotropin levels (follicle stimulating hormone [FSH] and luteinizing hormone [LH]) was done. Patients were subjected to 500 mg metformin twice daily orally for 1 year, and then the patients were re-evaluated for clinical and biochemical parameters. Results Metformin therapy resulted in a significant reduction in weight (p = 0.001), BMI (p = 0.002), acne (p = 0.008), hirsutism score (0.007), LH (p = 0.008), testosterone (p < 0.001) and androstenedione levels (p = 0.028) in adolescent girls with T1D. Regarding menstrual irregularities, there was a significant reduction in the number of patients with oligomenorrhea (68%) with a p value of <0.001. However, there were no significant reduction in the daily insulin requirements (p = 0.782) or HbA1c (p = 0.068). Nausea and/or abdominal pain were the commonly reported side effects of metformin (64%). Conclusions Metformin as an insulin sensitizing agent improved the BMI and cycle regularity together with clinical and biochemical hyperandrogenism in T1D adolescent girls. However, it did not improve their glycemic control.
Collapse
Affiliation(s)
- Mona Hafez
- Department of Pediatric Endocrinology, DEMPU, Cairo University, Cairo, Egypt
| | - Noha Musa
- Assistant Professor of Pediatric Endocrinology, Diabetes, Endocrine and Metabolism Pediatric Unit, Pediatric Department, Cairo University,Cairo 12111, Egypt, Phone: +2 01225304041
| | - Shaimaa Elbehairy
- Department of Pediatric Endocrinology, DEMPU, Cairo University, Cairo, Egypt
| | - Sahar Abdel Atty
- Department of Chemical Pathology, DEMPU, Cairo University, Cairo, Egypt
| | - Menna Elbarbary
- Pediatric Ultrasonography Unit, Children Hospital, Cairo University, Cairo, Egypt
| | - Maha Amin
- Department of Pediatric Endocrinology, DEMPU, Cairo University, Cairo, Egypt
| |
Collapse
|
18
|
|
19
|
Madani H, Elkaffas R, Alkholy B, Musa N, Shaalan Y, Elkaffas R, Hassan M, Hafez M, Flanagan SE, De Franco E, Hussain K. Identification of novel variants in neonatal diabetes mellitus genes in Egyptian patients with permanent NDM. Int J Diabetes Dev Ctries 2019. [DOI: 10.1007/s13410-018-0658-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
20
|
Musa N, Law Y, Richardson N, Albers E, Kemna M, Friedland-little J, Hong B, Mazor R. Use of Isosorbide Dinitrate/Hydralazine Combination in Pediatric Patients with Heart Failure. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.1003] [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: 11/29/2022] Open
|
21
|
Martines G, Musa N, Aquilino F, Capuano P. Severe neurological complication following adjustable gastric banding. G Chir 2018; 39:92-96. [PMID: 29694308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
AIM In the last years with the increase of bariatric surgery, first of all as a result of new indications, a rise in the incidence of nutrient-related complications has been observed. Currently little is known about the impact of post-bariatric malnutrition and neurological complications. Wernicke's encephalopathy is a severe neurological syndrome which occurs as a result of thiamine deficiency. Wernicke-Korsakoff syndrome must be considered a serious neurological complication of bariatric surgery with significant morbidity and mortality, with rapidly progressing neurological symptoms, and must be treated immediately. CASE REPORT We report the case of a 35 years-old male patient, affected by morbid obesity, anxious-depressive syndrome and alcohol use disorder, who after adjustable gastric banding implanted in another hospital developed a severe malnutrition and neurological syndrome. The patient showed poor adherence to the follow-up and to the dietary indications and after all, we needed to place a PEG for enteral nutrition in order to resolve the malnutrition condition and the neurological syndrome. Our experience emphasizes that preoperative selection and assessment of a patient's nutritional status according to guidelines, is required to identify potential problems, and that bariatric surgeons or physicians caring for patient who have undergone bariatric surgery should be familiar with the constellation of nutritional and neurological disorder that may occur after surgery. CONCLUSION We want to remark the importance of preoperative selection of the patients, the follow-up and the cooperation between patient and physician in order to obtain the best result and avoid severe complications.
Collapse
|
22
|
Elmougy F, Sharaf S, Hafez M, Khattab A, Abou-Yousef H, Elsharkawy M, Baz H, Ekladious S, Sherif B, Musa N, Elshiwy Y, Afif A, Abdullatif M, Thabet G, Rady N, Ibrahim A, Soliman H. CYP21A2 genetic profile in 14 Egyptian children with suspected congenital adrenal hyperplasia: a diagnostic challenge. Ann N Y Acad Sci 2017; 1415:11-20. [PMID: 29266270 DOI: 10.1111/nyas.13540] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 09/28/2017] [Accepted: 10/02/2017] [Indexed: 11/28/2022]
Abstract
CYP21A2 genotyping remains an important element in the diagnosis and management of congenital adrenal hyperplasia, and establishing accurate genotype-phenotype correlations has facillitated adequate genetic counseling and prenatal management for at-risk families. Despite extensive efforts to establish a clear genotype-phenotype correlation, some discordance remains. Establishing a diagnosis of congenital adrenal hyperplasia on the basis of biochemical and clinical data is occasionally challenging, and the identification of CYP21A2 mutations may help confirm the diagnosis. We review the diagnostic challenges despite an extensive genetic evaluation for 14 patients with a suspected clinical and biochemical diagnosis of congenital adrenal hyperplasia. Other diagnostic entities should be considered in the absence of convincing genetic data.
Collapse
Affiliation(s)
- Fatma Elmougy
- Department of Clinical and Chemical Pathology, Cairo University, Giza, Egypt
| | - Sahar Sharaf
- Department of Clinical and Chemical Pathology, Cairo University, Giza, Egypt
| | - Mona Hafez
- Diabetes, Endocrine and Metabolism Pediatric Unit, Cairo University, Giza, Egypt
| | - Ahmed Khattab
- Icahn School of Medicine at Mount Sinai, New York, New York
| | - Hazem Abou-Yousef
- Department of Clinical and Chemical Pathology, Cairo University, Giza, Egypt
| | - Marwa Elsharkawy
- Department of Clinical and Chemical Pathology, Cairo University, Giza, Egypt
| | - Heba Baz
- Department of Clinical and Chemical Pathology, Cairo University, Giza, Egypt
| | - Sherif Ekladious
- Department of Clinical and Chemical Pathology, Cairo University, Giza, Egypt
| | - Balsam Sherif
- Department of Clinical and Chemical Pathology, Cairo University, Giza, Egypt
| | - Noha Musa
- Diabetes, Endocrine and Metabolism Pediatric Unit, Cairo University, Giza, Egypt
| | - Yasmin Elshiwy
- Department of Clinical and Chemical Pathology, Cairo University, Giza, Egypt
| | - Alaa Afif
- Department of Clinical and Chemical Pathology, Cairo University, Giza, Egypt
| | - Mona Abdullatif
- Department of Clinical and Chemical Pathology, Cairo University, Giza, Egypt
| | - Ghada Thabet
- Department of Clinical and Chemical Pathology, Cairo University, Giza, Egypt
| | - Normeen Rady
- Department of Clinical and Chemical Pathology, Cairo University, Giza, Egypt
| | - Amany Ibrahim
- Diabetes, Endocrine and Metabolism Pediatric Unit, Cairo University, Giza, Egypt
| | - Hend Soliman
- Diabetes, Endocrine and Metabolism Pediatric Unit, Cairo University, Giza, Egypt
| |
Collapse
|
23
|
Low CF, Rozaini MZH, Musa N, Syarul Nataqain B. Current knowledge of metabolomic approach in infectious fish disease studies. J Fish Dis 2017; 40:1267-1277. [PMID: 28252175 DOI: 10.1111/jfd.12610] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 12/17/2016] [Accepted: 12/19/2016] [Indexed: 05/20/2023]
Abstract
The approaches of transcriptomic and proteomic have been widely used to study host-pathogen interactions in fish diseases, and this is comparable to the recently emerging application of metabolomic in elucidating disease-resistant mechanisms in fish that gives new insight into potential therapeutic strategies to improve fish health. Metabolomic is defined as the large-scale study of all metabolites within an organism and represents the frontline in the 'omics' approaches, providing direct information on the metabolic responses and perturbations in metabolic pathways. In this review, the current research in infectious fish diseases using metabolomic approach will be summarized. The metabolomic approach in economically important fish infected with viruses, bacteria and nematodes will also be discussed. The potential of the metabolomic approach for management of these infectious diseases as well as the challenges and the limitations of metabolomic in fish disease studies will be explored. Current review highlights the impacts of metabolomic studies in infectious fish diseases, which proposed the potential of new therapeutic strategies to enhance disease resistance in fish.
Collapse
Affiliation(s)
- C-F Low
- Institute of Systems Biology, Universiti Kebangsaan Malaysia, Selangor, Malaysia
| | - M Z H Rozaini
- Institute of Marine Biotechnology, Universiti Malaysia Terengganu, Terengganu, Malaysia
| | - N Musa
- School of Fisheries and Aquaculture Sciences, Universiti Malaysia Terengganu, Terengganu, Malaysia
| | - B Syarul Nataqain
- Institute of Systems Biology, Universiti Kebangsaan Malaysia, Selangor, Malaysia
| |
Collapse
|
24
|
Hafez M, Hassan M, Musa N, Abdel Atty S, Azim SA. Vitamin D status in Egyptian children with type 1 diabetes and the role of vitamin D replacement in glycemic control. J Pediatr Endocrinol Metab 2017; 30:389-394. [PMID: 27997353 DOI: 10.1515/jpem-2016-0292] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [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: 07/20/2016] [Accepted: 11/03/2016] [Indexed: 01/16/2023]
Abstract
BACKGROUND The association of low serum 25 hydroxy cholecalciferol (25OHD) levels with high glucose level and diminished insulin sensitivity suggests that vitamin D (VD) may modulate insulin metabolism. The aim of the study was to screen for vitamin D deficiency (VDD) in pediatric patients with type 1 diabetes (T1D) and study the effect of VD supplementation on their glycemic control and insulin requirements. METHODS A prospective cohort study including 50 patients with T1D. VD level was assessed initially and after 3 months of VD supplementation (in those with VDD). HbA1c and insulin requirements were studied at 0, 3 and 6 months of supplementation. RESULTS Fifty patients with T1D were included with mean diabetes duration of 4.11±2.34 years. VD level ranged from 0.2 to 33 ng/mL. VD status correlated significantly with daily insulin dose (p=0.030, r=0.306) and HbA1c (p<0.001, r=0.243). Thirty-five patients (70%) had VDD and were allocated for VD supplementation for 3 months. The mean HbA1c improved significantly after supplementation (p=0.003), followed by a significant deterioration at 6 months with no change in their insulin requirements at 3 or 6 months. CONCLUSIONS VD was highly prevalent in Egyptian T1D patients. VD supplementation improved glycemic control at 3 months after therapy with no reduction in insulin requirements.
Collapse
Affiliation(s)
- Mona Hafez
- Diabetes, Endocrine and Metabolism Pediatric Unit, Cairo University, Cairo
| | - Mona Hassan
- Diabetes, Endocrine and Metabolism Pediatric Unit, Cairo University, Cairo
| | - Noha Musa
- Lecturer of Pediatrics, Diabetes, Endocrine and Metabolism Pediatric Unit, Pediatric Department, Cairo University, Cairo
| | | | - Sally Abdel Azim
- Diabetes, Endocrine and Metabolism Pediatric Unit, Cairo University, Cairo
| |
Collapse
|
25
|
Khattab A, Haider S, Kumar A, Dhawan S, Alam D, Romero R, Burns J, Li D, Estatico J, Rahi S, Fatima S, Alzahrani A, Hafez M, Musa N, Razzghy Azar M, Khaloul N, Gribaa M, Saad A, Charfeddine IB, Bilharinho de Mendonça B, Belgorosky A, Dumic K, Dumic M, Aisenberg J, Kandemir N, Alikasifoglu A, Ozon A, Gonc N, Cheng T, Kuhnle-Krahl U, Cappa M, Holterhus PM, Nour MA, Pacaud D, Holtzman A, Li S, Zaidi M, Yuen T, New MI. Clinical, genetic, and structural basis of congenital adrenal hyperplasia due to 11β-hydroxylase deficiency. Proc Natl Acad Sci U S A 2017; 114:E1933-E1940. [PMID: 28228528 PMCID: PMC5347606 DOI: 10.1073/pnas.1621082114] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Congenital adrenal hyperplasia (CAH), resulting from mutations in CYP11B1, a gene encoding 11β-hydroxylase, represents a rare autosomal recessive Mendelian disorder of aberrant sex steroid production. Unlike CAH caused by 21-hydroxylase deficiency, the disease is far more common in the Middle East and North Africa, where consanguinity is common often resulting in identical mutations. Clinically, affected female newborns are profoundly virilized (Prader score of 4/5), and both genders display significantly advanced bone ages and are oftentimes hypertensive. We find that 11-deoxycortisol, not frequently measured, is the most robust biochemical marker for diagnosing 11β-hydroxylase deficiency. Finally, computational modeling of 25 missense mutations of CYP11B1 revealed that specific modifications in the heme-binding (R374W and R448C) or substrate-binding (W116C) site of 11β-hydroxylase, or alterations in its stability (L299P and G267S), may predict severe disease. Thus, we report clinical, genetic, hormonal, and structural effects of CYP11B1 gene mutations in the largest international cohort of 108 patients with steroid 11β-hydroxylase deficiency CAH.
Collapse
Affiliation(s)
- Ahmed Khattab
- Division of Adrenal Steroid Disorders, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029
| | - Shozeb Haider
- School of Pharmacy, University College London, London WC1N 4AX, United Kingdom
| | - Ameet Kumar
- Division of Adrenal Steroid Disorders, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029
| | - Samarth Dhawan
- Division of Adrenal Steroid Disorders, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029
| | - Dauood Alam
- Division of Adrenal Steroid Disorders, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029
| | - Raquel Romero
- School of Pharmacy, University College London, London WC1N 4AX, United Kingdom
| | - James Burns
- School of Pharmacy, University College London, London WC1N 4AX, United Kingdom
| | - Di Li
- School of Pharmacy, University College London, London WC1N 4AX, United Kingdom
| | - Jessica Estatico
- Division of Adrenal Steroid Disorders, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029
| | - Simran Rahi
- Division of Adrenal Steroid Disorders, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029
| | - Saleel Fatima
- Division of Adrenal Steroid Disorders, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029
| | - Ali Alzahrani
- King Faisal Specialist Hospital and Research Centre, Riyadh 12713, Saudi Arabia
| | - Mona Hafez
- Diabetes, Endocrine, and Metabolism Pediatrics Unit, Department of Pediatrics, Cairo University, 11617 Cairo, Egypt
| | - Noha Musa
- Diabetes, Endocrine, and Metabolism Pediatrics Unit, Department of Pediatrics, Cairo University, 11617 Cairo, Egypt
| | - Maryam Razzghy Azar
- Ali Asghar Children's Hospital, Iran University of Medical Sciences, 10000 Tehran, Iran
| | - Najoua Khaloul
- Laboratory of Human Cytogenetic Molecular Genetics and Biology of Reproduction, Farhat Hached University Hospital, Sousse, Tunisia
| | - Moez Gribaa
- Laboratory of Human Cytogenetic Molecular Genetics and Biology of Reproduction, Farhat Hached University Hospital, Sousse, Tunisia
| | - Ali Saad
- Laboratory of Human Cytogenetic Molecular Genetics and Biology of Reproduction, Farhat Hached University Hospital, Sousse, Tunisia
| | - Ilhem Ben Charfeddine
- Laboratory of Human Cytogenetic Molecular Genetics and Biology of Reproduction, Farhat Hached University Hospital, Sousse, Tunisia
| | - Berenice Bilharinho de Mendonça
- Developmental Endocrinology Unit, Hormone and Molecular Genetics Laboratory, University of São Paulo, Sao Paulo 05508, Brazil
| | | | - Katja Dumic
- University Hospital Centre Zagreb, 10000 Zagreb, Croatia
| | - Miroslav Dumic
- University Hospital Centre Zagreb, 10000 Zagreb, Croatia
| | - Javier Aisenberg
- Pediatric Endocrinology and Diabetes Medicine, Hackensack University Medical Center, Hackensack, NJ 07601
| | - Nurgun Kandemir
- Faculty of Medicine, Hacettepe University, 06100 Ankara, Turkey
| | | | - Alev Ozon
- Faculty of Medicine, Hacettepe University, 06100 Ankara, Turkey
| | - Nazli Gonc
- Faculty of Medicine, Hacettepe University, 06100 Ankara, Turkey
| | - Tina Cheng
- Division of Adrenal Steroid Disorders, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029
| | | | | | - Paul-Martin Holterhus
- Department of Pediatrics, University Hospital of Schleswig-Holstein, 24105 Kiel, Germany
| | - Munier A Nour
- Department of Pediatrics, University of Saskatchewan College of Medicine, Saskatoon, SK, Canada S7N 0W8
| | - Daniele Pacaud
- Department of Pediatrics, University of Calgary, Calgary, AB, Canada T3B 6A8
| | - Assaf Holtzman
- Division of Adrenal Steroid Disorders, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029
| | - Sun Li
- Division of Adrenal Steroid Disorders, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029
| | - Mone Zaidi
- Division of Adrenal Steroid Disorders, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029
| | - Tony Yuen
- Division of Adrenal Steroid Disorders, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029
| | - Maria I New
- Division of Adrenal Steroid Disorders, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029;
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029
| |
Collapse
|
26
|
Hassan M, Musa N, Abdel Hai R, Fathy A, Ibrahim A. Assessment of health-related quality of life in Egyptian adolescents with type 1 diabetes: DEMPU survey. J Pediatr Endocrinol Metab 2017; 30:277-283. [PMID: 28236627 DOI: 10.1515/jpem-2016-0147] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Accepted: 01/02/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Type 1 diabetes (T1D) is a serious chronic illness that imposes significant morbidity and mortality with a major impact on the quality of life (QoL) that became a core issue in diabetes care. Understanding the effect of diabetes on QoL is important for day-to-day clinical management and also for public health policy initiatives aiming at improving health outcomes for those with diabetes. The objective of the study was to assess the QoL in adolescents with T1D and assess the applicability of the use of the "Quality of Life for Youth" questionnaire at the Diabetes, Endocrine and Metabolism Pediatric Unit (DEMPU) clinic. METHODS One hundred and fifty adolescents (82 males and 68 females) (10-18 years), with T1D of at least 1 years' duration, completed the questionnaire that evaluated symptoms related to diabetes, treatment, activities, parent issues, worries about diabetes and health perception. Higher scores indicated a more negative impact of diabetes and poorer QoL. RESULTS Males showed a significantly better mean QoL score than females (p=0.004). Different age groups showed different QoL scores (p=0.047). Urban adolescents had a better QoL than rural counterparts (p=0.02). Adolescents with poor QoL had generally lower educational level (p=0.02). Better metabolic control was associated with a better QoL (p=0.01). However, duration of diabetes and body mass index (BMI) had no statistically significant effect on QoL. CONCLUSIONS QoL had a variable significant association with certain socio-demographic and clinical characteristics of diabetics (sex, residence, educational level as well as metabolic control).
Collapse
|
27
|
|
28
|
Marei MM, Fares AE, Musa N, Abdelsattar AH, Sharaf A, Hassan MM, Elkotby M, Eltagy G, Hafez M, Elbarbary MM. Timing and Outcome Concerns regarding Feminizing Genitoplasty from the Perspective of Egyptian Families of Girls with Virilized External Genitalia. Horm Res Paediatr 2016; 85:49-57. [PMID: 26645541 DOI: 10.1159/000442200] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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] [Received: 07/24/2015] [Accepted: 11/03/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Congenital adrenal hyperplasia in females leads to virilization of external genitalia and persistent urogenital sinus. There are controversies regarding the timing and outcomes of surgery. Deferring surgeries beyond childhood is difficult to implement in conservative societies, and may result in stigmatization and distress to individuals with disorders of sexual differentiation and their families. METHODS Thirty girls with virilization due to congenital adrenal hyperplasia were admitted for single-stage feminizing genitoplasty, between 2011 and 2014. We prospectively studied the concerns and input of the families represented by the mothers. After comprehensive counselling, the mothers completed a questionnaire to clarify their priorities and concerns related to surgery. RESULTS Surgeries were performed at a mean age of 22 months. Most cases ranged between Prader's degrees III and IV. Egyptian families believe that early surgical reconstruction is in the best interest of their girls. They are marginally more concerned about functional outcomes and future child bearing than external appearance and cosmetic outcomes. CONCLUSIONS Social difficulties noticeably add challenges to the management plan within conservative societies. Early genital reconstructive surgery, when reasonably indicated, needs to remain a viable option. Comprehensive psychosocial support within a multidisciplinary approach is needed to defer feminizing genitoplasty in selected cases to adolescence.
Collapse
Affiliation(s)
- Mahmoud M Marei
- Department of Pediatric Surgery, Endocrinology and Metabolism Pediatric Unit (DEMPU), Cairo University, Cairo, Egypt
| | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Hafez M, El-Masry S, Musa N, Fathy M, Hassan M, Hassan N, El Husseiny M, Tareef M. Relationship between visceral obesity and plasma fibrinogen in obese children. J Pediatr Endocrinol Metab 2016; 29:289-96. [PMID: 26565545 DOI: 10.1515/jpem-2015-0264] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 09/03/2015] [Indexed: 12/23/2022]
Abstract
BACKGROUND The prevalence of obesity in children and adolescents has increased significantly worldwide with an alarming rise of its co-morbidities. The excess of visceral adipose tissue is associated with hypertension, prothrombotic and pro-inflammatory states. Our aim was to find a possible association between visceral obesity and plasma fibrinogen, as one of the cardiovascular risk factors, in obese children. METHODS Forty-three obese children and 40 non-obese controls were studied regarding their history, complete physical examination, anthropometric assessment, body composition analysis, ultrasonographic measurement of visceral adipose tissue and subcutaneous fat as well as laboratory measurement of plasma fibrinogen. RESULTS Our study revealed significant higher levels of fibrinogen in obese children than controls (14.5+5.1 and 2.9+0.52 mg/mL, respectively) with p-value <0.01. Moreover, the obese group had statistically significant difference in visceral fat (5.96+0.77 cm) and subcutaneous fat (2.66+0.70 cm) than controls (2.45+0.65 and 0.70+0.18 mg/mL, respectively) with p-value <0.01. In addition, fibrinogen had significant positive correlation with body mass index (r=0.327), waist/hip ratio (r=0.394), fat percentage (r=0.301), visceral adipose tissue (r=0.323) and subcutaneous fat (r=0.301). CONCLUSIONS There was highly significant increase in the fibrinogen level, visceral and subcutaneous abdominal fat in the obese group with insignificant sex differences. Fibrinogen had a significant positive correlation with the different adiposity markers, blood pressure, visceral and subcutaneous fat. Visceral adipose tissue is a stronger predictor for cardiovascular risk compared to subcutaneous fat.
Collapse
|
30
|
Abubakar U, Liman HM, Makusidi AM, Agwu NP, Opara AC, Musa N, Nazish PA, Jamalu IR, Opara OO, Ukwuani SI. Arterovenous fistula creation using the brachial artery and cubital fossa veins: a viable option in our environment. Saudi J Kidney Dis Transpl 2015; 26:135-6. [PMID: 25579734 DOI: 10.4103/1319-2442.148762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- U Abubakar
- Cardiothoracic Surgery Unit, Department of Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Anwar GM, Fouad HM, Abd El-Hamid A, Mahmoud F, Musa N, Lotfi H, Salah N. A study of familial Mediterranean Fever (MEFV) gene mutations in Egyptian children with type 1 diabetes mellitus. Eur J Med Genet 2015; 58:31-4. [DOI: 10.1016/j.ejmg.2014.10.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 10/19/2014] [Indexed: 02/06/2023]
|
32
|
Zahari Z, Lee CS, Ibrahim MA, Musa N, Yasin MAM, Tan SC, Mohamad N, Ismail R. P-38 * NO INFLUENCE OF OPIOID RECEPTOR, MU 1 (OPRM1) GENE POLYMORPHISMS ON PAIN SENSITIVITY AMONG OPIOID DEPENDENT PATIENTS ON METHADONE MAINTENANCE THERAPY (MMT) IN MALAYSIA. Alcohol Alcohol 2014. [DOI: 10.1093/alcalc/agu054.38] [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: 11/12/2022] Open
|
33
|
|
34
|
Au B, Hassan T, Musa N. The effect of feed restriction on certain haematological indices, enzymes and metabolites in Nubian goats. ACTA ACUST UNITED AC 1984. [DOI: 10.1016/0300-9629(84)90520-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
35
|
Zuhdi N, Musa N, Carey J, Greer A. A wrapping technique for the Magovern aortic prosthesis. Ann Thorac Surg 1966; 2:617-20. [PMID: 5934078 DOI: 10.1016/s0003-4975(10)66626-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
|
36
|
Zuhdi N, Carey J, Musa N, Rickey O, Greer A. Total replacement of aortic valve. J Okla State Med Assoc 1965; 58:540-3. [PMID: 5844320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
|
37
|
Zuhdi N, Ritchie C, Musa N, Carey J, Greer A. The permanently implanted bypass heart. J Thorac Cardiovasc Surg 1965; 50:800-10. [PMID: 5846182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
|