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Background: The pandemic caused by novel coronavirus disease 2019 (COVID-19) is considered the worst health crisis facing the entire world today. At the topmost of this crisis are the healthcare workers (HCWs) who are working to maintain well-being of all people. COVID-19 pandemic added more and more stress to healthcare workers in particular, depending on their work position. Objective: To assess mental health outcomes among HCWs dealing with confirmed or suspected COVID-19 patients. Methods: This is cross-sectional, hospital-based survey study conducted between Feb 6 and April 28, 2021. A total of 548 HCWs participated in the study. Mental health impact was assessed by using the 9- item Patient Health Questionnaire (PHQ-9), the 7-item Generalized Anxiety Disorder (GAD-7) and the 7-item Insomnia Severity Index (ISI) questionnaires. Multivariable logistic regression analysis was done to determine the risk factors of mental health outcomes. Results: Among the 548 HCWs surveyed;64.8% were nurses and 50.0% aged from 26-30 years old. About 52.0% worked in Benha University Hospital, 21.2% worked in Toukh Fever Hospital, and 26.8% worked in Qaha Central Hospital. A considerable proportion of HCWs had symptoms of anxiety, depression and insomnia. Nurses, workers aged from 26-30, those working in Qaha Central Hospital and those who had shift hours from 7–10 experienced more severe symptom levels of depression, anxiety, and insomnia. Nurses were associated with severe symptoms of anxiety, depression and insomnia. Conclusion: The COVID-19 pandemic represents a new working challenge for HCWs and intervention strategies to prevent depression and anxiety to reduce the risk of adverse mental health outcomes are needed. [ABSTRACT FROM AUTHOR] Copyright of Egyptian Journal of Hospital Medicine is the property of Egyptian Journal of Hospital Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Heart failure (HF) in children is a clinical and pathophysiological syndrome that results from ventricular dysfunction, volume or pressure overload, either alone or in combination. This study aimed to estimate serum level of H-FABP before and after treatment of congestive heart failure, and correlate its level with severity of the disease. Patients and methods: The study was cohort control study. It included 30 infants and children; their ages ranged from two months to four years with heart failure diagnosed clinically and were admitted to Cardiology Unit of Pediatric Department, at Zagazig University Hospitals during the period from November 2017 to April 2018. They were divided into four groups, first group aged (2-12 month), second group (13-24 m), third group (25-36 m) and fourth group (37-48 m). Echocardiographic assessment of the heart was done using conventional Doppler echocardiography. Serum heart type fatty acid binding protein (H-FABP) level (estimated on patient admission and 1 week after treatment) was determined by quantitative sandwich enzyme linked immunosorbent assay (ELISA) technique. Results: There was a significant difference in the serum level of H-FABP in our patients before treatment (2.156 ± 1.156 ng/ml) compared with after treatment (0.882 ± 0.716 ng/ml). There was a significant positive correlation between serum H-FABP level and Ross classification. Conclusion: H-FABP may be used as diagnostic and prognostic predictor of adverse outcome in children with heart failure.

Background: Congenital heart diseases are abnormalities of the heart and/or great vessels present at birth. 1% of live births have a congenital heart defect. Cardiac Troponin, especially cardiac Troponin I (cTnI), are the preferred biomarkers for the detection of cardiac injury. International cardiology and laboratory medicine guidelines recommend highly sensitive Tn1 (hscTnI) that has excellent precision (

Background: Heart failure is one of the cardiovascular diseases that have high morbidity and mortality especially among children. It accounts for 2% of all pediatric inpatient admission. Cardiac Myosin Binding Protein-C (cMyBP-C) is cardiomyocyte specific sarcomeric protein that regulates sarcomeric structure and its function where it is released in circulation in response to cardiac injury. Objective: To explore the role of cMyBP-C as a biomarker in heart failure in children. Patients and Methods: This prospective cohort study was carried out during the period from October 2017 to October 2018 in Pediatric Cardiology Unit, Zagazig University Hospital. It included 26 selected patients with heart failure diagnosed clinically and by echocardiography. Results: The study revealed that the most common cause pf heart failure in our patients was VSD (30.8%) then DCM (26.9%). 57.7% of studied patients were grade III of ROSS classification while 30.8% were grade IV and 11.5% were grade II. In ECHO findings, mean EF% was 52.3% while mean FS% was 33 % with negative correlation between plasma level of cMyBP-C and EF% and FS%. There was high statistical significant difference in cMyBP-C plasma level at time of admission and after treatment (123.5 ng/ml and 78.8 ng/ml respectively). There was high statistical significant difference in level of cMyBP-C among improved cases before and after treatment. There was no statistical significant difference in level of cMyBP-C before and after treatment among cases with bad prognosis. Conclusion: cMyBP-C could be a prognostic biomarker in children with HF and may be used as a tool to help in HF diagnosis in children as a marker of disease severity.

Background: Advances in echocardiographic technology have made a revolution in the quality of image and acquisition of data; however, it has also increased the cost of this diagnostic test. Objective: To determine if chest x ray (CXR) and electrocardiography (ECG) are still valuable in evaluation of new patients with heart murmurs in presence of echocardiography (ECHO). Patients and Methods: This was a six month, prospective clinical study undertaken in the Outpatient Pediatric Cardiology Unit, Zagazig University Children Hospital, between April 2018 and October 2018. The study included 44 patients (boys and girls) between the ages of 1 month and 14 years. All cases were subjected to detailed history, full clinical examination and imaging modalities as CXR, ECG and ECHO. Results: The highest accuracy of CXR was detection of right atrium (96.9%) followed by left ventricle (95.1%). The highest accuracy of ECG was detection of right atrium (98.5%) and left ventricle (95.5%). The agreement between CXR and ECHO in detection of pulmonary hypertension was 0.4 while that for ECG was 0.6. The agreement between CXR and ECHO in diagnosis of congenital heart diseases was 0.6 and that for ECG was 0.9. The accuracy of ECG in diagnosis of congenital heart disease was 95.4% while that for CXR was 70.4%. Conclusion: ECG is more accurate than CXR in detection of cardiac chamber enlargement and heart diseases in general but echocardiography still the most accurate method in this regard. The chest radiograph and electrocardiogram had limited values in the diagnosis of pulmonary pressure changes and echocardiography is the method to be used in this regard.

Introduction: Subclinical hypothyroidism (SCH) is a laboratory finding which may be asymptomatic or associated with signs and symptoms of hypothyroidism. However, benefits of L-Thyroxin (LT4) treatment are not well established. Aim of the Work: The aim of the study was to evaluate the impact of treatment of SCH on thyroid clinical scores, bone mineral density (BMD), cardiac function and health related quality of life (HR-QOL). Subjects and Methods: a total number of 65 women, who were diagnosed with SCH, constituted the study subjects. They were within the age range of 40-70 years. They were randomly divided into two groups (group I, included 25 patients who were treated with L Thyroxin (L-T4), and group II included 40 women with SCH who were not treated and kept under follow up for one year. Effects of L-T4 treatment on BMI, cardiac function, BMD, lipid profile, thyroid clinical score and HR-QOL were assessed. Results: After one year; regarding body mass index (BMI), Group II had significantly higher BMI (p=0.006) though the percentage change of BMI after one year was comparable in the two groups. Total thyroid clinical score and the total HR-QOL score were significantly lower in Group I compared to group II (p < 0.001). Regarding thyroid hormone profile; free T4 was significantly higher and thyroid stimulating hormone (TSH) was significantly lower in-group I compared to group II (p=0.033 & p < 0.001 respectively). Conclusion: LT4 treatment for women with SCH was found to improve total clinical thyroid score, HR-QOL, systolic and diastolic dysfunction besides lowering TC, LDL and TG levels. However, there was evidence of bone loss in patients with SCH treated with L-T4. Thus, decision to treat or not should be individualized according to the patient’s risk benefit ratio assessment.

Background: preeclampsia (PE) is a pregnancy related complication defined as a disease that begins in the placenta and ends at the maternal endothelium. It is a multi-stage disease that starts by utero-placental insufficiency and leads to generalized maternal endothelial dysfunction.Lipocalin2 (LCN2) is a 25kDasecretory glycoprotein implicated in many functions such as apoptosis and innate immunity. Also, it has been recognized to have potential effects in obesity, inflammation and insulin resistance in mice and humans. Many controversial studies about the changes in the plasma LCN2 levels in PE are reported. Aim: The current study was designed to perform an animal model of experimental PE in a trial to demonstrate the possible relationship between PE and the circulating LCN2 levels. Design: forty eight healthy adult female albino rats and eight adult male albino rats were used. The male rats were used for induction of pregnancy. The adult female rats (n=48) were divided into four equal groups: group I (control non-pregnant group), group II (non-pregnant treated with L-NAME), group III (normal pregnant group) and group IV (pregnant treated with L-NAME to induce a model of experimental PE). In all groups, body weight, body mass index (BMI), blood pressure, circulating levels of urea, creatinine, triglycerides (TGs), IL-6, endothelin-1(ET-1), vitamin D (VD), LCN2 and D-dimers in addition to total urinary proteins are measured. Histopathological examination of placental sections was done in group III and group IV. Results: The results of the present study revealed a significant increase in the body weight, BMI, MAP, total urinary proteins, circulating levels of urea, creatinine, TGs, IL-6, ET-1, LCN2 and D-dimers in both group II and IV. In addition to a significant decrease in VD in the same two groups. In group III, there was a significant increase in body weight, BMI, total urinary proteins and circulating levels of TGS, D-dimers and LCN2. There was a significant decrease in VD and MAP. Moreover, there was a positive significant correlation between LCN2 and all measured parameters except VD in group IV together with a positive significant correlation between LCN2 and MAP, IL-6, ET-1and D-dimers in group II.The results in group IV are supported by the histopathological examination results. Conclusion: L-NAME can be used for induction of experimental PE and plasma levels of LCN2 can be used as an indicator for the renal complications and coagulopathies in PE. Further studies are needed to ascertain this association.

Background: Osteoarthritis (OA) is the most common type of arthritis. It is a degenerative joint disease. OA is usually defined according to radiographic changes. Conventional radiographs (CR) were considered the most relevant outcome measure to assess the progression of OA in clinical trials and epidemiological studies. Many modalities are used in treatment of knee OA. There is a distinct need for new procedures that are cost effective by reducing the need for pharmaceutical and surgical management, while targeting the biochemical process of OA. Platelet-rich plasma (PRP) is one of these new procedures. PRP was found to increase hyaluronic acid (HA) concentration, stabilizing angiogenesis in patients with osteoarthritic knees. Aim of the study: Was to assess the value of intra articular injection of autologous platelet rich plasma in management of knee osteoarthritis. Patients and methods: This study was conducted on 40 patients with primary knee osteoarthritis, divided into 2 groups; study group treated with 3 injections of PRP, and control group treated with single dosed high-molecular weight HA. Clinical assessment and visual analogue scale (VAS) scoring were done pretreatment and 3 months post treatment. Results: Clinical improvement and reduction of VAS in both groups which is significant at the study group. Conclusion: PRP injection could be considered as a simple, safe, effective and non-palliative treatment that may promote cartilage healing in knee osteoarthritis as it improve the clinical condition and the function of the joint. Hence, it may represent a useful addition to the available therapeutic options for knee osteoarthritis.