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Background: Extreme body mass index (BMI) is an influential pathophysiological risk factor for serious illnesses following lower respiratory tract infection. The purpose of the current study was to examine how the BMI of Coronavirus disease-19 (COVID-19) patients affects their prognosis.Methods: Two hundred patients with COVID-19 admitted to Al-Azhar, Qena, Aswan, and Sohag University hospitals in Egypt were included and categorized into four groups according to their BMI. The diagnosis was made according to a real-time reverse transcription-polymerase chain reaction (rRT-PCR) positive result for the SARS-CoV-2 nucleic acid in swabs from upper respiratory tract. A detailed history, clinical examination, and outcomes (disease severity and complications, hospital stay, ICU admission, mortality) were recorded for all patients. SPSS version 24 software was used for data analysis.Results: Average age of participants (19– 90 years old), 92 (46%) males and 108 females (54%). ICU admission was significantly higher among underweight patients (75%) and obese patients (78.6%). The majority of underweight (62.5%) and obese (57.1%) patients had critical disease. Invasive mechanical ventilation (MV) is frequently used in underweight (50%) and obese patients (42.9%) patients. Adult respiratory distress syndrome (ARDS), cardiac, neurological, and hematological complications, and incidence of myalgia and bed sores were most frequent among obese and overweight patients. Acute kidney injury was significantly higher among underweight patients (37.5%) and obese patients (28.6%) than among other classes (p=0.004). Frequency of endocrine complications was significantly higher in underweight patients than that in other classes (p=0.01). The majority of underweight (75%) and obese patients (50%) deteriorated and died, whereas the majority of normal-weight patients (90.3%) and overweight patients (75.8%) improved and were discharged (p< 0.001).Conclusion: Body mass index is a major contributing factor to the outcome of patients with COVID-19, and patients with extreme of body mass index were associated with the worst prognosis. [ABSTRACT FROM AUTHOR]

Aim of the study: To evaluate the role of MIF gene polymorphism rs755622 G>C in occurrence and progression of hepatocellular carcinoma (HCC) among a cohort of Egyptian patients. Material and methods: This case-control study was conducted on 50 patients with HCC after chronic viral hepatitis and 50 healthy volunteers, recruited between July 2021 and January 2022. All patients with HCC were evaluated for severity of liver disease using a Child-Pugh score, and TNM and BCLC scoring systems. MIF 173 G>C (rs755622) single nucleotide polymorphism was performed for all participants by polymerase chain reaction using restriction fragment length polymorphism technique (RFLP-PCR). Results: Overall results showed significantly higher frequencies of GG (wild homozygous genotype) and mutant heterozygous genotype GC and G allele (OR = 6.303, 95% CI: 3.374-11.775) among patients with HCC compared to the control group (p = 0.001) for all. Also, significantly higher frequency of genotype GG was detected among patients with advanced Child scores (B and C) (p = 0.039) and TNM stages (III and IV) (p = 0.013). There was significantly higher frequency of the G allele among patients with multiple hepatic focal lesions compared to those with a single focal lesion (p = 0.01). Conclusions: An obvious role of MIF (rs755622) gene polymorphism could have an important role in susceptibility and progression of HCC among patients with chronic viral hepatitis induced liver cirrhosis. [ABSTRACT FROM AUTHOR]

Background and Aim: We examined the relationship among vit.D3, AMH, FT3, FT4, and TSH, in addition to the serum levels of reproductive hormones (FSH, LH, prolactin, and free testosterone), in oligoasthenoteratozoospermia and azoospermia patients in a cohort of infertile men from Egypt to establish a clinical marker/cause-effect relationship.Methods: This cross-sectional cohort study was carried out on 301 men (105 males with oligoasthenoteratozoospermia and 96 males with azoospermia), in addition to 100 controls. Measurements of serum vit.D3, AMH, FT3, FT4, and TSH levels, in addition to reproductive hormone assays, were performed on all included subjects, using ELISA kits.Results: Overall, results showed significantly lower serum levels of vit.D3 in infertile men than in the controls, with a greater decrease observed in men with azoospermia than in oligoasthenoteratozoospermia patients, (p < .05 for all). Significantly higher serum TSH and FSH levels and significantly lower serum free testosterone levels were observed in males with azoospermia than in males with oligoasthenoteratozoospermia and the controls (p < .05 for both). There were no significant differences between the studied groups in terms of AMH, FT3 or FT4 levels. LH levels were negatively correlated with TSH levels and positively correlated with AMH levels among men with oligoasthenoteratozoospermia, while among men with azoospermia, LH levels were positively correlated with vit.D3 levels (p < .05 for all).Conclusion: Decreased Vit.D3 could play a role in male infertility, in addition to abnormal thyroid function, which needs further investigation. [ABSTRACT FROM AUTHOR]

Background: The risk factors, disease characteristics, severity, and mortality of COVID-19 are unclear, particularly in Egypt. Objective: The objective was to analyze the patients' characteristics, hematological, biochemical, and chest imaging findings among the cohort of patients with COVID-19 in Egypt and also to shed light on the predictors of COVID-19 severity. Patients and Methods: A retrospective study was conducted on 66 patients with COVID-19 in Egypt. Medical history, imaging data (CT chest findings), and measured hematological and biochemical parameters at diagnosis were recorded in the form of complete blood counts and differential counts; CRP, ESR, serum ferritin, creatinine, and liver function tests. Results of real-time reverse transcription-polymerase chain reaction (rRT-PCR) for detection of SARS-CoV-2 RNA at diagnosis and during follow up of these patients were also recorded. Results: The study included 36 patients with mild to moderate COVID-19 and 30 patients with severe/critical infection. There was a significant older age among severe (62.6 years old ± 10.1SD) than mild to moderate infection (55.5 ± 10.1) (p˂0.05). Fever, dry cough, dyspnea, and sore throat malaise were highly frequent among COVID-19 patients, while headache and diarrhea were the least frequently occurring manifestations. All included cases (30 patients, 100%) with severe COVID-19 showed crazy-paving appearance (in the form of reticular and/or interlobular septal thickening) with or without GGO. There were significantly lower mean values of WBCs, lymphocytic count, total protein, and albumin among the severely infected than those who had mild to moderate COVID-19 infection, p˂0.05 for all. Additionally, there were significantly higher mean values of CRP, ESR, ferritin, ALT, and AST among patients with severe/critical COVID-19 when compared with those having mild to moderate COVID-19, p˂0.05 for all. Conclusion: Among the studied demographic, clinical, hematological, biochemical, and imaging data, dyspnea, diabetes mellitus, lymphopenia, raised CRP, ESR, ferritin, ALT, AST, low albumin, and presence of CT chest findings could be considered as predictors for COVID-19 severity using binary logistic regression analysis. [ABSTRACT FROM AUTHOR]

Abstract In the present study, 45 children in Upper Egypt (less than 16 years old) were admitted to the Pediatric Intensive Care Unit for scorpion envenomation (SE). They were compared with 30 apparently healthy children of matching age and sex as controls. Out of the studied victims, 35 children (78%) showed signs of severe envenomation, while 10 victims (22%) showed signs of mild envenomation. The case fatality was 33%. The serum levels of cardiac markers, cardiac troponin T (cTnT) and I (cTnI), as well as the enzymatic activities of creatine kinase-MB (CPK-MB) and lactate dehydrogenase (LDH) were determined for both victims and controls. In addition, the serum levels of oxidative stress markers, nitric oxide (NO), malondialdehyde (MDA), superoxide dismutase (SOD), reduced glutathione (GSH) and zinc (Zn) were measured. Electrocardiography and echocardiography were done. All the envenomed victims showed significantly higher mean values of cTnT, cTnI, CPK-MB and LDH than control group. These cardiac markers were elevated in severe cases and in non survivors in comparison with mild cases and survivors respectively. Furthermore, the serum levels of NO and MDA were significantly higher while the serum levels of SOD, GSH and Zn were significantly lower in all envenomed victims than the controls (p < 0.05 for all). There were no significant differences in the serum levels of oxidative stress markers among severe and mild cases or between survivors and non survivors victims. There were no significant correlations between the serum levels of cardiac markers and the oxidative stress markers in envenomed victims. In conclusions, oxidative stress occurs in scorpion envenomed children, but does not determine prognosis. Cardiac markers, but not the oxidative stress, remain the most important determining factor for the severity and the outcome of SE. Highlights • Oxidative stress occurs in scorpion envenomed children. • Cardiac markers are essential determining factor for envenomation severity and the outcome. • Oxidative stress not correlated to cardiac markers in scorpion envenomed children. • Oxidative stress not related to the envenomation severity and the outcome. [ABSTRACT FROM AUTHOR]

Background: Epilepsy is one of the most common neurological disorders, and it places a significant economic strain on the healthcare system around the world. Although the exact mechanism of epilepsy has yet to be illustrated, various pathogenic cascades involving neurotransmitters and trace elements have been reported. We aimed to investigate the serum levels of growth-associated protein-43 (GAP-43) and neurotrophin-3 (NT-3) among cohort of Egyptian children with epilepsy and correlate these biomarkers with their zinc levels., Methods: This case-control study included 50 pediatric patients with epilepsy who were comparable with 50 controls. Neurological assessment and electroencephalogram (EEG) were done to all included children. Biochemical measurements of serum GAP-43 and NT-3 using enzyme linked immunosorbent assays (ELISA), and total antioxidant capacity (TAC) and zinc using colorimetric assays, were performed to all participants., Results: There was significantly frequent positive parental consanguinity among cases with significantly frequent generalized onset seizures (94%) than simple partial seizure (6%). There were significantly lower serum GAP-43 and zinc levels with significantly higher TAC among cases vs. the controls, p˂0.05 for all. There was no significant difference in the serum levels of NT-3 among epileptic children vs. the controls, p = 0.269. Serum Zn was positively correlated with GAP-43 level among epileptic children (r = 0.381, p = 0.006). Serum GAP-43 in diagnosing childhood epilepsy at cut-off point ≤ 0.6 ng/mL showed 78% sensitivity, 62% specificity, positive predictive value (PPV) = 50.6%, negative predictive value (NPP) = 84.9% with AUC = 0.574., Conclusion: GAP-43 can be considered a sensitive good negative biomarker in childhood epilepsy which correlated positively with the zinc status., (© 2022. The Author(s).)

Background: Glutaric acidemia type 1 (GA1) is an inherited neurometabolic disease with significant morbidity. However, neuro-radiological correlation is not completely understood., Objective: The study aimed to characterize the neuroimaging findings and their association with neurological phenotype in GA1 children., Methods: Twenty-six Egyptian children (median age = 12 months) diagnosed with GA1 underwent clinical evaluation and brain magnetic resonance imaging (MRI). We objectively assessed the severity of neurological phenotype at the time of MRI using movement disorder (MD) and morbidity scores. Evaluation of brain MRI abnormalities followed a systematic and region-specific scoring approach. Brain MRI findings and scores were correlated with MD and morbidity scores, disease onset, and presence of seizures., Results: Fifteen (57.7%) cases had insidious onset, eight (30.8%) manifested acute onset, whereas three (11.5%) were asymptomatic. Ten (38.5%) cases had seizures, five of which had no acute encephalopathic crisis. Putamen and caudate abnormalities (found in all acute onset, 93.3 and 73.3% of insidious onset, and one of three asymptomatic cases) were significantly related to MD ( p  = 0.007 and 0.013) and morbidity ( p  = 0.005 and 0.003) scores. Globus pallidus abnormalities (50% of acute onset, 46.7% of insidious onset, and one of three of asymptomatic cases) were significantly associated with morbidity score ( p  = 0.023). Other MRI brain abnormalities as well as gray and white matter score showed no significant association with neurological phenotype. Younger age at onset, acute onset, and seizures were significantly associated with worse neurological manifestations., Conclusion: Patients with GA1 manifest characteristic and region-specific brain MRI abnormalities, but only striatal affection appears to correlate with neurological phenotype., Competing Interests: Disclosure The authors report no conflicts of interest in this work., (Thieme. All rights reserved.)

COVID-19 is a severe acute respiratory syndrome caused by coronavirus 2 (SARS-CoV-2). Deficiency of zinc has been supposed to contribute to loss of smell and taste in COVID-19 patients. Our study aimed to assess the serum zinc levels among patients with COVID-19 of various severities, with and without olfaction dysfunction, and to evaluate the effect of zinc therapy in recovery of smell dysfunction among such patients. This study included 134 patients; real-time reverse transcription-polymerase chain reaction (rRT-PCR) proved SARS-CoV-2. Serum zinc levels were measured for all infected patients. One hundred and five patients were detected to have anosmia and/or hyposmia and were categorized randomly into 2 groups; the first group included 49 patients who received zinc therapy and the second group included 56 patients who did not received zinc. All patients were followed up for the recovery duration of olfactory and gustatory symptoms and duration of complete recovery of COVID-19. Olfactory dysfunction was reported in 105 patients (78.4%). Serum zinc levels were not significantly different between the patient subgroups regarding disease severity or the presence or absence of olfactory and/or gustatory dysfunction (p ˃ 0.05). The median duration of recovery of gustatory and/or olfactory function was significantly shorter among patients who received zinc therapy than those who did not received zinc (p < 0.001), while the median duration of complete recovery from COVID-19 was not significantly different among the two groups (p ˃ 0.05). Although the zinc status of COVID-19 patients did not exhibit a significant role in development of anosmia and/or hyposmia or disease severity, zinc therapy may have a significant role in shortening the duration of smell recovery in those patients without affecting the total recovery duration from COVID-19., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature.)

Background: Ivermectin is an FDA-approved broad-spectrum anti-parasitic agent that has been shown to inhibit SARS-CoV-2 replication in vitro ., Objective: We aimed to assess the therapeutic efficacy of ivermectin mucoadhesive nanosuspension intranasal spray in treatment of patients with mild COVID-19., Methods: This clinical trial included 114 patients diagnosed as mild COVID-19. Patients were divided randomly into two age and sex-matched groups; group A comprising 57 patients received ivermectin nanosuspension nasal spray twice daily plus the Egyptian protocol of treatment for mild COVID-19 and group B comprising 57 patients received the Egyptian protocol for mild COVID-19 only. Evaluation of the patients was performed depending on improvement of presenting manifestations, negativity of two consecutive pharyngeal swabs for the COVID-19 nucleic acid via rRT-PCR and assessments of hematological and biochemical parameters in the form of complete blood counts, C-reactive protein, serum ferritin and d-dimer which were performed at presentation and 7 days later., Results: Of the included patients confirmed with mild COVID-19, 82 were males (71.9%) and 32 females (28.1%) with mean age 45.1 ± 18.9. In group A, 54 patients (94.7%) achieved 2 consecutive negative PCR nasopharyngeal swabs in comparison to 43 patients (75.4%) in group B with P = 0.004. The durations of fever, cough, dyspnea and anosmia were significantly shorter in group A than group B, without significant difference regarding the duration of gastrointestinal symptoms. Duration taken for nasopharyngeal swab to be negative was significantly shorter in group A than in group B (8.3± 2.8 days versus 12.9 ± 4.3 days; P = 0.0001)., Conclusion: Local use of ivermectin mucoadhesive nanosuspension nasal spray is safe and effective in treatment of patients with mild COVID-19 with rapid viral clearance and shortening the anosmia duration., Clinicaltrialsgov Identifier: NCT04716569; https://clinicaltrials.gov/ct2/show/NCT04716569., Competing Interests: No potential conflicts of interest between authors to be declare., (© 2021 Aref et al.)

Purpose: The current study aimed to assess the serum levels of vitamin D and immunoglobulin E (IgE) among asthmatic Egyptian children and to find out the possible associations of vitamin D receptor (VDR) polymorphisms with bronchial asthma development., Methods: The study included 100 Egyptian children, 50 asthmatic children who were comparable with 50 age, sex, and body mass index-matched, unrelated healthy controls (HCs) clinical assessments of asthmatic children were done using global initiative of asthma. Pulmonary function tests (forced expiratory volume in 1 second [FEV1], forced vital capacity [FVC], FEV1/FVC ratio) were performed. Enzyme-linked immunosorbent assays of serum vitamin D3 and total IgE were done. VDR-single nucleotide polymorphisms (SNPs) (ApaI, TaqI, and BsmI) detection has performed using polymerase chain reaction through restriction fragment length polymorphism technique. Data analysis was performed using SPSS version 20.0. The studied SNPs were followed the Hardy Weinberg equation., Results: The mean serum level of 25(OH) D3 was significantly lower among asthmatic children (13.46 ng/mL ± 10.50 SD) in comparison to HCs (37.53 ng/mL ± 13. 0.40 SD), P < .05. Vitamin D deficiency was detected in 72% of cases with no significant difference in its level regarding asthma control. There was significantly higher IgE level among asthmatic children (99.83 ku/L ± 233.81 SD) versus HCs (7.52 ku/L ± 3.32 SD), P < .05. Asthmatic children were presented more commonly with TaqI t allele (odds ratio [OR], 2.25; 95% confidence interval [CI], 1.28-3.96; P < .05) and BsmI b allele (OR, 1.83; 95% CI, 1.05-3.21; P < .05). ApaI a allele was not significantly different among patients versus controls (P > .05). TT + Tt and Bb + bb genotypes were significantly higher among cases versus the controls, P < .05 for all., Conclusions: TaqI and BsmI were associated with risk of bronchial asthma development among Egyptian children. High IgE and Low vitamin D status were frequently occurring among asthmatic children., (© 2020 Wiley Periodicals, Inc.)