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Background: Tacrolimus is the backbone drug in kidney transplantation. Single nucleotide polymorphism of Multidrug resistant 1 gene can affect tacrolimus metabolism consequently it can affect tacrolimus trough level and incidence of acute rejection. The aim of this study is to investigate the impact of Multidrug resistant 1 gene, C3435T and G2677T Single nucleotide polymorphisms on tacrolimus pharmacokinetics and on the risk of acute rejection in pediatric kidney transplant recipients. Methods: Typing of Multidrug resistant 1 gene, C3435T and G2677T gene polymorphism was done using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) for 83 pediatric kidney transplant recipients and 80 matched healthy controls. Results: In Multidrug resistant 1 gene (C3435T), CC, CT genotypes and C allele were significantly associated with risk of acute rejection when compared to none acute rejection group (P = 0.008, 0.001 and 0.01 respectively). The required tacrolimus doses to achieve trough level were significantly higher among CC than CT than TT genotypes through the 1st 6 months after kidney transplantation. While, in Multidrug resistant 1 gene (G2677T), GT, TT genotypes and T allele were associated with acute rejection when compared to none acute rejection (P = 0.023, 0.033 and 0.028 respectively). The required tacrolimus doses to achieve trough level were significantly higher among TT than GT than GG genotypes through the 1st 6 months after kidney transplantation. Conclusion: The C allele, CC and CT genotypes of Multidrug resistant 1 gene (C3435T) and the T allele, GT and TT genotypes of Multidrug resistant 1 gene (G2677T) gene polymorphism may be risk factors for acute rejection and this can be attributed to their effect on tacrolimus pharmacokinetics. Tacrolimus therapy may be tailored according to the recipient genotype for better outcome. [ABSTRACT FROM AUTHOR]

Background: Cognitive impairment (CI) is common in multiple sclerosis. We assessed the relationship between CI and demographic, motor disability, and volumetric brain atrophy in relapsing remitting multiple sclerosis (RRMS). Methods: In all, 43 RRMS patients and 40 age‐ sex‐, and education‐matched normal volunteers were enrolled. Assessments included: demographic, Expanded Disability Status Scale (EDSS); Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS); and brain volumetric assessment. Results: The mean age of onset of RRMS patients was 25.72 y and the mean number of attacks was 3.30 ± 2.33/year. The total brain volume, cerebral, and cerebellar hemispheres, brainstem as well as thalamic and hippocampal gray matter were significantly reduced in RRMS patients compared with controls. CI was detected in 41.9% of patients. Patients with CI had fewer years of education (P =.001), a higher number of attacks (P =.002), worse EDSS scores (P =.030); reduced gray matter volume, particularly of the thalamus, and hippocampus compared with patients without CI. There were significant negative correlations between CI with duration of illness, number of attacks, time elapsed between onset and diagnosis, and EDSS. Thalamic volume showed strong positive correlations with CI (P <.0001). The best predictors of CI were thalamic atrophy, duration of illness, and years of education (P =.001,.010, and.035 respectively). Conclusion: We confirmed the presence of gray matter atrophy of the brain in RRMS patients. Volumetric magnetic resonance imaging measures of thalamus, duration of illness, and years of education could be useful biomarkers of CI in RRMS. [ABSTRACT FROM AUTHOR]

Background: Asthma is a major global public health issue worldwide. It's the most frequent chronic disease in children and one of the primary causes of morbidity. Hemoglobin, myoglobin, and a number of enzymes all include iron, which is an essential mineral. Objective: It was to evaluate iron deficiency as a risk factor affected children with bronchial asthma in order to back up the clinical findings at Mansoura University Children Hospital. Patients and Methods: In this study, 50 asthmatic patients and 50 control participants, ranging in age from 6 to 18, were matched. We investigated the effects of iron deficiency on children with bronchial asthma by analysing laboratory results for the following tests and parameters; 1) Pulmonary function tests (FEV1, FVC, PEF, FEV1/FVC), 2) Complete blood count (HB, MCV, MCH, MCHC, RBC, RDW, HCT), 3) Serum iron, 4) Serum ferritin level, 5) Total iron binding capacity, and 6) Transferrin saturation. Results: Both FEV1/FVC and FEV1/FVC percent had statistically significant relationships with RBCs. Among the cases analysed, there was no statistically significant association between ferritin and pulmonary function tests or between TIBC and pulmonary function tests. All lung function tests had no statistically significant link with transferrin saturation (Tsat). Conclusion: Iron deficiency anaemia may have a negative impact on spirometry in asthmatic children, resulting to an increase in the severity of asthmatic attacks. Iron supplementation in infants may show to be a safe and successful technique for reducing the incidence of asthma, but further research is needed to determine the causality. [ABSTRACT FROM AUTHOR]

Background There is an increasing evidence of an association between low vitamin-D levels and depression. Consequently, the present study aimed to investigate the serum levels of vitamin D in cases with major depressive disorder in Sohag Governorate in Upper Egypt. Also, we studied the correlation between serum vitamin-D level and different demographic and clinical variables in these patients. This study included 60 patients who attended our outpatient psychiatric clinic at Sohag University Hospital, who were diagnosed as major depressive disorder (group I) and a similar number (60) of age-matched and sex-matched controls (group II). The diagnosis was based on Diagnostic and statistical manual of mental disorders, 5th ed. criteria and verified by application of Quick Inventory of Depressive Symptomatology. A blood sample was taken from all participants for assessment of the levels of serum vitamin D. Results Patients with major depressive disorder have significantly lower serum vitamin-D levels than controls (mean±SD was 17.2±12.3 for patients and 33.4±24.2 for controls, P=0.001). About 58.33% of patients had deficient vitamin D, while 45% of controls had deficient vitamin D (P=0.022). There is a statistically significant negative correlation between the severity of depression and serum vitamin D. Conclusions Serum vitamin D was significantly lower in major depression patients than controls. In addition, it is evident to have a direct correlation with severity of symptom depression. [ABSTRACT FROM AUTHOR]

Background Recent application of unrivaled public health measures for COVID-19 pandemic could have significant implications on other infectious diseases. Objectives We aim to detect the influence of the recently applied health measures on acute bronchiolitis-associated hospitalizations. Methods We analyzed patients’ electronic records at our tertiary hospital to obtain data of hospitalized patients with acute bronchiolitis for the period between November 1, 2017, to February 28, 2021. We compared the frequencies of hospitalizations in the peak respiratory syncytial virus epidemic months (November–February) in 2020 with those in 2017–19. Results There were 16,466 all-cause hospitalizations during the period (November-February) from 2017 to 2021. We observed significant lower frequencies of acute bronchiolitis associated hospitalizations in 2020/2021 compared with 2019/2020, 2018/2019, and 2017/2018 (0.6% vs. 8.2%, 7.4%, and 9.9%, respectively) (P <0.05). Conclusion The social isolation measures adopted during the COVID-19 pandemic have significant unexpected effects on the seasonality of acute bronchiolitis in our population, which could be due to inhibition of diseases transmission practiced by adults and older children. [ABSTRACT FROM AUTHOR]

Background: The exact pathogenesis of autism is still unknown. Both thyroid hormones and 25(OH)D are important for brain development, in addition to CD5; all have immunomodulatory actions by which their dysregulation may have a potential role in autism pathogenesis. Objectives: The objectives of this study were to assess the thyroid profile, serum 25(OH)D levels and CD5 expression levels among autistic patients and to find out the correlations between the measured biomarkers with each other on one side and with the disease severity on the other side. Patients and methods: This cross-sectional case-control study has been conducted on 60 children with autism and 40 controls, recruited from Qena Governorate, Upper Egypt. Childhood Autism Rating Scale (CARS) score was used to assess the included patients. Biochemical assays of thyroid function in the form of free triiodothyronine (FT3), free tetraiodothyronine (FT4), thyroid-stimulating hormone (TSH) and 25(OH)D were done using commercially available enzyme-linked immunosorbent assay (ELISA) kits, while CD5 expression levels were measured using flow cytometry (FCM) analysis for all the included patients and controls. Results: The overall measurement results show significant higher mean serum TSH levels, mean CD5 expression levels with significant lower mean serum 25(OH)D levels among autistic children when compared with the control group (p,0.05 for all). Significant negative correlations between CD5 with FT3, FT4 and 25(OH)D were observed. CARS score showed significant negative correlations with both FT3 and 25(OH)D, while it was positively correlated with CD5 in a significant manner (p,0.05 for all). Conclusion: Elevated CD5 expression and decreased 25(OH)D stores could play a potential role in the pathogenesis of autism via their immune-modulator actions. High TSH serum levels among autistic children, although within the physiological range, reflect the presence of thyroid dysfunction among such children, which needs further assessment. [ABSTRACT FROM AUTHOR]

Background: Epilepsy is a prevalent disease worldwide. Executive functions and social cognition are essential in daily living functioning, academic performance, and social adjustment. This study attempts to investigate the executive functions and ability to abstract social concepts in adolescents who have idiopathic generalized epilepsy and assess if the deterioration in executive functions can predict deterioration in the ability to abstract social concepts. Sixty adolescents with idiopathic generalized epilepsy aged between 12 and 19 collected from the neurology outpatient clinic at Sohag University Hospital in Upper Egypt were compared with 60 age- and sex-matched healthy adolescents regarding performance on executive function tests and ability to abstract social concepts tests. We used the Tower test to assess planning, the design fluency test to assess cognitive flexibility, the verbal fluency test to assess verbal fluency, and the Stroop test (overlapping between colour and word test) to assess inhibition and ability to abstract the social concepts test, which is composed of verbal part and performance part. Results: Adolescents who have idiopathic generalized epilepsy have worse executive function impairment in all executive functions than control adolescents. Adolescents with idiopathic epilepsy have significantly more impairment in the ability to abstract social concepts (verbal and performance) compared to control adolescents. There is a significant correlation between executive functions and the ability to abstract social concepts (verbal and performance) in epileptic and control adolescents. Impairment in some executive functions can predict impairment in the ability to abstract social concepts (verbal and performance) in epileptic and control adolescents. Executive function impairment is correlated with the duration of illness, frequency of seizures per year, time since last epileptic fit, and presence of interictal epileptic discharge in EEG in the patient group. Conclusions: Executive functions and the ability to abstract social concepts are significantly impaired in adolescents who have idiopathic generalized epilepsy. Impairment in executive functions can predict impairment in the ability to abstract social concepts. There is a need to screen executive functions and social abilities of adolescents with epilepsy and programmes to enhance these abilities. [ABSTRACT FROM AUTHOR]

Background: Post-stroke depression (PSD) has worse functional outcomes and quality of life. Despite the extensive literature on this topic, there is no agreement on the frequency or risk factors for post-stroke depression. Objectives: To establish the frequency and risk factors of post-stroke depression and its impact on quality of life. Patients and methods: One hundred three stroke patients were recruited from the out-patient clinic of Qena University Hospital who satisfied the WHO definition for stroke, together with a control group of 50 age- and sex-matched healthy volunteers. A complete history, neurological examination, and CT brain were obtained for each patient. DSM-IV TR criteria were used for diagnosis of depressive disorders which was scored with the Hamilton depression rating scale (HAM-D); Barthel Index (BI), and quality of life were also measured. Results: Thirty-eight (36.9%) stroke patients had PSD which was significantly higher than in the normal population (control group 12%). Statistically significant risk factors for PSD included low educational level, low socioeconomic status, smoking, and post-stroke functional impairment. Post-stroke depression has an impact on quality of life. Conclusion: Post-stroke depression is a relatively common complication of stroke and can affect the quality of life. Low educational level and socioeconomic status, as well as smoking and functional impairments, were considered as risk factors for the occurrence of post-stroke depression. Early detection of predictors of post-stroke depression may improve the outcome of stroke and prevent the psychiatric consequences. [ABSTRACT FROM AUTHOR]

Fatigue is a common disabling symptom of relapsing remitting multiple sclerosis (RRMS). Many studies have linked grey matter atrophy to fatigue, but white matter lesion load (WM-LL) has received less attention. Here we assess the relation between fatigue and regional WM-LL volumetric measures. 63 patients with RRMS participated in this study; mean age was 31.9 ± 8.1 years. Each patient provided demographic details and was scored on the expanded disability status scale (EDSS) and fatigue severity scale (FSS). VolBrain, a fully automated, operator-independent tool was used to assess WM-LL and whole brain volume. The patients were classified into three groups: no fatigue (FSS < 4), low to moderate fatigue (FSS ≥ 4 ≤ 5) and high fatigue (FSS > 5). 33.3% of patients had no significant fatigue, 25.4% had mild-to-moderate fatigue, and 41.3% had significant fatigue. Age, disease duration, relapses, and EDSS were positively correlated to fatigue severity (P = 0.034, 0.002, 0.009 and 0.001 respectively). Whole brain volume, total and regional WM-LL (juxtacortical, periventricular, infratentorial) were also correlated with fatigue severity. Ordinal regression analysis for fatigue severity showed EDSS and infratentorial lesion volume were the best predictors. In conclusion, EDSS and infratentorial lesion volume (cerebellar and brainstem) are the best predictors of fatigue severity. [ABSTRACT FROM AUTHOR]