1.Prevalence and Predictors of Pulmonary Hypertension in Children with Portal Hypertension: A Single Center Study
Nehal El KOOFY ; Sawsan Hassan OKASHA ; Hala Mounir AGHA ; Noha ALI ; Ahmed Said BEHAIRY ; Hanan Mina FOUAD ; Rehab Hamdy ZAWAM
Pediatric Gastroenterology, Hepatology & Nutrition 2025;28(2):101-112
Purpose:
This study aimed to estimate the prevalence and predictors of portopulmonary hypertension (POPH) in children with portal hypertension.
Methods:
We recruited children of both sexes aged 3–15 years with portal hypertension that was clinically suspected and confirmed by the presence of varices on esophagogastroduodenoscopy (EGD). The participants underwent clinical examination, 6-min walk distance (6-MWD), and echocardiography.
Results:
We enrolled 94 children with portal hypertension: 26.6% with pre-hepatic causes and 73.4% secondary to chronic liver disease. Among our participants, 13.8% had one or more cardiac manifestations, such as exercise intolerance, dyspnea on exertion, cyanosis, or orthopnea, whereas 86.2% were asymptomatic. EGD examination revealed grade I varices in 54.3% of cases, grade II–III in 43.6%, and grade IV in 2.1%. Pulmonary hypertension (>35 mmHg) was detected in 30.9% of cases using echocardiography; two of them were >45 mmHg. Patients with POPH had significantly more frequent dyspnea on exertion, lower O 2 saturation, and more severe variceal grades than those with normal pulmonary artery pressure. Five (6.9%) cases had <300 m 6-MWD, with no significant difference between patients with normal and those with elevated pulmonary artery pressure. The duration of portal hypertension and 6-MWD were correlated significantly with the echocardiographic measures. High-grade varices (p=0.04) and low O 2 saturation (p=0.03) were identified as risk factors for POPH.
Conclusion
POPH was detected in 30.9% of our study group. High-grade varices and low O 2 saturation are predictors of POPH. Echocardiography screening is crucial for the early detection of cases.
2.Prevalence and Predictors of Pulmonary Hypertension in Children with Portal Hypertension: A Single Center Study
Nehal El KOOFY ; Sawsan Hassan OKASHA ; Hala Mounir AGHA ; Noha ALI ; Ahmed Said BEHAIRY ; Hanan Mina FOUAD ; Rehab Hamdy ZAWAM
Pediatric Gastroenterology, Hepatology & Nutrition 2025;28(2):101-112
Purpose:
This study aimed to estimate the prevalence and predictors of portopulmonary hypertension (POPH) in children with portal hypertension.
Methods:
We recruited children of both sexes aged 3–15 years with portal hypertension that was clinically suspected and confirmed by the presence of varices on esophagogastroduodenoscopy (EGD). The participants underwent clinical examination, 6-min walk distance (6-MWD), and echocardiography.
Results:
We enrolled 94 children with portal hypertension: 26.6% with pre-hepatic causes and 73.4% secondary to chronic liver disease. Among our participants, 13.8% had one or more cardiac manifestations, such as exercise intolerance, dyspnea on exertion, cyanosis, or orthopnea, whereas 86.2% were asymptomatic. EGD examination revealed grade I varices in 54.3% of cases, grade II–III in 43.6%, and grade IV in 2.1%. Pulmonary hypertension (>35 mmHg) was detected in 30.9% of cases using echocardiography; two of them were >45 mmHg. Patients with POPH had significantly more frequent dyspnea on exertion, lower O 2 saturation, and more severe variceal grades than those with normal pulmonary artery pressure. Five (6.9%) cases had <300 m 6-MWD, with no significant difference between patients with normal and those with elevated pulmonary artery pressure. The duration of portal hypertension and 6-MWD were correlated significantly with the echocardiographic measures. High-grade varices (p=0.04) and low O 2 saturation (p=0.03) were identified as risk factors for POPH.
Conclusion
POPH was detected in 30.9% of our study group. High-grade varices and low O 2 saturation are predictors of POPH. Echocardiography screening is crucial for the early detection of cases.
3.Prevalence and Predictors of Pulmonary Hypertension in Children with Portal Hypertension: A Single Center Study
Nehal El KOOFY ; Sawsan Hassan OKASHA ; Hala Mounir AGHA ; Noha ALI ; Ahmed Said BEHAIRY ; Hanan Mina FOUAD ; Rehab Hamdy ZAWAM
Pediatric Gastroenterology, Hepatology & Nutrition 2025;28(2):101-112
Purpose:
This study aimed to estimate the prevalence and predictors of portopulmonary hypertension (POPH) in children with portal hypertension.
Methods:
We recruited children of both sexes aged 3–15 years with portal hypertension that was clinically suspected and confirmed by the presence of varices on esophagogastroduodenoscopy (EGD). The participants underwent clinical examination, 6-min walk distance (6-MWD), and echocardiography.
Results:
We enrolled 94 children with portal hypertension: 26.6% with pre-hepatic causes and 73.4% secondary to chronic liver disease. Among our participants, 13.8% had one or more cardiac manifestations, such as exercise intolerance, dyspnea on exertion, cyanosis, or orthopnea, whereas 86.2% were asymptomatic. EGD examination revealed grade I varices in 54.3% of cases, grade II–III in 43.6%, and grade IV in 2.1%. Pulmonary hypertension (>35 mmHg) was detected in 30.9% of cases using echocardiography; two of them were >45 mmHg. Patients with POPH had significantly more frequent dyspnea on exertion, lower O 2 saturation, and more severe variceal grades than those with normal pulmonary artery pressure. Five (6.9%) cases had <300 m 6-MWD, with no significant difference between patients with normal and those with elevated pulmonary artery pressure. The duration of portal hypertension and 6-MWD were correlated significantly with the echocardiographic measures. High-grade varices (p=0.04) and low O 2 saturation (p=0.03) were identified as risk factors for POPH.
Conclusion
POPH was detected in 30.9% of our study group. High-grade varices and low O 2 saturation are predictors of POPH. Echocardiography screening is crucial for the early detection of cases.
4.Prevalence and Predictors of Pulmonary Hypertension in Children with Portal Hypertension: A Single Center Study
Nehal El KOOFY ; Sawsan Hassan OKASHA ; Hala Mounir AGHA ; Noha ALI ; Ahmed Said BEHAIRY ; Hanan Mina FOUAD ; Rehab Hamdy ZAWAM
Pediatric Gastroenterology, Hepatology & Nutrition 2025;28(2):101-112
Purpose:
This study aimed to estimate the prevalence and predictors of portopulmonary hypertension (POPH) in children with portal hypertension.
Methods:
We recruited children of both sexes aged 3–15 years with portal hypertension that was clinically suspected and confirmed by the presence of varices on esophagogastroduodenoscopy (EGD). The participants underwent clinical examination, 6-min walk distance (6-MWD), and echocardiography.
Results:
We enrolled 94 children with portal hypertension: 26.6% with pre-hepatic causes and 73.4% secondary to chronic liver disease. Among our participants, 13.8% had one or more cardiac manifestations, such as exercise intolerance, dyspnea on exertion, cyanosis, or orthopnea, whereas 86.2% were asymptomatic. EGD examination revealed grade I varices in 54.3% of cases, grade II–III in 43.6%, and grade IV in 2.1%. Pulmonary hypertension (>35 mmHg) was detected in 30.9% of cases using echocardiography; two of them were >45 mmHg. Patients with POPH had significantly more frequent dyspnea on exertion, lower O 2 saturation, and more severe variceal grades than those with normal pulmonary artery pressure. Five (6.9%) cases had <300 m 6-MWD, with no significant difference between patients with normal and those with elevated pulmonary artery pressure. The duration of portal hypertension and 6-MWD were correlated significantly with the echocardiographic measures. High-grade varices (p=0.04) and low O 2 saturation (p=0.03) were identified as risk factors for POPH.
Conclusion
POPH was detected in 30.9% of our study group. High-grade varices and low O 2 saturation are predictors of POPH. Echocardiography screening is crucial for the early detection of cases.
5.Prevalence and Predictors of Pulmonary Hypertension in Children with Portal Hypertension: A Single Center Study
Nehal El KOOFY ; Sawsan Hassan OKASHA ; Hala Mounir AGHA ; Noha ALI ; Ahmed Said BEHAIRY ; Hanan Mina FOUAD ; Rehab Hamdy ZAWAM
Pediatric Gastroenterology, Hepatology & Nutrition 2025;28(2):101-112
Purpose:
This study aimed to estimate the prevalence and predictors of portopulmonary hypertension (POPH) in children with portal hypertension.
Methods:
We recruited children of both sexes aged 3–15 years with portal hypertension that was clinically suspected and confirmed by the presence of varices on esophagogastroduodenoscopy (EGD). The participants underwent clinical examination, 6-min walk distance (6-MWD), and echocardiography.
Results:
We enrolled 94 children with portal hypertension: 26.6% with pre-hepatic causes and 73.4% secondary to chronic liver disease. Among our participants, 13.8% had one or more cardiac manifestations, such as exercise intolerance, dyspnea on exertion, cyanosis, or orthopnea, whereas 86.2% were asymptomatic. EGD examination revealed grade I varices in 54.3% of cases, grade II–III in 43.6%, and grade IV in 2.1%. Pulmonary hypertension (>35 mmHg) was detected in 30.9% of cases using echocardiography; two of them were >45 mmHg. Patients with POPH had significantly more frequent dyspnea on exertion, lower O 2 saturation, and more severe variceal grades than those with normal pulmonary artery pressure. Five (6.9%) cases had <300 m 6-MWD, with no significant difference between patients with normal and those with elevated pulmonary artery pressure. The duration of portal hypertension and 6-MWD were correlated significantly with the echocardiographic measures. High-grade varices (p=0.04) and low O 2 saturation (p=0.03) were identified as risk factors for POPH.
Conclusion
POPH was detected in 30.9% of our study group. High-grade varices and low O 2 saturation are predictors of POPH. Echocardiography screening is crucial for the early detection of cases.
6.Preparation of anti-staphylococcal packaging material using antimicrobial metabolite from Lactiplantibacillus plantarum strain N1 isolated from fermented sausage from Egypt
Noha Adel Ali ; Einas Hamed El-Shatoury ; Asrar Yaseen Mohamed ; Ali Mohamed Saeed
Malaysian Journal of Microbiology 2024;20(no.2):197-209
Aims:
This study was aimed to produce biodegradable cellulose acetate films impregnated with bacteriocin-like
inhibitory substances to be used in food packaging.
Methodology and results:
Bacterial isolates were isolated from different sources and tested for their antimicrobial activity by agar well diffusion assay. The isolate that showed the highest antimicrobial activity against Staphylococcus
aureus ATCC 29213, Escherichia coli ATCC 51659, Pseudomonas aeruginosa MG847103 and Streptococcus mutans ATCC 25175 was identified as Lactiplantibacillus plantarum strain N1 (OM019104) based on 16S rRNA based method of identification. The extracted bacteriocin-like inhibitory substances were partially purified with acetone precipitation and SP-Sephroase cation exchange chromatography. There was no change in the antimicrobial activity after treatment with
the catalase enzyme, but there was a total loss in the activity after treatment with proteolytic enzymes. The obtained bacteriocin-like inhibitory substances showed pH stability over a wide range of pH values and thermal stability as it recovered 95% of its antimicrobial activity even after autoclaving for 15 min. Different concentrations of cellulose acetate (3 to 12%) were tested to develop the active antimicrobial films. The most flexible concentrations for food packaging were prepared and impregnated with partially purified bacteriocin-like inhibitory substances. The prepared films showed promising antimicrobial activity against S. aureus.
Conclusion, significance and impact of study
This study highlights the usage of active packaging in food preservation. Cellulose acetate films activated with the partially purified bacteriocin-like inhibitory substances have anti-staphylococcal activity, which can potentially be used in food packaging to prolong the shelf-life of perishable foo
7.Significance of tumor-associated neutrophils, lymphocytes, and neutrophil-to-lymphocyte ratio in non-invasive and invasive bladder urothelial carcinoma
Wael Abdo HASSAN ; Ahmed Kamal ELBANNA ; Noha NOUFAL ; Mohamed EL-ASSMY ; Hany LOTFY ; Rehab Ibrahim ALI
Journal of Pathology and Translational Medicine 2023;57(2):88-94
Background:
Tumor-infiltrating neutrophils and lymphocytes play essential roles in promoting or combating various neoplasms. This study aimed to investigate the association between tumor-infiltrating neutrophils and lymphocytes and the neutrophil-to-lymphocyte ratio in the progression of urothelial carcinoma.
Methods:
A total of 106 patients diagnosed with urothelial carcinoma were was. Pathological examination for tumor grade and stage and for tumor-infiltrating neutrophils, both CD4 and CD8+ T lymphocytes, as well as the neutrophil- to-lymphocyte ratio were evaluated.
Results:
The presence of neutrophils and the neutrophil-to-lymphocyte ratio correlated with high-grade urothelial neoplasms. In both low- and high-grade tumors, the lymphocytes increased during progression from a non-invasive neoplasm to an early-invasive neoplasm. CD8+ T lymphocytes increased in low-grade non–muscle-invasive tumors compared to non-invasive tumors. Additionally, there was a significant decrease in CD8+ T lymphocytes during progression to muscle-invasive tumors.
Conclusions
Our results suggest that tumor-infiltrating neutrophils and CD8+ T lymphocytes have a significant effect on tumor grade and progression.
8.Assessment of Behavioral Problems in Children Pre- and Post-Cochlear Implant: An Egyptian Study
Ahmed Ali ABDELMONEM ; Hisham SALAH ; Heba Ashour MOSTAFA ; Noha A. Abd ELMONEM ; Doaa Mahmoud KHALIL ; Rabie Sayed YOUSSEF ; Reham Ahmed FAHIEM
Psychiatry Investigation 2022;19(9):763-769
Objective:
The present study aimed to detect the behavioral problems pre- and post-cochlear implantation in comparison to normal hearing group to be able to manage these problems to get more benefit from using cochlear implants.
Methods:
A case-control study included 53 children was done. They were divided into 2 groups, the control group included 28 healthy volunteers with normal hearing and the case group included 25 children with severe to profound hearing loss, fitted for cochlear implantation. The Arabic Child Behavior Checklist (CBCL) was used to detect different behavioral problems in both groups. Case group children were followed up and reassessed again by CBCL 3 months later after cochlear implantation.
Results:
There were highly significant differences regarding total scores of internalizing and externalizing domains of empirically based CBCL between the control group and the case group after cochlear implants (p=0.001). There were non-significant differences in children within case group (pre- and post-cochlear implantation) regarding emotional and behavioral problems on both empirically based and Diagnostic and Statistical Manual of Mental Disorders-based CBCL.
Conclusion
For better results, it is necessary to include a specialist of psychosomatic medicine in the cochlear rehabilitation teamwork.
9.Histological and Physiological Studies of the Effect of Bone Marrow-Derived Mesenchymal Stem Cells on Bleomycin Induced Lung Fibrosis in Adult Albino Rats
Dina Mohamed ZAKARIA ; Noha Mahmoud ZAHRAN ; Samia Abdel Aziz ARAFA ; Radwa Ali MEHANNA ; Rehab Ahmed ABDEL-MONEIM
Tissue Engineering and Regenerative Medicine 2021;18(1):127-141
BACKGROUND:
Lung fibrosis is considered as an end stage for many lung diseases including lung inflammatory disease, autoimmune diseases and malignancy. There are limited therapeutic options with bad prognostic outcome. The aim of this study was to explore the effect of mesenchymal stem cells (MSCs) derived from bone marrow on Bleomycin (BLM) induced lung fibrosis in albino rats.
METHODS:
30 adult female albino rats were distributed randomly into 4 groups; negative control group, Bleomycin induced lung fibrosis group, lung fibrosis treated with bone marrow-MSCs (BM-MSCs) and lung fibrosis treated with cell free media. Lung fibrosis was induced with a single dose of intratracheal instillation of BLM. BM-MSCs or cell free media were injected intravenously 28 days after induction and rats were sacrificed after another 28 days for assessment. Minute respiratory volume (MRV), forced vital capacity (FVC) and forced expiratory volume 1 (FEV1) were recorded using spirometer (Power lab data acquisition system). Histological assessment was performed by light microscopic examination of H&E, and Masson’s trichrome stained sections and was further supported by morphometric studies. In addition, electron microscopic examination to assess ultra-structural changes was done. Confocal Laser microscopy and PCR were used as tools to ensure MSCs homing in the lung.
RESULTS:
Induction of lung fibrosis was confirmed by histological examination, which revealed disorganized lung architecture, thickened inter-alveolar septa due excessive collagen deposition together with inflammatory cellular infiltration. Moreover, pneumocytes depicted variable degenerative changes. Reduction in MRV, FVC and FEV1 were recorded. BM-MSCs treatment showed marked structural improvement with minimal cellular infiltration and collagen deposition and hence restored lung architecture, together with lung functions.
CONCLUSION
MSCs are promising potential therapy for lung fibrosis that could restore the normal structure and function of BLM induced lung fibrosis.
10.Histological and Physiological Studies of the Effect of Bone Marrow-Derived Mesenchymal Stem Cells on Bleomycin Induced Lung Fibrosis in Adult Albino Rats
Dina Mohamed ZAKARIA ; Noha Mahmoud ZAHRAN ; Samia Abdel Aziz ARAFA ; Radwa Ali MEHANNA ; Rehab Ahmed ABDEL-MONEIM
Tissue Engineering and Regenerative Medicine 2021;18(1):127-141
BACKGROUND:
Lung fibrosis is considered as an end stage for many lung diseases including lung inflammatory disease, autoimmune diseases and malignancy. There are limited therapeutic options with bad prognostic outcome. The aim of this study was to explore the effect of mesenchymal stem cells (MSCs) derived from bone marrow on Bleomycin (BLM) induced lung fibrosis in albino rats.
METHODS:
30 adult female albino rats were distributed randomly into 4 groups; negative control group, Bleomycin induced lung fibrosis group, lung fibrosis treated with bone marrow-MSCs (BM-MSCs) and lung fibrosis treated with cell free media. Lung fibrosis was induced with a single dose of intratracheal instillation of BLM. BM-MSCs or cell free media were injected intravenously 28 days after induction and rats were sacrificed after another 28 days for assessment. Minute respiratory volume (MRV), forced vital capacity (FVC) and forced expiratory volume 1 (FEV1) were recorded using spirometer (Power lab data acquisition system). Histological assessment was performed by light microscopic examination of H&E, and Masson’s trichrome stained sections and was further supported by morphometric studies. In addition, electron microscopic examination to assess ultra-structural changes was done. Confocal Laser microscopy and PCR were used as tools to ensure MSCs homing in the lung.
RESULTS:
Induction of lung fibrosis was confirmed by histological examination, which revealed disorganized lung architecture, thickened inter-alveolar septa due excessive collagen deposition together with inflammatory cellular infiltration. Moreover, pneumocytes depicted variable degenerative changes. Reduction in MRV, FVC and FEV1 were recorded. BM-MSCs treatment showed marked structural improvement with minimal cellular infiltration and collagen deposition and hence restored lung architecture, together with lung functions.
CONCLUSION
MSCs are promising potential therapy for lung fibrosis that could restore the normal structure and function of BLM induced lung fibrosis.


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