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DOG1/ANO1 in Breast Pathology: Diagnostic Utility, Interpretive Pitfalls, and Biological Significance
Background: Demonstration of the myoepithelial cell layer is central to separating benign and in-situ breast proliferations from invasive carcinoma. Conventional markers are valuable but imperfect because staining may be attenuated in ductal carcinoma in situ, duplicated by tumor cells, or obscured by stromal and vascular cross-reactivity. DOG1, the immunohistochemical surrogate of the calcium-activated chloride channel ANO1/TMEM16A, has emerged as a complementary breast myoepithelial marker.
DOG1; ANO1; myoepithelial cells; breast pathology; invasion
Sagda Mohamed Morgan; Yousria Mohamed El-Gohary; Hanaa A. Atwa ; Basma Hamed Ibrahim
Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0/deed.en
The Healing Power of the Himalayan Landscape in the Fiction of Ruskin Bond
Ruskin Bond’s literary corpus is profoundly intertwined with the majestic landscape of the Indian Himalayas. Known as the "resident Wordsworth" of India, Bond is often hailed as depicting nature not just as a backdrop but as an animate
The Architecture of Patriarchy and the Strategies of Subaltern Resistance in Indian English Literature
This paper examines the difference and the complementariness of the strategies adopted by the modern Indian English novelists – Arundhati Roy and Namita Gokhale – when they challenge the pervasive power structures of patriarchy. Roy's novels, especially The God of Small Things and The Ministry of Utmost Happiness, reveal through the postcolonial and systemic perspective the catastrophic consequences of exclusion
submissive Indian female. The postcolonial.Catastrophic consequences, subversive historical memory
The Shamanic Tradition and Creation Myths in Mamang Dai’s Illustrated Folklore
The indigenous people of Arunachal have an enormous task to maintain the core of their cosmology in the transition from a preliterate, oral culture to a modern, literate society. The memory is a single repository of history and identity in a society without a written script, in which all the ancestor did is eat the divine written word out of hunger
The colonial, indigenous, insistent globalization, rhapsodists perish, cosmological cornerstone
Gender, Education, and Resistance: Transformational Journeys of Women in Manju Kapur’s Novels
Manju Kapur has become an important name in the present Indian English fiction for her subtle representation of the anguish of Indian urban middle-class female identity. This article discusses how her female protagonists (Virmati, Astha, Nisha, Nina, Shagun, Tapti) take journey of transformation through the stringent landscapes of tradition,
Patriarchy, Identity Crisis, Resistance, Education, Marriage, Modernity,
PREDICTORS OF FUNCTIONAL RECOVERY FOLLOWING SURGICAL DECOMPRESSION IN LUMBAR CANAL STENOSIS: A PROSPECTIVE COHORT STUDY
Background: Decompressive surgery reliably relieves symptoms of lumbar canal stenosis (LCS), but functional recovery varies between patients. Identifying preoperative predictors of recovery would improve patient selection and counselling. Objectives: To quantify functional improvement after surgical decompression for LCS and to identify preoperative predictors of six-month improvement in the Oswestry Disability Index (ODI). Methods: A prospective cohort of 120 patients undergoing decompressive surgery for symptomatic LCS was assessed preoperatively and at 3 and 6 months. Outcomes were the ODI (0–100), back and leg visual analogue scale (VAS) pain and walking distance. The primary endpoint was 6-month ODI improvement; a secondary binary endpoint was meaningful recovery (≥12.8-point ODI improvement). Predictors were examined with multivariable linear regression. Results: The cohort (mean age 64.3 ± 9.3 years; 61.7% male) improved substantially. Mean ODI fell from 54.0 ± 11.3 to 28.4 ± 10.9 (mean improvement 25.6 ± 5.9 points; p < 0.001); leg VAS fell from 7.1 ± 1.3 to 3.8 ± 1.5 and back VAS from 6.0 ± 1.4 to 3.4 ± 1.6 (both p < 0.001); mean walking distance rose from 280 ± 163 m to 886 ± 234 m. Meaningful recovery was achieved by 117 patients (97.5%). In multivariable regression (R² = 0.44), greater ODI improvement was independently predicted by higher baseline ODI (β = +0.22, p < 0.001) and was reduced by older age (β = −0.20/year, p < 0.001), diabetes (β = −3.89, p < 0.001), depression or anxiety (β = −2.88, p = 0.015), longer symptom duration (β = −0.10/month, p = 0.003) and higher BMI (β = −0.24, p = 0.035); sex, smoking and stenosis severity were not significant. Conclusion: Surgical decompression produced large functional gains in LCS. Older age, diabetes, depression or anxiety, longer symptom duration and higher BMI predicted smaller functional recovery, whereas higher baseline disability predicted greater absolute gain — findings that support earlier surgery and attention to modifiable comorbidity
FUNCTIONAL OUTCOMES AFTER ARTHROSCOPIC ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION USING HAMSTRING AUTOGRAFT: A PROSPECTIVE STUDY
Abstract Background: Arthroscopic anterior cruciate ligament (ACL) reconstruction with a quadrupled hamstring tendon autograft is a widely used technique for the ACL-deficient knee, but functional recovery and return-to-sport in a consecutive prospective cohort deserve continued documentation. Objectives: To evaluate functional, clinical and stability outcomes at 6 and 12 months after arthroscopic ACL reconstruction using hamstring autograft, and to describe return to sport and complications. Methods: A prospective cohort of 120 patients undergoing primary arthroscopic single-bundle ACL reconstruction with a four-strand semitendinosus–gracilis autograft was assessed preoperatively and at 6 and 12 months. Outcomes included the International Knee Documentation Committee (IKDC) subjective score, Lysholm score, visual analogue scale (VAS) for pain, Tegner activity level, range of motion, single-leg-hop and isokinetic limb-symmetry indices (LSI), Lachman and pivot-shift tests, return to sport and complications. Paired comparisons used the paired t test. Results: The cohort (mean age 26.9 ± 6.4 years; 69.2% male) improved markedly from baseline to 12 months. Mean IKDC rose from 50.0 ± 9.4 to 89.7 ± 5.3 and Lysholm from 59.4 ± 8.8 to 92.8 ± 4.1 (both p < 0.001); VAS pain fell from 4.4 ± 1.6 to 0.9 ± 0.5 (p < 0.001). At 12 months, 71.7% had a negative Lachman and 75.8% a negative pivot-shift test; mean single-leg-hop LSI was 92.5 ± 7.6%. Return to sport at any level occurred in 48.3%, and 42.5% returned to their pre-injury Tegner level at 12 months. Complications occurred in 7 patients (5.8%) and graft failure in 2 (1.7%). Conclusion: Arthroscopic hamstring-autograft ACL reconstruction produced large, statistically significant improvements in knee-specific function, pain and stability by 12 months, with a low complication rate; recovery of pre-injury sporting level within one year remained incomplete, underscoring the value of structured rehabilitation and realistic counselling
Conceptualizing Brand Antecedents and Ideal Social-Self Congruency in Egyptian Fashion Apparel Consumption
Background: Within fashion apparel consumption in emerging markets, clothing serves as a prominent symbolic mechanism for public identity projection and impression management. While classical self-congruity literature focuses heavily on actual and ideal self-concepts, ideal social-self congruency—the alignment between a brand's symbolic image and an individual's aspirational public image—acts as a fundamental driver in collectivistic, status-sensitive cultures like Egypt.
Ideal Social-Self Congruency; Brand Antecedents; Fashion Apparel; Egyptian Consumer Behavior; Self-Congruity Theory; Status Consumption; Compulsive Buying.
Marwa Mahmoud Abdel Aziz Meselhy, Prof. Sherif Al-Assi, Prof. Abeer Othman
The CXCL5/CXCR2 Axis in Urothelial Bladder Carcinoma: Mechanistic Biology, Biomarker Evidence, and Therapeutic Prospects
Background: Urothelial bladder carcinoma is heterogeneous, and conventional clinicopathological variables incompletely explain recurrence, progression, and treatment resistance. C-X-C motif chemokine ligand 5 (CXCL5), which predominantly signals through CXCR2, may link malignant urothelial cells with vascular and myeloid compartments.
bladder cancer; CXCL5; CXCR2; chemokines; tumor microenvironment
Alaa Nagy Abdou Mousa, Mona Mohamed El-Sayed, Abeer Mohamed Abd-Elbary, Maha Ahmed Mahmoud
Nurses’ Knowledge, Perceptions, and Preventive Beliefs Regarding Emerging Respiratory Infections: Application of the Health Belief Model
Background: Emerging respiratory infections continue to pose a substantial threat to global health security because of their potential for rapid transmission, severe clinical outcomes, healthcare-associated spread, and disruption of health systems. Nurses are especiallyvulnerable because they maintain prolonged and close contact with patients, perform high-risk procedures, and play a central role insurveillance, triage, infection prevention, patient education, and outbreak response. Their knowledge, perceptions, and preventive beliefs therefore directly influence adherence to infection-control measures and the effectiveness of institutional preparedness. However, adequate knowledge alone does not consistently translate into protective behavior, as preventive practices are also shaped by perceived risk, confidence, organizational support, resource availability, and psychological readiness.
Nurses; emerging respiratory infections; Health Belief Model; preventive behavior
Rewaa Maged Hassan Aiat El-malt, Mohamed Adel Foda, Salah Abdelrahman Ibrahem Shaheen, Lamyaa Elsayed Nasr Saeed Asker
Evidence With Emphasis on Toxicity Profile of Metronomic Capecitabine in Non-Metastatic Triple-Negative Breast Cancer
Background: Metronomic chemotherapy, defined as the continuous administration of low-dose cytotoxic agents without extended drug-free intervals, has emerged as a promising therapeutic strategy aimed at minimizing toxicity while maintaining antitumor efficacy. Capecitabine, an oral fluoropyrimidine prodrug widely used in breast and gastrointestinal malignancies, has been increasingly investigated in metronomic regimens due to its favorable pharmacokinetic profile and tumor-selective activation. This approach is particularly relevant in patients with limited tolerance to conventional chemotherapy, including those with early-stage triple-negative breast cancer (TNBC), where treatmentrelated toxicity may compromise adherence and outcomes.
Toxicity Profile, Metronomic Capecitabine, Non-Metastatic Triple-Negative Breast Cancer
Alaa Gaber Mohamed Hegazy, Shaimaa Farouk Abdelhai, Abdelmotaleb Mohamed Ibrahim, Adel Mohamed Ismail, Moamna M. Fahmy
Immunometabolic Crosstalk at the Blood-Brain Barrier in Multiple Sclerosis: Monocytes, HDL Dysfunction, and Accessible Biomarkers of Neuroinflammatory Burden
Multiple sclerosis arises from an evolving interaction between peripheral immunity and compartmentalized central nervous system injury. Monocytes and monocyte-derived macrophages participate in leukocyte recruitment, bloodbrain barrier disruption, myelin phagocytosis, cytokine production, oxidative injury, and tissue remodeling. Highdensity lipoprotein is equally relevant but biologically more complex than its routine cholesterol concentration suggests
Multiple sclerosis; monocytes; high-density lipoprotein; blood-brain barrier; oxidative stress; immunometabolism
Alaa Abdullah Abd Elmotaleb Mohammed, Mahmoud Elsayed Alebiary, Wael Mahmoud Elsayed, Sabah Elsayed Fathy
RADIOGRAPHIC ASSESSMENT OF FRACTURE NECK OF FEMUR IN THE ELDERLY AND ITS CORRELATION WITH CLINICAL OUTCOME: A HOSPITAL-BASED CROSS-SECTIONAL STUDY
Background: Fracture of the neck of the femur is a common, disabling injury of the elderly, driven by osteoporosis and low-energy falls. Plain radiographic classification—principally the Garden and Pauwels systems—guides the choice between internal fixation and arthroplasty and predicts complications such as avascular necrosis and nonunion. Understanding the relationship between radiographic pattern and clinical outcome is central to rational management. Objectives: To describe the radiographic profile of femoral neck fractures in elderly patients, and to correlate the radiographic classification with treatment and clinical outcome, at a tertiary care hospital in South India. Methods: In this hospital-based cross-sectional study, 250 elderly patients (≥60 years) with a femoral neck fracture underwent standardised anteroposterior and lateral radiographic assessment with Garden and Pauwels classification, and were followed for a protocol-defined interval. Treatment, functional outcome (Harris Hip Score, pain, mobility) and complications were recorded. Results: The mean age was 72.9 ± 7.3 years (60.0% female); 80.4% of fractures followed a trivial fall and 54.4% had diagnosed osteoporosis. By the Garden classification, 13.2% were type I, 17.2% type II, 35.6% type III and 34.0% type IV, giving a displaced-fracture rate of 69.6%; Pauwels type II predominated (38.0%). Arthroplasty was performed in 63.2% (hemiarthroplasty 38.0%, total hip replacement 25.2%) and internal fixation in 36.8%. At a mean follow-up of up to 12 months, the mean Harris Hip Score was 79.0 ± 10.7 and 60.0% had returned to their pre-fracture mobility. Complications included reoperation (14.8%), delirium (14.0%), avascular necrosis (5.6%), nonunion (5.6%), surgical-site infection (4.8%) and deep-vein thrombosis (3.6%); in-hospital/short-term mortality was 5.6%. Among displaced fractures treated by internal fixation, avascular necrosis occurred in 28.1%. Conclusion: Displaced (Garden III–IV) fractures predominated and were managed mainly by arthroplasty, with good functional recovery and low mortality, whereas internal fixation of displaced fractures carried a high avascular-necrosis and reoperation burden. Radiographic classification remains central to treatment selection and outcome prediction
PLAIN RADIOGRAPHIC GRADING OF PRIMARY KNEE OSTEOARTHRITIS USING THE KELLGREN–LAWRENCE SYSTEM AND ITS CORRELATION WITH CLINICAL SEVERITY: A CROSS-SECTIONAL STUDY
Background: Primary knee osteoarthritis (OA) is a leading cause of pain and disability in adults. The Kellgren–Lawrence (KL) system is the most widely used plain-radiographic grading scheme, but the relationship between radiographic grade and clinical severity is variable and clinically important, since management decisions rest on both. Objectives: To grade primary knee OA using the KL system and its component radiographic features, and to correlate the radiographic grade with clinical severity (pain and function), at a tertiary care hospital in South India. Methods: In this hospital-based cross-sectional study, 250 patients with symptomatic primary knee OA underwent standardised (preferably weight-bearing) radiography of the index knee with KL grading and scoring of individual features (joint-space narrowing, osteophytes, subchondral sclerosis, cysts). Clinical severity was assessed by the visual analogue scale (VAS) for pain and the WOMAC index, and correlated with KL grade. Results: The mean age was 57.1 ± 9.3 years (63.6% female), with a mean BMI of 27.8 ± 3.7 kg/m² (78.8% overweight/obese); 50.8% reported occupational squatting/kneeling and 67.2% had bilateral symptoms. KL grade distribution was grade 1 in 10.4%, grade 2 in 38.8%, grade 3 in 33.6% and grade 4 in 17.2%; weight-bearing radiographs were used in 84.4%. Medial joint-space narrowing (≥grade 1) was present in 96.4% and osteophytes (≥grade 1) in 96.8%. The mean WOMAC total score was 53.6 ± 15.6 and mean VAS 6.1. Clinical severity rose steadily with radiographic grade: mean WOMAC increased from 32.7 (KL 1) to 46.1 (KL 2), 58.5 (KL 3) and 73.4 (KL 4), and KL grade correlated strongly with WOMAC (Spearman r = 0.76, p < 0.001) and with VAS (r = 0.75). Clinical severity was mild in 10.4%, moderate in 38.8% and severe in 50.8%. Conclusion: KL radiographic grade correlated strongly with clinical pain and functional severity in primary knee OA, supporting its role as a simple, informative bedside tool, though the imperfect concordance means that radiographic grade should complement rather than replace clinical assessment
FETO-MATERNAL OUTCOMES IN OLIGOHYDRAMNIOS DIAGNOSED IN THE THIRD TRIMESTER: A HOSPITAL-BASED CROSS-SECTIONAL STUDY
Background: Oligohydramnios, a pathological reduction of amniotic fluid volume, is a recognised marker of the compromised fetoplacental unit and is frequently identified during routine third-trimester ultrasonography. In resource-constrained settings of South India, it remains an important antenatal finding that influences the timing and mode of delivery and is associated with adverse perinatal outcomes. Objectives: To describe the sociodemographic and obstetric profile of women with third-trimester oligohydramnios and to determine the associated feto-maternal outcomes in a tertiary care teaching hospital. Methods: This hospital-based, cross-sectional, STROBE-compliant study analysed a dataset of 280 women with third-trimester oligohydramnios, defined as an amniotic fluid index (AFI) below 5 cm or a single deepest pocket below 2 cm. Sociodemographic characteristics, diagnostic profile, fetal surveillance findings, management approach, mode of delivery and neonatal outcomes were summarised using descriptive statistics. Results: The mean maternal age was 29.3 +/- 7.0 years and the mean gestational age at diagnosis was 33.9 weeks. Oligohydramnios was mild in 130 (46.4%), moderate in 100 (35.7%) and severe in 50 (17.9%). Fetal growth restriction was documented in 26.4% and abnormal umbilical artery Doppler in 33.2%. The overall caesarean rate was 42.9% (120/280), most commonly for fetal distress. Adverse neonatal findings included low birth weight (49.6%), preterm birth (39.6%), NICU admission (31.4%) and neonatal respiratory distress (15.0%). Perinatal mortality was 4.6% (13/280). Conclusion: In this cohort, third-trimester oligohydramnios was associated with a substantial burden of operative delivery and adverse neonatal outcomes, underscoring the value of structured fetal surveillance and timely delivery
PREVALENCE, RISK FACTORS, AND OUTCOMES OF RECURRENT PREGNANCY LOSS: A CROSS-SECTIONAL STUDY AT A TERTIARY CARE HOSPITAL
Background: Recurrent pregnancy loss (RPL) is a distressing reproductive condition that affects a substantial proportion of couples seeking obstetric care and carries considerable psychological, clinical, and health-system consequences. In South India, contemporary hospital-based estimates of its burden and associated risk factors remain limited, hampering context-specific counselling and service planning. Objectives: To estimate the prevalence of RPL among women with a history of pregnancy loss attending a tertiary care teaching hospital, to characterise the sociodemographic, obstetric, clinical, and laboratory factors associated with pregnancy loss, and to describe management advice given and short-term follow-up outcomes. Methods: A STROBE-compliant, hospital-based cross-sectional study was conducted at a tertiary care teaching hospital in South India during [study period]. A dataset of 420 women (N = 420) with a history of one or more pregnancy losses, generated for methodological and purposes, was analysed. RPL was defined as two or more clinically recognised pregnancy losses. Sociodemographic, obstetric, associated risk-factor, laboratory, management, and follow-up variables were summarised using descriptive statistics. Results: Mean maternal age was 29.8 ± 7.0 years and mean body mass index (BMI) was 27.3 ± 4.9 kg/m². RPL (≥2 losses) was present in 83 women (19.8%); of these, 25 (6.0%) had primary and 58 (13.8%) secondary RPL. The most frequent associated factors were polycystic ovary syndrome (PCOS) history (15.0%), diabetes or impaired glucose tolerance (11.7%), consanguinity (9.3%), uterine anomaly (8.3%), and thyroid disorder (7.9%). Antiphospholipid antibodies were positive in 4.3% and parental karyotype abnormalities in 2.9%. Most women were advised routine antenatal or preconception care (80.2%). Among 267 currently pregnant women, 194 had ongoing pregnancies and miscarriage during follow-up occurred in 26 (9.7%). Conclusion: In this South Indian tertiary care, approximately one in five women with prior pregnancy loss met criteria for RPL, and metabolic and endocrine factors predominated among associated conditions.
CLINICAL PROFILE AND MANAGEMENT OUTCOMES OF HYPERTENSIVE DISORDERS OF PREGNANCY (PRE-ECLAMPSIA/ECLAMPSIA) AT A TERTIARY CARE HOSPITAL: A CROSS-SECTIONAL STUDY
Background: Hypertensive disorders of pregnancy (HDP), encompassing gestational hypertension, pre-eclampsia, eclampsia and chronic hypertension with superimposed pre-eclampsia, remain a leading cause of maternal and perinatal morbidity and mortality, particularly in low- and middle-income settings such as South India. Characterising the clinical spectrum and short-term outcomes of these disorders at the tertiary-care level can inform triage, referral and resource allocation. Objectives: To describe the sociodemographic and clinical profile, management patterns and maternal and perinatal outcomes of women admitted with HDP at a tertiary care teaching hospital. Methods: This was a STROBE-compliant, hospital-based, cross-sectional study of 240 pregnant women with HDP. Sociodemographic characteristics, diagnostic subtype, admission blood pressure, proteinuria, platelet count, symptoms, antihypertensive and magnesium sulphate use, mode of delivery, maternal complications and perinatal outcomes were summarised using descriptive statistics. Results: Mean maternal age was 30.1 ± 7.0 years; 132 (55.0%) were from rural areas and 96 (40.0%) were unbooked. Pre-eclampsia with severe features (31.2%) and gestational hypertension (30.8%) predominated; eclampsia occurred in 14 (5.8%). Mean admission blood pressure was 174 ± 20 / 110 ± 11 mmHg. Labetalol (44.6%) was the most frequent antihypertensive and magnesium sulphate was administered to 172 (71.7%). The caesarean rate was 58.8%. Maternal ICU admission occurred in 9.6% and maternal mortality in 0.8%. Preterm birth (43.8%), NICU admission (37.5%) and perinatal mortality (8.75%) were common. Conclusion: HDP in this tertiary-care cohort was associated with substantial maternal and perinatal morbidity, high caesarean and preterm rates, and a notable burden among rural and unbooked women.
Copyright (c) 2026 Dr. Gayathri Devi (Author) https://creativecommons.org/licenses/by/4.0/deed.en
Obsessive-Compulsive Disorder and Illness Anxiety Disorder Following COVID-19: Shared Mechanisms and Primary Care Management
Background: The COVID-19 pandemic produced sustained psychological consequences that extended beyond the acute infectious period. Fear of infection, repeated public-health messaging, social isolation, uncertainty, exposure to illness-related information, and disruption of usual healthcare pathways contributed to increased anxiety, contamination concerns, compulsive behaviors, and excessive preoccupation with health. These effects were particularly relevant to obsessive-compulsive disorder and illness anxiety disorder, two conditions that may overlap in their presentation through recurrent health-related thoughts, reassurance seeking
obsessive-compulsive disorder; illness anxiety disorder; COVID-19; primary care
Shereen Mohammed Bahgat Awad, Azza Mohamed Elsayed, Nada Abbas Hasan
Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios in Hashimoto Thyroiditis: Biological Rationale, Clinical Evidence, and Interpretive Limits
Background: Hashimoto thyroiditis is sustained by thyroid-directed adaptive immunity, yet its biological effects may extend beyond the gland. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are inexpensive blood count-derived indices proposed to reflect this systemic component
Hashimoto thyroiditis; neutrophil-to-lymphocyte ratio; platelet-to-lymphocyte ratio; systemic inflammation; thyroid autoimmunity
Nahla Abdelkarem Salama, Amira Ahmed Mahmoud Ghiaty , Mohamed Sabry Mohamed Elmahdy, Lamiaa Mahmoud Kamel, Rodalia M. Makhlouf
Beyond Magnification: Biological, Technical, and Rehabilitation Determinants of Sensory Recovery After Primary Digital Nerve Repair
Background: Recovery after digital nerve repair is often treated as a technical consequence of coaptation. In practice, sensibility reflects injury biology, nerve-end quality, mechanics, axonal regeneration, target reinnervation, cortical adaptation, pain, and rehabilitation
digital nerve repair; sensory recovery; nerve regeneration; rehabilitation; microsurgery
Hadir Mohamed Ibrahim El-Sayed, Mahmoud Elsayed Gouda, Yehia Zakaria Awwad
Sleep Quality During Pregnancy and Its Relationship With Postpartum Depression and Anxiety: A Family Medicine Perspective
Background: Sleep disturbance is frequent during pregnancy and often persists after childbirth. Poor sleep overlaps clinically and biologically with perinatal depression and anxiety, yet sleep symptoms may be normalized as an unavoidable feature of pregnancy and remain untreated. Aim: To synthesize evidence on pregnancy-related sleep change, its association with postpartum depression and anxiety, and practical opportunities for prevention and early intervention in family medicine.
pregnancy; sleep quality; insomnia; postpartum depression; postpartum anxiety; family medicine
Alaa Magdy Ali Abdallah, Shereen Mohammed Bahgat Awad, Samar Ahmed Abd-El Salam
Functional Constipation and Health-Related Quality of Life in Elementary School Children: A Narrative Review
Background: Functional constipation is one of the most frequent gastrointestinal disorders in childhood and is particularly disruptive during the elementary-school years. Although the disorder is defined by bowel symptoms, its consequences extend to pain, appetite, sleep, emotional well-being, peer relationships, school participation, and family life. This narrative review examines the pathways through which functional constipation affects health-related quality of life and translates the evidence into practical recommendations
functional constipation, child, quality of life, school health, primary health care
Alaa Adel Fetoh Mohamed, Nora Nabil Hussien, Noha Osman Frere
Mid-Regional Pro-Adrenomedullin in Spontaneous Bacterial Peritonitis Complicating Decompensated Cirrhosis
Background: Spontaneous bacterial peritonitis (SBP) remains a major cause of deterioration in decompensated cirrhosis. Ascitic polymorphonuclear neutrophil counting is indispensable for diagnosis but does not fully represent endothelial injury or circulatory failure. Mid-regional pro-adrenomedullin (MR-proADM), a stable fragment released with adrenomedullin, reflects inflammatory and vascular stress
cirrhosis; spontaneous bacterial peritonitis; MR-proADM; adrenomedullin; biomarker; prognosis
Walid Mohamed Attiah , Abdallah Moatasem Nawara , Mahmoud Abdelaziz Elsayed Taha , Yosra Abdelfattah Osama Mohamed
Pediatric Hemophilia in the Era of Subcutaneous Prophylaxis: Translating Hemostatic Innovation Into Safe Everyday Care
Background: Pediatric hemophilia care has moved from episodic rescue toward sustained bleed prevention, yet the growing number of factor and non-factor options has made treatment selection more complex. The clinically relevant question is no longer whether prophylaxis is needed, but how to match a hemostatic strategy to a child’s biology, developmental stage, daily activity, family capacity, and local resources.
Hemophilia; Child; Prophylaxis; Emicizumab; Non-factor therapy.
Shaimaa Hashem Abd El-Aziz , Mervat Atfy Mohammed , Hosam Fathi El-Saadany , Ahmed Mohammed Barakah
SPECTRUM OF ELECTROLYTE ABNORMALITIES AND THEIR CLINICAL CORRELATES AMONG MEDICAL INPATIENTS: A HOSPITAL-BASED CROSS-SECTIONAL STUDY
Background: Electrolyte abnormalities are among the commonest biochemical derangements in hospitalised medical patients and are associated with prolonged hospital stay, higher morbidity and increased mortality. Because they are frequently asymptomatic yet clinically consequential, systematic assessment of the spectrum of electrolyte disturbances and their clinical correlates is important for rational inpatient care. Objectives: To determine the spectrum and prevalence of electrolyte abnormalities among adult medical inpatients, and to describe their clinical correlates including presenting symptoms, comorbidities, acute kidney injury (AKI), intensive care transfer and in-hospital outcome, at a tertiary care hospital in South India. Methods: In this hospital-based cross-sectional study, 500 consecutive adult medical inpatients were studied. Admission serum sodium, potassium, chloride, bicarbonate, total calcium, magnesium and phosphate were recorded, and abnormalities were defined using standard laboratory reference ranges. Demographic, clinical and outcome variables were captured on a structured proforma. The analysis is based on a synthetic dataset (see Methods). Data were summarised using descriptive statistics. Results: The mean age was 50.9 ± 16.6 years; 256 (51.2%) were women. At least one electrolyte abnormality was present in 96.8% of patients, and 82.4% had two or more concurrent abnormalities. Sodium disturbance was the commonest (51.8%), predominantly hyponatremia (48.6%; hypernatremia 3.2%), followed by low bicarbonate (50.6%), chloride disturbance (47.4%), hypocalcemia (36.8%), potassium disturbance (30.4%; hypokalemia 21.4%, hyperkalemia 9.0%), magnesium disturbance (28.2%; hypomagnesemia 25.6%) and phosphate disturbance (19.4%). AKI was present in 21.4%, ECG abnormality in 10.8% and ICU transfer in 10.0%. The mean hospital stay was 5.8 ± 2.3 days; 450 (90.0%) were discharged and in-hospital mortality was 1.4%. Conclusion: Electrolyte abnormalities were near-universal among medical inpatients, with hyponatremia the single commonest disturbance and multiple concurrent abnormalities the rule rather than the exception. Routine admission electrolyte screening, attention to precipitating illnesses and drugs, and prompt correction are recommended
CLINICAL PROFILE, COMPLICATIONS, AND RISK FACTORS OF DENGUE FEVER AMONG HOSPITALIZED ADULTS: A CROSS-SECTIONAL STUDY
Background: Dengue is the most rapidly spreading mosquito-borne viral disease in the tropics and a major cause of febrile hospital admission in India. Although often self-limiting, dengue in adults can progress to plasma leakage, severe bleeding, organ involvement and shock, making early clinical characterisation important for triage and management. Objectives: To describe the clinical profile, laboratory features, complications and outcomes of dengue fever among hospitalized adults, and to identify features associated with severe disease, at a tertiary care hospital in South India. Methods: In this hospital-based cross-sectional study, 500 adults admitted with serologically supported dengue (NS1 antigen and/or dengue IgM) were studied. Clinical features, warning signs, haematological and biochemical parameters, complications, and in-hospital outcomes were recorded on a structured proforma using standard/WHO-based definitions. The analysis is based on a synthetic dataset (see Methods). Data were summarised using descriptive statistics. Results: The mean age was 38.9 ± 13.1 years, with an equal sex distribution; the mean duration of fever before admission was 4.9 ± 1.6 days. Fever was universal (100%), followed by myalgia (72.8%), headache (60.0%), nausea/vomiting (51.2%), arthralgia (50.2%), retro-orbital pain (41.8%), rash (21.6%) and abdominal pain (16.8%). NS1 antigen was positive in 55.4% and dengue IgM in 69.2%. The mean platelet count was 79,730 ± 45,948/µL and mean haematocrit 42.8 ± 5.4%; transaminases were elevated (mean AST 103.9 U/L, ALT 84.7 U/L). Complications included pleural effusion (10.4%), ascites (10.2%), shock (4.6%), severe bleeding (2.6%), severe hepatitis (2.4%), myocarditis (2.4%) and acute kidney injury (2.2%). ICU admission was required in 13.2% and platelet transfusion in 19.4%. The mean hospital stay was 5.2 ± 1.9 days; 450 (90.0%) were discharged and in-hospital mortality was 1.6%. Conclusion: Dengue in hospitalized adults presented with a characteristic febrile syndrome, thrombocytopenia and transaminitis, with plasma-leakage phenomena and bleeding accounting for most severe disease. Recognition of warning signs, serial platelet and haematocrit monitoring, and judicious fluid management are central to reducing morbidity and mortality
From Variant to Clinical Trajectory: Genotype-Phenotype Correlations in Pediatric Lysosomal Storage Disorders
Background: Lysosomal storage disorders are important causes of progressive multisystem disease in childhood. Molecular diagnosis may precede symptoms, yet the clinical meaning of a detected variant is often uncertain. To synthesize clinically useful genotype-phenotype relationships across major pediatric lysosomal storage disorders and clarify how molecular findings should influence diagnosis, prognosis, surveillance, counseling, and treatment timing. A focused narrative synthesis of peer-reviewed literature and authoritative laboratory standards
lysosomal storage disorders; genotype-phenotype correlation; pediatric genetics; newborn screening; precision medicine
Hany Abdelhameed Hassan, Mona Mohamed Al Shafei, Wesam Abd El Monem Mokhtar
THE COMPOUNDING OF ALARMS: PSYCHOLOGICAL EFFECTS ON A MOTHER CARING FOR AN INFANT WITH A GLUCOSE MONITOR DURING WARTIME: A REVIEW AND CONCEPTUAL ANALYSIS
Caregivers of infants with continuous glucose monitors (CGMs) already carry a well-documented psychological burden, driven in large part by loud, unpredictable device alarms that signal hypoglycemic danger. When this burden is layered onto a wartime environment in which air-raid sirens are a recurring feature of daily life, the caregiver is exposed to two structurally similar but functionally distinct alarm systems that compete for the same threat-detection circuitry in the brain. This paper reviews the literature on CGM-related caregiver anxiety and on the psychological effects of war sirens on mothers, and integrates it with research on fear-potentiated startle and auditory trauma sensitization to propose a conceptual model of "compounded alarm exposure." It argues that the co-occurrence of a medical alarm and a war alarm does not simply add two independent stressors but may amplify each through shared neurobiological pathways, producing heightened hypervigilance, sleep disruption, and anticipatory dread. The paper closes with recommendations for device design, clinical screening, and psychosocial support for mothers in conflict settings
LAPAROSCOPIC HYSTERECTOMY FOR WOMEN WITH BENIGN GYNECOLOGICAL DISEASES: A REVIEW ARTICLE
Benign gynecological diseases, including uterine fibroids, endometriosis, adenomyosis, ovarian cysts, pelvic organ prolapse, and other reproductive tract disorders, are common conditions that may cause abnormal bleeding, pelvic pain, infertility, and reduced quality of life. Laparoscopic hysterectomy (LH) has become an important minimally invasive approach for definitive treatment of selected benign gynecological diseases. This review article aims to summarize the common benign gynecological conditions and illustrate the role of LH by discussing its types, indications, contraindications, surgical techniques, advantages, complications, and clinical outcomes. The article highlights that LH provides reduced surgical trauma, lower blood loss, shorter hospital stay, faster recovery, less postoperative pain, and improved visualization of pelvic anatomy compared with conventional abdominal surgery. With proper patient selection and surgical expertise, laparoscopic hysterectomy represents an effective and safe approach for managing benign gynecological diseases and improving women quality of life.
Copyright (c) 2024 Osama Ahmed Mohammed, Ahmed Abdelbaky Moubarak, Mostafa Mohamed Khodary, Ahmed Hashem Abdellah, Yasser Ahmed Abuelwafa Abdellatif (Author) https://creativecommons.org/licenses/by/4.0/deed.en
The Role of Insulin-Like Growth Factor-1 in Anemia Among Adults Undergoing Maintenance Hemodialysis: A Comprehensive Review
Background: Anemia remains one of the most common and clinically significant complications of chronic kidney disease (CKD), particularly among adults receiving maintenance hemodialysis (MHD). Although impaired renal erythropoietin production is considered the principal mechanism, anemia in this population is multifactorial and is influenced by iron dysregulation, chronic inflammation, uremic toxins, nutritional deficiencies, shortened erythrocyte survival, and resistance to erythropoiesis-stimulating
Chronic kidney disease; Maintenance hemodialysis; End-stage kidney disease; Anemia; Insulin-like growth factor-1; Erythropoiesis; Growth hormone; Protein-energy wasting; Erythropoiesis-stimulating agents.
Mahmoud M Magdi , Mohamed Ali Elzanaty , Hala M Allam , George Emad Shaker , Fatma Magdy Mohamed Ibrahim, Haytham Kamal Ahmed Mahrous