Context Speech of prelingual hearing impaired (HI) speakers is commonly characterized by the presence of resonance abnormalities which is related with nasality. Aim To investigate and compare nasalance scores of Egyptian HI children including cochlear implant (CI) and hearing aid (HA) users with normal hearing (NH) children. Settings and design It is an observational case–control study. Patients and methods The study consisted of group I: 41 HA children, group II: 24 CI children, and the control group: 31 age‑matched and sex‑matched children with NH. Nasometer II 6200 was used for evaluation of their nasalance scores. Statistical analysis used IBM SPSS, version 20, was used. Kruskal–Wallis and one‑way analysis of variance tests were performed to compare the mean differences between the nasalance scores of the three studied groups. While Mann–Whitney and post‑hoc tests were used for pairwise comparison. A correlation analysis was computed between the nasalance scores and many parameters using Spearman’s and Pearson’s coefficients. Results For oral sentence, both CI and HA children showed higher nasalance values in comparison with NH children. However, lower nasalance scores were observed for the nasal sentence. CI experience and enrollment into language therapy were found to have an effect on nasalance scores. Conclusions Resonance quality of the HI children is still at risk despite the fact that a significant number of them demonstrate normal resonance.

Context Speech of prelingual hearing impaired (HI) speakers is commonly characterized by the presence of resonance abnormalities which is related with nasality. Aim To investigate and compare nasalance scores of Egyptian HI children including cochlear implant (CI) and hearing aid (HA) users with normal hearing (NH) children. Settings and design It is an observational case–control study. Patients and methods The study consisted of group I: 41 HA children, group II: 24 CI children, and the control group: 31 age‑matched and sex‑matched children with NH. Nasometer II 6200 was used for evaluation of their nasalance scores. Statistical analysis used IBM SPSS, version 20, was used. Kruskal–Wallis and one‑way analysis of variance tests were performed to compare the mean differences between the nasalance scores of the three studied groups. While Mann–Whitney and post‑hoc tests were used for pairwise comparison. A correlation analysis was computed between the nasalance scores and many parameters using Spearman’s and Pearson’s coefficients. Results For oral sentence, both CI and HA children showed higher nasalance values in comparison with NH children. However, lower nasalance scores were observed for the nasal sentence. CI experience and enrollment into language therapy were found to have an effect on nasalance scores. Conclusions Resonance quality of the HI children is still at risk despite the fact that a significant number of them demonstrate normal resonance.

ackground: Iron deficiency anemia (IDA) is the most common nutritional deficiency primarily in developing countries. Objective: This study evaluates the effect of IDA on language development in preschool children. Methodology: The study is a multicenter, comparative cross-sectional study included 226 children between ages 4–6 years. The children were classified into two groups’ anemic (patients) and non anemic (controls) according to the hemoglobin level. All anemic children subjected to complete iron study including; Serum iron, total iron binding capacity (TIBC), Serum ferritin level, to confirm the diagnosis of iron deficiency anemia. Cognitive assessment was done using the Arabic translation Stanford Binet intelligence scale, version four which comprised of four cognitive area scores; visual reasoning, verbal reasoning, quantitative reasoning and short-term memory. Measurement of IQ and mental age were calculated for each child. Language evaluation was done using the Arabic Language test. Receptive language quotient, expressive language quotient and total language quotient were calculated for each child. Results: 122 children were anemic and 90 were non-anemic with hemoglobin level 10.65 and 11.96 g/dL, respectively (P 0.000). Anemic children had significantly lower serum ferritin (p 0.0001), and serum iron (p 0.0001) compared to the controls. Both groups were matched as regards age, sex, socioeconomic levels and parental educational level. No significant differences observed regarding IQ, mental age, receptive, expressive and total language quotients between anemic and non-anemic children. Conclusions: IDA does not seem to have an effect on language development in preschool Egyptian Children. Future large controlled studies with long follow-up time for the younger age group are needed to determine whether there are existent associations between IDA with language development.

ackground: Iron deficiency anemia (IDA) is the most common nutritional deficiency primarily in developing countries. Objective: This study evaluates the effect of IDA on language development in preschool children. Methodology: The study is a multicenter, comparative cross-sectional study included 226 children between ages 4–6 years. The children were classified into two groups’ anemic (patients) and non anemic (controls) according to the hemoglobin level. All anemic children subjected to complete iron study including; Serum iron, total iron binding capacity (TIBC), Serum ferritin level, to confirm the diagnosis of iron deficiency anemia. Cognitive assessment was done using the Arabic translation Stanford Binet intelligence scale, version four which comprised of four cognitive area scores; visual reasoning, verbal reasoning, quantitative reasoning and short-term memory. Measurement of IQ and mental age were calculated for each child. Language evaluation was done using the Arabic Language test. Receptive language quotient, expressive language quotient and total language quotient were calculated for each child. Results: 122 children were anemic and 90 were non-anemic with hemoglobin level 10.65 and 11.96 g/dL, respectively (P 0.000). Anemic children had significantly lower serum ferritin (p 0.0001), and serum iron (p 0.0001) compared to the controls. Both groups were matched as regards age, sex, socioeconomic levels and parental educational level. No significant differences observed regarding IQ, mental age, receptive, expressive and total language quotients between anemic and non-anemic children. Conclusions: IDA does not seem to have an effect on language development in preschool Egyptian Children. Future large controlled studies with long follow-up time for the younger age group are needed to determine whether there are existent associations between IDA with language development.

Background:Inflammatory and oxidative stress caused by infection has recently been proposed as a mechanism of association between the red cell distribution width (RDW) and infectious diseases, such as community-acquired pneumonia(CAP). Objective:The present goal was to assess the prognostic importance of the RDW test in patients with CAP. Patients and methods: The present research was a descriptive and prospective study of patients diagnosed with CAP. All were admitted to Chest Department of Assiut University Hospital between April 2017 and July 2018.Assessment of CAP severity at time of hospital admission using Pneumonia Severity Index was done for all enrolled patients. Complete blood count was measured by automated hematology analyzer, and RDW was reported as a part of the complete blood count result. Normal reference range of RDW was 11.5–14.5%. All of the patients were followed up until being discharged. The outcome variable was in-hospital mortality. Results:The current study involved 94 patients with CAP: 77(82%) survived and 17 (18%) died. RDW level was significantly higher in non survivors compared with survivors(18.52±3.07 vs. 12.76±2.08;P=0.022). A significant positive relationship was found between RDW level and Pneumonia Severity Index points (r=0.664;P=0.000). Regarding the diagnostic performance of the RDW test, it was observed that RDW level at cutoff point more than 16.1% had 94.12%sensitivity and 98.70% specificity for the prediction of in-hospital mortality in patients with CAP. Conclusion: The present data indicated that the measurement of RDW on admission may provide the physician with a tool to predict the outcomes of patients with CAP and thus assist in decision making and management in such cases either alone or alongside the other well-established means, taking into account that RDW testing is simple, cheaper, and readily available.

Background:Inflammatory and oxidative stress caused by infection has recently been proposed as a mechanism of association between the red cell distribution width (RDW) and infectious diseases, such as community-acquired pneumonia(CAP). Objective:The present goal was to assess the prognostic importance of the RDW test in patients with CAP. Patients and methods: The present research was a descriptive and prospective study of patients diagnosed with CAP. All were admitted to Chest Department of Assiut University Hospital between April 2017 and July 2018.Assessment of CAP severity at time of hospital admission using Pneumonia Severity Index was done for all enrolled patients. Complete blood count was measured by automated hematology analyzer, and RDW was reported as a part of the complete blood count result. Normal reference range of RDW was 11.5–14.5%. All of the patients were followed up until being discharged. The outcome variable was in-hospital mortality. Results:The current study involved 94 patients with CAP: 77(82%) survived and 17 (18%) died. RDW level was significantly higher in non survivors compared with survivors(18.52±3.07 vs. 12.76±2.08;P=0.022). A significant positive relationship was found between RDW level and Pneumonia Severity Index points (r=0.664;P=0.000). Regarding the diagnostic performance of the RDW test, it was observed that RDW level at cutoff point more than 16.1% had 94.12%sensitivity and 98.70% specificity for the prediction of in-hospital mortality in patients with CAP. Conclusion: The present data indicated that the measurement of RDW on admission may provide the physician with a tool to predict the outcomes of patients with CAP and thus assist in decision making and management in such cases either alone or alongside the other well-established means, taking into account that RDW testing is simple, cheaper, and readily available.

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Objectives Risk of cardiovascular events in ST-segment–elevation myocardial infarction survivors remains substantial despite advances in management of STEMI. Efforts have been directed to identify factors endangering those survivors, admission hyperglycemia (AH) is a considerable one. We aimed to determine effect of AH on area at risk (AAR), final infarct size (FIS) and myocardial salvage in STEMI patients using cardiac magnetic resonance (CMR). Methods We recruited 43 successfully reperfused STEMI patients. AH was defined as a glucose level ≥ 140 mg/dl in non-diabetics while a cut-off value 250 mg/dl for diabetics. We assigned the recruit into AH group (n=21) and euglycemic group (n=22). T2-weighted sequences short-tau inversion-recovery turbo-spin echo sequence (STIR) was utilized to estimate AAR, segmented inversion recovery steady-state free precession sequence (PSIR) was used to estimate IS, then salvage index (SI) was calculated: SI = AAR- FIS/ AAR. Results AH showed significant positive correlations to FIS (r value = 0.538, P = 0.001), and AAR (r value = 0.435, P=0.002), and a significant negative correlation with SI (r value = -0.378, P=0.006). Moreover, AH group had higher CMR estimated WMSI (1.56 ± 0.2 -1.39 ± 0.3 respectively, p =0.021) and lower segmental 65-40-15 ejection fraction (EF) score (49.36 ± 7.1 - 55.26 ± 6.1 respectively, p = 0.006). Multivariate analysis showed that AH was independent predictor of SI. Conclusion Current study showed an adverse effect of AH on SI in STEMI patients. So, we recommend strict glycemic control.

Objectives Risk of cardiovascular events in ST-segment–elevation myocardial infarction survivors remains substantial despite advances in management of STEMI. Efforts have been directed to identify factors endangering those survivors, admission hyperglycemia (AH) is a considerable one. We aimed to determine effect of AH on area at risk (AAR), final infarct size (FIS) and myocardial salvage in STEMI patients using cardiac magnetic resonance (CMR). Methods We recruited 43 successfully reperfused STEMI patients. AH was defined as a glucose level ≥ 140 mg/dl in non-diabetics while a cut-off value 250 mg/dl for diabetics. We assigned the recruit into AH group (n=21) and euglycemic group (n=22). T2-weighted sequences short-tau inversion-recovery turbo-spin echo sequence (STIR) was utilized to estimate AAR, segmented inversion recovery steady-state free precession sequence (PSIR) was used to estimate IS, then salvage index (SI) was calculated: SI = AAR- FIS/ AAR. Results AH showed significant positive correlations to FIS (r value = 0.538, P = 0.001), and AAR (r value = 0.435, P=0.002), and a significant negative correlation with SI (r value = -0.378, P=0.006). Moreover, AH group had higher CMR estimated WMSI (1.56 ± 0.2 -1.39 ± 0.3 respectively, p =0.021) and lower segmental 65-40-15 ejection fraction (EF) score (49.36 ± 7.1 - 55.26 ± 6.1 respectively, p = 0.006). Multivariate analysis showed that AH was independent predictor of SI. Conclusion Current study showed an adverse effect of AH on SI in STEMI patients. So, we recommend strict glycemic control.

Objectives Risk of cardiovascular events in ST-segment–elevation myocardial infarction survivors remains substantial despite advances in management of STEMI. Efforts have been directed to identify factors endangering those survivors, admission hyperglycemia (AH) is a considerable one. We aimed to determine effect of AH on area at risk (AAR), final infarct size (FIS) and myocardial salvage in STEMI patients using cardiac magnetic resonance (CMR). Methods We recruited 43 successfully reperfused STEMI patients. AH was defined as a glucose level ≥ 140 mg/dl in non-diabetics while a cut-off value 250 mg/dl for diabetics. We assigned the recruit into AH group (n=21) and euglycemic group (n=22). T2-weighted sequences short-tau inversion-recovery turbo-spin echo sequence (STIR) was utilized to estimate AAR, segmented inversion recovery steady-state free precession sequence (PSIR) was used to estimate IS, then salvage index (SI) was calculated: SI = AAR- FIS/ AAR. Results AH showed significant positive correlations to FIS (r value = 0.538, P = 0.001), and AAR (r value = 0.435, P=0.002), and a significant negative correlation with SI (r value = -0.378, P=0.006). Moreover, AH group had higher CMR estimated WMSI (1.56 ± 0.2 -1.39 ± 0.3 respectively, p =0.021) and lower segmental 65-40-15 ejection fraction (EF) score (49.36 ± 7.1 - 55.26 ± 6.1 respectively, p = 0.006). Multivariate analysis showed that AH was independent predictor of SI. Conclusion Current study showed an adverse effect of AH on SI in STEMI patients. So, we recommend strict glycemic control.