Validation of the autism behavior checklist in Egyptian children with autism spectrum disorder.

This study was designed to validate the Arabic version of the Autism Behavior Checklist (ABC) for the Egyptian population. A total of 500 mothers of children aged 4-14 years, of whom 150 had a diagnosis of ASD, 100 with intellectual disability, and 250 typically developing children completed the ABC. The factor analysis showed that 48 of 57 ABC items yielded a five-dimensional factor structure. The ABC-Arabic version indicated acceptable internal consistency (α = 0.85) and test - retest reliability (0.82). Also, the ABC exhibited good concurrent validity and discriminative validity. A cutoff score of 58 obtained a sensitivity of 94.7% and a specificity of 92.14% for detecting children with ASD. Our findings support the use of the ABC as a valid screening measure for ASD cases, and it may promote the use of the ABC for clinical and research purposes among Arabic-speaking communities.

Assessment of probiotic strain Lactobacillus acidophilus LB supplementation as adjunctive management of attention-deficit hyperactivity disorder in children and adolescents: a randomized controlled clinical trial.

BACKGROUND: This study was designed to examine the possible efficacy of the probiotic strain Lactobacillus acidophilus LB (Lacteol Fort) on attention-deficit/hyperactivity disorder (ADHD) symptomatology and evaluate its influence on cognition function. METHODS: In this randomized controlled trial, 80 children and adolescents with ADHD diagnosis, aged 6-16 years, were included. The participants were randomly assigned to two groups: one group received probiotics plus atomoxetine, whereas the other group received atomoxetine only. ADHD symptomatology was assessed using the Conners Parent Rating Scale-Revised Long Version (CPRS-R-L) and Child Behavioral Checklist (CBCL/6-18). The participants were evaluated for their vigilance and executive function using Conner's Continuous Performance Test (CPT) and Wisconsin Card Sort Test (WCST). Both groups were assessed at the beginning of the study and the end of the twelve weeks. RESULTS: The probiotic group comprised 36 patients, whereas the control group comprised 40 patients in the final analysis after four patients dropped out of the trial. After 3 months of probiotic supplementation, a significant improvement in the CPRS-R-L and CBCL total T scores was observed compared with those in the control group (p = 0.032, 0.024, respectively). Additionally, the probiotic group demonstrated improved focus attention (target accuracy rate and omission errors;p = 0.02, 0.043, respectively) compared with the control group. An analysis of the Wisconsin Card Sorting Test (WCST) performance demonstrated that the probiotic group had significantly lower perseverative (p = 0.017) and non-perseverative errors (p = 0.044) but no significant differences compared to the control group. CONCLUSION: Lactobacillus acidophilus LB supplementation combined with atomoxetine for 3 months had a beneficial impact on ADHD symptomology and a favorable influence on cognitive performance. As a result, the efficacy of probiotics as an adjunctive treatment for managing ADHD may be promising. TRIAL REGISTRATION: ClinicalTrials.gov (identifier: NCT04167995). Registration date: 19-11-2019.

Adherence to Insulin Therapy Among Children with Type 1 Diabetes: Reliability and Validity of the Arabic Version of the 4-Item Morisky Medication Adherence Scale.

Background: Inadequate adherence to insulin is a major concern, necessitating the use of reliable and valid metrics for assessing adherence. Up to date, there are no Arabic validated tools assessing adherence to insulin therapy among children with type 1 diabetes (T1DM). Thus, the aim of this study is to evaluate the psychometric properties of an Arabic version of the four-item Morisky Green Levine Medication Adherence Scale (MGLS-4) as a self-reported measure of adherence to insulin among a cohort of Egyptian children with T1DM. Methods: The MGLS-4 was translated using forward and backward translation. The Cronbach's alpha was used to assess reliability. Criterion validity of the scale was tested by examining the correlation coefficients between the compliance score (level of adherence) and the HbA1c levels. Results: A total of 400 patients completed the Arabic version of MGLS-4. 26.25% of the studied cohort was found to be non-adherent to insulin therapy; non-adherent patients were significantly older (P=0.001). Decreased maternal education level, decreased frequency of blood glucose monitoring and prolonged disease duration best predicted the occurrence of non-adherence among the studied cohort. The internal consistency of the current version showed good reliability (Cronbach's alpha = 0.857). The adherence score and adherence level showed very strong correlation with HbA1c level (rho = 0.830, P < 0.001 and rho = 0.808, P < 0.001, respectively). Conclusion: The Arabic version of MGLS-4 showed good reliability and validity as a self-administered tool for assessing adherence to insulin in pediatric patients with T1DM.

Measurement of Cumulative Preterm Neonatal and Maternal Stressors During Neonatal Intensive Care Unit Admission.

OBJECTIVES: By nature, the neonatal intensive care unit (NICU) environment is stressful for both infants and mothers. This study aimed to explore and quantify the severity of early life stressors in premature infants admitted to the NICU and evaluate the effect of cumulative neonatal stressors on maternal mental health. METHODS: This cross-sectional study included 100 preterm infants admitted to the NICU for at least 10 days. Daily experiences with painful/stressful procedures for 10 days were determined using the Neonatal Infant Stressor Scale. The included mothers were assessed for their psychological well-being 1 week after NICU admission using the Parental Stressor Scale: NICU and Edinburgh Postnatal Depression Scale. RESULTS: During the first 10 days of NICU admission, preterm infants experienced an average of 350.76 ± 84.43 acute procedures and an average of 44.84 ± 11.12 cumulative hours of chronic events, with the highest scores recorded on first 3 days of admission. Although intravenous flushing for patency was the most frequent acute procedure, blood gas sampling was the most painful. Forty-five percent of the mothers showed significant depressive symptoms, with the maternal role alteration reported as the most stressful experience, especially for young and new mothers (p < .001). The cumulative stressors experienced by infants were significantly associated with elevated maternal perception of psychological maladjustment (p < .001). CONCLUSION: This study confirmed that the NICU environment is stressful for both infants and mothers, with the total cumulative stressors experienced by preemies in the NICU having an negative impact on maternal mental health.

Coping strategies among children and adolescents: validity and reliability of the Arabic version of the Kidcope scale.

Coping strategies adopted by children and adolescents play a crucial role in their mental health. This study aimed to develop the Arabic version of the Kidcope, assess its psychometric properties, and examine age and gender differences in the use of coping strategies by children and adolescents. A total of 800 children and adolescents siblings of patients with type 1 Diabetes mellitus completed the Kidcope scale. The developed Arabic Kidcope was checked for its construct validity, reliability, reproducibility, and confirmed by confirmatory factor analysis (CFA). Age and gender differences in coping styles utilization were assessed by one-way analysis of variance (ANOVA) and student t tests. Kidcope chid version yielded a three factors model by exploratory factor analysis (EFA). Overall, the 15-items revealed good internal consistency, Cronbach's alpha (0.89), and an intra-class correlation coefficient (ICC) of 0.82. EFA identified a two-factor solution for adolescents' Kidcope version. Overall, the 11-items showed acceptable internal consistency, Cronbach's alpha (0.74), and satisfactory (ICC) of 0.84. For both versions, the CFA supported the yielded factors models with good model fit indices. Developmental age changes were apparent for problem-solving, emotional regulation, and distraction coping strategies, and girls showed an enhanced use of adaptive strategies (problem-solving, social support). The Arabic Kidcope version is a reliable and valid tool to measure coping strategies used by children and adolescents.

Screening of Egyptian obese children and adolescents for insertion/deletion (I/D) polymorphism in angiotensin-converting enzyme gene.

BACKGROUND: /aims: The role of angiotensin-converting enzyme (ACE) gene polymorphism in the development of obesity and hypertension in children has not been widely studied. We aimed to screen Egyptian obese children and adolescents for insertion/deletion (I/D) polymorphism in the ACE gene. METHODS: One hundred forty-two children and adolescents were included (70 with simple obesity and 72 controls). Blood pressure was measured, and anthropometric parameters were assessed in all included children and adolescents. Fasting lipid profile, fasting glucose, and insulin were measured. DNA extraction and ACE I/D polymorphism genotyping were also performed. RESULTS: Obese children had a higher frequency of DD genotype (30% in obese versus 11.1% in controls, P = .01) and D alleles (61.8% in obese versus 48.6% in controls, P = .01). Obese children with hypertension and prehypertension had higher frequency of DD genotype than II genotype and higher D alleles than I alleles. DD genotype and D allele were independently associated with hypertension (OR: 9.86 and 11.57, respectively, P < .001), while dyslipidemia and insulin resistance were not associated with the ACE I/D gene polymorphism. CONCLUSION: DD genotype and D-allele of the ACE gene polymorphism were associated with obesity and with hypertension and pre-hypertension in Egyptian children.