Ameliorative Effect of Borage Seeds Oil against Radiation- Induced Hepatotoxicity in Rats
Mohamed M.
Rezk
Geological Isotopes Dept., Nuclear Materials Authority
author
Hazem, K.A.
Sarhan
Medical and Radiation Research Dept., Nuclear Material Authority, Cairo, Egypt
author
Amal A. A.
Ammar
Medical and Radiation Research Dept., Nuclear Material Authority, Cairo, Egypt
author
text
article
2018
eng
Background: Oxidative stress is known to be a key factor in several diseases and was reported as a result of radiation exposure in human and experimental animals. Borage (Borago officinal L.) oil contains a high percentage of g-linolenic acid, which reported as a preventive treatment of a wide range of disorders. Aim: The present study was designed to determine the possible protective effects of borage seeds oil against gamma (γ-) radiation induced oxidative stress in male rats.Materials and Methods: Thirty rats were divided into five groups (6 rats each): Control, irradiated; rats were exposed to (6.5 Gy) of whole body γ-radiation, borage seeds (50 mg/kg b.wt), irradiated borage treated pre-irradiated and borage treated post-irradiated. Serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma glutamyl transferase (GGT) levels, as well as serum and hepatic reduced glutathione (GSH), superoxide dismutase (SOD) and lipid peroxide (malondialdehyde) (MDA) levels were assessed.
Results: The results showed that, activities of GSH were highly significant decrease, while marked highly significant increase in MDA due to irradiation. Supplementation with BO before or treated after irradiation, exerted marked amelioration of irradiation induced disturbances in all the investigated parameters. Therefore, borage could have a beneficial role in modulating oxidative stress by improving the natural antioxidant mechanism.
Conclusion: borage has a beneficial role in reducing hepatotoxicity and oxidative stress induced by radiation exposure.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
73
v.
7
no.
2018
6987
6994
https://ejhm.journals.ekb.eg/article_17218_d123e41faa8f7531e1761f221203ff2c.pdf
dx.doi.org/10.21608/ejhm.2018.17218
Comparative Study between Hysterosalpingography, Saline Infusion Transvaginal Ultrasound and Doppler Studies in Assessment of Uterine Factor of Infertility
Mohammed Hesham Hassan
Anwar
Obstetrics and Gynaecology Department, Faculty of Medicine, Al Azhar University
author
Osama Elsaeid
Ali
Obstetrics and Gynaecology Department, Faculty of Medicine, Al Azhar University
author
Bassem Ragab
Abdelaziz
Obstetrics and Gynaecology Department, Faculty of Medicine, Al Azhar University
author
Mohammed Abdalla
Hassanin
Obstetrics and Gynaecology Department, Faculty of Medicine, Al Azhar University
author
text
article
2018
eng
Background: One of the basic steps of an infertility workup is to evaluate the shape and regularity of the uterine cavity. Acquired uterine lesions, such as uterine fibroids, endometrial polyps, intrauterine adhesions, or all of these, may cause infertility by interfering with proper embryo implantation and growth.
Aim of the Work: to compare the findings of hysterosalpingography, saline infusion transvaginal sonohysterography and Doppler studies in patients with suspected uterine causes of infertility. Patients and Methods: This is a comparative observational cross sectional study, which was conducted in the Obstetrics and Gynecology Department at Al Hussein and Sayed Galal University Hospitals, Al Azhar University in Cairo during the period from April 2017 to the end of September 2018. Sixty patients were included at the study who were recruited from the infertility outpatient clinics, with suspected uterine factors of infertility clinically, by hysterosalpingography (HSG) or by ultrasound. Results: HSG showed the highest sensitivity in the diagnosis of bicornuate uterus, septate uterus and intrauterine synechia (100%) followed by endometrial polyp (70%) then submucous myomas (62.5%). High specificity (100%) was in the diagnosis of endometrial polyp and submucous myoma. Also it showed high false negative values as it missed the diagnosis of 7 cases.
Conclusion: SIS is the gold standard of our study in assessment of uterine factor of infertility. Doppler studies showed high false negative results compared to HSG and saline infusion sonohysterography (SIS). Some lesions were missed from HSG and diagnosed by SIS and these missed lesions may play a role in infertility, so SIS is very important modality in diagnosis and assessment of uterine factor of infertility.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
73
v.
7
no.
2018
6995
7005
https://ejhm.journals.ekb.eg/article_17219_ad539e85df9455c20898021fd831e1c1.pdf
dx.doi.org/10.21608/ejhm.2018.17219
Knowledge about Waiting Time Spent in the Emergency Department for Patients in Saudi Arabia and Overall Patient Satisfaction
Abdulrahman Saeed Saad
Alharbi
College of Medicine University of Hail
author
Adnan Meteb Mohamed
Almezani
College of Medicine University of Hail
author
Ayman Mamdouh
Alrashdi
College of Medicine University of Hail
author
Hisham Mohammed
Almomen
Gulf Medical University Ajman, UAE
author
text
article
2018
eng
Background: Despite the modern society and medical services, waiting in emergency department is taking too long time for patients in Saudi Arabia. Time spent in the emergency department is crucial and can affect the overall health outcomes. Knowing the time spent in the emergency department and overall patient’s satisfaction can provide an important information of health care that is provided in Saudi Arabia. Comparing the time spent in the emergency department in Saudi Arabia to other countries will help us know the quality of health care provided.
Objectives: Waiting in the emergency department is a global issue not only in the developing countries but also in modern countries. This study aimed at assessing how long is the waiting time spent by patients in the emergency department before receiving the medical care and the overall patients’ satisfaction. Methods: A cross-sectional study on the time spent in the emergency department before getting help for patients in Saudi Arabia and overall patients’ satisfaction was carried out on 528 participants during the period from February to March 2018. Results: 42% of the participants, indicated that the main complain that brought them to the emergency department was in the abdominal area and 29.5% of the patients spent more than one hour before getting helped from healthcare providers. 18.8% of the participants evaluated the emergency department service by 1 out of 10. Conclusion: Ourresults showed that large number of patients was suffering from waiting too long time in the emergency department before receiving the required medical care.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
73
v.
7
no.
2018
7006
7010
https://ejhm.journals.ekb.eg/article_17221_eedf4eee4f19aef175e40ff302e6536d.pdf
dx.doi.org/10.21608/ejhm.2018.17221
Role of cluster of differentiation 39 (CD39) in the immunosuppressive status associated Acute myeloid leukemia (AML)
Karima A.
Mahfouz
Clinical Pathology Department, Al-Azhar University Egypt
author
Ibraheem M.
Bayomi
Clinical Pathology Department, Al-Azhar University Egypt
author
Lamis M.
El-toukhy
Clinical Pathology Department, Al-Azhar University Egypt
author
text
article
2018
eng
Background: CD39 is an integral membrane protein (ectoenzyeme) that phosphohydrolyzes ATP in a Ca2+- and Mg2+-dependent fashion to yield AMP, Can be viewed as immunological switch, and is expressed in spleen, thymus, lung, and placenta, and in these organs it is associated primarily with endothelial cells and immune cell populations, such as B cells, NK cells, dendritic cells, Langerhans cells, monocytes, macrophages, mesangial cells, neutrophils, and regulatory T cells. Aim of the study is to assess the expression of CD39 on CD4+ CD25high T-reg cells in patients with acute myeloid leukemia to identify its role in immunosuppressive status of AML patients. Methods: Flow cytometric analysis of T-reg cells using CD4 CD25 and CD39 in 60 AML patients and 15 apparently healthy controls with matched age and sex was done. Results: There was a significant difference between cases and controls as regards expression of CD39 on T-helper cells. A highly significant elevation of expression of CD39 has been obtained on T-reg cells in AML patients compared with Controls with increased expression of CD39 on T-reg cells than on helper T cells. Conclusion: CD39 plays a significant role in immunosuppressive status of AML patients particularly with expressing the receptor of α chain of IL-2 (CD25)
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
73
v.
7
no.
2018
7011
7017
https://ejhm.journals.ekb.eg/article_17222_70ff5432c7261965be2606e4dfe97210.pdf
dx.doi.org/10.21608/ejhm.2018.17222
Assessment of knowledge about radiation risk among fellows and residents in pediatric department in Tabuk city
Ahmed yaseen
alrefaei
Medical interns at Tabuk University
author
Ahmed hussain
alshaikhi
Medical interns at Tabuk University
author
Abdulaziz saad
alharthi
Medical interns at Tabuk University
author
Maram saad
alrubayyi
Medical interns at Tabuk University
author
Abdulrahman mohammed
alharbi
Medical interns at Tabuk University
author
Mohammed khaled
alshehri
Medical interns at Tabuk University
author
text
article
2018
eng
Background: The study aimed at investigating the knowledge in pediatric residents and fellows in two Saudi hospitals, putting shedding lights on the information available for patients and their relatives concerning the risk assessment of radiation used in radiological investigations for children.
Methods: This study was a cross sectional study based on a questionnaire of multiple-choice questions. The questionnaire was distributed to 40 pediatric residents and fellows from two hospitals in Tabuk city in Saudi Arabia, military hospital (NWAFH) and KKH. Statistical analysis of the data was done using SPSS, version 17.0 (SPSS, Chicago, IL, USA). The percentage of participants who gave correct answers was calculated for each question. Individual questions were analyzed using Chi-squared test of independence. All statistical significance valueswere P < 0.05.
Results: Only35 fromthe 40 questionnaires were completed then analyzed (87.5%). Only 10 surveyed (34.5%)was considered competent torisk radiation knowledge for commonly performed radiological examination. Regarding to the Percentage of correct answers,at least 50% (adequate knowledge was considered withsevenminimum score of correct answers out of thirteen).
Conclusion: The knowledge of radiation doses and risks from common radiological tests was sub-optimal amongthe fellows and residentsin pediatric department. Awareness of radiation hazards for fellows and residents during radiation exposure risk examinationsshould be considered an essential part of medical education.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
73
v.
7
no.
2018
7018
7024
https://ejhm.journals.ekb.eg/article_17223_4d9b113a520fcec96a52ee7e754f99a1.pdf
dx.doi.org/10.21608/ejhm.2018.17223
Effects of Intravitreal Injection of Ranibizumab on Intraocular Pressure
Abdel Kader S.
Abdel Kader
Ophthalmology Department, Faculty of Medicine, Al-Azhar University
author
Ahmed A.
Ghalwash
Ophthalmology Department, Faculty of Medicine, Al-Azhar University
author
Ahmed N.
El-Sayed
Ophthalmology Department, Faculty of Medicine, Al-Azhar University
author
Abdul Rahman E.
Refaee
Ophthalmology Department, Faculty of Medicine, Al-Azhar University
author
text
article
2018
eng
Background: the administration of anti-vascular endothelial growth factor (anti-VEGF) agents has become an application of IVIs to treat a variety of retinal and choroidal neovascular diseases including neovascular age-related macular degeneration, vein occlusion with macular edema, and diabetic maculopathy. ranibizumab is the most commonly used anti-VEGF treatments for retinal disease. While Intravitreal ranibizumab appears to be safe and effective but it can cause adverse effects as intraocular inflammation, cataract, vitreous haemorrhage, and increased intraocular pressure.
Aim of the work: this study aimed to Evaluation of Iop changes after intravitreal injection of Ranibizumab retinal and choroidal neovascular diseases as neovascular age-related macular degeneration (AMD), central vein or branch vein occlusion with macular edema, and diabetic maculopathy
Patients and Methods: this prospective study was carried out from March 2018 to September 2018 on 35 eyes of patients attending outpatient clinic of Al-Azhar University Hospitals and Ophthalmology Department of Research Institute of Ophthalmology in Giza.
All participant names were hidden and were replaced by code numbers to maintain privacy of the patients. IOP was measured Using Applanation tonometer and Perkins tonometer before IVI of ranibizumab immediately after injection, 30 minutes, 1ST day, 1st week, and 1st month after injection.
Results: IOP was highly increased immediately after injection of ranibizumab, preoperative mean IOP 15.31±3.70, immediate after injection mean IOP 24.62±11.38, then it started to decrease till reaching normal values in the first 24h after injection, 1st 24hours mean IOP 16.31±3.60.The mean IOP for patients who were previously injected was 16.47±3.74 pre injection, and it was 30.88±12.55 immediately after injection, it still decreasing till reaching 20.24±2.77 after 30 minutes, we follow the patients after 1 day it was 18.41±3.12, then it became 18.29±3.62 after 1 week, and 17.88±3.33 after 1 month. The mean IOP for patients who were the first time to be injected was 14.22±3.41 pre injection, Immediate after injection the mean IOP was 18.72±5.92, after 30 minutes of injection the mean IOP was 15.44±3.99 mm Hg, after 1 day of injection the mean IOP was 14.33±2.87 mm Hg, We followed up the patients to one week after injection and we checked the IOP. The mean IOP after one week was 13.72±2.93mm Hg, We continue following the patients for one month and checked IOP, The mean IOP was 14.06±3.21 mm Hg.
Conclusion: IOP tends to increase after intravitreal injection of Ranibizumab 0.05ml (0.5 mg). It causes mainly a transient immediate increase in intraocular pressure especially in patients who exposed to repeated intravitreal injection. This elevation of IOP tends to normalize after one day.
Recommendations: this study recommend monitoring of IOP after intravitreal injection of ranibizumab and Care should be taken for cases with multiple injections and predisposing risk factors like glaucoma and glaucomatous patients
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
73
v.
7
no.
2018
7025
7031
https://ejhm.journals.ekb.eg/article_17228_d6323f2a4445c04f2f8052952b2a6c37.pdf
dx.doi.org/10.21608/ejhm.2018.17228
Extended Letrozole Therapy for Ovulation Induction in clomiphene resistant Women with Polycystic Ovary Syndrome
Mohammad Salah El-Dein
Hassanein
Department Of Obstetrics and Gynecology, Al-Azhar Faculty of Medicine, Cairo
author
Mostafa Hussein
Hegab
Department Of Obstetrics and Gynecology, Al-Azhar Faculty of Medicine, Cairo
author
Attia Mohammad
Attia
Department Of Obstetrics and Gynecology, Al-Azhar Faculty of Medicine, Cairo
author
Mostafa Ahmed Abd El-Maksoud
Zayed
Obstetrics and Gynecology at Manshiet El-Bakry General Hospital
author
text
article
2018
eng
Objective: This study aimed to evaluate the efficacy of short and extended long course of letrozole therapy for ovulation induction in clomiphene resistant women with polycystic ovary syndrome.
Patients: One hundred infertile women were selected from the patients attending the outpatient clinic of Manshiet El-Bakry general hospital. All patients were diagnosed as having anovulation due to polycystic ovary syndrome (PCOS).
Interventions: Patients were randomly allocated to treatment with either long letrozole group took 2.5 mg of letrozole daily starting day 1 of spontaneous or progesterone inducing menstrual bleeding for 10 days (50 patients, up to 3 cycles) or short letrozole group took 5 mg of letrozole daily starting day 1 of spontaneous or progesterone inducing menstrual bleeding for 5 days (50 patients, up to 3 cycles).
Results:The number of ovulating patients was greater in the long letrozole group (74% vs. 56%), but without statistical differences. The total number of follicles during stimulation was insignificantly greater in the long letrozole group (8.2 vs. 8.17). The numbers of follicles ≥18 mm were significantly greater in the long letrozole group. Pregnancy occurred in 7 in the short group (14%) and 12 of (24%) in the long letrozole group, and the difference was statistically insignificant.
Conclusion: The long letrozole protocol (10 days) can produce more mature follicles and subsequently more pregnancies than the short letrozole therapy (5 days).
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
73
v.
7
no.
2018
7032
7036
https://ejhm.journals.ekb.eg/article_17230_0a1f7bcfeac351799f9438a94988e7ea.pdf
dx.doi.org/10.21608/ejhm.2018.17230
Characterization of Respiratory Manifestations of Chronic Hepatitis C Virus Infected Patients
Refaat Abo-Elfetouh
Abo-Elsaad
Chest Department, Al-Azhar Univeristy, Cairo
author
Ezzat Atwa Ali
Rezk
Chest Department, Al-Azhar Univeristy, Damietta
author
Kamel Abd-Elghafar
Hassan
Chest Department, Al-Azhar Univeristy, Damietta
author
Fathiya Mostafa
EL-Raey
Tropical Medicine Department, Al-Azhar Univeristy, Damietta
author
Ebrahim Fathi Abo-Elfetouh
Hasanin
Chest Department, Al-Azhar Univeristy, Damietta
author
text
article
2018
eng
Background: chronic hepatitis C virus (HCV) infection has been reported in association with several extrahepatic manifestations. Chronic HCV infection is also associated with both direct and indirect effects on pulmonary tissue.
Purpose: to evaluate phenotypes of respiratory manifestations of chronic hepatitis C virus.
Patients and Methods: 1-this study was conducted on 150 Egyptian patients with chronic hepatitis C. Patients were selected from those attending the in patients and out patients clinic of the Tropical Medicine and Chest Departments, Al-Azhar University Hospital-Damietta from September 2016 to Septamber 2018.
2-also ,50 healthy subjects matched for age and sex were included as volunteer.
3-consent was informed by all patients and volunteer shared in this study.
Results: C.O.P.D: documented in 32 patients (21.3%).
Asthma: documented in 15 patients (10%) of all patients.
Air way hyperreactivity: documented in 15patients (10%) of all patients.
Idiopathic pulmonary fibrosis (IPF): is presented in 37 patients (24.6%).
Pneumonia: documented in 10 patients (6%) of all patients.
Transudative pleural effusion: documented in 10 patients (6%) of all patients.
Adenocarcinoma: documented in 5 patients (3.3%) of all patients.
Pseudolymphoma: documented in 1 patient (0.006%) of all patients.
Lung abscess: documented in 10 patient (6%) of all patients.
Pulmonary embolism: documented in 5 patients (3.3%) of all patients.
Hepatopulmonary syndrom: documented in 10 patients (6%) of all patients.
Conclusion: Chronic hepatitis C virus infection is related to the development of several pulmonary abnormalities. These pulmonary manifestations of HCV infection are frequently underdiagnosed.
Recommendations: Any patient with chronic HCV infection should be evaluated with HRCT chest and pulmonary function tests for early diagnosis of pulmonary abnormalities to prevent further complications.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
73
v.
7
no.
2018
7037
7041
https://ejhm.journals.ekb.eg/article_17231_9042e42183c2bbc377eb1d693948b67e.pdf
dx.doi.org/10.21608/ejhm.2018.17231
Sleep Quality and Internet Addiction Level among University Students
Maie Abdulrhman
Khayat
Medical Student, Faculty of Medicine, King Abdulaziz University, Saudi Arabia
author
Mohamad Hasan
Qari
Department of Hematology, Faculty of Medicine, King Abdulaziz University
author
Basmah Salman
Almutairi
Medical Student, Faculty of Medicine, King Abdulaziz University, Saudi Arabia
author
Bashayer hassan
Shuaib
Medical Student, Faculty of Medicine, King Abdulaziz University, Saudi Arabia
author
Marwah Ziyad
Rambo
Medical Student, Faculty of Medicine, King Abdulaziz University, Saudi Arabia
author
Manal Jobran
Alrogi
Medical Student, Faculty of Medicine, King Abdulaziz University, Saudi Arabia
author
Sulaf Zaki
Alkhattabi
Medical Student, Faculty of Medicine, King Abdulaziz University, Saudi Arabia
author
Dalya Abdulrahman
Alqarni
Medical Student, Faculty of Medicine, King Abdulaziz University, Saudi Arabia
author
text
article
2018
eng
Background: Sleep is an essential need of humankind; it is necessary for quality of life and health at all ages. Poor sleep quality is closely associated with lifestyle habits including Internet use. This study aimed to evaluate the relationship between sleep quality and the level of Internet addiction among students at King Abdulaziz University (KAU). Methodology: This was a cross-sectional study carried out on July 2017 among 511 students aged 18-25 years enrolled at KAU in Jeddah, Saudi Arabia. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality and habits, and Young’s Internet Addiction Test was used to assess Internet addiction among students. Frequencies, chi-square, Pearson’s correlation coefficient and multivariate analysis were used in data analysis. Results: A total of 511 students participated; 350 (68.5%) were women. Poor sleep quality was found in 54.4% of the participants, whereas Internet addiction was found to be mild in 42.3 %, moderate in 29.9%, and severe in 1.8%. A significant correlation was found between sleep quality and Internet addiction (p = .00). Other significant associations linked the quality of sleep to smoking and caffeine consumption. Conclusion: Sleep problems and poor sleep quality among KAU students were related to high Internet use. Further studies are needed to fully understand the factors that affect sleep behavior and Internet addiction among university students in Jeddah.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
73
v.
7
no.
2018
7042
7047
https://ejhm.journals.ekb.eg/article_17224_789b214ff0d9895d7f31d0b93cc07ecd.pdf
dx.doi.org/10.21608/ejhm.2018.17224
Knowledge and Attitude of Breastfeeding among Women in Al-Madina Al-Munawwarah, Saudi Arabia, 2017
Shireen
Albouq
College of Medicine, Taibah University, Al-Madina Al-Munawwarah, Kingdom of Saudi Arabia
author
Raghad
Alsubhi
College of Medicine, Taibah University, Al-Madina Al-Munawwarah, Kingdom of Saudi Arabia
author
Manal
Othman
College of Medicine, Taibah University, Al-Madina Al-Munawwarah, Kingdom of Saudi Arabia
author
Rawabi
Almutiri
College of Medicine, Taibah University, Al-Madina Al-Munawwarah, Kingdom of Saudi Arabia
author
Alaa
Alraheili
College of Medicine, Taibah University, Al-Madina Al-Munawwarah, Kingdom of Saudi Arabia
author
text
article
2018
eng
Background: breastfeeding is considered to be beneficial for both babies and mothers. Objective: this study aimed to assess the knowledge and attitude of breastfeeding among women in Al-Madina Al-Munawwarah, Saudi Arabia. Methods: this was an analyticalcross-sectional study and it was carried out in Al- Madina, Kingdom of Saudi Arabia during the year 2017. Data were collected by electronic self-administered semi-structured questionnaire. Results: data were collected from 388 female. The majority of the respondents were above 36 years old (48.2%). More than half of our respondents 225 (58.0%) were unemployed and 277 (71.4%) had a college-level education or higher. 138 (35.6%) of the women were exclusively feeding their baby by breastfeeding, while the majority of the respondents 220 (56.7%) chose a mix of both breast and formula feeding. The percentage of women who received hospital education regarding breastfeeding was equal to the women who had not received the hospital education 194 (50.0%). 175 (45.1%) of the respondents reported that health problem is the most reason that preventing them from breastfeeding their babies. Mothers believed that breastfeeding helped them by preventing breast and ovarian cancer 308 (79.4%) and the majority of the respondents 334 (86.1%) believed that breastfeeding improved the immunity and protect from different illness. Conclusion: in spite of the low percentage of exclusive breastfeeding, all the mothers were certain about the importance of breastfeeding to them and to their babies. There is a significant opportunity to improve awareness among women regarding the importance of exclusive breastfeeding.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
73
v.
7
no.
2018
7048
7054
https://ejhm.journals.ekb.eg/article_17225_ed6c4846f268b1d4c76751ea59444aab.pdf
dx.doi.org/10.21608/ejhm.2018.17225
Pharmacological Study on the Effect of the Aqueous Extract of Mangifera Indicaa Leaves on Vascular Activity of Diabetic Albino Rats
Hassan Helaly
Abu Rahma
Pharmacology Department, Faculty of Medicine, Al-Azhar University, Assuit
author
Haredy Hassan
Haredy
Pharmacology Department, Faculty of Medicine, Al-Azhar University, Assuit
author
Hoda khalifa
Abd-Elhady
Physiology Department, Faculty of Medicine, Al-Azhar University, Assuit
author
Saleh Mohamed
Hussein
Food Science and Technology Department, Faculty of Agriculture, Al-Azhar University, Assuit
author
Ahmed Abdelnaser
Ahmed
Pharmacology Department, Faculty of Medicine, Al-Azhar University, Assuit
author
text
article
2018
eng
Background: diabetes mellitus is the most common endocrine disease, which is considered one of the most important causes of morbidity and mortality worldwide. Diabetes can affect many different organ systems in the body and can lead to serious complications. These complications can be classified as microvascular or macrovascular. Microvascular complications include nervous system damage, renal system damage and eye damage. Macrovascular complications include cardiovascular disease, stroke and peripheral vascular disease. Objective: it aimed to assess effects of aqueous mango leaves extract on diabetes mellitus. Materials and Methods: aqueous mango leaves extract were assessed for their effects on blood glucose, blood pressure, lipid profiles and body weight in diabetic rats. Also, check out photochemical agents including total phenolics, flavonoids, tannins and antioxidant activity in the aqueous mango leaves extract. Results: aqueous mango leaves extract are rich in total phenols, flavonoides and tannins content, so the antioxidant activity is high. Random blood glucose level and systolic blood pressure were decreased in diabetic rats treated with either aqueous extract of mango leaves or glibenclamide, while, body weight was increased in diabetic rats treated with either glibenclamide or aqueous extract of mango leaves. The contractile responses to norepinephrine were decreased and the relaxant effect of acetylcholine were increased significantly in diabetic rats treated with either glibenclamide or aqueous extract of mango leaves. The treatment of glibenclamide with aqueous mango leaves extract gave the best results with diabetic rats compared to other treatments. Conclusion: aqueous mango leaves extract produced a significant hypoglycemic effect in diabetic rats and improved the diabetes mellitus induced changes in the vascular reactivity, so possibility of its usingas dietary supplements have healthy and therapeuticproperties.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
73
v.
7
no.
2018
7055
7063
https://ejhm.journals.ekb.eg/article_17232_758ac865b8cd72b10dffd38fe41c12af.pdf
dx.doi.org/10.21608/ejhm.2018.17232
Evaluation of knowledge, attitudes and practice of coronary artery disease risk factors among general population in Tabuk City, Saudi Arabia
Abdulrahman abdulaziz
alwakeel
Faculty of Medicine, University of Tabuk, Saudi Arabia
author
Raid Awad
Alshehri
Faculty of Medicine, University of Tabuk, Saudi Arabia
author
Radhi Ali
Alshehri
Faculty of Medicine, University of Tabuk, Saudi Arabia
author
Tarig
Merghani
Faculty of Medicine, University of Tabuk, Saudi Arabia
author
text
article
2018
eng
Background: The prevalence of the coronary artery disease (CAD) is increasing in the developing countries, including Saudi Arabia. The aim of this study was to evaluate knowledge of CAD risk factors and to appraise the related attitude and practice among the general population of Tabuk city, Saudi Arabia. Methods: A cross-sectional descriptive study was conducted on a random sample of Tabuk city population. Each participant responded to a questionnaire paper requesting information about his personal details, knowledge about the CAD risk factors, his attitude, and his actual practice towards the risk factors. Study permission was obtained from the Research Committee (Faculty of Medicine/ University of Tabuk). Informed consents were obtained from the participants before entry into the study. The collected data were analyzed using the Statistical Package for the Social Sciences (SPSS Inc., Chicago, IL), version 20. Statistical significance was accepted when P value is less than 0.05. Results: A total of 126 adult subjects (69.84% males) participated in this study. Of the participants, 71.42% received university education, 2.4% had a past history of heart attack, 3.2% were known cases of diabetes mellitus, and 6.3% were known cases of hypertension. The commonest risk factors identified by the participants were smoking (81%). Those who could identify hypertension, obesity, smoking and diabetes mellitus were 65.9%, 77.8%, 81.0%, and 37.3% respectively. Less than two thirds (64.3%) of individuals could identify stress as a risk factor, and less than half (44.4%) could identify the genetic tendency as a risk factor of CAD. The majority of participants (72.2%) know that lack of exercise or the sedentary life style is a risk factor for CAD; however, only 8.16% were fully aware of the principal five modifiable risk factors of heart disease. Conclusion: The study showed critical deficiencies in CAD risk factors knowledge and perception that could result in underestimation of the disease severity. Educational health programs are highly recommended to increase awareness about the modifiable risk factors of the CAD.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
73
v.
7
no.
2018
7064
7068
https://ejhm.journals.ekb.eg/article_17503_96b16209507563d30c1ba5ceb64d78dd.pdf
dx.doi.org/10.21608/ejhm.2018.17503
Evaluation of Diagnosis and Management Plan of Diabetes Mellitus Related Cystic Fibrosis in Children
Eyman Abdulmajeed
Alfaraj
Imam Abdulrahman bin Faisal University
author
Fatimah Mohammed
AlOmran
Imam Abdulrahman bin Faisal University
author
Hassan Abdullah
Alashwan
Imam Abdulrahman bin Faisal University
author
Abdullah Jameel
Almajed
Imam Abdulrahman bin Faisal University
author
Redha Ali
Alsaleh
Imam Abdulrahman bin Faisal University
author
Hassan Abdulmohsen
Alhumrran
Imam Abdulrahman bin Faisal University
author
Rawan Abdulqawi
Bobakr
Umm Al-Qura University
author
Seham Matar
Alotaibi
Umm Al-Qura University
author
Nouf ghazi S.
Abuhekmah
King Khaled university
author
Nasser Subeeh
Alshammri
Jordan University of Sciences and Technology
author
text
article
2018
eng
Background: Cystic fibrosis (CF) is a disease that occurs as a result of genetic mutations in cystic fibrosis transmembrane conductance regulator gene (CFTR). CFTR can be found in airways epithelial cells, intestine and cells with exocrine and exocrine function. CF is associated with variant complications, Cystic Fibrosis-Related Diabetes (CFRD) is considered as one of the most common complications of CF. Objective: In this review, we discussed the recent updates about Cystic Fibrosis-Related Diabetes (CFRD) diagnosis and management plan. Methods: PubMed database were used for articles selection. All relevant articles related to our review were chosen to cover the following topics: Cystic Fibrosis, Cystic Fibrosis Related Diabetes management, Cystic Fibrosis Related Diabetes diagnosis. We excluded other articles, which are not related to our objectives. Conclusion: CFRD can significantly worse the health condition of CF patients. However, with the recent advancement of management plans of CFRD, previous sex differences in mortality have disappeared and that the gap in mortality between CF patients with diabetes and CF patients without diabetes has considerably narrowed. Early diagnosis and early intervention also helped in improving the quality of CFRD patients and preventing the complications. This can be obtained by annual screening for DM among CF patients since 10 years of age using OGTT as recommended by ADA. The primary pathologic feature of CFRD is insulin insufficiency. It leads to increased breakdown of protein and fat. So, insulin replacement is the only recommended medical treatment and it has been shown to improve clinical outcomes. Oral diabetes agents are usually not recommended in CFRD.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
73
v.
7
no.
2018
7069
7076
https://ejhm.journals.ekb.eg/article_17504_e9541535ca5a7493c0cef867ddec9ef3.pdf
dx.doi.org/10.21608/ejhm.2018.17504
Motives and Knowledge towards Bariatric Surgeries among Adults in Al-Madinah, Saudi Arabia, 2018
Shireen G.
Albouq
College of Medicine, Taibah University, Al-Madinah, Kingdom of Saudi Arabia
author
Yousef M.
Alturk
College of Medicine, Taibah University, Al-Madinah, Kingdom of Saudi Arabia
author
text
article
2018
eng
Background: recent studies have shown the effectiveness of bariatric surgery in improving severe obesity, it’s associated with co-morbidities and the level of mortality. Objective: this study aimed to determine the motives of bariatric surgeries among Saudi adults in Al-Madinah and to assess their beliefs and knowledge toward surgical intervention in treating obesity. Methods: this was an observational analytical cross-sectional study and it was carried out in Al- Madinah, Kingdom of Saudi Arabia during 2018. Results: the data were collected from 406 participants. 61.8% of them were female. The mean age was 33.5 ± 9.12 and the mean of BMI of the participants was 29.89 ±8.22. The majority of the participants were married (62.6%). More than half of our respondents (80.3%) had a college-level education or higher. 51.5% were employed. 79.6% of participants tried to lose weight by traditional methods. The majority of the participants (77.6%) did not undergo weight loss surgery. 75% of the respondents who did the surgery reported that health problem was the most reason motivated them to do the surgery. 364 (90.8%) of the participants believed that bariatric surgeries were effective in treating of obesity. However, 67.8% of the participants didn’t prefer the surgery over traditional methods to lose weight. The majority of the respondents (77.6%) believed that bariatric surgery was not the best choice to lose weight and 95% of the participants believed that bariatric surgeries had complications. Conclusion: health problem is the major motive for our population to do bariatric surgery.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
73
v.
7
no.
2018
7085
7089
https://ejhm.journals.ekb.eg/article_17506_aad512d2e2943c8a8f81d222dd30b5b4.pdf
dx.doi.org/10.21608/ejhm.2018.17506
TMPRSS6 Gene Polymorphism and Serum Hepcidin in Iron Deficiency Anemia
Magda
Elmahdy
Department of Clinical Pathology Faculty of Medicine (for girls),Al-Azhar University, Cairo,Egypt
author
Heba
Elhakeem
Department of Clinical Pathology Faculty of Medicine (for girls),Al-Azhar University, Cairo,Egypt
author
Fatma
Gaber
Department of Clinical Pathology Faculty of Medicine (for girls),Al-Azhar University, Cairo,Egypt
author
Fatma
Mourad
Department of Internal Medicine,Faculty of Medicine (for girls),Al-Azhar University, Cairo,Egypt
author
text
article
2018
eng
Background: Iron deficiency anemia (IDA) is a global health problem and common medical condition seen in everyday clinical practice. Hepcidin which is the key regulator of iron homeostasis, that down-regulates iron export by binding to ferroportin which is expressed on the surface of iron-releasing cells, leading to its degradation thus reducing plasma iron levels. Overexpression of hepcidin leads to iron deficiency anemia. Matriptase-2 (MT-2) which is encoded by transmembrane protease serine 6 (TMPRSS6) gene regulates hepcidin expression. Objective: Was to evaluate the role of TMPRSS6 gene polymorphisms and serum hepcidin level in IDA patients. Subjects and methods: This study was carried out on 30 patients with iron deficiency anemia and 30 age and sex matched individuals as control group. Patients were subdivided into (group 1) 14 patients with acquired iron deficiency anemia (IDA) and (group 2)16 patients with iron refractory iron deficiency anemia(IRIDA).TMPRSS6 gene single nucleotide polymorphisms(SNPS), (rs4820268)and(rs855791)were evaluated using real time – polymerase chain reaction (RT-PCR) while serum hepcidin level was measured by enzyme linked immunosorbent assay (ELISA). Results: There was a significant increase in frequency of the TMPRSS6 SNPs rs855791 and rs 4820268 separately in IRIDA group compared to IDA group,(P=0.003),(P=0.007) respectivelyand to control group(P=0.000) and (P=0.000) respectively.Also, there was highly significant increase in frequency of both mutations together in IRIDA group compared to IDA group (P=0.000) and to control group (P=0.000). In IDA group there was a significant increase in the frequency of TMPRSS6 SNPs rs 855791 when compared to control group (P=0.013), and a non-significant difference in frequency of SNPs rs 4820268 when compared to control group (P=0.092).Also, there was a non-significant difference in frequency of both mutations together in IDA group in comparison to control group (P> 0.05).There was a highly significant decrease in serum hepcidin level in IDA group and highly significant increase in hepcidin levels in IRIDA group compared to control group (P=0.000).In IRIDA patients group only there was highly significant increase in hepcidin level in those with mutation in both SNPs together (rs4820268 and rs855791) than patients with one mutation or with wild type(P=0.000).There was a significant decrease in Hb and iron and highly significant decrease in MCV, MCH and ferritin in IRIDA patients with mutation of both SNPs together (rs 4820268 and rs855791) compared to one mutation or wild type (P=0.015,0.016,0.002 ,0.000, 0.006 respectively).Also, there was highly significant decrease in Hb, MCV, MCH and ferritin in IDA patients with mutation of both SNPs together(rs 4820268 and rs 855791) compared to one mutation or wild type (P= 0.002,0.002 ,0.004, 0.009 respectively). In IDA patients there was a significant positive correlation between hepcidin and ferritin (P =0.034, r = 0.279),while there was a significant negative correlation between hepcidin and MCH in IRIDA group (P =0.032, r = - 0.536).Conclusion: In IRIDA the rs4820268 and rs855791 mutations separately or in combination lack inhibitory effect on hepcidin and consequently iron profile and hemoglobin while in IDA although there was significant increase in frequency of rs855791 mutations, there was no effect on hepcidin which suggests that the rs 4820268 mutation is necessary for affecting hepcidin either alone or in combination with rs 855791 mutation. In IDA, there may be other mechanisms or mutations causing anemia.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
73
v.
7
no.
2018
7090
7103
https://ejhm.journals.ekb.eg/article_17507_7c062159fe452e4d2d5f8349710699f8.pdf
dx.doi.org/10.21608/ejhm.2018.17507
Effect of Pravastatin on the Incidence of Preeclampsia
Mohamed S.
Hassanain
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
author
Bassem R.
Abdel-Aziz
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
author
Mohamed A.
Elsayed
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
author
text
article
2018
eng
Background: Preeclampsia is a disorder of widespread vascular endothelial malfunction and vasospasm that occurs after 20 weeks' gestation and can present as late as 4-6 weeks post-partum. It is clinically defined by hypertension and proteinuria, with or without pathologic edema. Aim of the Work: is to study the effect of pravastatin given for primigravidae from 13th week to 16th week of gestation on the incidence of preeclampsia compared to a control group in Egyptian women. Subjects and methods: This prospective case control study included 400 pregnant women presenting for routine antenatal care at 13th to 16th weeks’ gestation at EL Sayed Galal Obstetric outpatient clinic, Al-Azhar University. Results: In our study, 16 cases developed preeclampsia in the control group (11 cases were severe and the remaining 5 were mild) with a percentage of 8% instead of 6 cases in the study group (4 cases were severe and 2 were mild) with a percentage of 3%.
Conclusion: Pravastatin can be used as an effective agent in the prevention of preeclampsia in newborns within neonatal period including fetal weight, gestational age at time of delivery and NICU admission. However, extended follow up is needed till the age of 5 years to assess cognitive functions and school performance among children born for women who received pravastatin for prevention of preeclampsia.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
73
v.
7
no.
2018
710
7111
https://ejhm.journals.ekb.eg/article_17508_c4fdc3a56f859b9a3f99910c60129120.pdf
dx.doi.org/10.21608/ejhm.2018.17508
Role of Right Liver Lobe Diameter/Serum Albumin Ratio in Esophageal Varices Assessment in Cirrhotic Patients
Mohamed Negm Eldin
Salem
Department of Tropical Medicine Faculty of Medicine Al-Azhar University, Cairo, Egypt
author
Mostafa Abdel Aziz
Elhawary
Department of Tropical Medicine Faculty of Medicine Al-Azhar University, Cairo, Egypt
author
Mohamed Ghareb Mohamed Shekh
roho
Department of Tropical Medicine Faculty of Medicine Al-Azhar University, Cairo, Egypt
author
Sobhi Ramadan
Abdallah
Department of Tropical Medicine Faculty of Medicine Al-Azhar University, Cairo, Egypt
author
Mohamed Abdel Hamid Bassyoni
Khedr
Department of Clinical Pathology Faculty of Medicine Al-Azhar University, Cairo, Egypt
author
text
article
2018
eng
Background: Liver cirrhosis is a pathologic condition characterized by fibrosis of the liver parenchyma and evidence of regenerative activity, resulting in portal hypertension. Portal hypertension plays a crucial role in the transition from the pre-clinical to the clinical phase of the disease. Bleeding from ruptured esophagogastric varices is the most severe complication of cirrhosis and is the cause of death in about one third of cirrhotic patients. Cirrhotic patients frequently undergo screening endoscopy for the presence of varices. These recommendations imply a considerable burden of endoscopies and related costs. Objective: the aim of the study was to determine the predictive value of noninvasive parameters (Rt. lobe diameter/ serum albumin ratio) in the prediction of esophageal varices. Subjects and Methods: This study was done on 120 patients divided into four groups: Group A: includes 30 cirrhotic patients with esophageal varices (OVs) grade I to II. Group B: includes 30 cirrhotic patients with OVs grade III to IV. Group C: includes 30 cirrhotic patients without OVs. Group D: includes 30 none cirrhotic patients presented for esophagogastroduodenoscopy (EGD) screening because of other etiologic factors that are not associated with liver cirrhosis. All participants were subjected to clinical examination; laboratory investigations (CBC, Liver function tests including serum albumin concentration, prothrombin time and concentration, modified Child-Pugh score and abdominal ultrasonography (studying the right lobe and left lobe diameter, the presence of periportal thickening, the splenic longest axis and the presence of ascites and Portal vein diameter, Right liver lobe diameter/albumin ratio were calculated for all patients). Upper endoscopy was done for detection and grading of esophageal varices. Results: This study revealed that The predictors that showed statistically significantly associated with the presence of varices were increased right lobe diameter/Albumin ratio, shrunken Rt. hepatic lobe, splenomegaly, thrombocytopenia, and the more advanced liver disease (according to child class scoring of the patients), the more likely the presence of varices. Conclusion: Right lobe diameter/Albumin ratio is good predictor for the presence and grading of esophageal varices.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
73
v.
7
no.
2018
7112
7118
https://ejhm.journals.ekb.eg/article_17509_d54ceb33ad9c5d71e2853de67085d378.pdf
dx.doi.org/10.21608/ejhm.2018.17509
Comparative Study of Local Injection of Platelet Rich Plasma versus Corticosteroids in the Treatment of Lateral Epicondylitis (Tennis Elbow)
Hesham D.
Abd El Wahhab
Department of Physical Medicine, Rheumatology and Rehabilitation Damietta Faculty of Medicine, Al-Azhar University
author
Tarek M.
Emran
Department of clinical pathology, Damietta Faculty of Medicine, Al-Azhar University
author
Ashraf Abd S.
Ahmed
Department of Physical Medicine, Rheumatology and Rehabilitation Damietta Faculty of Medicine, Al-Azhar University
author
El Sayed M.
Abd El Hami
Department of Physical Medicine, Rheumatology and Rehabilitation Damietta Faculty of Medicine, Al-Azhar University
author
Mai M.
Khalifa
Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Cairo University,
author
text
article
2018
eng
Background: Lateral epicondylitis, also known as 'tennis elbow', is a very common condition affecting mainly middle-aged patients that is associated with local tendon pathology, alteration in pain perception and motor impairment. Several approaches to treatment have been proposed, the most frequently used is PRP. Platelet-rich plasma (PRP) is a growing modality for tissue healing, regeneration and has more pain relief lasting effect.
Aim of the work: was to estimate the clinical efficacy of local injection of Platelet Rich Plasma compared to local injection of corticosteroids in cases of lateral epicondylitis.
Patients and Methods: This study was a prospective clinical trial study in which 80 patients with lateral epicondylitis of both sexes between 2l - 60 years of age were recruited for the study. The included patients were divided into two groups: 1- Platelet Rich Plasma group (40 patients) were received a two injections of 1 ml of PRP with one month interval between the two injections, with absolute platelet count of 1 million platelets/ mm3 as confirmed by automated cell counter. . PRP were prepared under complete aseptic conditions. 2- Corticosteroids group (40 patients) were received a two injections of corticosteroid (methyl-prednisolone, 40mg in l ml) with one month interval between the two injections. The site of injection and the technique used was same in both the groups.
Results: Affected side was higher in right hand than left hand in both studied groups. In PRP group, there were 92.5 % right hand and 7.5 % left handed patients. Whereas, in corticosteroid group, there were 95.0 % right handed and 5.0 % left handed patients; and there was no significant difference between the studied groups. Visual Analog Scale (VAS) was significantly improved at 1 and 3 months in PRP patients compared to only significant improvement at 3 months in corticosteroid group. Both studied groups showed significant improvement of grip strength at 1 and 3 months. qDASH at 1 and 3 months was significantly better in the PRP group, but it statically not reached. On the other hand, significant improvement of US edema was estimated in the corticosteroid group at 3 months when compared with PRP group. In addition, slight improvement of US tears was appeared in both groups after 3 months.
Conclusion: It could be concluded that both PRP and corticosteroids showed better improvement of pain, grip strength and qDASH at 3 months. However, PRP is suggested to be an effective treatment for lateral epicondylitis. PRP provides better improvement in all parameters with nearly durable effect when compared to corticosteroids. On the other hand, corticosteroids treatment resulted in better improvement of US detected edema.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
73
v.
7
no.
2018
7119
7126
https://ejhm.journals.ekb.eg/article_17510_937c3055e78bb7c83a501cbc6bdda379.pdf
dx.doi.org/10.21608/ejhm.2018.17510
Assessment of Practice of screening, Knowledge about Risk Factors, Perceived Barriers and Attitude of Colorectal Cancer among Tabuk Population, Saudi Arabia-2018
Abdulelah Mohammed
Alqarni
General Practitioner, Tabuk
author
Abdulrahman Abdulaziz
Alwakeel
Medical Intern, University of Tabuk, Tabuk, Saudi Arabia
author
text
article
2018
eng
Background: In Tabuk region, colorectal cancer (CRC) ranked the first among male and the third among female. Therefore, the current study was carried out to investigate the extent of both knowledge and attitude toward CRC risk factor and screening among specific age group (31 and above) from both males and females through conducting self-administrated questionnaire. In addition, the study aimed at identifying the practice of CRC screening tests through fecal occult blood testing (FOBT), flexible sigmoidoscopy (FS) and colonoscopy, which are the main tests in cancer screening programme in Saudi Arabia. The study also identified perceived barrier of CRC screening of those who aged 51 year and above. Methods: We have conducted a descriptive cross-sectional study in Tabuk city population, Saudi Arabia. A self-administered questionnaire, about colorectal cancer was filled by participants. A 33-item instrument was developed based on an earlier studies and instruments used in other prior studies. Results: Participants were classified to three categories according to age. Male and female groups contributed to (26.3%) and (73.6%) respectively. Mostly noticed perceived barriers for doing FOBT were: because of no symptoms and because I do not know if I have to do it, and the similar results documented for doing flexible sigmoidoscopy and colonoscopy. Participants were more likely not to be familiar with CRC screening. Conclusion: Many misconceptions regarding cancer and its development were evident in the discussions. Collective efforts are needed to broadcast this knowledge through media and public schools, with a hope that it will alter the current aggressive disease presentation in Saudi Arabia.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
73
v.
7
no.
2018
7127
7132
https://ejhm.journals.ekb.eg/article_17511_41193a6fce06bec09d0d9e001ad7c5ff.pdf
dx.doi.org/10.21608/ejhm.2018.17511
A comparative study between sinotomy with or without marsupialization versus sinotomy and primary closure with or without drain in the management of pilonidal sinus
Mahmoud Mohamed
Mahran
Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo
author
Mahmoud Salah
Shehata
Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo
author
Akram Mohamed Mohamed
Abd-Elwahab
Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo
author
text
article
2018
eng
Background: pilonidal sinus (PNS) is a common condition. Although many methods for treatment are available, there is no consensus on the optimal treatment.
Aim of the study: The aim of the work was to compare the outcome of sinotomy procedure with or without marsupialization versus sinectomy and primary closure with or without drain in the management of pilonidal sinus as regards operative times, postoperative complications, and time of healing and return of work.
Patients and Methods: This is a comparative randomized comparative study. Sixteen patients undergoing surgery for primary PNS were enrolled. The patients were randomized into four groups. Each group included 15 patients. Group A underwent sinotomy without marsupialization; group B underwent sinotomy with marsupialization; group C underwent limited excision and primary closure with a drain and group D underwent the same procedure as group C but without drain. Each patient was followed up for 6 months.
Results: Significantly short operative time was recorded in group B. Postoperative wound complications occurred in 3.2% of patients in group A, in 1.7% of patients in B, in 7.4% of patients in group C and in 4.2% of patients in group D. Recurrence rate was a slightly higher in group C but with no statistical significance.
Conclusion: The sinotomy with marsupialization for treatment of PNS is superior to excision with primary closure either with or without a drain and sinotomy without marsupialization.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
73
v.
7
no.
2018
7133
7140
https://ejhm.journals.ekb.eg/article_17602_8c561b6a088363fdce14bd3491678b38.pdf
dx.doi.org/10.21608/ejhm.2018.17602
Prophylactic Use of Intraumbilical Vein Oxytocin in the Management of Third Stage of Labor
Mohamed Ahmed
Mohamed
Obstetrics and Gynecology department, Faculty of Medicine, Al-Azhar University
author
Hassan I.
Mohamed
Obstetrics and Gynecology department, Faculty of Medicine, Al-Azhar University
author
Osama
Ali
Obstetrics and Gynecology department, Faculty of Medicine, Al-Azhar University
author
Ahmed
Shabaan
Obstetrics and Gynecology department, Faculty of Medicine, Al-Azhar University
author
text
article
2018
eng
Background: the third stage of labor is defined as the period of time between delivery of the fetus and delivery of the placenta. The most common complication accompanying this stage is postpartum hemorrhage (PPH) and prolonged third stage of labor owing to placenta retention and uterine atony are among the underlying cause of most cases of PPH. The duration of the third stage of labor is 5-15 min.
Aim: to assess the efficacy of intraumbilical vein oxytocin in reducing duration of third stage of labour and the amount of blood loss.
Patients and Methods: this study included 150 women attending the delivery room of Department of Obstetrics and Gynecology which was divided according to the inclusion and exclusion criteria into two groups:
Group A (study group): include 75 cases which received 10 IU (1ml) of oxytocin in umbilical vein.
Group B (control group): include 75 cases which received 1ml of saline in umbilical vein.
Results: the time of third stage took seconds in each group with no statistically significant difference detected (p>0.05).
Conclusion: intra-umbilical oxytocin is a useful alternative in patients where methylergometrine is contraindicated or in cases where intravenous fluids need to be restricted. For optimum effect, rapid injection immediately after clamping of the cord is essential.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
73
v.
7
no.
2018
7141
7145
https://ejhm.journals.ekb.eg/article_17603_c2d93e9c3c85725f8681fdb5758b72bd.pdf
dx.doi.org/10.21608/ejhm.2018.17603
Accuracy of ultrasound in diagnosis of cholecystitis
Ali Omar
Alshargi
Ibn Sina National College for Medical Studies
author
Swedi Essa
Al-sallami
King Khalid University
author
Hamed Arif Mohammad
Hejazi
Ibn Sina National College for Medical Studies
author
Abdulmaajid Ibrahim O
Alahdal
Ibn Sina National College for Medical Studies
author
text
article
2018
eng
Background: Acute cholecystitis- inflammation of the gall bladder- is most usually brought on by gall stones. Gall stones are one of the most typical problems of the gastrointestinal system, impacting regarding 10% of individuals in Western world.
Aim of the study: In this review we discussed background of cholecystitis, symptoms and possible complications. As well we highlighted importance and use of ultrasound in diagnosis of cholecystitis and other diagnoses possibilities and their efficiency.
Materials: Articles search was performed in MEDLINE, EMBASE, and CINAHL databases up to May 2018 to identify studies about evaluation ultrasound in diagnosis of cholecystitis and other diagnoses possibilities and their efficiency.
Conclusion: CT is debatably the most effective technique for imaging of challenging gallbladder condition, especially for straight imaging of emphysematous cholecystitis, gallstone ileus, and verification of presumed gallbladder perforation. Cholescintigraphy may assist ultrasound and CT for differentiating acute from chronic cholecystitis and for the diagnosis of acalculous cholecystitis.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
73
v.
7
no.
2018
7146
7152
https://ejhm.journals.ekb.eg/article_17604_2de09f14a4b6ce244054b3eb25899283.pdf
dx.doi.org/10.21608/ejhm.2018.17604
HCV INFECTION AND ERYTHROPOIETIN IN HAEMODIALYSIS PATIENTS
Safwat F.
Ahmed
Internal Medicine (Nephrology Division) and Clinical Pathology departments, Faculty of Medicine, AL Azhar University, Cairo, Egypt
author
Al -Sayed M.
Rashed
Internal Medicine (Nephrology Division) and Clinical Pathology departments, Faculty of Medicine, AL Azhar University, Cairo, Egypt
author
Mohammed S.
El Shorbagy
Internal Medicine (Nephrology Division) and Clinical Pathology departments, Faculty of Medicine, AL Azhar University, Cairo, Egypt
author
Mohammed I. Abd El Aziz
Abd El Aziz
Internal Medicine (Nephrology Division) and Clinical Pathology departments, Faculty of Medicine, AL Azhar University, Cairo, Egypt
author
text
article
2018
eng
Background: Renal anemia is associated with increased cardio vascular morbidity and mortality and decreased quality of life. It may worsen the preexisting heart disease and consequently may accelerate the progression of renal dysfunction in a vicious circle.Renal anemia related mainly to decreased production of erythropoietin (EPO) by the kidney, decreased it’s response by bone marrow and disturbed iron status. Aim of the Study: Was to evaluate the relationship between HCV infection and erythrropoietin in patients on regular HD. Patients and Methods: This study included 50 hemodialysis patients (25 patients +ve HCV and 25 -ve HCV), 16 were male and 34 were female, and their ages ranged from 20 to 67 years, with a mean ± SD of 50.5 ± 12.7 years, 15 apparently healthy individuals with normal kidney function and not anemic were included in the study as a control Group. Results: The patients were divided into two groups as the following: Group I consisted of 25 hemodialysis patients were positive for HCV antibody, which was confirmed by PCR, and their ages ranged from 27 to 67 years, with a mean of 47.28 ± 11.91 years. Group II consisted of 25 hemodialysis patients were negative for HCV antibody; their ages ranged from 20 to 65 years, with a mean age of 46.32 ± 11.50 years. In contrast, 15 patients served as age-matched and gender-matched; their ages ranged from 20 to 55 years, with a mean age of 44.13 ± 10.76 years, and were used as controls. Conclusion: Serum levels of erythropoietin correlate with chronic hepatitis C infection, which was associated with an increased number of RBCs and higher values of hemoglobin and hematocrit, which Result in lowering of the necessary erythropoietin dose and iron therapy.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
73
v.
7
no.
2018
7153
7159
https://ejhm.journals.ekb.eg/article_17605_d4bd6f085e6c6116c6646ae5fefc2793.pdf
dx.doi.org/10.21608/ejhm.2018.17605
Comparison between 3D-Transvaginal Ultrasound and Hysteroscopy in Detecting Uterine Cavity Abnormalities
Prof.Dr. Ahmed Hassan
El Tagy
Department Of gynecology and obstetrics, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
Dr. Ahmed Osama
Abd El Motaal
Department Of gynecology and obstetrics, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
Dr. Mahmoud
Awaly
Department Of gynecology and obstetrics, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
text
article
2018
eng
Background: unsuspected uterine cavity abnormalities, such as endometrial polyps, small submucous myomas, adhesions, and uterine septum may cause different gynecological complaints such as bleeding and negatively impact chances of success in ART by interfering with implantation or causing spontaneous abortion. Therefore, exclusion of intrauterine pathology is an important step before starting ART and treatment of any discovered lesion may improve ART outcome. The uterine cavity can be evaluated by hysterosalpingography (HSG), transvaginal ultrasound (TVS), sonohysterography (SHG), and hysteroscopy. Hysteroscopy is the gold standard for investi-gation of the uterine cavity, particularly when pathology is suspected.
Objective: to assess diagnostic accuracy of three dimensional transvaginal ultrasound (3D-TVS) compared with hysteroscopy in detecting uterine cavity abnormalities.
Study design: this prospective observational cross-sectional study was conducted during the January 2018 to June 2018. One hundred women with different uterine pathologies were enrolled. In the mid to late follicular phase of each subject’s menstrual cycle, three D transvaginal ultrasound and hysteroscopy were performed in each patient. Hysteroscopy is widely considered to be the gold standard method for investigation of the uterine cavity. Uterine cavity characteristics and abnormalities were recorded. Diagnostic accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and positive and negative likelihood ratios were evaluated.
Results: hysteroscopy was successfully performed in all subjects. Hysteroscopy diagnosed pathological findings in 100 of 100 cases (100%). There were 50 endometrial polyps, 13 submucous myomas, 29 septate uterus, and 8 intrauterine adhesions. Three-dimensional transvaginal ultrasound in comparison with hysteroscopy had 85% diagnostic accuracy, 68.2% sensitivity, 91.5% specificity, 79% positive predictive value, and 86% negative predictive value. The positive and negative likelihood ratios were 8.01 and 0.3, respectively. 3D-TVS successfully detected every case of submucous myoma. For detection of endometrial polyps, 3D-TVS had 80.0% sensitivity, 100.0% specificity, and 90% diagnostic accuracy. For detection of septate uterus, 3D-TVS had 93.10% sensitivity, 100.0% specificity, and 98% diagnostic accuracy.
Conclusion: three D-TVS demonstrated 84.1% diagnostic accuracy for detecting uterine cavity abnormalities in infertile women. A significant percentage of patients had evidence of uterine cavity pathology. Hysteroscopy is, therefore, recommended for accurate detection and diagnosis of uterine cavity lesion.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
73
v.
7
no.
2018
7160
7164
https://ejhm.journals.ekb.eg/article_17606_62ddc55c4e3072b02265490cc2db8914.pdf
dx.doi.org/10.21608/ejhm.2018.17606
Comparison of the Modified Lateral Position and Prone Position Techniques in Percutaneous Nephrolithotomy
Ahmad
Gomaa
Urology Department, Al-Azhar University, Cairo, Egypt
author
Abul-fotouh
Abdel-maguid
Urology Department, Al-Azhar University, Cairo, Egypt
author
Abdullah
Mohamed
Urology Department, Al-Azhar University, Cairo, Egypt
author
Ahmed Mohamed
Soliman
Urology Department, Al-Azhar University, Cairo, Egypt
author
text
article
2018
eng
Objectives: To evaluate the feasibility, operative time, efficacy and safety of the modified lateral position in percutaneous nephrolithotomy (PCNL) for renal calculi, comparing it with the standard prone position PCNL. Material and Method: The patient is placed with the thorax in the lateral position and the pelvis in an oblique position. Then the lower limbs are split and bent in the lowest position. Initial placement of a retrograde ureteral catheter, tract formation, stone fragmentation and retrieval, and optional extra procedures were accomplished with the patient in the same position. Results: The study comprised 82 patients; 29 in split-leg modified lateral position (SL-MLP) group and 53in conventional prone position (PP) group. Three patients (all in PP group) underwent sequential bilateral percutaneous nephrolithotomy (PNL) during the study period and each procedure was considered as an independent case. So, the studied cases, according to the number of PNL procedures, were 85; 29 in SL-MLP group and 56 in PP group. Conclusions: split-leg modified lateral position in percutaneous nephrolithotomy (SL-MLP PNL) has significantly lower operative time compared with conventional PP PNL. The stone free rate, need for ancillary procedures and complication rate were equal in both groups.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
73
v.
7
no.
2018
7168
7176
https://ejhm.journals.ekb.eg/article_17608_292994d9060072cb0152fb61b80ea31e.pdf
dx.doi.org/10.21608/ejhm.2018.17608
The Effect of General and Spinal Anesthesia on Maternal Blood Loss in Elective Cesarean Section: a prospective Study
Prof. Ahmed Altaf
Abbas
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo
author
Prof. Tarek Ramadan
Abbas
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo
author
Ahmed Shawkey
Dewidar
Department of Obstetrics and Gynecology, El-Galaa Maternity Teaching Hospital, Cairo
author
text
article
2018
eng
Background: This study aims to compare between general and spinal anesthesia regarding to the amount of maternal blood loss in cesarean section.
Methods: This is a randomized controlled study conducted at Bab El Shaaria Hospital to compare maternal blood loss by general and spinal anesthesia.
Results: The results showed that the group which had a cesarean section under spinal anesthesia has a statistically significant 2nd day postoperative higher level of hemoglobin (P< 0.001), when compared with general anesthesia, with a mean difference of 0.660g/dL and also a statistically significant 3rd day postoperative hematocrit percentage higher with the spinal anesthesia group with a mean difference of 1.507% (P= 0.002).
Conclusion: The spinal anesthesia showed definite advantages over general anesthesia; being higher postoperative hemoglobin level and hematocrit value, less intraoperative blood loss, less need for blood transfusion, less postoperative pain and need for postoperative analgesia, and earlier ambulation. In addition; mothers were faster in starting breast feeding their babies
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
73
v.
7
no.
2018
7177
7181
https://ejhm.journals.ekb.eg/article_17609_54d5472f59f097b9c72d1f6fa140fc37.pdf
dx.doi.org/10.21608/ejhm.2018.17609
Management of Isolated Lateral Malleolar Fracture
Ismail A.
Yassin
Department of Orthopedic Surgery,Faculty of Medicine, Al-Azhar University
author
Mohammed A.
Hassan
Department of Orthopedic Surgery,Faculty of Medicine, Al-Azhar University
author
Mohammed A.
Sultan
Department of Orthopedic Surgery,Faculty of Medicine, Al-Azhar University
author
text
article
2018
eng
Background: fractures of the lateral malleolus are the most common type of fracture. Various methods of lateral malleolar fixation have been utilized, all with acceptable results. Aim of the Work: to focus light on important modalities in management of isolated lateral malleolar fracture considering the advantages, the disadvantages and determine different protocol of management regarding the most recent guidelines for this group of patients. Patients and Methods: this study was conducted on twenty patients with fresh isolated lateral malleolar fracture. No or only minimal pain on the medial side was also a prerequisite, safeguarding against a ligamentous SE IV injury of the deltoid ligament. The patients were 4 men and 16 women with a mean age of 36 (22-50) years old. Results: all fractures united within an average time to union of 8.2 weeks. in all patients the average time to full weight bearing was 7.2 weeks. Most of complications were minor and resolved within 21 days. Conclusion: good anatomical reduction is essential for good clinical outcome irrespective of the type of fracture. Nevertheless, if an acceptable reduction cannot be achieved using closed techniques, one should proceed with open reduction and internal fixation without hesitation.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
73
v.
7
no.
2018
7182
7188
https://ejhm.journals.ekb.eg/article_17677_3690df237d7b664949b3072afb33644a.pdf
dx.doi.org/10.21608/ejhm.2018.17677
Comparative study between preoperative and operative staging in endometrial cancer patients
Said Hosny
Bendary
Surgical Oncology Unit, Faculty of Medicine, Al-Azhar University, Cairo
author
Elsayed Ragab
Mostafa
Surgical Oncology Unit, Faculty of Medicine, Al-Azhar University, Cairo
author
Mohamed
Esmat
Surgical Oncology Unit, Faculty of Medicine, Al-Azhar University, Cairo
author
text
article
2018
eng
Background: endometrial cancer is the most common gynecological cancer in developed countries and is primarily treated surgically. This study aimed to compare between preoperative findings by Vaginal U/S & MRI with postoperative pathological data regarding Endometrial thickening, Myometrial Invasion Depth and Lymph Node Metastasis. Methods: It is a prospective cohort study of 20 consecutive patients with endometrial cancer, in the Department of General Surgery at Al-Azhar University Hospitals. To assess the depth of myometrial invasion, we performed a pelvic MR. Subsequently; myometrial invasion was detected with MRI by the recognition of the disruption, whilst transvaginal sonography was performed by experienced sonographers who used a 5.0- to 7.5-MHz curvilinear-array transducer probe.
Results: Our results showed that the employment of magnetic resonance imaging to detect the myocardial invasion established that the sensitivity, specificity, positive and negative predicted values of MRI was 92.3%, 76.5%, 60.0% and 96.3% subsets, respectively. US was accurate in 12 of 20 cases and overestimated the depth of invasion in 2 cases. In comparison with histopathological findings; the results of MRI images were accurate in 13 patients whilst TVUS images were accurate in 12 patients (60%) with 3 patients underestimated and two patients over estimated.
Conclusion: MRI and TVUS detect myocardial invasion with accurate results that help the surgeon to make the appropriate decision. Brings to light that, MRI and TVUS perform best in the pretreatment evaluation of endometrial cancer and differentiating deep from superficial myometrial invasion.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
73
v.
7
no.
2018
7189
7195
https://ejhm.journals.ekb.eg/article_17678_010101f141eeab78f9c8768f0e912d1e.pdf
dx.doi.org/10.21608/ejhm.2018.17678