@article { author = {Mohammed Fathy Adel Ali3, Hieder Al-Shami1, Farah Sameer Othman2, Ahmed Hegazy3,}, title = {Bilateral Foraminal Stenosis in Patient with Dandy-Walker Malformation: Hiding Pathology}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {71}, number = {3}, pages = {2633-2635}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: Etiologies of hydrocephalus are many and sometimes it can be attributed to be multifactorial in origin. Presence of known cause of hydrocephalus like fourth ventricular pathology may mask foramenal stenosis. Diagnosis of unilateral and bilateral stenosis of foramen of Monro should be included in the treatment plan in hydrocephalus A case report of a 9 months-old boy presented with delayed milestones of development and an increase in head circumference. The patient has been diagnosed as hydrocephalus and associated Dandy-Walker malformation. Ventriculoperitoneal shunt was inserted successfully but drained only one lateral ventricle. The association of isolated lateral ventricle with Dandy-Walker malformation is due to stenosis of foramen of Monro. Our case report is unique due to association between foramen occlusion and Dandy-Walker malformation. }, keywords = {foramen of Monro,Dandy-Walker malformation,VP shunt}, url = {https://ejhm.journals.ekb.eg/article_8673.html}, eprint = {https://ejhm.journals.ekb.eg/article_8673_67855e2065b32aaf699f615481f08eef.pdf} } @article { author = {Alrowili,Amjad Saud Mhrb1, Alsharif , Shahad Ahmed S1, Alshammari, Nada Naif Z1, Alshammari , Manal Nashi O1, Alenazy , Maram Khalf A1., Alshalan,Maha Hazzaa F1, Wesam Mohamed Tharwat 2, Alruwaili , Anwar Eid M1 , Alfuhigi ,Zuhur Dhaher M1, Alanazi , Yasamiyan Mohammed A1, Alenazy , Asmaa Enad S1,}, title = {Epidemiology of Tinea Capitis among Population of Arar city, Northern Saudi Arabia}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {71}, number = {3}, pages = {2643-2650}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: Tina capitis is a mycosis caused by dermatophytes that invade the keratinized tissues such as skin, nails, and hair. It is important to know the prevalence, route of transmission and risk factors of these infections for prevention and treatment of this disease. The objective of this study was to determine the prevalence rate and risk factor associated with tinea capitis in the general population of Arar city, Northern Saudi Arabia. Methods: Cross sectional hospital based study. Data collected from 180 participant aged 5- 60 years, attending three randomly selected primary healthcare centers in Arar city during the period from 1st January to 30th June 2017. Participants selected using a systemic random sampling procedure as we take every second person attending the PHC during the study period. Each participant interviewed separately, and confidentiality assured. Data was collected by means of personal interview with the sampled person using a predesigned questionnaire covering the needed items. Results: The overall prevalence of tinea capitis among the studied population was 31.1%. Males were more affected (56.7%) than females (P value>0.05) and 35% of cases aged from 16-21 years (P value>0.05). Conclusion: The overall prevalence of tinea capitis among Arar population was 31.1%. This indicates the high tendencies of spread of tinea capitis through human-to-human mode of transmission and possible animal contact. Community health education on the cause, mode of transmission, prevention, and prompt treatment of tinea capitis is recommended. }, keywords = {Epidemiology,prevalence,Tinea Capitis,Arar city,Northern Saudi Arabia}, url = {https://ejhm.journals.ekb.eg/article_8675.html}, eprint = {https://ejhm.journals.ekb.eg/article_8675_fe341f4e3b6c72d0689a648bc9c1bc88.pdf} } @article { author = {Muaz Bilal Wali1, Munif Saleh Alenezi1, Alanazi Abdullah Saad1, Abdulaziz Salamah Alanazi1, Wael Abdullah Alanazi1, Mohammed Khalil Al Shakarh1, Adel Turki Alenezi 1, Nagah Mohamed Abo El-Fetoh2, Osama Mazha Mutkhan Alanazi1, Aldaghmi, Ahmed Saud A1, Bader Arar Shadad Alruwaili1, and Hussain3, Malik Azhar}, title = {Congenital Hydrocephalus in Arar, Northern Saudi Arabia}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {71}, number = {3}, pages = {2651-2655}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: Congenital hydrocephalus, an important cause of neurologic morbidity and mortality in children, is a medical condition characterized by an abnormal accumulation of cerebrospinal fluid in the brain. Objectives: To estimate the prevalence and the recent progresses in diagnosis of hydrocephalus as well as the changes in epidemiology and treatment outcomes of the disease. Methods: This is a descriptive study involved all neonates born in Maternity and child hospital in Arar city, Northern Saudi Arabia, KSA, during the period from 1 January to 31 December 2017. Among 6000 delivered infant in 2017; there was 23 cases of hydrocephalus. Data was collected by using predesigned questionnaire which include questions designed to fulfill the study objectives. Results: the prevalence of hydrocephalus among studied infants was 0.38%. Consanguinity between parents was reported among 60.9% of the cases. Other congenital anomalies reported, cardiac anomalies 39.1%, spina bifida 17.4% and cleft palate 8.7%. Cause of hydrocephalus was 65.2% hereditary and 34.8% infection (secondary cause). Swelling of the eyelid, increased vascular clarity on the skull, transparent skin in the head, the child's tendency to sleep, disorientation, irritability and nervousness, high crying, weakness of feeding and vomiting, delayed child skills, convulsions, increased size of the head, the sun's sign in the eye and the child is always looking down were the symptoms reported by the cases. 56.5% of the cases had shunt insertion and 43.4% had ordinary medical treatment. 30.4% of the shunt cases were complicated (17.4% had shunt blockage with infection and fever, 13% shunt blockage and 69.6% had other complications). Outcome of the case; 39.1% were stable, 13% worsen and 47.8% died (34.7% died by complications, 8.7% during operation and 4.3% did not receive treatment). Conclusion: The prevalence of hydrocephalus is comparable to that of other countries. More research is recommended because it is probable that the real prevalence of congenital hydrocephalus was underestimated and no account of how often abortions are performed among mothers of hydrocephalic fetuses. So more efforts from the ministry of health is needed. }, keywords = {Hydrocephalus,prevalence,Outcome,Arar,Northern Saudi Arabia}, url = {https://ejhm.journals.ekb.eg/article_8676.html}, eprint = {https://ejhm.journals.ekb.eg/article_8676_d3a38c1b6612a616f1d4b464741435cb.pdf} } @article { author = {Abdulaziz Sael Alshammari1, Sultan Theyab Alshammari1, Jazzaa Hammad Alshammari1, Abdullah Zidane Alshammari1, Raghad Aladham Alanazi1, Sara Emad Alrayya1, Muharib Mana Alshammari1, Mushref Saeid Alshammari1, Bdoor Attaulla Alenezi1, Sarah Musharraf Alanazi1, Shouq Saud Alanazi1, Deema Faleh Alanazi1,}, title = {Pattern of Gastrointestinal Diseases among Elderly Patients in Arar City,Kingdom of Saudi Arabia (KSA)}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {71}, number = {3}, pages = {2656-2663}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {The world's population is aging and the number of people who are ≥ 60 years old increased worldwide. The elderly population is susceptible to various benign and malignant diseases. Gastrointestinal diseases are among the common health problems that affect the elderly. Aim of the study: to identify the pattern of gastrointestinal diseases among elderly patients in Arar city (KSA) and the relation with gender in the study population. Subjects and methods: a cross sectional study was conducted in five randomly selected primary healthcare centers in Arar city (KSA), from September 2016 to March 2017. It included 118 elderly patients. A questionnaire was designed for data collection about socio-demographic variables, smoking, BMI, chronic diseases and types of gastrointestinal diseases among participants. Results: findings showed that all participants suffered from dental problems and 24.6% had gum problems. Other diseases affected various proportions of the studied elderly population including loss of appetite, gastric regurgitation, chronic constipation, irritable bowel syndrome, chronic colitis, peptic and duodenal ulceration, liver cirrhosis, viral hepatitis, cholecystitis, gall stones, pills, anal fissure and GIT tumors. Statistically significant differences were found between males and females regarding having piles, gall stones and anorexia. On contrary, all other GIT diseases showed insignificant differences between males and females. Conclusion: different types of GIT diseases were found among the participants with varying rates. Significant gender differences were observed in some diseases (piles, gall stones and loss of appetite) while most of the studied GIT diseases showed insignificant differences between both sexes. }, keywords = {gastrointestinal diseases,pattern, elderly}, url = {https://ejhm.journals.ekb.eg/article_8677.html}, eprint = {https://ejhm.journals.ekb.eg/article_8677_0543c28ffc3f6b21e8b7181aeb4b1de1.pdf} } @article { author = {Eiman S. Alajyan, Ghadeer S. Alabbadi,Osama Alsultan, Aqeela M. Alredwan, Ghadeer M. AlHajjaj,}, title = {A Traveler to Holland With a Benign Killer: A Case Report of a Sickle Cell Trait Male with Splenic Infarction}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {71}, number = {3}, pages = {2664-2666}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Sickle cell trait is highly prevalent in Saudi Arabia. However, most of the patient are asymptomatic, only few present with symptoms of the complications of the disease. We report a case of 24-year-old male who presented to the hospital with history of dull left upper quadrant, nausea and vomiting while he was on the airplane. Investigation showed a picture of sickle cell trait with hemoglobin S of 40%. Peripheral blood smear was within normal. CT scan of the abdomen confirmed the presence of splenic infraction. This case emphasized on the need to increase the level of threshold to recognize the rare complications of sickle cell trait and how to manage them appropriately. }, keywords = {altitude,sickle cell trait, splenic infarction}, url = {https://ejhm.journals.ekb.eg/article_8678.html}, eprint = {https://ejhm.journals.ekb.eg/article_8678_6f7f71d219ec149291ef9ef4fb458a20.pdf} } @article { author = {Aliaa Abdelrazek Mohamed**, Maged Ramadan Abu Seada*, Tamer Farouk Borg*, Mohammed Mahmoud Samy*,}, title = {Continuous versus Interrupted Suturing in Repair of Lateral and Mediolateral Episiotomy: A Randomized Controlled Trial}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {71}, number = {3}, pages = {2667-2680}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: Episiotomy is the surgical enlargement of the posterior aspect of the vagina by an incision to the perineum during the last part of the second stage of labor. The incision is performed with scissors or scalpel and is lateral or mediolateral in location. Aim: This study aims to compare postoperative pain following repair of episiotomy between continuous or interrupted suturing technique. Methodology: In the second stage of labor, 260 pregnant women received a mediolateral and lateral episiotomy 130 each in Ain Shams University, Maternity Hospital were chosen to participate in the study after obtaining a verbal consent. They were randomly allocated into two groups A and B, randomization was done using opaque sealed envelopes. Group A: was repaired by interrupted suturing technique and include 130 pregnant women 65 with mediolateral and 65 with lateral episiotomies. Group B: was repaired by continuous suturing technique and include 130 pregnant women 65 with mediolateral and 65 with lateral episiotomies. Result: This study was carried out on (260) women who were randomly selected to receive a mediolateral or lateral episiotomy in the second stage of labor repaired by either continuous or interrupted suture technique. There was significant difference detected between continuous and interrupted groups as regard pain 6 hours after delivery and dyspareunia. We found that the interrupted group had higher VAS pain score and dyspareunia scale. Conclusion and Recommendations: The use of a continuous knotless technique for perineal repair is associated with less perineal pain at 6 hours, less need for analgesia, lower VAS scores, lower dyspareunia scale and less wound complication than interrupted sutures techniques. For that, the introduction of a continuous suturing policy would provide more comfortability, less analgesia, less perineal pain, less dyspareunia and less wound complications are needed for the interrupted method of repair. }, keywords = {Episiotomy,Perineal pain,Dyspareunia}, url = {https://ejhm.journals.ekb.eg/article_8679.html}, eprint = {https://ejhm.journals.ekb.eg/article_8679_c66661e4eccbfec7202b32ca2466e4cf.pdf} } @article { author = {Ahmed Mohamed Osman., Mohamed Mahmoud Noser, Maha Abdel Meguid El-Shinnawy,}, title = {Assessment of Pulmonary Embolism Severity and Scoring Using Multi Slice CT in Correlation with Clinical Presentation and Echocardiography}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {71}, number = {3}, pages = {2681-2688}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Aim of the work: The aim of this study is to evaluate the correlation between pulmonary embolism severity and scoring obtained using multi slice CT (MSCT) and the clinical presentations and echocardiography in patients with pulmonary embolism (PE). Patients and method: this study was carried out in the Radiology Department of Ain Shams University Hospitals. 21 patients with PE. The CT obstruction index (OI) using Qanadli score and the RV/LV diameter Right ventricle dysfunction ratio (RVD-ratio) using the four-chamber view of the heart were calculated for all patients. The cut-off for the OI to detect RVD was constructed using ROC curve. They were 13 (61.9%) females and 8 (38.1%) males. Their age was ranged from 22 -83 years old. Results: Dyspnea and RVD (RVD-ratio >1) were significantly more common in patients with severe pulmonary embolism. Regarding the echo findings with PE high Right ventricular systolic pressure (RVSP) was the commonest echo finding among our studied patients. The cutoff point of obstruction index (OI) >15 (Qanadli score >37.5 %) has the highest prediction value of right ventricular dysfunction, indicating that most of the patients with a score of more than 37.5% had RVD that was agreed with echo findings. }, keywords = {MSCT,OI,ECHO}, url = {https://ejhm.journals.ekb.eg/article_8680.html}, eprint = {https://ejhm.journals.ekb.eg/article_8680_5cc73912d0c67fef664909108578ca42.pdf} } @article { author = {Ahmad S. Aly, Mustafa F. Abd Alkader, Mootaz F. Thakeb,}, title = {Low Profile Ilizarov Frame in Correction of Varus Deformity in Patients with Adolescent Blount’s Disease}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {71}, number = {3}, pages = {2689-2696}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: Adolescent Blount disease or late onset tibia vara constitutes the most common cause of pathologic genu varum in late childhood and adolescence. It is a developmental condition characterized by disordered endochondral ossification of the posteromedial part of the proximal tibial physis resulting in multiplanar deformities of the lower limb. Objective: the aim of This work was to evaluate the results of treatment of acute correction of varus deformity in patients with Blount disease by using low profile Ilizarov frame. Patients and Methods: It is a retrospective and a prospective study for 10 patients who had adolescent Blount disease treated by acute correction using low profile Ilizarov frame. We looked principally into the following variables to evaluate the results of the treatment: Deformity correction (expressed as mechanical axis restoration), the average normal values were used as a reference (medial proximal tibial angle, 85–90; posterior proximal tibial angle, 77–84; thigh–foot angle, +10 external rotation) Results: the patients were 9 boys (90%) and one girl (10%). The mean age at presentation was 13.60 years, range ( 11- 17 years) , 6 patients (60%) presented with unilateral affections and 4 patients (40%) presented with bilateral affection. Mean preoperative to postoperative changes of MPTA from 74.57 (range 65-80) improved to 89.21 (range 86-95), Mean preoperative to postoperative changes of PPTA from 74.21 (range 66-80) improved to 79.07 (range 77-82) , Mean preoperative to postoperative changes of MAD from 31.14 mm (range 18-45 mm) improved to 3.64 mm (range 0-8 mm). Mean preoperative to postoperative changes of TFA from -23.57 (range -30 -15) of internal tibial torsion improved to 5.36 (range 0-10) of external tibial torsion Conclusion: Management of adolescent Blount disease by acute correction strategy using a low profile Ilizarov is a safe technique offering excellent results with low incidence of complications. ,Low profile Ilizarov is lighter and less bulky so more comfortable for patients than classic Ilizarov external fixation , Acute correction technique can achieve the same result of correction as gradual correction technique in patient with no limb length discrepancy , Acute correction offers a shorter time in frame as compared to gradual correction with fewer follow-up visits and exposure to radiation. }, keywords = {Blount disease,Low profile Ilizarov,acute correction}, url = {https://ejhm.journals.ekb.eg/article_8681.html}, eprint = {https://ejhm.journals.ekb.eg/article_8681_936ba16ceb66c32d102fa689370ecd12.pdf} } @article { author = {Hana Muhammed Abdulsalam, Howaida Elsayed Mansour, Sherin Mohamed Hosny, Nermeen Samy Khalel,}, title = {Matrix Metalloproteinase 7 in Rheumatoid Arthritis Patients with Interstitial Lung Disease}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {71}, number = {3}, pages = {2697-2700}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {The study aim: The purpose of this study is to measure the matrix metalloproteinase 7 (MMP7) in rheumatoid arthritis (RA) patients with interstitial lung disease (ILD) and to assess for any correlation with RA-disease activity. Research design: A cross sectional study. Sample: a purposive sample included 40 rheumatoid arthritis patients from Ain Shams University Hospitals Inpatient Department of Rheumatology and Outpatient Clinic. The results revealed that serum (S) MMP7 was significantly higher among RA patients with interstitial lung disease than patients without. Conclusion: The study documented that S.MMP7 may be used as a screening test for detection of interstitial lung disease in patients with rheumatoid arthritis. The study recommended: Measurement of serum MMP7 level to RA patients may be used as screening test for detection of ILD }, keywords = {RA: Rheumatoid arthritis. MMP7: Matrix metalloproteinase 7. ILD: Interstitial lung disease}, url = {https://ejhm.journals.ekb.eg/article_8682.html}, eprint = {https://ejhm.journals.ekb.eg/article_8682_9638b6e2a75248712c2fc1eccba4142c.pdf} } @article { author = {Mohamed Gamal El Din Abdel Mutaleb, Sara Ramadan Morsi Mohamed, Sherine George Moftah,}, title = {Assessment of Multidetector CT Virtual Hysterosalpingography as a Reliable Modality for the Evaluation of Female Genital System Abnormalities}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {71}, number = {3}, pages = {2701-2711}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: virtual hysterosalpingography is a novel, noninvasive modality that combines the capabilities of multidetector CT with the established technique of hysterosalpingography to allow a simultaneous non-invasive evaluation of the entire uterine wall, uterine cavity, cervix and Fallopian tubes. The evaluation of the para-uterine pelvic structures is considered as a great advantage of the procedure that can be an alternative diagnostic technique in the infertility workup algorithm. Virtual hysterosalpingography with the reconstruction of two-dimensional, three-dimensional, and virtual endoscopic views allows a comprehensive evaluation of the female reproductive system with a single imaging test, it gives well-appointed anatomic information and a detailed characterization of the different pathologic processes.  In comparison with HSG, US and MR imaging techniques that have been used for the diagnostic work-up of female infertility; virtual hysterosalpingography provides more detailed information about abnormalities of the cervix, uterus, Fallopian tubes and other pelvic structures and it may allow a more accurate evaluation of tubal patency. However, the resultant exposure of the patient to ionizing radiation is a relative disadvantage that must be weighed against the clinical purpose. Aim of the work: this study aimed to evaluate the role of virtual CT hysterosalpingography as a new noninvasive modality for the assessment of the uterus and the Fallopian tubes abnormalities. Conclusion: VHSG has the ability to integrate most of the advantages of the diagnostic studies methods in the diagnosis and evaluation of the infertile female. Whether it should completely replace the use of standard conventional HSG among the infertile females, or be used as a back up to HSG and indicated when questionable or abnormal findings are encountered.}, keywords = {hysterosalpingography,Multidetector CT,Female genital system,abnormalities}, url = {https://ejhm.journals.ekb.eg/article_8683.html}, eprint = {https://ejhm.journals.ekb.eg/article_8683_bdc367b7f5f984c45bc6debdd220591f.pdf} } @article { author = {Esraa Elsayed Ragab2, Osama Nour Alden 1, Rania Hamed Shatla1,}, title = {Tandem Mass Spectrometry in Patients with Drug Resistant Epilepsy}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {71}, number = {3}, pages = {2712-2714}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: Inherited metabolic abnormality was a common influential factor in the pathogenesis of intractable epilepsy. Screening of inborn metabolic abnormality in children with intractable epilepsy should be conducted as early as possible, to achieve early treatment and improve their prognosis. Methods: Descriptive study was conducted in Outpatient Neurology Clinic –Ain Shams University Pediatric Hospital. It included 30 (12 male and 18 female) patients with intractable epilepsy during the period from February 2017 to December 2017. All patients presented with drug resistant epilepsy. subjected to full history talking , clinical examination and were investigated by serum lactate, serum ammonia, arterial blood gases, Extended Metabolic Screen using tandem mass spectrometry, urinary organic acids, fundus examination, EEG and neuroimaging. Results: Abnormal urinary organic acid analysis was present in 5 patients as follows: 3-hydroxyglutaric acid in one patient, increase lactic acid in three patients and 2-oxoglutaric in one patient. Plasma amino acid analysis results were alanine elevation in 4 patients, elevated C5-DC in one patient, abnormal co-carnitine in three patients, 2 of them had low concentration and one had high concentration, elevated glycine in two patients and phenylalanine elevation in only one .Conclusion: Inherited metabolic abnormality was a common influential factor in the pathogenesis of intractable epilepsy. }, keywords = {Tandem mass spectrometry,intractable epilepsy}, url = {https://ejhm.journals.ekb.eg/article_8684.html}, eprint = {https://ejhm.journals.ekb.eg/article_8684_3c35073a2b0b7e73b1b24c3436c39bf2.pdf} } @article { author = {Nada Abdulqader 2, Buthaina Alwafi 1, Sarah Al-Sharief 2,}, title = {Case Report: Transverse Vaginal Septum in A Down’s Syndrome Patient}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {71}, number = {3}, pages = {2715-2717}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = { Transverse vaginal septa are relatively rare anomalies. It has been shown to occur at different depths within the vagina. It results from vertical fusion or canalization disorder between the vaginal components of Müllerian ducts and urogenital sinus during embryological development of the vagina and can present with or without obstruction. The condition was initially described by Delaunay in 1877. The authors describe a rare case of a middle-aged female with Down's syndrome, presented with secondary amenorrhea for 3 years. Initial examination and imaging investigation revealed the presence of a transverse vaginal septum. The diagnosis was facilitated using a combination of abdominal and transvaginal ultrasound scanning and CT. And it has been revealed that she has a high rising microperforate transverse vaginal septum. Surgery and follow up was also done.}, keywords = {Transverse vaginal septum,hypothyroidism,Down’s syndrome}, url = {https://ejhm.journals.ekb.eg/article_8685.html}, eprint = {https://ejhm.journals.ekb.eg/article_8685_1f229cc357eeebce62a5f8b37a54565f.pdf} } @article { author = {Ahmed Salem Eid*, Ahmed Ruby AbdelHamid, Atef Mohamed Fathy El-beltagy,}, title = {Ankle Arthroscopy versus Conservative Modalities in Management of Ankle Impingement Syndrome: A Systematic Review of Literature}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {71}, number = {3}, pages = {2718-2726}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: it has been well established that chronic ankle pain negatively affects the lives of patients. Surgical techniques for ankle pain have evolved dramatically over the past decade, as arthroscopic equipment has improved to allow excellent exposure to the ankle joint and surrounding anatomic areas. Soft- tissue and osseous impingement syndromes are now increasingly recognized as a significant cause of chronic ankle pain, The exact cause of this condition is debated but seems to involve osteophyte formation due to either repetitive microtrauma or macrotrauma associated with major injuries. Careful analyses of patient history and signs and symptoms at physical examination can suggest a specific diagnosis in most patients. Aim of the work: this systematic review aimed to assess the outcome of ankle arthroscopy versus conservative modalities in management of ankle impingement syndrome. Methods: a systematic literature search of the PubMed, Embase (classic), and Chochrane library databases, for articles that published from January 1990 to June 2017 was performed using the following inclusion criteria English language puplications, human clinical trials, studies that reported on at least one of the chosen outcome measures which are patient satisfaction, time to return to full activity, AOFAS score, visual analog scale (VAS) score for pain, and complications, we found 9 studies met our inclusion criteria, data extraction was done which is consisted of population characteristics, in addition to the outcome measures. Results: nine articles were included in this systematic review. Overall, good results were found for arthroscopic treatment in patients with ankle impingement syndrome, patient satisfaction rates was reported in 5 studies, we reported high percentages of good to excellent satisfaction rates, ranging 74% to 94%, especially in patients treated with arthroscopy, Complication rates were 14.1%, as regard to patients treated with arthroscopy the rate was 13.2%, on the other hand the rate was 17.6% in those patients treated with injection therapy technique, conventional conservative modalities reported to be ineffective in treating ankle impingement except injection therapy technique in case of ankle soft tissue impingement. Conclusion: our systematic review showed that Patients may respond to conservative treatment modalities, especially ultra-sound guided injection mainly in soft tissue impingement type, arthroscopic debridement is the treatment of choice for patients of ankle impingement syndrome of both osseous and soft tissue nature with least morbidity and early return to function, and also it is noted to be superior to conservative modalities. }, keywords = {ankle arthroscopy,Ankle impingement,Bony, Soft tissue impingement,Chronic ankle pain,sport injury,Os trigonum, Osteophytes,Treatment, Conservative}, url = {https://ejhm.journals.ekb.eg/article_8686.html}, eprint = {https://ejhm.journals.ekb.eg/article_8686_36b6969bfae3a2527cdaa2f1c3e88e92.pdf} } @article { author = {Abdulkarim Mansour T Alshamrani2, Abdul Qadir Abdul Wahid1,}, title = {General Public Perceptions and Knowledge on Tooth Bleaching in Riyadh, KSA}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {71}, number = {3}, pages = {2727-2737}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Objective: To assess the perceptions and knowledge on tooth bleaching among general public in 5 different areas in Riyadh, KSA. Method: We assessed a population sample of 300 individuals aged between 15 and 65 years old resident in Riyadh region (2016). We used frequency distribution and Chi-square test to investigate the association between socio-demographic factors and knowledge/use of bleaching products. Results: The sample is consisted of 66.7% of males and 33.3% of females. 83.3% of the respondents reported knowing bleaching products and advertisements seemed to be the most popular source of information (65.2%). However only 53.1% reported using bleaching products. Most respondents tried using bleaching products at home (86%), while only 9% undergone tooth bleaching treatment in dental clinics. The commonest reason reported for bleaching was to improve esthetics (66.7%). Data analysis showed that knowledge of bleaching in Riyadh City is not related to gender, nationality, education and occupation (p >0.05). Conclusion: Large majority of patients were not happy with the appearance of their teeth, the main complaint being the color. Most of the patients knew that bleaching is a treatment option to improve dental aesthetics, and those who knew only half tried the treatment. More efforts are needed by the dental professions }, keywords = {Bleaching products,Knowledge,Use}, url = {https://ejhm.journals.ekb.eg/article_8687.html}, eprint = {https://ejhm.journals.ekb.eg/article_8687_8a0441a4ea9896aaa0246ef96b749eb1.pdf} } @article { author = {Reem Muharib R Alruwaili1, Maetham Almusawi2, Alaa Jameel A Ahmed1, Adel Turki ALenezi1, Areej Muteb S Alanazi1, Sara Ghazi Eid Alenezi1, Shumukh Fahad Aish Alshammari1, Futun Fahad Alabdali1,}, title = {Convulsions in Children, Arar, Northern Saudi Arabia}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {71}, number = {3}, pages = {2738-2741}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: Febrile seizure is one of the most common types of seizure in children aged between 5 months and 5 years and accounts for 30% of all childhood seizures, but it is generally considered benign. The objective of the study was to determine the percentage of febrile seizures in Pediatrics Emergency, Maternity and Children's Hospital of Arar City and to study some of the clinical and demographic characteristics of those children. Methods: This was a cross-sectional study conducted during 6 months period, from 1 January to 30 July 2017. All admitted cases (0–12 years) presenting with seizures, both unprovoked and symptomatic (acute and remote), were enrolled. All children 0 to 12 years of age who were hospitalized at the emergency department with seizures were included in this study. Data was recorded in predesigned proforma including age, sex, nature of seizure, fever, history of head trauma, epilepsy, infectious diseases, previous history and family history of seizures and the final diagnosis was fulfilled. Results: Among the studied children presented to the emergency department with attack of convulsions 72.2% of cases had febrile convulsions and 27.8% of cases had convulsions due to other causes. The majority (49.1%) of cases were 1-3 years old. Most (87.7%) of the cases of febrile convulsions had generalized convulsions and in 84.2% it was the first attack but there was a history of repeated attacks in 15.8%. Family history of febrile convulsions was found in 15.8% of the cases. Conclusion: Febrile convulsions was the main etiology of convulsions in children admitted to emergency department of Maternity and Children's Hospital in Arar city. We suggested other researchers to follow the patients to show the recurrence of seizure and the prognosis in them, physical and neurological examinations and good history taking may provide important information for primary emergency physicians when evaluating children with attack of febrile convulsions.}, keywords = {Febrile convulsions,children,Emergency department of Maternity and Children's Hospital,Arar city}, url = {https://ejhm.journals.ekb.eg/article_8688.html}, eprint = {https://ejhm.journals.ekb.eg/article_8688_1c4e24334bfb133b22de17e69485b725.pdf} } @article { author = {Nermeen Nasry Keriakos, Nada Ahmed Hussein, Naglaa Hussein Shebrya,}, title = {Role of dynamic MRI in assessment of Pelvic Floor Dysfunction in Females}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {71}, number = {3}, pages = {2742-2750}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Introduction: Pelvic floor dysfunction is a major medical and social problem. Dynamic MR imaging of the pelvic floor is an excellent tool for assessing functional disorders of the pelvic floor. Findings reported at dynamic MR imaging of the pelvic floor are valuable for selecting patients who are candidates for surgical treatment and for choosing the appropriate surgical approach. Aim of the work: To highlight the role of dynamic MRI as a non-invasive method in the assessment of pelvic floor dysfunction in females. Methods: Dynamic and static MRI were performed in 20 female patients complaining of pelvic organ prolapse and/or stress urinary incontinence or defecation disorder. Full history was taken and clinical examination performed and findings compared with MRI results. Results: Good concordance was found between dynamic MRI and clinical examination in all three compartments, it was 75% in the anterior compartment, 80% in the posterior compartment, 65% in enteroceles and 75.0% in the middle compartment. Conclusion: MR imaging provides excellent soft tissue contrast to ensure adequate diagnosis of the muscular and fascial defects responsible for pelvic floor dysfunction. }, keywords = {dynamic MRI,Pelvic organ Prolapse,INCONTINENCE,Pelvic floor}, url = {https://ejhm.journals.ekb.eg/article_8689.html}, eprint = {https://ejhm.journals.ekb.eg/article_8689_353919bdb3457994140b50a3bb211d7c.pdf} } @article { author = {4 Mohammed Abobakr Hassan Balkheir, 2 Taj Elsir Mohamed Ali**, 1 Abdullah Hameed Saleh Alghamdi*, 1 Fahad Ali Abdullah Dokhaikh, 1 Osama Hamdan Ahmed Alhabi,}, title = {Prevalence And Demographic Features of Miscarriages at Baljurashi General Hospital, Albaha, Saudi Arabia}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {71}, number = {3}, pages = {2751-2758}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: Miscarriage is the most common encountered complication of pregnancy. It may be repeated for 3 or more times; a condition called habitual or recurrent miscarriage. Aim: To determine the incidence of miscarriage at Baljurashi General Hospital, the demographic characteristics of women who presented with miscarriage, and the most common gestational age at time of miscarriage. Materials and methods: A self-administered questionnaire was distributed to women attending Baljurashi General Hospital who suffer from miscarriage. Results: The incidence of miscarriage was 10%. Ninety-two women responded to the questionnaire. Most of the respondents aged more than 25 years, had no job, and were in their first trimester. Half of the respondents had secondary education. Approximately one tenth suffered from repeated miscarriages. Conclusion: The incidence of miscarriage, among patients presenting to Baljurashi hospital, was comparable to those reported in other regions. However, the percentage of repeated abortion is high and these cases were not appropriately investigated. We recommend for the introduction of routine genetic studies into the work up of repeated miscarriages. }, keywords = {repeated miscarriage,Abortion,Pregnancy,Survey}, url = {https://ejhm.journals.ekb.eg/article_8690.html}, eprint = {https://ejhm.journals.ekb.eg/article_8690_a7767f13561b6736488dd5adb7a9c1b1.pdf} } @article { author = {Yahia Mamdouh Hassan Mekki, Moustafa Atef Moustafa Hamouda, Mohamed Sidky Mahmoud Zaki, Ahmed Mohamed El Sayed El Hennawy,}, title = {Comparative Randomized Controlled Blind Study of the Anti-Shivering Effect of Hydrocortisone, Granisetron and Meperidine in Post-Spinal Anesthesia in Patients Undergoing Cesarean Section}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {71}, number = {3}, pages = {2759-2764}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: it was observed that a considerable proportion of patients undergoing surgery experience intraoperative and postoperative hypothermia and it was found that misregulation of body temperature due to anesthesia as well as the cold temperature of the operation room were the main cause. Purpose: to compare the anti-shivering effect of meperidine, hydrocortisone and granisetron after spinal anesthesia during elective cesarean section. Patients and Methods: this study presents a placebo-controlled prospective randomized blind study. Included patients were randomly (using computer generated randomization table) allocated into four equal groups each group consists of 28 patients. Results: in our study, age, sex, and ASA grade distribution of patients were nearly identical in the four groups. Furthermore, the duration of surgery and amount of irrigation fluid used in the four different groups were also similar. We did not observe a change in temperature gradient between the four groups. A study with a more prolonged duration of postoperative temperature monitoring is needed to note if core-periphery temperature changes occur with passage of time. Conclusion: the results indicate that IV granisetron 40 μg/kg was effective as IV meperidine 0.4 mg/kg and both are slightly effective than IV hydrocortisone 2 mg/kg in reducing the incidence and intensity of shivering during spinal anesthesia compared to control group. }, keywords = {Anti-shivering,Hydrocortisone,Granisetron – Meperidine,cesarean section,Post-spinal Anesthesia}, url = {https://ejhm.journals.ekb.eg/article_8691.html}, eprint = {https://ejhm.journals.ekb.eg/article_8691_10d9128079d188f0ab87435f67e38f52.pdf} } @article { author = {Asem Matrouk Zayed Alrowaili, Alanazi, Mona Abdulaziz M, Mohammad Humood Meshref Alenezi, Amjad Mufarh Alrwuaili, Amer Ahmed Balla Ahmed, Alruwaili , Anwar Eid M, Alshalan, Maha Hazzaa F , Alfuhigi , Zuhur Dhaher M, Abdulhamid, Mohmoud A. Alshaheen, Alanzi, Najah Dhaher Y, Alanazi, Ahmed Nidaa K, Razan Mohmoud A. Alshaheen, Waad Salamah Alaleimi, Noor Ghazy Johiman Alenezy,}, title = {Prevalence of Hypothyroidism and Its Associated Risk Factors in Arar City, Saudi Arabia}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {71}, number = {3}, pages = {2765-2769}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: Hypothyroidism is a common endocrine disorder worldwide. The prevalence of hypothyroidism depends on many factors, such as age, sex and geographical factors. Objective: This study is carried out to assess the prevalence of hypothyroidism and the related etiology and risks in the general population of Arar city, northern border of Saudi Arabia. Methods: A cross-sectional study was conducted in Arar, Northern Saudi Arabia. A multistage stratified random sampling technique was used. A pre-designed online questionnaire was distributed among the targeted population and filled by participants after a brief introduction or explanation of the idea of the research to the public. Sampled participants filled out the self-reported predesigned questionnaire to collect socioeconomic and thyroid diseases related data. Results: In our study, the prevalence of hypothyroidism was 25.5% (116/454), females are more affected than males, as 57.7% of the cases were female, most of them (80%) aged 21-60 years old and 40% of the cases has a family history of the disease. 64.7% of the cases were on medical treatment but only 16% of them responded. While surgical treatment were found in only 8% of the cases. Conclusion: Hypothyroidism is prevalent in Arar, Northern Saudi Arabia, females were more affected than males. Knowledge of factors influencing thyroid dysfunction help the public to guard against these prevalent diseases. More studies should be carried out in Arar city to stress on the individual thyroid disorder. The studies should be community based with clinical and laboratory diagnosis of cases. }, keywords = {hypothyroidism,risk factors,manifestations,Arar, Northern Saudi Arabia}, url = {https://ejhm.journals.ekb.eg/article_8692.html}, eprint = {https://ejhm.journals.ekb.eg/article_8692_72a4cc62c32c4177de4680c778e7595f.pdf} } @article { author = {Ibrahim Mohamed Ibrahim El Karmout, Hosny Hassan Mohammad, Abd Elghany Ibrahim Abd Elghany,}, title = {Correlation of Average Retinal Nerve Fiber Layer Thickness Using OCT with The Perimetric Staging in Primary Open Angle Glaucoma}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {71}, number = {3}, pages = {2770-2774}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: Primary open angle glaucoma (POAG) is the most common type of glaucoma which is considered chronic progressive optic neuropathy, accompanied by a characteristic cupping and atrophy of the optic disc, visual field loss, open angle and no obvious systemic or ocular cause. Subjects and Methods: In this study all cases were examined in the period extending from December, 2016 to august, 2017, including 46 eyes of 30 subjects, the eyes were classified according to disease severity into 22 cases with early glaucoma, 16 cases with moderate glaucoma and 8 cases with severe glaucoma according to Hodapp, Parrish, and Anderson classification. Objectives: Inclusion criteria included: All cases have primary open angle glaucoma, presence of at least one reliable visual field, controlled IOP within range 12-21 mm/Hg. Exclusion criteria included: Cases with closed angles or any angle abnormality on gonioscopy, any other retinal or choroidal insult, including other causes of optic atrophy, patients with affected visual field due to any cause rather than POAG, secondary glaucomas. Results: This study included 46 eyes of 30 subjects which were classified according to disease severity into: Early glaucoma: included 22 eyes. Moderate glaucoma: included 16 eyes. Severe glaucoma: included 8 eyes. Conclusion: There is significant direct correlation between average retinal nerve fibre layer thinning and visual field mean deviation. }, keywords = {EMGT, Early manifest glaucoma trial,GPA, Guided progression index,IOP, Intraocular pressure}, url = {https://ejhm.journals.ekb.eg/article_8693.html}, eprint = {https://ejhm.journals.ekb.eg/article_8693_48c3309e2583b471b41f27243fced88f.pdf} } @article { author = {Bassem Fayez Aziz Riad, George Adel Aziz Mansour, Ahmed Hassan Samir Assaf, Rania Gamal Eldin Zaky,}, title = {Study of Accuracy of Corneal Flap Thickness by Using Femtosecond Laser Technology}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {71}, number = {3}, pages = {2775-2779}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background- LASIK is the most popular surgery to correct the refractive errors nowadays. It is proved to be safe, effective and well predictable. It is important to produce a uniform flap with a narrow SD from the intended thickness. The Integrated optical pachymetry is a convenient and useful feature of the EX500 excimer laser which can be used to measure flap thickness intraoperatively.Objectives: this study aimed to detect the accuracy of Allegretto Wavelight FS200™ platform in creation of different corneal flap thicknesses. Patients and Methods:  sixty eyes of 30 myopic patients were included in our study, the patients were operated by 2 different surgeons from June 2017 till December 2017. The patients were distributed randomly into 3 studied groups. Group I (20 eyes with intended fs flap 100um), group II (20 eyes with intended fs flap 110um) and group III (20 eyes with intended fs flap 120um). All participants were subjected to full medical history taking, uncorrected distance visual acuity, slit-lamp microscopy, corneal topography using oculus® pentacam device, manifest and cycloplegic refraction, corrected distance visual acuity, fundus bio-microscopy examination using 90 D lens.  Results: inthis study 100μm thickness group (Group A) showed the lowest difference between the mean result and the intended flap (-0.35um) followed by the 120um group (Group C) with difference of (-2.9um) between the mean result and the intended flap thickness followed by the 110μm group (group B) with the highest difference (-3.45um) from the intended flap thickness. Conclusion: the flaps made with the Wavelight FS200 femtosecond laser were predictable and uniform more predictable in group A than in group C and B, but with no statistical significance between the three studied groups (P=0.402).}, keywords = {femtosecond laser,LASIK,allegretto Favelight FS200TM,EX500 optical pachymetry}, url = {https://ejhm.journals.ekb.eg/article_8694.html}, eprint = {https://ejhm.journals.ekb.eg/article_8694_98c16baa4b02e639d112fb7055b1e078.pdf} } @article { author = {Bandar Mohammed Albukairi, Ahmed Maashi Alanazi, Abdulwahab Abdulhaq Abdulwahab Alkhars, Hussein Ali Albakheit, Fahad Abdullah Al-Anazi, Saud Mohammed Alharbi, Ahmed Hassan Alsomali,}, title = {Awareness of Risk Factors of Hernia among Adults in Riyadh, KSA}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {71}, number = {3}, pages = {2780-2787}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: Abdominal wall hernias are a very common surgical condition affecting all ages and both genders. The main predisposing factors of hernias include pregnancy, weight lifting, constipation, weight gain as well as some chronic diseases such as Asthma Diabetes Mellitus. Aim of the study: was to assess the awareness of the risk factors of abdominal hernias among adults of both genders and different BMI ranges in Riyadh population (Saudi Arabia).  Methods: This is a questionnaire-based cross-sectional study enrolling a total of 100 randomly selected high-risk to development Hernia Saudi adults ensuring diversity in age range and educational stages. Descriptive analysis was done using Statistical Package for Social Sciences (SPSS) 23. Awareness levels for Hernia were calculated as absolute frequencies and were reported as overall percentages.  Results: overall results showed that only 48% of the respondents could relate hernia to the key underlying risk factors while 22% denied the correlation and 30% claimed no knowledge on the risk factors and the association with hernia development. However, majority of participants (87%) suggested a correlation between hernia and heavy lifting. Moreover, more than half of the study group (65% and 62%) related pregnancy and surgery as a contributing factor for hernia. While a lack of awareness was obvious on other risk factors such as smoking, chronic, constipation prostate enlargement, asthma and DM with a knowledge score of 37%, 36%, 32%, 32% and 29% respectively.  Conclusion: Our study revealed lack of public knowledge on the predisposing factors for hernia among the study group of young Saudi female and male adults regardless to the age and BMI range. Despite the fact that 87% related hernia to heavy lifting, less than 65% of participants could correlate hernia to pregnancy and surgery while not more than 36% could correlate hernia with other key predisposing risk factors such as smoking, enlarged prostate, asthma, DM and chronic constipation. This indicates that proper intervention is needed to broadly raise the awareness of hernia risk factors among Saudi adults. This can be achieved by mass media awareness campaigns such as TV and radio health education programs as well as campaign at schools, universities and health centers.}, keywords = {Adult,Hernia,Inguinal,prospective studies,risk factors,KSA,Riyadh}, url = {https://ejhm.journals.ekb.eg/article_8695.html}, eprint = {https://ejhm.journals.ekb.eg/article_8695_f30a01831c7122a020d7e6c1bf369427.pdf} } @article { author = {Mohammed Aldameg, Fares Abdullah Alaskar and}, title = {Hydatid Disease with Water Lily Sign Manifesting as a Soft-Tissue Mass in The Soleus Muscle of an Adult Woman- Case Report}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {71}, number = {3}, pages = {2788-2791}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Due to the high lactic acid levels and the contractility of the muscle soft-tissue hydatid disease is unusual even in endemic areas, and skeletal muscle involvement is extremely rare. Here we discuss an extremely unusual and rare case of hydatid disease found in the medial aspect of the soleus muscle in 46 years old female. MRI imaging is essential for identification and differential diagnosis.}, keywords = {Hydatid cyst,skeletal muscle hydatosis,Water Lily Sign,Echinococcosis}, url = {https://ejhm.journals.ekb.eg/article_8696.html}, eprint = {https://ejhm.journals.ekb.eg/article_8696_eca43dd5869632ec1ce04fca11d99c4a.pdf} } @article { author = {Nouran A. Abououf,2 Hend M. El-Menyawy 2, Hanaa M.M. El-Khayat 1, Karima M. Metwally2,}, title = {Histopathological and Ultrastructural Studies on Biomphalaria alexandrina Snails Infected with Schistosoma mansoni miracidia and Treated with Plant Extracts}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {71}, number = {3}, pages = {2792-2804}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: Biomphalaria alexandrina snails are the intermediate host of Schistosoma mansoni in Egypt. Aim of the work: this study aimed  to evaluate the molluscicidal activity of the methanol extract of the plants Anagallis arvensis and Viburnum tinus against B. alexandrina (Normal and S. mansoni infected). Results: the present results proved high activity for both plant extracts (LC50 & LC90 which reached 45& 60 ppm and 38&59 ppm for A. arvensis and V. tinus, respectively). The effect of sub-lethal concentration, ½ LC5, of the two plant extracts (26 and 11 ppm, respectively) affected B. alexandrina survival rate to be in the following order, control > V. tinus treated > A. arvensis treated > infected > infected-A. arvensis treated > infected-    V. tinus treated. On the other hand, exposure to those sub-lethal doses caused considerable reduction in the infection percentages. In addition, the histopathological effects of the examined sub-lethal concentrations on hepatopancreatic tubules of the treated snails showed cells vacuolation, presence of hyaline substances filled the lumens of the tubules and necrotic focal areas in case of A. arvnsis and vacuolar degeneration with the necrotic changes in case of V. tinus. While, alterations in the hermaphrodite glands of the treated snails included: degeneration and necrotic changes in the acini. The severity of lesions was progressed with infection as a result of invading of snail tissue by developmental stages of the S. mansoni cercariae. The ultrastructural micrographs were used to explain and confirm the recorded histopathological alterations in the hermaphrodite glands of the infected-treated snails. In comparison with the control and infected snail groups, infected-treated snails showed degeneration with severe deformation and destruction in their reproductive units, degeneration in developmental stages tissues of S. mansoni cercariae and accumulation of the toxic agents.Conclusion: the two examined plants, A. arvensis and V. tinus plant extracts  showed high activity against B. alexandrina  and provide a considerable scope in exploiting local indigenous resources for snail’s molluscicidal agents. The sub-letal concentrations, ½ LC5, of the two plant extracts caused a considerable reduction in survival rate and infection rate among  S. mansoni infected snails. Histopathological changes in the digestive glands showed cells vacuolation, hyaline substance filled lumens of the tubules and necrotic focal areas in the digestive glands.   Histopathological effects explained and confirmed by TEM images showed degeneration with severe deformation and destruction in the reproductive units.}, keywords = {Biomphalaria alexandrina,snail control,Anagallis arvensis,Viburnum tinus,Schistosoma mansoni infection,histology,Transmission Electron Microscope (TEM)}, url = {https://ejhm.journals.ekb.eg/article_8697.html}, eprint = {https://ejhm.journals.ekb.eg/article_8697_d5d022d0b603b20aa3529d2552847613.pdf} } @article { author = {Sara Mohammed Sayed Ahmed Dower1, Mohamed Hesham Mohamed Ezzat Abdelhameed1, Sahar Samir Abd El Maksoud2, Hanan Mohamed Abd El Lateef1,}, title = {Serum Neopterin Level in Children with Juvenile Idiopathic Arthritis}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {71}, number = {3}, pages = {2805-2819}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: Juvenile idiopathic arthritis (JIA) is generally considered a clinical syndrome involving several disease subsets, with a number of inflammatory flows, leading to an eventual common pathway in which persistent synovial inflammation and associated damage to articular cartilage and underlying bone are present. Neoptrin is a reliable marker in the assessment of the rate of IFN-γ production. Levels of neoptrin increase in direct proportion with the level of interferon. Measurement of neopterin level is useful because of its relative stability also it is a prognostic indicator for cell-mediated immunity. Aims: This study aims to assess serum level of neopterin in patients with Juvenile Idiopathic Arthritis (JIA) in relation to the disease activity, severity and response to conventional and biological therapy. Methodology: The study was conducted on 30 patients (Group A) previously diagnosed as SoJIA, they were divided into two subgroups according to their therapy into Group AI on biological therapy (15 patients) and Group AII on conventional therapy (15 patients). These in addition to 20 healthy controls (Group B). Results: Basic clinical evaluation and laboratory investigations were done. We found that JIA patients had significantly higher levels of serum neopterin than healthy controls. We also found a highly significant difference between neopterin levels in the activity and remission states among all patients (Group AI and Group AII). Conclusion: We concluded that serum neopterin is a useful marker for cellular immune activation and also indicative of the activity of JIA. Our findings are supported by positive correlations between serum neopterin levels and other markers of activity as TLC, PLT counts, ESR, and CRP. We also concluded that serum neopterin is a sensitive and accurate predictor of disease activity where sensitivity of that test was 93.3% and accuracy was 72.5%. Recommendations: Investigating the serum neopterin measurement in other autoimmune collagen diseases. Assessment the influence of biological therapy on neopterin levels in relation to disease progression.}, keywords = {Serum Neopterin,Juvenile idiopathic arthritis}, url = {https://ejhm.journals.ekb.eg/article_8698.html}, eprint = {https://ejhm.journals.ekb.eg/article_8698_6caf71b4aa29b150961d2e02aee01fbf.pdf} } @article { author = {Nizar J. Kamal 3, Maram R. Shami1, Jamal Kamal 2,}, title = {Abdominal Teratoma, A Case Report and Review of Cases Reported from Saudi Arabia}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {71}, number = {3}, pages = {2820-2825}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: teratomas is defined as germ cell tumors that derived from totipotent cells, some are entirely benign (mature) and some are malignant (immature) account for 80%, 3%, respectively. The majority of teratomas are found in gonads (ovary, testis) followed by extra-gonadal sites (sacrococcygeal, retroperitoneal, gastric, etc.). Aim of the study: this study aimed to report a rare case of teratoma in Saudi Arabia. Method: this study was a case of a one-year old child with abdominal teratoma, which was discovered incidentally, and on reviewing the literature we found that only two cases of extragonadal abdominal teratomas reported from Saudi Arabia and this is the third one. Data were collected from patient’s medical file after approval has been taken from bioethics department and the patient’s family. Result: abdominal teratoma is rare and should be taken into consideration as one of the differential diagnosis of abdominal mass. Total excision is the mainstay of treatment. Conclusion: Abdominal teratoma is rare and should be taken into consideration as one of the differential diagnosis of abdominal mass, it is usually benign. Total excision is the mainstay of treatment.  Careful histopathological examination and close follow-up is mandatory, only two cases were reported from Saudi Arabia and our case could be the third one.}, keywords = {abdominal teratomas, incidental finding,rarely reported from Saudi Arabia}, url = {https://ejhm.journals.ekb.eg/article_8699.html}, eprint = {https://ejhm.journals.ekb.eg/article_8699_f4d13ef7009106c0beb0198d93d6227f.pdf} } @article { author = {Sara S. Hashem, Tarek A. Almaamon, Safaa S. Mahmoud, Tamer F. Eliwa,}, title = {Myopic Vitreomacular Traction Syndrome}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {71}, number = {3}, pages = {2826-2835}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: Myopic traction maculopathy (MTM), also known as myopic foveoschisis typically occurs in highly myopic eyes often leads to blindness. The pathologic features of foveoschisis may be alone or it may be associated with foveal detachment or macular hole. Aim of the work: To assess the role of vitrectomy with internal limiting membrane (ILM) peeling in changing visual outcomes and optical coherence tomography (OCT) findings of the macula in patients with myopic vitreo-macular traction syndrome. Design of the study: prospective Interventional case series. Methodology: 19 high myopic eyes of 17 patients divided into 3 groups: Group 1 (Foveoschisis only): (6 eyes) Group 2 (foveoschisis and foveal detachment): (6 eyes) Group 3 (foveoschisis, foveal detachment and macular hole): (7 eyes) Results: In our study, the visual acuity significantly improved in all eyes at 6 months postoperatively. This was associated with significant reduction of central foveal thickness. There was statistically significant inverse correlation between changes in best corrected visual acuity (BCVA) and both basal refraction and basal BCVA. There was statistically significant direct correlation between changes in central foveal thickness (CFT) and basal refraction. On the other hand, there was significant inverse correlation between changes in CFT and basal CFT. Conclusion: Visual improvement was better in foveoschisis with foveal detachment eyes than in foveoschisis or macular hole eyes.}, keywords = {Vitreomacular Traction,High myopia,myopic foveoschisis,Macular Hole,BCVA,CFT,OCT,ILM,Peeling,Pars Plana Vitrectomy}, url = {https://ejhm.journals.ekb.eg/article_8700.html}, eprint = {https://ejhm.journals.ekb.eg/article_8700_ce96d1f35668b979ae32950f9fa3ee81.pdf} } @article { author = {Mayada Ahmed Ibarhim, Ahmed Mohamed Tawfik Elkhateeb, Gihan Seif Elnasr Mohamed*, Amr Ahmed Kasem,}, title = {Ketorolac versus Magnesium Sulphate as an Adjuvant to Lidocaine in Intravenous Regional Anesthesia for Upper Limb Surgeries}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {71}, number = {3}, pages = {2836-2844}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: intravenous regional anesthesia (IVRA) was first described almost a century ago by August Bier and has been used for the past 50 years. It is a safe anesthetic technique for upper or lower distal limb surgery. Purpose: to compare the onset time of sensory blockade when adding ketorolac versus adding magnesium to the IVRA solution, and to compare the duration of postoperative analgesia. Material and Methods: this is a randomized controlled trial in two groups. The study was performed in Ain Shams University Hospitals. Study period range was 1-2 years. Results: there are 146 patients participated in our study, patients were allocated to two groups 73 patients in each group, a group of which received magnesium sulphate solution and the other received ketorolac solution. Conclusion: we evaluated the effects of adding ketorolac and compared it to the effects of adding magnesium sulphate to the anesthetic solution used in IVRA and we found that magnesium sulphate addition can be of benefit in faster onset of sensory block in the operative limb. However, magnesium sulphate in the used concentration (10 ml MgSo4 10% in 40 ml solution) appeared to cause burning pain varying in intensity while injecting the anesthetic solution.}, keywords = {Magnesium sulphate,Intravenous regional anesthesia,Upper Limb Surgeries – Ketorolac}, url = {https://ejhm.journals.ekb.eg/article_8701.html}, eprint = {https://ejhm.journals.ekb.eg/article_8701_cc530ea7fefa75a20198635b093a25f3.pdf} } @article { author = {Shaimaa Abdelsattar Mohammad2 and Nagat Mansour Khalifa3, *Tarek Mahmoud Fouad Gad Mohamed1, Walid Hetta2,}, title = {Role of Multi-slice CT in Staging of Neuroblastoma}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {71}, number = {3}, pages = {2845-2850}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: The International Neuroblastoma Risk Group Staging System (INRGSS) is a recent pretreatment staging system for neuroblastoma (NB), based on imaging by CT before surgery. Purpose: this study aimed to stage NB cases using CT scan, in relation to available clinicopathologic data. Patients and Methods: Twenty pathologically proven NB cases were included. All were reviewed for patients' characteristics, includingage; sex, clinical picture, LN status and metastatic spread. All cases underwent CT scan for diagnosis. Stagingwas done using IDRFs, LN status and metastatic spread according to the INRGSS and INSS when available. Results: an abdominal mass was found in 85% of cases and the suprarenal gland was the most common site of primary tumor (50% of cases). Concerning tumor grade, 85 % of cases were poorly differentiated. LNs were positive in 70%, and metastatic spread was found in 35% of patients respectively. Staging according to the INRGSS showed that L2 was the most common stage (45% of cases), followed by M stage (35%). L1 and MS stages were found in 15% and 5% of cases respectively. Only 7 cases had postsurgical CT scans, and were staged according to the INSS. Conclusion: it was concluded that the use of the INRGSS using CT scan, is a recent valuable pretreatment staging system, allowing accurate classification of neuroblastoma.}, keywords = {Neuroblastoma (NB),Computed tomography (CT) scan,Image Defined Risk Factors (IDRFs),International Neuroblastoma Risk Group Staging System (INRGSS),International Neuroblastoma Staging System (INSS)}, url = {https://ejhm.journals.ekb.eg/article_8702.html}, eprint = {https://ejhm.journals.ekb.eg/article_8702_3a93a952fe0eefdc4d0d83e97650a28d.pdf} }