@article { author = {Metwally, Mohsen Fahmy}, title = {Clinical Short-Term Outcome of Severe Untreated Aortic Stenosis}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {1}, pages = {806-814}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0038178}, abstract = {Background: sclerocalcific aortic valve is a common condition. Risk stratification and decision making are particularly complex in adults with aortic stenosis (AS), because the disease mainly affects elderly patients who represent a heterogeneous population and require balanced and individualized analysis using a multidisciplinary collaboration. Further research is needed to provide better evidence in particular on spontaneous risk, earlier detection of LV dysfunction, and the results of transcatheter treatment and medical therapy. Objectives: to study the clinical short term outcome of the severe untreated severe sclerocalcific aortic valve stenosis and also to evaluate the correlation between echocardiography assessment of aortic stenosis and clinical history and examination. Methods: in our study of 50 patients with severe sclerocalcific aortic stenosis, were subjected to full history taking along with full clinical examination and transthoracic echocardiography at baseline and follow up. The TTE criteria for diagnosis of severe Sclerocalcific aortic stenosis are increased echogenicity and thickening of the aortic valve leaflets with mean gradient greater than 40 mm Hg, and maximum jet velocity greater than 4 m per second, valve area less than 1.0 cm2. Results: at short term follow up of our patients (2 years), there were significant increase in the number of patients who developed symptoms of angina and heart failure (p<0.01) but there was no statistically significant increase in those who develop syncope (P=0.106). There were very evident echocardiographic findings in the form of highly significant (p<0.01) decrease in the EF & valve area and increase in the MPG, PPG, Max. Jet velocity. Conclusion: 41.2% of previously asymptomatic patient developed symptoms at follow up. There were very evident and significant changes in the echocardiographic findings related to significant decrease in the EF & vave area and increase in the MPG, PPG, Max. jet velocity and intracardiac dimensions that is reflected in the clinical symptoms progression throughout the follow up period.  }, keywords = {Sclerocalcific,Severeaortic stenosis,aortic valve replacement,Ejection fraction – aorticvalve area- Max. Jet velocity-mean pressure gradient}, url = {https://ejhm.journals.ekb.eg/article_12977.html}, eprint = {https://ejhm.journals.ekb.eg/article_12977_d247d7201f8c930b51dcace5744ecf61.pdf} } @article { author = {Azab, Ahmad M and Shoman, Hoda M and El-Deeb, Ragaa M and Abdelhafez, Hemmat M and Samei, Sanaa E Abdel}, title = {Comparative Studies on the Histology of Eye Retina in Some Nile Fishes with Different Dial Activities}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {1}, pages = {815-823}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0038179}, abstract = {Aim of the work: the present work aimed to study the comparative histology of some fresh water fishes inhabiting the Nile River in Egypt. These fishes have different dial activities; Oreochromis niloticus is diurnal,while Clarias gariepinus, Bagrus bajad and Chrysichthys auratus  are nocturnal. Results: the retinae of all studied fishes (O. niloticus,C. gariepinus, B. bajad and Ch. auratus) are composed of ten layers. These layers are the inner limiting membrane (ILM), nerve fiber layer (NFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL), outer limiting membrane (OLM), photoreceptor layer (PL) and pigmented epithelial layer (PE). The histological structure showed three types of  the  photoreceptors  (single and double cones as well as single rods) in Oreochromis niloticus. The pigment epithelium layer in C. gariepinus, B.bajad and Ch. auratus completely hides the photoreceptors. A considerable variation was recorded between the different studied fishes in the whole retinal thickness as well as their retinal layers.  Conclusion: Whole retinal thickness in O. niloticus (diurnal activity) is large in comparison with that of the other three siluriform fishes (nocturnal activity).  }, keywords = {Nile,fish,Oreochromis niloticus,Clarias gariepinus,Bagrus bajad,Chrysichthys auratus,Eye,retina,histology,Diurnal,Nocturnal}, url = {https://ejhm.journals.ekb.eg/article_12979.html}, eprint = {https://ejhm.journals.ekb.eg/article_12979_d5f67c94dd624810013ff5ef0b69bca7.pdf} } @article { author = {Al-Safran, Fahad and Al-Bar, Mohammad and Almazrua, Abdulaziz and Alzahrani, Bander}, title = {The Introduction and Validation of Arabic Sino-Nasal Outcome}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {1}, pages = {824-828}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0038180}, abstract = {Background: the Sino Nasal Outcome Test questionnaire 22 (SNOT-22) is recommended among the validated and published instruments to assess the impact of CRS on the quality of life in adults. Aim of the work: is to perform translation, cross-cultural adaptation and validation for the Sino Nasal Outcome Test (SNOT)-22 in the Arabic language and. Methods: SNOT-22 questionnaire were translated from English to Arabic by two independent native Arabic translators. This was followed by retranslation back from Arabic to English by two independent native English translators, questionnaires were then distributed to patients diagnosed with CRS at the Otolaryngology clinic in King Fahd Hospital of The University and grouped healthy volunteers. Results: the study included individuals divided into 104 cases and 110 controls, who reported no Sino nasal disease. Cronbach’s alpha was 0.939, while controls scored 0.943 suggesting good internal consistency within the SNOT-22 questionnaire. The SNOT scores for the cases and controls (median (IQR)) were 42.0(25, 58, 25) and 12.5(4, 31, 25) respectively and were compared using a Mann-Whitney test showing a statistically significant difference in the scores between two groups (p=0.000). Conclusion: the results indicate that the Arabic version of the SNOT-22 is a valid and a reliable instrument.  }, keywords = {Chronic Rhino sinusitis,Sino-nasal Outcome Test-22,Arabic language,quality of life}, url = {https://ejhm.journals.ekb.eg/article_12990.html}, eprint = {https://ejhm.journals.ekb.eg/article_12990_00cc699194a2884f7ea91add20df430d.pdf} } @article { author = {Alshaalan, Ahmed Marwan and Arafsha, Forsan Hani and Othman, Mohammed Abdulaziz and Sindi, Basam Zuhaer and Sanai, Eisa Adil and Alwabisi, Mohammed Hamdan and Dumyati, Mohammed Saleh and Alsinnari, Mahir Mazin and Halawani, Abdulghaffar Talal and Alahmed, Ali Malik and Alharbi, Dalal Aayed and Algharbi, Abrar Mubarak and Al-Jabri, Louai Ahmad Zakwan and Alshabrawi, Faisal Adnan and Alkhadrawi, Hussain Mahfood and Niyazi, Rayan Abdulshakur}, title = {Surgical Intervention versus Endoscopy in the Treatment of Bile Duct Stones}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {1}, pages = {829-836}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0038181}, abstract = {   Bile duct stones (BDSs) may happen in up to 4%–15% of all patients for whom cholecystectomy is performed. Patients giving CBDS have manifestations including: biliary colic, jaundice, cholangitis, pancreatitis or might be asymptomatic. It is critical to recognize essential and auxiliary stones, in light of the fact that the treatment approach shifts. Stones found some time recently, amid, and after cholecystectomy had likewise contrasting medicines. Distinctive strategies have been utilized for the treatment of CBDS yet the appropriate treatment relies on upon conditions, for example, quiet' fulfilment, number and size of stones, and the specialists involvement in laparoscopy. Endoscopic retrograde cholangiopancreatography with or without endoscopic biliary sphincterotomy, laparoscopic CBD investigation (transcystic or transcholedochal), or laparotomy with CBD investigation (by T-tube, C-tube inclusion, or essential conclusion) are the most regularly utilized strategies overseeing CBDS (Common bile duct stones). We will survey the pathophysiology of bile duct stones, finding, and distinctive procedures of treatment with particular concentrate on the different surgical modalities}, keywords = {}, url = {https://ejhm.journals.ekb.eg/article_12999.html}, eprint = {https://ejhm.journals.ekb.eg/article_12999_cd7ebc92e3cd876a0ee8c3fad1ce62a7.pdf} } @article { author = {Amer, Hanaa A. and Abo-Shady, Rania A. and Abd Elaziz, Doaa M. and Khattab, Yara M.}, title = {The Role of Serum Adiponectin Levels in Women with Polycystic Ovarian Syndrome}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {1}, pages = {837-844}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0038182}, abstract = {Background: Adiponectin is a recently identified adipocyte-derived collagen-like protein. In humans, adiponectin levels were found to be decreased in obese, compared to normal individuals, whereas high adiponectin levels are independently associated with increased insulin sensitivity. The specific role of adiponectin in these metabolic conditions is not clear: it may have a causative role, or it could be regulated by insulin and serve as a marker for insulin resistance. Adiponectin levels hold great promise for use in clinical applications as a potent indicator of underlying metabolic complications.   Aim of the work: The present study was aimed to evaluate the link between adiponectin and polycystic ovarian syndrome (PCOS) and the potential use of adiponectin as a biomarker for PCOS.   Patients and methods: The study included 84 female patients presenting to the Reproductive and Infertility Clinics at Ain Shams University Maternity Hospital, starting from June 2016 till January 2017. They were divided into four groups based on the diagnosis of polycystic ovarian syndrome (PCOS); Cases were selected as: Group I non-obese PCOS group (n = 21), Group II obese PCOS group (n = 21). Controls were selected as: Group III non-obese control group (n = 21) and Group IV obese control group (n = 21).  All the Control subjects had normal, regular menstruation, normal ovarian findings on ultrasound, and normal luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels. None displayed hirsutism. PCOS subjects were enrolled when they had satisfied two of the three following inclusion criteria: 1. Oligomenorrhea or amenorrhea. 2. Clinical or biochemical hyperandrogenism. 3. Ultrasonographic polycystic ovarian morphology. Serum adiponectin, metabolic and hormonal parameters were compared in PCOS patients with BMI matched controls. Measurement of plasma adiponectin levels done by Enzyme Immunoassay kit in Ain Shams University Maternity Hospital lab.   Results: Serum adiponectin level was significantly lower among cases than controls (p value < 0.001). No significant difference was found between cases and controls regarding their hormonal profile except for testosterone and insulin levels which were significantly higher among cases (p value <0.001). As regard insulin resistance, there was a significant difference where cases were higher than control (p value <0.001).   Conclusion: It could be concluded that PCOS was found to correlate with low adiponectin levels, independently of BMI. The relationships between adiponectin and insulin resistance and sensitivity, metabolic syndrome, and BMI in women with PCOS suggest that adiponectin potentially could serve as a marker for disease risk and provide opportunity for earlier intervention if knowledge is successfully translated from laboratory to clinical practice.  }, keywords = {adiponectin,PCOs,Enzyme-Linked Immuno-Sorbent Assay}, url = {https://ejhm.journals.ekb.eg/article_13013.html}, eprint = {https://ejhm.journals.ekb.eg/article_13013_bc94e766cde9977a78b743645851581f.pdf} } @article { author = {H.A., Salama and A.N, Sakna. and H.M, Salama and S.A., Abdelhafeez}, title = {Impact of Scissors Type Used for Episiotomy on the Prevalence of Obstetric Anal Sphincter Injury: Randomised Controlled Trial}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {1}, pages = {845-852}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0038183}, abstract = {Aim: to compare between the prevalence of obstetric anal sphincter injury (OASIS) after cutting mediolareral episiotomy by angled, curved or straight scissors in women in labour. Methods: The current randomized controlled trial was conducted at Ain Shams University Maternity Hospital. The participating women were randomly allocated into three arms. Arm (A): women had mediolateral episiotomy cut by angled scissors. Arm (c): women had mediolateral episiotomy cut by curved scissors .Arm (s): women had mediolateral episiotomy cut by straight scissors. Primary outcome was the occurrence of Obstetric Anal Sphincter Injuries (OASIS). Results A total of 300 primiparous women were included. The overall incidence of OASIS was 5%,17% and 15 % in arm A,C and S respectively. Conclusion: using angled scissors in cutting mediolateral episiotomy results in less cases of obstetric anal sphincter injury compared to cutting episiotomy by straight or curved scissors.  }, keywords = {Episiotomy,obstetric anal sphincter injury,scissors,mediolateral,angled,straight}, url = {https://ejhm.journals.ekb.eg/article_13015.html}, eprint = {https://ejhm.journals.ekb.eg/article_13015_9bcb2d73cff2320467df138be37ef5fd.pdf} } @article { author = {Awad, Obada Bashir and Alqarni, Sami Amer M and Alkhalaf, Hani Mousa and Alnemer, Faris Ali and Alahmari, Khalid Ayed Abdullah and Alshahrani, Saeed Mubarak Saeed and Alahmari, Sami Aoudah Tami and Ahad, Mohammad Abdul Majeed Abdul and Habtar, Haitham Sulaiman A and Almousa, Mohammed Ali S and Alarabi, Abrar Abdulrahman M and Alshahrani, Salem Baty D and Alshaalan, Fawaz Nawaf and Alghalibi, Mohammed Thamer Shaker and Alshahrani, Mohammad Abdullah M and Dowaikh, Abdullghany Mohammed}, title = {A Systematic Review of ACL Reconstruction Rehabilitation}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {1}, pages = {845-864}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0038184}, abstract = {Background: Anterior Cruciate Ligament (ACL) reconstruction is a well-known surgical knee procedure performed by orthopaedic surgeons. There is a general consensus for the effectiveness of a postoperative ACL reconstruction rehabilitation program, however there is little consensus regarding the optimal components of a program Objective of the Study: to assess the merits and demerits of current ACL reconstruction rehabilitation programs and interventions based on the evidence supported by previously conducted systematic reviews.   Methods: a Systematic search in the scientific database (Medline, Scopus, EMBASE , and Google Scholer) between 1970 and 2017 was conducted for all relevant Systematic reviews discussing the primary endpoint ( ACL reconstruction rehabilitation ) studies were analyzed and included based on the preset inclusion and exclusion criteria. Study screening and quality was assessed against PRISMA guidelines and a best evidence synthesis was performed. Results: the search results yielded five studies which evaluated eight rehabilitation components (bracing, Continuous passive motion (CPM), neuromuscular electrical stimulation (NMES), open kinetic chain (OKC) versus closed kinetic chain (CKC) exercise, progressive eccentric exercise, home versus supervised rehabilitation, accelerated rehabilitation and water based rehabilitation). A strong evidence suggested no added benefit of short term bracing (0-6 weeks post-surgery) compared to standard treatment. Whilst a moderate evidence reinforced no added advantage of continuous passive motion to standard treatment for boosting motion range. Furthermore, a moderate evidence of equal effectiveness of closed versus open kinetic chain exercise and home versus clinic based rehabilitation, on a range of short term outcomes. There was inconsistent or limited evidence for some interventions including: the use of NMES and exercise, accelerated and non-accelerated rehabilitation, early and delayed rehabilitation, and eccentric resistance programs after ACL reconstruction. Conclusion: short term post-operative bracing and continuous passive motion (CPM) introduce no benefit over standard treatment and thus not recommended. A moderate evidence suggested equal efficiency for 1) CKC and OKC are equally effective for knee laxity, pain and function, at least in the short term (6-14 weeks) after ACL reconstruction and 2) home based and clinic based rehabilitation. Nevertheless, the degree of physiotherapy input remains unclear.  }, keywords = {ACL rehabilitation,pre-operative rehabilitation,post-operative rehabilitation}, url = {https://ejhm.journals.ekb.eg/article_13019.html}, eprint = {https://ejhm.journals.ekb.eg/article_13019_ea8fb230c6fbf437e1bf587f379c2378.pdf} } @article { author = {El Margoushy, Nesriene M. and Al-Suwat, Rawan W. and Al-Otaibi, Wejdan A. and Mougrabi, Mohammed M.}, title = {Incidence of Pulmonary Embolism in CCU at King Faisal Hospital, Taif, Saudi Arabia}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {1}, pages = {865-877}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0038185}, abstract = {Background: Pulmonary embolism (PE) is a frequent cause of death and serious disability with a risk extending far beyond the acute phase of the disease. Despite advances in diagnosis and treatment, high mortality rates are still a common problem. Aim of the work:  was to assess the incidence rate of pulmonary embolism among patients attending CCU of King Faisal hospital in Taif, Saudi Arabia and the most common risk factors of pulmonary embolism in these patients. Patients and methods: across sectional study for 6 month duration, in the period from June 2016 to December 2016. Patients were chosen from CCU of King Faisal hospital, Taif, Saudi Arabia. The study includes 20 patients diagnosed as pulmonary embolism from both sexes (male/female =10/10) with mean age 58.9±19.9 years old and 20 healthy control volunteers (male/female =14/6) with mean age 52.1±19.5 years old were chosen for comparison;incidence rate of pulmonary embolism was calculated and the related risk factors in these patients were evaluated via a questionnaire done to each patient and control. Results: 80% and 70% of patients and control lived in Taif, respectively. Incidence rate of pulmonary embolism was 5.5%. 25% of patients were smoker and 15% of control group were smoker. Conclusion: the presented study assessed the incidence of pulmonary embolism and its risk factors in King Faial hospital in Taif, Saudi Arabia. All risk factors of pulmonary embolism mentioned in international researches were emphasized in this research particularly travelling history, oral contraceptive therapy and cancer with respect to other risk factors.  }, keywords = {pulmonary embolism,risk factors,Saudi Arabia and Taif city}, url = {https://ejhm.journals.ekb.eg/article_13022.html}, eprint = {https://ejhm.journals.ekb.eg/article_13022_203d0949cc28ff61bf548bdb7f5f9e5a.pdf} } @article { author = {Khairy, Hassan Tawfik and El-Mekkawi, Sherif Fathi and El-Kotb, Ahmed Mohamed and El-Sorady, Soad Ismail}, title = {Misoprostol before Elective Caesarean Section for Decreasing the Neonatal Respiratory Morbidity: A Randomized Control Trial}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {1}, pages = {878-884}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0038186}, abstract = { Background: neonatal respiratory morbidities are common neonatal outcome the worrisome the mothers the most when approaching labour. They vary in clinical presentations with various long term effects, the most importantly related to caesarean section are Transient Tachypnea of the Newborn (TTN), Respiratory Distress Syndrome (RDS), Persistent Pulmonary Hypertension (PPHN). Aim of the Work: the aim of this study is to assess the efficacy of Misoprostol or the Prostaglandin E1( PGE1) on the reduction of the neonatal respiratory morbidity in women scheduled for term caesarean section (38-38+6 weeks Gestational Age (GA). Patients and  Methods: this is a Randomized Controlled Trial (RCT) which was conducted over six months from November 2016, to April 2017 on 120 pregnant women who were approached before elective caesarean section (ECS), managed in Ain Shams University Maternity Hospital (ASUMH), and their neonates followed up in the Neonatal Intensive Care Unit (NICU) of Ain Shams University Maternity Hospital to assess the effect of Misoprostol when given for women one hour before their scheduled caesarean section upon reducing the neonatal respiratory morbidity. Results: the current study revealed a highly statistically significant difference between groups according to respiratory morbidity, and especially the TTN using Chi-square test, with p-value <0.001 Highly Significant. Conclusion: the study concluded that when a vaginal tab containing Misoprostol 200 microgram given to women one hour before term elective caesarean section between 38-38+6 weeks compared to placebo, it simulates the normal labour to enable the neonate through catecholamines surge, and thus surfactant secretion for better adaptation to the extrauterine life. Recommendations: Misoprostol can be administered vaginally to candidate pregnant women with term pregnancies with certain inclusion criteria before an elective caesarean section (after exclusion of any contraindication and thorough good history taking and clinical examination) in order to reduce the neonatal respiratory morbidity and especially the transient tachypnea of newborn. Thus, decrease the duration of neonatal NICU admission and mortality.  }, keywords = {neonatal respiratory morbidities,TTN,RDS,PPHN,PG,misoprostol,cesarean section,GA,NICU}, url = {https://ejhm.journals.ekb.eg/article_13026.html}, eprint = {https://ejhm.journals.ekb.eg/article_13026_f63d4935f0d904d9e63004efbb438242.pdf} } @article { author = {El-Monem, Atef A. and Mahfouz, Mohamed H. and Mohamed, Mona A. and Abd El-Aziz, Heba Gamal and Hussien, Nora}, title = {Microrna 192 Gene Expression in Type II Diabetic Nephropathy}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {1}, pages = {885-893}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0038187}, abstract = {Background: Diabetic nephropathy (DN) is the common cause of kidney failure in patients with diabetes mellitus. MicroRNAs (miRNAs) are short non-coding RNAs of about 22 nucleotides which recently have been shown to play vital roles in mammalian gene expression. Aim of the study: was to investigate the role of miRNA-192 in the pathogenesis of diabetic nephropathy and disease progression. Patients and Method: Sixty five patients with uncontrolled diabetes mellitus, they were subdivided into; thirty nine patients with normoalbuminuria (<20mg/L); their ages ranged between 48-67 years and the onset of disease between 1-5 years; twenty six patients with microalbuminuria (20-200 mg/L), their ages ranged between 47-66 years and the onset of disease between 5-15 years, in addition to twelve apparently healthy individuals as control; their ages ranged between 51-67 years. Serum Transforming growth factor beta (TGF-β), Interleukin 18 (IL-18) were determined using ELISA technique, the expression level of miRNA-192 in whole blood using (RT-PCR) was determined, other biochemical parameters as fasting plasma glucose (FPG), glycated haemoglobin (HbA1c), lipid profile and creatinine were estimated using commercial available kits. Patients were given written contest. Results: The level of miRNA-192 expressions was significantly lower in microalbuminuria group when compared to normoalbuminuria group. Serum level of IL-18 and TGF-β were significantly higher in both patient groups when compared to control group and their levels were significantly higher in microalbuminuria group than normoalbuminuria group. Conclusion: Together with TGF-β1 and IL-18, miRNA- 192 may not only be used as molecular biomarker in diabetic microvascular complications but also as early marker of alterations in specific biological processes in the kidney.  }, keywords = {diabetic nephropathy,miRNA-192,IL-18,TGF-β}, url = {https://ejhm.journals.ekb.eg/article_13039.html}, eprint = {https://ejhm.journals.ekb.eg/article_13039_3e934770f4ee04afe4f67479843c689d.pdf} } @article { author = {Senna, Hala Abou and Taha, Tojan and Hatm, Zahraa Udyi}, title = {The Role of Diffusion-Weighted Magnetic Resonance Imaging in the Evaluation of Patient with Non Traumatic Orbital Lesions}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {1}, pages = {894-898}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: orbital lesions represent a spectrum of benign and malignant lesions in adults and children that can be challenging to diagnose and treat. Imaging plays an important role in diagnosis, due to a potentially limited clinical examination and risks associated with biopsy. Magnetic resonance imaging (MRI) is a powerful tool for imaging the orbit, due to the excellent tissue contrast it provides. Aim: this study aims at assessing the ability of diffusion weighted magnetic resonance imaging to differentiate the benign from malignant orbital lesions. Patients and Methodology: this study population included 25 patients; they were attended El-Demerdash University Hospital with non-traumatic orbital lesions. All patients had fulfilled specific inclusion and exclusion criteria. The patients were evaluated by MRI orbit and diffusion study in attempt to differentiate the benign orbital lesions from malignant one. Results: the pool of our study is 25 patients (16 female and 9 males) with orbital lesions, the patients age ranged from 1 year to 70 years. There are 48% of the cases diagnosed as having benign lesions and 52% have malignant lesions.Retinoblastoma is the commonest (12%) pathological diagnosis.The calculated apparent diffusion coefficient (ADC) values of the lesions ranged from 0.6 – 2.1 x 10-3 mm2/sec. The ADC value of 0.89 x10-3 mm2/sec is a cut off between benign and malignant orbital masses. Conclusion: we concluded that the combination of conventional MRI finding and ADC calculation together with clinical finding could improve the diagnostic efficacy of MRI in the differentiation between benign and malignant orbital masses with considering the cut off ADC value between benign and malignant orbital masses.  }, keywords = {Diffusion-Weighted Magnetic,Resonance Imaging in,Non Traumatic Orbital Lesions}, url = {https://ejhm.journals.ekb.eg/article_13041.html}, eprint = {https://ejhm.journals.ekb.eg/article_13041_a24821d28edebc72847926069fd7e57f.pdf} } @article { author = {Andrawes, Nevine G. and Ismail, Eman A. and Roshdy, Maged Maher Salib and Ibrahim, Amna Mohamed}, title = {Evaluation of Serum Angiopoietin-2 in Children and Adolescents with Sickle Cell Disease}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {1}, pages = {899-903}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0038189}, abstract = {Background: A pro-angiogenic state has been found in adults with sickle cell disease (SCD), mainly because of elevated angiopoietin-2 levels. Aim of the work was to determine the level of Angiopoietin-2 in children and adolecents with SCD and assess its relation to markers of hemolysis and iron overload. Methods: Forty SCD patients in steady state were studied focusing on hydroxyurea therapy, hematological profile and serum ferritin. Patients were compared to 40 healthy controls. Results: Angiopoietin-2 levels were significantly higher in SCD patients compared with healthy controls (8506.3 ± 3789.5 pg/mL versus 2791.7 ± 1263.6 pg/mL; p<0.001). Angiopoietin-2 levels were significantly higher in SCD patients with cardiopulmonary complications. Significant positive correlations were found between serum angiopoietin-2 levels and age as well as HbS. Conclusions: Elevated angiopietin-2 levels in SCD highlights the role of angiogenesis in the pathophysiology of SCD. Angiopoietin-2 may be considered a promising risk marker for screening of SCD patients at risk of cardiopulmonary complications.  }, keywords = {Serum Angiopoietin-2,children,Adolescents,Sickle Cell}, url = {https://ejhm.journals.ekb.eg/article_13042.html}, eprint = {https://ejhm.journals.ekb.eg/article_13042_97fa8cc67943badc8c49edc2f2c98012.pdf} } @article { author = {ElShourbagy, Mahmoud Aly Ahmad and Hemeda, Hossam Mohamed Mohamed and Islam, Bassem Aly and Abd Ellatif, Amal Saeed Bakr}, title = {Maternal Serum Amyloid A level in Pregnancies Complicated with Preterm Premature Rupture of Membranes}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {1}, pages = {904-909}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0038190}, abstract = {Background: serum amyloid A (SAA) is a cytokine-inducible acute-phase reactant whose plasma concentrations can exceed 1 mg/mL during an acute-phase response (500 to 1000 fold of plasma levels  greater than in the non inflammatory state) thus representing an ideal marker for clinical use. Preterm premature rupture of membranes (PPROM) complicates only 2% of pregnancies but is associated with 40% of preterm deliveries and can result in significant neonatal morbidity (Prematurity, sepsis and pulmonary hypoplasia) and mortality. Aim of the work: this study aimed to find out association between maternal serum amyloid A level and preterm premature rupture of membranes. Also to compare SAA, CRP levels, N/L ratio in the study group. Patients and methods: this study is a cross sectional study conducted in Ain Shams University Maternity Hospital from December 2015 – December 2016 on 58 pregnant women. Women have been allocated in this study, represented in two groups: 1- Study group: including 29 women complaining of preterm premature rupture of membranes. 2- Control group: including 29 women as control group with no complain. Venous blood sample was taken from each participant (study group within 1hour from onset of PPROM, control group during their follow up visit to the clinics). Serum amyloid A, Micro C reactive pretein, total WBCs and neutrophil/lymphocyte ratio (NLR) were calculated.  Results: the results point out that PPROM cases had significantly lower GA and APGAR scores at 1 min and more prone to neonatal sepsis which may lead to death. PPROM women have significantly higher total WBC, N/L ratio CRP and serum amyloid A. There were significant positive correlations between amyloid-A, N/L ratio& CRP in both groups. Serum amyloid A level above 2 ng/ml is a risk factor for PPROM and low Apgar score at 1 min. but has low predictive value. CRP with cut off value 5.0 mg/dl has better predictive value in discrimination between PPROM group and control group.Conclusion: Results assessed possible association between maternal SAA, maternal and fetal parameters in pregnancies complicated with PPROM.    }, keywords = {preterm premature rupture of membranes,Serum Amyloid A,C reactive protein,Neutrophil/lymphocyte ratio}, url = {https://ejhm.journals.ekb.eg/article_13046.html}, eprint = {https://ejhm.journals.ekb.eg/article_13046_3be8feaa364687bb6885250c342bdf13.pdf} } @article { author = {Sammour, Hany M. and Ismail, Mahmoud M. and Abdelghany, Abdelghany I. and Shafeek, Mahmoud A.}, title = {Comparative Study between Myoring and Ferrara Ring Intracorneal Implantation Using Femtosecond Laser for Treatment of Keratoconus}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {1}, pages = {910-922}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0038191}, abstract = { Background: Keratoconus is a bilateral progressive, non-inflammatory ectatic corneal disease characterized by changes in corneal collagen structure and organization. Though the etiology remains unknown, novel techniques are continuously emerging for the diagnosis and management of the disease. Intracorneal rings are an effective way for treating keratoconus; the surgery is safe and has an adequate biocompatibility. The procedure is adjustable and reversible and, most importantly, effective in improving unaided visual acuity (UAVA), best corrected visual acuity (BCVA). Aim of the Work: To compare the efficacy of MyoRing versus Ferrara ring using femtosecond laser for treatment of keratoconus as regards the visual outcome, refractive changes, keratometery reading (K-max), proper depth tilt and haze by anterior segment OCT and complications. Patients and Methods: This study included forty eyes of patients with keratoconus. They were divided into two groups. Group (A) included twenty eyes of patients with keratoconus subjected to femtosecond laser assisted MyoRing implantation, while Group (B) included twenty eyes of patients with keratoconus subjected to femtosecond laser assisted Ferrara ring implantation. Results: In group (A) MyoRing all patients showed improvement in UAVA, BCVA, refraction and K-max except 4 patients (20%) who showed no visual improvement despite the refractive and topographic improvement. Using the anterior segment OCT in interpretation of visual, refractive and topographic findings showed that those 4 patients had their MyoRings implanted at shallower depth with presence of intracorneal ring tilt. In group (B) Ferrara ring all patients showed improvement in UAVA, BCVA, refraction and K-max except 2 patients (10%) who showed no visual improvement despite the refractive and topographic improvement. Using the anterior segment OCT in interpretation of visual, refractive and topographic findings showed that those 2 patients had their Ferrara rings implanted at shallower depth with presence of intracorneal ring tilt. Conclusion: In comparison between two rings, there were no differences in different parameters except that the Ferrara ring showed more improvement in BCVA and spherical component. Using the anterior segment OCT in assessment of implanted rings, helped us to explain the non-improvement in visual outcomes despite the refractive and topographic improvements.  }, keywords = {Keratoconus,Anterior segment OCT,Myoring,Ferrara ring,femtosecond laser}, url = {https://ejhm.journals.ekb.eg/article_13049.html}, eprint = {https://ejhm.journals.ekb.eg/article_13049_185995b1fd36b6a6bb0968baee4198e6.pdf} } @article { author = {Al Shareef, Khalid and Asadullah, Muhammad and Helal, Muhammad}, title = {Fat Embolism Syndrome Due to Fracture Right Femur: A Case Report}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {1}, pages = {923-928}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0038192}, abstract = {Fat embolism syndrome (FES) is usually associated with fractures of long bones and pelvis.   Symptoms usually occurs hours to days after injury. We present a case with fat embolism syndrome due to fracture femur. Prompt supportive treatment of patient's respiratory system and additional pharmaceutical treatment provides the positive outcome. There is no specific therapy for fat embolism syndrome. Prevention, early diagnosis, and adequate symptomatic treatment are very important. The incidence of fat embolism syndrome is reduced markedly in last decades due to early stabilization and surgical correction of fractures of long bones.  }, keywords = {Fat embolism syndrome,Trauma,Femur fracture}, url = {https://ejhm.journals.ekb.eg/article_13051.html}, eprint = {https://ejhm.journals.ekb.eg/article_13051_0ffb13c046614310e64b4afae5e72c35.pdf} } @article { author = {El-M&#039;amon, Tarek A. and Salman, Abdel-rahman G. and Mahmoud, Safaa S. and Mohammed, Alyaa B.}, title = {Recent Trends in Retinal and Choroidal Imaging}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {1}, pages = {929-935}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0038193}, abstract = {The last decade have witnessed a tremendous advancement in retinal and choroidal imaging technologies thanks to improved light sources, detectors and high speed computers which are continuously improving. There are many examples as Fundus autofluorescnce is a relatively novel imaging method that allows topographic mapping of lipofuscin distribution in the retinal pigment epithelium cell monolayer as well as of other fluorophores that may occur with disease in the outer retina and the subneurosensory space. Optical coherence tomography is a method of using low-coherence interferometry to determine the echo time delay and magnitude of backscattered light reflected off an object of interest. This method can be used to scan the retina with very high axial resolution. Optical coherence tomography angiography (OCTA) is a new non-invasive imaging technique that employs motion contrast imaging to get high-resolution volumetric blood flow information generating angiographic images in just a few seconds. OCT is undergoing  another transformation with Multicolor technology  by combining with confocal scanning laser ophthalmoscope t to acquire images using data from three simultaneous lasers red, green and blue taking advantage of the different wavelengths of each of these colors  to image 3 different zones of the retina .  }, keywords = {Fundus autofluorescence (FAF) – Age related macular degeneration (AMD) – Optical coherence tomography (OCT),Optical coherence tomography angiography (OCTA) –Multicolor imaging (MCI)}, url = {https://ejhm.journals.ekb.eg/article_13052.html}, eprint = {https://ejhm.journals.ekb.eg/article_13052_24d562ca136c2493d68d5c7bdfc7f9b5.pdf} } @article { author = {Abd Allah, Hany and farhoud, Hesham Mohamed Elsaady and Mahmud, Hany gamil yousef Wael Shaaban and Mohamed, HanyZaky}, title = {Percutaneous Coblation nucleoplasty in patients with Contained lumbar disc prolapse: One year follow-up in Prospective case series}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {1}, pages = {936-953}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0038194}, abstract = {Background:clinical outcome data was analyzed for 100 patients withcontained disc herniation who underwent percutaneous discdecompression procedure using Coblation® technology,after failing to respond toconservative management.   Patients and Methods: Patients presented with clinicalsymptoms of discogenic low back pain and/or leg painFollow-up data was collected up to 12 months.Patient gender distribution was 68% female, 32% male, witha mean age of 39 years.With mean duration of back pain of 8.57 ,ranging from 3 to 17 month and mean duration of leg pain of 4.36 .ranging from 2 to 10 monthaccording to visual analogue scale for pain assessment.The mean pre-procedure pain level for all patients wasReported as 7.56 for back and 7.72 for leg while average pain level was 4.86 for back and 3.42 for leg at the 12-month follow-up post procedure period. And according to Oswestry disability index for functional assessment. The mean pre procedure index was 31.48 range from 23-40. It decreased after 12 month to 13.82 range from 5-32. Results:The results of this analysis indicated that PDD usingCoblation technology, isan effective procedure for patients presenting withdiscogenic back and/or leg pain who have failed conservativetherapies.    }, keywords = {Percutaneous disc decompression,nucleotomy,contained disc herniation,coblation,Nucleoplasty,Radiofrequency}, url = {https://ejhm.journals.ekb.eg/article_13054.html}, eprint = {https://ejhm.journals.ekb.eg/article_13054_4e224528004723419a5c252b26880741.pdf} } @article { author = {El gaafary, Sahar Mohamed and Abdelrahman, Ahmed Samy and Muhammed, Zeinab Mahmood}, title = {Role of Magnetic Resonance Cholangio-Pancreaticography in Differentiating between Benign and Malignant Causes of Biliary Obstruction}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {1}, pages = {954-966}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: the initial evaluation of obstructive jaundice involves distinguishing between intra and extra hepatic biliary obstruction. The goal of any radiologic procedure is to confirm the presence of biliary obstructive by detecting biliary dilatation, its exact location, extent and probable cause. Aim of the Study: to evaluate the role of Magnetic Resonance Cholangio-Pancreatography in differentiating benign from malignant causes of biliary obstruction using surgical, ERCP or histopathological findings as a gold standard.Patients and Methods: a prospective study done on 20 patients with clinical and laboratory finding suggestive of biliary obstruction. All patients underwent non enhanced MRCP on 1.5 Tesla machine (Philips). The final diagnosis of MRCP was correlated with results of ERCP in addition to biopsy and histological diagnosis to those patients had neoplasms. Results: Out of 20 cases, there were 11 benign and 9 malignant cases. Mean age of patients with malignant obstruction was more than benign with slight female preponderance. The diagnostic accuracy of MRCP in differentiating benign from malignant biliary obstructive diseases in correlation with surgical, ERCP and histopathological outcome was85.7%, 96.3%, and 93.3% respectively. It was found that irregular, asymmetric and long segment narrowing was more common in malignant stricture. Conclusion: MRCP is a rapid and non-invasive, procedure in assessing cases with suspicions biliary obstructions. It offered a diagnostic accuracy nearly equivocal to ERCP. MRCP can also replace the diagnostic part of ERCP procedure, so that time is spent only on its th erapeutic part, and hence decreasing complications of a lengthy ERCP. Recommendations: benign or malignant nature of biliary obstruction can be assured by MRCP by observation of stricture margin, dilatation, and length and accordingly proceed to next step in management. MRCP is an efficient diagnostic procedure for detection of presence, level, cause of obstruction and routinely advocated before any intervention is planned.  }, keywords = {Magnetic resonance cholangio-pancreaticography,benign,malignant,Biliary obstruction}, url = {https://ejhm.journals.ekb.eg/article_13055.html}, eprint = {https://ejhm.journals.ekb.eg/article_13055_a78d0da3c6db0a03aacaa0b246bff0c0.pdf} } @article { author = {Saad, Mohammed Youssef and El-Khaleegy, Hany Abd El-Hady}, title = {Specific IgE Immunoassay for House Dust Mites by Using Multiple Allergen Simultaneous Test (MAST) in Asthmatic Children}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {1}, pages = {967-973}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0038196}, abstract = {Background: house dust mites are considered as a major cause of bronchial asthma in young children. Inhalation of dust mite allergens by hypersensitive individuals can result in acute attacks of bronchial asthma. Multiple allergen simultaneous test (MAST) for the detection of specific IgE of different allergens is one of the important diagnostic tools for bronchial asthma. Patients and Methods: the study group consisted of forty children suffering from bronchial asthma selected from the outpatient clinic of Pediatrics, Faculty of Medicine, Al-Azhar University, New Damietta, Egypt as well as another normal forty healthy volunteer children were selected as controls. Total IgE immunoassay and quantitative measurement of allergen specific IgE (Biocheck GmbH, Germany) were estimated for all of them. Results: it was found that, out of 27 positive IgE subjects, 20 were positive by poly-check test providing sensitivity of 74.1%; and out of 53 negative IgE subjects, 50 were negative, providing specificity of 94.3%. Conclusion: Poly-check (MAST), in vitro tests can be used in screening for allergens in asthmatic children with high specificity.  }, keywords = {house dust mites,bronchial asthma,allergy,specific IgE,multiple allergen simultaneous test (MAST)}, url = {https://ejhm.journals.ekb.eg/article_13056.html}, eprint = {https://ejhm.journals.ekb.eg/article_13056_e9793dd983dd7ea8701e84ee7ef350c6.pdf} } @article { author = {alsalameh, Najeeb saleh and alkhalifah, Adnan khalifah and alkhaldi, Najat kreem and alkulaib, Alsafa abdulaziz}, title = {Depression among Medical Students in Saudi Arabia}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {1}, pages = {974-981}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: stress may be experienced by college students especially medical students because they have several psychological and academic stressors. Due to the increase in stress the depression prevalence increases. There are several factors for depression including gender. Assessing depression between medical students is very important for early treatment as a lack in treatment leads to poor outcomes.                                                                                                                Aim: To investigate the prevalence rate of depression in medical students in KSA. Methods: this study was performed on 1171 medical students from different years of college; the PHQ-9 questionnaire was used. Results: low rates were found for the depressive syndrome and depressive disorder with equal rates for moderate and severe symptoms, females expressed more depression severity than males. Conclusion: depression prevalence rate was low between medical students and females expressed more depression and depressive symptoms than males.    }, keywords = {Depression prevalence,Depression in KSA,Medical student’s depression}, url = {https://ejhm.journals.ekb.eg/article_13058.html}, eprint = {https://ejhm.journals.ekb.eg/article_13058_206572fb51423ce77d138b1f896f57a7.pdf} } @article { author = {Mohamed, Jihan A. and Abdallah, Salah M. and Alatrouny, Almahdy M. and Newishy, Hatem M.}, title = {BACTERIAL INTERACTIONS AMONG SOFT CONTACT LENS USERS AND LENS CARE SOLUTIONS WITH ANTIBIOTIC SUSCEPTIBILITY PATTERN.}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {1}, pages = {982-990}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0038200}, abstract = {PURPOSE: To evaluate the bacterial contamination associated with contact lenses and lens care solutions used by a group of soft contact lens (CL) users (daily & extended wear CL) and the susceptibility pattern of the isolated organisms to antibiotics for 12 months duration. METHODS: This prospective case controlled, non randomized study included 50 participants of contact lens (CL) wearers from Outpatient Clinics at Al-Azhar University Hospitals, International Eye Hospital New Damietta and available special clinics, (between 2013 and 2014). The sample population was divided into two groups: a Case group: 30 contact lens users (60 eyes) were suffering from symptoms and signs of conjunctivitis in one or both eyes; a Control group: 20 CL users were not suffering from conjunctivitis. Samples were takenfromsolution in contact lens storage cases; daily wear CL, extended wear CL, andconjunctiva were cultured on different media. Microbiological identification of the organisms and their antimicrobial susceptibility were done in accordance to standard protocols. RESULTS: In the case group, positive growth was found in 85% of the lens care solution, 65% of the contact lenses, and 56.7% of the conjunctiva of participants. While in the control group, it was found in 10% , 20% and 15% respectively, with a statistically significant difference between both groups (P<0.001). There was no statistically significant differences between the two usage schedules (daily wear and extended wear) regarding results of solution and contact lens cultures (p =0.599) and (p=0.694) respectively, but there was a significant higher growth in the conjunctival cultures of extended wear contact lenses (p =0.014). The isolated organisms in case group were; Staphylococcus epidermidis (36.3%), followed by Pseudomonas aeruginosa (34.7%), Staphylococcus aureus (15.3%), Anthracoid (5.6%), Escherichia coli (4.1%), Diphtheroid (1.6%), Non haemolytic streptreptococci (1.6 %) and least was found to be Mycoplasma (0.8%). Antibiotic susceptibility tests revealed that all isolates are sensitive to gatifloxacin, Impenem and ciprofloxacin which are commercially ophthalmological antibiotics. CONCLUSION: Prevention of bacterial contamination of contact lens can reduce the risk of developing ocular infections. Lens care practices amongst the participants were not optimum which resulted into high contamination level. Hence, creating awareness among the users about the lens care practices and regular cleaning and replacements of lens cases are required.    }, keywords = {Contact lens infections,lens care accessories,microbial contamination,Antibacterial susceptibility}, url = {https://ejhm.journals.ekb.eg/article_13060.html}, eprint = {https://ejhm.journals.ekb.eg/article_13060_7d3668e34744aab9b95cc59161c44a14.pdf} } @article { author = {Soliman, Salah M. E. and Al-Sharkawi, Ismail M. and El-Shaikh, Kamal A. and Salem, Fatma E.}, title = {Anti-inflammatory effect of Hostacortin (steroidal) or Vioxx (non-steroidal) on mice infected with Schistosoma mansoni and treated with praziquantel.}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {1}, pages = {991-1002}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: Schistosoma mansoni, a helminthic parasite induces granulomatous inflammation following deposition of the eggs in the liver. The present study was conducted to evaluate the efficacy of two anti-inflammatory drugs; Hostacortin (steroidal) and Vioxx (non-steroidal) in ameliorating the damaging effects of S. mansoni infection in mice. The effects of the two anti-inflammatory drugs after treatment of schistosomiasis mansoni with praziquantel (PZQ) in mice were assessed for management of S. mansoni infection. Materials and Methods: The PZQ drug was administered to 6-weeks S. mansoni infected mice at one oral dose of 685 mg/kg body weight. The anti-inflammatory activity of the two drugs was evaluated at dose levels of 10, 50,100 and 200 mg/kg body weight in mice infected with 80 S.mansoni cercariae / mouse and treated for 10 consecutive days after 6-weeks of infection. Some biochemical parameters indicating the hepatic function as enzymatic activity of transaminases; alanine aminotransferase (ALAT), aspartate aminotransferase (ASAT) and alkaline phosphatase (ALP) in liver as well as serum albumin and liver total protein were performed to evaluate the possible anti-inflammatory effect of any of the two used anti-inflammatory drugs in ameliorating the severity of the disease. In addition, some parasitological parameters as worm burden, liver egg count, hepatic granuloma size and hepato-somatic index were performed to evaluate the possible anti-inflammatory effect of any of the two used anti-inflammatory drugs in ameliorating the severity of the disease. Results: The results indicated that Hostacortin had no marked effect on the parasite burden and liver egg count. However, it caused a percentage decrease by 14.9 in the elevated ALP activity and pronounced increases by 33.2% and 11.3% in ALAT and ASAT activities, respectively, in liver tissue homogenate. Also, a significant reduction in granuloma size by 22.5% and 31.6% for doses 100 and 200 mg/kg, respectively, was recorded. Hostacortin treatment with PZQ improved the liver status as indicated by a significant reduction in number of worms, eggs count and size of the liver granuloma. However, Vioxx did not affect the parasite burden and liver egg count, it caused high reduction in the enzymatic activities of ALAT, ASAT, and ALP in liver tissue homogenate. In contrast with Hostacortin, Vioxx significantly increased the granuloma size by 27.6% at a dose level of 200 mg/kg. Conclusion: the treatment with Hostacortin, after PZQ treatment, ameliorates to some extent the severity of the disease, but Vioxx treatment causes additional hepatotoxicity in the S. mansoni infected mice after treatment with PZQ.                                                                          }, keywords = {Anti-inflammatory drugs,Granuloma,Hostacortin,praziquantel,S. mansoni.Vioxx}, url = {https://ejhm.journals.ekb.eg/article_13061.html}, eprint = {https://ejhm.journals.ekb.eg/article_13061_ee076c18a70a1562145193464569d973.pdf} } @article { author = {Sehaqi, Sawsan Badr and Saleh, Anfal Abdullah Almohammed and Alhaddad, Maryam and Almalki, Danh Abdullah and Alnasser, Marwah Radi and Abu Rass, Naif Abdullah and Mohsen, Mohsen Shinpir and al TawiL, Dhay Abdullah a. and Baaboud, Maha Salem and Almarzouq, Abrar}, title = {Flexural Strength of Provisional Crown and Fixed Partial Denture Resins}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {1}, pages = {1003-1009}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0038217}, abstract = {Purpose: The purpose of this study was `to appraise the fracture strength of provisional crown and fixed partial denture resins with an in vitro test system. Materials and Methods: Bar-type specimens were fabricated according to American National Standards Institute/American Dental Association specification number 27. Reinforcement materials; polyethylene fiber and glass fiber are compared.  Provisional crown-bridge materials are autopolymerising Poly Ethyl Metacrylate (PEMA), autopolymerising Poly Methyl Metacrylate (PMMA), bis-acryl composite resin and light cured composite resin). A total of 150 specimens are arranged for the flexural strength test. The specimens are divided into 5 groups according to the type of resin used (Dentalon Plus, Tetric Ceram, Charisma, Protemp 3, TAB 2000) and then every group was distributed into 3 subgroups rendering to the type of fiber reinforcement (Construct, Fiber-splint ML). Unreinforcement specimens functioned as the control. Specimens were fractured in a universal testing instrument until the point of rupture. Mean flexural strengths were calculated in MPa. Comparisons were completed with analysis of variance and then Duncan's multiple range tests. Results: Mean flexural strengths ranged from 63.45 to 397.8 MPa. There are statistical difference between the groups (Fiber-splint ML, Construct and control). Conclusion: Flexural strengths were material- rather than classification precise. Several, but not all, bis-acryl resins validated expressively superior flexural strength over traditional methacrylate resins. There was significant difference between Fiber-splint ML, Construct and control group.    }, keywords = {flexural strength,Bis-acryl composite resin,Provisional crown}, url = {https://ejhm.journals.ekb.eg/article_13062.html}, eprint = {https://ejhm.journals.ekb.eg/article_13062_b42510d695ce7f86ff21fea6e02e43d6.pdf} } @article { author = {Hegazy, Laila Mahmoud Abd El Ghafar and Al Sharkway, Asmaa Al Husseiny Ahmed and Sakr, Hossam Moussa and Ahmed, Ahmed Essam El-Said}, title = {A Study of lung Ultrasonography in Infants with Acute Lower Respiratory Tract Infection as a Quick and Safe Alternative Tool in a Group of Egyptian Infants}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {1}, pages = {1010-1021}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0038202}, abstract = {Background: Acute lower respiratory infections (ALRI), such as pneumonia and bronchiolitis, are the leading cause of morbidity and mortality in children under five years of age. Aim of the Work: To study ultrasonography findings in infants with acute lower respiratory tract infection and to test its sensitivity and specificity in comparison to clinical and conventional x- ray for diagnosis of childhood acute lower respiratory tract infection. Patients and Methods: The present cross sectional study was conducted on sixty patients were chosen according to inclusion criteria (fever with signs of respiratory distress) to compare chest ultrasonography to chest x-ray in diagnosis of children with acute lower respiratory tract infection. Results: In our study, diagnostic Accuracy of ultrasound was 93.45%, while diagnostic Accuracy of chest X- ray was 81% in patients’ group. Sensitivity of ultrasound in cases of Bronchiolitis was 87.5% in comparison to chest X-ray was 78.1%, sensitivity of ultrasound in cases of pneumonia was 84.2% in comparison to chest X- ray was 52.6%. According to specificity, there is no difference in specificity between all patients’ groupConclusion: In view of our study it can be concluded that, chest US offers an important contribution to the diagnostic procedures of acute lower respiratory tract infection in children, as Bronchiolitis, pneumonia and pleural effusion with higher sensitivity, specificity and positive predictive index comparable to chest X-ray.  }, keywords = {lung ultrasonography,infants,acute lower respiratory tract infection,pneumonia,bronchiolitis}, url = {https://ejhm.journals.ekb.eg/article_13351.html}, eprint = {https://ejhm.journals.ekb.eg/article_13351_fadab1aab02b81c8a45e6f2ecf1781cc.pdf} } @article { author = {Soliman, Salah M. E. and Al-Sharkawi, Ismail M. and El-Shaikh, Kamal A. and Salem, Fatma E.}, title = {Effect of the anti-inflammatory drugs Hostacortin (steroidal) or Vioxx (non-steroidal) on the liver of mice infected with Schistosoma mansoni.}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {1}, pages = {1022-1034}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0038204}, abstract = {Background: Theschistosomeparasite induced granulomatous inflammation in the host following oviposition in the liver.Aim:The present study aimed to evaluate the efficacy of two anti-inflammatory drugs; Hostacortin (steroidal) and Vioxx (non-steroidal) in ameliorating the damaging effects of S. mansoni infection in mice. Materials and methods: The anti-inflammatory activity of the two drugs was evaluated at dose levels of 10, 50,100 and 200 mg/kg body weight. Each drug was orally administered to mice infected with 80 S.mansoni cercariae / mouse for 10 consecutive days after 6-weeks of infection. Some biochemical parameters including the hepatic function as enzymatic activity of aminotransaminases; alanine aminotransferase (ALAT), aspartate aminotransferase (ASAT) and alkaline phosphatase (ALP) in liver as well as serum albumin and liver total protein were determined.  In addition, some parasitological parameters as worm burden, liver egg count hepatic granuloma size and relative liver weight were performed to evaluate the possible anti-inflammatory effect of the two anti-inflammatory drugs in ameliorating the severity of the schistosomiasis disease. Results: The results showed that Hosstacortin treatment had no marked effect on the parasite burden and liver egg count. However, it caused a pronounced improvement with a high tendency for normalization in transaminases (ALAT and ASAT) and alkaline phosphatase (ALP) activities in liver tissue homogenate. In addition, serum albumin and liver total protein was observed to attain, to some extent, their normal levels by increasing dose regimens of Hostacortin. Also, a significant reduction in granuloma size by 22.2% and 31.6% was detected for doses of 100 and 200 mg/kg Hostacortin, respectively. On the other hand, Vioxx did not affect the parasite burden and liver egg count while it caused high reduction in the enzymatic activities of ASAT, ALAT and ALP in liver tissue homogenate. Also, a moderate increase in serum albumin and a significant reduction in liver total protein levels were observed in mice treated with Vioxx. In contrast to Hostacortin, Vioxx treatment induced a significant increase in the granuloma size by 29.3% at a dose level of 200 mg/kg. Conclusion: The treatment with Hostacortin was found to ameliorate to some extent the severity of the disease, but Vioxx treatment caused additional hepatotoxicity in the S. mansoni infected mice.                         }, keywords = {Anti-inflammatory drugs,Granuloma,Hostacortin,Mice,S. mansoni,Vioxx}, url = {https://ejhm.journals.ekb.eg/article_13352.html}, eprint = {https://ejhm.journals.ekb.eg/article_13352_7f65894e5d6c89f9f9ee9962b1e70b33.pdf} } @article { author = {A.H, El zeneny and A.M, Sayed and A.M, Abdel hafez and S.A., Hafez}, title = {Adjusted Serum leptin and leptin Adiponectin ratio in correlation with Hyperemesis gravidarum}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {1}, pages = {1035-1041}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0038205}, abstract = {Aim: to determine the level of serum leptin, adiponectin and leptin /adiponectin ratio in women with hyperemesis gravidraum and compare  them  with those with normal pregnancy in order to speculate  their role in prediction and assessement of severity of the disease. Patients and method : This case control study was conducted at the department of Obstetrics and Gynecology, Ain-shams university maternity hospital. A total of 90 women are  included in the study and are divided into two groups.Group A: Fourty -five pregnant women with  hyperemesis gravidarum.. Group B  : Fourty -five pregnant women with no hyperemesis gravidarum..the groups were compared for  age, gestational age, body mass index,Leptin ,adiponectin, adjusted leptin level,,leptin to adiponectin ratio were calculated in each group. Primary outcome was the increase in adjusted leptin level in hyperemesis gravidarum group. Results: leptin was found to be significantly high in the HG group (37.91± 6.42 ) , also Adjusted  leptin  level were found to be significantly higher in the  hyperemesis gravidarum group(4.36± 1.26)  than in the control group (P = 0.001 ) and adiponectin  level were found to be  lower in the  HG (9.34±1.49) than in the control  group. There was increase in leptin to adiponectin ratio as compared with severity of the disease. The maternal  leptin level was positively correlated with gestational age in the HG group ( r = 0.011, p= 0.944 ). Also the maternal  adiponectin  level was positively correlated  with BMI  in the HG group ( r = 0.290 , p =  0.054).  Etiology of the hyperemesis gravidarum is multifactorial. However we can postulate the adjusted leptin level as a good predictor for hyperemesis gravidarum.,alsoLeptin to adiponectin ratio can be used to determine severity of the disease.  }, keywords = {Hyperemsis gravidarum,Adjusted leptin,leptin,adiponectin,leptin to adiponectin ratio}, url = {https://ejhm.journals.ekb.eg/article_13353.html}, eprint = {https://ejhm.journals.ekb.eg/article_13353_86949de20e3c7afe395480cc58e07f8c.pdf} } @article { author = {Mohamed, Ahmed and Bayoumy, Hassan Awwad and Abou-Gamrah, Amgad Al-Said and El-shahawy, Ahmed Abdel Shafy}, title = {Placental Cord Drainage versus no Placental Drainage in the Management of Third Stage of Labour: Randomized controlled trial}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {1}, pages = {1042-1048}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0038206}, abstract = {Back ground:the third stage of labour begins immediately after the birth of the baby and ends with the expulsion of the placenta and fetal membranes.It is preceded by contraction and retraction of the uterus to reduce uterine size and expel the placenta with minimal haemorrhage. Placental cord drainage involves clamping and cutting of the umbilical cord after the birth of a baby and then, immediately unclamping the maternal side of the cord so the blood can drain freely into a container. Aim of the work:the aim of this study is to assess the effect of placental cord drainage during active management of the third stage of labour on reducing both blood loss and the length of the third stage. Materials and Methods:a randomized controlled trial was carried out on180 patients who underwent vaginal delivery at Ain Shams University Maternity Hospital labour ward.Population of this study were randomly assigned to either:Group A: 90 patients was the study group(cord drainage).Group B: 90 patients was the control group(no cord drainage). Moreover,the duration of third stage was compared as the primary outcome. The incidence of postpartum hemorrhage, retained placenta, manual removal of placenta, and the need for blood transfusion were compared. Results:the duration and amount of blood loss of third stage of labour was significantly lower in study group than control group.Furthermore,the Postoperative pulse rate,Systolic Blood Pressure, Diastolic Blood Pressure,Hemoglobin and hematocrit value were significantly higher in study group than control group. The retained placenta (manual removal),Postpartum hemorrhageand Blood transfusion were non-significantly less frequent among study group than among control group. Conclusion:active management of the third stage of labour with the cord drainage method significantly reduced postpartum hemorrhage and the duration of the third stage.    }, keywords = {Placental cord,Third stage,Postpartum Hemorrhage,Labour,drainage}, url = {https://ejhm.journals.ekb.eg/article_13354.html}, eprint = {https://ejhm.journals.ekb.eg/article_13354_ed599dc3c5468fc97487729fd22c5e77.pdf} } @article { author = {El-Samahy, May and Sharara, Manal Ahmed and Abd Elaziz, Sally Sobhy}, title = {Effect of Topical Application of Nano Retinol on Mild to Moderate Acne Vulgaris}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {1}, pages = {1049-1058}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0038208}, abstract = {Background: Acne vulgaris is a common skin condition with substantial cutaneous and psychologic disease burden. Estimates of acne prevalence vary substantially given the absence of a universally accepted or grading schema. Aim of the Work: The aim of work is to assess the efficacy and tolerability of topical application of Nano retinol in the treatment of mild to moderate facial acne vulgaris in comparison to classic retinoids. Patients and Methods: This study was conducted as a prospective, split face comparative clinical study on 30 female patients participated for treatment of facial acne vulgaris. All patients recruited from outpatient clinic of dermatology department, Ain Shams University in the period from November 2015 to December 2016.History and clinical examinations were done for each patient. Results: reduction in the total and inflammatory acne lesion count were reported to be significantly greater in the nano formulation as compared to the conventional formulation .local adverse events were significantly less in the nano formulation as compared to the conventional formulation. Conclusion: nanosomal retinol with iontophoresis is more effective and better toletated than its convential formulation with nearly no side effects and no precautions for use. Recommendations: More studies are needed on a wider scale, greater number of patients with different grades of acne vulgaris to support our findings.  }, keywords = {topical application,nano retinol,Acne vulgaris}, url = {https://ejhm.journals.ekb.eg/article_13355.html}, eprint = {https://ejhm.journals.ekb.eg/article_13355_836089130dd3d548f01cd78b1f98a842.pdf} } @article { author = {Ragb, Tamer Mohamed and Saad, Ahmad AlaaEldin Ahmad and Abd Elaal, Moneir Osman Amin and Yassin, Abdellah Nazeer and Rashed, ALSayed Mohamed}, title = {The Relationship between Abdominal Aortic Calcification and Cardiac Abnormalities in Hemodialysis Patients}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {1}, pages = {1059-1068}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0038209}, abstract = {Background: Abdominal aortic calcification (AAC) is a marker of subclinical atherosclerotic disease and an independent predictor of subsequent vascular morbidity and mortality. Aim of the work: This study was conducted to investigate the association of abdominal aortic calcification with cardiac abnormalitiesin hemodialysispatient (HD). Methods: This cross-sectionalobservational study wasperformed on 90 patients (50 males and 40 females)with chronic kidney disease, stage 5 (CKD)of varying etiologies from hemodialysis unit at Al-Hussein UniversityHospital. They wereundergoing regularhemodialysis for more than 6 monthes.Laboratory investigations were done including liver function tests, kidney function tests,complete blood count (CBC),C-reactive protein (CRP), fasting and random blood glucose,lipid profile, calcium, phosphorus,calcium phosphate productandparathormone(PTH).In addition, Echocardiography and X-ray plain radiography were determined. Results: Out of 90 HD patients, 37 patients (41.1 %) had valvular calcification, all of them (41.1 %) had aortic valve calcifications and AAC score exceeded 6.  Only 7 patients (7.8%)had mitral valve calcifications. Moreover, cases with mitral valve calcifications had aortic valve calcification and AAC score above 12. Seven patients (7.8 %) had mildaortic regurgitation (AR)and 4 patients (4.44%) had aortic stenosis. Conclusion: AAC precedes the occurrence of cardiac abnormalities in HD patients and has been shown to have significant prognostic significance for cardiovascular events and mortality.  }, keywords = {abdominal,calcification,Cardiac,Kidney disease,chronic,Radiography}, url = {https://ejhm.journals.ekb.eg/article_13356.html}, eprint = {https://ejhm.journals.ekb.eg/article_13356_7502c9ff58833a8768f9de71fe39484c.pdf} } @article { author = {K, Labib and A, Hamedy and W, Ali}, title = {Impact of Second Hand Smoke Exposure on Birth Weight: A Pilot Cohort Study}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {1}, pages = {1069-1074}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0038210}, abstract = {Objective: to examine the associations of passive smoking during 3rd trimester of pregnancy and birth outcomes. Design: prospective (cohort) study. Setting: this study was conducted at Ain Shams University maternity hospital between period June 2015 and May 2016. Study subjects: A total of 200 women during their 3rd trimester of pregnancy were included in the study with verbal consent from each woman Measures: through written (self-administered questionnaire) and exhaled carbon monoxide (CO) test Results: Current SHS was significantly associated with lower gestational age at delivery, lower birth weight, lower 1-min Apgar score and higher rates of SGA neonates. Conclusion: the current study showed a significant association between SHS in pregnant women and increased rates of preterm delivery, low birth weight and SGA neonates.    }, keywords = {second hand smoke exposure,pregnant women in 3rd trimester of pregnancy,birth outcomes}, url = {https://ejhm.journals.ekb.eg/article_13357.html}, eprint = {https://ejhm.journals.ekb.eg/article_13357_7538bf565adf3306c2502a5cfc09f596.pdf} } @article { author = {Alsbhani, Wafaa M. and Basam, Z. Sindi and Dumyati, Mohammed S. and Alammari, Anwar A. F and Alenzi, Shorooq A. and Sindi, Sulafa T. and Nazer, Njood W. and hakami, Abrar H. and Maimsh, Omar M. and Alzahrani, Anas H. and Alrubaian, Mashael B. and hammam, Kawkab A. and Alsharief, Ahad A. and Alshubaily, Ali M. and AlQarni, Hailah H. and Magram, Weaam S.}, title = {Helicobacter Pylori in Pediatrics}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {1}, pages = {1075-1081}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0038212}, abstract = {   This review includes the main pediatric studies published from April 2011 to march 2016. The important studies involving H. pylori genomes, especially those pertaining to genomic diversity, disease outcome, H. pylori population structure and evolution are reviewed. Genotypic variability in H. pylori strains influences the clinical manifestation of the infection. The antigen stool test is becoming the “gold standard” in prevalence studies, and according to the epidemiologic studies, the prevalence of H. pylori in childhood is not decreasing any more in the developed world. Studies showed conflicting results regarding the association between H. pylori infection and iron deficiency anemia. One study suggests that H. pylori eradication plays a role in the management of chronic immune thrombocytopenic purpura. The prevalence of H. pylori was higher in chronic urticaria patients and following H. pylori eradication, urticarial symptoms disappeared. An inverse relationship between H. pylori infection and allergic disease was reported. The resistance rate of H. pylori strains is high in children. Therefore, among other important issues concerning H. pylori in pediatrics, guidelines published by ESPGHAN and NASPGHAN last year also recommended culture and susceptibility testing before first-line treatment in areas with high or unknown antibiotic resistance rates.    }, keywords = {Helicobacter pylori,H pylori,Infection,Pediatrics}, url = {https://ejhm.journals.ekb.eg/article_13358.html}, eprint = {https://ejhm.journals.ekb.eg/article_13358_8bc732ca3a438a57cf61cb6add8815d6.pdf} } @article { author = {Ahmed A, Halawi Azhar and Abid A, Almalki Zahrah and Alsadah, Ahmed and Abdullah S, Aseeri Arwa and Abdullah H, Jabri Shagra and Saeed, Alasmri Boshra and Abdulwahab, Alhawaj Fatimah and Abdulwahab, Alhawaj hanan}, title = {Prevalence and Risk Factors for Abuse among Saudi Females, KSA}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {1}, pages = {1082-1087}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0038213}, abstract = {Background: Domestic violence against Saudi women is arising recently. Also, statistics indicate that married women are the largest segment of abuse victims in Saudi society. Objectives: Estimating the prevalence of female abuse allover Saudi Arabia as well as assessing the most important factors associated with abuse. Methods: The survey was conducted during the period from January to April   2017. The study population consisted of 758Saudi Arabian females from thirteen governorates of Saudi Arabia. A self-administrated questionnaire that consists of 3 scales including demographics of females and husband’s and the perception of women toward causes of abuse, frequency and types was distributed among participants. Results: The prevalence of abuse among the studied population was 32%%. The most common risk factors for being abused were addiction to drugs and alcohol. The majority of women reported minor physical abuse.About 40.5% of women asked for divorce after abuse. Being divorced, low educated, jobless, polygamy family were considerably associated with being abused. Illiterate husbands, jobless and low income were shown to be the most important male variables that were associated with abuse. Conclusion: The abuse showed a high prevalence rate (36%) indicating high ignorance of female rights as well as increasing the range of abuse allover KSA. The most significant factors associated with abuse were being working, low education of female and husband. Also, non-working husbands and poor income were related to high abuse levels.    }, keywords = {wife,Abuse,physical,KSA}, url = {https://ejhm.journals.ekb.eg/article_13359.html}, eprint = {https://ejhm.journals.ekb.eg/article_13359_b5cbb586fdfd6075d94e854dfb21542e.pdf} }