@article { author = {Abdullah, Randa Hussein and Othman, Amal Ibrahim and Hussein, Hussein Abdullah}, title = {The Role of Dynamic Contrast Enhanced and Diffusion Weighted MRI in Characterization of Suspicious Breast Masses}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1301-1307}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039666}, abstract = {Background: Early detection and diagnosis of breast cancer are mandatory for accurate management. Traditionally, mammography and ultrasound are the basic imaging techniques for the detection and localization of breast masses. The low sensitivity and specificity of these imaging tools resulted in a demand for new imaging modalities. Aim of study: to evaluate the role of either diffusion weighted images-MRI or dynamic contrast enhanced MRI in differentiating malignant from benign breast lesions comparing with histopathology results. Patients and Methods: from November 2016 to July 2017, a total of 20 patients presented with suspicious breast lesions BIRADS (4&5) were included in the study. All participants underwent breast DWI and DCE-MRI. Results were compared with histopathological results as a standard final diagnostic method. Results: the study included 20 female patients with suspicious breast lesions, there was 15 (75%) malignant lesions while benign lesions, while benign lesions were 5 (25%) cases. DCE-MRI was found to have a sensitivity of 86.7% and specificity of 80%. ADC cutoff value was found to have a value of 1.143*10-3, which was the best to differentiate between benign and malignant breast masses. DWI MRI was found to have sensitivity of 93.3% and a specificity of 80%. Conclusion: DW-MRI alone gave the same performance as in combination with DCE-MRI. The comparison of DWI and DCE-MRI provides a dramatic superiority in the sensitivity, specificity and accuracy of breast DWI-MRI over other modality.  }, keywords = {Breast,DWI,DCE,BIRAD}, url = {https://ejhm.journals.ekb.eg/article_13578.html}, eprint = {https://ejhm.journals.ekb.eg/article_13578_e2a1178103ba73de61c0df1b91b426ae.pdf} } @article { author = {Abdallah, Hatem Mohamed and Ghali, Ramy Refaat Youssef and Ezz El Din, Mai Mohamed Ali and Elshimy, Hesham Mahmoud}, title = {Male Breast Cancer: A Retrospective Study}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1308-1315}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039667}, abstract = {Background: The male breast cancer (MBC) is a rare disease and represents less than 1% of all malignancies in men and less than 1% of all breast cancers incident. Aim of study: In this descriptive retrospective study we aimed to provide clinico-epidemiological characteristics of MBC. To present the treatment given with respect to DFS , TTP & OS, to identify possible prognostic factors of the disease and the toxicities encountered by the treatment given. Patients and Method:  Out of 11313 cancer patients 3046 were breast cancer; 28 of them were MBC. All patients presented to clinical oncology department in Ain Shams University in the period from January 2008 to December 2014 and follow up till December 2016 Results: The median age of patients was 59 years. Around 90% had hormone receptor positive (estrogen and/or progesterone receptors).Two third of the patients had advanced T-stage (T3 and T4). Infiltrating ductal carcinoma the most common type of histology was encountered. Modified radical mastectomy was the most common (75%) type of surgery done followed by chemotherapy for 21 patients and loco-regional radiotherapy for 20 patients. Tamoxifen was administered in 19 patients. Relapse occurred in 14 patients (50%). The 5-year disease-free survival (DFS) was 21.4%, the 5-year time to progression (TTP) rate was 21.4% and the 5-year old overall survival (OS) rate was 35.7%. Conclusion: There is always a delay in the male patients since the first complaint until they seek medical advice, which results in an advanced disease at presentation.  }, keywords = {Male breast cancer,Female breast cancer,BRCA gene,tamoxifen,Aromatase inhibitor}, url = {https://ejhm.journals.ekb.eg/article_13580.html}, eprint = {https://ejhm.journals.ekb.eg/article_13580_ae5f4f15e54906def62f7cf0fff2777e.pdf} } @article { author = {Masoud, Mohamed Abd El Raouf and ElKahky, Ayman Mohamed and Hassan, Mohamed Amir and Shahba, Nadia Hassan}, title = {Conservative Management versus Ventilation Tube Insertion in Children with Otitis Media with Effusion Accompanying Cleft Palate}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1316-1324}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039668}, abstract = {Background: Otitis media with effusion (OME) is a collection of non-purulent fluid in the middle ear space; it is almost universal in children with cleft palate. Cleft palate (CP) is among the most common congenital malformations, with an overall incidence of around 1 in 700 individuals. Surgical closure of the cleft palate may lead to improvement in the audiological status of the patients, but whether early surgical correction can improve the middle ear status in CP children remains open for debate. Aim: A meta-analytical study to evaluate and compare the outcome of ventilation tube insertion versus conservative management in management of otitis media with effusion accompanying cleft palate. Methods: A review process was used to assess eligible studies drawn from included published medical articles about conservative management versus ventilation tube insertion in children with otitis media with effusion accompanying cleft palate through searching the Medline data base (www.pubmed.com) and Cochrane library. Then Data were extracted and analyzed from the included studies. Results: 30 relevant articles were found, by application of inclusion criteria 8 articles were found meeting the inclusion criteria and could undergo Meta-analysis. Our results have shown that OME in children with repaired cleft palate can be managed satisfactorily without routine use of ventilation tube (VT). The presence of OME does not lead to long term complications in all patients. Hearing impairment due to OME can be satisfactorily treated with hearing aid (HA) in a majority of children. VT need to be inserted only if the child is not compliant with using a HA or develops recurrent suppurative otitis media. Patients should be followed-up closely for OME to prevent complications. Conclusion: Routine use of ventilation tube in CP patients should be discouraged; instead Treatment should be based on the need and willingness of the children and their parents. Also with respect to individual bases such when the child is proved to have OME and hearing loss that affect child language and speech development. Insertion of ventilation tubes should be offered as an alternative to hearing aids or conservative management by close otological and audiological follow up.    }, keywords = {otitis media with effusion,cleft palate,Ventilation Tube,conservative management}, url = {https://ejhm.journals.ekb.eg/article_13581.html}, eprint = {https://ejhm.journals.ekb.eg/article_13581_c757d88f8367e3b0d9546dfc79e6baea.pdf} } @article { author = {El-Gayar, Mohamed H. and Makboul, Khaled M. and Bahaa El Din, Ahmed M. and Mohamed, Mohamed S.}, title = {Study of Serum Irisin in Patients with Thyroid Dysfunction}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1325-1331}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039669}, abstract = {Background: irisin, identified as a proteolytic cleavage product of the fibronectin type III domain-containing protein 5 (FNDC5), It is a novel myokine secreted by contracting skeletal muscle, possibly mediating some exercise health benefits via ‘browning’ of white adipose tissue. Irisin causes a significant increase in total body energy expenditure and resistance to obesity-associated insulin resistance in mice, while controversy still exists concerning irisin origin, regulation and function in humans. Aim of the work: our study aimed to detect relation of thyroid status (hypo, hyperthyroid) with serum irisin, ck and peripheral neuropathy. Patient and methods: this study was conducted on 60 candidates consisted of 40 patients with thyroid dysfunction selected from Endocrine outpatient Clinic and Inpatient Department of Ain Shams University Hospitals and 20 healthy volunteers from April 2016 to October 2016. Informed consent was obtained from all participants. Patients of both genders, age more than 18 years old, 20 patients with hypothyroidism, 20 patients with hyperthyroidism and 20 healthy volunteers. We excluded significant renal, hepatic and cardiac disease, severe associated acute illness or depression, pregnant females, diabetes, hypercortisolism, hypocortisolism, muscular or neurological disorders, routinely taking drugs as statins, intensively involved in a sport or any strenuous physical activity. All participants were subjected to full medical history taking, general clinical examination and laboratory investigations as thyroid and thyroid-related hormone concentrations as well as a thyroid ultrasound examination and thyroid scan for patients with hyperthyroidism. Serum irisin level, CK and nerve conduction velocity were measured. Results: irisin level was higher in hyperthyroid group than euthyroid group with a significant difference. In comparison with normal NCV candidates and reduced NCV candidates with other variables there was only border line significant difference with irisin p-value. Non significant value of irisin and CK level were detected for diagnosis of hypothyroidism. Irisin has highly significant value for diagnosis of hyperthyroidism with (sen 95%, sp 42.5). Increased BMI is the only independent predictor for hypothyroidism by using multivariable binary logistic regression analysis. Decreased BMI and irisin are independent predictors for hyperthyroidism. Conclusion: serum irisin level is one of predictors for hyperthyroidism, on the other hand irisin does not have a significant value to predict hypothyroidism. Serum irisin was found to be higher in patients with hyperthyroidism in comparison with euthyroid participant with non statistically significant difference between hypo and hyperthyroidism. Serum CK level does not have a significant value in diagnosis of thyroid dysfunction (hypothyroidism or hyperthyroidism). Serum irisin level was low in thyroid dysfunction cases with delayed NCV compared to thyroid dysfunction cases and normal NCV with border line significant difference.    }, keywords = {Irisin,thyroid dysfunction and nerve conduction}, url = {https://ejhm.journals.ekb.eg/article_13582.html}, eprint = {https://ejhm.journals.ekb.eg/article_13582_29325af19e3228caff262e6d9bb63e3d.pdf} } @article { author = {M., Bayoumi}, title = {Effect of General Anesthesia versus Spinal Anesthesia in Cesarean Section on Regain of Gastrointestinal Motility}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1332-1338}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039670}, abstract = {Background: cesarean section is a common major hospital surgical procedure performed nowadays. One of the most common postoperative complications is postoperative gastrointestinal paralysis (Ileus) that must be minimized due to its possible serious consequences. Objectives: this study aims to compare the time to regain intestinal motility after general anesthesia versus spinal anesthesia for cesarean section. Methods: this prospective controlled study was carried out at Ain Shams University Maternity Hospital during the period from April 2016 to June 2017 after approval of the hospital health ethical committee. It included 150 patients who had C.S and they were subdivided into 2 groups according to a randomization scale (spinal versus general). Results: spinal anesthesia results in a quicker return of bowel activity after cesarean section, decreased hospital stay and less use of post-operative opioids than general anesthesia. Recommendations: we recommend the use of spinal anesthesia for cesarean section especially if there's no contraindication for that.  }, keywords = {post-caesarean section ileus,GI hypomotility,spinal and general anesthesia}, url = {https://ejhm.journals.ekb.eg/article_13583.html}, eprint = {https://ejhm.journals.ekb.eg/article_13583_34506ead4825bdcc830ca366f96a6dbf.pdf} } @article { author = {Mohamed, Ahmed Mostafa and Louka, Amir Louis and Ghazee, Akeel Faisal}, title = {The Role of Diffusion Weighted MR Imaging in Assessment of Hepatocellular Carcinoma After Radiofrequency Ablation}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1339-1341}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039671}, abstract = {Hepatocellular carcinoma (HCC) is the most common primary liver malignancy. Surgical resection and local ablative therapies represent the most frequent first lines therapies adopted when liver transplantation cannot be offered. Aim of the work: was to evaluate the feasibility of DWI and the corresponding ADC values to detect tumor response after radiofrequency ablation for hepatocellular carcinoma. Materials and methods: MR examinations were done for 20 HCC patients post-RFA. Pre and postgadolinium enhanced images as well as DW sequences were performed. ADC values of ablation zones and liver parenchyma were assessed. ADC values of ablation zones and adjacent signal alterations identified in DWI were analyzed. Results: Residual or recurrent lesions were detected in 4 patients (20%). The mean ADC value of ablated zones differed significantly from that of normal liver parenchyma. The corresponding ADC values were significantly lower in patients with residual lesion than in patients without residual lesion. Conclusion: It could be concluded thatDWI is a feasible follow-up tool for postablation liver contributing in detection of residual lesion.  }, keywords = {MR,Hepatocellular carcinoma,Radiofrequency ablation}, url = {https://ejhm.journals.ekb.eg/article_13584.html}, eprint = {https://ejhm.journals.ekb.eg/article_13584_71556a88743a74cc986b94dfcaf0e672.pdf} } @article { author = {Mohamed, Sabry Sayed and Rabei, Noha Hamed and Faisal, Malames Mahmoud and Amin, Amira Sayed}, title = {Association between Chlamydia Trachomatis Cervicitis and Preterm Labor}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1342-1349}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039672}, abstract = {Background: Preterm labor (PTL) is a major determinant of neonatal morbimortality with adverse consequences for health. The causes are multifactorial, with intrauterine infection probably explaining most of these outcomes. It is believed that infection with Chlamydia trachomatis (CT) is also involved in PTL. Objective: To compare the prevalence of chlamydia trachomatis cervicitis in women with preterm labor and control at term. Methods: This was a case-control study conducted at Ain Shams University Maternity Hospital. This study included 70 pregnant women with singleton fetus who attended the causality and were selected to participate in the study. They were divided into two groups, cases and control group each 35 patients. Swab was taken from endocervix and chlamydia trachomatis DNA was examined by real time polymerase chain reaction (PCR). Data were analyzed by Chi-square test. Results: The prevalence of chlamydia trachomatis cervicitis in women with preterm labor is higher than in women at term; 8 cases out of 35 (22.9%) as compared to the women in the control group which was 2 cases out of 35 (5.7%) and this difference was statistically significant using (p =0.04). Conclusion: This study proved that there is an association between chlamydia trachomatis cervicitis and preterm labor. Screening and treatment of Chlamydia trachomatis infection are recommended to decrease cases of preterm labor.  }, keywords = {Chlamydia Trachomatis,preterm labor,polymerase chain reaction}, url = {https://ejhm.journals.ekb.eg/article_13585.html}, eprint = {https://ejhm.journals.ekb.eg/article_13585_4363ff443876f84692ce910ad894fd73.pdf} } @article { author = {Issa, Hanan Mohamed and Soliman, Ahmed Hassan and Hasan, Alyaa Lateef}, title = {Role of Magnetic Resonance Imaging in Diagnosis of Chronic Hip Joint Pain in Adults}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1350-1357}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039673}, abstract = {Background: Chronic hip pain is a common problem in adults. In the absence of a known acute trauma, it can be a diagnostic problem as it can be attributed to many causes. The most common causes are avascular necrosis, inflammatory causes, transient osteoporosis or neoplastic lesions. Aim of the Work: The aim of this study is to evaluate the role of magnetic resonance imaging (MRI) in the evaluation and diagnosis of different causes of chronic hip pain in adults. Patients and Methods: The study was conducted on thirty patients who had chronic hip pain and they were referred to undergo MR imaging of hip joints in MRI Unit in Al-Hussain Teaching Hospital in Thi-Qar / Iraq and Ain Shams University Hospital in Cairo / Egypt. Conclusion: MRI is an essential imaging modality in musculoskeletal system in general and in hip region specifically. Recommendations: MRI should be done preferably with a limited number of sequences. If the diagnosis is still query or whenever inflammation or a neoplastic process is suspected, we should do other sequences in different imaging planes and go for contrast injection and post contrast studies (T1WI).  }, keywords = {MRI,chronic hip joint,adults}, url = {https://ejhm.journals.ekb.eg/article_13586.html}, eprint = {https://ejhm.journals.ekb.eg/article_13586_37e785ce7098e4b2ba39bd8e260a1bb6.pdf} } @article { author = {El Kerdany, Tahany Ali and Abo El Ela, Soha and Aziz, Janette Botros Shoukry}, title = {Study of Automated Red Blood Cells Parameters in Correlation with Routine RBCs Morphology by Smear Review}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1358-1363}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039674}, abstract = {Background: sysmex XT 1800i coulter is a hematology analyzer incorporating new electronic and mechanical design with advanced algorithm technology to perform CBC. The principles of sysmex XT1800 are electrical impedance technology, optical scatter technology, flow cytometry. The sysmex XT-1800i haematology  analyser is used in unique fluorescence flow cytometry (FFC) technology. FFC looks at deoxyribonucleic acid (DNA) content, cell size and inner cell complexity rather than cell size alone. This generates remarkably accurate results. Review rates and turnaround time are reduced due to specific fluorochrome labelling. The XT-1800i offers true quantitative immunoglobulin ( IG) counting instead of the flagging delivered by other technologies.  Patiant and Method: Evaluation of this instrument was performed on 200 samples of inpatient and outpatient people in Ain Shams University Hospitals. We collected samples from all departments of the hospital randomly of any age and sex except those of age less than 18 years old. Results : this study was centered upon RBCs indices which were  mean corpuscular volume (MCV),mean corpuscular hemoglobin(MCH),red cell distribution width (RDW) after comparing sysmex XT 1800 coulter results  for RBCs parameters with  morphology  by smear review under the microscope. We found that the device sensitivity was 74.7%  , 75 % ,83 % and specificity was 74.3% , 79.5 % ,78.7%  according to RBCs size ,chromasia and anaesocytosis respectively. Conclusion: at the end of our study we reached to specific criteria at which we must do a blood film smear review to evaluate RBCs abnormalities which cannot be evaluated by the device.  }, keywords = {hematology analyzer,abnormal RBCs morphology}, url = {https://ejhm.journals.ekb.eg/article_13587.html}, eprint = {https://ejhm.journals.ekb.eg/article_13587_393109a5c54c74e5d5cf42df8a5b5f07.pdf} } @article { author = {Nasr Eldin, Annie Mohamed and Sakr, Hossam Moussa and Ahmed, Aml Ibrahim and El Afify, Wesam Kamel}, title = {Role of PET/CT in Monitoring Response in Treatment of Non-Hodgkin Lymphoma Patients}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1364-1367}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039675}, abstract = {Aim of the work: positron emission tomography (PET) response assessment of residual nodal masses in patients with lymphoma after completion of therapy is performed visually using Douveille as the reference. The primary objective of this study was to define the role of PET in response assessment of Non Hodgkin Lymphoma patients and define various response criteria. Patients and methods: our prospective study included 40 patients with Non Hodgkin’s lymphoma diffuse large B cell type assessed for response assessment after completion of therapy, two readers independently assessed response by IHP and Deauville criteria. The addition of morphological parameters on CT was assessed in relation to therapy response. Results: Non Hodgkin lymphoma is one of chemosensitive tumors with high ability of nodal and extranodal spread and PET /CT is more sensitive than CT in monitoring response to treatment in non Hodgkin lymphoma diffuse large B cell type patients. Conclusions: PET/CT is the best tool for evaluation of the response to treatment in patients with Non Hodgkin lymphoma diffuse large B cell type, as well as Douveille criteria represent the accurate indicator of response categories determination.PET/CT has an obvious impact on clinical practice according to the response results and activity of residual lesion.    }, keywords = {Fluorodeoxyglucose 18F,Positron emission tomography,Computed tomography,Lymphoma and Therapy}, url = {https://ejhm.journals.ekb.eg/article_13589.html}, eprint = {https://ejhm.journals.ekb.eg/article_13589_1dbfce37f58878221efcb862affa9132.pdf} } @article { author = {Ali, Marwa and Mohammed, Yasser Ali and Abdel Rahman, Marwa El-Sayed}, title = {Role of Electrocardiogram-Gated Multidetector Computed Tomography in Diagnosis of Congenital Heart Disease}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1368-1373}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039676}, abstract = {Aim of the work: this study aimed to assess the role of ECG gated multidetector computed tomography in detection and characterization of congenital heart diseases. Patients and method: this study was carried out in the Radiology Department of Ain Shams University Hospitals. A total of 30 patients presented with clinically/echocardiographically known to have congenital heart disease. They were 17(56.7%) females and 13 (43.3%) males. Their age was ranged from 3 days -18 year old. Results: Regarding the cardiac abnormalities, we found good agreement between Echo and ECG gated MDCT as regard cardiac abnormalities with kappa value measuring 0.771. Regarding great vessels anomalies, we found overall good agreement between Echo and MDCT where k measuring 0.790. As regard extracardiac findings, lung changes that were seen in MDCT only in form of lung consolidation in three cases (10%) and one case of unilateral lung hypoplasia (3.3 %). Conclusion: ECG gated MDCT is considered as an essential non-invasive diagnostic tool for the evaluation of congenital cardiac and extra cardiac great vessels. MDCT is complementary to the cardiac echocardiography especially in complex heart abnormalities.    }, keywords = {MDCT,eCG,congenital}, url = {https://ejhm.journals.ekb.eg/article_13590.html}, eprint = {https://ejhm.journals.ekb.eg/article_13590_0d7c8a53ca37dc0080cf8f2c62aa1ac4.pdf} } @article { author = {Yousrya, Ahmed H. and El-Beshrya, Shady S. and Benyameen, Gergis Nabil}, title = {Fixation of Unstable Neck Femur Fractures in Adults, Review Article}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1374-1380}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039677}, abstract = {Background ː Femoral neck fracture is a common problem especially in young adults. There are different methods of fixation of unstable neck femur fractures in adults, some of which are accompanied by complications. Aim of study: A systematic review on the different methods of fixation of unstable femoral neck fractures in adults with clarifying the incidence of nonunion, avascular necrosis, displacement and other complications in each type of fixation. Methods ː A systematic review of literatures was conducted  on five studies  (306 patients )  published in literature in the  last 10 years using different methods of fixation with inclusion criteria including ː English literature, human studies  on adults aged 18-60 years with unstable neck femur fractures Pauwel grade 3. Exclusion criteria including ːin vitro studies, pathological and non united fractures in people aged below 18 or above 60 years with stable neck femur fractures Pauwel grade 1,2 Results: showed that Achieved union in management by osteosynthesis and primary valgus intertrochntric osteotomy using broad DCP showed better results than by other methods of fixation (cannulated screws , DCS, cephalomedullary nail) and by achieving union percentage of 92,7% as in (MP Singh 2008), the same percentage achieved by fixation by DHS as in (Frank Liporace 2008), followed by 92% rate of union achieved by fixed angle device (DCS or cephalomedullary nail) in (Frank Liporace 2008) Comparing complications in different fixation methods showed that complications are inevitable yet manageable, but higher complications rate associated with fixation of neck femur fractures using DHS by achieving 26,4% rate of nonunion and 26,4% rate of AVN in (carlos Roberto schwartsmann 2017) while rate of non union was 7,3% in valgus intertrochntric osteotomy by broad DCP and rate of AVN was 11% as in (MP Singh 2008). Summary and conclusion Management of unstable neck femur fractures in adults is done by means of direct fixation with cannulated screws, DHS, fixed angle device (DCS or cephalomedullary nail) or osteosynthesis and valgus intertrochntric osteotomy to avoid some adverse effects of the direct fixation methods,  so,recent studies showed that valgus intertrochntric osteotomy achieve better results than traditional methods with  less complications.    }, keywords = {Unstable femoral neck fractures,pauwelʾs III,young adults,primary valgus osteotomy}, url = {https://ejhm.journals.ekb.eg/article_13591.html}, eprint = {https://ejhm.journals.ekb.eg/article_13591_a1272a9d7e4604eff8e1926a36b48df9.pdf} } @article { author = {Althbiti, Abeer Abdulrahman J and Al Khatib, Farah Mamoun and AL-Ghalayini, Nuha Ayman}, title = {Telemedicine: Between Reality and Challenges in Jeddah Hospitals}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1381-1389}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039678}, abstract = {Background: Telehealth system is defined as the use of electronic information and telecommunication technologies to support and promote long-distance clinical health care, patient and professional health-related education, public health and health administration. The main aim of this study is to assess difficulties and limitations in hospitals that have healthcare system in Jeddah ,Saudi Arabia from applied new techniques such as Telehealth and if they have tendency to use this technique or not . This study also aims to determine the association between increase in quality of healthcare system and new techniques applied such as Telehealth system by literatures reviews. Methods: A cross-sectional study was conducted in 114 medical providers who worked at hospitals in Jeddah, Saudi Arabia. The medical providers were interviewed using paper-based questionnaire as well as electric-based questionnaire, data collected and analyzed by using SPSS. Results: Interested participants in technology were high by 59%, participants actually interested to implement advanced Telehealth Technologies by percent of 84%, and respectively that factor of lack of awareness were a major factor by 90%, factor of this technique may take a new health care system and it may being a time consuming and take a lot of money and training 71%, this previous percentage and frequency also present factor of resistance in both medical social and community. 63% saw that it is hard to get someone qualified as well as 62% saw that there is a lack of human resources in hospitals and misusing factor took a percent of 50%, some of participants saw that There is no strong need for this technique and he is think it is not important or it is not differ from face to face visit by percent of 40%. Conclusion: There are a high acceptance of new technique in hospitals and regardless of demographic information there is a high interest in technology, we determine most factors that may limit implementation of this technique and these factors may give us a general look about challenges of implementing the other techniques too, if we can determine the problems then we can resolve them to achieve high quality healthcare systems in our hospitals.  }, keywords = {Telehealth,Telemedicine,Quality of healthcare system,limitations,New technologies}, url = {https://ejhm.journals.ekb.eg/article_13592.html}, eprint = {https://ejhm.journals.ekb.eg/article_13592_1ce71ec435c9cab1f66f814947f8a8fb.pdf} } @article { author = {Hasan, Omar Adnan and Hassan, Mohamed Amir and Fawzy, Ehab Kamal and Maarouf, Ahmed Mahmoud}, title = {Anatomical Variations of Nasal Structures in Chronic Rhinosinusitis as Detected by Computed Tomography Scan}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1390-1394}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039679}, abstract = {Background: There is a wide range of anatomical variations affecting the nose, paranasal sinuses (PNS) best diagnosed by Computed Tomography (CT). These variations may cause impairment of mucociliary drainage of the PNS resulting in sinusitis. Objectives: In this paper, the aim is to study the relationship of the anatomical variations of the lateral nasal wall, nasal septum and paranasal sinuses with the occurrence of chronic rhinosinusitis. Methods: The study included two groups of patients, the first has chronic rhinosinusitis while the second was without chronic rhinosinusitis. Anatomical variations of nose and paranasal sinuses which are nasal septal variations, concha bullosa, agger nasi cells, haller cells, paradoxical middle turbinatesand uncinate process variations were detected in both groups to investigate the relation between the anatomical variations and chronic rhinosinusitis. Results: A case control study was done which showed that there a significant statistical relation between nasal septal deviation and chronic rhinosinusitis. Conclusion: There was a significant relation between nasal septal deviation and chronic rhinosinusitis.  }, keywords = {Anatomical variations,Chronic Rhinosinusitis,CT scan}, url = {https://ejhm.journals.ekb.eg/article_13593.html}, eprint = {https://ejhm.journals.ekb.eg/article_13593_0b010ba94f9d6052e329b14300e0377c.pdf} } @article { author = {Badri, Sultan Mohammed and Arafsha, Lujain Hamza and Bin Hassan, Khaled Abdullah and Shawani, Mishary Ali and Alasmari, Ahmed Ali and Rofidi, Khalid Ali and Alnomari, Lojein Faisal and Tammar, Aseel Sameer and Calacattawi, Abdullah Waheed and Almosfer, Waleed Abdulaziz and Baqasi, Abdulrahman Mohammedsaeed}, title = {Prevalence of Metabolic Syndrome and Its Related Factors among Adults}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1395-1399}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039680}, abstract = {Background: This study was designed to estimate the prevalence of metabolic syndrome and its determinants, as well as baseline information about the related factors among the adult population. Method: A cross sectional study of 252 participants has been conducted in February 2017 at King Abdulaziz Hospital and Oncology Center. A structured questionnaire was administered, collecting information on personal medical history as well as socio-demographic and behavioral characteristics. Anthropometrics, blood pressure, and venous blood samples were obtained. Metabolic syndrome was defined according to the International Diabetes Federation (IDF) criteria. Results: The prevalence of metabolic syndrome was 32% according to the IDF. In addition to WC is the best predictor for meta­bolic syndrome in the Saudi population. Conclusion: This study showed that Metabolic Syndrome is highly prevalent in Jeddah, Saudi Arabia. Also there is a high prevalence of hypertension, obesity and diabetes. Therefore, to reduce the risk of cardiovascular events, screening for and early detection of risk factors for Metabolic Syndrome are suggested.  }, keywords = {Metabolic syndrome,adults}, url = {https://ejhm.journals.ekb.eg/article_13595.html}, eprint = {https://ejhm.journals.ekb.eg/article_13595_24deca68a935596b18189f70f151c6ed.pdf} } @article { author = {M.M, Abdellatif and A.K, El Gogary and H.F, El Shishtawy and D.A, Farrag}, title = {New Agents in Treatment of Psoriatic Arthritis}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1400-1404}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039681}, abstract = {Background: psoriatic arthritis is a long term inflammatory arthritis. Psoriatic arthritis is leading to bone erosion, joint destruction and associated with nail diseases, dactylitis, enthesitis, sponnylitis and uveitis. Aim of this study was to review the new lines of treatment for psoriatic arthritis with or without skin affection. Treatment, the underlying process in psoriatic arthritis is inflammation; so, treatments are directed to reduce and control inflammation. Although no clear correlation exists between joint inflammation and the skin in every patient, the skin and joint aspects of the disease often must be treated simultaneously. However, only certain therapies are effective for psoriasis and psoriatic arthritis. Systemic agents, can be used for both skin and joint manifestations, it includes methotrexate and ciclosporin. For the biologic agents, the tumour necrosis factor inhibitors such as adalimumab, etanercept, infliximab, golimumab and certolizumab are effective. Ustekinumab is a recently agent belonging to the group of anti-IL-12p40 antibodies and has been shown to be efficacious. Newer drugs in the treatment which have shown efficacy for both psoriasis and psoriatic arthritis consist of the anti-IL-17 agent, secukinumab, and a phosphodiesterase-4 inhibitor, apremilast.  As well as the oral JaK inhibitor, tofacitinib, have very limited but promising data.    }, keywords = {Psoriasis,Psoriatic arthritis,anti- TNF,anti-IL-17,small molecules inhibitors}, url = {https://ejhm.journals.ekb.eg/article_13597.html}, eprint = {https://ejhm.journals.ekb.eg/article_13597_b735aad3330b95516d2732e307cf3923.pdf} } @article { author = {Sabet, Sameh Saleh and Fakhry, Hany Mohammed and Abdelkader, Khaled Aly and Elkiey, Alaa Ahmed Reyad}, title = {The Relationship of Complexity of Coronary Artery Disease and Complexity of Peripheral Arterial Disease}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1405-1410}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039682}, abstract = {Background: Atherosclerosis is a disease of the large and medium-sized arteries causing luminal narrowing (focal or diffuse). Aim of the Work: Measure the relationship between coronary artery disease complexity using SYNTAX score and peripheral arterial disease complexity using TASC II score. Patients and Methods: The study was designed as a prospective single center cross-sectional study conducted at Ain shams university hospitals. The study included 50 patients referred for elective coronary angiography in the time period from August 2016 till July 2017.  Results and conclusion: Patients with complex PAD had complex CAD. This finding suggested that PAD and CHD are different clinical manifestations of atherosclerosis and systemic pan vascular involvement is present in patients with complex lesions. (P-value 0.046).  }, keywords = {Peripheral vascular disease,Coronary,Artery Disease,Complexity}, url = {https://ejhm.journals.ekb.eg/article_13599.html}, eprint = {https://ejhm.journals.ekb.eg/article_13599_6f5ca4cbfb3ac08a296ba849c43081ea.pdf} } @article { author = {Gashgary, Rami Amin and Alshehri, Tariq Mohammed and Aljomai, Ibraheem Abdulrahman and Alghamdi, Hani Hussain and A Alasmri, Mohammed Ali and Alshamrani, Roya Aali and jumaymi, Amal kamal and alsharif, Alaa jafar and AlHakami, Roaa Saeed and Musallam, Sara talal and Almazrouie, Waad ahmed and Azzeem, Reema Abdulkader and Baaboud, Maha Salem and Sehaqi, Sawsan Badr}, title = {Relationship between Ceramic Restorations}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1411-1417}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039683}, abstract = {Sintered ceramics and glass-ceramics are broadly utilized as biomaterials for dental restoration, particularly as dental onlays, inlays, veneers, crowns or bridges. Biomaterials were advanced whichever to veneer metal frameworks or to create metal-free dental restorations. Diverse sorts of glass-ceramics and ceramics are obtainable and important today to satisfy customers' needs (patients, dentists and dental technicians) with respect to the properties of the biomaterials and the processing of the products. All of these different types of biomaterials already cover the entire range of indications of dental restorations. Today, patients are increasingly interested in metal-free restoration. Glass-ceramics are particularly suitable for fabricating inlays, crowns and small bridges, as these materials attain extremely solid, aesthetic outcomes. High-strength ceramics are favoured in conditions where the material is exposed to high masticatory forces.  }, keywords = {Dental Restoration,Ceramics,Computer-Aided Design,Computer-Aided Manufacturing,Zirconia}, url = {https://ejhm.journals.ekb.eg/article_13600.html}, eprint = {https://ejhm.journals.ekb.eg/article_13600_8fdb736c3562323e38dd6af68fc0bfa5.pdf} } @article { author = {Mohamed, Jihan A. and Abo-Elkhei, Omaima I.}, title = {The Role of Brimonidine Eye Drops as an Adjunctive Therapy for Optic Nerve Protection in Patients with Controlled Open Angle Glaucoma}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1418-1424}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039684}, abstract = {Objective:  This study aims to evaluate the neuroprotective role of brimonidine eye drops in patients with controlled open angle glaucoma. Methods: This study is prospective and non-randomized. It was done between January,2014 and April, 2016. It included 33 eyes with controlled open angle glaucoma who were referred to Al Zahraa University Hospital. Brimonidine eye drops (BMD) were administrated. Follow up was done every 6 months for 12 months and three visual field (VFs) examinations were done to all patients using Humphrey Visual Field Analyzer II 745.Results: There is a gradual decline of IOP mean values from 15.3 ± 3.6 mmHg baseline to 13.5 ± 3.0 mmHg after 6 months and to 11.7±2.1 mmHg after one year of the use of BMD eye drops. The mean values of MD measurements showed improvement after BMD eye drops useas it becomes lower than baseline values after 6 months (-7.2 ± 5.2 vs -5.1 ± 3.7 respectively), with further improvement after one year of BMD eye drops use as it becomes lower than that after 6 months (-5.1 ± 3.7 vs -3.3 ± 3.6 respectively). Similarly, PSD measurements after 6 months (4.6 ± 3.1 vs 4.0 ± 3.1). Furthermore, measurement after one year of BMD eye drops use show more improvement as it becomes lower than measurements after 6 months (4.0 ± 3.1 vs 3.4 ± 4.4). Conclusion: Neuroprotection can be used to reduce the risk of glaucomatous progression independent of its effects on IOPas the future treatment modality.    }, keywords = {Glaucoma,IOP,visual field,Brimonidine eye drops}, url = {https://ejhm.journals.ekb.eg/article_13601.html}, eprint = {https://ejhm.journals.ekb.eg/article_13601_5db129cdee84618d7d1fc95c4289567d.pdf} } @article { author = {Zaki, Christien Magdy Fouad and Nasr Al Deen, Mohammad Abd El Hameed and Mamdouh, Ahmed Mohamed}, title = {The Role of local Anesthesia Instillation in Pain Alleviation Post Laparoscopy}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1425-1435}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039685}, abstract = {Background: Gynecological laparoscopy is now becoming a more popular technique for diagnosis and treatment of infertility cases; however gynecological laparoscopy is usually followed by Post-operative pain which may be attributed to small incision in abdominal wall or as a result of diaphragmatic irritation by inflating gases. Aim of the Study:  was to assess the role of local anesthesia instillation in pain relief after laparoscopy. Patients and methods: the present study was a randomized trial study performed on 146 women aged 20-35 years, admitted to Ain Shams University hospitals. Patients were split into 2 equal groups, Group(A): further subdivided into A1 and A2 whom undergone diagnostic and operative laparoscopy respectively- patients administrated 20ml of 0.25% of Bupivacaine instilled intraperitoneal-and Group (B): further subdivided into B1 and B2 -whom undergone diagnostic and operative laparoscopy respectively-Patients administrated 20ml of 0.75% of Ropivacaine instilled intra-peritoneal. Vital signs and Pain scores were measured preoperatively, immediate postoperative, 1 hours, 2 hours, 4 hours, 8 hours, 12 hours postoperatively. Data was collected, tabulated, then analyzed using IBM© SPSS© Statistics version 22 (IBM© Corp., Armonk, NY). Results: administration of 20mL of Ropivacaine 0.75% at the end of technique gave pain relief for four hours in group B1 and pain relief for three hours in group B2, associated with an increase in heart rate and blood pressure for two hours in group B1 and B2 for three hours. Conclusion: instillation of local anesthetic after laparoscopy promotes pain relief post operatively and further minimizes the postoperative hospital stay.  }, keywords = {Laparoscopy,ropivacaine,Bupivacaine,local anesthesia,Postoperative Pain,intraperitoneal instillation}, url = {https://ejhm.journals.ekb.eg/article_13603.html}, eprint = {https://ejhm.journals.ekb.eg/article_13603_60df40a7c7a0eda3735437111a076d62.pdf} } @article { author = {Kashha, Ahmad Mohammad and Zailai, Ayat Hassan and Alsaadi, Waad Suliman and Almutawa, Rahaf Yaseen and Albarakati, Moath Hassan and Almhmadi, Amir Hamoud and Alkhuzaie, Wafa Saleh and alZahrani, Abdullah Hussain and balbaid, Shahad Khalid Ali}, title = {Causes and Management of Wound Infection}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1436-1441}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039686}, abstract = {Aim of the work: the care of patients with a wound infection may seem conflicting, various diverse antibiotic preparations may be utilized after some time with an end goal to control the causative organism and a kwide range of treatment procedures might be utilized by various healthcare experts. With the approach of Independent (Supplementary) Nurse Prescribing Courses and the future potential for medical caretakers with reasonable capabilities to recommend antibiotics for patients with wound infections, there is  a requirement for attendants and different specialists to review and update their insight into this vital subject.  }, keywords = {wound infection,Treatment,antibiotic,Antiseptics}, url = {https://ejhm.journals.ekb.eg/article_13604.html}, eprint = {https://ejhm.journals.ekb.eg/article_13604_296d046d7d997be1c3b99135fc3e4760.pdf} } @article { author = {Elkady, Osama Saleh and Kamel, Osama Ismail and Badawy, Wesam Abd Elmohsen Mohammed}, title = {Role of The First Trimester Maternal Serum High Sensitivity C–Reactive Protein and Second Trimester Placental Volume Measurement by 3d Doppler Ultrasound in Early Detection of Pre-Eclampsia}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1442-1451}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039687}, abstract = {Background: Pre-eclampsia (PE) is a disorder of pregnancy characterized by the onset of high blood pressure and a significant amount of protein in the urine. It affects 2–8% of pregnancies worldwide. Complications include impaired liver function, kidney dysfunction, visual disturbances and red blood cell Breakdown. PE continues to be a major cause of maternal and fetal mortality. Thus, efforts at discovering reliable prediction models to identify those at risk at an early stage are critical. And since Placental maldevelopment plays a pivotal role in the pathogenesis of PE, therefore, evaluation of the placental volume and vascular flow indices using different techniques can contribute in the prediction of adverse pregnancy outcomes. Aim of the Work: to assess the ability of high sensitivity c reactive protein (Hs CRP) and 3D power Doppler of  placental volume and vascular flow indices to predict Preeclampsia. Patients and methods: This is a prospective cohort study by multi operators conducted on 200 women with singleton pregnancy who underwent screening for eligibility and eventually included with respect to the inclusion criteria. The study has been done during the period from October 2015 till December 2016. 1st trimesteric serum level of HsCRP detection tests, 1st trimesteric abdominal ultrasonographic examination and 2nd trimesteric color-Doppler techniques were done and placental volume was measured and Follow up at delivery to confirm Pre-eclampsia has followed.  Study Outcomes included the development of hypertention, limb edema or other of pre-eclampsia complication. Data were statistically analyzed using IBM© SPSS© Statistics version 23. Results: HsCRP was significantly (P≤ 0.05 and 0.01) high in Pre-eclampsia group compared to the normal pregnancy group. Moreover, Placental volume (PV), Vascularization index (VI), Flow index (FI) and Vascularization flow index (VFI) were significantly (P≤ 0.05 and 0.01) lower in Pre-eclampsia group than the normal pregnancy group.Conclusion: there was a statistically significant correlation between first-trimester HsCRP and the 2nd trimester placental volume and its vascular indices in the prediction of complications of uteroplacental insufficiency. Further studies with large number of patients have to be carried out to reach conclusive evidence of the significance Doppler in prediction of pre-eclampsi, .and HsCRP.     }, keywords = {preeclampsia,C –Reactive Protein,3d Doppler Ultrasound,Placental Volume Measurement}, url = {https://ejhm.journals.ekb.eg/article_13605.html}, eprint = {https://ejhm.journals.ekb.eg/article_13605_8dd75b513f2735c4e947fb022de56ed7.pdf} } @article { author = {Swidan, Khaled H. and Abou-gamrah, Amgad A. and AbdelShafy, A. and Abughanima, Marwa O.}, title = {Effect of Normal Saline Infusion versus Dextrose 5% Infusion on The Duration of Labor in Nulliparous Women: Randomized Controlled Trial}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1452-1461}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039688}, abstract = {Background: During labor, it is common for women to have no or little nutrient intake, inspite of the fact that the demand of energy increases as a result of skeletal and smooth muscle contraction. Aim of the Work: This study aims to evaluate the effect of intravenous dextrose-saline infusion compared with intravenous normal saline infusion in acceleration of active phase of labor in nulliparous women. Patients and Methods: Thisprospective randomized controlled trial was conducted on nulligravida patients recruited from those attending labor ward of Ain Shams University, Maternity hospital who are, singleton gestation, 36 weeks or more. Results: Total duration of first and second stages of laborwas significantly shorter among Dextrose 5% group than among Normal saline group. Conclusion: Dextrose 5% solution administration is associated with shortened duration of labor because it provides the required energy for pregnant mothers during the labor procedure through the detraction of harmful metabolites produced together with ATP production and results in acceleration of the labor process. Recommendations: Dextrose 5% administration during labor is associated with shortened duration of labor. Further studies with larger sample sizes, more outcomes and different dextrose concentration is required to determine the exact effect of dextrose.  }, keywords = {Dextrose,Labor,nulliparous women,saline infusion}, url = {https://ejhm.journals.ekb.eg/article_13606.html}, eprint = {https://ejhm.journals.ekb.eg/article_13606_a7371c7b760dc9860d9b5f2b5aad5bae.pdf} } @article { author = {Alkulaib, Faisal K and AlFuraih, Ibrahim M and Alabbad, Zainab M and Almusaad, Mohammed N and ALmeshari, Ahmed A and ALwesaibie, Ahmed S and Alhamdan, Zaid A and Alsaleh, Kawthar H and AlJazzar, Ali M and Alshuwair, Faisal N and AL-Thobiati, Hanadi H and Shaikh, Mohammed A and Alqahtani, Nouf and Alamri, Nawaf M and Alharthi, Mohammed S and Alhawaj, Ali H}, title = {Awareness of Tuberculosis Among General Populations in Riyadh Region and Its Surroundings}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1462-1468}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039689}, abstract = {Background: In the past, and until the end of the twentieth century, TB was one of the major causes of death. Nowadays, the world is still challenging with TB control, even though the percentage of TB has been decreased. In Saudi Arabia, annual TB incidence rate is 12/100,000 population. Even though incidence rate of TB has been decreased in Saudi Arabia, still TB not fully control. Getting the world free from TB will not happen if general populations don’t aware about TB. Aim: To evaluate knowledge, attitude and practice towards TB among general populations in Riyadh region of Saudi Arabia. Method: This is a cross-sectional study done by selection of general populations in Riyadh region by random sample. The study was done by a self-administrated questionnaire that contains demographic data part and other parts that evaluate the awareness of TB. Comparison of results between many variables by Chi-Square Test and P-value < 0.05 was considered as a significant level. Result: Around 519 participants in this study (Response rate 94.36%) by mean age 33. Only 3.3% have a history of TB and 21.1% have relative with a history of TB. Only 19.4% of participants have good knowledge, only 18.0% have favorable attitude and most of the participants have a good practice (67.6%). People with high degree educational level have better knowledge than others. Non-Saudi people are better than Saudis in practice and people who have relative with a history of TB are better in attitude than others. In practice, Female are better than male, married people also better than single, people with a history of TB or relative with a history of TB are better than others. Conclusion: Papulations in Riyadh and its surroundings have a very low level of knowledge toward TB. Most people have unfavorable attitude level. Even though there is a high level of good practice but still it needs to be increased. Education has an important role to increase the level of knowledge about TB.        }, keywords = {tuberculosis,TB,Saudi Arabia,General papulation,Riyadh Region}, url = {https://ejhm.journals.ekb.eg/article_13608.html}, eprint = {https://ejhm.journals.ekb.eg/article_13608_cabca2bd6c713b0e8bed88326f091f80.pdf} } @article { author = {El-Shahawy, Hazem F. and Hendawy, Sherif F. and Hassanin, Alaa S. and Abd El-Azeem, Mona M.}, title = {Estimation of Serum Ferritin Level in Preterm Labour}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1469-1474}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039690}, abstract = {Background: Preterm birth is the leading cause of newborn deaths and also the leading cause of death in children under 5 years of age. There is wide spread suspicion that subclinical infection is a common accompaniment and cause of preterm labour. Ferritin is an acute phase reactant and it increases during inflammation. Aim: The objective of this study is to measure serum ferritin level in cases of established preterm labour (PTL) as a possible marker of infection. Study Setting: This study conducted at Ain Shams University Maternity Hospital from March 2015 to November 2015. Study design:  A case-control study. Patients and Methods: The study involved 2 groups. Study population: 60 cases divided into two groups: Group (I): included 30 patients with established (PTL) between 30 to 34 weeks gestational age (GA). Group (II): (Control group) 30 patients with uncomplicated pregnancies between 30 to 34 weeks GA. Serum ferritin was analyzed in the 2 groups.  Results: The results pointed out that there was statistically significant difference between two groups as regarding serum ferritin level as p value was  <0.0001 . The median serum ferritin level in preterm labour group and control group was 150 (100 – 150) ng/ml and 20 (15 – 25) ng/ml respectively. The best cut off value of serum ferritin as predictor of preterm labour was >55 ng/ml  with a sensitivity of 96.7% and specificity of 96.7 %. Conclusion: Serum ferittin can be used as a marker of preterm labour.  }, keywords = {Infection,Preterm Labour,serum ferritin}, url = {https://ejhm.journals.ekb.eg/article_13609.html}, eprint = {https://ejhm.journals.ekb.eg/article_13609_35497690ef3915b6c1690480ad19921f.pdf} } @article { author = {Ibrahim, Mοhamed Harοun Haѕѕan and Abοgamra, Ѕhrief Hamed Mοѕtafa and Abdelazeem, Ahmed Ѕamy Abdelrahman}, title = {The Effect of Partial Ѕplenic Artery Embοlizatiοn in The Cοntrοl of Hyperѕpleniѕm}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1475-1480}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039691}, abstract = {Aim of the work: A descriptive study to investigate the effect of partial splenic artery embolization in the control οf hyperѕpleniѕm. Patients and methods: Fifteen patient with hyperѕpleniѕm due to chronic liver disease were included. This was a prospective study that included patients with thrombocytopenia (platelet count <70.000) which referred from the Tropical Department at Ain Shams University Hospitals to the Interventional Radiology Unit for partial splenic embolization. Partial splenic arterial embolization was performed to reduce the hyperfunction of the spleen in patient with hypersplenism. Results: The mean age of the selected patients was about 48years old. The most common cause of hypersp1enism is chronic 1iver disease due to HCV infection in 12 patients (80%), bi1harzial disease in 2 patients (13%) and mixed HCV and bi1harzial infection in 1 patient (7%). The moѕt frequent riѕk factorѕ were paѕt history of b1ood transfusion in 7 patientѕ (47%), paѕt history of ѕurgery in 5 patientѕ (33%), and paѕthiѕtory of parentral antibilharzia1 treatment in 3 patientѕ (20%). Bleeding tendency waѕ found in 15 patientѕ (100%), while abdominal pain waѕ found in 12 patientѕ (80%). Aѕ regardѕ other ѕymptomѕ, lower limb swelling and abdominal enlargement were noticed in 30% and 20% of patient reѕpectively, anemic manifeѕtationѕ and recurrent infectionѕ were noticed in 53% and 47% of patient reѕpectively. Poѕtembolization syndrome waѕ the moѕt common complication and occurred in all patientѕ (100%). Newly developed aѕciteѕ occurred in 2 patientѕ (13%). Ѕplenic abѕceѕѕ waѕ developed in 2 patientѕ (13%). No other complications had been reported. Conclusion: Partial splenic arterial embolization is an effective method for the treatment of thrombocytopenia resulting from hypersplenism in patients with liver cirrhosis; however, the procedure is associated with complications, and hence must be performed only if clearly indicated and by an expert person.  }, keywords = {Splenic arterial embolization (SAE),Partial splenic arterial embolization (PSE),Hepatitis C Virus (HCV),Complete blood count (CBC),Ultrasound (US), Computed Tomography (CT)}, url = {https://ejhm.journals.ekb.eg/article_13610.html}, eprint = {https://ejhm.journals.ekb.eg/article_13610_0285570308d79bd435efd05141aed7e8.pdf} } @article { author = {M.M, Sadek and M.I, Amer and M.M., Abd El Aleem}, title = {Fetal Head Circumference as a Predictor of Successful Spontaneous Vaginal Delivery}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1481-1485}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039692}, abstract = {Background: Intrapartum head circumference is an integral part of sonographic models and important for the purpose of fetal weight estimation as well as in cases which abnormal fetal head growth is suspected, it is considered the interface between maternal pelvis and fetus. Aim: This study aims to assess the accuracy of fetal head circumference compared to expected fetal weight as a predictor of spontaneous vaginal delivery Methods: A prospective observational study was conducted on 996 women in active stage of labor admitted to Labor ward of Ain Shams University Maternity Hospital and Labor ward in Manshiet El Bakry general hospital. Results large head circumference (odds ratio, 2.8; 95% CI, 1.37–5.73; p-value; .005  was independent predictors for cesarean delivery, and no significant difference on mode of delivery between different expected fetal weight, Conclusion: A large head circumference is more strongly associated with unplanned caesarian section than high expected fetal weight.    }, keywords = {intrapartum head circumference,spontaneous vaginal delivery}, url = {https://ejhm.journals.ekb.eg/article_13611.html}, eprint = {https://ejhm.journals.ekb.eg/article_13611_abde6ea843c2daa0a46c62de8570eec6.pdf} } @article { author = {Alqurashi, Amani Jamil and Alshafi, Abdullah Saleh and Aleisa, Saud Mohammed Saud and Albahrani, Zainab Yaseen and Alalyani, Abdullah Saad and Almutairi, Abdulrahman Mubarak M and Abdulghani, Alzaidi Ahmed and Almoumen, Faisal Abdullah and Alkhudhairi, Osama Sulaiman}, title = {Assessment of Knowledge and Attitude and Practice of Safety, Effectiveness and Consequences of Bariatric Surgery Among Community In Saudi Arabia}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1486-1490}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039693}, abstract = {Background: Obesity was reported to be highly prevalent in KSA. Bariatric surgery is considered as the most effective, beneficial, and permanent method for treatment of obesity and decreasing the long-term mortality Objectives: Evaluating the knowledge and beliefs about the safety and effectiveness of bariatric surgery among adult Saudi population.        Methods: A questionnaire based on cross-sectional study was distributed among 790 adult Saudi population form January 2017- June 2017. The questionnaire was based on 4 aspects including subject’s demographics, anthropometric measures, knowledge about obesity and its causes and beliefs about Bariatric surgery. Results: Overweight and obesity were found to be high among the studied population. The most common causes for obesity were bad life style habits and genetic factors. There was a good knowledge about obesity but low favorable beliefs about bariatric surgery as 55.7% of subjects have non-favorable beliefs about the Bariatric surgery and 44.3% have favorable beliefs about the surgery. The favorable beliefs about bariatric surgery were significantly associated with female gender and subjects having high BMI scores. Conclusion: The knowledge of subjects about obesity and its preventive measures were high but the favorable perceptions about Bariatric surgeries were low. These results indicated that efficient educational programs about obesity and Bariatric surgeries are needed for control of obesity and its complications as well as increasing the availability of weight loss surgeries.  }, keywords = {KAP,safety,Effectiveness,Consequences,Bariatric surgery,KSA}, url = {https://ejhm.journals.ekb.eg/article_13624.html}, eprint = {https://ejhm.journals.ekb.eg/article_13624_1a8bf48c0b5996c3e6888bab424f36b2.pdf} } @article { author = {Alolaywi, Ahmed Naif and Kilani, Mohammed Ahmedhani and Almani, Abdullah Zamil and Najmi, Hatim Hassan and Alanazi, Abdulaziz Dhaifallah and Alruwaili, Fahad Saleh and alrubayyi, Abdulaziz Faisal and Zaky, Khaled abd Alsalam}, title = {Assessment and Evaluation of the Level of Satisfaction After Lasik Among Myopic Patients in Aljouf City}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1491-1496}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039694}, abstract = {Background: Laser in situ keratomileusis (LASIK) has being used as the most effective and common refractive surgical procedure of choice for correction and elimination of myopic errors. The use of refractive surgeries has aided subjects to get rid of contact lenses either soft or rigid as well as eye glasses. Objective: Evaluate the level of satisfaction and the impact on the quality of life in myopic patients after a LASIK operation. Methods: This is a cross-sectional and community based survey study in which 111 participants were enrolled. All patients underwent a data collection and Satisfaction assessment including a 29 Likert model statements. Results: High levels of satisfaction (81.9%) and quality of life (76.5%) were found among myopic patients. Most of patients did LASIK to get rid of their glasses and to have good visual results regarding to reading, driving, swimming at day light or at night. The majority of subjects revealed that the surgery achieved their goal, and 83.8% would praise LASIK for friends. Females showed a significant higher motive for performing LASIK to improve their general look. The medical professions showed lower levels of satisfaction toward quality of vision than educational professions. Conclusion: A high level of satisfaction, quality of life and vision satisfaction was found in the present study after LASIK among myopic patients in Aljouf city.  }, keywords = {LASIK,Level of Satisfaction,Myopic Patients,Aljouf City,KSA}, url = {https://ejhm.journals.ekb.eg/article_13625.html}, eprint = {https://ejhm.journals.ekb.eg/article_13625_c0b265b301fe2bd5c7eaa02409969e1b.pdf} } @article { author = {Elkady, Galal A. and GabAllah, Raoof R. and Mansour, Amr Z.}, title = {Magnesium in Intensive Care Unit: A Review}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1497-1504}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039695}, abstract = {Aim of the work:  there is an increased interest in the role of magnesium ions in clinical medicine, nutrition and physiology. Magnesium affects many cellular functions, including transport of potassium and calcium ions and modulates signal transduction, energy metabolism and cell proliferation. Magnesium deficiency is not uncommon among the general population: its intake has decreased over the years. Magnesium derangement results in various symptoms and signs; magnesium supplementation or intravenous infusion may be beneficial in various diseased states; so this review aimed to highlight the physiology of magnesium in humans, the derangement of magnesium in the form of hyper and hypomagnesemia , their clinical picture and the clinical and therapeutic uses of magnesium in the critical ill patients  . Methods: references were obtained from Medline, Google Scholar and Ovid from 1960 to 2017. All categories of articles (clinical trials, reviews, or metaanalyses) on this topic were selected. Conclusion: magnesium is a critical physiological ion; it has many known indications in anesthesiology and intensive care because of its interactions with drugs used in intensive care. Intensive care specialists need to have a clear understanding of the role of this important cation. Magnesium is gaining recognition as a clinically important electrolyte in intensive care and emergency medicine .Recent clinical trials and case reports increase interest of magnesium as an effective therapeutic agent for potentially life-threatening problems such as torsade de pointes, digitalis toxicity, bronchospasm and alcohol withdrawal, subarachnoid hemorrhage, acute myocardial infarction, preecalmsia , eclamsia ,hypertension , diabetes , metabolic syndrome and cardiac arrhthymias  .  }, keywords = {physiology of magnesium,hyper and hypomagnesemia,magnesium in ICU}, url = {https://ejhm.journals.ekb.eg/article_13626.html}, eprint = {https://ejhm.journals.ekb.eg/article_13626_a03d5f65efa9f4b6460056e47d3f1ac2.pdf} } @article { author = {Saleha, Hanan M and Shararab, Manal A and Habib, Mohamed A}, title = {Assessment of Serum Desnutrin Levels in Patients with Acne Vulgaris}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1505-1512}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039696}, abstract = {Background: Acne vulgaris is a common chronic skin disease involving blockage and/or inflammation of pilosebaceous units (hair follicles and their accompanying sebaceous gland). Desnutrin is the major triglyceride lipase in the adipose tissue of mice and excessive secretion from adipocytes results in decreased triacylglycerol storage and increased lipolysis, fatty acid oxidation and thermogenesis. Objective: The aim of this study is to evaluate serum level of Desnutrin in acne vulgaris patients and correlate it with disease severity. Patients and Methods: This study was performed on 40 patients with active acne lesions and 40 healthy subjects with no previous history of acne and no active acne lesions as controls. The control group was composed of age, gender, and Body mass index (BMI) matched individuals. All the patients were recruited from the outpatient clinic of Dermatology & Venereology Department, Ain Shams University hospitals, from March 2016 till August 2016.Serum desnutrin assessment was done by ELISA kit using Sandwich-ELISA as a method. The Micro elisa stripplate has been pre-coated with a Horse Radish Peroxidase antibody specific to desnutrin. The optical density was measured spectrophotometrically. Results: There was a significantly lower level of serum desnutrin among cases compared to that of control group, while the fasting blood glucose level was significantly higher among cases compared to that of control group. The collective data from both study groups showed a significant negative correlation between the mean serum fasting blood glucose level and desnutrin level. There was no significant correlation between the severity of acne and serum desnutrin level. Conclusion: The level of serum desnutrin can affect the occurrence and the progression but not the severity of acne among susceptible individuals. The level of fasting blood glucose is also of value regarding the occurrence of acne and has a negative effect on the level of desnutrin.    }, keywords = {Acne,Serum desnutrin,severity,fasting blood glucose,Lipid profile}, url = {https://ejhm.journals.ekb.eg/article_13627.html}, eprint = {https://ejhm.journals.ekb.eg/article_13627_3ef9a3e11bf8161ed38f89fde5d8e194.pdf} } @article { author = {Almutairi, Abdulrahman Faleh N and Shafi, Rahaf Wajih and Albalawi, Shahad Ahmed and Basyuni, Mohammed Adel and Alzahrnai, Abdulaziz A. and Alghamdi, Ayman Saeed and Alhaifi, Abdulaziz Abdulilah and Alshehri, Adel Ahmed and Al-Gadouri, Muath Ahmad}, title = {Acute and Chronic Sinusitis Causes and Management}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1513-1519}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039697}, abstract = {Sinusitis is categorized by inflammation of the lining of the paranasal sinuses. As the nasal mucosa is instantaneously involved and as sinusitis infrequently occurs without concurrent rhinitis, rhinosinusitis is currently the preferred term for this condition. Acute sinusitis is a clinical diagnosis; thus, an understanding of its presentation is of paramount importance in differentiating this entity from allergic or vasomotor rhinitis and common upper respiratory infections. No precise clinical sign or symptom is sensitive or specific for acute sinusitis, so the overall clinical impression should be used to guide management. Chronic sinusitis is an inflammatory procedure that includes the paranasal sinuses and persists for 12 weeks or longer. The literature has reinforced that chronic sinusitis is nearly always accompanied by concurrent nasal airway inflammation and is frequently preceded by rhinitis symptoms; hence, the term chronic rhinosinusitis (CRS) has evolved to more accurately define this condition. Treatment of sinusitis, whether medical or surgical, is intended at decreasing inflammation and obstruction in the sinonasal passages. Antibiotics, even though frequently used in sinusitis, ought to not be managed unless there is suspicion of an acute bacterial infection.  }, keywords = {chronic,Rhinosinusitis,Antimicrobial Treatment,sinus}, url = {https://ejhm.journals.ekb.eg/article_13629.html}, eprint = {https://ejhm.journals.ekb.eg/article_13629_cd909103c14e67a3f2ede14e35a907f4.pdf} } @article { author = {Abdelmegeed, Abdelmegeed I. and M.Riad, Amr A. and Al Ansary, Amin M. and Darwish, Mohamed A. A.}, title = {Lidocaine and Dexamethasone for Paracervical Block Anesthesia in Women with Missed Abortion (Randomized Controlled Trial)}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1520-1526}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039698}, abstract = {Aim of the work: nerve block is a technique whereby local anesthetic solutions are infiltrated around a nerve (or perineurally) to provide anesthesia and analgesia. Nerve block for intraoperative and postoperative pain management is associated with improved analgesia, fewer opioid-related adverse events, earlier ambulation and shorter hospital stay when compared to intravenous opioid analgesia alone.This study aimed to assess the efficacy of adding dexamethasone to lidocaine for cervical block anesthesia for prolonging the duration and anesthetic effect in women with missed abortion undergoing vacuum evacuation.  Patients and methods: this study is a randomized controlled trial and it was conducted in accordance with the ethical committee protocols and informed consent procedures of Ain Shams University Maternity Hospital during the period between Augusts to December 2016.Sample size was calculated using PASS® version 11 programs, setting the type-1 error (α) at 0.05 and the power (1-β) at 0.8.   Conclusion: para cervical block can be used as a safe and effective anesthetic technique in patients who need surgical uterine evacuation of missed abortion. Adding dexamethasone can increase effectiveness and duration of para cervical block. Intraoperative pain level was accepted in 80% of patients, these patients had no or mild to moderate accepted pain. We did not detect any postoperative complications in our patients including (excessive vaginal bleeding, hematoma or general manifestations of lidocaine toxicity) and It is recommended to apply PCB for cases of first trimester missed abortion who require uterine suction evacuation. Lidocaine is preferably mixed with dexamethasone to have better results as regards pain score. It is the anesthetic method of choice especially when general anesthesia is a high risk procedure.  }, keywords = {anti cardiolipin antibody (ACL),Anti-phospholipid syndrome (APS),Beta-human chorionic gonadotropins (B-HCG),BPD,parietal diameter (Bi),Crown rump length (CRL)}, url = {https://ejhm.journals.ekb.eg/article_13631.html}, eprint = {https://ejhm.journals.ekb.eg/article_13631_71d45d4f804e52288dcebe56943951ee.pdf} } @article { author = {Elsayed, Helmy M. and Ibrahim, Mohammed EM. and El Safty, Mohammed SL and Salim, Samar MM}, title = {1,5 Anhydroglucitol Evaluation as Glycemic Control Parameter of Diabetes Mellitus in Pregnancy}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1527-1532}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039699}, abstract = {Background: 1,5-Anhydroglucitol (1,5-AG) provides a reliable opportunity to assess the frequency and extent of intermittent hyperglycemic episodes. Aim of the Work: this study aimed to evaluate an alternative parameter to monitor blood glucose in pregnancies complicated with diabetes mellitus by studying the relationship between 1,5 Anhydroglucitol and self-monitoring of blood glucose level in pregnant women complicated with diabetes mellitus. Patients and Methods: this cross-sectional study with retrospective data was conducted on seventy pregnant women known to have pre-gestational or gestational diabetes mellitus attending Ain Shams University Maternity Hospital fulfilling the inclusion criteria of pre-gestational or gestational diabetes mellitus according to the criteria of the American Diabetes Association. Results: this study revealed a highly significant negative correlation between MMG (mean maximum glycemia) and 1,5 AG (r: -0.817, p-value: <0.001), also pre prandial blood glucose level (r: -0.500, p-value: <0.001) and a negative correlation and highly significant was found between post prandial blood glucose level and 1,5 AG (r: -0.640, p-value: <0.001). Conclusion: 1,5-AG is better than HbA1c as a tool for monitoring the glucose profile in pregnancies complicated by diabetes mellitus especially for the hyperglycemic episodes. Recommendations: as majority of interpretations for utility of 1,5-AG in pregnancy are based on scanty few clinical data so there is a scope of potential possibilities for its use in pregnancy and continuous research may allow its new applications and usefulness in pregnancy in the future.  }, keywords = {1,5 Anhydroglucitol,Glycemic Control Parameter,Diabetes mellitus,Pregnancy}, url = {https://ejhm.journals.ekb.eg/article_13633.html}, eprint = {https://ejhm.journals.ekb.eg/article_13633_0589a57544eb8cf4cefea7fb168fa0fb.pdf} } @article { author = {Ahmad, Mona Mansour and Abdel-Hamid, Hossam EL Dien M and AL Makawy, Marwa Hassan}, title = {The Impact of Comorbidities on the Outcome of Tuberculous Patient in Respiratory Intensive Care Unit}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1533-1540}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039700}, abstract = {Aim of the work: there are limited data regarding active pulmonary tuberculosis (APTB) patients requiring ICU admission.This study aimed to determine the mortality rate and risk factors associated with TB patients with comorbidities requiring respiratory intensive care unit (RICU) admission. Patients and methods: a combined retrospective-prospective study was conducted from November 2014 to October 2016 and from November 2016 to April 2017 on adult patients with APTB admit to the RICU of Abbassia Chest Hospital for a period of more than 24 h. Demographic, clinical and therapeutics characteristics as well as outcome (RICU morality) were obtained from the medical records. Results: in this study a total of 43 patients were considered (median age 45 years for non survived patients and 36 years for survived patients). The RICU morality rate was 81.4%. Respiratory failure was the most common cause of admission to RICU 37,2% (16 patient). Mechanical ventilation (MV) was needed in 69.8% of patients (30 patients). Death rate in the diabetic patients was14.29%, in patients with renal disease it was 20% , in case of HIVit was 17.14% and in case of malignancy it was 8.57%.There was highly significant mortality rate accompanying LCF and the ratio was 31.43%,in case of respiratory failure type II it was 94.28% and in mechanical ventilation it was 80%. Non survived patients had high significant  APACHE SCORE 21.4±6.2 and the main cause of death was mainly ventilatory 80%(28 patients). Conclusion: the present study showed a very high mortality rate among TB patients with comorbidities requiring respiratory intensive care unit (RICU) admission and identified associated co morbidities, risk factors and a predictor of RICU mortality.                               }, keywords = {active pulmonary tuberculosis,mortality,Respiratory intensive care unit,co morbidities}, url = {https://ejhm.journals.ekb.eg/article_13634.html}, eprint = {https://ejhm.journals.ekb.eg/article_13634_00e2cdc43f81cc7eb028023b21d76b1d.pdf} } @article { author = {Elsharkway, Magdy M.S. and Bichari, Walid A. and Mohamed, Mohamed M. and Ahmed, Mohamed I.A.}, title = {Impact of Chronic HCV Infection on Coronary Calcification in Prevalent Haemodialysis Patients}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1541-1548}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039701}, abstract = {Background: Hepatitis C virus (HCV) chronically infects an estimated 170 million people worldwide. Approximately 30% of patients who develop acute hepatitis C recover spontaneously, signaled by improved symptoms, normalized liver-related chemistries, loss of HCV RNA from serum, and the development of HCV antibody. Cirrhosis rates become significant after 20 years of HCV infection. Haemodialysis is a process that uses a man-made membrane (dialyzer) to clear wastes such as urea from the blood, restore the proper balance of electrolytes in the blood and eliminate extra fluid from the body. Vascular calcification is common in patients with advanced haemodialysis and is associated with poorer outcomes. Objectives: The aim was to evaluate the possible impact of chronic HCV infection on coronary calcification in prevalent haemodialysis patients in Naval Forces hospital, Alexandria, Egypt and its relation to demographic data, haemodialysis data and other laboratory findings. Patietns and methods: This cross-sectional study was carried out on 60 patients with at least one year duration on regular haemodialysis; 30 HCV negative prevalent haemodialysis patients and 30 HCV positive prevalent haemodialysis patients. Results: Our study revealed that HCV negative patients included 25 (83.3%) males and 5 (16.7%) females, their mean age was 51.67 ± 6.91 years. The mean haemodialysis duration was 7.5 ± 1.89 years. There were statistically a high significant difference between HCV negative prevalent haemodialysis patients and HCV positive prevalent haemodialysis patients regarding AST, significant differences regarding ALT and albumin and non-significant differences regarding bilirubin, prothrombin time, international normalized ratio, cholesterol and total glycerides. But, there were no significant differences between HCV negative prevalent haemodialysis patients and HCV positive prevalent haemodialysis patients regarding CKD-MBD parameters (including PO4 and iPTH), except for calcium which exhibited statistically a significant difference. Also, there were no significant differences between HCV negative prevalent haemodialysis patients and HCV positive prevalent haemodialysis patients regarding creatinine, sodium and potassium, significant differences regarding URR, C-reactive protein and a high significant difference regarding Ca score. In HCV negative prevalent haemodialysis patients, there were statistically significant correlations regarding dialysis duration and international normalized ratio and high significant correlations between Ca score and creatinine, AST and prothrombin time. In HCV positive prevalent haemodialysis patients, there were statistically significant correlations between Ca score and dialysis duration and creatinine. Other correlations were insignificant. There were non-significant relations between Ca score and gender and dialysis vascular access.   Conclusion: A very high incidence of vascular calcification was found in chronic haemodialysis patients in our study as compared to other studies. Vascular calcification is correlated with many risk factors and control of the modifiable risk factors can help to decrease prevalence of vascular calcification.  }, keywords = {Chronic hepatitis C virus,coronary calcification,vascular calcification,haemodialysis}, url = {https://ejhm.journals.ekb.eg/article_13635.html}, eprint = {https://ejhm.journals.ekb.eg/article_13635_1f53f107fafa953f92c8963e759100fa.pdf} } @article { author = {Almnabri, Abdulrahman Abdulelah and Al Ansari, Emtenan Abed and Abdulmane, Murooj Mohammed and Saadawi, Deyala Wadie and Almarshad, Taghreed Abdualaziz and Banoun, Ahmad Abdullatif and Mufti, Nora Samir and Bati, Bashayer Sadagah and Almarwanie, Miznah Saud and Alahdal, Leena Abdulrahman and Ebrahim, Afaf Mohammed Mas and Al-Hasani, Safaa Mahmood and Alghamdi, Mohannad Ali}, title = {Management of Placenta Previa During Pregnancy}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {68}, number = {3}, pages = {1549-1553}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0039702}, abstract = {Placenta previa is an obstetric complication (OS) that traditionally shows painless vaginal bleeding in the third trimester secondary to a strange placentation close or covering the interior cervical OS. Due to the inherent risk of hemorrhage, placenta previa may cause serious morbidity and mortality to both the fetus and the mother. Recently there have been two defined types of placenta previa: complete, and marginal. We here review the complications, incidence, risk factors, and management options of placenta previa.  }, keywords = {Placenta Previa,fetus,Cesarean Hysterectomy,Vaginal Bleeding}, url = {https://ejhm.journals.ekb.eg/article_13638.html}, eprint = {https://ejhm.journals.ekb.eg/article_13638_25c4d0b9ed892b17af538114fa7a3fc6.pdf} }