@article { author = {Korraa, Soheir and M.S, Tawfik and Maher, Mohamed and Zaher, Amr}, title = {Endothelial Progenitor Cells in Peripheral Blood of Cardiac Catheterization Personnel}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {56}, number = {1}, pages = {261-270}, year = {2014}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0005573}, abstract = {Background: The aim of the present study was to evaluate the rejuvenation capacity among cardiac catheterization technicians occupationally exposed to ionizing radiation. Subjects and methods: The individual annual collective dose information was measured by thermoluminscent personal dosimeters (TLD) for those technicians and found to be ranging between 2.16 and 8.44 mSv/y. Venous blood samples were obtained from 30 cardiac catheterization technicians exposed to X-ray during fluoroscopy procedures at the National Heart Institute in Embaba. The control group involved 25 persons not exposed to ionizing radiation and not working in hospitals in addition to 20 persons not exposed to ionizing radiation and working in hospitals. Blood samples were assayed for total and differential blood counts, micronucleus formation (FMN) plasma stromal derived growth factor-1α (SDF-1 α) and cell phenotype of circulating endothelial progenitorcells (EPCs), whose surface markers were identified as the CD34, CD133 and kinase domain receptors (KDR). Results: SDF-1α (2650± 270 vs. 2170 ± 430 pg/ml) and FMN (19.9 ± 5.5 vs. 2.8 ± 1.4/1000 cells) were significantly higher among cardiac catheterization staff compared to those of the controls respectively.  Similarly, EPCs: CD34 (53 ± 3.9 vs. 48 ± 8.5/105 mononuclear cells), CD133 (62.4 ± 4.8 vs. 54.2 ± 10.6 /105 mononuclear cells) KDR (52.7 ± 10.6 vs.43.5± 8.2 /105 mononuclear cells) were also significantly higher among cardiac catheterization staff compared to the values of controls respectively. Smoking seemed to have a positive effect on the FMN and SDF-1 but had a negative effect on EPCs.  It was found that among cardiac catheterization staff, the numbers of circulating progenitor cells had increased and accordingly there was an increased capacity for tissue repair. Conclusion: In conclusion, the present work shows that occupational exposure to radiation, well within permissible levels, leaves a genetic mark on the somatic DNA of the cardiac catheterization technician. On the other hand, exposure of workers to ionizing radiation stimulates regenerative processes as indicated by the increase in EPCs numbers and SDF-1 levels. This regenerative process is decreased by smoking as evidenced by increased levels of SDF-1 and decreased numbers of EPCs. The technicians who work in cardiac catheterization laboratories should therefore carefully follow radiation protection procedures and should minimize radiation exposure to avoid possible genotoxic effects.   }, keywords = {Cardiac catheterization personnel,Ionizing radiation,Smoking,Endothelial progenitor cells,Stromal Derived Factor-1 α}, url = {https://ejhm.journals.ekb.eg/article_15656.html}, eprint = {https://ejhm.journals.ekb.eg/article_15656_f36483478e039437f3ee29efaa5d421c.pdf} } @article { author = {M.S, Tawfik and Korraa, Soheir and Yousri, Mona}, title = {Apoptosis, Cytogenetic and Endothelial Progenitor Cells in the Peripheral Blood of Industrial Radiographers}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {56}, number = {1}, pages = {271-279}, year = {2014}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0005574}, abstract = {Background: Radioactive sources and fixed or mobile X-ray equipment are used for both process and quality control in the metallurgical and fertilizer industries. Workers in the nuclear industry are a suitable sector of the populace for the direct estimation of radiation effects at low doses as they are typically monitored and restricted to effective doses of 100 mSv every 5 years. A dose-related increased mortality from circulatory diseases has been observed in some studies of nuclear industry workers, but it is unclear whether this reflects a real effect of radiation exposure or a spurious one. The aim of the present study was to detect the circulating endothelial progenitor cells (EPCs) in the peripheral blood and the frequency of micronuclei (FMN) among industrial radiographers occupationally exposed to ionizing radiation at the Steamer’s Welding Company and EL Nasr Company for the manufacture of Fertilizers and Chemicals in Suez and Talkha, Egypt. Material and Methods: Venous blood samples were obtained from 30 industrial radiographers exposed to x-rays during industrial procedures vs. 20 persons not exposed to ionizing radiation as control subjects. Blood samples were assayed for total and differential blood counts  and cell phenotype of circulating EPCs, whose surface markers were identified as CD34, CD133 and kinase domain receptor (KDR), frequency of chromosomal aberrations (FCA), apoptosis percentage in circulating lymphocytes together with plasma stromal cell derived factor-1α (SDF-1α) and vascular endothelial growth factor (VEGF).  Results: The results of this study revealed a significant increase in FCA with respect to total number of dicentrics (0.09 ± 0.03 vs. 0.0005 ± 0.0001) and rings (0.01 ± 0.0012 vs. 0) together with apoptosis percentage (7.3 ± 2.8 % vs. 2.4 ± 1.5 %) among industrial radiographers compared to control subjects respectively, indicating radiation exposure among such workers. Also a significant increase was observed in plasma SDF-1α (2750 ± 370 vs. 2270 ± 430pg/ml), VEGF (157.9 ± 16.9 vs. 137.5 ± 12.6 pg/ml) among industrial radiographers compared to control subjects. Percentage of circulating mononuclear cells expressing CD34 (53 ± 3.9 vs. 54.2 ± 10.6/ 105 mononuclear cells), CD133 (82.4 ± 4.8 vs. 54.2 ± 10.6/ 105 mononuclear cells) and KDR (48.7 ± 12.5 vs. 43.5 ± 8.2/ 105 mononuclear cells) was significantly higher among industrial radiographers compared to control subjects. Conclusion: It is concluded that the industrial radiographers have increased numbers of circulating EPCs and increased levels of SDF-1 and VEGF, which denotes an increased capacity for tissue repair.  }, keywords = {Endothelial progenitor cells,apoptosis,stromal derived factor-1α,Industrial Radiographers,Ionizing radiation}, url = {https://ejhm.journals.ekb.eg/article_15658.html}, eprint = {https://ejhm.journals.ekb.eg/article_15658_d6317f3e86f9d5c2d33c9927ddc58d54.pdf} } @article { author = {Serwah, Abdel Hamid A. and Mohamed, Waleed S. and Serwah, Mohamed and Edreis, Awateif and El Zaydi, Ahmad}, title = {Occult Hepatitis C Virus Infection in Haemodialysis Unit: A Single-center Experience}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {56}, number = {1}, pages = {280-288}, year = {2014}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2014.15668}, abstract = {Background & Aims: Detection of hepatitis C virus RNA in peripheral blood mononuclear cells (PBMC) and/or hepatocytes in the absence of HCV RNA in serum, designated as ‘occult HCV infection’, has been a matter of controversy in the recent years. Occult hepatitis C virus (HCV) infection has not been investigated in haemodialysis patients. We investigated for the first time the prevalence of occult HCV infection in large cohorts of chronic hemodialysis (CHD) patients in a single heamodialysis center at Al-Taif, KSA. Methods: We enrolled 84 CHD patients, whose sera are negative for HCV markers. HCV RNA was tested in PBMC using a sensitive commercial real time assay. In this study, real-time PCR was used to test for the presence of genomic HCV-RNA in peripheral blood mononuclear cells of all of these patients. For comparison, 20 patients on HD with evidence of chronic hepatitis C virus infection were included as a control group. Results: In CHD patients, occult HCV infection, determined by the presence of genomic HCV-RNA in peripheral blood mononuclear cells (PBMNCs), was found in 13.4 % of the patients; 83 % of these patients had ongoing HCV replication, indicated by the presence of HCV-RNA. Patients with occult HCV infection had spent a significantly longer time on heamodialysis and had significantly higher mean alanine aminotransferase levels during the 3 months before study entry. Compared to CHCV patients, those with occult HCV have less elevated bilirubin, AST and ALT. Conclusions: The prevalence of occult HCV infection was moderate in our CHD patients, and it did not appear to be clinically relevant. Further studies in other geographic populations with high HCV endemicity are required to clarify the significance of occult HCV infection in these patient groups. Abbreviations HCV, Hepatitis C Virus ; antibody against HCV; PBMC, peripheral blood mononuclear cells; rRT-PCR, real time reverse transcriptase polymerase chain reaction; CHD, chronic hemodialysis.  }, keywords = {Occult hepatitis C,HCV,PBMCs,Peripheral blood mononuclear cells,prevalence,Hemodialysis,HCV RNA,anti-HCV}, url = {https://ejhm.journals.ekb.eg/article_15668.html}, eprint = {https://ejhm.journals.ekb.eg/article_15668_8c32b714974e5132552b35b029ceaa6d.pdf} } @article { author = {Sayed, Ahmed Tharwat and El Fiky, Sahar M and Hetta, Osama M and Khallaf, Osama A}, title = {Role of Percutaneous Microwave Ablation in Treatment of Hepatocellular Carcinoma}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {56}, number = {1}, pages = {289-299}, year = {2014}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Introduction: Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide with an annual occurrence of one million new cases. An etiologic association between HBV infection and the development of HCC has been established. Hepatitis C virus is also proving an important predisposing factor for this malignancy, the use of minimally invasive Percutaneous ablative technique (e.g. Radiofrequency (RF) and Microwave ablation (MW) has gained great momentum and because of the drawbacks of RF ablation, several groups have successfully proved the efficacious nature of Microwave ablation in the treatment of hepatocellular carcinoma. Aim of the Work: The aim of this work is to highlight the role, the principles and the applications of percutaneous Microwave Ablation in Hepatocellular carcinoma. Methods: The studied group included 30 patients (25 men and 5 women) with hepatocellular carcinoma. All patients underwent microwave ablation for the hepatocellular carcinoma. Results: The results of the procedures will be assessed as regarding sizeand enhancement of the lesion (s) on triphasic CT abdomen before the procedure and at the follow up at one month as well as the Alpha fetoprotein levels.    }, keywords = {MWA technique represents a safe, fast and efficacious way to perform hepatic ablation in patients with HCC. Initial results are encouraging,however, longer follow-up is needed for further classification of our results}, url = {https://ejhm.journals.ekb.eg/article_15688.html}, eprint = {https://ejhm.journals.ekb.eg/article_15688_4fcfb6a01d7dd7e29a14198f0f55663f.pdf} } @article { author = {Hassan, Ahmed R. and Al-Shinnawy, Mohamed S. and Ismail, Dalia N. and Shahin, Mohamed A.}, title = {The Potential Protective and Therapeutic Effects of Aloe Vera Juice Against Malathion Induced Haematological Changes in Rabbits}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {56}, number = {1}, pages = {300-310}, year = {2014}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: the potential protective and therapeutic effects of Aloe vera juice against malathion induced haematological changes in young rabbits (Oryctolagus cuniculus) were evaluated in this study. Material and methods: Rabbits were allocated into two sets of experiments short (7 days) and long (21 days) periods. Animals of each set were divided into eight groups; four treated groups and each treated group had its own control. The animals of the first group were orally dosed with Aloe vera juice (0.84 ml/kg b. wt.). Rabbits of the second group were orally dosed with malathion (5 mg/kg b. wt.).  In the third group (the protective group) animals were dosed orally with malathion concomitant with Aloe vera juice. Animals of the fourth group (the therapeutic group) were dosed orally with malathion; for 7 days followed by Aloe vera juice for the same period. All the animals were sacrificed, blood samples were collected and used to determine the levels of hematological indices: red blood cells (RBCs), white blood cells (WBCs), haemoglobin (Hb), haematocrit (Hct), mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration (MCHC).  Results: rabbits treated with Aloe vera juice (group 1) showed insignificant change in WBCs count, MCH and MCHC after treatment for both periods. On the other hand, other parameters exhibited significant (RBCs count) and highly significant (Hb and Hct values) change in rabbits treated for the short period. The rabbits of the second group (treated with malathion) exhibited a marked increase in WBCs count, MCV and MCH values, while, the values of RBCs, Haemoglobin and Hct were decreased. The protective group (Group3) showed that the values of all the tested haematological parameters (except MCHC, in both periods of treatment, and WBCs count in the short period of treatment) recorded a significant change in rabbits  treated for short (7 days) or long (21 days) periods. A marked recovery in RBCs count and MCH value was observed in rabbits treated for 21 days. Regarding to group 4 (the therapeutic group), it was found that in both terms the rabbits exhibited insignificant changes in the values of all the tested haematological parameters compared to their corresponding controls, except three parameters in which they recorded significant (WBCs count, MCHC) and highly significant (Hct) increase compared to their control values after the long period only. These observations indicated the ability of Aloe vera juice to improve the deleterious effects caused by malathion administration.  }, keywords = {Haematology,Aloe vera juice,malathion,Rabbits}, url = {https://ejhm.journals.ekb.eg/article_15689.html}, eprint = {https://ejhm.journals.ekb.eg/article_15689_f6e7a31d815336e87f52da4cbc9268e8.pdf} } @article { author = {Ahmed, Kareman M. and Mohamed, Sahar N. and Abo Gamra, Sherif H. and Chalabi, Nivine A.}, title = {Diagnostic Accuracy of Multi-detector CT Angiography in Evaluation of Lower Limb Arterial Diseases: Comparative Study with Conventional Angiography}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {56}, number = {1}, pages = {311-320}, year = {2014}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2014.15690}, abstract = {Purpose: To assess the diagnostic accuracy of multi-detector CT angiography in the assessment of lower extremity arterial diseases by comparing the results with thestandard of reference, conventional angiography. Patients and Methods: The studied group included 140 patients with suspected diagnosis of lower limb arterial disease on the basis of clinical examination or Doppler study with no age or sex predilection between March 2011 and November 2013. All patients were evaluated with lower limb angiography by multi-detector computed tomography and conventional angiography. The data obtained was statistically analysed to assess the accuracy of diagnosis of lower limb arterial diseases by MDCT angiography compared to conventional angiography that described in terms of count and percentage. Results: MDCT angiography findings showed 90.3% overall agreement with CA findings regarding the degree of stenosis while regarding the stenosis length MDCT angiography results showed 87.5% overall agreement with CA results. The overall sensitivity of MDCT angiography was 94.5%, specificity was 92.2%, and accuracy was 95.3%.  Conclusion: Multi–detector row CT angiography can be used as an alternative to conventional angiography in the evaluation of aortoiliac and lower extremity arteries in patients with peripheral arterial disease.  }, keywords = {Computed tomography (CT),Conventional Angiography (CA),multi-detector computed tomography (MDCT)}, url = {https://ejhm.journals.ekb.eg/article_15690.html}, eprint = {https://ejhm.journals.ekb.eg/article_15690_2434f13c9eb7cb57d64e4bf74093209e.pdf} } @article { author = {Abdel Fatah, Wafaa M. E. and Atef, Laila and Mohamed, andNareman Y and Refaat, Doaa and Mohsen, Malka A and Abd El-Raof, Mona and Eissa, Fawkia}, title = {Study of Serum Monocyte Chemoattractant Protein-1AS A Marker in Rheumatoid Arthritis}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {56}, number = {1}, pages = {321-332}, year = {2014}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2014.15691}, abstract = {Background: Rheumatoid arthritis (RA) is a chronic, multisystem autoimmune disease which manifests itself in multiple joints of the body. It is characterized by infiltration of inflammatory cells such as monocytes and it is believed to be the result of a faulty immune response.       Chemokines play a major role in selectively recruiting monocytes, neutrophils, and lymphocytes, as well as in inducing chemotaxis through the activation of G-protein-coupled receptors. Monocyte chemoattractant protein-1 (MCP-1/CCL2) is one of the key chemokines that regulates migration and infiltration of monocytes/macrophages. Aim of The Work: was to study the role of serum Monocyte chemotactic protein-1 (MCP-1) in patients with rheumatoid arthritis as a diagnostic and prognostic marker and the possible association with disease activity. Subjects and methods: Forty   rheumatoid arthritis diseased patients were selected  , they were 3 males and 37 females. The patients were categorized into two groups according to activity of the disease regarding DAS score . Another 20 healthy subjects, 2 males and 18 females, with no history of rheumatoid disease were recruited as controls .Results: this study showeda highly significant increase in MCP-1 and ESR in all rheumatoid arthritis patients groups   , active rheumatoid arthritis patients group and inactive rheumatoid arthritis patients group compared to control group. Correlation study of serum MCP-1 revealed a significant positive correlation between serum MCP-1 and ESR and DAS score in all patients versus the healthy group and a significant positive correlation between serum MCP-1 and ESR in the active group. ROC curve analysis was showing the diagnostic performance of serum MCP-1 in   rheumatoid   arthritis patients(active and inactive) versus the healthy control group, at a cut-off level of 52.5 ng/ml., the diagnostic sensitivity, specificity, negative predictive value and positive predictive value were 98%, 93%, 93% and 98% respectively. Also, it shows the diagnostic performance of serum MCP-1 in discriminating active  rheumatoid   arthritis patients from the inactive group, at a cut-off level of 61ng/ml Conclusion: - Serum MCP-1 is one of the best indicator of clinical arthritic activity in RA patients. It represents a novel, independent indicator of clinical arthritic activity that also provides a good reflection of effect of treatment in rheumatoid arthritis patients.    }, keywords = {Rheumatoid arthritis (RA),serum Monocyte chemotactic protein-1 (MCP-1)}, url = {https://ejhm.journals.ekb.eg/article_15691.html}, eprint = {https://ejhm.journals.ekb.eg/article_15691_10fe8d751243c33c444b9bb611578b53.pdf} } @article { author = {Helal, Eman G. E. and Abou- Aouf, Noran Ahmed and Mohamed, Nareman Y. and Taha, Neama M.}, title = {Effect of Noise and Crowding Stresses on Hypothalamic–Pituitary–Gonadal Axis and Protective Effect of Sulpiride Drug in Adult Female Albino Rats}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {56}, number = {1}, pages = {333-344}, year = {2014}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2014.15692}, abstract = {Background: Noise and crowdingare the most stressful factors which cause depressant effects on human beings, especially females.Therfore this study was aimed at clarifying their effects on hypothalamus pituitary gonadal axis hormones (luteinizing hormone (LH) and follicle-stimulating hormone (FSH), estrogen (E2)and progesterone  as well as prolactin (PRL)and the possible protective effect of antidepressant drug;sulpiride.  Material and Methods: Sixty adult female rats were divided into six groups (10/each): 1- Rats served ascontrol, 2- Rats treated with sulpiride drug only, 3- Rats exposed to noise (90db, 3hr. per day) for 45 days, 4- Rats exposed to noise and treated with sulpiride drug, 5- Rats exposed to crowding and 6- Rats exposed to crowding and treated with sulpiride drug. Results: Noise and crowding stresses caused a significant decrease of estrogen (E2), progesterone (P), LH and FSH levels and high significant increase in PRL level. Sulpiride drug   ameliorated these parameters changes except PRL level which showed a high significant level compared to control group. Conclusion: it is useful to use antidepressant drug (e.g. sulpiride)  with   people who are exposing to noise and   crowding stress.  }, keywords = {Noise,crowding,Sulpiride drug,hypothalamic–pituitary–gonadal axis FSH,LH,PL estrogen,and progesterone}, url = {https://ejhm.journals.ekb.eg/article_15692.html}, eprint = {https://ejhm.journals.ekb.eg/article_15692_482a183aa6311391df1b7ac8a2403814.pdf} } @article { author = {EL Baz, Rizk Ahmed and Ramadan, Manal Mohamed and Fayad, Eman and Shaltot, Ali Ali and Shershaby, Effat Mahmoud EL}, title = {Comparative Study on the Effect of Factor V Leiden and Prothrombin Gene Polymorphism in Preeclampsic Cases}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {56}, number = {1}, pages = {345-354}, year = {2014}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2014.15693}, abstract = {Objective: To identify polymorphism of Factor V Leiden and Prothrombin gene in women suffering from preeclampsia.                         Study design:   From 142 pregnant women we identified 92 women suffering from preeclampsia and 50 healthy controls with normal pregnancy matched for age and socioeconomic status, preeclampsic patient classified as mild preeclampsia 42(45.7%) and severe preeclampsia 50(54.3%). Blood samples were tested for DNA polymorphism affecting thrombophilia Factor V Leiden and Prothrombin gene polymorphism.                         Results:   Heterozygous AG genotype showed a significant high frequency among preeclampsic patients (20.7%) compared to controls (4.0%), (OR 6.2, P= 0.006) regarding to Prothrombin gene but: Factor V Leiden, AG genotype showed (8.7%) of preeclampsic patients which was absent in any of the controls.  }, keywords = {Factor V Leiden,Prothrombin gene,preeclampsia}, url = {https://ejhm.journals.ekb.eg/article_15693.html}, eprint = {https://ejhm.journals.ekb.eg/article_15693_33ffe767016da4111e1cc69b4e599bcc.pdf} } @article { author = {EL Baz, Rizk Ahmed and Ramadan, Manal Mohamed and EL Shershaby, Effat Mahmoud and Fayad, Eman and Shaltot, Ali Ali}, title = {Comparative Study on the Effect of C667T and A1298C Polymorphism in Preeclampsic Cases}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {56}, number = {1}, pages = {355-367}, year = {2014}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2014.15694}, abstract = {Objective: To identify polymorphism of methylenetetrahydrofolate reductase gene in women suffering from preeclampsia.                                   Study design:   From 142 pregnant women we identify 92 women suffer from preeclampsia and 50 healthy controls with normal pregnancy matched for age and socioeconomic status, preeclampsic patient classified as mild preeclampsia 42(45.7%) and severe preeclampsia 50(54.3%). Blood samples were tested for DNA polymorphism affecting thrombophilia methylenetetrahydrofolate reductase C677T and   A1298C. Results: Homozygous TT genotype, T allele of C677T polymorphism has a significantly higher frequency among preeclampsic cases compared to healthy controls (OR=21.7, 1.46, respectively). Thus TT genotype and T allele may be considered as genetic risk factors for preeclampsic cases. on the other hand, non significant association in either genotype among preeclampsic cases compared to controls regarding to A1298C.  }, keywords = {C667T gene,A1298C,preeclampsia}, url = {https://ejhm.journals.ekb.eg/article_15694.html}, eprint = {https://ejhm.journals.ekb.eg/article_15694_9c176ed7cb3f4d2c6e12c67946a0169e.pdf} } @article { author = {Eid, Samia Mohammed and El Karef, Amr}, title = {Role of Increasing Vaginal Acidity in Histological Changes and Softening of the Cervix Prior to Dilatation in Perimenopausal Women}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {56}, number = {1}, pages = {368-375}, year = {2014}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2014.15695}, abstract = {Background: cervical dilatation, along with hysteroscopy or endometrial curettage, is one of the most common procedures in gynecological practice. However, difficulty in entering the internal cervical os may be encountered; Therefore, there is a need for an effective cervical priming agent which can be used in general gynecological practice. Vaginal acidification might increase collagen degradation. It is known that cervical collagen degradation contributes to the ripening process.          Aim of the work: the present study was designed to evaluate the efficacy of acidifying vaginal cream in cervical tissue remodeling and softening. Patients and methods: this study is a double-blinded clinical trial study, conducted in Obstetrics and Gynecology Department of Al-Azhar University hospital (Damietta). It included fifty perimenopausal women, their age ranged from 45-55ys, planned for cervical dilatation before endometrial biopsy due to irregular uterine bleeding. They were divided into two main groups: Group I: women who were treated with acidifying vaginal cream (Eva base cream melted with acetic acid 5%). Group II: women who were treated with neutral (placebo) vaginal cream (Eva base cream only). Efficacy of acidifying vaginal cream on the cervix was assessed on the basis of improved cervical softening and degree of cervical changes on the histological examination. Results: there was no significant difference in both groups during the preoperative assessment of the cervix and premedication. During operation in the study group (I) 1st Hegar’s passed was No8  in 52% of cases and No9  in 28% of cases denoting the significant effect of acetic acid on cervical dilation in comparison  with placebo group (II)in which the cervix was closed in 44% of cases and Hegar’s No 3 passed in 36% of cases showing statistical significance between the two groups.  As regards the histological examination, it was found that in group (I) collagen dissociation grade II represent   56% and grade III 24% with statistical significance in comparison with  placebo group  (II) in  which collagen was  grade 0, in 76% . Also, the inflammatory changes in group(I) showed moderate changes  in 72% of cases and 20%  showed severe changes with statistical significance in comparison with the  control group(II) in  which 56% of cases showed no inflammatory changes. Conclusion: vaginal acidification with 5% acetic acid as a cervical softening agent appeared to be safe, effective, with no adverse effects.  }, keywords = {perimenopause,cervical softening,acetic acid}, url = {https://ejhm.journals.ekb.eg/article_15695.html}, eprint = {https://ejhm.journals.ekb.eg/article_15695_c655651b7dd3145b539bbbadbc875f65.pdf} } @article { author = {El-Said, Mourad Mohey El-Din and Abuelgar, Wessam Magdi and Sabba, Haitham Abdel Mohsin and Ramy, Ahmed and Ali, Radwa Rashidy and Nour EL Deen, Sahar Ahmed}, title = {Ultrasonographic Assessment Predicts Adverse Perinatal Outcomes}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {56}, number = {1}, pages = {376-383}, year = {2014}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2014.15696}, abstract = {Background: Objective:The aim of this work was to evaluate accuracy of the ultrasonographic assessment at the first or the second trimester of gestation as a predictor of adverse outcome in high risk pregnancies. Patients and methods:A cross sectional study was conducted on 85 consecutive high risk pregnancies attending the Antenatal Clinic and Medical Genetics Center of Ain Shams University. Nuchal translucency thickness was obtained for all cases recruited during 1st trimester. Nuchal fold thickness was obtained for all cases recruited during 2nd trimester.We prospectively evaluated the outcome of each pregnancy. Results:The mean age of participants, mean marriage duration, and gestational age were 32.5 ± 6 years, 7.1±3.3 years and 14.5±2.1weeks respectively.Increased NT thickness and NF thickness were present in5%, and 8.89% respectively.Down syndrome was found in 1.2% of current pregnancy outcome, while, cystic hygroma was found in 1.2%, cystic hygroma with hydrops was found in 1.2%, skeletal dysplasia and renal agenesis was found in1.2% missed abortion was found in 3.53%.There is a highly significant difference between normal outcome pregnancy and abnormal outcome pregnancy regarding mean NF thickness while no significant differences regarding NT thickness. Conclusion:The findings of our prospective study demonstrate the feasibility of using NF thickness to screen for aneuploidies, adverse perinatal outcome in high risk    pregnancies.    }, keywords = {Nuchal fold thickness,Nuchal translucency,Perinatal outcome,High risk pregnancy}, url = {https://ejhm.journals.ekb.eg/article_15696.html}, eprint = {https://ejhm.journals.ekb.eg/article_15696_4a70e925403d3ea66d61a29313ebf310.pdf} }