@article { author = {El Margoushy, Nesriene Mohamad}, title = {Evaluation of the Biological Effects of Radiations on Pulmonary functions of NMA Employees in the Black Sand Project at Rashid and Abou-Khashaba Sites Year 2012}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {51}, number = {1}, pages = {179-189}, year = {2013}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: Almost all workers in the Black Sand Project at Rashid and Abou-Khashaba sites of NMA (Nuclear Materials Authority) are obligatorily exposed to ionizing radiations during their routine work. The most apparent harmful effects in Rasheed employees were reflected easily on pulmonary function tests which may occur due to increase registered dust radio activities than the accepted level for air concentration. Objectives: This study was done mainly to evaluate the biological effects of ionizing radiations on lung and pulmonary functions of workers in the Black Sand Project at Rashid and Abou-Khashaba sites of NMA in the year 2012 and to start follow up of these workers Measurements: This research was done on 30 male workers aging 25 - 56 years to measure pulmonary function tests. Certain radiological measurements were also performed to assess the levels of exposure to radiations Results: Out of the 30 members; regarding the radiological measurements all levels measured were within the reference range accepted internationally, except radioactive dust levels were elevated mildly above the reference range accepted internationally this results in deterioration of pulmonary function of some workers. Conclusions: Generally, workers of the Black Sand Project at Rashid and Abou-Khashaba sites were receiving a good radiological protection protocol. Radioactive dust levels were elevated mildly above the reference range accepted internationally this result in pulmonary function disorders in some workers.}, keywords = {}, url = {https://ejhm.journals.ekb.eg/article_15969.html}, eprint = {https://ejhm.journals.ekb.eg/article_15969_4253b7e89d90703a4a4751239bf4f879.pdf} } @article { author = {El Margoushy, Nesriene Mohamad}, title = {Improving Health status of bronchial asthma patients in Nuclear Materials Authority}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {51}, number = {1}, pages = {190-199}, year = {2013}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2013.15970}, abstract = {Background: Asthma is a common chronic inflammatory disease of the airways characterized by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm. Symptoms include wheezing, coughing, chest tightness and shortness of breath. Asthma can result in variable restriction in the physical, emotional, and social aspects of the patient's life. Setting: out patient clinic in Nuclear materials Authority Objectives: This study was done mainly to Improve health status including symptoms and  quality of life in bronchial asthma patients in Nuclear Materials Authority Method: The study was carried out on 51 subjects, they were chosen from those attendants of the out patients clinic in Nuclear Materials Authority in el Katamya in the period from January to May 2012, by measurement of lung function and bronchial hyperresponsiveness as supplemental tools in evaluating the efficacy of treatment with inhaled corticosteroids (ICS) and other controller medications in asthmatic employees. Results: the asthmatic patients were 51 patients (36 males and 15 females), their ages ranged from 27-59 (46.2±7.3) years, they weredetected from those attendants of the out patient clinic in Nuclear Materials Authority in El Katamya representing (2.1% ) of workers. 15 (29.4%) patients were smoker, and 36 (70.6%) patients never smoked, 21 patients (41.2%) were exposed to radioactive materials in their labs in the form of radioactive substances and30 patients (58.8%)patients  were not exposed.19 (37.3%) patients had intermittent asthma, 11 (21.6%) patients had mild persistent asthma  9 (17.6%) patients had moderate persistent asthma and 12(23.5%) patients had sever persistent asthma. 11(21.6%)  patient used long acting anti-inflammatory medications, 23 (45.1%) patients received other controller medication in the form of short acting steroids as Clenil inhaler and ketotifen as  zaditen while the majority of patients received rescue medication 34(66.7%) in the form of short acting bronchodilators and oral steroids. Conclusion: Patient education, measurement of lung function and review of the treatment plan as supplemental tools in evaluating the efficacy of treatment with inhaled corticosteroids and other controller medications in asthmatic employees improve health status including symptoms and quality of life in bronchial asthma patients in Nuclear Materials Authority.}, keywords = {}, url = {https://ejhm.journals.ekb.eg/article_15970.html}, eprint = {https://ejhm.journals.ekb.eg/article_15970_706ec17ca02d25d93ca914f83ffcc5cc.pdf} } @article { author = {Abdel Hamid, Wafaa Raafat Ali}, title = {A Comparative Study Between Whole Body Magnetic Resonance Imaging and Bone Scintgraphy In Detection of Bone Metastases In Patients With Known Breast or Lung Cancer}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {51}, number = {1}, pages = {200-215}, year = {2013}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2013.15971}, abstract = {Purpose: The aim of this work is to compare the ability of whole body MRI including diffusion study with that of 99m Tc-Methylene Diphosphonate Scintigraphy to detected skeletal metastases in patients with breast and lung cancer. Patients and methods: 60 patients comprising 38 females and 22 males ranging in age from 30 to 60 years with a mean age of 48.1 years (mean age 47.3 years for females and 49 years for males) were enrolled in the study. 29 females are histopathologically proven cases of breast malignancy, 9 females and the 22 males are histopathologically proven cases of lung cancer. The patients were referred from Oncological departments to perform the whole body MR study and bone scan at Ain Shams University hospitals MRI units and a private center during the time interval from December 2008 till December 2012. All patients were subjected to both whole body MRI and bone scintigraphy. The whole body MRI was mainly obtained using 4 contiguous coronal stations for body coverage using the body coil and 2 contiguous sagittal stations for the spine using T1W FSE and STIR sequences. 48 out of 60 patients toke IV contrast and post contrast T1W imagaes with fat suppression were taken. The MRI examinations were performed using a superconducting 1.5 Tesla magnet (Achieva: Philips Medical Systems).   Standard skeletal Scintigraphy was performed using a planar one phase technique (delayed phase). The examination was done 2-3 hours after IV injection of  technicium 99m labeled Methylene Diphosphonate with a maximum dose of 20 mCi.   Results: 42 patients out of 60 were positive for metastases based on histopathological verification or follow up. On MRI, 39 patients had metastases, 3 were false negative, 12 were true negative and 6 were false positive. On bone scan, 35 were true positive, 7 were false negative, 4 were false positive and 14 were true negative. Based on lesion detection, on comparing bone scan to WB-MRI with and without diffusion, bone scan  had an overall sensitivity of 85.6%, specificity 67.5 %, PPV 61.7% and NPV 66.3%, while WB-MRI had statistical values of 73.4%, 68.8%, 78.1% and 62.6% respectively. On adding DWI, values raised to 88.9%, 82.9%, 93% and  69% respectively. Quantitative analysis of DWI was also included in this study revealing an overlap between the Low ADC values of red marrow and metastasis at the range of 0.61 to 0.69 x10-3 mm2/sec and then between metastasis and other benign pathological marrow entities at the range of 0.9 to 1.03 x 10-3 mm2/sec. WB-MRI also detected 64 soft tissue metastatic lesions which became 71 lesions on adding DWI with a distribution of hepatic, pulmonary, brain, adrenal, lymph nodes, pleural, leptomeningeal and renal lesions.   Conclusion: we don't think that WB-MRI should replace bone scan in the quest for skeletal metastases. However, we believe that WB-MRI should be the modality of choice when both skeletal and soft tissue metastases are suspected and in the follow up of a known metastatic patients for adequate coverage of both skeletal and soft tissue structures combined with qualitative and quantitative features of DWI helping assess tumors at cellular levels even prior to gross morphological changes verifying response to therapy as early as possible sparing patients precious time  from drifting with delayed decision making.}, keywords = {}, url = {https://ejhm.journals.ekb.eg/article_15971.html}, eprint = {https://ejhm.journals.ekb.eg/article_15971_376c4fd0562b515548642ef23f21a1fb.pdf} } @article { author = {Sheha, Aliaa S and Nouh, Ola M and Azab, Inas M and Nassef, Mohamed A and Ibrahim, Ahmed M}, title = {Role of Dynamic Magnetic Resonance Imaging in Assessment of Female Pelvic Floor Dysfunction}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {51}, number = {1}, pages = {216-225}, year = {2013}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2013.15972}, abstract = {Introduction: Pelvic floor weakening is a major health problem in older women, with an 11.1% lifetime risk of women over 50 years old to undergo surgery for pelvic organ prolapse and urinary incontinence. Clinical examination is the main method of diagnosis, yet imaging is essential especially in patients with multicompartment defects. Pelvic Magnetic Resonance (MR) Imaging is expected to play a role in the preoperative planning for complex cases due to its high soft tissue resolution, which will help perform site-specific repair and so avoid recurrence.   Aim of the work: The aim of this work is to evaluate the role of Magnetic Resonance Imaging as a non invasive method in the assessment of female pelvic floor dysfunction.   Methods: The studied group included 40 female patients complaining of pelvic organ prolapse and / or stress urinary incontinence or fecal incontinence. All patients were subjected to full history taking, clinical examination and Dynamic Magnetic resonance Imaging using 1.5 Tesla Philips MR Scanner.   Results: Good concordance was found between Dynamic MRI and clinical examination in all three compartments. The concordance was 82.5% in the anterior compartment, 80% in the posterior compartment, 85% in enteroceles and 65.0% in the middle compartment.   Conclusion: Dynamic MRI is a promising method that can be used as an imaging tool in the preoperative planning of pelvic organ prolapse.  }, keywords = {}, url = {https://ejhm.journals.ekb.eg/article_15972.html}, eprint = {https://ejhm.journals.ekb.eg/article_15972_91cce0f13764473e30d20030e17d2726.pdf} } @article { author = {Darwish, Eman AF and Darwish, Mohammed Abu-el Huda and Wagdy, Hisham H and Al Gaafary, Sahar M}, title = {Role Of CT Virtual Colonoscopy In Diagnosis Of Colo-Rectal Neoplasms}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {51}, number = {1}, pages = {226-239}, year = {2013}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2013.15973}, abstract = {Purpose: to assess the role of CT colonography (virtual colonoscopy) as a non-invasive imaging technique in detection and diagnosis of colorectal neoplasia using conventional colonoscopy and/or operative findings as a reference standard, as well as highlighting its advantages and possible pitfalls.   Methods: sixty patients were examined by CT after standard bowel preparation, rectal insufflation and IV contrast injection. Imaging was performed in both supine and prone positions. Evaluation consisted of review of the transverse CT images, sagittal and coronal reformations and 3D endoluminal lmages. CT colonographic findings were correlated with standard conventional colonoscopic and/or operative findings.   Results: Virtual colonoscopy correctly identified all 6 carcinomas (100%), 12 out of the 13 polyps that measured 10mm or more (92.3%), 19 of the 23 polyps that measured 6 - 9 mm (82.6%) and 28 out of 48 polyps that measured 5mm or less (58.3%). There were 11 false positive findings of polyps by virtual colonoscopy and no false positive findings of cancer. Virtual colonoscopy also detected 35 incidental extracolonic findings in 25 patients while non were detected by conventional colonoscopy. 17 of the 24 patients who had no lesions during conventional colonoscopy were considered free of lesions by CT colonography yielding a per-patient specificity of 70.8%   Conclusion: CT colonography has high sensitivity for the detection of clinically important polyps and cancer as well as multiple advantages over conventional colonoscopy in imaging of colorectal neoplasms}, keywords = {}, url = {https://ejhm.journals.ekb.eg/article_15973.html}, eprint = {https://ejhm.journals.ekb.eg/article_15973_09949d809014186ef9847c9e55b37816.pdf} } @article { author = {Hassan, Mona El Sayed Ali}, title = {Epi- On versus Epi- Off Techniques of Corneal Collagen Cross Linking for Treatment of Keratoconus}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {51}, number = {1}, pages = {240-252}, year = {2013}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2013.15974}, abstract = {Aim of the Work: The aim of this study is to evaluate and compare the epi-on versus the epi-off techniques of corneal collagen cross linking as regards their safety and efficacy for treatment of mild to moderate degree keratoconus.   Design: Prospective, non randomized study.   Patients and Methods: Thirty eyes in 15 patients (9 males and 6 females) with bilateral mild to moderate degree keratoconus were included in this study. Their mean age ± SD was 26.2 ± 3.9 years. Diagnosis of keratoconus was based on clinical evaluation as well as pentacam examination. All patients were subjected to corneal collagen cross linking. According to the technique used, eyes were classified into 2 groups:   Group I: Included 15 eyes in 15 patients, where cross linking was performed after removal of the corneal epithelium (Epi-off). Group II:  included the other 15 eyes of the same patients, where cross linking was performed with intact epithelium (Epi-on). Comparison between the two groups as regards visual outcome, keratometric readings, least corneal thickness, refraction outcome and corneal haze was done.   Results: No intra operative complications were reported in our study. Re-epithelialization in eyes of group I was reported within a week except three eyes were re- epithelialization was reported after 10,14and 21 days. There was a statistically significance improvement in best corrected visual acuity in both groups (0.36 before versus 0.60 six months after surgery) but the difference between both groups was not significant. As regards refraction, there was reduction in spherical error 6 months after surgery in both groups (-6.14D before,-5.22D 6 months after surgery) as well as cylindrical error (4.87D before 3.79 D 6 month after surgery). Differences between both groups were statistically not significant. There was increase in the least corneal thickness after surgery (448.6 microns before surgery versus 451.9 microns 6 months after surgery) but statistically the difference was not significant (P=0.75) and the difference between both groups was also not significant. Changes in keratometric readings were statistically not significant, and the difference between both groups was also not significant. Corneal haze was observed one month post operatively in four eyes in group one versus 3 eyes in group II. Persistent haze at the end of follow up was reported in three eyes in group I versus two eyes in group II. The incidence of haze as well as its density was higher in group I than group II with statistical significant difference.            Conclusion: Both epi-on and epi-off techniques of corneal collagen cross linking are safe and effective in stabilization or even improvement of mild to moderate degree keratoconus as regards best corrected visual acuity, refraction, keratometric readings, and least corneal thickness. The epi-on technique is easier and more tolerable by the patient with less postoperative corneal haze.    }, keywords = {Keratoconus- collagen cross linking- Epi-on,Epi-off - corneal haze}, url = {https://ejhm.journals.ekb.eg/article_15974.html}, eprint = {https://ejhm.journals.ekb.eg/article_15974_800b2b5cd495597774b03b598397355e.pdf} } @article { author = {Rabei, Hanan Mostafa}, title = {Immunomodulatory Changes Induced By High Doses Of Dextromethorphan In Male Rats}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {51}, number = {1}, pages = {253-263}, year = {2013}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2013.15975}, abstract = {Background: Dextromethorphan (DXM) is a synthetic opioid analogue, similar to codeine that has antitussive effect but no opiate-like analgesic activity. It is widely used as an over-the-counter cough suppressant available in various cough and cold preparations; it is one of the often overlooked types of substance abuse by adolescents and young adults in the United States and around the world. So, the present study aims to investigate the side effects of the DXM abuse (sub-chronic and lethal doses) on the immune functions in rats.  Material and Methods: The rats were divided into three equal groups, the first one served as control, and the second and third were treated. Treated groups received oral doses of DXM which increasing per 10 days (double dose) for a month. Results We examined the sub-chronic and lethal effects of DXM administration on the cellular immune responses in rats. T cell stimulator, Phytohemagglutinin showed a significant suppress on lymphocytes  of peripheral blood proliferation and a highly significant decrease  on phagocytic and killing of S. aureusby PMN and macrophage cells. Moreover, it induced a significant decrease in serum IL-6, andIFN-γ levels, but, it exhibited a highly significant increase in serum IL-10 level throughout the period of experiment. In addition, it induced also a significant decrease in the production of cortisol during the experimental time except the last period of treatment in the 3rd group, where, serum cortisol level gradually return to normal level. Conclusion: These results suggest that sub-chronic and lethal doses of DXM administration in rats disturbed cellular immune responses, exhibited potent anti-inflammatory actions, suppressed of leukocytes dependent production of cytokines such as IL-6 and IFN-γ. Moreover, it has some effects on serum cortisol concentration presumably via blockade of NMDA receptors.    }, keywords = {Dextromethorphan,IFN-γ,IL-10,IL-6,phagocytosis,Lymphocytes transformation,Cortisol,albino rat}, url = {https://ejhm.journals.ekb.eg/article_15975.html}, eprint = {https://ejhm.journals.ekb.eg/article_15975_4e06cd01cc113eb9dc0a834028733c7d.pdf} } @article { author = {Mohamed, Waleed S. and Mostafa, Ashraf M. and Serwah, Abdel Hamid A. and Mohamed, Khaled M.}, title = {CARDIOMETABOLIC PROTECTIVE EFFECTS OF SOME MEDICINAL PLANTS IN DIABETIC ALBINO RATS}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {51}, number = {1}, pages = {264-274}, year = {2013}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2013.15976}, abstract = {Background and aim of the study: DM represents an important independent risk factor for the development of and mortality from coronary heart disease (CHD), increasing the risk by    2 to 4 times. According to WHO data, more than 75% of patients with DM die due to vascular accidents. This study investigated the effects of some plants used in Saudi Arabia and some other Arab countries as antidiabetic agents and explores its metabolic effects. Material and Methods: One hundred fifty adult male Albino Rats were divided into six experimental groups each consist of twenty five rats. The first group was considered as a control group. The rest of groups were affected by induction of experimental diabetes by subcutaneous injection of Alloxan. The second group consisted of diabetic rats without any treatment. The third group was treated by the aqueous extract of mixture contains Foenugreek, Nigella sativa and Termis seeds. The fourth group was treated with the aqueous extract of Nigella sativa seeds (100 mg / kg of body weight), while the fifth group was treated with the aqueous extract of Foenugreek seeds (100 mg / kg of body weight). The sixth one was treated with the aqueous extract of Termis seeds (100 mg/kg body weight). After four weeks of treatment, different biochemical parameters were performed including estimation of blood sugar level and serum insulin level. Pancreatic and liver samples were obtained and processed for microscopic and quantitative evaluation after staining the prepared sections with both Heamatoxylin and Eosin as well as special stain for demonstration of the different pancreatic cells in the Islet of the Langerhans. Results: The usage of the mixture or each plant alone corrected the glucose level and insulin level. Microscopically there was definite decrease in the number and diameter of beta pancreatic cells in the diabetic group while the other pancreatic cells were not affected (alpha and delta cells). The use of medicinal plants in the different groups of this study greatly improved such cellular changes and the level of blood sugar level was corrected. Also, improve dyslipidemia present in diabetic rats. The results showed that the activity of the mixture was better when compared with Nigella, Foenugreek or Termis seeds alone. Conclusions: The water extract of the mixture is the most powerful in amelioration hyperglycemia and most of all damage effects of Alloxan on hematological parameters and lipid profile. Also, it can control most of the metabolic risk factors of CAD in diabetic rats. So it is advised to use the plant mixture as an antidiabetic agent rather than the use of each plant separately. Repeating such study with the use of variable doses may be helpful in better evaluation for the required dose.    }, keywords = {alloxan,diabetes,Antidiabetic plants – Pancreas – coronary artery disease}, url = {https://ejhm.journals.ekb.eg/article_15976.html}, eprint = {https://ejhm.journals.ekb.eg/article_15976_b78987aa15e09c99835add710c150f8a.pdf} } @article { author = {Moghannem, Saad AM and Elsheikh, Hussein H and Abd-elwahab, Kouka SE}, title = {Purification of The Antitumor Active Metabolite from Streptomyces xylophagus Ha.Ph-7 Crude Extract Isolated from Hamam Pharaoh Hot Spring}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {51}, number = {1}, pages = {275-284}, year = {2013}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2013.15977}, abstract = {Aim: This study aimed at production, extraction, purification and characterization of active antitumor compound from marine actinomycete secondary metabolites crude extract that was selected as most potent crude secondary metabolites from the preliminary screening of total fifty one extract. Material and methods: These tumor cell lines were breast cancer (MCF-7) (ATCC HTB-22) and Hepato-cellular carcinoma (HepG2) (ATCC 77400), colon cancer (Caco) (ATCC HTB-37) and cervix carcinoma(HeLa) (ATCC CRL-13011) cells. Purification process was done using silica gel  column chromatography while purity was detected using thin layer chromatography (TLC). The active fraction was detected using morphological changes (cytotoxicity) by microscopic examination and anti-proliferative activity using MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] assay. Result: The result indicated that there is only one fraction responsible for antitumor activity. This active fraction has cytotoxic and anti-proliferative activity against HepG2, MCF7, Caco and HELA cells with IC50=24.5, 20.1, 27.6 and 17.7µg/ml respectively. The analysis of physico-chemical, elemental and spectroscopic analysis (UV, IR, H.NMR, Mass spectroscopy) indicated that; the active compound has the nature of anthracycline compound. Conclusion: This purified compound has promising broad spectrum cytotoxicity and anti-proliferative activity in an in vitro system. The next research step shall include different optimization parameter that maximize productivity  with long-term goal; discovery of an antitumor drug from actinomycetes native to Egyptian hot springshabitat.  }, keywords = {Actinomycete extracts,antitumor,Cytotoxicity,Anti-infectivity,HePG2,Caco,MCF7,Hela}, url = {https://ejhm.journals.ekb.eg/article_15977.html}, eprint = {https://ejhm.journals.ekb.eg/article_15977_4b456fc89fe2a0121349cdfc2247cd1f.pdf} } @article { author = {Amer, Moatasem S and Tawfik, Heba M and Maamoun, Manar MA and Abd Elmoteleb, Ayman M}, title = {Relationship between Peripheral Artery Disease and Cardiac Function in Elderly Patients with Ischemic Heart Disease}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {51}, number = {1}, pages = {285-288}, year = {2013}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2013.15978}, abstract = { Background: There is high prevalence of combined peripheral and coronary artery disease (CAD) related to atherosclerosis  with associated increase in morbidity and mortality . Objectives:The aim of our study was to find an association between ankle brachial index (ABI) and cardiac function in elderly patients with CAD using ejection fraction (EF). Method: A Case control study. The case group included 100 elderly patients who had peripheral artery disease ( PAD) divided into 2 groups according to age ( 60- 70 and > 70 years). The control group included 100 elderly subjects who didn't have PAD which were divided also into 2 groups according to age . Both groups have CAD and underwent coronary angiography (CA) showing significant CAD lesions. Echocardiography were done to all patients showing cardiac function. Results: EF was lowest in cases > 70 years (46.84 ± 9.82)and was highest in controls > 70 years (53.02 ± 5.53) which is statistically significant (P- Value 0.009). Also EF is correlated with ABI. Conclusion: There is a significant positive relationship between ABI and EF.  }, keywords = {Coronary artery disease – Peripheral artery disease – Ankle brachial index – Ejection Fraction – Elderly}, url = {https://ejhm.journals.ekb.eg/article_15978.html}, eprint = {https://ejhm.journals.ekb.eg/article_15978_08a7fe12d550799a134b9babdf1717ac.pdf} } @article { author = {Yassen, Mohy Eldin abdel Fattah abdel Atty and Hammam, Olfat Ali Ibrahim and Sarhan, Hazem Kamel Abdel-Aziz Mohamed}, title = {Expression of Matrix Metalloproteinase 1(MMP1) in HepatoCellular Carcinoma (HCC): Immunohistochemical and Biochemical Studies}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {51}, number = {1}, pages = {289-299}, year = {2013}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2013.15979}, abstract = {Background: The present study aimed to evaluate the expression of Matrix Metalloproteinase-1 (MMP1) in HepatoCellular Carcinoma (HCC) by using the Immunohistochemical technique, which allows us to integrate the biological aspects of this enzymatic expression in the morphological context of HCCs.   Material and Methods: The study was performed on 70 subjects from out and in patients of Tropical medicine Department, Thiodor Billhars Institute during the period from January 2011 until June 2012. The present study included 60 patients with chronic hepatitis C who had undergone liver biopsy. They consisted of 42 men and 28 women with ages ranging from 36 to 66 years. The diagnosis of chronic hepatitis C was made on the basis of positivity for anti-HCV (by the second generation ELISA), and confirmed by HCV-RNA reverse transcription polymerase chain reaction (RT-PCR). Patients were divided into four groups: Group I: included 10 normal persons with no history of liver disease with normal liver enzymes and free ultrasonographic finding as normal control. It included 6 males, 4 females, with ages ranging from 34 to 48 years. Group II: included 20 HCV infected patients without cirrhotic changes. It included 11 males, 9 females, with ages ranging from 39 to 53 years. Group III: included 20 HCV infected patients with liver cirrhosis, 12 males, 8 females, with ages ranging from 48-63 years. Group IV: included 20 HCV infected patients with HCC, 16 males, 4 females, with ages ranging from 53-64 years.   Results: Blood Picture, (Hb, WBCs, RBCs, Plts, PC and ESR). Liver Function Test (ALT, AST, ALB, GGT, ALP, T. BIL and D. BIL). Matrix Metalloprotenase 1(MMP1) Measurements: Serum MMP1. Histopathological investigation Including histopathological changes in the liver tissue.   Conclusion: our results suggest that MMP-1 is overexpressed in a large proportion of patients with HCC and the high expression level of protein correlated with the disease progression and poor clinical outcome in HCC. Furthermore, MMP-1 high expression proved to be a risk factor for tumor recurrence and independent molecular marker of prognosis in HCC and may become a novel target in the strategies for the prediction of tumor progression and prognosis of this disease.    }, keywords = {patients,HCV,Cirrhosis,HCC,and MMP-1}, url = {https://ejhm.journals.ekb.eg/article_15979.html}, eprint = {https://ejhm.journals.ekb.eg/article_15979_5dd1ff71c213488229f9cbf3445e857d.pdf} } @article { author = {Bassiouny, Ahmed M and Arafa, Maher M and Abdelwahab, Sameh M and Albeblawy, Motaaz M and Abdelsamad, Amr M}, title = {Role of 3-D Conventional Angiography In Evaluation of Intra Carnial Aneurysms}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {51}, number = {1}, pages = {300-305}, year = {2013}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2013.15980}, abstract = {Introduction: intracranial aneurysms are pathological enlargement of the brain arteries that are most commonly located in the circle of Willis. Intracranial aneurysms are relatively common with a prevalence of approximately 4%. The real danger of aneurysms is subarachnoid hemorrhage. 3D digital subtraction angiography has become a critical imaging tool in neuroradiology allowing for the visualization of detailed cerebral vasculature prior to any intervention.   Aim of the work: The aim of this work is to evaluate the diagnostic performance of 3D conventional angiography in the evaluation of intracranial aneurysms compared with the conventional cerebral angiography.  Methods: The studied group included 20 patients (5 men and 15 women) with subarachnoid hemorrhage or known to have cerebral aneurysms. All patients were subjected to conventional cerebral angiography and 3D cerebral angiography, using C-arm (Toshiba) rotational technique. Results: 3D digital subtraction angiography is superior to conventional digital subtraction angiography in 100% of the cases 3D imaging revealed the proper aneurysmal shape, size, precise assessment of its neck and relation to the surrounding vessels. Conclusion: Three-dimensional DSA improves the detection and delineation of intracranial aneurysms  }, keywords = {3-D Conventional Angiography,Intra Carnial Aneurysms}, url = {https://ejhm.journals.ekb.eg/article_15980.html}, eprint = {https://ejhm.journals.ekb.eg/article_15980_be96932c0177ed6aac138817531d64d8.pdf} } @article { author = {Koura, Ahmed F and Yehia, Mohamed A and ElTantawy, Waleed H and Salah El Din, Adel S and ElShennawy, Dina El-Sayed}, title = {Diagnostic Validity of Serum and Peritoneal TNF-alpha, high sensitivity CRP and Plasma Cell-Free Nuclear DNA (ccf nDNA) as Biomarkers of Pelvic Endometriosis- A Case Control Study}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {51}, number = {1}, pages = {306-316}, year = {2013}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2013.15981}, abstract = {Introduction:Endometriosis is a disease defined by the presence of endometrial glands and stroma located outside the uterine cavity. These ectopic implants can be found throughout the pelvis, on and within the ovaries, abutting the uterine ligaments, occupying the rectovaginal septum, invading the intestinal serosa, and along the parietal peritoneum. Endometrial implantation at distant sites such as the pleura, lung, within surgical scars, and along the diaphragm also has been reported. (1).  It results often in subfertility and pain, occurs mainly in women of reproductive age (16–50 years) and has a progressive character in at least 50%, but the rate and risk factors for progression are unknown. Endometriosis can be classified into four stages: minimal, mild, moderate and severe. The gold standard for the diagnosis of endometriosis is laparoscopic inspection, ideally with histological confirmation. (2), however, is an invasive technique and should be performed only after imaging techniques prove insufficient for confident diagnosis. (3) Lack of a non-invasive diagnostic test contributes to the long delay between onset of symptoms and diagnosis of endometriosis. (2) Additional tools are needed for non-invasive classifications in order to reduce the number of unnecessary laparoscopies without adversely affecting outcomes. Finding specific and   more sensitive biomarkers in endometriosis is critical, because endometriosis is usually diagnosed only in advanced stages, and there is a high rate of morbidity for this disease. (4)   Aim of the work: The aim of the current study is to assess the validity of serum and peritoneal high sensitivity CRP and TNF-alpha and plasma cell-free nuclear DNA (ccf nDNA) as biomarkers in early diagnosis of pelvic endometriosis. Methods: This study was conducted at the Obstetrics & Gynecology department, Maternity Hospital, Ain Shams University. This is a case control study of 120 women scheduled for diagnostic laparoscopy. Laparoscopy was indicated in these women whether for various causes of subfertility or for chronic pelvic pain between January 2011 and January 2012. The patients were divided into the following groups: Group I (endometriosis group/ study group) consisted of 80 patients diagnosed to have endometriosis during laparoscopy. Group I cases were subdivided into two subgroups, Group IA: consisted of 34 cases with stage 1or minimal endometriosis and Group IB: consisted of 46 cases with stage 2 or mild endometriosis. Group II (non-endometriosis group/Control group): consisted of 40 cases with no detected pelvic pathology. During the laparoscopy procedure, both peripheral venous blood and peritoneal samples were withdrawn. Serum and peritoneal levels of high sensitivity CRP and TNF-alpha as well as plasma levels of ccf nDNA were compared in both groups and in early stages (minimal and mild) of endometriosis within the study group. Results: Serum TNF-a, serum hs-CRP and plasma ccf DNA were significantly elevated in cases compared with the control group. They were also elevated in patients with group IA and group IB as compared to control group. However, there was no statistically significant difference between cases and control group as regards peritoneal TNF-a and peritoneal hs-CRP. There was no significant difference between the group IA and group IB as regards all biomarkers. Conclusion: Our results showed that serum TNF-alpha , serum hs-CRP and plasma ccf DNA are highly reliable biomarkers for screening and early diagnosis of endometriosis,  but they  can not be used to discriminate between stage I and stage II. On the other hand, peritoneal TNF-a and peritoneal hs-CRP are non reliable for early diagnosis of endometriosis and can not be used to discriminate between stage I and stage II of endometriosis.}, keywords = {}, url = {https://ejhm.journals.ekb.eg/article_15981.html}, eprint = {https://ejhm.journals.ekb.eg/article_15981_20482328566c51bcb0d3a498e6d17fce.pdf} } @article { author = {Taha, Inass M. and Ali, Sahar M. and Mohammad, Ahmad Abdelsadek and Nawar, Nany M.S.}, title = {STUDY OF SOME FACTORS ASSOCIATED WITH HIGH-RISK ASTHMA IN CHILDREN}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {51}, number = {1}, pages = {317-325}, year = {2013}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2013.15982}, abstract = {Background: Bronchial asthma is characterized by lower respiratory tract inflammation associated with bronchial hyper responsiveness with variable and reversible airflow obstruction. The majority of asthmatics are sensitized to at least one common allergen. Aim of the study: The aim of this study is to determine the association of high-risk asthma with allergy-related parameters (total serum IgE levels, serum levels of allergen- specific IgE, eosinophil count, eosinophil percentage ) and pulmonary functions in children. Subjects and methods:  50 Children aged 8-15 years diagnosed with atopic asthma were enrolled in the study. Pulmonary function tests, total leukocyte count (TLC), eosinophil count, and eosinophil percentage were estimated.  Total serum immunoglobulin E (IgE) levels and serum  IgE levels specific to antigens from 1 to 9 allergens with class 1 or higher, namely, Dermatophagoides pteronyssinus (D. pteronyssinus) , Dermatophagoides farina (D. farina ), cat dander , dog dander, cockroach, egg white, milk, Aspergillus fumigatus, and fish, were measured using  UniCAP fluoroenzyme immunoassay (FEIA).   Results: This study includes 50 participants, 20 (40%) belonged to the high-risk and 30 (60%) to the low-risk groups. This study revealed no significant association in peak expiratory flow rate (PEFR, %) values between high-risk and low-risk asthma groups (p ˃ 0.05). There was no significant association in forced expiratory volume in first second           [ FEV1 (L)] values between high-risk and low-risk asthma groups ( p ˃ 0.05), whereas there was significant association in FEF 25-75% (forced expiratory flow 25-75%) values between high-risk and low-risk asthma groups ( p ˂ 0.05). There was a significant association between total serum IgE level and high-risk asthma, but TLC, eosinophil count, and eosinophil percentage showed non  significant association with high-risk asthma. Serum levels of IgE specific to D. pteronyssinus, D. farina, cat dander, and dog dander were significantly associated with high-risk asthma. The high-risk group had  higher serum levels of IgE specific to D. pteronyssinus ( p < 0.0001), D. farina ( p < 0.0001), cat dander ( p < 0.0001), and dog dander antigens ( p < 0.0001) compared with those in the low-risk group. There was no significant association between high-risk asthma and the serum levels of IgE specific to antigens from other allergens (including cockroach, egg white, and milk). Serum levels of IgE specific to Aspergillus fumigatus and fish were both negative (class level < 1) in both the high-risk group and the low-risk group.   Conclusion Children with higher serum levels of IgE specific to D.pteronyssinus, D. farina, cat dander and dog dander antigens, and total serum IgE levels, and lower FEF25-75% values belong to the high-risk asthma group. The characterization of risk factors has enabled us to identify high-risk asthma in children , leading to better treatment options.    }, keywords = {HIGH-RISK ASTHMA,children}, url = {https://ejhm.journals.ekb.eg/article_15982.html}, eprint = {https://ejhm.journals.ekb.eg/article_15982_048766340e108f503a50e318adb81594.pdf} } @article { author = {Shousha, Wafaa Gh. and El-Haddad, OM Kolsoum and Basuni, Ashraf A. and El-Mezayen, Hatem A. and Abdalla, Amany A.}, title = {Association of A Novel Adipokine With Insulin Resistance And Disease Severity in HCV Infected Patients}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {51}, number = {1}, pages = {326-331}, year = {2013}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2013.15983}, abstract = {Retinol-binding protein 4 (RBP4) has been identified as a protein contributing to insulin resistance (IR). As insulin resistance is present in nearly all patients with liver cirrhosis, we evaluated RBP4 in patients with chronic hepatitis C virus infected patients (CHC). This study aimed to evaluate the role of serum retinol binding protein 4 (RBP-4) as a predictor for early detection of insulin resistance (IR) in patients with CHC infection. Research Design and Methods: Serum RBP4 was measured in 60 non diabetic CHC Patients classified according to Child- Pugh classification (Child A, Child B, Child C), 20 diabetic CHC patients and 20 age- and sex-matched healthy blood donors served as control subjects. RBP-4 correlation with the homeostasis model assessment of insulin resistance index (HOMA-IR) and metabolic factors was investigated.  Results: Serum RBP-4 levels were significantly lower in HCV infected patients and HCV diabetic patients compared with controls (HCV 16545.17± 10633.16, Diabetic HCV 10310 ± 4371.31, Control 27820.0 ± 9316.46, P< 0.001). In addition, serum levels of RBP-4 significantly decreased between all stages of cirrhosis, with the lowest level in Child C. HOMA-IR not significantly higher in HCV infected patients compared to control (HCV 5.54 ± 3.67, and Control 4.11 ± 2.42). RBP-4 levels correlate positively with GGT (P<0.01), CHOL (P<0.05) and TG (P<0.05) in HCV Child C, additionally, it shows significant positive correlation with TG (P< 0.05) in HCV Child B.  Conclusions: Disease severity may limit the role of RBP4 as a predictor of IR in CHC. These data demonstrate that RBP4 in CHC patients decreased due to reduced hepatic production, and it is not associated with insulin resistance. Keywords: HCV, RBP4, Insulin Resistance Abbreviations: RBP4: Retinol-binding protein 4, IR: insulin resistance, HOMA-IR: homeostasis model assessment of insulin resistance index, CHC: Chronic Hepatitis C Virus.}, keywords = {}, url = {https://ejhm.journals.ekb.eg/article_15983.html}, eprint = {https://ejhm.journals.ekb.eg/article_15983_0871920bb7a114dd4b06d18433bf5d50.pdf} } @article { author = {El- Gohary, Zeinab M. and El-Sayad, Fawkeia I. and Hassan, Hanaa A. and Hamoda, Aya M.}, title = {Structural Adaptations Associated with Osmotic Stress of The Salt Gland in Birds}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {51}, number = {1}, pages = {332-345}, year = {2013}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2013.15984}, abstract = {Introduction:When the drinking water of many species of ducks is changedfrom freshwater to saline, their salt glands hypertrophy and the principal cells showed numerous lateral cell evaginations and abundant mitochondria, enhancingtheir capacity to excrete salt.    Aim of the work:The purpose of this investigation was to demonstrate and evaluate the anatomical, histological, and ultrastructural adaptations of the salt gland of the  domestic  female ducks associated with high salt osmotic stress.    Material and methods:      The present study was carried out on two groups of female domestic ducks and one group of wild ducks. Where as one group of domestic ducks was exposed to osmotic stress; imposed by replacing drinking  tap water with 1% sodium chloride solution for two consecutive weeks. Morphometric measurements as well as histological and ultrastructural aspects of the salt glands were considered.     Results: The investigation revealed that the weight and  size of the salt glands of the salt-stressed ducks were markedly heavier and larger in comparison to those of the control and wild ducks. The number and the diameter of secretory lobules as well as the length of secretory tubules of the salt-stressed group were greater compared to the control ones.The degree of the proliferation and differentiation of the peripheral cells was distinctly greater for the salt-stressed than the control and wild ducks. The basal and lateral surfaces of the fully specialized secretory cell type in the salt-stressed and wild birds were obviously amplified and in many cases the folds of adjacent cells meshed with one another forming an elaborate complex of extracellular spaces and intracellular compartments. The cytoplasm of the fully specialized principal cells displayed abundant endoplasmic reticulum, numerous well developed mitochondria  and deeply well developed basal foldings which increase the absorptive surface.     Conclusion: The recorded peculiar features of the salt glands of the salt-stressed birds  may be presented as an adaptive features to satisfy its special demands to eliminate the remarkable increased levels of sodium chloride load effectively.      }, keywords = {histology,Supraorbital salt gland,Adaptations,Osmotic stress,Ultrastructure}, url = {https://ejhm.journals.ekb.eg/article_15984.html}, eprint = {https://ejhm.journals.ekb.eg/article_15984_fea0bee2c3ef803cb58c21ea4e417560.pdf} } @article { author = {El–Gohary, Zeinab M. and El-Sayad, Fawkeia I. and Hassan, Hanaa Ali and Hamoda, Aya Mohammed Magdy}, title = {The Functional Alterations of The Avian Salt Gland Subsequent to Osmotic Stress}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {51}, number = {1}, pages = {346-360}, year = {2013}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2013.15985}, abstract = {Background: Many terrestrial non-marine birds have functional salt glands. Their salt glands are usually quiescent. However, such  glands show remarkable levels of phenotypic plasticity both morphological and physiological as a consequence of drinking saline water. Objective: The current investigation was conducted to reveal in more detail the different functional alterations of the duck`s salt glands subsequent to high salt osmotic stress. Material and methods: The selected avian species were  the  domestic  female (Anas platyrhyncha)and the wild migratory  (Anas clypeata ) ducks. Two groups of domestic and one group of wild ducks were considered in the present study , each of which included nine adult ducks. The high salt osmotic stress was induced by replacing drinking tap water of the domestic ducks with 1% sodium chloride solution for two consecutive weeks. The measured parameters were included some  electrolytes in both serum and glandular tissue. Also, Na-K-ATPase activity and aldosterone concentrations were considered.    Results: The present study elucidated that serum sodium, potassium, chloride and uric acid of the wild migratory ducks were markedly higher than those of  both salt-stressed and control ducks. In addition, serum aldosterone concentration of the wild migratory ducks was distinctly higher  in comparison with those of the control and the salt-stressed ones. Moreover,  salt gland tissue homogenate electrolyte contents followed the same pattern as those of serum electrolyte concentrations. In contrast, the  activity of  Na-K-ATPase of the salt gland homogenates was higher in  the salt-stressed ducks in comparison to both wild migratory and control groups. Conclusion: From the above mentioned results, it was concluded that the peculiar functional status of the salt gland of the experimentally salt-stressed ducks comparing to the control  may be presented as an adaptive features to satisfy its special demands to eliminate the remarkable increased levels of sodium chloride load effectively.    }, keywords = {Ducks,Salt gland,Osmotic stress,electrolytes,Na-K-ATPase}, url = {https://ejhm.journals.ekb.eg/article_15985.html}, eprint = {https://ejhm.journals.ekb.eg/article_15985_1ba6d9adf482de5488ee1ac3d2db86b2.pdf} } @article { author = {Metwally, Mohamed A. and Moawad, Galal A. and Mohammad, Ahmad Abdelsadek}, title = {Pulmonary Functions After Injection Sclerotherapy Of Esophageal Varices & After Band Ligation}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {51}, number = {1}, pages = {361-366}, year = {2013}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2013.15986}, abstract = {  Aim of the study: To study changes in pulmonary function tests after esophageal variceal injection sclerotherapy in comparison to changes after esophageal variceal band ligation. Patients & methods: This study was designed as non randomized controlled study. Thirty  patients with hepatic cirrhosis & portal hypertension who were admitted to Hepatology, Gastroenterology and Infectious Diseases department , Benha university hospital for elective esophageal variceal therapy (secondary prophylaxis) were  classified into group I:15 patients treated with sclerotherapy by using 5-15 ml ethanolamine oleate and group II:15 patients treated with band ligation. Patients were subjected for full clinical evaluation including history, general, chest, and abdominal examination. Laboratory and radiological investigation including complete blood count, liver function tests, kidney function tests and blood sugar and plain chest x-ray (P.A. and lateral views) were done. Pulmonary function tests and arterial blood gasses were done before, one day after and one week after the procedure. Results: The results revealed , significant decrease in vital capacity in group I one day after injection  ( p ˂ 0.05),but no significant decrease in vital capacity in group II. There was a significant decrease in PaO2 in group I one day after injection sclerotherapy ( p ˂ 0.05) but no significant changes in group II and no significant changes in PaCO2 in both groups one day after the procedures. The study has also revealed no significant changes in FVC,FEV1/FVC and PaCO2 in group I and group II after procedures. The study revealed significant linear correlation between the decreases in PaO2 and the percentage decrease in vital capacity( p ˂ 0.05). One week after procedure, pulmonary functions that has been affected in group I returned back to baseline values. Conclusions: esophageal injection sclerotherapy produces restrictive defect (decrease in PaO2 and vital capacity) in pulmonary functions one day after injection and improved within one week, while there was no effect for band ligation on pulmonary functions tests.    }, keywords = {Esophageal varices,sclerotherapy,band ligation,pulmonary functions test}, url = {https://ejhm.journals.ekb.eg/article_15986.html}, eprint = {https://ejhm.journals.ekb.eg/article_15986_0c95fc6effe64a1b988e3bae32018640.pdf} } @article { author = {Fayed, Soheir Bahgat and Abd EL-Salam, Manal and Moussa, Rabab and El-Bagoury, Iman Mouhamed}, title = {Assessment of Growth and Oxidized High-Density Lipoprotien Level in Children on Regular Hemodialysis}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {51}, number = {1}, pages = {367-375}, year = {2013}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2013.15987}, abstract = {Background: The cause of growth failure in chronic kidney disease (CKD) is multi-factorial with linear impairment being a final common pathway of various factors including malnutrition, increased catabolism, loss of nutrients and antioxidants, and aggressive dietary restrictions during dialysis .Anemia, metabolic acidosis and persistent micro inflammations are also causative factors. Objectives: To assess growth in children with CKD on regular hemodialysis and measure oxidized high density lipoprotein (OX-HDL), highly sensitive C-reactive protein (hsCRP) and to discuss their roles as a risk factors of malnutrition among studied cases. Patients and Methods: The study included 25 children with end stage renal disease (ESRD) on regular hemodialysis more than 6 months. Their ages ranged from 5-15 years with a mean of 10.76 years, also 25 of apparently healthy, age and sex matched were included. The study sample was selected from pediatric dialysis unit and outpatients clinic, of AL-Zahraa University hospital .Anthropometric measurements were assessed with determination of OX-HDL and hsCRP serum levels in both cases and the controls. Results: Anthropometry showed significant decrease in weight, height, body mass index, mid arm circumference and triceps skin fold thickness in patients when compared to the controls. 100% of patients had high level of OX-HDL and hsCRP, and positive correlation between OX-HDL and Z-score for Wt and Ht were detected. Conclusion: Malnutrition, and growth delay are common in children with chronic kidney disease on regular hemodialysis. High rate of inflammation in dialysis children as there were high level of hsCRP and OX‑HDL. HDL, in regular hemodialysis children loses its protective function as an anti-oxidant, anti-inflammatory and becomes pro-inflammatory factor.      }, keywords = {CKD,dialysis,OX‑HDL,Malnutrition}, url = {https://ejhm.journals.ekb.eg/article_15987.html}, eprint = {https://ejhm.journals.ekb.eg/article_15987_6ed027bcf7040d10c8c61dc76888c5c8.pdf} } @article { author = {Elbeih, Dalia F and El-Gohary, Mervat M and Shebrya, Naglaa H and Saleh, Mohammed A}, title = {Value of Multidetector Computed Tomography in Evaluation of Thoracic Venous Abnormalities among Pediatrics with Congenital Heart Disease}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {51}, number = {1}, pages = {376-384}, year = {2013}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2013.15988}, abstract = {Introduction: Venous anomalies of the thorax can involve systemic or pulmonary veins and range from isolated incidental findings to components of more complex anomalies, most often congenital heart disease (CHD). Although echocardiography and catheter directed cardiac angiography are generally accepted as the primary imaging techniques for evaluation of CHD, CT and MRI are important complementary diagnostic tools. Multi-detector computed tomography (MDCT) with its increasing availability and utility is now becoming a further method of imaging CHD. In light of its widespread availability, MDCT and 3D imaging are increasingly considered as a viable “one-stop shop” for preoperative imaging evaluation of cardiovascular structures in selected pediatric patients. Aim of the work: The aim of this work is to evaluate the role of MDCT in visualization of the thoracic venous system in pediatrics with congenital heart disease, show prevalence and types of venous anomalies and to compare this data with echocardiographic findings. Methods: The studied group included 30 cases referred to us by pediatric cardiologists to be examined by MSCT angiography of the heart and thoracic vessels. All the patients were known cases of congenital heart disease and underwent echocardiography. They were referred to answer specific anatomic question raised by inconclusive echocardiography, to assess suspected systemic and suspected pulmonary venous anomalies. All patients were subjected to full history taking, clinical examination and MDCT examination with CT lightspeed VCT XT 64-detectors row scanner (General Electric, Medical Systems, Milwaukee, Wisconsin, USA). Results: CTA findings had 77.8 % concordance with echocardiographic findings regarding SVC anomalies, 66.7 % concordance with echocardiography regarding IVC anomalies and 90 % concordance regarding pulmonary venous anomalies. Conclusion: Low dose protocol CTA is a promising method that complementary to Echocardioraphy for imaging of extracardiac vascular structures in pediatrics with congenital heart diseases.  }, keywords = {Congenital heart disease. Computed Tomography Angiography. Systemic venous anomalies. Pulmonary venous anomalies}, url = {https://ejhm.journals.ekb.eg/article_15988.html}, eprint = {https://ejhm.journals.ekb.eg/article_15988_76a31d9f989e18d8c1bfd9298252a199.pdf} } @article { author = {Sayed, Rania S and Mansour, Hisham M and Abo Gamra, Sherif H and Nasr, Merhan A and Khaleel, Mohammad H}, title = {Role of Multidetector CT in Evaluation of Acute Chest Pain: Non-Cardiac Vascular and Pulmonary Causes}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {51}, number = {1}, pages = {385-394}, year = {2013}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2013.15989}, abstract = {Background: Triage of patients with acute chest pain is one of the most important issues currently facing physicians in the emergency department. Acute chest pain may be a symptom of a number of serious conditions and is generally considered a medical emergency. The causes of acute chest pain range from non-serious to life threatening. A rapid, accurate and cost-effective approach for the evaluation of emergency department patients with chest pain is needed. Aim of the work: This work aims to emphasize the role of multidetector CT in assessment of non-cardiac vascular and pulmonary causes of acute chest pain. Method: The studied group included 89 patients (59 men and 30 women) presented by acute chest pain. All patients were subjected to MDCT and/or MDCT angiography using a Toshiba 64 detectors CT scanner. Results: The high spatial resolution and relatively non-invasive nature make MSCT angiography a strong and serious competitor to established vascular imaging techniques. Having the additional ability to simultaneously acquire information on other organs, which enables the early diagnosis of complications. Conclusion: Continued technical improvements in acquisition speed and spatial resolution of computed tomography images, and development of more efficient image reconstruction algorithms which reduce patient exposure to radiation and contrast result in increased popularity of MDCT.  }, keywords = {Acute chest pain,Aortic dissection,pulmonary embolism,Pneumothorax,Computed tomography angiography}, url = {https://ejhm.journals.ekb.eg/article_15989.html}, eprint = {https://ejhm.journals.ekb.eg/article_15989_3813a9b11d2607d2d55a8a833ee184c5.pdf} } @article { author = {Farid, Saadia and Rashid, Laila and Swelam, Samya}, title = {Tumour Necrosis Factor-Alpha Gene Expression in Chronic Hepatitis C Virus Infection.}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {51}, number = {1}, pages = {395-404}, year = {2013}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2013.15990}, abstract = {Objective: Tumour necrosis factor (TNF)-alpha, a prototype proinflammatory cytokine, has been implicated as an important pathogenic mediator in a variety of liver conditions. Some genetic polymorphisms in the human TNF-alpha promoter region, such as the G-A transitions -308 and – 238, have been shown to influence TNF-alpha expression in chronic hepatitis C virus infection. Aim of the work: The present study was to investigate the influence that the – 308and – 238 TNF- alpha promoter polymorphisms have on the response to interferon and ribavirin therapy in chronic hepatitis C virus infection. Patients and methods: One hundred forty patients with chronic hepatitis C virus infection, their age ranges between (20-56) years, selected from the National Hepatology and Tropical Medicine Research Institute were included in this study, during interferon and ribavirin therapy and thirty five healthy individuals were included to serve as controls, the patients and controls were divided into two groups the first group forty patients and fifteen controls for the detection of TNF-alpha -308, -238 genotypes polymorphisms, the second group were one hundred patients and twenty healthy controls for the detection of  serum levels of   TNF-α. All the patients and controls were subjected to the following history, clinical examination, abdominal ultrasonography and collection of blood samples for routine laboratory investigation, CBCs and serological assay, genotyping of 308, 238 TNF-alpha promoter polymorphism and serum levels of  TNF-α. Results: There was no statistically significant difference between chronic HCV patients   and healthy controls as regarding TNF-alpha -238 different alleles. The frequencies of TNF-alpha gene polymorphism with A/G and G/G mutation at – 308 were significantly higher in chronic HCV patients than those in the controls. The serum level of TNF-alpha was markedly higher in the chronic HCV patients than in the healthy controls. There were significant association between TNF- alpha gene polymorphism in the – 308 A/G, G/G alleles and increased serum TNF- alpha in CHCV infection. Conclusion: The results indicate that the TNF-alpha gene polymorphism at position -308 is associated with susceptibility of chronic HCV infection. Recommendations: Our major concern was to improve the response to treatment in patients with chronic  HCV infection, whether the disadvantage of having the TNF-alpha -308 allele became more apparent after interferon and ribavirin therapy is unclear and needs further study that detecting the polymorphism of the -308 TNF-alpha allele before administering interferon therapy may be valuable for predicting the treatment response, especially in difficult- to treat patients.  }, keywords = {TNF-alpha,apromoter polymorphism at position 238,308,chronichepatitisC virus infection therapy}, url = {https://ejhm.journals.ekb.eg/article_15990.html}, eprint = {https://ejhm.journals.ekb.eg/article_15990_0fbdeafe68002a3033222c36ca427c32.pdf} } @article { author = {H, Abu Gabal and M, Moamena and H, Al Moalla}, title = {The Role of Bee Venom in Controlling Albino Rats Fetal Morphometric and Morphological Changes by Carbimazole Induced Hypothyroidism}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {51}, number = {1}, pages = {405-421}, year = {2013}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2013.15991}, abstract = {Aim of the work. The present study was planned to investigate the role played by Bee venom in improving the morphometric and morphological changes induced by carbimazole in pregnant albino rats and their embryos.  Materials and method .A total number of 60 mature virgin female and 30 male Wistar wistar albino rats (for fertilization) were used in this study.Pregnancy was ascertained by vaginal smears.The experimental animals were divided into the following groups: І- (Normal group): in this group the pregnant rats were injected intraperitonealy by distilled water (The solvent of both carbimazole and bee venom) by dose 1ml/200g.body weight, from day 1 to day 18 of gestation. II-The group of treated animals: this group was divided into 3 subgroups: 1-The carbimazole group: this group was divided into2 subgroups, the pregnant rats were orally injected at a dose 2 and 3mg /200g.body weight, daily from day 1 to day 18 of gestation. 2-The Bee venom group: the pregnant rats were intraperitonealy injected with a dose 0.6 mg/200g. body weight on days 2,3,4,7,8,9,10,11,12,15 and 16 of gestation.            3-The treatment group: the pregnant rats were intraperitonealy injected with Bee venom at a dose 0.6 mg/200g. body weight 1 hour after the intraperitonealy injection by the 2 doses of carbimazole (2 and 3mg /200g. body weight).The days of injection for both treatments (Bee venom and carbimazole) were  as mentioned before. Results. The results of the present study showed thatcarbimazole treatment with its 2 doses induced highly significant increase in the body weights of pregnant rats, highly significant reduction of the  uterus weight with shortness of the horns as well as unequal distribution of the embryos between them, increased  number of the resorbed fetuses when comparing with the control group, Bee venom injection revealed  improvement of  these changes .The  orally injection of the 2 doses of carbimazole resulted in very highly decrease in fetuses body weights and lengths; however Bee venom induced obvious improvement as compared with the carbimazole effects. Orally injection of carbimazole at the dose 3mg /200g body weight showed increased fetal mortality rate as compared with the control group; however, intraperitonealy injection of Bee venom resulted in improvement in the rate of live fetuses and never of dead ones was observed after Bee venom treatment. The 2 doses of carbimazole induced  lots of  malformations of embryos such as variations in the size of embryos of the same mother, the embryos exhibited  fragile skin, sub dermal blood coagulation beside edema in different regions of the  fetal body ,as well as malformations of the regions of the eye resembled in  exophthalmos and rostrum region such as cleft lips, beside  clubbed fore and hind limbs , kyphosis of the body of the embryos, exencephaly.Bee venom treatment resulted in control  of the changes induced by carbimazole injection. The fetuses were resembled to those of the control group. Conclusion: It is clear that bee venom plays an important role in controlling the morphometric and morphological changesin fetuses of albino rats suffering from hypothyroidism induced by carbimazole ٠  }, keywords = {Carbimazole,Thyroid gland,Bee venom. Pregnant Rats,fetuses}, url = {https://ejhm.journals.ekb.eg/article_15991.html}, eprint = {https://ejhm.journals.ekb.eg/article_15991_0e56101eaaccfd3cdde0ac695cac9973.pdf} } @article { author = {Zaki, Nadia Gamal and Abdel Kawy, Laila}, title = {Chronic exposure to MDMA (ecstasy)induces DNA damage, impairs functional antioxidant cellular defenses, enhances the lipid peroxidation process and alters testes histopathology in male rat.}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {51}, number = {1}, pages = {422-433}, year = {2013}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2013.15992}, abstract = {3,4-Methylenedioxymethamphetamine (MDMA or "ecstasy") is consumed mainly by young population. For this reason, it is especially relevant to take into consideration the effects on the reproductive system. The influence of MDMA on the fertility and reproduction of the male rat was assessed in this study.  Material and methods: MDMA was administered orally at 0 mg/kg (control), 10 and 30 mg/kg to male rats  for 15,30,45 consecutive days followed by 15 days withdrawal. Hormonal, biochemical, histological and testicular were evaluated in the rats. The present study aimed to investigate if daily oral administration of ecstasy at low doses(10mg) for 45 days has any deleterious effects on reproductive functions of male rats. Animals were randomly divided into four groups of ten rats each, assigned as control rats, or(0mg ecstasy), rats treated with 10mg ecstasy for, (15,30,45) days, rats treated with 30mg/kg body weight ecstasy for(,15,30,45)days by oral gavage. The third group(45 days) was followed by 15 withdrawal  period(W15). Results: The activities of superoxide dismutase, catalase, glutathione reductase and glutathione peroxidase in testicular homogenate were decreased while the levels of lipid peroxidation increased significantly in the treated rats as compared with the corresponding group of control animals.  In group 30mg, only, arachidonic acid was significantly elevated in the testicular homogenate while linoleic acid was decresed when compared to control. Testis DNA fragmentation was observed in 30mg group, but not 10.mg. It is concluded that low doses of ecstasy exposure(10 mg/Kg) had moderate detrimental effects on reproductive organ system and more severe effects are likely to be observed at higher dose levels. These results indicate that ecstasy is directly toxic to primary Leydig cells, and that the decreased percentage of normal cells and the increased level of DNA damage in ecstasy -exposed Leydig cells may be responsible for decreased testosterone secretion. The results suggested that graded doses of ecstasy elicit depletion of antioxidant defence system and induce oxidative stress in testis of rats.  In conclusion:  the adverse effect of ecstasy on male reproduction may be due to induction of oxidative stress.  }, keywords = {MDMA(ecstasy),testes,Free fatty acids,oxidant/antioxidant status}, url = {https://ejhm.journals.ekb.eg/article_15992.html}, eprint = {https://ejhm.journals.ekb.eg/article_15992_833b47ff729ab30dc51f4187c2ae8354.pdf} } @article { author = {Helal, Eman G. E. and Abd-Elwahab, Samia M. and Mohammad, Anwaar Alkamel}, title = {Comparison between the effect of ozone and vitamin C in treatment of diabetes mellitus}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {51}, number = {1}, pages = {434-447}, year = {2013}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2013.15993}, abstract = {Objectives: There is strong evidence that diabetes results a state of oxidative stress and that reactive oxygen species contribute to the production of insulin resistance, β-cell dysfunction and both the microvascular and macrovascular long-term complications of diabetes. Antioxidants are used as supportive therapy in the treatment of DM, so, we use ozone and vitamin C to study if they can regulate the oxidative complications of DM.  Material and method: twenty male adult albino rats were divided into two groups; group 1: control group, group 2: alloxan induced diabetic rats which divided into three subgroups. subgroup1: diabetic untreated rats, subgroup2: diabetic treated with ozone and subgroup 3: diabetic rats treated with vitamin C. After thirty days of treatment the body weight gain was detected. Blood sample were collected to1- estimate biochemical parameters as: glucose, serum insulin, lipid and protein profiles and liver and kidney functions 2- estimate some hematological parameters. Also, liver samples collected to determine their glycogen content and pancreatic samples were obtained for microscopic and quantitative evaluation. Results: in diabetic untreated rats the results showed reduction of gained body weight, hyperglycemia, and hypoinsulinemia, significant increase in liver and kidney functions and change in lipid and protein profiles and decreased liver glycogen content. While, O3 and vitamin C treated rats reported an amelioration of the most toxic effect of alloxan and returned most of these parameters nearly normal. Microscopically pancreatic beta cells showed definite vaculation, degeneration, karyolysis and pyknosis in the diabetic group while pancreatic alpha and delta cells were not affected. The use of O3 and vitamin C treatment in this study showed significant improves of such cellular changes when compared to diabetic untreated rats but still abnormal when compared with normal rats. Conclusion: it was recommended that the use of the O3 or vitamin C as a supplementary agent to reduce oxidative stress damage of hyperglycemia and recommended to use variable doses and different periods of treatment to evaluate the best dose and period.    }, keywords = {alloxan,Hypoglycemia,diabetic,antioxidant}, url = {https://ejhm.journals.ekb.eg/article_15993.html}, eprint = {https://ejhm.journals.ekb.eg/article_15993_c6fe553429a438a42a6c417d2b1f1611.pdf} } @article { author = {Shousha, WafaaGh. and El-mezayen, Hatem A. and Abdul-Halim, Shawkia S. and Mohmmed, Elham A.}, title = {Antioxidant effect of Flaxseed against liver Cirrhosis induced in Thioacetamide intoxicated rats}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {51}, number = {1}, pages = {448-460}, year = {2013}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2013.15994}, abstract = {Background/Aim:There has been a current upsurge in the medical implications of free radicals and related species during the past several decades. These chemical species are integral components produced during normal biochemical and physiological processes but leads to oxidative stress when produce in excess and causes potential damage to cells. A wide range of non-enzymatic and enzymatic antioxidant defenses exists to counteract the damaging effects of free radicals. There exist epidemiological evidences correlating higher intake of antioxidant rich foodstuffs with greater free radical neutralizing potential to lower incidence of several human morbidities or mortalities.   Material andMethods: liver cirrhosis model was induced by TAA,hepatobichemical and antioxidant parameters were assayed. Results: Flaxseed induced enhancement in liver function test, antioxidant status and lipid profile. Conclusion: Flaxseed can be used as hepatoprotective against liver cirrhosis induced with TAA as compared to reference drug Silymaringroup.  }, keywords = {Liver cirrhosis,Thioacetamide,Flax seed,Silymarin,antioxidant}, url = {https://ejhm.journals.ekb.eg/article_15994.html}, eprint = {https://ejhm.journals.ekb.eg/article_15994_c522c4ca481691d78c50761e5e33c1c1.pdf} } @article { author = {N. A, Ismail, and S, Dewedar and S.I, Abdlrhman and M. M, Abd El-Maksoud}, title = {Unmet Health Care Needs Among Clients from Outpatient Clinic of Ain Shams University Hospitals , Cairo, Egypt}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {51}, number = {1}, pages = {461-472}, year = {2013}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2013.15995}, abstract = {Background: The concept of unmet needs refers to the difference between health services necessary to treat a particular health problem and services actually received. Aim: This study examined the prevalence of self-reported unmet needs for health care and the extent to which they were attributable to perceived problems with service availability or accessibility or acceptability. Study design: descriptive analytical study. Sample: 1316 individuals Clients from some out patients, clinic of Ain Shams University hospitals.  Setting: out patients, Clinic of Ain Shams University Hospitals, Cairo, Egypt. Subjects: patients randomly chosen from out patients, clinic of Ain Shams University hospitals. Tools of the study: A questionnaire tool developed to collect data about the prevalence of unmet needs for health care in the previous 6 months.  Results:  This study conducted on 1316 individuals where 580 (44.8%) reported unmet health care needs. As regard causes of unmet needs, 33.6% of unmet needs attributed to accessibility problems, while service availability problems accounted for 57.4% of the unmet needs. The largest group, accounting for 92.4% of unmet needs was acceptability problems.    Conclusions: The causes of unmet needs attributed to accessibility and availability problems. The most common reported reason for an unmet health care need was that the too long waiting time, and the high cost of examination. Recommendations: Re-plan health care service to treat causes of unmet needs, which attributed to accessibility and availability problem.    }, keywords = {Prevalence - Unmet health care needs- availability,Accessibility,acceptability reasons}, url = {https://ejhm.journals.ekb.eg/article_15995.html}, eprint = {https://ejhm.journals.ekb.eg/article_15995_51a146a0f641b625ba2953d5440a7ea3.pdf} } @article { author = {Abd-Elmoneim, Mohamed A. and Bakar, Ashraf A. and Awad, Isis M and Moharib, Sorial A. and Mohamed, Ehab M.}, title = {Anticarcinogenic Effect of Raphanus sativus on 1, 2 Dimethylhydrazine (DMH) Induced Colon Cancer in Rats}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {51}, number = {1}, pages = {473-486}, year = {2013}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2013.15996}, abstract = {Background:Colon cancer is a major health problem worldwide and rated among as one of the top frequent cancers and is a major cause of morbidity and mortality. Treatment outcome is still not satisfactory and other treatment options are strongly needed. Carbohydrate protein interactions play a major role in numerous biological processes including cancer. However, the seeds of Raphanus sativus have never been tested for its anticancer effects on colon cancer. Therefore, this study aimed at elucidating the anti-carcinogenic effect of Raphanus sativus in combating chemically (DMH) induced colon cancer.  Materials and methods: polysaccharides extract of Raphanus sativus (RS) was tested for its ability to reverse the carcinogenic effects of 1, 2 dimethylhydrazine (DMH) which is used for chemical induction of colon cancer in animal models.Rats were injected with DMH and the effects of RS extract either concomitant with or after the administration of DMH were evaluated. . We measured the serum Carcinoembryonic antigen and Carbohydrate antigen as a tumor markers, Glutathione reducatse and Glutathione S transferase as markers of antioxidant activity and liver functions. Results: RS significantly reduced Serum CEA (P<0.01) and CA19-9 (P<0.01) as an evidence of its anticarcinogenic effect in colon cancer. Moreover, RS was able to significantly increase activity of Glutathione reductase (p<0.01) and Glutathione- S- transferase (p<0.01) as a measure of antioxidant compared with DMH untreated group.Also RS was able to significantly increase activities of ALAT, ASAT and ALP (p<0.01). Chemical analysis of RS done by NMR and paper chromatography revealed that the polysaccharide in RS was b-galactan and the type of bond that exists between sugar residues is 1, 3 and 1, 6 glucosidic linkages. Conclusions:This study shows that b-galactan of Raphanus sativus has pronounced cytotoxic effects on colon cancer cell line. Moreover, it reduces serum tumor markers and enhancing antioxidant activity in the DMH injected animals. This polysaccharide might be a suitable candidate as a chemopreventive and as an adjuvant therapy for colon cancer.  }, keywords = {Raphanus sativus,b-galactan,DMH,Colon cancer,tumor markers}, url = {https://ejhm.journals.ekb.eg/article_15996.html}, eprint = {https://ejhm.journals.ekb.eg/article_15996_a9fc3129007741b800440cd7a56659d6.pdf} }