@article { author = {}, title = {Inhibitory Effect of Dietary Curcumin on 1, 2-Dimethylhydrazine-Induced Colon Preneoplasia in Irradiated Rats}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {26}, number = {1}, pages = {1-21}, year = {2007}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2007.17776}, abstract = {Introduction: Prevention of cancer remains a primary need and new chemopreventive agents must be developed for this purpose. It is well known that the radiotherapy is associated with severe side effects and offers no firm expectation for a cure. Thus, there is a constant need for the investigation of other potentially useful options. One of the widely sought approaches is cancer chemoprevention that uses natural agents. Curcumin, a natural plant product, has been shown to have anti-inflammatory and antioxidant properties and which, thus, may be a potential anticancer drug. Material and Methods: The inhibitory effects of dietary curcumin (0.6 % in diet) on colonic precancerous lesions in rats treated with 1,2-dimethylhydrazine, (DMH, 20 mg/kg, s.c. once weekly for 6 weeks) or exposed to γ-radiation (6.5 Gy) alone or in combination were evaluated histologically and histochemically. Results: The results showed clear features of colonic dysplasia with DMH treatment. The dysplastic crypts exhibited marked hyperchromatism, loss of polarity besides nuclear and cellular stratification. Whereas, γ-irradiation revealed marked crypt dilatation accompanied by disorganized crypt structure and alteration of surface epithelium. The results also demonstrate an apparent synergy between the radiation and the chemical carcinogen in the induction of augmentation of mucosal abnormalities accompanied with increased total DNA content and cell proliferation. Consistent with these observations, changes in the type of mucous secretion with predominance of sialomucins were observed in the areas of mild to moderate dysplasia whilst the surrounding normal epithelium produced sulphated material. Mucus depletion was a common feature in areas of severe dysplasia. Addition of curcumin to the diet remarkably reduced the amount and severity of dysplastic lesions with DMH-induced colon preneoplasia without appreciable toxicity. Moreover, curcumin could prevent or improve the disruption of colonic architecture caused by γ- irradiation. Such improvement was also investigated but to a lesser extent with the combined radiation and DMH. Conclusion: These results indicated that curcumin is potent in inhibiting the preneoplastic lesions and other cellular events relevant to colon and was, therefore, of value as a safe chemotherapeutic agent. }, keywords = {}, url = {https://ejhm.journals.ekb.eg/article_17776.html}, eprint = {https://ejhm.journals.ekb.eg/article_17776_e576f03c1b1304c12113f6405bf42940.pdf} } @article { author = {N, Hanafi and El Aaser, Abel Baset and Gabry, Mohamed S. and Tohamy, Amany A and Ebrahim, Manal El Saied}, title = {Effect of increase in Antioxidants Supplementation on Kidney Tissue of Mice Subjected to Fractionated Dose of γ-Irradiation.}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {26}, number = {1}, pages = {22-30}, year = {2007}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2007.17777}, abstract = {Introduction: Although there is little doubt that antioxidants are a necessary component for good health, no one knows if supplements should be taken and, if so, how much. Materials and methods: To investigate the increase in antioxidants supplementation, a group of mice feeding on a diet containing 20% soybean was used as control group. The control group treated with 5% Nigella sativa and Antox drug (3 mg/mouse/day) either alone or in combination for 15 days. Another control group was treated with the same antioxidants and subjected to 1 Gy of γ- irradiation x 5 times day after day. In kidney tissue the levels of malonaldehyde (MDA) and reduced glutathione (GSH) were estimated. Also, the histopathological changes were recorded. Results: 5% Nigella sativa revealed a little decrease in MDA level and a highly significant decrease in GSH in kidney tissue while the exposure to fractionated dose of γ- irradiation predicted a highly significant decrease in MDA and a highly significant increase in GSH level. Gastric intubations of Antox drug showed a highly significant increase in MDA and GSH levels in kidney tissue either alone or in addition to fractionated radiation exposure. Combined treatments of Nigella sativa and Antox drug showed a highly significant decrease in MDA level and a highly significant increase in GSH level in kidney tissue in comparison to the control group. Histopathological changes showed that treatment with 5% Nigella sativa and Antox drug either alone or in combination revealed toxic effect on kidney tissue. However, their treatments prior to radiation exposure showed ameliorating effect. Conclusion: Our findings indicated that we under oxidative stress. }, keywords = {}, url = {https://ejhm.journals.ekb.eg/article_17777.html}, eprint = {https://ejhm.journals.ekb.eg/article_17777_190f2d18c708dbe7c34305617431f9e6.pdf} } @article { author = {Farghaly, Lamia M. and Sabak, Nagwan A. and El-sherbeny, Naglaa A.}, title = {The protective effect of L-tryptophan versus alpha lipoic acid against L-arginine-induced experimental acute pancreatitis in albino rats}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {26}, number = {1}, pages = {31-45}, year = {2007}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2007.17778}, abstract = {Aim of the study: This study was conducted to investigate the possible protective effects of L- treptophan "a precursor of melatonin" and alpha lipoic acid against L- arginine-induced experimental acute pancreatitis in albino rats. Methods: Fourty adult male albino rats (200- 250g) were randomized into 4 groups (n= 10). Group I, the control group was given 0.9% saline intraperitoneally (i.p). Group II, was given 500 mg/100g L-arginine (i.p) as a single dose to induce acute pancreatitis. Group III: was given 250mg/kg L-tryptophan (i.p) 30 min prior to L- arginine injection. Group IV: was given 50mg/kg alpha lipioc acid(i.p) 30 min prior to L-arginine. Before scarifice, blood samples were obtained from all groups to assay serum amylase and interleukin 6. Animals were sacrificed after 6 hours. For the histopathological study, pancreatic tissue was prepared for histological (H&E, PAS) histochemical ( Tween stain for lipases) and immunohistochemical ( Bax stain for apoptosis) techniques. Both qualitative and quantitative analyses were done to assess the degree of acinar cells affection Results: It was revealed that serum amylase and interleukin 6 in group II rose rapidly. Microscopically, severe acinar cells degeneration, interstitial edema, diffuse bleeding and inflammatory infiltration were demonstrated. These changes were markedly improved with the administration of both L- tryptophan and alpha lipoic acid. Conclusion: It was concluded that both L- tryptophan & alpha lipoic acid reduced the effects of L-arginine-induced acute pancreatitis with better protection achieved by L-tryptophan administration. }, keywords = {}, url = {https://ejhm.journals.ekb.eg/article_17778.html}, eprint = {https://ejhm.journals.ekb.eg/article_17778_9a153d8f8719f6a23ea7902a087ab58c.pdf} } @article { author = {Atia, Tarek A. and Mourad, Salah E. and H., Salem}, title = {Cytogenetic Study in Couples with Recurrent Miscarriage}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {26}, number = {1}, pages = {46-54}, year = {2007}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2007.17779}, abstract = {Introduction: Recurrent miscarriage (RM) is a mysterious reproductive problem affecting a proportion of couples trying to conceive. Although spontaneous abortion occurs in approximately 15 to 20% of clinically diagnosed pregnancies of reproductive-aged women, recurrent miscarriage occurs in approximately 1 to 2% of these women. Many syndromes are involved in the aetiology of RM, where genetic factors appear to be highly associated. Indeed, chromosomal anomaly constitutes the single most common cause. About 7% of couples with RM have one partner with balanced chromosomal rearrangement. Aim of the study: This study is a prospective study carried out to evaluate the incidence of chromosomal abnormalities in couples suffering recurrent miscarriage. Patient and methods: The present study included one hundred couples attending the antenatal clinic. They have been divided into two groups; the first, is a study group, included 50 couples with recurrent miscarriage. And the second, is a control group, included 50 couples with normal reproductive history. Conventional cytogenetic analysis was done for both groups. Result: We have found four cases (8%) carrying chromosomal rearrangements (two reciprocal translocations, one Robertsonian translocation, and one with duplicated chromosome segment) among RM group, and no cases of chromosomal rearrangement among those with normal reproductive history. Statistically, there was a significant association between recurrent miscarriage and chromosomal rearrangement. Conclusion: We have concluded that chromosome analysis is highly important to evaluate such cases with RM.  }, keywords = {recurrent miscarriage,Cytogenetics,chromosome anomalies}, url = {https://ejhm.journals.ekb.eg/article_17779.html}, eprint = {https://ejhm.journals.ekb.eg/article_17779_f1bed4004802d0fb49cf616110e2f4d5.pdf} } @article { author = {Abdesallam, Hesham A. and Mahrous, Ali K. and Hashim, Abdelsalam H.}, title = {Epistaxis Management}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {26}, number = {1}, pages = {55-62}, year = {2007}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2007.17780}, abstract = {Introduction: Epistaxis is common and has been reported to occur in up to 60 percent of the general population. The affected person usually does not seek medical attention, particularly if the bleeding is minor or self-limited. In rare cases, however, massive nasal bleeding can lead to death. The nose has an abundant blood supply. The arterial supply to the nose comes from carotid arteries. Nasal bleeding usually responds to first-aid measures. When epistaxis does not respond to simple measures, the source of the bleeding should be located and treated appropriately. There is no unanimity amongst Otorhinolaryngologists in terms of the sequence of different treatment methods in Epistaxis patients. We aimed in this study to examine our existing practice in terms of management of epistaxis, and to try to come up with suggestions of sequential treatment steps. This is a retrospective study conducted from November 2004 to January 2005 in the Otolaryngology Department in Midway Maritime Hospital. Subjects and Methods: The study group consisted of 100 case notes requested. The demographic data of the patients were collected and the history of epistaxis in each patient. Results: The study showed the peak of incidence of epistaxis (66%) was in adults (51 – 91 years old). No sex predilection. It was mostly spontaneous. 60% of the patients presented for the first time. 63% of the patients have co-morbid conditions. 60% of the patients needed hospital admission. The patients were treated with different measures. Conclusion: We concluded that the cases of epistaxis caused by trauma in our series is far less than expected. Co-morbidity plays a major role in the causation of epistaxis according to this study. We recommend the use of chemical cautery, merocele or both as the first line of local treatment of epistaxis. If it does not work, Rapid Rhino with or without anterior packing should be considered. If this does not work, then sphenopalatine artery ligation is the next step. }, keywords = {}, url = {https://ejhm.journals.ekb.eg/article_17780.html}, eprint = {https://ejhm.journals.ekb.eg/article_17780_5dbf1af4618bb53b180e39a44925bbe4.pdf} } @article { author = {Abdelhady, Ayman S.}, title = {Assessing Knowledge, Attitude and Practices of Primary Health Care Physicians Towards Screening Patients for Hypertension in Cairo.}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {26}, number = {1}, pages = {63-72}, year = {2007}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2007.17781}, abstract = {Introduction : Hypertension (HTN) is a common serious health problem associated with high morbidity and mortality rates .At the same time ,HTN is widely prevalent all over the world including Egypt. For many people, the primary care physician is their first point of contact with the health care system, as well as their main source of preventive and essential care. Objective: Assessing knowledge, attitude and practices of primary health care physicians towards screening patients for hypertension in Cairo. Methodology:A cross-sectional study , conducted in the primary health care centres (PHCC) in Nasr city, which was chosen randomly to represent Cairo city , where all doctors working in these centres were asked to complete a self administered structured and open ended questionnaire contained the relevant variables : Results: About 90% of the studied physicians were convinced with the importance of routine measuring blood pressure for risky patients and 79% stated that role of the PHC physician should be the early detection of HTN. As regards knowledge towards HTN items, only 23.5% knew the prevalence and 18.5% knew the most recent definition and grading. The practices of the doctors towards screening patients for HTN ,showed that only 63.9% of the doctors usually perform accurate and enough procedures to diagnose HTN patients and 46.2% routinely screen patients around forty years old while only 43.7% were regularly checking up the accuracy of the used sphygmomanometers . Conclusion: The participating physicians had poor knowledge towards some important items especially the prevalence and new classification of HTN. Their practices were not optimal as regards the accurate diagnosis of HTN and routine checkup and measuring blood pressure for people attending the PHC clinics. Recommendations to manage these defects were suggested. }, keywords = {}, url = {https://ejhm.journals.ekb.eg/article_17781.html}, eprint = {https://ejhm.journals.ekb.eg/article_17781_4c1b9c2ae037823b891423c31f7ed3ea.pdf} } @article { author = {Helal, Eman G.E. and Radwan, Shadia, A.}, title = {Effect Of Some Slimming Drugs On Haematological And Some Vital Signs Of Albino Rats}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {26}, number = {1}, pages = {73-83}, year = {2007}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2007.17782}, abstract = {Some of slimming drugs had been withdrawn from markets so, the present study was conducted to follow the effect of three different anorexic drugs; on the haematological and physical parameters of adults albino rats. The used drugs differ in their nature, where the first one i.e., apple-lite is a fully natural substance, the 2nd one i.e., mirapront-N. is a chemical substance and the 3rd one i.e., tenuate is a synthetic foamy filler substance. Fourty adult male albino rats (130  20g) were randomly divided into four groups, ten on each treated group and ten for the first group which conserved as control group. The 2nd group was treated daily with apple-lite (3.5mg/ 100g.b.wt), the 3rd group was treated daily with mirapro-N (0.14mg/100g.b.wt) and the 4th group was treated daily with tenuate (0.1 mg/100g.b.wt). Haematological parameters (RBCs, WBCs count, haemoglobin content (Hb), hematocrit value (Hct%), mean cell volume (MCV), mean cell heamoglobin (MCH) and mean cell heamoglobin concentration (MCHC) were detected after 30 days of treatment and also after 15 days of the last treatment as a recovery period. Also, body weight, percent of organs weight/body weight, skin-fold thickness and some vital measurements i.e. heart beats, respiratory rate and rectal temperature were recorded after the same periods of treatment and recovery. Haematological studies revealed that RBCs count, total WBCs count, Hb and Hct values were significantly decreased in the three groups treated daily with anorexic drugs for 30 days. These changes aere also recorded after the recovery period except in apple-lite treated group which showed insignificant change in RBCs and Hb after the recovery period. The calculated mean cell haemoglobin concentration (MCHC) recorded significant increase in apple-lite after treated and recovery periods, while non significant changes in MCHC were observed after mirapro-N and tenuate groups after treatment 30 daysfor 30 days but significant increase of MCHC was recorded after the recovery period of tenuate treated group. Skin-fold thickness of the three regions tested (gluteal, back and belly) revealed significant decrease in all the treated groups except the belly region in apple-lite treated group which showed insignificant decrease after treatment for 30 days. Significant decrease of skin-fold thickness of different regions still present after the recovery period of 15 days in the three treated groups except the back region of mirapro-N and the belly region of apple-lite- treated rats which showed insignificant decrease. Percent of organs weight/body weight were affected according the type of tested drug, while apple-lite- caused non significant changes, mirapro-N caused significant increase in hepatosomatic ratio and cardiosomatic ratio, and significant decrease in gonadosomatic ratio. On the other hand, tenuate resulted in a significant increase in percentage weight of kidneys and hepatosomatic ratio and significant decrease of gonadosomatic ratio after treatment for 30 days. After the recovery period, apple-lite revealed significant decrease in brain/b.wt. ratio, while mirapro-N still affected kidneys, gonadosomatic ratio and brain and tenuate still affected gonadosomatic ratio and brain; they recorded significant decrease. The physical measurement of vital signs, i.e. heart rate, respiratory rate and rectal temperature recorded insignificant change after treatment with apple-lite, mirapro-N and tenuate for 30 days, but significant increase of rectal temperature was recorded in the tenuate group of the treated rats. After recovery period insignificant changes in heart rate, respiratory rate and rectal temperature of the treated rats were observed in the three treated groups. }, keywords = {Slimming drugs,Haematology,vital signs,albino rats}, url = {https://ejhm.journals.ekb.eg/article_17782.html}, eprint = {https://ejhm.journals.ekb.eg/article_17782_6daa1da9cd8457d217908bea98d57513.pdf} } @article { author = {Mahmoud, Manal and El Fangary, Mona and Abdel Dayem, Aya M and El Margoushy, Nesriene and Said, Mohamed}, title = {Platelet Derived Growth Factor And The Extent Of Skin Thickening As Potential Indicators Of Pulmonary Affection In Systemic Sclerosis}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {26}, number = {1}, pages = {84-95}, year = {2007}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2007.17783}, abstract = {Background and objective: Systemic sclerosis is a multisystem disease that has considerable variability in its presentation, course, and prognosis. The aim of this study was to determine serum levels of platelet-derived growth factor (PDGF A/B) in patients with systemic sclerosis (SSc) and to correlate these levels with the extent of skin sclerosis and presence of pulmonary affection. Moreover, the efficiency of PDGF and skin score in early detection of pulmonary affection were assessed. Patients and methods:The study included 22 female patients with SSc (according to the American College of Rheumatology) (Masi et al., 1980) and 15 age-matched healthy control females. According to the classification by LeRoy et al. (1988), we divided our patients into limited SSc (10 patients-45.5%) and diffuse SSc (12 patients- 54.5%). The extent of skin sclerosis was assessed by the modified Rodnan total skin thickness scoring (TSS) system (Clements et al.,1995). In our study, patients with limited SSc had a skin score <25, while those with diffuse SSc had skin score >25. Five diffuse SSc patients had associated pulmonary affection, diagnosed by history taking, clinical examination, chest x-ray, arterial blood gases, spirometry and diffusing capacity of the lung for carbon monoxide (DLCO). Serum levels of PDGF were determined in SSc patients and healthy controls using quantitative sandwich ELISA technique. Results: Serum PDGF mean and standard deviation in healthy subjects was 5.2+2.466 ug/l. PDGF values showed continuous significant increment with progression of the disease. Mean PDGF serum levels in limited SSc, diffuse SSc without pulmonary affection and with pulmonary affection were 15.8+2.3, 20.86+2.41 and 32+3.08 ug/l, respectively. Furthermore, the results revealed that PDGF value <10 ug/l, tend to exclude the diagnosis of SSc with 100% sensitivity and specificity, respectively. Moreover, all patients with diffuse SSc and having pulmonary affection had PDGF values >25 ug/l. This value provided a diagnostic sensitivity and specificity of 100 %. As regards the total skin score, a statistical significance was found between limited and diffuse SSc but did not show a statistically significant difference between SSc patients with (32.2+4.49) and without (29.71+3.25) pulmonary affection (p>0.05). However, in patients with diffuse SSc, PDGF levels tended to correlate positively with the skin score (p=0.05). ROC plot showed that skin score at a value of 29 was the best cut-off level to diagnose pulmonary affection in patients with diffuse SSc with a diagnostic sensitivity of 80% and specificity of 71.4%. Conclusion: PDGF is a simple and easy laboratory test that tends to exclude the presence of SSc at a cut-off value of 10ng/ml with 100% sensitivity and specificity, respectively. PDGF correlates positively with extent of skin involvement and significantly with pulmonary affection. PDGF and skin scoring system are simple laboratory and physical measures for evaluating patients with systemic sclerosis with cut- off levels of 25 ug/l, and 29 respectively in detecting pulmonary affection. However, }, keywords = {}, url = {https://ejhm.journals.ekb.eg/article_17783.html}, eprint = {https://ejhm.journals.ekb.eg/article_17783_41ef817ac1a2b7de520e7e1654bc3c8a.pdf} } @article { author = {Shaldoum, Fayez Muhammad}, title = {Role of Complements C5, C6 in the Pathogenecity of Psoriasis}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {26}, number = {1}, pages = {96-105}, year = {2007}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2007.17784}, abstract = {Background: Psoriasis lesion/scale contains C5a des Arg and C5b-9 (Takematsu et al., 1992; Terui et al., 2000 and Uyemura et al., 1993). These activation products may have arisen from C5-C9 produced supposedly by keratinocytes (KC). In this work we have started with C5 and C6 to prove our hypothesis. Since psoriatic lesions contain several pro-inflammatory cytokines, it is important to find out which pro-inflammatory cytokines can differentially regulate the expected synthesis of C5 and C6 by keratinocytes. Methods: Human KC have been cultured in the absence and the presence of varying concentrations of pro-inflammatory cytokines and the synthesis of C components C5 and C6 have been measured by ELISA at the protein level and RT-PCR at the mRNA level. To test whether KC also secrete these C components, the same measurements have been performed to find out if these late components are present in the supernatant of the medium where these KC were cultured. The keratinocytes cell-line A431 was also used and the monocytes cultures were considered as the positive control. Results: The results showed that resting KC synthesize C5 mRNAs in detectable amounts. C5 mRNA which is synthesized by resting KC is not translated into detectable amount of protein. Although resting KC did not produce C6 mRNA in detectable amounts the levels of C6 protein were detectable. However, These C6 protein levels were minimally secreted by resting KC, into the culture medium. TCGF induced the secretion of C5 and C6 while TGF-β induced only the secretion of C6. Conclusion : Normal KC synthesize their own C5 and C6. The synthesis of them is activated by TCGF. While TGF- 2خ activated the synthesis of C6 other factors might be responsible for activating the synthesis of C5. These factors could be secreted from other cell types than KC in human skin }, keywords = {}, url = {https://ejhm.journals.ekb.eg/article_17784.html}, eprint = {https://ejhm.journals.ekb.eg/article_17784_e736d210c29828c6e599487ceeaf13a9.pdf} } @article { author = {Hafez, Kawther A. and Afifi, Nahla M. and Saudi, Fardous Z.}, title = {Anatomical Variations of the Circle of Willis in Males and Females on 3D MR Angiograms}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {26}, number = {1}, pages = {106-121}, year = {2007}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2007.17785}, abstract = {Objective: The objective of the present work was to study the anatomical variations of the circle of Willis as regard its component vessels and their average diameters in a sample of adult Egyptians and to detect any sex-related differences in these variations. Material and Methods: One hundred and twenty adult patients were observed (60 males and 60 females). They all had problems unrelated to any ischemic or vascular diseases, so they were considered as healthy control, concerning the morphology of the circle of Willis. In addition, ten cadavers' brains were obtained from the Anatomy department, Faculty of Medicine Ain Shams University for examination of the circle of Willis and for detection of any variations. Results: The anatomical variations of the anterior part, posterior part and completeness of the circle were inspected. Also, the diameters of all component vessels were assessed. The results indicated that, the anterior part of the circle was completed in 70% males and 75% females of the study sample. No statistically significant difference was detected between sexes. The most common variant of the anterior part was the single anterior communicating artery followed by the hypoplastic or absent anterior communicating artery. The posterior part of the circle was completed in 44% males and 58% females. The most common variant was the bilateral posterior communicating arteries, followed by the unilateral posterior communicating artery. An entirely complete circle was found only in 45% of the entire population; and it was higher in the females than the in males. The vessels diameters were smaller in the females than in the males, except for the diameter of the posterior communicating artery. Cadavers' examination revealed six cases with complete circle, 3 cases of unilateral fetal posterior communicating and one case of absent posterior communicating artery. Conclusion: The present study showed the amazing great variability of the anatomy of the circle of Willis in asymptomatic persons. Nevertheless, there were no marked differences between both sexes in most of the components and the mean diameters of the circle. Therefore, these anatomical variations have to be considered during radiological interpretation and would be reported in the current anatomy text to be aware of all these normal variations. }, keywords = {}, url = {https://ejhm.journals.ekb.eg/article_17785.html}, eprint = {https://ejhm.journals.ekb.eg/article_17785_b429f14a773b14cb22d54a2fa9473a2a.pdf} }