eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
71
1
2214
2216
8833
Original Article
Serum Procalcitonin and C-reactive Protein Level as Markers of Bacterial Infection
Fahad Hassan Alami Hakami
boss7711@hotmail.com
1
MOH Public Health Center, Gizan City, KSA
Background: C-reactive protein (CRP) and procalcitonin (PCT) are useful diagnostic tools used to estimate the risk of bacterial infection and the severity of the infection. The accurate diagnosis of bacterial infection is crucial to avoid unnecessary antibiotic use and to focus on the appropriate therapy.
Aim of the work: this study aimed to summarize the sensitivity and specificity of both PCT and CRP and their serum levels as markers in bacterial infection
Methods: scientific websites were used to search for articles such as Pubmed and Google Scholar. Several keywords were used to obtain all possible articles about the subject.
Conclusion: overall accuracy of PCT markers is higher than that of CRP markers in differentiation of bacterial infections
https://ejhm.journals.ekb.eg/article_8833_88c09094b0e6eb3152cd5ad5d6c4a241.pdf
prolactonin
C - reactive protein
markers
bacterial infection
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
71
1
2217
2225
8841
Original Article
Review on Dental Implantology
Wedad Qassadi1, Tahani AlShehri 1, Amani Alshehri 1, Kholud ALonazi 1 Ibtihal Aldhayan 2
1
1-Alfarabi College of Dentistry, 2- Riyadh College of Dentistry
Aim of the work: in this review, we tried to show all details about dental implant, its components, types in the market, usage, case selection and diagnosis, indications and contraindications.
Patients and method: Pubmed, Google Scholar have been used to search for papers that addressed dental implantology, preoperative diagnosis of the cases and both of their medical and dental history were considered during searching. Results: it was obvious that dental implant has been the first choice by patients for replacing their missed teeth because of their numerous advantages specially in preserving the adjacent teeth and esthetics, but it may be more expensive than fixed bridges or removable prosthodontics. Conclusion: dental implant is a root-like structure made of titanium. It is composed of three main parts (fixture, abutment, crown). Case selection is the main point for implant success, so, before implant surgical procedure, the dentist asks the patient for full mouth x-ray, medical history and dental history.
https://ejhm.journals.ekb.eg/article_8841_19f009a3ccbc448527685dc849db5ee6.pdf
Implant
types of implants
case selection
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
71
1
2226
2231
8842
Original Article
The Effectiveness and Tolerability of Budesonide in Treatment of Autoimmune Hepatitis: A Systematic Review
Mohammed Ahmed Alahmari, Mohammed Bakr Bazayd, Salem Hamed Alshuoqayh, Turki Abdullah Alsulami, Hasan Hayaza Albarqi, Mohammed Hassan Al Tahnoon
dr.resaerch222@gmal.com
1
Debrecen University, Maastricht University, Debrecen University, Debrecen University, King Khalid University, Debrecen University
Background: Budesonide was effective in treating and keeping short-term remission with a fewer steroid-specific side effects in contrast to prednisone. Contradicting outcomes were detailed on the efficiency of budesonide in the management of Autoimmune Hepatitis. This review aiming at evaluating the use of budesonide for the treatment of autoimmune hepatitis.
Methods: An electronic search was conducted in MEDLINE and EMBASE using these keywords steroids, autoimmune, liver, effectiveness, and side effects. The search was limited to clinical setting which resulted in 24 clinical studies.
Results: The total number of AIH patients included in this review were 386 of which 304 females (78.7%), the sample size ranged from 9 patients to 207 and the mean age ranged from 13 years in to 54. Concerning the efficacy of Budesonide, it ranged from 15% to 78% as the end points were different among the included studies. Regarding the tolerability and side effects like Moon faces or cushingoid features, acne, heartburn, hirsutism, alopecia, osteoporosis, diabetes mellitus and easy bruising. Side effects reported in X studies and the incidence ranged from 28% to 56%.
Conclusion: Budesonide could be a promising treatment option especially in patients prone to corticosteroid side effects like elderly individuals and postmenopausal women with high risk for osteoporosis or children with risk for impaired growth.
https://ejhm.journals.ekb.eg/article_8842_ecd715dd787f1878de7a6026b082ba5a.pdf
Hepatitis
Autoimmune
Liver
Treatment
Tolerability
Effectiveness
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
71
1
2232
2237
8843
Original Article
Effectiveness of Psychological Intervention in Management of Postpartum Depression
Abdulrahman Abdulkhaliq Abdullah Alshehri (1), Husam Mohsen Bin Alhasel (2), Hiba Salah Abdelgadir (3)
1
(1) The faculty of Medicine, Albaha University, (2) Ibn Sina National College for Medical Studies, (3) Family Medicine, UMST University
Background: In order to prevent postpartum depression many primary preventive programs were done. Psychological interventions are thought to be effective in decreasing the incidence of postnatal depression. Many studies aimed to evaluate the effect of Psychotherapy in treatment of postpartum depression.
Methods: An electronic search was obtained in MEDLINE and EMBASE databases with search terms such as psychology, postpartum, depression, intervention, effectiveness. The primary search resulted in 128 studies which have been screened for eligibility. After exclusion of irrelevant, duplicated and review studies, 11 studies were included in the review as they met the inclusion criteria.
Results: Psychotherapy decrease the likelihood of PPD and decrease postpartum depressive symptoms, increased awareness, depression reduction, general improvement and psychological health and prevention of PPD, improve depression, functioning and anxiety. Training for health visitors (HVs) intervention was found to be cost-effective in reducing the proportion of women at risk. It was only noted that there was no outcome difference between the CBA and the PCA groups. Health visitor (HV) training was noted to have preventive effect for depression.
Conclusions: There is evidence to recommend that interventions carried in pregnancy can be effective in preventing postnatal depression. Interventions are mainly effective when grounded on psychological treatments and provided to women suffering from antenatal depression.
https://ejhm.journals.ekb.eg/article_8843_674bb96dc6c40b5c80cfba2059618150.pdf
Psychology
Postpartum
depression
Intervention
Effectiveness
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
71
1
2238
2242
8844
Original Article
The Risk of Renal Injury in Infants Associated with Ibuprofen Use: A Systematic Review
Salem Hamed Alshuqayh, Mohammed Ahmed Alahmari, Abdullah Mohammed Beneissa, Nouf Abdullah Alkhattaf, Saad Mohammed Alqahtani, Abdulaziz Aati Alharbi, Wejdan Ahmed AlBarqi
1
Debrecen University, Debrecen university, Debrecen University, Batterje Medical College, King Khalid University, Ibn Sina National Collage, King Khalid University
Background: More recently ibuprofen, was used for the indication of the patency of ductus arteriosus closure in preterm infants; this drug is associated similar side effects include cerebral, renal, and mesenteric circulation.
Methods: An electronic search was carried out using search terms such as “renal failure”, “kidney failure”, “renal injury”, ibuprofen, “side effects”, “adverse effect”, complications. The search in MEDLINE and EMBASE through PubMed search engine resulted in 31 articles. These articles were screened for eligibility criteria included studies aimed to assess renal injury caused by ibuprofen use in infants.
Results: After exclusion of irrelevant duplicated and review studies, 12 studies were included in this review. Eight studies were randomized control, 3 retrospective evaluation and 1 retrospective cohort study. the effect of the treatment on the renal function there are two outcomes reported either reduction in serum creatinine or incidence of acute renal failure. Incidence of acute renal failure reported in 4 studies.
Conclusion: Although renal failure was more common in infants receiving Indomethacin compared to Ibuprofen, oral Ibuprofen was less toxic to the kidneys than intravenous and the serum creatinine levels after treatment did not differ, this is not significant.
https://ejhm.journals.ekb.eg/article_8844_7f17d724f7064ed09e8a8ce6d432f6b5.pdf
Ibuprofen
kidney
Failure
infants
creatinine
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
71
1
2243
2249
8845
Original Article
Prevalence of Depression among Diabetic Patients in Makkah
Adel Ahmed Alshehri1, Muath Ahmed Al-Gadouri1, Feras Majed Abdulrahim1, Bayan Zaid Fatani1, Amal Joiber Alsaedi1, Daham Al-Daham2, Fahad D. Alosaimi3
adelalshe93@gmail.com
1
1Umm Al-Qura University, Makkah, 2Department of Biostatistics and Bioinformatics, King Abdullah International Medical Research Center, Riyadh,3Department of Psychiatry, King Saud University, Riyadh, Saudi Arabia
Background: Diabetes mellitus (DM) is a major health problem that is associated with psychological, as well as physical, complications particularly depression. Depression is well-known to be prevalent among diabetic patients and to be associated with poor glycemic control, poor adherence to medication, increased diabetic complication and higher risk of mortality. Objectives: The purpose of the study is to determine the prevalence rate of depression among diabetic patients in primary health care units and diabetic centers at Makkah city – Saudi Arabia, and to explore the associated factors that co-exist with depression among diabetic patients.
Methods: This was a descriptive cross-sectional study conducted on 382 diabetic patients (both type I and II) recruited from diabetic centers at Al-Noor hospital, Hera’a hospital, and East of Al-aziziah hospital in Makkah, KSA. Data were collected via a self-administered questionnaire including demographic variables and the Arabic translation of Patient health questionnaire the Tunisian version (PHQ-9). The data collected were analyzed using SAS 9.4. Results: After data analysis of the 382 participants 43.19% were males and 56.81% were females, with a mean age of 50.28±11.43 years. The prevalence of depression was 20.68%, with 12.83%, 7.07%, and 0.79% having moderate, moderately severe, and severe depression, respectively. Hypertension, duration of hypertension, number of co-morbidities, and high education level were significantly associated with depression (p=0.0111, 0.0029, 0.0491, and 0.0158, respectively). The odd’s ratio of number of co-morbidities was 1.565 (p=0.0039). Conclusions: Depression and suicidality are prevalent among diabetic patients in Makkah. When diabetes co-exists with hypertension and/or other comorbid illnesses the prevalent doubles. Hypertension, increased number of associated co-morbidities, and high educational level are significantly associated with depression in diabetic patients.
https://ejhm.journals.ekb.eg/article_8845_1b652f6fe7f0f31a0edadb926ddfd965.pdf
depression
prevalence
diabetes
KSA
Makkah
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
71
1
2250
2252
8847
Original Article
Causes, Diagnosis, and Management of Hypothyroidism
Mahmoud Shehab Halawani1, Ruaa Omar Nughays2, Alwaleed Fahad Altemani2, Nihal Mubarak Mohamed Hussien3, Nuha Mohamad Alghamdi4, Farah Haytham A Alasadi2, Lina Ahmed Wasfi2, Muath Aziz Alrehaili5, Asim Abdullah Alharbi5, Manal Mohammad Siraj6
mahmoudsh@moh.gov.sa
1
1Ohud Hospital,2King Abdulaziz University, 3University Of Bahri, 4King Fahad Hospital, 5Taibah University, 6 AlMaarefa Colleges of Science & Technology
Background: Among hormone deficiency, hypothyroidism is considered to be the most common disease, and is subdivided into congenital or acquired, based on the onset. The exact site of dysfunction can further classify the disease into primary and secondary. It is crucial to determine the level of severity of the disease as severe cases may end up in a coma. On the other hand, mild cases may be asymptomatic. Diagnosis is mainly based on serum thyroid hormones levels, and the treatment depends on thyroxine administration with an excellent prognosis. Aim of this review: was to explore the types of hypothyroidism, its diagnosis, and study the best course of management that must be followed.
Methodology: We conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE, January 1985, through February 2017. The following search terms were used: hypothyroidism, myxedema, classification of thyroid diseases, investigation of hypothyroidism, management of hypothyroidism.
Conclusion: Hypothyroidism is a common disease that usually affects females more than males. Populations at higher risk include, old women, pregnant women, dyslipidemic patients, and patients with a history of radiation exposure. Diagnosis is based on measurement of TSH along with the thyroid hormone levels. Management includes administration of thyroxine and must be done early.
https://ejhm.journals.ekb.eg/article_8847_bbaa07212cb2533e5550b60f6e3d1ff2.pdf
Keywords: hypothyroidism
myxedema
manifestation of hypothyroidism
Thyroid diseases
management of hypothyroidism
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
71
1
2253
2256
8848
Original Article
Methods to Improve Quality of Life in Diabetics
Mohammed Sheker Al-Kalif1, Bader Hulayyil Almansouri2, Haneen Anees Moumina3, Hussam Mahmoud O Baeissa4, Faris Hassan Aljewayed1, Anas Mohammed Alessa5, Magran Saad Zahi Almutairi6,
mohmed1426@gmail.com
1
Sara Mohammed Kayal3, Amal Ibrahim Alghabban7, Malik Dham Alanazi8, Zahra Issa A Al Ali9
2
1 Imam Abdulrahman Bin Faisal University, 2 Security Forces Hospital, 3 King Abdulaziz University, 4 King Abduallah Medical Complex, 5 King Saud University,
6 Badr Primary Care Center, 7 Ibn Sina National College, 8 King Faisal University, 9 Maternal And Children Hospital
Background: Severe complications and morbidities are associated with diabetes, especially with poor control of the disease. Diabetes is thought to be the most common cause of renal failure and responsible for about half cases of end stage kidney disease, coronary artery disease, myocardial infarctions, congestive heart failure, strokes, foot problems and eye damage. The presence of any chronic illness with diabetes causes deterioration clinical status which makes tight glycemic control a necessity to improve quality of life and prevent these serious and potentially fatal complications.
Aim: This review was aimed to shine light upon measures that must be taken to improve the quality of life in a patient with diabetes mellitus.
Methodology: We conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE, January 1997, through February 2017. The following search terms were used: diabetes mellitus, chronic disorders, management of chronic diabetes, quality of life in diabetic patients, weight control, diabetic diet
Conclusion: Many factors affect the quality of life in diabetic patients including glycemic control, prevention of complications, and socioeconomic/demographic factors. Lifestyle modifications like weight loss and good dietary habits can help patients manage their disease better. Insulin pumps have eased the management of this disease and improved patients’ quality of life drastically. Patients should be educated about the importance of support groups that may lead to a better quality of life.
https://ejhm.journals.ekb.eg/article_8848_f612525fd914661c49a0771cc29f97cd.pdf
Diabetes mellitus
chronic disorders
management of chronic diabetes
quality of life in diabetic patients
weight control
diabetic diet
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
71
1
2257
2261
8849
Original Article
Management Approaches to Hairy Cell Leukemia; Overview
Akeelah Abdullah Al-Haddad, Batool Saad Alsalim, Huriyyah Alawi AlJarrash, Halah Ahmad Alfaraj, Ranim Yahya Nasr
akeelah.hdd@hotmail.com
1
King Salman Hospital, Riyadh, Saudi Arabia
Hairy cell leukemia is a rare disease comprising about 2% of lymphoid neoplasms. In this review, the biology, diagnostic criteria, and current therapeutic options in HCL-V and HCL-JV are presented.We conducted a database; PubMed and Embase comprehensive search up to December 2017, we search a relevant trail to our concern topic (hairy cell leukemia). HCL-V is a distinct clinico-pathological entity. However, differentiating HCL-V from classical HCL and splenic marginal zone lymphoma (SMZL), which are both connected with noticeable splenomegaly and circulating neoplastic cells with 'hairy' projections remain a problem. Patients with HCL-V are usually older, splenomegaly is less typical and leucopenia with granulocytopenia and monocytopenia are generally not seen. Bone marrow is usually easily aspirable, hyper-cellular with mild myelofibrosis.
https://ejhm.journals.ekb.eg/article_8849_f0a4c1c969b41f700d9a790abe4a98fc.pdf
Hairy cell leukemia
Treatment
Irradiation
Leukemia
Management
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
71
1
2262
2265
8850
Original Article
Risk Factors of Dyslipidemia among Saudi Population, 2017
Ghaedaa Saad Alzahrani, Saja Mohammad Aljehani , Jana Jamalaldeen Al-Johani
1
King Abdelaziz University
Background: the dyslipidemia and its associated risk factors and co-morbid diseases are the focus of many studies in KSA, however the data regarding the prevalence are very little. Objectives: this study aimed to assess the risk factors of dyslipidemia and its association with the subject’s demographics and life style pattern in Kingdom of Saudi Arabia (KSA). Methods: this was a cross-sectional study based on a check list and questionnaire sheet conducted for 6 months among 840 Saudi adults. Results: about 33%of the subjects were suffered from dyslipidemia after checking their lipid profile and anthropometric measures. The subjects were divided into two groups: group I included dyslipidemic subjects and group II included control subjects. The older age and jobless subjects showed a significant association with the prevalence of dyslipidemia. Group I showed a significant association between dyslipidemia and comorbid conditions than group II. The irregular physical activity, consuming less healthy food and consuming more fast food are significantly related to Group I than group II.
Conclusion: dyslipidemia is common among Saudi subjects and associated with health problem as hypertension, diabetes and obesity as well as bad lifestyle habits.
https://ejhm.journals.ekb.eg/article_8850_1abf6838675cc00198f7206faedc57d1.pdf
risk factors
dyslipidemia
Saudi population
KSA
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
71
1
2274
2279
10.21608/ejhm.2018.8853
8853
Original Article
Relation of Serum Albumin Level and C- reactive Protein to Hypotensive Episodes during Hemodialysis Sessions
Mohammed Z Hafez, Wael A Abd El Aziz, Sally M Abd El Wahab
sally1111986@gmail.com
1
Department of Internal Medicine, Aswan University Hospital
Background: Intradialytic hypotension (IDH) remains the most common complication of hemodialysis (HD) with potentially devastating consequences despite the technological advances regarding the hemodialysis techniques of the last decades. The increasing number of advanced-age patients, diabetics and patients with cardiovascular comorbidities undergoing hemodialysis emphasizes the need on implementation of new IDH avoidance tactics. Aim of the Work: Our work aimed to evaluate serum albumin (Alb) level and C-reactive protein level in hemodialysis patients and their correlation with dialysis-induced hypotension (DIH).
Patients and Methods: This prospective study was conducted based on data collected from HD patients treated at Aswan University Hospital, dialysis unit, in a period from 1/1/2017 to 30/5/2017. It included 40 chronic HD patients with no history of endocrine tumors, diabetes mellitus, liver failure, heart failure, or unstable coronary artery disease. Patients with hemoglobin less than 9 mg/dL, feverish patients, and patients with any source of apparent infection were excluded. The age of the patients ranged from over 18 to less than 75 years. Results: : the mean value of serum albumin level in group (A) was (2.97 ± 0.71) with the highest serum albumin was 4.4 and the lowest serum albumin was 2.1, while in Group (B) the mean value of serum albumin level was (4.53 ± 0.74) with the highest serum albumin was 5.5 and the lowest serum albumin was 2.8. There was a significant decrease in serum albumin level in patients in group (A) who had developed hypotensive episodes during hemodialysis ( P value < 0.001), in group (A) also there were 18 patients had positive C-reactive protein (90 %) and 2 patients had negative C-reactive protein (10 %) with a mean value (15.67 ± 13.27), while in group B : there were 2 patients had positive C-reactive protein level (10 %) and 18 patients had negative C-reactive protein level ( 90 %) with a mean value (2.07 ± 1.48) , So, there was a significant increase in C-reactive protein level in patients in group (A) who had developed hypotensive episodes during dialysis ( P value < 0.001). Conclusion: Serum Alb. levels and high levels of CRP may predict an increased risk of DIH in regular HD patients and this was the main issue for our study, however we also found that there were some other biochemical markers, which can come inbetween with our two main markers, which confirm our results. Recommendations: Further studies on a larger scale of patients are needed to confirm these results.
https://ejhm.journals.ekb.eg/article_8853_211e2a20ae398d27e95817b8d539887c.pdf
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
71
1
2280
2286
8854
Original Article
Self-reported Unintentional Injuries in Families Visiting the ‘Childhood Safety Campaign’ in Saudi Arabia
Mosa Ali Al-Zahrani, Mohamad-Hani Temsah, Fahad Al-Sohime, Badr Solayman Al-Mosned, Muath Abdulaziz Al-Soliman, Mohammed Saleh Abaalkhail, Mohannad Saeed Al-Zahrany and Faisal Nasser Al-Shuwair
mosa.alzahrani.a@gmail.com
1
Pediatric department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Background: As a consequence of unintentional injury or trauma, children may develop permanent disabilities such as limb amputations or disfigurement; and in severe cases these injuries can lead to death or severe neurological disabilities.
The aim of this study was to identify the most frequently reported type of unintentional injury sustained by children in Saudi Arabia, as well as the most common locations in which such injuries take place. This paper will also examine the long-term consequences of children’s unintentional injuries on their parents and the different types of care that are needed post-injury
Methodology: This research was carried out in the form of a cross-sectional survey that was intended to be used as an evaluation tool during the first ‘Childhood Safety Campaign’ in Riyadh, Saudi Arabia. The campaign was conducted over 4 days (14 - 17 March 2017) and provided parents with free childhood safety educational resources. The campaign also aimed to capture the personal experiences of families using pre-designed electronic surveys that were completed both before and after attending the campaign. Data was subsequently analyzed using SPSS® version 21.0 basic descriptive software.
Results: Out of the 374 parents who were surveyed, 32% (N=122) reported that at least one child of theirs had sustained an injury of some sort in the 12 months preceding the campaign.
The most common type of unintentional injuries that were reported were falls (50.9%), whilst the most common location for the occurrence of such injuries was at home (66%).
Parents also reported that, as a consequence of the injuries, most children endured a contusion/abrasion (28.7%). The families that took part in this survey also reported that most of the medical care needed as a consequence of injury took place in the Emergency Department. However, hospitalization was needed in (2.3%) of cases.
Conclusion: Accidental injuries are most commonly reported by the parents of children in Saudi Arabia, Incidentally, the majority of these accidents occur at home and can be easily treated in the ER Department. Occasionally, however, certain serious types of injury toke place thereby requiring hospitalization. By raising awareness of these types of preventable injuries via the use of educational awareness campaigns, the risks posed to vulnerable young children may be greatly reduced.
https://ejhm.journals.ekb.eg/article_8854_943247435aeb8de19ae9c593f45e9be4.pdf
Unintentional
injury
Pediatric
self-reported
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
71
1
2287
2293
8855
Original Article
Dinoprostone Versus Misoprostol for Cervical Ripening before Diagnostic Hysteroscopy in Nulliparous Women: A Randomized Controlled Trial
Ayman Abd El-Razek Abulnour*, Mohamed El-Mandooh Mohamed*, Waleed Mohamed Khalaf*, Shady Ali Tarek**
shaditarek@gmail.com
1
*Obstetrics & Gynecology Department, Ain Shams University; ** M.B.B.Ch. October University
Background: Hysteroscopy has revolutionized the field of Gynecology and the management of many gynecological conditions. It has now become a standard part in the diagnosis of postmenopausal bleeding by the gynecological surgeons. Cost, convenience, accuracy, and patient acceptability of these procedures are clearly superior to those of traditional surgeries. As gynecologists have grown better acquainted with the benefits and techniques of operative hysteroscopy, it has become the method of choice for treatment of intrauterine pathology.
Cervical ripening is a complicated process, being mediated by cytokines, growth factors, hormones and other biochemical compounds.
Both dinoglandin and Misoprostol can be used for cervical ripening before introduction of hysteroscopy and hence reduce the incidence of complications.
Objects: This study aims to assess the efficacy of dinoprostone compared to misoprostol in cervical ripening in nulliparous women undergoing diagnostic hysteroscopy.
Methodology: a randomized controlled clinical trial comparing dinoprostone versus misoprostol for cervical ripening before diagnostic hysteroscopy in nulliparous women, it included 2 groups, 33 patients each. In the first group named (group D) dinoprostone 3 mg was applied vaginally 6 hours before diagnostic hysteroscopic procedure while in the second group named (group M) 400 mcg misoprostol was applied vaginally at the same timing.
Results: There was no statistically significant difference between the groups that received misoprostol or dinoprostone with regard to age, duration of marriage, medical disorder, history of gynecological operations and type of gynecological operations. However, the use of misoprostol caused slightly less pain compared to dinoprostone but more side effects occurred with the use of misoprostol.
Conclusion: There was no significant difference between dinoprostone and misoprostol in priming of cervix before diagnostic hysteroscopy in nulliparous women regarding ease of hysteroscope entry, pain or side effects.
https://ejhm.journals.ekb.eg/article_8855_042b105624bd5847e8c8c8594bd2d621.pdf
Dinoprostone
misoprostol
Diagnostic hysteroscopy
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
71
1
2294
2303
8856
Original Article
Validation of The Modified Falls Efficacy Scale –International (FES-I) in Egyptian Geriatric Population
Nagwa Hazzaa1, Fathy Naeem1, Heba Gamal Eldin2, Lamiaa Abd El Fattah3
1
1Audiology Department, Faculty of Medicine, Ain Shams University. 2 Geriatric Medicine Department, Faculty of Medicine, Ain Shams University. 3 Department of Audiology, Mansheyat Al Bakry Hospital.
Background: Falls are a common and complex geriatric syndrome. The fear of falling has negative consequences for older adults. Fall Efficacy Scale-International (FES-I) is one of the questionnaires that assesses fear of falling and its Arabic version has established validity. Aim ofthe work: To evaluate the validity of the modification on original Arabic FES-I to be suitable for the Egyptian culture.
Materials and Methods: 100 geriatric patients participated in this research. All participants were subjected to full medical history taking, application of the modified Arabic Falls Efficacy Scale–International (FES-I), Mini mental state examination, Time Up and go test. Results: The present study group included 100 participants 46 men and 54 women with female predominance, with a mean age of 66 years, the minimum age was 60 years and maximum was 85 years. Most of participants age lies between 60ys & 69ys. Medical history revealed that 67 % of participants had no history of falling and 33% with positive history of falling once or more; also 31 % with history of imbalance and 69 % without history of imbalance. From the participants in our study there were 40% below cut off value of TUG (14 sec) (low risk of falling), and 60% above or equal cut off value of TUG (14 sec) (high risk of falling). Also according to Mini Mental Status Examination (MMSE), 59% with mild cognitive impairment (21 to 26 points) and 41% with normal cognitive function. As regards the categories of modified Arabic FES-I; 16% in low concern category, 22% in moderate concern category, 62% in high concern category. In the current study, the validity and reliability of the modified Arabic FES-I have been proved, there was a statistically significant difference between the two ROC curves in favor of the modified FES-I regarding sensitivity (90.9% compared to 72.7%) and in favor of original FES-I regarding specificity (68.7% compared to 58.2%). Modified Arabic FES-I showed significant positive correlation with age and Time Up and go test, history of falling and history of imbalance and a negative correlation with the MMSE. Conclusion: The validated modified Arabic FES-I can be used in assessment of risk of falling among Egyptian geriatric population. The modified Arabic FES-I is more sensitive than the original Arabic FES-I.
https://ejhm.journals.ekb.eg/article_8856_63b89e7321bf4582ff92e9ab26854ec2.pdf
Arabic FES-I
modified Arabic FES-I
TUG
MMSE
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
71
1
2304
2309
8857
Original Article
Awareness of Risk Factors of DKA among Diabetic Adults in KSA
1Ahmed Maashi Alanazi, 1Abeer Jalawi Alotaibi, 1Hussein Ali Albakheit, 1Sarah Naif Aldewish,2Maram Khalf Ayad Alenzi, 3Alhanouf Abed Salim
dr.maashi@hotmail.com
1
1Faculty of Medicine, Almaarefa College, 2Northern Border University,3Taif university,Saudi Arabia
Background: Diabetic ketoacidosis (DKA) is a complication of Diabetes mellitus (DM) that lingers to have high rates of morbidity and mortality regardless of advances in the management of DM. DKA mainly results from insulin deficiency from new-onset diabetes, insulin noncompliance and increased insulin need because of infection. Most persons with DKA have type 1 diabetes however, a subgroup of type 2 diabetes patients might as well have ketosis-prone diabetes. Aim of the work: To assess the level of awareness of the risk factors of DKA as well as the adherence of DM patients with drugs.
Methods: This is a questionnaire-based cross-sectional study enrolling a total of 100 randomly selected diabetic Saudi adults ensuring diversity in age range and educational stages. Descriptive analysis was done using Statistical Package for Social Sciences (SPSS) 23. Awareness levels for DKA were calculated as absolute frequencies and were reported as overall percentages.
Results: a total of 100 randomly selected diabetic Saudi adults (81 females and 19 males), 56% were diagnosed with DM-1 while 44% had DM-2 and only 11% were active sport practitioners. Moreover, only 62% reported a robust adherence to DM medications.
The majority of the respondent scored low knowledge on DKA (54%). Regarding awareness of predisposing risk factors: 9% and 29% of the participants have related DKA to infection and febrile illness respectively. While, 50% of them suggested that there was an association between physical stress and DKA.
Conclusion: Our results revealed a compelling need to bridge the disparity in awareness of DKA among Saudi adults with both types. The current knowledge gap doesn’t only incur a significant cost burden on the patients and their sponsors because of the high cost treatment and rehabilitation but also and more severely the complications that can be life-threatening if not spotted and treated quickly.
Accordingly, we recommend the launch of education and awareness programs for the public at large, in the hope that this will lead to improved quality of life particularity for DM patients and their caregivers as well as establishing nutrition and sports programs at schools and universities that can teach children and young adults the preventive measures and appropriate management of DKA early on in life. Other public Awareness raising campaign through TV & Radio spots, culture and art activities and informational events would add a great value.
https://ejhm.journals.ekb.eg/article_8857_7288fc0ca506bb8a64d92c6c4b0fdc4c.pdf
Diabetic ketoacidosis
DKA
type 1 diabetes mellitus
Type 2 diabetes mellitus
cross section
Awareness
risk factors
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
71
1
2310
2314
8858
Original Article
Ewing`s Sarcoma of Temporal Bone: Case Report
(1) Alakeel, Abdurahman Mansour, (2) Aldajani N, (2) Shami I M, (3) Orz Y
abdulrahman.alakeel@gmail.com
1
1. College of Medicine, King Saud University, 2. King Fahad Medical City (KFMC), Riyadh, 3.Alexandria University and King Fahad Medical City (KFMC), Riyadh
Primary Ewing`s Sarcoma (ES) is a small round tumor, more likely to present in long bones and rarely in skull bones. ES commonly present in the second decade of life, and it is usually treated by multi‐modality including surgery, chemotherapy, and radiotherapy. In this case, a 13 years old boy presented with left facial palsy and hearing loss for two weeks, treated with steroid but no improvement. MRI was done and showed left jugular foramen and cerebellopontine mass measuring 4.8*4.4* 3 cm. Debulking surgery of the tumor was done with multiple biopsies reported by histopathology as malignant small round cell tumor consistent with Ewing sarcoma.
https://ejhm.journals.ekb.eg/article_8858_5eb1cf495b0f4df5922ee6b4e3b72875.pdf
Ewing`s Sarcoma
temporal bone
Case Report
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
71
1
2315
2321
8859
Original Article
Role of MRI in Assessment of Hepatocellular Carcinoma (HCC) after TACE (Trans-arterial Chemoembolization) with Persistent High Alfa Fetoprotein (AFP)
Omar Hussein Omar, Mohamed Sobhy Hassan, Ahmed Mohamed Tawfik
tawfeekahmed89@gmail.com
1
Department of Radiodiagnosis, Faculty of Medicine, Ain Shams University
Background: evaluation of treatment success after TACE is essential for making therapeutic decisions, e.g., to repeat, interrupt or completely terminate TACE. An understanding of the various therapeutic strategies and their post therapy imaging appearance is essential for accurately assessing treatment response. Evaluation of tumor response should include not only tumor markers, but also imaging modalities. Evaluation of the therapeutic effect of HCC after TACE is primarily based on the findings of imaging studies. CT is the standard imaging technique for monitoring the effectiveness of TACE. MRI is complementary to CT in the evaluation of the therapeutic response. To know the advantages and limitations of each imaging technique in the evaluation of the therapeutic effect of HCC is important in determining if the treated tumor is completely necrotic or requires additional treatment.Objective: the purpose of this work was to study the MRI appearance of the HCC lesion after TACE in patients with high persistent AFP in cases when hyper-attenuating iodized oil impairs the assessment of residual tumor enhancement on contrast enhanced CT.
Patients and Methods: the age of patients ranged between 50 to 73 years with a mean age 58 year.All patients were diagnosed as HCC patients on a background of liver cirrhosis. Twelve patients were positive for HCV and three patients were positive for HBV infection.
Results: our study included 15 patients, 12 males and 3 females with age 51 and 73 years with a mean age of 58years.All patients included were diagnosed with HCC by a previous triphasic CT and alfa feto protein. The patients underwent TACE and the patient’s response to embolization was assessed by AFP and CT or MRI within 1-3 months post chemoembolization. All the selected candidates showed persistent elevation of alfa feto protein after the procedure and within the 1-3 months post TACE. MRI was performed to these patients and their MRI results were either negative or positive explaining the persistent rise of AFP where 13 patients showed positive results and 2 patients showed negative MRI findings. The positive patients were further categorized into groups according to their posttaceMRI findings. 4 patients had de novo new lesions, 6 patients had recurrence and 3 residual tumor patients.
Conclusion: diffusion-weighted MR imaging was found to be a reliable predictor along with contrast enhanced MR imaging when CT was not conclusive.
https://ejhm.journals.ekb.eg/article_8859_d4a5c72110f8cb0fde414e0fe136293b.pdf
Hepatocellular carcinoma
hepatitis B virus (HBV) or hepatitis C virus
transarterial chemoembolization
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
71
1
2322
2350
8860
Original Article
Maternal and Fetal Toxicity of Carisoprodol
Magdy H. Abouel-Magd
1
Narcotic Research Department, the National Center for Social and Criminological Research, Cairo, Egypt
Aim of the work: this study aimed to detect the histological and histochemical changes in liver tissue of pregnant rats and their fetuses after treatment with carisoprodol. Material and methods: thirty pregnant female rats were randomly categorized into three groups (ten pregnant female rats in each group). The first was administered oral doses of distilled water and was served as control. The other two groups were administered oral doses of carisoprodol in the distilled water equivalent to 10.8 mg and 21.6 mg/100g body weight/day respectively for 15 days from the 6th day to the 20th day of gestation. Numerous histological and histochemical studies were done to detect the histopathological and histochemical changes. Results: maternal and fetal liver tissue of both treated groups showed lots of degenerative changes post-treatment withcarisoprodol. The severity of these changes was more obvious in fetal liver tissue of both groups this was accompanied with numerous histochemical changes. Conclusion: treatment of pregnant rats withcarisoprodol led to numerous dystrophic changes in maternal and fetal liver tissue.
https://ejhm.journals.ekb.eg/article_8860_af4b1c31c9942e54f9169698b0ebf7ea.pdf
Keywords: carisoprodol
Mammals
pregnant rats
fetuses
histopathology and histochemistry
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
71
1
2351
2357
8861
Original Article
Screening of Some Drugs of Abuse in Outpatient Clinics in Al-Azhar University Hospitals
Fouad H Eldabah*, Nagy M Alfadaly, Essam S Amer, Wael M Fathy,Mohammed S Mohammed*
mohamudsadawy@gmail.com
1
Department of Forensic Medicine and Clinical Toxicology Faculty of Medicine, Al-Azhar University
Background: Substance, which use among the youth worldwide is a major problem that has elicited concern from different individuals and groups. In Egypt, drug dependence is considered one of the serious problems that worry both the people and government; however, epidemiological data on drug dependence are still few. Drug addiction is one of the serious problems that worry the Egyptian government, as it deals with young people within the age of work and productivity. It may lead to many problems such as bad social adaptation, decreasing productivity at work or dismissing from job.
Aim of the work: The study aims to give an information about the degree of prevalence of a social problem like drugs of abuse in ages more than 18 years in the Egyptian society from May 2016 to April 2017.
Methods: This study was a cross sectional study which done on random urine sample of 500 persons in age of more than 18 years coming to outpatient clinics of Al-Azhar university hospitals namely El-Hussein and Bab Elshaaria university hospitals after taking full history for each one (patient sheet) with informed written consent.
Results: This study found that prevalence of drugs abuse among all studied sample, negative were 215 (43.0%), and positive were 285 (57.0%). Regarding prevalence of types of drugs abuse among all studied sample; negative was 215 (43.0%), THC 105 (21.0%), THC & Opiate 15 (3.0%), THC & tramadol were 40 (8.0%), THC, tramadol & opiate 20 (4.0%), tramadol 55 (11.0%) and tramadol & opiate were 50 (10.0%). Percent of males was significantly higher among the studied groups positive than negative (100.0%, 95.3% respectively, p =0.000). Mean value of age was significantly lower among the studied groups positive than negative (37.96, 43.88 respectively, p <0.000).
Conclusion: prevalence of drugs abuse among all studied sample, negative was 215 (43.0%), and positive were 285 (57.0%).
https://ejhm.journals.ekb.eg/article_8861_a1e926a3f1ad850d0805ccbe3c7ad6ad.pdf
Drugs abuse
Prevalence –Social problems
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
71
1
2358
2364
8862
Original Article
Causes and Outcomes of Hospitalization among Systemic Lupus Erythematosus Patients in Aseer Central Hospital, Saudi Arabia: A Retrospective Study
Mansour Somaily,1 Saeed Asiri2, Lamia Aseery,2 Bader Asiri,2 Nora Gammash,2 Razan Alhumayed,2 Ali Alasmari,
syogran@gmail.com
1
Alhusain Asiri,3 Fatema Althabet,2 Abdullah Alsabaani4
2
1 King Khalid University Medical City, King Khalid University, Abha, 2 College of Medicine, King Khalid University, Abha,
3 Ministry of Health, 4 Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia
Objective: To identify frequency, causes and outcomes of hospitalisations among adult patients with systemic lupus erythematosus (SLE).
Methods: A record-based retrospective study was conducted at Aseer Central Hospital for a period of four and half years from January 2012 to June 2016. The study includes adult SLE patients who were diagnosed according to the 1997 SLE criteria.
Results: A total of 155 patients (8 males and 147 females) with 251 hospital admissions were included. The average admission rate for all cases was about 2.0 ± 1.0 times. The most commonly recorded causes of admissions were SLE nephritis flare (33.9%), and infections (16.3%). Mortality rate for SLE patients is almost 7.7% and the recorded main causes of death were pulmonary hemorrhage (33.3%), sepsis (25%), bilateral massive pulmonary oedema and pneumonia (8.3% for each).
Conclusion: Almost half of adult SLE patients are frequently hospitalized. Female patients and those with associated chronic co-morbidity have more frequent admissions. Consequences of SLE remain the most frequently recorded causes for hospital admission. Pulmonary complications are the main cause for death. Therefore, prompt and aggressive management of pulmonary consequences could markedly reduce disease mortality. Adopting preventive measures such as using prophylactic antibiotics and pneumococcal vaccination, early in the disease course, should be accentuated.
https://ejhm.journals.ekb.eg/article_8862_94e563065e6a5a5fd2f26663bb5981ff.pdf
Keywords: Systemic lupus erythematosus
Hospitalization
Complications
Saudi Arabia
Retrospective study
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
71
1
2365
2369
8863
Original Article
Assessment of Pelvic Parameters before and after Postero-lateral Interbody Fusion Surgery in Patient with Lumbo-sacral Instability
Kamal Abdelrahman Abd Elhafez, Mohamed Abd Elmonem Negm, Abdelrhman Gamal Ramadan
1
Department of Orthopedic Surgery, Faculty of Medicine, Al-Azhar University
Background: pelvic incidence (PI) is a fundamental pelvic anatomic parameter that is specific and constant for each individual and determines pelvic orientation as well as the size of lumbar lordosis (LL). Pelvic incidence (PI) is a descriptor of pelvic morphology and not of pelvic orientation: therefore, its angular value is unaffected by changes in human posture. The pelvic tilt (PT) and the sacral slope (SS) are position-dependent variables and are very useful to characterize the spatial orientation of the pelvis. Pelvic incidence, sacral slope and pelvic tilt are particularly useful because it can be demonstrated that pelvic incidence (PI) is the arithmetic sum of the sacral slope (SS) + pelvic tilt (PT). Objective: this study aimed to determine the effect of Postero-Lateral Inter Body Fusion Surgery (PLIF) in 25 patients with Lumbo-Sacral instability by measuring these three pelvic parameters by plain x- ray before and after surgery. Patients and Methods: when compared to normal populations, pelvic incidence (PI) is significantly higher in spondylolisthesis and the difference in PI tends to increase in a direct linear fashion as severity of the spondylolisthesis increases. The cause effect relationship between pelvic morphology and spondylolisthesis remains to be clarified. Taking into consideration the pelvic parameters stimulated a renewed interest for the radiological evaluation and classification of spino-pelvic alignment in L5-S1 spondylolisthesis. Results: we found that Postero-Lateral Inter Body Fusion Surgery (PLIF) is sucssessful operation for treatment of lumbo sacral instability such as degenerative spondylolisthesis, isthmic spondylolisthesis and post laminectomy instability. In comparison with lateral view x-ray before and after the operation, the pelvic incidence increased and pelvic tilt decreased. Conclusion: PLIF is successfully used to treat degenerative and isthmic spondylolisthesis. PLIF is successful regardless of age, sex and concomitant morbidities such as diabetes mellitus, hypertension and ischemic heart disease.
https://ejhm.journals.ekb.eg/article_8863_0d598baae44b9dd3c66377a8991fcb49.pdf
antero-posterior
Lateral
pelvic incidence
posterior lumbar interbody fusion
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
71
1
2370
2372
8864
Original Article
Squamous Cell Carcinoma Presenting as Cutaneous Horn: A Case Report
Samaher Alaauldeen1, Khalid Al Hawsawi2, Haneen Al Sufyani3, Lina Bugis4,
1
Ayat Al Dosari5, Taghreed Al Hetairshi6
2
1- Al-Noor Specialist Hospital, Makkah, Saudi Arabia, 2- Dermatology Department King Abdul Aziz Hospital Makkah, Saudi Arabia, 3- King Abdul Aziz Hospital Makkah, Saudi Arabia,
4- Umm Al Qura University Makkah, Saudi Arabia, 5- Makkah, Saudi Arabia, 6- Makkah, Saudi Arabia
Background: Cutaneous horn is a clinical term used to describe a hard, keratotic conical lesion. Its base may be a papule, plaque or nodule.
Objectives: An approach for how to diagnose and manage a cutaneous horn.
Materials and methods: Here-in we report an aged male 85-years old presented with a history of painful slowly progressive skin lesion over his right foot 7 months ago.
Results: The past medical history revealed that the lesion was preceded by presence of a cutaneous horn (CH) at the same site of the current skin lesion. That CH was persistent for a year before it spontaneously fell down. Skin biopsy from the base of the CH was taken at that time, it was consistent with underlying actinic keratosis. He did not receive any treatment for his CH. Currently skin examination revealed fungating ulcer measuring 6X6 cm on the dorsum of the right foot. There was no inguinal lymphadenopathy. Punch skin biopsy was taken from the edge of the ulcer for histo-pathological examination.
Conclusion: On the basis of the above clinicopathological findings, a diagnosis of well differentiated Squamous Cell Carcinoma was made. The patient was referred to Oncologist for appropriate management.
https://ejhm.journals.ekb.eg/article_8864_3db03982a95cb83f851bcef6137e1b8d.pdf
Cutaneous horns
Cornu Cutaneum
Squamous cell carcinoma
ulcer
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
71
1
2373
2379
8865
Original Article
Mean Platelet Volume versus Total Leukocyte Count and C-reactive Protein as an Indicator for Mortality in Sepsis
Hazem M. Abd El Rahman, Sanaa F. Mahmoud, Ahmed W. Ezzat, Alaa E. Roshdy
alaaroshdy86@gmail.com
1
Department of Anesthesia, Intensive Care and Pain Management Faculty of Medicine, Ain Shams University
Background: sepsis is a major cause of morbidity and mortality, and the incidence is rising, probably due to the growing elderly population, antibiotic resistance, immunosuppressive medication and, invasive surgery. Pneumonia is the most common infection leading to sepsis, followed by urinary tract infections and abdominal infections. These infections are usually localized and controlled by the immune system, but they can sometimes spread and cause sepsis. Mean platelet volume (MPV) is a measurement that describes the average size of platelets in blood. MPV is ordered routinely as part of the complete blood count panel by an automated flow cytometry machine. In septic shock, most of the coagulation factors are depleted and platelet count is decreased, a close relationship between sepsis severity and thrombocytopenia has already been documented. Aim of the Work: this work aimed to find a relation between the mean platelet volume and mortality in patients with sepsis in correlation with C-reactive protein and total leukocyte count. Methods: 80 adult critically ill patients of both sexes with sepsis and sever sepsis who admitted to the units of Critical Care Medicine Ain Shams University Hospitals. The mean platelet volume (MPV) evaluated and correlated to both total leukocyte count (TLC) and C-reactive protein (CRP) on a daily basis starting from the day of admission and over 14 days. In addition, patients observed regarding outcomes including mortality and discharge from ICU. Results: MPV was able to detect sepsis prognosis with high statistical significance from admission, CRP also was a good predictor and on the contrary TLC had poor prognostic value on admission and after 24 hours, but for the whole hospital stay a significant association was found. Conclusion: elevated MPV on admission is an important marker for sepsis diagnosis and prognosis. Progressively elevated MPV during hospital stay correlates well with mortality. Decreased platelet count after admission is significantly associated with mortality in septic patients. MPV and platelet count can be used as prognostic markers for sepsis and indicators of mortality on daily basis.
https://ejhm.journals.ekb.eg/article_8865_839467c56c5c318622d6c2456eb57747.pdf
Sepsis
sepsis markers
Mean Platelet Volume (MPV)
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
71
1
2380
2386
8866
Original Article
Road Traffic Accident: What Is Being Practiced on The Scene to RTA Casualties in Al-Ahsa City, Saudi Arabia?
Mohammed Abdullah Alsaeeda*, Abdulrhman Mohammed Aljohera, Abdulaziz Khalid Althafar, Abdullatif Abdulaziz Alarifia, Abdulalbary Mohammed Aljohera, Mohammed Nineaa, Iheb Bougmiza
m.alsaeed.94@gmail.com
1
a College of Medicine, King Faisal University, Alahsa, Saudi Arabia
Background: In Saudi Arabia, road traffic accidents (RTA) is a burden to health, economy and community because of the increasing number of deaths and disabilities. Many victims of RTA had poor pre-hospital care undertaken by untrained lay people. Provision of first aid to RTA victims has helped in reduction the related morbidity and mortality.
Aim: To assess how the car drivers’ attitude and practice in case of RTA in Al-Ahsa city, Eastern Province, Saudi Arabia.
Methods: This is a descriptive cross-sectional study between March and May, 2017 among drivers in Al-Ahsa city situated in the eastern part of Saudi Arabia. Using pretested interview-based questionnaires. More than 252 responses have been collected by trained medical students, and 249 responses have been included.
Results: All the participants were male. 44.2% were bachelors and 45.4% students. A large number of the participants are non-first aid trained (73.9%). 70.7% of the participants do not have willingness to provide first aid for road traffic accident victim. The majority (71.1%) have witnessed an RTA sustaining injured individuals and 36.9% have intervened. 67.5% of the responders have been involved in RTA themselves, and 29.3% of them have sustained at least one injury.
Conclusion: There is an insufficient experience in dealing with RTA. The knowledge of the drivers about first aid should be sought further and explored. RTA in Saudi Arabia is a major problem that require an action and consideration from both the community and the government by increasing awareness and putting strict rules to enhance the community to assume a safe driving and improve their skills.
https://ejhm.journals.ekb.eg/article_8866_61e534a39ca5af51f13c292f55c0ee6d.pdf
road traffic accident
RTA
Saudi Arabia
First aid
Car
Drivers
Attitude
Practice
Resuscitation
Pre-hospital Care
Emergencies
injuries
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
71
1
2387
2393
8867
Original Article
Evaluation of Inhaler Use Techniques among Asthmatic Patients in King Faisal Medical Complex, Taif, Saudi Arabia
Faizah Abdullah Alghamdi 1, Maha Olayan Alsufyani 1, Amjad Awwadh Althobaiti 3 1, Bader Al Harthi2 Raad Nassif 2, Nadeem S. Butt 3, Ahmad A. Malik 3, Marwan A. Bakarman3
faizah.111@hotmail.com
1
1-Medical interns, Taif Univeristy, 2- King Faisal Medical Complex, Taif, 3- Rabigh Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
Background: bronchial asthma is a prevalent health problem globally. Inhaled route is commonly used over other routes to manage asthmatic patients. Despite the efficacy of inhalers, the poor inhaler technique used by asthmatic patients leads to decrease drug delivery to lungs and poor asthma control. Objective: the main objective of this study was to evaluate the proper use of inhaler devices by asthmatic patients according to the standard recommended steps and to identify the factors related to the inaccurate or poor inhaler use among asthmatic patients at King Faisal Hospital in Taif, Saudi Arabia. Methods and Materials: this was a cross-sectional observational study conducted among Saudi asthmatic patients using inhaler devices and visiting out-patient’s respiratory clinic. Patients were asked to use their inhaler devices and their inhaler technique and using a validated checklist. MDI, TurboHaler and Handihaler were the most commonly used whether alone or in combinations. Results: around 74% and 92% responded to receive any education for asthma and asthma devices respectively. Of those who received any education, mostly reported that they received education about asthma and/or devices from their physicians. Breathing out, breath holding pattern and position of head during inhaling condition were three critical steps that led to improper use. Conclusion recommendation: inhalation technique in asthma patients was unsatisfactory and was accompanied with errors, especially in patients with low education levels. This study suggested prioritizing and establishing the proper practice of inhaling devices to better manage asthmatic patients and quality of life.
https://ejhm.journals.ekb.eg/article_8867_51a3a6dd5eabc4589e746414dbfc5cc4.pdf
bronchial asthma
inhaler devices
inhaler technique
Compliance
Saudi Arabia
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
71
1
2394
2404
8868
Original Article
The New Era in the Surgical Management of Tetrology of Fallot in Pediatric Patients: A Meta-Analysis
Tarek Mounir El-Sayegh, Hamdy Abdel Wareth Singab, Mohamed Ali Elghanam, *Mina Nathan Zaki
dr.mina.zaki86@gmail.com
1
Cardiology Department, Ain Shams University, Faculty of Medicine, Cairo, Egypt
Background: Provided the high incidence of Tetrology of Fallot, a compelling need for different surgical management techniques have been raised. Thus, a new era was developed in this field that gave favorable results, however a debate still exists on the optimal technique to relieve the Right Ventricular Outflow Tract Obstruction that could lead to less mortality and morbidity, hence it was necessary to analyze data that compare these different techniques.
Moreover, there is a controversy between cardiac surgeons about the best technique to correct the RVOT in infants with Tetrology of fallot and so this study was done to compare between two frequent techniques according to their mortality and morbidity.
Aim of the work: Assess the outcome after surgical repair of tetrology of fallot in pediatric patients comparing between transannular patch and valve sparing techniques.
Methods: The present study was planned in accordance with current guidelines for performing comprehensive systemic reviews and meta-analysis including the PRISMA (Preferred Reporting Items for Systemic Review Meta-Analysis), MOOSE (Meta-analysis of Observational Studies in Epidemiology) and guidelines for randomized and nonrandomized studies.
In this study a meta-analysis was done to compare between the two most common techniques (21-32) that are used to relieve the RVOT that are Transannular patch VS Valve Sparing Repair the variable chosen include: Mortality the Indexed Right Ventricular Volumes, QRS duration, incidence of pulmonary regurgitation, right ventricular Ejection Fraction, Left Ventricular Ejection Fraction and incidence of Reoperation. The principal summary measures were difference in means with 95% confidence interval and p value (to be of significant if p < 0.005) . The difference in means were combined across studies with MedCalc© version 15.8 (MedCalc© Software bvba, Ostend, Belgium.
Results: A total of 72 citation were identified of which 20 studies were potentially relevant and retrieved in full text only 12 studies fulfilled the eligibility criteria There was 74% of patients had a TAP and 26% of patients had VSR. Mortality was 291 among patients with patch repair and 104 among valve sparing repair. Reoperation was detected in 7 patients with TAP VS 6 patients in VSR. Occurrence of PR was detected in 14 patients in TAP VS 12 patients in VSR. The study detected favorable measures in Indexed right ventricular volumes, RV ejection fraction and QRS duration in patients with VSR than those with TAP. This study detected that both group of patients had approximately equal results of LV ejection fraction.
Conclusion: Our results reflected thatValve Sparing Repair for pediatric patients has better outcome in Mortality to relieve pulmonary stenosis, occurrence of pulmonary valve regurgitation as well as a less harmful effect on the right ventricular ejection fraction, better Indexed right ventricular volume and QRS duration than using transannular patching technique.
Both transannular patching and valve sparing repair have approximately the same effect on the left ventricular ejection fraction that may need further studies.
https://ejhm.journals.ekb.eg/article_8868_b043041de4281d29ba97183357af1cfa.pdf
Tetralogy of Fallot
Surgical Correction. Transannular patch
Valve Sparing Repair
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
71
1
2405
2410
8869
Original Article
Role of Multi-Detector Computed Tomography in Assessment of Pulmonary Arterial Hypertension
Aya Essam, Omnia Ahmed Kamal, Ahmed Mohamed Osman
ayaessam894@gmail.com
1
Radiology Department, Ain Shams University
Pulmonary arterial hypertension (PAH) may be suspected based on the clinical history, physical examination and electrocardiogram findings but imaging is usually central to confirming the diagnosis, establishing a cause and guiding therapy. The diagnostic pathway of PAH involves a variety of complimentary investigations of which computed tomography pulmonary angiography (CTPA) has established a central role both in helping identify an underlying cause for PAH and assessing resulting functional compromise. In particular, CTPA is considered as the gold standard technique for the diagnosis of thromboembolic disease.
This article reviews the CTPA evaluation in PAH, describing CTPA techniques, a systematic approach to interpretation and spectrum of key imaging findings.
https://ejhm.journals.ekb.eg/article_8869_6f8f633612bc3bd871dad6645d86de6f.pdf
Pulmonary arterial hypertension (PAH)
Computed tomography (CT)
Echocardiography
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
71
1
2411
2421
8870
Original Article
Role of Diffusion Weighted MRI in Diagnosis of Cervical Cancer
Sherif H Abo Gamra, Mohamed G Abdel Mutaleb, Haydar M Sinjawi
haydar_sinjawi@yahoo.com
1
Department of Radiodiagnosis Faculty of Medicine, Ain shams University
Background: Diffusion weighted magnetic resonance imaging (DW-MRI) is a functional, non-invasive imaging technique which generates tissue contrast from differences in mobility of water molecules that occurs during an MR pulse sequence. Information regarding the integrity of cellular membranes and tissue cellularity can be obtained, so that DW-MRI can now be included in routine patient assessment. Aim of the Work: The aim of this study is to evaluate the role of DW-MRI in the diagnosis of cervical carcinoma, withpathological diagnosis was taken as the reference. Patients and Methods: This is a retrospective study that included 20 patients in whom cervical cancer had been suspected clinically or by transvaginal ultrasound (U/S) and the control group consisted of 20 patients in whom cervical cancer had not been suspected and MRI was performed because of other Pelvic diseases. The study was conducted in El-Demerdash Hospital. The patients were referred from the Gynecology Department to the Radiology Department (Women’s imaging unit) for further MRI assessment with diffusion weighted images (DWIs). Results: Lesions in all cases show restricted diffusion, however on apparent diffusion coefficient (ADC) map, only one case showed high signal proved to be chronic cervicitis on histopathology. Also, the mean ADC values for malignant lesions were (0.82 x10-3 mm2/sec), while the mean ADC value in the control group was (1.58x10–3 mm2/sec). Therefore, ADC value of (1.04 x10-3 mm2/sec) is a cut off between normal cervical tissue and malignant cervical lesion by sensitivity 95% and specificity 95 %. DWIs had elicited the same accuracy to Dynamic contrast-enhanced (DCE) sequences (95%) when added to the non-contrast MRI in the estimation of cancer cervix.
Conclusion: Our results proved that (DW–MRI) was significantly beneficial in terms of diagnostic performance that increases the radiologist’s confidence in image interpretation. So, it implies a non-invasive technique which can be used especially if contrast intake is avoided as in pregnancy. Thus, we suggest that DWI should be included in the routine pelvic MRI protocol. The ADC value in case of cervical carcinoma was significantly lower than in the normal cervical tissue. The ADC threshold of (1.04 x10-3 mm2/sec) was a cut off value, which was detected when differentiating between cancer-affected and non-affected cervical tissues
https://ejhm.journals.ekb.eg/article_8870_4c30dcc8a43813227ec355236dd59a5d.pdf
MRI
DW-MRI
Cervical Cancer
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
71
1
2422
2428
8871
Original Article
General Background and Attitude of the Saudi Population owards Mental Illness
* Malik Jelaidan, *Lamees AbuAlkhair, *Tafani Thani, *Abdulqader Susi, Raafat Shuqdar
1
* Taibah University, Medinah, Psychiatrist, Taibah University, Medinah
Mental illnesses or psychiatric disorders are very common worldwide although, a lot of patients might go undiagnosed and untreated due to the stigma towards mental illness that drives the patients away from seeking medical help. Aim of the work: this study aimed to evaluate the background and attitude of the general population throughout Saudi Arabia about mental illnesses. Method: a cross sectional study analyzed data from 5850 participants aged 18 and up. From all 13 districts of Saudi Arabia. The data were collected using self-administered anonymous electronically distributed questionnaire, between the months of April- May of 2017. The data were analyzed using the statistical analysis system (SAS version 9.1; SAS Institute, Cary, NC). Crude associations were assessed using Pearson Chi -square test. P value of less than 0.05 was used to indicate statistically significant differences. Result: the mean age of the studied subjects was 28.7 ± 9.8 years. Subject’s background about the general nature of psychiatric disorders was high and exceeding 90% regarding the nature of psychiatric disorders and whether they were similar or not, a very low percent (7%) showed that psychiatric patients cannot socially adapt, while 96.9% believed that psychiatric patients were considered insane. (52%) believed psychiatrists are affected by their patients on long term exposure. Conclusion: he background of Saudi population regarding mental illnesses is considered fair, the attitude towards psychiatric patients need further education to minimize the stigma towards them.
https://ejhm.journals.ekb.eg/article_8871_1b28162afaf1e5d03054aafac9d82ec1.pdf
Saudi Arabia
Stigma
Mental Illness
general background