eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2017-04-01
67
2
518
527
10.12816/0037801
14202
Original Article
A Study of Effect of Experimental Pre-Eclampsia on Plasma Lipocalin-2 Level in Rats
Mohamed S. A. Zamzam
1
Ahmed B. E. Abd Allah
2
Azza A. Y. Megahed
3
Eman Mahmoud Farg Allah
4
Department of Physiology, Faculty of Medicine, Zagazig University
Department of Physiology, Faculty of Medicine, Zagazig University
Department of Physiology, Faculty of Medicine, Zagazig University
Department of Physiology, Faculty of Medicine, Zagazig University
Background: preeclampsia (PE) is a pregnancy related complication defined as a disease that begins in the placenta and ends at the maternal endothelium. It is a multi-stage disease that starts by utero-placental insufficiency and leads to generalized maternal endothelial dysfunction.Lipocalin2 (LCN2) is a 25kDasecretory glycoprotein implicated in many functions such as apoptosis and innate immunity. Also, it has been recognized to have potential effects in obesity, inflammation and insulin resistance in mice and humans. Many controversial studies about the changes in the plasma LCN2 levels in PE are reported. Aim: The current study was designed to perform an animal model of experimental PE in a trial to demonstrate the possible relationship between PE and the circulating LCN2 levels. Design: forty eight healthy adult female albino rats and eight adult male albino rats were used. The male rats were used for induction of pregnancy. The adult female rats (n=48) were divided into four equal groups: group I (control non-pregnant group), group II (non-pregnant treated with L-NAME), group III (normal pregnant group) and group IV (pregnant treated with L-NAME to induce a model of experimental PE). In all groups, body weight, body mass index (BMI), blood pressure, circulating levels of urea, creatinine, triglycerides (TGs), IL-6, endothelin-1(ET-1), vitamin D (VD), LCN2 and D-dimers in addition to total urinary proteins are measured. Histopathological examination of placental sections was done in group III and group IV. Results: The results of the present study revealed a significant increase in the body weight, BMI, MAP, total urinary proteins, circulating levels of urea, creatinine, TGs, IL-6, ET-1, LCN2 and D-dimers in both group II and IV. In addition to a significant decrease in VD in the same two groups. In group III, there was a significant increase in body weight, BMI, total urinary proteins and circulating levels of TGS, D-dimers and LCN2. There was a significant decrease in VD and MAP. Moreover, there was a positive significant correlation between LCN2 and all measured parameters except VD in group IV together with a positive significant correlation between LCN2 and MAP, IL-6, ET-1and D-dimers in group II.The results in group IV are supported by the histopathological examination results. Conclusion: L-NAME can be used for induction of experimental PE and plasma levels of LCN2 can be used as an indicator for the renal complications and coagulopathies in PE. Further studies are needed to ascertain this association.
https://ejhm.journals.ekb.eg/article_14202_0ac20a9a4e89719ff96267bc46997bf0.pdf
Pre-eclampsia
lipocalin2
L-NAME
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2017-04-01
67
2
528
535
10.12816/0037802
14203
Original Article
Anti-Diabetic Effect of Balanites Aegyptiacea Leaves Extract (Heglig) by Regulation of Erythrocyte Glucose Uptake in Diabetic Patients Type 2 in Vitro
El-Sayed M. El-Sayed Mahdy
1
Hatem A. El-Mezayen
2
El-Mowafi Abdo Elmowafi
3
Shaimaa Sabry Mohamed
4
Biochemistry Unit, Chemistry Department Faculty of Science, Helwan University,
Biochemistry Unit, Chemistry Department Faculty of Science, Helwan University,
Medicinal and Aromatic Plants Unit, Horticulture Research Institute and National Gene Bank, Agricultural Research Center and
Medicinal Plant Department, Horticulture Institute Agricultural Research Center
Background: in Diabetes, the increase in the oxidative stress and decrease in the antioxidant defense may elevate he susceptibility of diabetic patients to many pathological complications, oxidative induced cell damage has been proposed to play an important role in the etiology of numerous pathological conditions. So, the aim of the present study was to investigate the antioxidant potential of Alcoholic Leaves extract of Balanites aegyptiacea (Heglig) due to the presence of phenolic and flavonoids compounds on uptake of glucose in vitro by erythrocytes of diabetic patients. Results: in hyperglycemic patients, erythrocytes malondialdehyde level was highly significantly increased (P<0.0001) than that of control. However, the erythrocytes glutathione content was highly significantly decreased (P< 0.0001) when compared to that of corresponding control values. The glucose uptake by erythrocytes of diabetic patients was highly significantly decreased (P < 0.0001) with increasing hyperglycemia (Fasting Blood glucose), while it was highly significantly elevated (P< 0.0001) after addition of Balanites aegyptiacae leaves extract to the incubation medium. On the other hand, the malondialdehyde concentration was highly significantly reduced (P < 0.0001) on adding the extract. So, it could be concluded that , an appreciate support for enhancing Antioxidant supply from natural sources such Balanites aegyptiace leaves extract may help control blood glucose levels and prevent pathological complications of diabetes
https://ejhm.journals.ekb.eg/article_14203_cbecaf2a0da6ed1ccfcd20b8e994e824.pdf
Diabetes mellitus
Balanites Leaves Extract
phenolic and flavonoids cpd
Oxidative Stress
Human Erythrocytes
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2017-04-01
67
2
536
543
10.12816/0037803
14204
Original Article
Surgical Correction of Alar Collapse with Alar Batten Graft:Technique and Results
Abdel Aziz Kamal Saad
aksaad@hotmail.com
1
Ahmed Taha
2
Departments of Otolaryngology Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Plastic & Reconstructive Surgery,Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Background: nasal valve collapse has great perception of nasal obstruction. The alar batten graft technique has proven to be a valid method for treatment of external and internal valve collapse. Aim: the aim of the present study was to evaluate a two year experience and follow up for external nasal valve collapse treatment using alar batten graft technique regarding results and complications. Patients and Methods: this prospective study was carried out on 18 patients attended the ENT and Plastic Surgery outpatient clinics of Al-Azhar University hospitals from January, 2014 to January 2016. Written consent was taken from every patient. All patients were complaining of nasal obstruction of gradual onset and progressive course with 7 years average. All patients were subjected to detailed history taking and questionnaire including the NOSE scale. Surgical correction was performed to all patients using the alar batten graft harvested from the septa cartilage or conchal cartilage. Postoperative results recorded in relation to subjective sensation of nasal obstruction and aesthetic appearance of the nose. Results: eleven patients (61.1%) were males and seven (38.9%) were females. Their age ranged from 18 to 45 years with a mean of 32±2. Bilateral obstruction was found in 33.3% of cases and unilateral obstruction in 66.7% of cases. There were 22.2%, 27.8%, and 50.0% of the cases had moderate, fair, and severe obstruction, respectively. Postoperatively, these figures were changed to no obstruction77.8% (P=0.0), mild 0.0%, moderate 11.1%, fair 11.1%, and sever 0.0%(P=0.0005). The technique significantly abolishes the severe nasal obstruction. Postoperative complications include 1 case with graft resorption (4.2%) and 1 case of graft displacement (4.2%). Both were improved on subsequent surgery. Regarding postoperative findings there was tenderness and hypertrophic postauricular scar in 5.5% of patient and nasal tip edema in 22.2%, all resolved. In the early postoperative period, 33.3% of patients complained of fullness in the supraalar region. Conclusion: Successful surgical correction of nasal obstruction requires the precise diagnosis of the anatomic point of collapse. Alar batten graft improves the rigidity of lower lateral cartilage preventing collapse of the lateral nasal wall preventing collapse during moderate and deep inspiration. The graft varies according to the severity of the obstruction and size of the collapsible area of the lateral nasal wall. The septal cartilage is usually sufficient. The technique significantly improves nasal breathing.
https://ejhm.journals.ekb.eg/article_14204_6329e16853459f4015dd5484ad254081.pdf
Alar Collapse
Alar Batten Graft
Functional rhinoplasty
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2017-04-01
67
2
544
546
10.12816/0037804
14205
Original Article
Impact of Kangaroo Position on Serum Nitric Oxide in Preterm Infants
Layla A El Shall
1
Afaf A Korraa
2
Ragaa A Mohamed
3
Reham B Abo El-Hagag
4
Clinical Pathology, Al-Azhar University
Pediatrics Department,Al-Azhar University
Pediatrics,Al-Azhar University
Background: Kangaroo mother care is a standardized protocol-based care for preterm and low birth weight infants. The core feature is early positioning of the infant, prone and upright on the mother or father’s chest to maximize skin to skin proximity. Kangaroo mother care (KMC) is a safe and effective method of caring for low birth weight infants and is promoted for its potential to improve newborn survival. The aim of this study was to investigate serum nitric oxide (NO) in stable preterm infants before and after 60 min kangaroo position & to find out a relation between serum NO and neonatal temperature during that position. Results: showed a statistically significant increase in body temperature, peripheral oxygen saturation and mean arterial blood pressure immediately after 60 min of KMC compared to the results before this maneuver. There was significant increase in NO immediately after 60 minutes KMC. Conclusion: Kangaroo position could increase body temperature through NO dependent mechanisms. KMC is effective in improving all vital signs especially Temperature in preterm infants avoiding the harmful consequences of hypothermia in those infants.
https://ejhm.journals.ekb.eg/article_14205_577d9b987636106ca0093ace67623fa5.pdf
Nitric oxide
Kangaroo mother care
Preterm
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2017-04-01
67
2
547
552
10.12816/0037805
14206
Original Article
Hepatitis C Virus in Peripheral Mononuclear Cells in Patients on Regular Hemodialysis
Emad Allam Mohamed
1
Mostafa Abd Elfattah Elballat
2
Mostafa Mostafa Kamel El-Awdy
3
Ahmed Abo-Elyazid Ali
4
Internal Medicine Department, Faculty of Medicine ,Al-Azhar University
Internal Medicine Department, Faculty of Medicine ,Al-Azhar University
Internal Medicine Department, Faculty of Medicine ,Al-Azhar University
Internal Medicine Department, Faculty of Medicine ,Al-Azhar University
Background: Occult hepatitis C virus infection (OCI) was identified as Hepatitis C virus (HCV), characterized by undetectable HCV antibodies and HCV RNA in serum, while HCV RNA is detectable in liver and peripheral blood mononuclear cells (PBMCs) only. Nosocomial transmission in dialysis units maintains a higher prevalence of hepatitis C virus (HCV) infection in patients on maintenance dialysis than in the general population. HCV infection has a detrimental effect on survival in patients on maintenance dialysis and after renal transplantation. The excess risk for death in HCV-positive patients was partially attributed to chronic liver disease with its attendant complications, particularly hepatocellular carcinoma and liver cirrhosis(1). The aim of this study: was to evaluate the hidden infection of hepatitis C virus among regular hemodialysis patients in Bab Al Sharia University Hospital with negative ELISA and PCR by using PCR in mononuclear cells as a marker in the serum of these patients Patients and methods:in this prospective study, 60 patients with end-stage renal disease on regular hemodialysis(for at least 6 months duration)were included. For all patients thorough medical history, clinical examination, kidney function tests, liver function tests, complete blood count, pelvi-abdominal ultrasound, HCVantibodies, hepatitis C viral RNA, quantitative, HbsAg,. HCV PCR done for all patients in serum and mononuclear cells.. Patients with acute or chronic HCV infection as marked by positive hepatitis C antibody,acute or chronic HBV infections marked by hepatitis B surface antigen,other causes of liver dysfunction ( e.g., primary biliary cirrhosis, autoimmune hepatitis, HIV infection) and patient on anti HCV treatment.were excluded. Results: showed detection of HCV-PCR in PBMCs in the absence of HCV-PCR in plasma; was found in three of the 60 patients (3.3%). All patients had negative HIV, HBsAg, HCV Ab and serum HCV PCR. Conclusion: it could be concluded that testing for HCV-RNA in PBMCs is more reliable than hepatitis serological markers in identifying patients with an OCI when a liver biopsy is not available.
https://ejhm.journals.ekb.eg/article_14206_c589eaa435fab3cc9e826193ec2e1aaf.pdf
Occult hepatitis C virus infection
Regular Hemodialysis
liver disease
HCV PCR PMNL
ELISA and serum PCR HCV
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2017-04-01
67
2
553
563
10.12816/0037806
14207
Original Article
Subclinical Peripheral Nerve Affection in Hypothyroidism
Mai Abdelazeem
dr_mai_rabie@yahoo.com
1
Abeer ElZohiery
2
Mona Elhussieny
3
Mohamed Ragaai
4
Physical Medicine, Rheumatology and Rehabilitation Department Faculty of Medicine, Ain Shams University,Cairo, Egypt
Physical Medicine, Rheumatology and Rehabilitation Department Faculty of Medicine, Ain Shams University,Cairo, Egypt
Physical Medicine, Rheumatology and Rehabilitation Department Faculty of Medicine, Ain Shams University,Cairo, Egypt
Physical Medicine, Rheumatology and Rehabilitation Department Faculty of Medicine, Ain Shams University,Cairo, Egypt
Background: Hypothyroidism is most common endocrinal disorder. The existence of hypothyroid neuropathy is a point of debate and its pathogenesis is incompletely understood. Objective: To detect subclinical motor or sensory peripheral nerve affection among hypothyroid patients. Methods: The study was conducted on 30 hypothyroid patients without any neurological symptoms and signs. 10 healthy subjects were included as a control group. All participants were subjected to full medical history taking thorough clinical examination; full general and neurological examination, laboratory & radiological investigations and neurophysiologic nerve conduction study. Results: The study revealed polyneuropathy, mainly sensorimotor, in 86.6% of the patients either axonal demyelination or axonal affection. Median and peroneal nerves were the dominantly affected nerves. High incidence of entrapment neuropathy was encountered among the patients especially carpal tunnel CTS (66.67%).Conclusion: Hypothyroidism is associated with polyneuropathy,mainly of a mixed type (axonal -demyelinating type).Nerve conduction tests should be performed routinely in hypothyroid patients early in the course of the disease, even among asymptomatic patients, to minimize structural damage and disability.
https://ejhm.journals.ekb.eg/article_14207_bd24360cb8be5bd2d4140d708c87ee49.pdf
hypothyroidism
nerve conduction study
Neuropathy
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2017-04-01
67
2
564
570
10.12816/0037807
14208
Original Article
The Role of Tonsillectomy in the Treatment of Obstructive Sleep Apnea
Abdullah Ghafouri
1
Suzan Sulaiman Alzaidi
2
Reem Raddah AL-Zayedi
3
Nihal Khalid N Alsolu
4
Maria Khalifah Alhamed
5
Fetoon Nasser Alsharif
6
King Fahad Armed Forces Hospital, Jeddah
King Fahad Armed Forces Hospital, Jeddah
King Fahd Hospital, Jeddah2
Arabian Gulf University, Bahrain
King Faisal University4
Ibn Sina National College5
Background: Obstructive Sleep Apnea (OSA) is caused by a partial or complete obstruction of the upper airway. OSA is a very inconvenient and relatively common disorder with daytime and nocturnal symptoms. The intervention and management of OSR is dependent on the patients’ case severity. The aim of this study was to evaluate the role and the optimal choice of Tonsillectomy for treatment of OSR. Methods: a systematic search in the scientific database (Medline, EMBASE, Google Scholer and Ovid) from 1980 to 2016 was conducted for all relevant retrospective studies including; randomized controlled trials, cohort studies and case–control studies were analyzed and included based on the preset inclusion and exclusion criteria. Results: the search has yieldedtwelve studies to be included in the present SR (n = 206 patients, 34.4 ± 10.0 years and body mass index: 29.3 ± 9.6 kg/m2) met criteria. Tonsils sizes were hypertrophied, large, enlarged, extremely enlarged, or grades 2 to 4. Apnea-Hypopnea Index decreased by 65.2% (from 43.7± 21.7 /hour to 13.7 ± 12.7 /hour) (n = 198). The AHI mean difference (MD) was −30.2 per hour (95% confidence interval [CI] −39.3, −21.1) (P value < 0.00001). The AHI SMD was −1.37 (−1.65, −1.09) (large effect). Lowest oxygen saturation improved from 77.7 ± 11.9% to 85.5 ± 8.2% (n = 186). Lowest oxygen saturation MD was 8.5% (95% CI 5.2, 11.8) (P value < 0.00001). The Epworth Sleepiness Scale decreased from 11.6 ± 3.7 to 6.1 ± 3.9 (n = 125). Individual patient outcomes (n = 52) demonstrated an 85.2% success rate (AHI < 20/hour and ≥ 50% reduction) and a 57.4% cure rate. Conclusion: tonsillectomy is an effective and safe surgical intervention for treatment of OSA in adults, particularly among carefully selected patients with large tonsils and mild to moderate OSA severity.
https://ejhm.journals.ekb.eg/article_14208_06cba23ccb86d377ae75aefb5fbbd78d.pdf
Tonsillectomy
OSA
sleep apnea syndromes
tonsillar hypertrophy
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2017-04-01
67
2
571
577
10.12816/0037808
14209
Original Article
First Line Management of Adult Diabetic Ketoacidosis Patients
Amirah Ali Alshammari
1
Louai M Alahdal
2
JenanTajuddin Jawi
3
Hanouf Abdullah Alnofaie
4
Nourah Ali Aldossari
5
Hala Mohammad Abdulaziz Alassaf
6
Hail University
SFH
Ibn Sina Collge
Taif University
King Faisal University
Hail University
Background:Diabetic Ketoacidosis (DKA) is a hyperglycemic crisis that can occur in patients with both type 1 and 2 diabetes mellitus. It is a medical emergency with a significant morbidity and mortality. It is however a potentially reversible condition in case an emergency and immediate medical attention, prompt recognition, diagnosis and treatment were provided. Aim of the Study:was to leverage the current research data in order to construct a treatment guideline for diabetic ketoacidosis in the emergency department. Methods:A literature search was carried out on MEDLINE (including MEDLINE in-process), CINAHL,Embase and the Cochrane Library. Databases using “diabetic ketoacidosis” as a MeSH heading and as textword. High yield journals were also hand searched. Findings:The initial treatment phase aims to restore circulating volume, reduce blood glucose levels, to correct any electrolyte imbalances and to reduce ketone levels which in turn corrects the acidosis. Evidence also showed that there is no need for insulin bolus prior to starting an insulin drip in the treatment of diabetic ketoacidosis. Also, using beta-hydroxybutyrate at presentation can expedite diagnosis and therefore treatment. Implementing treatment guidelines into the emergency department may help expedite diagnosis and treatment. Conclusion:Prompt first line management of DKA is the most critical stage to profoundly reduce morbidity and mortality rates of this potentially fatal crisis. It’s therefore crucial to follow the evidence-based guidelines and DKA protocol in the emergency department to expedite diagnosis, guide treatment, and improve continuity of care between the emergency department and the ICU as well as improving the clinical outcomes of patients with DKA. Initially, this will improve outcomes by decreasing the delay until treatment is initiated andprovide a continuum of treatment between the emergency department and the intensive care unit. Furthermore, the healthcare providersmust ensure that they have the ability to provide support and education to people at risk of developing DKA and those that have had an episode of DKA by spreading awareness and education to help reduce both the initial occurrence and recurrence of this often preventable life-threatening condition.
https://ejhm.journals.ekb.eg/article_14209_b072d2f80afa81d5ea459a3a50502871.pdf
Diabetes complications
DKA
ketosis
Diagnosis
Pathogenesis Type 1 diabetes Type 2 diabetes
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2017-04-01
67
2
578
590
10.12816/0037809
14210
Original Article
Role of Positron Emission Tomography/Computed Tomography (PET/CT) in Detection of Bone Metastases
Ahmed Farad
1
Islam El-Shazley
2
Ahmed Sherif
3
Department of Radiology, Faculty of Medicine, Benha University,Egypt
Department of Radiology, Faculty of Medicine, Benha University,Egypt
Department of Radiology, Faculty of Medicine, Benha University,Egypt
Background and Aim of the Work: Early detection of skeletal metastasis is critical for accurate staging and optimal treatment. Among the various imaging modalities currently available for imaging skeletal metastasis, hybrid techniques which fuse morphological and functional data are the most sensitive and specific, and positron emission tomography (PET)/computed tomography imaging will almost become increasingly important in this regard. We tried to assess the efficacy of fluorine-18 fluoro-deoxy-glucose Positron Emission Tomography/Computed Tomography (PET/CT) ((18) F-FDG-PET/CT) scan in detecting bone metastases among various primary malignancies. In order to detect accuracy of fused PET/CT in the initial detection & characterization of osseous metastases compared to isolated PET and CT with contrast. Patients and methods: The study included thirty patients (with a mean age = 27) with various primary malignancies (pathologically proven) to whom PET/CT was done. In this study population, a detailed retrograde lesion based analysis was performed for a total of 80 detected bone lesions on PET, CT and fused PET/CT images. Sensitivity, specificity, PPV and NPV of each modality were calculated. Stastical analysis of the lesions were performed to study the relationship between the lesion’s SUV and its corresponding morphologic pattern on CT and to set a reliable SUVmax cut-off value that can predict the presence of malignant lesion. Results: The calculated fused PET/CT sensitivities and specificities in various malignancies ranged from 95.2% to 99.6% and 75% to 100%, respectively. The combined PET/CT has significantly improved the low CT sensitivity (especially in lymphoma) as well as both separate CT and PET specificities (using SUVmax of 3 as a cut off value for malignant osseous lesions). Conclusion: Detection of early bone marrow infiltration not apparent on CT, resolution of metabolic activity before definite signs of complete healing on CT, detection of missed sclerotic metastases on PET due to their relatively low metabolic activity, detection of intra and extra osseous recurrence and differentiation of benign from malignant bone lesions.
https://ejhm.journals.ekb.eg/article_14210_6f51e7c91c532ab269e3c939abb9fcd8.pdf
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2017-04-01
67
2
591
598
10.12816/0037810
14211
Original Article
The Therapeutic Effects of Stem Cell Enhancer on Changes of Some Physiological Parameters in Male Albino Rats Treated With Mixture of Food Additives )Food Preservative, Food Coloring Agent, and Flavor Enhancer)
Eman G.E. Helal
1
,Rasha A.A. El-Sayed
2
GomaaMostafa- Hedeab
3
Mariam S. El-Gamal
4
Department of Zoology, Faculty of Science (Girls), Al-AzharUniversity,Cairo, Egypt
Department of Zoology, Faculty of Science (Girls), Al-AzharUniversity,Cairo, Egypt
Pharmacology Department, Faculty of Medicine, Beni Suef University, Egypt,
Department of Zoology, Faculty of Science (Girls), Al-AzharUniversity,Cairo, Egypt
Background: food additives are substances intentionally added to food to change its characteristics, to maintain and improve safety, to improve or maintain the nutrient value and to improve taste, texture, and appearance. Sodium nitrite is an inorganic salt with widespread applications in the food industry as a food preservative in meat and fish. However, Annatto is used as a dyeing agent in the food industry in coloring butter, cheese, and ice-cream whereas Monosodium Glutamate (MSG) is one of the most used flavorenhancers which is ingested as part of commercially processed foods. Stem cell enhancer is a natural stem cell mobilizer that can trigger the release of millions of adult stem cells from bone marrow into the circulation, and its considerable safety allows for a sustained oral daily intake over long periods of time. Aim of the work: this study was aimed to determine the therapeutic effects of Stem Cell Enhancer (SCE) against the hazardous effects of sodium nitrite, annatto and monosodium glutamate on some physiological parameters in male albino rats. Materials and methods: this study had been done on thirty male albino rats with an average body weight 120-140 g. The animals were divided into three groups; Group 1: control (untreated group), Group 2:rats treated with food additives mixture (sodium nitrite, annatto, and monosodium glutamate); Group 3: rats treated with food additives mixture, in addition to Stem Cell Enhancer. Blood samples were collected, and the separated sera were used for estimation of some biochemical parameters (liver enzymes, kidney functions, glucose, protein profile and lipid profile) and hormonal levels [testosterone,triiodothyronine (T3) and thyroxine(T4)]. Results: the biochemical results showed an increase in the activities of liver enzymes [aspartate aminotransferase (AST) and alanine aminotransferase (ALT)], and the levels of glucose, kidney functions (urea, and creatinine), lipid profile [total cholesterol, triglycerides, low-density lipoprotein(LDL-c), high-density lipoprotein(HDL-c)and risk factors 1& 2] and thyroid hormones [T3 and T4]in the mixture accompanied by a significant decrease in protein profile (total protein, albumin and globulin), HDL-and testosterone hormone levels as compared to the control rats. On the other hand, these results turned back to nearly to the normal values after receiving the Stem cell Enhancer. Conclusion: the present study clearly revealed thetherapeutic capability of SCE to fight the grievous effects of food additives mixture on major physiological parameters.
https://ejhm.journals.ekb.eg/article_14211_e6c3a7f5808ccdf84c6e3e7b750d3ce4.pdf
food additives
Sodium Nitrite
Annatto
Monosodium glutamate
Stem Cell Enhancer
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2017-04-01
67
2
599
604
10.12816/0037811
14212
Original Article
The Effect of Mehotrexate in the Treatment of Alopecia Areata
Haneen Saud Alsufyani
haneen.saud.ss-123@hotmail.com
1
Wahhaj Abdullah Rawas
2
Sufyan Saud Alsufyani
3
Nebras Faisal Alsaadi
4
Mohannad Sami Felemban
5
Mouad Mohammed alqadi
6
Jameel Abdullah Awadain
7
Meshal Mohammed Abdullah Albaqami
8
Ali Mohammed Alasmari
9
Mohammed Aiman A Halawani
10
Wael Hamed Alsaedi
11
Umm Al Qura University, Makkah, KSA
Umm Al Qura University, Makkah, KSA
Umm Al Qura University, Makkah, KSA
Umm Al Qura University, Makkah, KSA
Umm Al Qura University, Makkah, KSA
Umm Al Qura University, Makkah, KSA
Umm Al Qura University, Makkah, KSA
Umm Al Qura University, Makkah, KSA
Umm Al Qura University, Makkah, KSA
Umm Al Qura University, Makkah, KSA
Umm Al Qura University, Makkah, KSA
Background: Alopecia areata (AA) is one of the most common autoimmune disorders and its severe types are resistant to almost all conventional therapies. Methotrexate (MTX) has been used as an adjunctive therapy in some autoimmune disorders and has been proposed to be effective in the treatment of severe alopecia areata both as a monotherapy and in combination with corticosteroids. Aim of the study: was toevaluate the outcome and safety of MTX therapy in patients with severe forms of AA, whether as monotherapy or in combination with systemic or intralesional corticosteroids; and to assess therapeutic response according to sex, age, pattern of AA, disease duration and cumulative MTX dose. Methods: 28 patients were evaluated in a retrospective, non-controlled study, with alopecia areata in current or prior treatment with methotrexate to assess the therapeutic response according to sex, age, pattern of alopecia areata, disease duration, and cumulative dose of methotrexate as well as the use of systemic corticosteroids or other treatments, and drug safety. Results: 77.8% % of patients experienced a more than 50% regrowth rate, with the best responses observed in those with Conclusion: methotrexate is a convenient and relatively inexpensive drug that could be used as a safe and well tolerated adjunctive therapy for severe alopecia areata although careful monitoring of adverse effect is necessary.
https://ejhm.journals.ekb.eg/article_14212_face0b1bbcb31a6ca43498e472cc91b6.pdf
Alopecia Areata
Methotrexate
severe alopecia areata
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2017-04-01
67
2
605
613
10.12816/0037812
14213
Original Article
Effects of Some Food Additives on Some Biochemical Parameters in Young Male Albino Rats and the Ameliorative Role of Royal Jelly
Eman G.E. Helal
emanhelal@hotmail.com
1
Rasha A.A. El-Sayed
2
, GomaaMostafa Hedeab
3
Mariam S. El-Gamal
4
Department of Zoology, Faculty of Science (Girls), Al-AzharUniversity,Cairo, Egypt
Department of Zoology, Faculty of Science (Girls), Al-AzharUniversity,Cairo, Egypt
Pharmacology Department, Faculty of Medicine, Beni Suef University, Egypt
Department of Zoology, Faculty of Science (Girls), Al-AzharUniversity,Cairo, Egypt
Background: the use of food additives is one of the most important problems in the human health nutrition field. Food additives are widely used for various purposes; including preservation, coloring, and sweetening, however, the physiological and biochemical changes may be produced. Aim of the work: was to investigate the protective role of royal jelly (RJ) against abnormalities in metabolic biochemical parameters that induced by these food additives in male albino rats. Materials and Methods: thirty young male albino rats with an average body weight 120-140 g were divided into three groups (10/cage); Group I: served as normal control group, Group II: rats orally administrated with the mixture which consists of sodium nitrite (NaNO2 0.1 mg/kg b.wt./ day), annatto (0.065 mg/kg b.wt./day) and monosodium glutamate (MSG 15 mg/kg b.wt./day) and Group III: rats orally administrated with the previous mixture and then orally administrated with royal jelly (14.28 mg/kg b.wt./day soluble in maize oil). At the end of the experiment, blood samples were collected for biochemical estimations which including levels of serum glucose, creatinine, urea, testosterone, thyroid hormones (T3 and T4), activities of AST and ALT, total protein (TP), albumin, total cholesterol, triglycerides, high-density lipoprotein (HDL-c) and low-density lipoprotein (LDL-c). Results: the present study showed marked elevation in levels of fasting blood glucose, activities of AST, ALT, levels of serum urea, creatinine, TC, TG, LDL-c, VLDLand ratios of TC/HDL-c and LDL-c/HDL-c (risk factors) as well as albumin /globulin ratio and serum thyroid hormones (T3&T4) accompanied with significant reduction in the body weight, serum total proteins, albumin, globulin, albumin/creatinine, testosterone and HDL-C concentrations in the group that administrated with the mixture which consists of (NaNO2, MSG and annatto) as compared to control rats. While administration with royal jelly significantly ameliorated the disturbed biochemical parameters and showed significant improvement in most of these parameters. Conclusion: it could be concluded that royal jelly offers a therapeutic advantage that minimizes the metabolic abnormalities and biochemical changes which induced by these food additives.
https://ejhm.journals.ekb.eg/article_14213_b4811035d3f6196579f83ee543613328.pdf
royal jelly
testosterone
food additives
biochemical parameters
Sodium Nitrite
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2017-04-01
67
2
614
627
10.12816/0037813
14214
Original Article
Vaginal Misoprostol versus Bilateral Uterine Artery Ligation in Decreasing Blood Loss in Trans-Abdominal Myomectomy: A Randomized Controlled Trial
Ihab Hassan Abdel-Fattah
1
Ahmed Adel Tharwat
2
Walid,El Basuony Mohammad
3
Mortada El-Sayed Ahmed
4
Aliaa Mohammad Ali Maaty
5
Faculty of Medicine – Ain Shams University
Faculty of Medicine – Ain Shams University
Faculty of Medicine – Ain Shams University
Faculty of Medicine – Ain Shams University
Faculty of Medicine – Ain Shams University
Background: Uterine leimyomas are tumors of the smooth muscles and the connective tissues of the uterus. They are considered to be the most common benign pelvic tumor affecting about 20% of women above the age of 35. The diverse symptomatology of fibroids can be attributed to size, number and location of the tumors. The common symptoms include menorrhagia, infertility, abdominal mass and pressure effects. Aim of the Work: The aim of this study is to compare between the effect of medical (preoperative vaginal misoprostol) and non-medical (bilateral uterine artery ligation) regarding their efficacy to decrease blood loss in trans- abdominal myomectomy. Patients and Methods: Prospective randomized controlled interventional clinical trial. The study was conducted in Ain Shams University Maternity Hospital, Cairo, Egypt in the period between August 2015 till December 2016. It was approved by the Ethical Research Committee, Obstetrics and Gynecology Department, Ain Shams University, Cairo, Egypt. It included 60 women recruited from those attending the outpatient gynecology clinic, seeking treatment for symptomatic uterine myomas. Results: The current study revealed that there was no statistically significant difference between both groups regarding operative time, blood loss and postoperative hospital stay. Conclusion: A single pre-operative dose of 400 micrograms of vaginal misoprostol is as effective as uterine artery ligation in decreasing blood loss in transabdominal myomectomy. Misoprostol is a simple, cheap, fast, available and applicable tool that can be administered even an hour preoperatively. Recommendations: Preoperative vaginal misoprostol is an effective practical tool in decreasing blood loss in transabdominal myomectomy. Investigation of misoprostol use in larger population groups and with different dosages and administration routes, together with comparison of other methods used to reduce bleeding during myomectomy, is recommended.
https://ejhm.journals.ekb.eg/article_14214_59942721b75381a83e56cc94cbdc585a.pdf
uterine leimyoma
smooth muscles
connective tissues
Vaginal Misoprostol
bilateral uterine artery ligation
blood loss
Transabdominal Myomectomy
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2017-04-01
67
2
628
634
10.12816/0037814
14215
Original Article
Relationship between Diabetic Retinopathy and Methylenetetrahydrofolate Reductase Gene Polymorphism
Jihan Abdallah M
1
Seham Mohamed
2
Hamdia Ezzat A
3
Eman Salah M
4
,Ophthalmology Department ,Faculty of Medicine (for Girls), Al-Azhar University, Cairo, Egypt
clinical pathology Department, Faculty of Medicine (for Girls), Al-Azhar University, Cairo, Egypt.
clinical pathology Department, Faculty of Medicine (for Girls), Al-Azhar University, Cairo, Egypt.
clinical pathology Department, Faculty of Medicine (for Girls), Al-Azhar University, Cairo, Egypt.
Purpose: To assess MTHFR rs1801133 (C677T) gene polymorphism in diabetic patients as a risk factor for diabetic retinopathy and to establish the changes in Platelet indices & count in diabetic patient as compared to the healthy control group. Patients and Methods: The study included 40 patients with Type 2 Diabetes Mellitus. They were divided into 2 equal groups, 20 patients with Diabetic Retinopathy, 20 patients without Diabetic Retinopathy. Patients were selected from those attending the outpatient Ophthalmology Unit and Diabetes Clinic of Al-Zahraa University Hospital in the period from June 2014 to June 2015. Their ages ranged between 34 to 66 years old. They were 14 males and 26 females. Twenty cases apparently healthy individuals were selected as a control group. All cases were subjected to full history taking and complete ophthalmological examination. Also laboratory investigations were done including complete blood picture, kidney and liver function tests, coagulation profile, urine analysis, lipid profile, fasting and postprandial blood sugar and Genetic study for detection of MTHFR gene C677T mutation (rs 1801133)by real time PCR. Results: In all diabetic patients the mutant homozygous TT showed a highly statistically significant increase in FBS (p=0.000), PPBS (p=0.000), HbA1C (p=0.000) and cholesterol (p=0.001) as compared to wild type. Also in all diabetic patients the mutant homozygous TT showed a highly statistically significant increase in FBS (p=0.002), PPBS (p=0.001), HbA1C (p=0.019) and cholesterol (p=0.012) as compared to heterozygous mutant type. Conclusion: The homozygous mutant type (TT) of rs1801133 was detected in 10% of DR patients group while absent in DWR group and the control group. The heterozygous mutant type (CT) was increased in DR group (50%) as compared to DWR group (35%) and the control group (25%).
https://ejhm.journals.ekb.eg/article_14215_9aac0903ab91ac24d39d4abcd7c5345d.pdf
diabetic retinopathy
Methylenetetrahydrofolate gene
Platelet indices
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2017-04-01
67
2
635
644
10.12816/0037815
14216
Original Article
Interferon Lambda 4 Gene (IFNL4) Linked to Hepatitis C virus clearance, treatment
Saadia Farid
1
Laila Rashed
2
Samya Sweilam
3
Department of Tropical Medicine,National Hepatology and Tropical Medicine Research Institute and Faculty of Medicine, Cairo University
Department of Biochemistry,National Hepatology and Tropical Medicine Research Institute and Faculty of Medicine, Cairo University
Department of Medical Biochemistry National Hepatology and Tropical Medicine Research Institute and Faculty of Medicine, Cairo University
Background: AdesignatedIFNL4 gene, encoding the interferon-λ4 protein (IFNL4), which is moderately similar to IFNL3, is more strongly associated with HCV clearance in individuals of African ancestry, whereas it provides comparable information in Europeans and Asians. Aim of the work: The study was attempted for the identification of interferon Lambda 4 (IFNL4) gene expression in the liver biopsy and the recombinant IFNL4 protein in the serum of CHCV patients. Patients and methods: Eighty five patients with chronic hepatitis C virus infection (CHCV), whose age ranged between 19 and 57 years, were selected from the National Hepatology and Tropical Medicine Research Institute were included in this study, before chronic HCV therapy, during the preparation of patients, and ten healthy individuals were included to serve as controls. All the patients and controls were subjected to the following: history, clinical examination, abdominal ultrasonography and collection of blood samples for routine laboratory investigations, CBCs. Liver biopsy was done to all patients and controls. Patients revealed mild fibrosis (Metavir fibrosis from F1 to F3). Using freshly frozen liver biopsies to identify gene (IFNL4) by real time-PCR and the detection of its serum protein levels by ELISA. Results: Patientswith CHCVhave higher hepatic expression of IFNL4 before treatment and also recombinant IFNL4 protein expression was detectable in serum with high levels. Conclusion: An inducible human protein-coding gene IFNL4, which is related to, known IFNs have been identified in genotype 4 CHCV patients. Recommendations: Thetherapeutic inhibition of IFNL4 might represent a novel biological target for the treatment of HCV and HBV infection and possibly other diseases.
https://ejhm.journals.ekb.eg/article_14216_0e3cb3f44ac4293ebdcff8c4a2d4d998.pdf
HCV
IFNL4
clearance of HCV
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2017-04-01
67
2
645
655
10.12816/0037816
14217
Original Article
Effects of High Flux versus Low Flux on Serum C-Reactive Protein A as an Inflammatory Biomarker in Hemodialysis Patients
Emad Allam Mohamed
1
Magdy Elsayed Mohamed
2
Haytham Sabry Abdelhamid
3
Mohammed Al-Arabi Mohammed
4
Nephrology Unit, Faculty of Medicine, Al-Alzhar Universit.
Nephrology Unit, Faculty of Medicine, Al-Alzhar Universit.
Nephrology Unit, Faculty of Medicine, Al-Alzhar Universit.
Nephrology Unit, Faculty of Medicine, Al-Alzhar Universit.
Background: Traditional low-flux dialysis cannot improve micro-inflammatory status, while new high-flux dialysis can improve the micro-inflammation and lipid metabolism, it helps to improve the quality of life and survival rate of patients, so how to improve the micro-inflammatory status are a focus for researchers. Objective: was to observe the effect of high flux hemodialysis (HFHD) with Gambro polyflux 170H dialyser and low flux hemodialysis (LFPD) with polyflux 17L dialyser on high-sensitivity C-reactive protein in patients with maintenance hemodialysis. Methods: 60 patients with maintenance hemodialysis were randomly divided into HFHD group and LFHD group. Another 20 cases for physical examinations served as normal control group. The maintenance hemodialysis patients were treated with HFHD using 170H dialyser dliahyser and LFHD using 17L dialyser, three times per week, 4 hours once. After 6 months of the treatment, high-sensitive C-reactive protein was determined in patients as well as normal controls before and after treatment. Results and Conclusion: in two groups, the levels of high-sensitive C-reactive protein before the treatment were higher than normal control (P <0.001). In HFHD group, serum high-sensitive C-reactive protein markedly decreased (P <0.01). In LFHD group, these indices remained unchanged after the dialysis for 6 months. HFHD with 170H polysulfone dialyser is effective in improving micro-inflammation in maintained hemodialysis patients.
https://ejhm.journals.ekb.eg/article_14217_428779b5c17b4e37b27c6b1ce3738d75.pdf
CRP
ESRD
hemodialysis membrane
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2017-04-01
67
2
656
659
10.12816/0037817
14218
Original Article
Operational Difficulties in Obese Patients
Nawaf AL-Hazmi
1
Ahmad Al-Zahrani
2
Abdallah Ali
3
Hisham Adulbaset
4
College of Medicine, Taif University, Saudi Arabia
College of Medicine, Taif University, Saudi Arabia
College of Medicine, Taif University, Saudi Arabia
College of Medicine, Taif University, Saudi Arabia
Background and aim of the work: to give optimal care for obese surgical patients, surgeons and healthcare personnel should be aware about the surgical problems which may be met in obese patient and how to overcome a variety of challenges. In this study the awareness of the surgeons about the obesity as surgical problem would be evaluated from the surgical staff point of view. Patient and methods: a cross-sectional study was done by interviewing the surgeons to fill the questionnaire focusing on their awareness about the prevalence of operational difficulties in obese patients. Results: the study included 82 surgeons most of them practice general surgery. The majority of surgeons found that the main cause of obesity amongst their patients is dietary factors (91.5%). The same percent of surgeons (higher percentage in residents) agreed that obesity might modify the surgical decision. According to the survey, they patients of age between 30-45years represented the majority and most of them were females. Over 89% of surgeons found that the complications are more in obese patients than in average weight patients. All specialties (especially general surgeons) agreed that obesity increases the operative time. Infection was the major problem mentioned by surgeons followed by anesthetic problems and the size of the instrument used. Over 64.6% of surgeons agreed that some operations need to reduce patient weight to be performed. Most of surgeons (42.7%) agreed that surgical error is higher in obese patients; however, 37.8% agreed that surgical errors in obese and average weight patients are equal. The majority of surgeons (68.3%) agreed that experience of the surgeon will differ in theatre. 81.7% of surgeons agreed that obese patient needs more evaluation prior to surgery than average weight patient. 72% agreed that obese patients have prolonged hospital stay. Conclusion: The study revealed a good to excellent awareness of KSA surgeons about surgical problems which may be met in obese patient and how to overcome a variety of challenges reflecting the values of continuous medical education programs applied in their hospitals.
https://ejhm.journals.ekb.eg/article_14218_5a069451995b08841df25e17102f7a1a.pdf
KSA surgeons
obesity complications
perioperative care
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2017-04-01
67
2
660
665
10.12816/0037818
14219
Original Article
Laparoscopic Appendectomy between the Advantages and Complications:A Cross Section Study –Jeddah – Saudi Arabia – 2016
Asmaa Yaseen Nassir
1
Ahmad Mohammad Kashha
a-1k1@hotmail.com
2
Ali Hassan Altrabolsi
3
Abdullah N Ghannam
4
Omar Abdulelah Sindi
5
Ahmed Mohammed Alzimaity
6
Ibn Sina National College
Battarjee Medical College
Ibn Sina National College
Ibn Sina National College
Ibn Sina National College
King Abdulaziz Hospital & oncology center
Background: Appendectomy is the most common surgical procedure performed in emergency surgery. Laparoscopic appendectomy (LA) for acute appendicitis has several advantages over open appendectomy (OA). In cases of complicated appendicitis, LA is converted to OA at a constant rate, though converting appendectomy (CA). In this study, we aimed to assess the LA complication and the prevalence of CA. Methods: A cross Sectional survey conducted among 243 patients with acute appendicitis who were suitable for the study between April and July 2016. Operative time, length of hospital stay, post-operative complication return to normal activity has been assessed among the all patients. Results and Conclusion: Our results showed the advantages of the laparoscopic appendectomy approach including shorter hospital stay, decreased need for postoperative analgesia, early food tolerance, earlier return to work, lower rate of wound infection. Furthermore we found a considerable preference (during the collection of consent) of patients and a high satisfaction after the surgery.
https://ejhm.journals.ekb.eg/article_14219_3ccf86ae29d667708af576ecfad528bb.pdf
Appendicitis
Appendectomy
Laparoscopy
laparotomy
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2017-04-01
67
2
666
671
10.12816/0037819
14220
Original Article
The Prophylactic Role of Probiotics for Preterm Infants/Neonates
Abdulrahman Mohammedsaeed Baqasi
1
Ali Hussain ALAbdullah
2
Fares Ahmed Badghish
3
Jasseer Ahmed Alghamdi
4
Maram Mohammed Assiry
5
Ateeq Alharbi Koloud
6
Umm Alqura University
Medical University Of Warsaw
Ibn Sina National Collage
Ibn Sina National Collage
Ibn Sina National Collage
Ibn Sina National Collage
Necrotizing enterocolitis (NEC) is a major morbidity and cause of mortality in preterm neonates. Probiotics seem to have a beneficial role in preventing NEC, which is confirmed in meta-analyses of randomized controlled trials (RCTs). We therefore aimed to review and confirm the efficacy of probiotics in preterm neonates obtained in observational studies. To assess the effects of prophylactic probiotics in preterm infants.
https://ejhm.journals.ekb.eg/article_14220_ad9c44fefe1fc35f6b3f99d4a208c9e2.pdf
Prophylactic
probiotics
preterm infants
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2017-04-01
67
2
672
678
10.12816/0037820
14426
Original Article
Diagnosis and Management of Systematic Lupus Erythematosus (SLE)
Yousef Taleb Gaafar AL-katheri
1
Foad Assad M Bukhari
2
Murad Muneer Mawlawi
3
AL NIHAB ALI NAJI A
4
Reem Ahmed B Alanazi
5
Bayan Saeed A Alghamdi
6
Ahdab Abdulmuti Alkubaydi
7
Nada Talal Ibrahem Bima
8
Rayan Marzooq F Almutairi
9
Abdullah Salem Z Alghamdi
10
Ibn Sina College
King Abdulaziz University
King Fahd General Hospital
Anak General Hospital
Almaarefa collage
Ibn Sina College
ibn Sina College
ibn Sina College
Umm Alqura University
Umm Alqura University
Background: Systemic lupus erythematosus (SLE) is the prototypic multisystem autoimmune disorder with a wide range of clinical presentations impacting almost all organs and tissues, such extreme heterogeneity suggests that SLE represents a syndrome rather than a single disease. Although the precise etiologic mechanism is unknown, genetic, hormonal, and environmental factors, as well as immune abnormalities, have been detected. Associations between lupus onset and age, sex, geography, and race have also been established.
Aim of the work: This review will focus on advances in the diagnosis and management of SLE.
Conclusion: The diagnosis of SLE must be based on the proper constellation of clinical findings and laboratory evidence. Management of this disease should be individualized and should include both pharmacological and non-pharmacological modalities for symptom relief and resolution as well as improved quality of life.
https://ejhm.journals.ekb.eg/article_14426_bea9fc56997bfe9cba549b45b11f5588.pdf
Systematic Lupus Erythematosus
connective tissue disorder SLE
NSAID
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2017-04-01
67
2
679
682
10.12816/0037821
14427
Original Article
Cesarean Section among Primigravidae: Cross Section Study – Abha Saudi Arabia
Roaa Fahad Alshabanah
roaa-alshabanah@hotmail.com
1
Tahani Saeed Almohayya
2
Ebtesam Mohammed Alahmari
m.m.1993@hotmail.com
3
Sarah Saeed Alshahrani
4
Norah Ibraheem Almanie
5
Reem Ali Almanie
6
Amal Nasser Alqahtani
7
King Khalid University
King Khalid University
King Khalid University
King Khalid University
King Khalid University
King Khalid University
King Khalid University
Background:The Primary caesarean section (CS) delivery worldwide rate is increasing due to public interest to avoid fetal complications and acceptance by most of the couple to complete their family with one or two children. This study was undertook to study selected cases of primary CSs in primigravid women, keeping the objectives to study the complications lead to cesarean section, maternal morbidity and mortality.
Methods:Cross sectional survey conducted among Primigravidae in maternity & Pediatrics hospital – Abha – obstetrics & gynecology department between January 2016 and December 2016. Overall 170 cesarean section has been done out of 1167 births.
Conclusion: Preeclampsia, eclampsia, placenta previa, intrauterine growth restriction, macrosomic fetus, malpresentation of the fetus, loss of fetal moment, fetal distress and labor dystocia are all indication of cesarean section. Our study revealed that cesarean section among Primigravidae still low in our area of the study.
https://ejhm.journals.ekb.eg/article_14427_22739bdeb310f2a7b9de8d8e896aa632.pdf
cesarean section
Primigravidae
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2017-04-01
67
2
683
691
10.12816/0037822
14430
Original Article
Depression and Anxiety in Early Pregnancy and Its Risk for Preeclampsia
Abdullah Mohammedalsasi A Alawamir
1
Nadia Issa Zakaria
2
Wafaa Mohammed Alsbhani
3
Arij Mohammed Khalifah
4
Asma Abdulkarim Almohamad
5
Adhwaa Ahmed M Al Shamrani
6
Afrah Muhaisen Al Lehabi
7
Ruya Abdulaziz Althomali
8
Alaa Abdullah Alghamdi
9
Mada Salim Al Matrafi
10
Tithkar Abdu Othman
11
Safa Abdulkhaleq Almomen
12
Norah Abdullah Alhabshan
13
Nameer Mohammed A Alshinqeeti
14
Ghadir Alwan Abdullah Alnahari
15
Ibn Sina College – Jeddah
Ibn Sina College – Jeddah
Ibn Sina College – Jeddah
6th October University – Egypt
Ibn Sina College – Jeddah
Ibn Sina College – Jeddah
Taif Collage – Taif
Taif Collage – Taif
Ibn Sina College – Jeddah
Ibn Sina College – Jeddah
Resident-Coordinator of Breastfeeding Support Program in Jazan Health
King Faisal University
Almareefa College
Ibn Sina College
Ibn Sina College
Handling depression is one of the greatest challenges facing pregnant women across the globe. The level of antenatal depression and anxiety has a prevalence rate of above five percent but less than twelve. Escalated depression has been associated with increasing maternal and infant mortality because of the development of secondary disorders such as preeclampsia and other obstetric-related conditions. The objective of this review was to determine the relationship that exists between depression and anxiety and preeclampsia in early pregnancy.
The present paper draws conclusions on the etiology and potential predisposing factors of preeclampsia based on the studies consulted which ascertained the existence of a correlation between antenatal anxiety and depression and preeclampsia which should serve as the baseline for the assessment of the pathogenesis and future direction, the existing literature has
https://ejhm.journals.ekb.eg/article_14430_d1251aa20b4c8c5a385613e6b7a434a8.pdf
preeclampsia
depression
Early Pregnancy
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2017-04-01
67
2
692
696
10.12816/0037823
14431
Original Article
Incidence and Risk Factors for Neonatal Jaundice among Neonates with Urinary Tract Infection in Abha - Saudi Arabia
Tahani Saeed Almohayya
tahanialmohayya@hotmail.com
1
Roaa Fahad Alshabanah
roaa-alshabanah@hotmail.com
2
Ebtesam Mohammed Alahmari
m.m.1993@hotmail.com
3
Norah Ibraheem Almanie
4
Reem Ali Almanie
5
Amjaad Saleh Saad AlJelban
6
Salha Ali Ahmad Asery
7
King Khalid Univerity, Abha, Saudi Arabia
King Khalid Univerity, Abha, Saudi Arabia
King Khalid Univerity, Abha, Saudi Arabia
King Khalid Univerity, Abha, Saudi Arabia
King Khalid Univerity, Abha, Saudi Arabia
King Khalid Univerity, Abha, Saudi Arabia
King Khalid Univerity, Abha, Saudi Arabia
Background: Hyperbilirubinemia is one of the presenting signs of bacterial infection in newborns, and the association of neonatal jaundice with urinary tract infection (UTI) has been particularly emphasized. The aim of this study was to determine the prevalence of UTI in asymptomatic jaundiced neonates younger than 4 weeks old. Method: A cross sectional survey has been conducted at Newborn Unit of Maternity & Pediatrics Hospital – Abha from January 2016 to August 2016. A total of 15 patients have been included in the study, who were diagnosed with hyperbilirubinemia due to urinary tract infection (UTI) after exclusion of unrelated criteria. Conclusion: It could be concluded that UTI should be routinely investigated in early (⩽10 days) idiopathic neonatal jaundice in which all other etiologic factors of neonatal hyperbilirubinemia are ruled out, and the presence of UTI should be considered in case of a poor phototherapy response in cases receiving phototherapy.
https://ejhm.journals.ekb.eg/article_14431_385ec78585435339d370acc9a40ec653.pdf
Neonate
Jaundice
Urinary tract infection
UTI
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2017-04-01
67
2
697
704
10.12816/0037824
14433
Original Article
The Prophylactic Role of probiotics for Preterm Neonates
Waad Abdullah Saad Aljubairah
1
Eman Ahmad Almubarak
2
Fatimah Sharif Modawi
3
Fatimah Mohammed Alhabib
4
Sara Abdullah Binsalman
5
Nahla Shaker Saati
6
Wasan Usamah Shehatah
7
Abdullah Yahya Al Dhban
8
Areej Ahmad Abulela
9
Ammar Yasser Alansari
10
Maternity & Children Hospital – Alhassa
Imam Abdulrahman Bin Fisal University
King Khalid University
Imam Abdulrahman Bin Fisal University
Ibn Sina National College
Family Medicin/KAAU
Ibn Sina National College
King Khalid University
Ibn Sina National College
Ibn Sina National College
Background: Probiotics are live microorganisms which when administered in adequate amounts confer a health benefit on the host. Probiotics have been used for prevention and treatment of various medical conditions in children and adults. Studies on probiotics in premature infants have focused on normalizing intestinal flora, improvement in feeding intolerance, prevention of necrotizing enterocolitis which is the leading causes of death in the neonatal intensive care unit.
Objective of the Study: was to provide an overview of the controversies regarding probiotic use in preterm infants and to shed light on the practical considerations for implementation of probiotic supplementation.
Methods: A Systematic search in the scientific database (Medline, Scopus, EMBASE , and Google Scholer) from 1990 to 2016 was conducted for all relevant retrospective studies including; retrospective , prospective and randomized controlled trials and cohort studies were analyzed and included based on the preset inclusion and exclusion criteria.
Results: The search results yielded 16 studies, 12 of which were RCTs with 2340 premature neonates and 4 meta-analyses with 10227 neonates which showed a significantly decreased incidence of Necrotizing Enterocolitis (NEC) (risk ratio, RR = 0.35, 95% confidence interval, 95% CI, 0.23-0.54; p = 0.0006) and mortality (RR = 0.46, 95% CI, 0.32-0.67; p < 0.0001). Sepsis did not differ significantly between the two groups (RR = 0.93, 95% CI, 0.76-1.15; p = 0.05).
Conclusion: there is a strong body of evidence supporting that Probiotic supplementation reduces the risk of NEC and mortality in preterm infants yet there is no sufficient evidence to support the optimal strain, dose and timing need further investigation.
https://ejhm.journals.ekb.eg/article_14433_77391ad45b2cb72cdefdf41c066ade01.pdf
probiotics
Neonates
Lactobacillus reuteri
Necrotizing enterocolitis
premature infant
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2017-04-01
67
2
705
712
10.12816/0037825
14435
Original Article
Open Surgery versus Endoscopic Intervention in the Management of Bile Duct Stones
Bayan Saeed A Alghamdi
1
Omar Abdulelah Sind
2
Wahhaj Hani Rajab
3
Saeed Hamed Alzahrani
4
Hezab Abdulrahman T Alrayes
5
Leena Hatem Moshref
6
Nibras Khaled Al Jabri
7
Mana abdullah saud Al yami
8
Wafaa Mohammed Alsbhani
9
Shaima Mohammed Al-Ghuraybi
10
Mohammed Hundur Alasmari
11
Ibn Sina national College
Ibn Sina national College
Umm alqura university
Najran University
Aljouf university
King Abdulaziz university
Umm alqura university
Najran University
Ibn Sina national College
Battarjee medical colleges
Najran University
Background: Choledocholithiasis or the presence of common bile duct stones (CBDS) is one of the medical conditions that requires surgical intervention. The management of choledocholithiasis has evolved from open common bile duct exploration (OCBDE) to therapeutic endoscopic retrograde cholangiopancreatography (ERCP) to laparoscopic common bile duct exploration (LCBDE). Each entails a degree of difficulty. In this review we aim toassess and compare the benefits and pitfalls of open surgery (OCBDE) versus endoscopic retrograde cholangiopancreatography (ERCP) in management of common bile duct stones.
Methods: A systematic review of the electronically searched publications of the scientific literature. We searched the Cochrane HepatoBiliary Group Controlled Trials Register, Cochrane Central Register of Controlled Trials in The Cochrane Library, MEDLINE (1946 to 2016), EMBASE (1974 to 2016), and Science Citation Index Expanded (1900 to 2016). Initially all randomized clinical trials which compared the results from open surgery versus endoscopic clearance for common bile duct stones were included, articles were selectively screened according to the eligibility criteria.
Results: eight publications were selectively included with 761 participants compared to open surgical clearance with ERCP. All trials had a high risk of bias. There was no significant difference in the mortality between open surgery versus ERCP clearance (eight trials; 733 participants; 5/371 (1%) versus 10/358 (3%) OR 0.51;95% CI 0.18 to 1.44). Neither was there a significant difference in the morbidity between open surgery versus ERCP clearance (eight trials; 733 participants; 76/371 (20%) versus 67/358 (19%) OR 1.12; 95% CI 0.77 to 1.62). Participants in the open surgery group had significantly fewer retained stones compared with the ERCP group (seven trials; 609 participants; 20/313 (6%) versus 47/296 (16%) OR 0.36; 95% CI 0.21 to 0.62), P = 0.0002. Meta-analysis of the outcomes duration of hospital stay, quality of life, and cost of the procedures could not be performed due to lack of data.
Conclusion: open surgery intervention in order to remove the gallbladder and trapped gallstones appears to be as safe as endoscopy and further suggested to be more successful than the endoscopic technique in clearing the duct stones.
https://ejhm.journals.ekb.eg/article_14435_dbf4553dcde981d3a8321e39c2f63a89.pdf
CBDS
bile duct stones
gallstones
Choledocholithiasis
Cholecystectomy
ERCP
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2017-04-01
67
2
713
720
10.12816/0037826
14436
Original Article
Carotid Endarterectomy versus Medical Therapy in Stroke Prevention
Yazeed Musaad Alkhuzim
1
Hanouf Abdullah Alnofaie
2
Abaad Ayed AL Mutairi
3
Muna Darwish Fadhel
4
Israa Hassan Alamoudi
5
Ahmed Abdullah Jalal
6
Abdulrahman Waleed bagar
7
Ibrahim Abdulmajeed Affan
8
Salah Ghazi Almatrafi
9
Anas Awad Alsolami
10
Postgraduate KSU, MOH
Taif university
King Abdulaziz University
Ibn Sina National College
Ibn Sina National College
Umm Al-Qura University
Ibn Sina National College
Ibn Sina National College
Ibn Sina National College
King Abdulaziz University
Stroke is one of the leading causes of deaths in different parts of the world affecting individuals of different ages. it is mostly dominant among people having risk factors such drug abuse, having a background of a mild stroke, and overweight. Various approaches including carotid endarterectomy (CEA) and medical therapy have been used as mechanisms for preventing stroke particularly ipsilateral ischemia. However, there are several studies suggesting that even though CEA has the potential of reducing the risks of stroke, incidences of a high residual risk of stroke after carotid endarterectomy since Various cases of increased short-term myocardial infarction after CEA are recorded. Based on the results drawn from randomized trials comparing the effectiveness of CEA and medical therapy ,CEA provides better protection from ipsilateral strokes than the latter. The efficacy of CEA is more pronounced in patients presenting symptomatic and asymptomatic carotid artery disease. The aim of this study was to explore the comparative merits and demerits of using carotid endarterectomy and medical therapy to determine the most appropriate of the two approaches to be used in specific cases.
This research concludes that even through both therapeutic methods and carotid endarterectomy have the ability to reduce the predisposition of patients to different events of stroke, each of them have inherent limitations that must be addressed effectively to contribute to overall positive medical outcomes.
https://ejhm.journals.ekb.eg/article_14436_a65580b6a8853e60fb7bbfaecea16c1e.pdf
Carotid Endarterectomy
stroke
medical theray
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2017-04-01
67
2
721
725
10.12816/0037827
14437
Original Article
Evaluation of the Relationship between Air Bubbles Depth and Pregnancy Rate in ICSI Cycles
ElBishrey G
1
Makled A K
2
Gomaa I A
3
Elnashar H
4
Department of Obstetrics and Gynecology- Ain Shams University
Department of Obstetrics and Gynecology- Ain Shams University
Department of Obstetrics and Gynecology- Ain Shams University
Department of Obstetrics and Gynecology- Ain Shams University
Objective: to determine the relationship between embryo transfer outcome and the distance between fundal endometrial surface and air bubbles assessed by trans-abdominal ultrasound
Design: Prospective (cohort) study
Setting: This study was conducted in assisted reproductive technology (ART) unit of Ain Shams University Hospital from April 2015 to October 2016.
Patient(s): Eighty two women undergoing ICSI were enrolled in and a written informed consent was obtained from each participant.
Intervention(s): no patient received any additional procedure or intervention.
Outcome measuers: The primary outcome was biochemical pregnancy rate based on serum beta-hCG level at 14 days after ET. Secondary outcome was clinical pregnancy rate using trans-vaginal US examination at 6 – 8 weeks of amenorrhea to detect the presence of fetal sac & pulsation.
Results: Implantation, biochemical and clinical pregnancy rates were significantly higher in distance < 10 mm group than ≥ 10 mm group.
Conclusion: air bubble used as an identifier of the position of the embryo at ET can be determinative for pregnancy rates. Clinical PRs were higher in cases with air bubbles < 10 mm from fundal endometrial surface.
https://ejhm.journals.ekb.eg/article_14437_34eb1a334c74a5a5142c1357ee26e438.pdf
embryo transfer
air bubble
Ultrasound
ICSI outcome
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2017-04-01
67
2
726
730
10.12816/0037828
14439
Original Article
Prediction of Preterm Birth in Women with Short Cervix
Abdullah Mousa M Almadani
1
Rasha Ali Ahmed Abuandoos
2
Ruya Abdulaziz Althomali
3
Dina Nasser Aldhaban
4
Alanoud Abdulrahman Ali Alshamrani
5
Ahmed Saeed H. Alqahtani
6
Bshaer Haji A Alrizq
7
Eman Najib M Alsafwani
8
Khlood Ibraheem H
9
Ayah Ali Mohammed Mohammed
10
King Abdulaziz University
King Khalid University
Taif University
Alfaisal University
Alfaisal University
King Khalid University
Ibn Sina National College
IAU ( Imam Abdulrahman Bin Faisal University )
Ibn Sina National College
Taif University
Background: Second trimester short cervical length identifies women at increased risk for an early spontaneous Preterm birth (sPTB), hence raising a compelling needed for Cervical Assessment for prediction and possible Preventing Preterm Delivery.
Objective of the study: to assess the implications associated with a short cervical length as well as the use of ultrasonographic-derived cervical length measurement in predicting preterm birth.
Methods: the present review includes relevant randomized controlled trials (RCTs) that investigated the in Medline (via PubMed), Cochrane Library and Embase. Retrospective and Prospective Cohort studies, Case-control and Randomised controlled trials. There were no restrictions by outcomes examined, language or publication status.
Results: The critical search results yielded 6 articles (randomized trials=2, cohort studies=3, case-control study=1) representing 653 patients . Five of the 6 presented similar pregnancy outcomes (spontaneous preterm birth or pregnancy loss < 24 weeks’ gestation) between the ultrasound-indicated and the history-indicated cerclage groups. 45–69% of the patients followed with cervical ultrasound were able to avoid cerclage.
Conclusion: Evidence from randomized trials supports that transvaginal ultrasound is predictive of preterm birth in women with prior preterm birth and a short cervix. The thresholds proposed vary from 15 mm to 28 mm and cerclage is thus recommended.
https://ejhm.journals.ekb.eg/article_14439_cba1b6fc3ebd2847f254c3edd6840e01.pdf
Preterm birth, labour, ultrasound, cerclage, incompetent cervix, transvaginal, transperineal, cervical length, pPROM., obstetric ultrasound
prediction
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2017-04-01
67
2
731
741
10.12816/0037829
14441
Original Article
Evaluation of Antidiabetic and Antioxidant Activity of Aegle marmelos L. Correa Fruit Extract in Diabetic Rats
Inas Z.A. Abdallah
1
Ibrahim, S. Salem
2
Nayrouz A.S. Abd El-Salam
3
Nutrition and Food Science Department, Faculty of Home Economics, Helwan University
Nutrition and Food Science Department, Faculty of Home Economics, Helwan University
Nutrition and Food Science Department, Faculty of Home Economics, Helwan University
Background: Diabetes mellitus is regarded as a serious chronic disease that carries a high risk for considerable complications. The use of natural plant products for management of diabetes is increasing due to their minimal side-effects and economical aspects. Aegle marmelos L. Correa (A. marmelos), family Rutaceae is highly reputed medicinal plant commonly known as bael. A. marmelos fruit is widely used in folk medicine for the treatment of diabetes mellitus.
Aim of the work: This study was aimed to evaluate the antidiabetic and antioxidant activity of A. marmelos fruit ethanolic extract against alloxan-induced diabetes in male rats.
Material and Methods: Twenty five male albino rats with an average body weight 180-195g were divided into two main groups; first group: control (n=5) and second group: diabetic rats (n=20), which were divided equally to four subgroups as follows: diabetic untreated rats , diabetic rats treated with 125 mg/kg/day A. marmelos fruit extract; diabetic rats treated with 250 mg/kg/day A. marmelos fruit extract and diabetic rats treated with 500 mg/kg/day A. marmelos fruit extract. Diabetes was induced by a single intraperitonial injection of alloxan (120 mg/kg).
Results: Phytochemical screening of A. marmelos fruit extract revealed the presence of alkaloids, carbohydrates, glycosides, flavonoids, tannins, coumarins, sterols and triterpenoids. Results of the biological study reported that alloxan-induced diabetic group exhibited hyperglycemia, hyperlipidemia, elevation in malondialdehyde (MDA) level accompanied with weight loss and reduction in high density lipoprotein cholesterol (HDL-C) level, reduced glutathione (GSH) level and superoxide dismutase (SOD) enzyme activity when compared to control group. Treatment with A. marmelos fruit extract at the three dose levels reported improvement in the biological evaluation, lipid profile, glucose, insulin, MDA and GSH levels and SOD enzyme activity when compared to the diabetic group. The improvement was most pronounced in 500 mg/kg A.marmelos treated group.
Conclusion: It could be concluded that A. marmelos fruit extract had hypoglycemic activity; this effect may be attributed to its antioxidant activity and its high content of active constituents which was proved in this study. Therefore, it could be recommended that A.marmelos fruit may be useful as a healthy food and in the development of antidiabetic drugs.
https://ejhm.journals.ekb.eg/article_14441_1dffd20570c0375d13ff3eee41c0570c.pdf
Aegle marmelos fruit extract – phytochemichal
antidiabetic
antioxidant
diabetic rats
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2017-04-01
67
2
742
748
10.12816/0037830
14443
Original Article
Comparison of Endoscopic Papillary Large Balloon Dilation and Endoscopic Sphincterotomy for Retrieval of Choledocholithiasis
Mohamad Amer Afifi
1
Shaaban Salah Abd Elmoniem
2
Gamal Mohamad Mohamad Soliman
3
Hany Kamal Abd Elhameed
4
Ahmad Abd Elkader Elgendy
5
Department of Tropical Medicine, Faculty of Medicine, Al-Azhar University
Department of Tropical Medicine, Faculty of Medicine, Al-Azhar University
Department of Tropical Medicine, Faculty of Medicine, Al-Azhar University
Department of Tropical Medicine, Ahmad Maher Teaching Hospital
Department of Tropical Medicine, Ahmad Maher Teaching Hospital
Background: Endoscopic sphincterotomy (EST) combined with balloon catheters and/or baskets are the routine endoscopic techniques for stone extraction in the great majority of patients. Whereas large common bile duct (CBD) stones are treated conventionally with mechanical lithotripsy, large balloon papillary dilation after endoscopic sphincterotomy (ELPBD) represents the onset of an era in large CBD stone extraction and the management of “impaction”. That is because it seems effective, inexpensive, less traumatic, safe and easy method that does not require sophisticated apparatus and can be performed widely by skillful endoscopists. Studies comparing the efficacy and safety of EPLBD with EST have reported mixed outcomes. The aim of the study to compare the success and complications rates between endoscopic papillary balloon dilation and endoscopic sphincterotomy for enlargement of papillary opening during endoscopic removal of common bile duct stones.
Methods: Randomized prospective comparative study was conducted on seventy four patients with CBD stone(s), subjective to therapeutic ERCP procedures for endoscopic extraction of common CBD(s). The enrolled patients were randomly divided into two groups according to the maneuver for dilate the papillary orifice into: Group I: Thirty one patients underwent EPLBD technique combined with balloon catheters and/or baskets for stone extraction. Group II: Forty three patients underwent EST combined with balloon catheters and/or baskets, which is considered as conventional endoscopic technique for stone extraction in the great majority of patients. Results: Complete extraction CBD stones among the patients of group1; EPLBD was effective for clearance of (92.5%) of CBD stones in patients with the stone sized < 1cm and in (83%) of patients with stone size > 1cm, (overall clearance rate=87%). Overall adverse effects of patients of group1 was (29%) as mild self-limiting post ERCP pain occurred in (9.6%) and mild intra- procedure bleeding occurred in (9.6%), whereas more serious complication as melena which occurred in (3.2%), and mild pancreatitis occurred in (6.4%). Whereas complete CBD stones clearance among the patients of group 2; EST was effective in (96%) of patients with the stone sized < 1 cm, while stone clearance occurred in (56%) in patient with stone size> 1cm, (overall clearance rate=79%). Overall adverse effects of patients of group 2 was (18.5%) as mild self-limiting post ERCP pain occurred in (7%) and mild intra-procedure bleeding occurred in (4.6%), whereas more serious complications as mild pancreatitis developed in (4.6%), and post ERCP cholangitis in (2.3%). The comparison between the two groups regarding the extraction of CBD stones revealed combination of papillary large balloon dilation after EST is not required in patients whose the CBD stone size < 1 cm. Whereas the clearance rate of CBD stones in the patients with stone size > 1cm among the group 1 was (83%) which better than among the group 2 which was (56%) with nearly statistical difference (P value=0.07). Conclusion: Conventional EST is an effective method for removal of common bile duct stones < 1cm in diameter whereas the use of large papillary balloon dilation after endoscopic sphincterotomy improve the clearance rate of bile duct stones> 1cm which is difficult to be extracted by conventional sphincterotomy and extraction devices. Endoscopic papillary large balloon dilation is an adjunctive tool to endoscopic sphincterotomy for removing large or difficult CBD stones.
https://ejhm.journals.ekb.eg/article_14443_8cbcc6177eee049a405df082a07853c5.pdf
common bile duct (CBD) stones
ERCP
Endoscopic papillary large balloon dilation (EPLBD) and Endoscopic sphincterotomy (EST)
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2017-04-01
67
2
749
757
10.12816/0037832
14446
Original Article
Treatment of Iron Deficiency Anaemia in Patients with Inflammatory Bowel Disease
Abdulilah Ateeq M Alsolami
1
Hosam Wahid Wali
2
Houssam Nasser S Bajoudah
3
Mohammed Saleh Dumyati
mohammed.dumyati@gmail.com
4
Basam Zuhaer Sindi
5
Abdulaziz Saad M Alshamrani
6
Maha Abdullah Alzubaidi
7
Faisal Adnan Alshabrawi
8
Othman Rushdy Filfilan
9
King Abdulaziz University
Umm Alqura University
Medical University of Warsaw
Umm Alqura University
Umm Alqura University
Albaha University
Ibn Sina National College
Battarjee Medical College
Umm Alqura University
In spite of the fact that anemia is the most widely recognized systemic sign of inflammatory bowel disease (IBD), among the expansive range of extraintestinal malady complexities experienced in IBD, including joint inflammation and osteopathy, it has for the most part gotten little thought. In any case, as far as recurrence, as well as to its potential impact on hospitalization rates and on the personal satisfaction and work, sickliness is, in fact, a huge and expensive intricacy of IBD.
Frailty is multifactorial in nature, the most predominant etiological structures being iron deficiency anemia (IDA) and anemia of a chronic disease. In a condition related to irritation, for example, IBD, the assurance of iron status utilizing normal biochemical parameters alone is insufficient. A more exact evaluation might be achieved utilizing new iron lists including reticulocyte hemoglobin content, the rate of hypochromic red cells or zinc protoporphyrin. While oral iron supplementation has generally been a backbone of IDA treatment, it has likewise been connected to a broad gastrointestinal reactions and conceivable infection compounding. Be that as it may, numerous doctors are as yet hesitant to administer iron intravenously, in spite of the wide accessibility of an assortment of new IV arrangements with enhanced safety profiles, and in spite of the proposals of worldwide master rules. We present a review of the pathophysiologic mechanisms of IDA in IBD, improved diagnostic and therapeutic strategies, efficacy, and safety of iron replacement in IBD.
https://ejhm.journals.ekb.eg/article_14446_1cf296d3a5928de089c46176c40408a1.pdf
Treatment
Anaemia
inflammatory bowel disease
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2017-04-01
67
2
758
764
10.12816/0037833
14447
Original Article
Flexible Ureteroscopy and Laser Lithotripsy Intervention for the Management of Stone Disease
Daham Abdulmohsen Albdaiwi
1
Mohammed Ali Almuanni
2
Mohammad Sameer Shobian
3
Sarah Maher Moshref
4
Muhannad Basheer Qarah
5
Sahar Sameer Al-Jubali
6
Masstricht University
King Faisal University
King Abdullaziz University
King Abdulaziz Hospital & Oncology Center
King Faisal Specilaliset Hospital& Researh
Ibn Sina College
Background: The role of ureteroscopy has dramatically evolved over the past twenty years driven by profound enhancement in various factors and assisting techniques such as the ureteroscope size, deflection capabilities, video-imaging, and in lithotripsy (stone breakage) with the advent of holmium laser, however, the stone size plays a critical role in determining outcomes and operative approach. Aim of the work: we conducted a systematic review of the literature to look at the safety and efficacy of flexible utereroscopy and laser lithotripsy intervention in patients with stone disease; particularly those with stones larger than 2 cm.
Methods: A systematic search was performed in the scientific database particularlyMEDLINE (2000–2017), EMBASE (2000– 2017), Cochrane Central Register of Controlled Trials, CINAHL (2000–2017), Google Scholar, and individual urologic journals. Results: The search yielded eight studies involving 392 patients, (390 renal units) were reportedly treated with FURSL. The mean operative time was 80.7 minutes (26-215 min). The mean stone-free rate was 91.2% (77%-96.7%), with an average of 1.6 procedures per patient. The mean stone size was 2.5 cm except for one most recent study which reported stones size less than 0.5 cm. An overall complication rate was 8.1%. Major complications developed in 21 (4.2%) patients and minor complications developed in 19 (3.9%) patients. Conclusion: Flexible Ureteroscopy and Laser Lithotripsy intervention has proven to be not only a less invasive treatment but also a successful with a low complication and stone free rate (SFR) for renal calci larger than 2 cm. FURSL may represent an alternative therapy to standard percutaneous nephrolithotomy (PCNL) with satisfactory efficacy and low morbidity.
https://ejhm.journals.ekb.eg/article_14447_54c26df224619544ff19974fa046d8ae.pdf
Ureteroscopy
Laser Therapy
Urinary Calculi
Lithotripsy
kidney stone
ureteric stone
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2017-04-01
67
2
765
770
10.12816/0037834
14449
Original Article
Evaluation of Knowledge in Hypertensive Saudi Population in Makkah, KSA
Samah Ali Alharbi
1
Mohammad Abdulrahman Wedhaya
2
Maha Fahad Alluqmani
3
Sami Samran Alrehaili
4
Undergraduate students, Ibn Sina College of Medicine, KSA
Undergraduate students, Ibn Sina College of Medicine, KSA
Undergraduate students, Ibn Sina College of Medicine, KSA
Undergraduate students, Ibn Sina College of Medicine, KSA
Background: Hypertension remains a major health problem, causing high mortality and morbidity all over the world. It is considered a major risk factor for both cerebrovascular accidents (CVAs) and coronary artery disease (CAD).
Objectives: To assess the level of knowledge of hypertensive patients in Makkah City.
Methods: A cross-sectional analytical questionnaire based study among hypertensive patients of Makkah City.
Results: The mean age was 45 years, ranged from 35 to 70 and 63.33% were females and 36.67% were male respondents. The majority of them had college degree and were employed. Most of the respondents had good knowledge about hypertension, risks and treatments. Neither age nor gender showed association with the levels of knowledge in included subjects but education was significantly associated with high levels of knowledge.
Conclusion: The general knowledge score was good with high knowledge about risks and treatments. Doctors were not informative to patients about hypertension. Also, education significantly impacts the knowledge of population about hypertension.
https://ejhm.journals.ekb.eg/article_14449_f545eaca4d8c5b544675e2ca5964ef9d.pdf
Knowledge
Hypertension
Makkah
KSA
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2017-04-01
67
2
771
783
10.12816/0037835
14472
Original Article
Role of Bone Marrow Transplantation in Reducing the Dangerous Effect of Multi-Walled Carbon Nanotubes or/and Gamma Rays on Male Rats
Mona M. El Tonsy
1
Neamat H. Ahmed
2
Ahkam M. Elgendy
3
Amal G. Abo-El Fetouh
4
Zoology Department, Faculty of Science, Al-Azhar Univ
Radiation Biology Department, National Center for Radiation Research and Technology, Egyptian Atomic Authority.
Zoology Department, Faculty of Science, Al-Azhar Univ.
The Ministry of Manpower
Aim of the work: this study evaluated the efficacy of bone marrow (BM) transplantation to protect male rats from dangerous effect of multi-walled carbon nanotubes (MWCNTs) or/and γ-irradiation on the hematopoietic and lung tissues. Materials and methods: experimental animals were divided into 8 groups each consist of 6 male albino rats. Control group, BM-injected group, MWCNTs-injected group, 5Gy γ-irradiated group, 5Gy γ-irradiated+ MWCNTs-injected group, MWCNTs-injected+ BM-injected group, 5Gy γ-irradiated+ BM-injected group and 5Gy of γ-irradiated+ MWCNTs-injected + BM-injected group. All the treated animal groups were sacrificed after 28 days of the treatments. Blood components, MDA and GSH levels in the lung tissue were analyzed. The histopathological study in the lung tissue was also recorded. Results: exposure to MWCNTs or/and γ-radiation induced a significant decrease in certain blood components (WBCs, RBCs, Hb content, HCT value and PLT count). Furthermore, a significant elevation in MDA level and a significant decrease in GSH content were detected in the lung tissue. The histopathological changes after exposure of rats to MWCNTs recorded perivasculitis, atelectasis and interstitial pneumonia. Also, γ-radiation represented more collapsed and thickened walls in the alveoli, thickened bronchiolar walls with partial epithelial lining and foci of pulmonary hemorrhage in the lung tissue. The effect of BM transplantation after MWCNTs or/and γ-radiation ameliorated the values of blood components, MDA and GSH levels in the lung tissue. The improvement occurred by BM transplantation in rats treated with MWCNTs or/and exposed to γ-radiation were also recorded. The lung tissue showed numerous alveoli with thin interalveolar septa, alveolar sacs and terminal bronchioles with highly folded mucosa. Conclusion: treatment with BM transplantation improved the most deleterious parameters obtained in the blood and lung tissue of MWCNTs exposed or/and γ-irradiated rats.
https://ejhm.journals.ekb.eg/article_14472_f438387db9d4c9faf687fee1adbad9b8.pdf
Multi-Walled Carbon Nanotubes
γ- Radiation
Bone marrow
male rats
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2017-04-01
67
2
784
788
10.12816/0037836
14473
Original Article
Vitamin D Deficiency in Orthopedic Patients, Riyadh, Saudi Arabia
Faqih Eman Abdulaziz H, Abdulrahman Ahmed Alrehaili
1
Ahmed Mohammed Alzahrani
2
Nawaf Wael Alolayan
3
Nessreen Muhammad Algushiry
4
Hind Mesfer Alghamdi
5
Thekra Ali Mureh
6
Bashayer Ali Mureh
7
Summer Saeed Almutawa
8
Medical Students, Almaarefa colleges, Riyadh, Saudi Arabia
Medical Students, Almaarefa colleges, Riyadh, Saudi Arabia
Medical Students, Almaarefa colleges, Riyadh, Saudi Arabia
Medical Students, Almaarefa colleges, Riyadh, Saudi Arabia
Medical Students, Almaarefa colleges, Riyadh, Saudi Arabia
Medical Students, Almaarefa colleges, Riyadh, Saudi Arabia
Medical Students, Almaarefa colleges, Riyadh, Saudi Arabia
Medical Students, Almaarefa colleges, Riyadh, Saudi Arabia
Background: Low levels of blood serum vitamin D have been connected to various musculoskeletal and non musculoskeletal conditions. Vitamin D lack shows up moderately high among different patient subpopulations, including patients with break non-union. We directed a review study to decide the pervasiveness of vitamin D lack what's more, inadequacy in an expansive populace of patients with orthopedic trauma. Methods: The review incorporated all patients who were over age 18 years, had no hazard components for vitamin D inadequacy and was dealt with for an intense break at a Level 1 injury focus. Results: Between April 2016 and October 2016, 100 injury patients had recorded serum 25-hydroxyvitamin D levels. The general commonness of joined vitamin D inadequacy/deficiency was 77%; commonness of vitamin D inadequacy alone was 39%. There were no actually critical (P < .05) age or sex contrasts among the populace. There did not seem, by all accounts, to be a regular distinction. Vitamin D inadequacy and deficiency in intense orthopedic injury, patients showed up extremely normal. Assist examination is expected to completely comprehend the clinical noteworthiness. Conclusion: The Pervasiveness of low serum levels of vitamin D among patients experiencing orthopedic trauma is extremely normal. Given the significance of vitamin D in musculoskeletal wellbeing, such low levels may adversely affect tolerant results.
https://ejhm.journals.ekb.eg/article_14473_dd1f3a6d7cf89b178e6b8aa91426ef2a.pdf
Vitamin D
Orthopedic
Trauma
musculoskeletal
Deficiency
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2017-04-01
67
2
789
805
10.12816/0037837
14476
Original Article
Role of Rebamipide and \ or Pantoprazole in Preventing Dexamethasone Induced Gastritis in Senile Male Albino Rats
Amgad Ali El Zahaby
aymanelsharawy@hotmail.com
1
Ahmed Abdel Alim
2
Ayman F. El Sharawy
3
Tropical Medicine Departmen Faculty of Medicine, AlAzhar University
Tropical Medicine Departmen Faculty of Medicine, AlAzhar University
Histology and Cell Biology Department, Faculty of Medicine, AlAzhar University
Aim of the work: gastritis is the inflammation of the lining of the stomach .It is caused by many factors like infection by Helicobacter pylori, drug induced such as aspirin, Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), corticosteroids and alcohol consumption. Pantoprazole prevents HCL formation by blocking proton pumps in parietal cells of the stomach leading to stoppage of pepsinogen enzyme activation. Rebamipidestimulates prostaglandins synthesis so the mucous barrier can be build up to protect the gastric mucosa, so this study aimed to evaluate the efficacy of Pantoprazole and Rebamipide on stomach mucosa protection from the gastritis that was induced by Dexamethasone in rats.
Material and methods: twenty-five male senile albino rats were included in this study and divided into five groups: G1 (Control group), G2 (Dexamethasone administrated group), G3 (Pantoprazole administrated group), G4 (Rebamipide administrated group) and G5 (Pantoprazole and Rebamipide administrated group). The collected stomach specimens were subjected to hematoxylin and eosin, PAS and alcian blue stains.
Results: the most weight loss was detected in Dexamethasone administrated group, while the least weight loss was realized in dexamethasone and Rebamipide administrated group. Gastric samples showed improvement in gastric mucosa in G3 and G4, but the best improvement was demonstrated in G3.
Conclusion: Rebamipide has a better protective effect than the Pantoprazole in prevention of gastric mucosal injuries.
https://ejhm.journals.ekb.eg/article_14476_2da81864401726b0146d72c9a0c1a152.pdf
dexamethasone
Pantoprazole
rebamipide
mucous barrier