eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-04-01
75
4
2539
2542
10.21608/ejhm.2019.31082
31082
Original Article
Conventional Penetrating Keratoplasty Versus Femtosecond Laser Assisted Penetrating Keratoplasty
Mohamed Selim El Kadi
1
Mahmoud Mohamed Ismail
2
Mohamed Ahmed El Malah
3
Suzan Fouad Mohamadia
dr_suzi79@yahoo.com
4
Ophthalmology Medicine and Surgery Department, Al-Azhar University
Ophthalmology Medicine and Surgery Department, Al-Azhar University
Ophthalmology Medicine and Surgery Department, Al-Azhar University
Ophthalmology Medicine and Surgery Department, Al-Azhar University
Purpose: due to introduction of femtosecond Laser technology as new tool in penetrating keratoplasty (PKP), this study aims to compare this new tool and conventional PKP, also aims to compare between different shapes of femtosecond Laser (FSL) assisted PKP. Patients and methods: 40 eyes with different corneal pathologies were included in this study and they were categorized in to 2 groups. 20 eyes underwent penetrating keratoplasty by using manual trephination (I) and 20 eyes underwent PKP by using FSL assisted trephination (II). Results: femtosecond Laser assisted penetrating keratoplasty (FLAK) substantially improved wound healing, speeds up visual recovery and improved BCVA as it decreased MRA and corneal steepening but consumed more operative time. Conclusion: FLAK is the future in corneal graft surgery, where healing may not be a problem in the postoperative period
https://ejhm.journals.ekb.eg/article_31082_15cd8472e3f89781ed55ec3c4294e21c.pdf
Conventional PKP
FSL assisted PKP and wound healing
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-04-01
75
4
2543
2549
10.21608/ejhm.2019.31083
31083
Original Article
The Effect of Laparoscopic Sleeve Gastrectomy on Serum Lipids
Ashraf Ibrahim Attia Alsharkawy
1
Mohamed Aboulfotouh Ahmed
2
Ahmed Gamal Eldin Metwally
3
Department of General Surgery, Faculty of Medicine for Girls, Al-Azhar University
Department of General Surgery, Faculty of Medicine for Girls, Al-Azhar University
Department of General Surgery, Faculty of Medicine for Girls, Al-Azhar University
Background:morbid obesity is a growing health problem in the modern world and affects almost 20% of the population. Obesity associates with increased morbidity and mortality, one of which is dyslipidemia. Bariatric surgery is the only known method to induce significant weight loss and prevent its regain in morbidly obese patients. Aim of the work: the aim of this work was to evaluate the effect of laparoscopic sleeve gastrectomy on serum lipids (Cholesterol - TG - LDL - HDL) and analysis of these data and compare with other results from different centers, institutes all over the world. Methods: our study was a retrospective study on 20 patients hospitalized in General Surgery department of Al-zhraa University hospital who underwent laparoscopic sleeve gastrectomy in order to treat morbid obesity from August 2018 to February 2019. Results: In our study 3 month after LSG we observed significant changes in lipid profile parameters including significant decrease in total cholesterol, TG, LDL and significant increase in HDL. Conclusion: our retrospective study shows that LSG is very good bariatric procedure with excellent results on short term follow up regarding body weight reduction, BMI. Three months after operation improve metabolism and lipid profile was accompanied by decrease in Total Cholesterol, Triglyceride and LDL cholesterol and increase in HDL cholesterol change in significant way
https://ejhm.journals.ekb.eg/article_31083_fa51da2553695b848fb602286e7cec46.pdf
Laparoscopic Sleeve
LDL
HDL
SG
RYGB
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-04-01
75
4
2550
2555
10.21608/ejhm.2019.31084
31084
Original Article
Comparison between Sesame Oil and Glycyrrhizaglabra Effect as Phytoestrogen on Male Albino Rats
Eman G.E. Helal
emanhelal@hotmail.com
1
Mohamed A. El-Aleem
2
Shaimaa S. Ahmed
3
Zoology Department, Faculty of Science, Al-Azhar University (Girls), Cairo, Egypt
Physiology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Zoology Department, Faculty of Science, Al-Azhar University (Girls), Cairo, Egypt
Background: Phytoestrogen is a plant-derived compound, which has estrogenic effect and it is found in liquorice root extract and sesame oil.Aim of the work:To investigate some biochemical effects of liquorice root extract and sesame oil on male albino rats. Materials and methods: 18 animals were divided randomly into three groups. Group A: Control group, group B: rats treated with oral dose of liquorice10 mg/kg body weight/day for one month, andgroup C: rats treated with oral dose of sesame oil 1 ml/kg body weight/day. At the end of the experiment, blood samples were collected for biochemical analysis. Results: Liquorice and sesame oil induced highly significant decrease in TC, TG, LDL, VLDL, LDL/HDL(p<0.01)and significant increase in HDL(p<0.05). They also showedhighly significantly decrease in FSH, testosterone and sperm countcompared to control group(p<0.01). Conclusion:The study supports that the high level intake of liquoriceroot extract orsesame oil caused hormonal disturbance and decreases sperm count.
https://ejhm.journals.ekb.eg/article_31084_4b3de7afd6e073e9c463c789418ac39f.pdf
Liquorice root
Sesame oil
Lipid profile
albino rats
physiological parameters
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-04-01
75
4
2556
2562
10.21608/ejhm.2019.31085
31085
Original Article
Comparative Study between Medical and Surgical Modalities of Treatment of Chronic Allergic Nasal Polypi
Ali Khalaf Mahrous
1
Mohammed Ahmed El Sharkawy
2
Abd El Hakeem Abd El Salam Ibrahim
doctorah87@gmail.com
3
Department of Otorhinolaryngology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Department of Otorhinolaryngology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Department of Otorhinolaryngology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Background: Nasal polyposis is a common problem facing the otolaryngologist. Its incidence is estimated to be in the range of 0.2 to 4.3%. It may be associated with other conditions such as bronchial asthma (about 25%-30% of polyposis patients) and Aspirin sensitivity (12%). Objectives: The aim of this work was to study the importance of searching and identifying the effect of medical versus surgical modalities in treatment of chronic allergic nasal polyps. Patients and Methods: Thirty patients with bilateral nasal polyps were enrolled in this study. They were randomly arranged into 2 groups. Group I was treated by functional endoscopic sinus surgery while Group II was treated by local and systemic corticosteroids. The age in Group I ranged from 17 to 66 years with a mean of 42 ± 16.51 years while the age in Group II ranged from 19 to 60 years with a mean of 39.4 ± 11.24 years. In Group I, 12 patients (80%) were male while 3 patients (20%) were female. In Group II, 9 patients (60%) were male while 6 patients (40%) were female. No past history was found in 18 patients (60%) while bronchial asthma was found in 8 patients (26.67%) and aspirin sensitivity was found in 3 patients (10%). Both bronchial asthma and aspirin sensitivity were found in one patient in Group II. Results: The mean Total nasal symptoms score (TNSS) were 22.33 ± 1.21 in Group I and 20.07 ± 3.31 in Group II. The mean Total Nasal Polyp Score (TNPS) were 4.67 ± 0.82 in Group I and 4.8 ± 0.862 in Group II. The mean LundMackay Score (LMS) were 10.87 ± 0.74 in Group I and 11 ± 0.66 in Group II. Conclusion: Patients treated by FESS have less residual symptoms, size and severity of residual polyps and rate of recurrence than patients treated medically
https://ejhm.journals.ekb.eg/article_31085_277f89210394c5d749f528a766e0f316.pdf
Medical and Surgical Modalities
Chronic Allergic Nasal Polyps
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-04-01
75
4
2563
2569
10.21608/ejhm.2019.31086
31086
Original Article
Ologen Implant Application in Subscleral Trabeculectomy versus Non-Penetrating Deep Sclerectomy in Management of Primary Open Angle Glaucoma: A Prospective Randomized Study
Mohammed Ahmed El Malah
1
Asaad Nooreldin
asaad_nooreldin@yahoo.com
2
Mohamed Elmoddather
elmoddather2002@yahoo.com
3
Mahmoud Said El Labny
4
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University (Assuit), Egypt
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University (Assuit), Egypt
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University (Assuit), Egypt
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University (Assuit), Egypt
Background: trabeculectomy and deep sclerectomy (DS) aim to lower intraocular pressure (IOP) in cases of medically uncontrolled primary open angle glaucoma (POAG). The application of Ologen implant is thought to increase the success rate of both procedures. Objective: to compare the application of Ologen implant in trabeculectomy versus deep sclerectomy in patients with uncontrolled POAG. Patients and Methods: this was a follow-up randomized clinical comparative trial included 30 eyes of 26 patients with uncontrolled POAG. They were randomly assigned to two equal groups (n=15 eyes): group (A) underwent trabeculectomy and group (B) underwent deep sclerectomy. Both procedures were augmented with Ologen implant. All patients were subjected to full history taking and complete ophthalmologic examination. Postoperatively, patients were followed up at 6 months. Outcome and complications were assessed. Results: both groups experienced significant reduction in IOP after 6 months postoperative; preoperative and postoperative values were 22.8±3.73 mmHg and 11.07±2.63 mmHg, respectively in group (A) and 20.13±2.26 mmHg and 13.53±2.61 mmHg, respectively in group B, P≤ 0.01. The complete success was 93.0% in group (A) and 80.0% in group (B), (P= 0.475). Group (A) had significantly higher frequency of postoperative complications compared to group B (P≤ 0.01). Conclusion: the application of Ologen implant in both trabeculectomy and deep sclerectomy is effective for IOP reduction and it resulted in better operative success in patients with POAG. Also, deep sclerectomy using Ologen implant is a good and safe alternative to trabeculectomy in patients with POAG, but our obtained results need to be supported by subsequent studies.
https://ejhm.journals.ekb.eg/article_31086_1cfa4ff9e2ded06a92a7239e63c8abc3.pdf
Ologen implant
subscleral trabeculectomy
Deep Sclerectomy
Primary Open angle glaucoma
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-04-01
75
4
2570
2580
10.21608/ejhm.2019.31087
31087
Original Article
Hepatic and Epicardial Fat as Early Strong Predictors for Metabolic Syndrome
Mohammed Abdel-Hassib
1
Hossam Elashmawy
2
Yasser Elsayed Mohammed
yasserelsayed97_@yahoo.com
3
Internal Medicine Department, Faculty of Medicine, Al-Azhar University
Clinical Pathology Department, Faculty of Medicine, Al-Azhar University
Cardiology Department, Faculty of Medicine, Al-Azhar University
Introduction: hepatic steatosis (HS) has been previously considered as a valuable and long-established indicator for evaluation of metabolic syndrome (MetS) and cardio-metabolic risks. Recently, epicardial adipose tissue (EAT) has been proposed and up to be established to carry the same or more than of HS as regarding cardiometabolic risks. Hence, both of HS and cardiac steatosis coexist and interact with each other i.e. one reflects to the other. There are little data assessing the associations of hepatic and epicardial fat in non-metabolic-syndrome Egyptian adults. Objective: to evaluate the relationship between HS and EAT, and its relation to the components of metabolic syndrome. Patients and methods: We studied fifty HS patients accidentally discovered by abdominal ultrasound and fifty healthy matched controls with normal fat content in the liver (without HS) by ultrasound for comparison. Both groups underwent complete history taking, general examination, laboratory investigations and 2D transthoracic echo Doppler study at baseline and 18 months thereafter only for patient’s group. Results: this study showed that, there is a positive correlation between HS and EAT and metabolic syndrome. HS and EAT are early and sensitive predictors for metabolic syndrome. Conclusion: hepatic and epicardial fat are early and strong predictors of metabolic syndrome.
https://ejhm.journals.ekb.eg/article_31087_1ff6c58cab103461d597268c98794bfe.pdf
hepatic and epicardial fat
Metabolic syndrome
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-04-01
75
4
2581
2584
10.21608/ejhm.2019.31088
31088
Original Article
One Year Follow Up after Septal Myectomy for Hypertrophic Obstructive Cardiomyopathy
Ahmed M. El Ashkar
aelashkar@gmail.com
1
Ahmed N. Khallaf
2
Cardiothoracic Surgery, Beni-suef University, Beni-suef, Egypt
Cardiothoracic Surgery, Fayoum University, Fayoum, Egypt
Background: According to the European society of cardiology 2008, hypertrophic cardiomyopathies (HCM) are defined as increased ventricular wall thickness or mass, in the absence of loading conditions such as hypertension or valve disease. Objectives: The aim of the current study was to assess the short term (1 year) outcome of the Septal Myectomy for Hypertrophic Obstructive Cardiomyopathy (HOaCM). Patients and Methods: The study included 31 patients who underwent septal myectomy at Kasr El Einy University Hospital, to assess the short term (1 year) outcome of the procedure. This prospective study was done during the period between March 2014 and May 2018 excluding any patient with ischemic or rheumatic pathology or requiring any additional procedure. Results: All patients had an LVOT peak gradient of more than 50 mmHg. All of the patients had preoperative mitral regurge. The preoperative septal wall thickness ranged from 1.5 to 3.5 cm with a mean of 2.1±0.7 cm. TEE showed a pressure gradient across the LVOT ranging from 4 to 20 mmHg with a mean of 7±6 mmHg, which was statistically significant in comparison to the preoperative values. Echocardiography done at one year follow up showed a peak systolic gradient across the LVOT ranging from 6 to 40 mmHg, with a mean of 18±8 mmHg. There was a statistically significant difference between the preoperative and one-year follow-up data (p value<0.001). However, there was no significant difference between the early postoperative and one-year followup. Conclusion: Septal myectomy for Hypertrophic Obstructive Cardiomyopathy (HOCM) is a safe procedure with good immediate and short-term results, and with good outcome if done by an experienced surgeon with good selection criteria
https://ejhm.journals.ekb.eg/article_31088_e72f35dff79db0b7212b8bba7b04f3b9.pdf
Septal myectomy
Hypertrophic obstructive cardiomyopathy (HOCM)
Follow up after septal myectomy
Hypertrophic cardiomyopathies
Idiopathic hypertrophic subaortic stenosis (IHSS)
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-04-01
75
4
2585
2587
10.21608/ejhm.2019.31089
31089
Original Article
Loco-Regional Perforator Flaps for Reconstruction of Post Burn Contracted Elbow
Wael Mohamed Ayad
1
Moustafa Sayed Ahmed Meky
2
Osama Mohamed Abdel-Hafeez Abdallah
osa.eg2020@gmail.com
3
Department of Plastic & Reconstructive Surgery, Faculty of Medicine, Al-Azhar University
Department of Plastic & Reconstructive Surgery, Faculty of Medicine, Al-Azhar University
Department of Plastic & Reconstructive Surgery, Faculty of Medicine, Al-Azhar University
Context: the post-burn scar is inevitable problem even with the best treatment as it depends on the depth of the burn injury, so only superficial dermal burns, heal with no scarring, but the contracture is preventable problem especially with the best treatment. The post-burn elbow flexion contracture may be associated with heterotropic calcification of the elbow joint which needs orthopedic team consultation. The elbow reconstruction represents a demanding procedure for the plastic surgeon. Objective: aim of this study was to evaluate the validity and application of local arm forearm and regional chest perforator flaps for coverage after release of post burn elbow contractures. Patients and Methods: this prospective randomized study was done on 20 patients aged from 6 to 54 years old. All of them were asking for elective release of postburn flexion contracture of the elbow at outpatient clinics of Al Azhar University and Al-Ahrar Teaching Hospitals. It was done from March 2018 to March 2019. Results: we have performed in our study the local and regional perforator flaps as lateral arm flap, medial arm flap, PBUF flap, PBRF flap, thoracoabdominal pedicle flap. Skin grafting is an easy procedure, however, success is limited with the technique because there is always the risk of incomplete graft take and prolonged splinting and physiotherapy is imperative in the postoperative period. Conclusion: flaps are better for resurfacing the defects after post-burn contractures release. Flaps do not need vigorous post-operative physiotherapy or splint age and grow with age especially in children.
https://ejhm.journals.ekb.eg/article_31089_e3c2aee745a5911ac2b0fa85e5387f36.pdf
Loco-Regional Perforator Flaps
PBCs
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-04-01
75
4
2588
2593
10.21608/ejhm.2019.31090
31090
Original Article
Surgical versus Conservative Management of Lumbar Canal Stenosis in Elderly
Ahmed Mohamed Hassan Salem
1
Mostafa Elsayed Mohamed Elsayed
2
Mohamed Ahmed Mohamed Abdallah
dr.kali.555@gmail.com
3
Department of Neurosurgery, Faculty of Medicine, Azhar University
Department of Neurosurgery, Faculty of Medicine, Azhar University
Department of Neurosurgery, Faculty of Medicine, Azhar University
Background: Degenerative lumbar spinal stenosis is one of the common diseases in elderly, also may occur in younger ages. Usually presents with back pain, lower limbs pain and claudication pain. Diagnosis is confirmed by radiological studies such as plain X rays LSS, CT. LSS or MRI LSS. Objective: The aim of this prospective study was to evaluate the surgical versus conservative management of lumbar canal stenosis in old patient (age of 60 years old or more). Methods: A prospective comparative study was conducted on 100 old patients that were divide into two groups, each group 50 patients. The first 50 patients underwent surgical lumbar canal decompression and the other 50 patients underwent conservative management. Results: This study showed that elderly patients with moderate to severe lumbar stenosis without spondylolisthesis got benefit from surgery. They showed reduction in pain reported in the lower limbs (VAS Leg with p < 0.05) and improved function (Oswestry with p < 0.05) whoever there was no significance change regarding visual analogue scale (VAS) between the two groups. In addition, there was no significant difference between the result between 6 month and oneyear follow up. Conclusion: In patients with lumbar stenosis in old age, there was improvement in leg pain and function in patients underwent surgical posterior decompression but there was no difference in back pain compared to patients underwent conservative management.
https://ejhm.journals.ekb.eg/article_31090_cf0c0749fa7db652fffa90426b66688e.pdf
Surgical versus Management
Lumbar canal stenosis
Elderly
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-04-01
75
4
2601
2605
10.21608/ejhm.2019.31449
31449
Original Article
Value of Semiquantitative Assessment of Right Ventricular Systolic Function with A Modified Subcostal Echocardiographic View
Deya El-Den Mosa`d Sadek
deya.sadek@yahoo.com
1
Mohammad Ismail Al-Deftar
2
Wael Mohammad Attia
3
Abdul-Halem Mohammad Abo-El-Magd
4
Department of Cardiology, Faculty of Medicine, Al-Azhar University, Egypt
Department of Cardiology, Faculty of Medicine, Al-Azhar University, Egypt
Department of Cardiology, Faculty of Medicine, Al-Azhar University, Egypt
Department of Cardiology, Faculty of Medicine, Al-Azhar University, Egypt
Background: the assessment of right ventricular function (RVF) is an important component of routine echocardiography study. Tricuspid annular plane systolic excursion (TAPSE) is easy and validated method of RVF but in many patients, this method may be difficult to apply due to inadequate apical window. So, we proposed that Subcostal Echocardiographic assessment of Tricuspid annular Kick (SEATAK) could be comparable to TAPSE. Aims of the study: they were to assess of RVF with a new arising method SEATAK, to determine the sensitivity & specificity of SEATAK and correlation between SEATAK & TAPSE with the degree of RVF. Patients and Methods: this study included 100 consecutive patients presented to our echocardiography lab with different clinical indications. Right ventricular function was assessed by the following parameters: RV Myocardial Performance Index (RIMP), TAPSE, Peak Systolic velocity of right ventricular basal free wall by TDI (TASVTDI), SEATAK and Fractional Area Change (FAC) as reference method for RVF assessment. Results: according to RVF using FAC, the patient were classified into 2groups,group with FAC ≥35% and other with FAC <35%. There was a significant statistical difference between both study groups according to TAPSE (cm), SEATAK (cm), P-Value ˂0.05. SEATAK was significantly correlated with TAPSE, TASV-TDI, and FAC values. SEATAK cutoff value ≥1.60 cm has the highest combined sensitivity and specificity of 86% &67% respectively for normal RVF (FAC ≥35%). Positive& negative predictive values are 72% &83%, respectively. Area under the curve equals 0.79, P-Value < 0.001. Conclusion: SEATAK is correlated with TAPSE, TASV-TDI & FAC for evaluation of RVF with cut-off value of SEATAK for prediction of normal RVF is ≥1.60 with sensitivity and specificity of 86% &67% respectively
https://ejhm.journals.ekb.eg/article_31449_695a25384745b7cb468fffb0e436baa1.pdf
Subcostal echocardiographic assessment of tricuspid annular kick
right ventricular function
modified Subcostal Echocardiographic view
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-04-01
75
4
2606
2610
10.21608/ejhm.2019.31450
31450
Original Article
Result Evaluation between Laparoscopic Anterior and Posterior Mesh Rectopexy in Complete Rectal Prolapse
Ibrahim Aboulfotoh Mohammed
1
General Surgery, Al-Azhar University
Background: The prospectively and retrospective collected databases for identifying outcome in patients of 20 or more years of age with full thickness external rectal prolapse (ERP) treated by laparoscopic ventral rectopexy. Primary end-points were age, and mortality, morbidity, length of hospital stay and recurrence. Aim of the study: Evaluation of the comparative result between anterior and posterior mesh rectopexy and better method of rectopexy. Patient and methods Twenty-four adult patients with complete rectal prolapse underwent operative treatment for the prolapse between January 2016 and December 2018. The diagnosis of rectal prolapse was made clinically and confirmed by defecation proctography. Patients underwent pre-operative colonoscopy or flexible sigmoidoscopy to exclude organic disease. Data on gender, age, mortality, morbidity, length of stay and recurrence were prospectively collected on an institutionally approved electronic database. Non-parametric data were described as median and range, while parametric data were presented as average and standard deviation. Results: 24 patients of median age 38 (20-52 years old). Patients underwent laparoscopic ventral rectopexy. There was no mortality and 10 (13%) patients had complications. At a median follow up of 8 (2 – 12) months, two (3%) patients developed a recurrent full thickness prolapse. Conclusions: Abdominal procedures are generally better for young fit patients. The results of all abdominal procedures are comparable. Suture and mesh rectopexy are still popular with many surgeons. The choice depends on the surgeon’s experience and preference. Similarly, the procedure may be done through a laparoscope. Laparoscopic ventral or dorsal rectopexy is safe to treat full-thickness ERP. Morbidity, mortality, and hospital stay are comparable with published rates with a tenfold lower recurrence.
https://ejhm.journals.ekb.eg/article_31450_93f32949e3c9c90a62f7c432d0043a7d.pdf
Rectal prolapse
Laparoscopic (anterior and posterior) rectopexy
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-04-01
75
4
2611
2620
10.21608/ejhm.2019.31580
31580
Original Article
Assessment of LV Function by Three-Dimensional and Three-Dimensional Speckle Tracking Echocardiography after Percutaneous Coronary Intervention for Chronic Total Occlusion Coronary Artery Disease
Kamal Ahmed Marghany Mahgoub
1
Department of Cardiology, Faculty of Medicine, Al-Azhar University, Egypt
Background: Cardiovascular disease is the most leading cause of morbidity and mortality throughout the world today. Chronic total occlusions are defined as 100% occlusions with TIMI flow 0 with at least 3-month duration. New echocardiographic techniques is an important noninvasive method for assessing cardiovascular function and mechanics. Objective: Determination of the impact of revascularization for chronic total occlusion coronary artery disease on left ventricular function using three-dimensional and three- dimensional speckle tracking echocardiography. Patients and methods: The present study included (60) patients presenting with chronic total occlusion coronary artery disease at Al-Azhar University Hospitals, in the period between December 2015 and April 2018. The study compared the differences in echocardiographic parameters before the procedure (pre-procedure) and one month after successful PCI to CTO (post- procedure). Two-dimensional (2D) and three- dimensional (3D) transthoracic echocardiography (baseline and follow up study), 2D Global longitudinal strain (GLS) and 3D longitudinal strain (LS) speckle tracking echocardiography (base line and follow up study) were done. Results: Mean left ventricular ejection fraction significantly increased, while the left ventricular end-diastolic and end-systolic volumes significantly decreased. The left ventricular end-systolic and end-diastolic volumes and diameters were significantly decreased. The global longitudinal strain (2DSTE and 3DSTE) showed significant improvement after successful revascularization. Both patients with LVEF ≥ 50% and LVEF < 50% displayed significant improvement in the 2D GLS and 3D LS, also diabetic and non-diabetic patients displayed significant improvement in the 2D GLS and 3D LS. Improvement in the 2D GLS % was correlated with an improvement in the 3D LS %. Conclusion: Restoring the coronary blood flow in chronic total occlusion patients reduces the left ventricular volumes, dimensions and improves the left ventricular ejection fraction and global longitudinal strain of hibernating myocardium.
https://ejhm.journals.ekb.eg/article_31580_23909fdb21db5e40df127c8b0de8724d.pdf
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-04-01
75
4
2621
2630
10.21608/ejhm.2019.31451
31451
Original Article
Value of Two-Dimensional Strain Imaging in Prediction of Myocardial Function Recovery After Percutaneous Revascularization of Infarct-Related Artery
Kamal Ahmed Marghany Mahgoub
1
Ali Mohammed El Ameen Abd El Mageed
2
Ahmed Mohammed Galal
3
Department of Cardiology, Faculty of Medicine, Al-Azhar University, Egypt.
Department of Cardiology, Faculty of Medicine, Al-Azhar University, Egypt.
Department of Cardiology, Faculty of Medicine, Al-Azhar University, Egypt.
Background: Acute myocardial infarction (MI) is often accompanied by impaired regional myocardial systolic function. A novel approach known as two-dimensional speckle tracking echocardiography was used to quantify regional LV function. Objective: The aim of the current study was to evaluate of the role of Speckle Tracking Echocardiography in prediction of left ventricular function recovery after percutaneous coronary intervention to left anterior descending coronary artery in patients with anterior ST segment elevation myocardial infarction with impaired left ventricular ejection fraction. Patients and methods: This study included 50 patients and 15 normal control adult persons. Patients had suffered from first attack of anterior STEMI. They were admitted at the CCU units of Al-Azhar University Hospitals from September 2016 to September 2018 and treated with thrombolytic therapy. Each patient was subjected to conventional transthoracic echocardiography before hospital discharge and before reperfusion. Speckle tracking echocardiography and resting SPECT were done one week after MI. Percutaneous coronary intervention to LAD within one week after MI for patients with demonstrated myocardial viability by resting SPECT. Three months after percutaneous revascularization to LAD, all patients were reevaluated using conventional TTE and strain imaging. The studied population were divided into 2 Groups; group A: 24 patients who showed post-PCI LV function recovery and Group B: 26 patients who did not showed post-PCI LV function recovery. Results: There was statistically significant increase in the prevalence of diabetes mellitus, smoking and dyslipidemia in group B. There was high statistically significant difference between the two groups as regard baseline LVEF (%), baseline wall motion score index (WMSI), mean baseline and follow up WMSI values, baseline number of affected left anterior descending (LAD) segments as assessed by WMSI, baseline and 90 days follow up mean number of affected LAD segments, baseline strain values at both global LV and territorial LAD segments. Control group showed mean territorial LAD strain was - 20.41± 0.61, mean baseline territorial LAD strain of group (A) - 13.20 ± 2.05 and mean baseline territorial LAD strain of group (B) - 8.47 ± 2.12. Regarding mean baseline territorial LAD strain and mean GLS of the LV, Receiver Operating Characteristic curve was done between group A and B for obtaining a cut off value of – 11.3 % and – 11.8 % respectively. Conclusion: LV global and territorial strain measured by 2D STE is a good predictor of LV function recovery in STEMI patients after percutaneous revascularization of infarct–related artery.
https://ejhm.journals.ekb.eg/article_31451_3e72c51df28c65b75e1f01e31f29c9c9.pdf
Acute myocardial infarction
percutaneous revascularization
Speckle tracking echocardiography
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-04-01
75
4
2631
2638
10.21608/ejhm.2019.31452
31452
Original Article
Surgical Management of Destructive Neoplastic Spine Lesions
Mohammad Fathy
mohammadfathyeissa@azhar.edu.eg
1
Ramadan Shamseldien
ramadangalal77@gmail.com
2
Mohammed Soleiman
3
Hatem Saad Elkhouly
4
Department of Neurosurgery, Al-Azhar Faculty of Medicine for Girls
Department of Neurosurgery, Shebin Elkom Teaching Hospital
Department of Neurosurgery, Al-Azhar Faculty of Medicine for Girls
Department of Neurosurgery, Al-Azhar Faculty of Medicine Asuit Branch, Egypt
The spine is one of the most common sites of metastasis from distant structures, following the lung and the liver. Aim: to review the pathological distribution, clinical presentation and different surgical procedures and outcome of cases with neoplastic spine lesions managed at our departments. Patients and methods: this is a review of 29 patients presented with destructive spine lesion with compromised neural structure at different degrees, with no history of trauma or infection. All patients subjected to full neurological examination and ASIA scoring, and full radiological evaluation. Different surgical approaches were utilized. Results: this a retrospective study of 29 patients, 11males and 18 females. Mean age of presentation was 50years old. The affected vertebral bodies are 47 distributed among vertebral regions: 6 sacral (12.8%), 16 lumbar (34%), 6 thoracolumbar (12.8%), 12 thoracic (25.5%), 3 cervicothoracic (6.4%), and 4 cervical (8.5%). As regard surgical procedures, 5 patients CT guided biopsy. One case operated by core biopsy and vertebroplasty. 4 patients were managed by posterior neural decompression and debunking. 12 patients operated posterior excision and reconstruction. 3cases approached by anterolateral thoracotomy. 2 cases operated posterior excisional biopsy and Craniocervical fixation. One case was managed by anterior transoral excision. One case approached through anterior cervical corpectomy. Conclusion: in selected cases surgical management of patients with spine neoplastic lesions followed by adjuvant therapy is considered to relieve pain, decompress neural structures, stabilization and correction of deformed spine, and local control with also improvement of quality of life but not the survival.
https://ejhm.journals.ekb.eg/article_31452_b3c59867acc445a967fc93c3f2e51533.pdf
Destructive Neoplastic Spine Lesions
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-04-01
75
4
2639
2645
10.21608/ejhm.2019.31453
31453
Original Article
Correlation between Thrombolysis in Myocardial Infarction and The Global Registry of Acute Coronary Syndromes Risk Scores and Severity of Coronary Artery Disease in Patients with Non-ST Elevation Acute Coronary Syndrome
Mahmoud El-Sayed
taweel10@gmail.com
1
Abdelrahman Aly
2
Ashraf Abotaleb
3
Ahmed Gaafar
4
Mohammed Sarhan
5
Abdelrahman Elbokary
6
Monir Osman
7
Department of Cardiology, Mabaret Misr Alqadema Hospital
Department of Cardiology, Faculty of Medicine, Al-Azhar University
Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University
Department of Cardiology, Faculty of Medicine, Helwan University
Department of Cardiology, Faculty of Medicine, Al-Azhar University
Department of Cardiology, National Heart Institute, Cairo, Egypt
Department of Cardiology, Faculty of Medicine, Al-Azhar University
Background: the prognosis of non-ST elevation acute coronary syndrome (NSTEACS) patients is frequently done by using thrombolysis in myocardial infarction (TIMI) and global registry of acute coronary events (GRACE) risk scores. Only few studies were done for prediction ability of the scores with coronary artery disease. Methods: this prospective cross-sectional study included 100 patients was conducted at Mabaret Misr Alqadema and Al-Azhar University Hospitals from May 2017 till September 2018. We calculated the TIMI and the GRACE risk scores for all patients on admission then patients had coronary angiography to detect the extent of the coronary artery disease (CAD). We assessed the severity of CAD by using Gensini score and vessel score. Results: the TIMI and GRACE scores have an acceptable predictive value in identifying the extent of the CAD. A TIMI score ≥3 and GRACE score ≥102 was significantly associated with 3 vessel disease and left main disease (p <0.014 for TIMI and p <0.007 for GRACE). On comparison of the two risk scores, the discriminatory accuracy of the GRACE score was nonsignificantly superior to the TIMI score in predicting 3 vessel and left main (LM) diseases but the combination of both scores has a higher accuracy (p <0.006). Conclusions: the CAD is more extensive by coronary angiography in patients with NSTEACS who had higher TIMI or GRACE risk scores, as they have a good predictive value. However, when both compared, the GRACE score has a non-statistically significant superiority with multivessel and LM disease, and combination of both scores has a higher accuracy.
https://ejhm.journals.ekb.eg/article_31453_7d33667329e87ca70161c667fa8f806a.pdf
NSEMI-ACS
TIMI risk score
GRACE risk score
Gensini risk score
CAD
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-04-01
75
4
2646
2652
10.21608/ejhm.2019.31454
31454
Original Article
The Relationship between Amniotic Fluid Index (AFI) & Single Largest Vertical Pocket and Perinatal Outcome in Late Severe Preeclampsia
Abd-Elmonem Mohammed Zakaria
1
Ashraf Hamdy Mohamed
2
Khaled Abd-Elhaleem Kamel Badr
khaledobs83@yahoo.com
3
Department of Obstetrics and Gynecology, Faculty of Medicine - Alazhar University
Department of Obstetrics and Gynecology, Faculty of Medicine - Alazhar University
Department of Obstetrics and Gynecology, Faculty of Medicine - Alazhar University
Backgound: the amniotic fluid is a clear fluid that surrounds the fetus, and produced in part by the amniotic cells, maternal blood during the first trimester of pregnancy and fetal urine and lung fluid during the second trimester of pregnancy. It serves as a cushion to the fetus allowing musculoskeletal development and protecting it from trauma. It also maintains temperature and has a minimal nutritive function. Evaluation of AFV through ultrasound measurement is an essential part in tests of fetal well-being (BPP), by measuring the AFI or the MVP. Objective: the aim of this study was to evaluate both AFI and single deepest pocket in patients with late severe preeclampsia, and to correlate both markers with different parameters of fetal outcome. Patients and Methods: the study was a prospective controlled study involving 100 women with severe preeclampsia >34w managed at Al Hussein University Hospital and Al Arish General Hospital with the following inclusion criteria, pregnant patients, age 18- 40 years old, with variable parity and a singleton living fetus >34 weeks gestation, and with severe preeclampsia. Results: the neonatal outcomes regarding meconium is more with AFI group than MVP group while the neonatal outcome regarding NICU, RDS & Neonatal death in both groups were similar with no evidence of a statistical difference between both techniques. Conclusion: we concluded that AFI had more significant statistical relationship with perinatal outcome, hence AFI appeared to be a better predictor of perinatal outcome in preeclamptics in late severe preeclampsia.
https://ejhm.journals.ekb.eg/article_31454_3d1764b742f935cedf86e0e37f39f6b3.pdf
oligohydramnios – ultrasound – Perinatal outcome
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-04-01
75
4
2653
2660
10.21608/ejhm.2019.31456
31456
Original Article
Histopathological and Cytological Efficacy in The Diagnosis of Solitary Thyroid Nodules
Mohammed M. Elsawy
1
Hatem Salah Eldin Elhabashy
2
Marwa Abd ElMonem Soliman
3
Assem Ahmed Mohammed Ahmed
asem_zidan124@yahoo.com
4
Department of Otorhinolaryngology, Faculty of Medicine, Al-Azhar University
Department of Otorhinolaryngology, Faculty of Medicine, Al-Azhar University
Department of general Pathology, Faculty of Medicine, Al-Azhar University
Department of Otorhinolaryngology, Faculty of Medicine, Al-Azhar University
Background: thyroid nodules are found in 4-7% of the population, the preferred diagnostic approach is avoidance of numerous radiologic evaluations, and early performance fine-needle aspiration. Objectives: the aim of this study was to evaluate the efficacy of fine needle aspiration cytology (FNAC) and histopathological assessment in diagnosis of solitary thyroid nodules. Methods: this study was done on twenty patients diagnosed as solitary thyroid nodule. All the patients’ FNAC and histopathological results were reviewed, confirmed, correlated and evaluated. Results: there were 4(20%) men and 16(80%) women, with a male-to-female ratio of 1: 4. The patients studied ranged in age from 17 to 65 years, with the majority ranging in age between 25 and 40 years (30%). According to FNAC findings, 65% were benign/non-neoplastic and 35% were malignant aspirates. The most common benign lesion diagnosed by FNAC was a colloid nodule (25%), whereas the most common malignant lesion was papillary carcinoma (30%). There were no false-positive cases (0%). A false-negative result was found in only two cases (10%). According to the histopathological findings, 60% were benign/non-neoplastic lesions and 40% were malignant. The most common benign/non-neoplastic lesions were colloid goiter (25%) and follicular adenoma (15%), whereas the most common malignant lesion was papillary carcinoma (35%). Conclusion: FNAC is a useful diagnostic method, but it has some limitations in the diagnosis of subtypes of solitary thyroid nodules such as follicular lesion. Histopathological study provides a more accurate diagnosis and overcomes these limitations.
https://ejhm.journals.ekb.eg/article_31456_b7bf11120798612cba980991142ec239.pdf
Solitary thyroid nodule
Fine needle aspiration biopsy (FNAB)
Fine needle aspiration cytology (FNAC)
histopathology
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-04-01
75
4
2661
2666
10.21608/ejhm.2019.31581
31581
Original Article
Outcome of Snodgrass Repair of Distal Penile Hypospadias with Stented and Unstented Urethra
Gamal A.M Morsi
1
Mohamed A. Abdel Azez
2
Hussein A. Galal
3
Alsayed M.H Hathout
4
Mourad M. Mourad
5
Mo’men Roshdy Qobaissy
momnroshdy@gmail.com
6
Department of Urology, Faculty of Medicine - Al-Azhar University
Department of Urology, Faculty of Medicine - Al-Azhar University
Department of Urology, Faculty of Medicine - Al-Azhar University
Department of Urology, Faculty of Medicine - Al-Azhar University
Department of Urology, Faculty of Medicine - Al-Azhar University
Department of Urology, Faculty of Medicine - Al-Azhar University
Background: Hypospadias is the most common congenital malformation of penile shaft occurring in 1 per 300 male births; it is considered a common clinical problem as it causes not only functional problems but also psychological problems for parents. Objective: The objectives of this study is to review the result of TIP repair of distal penile hypospadias in terms of outcome and complications of stenting and unstenting the urethra. Patients and methods: As a prospective randomized study; this study has included patients with distal penile hypospadias operated with Snodgrass between year 2011-2018 and had divided to (group A) included 40 patients operated upon with stent preservation for a week (group B) was 20 patients with stent removed at the end of the operation. Results: Regarding group (A) the stent of 10 cases had slipped at the first 8 hour postoperative so they have been added to the count of (group B) and considered as unstented repair. It is clear here in our study that meatal stenosis rate were different from Snodgrass rate but were similar to other published studies. Other comparable items as fistula rate, urinary retention and hospital stay, were the same as published studies. Conclusion: It could tell that removing the catheter can reduce bladder spasm , urinary tract infections, and patient discomfort and improve the familiar compliance without increasing acute retention episodes and fistula rate, so that at least in some cases specially in distal types, leaving stent can be avoided.
https://ejhm.journals.ekb.eg/article_31581_cceec2d2c2565fbaf33002fcba9f2d94.pdf
Snodgrass
distal hypospadias
Unstented Urethra
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-04-01
75
4
2667
2672
10.21608/ejhm.2019.31582
31582
Original Article
Three-Versus Two-Dimensional Sonographic Biometry in the Third Trimester of Pregnancy for Predicting Birth Weight and Macrosomia in Diabetic Pregnancies
Kamel Nourel-Deen Abdul-Galeel
1
Abd Elmonsef Abd Elhamed Sedek
2
Karim Gamal Radwan
gamalkarim16@gmail.com
3
Department of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University
Department of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University
Department of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University
Background: diabetes is the most common metabolic disorder affecting pregnancy. Its prevalence seems to be growing in parallel with the epidemics of overweight and obesity. It‘s considered a modern epidemic disease that affects about 8.3% of adults (accounts for 382 million people of the global population) and 46% of cases are estimated to be undiagnosed. Recognizing and treating diabetes or any degree of glucose intolerance in pregnancy results in lowering maternal and fetal complications. Objective: our aim is to test the hypothesis that incorporating 3D fractional thigh volume would be superior to conventional 2D biometry for predicting birth weight and macrosomia in diabetic pregnancies. Patients and Methods: the study was done on 160 pregnant women suffering from pre-gestational or gestational diabetes at El-Hussien and Sayed Galal Hospitals. All women were evaluated by full obstetrical history taking, physical examination, pelvic examination, transabdominal ultrasound, routine laboratory investigations and assessment of the route of delivery. Results: one-fifth of the patients had macrosomia, and four fifths had no macrosomia. There were no statistical significant differences between macrosomia group and no macrosomia group in maternal age, parity, body mass index, obesity, diabetes, gestational age and gestational age at delivery. The mean ± SD was lower for the 2D than the 3D projected estimate. Our study showed that there were statistical high significant regarding birth weight at delivery and difference from 2D/3D (p < 0.001). Conclusion: we suggest that 2D sonography should remain the standard of care for predicting birth weight and macrosomia in diabetic pregnancies
https://ejhm.journals.ekb.eg/article_31582_d139e9328e047b5efa786a7c2981aa7a.pdf
Three-Versus Two-Dimensional Sonographic Biometry Trimester
Pregnancy for Predicting Birth Weight
Diabetic Pregnancies
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-04-01
75
4
2673
2678
10.21608/ejhm.2019.31583
31583
Original Article
Comparative Study between Fetal Biometry and Transverse Cerebellar Diameter in Estimating Gestational Age in Third Trimester
Osama E. Ali
1
Ibrahim R. Elsawy
2
Abdelhamed M. Elbedewy
3
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Background: The exact determination of gestational age is so important in management of the antepartum care, and for adequate planning of proper intervention or therapy. Tanscerebellar diameter has great advantages in prediction of gestational age in cases of uncertain dates or in suspected intrauterine growth retardation. There are minimal data available about the relationship between tanscerebellar diameter and biparietal diameter in third trimester of pregnancy. Objective: The aim of the present study was to assess the accuracy of transcerebellar diameter (TCD) measurement in estimation of the gestational age during the third trimester compared to the current fetal biometric measurements including femur length and biparietal diameter. Patient and Method: The study included 500 pregnant women with sure and reliable dates fulfilling the inclusion criteria at the Department of Obstetrics and Gynecology, Al-Azhar (Bab Alsheria ) university Hospital, (inpatient and outpatient) from May 2018 till November 2018. The entire subjects were in the third trimester of pregnancy seen at 31 – 36 weeks, the transcerebellar diameter, the biparietal diameter and femur length were measured for determination of gestational age. Results: The results showed that the transcerebellar diameter (TCD) is more accurate than the biparietal diameter (BPD). There were insignificant statistical difference between transcerebellar diameter (TCD) and femur length (FL) for determination of gestational age in the third trimester whereas there was a significant difference between the transcerebellar diameter (TCD) and the biparietal diameter (BPD) for determination of gestational age in the third trimester. All those data were compared to the last menstrual period. Conclusion: Transcerebellar diameter is more reliable method of gestational age determination in third trimester of pregnancy than biparietal diameter. Transcerebellar diameter (TCD) and femur length (FL) can be used as a tool to assist in the assessment of gestational age in third trimester
https://ejhm.journals.ekb.eg/article_31583_a873b9dff80c73e7a1871fc289cf9bc9.pdf
Transcerebellar Diameter
femur length
biparietal diameter – gestational age
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-04-01
75
4
2679
2683
10.21608/ejhm.2019.31586
31586
Original Article
Peribulbar Block Using Dexmedetomdine versus Magnesium Sulphate as Additives to Local Anesthetics for Cataract Surgery
Manal Foad Abd Elmoniem
1
Rehab Moustafa Kamel
rehabmoustafakamel@yahoo.com
2
Anesthiology, Intensive Care and Pain Management Department
Ophthalmology Department, Faculty of Medicine for Girls, Al-Azhar University
Background: peribulbar block is commonly used for cataract surgery in adults, most commonly local anesthetics were injected into peribulbar space, but using only local anesthetics for peribulbar anesthesia is associated with delayed onset of globe akinesia and, short duration of analgesia and frequent need of block supplementation Objective: to assess the efficacy and safety of addition of dexmedetomidine versus magnesium sulphate to local anesthetic mixture for peribulbar block in cataract surgery. Patients and Methods: the patients were divided randomly into two equal groups: Dexmedetomidine group (D Group) included 30 patients who received 50 µg dexmedetomidine adjuvant to local anesthetics mixture (lidocaine and bupivacaine). Magnesium sulphate group (M Group) included 30 patients who received 50mg of Magnesium sulphate adjuvant to local anesthetics mixture (lidocaine and bupivacaine). Results: The addition of Dexmedetomidine or Magnesium sulphate to local anesthetic in cataract surgery accelerates the onset of corneal anesthesia and globe akinesia . The decrease in the IOP is more in D Group . No significant changes in the hemodynamic measurements in both groups Conclusion: Use of 50ug dexmedatomedine or 50mg magnesium sulphate 10% with mixture of lidocaine 2% plus bupivacine 0.5% for peribulbar anesthesia in cataract surgery enhances the onset of globe anesthesia and akinesia . Dexmedetomidine causes more decrease in intraocular pressure magnesium sulphate.
https://ejhm.journals.ekb.eg/article_31586_cae494aacab70cc1818faba621e16ab8.pdf
Dexmedetomidine – Magnesium sulphate
Peri bulbar block
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-04-01
75
4
2684
2689
10.21608/ejhm.2019.31584
31584
Original Article
Different Modalities of Management of Liver Trauma (Operative and Nonoperative)
Mohammed Aboul Fotouh Ahmed
1
Hazem Ahmed Mostafa
2
Mohammed Mostafa Mohammed Elshiekh Aly
3
Department of General Surgery, Faculty of Medicine, Al Azhar University
Department of General Surgery, Faculty of Medicine, Al Azhar University
Department of General Surgery, Faculty of Medicine, Al Azhar University
Backgound: non operative management (NOM) of liver injury has generally become the most frequent treatment. Current rates of success for NOM for hepatic trauma of selected patients have been reported to be safe and efficient. Objective: The purpose of this work is to study and evaluate different modalities in management of liver trauma regarding the available diagnostic modalities and current management options. Patients and Methods: thirty patients with hepatic trauma were included in the study. They were classified according to their vital stability into 2 groups; conservative and operative groups. The conservative group was formed of 21 patients, while the operative group was formed of 9 patients. Results: a higher rate of morbidity and mortality during the course of management was found among the patients of the operative group, while 4 patients (19%) in conservative group suffered from complications 6 patients (66.7%) in operative group suffered after the operative management. The only mortality case was found in operative group. Conclusion: the operative management of liver trauma is associated with higher grade of injury, higher needs for blood transfusion, ICU admission and a higher rate of further management, morbidity, mortality and the presence of co-injuries
https://ejhm.journals.ekb.eg/article_31584_8dfc53f956060e5dee0f06e2df3adddb.pdf
Liver Trauma
Operative and Nonoperative management
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-04-01
75
4
2690
2698
10.21608/ejhm.2019.31585
31585
Original Article
Phacotrabeculectomy versus Trabeculectomy with Small Incision Cataract Extraction in Eyes Presenting with Cataract and Glaucoma
Mohammed IA
1
Abdelhameed MH
2
Eassa IM
mohamedmoustafa8787@gmail.com
3
Ophthalmology department -Faculty of medicine, Al -Azhar University (Cairo)
Ophthalmology department- Faculty of medicine, Al -Azhar University (Damietta)
Ophthalmology departmentFaculty of medicine, Al -Azhar University (Damietta)
Background: The association of glaucoma with cataract has been more frequent because of increase in life expectancy and the increased risk of cataract development in patient with glaucoma. Aim of the work: was to compare the outcome of phacotrabeculectomy versus subscleral trabeculectomy with small incision cataract extraction in patients with cataract and primary glaucoma. Patients and Methods: This prospective study included a total of 20 eyes of 19 patients with visually significant cataract and coexisting primary glaucoma. Patients were categorized randomly in two groups: group A who underwent phacotrabeculectomy and group B who underwent trabeculectomy with small incision cataract extraction from the same trab. Results: Statistically significant improvement was detected in postoperative BCVA and IOP. Preoperative BCVA ranged from 0.02 to 0.25 with the mean ±SD of 0.15± (0.07) in phacotrabeculectomy group (group A) while in small incision trabeculectomy group (group B) preoperative BCVA ranged from 0.01 to 0.25 with the mean ±SD of 0.11±(0.1). Preoperative IOP ranged from 30-35 mmHg with mean ±SD of 31.28 ± (1.25) in phacotrabeculectomy group while in small incision trabeculectomy group preoperative IOP ranged from 30-36 mmHg with mean ±SD of 31.14 ± (1.34). Conclusions: It could be concluded that there is significant improvement in the BCVA and IOP control after combined procedure for management of coexistent cataract and glaucoma. This improvement is statistically significant. There was no statistically significant difference in the final visual acuity, IOP control and postoperative complication rate between phacotrabeculectomy and small incision trabeculectomy.
https://ejhm.journals.ekb.eg/article_31585_457197b2265eae4f7f12ca02c0803cfc.pdf
Cataract
phacotrabeculectomy
small incision
Glaucoma
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-04-01
75
4
2699
2705
10.21608/ejhm.2019.31631
31631
Original Article
Effects of Süßstofftabletten on Some Physiological Parameters in Male Albino Rats and The Curative Effects of Vitamin E
Eman G.E. Helal
emanhelal@hotmail.com
1
Mohamed A. Abdelaziz
2
Mariam S. El-Gamal
3
Department of Zoology, Faculty of Science (Girls), Al-Azhar University
Medical Physiology, Faculty of Medicine, Al-Azhar University
Department of Zoology, Faculty of Science (Girls), Al-Azhar University
Background: Süßstofftabletten is an artificial sweetener, which is mainly composed of cyclamate and saccharin. Aim of the work: clarification of Süßstofftabletten effects and the amelioration effect of vitamin E in male albino rats. Materials and methods: thirty male albino rats weighing from 100 to 120 gm. The period of the experiment was 30 days. The animals were divided into three groups; group 1: control, group 2: rats received Süßstofftabletten (1 tablet/25kg b.w./day) and group 3: rats received Süßstofftabletten (1tablet/25kg b.w./day) + vitamin E (6 mg/kg b.w./day). The following parameters were measured: serum glucose, ASAT, ALAT, serum creatinine, serum urea, protein and lipid profiles and hormonal levels (insulin, testosterone, serum T3 and serum T4). Results: there were many disturbances that occurred in the previous parameters, and vitamin E ameliorated most of these hazardous effects. Conclusion: the assertions that artificial sweeteners are safe and healthy in use by consumers are false. Natural sweeteners whose benefits are important and necessary to our bodies must be used instead of artificial sweeteners. Also vitamin E is very important in our daily diet as it fights many damages that encounter us.
https://ejhm.journals.ekb.eg/article_31631_c0e4f99175e07f54b2c40df232772b49.pdf
Süßstofftabletten
cyclamate
saccharin
Vitamin E
ASAT
ALAT
T3
T4
testosterone
Insulin
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-04-01
75
4
2706
2711
10.21608/ejhm.2019.32061
32061
Original Article
Serum Sodium Levels in Hospitalized Children with Community- Acquired Pneumonia: A Hospital-Based Case-Control Study
Amira Mohamed Hamed
1
Mohamed Fahmey Ibrahim
2
Hamada Kawshty Fayed
kawshtey1978@yahoo.com
3
Mona Mohamed Abd EL-Meguid
4
Shimaa Esmail Hassen
5
Department of Pediatrics and Neonatology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
Department of Pediatrics and Neonatology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
Department of Chest Diseases, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
Department of Pediatrics and Neonatology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
Background: community-acquired Pneumonia (CAP) is one of the frequent causes of hospital admission, whereas hyponatremia is a common electrolyte abnormality in hospitalized patients and associated with considerable morbidity and mortality. Aim of the study: purpose of this study was to evaluate serum levels of sodium in children with CAP. Patients and Methods: a total of 200 children included in the study were classified into two groups as follow: Group (I) Cases group: Included 100 child with clinical and laboratory evidence of pneumonia ranging from one month to three years and Group (II) Control group: Includes 100 child apparently healthy control who attended for non chest problem or serious medical condition. Serum sodium levels, hemoglobin levels, platelet count, total leucocyte count, and C-reactive protein were done to all children. Results: Hyponatremia was present in 82% of patients with CAP (82 out of 100). Serum level of sodium was significantly lower in children with pneumonia than healthy control (132.08 ± 4.18 vs 139.42± 2.57). There was a statistically significant negative correlation between the grade of respiratory distress and the level of serum sodium (p <0.001). Conclusion: hyponatremia is common among hospitalized children with CAP. Serum sodium levels are lower in children with pneumonia than matched healthy controls.
https://ejhm.journals.ekb.eg/article_32061_2e8db788a7c308cb713b674abaa7f694.pdf
pneumonia
children
serum sodium
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-04-01
75
4
2712
2719
10.21608/ejhm.2019.32062
32062
Original Article
Phacoemulsification with Peripheral Iridectomy and Trabeculectomy: Comparing the Two Procedures in Management of Angle-Closure Glaucoma
Asaad Nooreldin
asaad_nooreldin@yahoo.com
1
Ophthalmology Department, Faculty of Medicine, Al-Azhar University (Assuit), Egypt
Background: glaucoma was ranked as one of the major causes of blindness worldwide. Angle-closure glaucoma (ACG) is a type of glaucoma characterized by narrowing or closure of the anterior chamber angle. Objective: to compare the clinical outcomes of phacoemulsification (Phaco) with peripheral iridectomy versus trabeculectomy in management of ACG. Patients and Methods: this study was a prospective, follow-up nonrandomized clinical trial, carried out on 50 eyes with ACG. Patients were divided into two groups: group A (n= 25); eyes underwent phacoemulsification with peripheral iridectomy, and group B (n= 25); eyes underwent sub-scleral trabeculectomy. Intraocular pressure (IOP), visual outcomes and postoperative complications were assessed. Patients were followed-up for 6 months. Results: postoperative visual acuity was significantly improved in phaco group compared to that of trabeculectomy group (P <0.001). The mean postoperative IOP was reduced significantly (P < 0.05) in both groups at all time intervals compared to their preoperative values. Anterior chamber depth increased significantly postoperatively in group (A) (p<0.001) however, almost no change was noticed in group (B). Meanwhile, postoperative angle opening distance was increased (p<0.001) in both groups. No significant differences were found between both procedures in Rim area, Rim volume, cup/disc area ratio and maximum cup depth. Eight cases (32.0%) in group (A) and 7 cases (28.0%) in group (B) suffered from postoperative complications with insignificant difference. Conclusion: both procedures are effective in lowering IOP in patients with ACG, but phacoemulsification with peripheral iridectomy significantly improved visual acuity compared to sub-scleral trabeculectomy with almost the same rate of complications.
https://ejhm.journals.ekb.eg/article_32062_760e8f7627eefca1fac34cdc022a13e4.pdf
Phacoemulsification
Peripheral Iridectomy
Trabeculectomy
Angle Closure-Glaucoma
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-04-01
75
4
2720
2728
10.21608/ejhm.2019.32063
32063
Original Article
Effect of Different Methods of Reperfusion on Short-Term Outcomes in Patients with Acute Inferior S-T Segment Elevation Myocardial Infarction Associated with Ischemic Mitral Regurge
Mohey Mansour El-Abbady
1
Mohammed Usama Taha
2
Mohammed Saeed Al-shorbagy
3
Ibrahim Abdelfattah Yassin
4
Haitham Alshahat Ramadan
drhaithamramadan@gmail.com
5
Department of Cardiology, Al-Azhar Faculty of Medicine, Al-Azhar University and National heart institute, Egypt
Department of Cardiology, Al-Azhar Faculty of Medicine, Al-Azhar University and National heart institute, Egypt
Department of Cardiology, Al-Azhar Faculty of Medicine, Al-Azhar University and National heart institute, Egypt
Department of Cardiology, Al-Azhar Faculty of Medicine, Al-Azhar University and National heart institute, Egypt
Department of Cardiology, Al-Azhar Faculty of Medicine, Al-Azhar University and National heart institute, Egypt
Background: Follow-up of patients with inferior STEMI having acute significant mitral regurgitation to assess the effect of mitral regurgitation and the type of reperfusion therapy whether thrombolytic therapy or PCI on the prognosis of these patients Patients and methods: This is a prospective, observational, non-controlled study included two hundred and forty patients with inferior STEMI admitted at National Heart Institute from august 2016 to August 2018. The patients were classified into 2 groups according to presence or absence of mitral regurgitation, 120 patients in each group. Group A (ischemic MR) was further subdivided into 2 subgroups, 60 patients who underwent primary PCI and 60 patients who received thrombolytic therapy. Results: Patients presenting with inferior STEMI and having ischemic mitral regurgitation (IMR) had more, in hospital, complications regarding life threatening arrhythmias, cardiogenic shock and mortality. On three months follow-up these patients had more incidence of developing congestive heart failure and low ejection fraction. On analyzing the data of each subgroup, the patients who had IMR and received thrombolytic therapy had more sever mitral regurgitation, more in-hospital complications and more incidence of congestive heart failure than those patients who had IMR but underwent primary PCI. Conclusion: Patients with inferior STEMI and having IMR are at more risk for developing in hospital complications and have higher incidence to develop congestive heart failure. However, in these patients those who underwent primary PCI have much better prognosis than those who received thrombolytic therapy.
https://ejhm.journals.ekb.eg/article_32063_718dfd2488b18080919a11d4bea55683.pdf
Inferior STEMI
Ischemic Mitral Regurgitation
Primary PCI
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-04-01
75
4
2729
2735
10.21608/ejhm.2019.32064
32064
Original Article
Sphincter Sparing Techniques for Treatment of Transsphincteric Anal Fistula
Abdul Salam Amer Emad
1
Mohamed Fathy Labib
2
Gamal Attia Mohamed Mohamed
gammamk@yahoo.com
3
Department of General Surgery, Faculty of Medicine, Al-Azhar University
Department of General Surgery, Faculty of Medicine, Al-Azhar University
Department of General Surgery, Faculty of Medicine, Al-Azhar University
Background: anal fistula is a common proctologic problem. It is a common cause of chronic irritation to both patients and surgeons. It is a disease of antiquity. Even with all that work and research, started 2500 years ago, or may be more, man didn’t find the ideal treatment for perianal fistulas. Objective: The purpose of this study is to evaluate sphincter saving techniques used in management of transsphincteric anal fistula as regard rapid recovery, incidence of postoperative stool incontinence and recurrence rate. Patients and Methods: our study was a prospective study of 60 patients who had transsphincteric anal fistula and were admitted to Al-Azhar University Hospitals from July 2017 till January 2019. The patients were divided into 3 groups according to the management procedure, group A was managed by seton technique, group B was managed by ligation of transsphincteric fistula tract (LIFT) and group C was managed by endorectal advancement flap (ERAF). Results: there were no differences of demographic data and characters of fistula among the three groups, however some differences were noticed regarding postoperative morbidity due to early complication including urine retention, bleeding, hematoma, infection and wound disruption but it was not statistically significant, there were statistically significant difference regarding postoperative pain, recurrence and incidence of stool incontinence. Conclusion: high transsphincteric fistula warrants more sphincter sparing techniques to avoid the most likely sphincter dysfunction which could be happened after traditional surgery like fistulectomy and cutting seton for this type of complex anal fistula.
https://ejhm.journals.ekb.eg/article_32064_69891ce5efc113d9eeabd0f4e536e27b.pdf
Anal fistula
sphincter sparing
seton, LIFT, Advancement flap
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-04-01
75
4
2736
2744
10.21608/ejhm.2019.32065
32065
Original Article
Adverse Effects of Two Kinds of Food Additive Mixtures (Sodium benzoate + Monosodium glutamate, Monosodium glutamate + Chlorophyllin and Sodium benzoate + Chlorophyllin) on Some Physiological Parameters in Male Albino Rats
Eman G.E. Helal
emanhelal@azhar.edu.eg
1
Mohamed A. Abdelaziz
2
Nahla S.A. EL-Shenawe
3
Department of Zoology, Faculty of Science (Girls), Al-Azhar University
Physiology Department, Faculty of Medicine, Al –Azhar University, Egypt
Department of Zoology, Faculty of Science (Girls), Al-Azhar University
Background: Food additives are substances used in food industry in order to improve the food’s taste and appearance by preserving its flavor and preventing it from souring. Materials and Methods: this study was conducted on twenty-four young male albino rats with an average 120-140 g body weight. Animals were divided into four groups (6 each). Group I: Control untreated group, Group II: it was administered sodium benzoate (SB) (5 mg/kg b.w./day) orally and monosodium glutamate (MSG) (15 mg/kg b.w./day), Group III: it was administered MSG (15 mg/kg b.w./day) and chlorophyllin (CHL) (15 mg/kg b.w./day) and Group IV administered orally with SB (5 mg/kg b.w./day) and CHL (15 mg/kg b.w./day). Blood samples were collected on the last day of experiment, for biochemical estimations. Results: There was marked elevation in levels of fasting glucose, insulin, HOMA-IR, activities of AST and ALT, urea, creatinine, total cholesterol (TC), triglycerides (TG), LDL-C , VLDL, ratios of TC/HDL-C and LDL-C/HDL-C (risk factors) in all treated group. Serum thyroid hormones (T3 and T4) increased in Group III. On the other hand, there was decline in levels of serum total proteins, albumin, testosterone and HDL-C in all treated groups in comparison with the control group. There was a highly significant reduction in the body weight, T3 and T4 in Group IV, while Group II showed highly significant increase in body weight and a highly significant reduction in globulin level as compared to control rats. Conclusion: The use of these compounds must be limited as it resulted in a vehement disturbance in the biochemical parameters.
https://ejhm.journals.ekb.eg/article_32065_48fd6acd26eca097af2f4021d5589ebd.pdf
food additives
thyroid hormones
Monosodium glutamate
biochemical parameters