eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
3
3618
3625
10.21608/ejhm.2019.40003
40003
Original Article
Epidemiology of End Stage Renal Disease Patients on Regular Hemodialysis in El-Beheira Governorate, Egypt
Mostafa El-Ballat
1
Mohamed El-Sayed
2
Hossam Emam
3
Department of Internal Medicine, Faculty of Medicine, Al-Azhar University
Department of Internal Medicine, Faculty of Medicine, Al-Azhar University
Department of Internal Medicine, Faculty of Medicine, Al-Azhar University
Background: End Stage Renal Disease (ESRD) is associated with severe morbidity, mortality, high cost for management and different impacts on general health and patient wellbeing. Total number of ESRD patients requiring renal replacement therapy has been growing drastically. Objective: the aim of the present work was to study the epidemiology of End Stage Renal Disease in one of the Egyptian areas in El Beheira Governorate, for getting some data about the distribution and most common causes of this disease. Identifying major risk factors on the onset of ESRD is an important part in preventing the development of ESRD. Patients and Methods: a cross-sectional study was conducted at dialysis centers in El Beheira Governorate, Egypt, by using questionnaire and direct interviewing technique with ESRD patients, in addition to using medical records for our data collections to identify major risk factors leading to ESRD. Results: The prevalence of ESRD patients on regular hemodialysis in El Beheira Governorate, Egypt, was 571 pmp (0.057%). The causes of ESRD in the present study were hypertension (31.7%), diabetes mellitus (18.0%), obstructive nephropathy (10.8%), glomerulonephritis (4.5%), urinary tract infection (3.9%), Autosomal Dominant Polycystic Kidney Disease (ADPKD) (2.9%), unknown (21.6%) and other causes such interstitial nephritis (1.9%) and Systemic lupus erythematous (1.5%). Conclusion: It could be concluded that increase public awareness about kidney problems and also increase awareness among primary health care physician about the early detection and prevention of Chronic Kidney Disease (CKD) will help to identify a probable correctable cause and to prevent progression to CKD.
https://ejhm.journals.ekb.eg/article_40003_f8162ca28d275fefb123c2bc72805349.pdf
Epidemiology of End Stage Renal Disease
Patients on Regular Hemodialysis
El Beheira Governorate
Egypt
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
3
3633
3640
10.21608/ejhm.2019.39900
39900
Original Article
Ultrasound Guided Platelet Rich Plasma Injection in Patients with Primary Knee Osteoarthritis
Ali Eed El-Deeb
1
Amal Mohamad EL-Barbary
2
Radwa Mostafa El Khouly
3
Nevien Ibrahim Elfeky
nova_elfeky87@yahoo.com
4
Department of Rheumatology and Rehabilitation, Faculty of Medicine, Tanta University
Department of Rheumatology and Rehabilitation, Faculty of Medicine, Tanta University
Department of Rheumatology and Rehabilitation, Faculty of Medicine, Tanta University
Department of Rheumatology and Rehabilitation, Faculty of Medicine, Tanta University
Background: Osteoarthritis is a leading cause of pain, disability, and socioeconomic cost worldwide and the knee is one of the most commonly affected joint. Objective: to evaluate clinical and functional therapeutic effect of ultrasound guided intraarticular or periarticular platelet rich plasma (PRP) injection in treatment of patients with primary knee osteoarthritis. Patients and Methods: eighty patients with primary knee osteoarthritis were divided into two groups: Group I: 50 knees, group II: 30 knees. Both groups were treated by PRP injection into the lateral recess of the knee group I or into painful periarticular structure that have previously been identified on ultrasound group II. Results: The VAS in group I (6.3±1.45) and II (6.57±1.30) significantly improved after injection (1.30±0.97 and 1.43±0.77; p<0.001). The range of movement (ROM) (flexion) significantly improved in both groups after injection. The WOMAC significantly improved in both groups after injection (p<0.001); (group I: 14.04±7.73 vs group II: 15.20±7.12). The KOOS score significantly improved in group I (41.93±11.05 to 75.43±7.70; p<0.001) and group II (39.83±12.46 to 76.08± 7.12; p<0.001) after injection. There was a significant improvement in the percentage of different parameters in mild and moderate knee osteoarthritis in both groups. Conclusion: Ultrasound guided single dose PRP injection is a safe and effective method for treating all grades of knee OA mainly mild to moderate also injection in periarticular pain generator structures reduce pain and improve knee function.
https://ejhm.journals.ekb.eg/article_39900_da1464b2e26577ce40c89f97eb3097b7.pdf
knee
osteoarthritis
Ultrasound-guided injection
platelet rich plasma
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
3
3641
3646
10.21608/ejhm.2019.39901
39901
Original Article
Factors Predicting Male Satisfaction after Penile Prosthesis Implantation
Alsaeed Abd Elbadea Alsayed
saeedaldmoky@gmail.com
1
Magdy Mohamed Sabrh
2
Yaser Ali Badran
3
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: penile prosthetic surgery is associated with satisfaction rates> 90% for the general implant population. However, it is suggested that satisfaction rates may be lower in certain populations. Objective: to analyze the factors affecting male satisfactionrates after penile prosthesis implantation (PPI). Patients and Methods: this observational retrospective and prospective study included all patients who underwent PPI surgery at Al-Azhar University Hospitals [Al-Hussein and Sayed Galal]; Cairo; Egypt during the period from January 2015 to May 2019. One hundred and three men were eligible for the study. The age of patients, body mass index (BMI), associated medical co-morbidities, etiology of erectile dysfunction (ED), duration of ED before PPI, date of the surgery, and intra- and post-operative complications were evaluated. Men`s satisfaction with PPI was evaluated at a time point at least 6 months postoperatively by using the validated Quality of Life and Sexuality with Penile Prosthesis (QoLSPP) questionnaire. Results: seventy-six (73.8%) subjects were highly satisfied while 27 (26.2%) were less satisfied. The BMI of highly satisfied subjects was significantly lower than those less satisfied (21.3±2.2 kg/m2 vs. 27.5±1.4 kg/m2 ; p<0.001) and a significant positive relationship was found between BMI and less satisfaction. Conclusion: the increase in is male´s BMI has a negative impact on his satisfaction levels post PPI; with every unit increase in male´s BMI > 24.5 kg/m2 , there is increase in the risk of less satisfaction by 11.1 times.
https://ejhm.journals.ekb.eg/article_39901_645a61b8df58dfeaf4286674d1bae600.pdf
Penile prosthesis implantation (PPI)
Satisfaction
Erectile dysfunction (ED)
Quality of Life and Sexuality with Penile Prosthesis (QoLSPP) questionnaire
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
3
3647
3652
10.21608/ejhm.2019.39902
39902
Original Article
Management of Lumbar Disc Prolapse Associated with Retrolisthesis
Ibrahim G. Ewaiss
1
Mustafa M. Abo Elkheir
2
Adnan M. Albanna
a_a5005@yahoo.com
3
Department of Neurosurgery, Faculty of Medicine, Al-Azhar University
Department of Neurosurgery, Faculty of Medicine, Al-Azhar University
Department of Neurosurgery, Faculty of Medicine, Al-Azhar University
Background: retrolisthesis is the posterior displacement of one vertebral body in relation to the adjacent vertebrae to a degree less than a dislocation. However, lots of neurosurgeons consider retrolisthesis as incidental finding a rising prove that it is not a rare condition and a cause of many backaches. Aim of work: to compare between discectomy with or without fixation as regards to pain, function and rate of reoperation in patients with lumbar disc prolapse associated with retrolisthesis. Patients and Methods: This study is prospective and retrospective study in fifty cases of patients with single level of lumbar disc prolapse associated with retrolisthesis in Al-Azhar University hospitals and Health Insurance hospitals in time between 2018 and 2019. Twenty-four patients were undergone discectomy alone and 26 patients were undergone discectomy plus lumbar fusion surgery. Results: the main level of retrolisthesis is L5-S1 with higher incidence than other high levels. Sixty six percent (33 cases of 50) and conservative treatment plays an important role in initiation of treatment but surgery by discectomy and fixation according to case demand is the main convenient solution. Conclusions: In this study we showed that patients with lumbar disc prolapse with retrolisthesis should be managed by discectomy alone in cases presented with radicular pain more than low back pain with dynamic study shows no instability. And should be managed by discectomy and fixation in cases presented with low back pain more than radicular pain with dynamic study showing instability or MRI finding shows advancing facet arthritis.
https://ejhm.journals.ekb.eg/article_39902_7ba85dae28a839a36cad6cb4c954c462.pdf
Retrolisthesis
Lumbar disc prolapse
Discectomy
fixation
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
3
3653
3658
10.21608/ejhm.2019.39903
39903
Original Article
Serum Protein and Prolactin in Evaluation of Uterine Fibroids
Abd Al Azim Mohamed Ahmed
1
Osama Mohamed Deif
2
Salma Saad Abd Al-Latif
3
Ahmed Mohamed ELHussieny Mohamed
4
Department of Obstetrics and Gynecology, Faculty of Medicine – Al-Azhar University
Department of Obstetrics and Gynecology, Faculty of Medicine – Al-Azhar University
Department of Clinical Pathology, Faculty of Medicine – Al-Azhar University
Department of Obstetrics and Gynecology, Faculty of Medicine – Al-Azhar University
Background: uterine fibroid (leiomyoma) is the most common benign uterine tumors in women of reproductive age. The majority of leiomyomas are asymptomatic, however up to 20% cause menorrhagia, pelvic pain and genitourinary symptoms. Objective: the aim of the study was to evaluate using of total protein or serum prolactin as a marker for evaluation and follow up of uterine leiomyomas. Patients and Methods: a randomized, controlled clinical trial study design was utilized to prove the relation between uterine fibroid and serum prolactin and serum protein. The study was performed at Obstetrics and Gynecology Department in AL Hussein Hospital. 100 females have myoma of different sizes are included in this research. Results: it was concluded that serum total protein and albumin levels in patients with elevated serum TNF levels were significantly lower (p < 0.05) than the corresponding values in patients with undetectable serum TNF levels. The study concluded that prolactin (PRL) levels are decreased following surgical therapy in patients with uterine fibroids. In addition, a slight increase in serum total protein was detected after surgery in uterine patients. Conclusion: in conclusion, a highly significant correlation was found between serum PRL and its ratio with serum total protein. This result ensured and supported the relation between the patient's serum PRL and serum total protein with their fibroid number. This enables to suggest these variables as a simple biochemical marker supporting other clinical findings.
https://ejhm.journals.ekb.eg/article_39903_5069059f7c364f995fb6df99a15f891d.pdf
Serum protein
prolactin
uterine fibroids
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
3
3659
3664
10.21608/ejhm.2019.39904
39904
Original Article
Uterine Tamponade Using Condom Catheter Balloon in The Management of Non-Traumatic Postpartum Hemorrhage
Mohammed Khaled Mostafa
1
Abd El-Samea Hassan Khalifa
2
Mohammed Shaaban Hamid Rady
mohammedrady480@gmail.com
3
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
Background: uterine tamponade can be lifesaving in PPH associated with deranged coagulation; as such women are at high risk for surgical intervention or angiographic embolisation. Successful tamponade with Rusch balloon catheter, Sengstaken-Blakemore tube, rolled gauze and recently with condom catheter are reported. Objective: the aim of this research was to study the efficacy and complications of uterine tamponade using condom catheter balloon in non-traumatic postpartum hemorrhage. Patients and Methods: this single-arm prospective study, that was conducted in Kafr Al-Dawar General Hospital and Al-Hussein Hospital. Twenty patients with non-traumatic postpartum hemorrhage not responding to medical treatment were included in this study. Results: outcome measures were the success rate in controlling hemorrhage, time required to stop bleeding, need for additional surgical measure, use of anesthesia, subsequent morbidity in terms of infection (measured by fever, total leucocyte counts >12 000 mm3 over next 5 days) and technical difficulties. There was significant statistical relation between volume of fluid in condom tamponade and pain in relation to the success in control of PPH in 15 min (P >0.05). There was no significant statistical relation between age, gestational age, Parity, fever and total leucocytes count in relation to the success in control of PPH in 15 min (P <0.05). Conclusion: condom catheters control PPH effectively and quickly. It is a simple, inexpensive and safe method of conserving the reproductive capacity along with saving the life of women with primary PPH.
https://ejhm.journals.ekb.eg/article_39904_9ae960743920b309e595a1a4324903b7.pdf
Uterine tamponade
Condom catheter balloon
Non-traumatic postpartum hemorrhage
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
3
3665
3672
10.21608/ejhm.2019.39906
39906
Original Article
Arthroscopic Management of Meniscal Root Injury
Younus Akl
1
Emad Zayed
2
Mahmoud Maher
mahercordoba@gmail.com
3
Department of Orthopedic Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Department of Orthopedic Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Department of Orthopedic Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Background: Meniscal root tear s are becoming increasingly recognized. They can cause rapidly progressive arthritis. Purpose: The purpose of this study was to document the radiological and functional outcome of arthroscopic management of meniscal root tears injuries. Patients and Methods: This study was held on 20 patients suffered from meniscal root tears at Al-Azhar University Hospitals. There were 11 males and 9 females with mean age 41.63 (23- 50) years old. All patients were evaluated preoperatively and postoperatively with mean follow up 6 months. Results: Clinical outcome measures significantly improved after surgery. Preoperatively there were 13 patients (65%) had poor score and 7 patients (35%) had fair score. Postoperatively there were 3 patients (15%) had poor score, 4 patients (20%) had fair score, 6 patients (30%) had good score and 7 patients (35%) had excellent score. The mean IKDC score for meniscal repair increased, and the mean IKDC score for partial meniscectomy increased. Postoperative MRI showed complete healing in 12 patients and failure in 8 patients.preoperative ME was ˃ 3 mm in 17 patients and ≤ 3 mm in 3 patients .postoperative ME was ≤ 3 mm in 11 patients and ˃ 3 mm in 9 patients. Conclusions: Meniscal root repair has increased in popularity and when done in selected patients results in a high rate of healing and restoring the ability of the meniscus to dissipate axial tibiofemoral loads, thereby slowing or halting arthritic progression.
https://ejhm.journals.ekb.eg/article_39906_f4f9318c25df097e3d75bb921f2caa39.pdf
Root tear injury
partial menisectomy
pullout suture repair
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
3
3673
3677
10.21608/ejhm.2019.39908
39908
Original Article
Comparative Study between Oral Zinc Sulphate versus Electrocautery in Treatment of Patients with Recurrent Warts
Mohamed Abdel Moneim Abdel Aal
1
Hamed Mohamed Abdo
2
Mohamed Abdel Latif Hasheesh
3
Mohamed Masoud Abdel Gayed
ebn.masoud2020@gmail.com
4
Department of Venereology and Anrology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Department of Venereology and Anrology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Department of Venereology and Anrology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Background: viral warts are benign proliferations of the skin and mucosa that are caused by HPV infection. They consider common and major health problem. Zinc can be a therapeutic option by medulating the immune system in patients with viral warts. Objective: the aim of this work was to compare the effect of oral zinc sulfate versus electrocautery in treatment of patients with recurrent warts. Patients and Methods: this study was carried on 90 patients with common warts. The patients were divided into three groups (A, B, C) of 30 patients. Group A consisted of 30 patients treated with oral zinc sulfate, 30 patients in group B treated by electrocautery while group C was given placebo in the form of starch capsules. Results: our results showed more improvement in group of electrocautery than in the group of zinc sulphate, and showed increase in complications in electrocautery group with statistically significant difference. In this study there was a positive correlation between percentage of improvement and serum level of zinc with a significance increase in the serum zinc level before and after treatment in zinc sulphate group. Conclusion: this study showed that the role of oral zinc sulphate as a systemic treatment modality for common warts could have the advantage of being non-invasive, non scarring and with minimal side effects, but it was not very effective so it can be taken with other modalities of treatment and not as monotherapy.
https://ejhm.journals.ekb.eg/article_39908_54adc33c3aff93a931b89aff4d807504.pdf
Oral Zinc Sulphate versus Electrocautery
HPV
Warts
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
3
3678
3683
10.21608/ejhm.2019.39909
39909
Original Article
Assessment of Serum Level of 25-Hydroxy Vitamin D in Patients with Acne Vulgaris
Abd El-Raouf Mohamed Elmohsen
1
Hassan Mamdouh Abd El-Aziz
2
Nagah Mohamed Abo Mohamed
3
Amr Farag Ibrahim Dabash
amrafandy8@gmail.com
4
Department of Dermatology, Venerology and Andrology, Faculty of Medicine – Al-Azhar University
Department of Dermatology, Venerology and Andrology, Faculty of Medicine – Al-Azhar University
Department of Clinical Pathology, Faculty of Medicine – Al-Azhar University
Department of Dermatology, Venerology and Andrology, Faculty of Medicine – Al-Azhar University
Background: acne vulgaris is a common chronic inflammatory disease of the pilosebaceous unit, characterized by the formation of non-inflammatory comedones and inflammatory papules, pustules, nodules and cysts. Objective: the aim of this study was to evaluate serum levels of vitamin D in a group of Egyptian patients with acne vulgaris in comparison to controls, in order to shed more light on its possible role in the pathogenesis and detect any relation between vitamin D and acne severity. Patients and Methods: the study recruited 90 subjects, 60 acne vulgaris patients and 30 age and sex matched healthy controls. All patients were subjected to detailed history taking and examination to detect extent and severity of acne vulgaris. Blood samples were taken from all participants to assess serum 25 OH D level. Results: revealed lower serum vitamin D levels in acne patients in comparison to controls, with statistically significant p value (0.009). Serum 25 OH D level showed no significant difference in females than in males in both patients (p = 0.726) and controls in comparison to patients (p = 0.794). There was no significant difference in level of 25 OH D between participants reporting adequate sun exposure and those reporting inadequate sun exposure in patients (p = 0.804) but it was statistically significant p value in controls in comparison to patients (p < 0.001). Conclusion: the present study revealed lower, statistically significant, serum vitamin D levels in acne patients, suggesting a possible role for vitamin D supplementation in acne treatment.
https://ejhm.journals.ekb.eg/article_39909_9565860164b3d8df7cb598075a5c2bd8.pdf
25-Hydroxy Vitamin D
Acne vulgaris
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
3
3684
3691
10.21608/ejhm.2019.39911
39911
Original Article
Strain Bull’s Eye Plot Derived from 3D Speckle Tracking Imaging in Children with Dilated Cardiomyopathy
Enas Talaat Mansor Madkor
enas_madkoor@yahoo.com
1
Osama Abd Rab El-Rassoul Tolba
2
Waleed Ahmed El-Shehaby
3
Shaymaa Basuny El-Nemr
4
Department of Pediatric Medicine, Faculty of Medicine, Tanta University, Egypt
Department of Pediatric Medicine, Faculty of Medicine, Tanta University, Egypt
Department of Pediatric Medicine, Faculty of Medicine, Tanta University, Egypt
Department of Pediatric Medicine, Faculty of Medicine, Tanta University, Egypt
Background: Cardiomyopathies (CMPs) are a group of myocardial diseases with adverse outcomes. Aim of the study: Was to evaluate the global and segmental 3–dimensional strain using speckle tracking echocardiography in children with dilated cardiomyopathy and correlate this parameter with other echocardiographic findings especially 2-dimensional strain (2DS bull's eye). Patients and Methods: 100 subjects were categorized into 2 groups: Group 1; 50 patients with dilated cardiomyopathy. Group 2; 50 healthy controls matched with the patient group. Echocardiographic studies were performed by the following: Routine echocardiographic examination, tissue Doppler examination (TDE): [systolic and diastolic mitral annulus velocities - LV myocardial performance Index (MPI)], speckling tracking technique [2D LV longitudinal strain (2DS bull's eye) - Auto EF for LV systolic function - sphericity index] and transthoracic 3DE examination (3DRTE) [3D longitudinal strain (3DS bull's eye)]. Results: There was a significant reduction in left ventricular ejection fraction (LVEF), sphericity index (SI), mitral annulus systolic velocity (S), early diastolic mitral annulus tissue velocity and late diastolic mitral annulus tissue velocity (E'/A') and LV GLS (global longitudinal strain) in patients when compared with controls but there was a significant increase in myocardial performance index (MPI) and 2 dimensional (2DS) than 3 dimensional (3DS) in patients when compared with controls. There was significant positive correlation between 2DS and 3DS GLS among patients also, there was good agreement between all items in 2DS and 3DS in patients group. Conclusion: The bull’s eye plot offers an intuitive visual overview of LV myocardial function status in cardiomyopathies.
https://ejhm.journals.ekb.eg/article_39911_e2017c5e2d06d5b759d8ff186ddd4622.pdf
Strain Bull’s Eye Plot
3D Speckle Tracking imaging
dilated cardiomyopathy
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
3
3692
3700
10.21608/ejhm.2019.39913
39913
Original Article
Studying the Auditory Effect of Maternal Iron Deficiency Anemia on Neonates Using Otoacoustic Emissions (Oaes)
Islam Gamal Ali El-Diasty
islam_gamal@yahoo.com
1
Hamed Mohamed El-Sharkawy
2
Trandil Hassan Elmehalawi
3
Mona Khaled Abo Almaaty Omar
4
Department of Pediatric Medicine, Faculty of Medicine, Tanta University, Egypt
Department of Pediatric Medicine, Faculty of Medicine, Tanta University, Egypt
Department of Audio-Vestibular Medicine, Faculty of Medicine, Tanta University, Egypt.
Department of Obstetrics and Gynecology, Faculty of Medicine, Tanta University, Egypt.
Background: The adverse effects of iron deficiency anemia on auditory nerve (AN) development have been showed a significant functional consequence on auditory brainstem response (ABR). Aim of the work was to study the effect of maternal iron deficiency anemia on auditory system of newborn infant using otoacoustic emissions (OAEs). Subjects and Methods: 60 full term neonates were divided into 2 groups: Group 1: 30 newborn infants as a control group with maternal blood Hb >10.5 g/dL. Group 2: study group: 30 newborn infants with maternal blood Hb ≤ 10.5 g/dL and diagnosed as maternal iron deficiency anemia (IDA). Results: In transient-evoked otoacoustic emissions (TEOAE) there was significant difference between the studied groups at frequency of 4000 Hz in both right and left ears. There was also significant difference between right and left ears as regard signal to noise ratio (SNR) and overall amplitude TEOAE at frequency of 2000Hz in control group and at 4000 Hz in study group. There was significant difference in study group between right and left ears as regard signal to noise ratio (SNR) distortion-product otoacoustic emissions (DPOAE) at frequencies 1409 with right ears showing a higher mean SNR than left ears. Conclusion: The peripheral auditory function, as tested by TEOAEs test, is affected in high frequency region of the cochlea in low ferritin babies while DPOAEs test was less sensitive in these patients for assessment of their cochlear function.
https://ejhm.journals.ekb.eg/article_39913_4579464f5679d4f63ba435a2c80ca647.pdf
Maternal iron deficiency anemia
Neonates
Otoacoustic emissions
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
3
3702
3708
10.21608/ejhm.2019.39915
39915
Original Article
Effects Of CANDEREL® and The Ameliorative Role of Stem Cell Enhancer on Some Physiological Parameters in Male Albino Rats
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: CANDEREL® is non-nutritive artificial sweetener, which is mainly composed of aspartame and acesulfame potassium. 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 CANDEREL® (1 tablet/25kg b.w./day) and group 3: rats received CANDEREL® (1 tablet/25kg b.w./day) + SCE (9 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 SCE ameliorated most of these hazardous effects. Conclusion: artificial sweeteners are not safe in use; their disadvantages are more than their advantages. So, we recommended replacing non-nutritive sweeteners with nutritive ones to be away from any hazardous effects that may result from the use of artificial sweeteners. Also, SCE made a great job in fighting the impairments that occur during the experiment.
https://ejhm.journals.ekb.eg/article_39915_6b5ea762fc07d21a24a6f1de69d3127a.pdf
CANDEREL®
Aspartame
acesulfame potassium
Stem Cell Enhancer
ASAT
ALAT
T3
T4
testosterone
Insulin
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
3
3709
3717
10.21608/ejhm.2019.39916
39916
Original Article
Role of Multidetector Computed Tomography in Gastric Cancers
Eisha Ramadan Mohamed
1
Alsiagy A. Abdel-Aziz
2
Eman Mohammed Mohammed Lofty
emanlotfy1000@gmail.com
3
Departments of Radiodiagnosis, Faculty of Medicine – Alazhar University
Departments of Radiodiagnosis, Faculty of Medicine – Alazhar University
Departments of Radiodiagnosis, Faculty of Medicine – Alazhar University
Background: Gastric cancer is the third most common cause of cancer-related death in the world. Currently, multislice computed tomography (MSCT) is a valuable tool for detection, staging, surveillance, and post-treatment evaluation of gastric neoplasm. Objective: The aim of this work is to clarify the role of multidetector CT in diagnosis and preoperative staging of gastric carcinoma. Patients and methods: The present study was conducted between October 2017 and June 2019 on 60 patients (26 males and 34 females) with age ranged from 28 to 73 years with mean age of 53 years. The patients were complaining of symptoms of gastric cancer or as a follow-up study for gastric cancer, referred to the CT Unit in Tanta University Hospital, Tanta Oncology Center and Health Insurance Hospital from the Oncology Department. Results: In our study we found that there was a significant relationship between pathological and CT staging by using MPR. CT with MPR was specific and accurate in diagnosis of all stages of gastric cancer with specificity ranged between (95-100%) and accuracy ranged between (94.5-97.5%). However, it showed lowest sensitivity in diagnosis of stage 1 of gastric cancer. On the other hand, it showed highest sensitivity (97.5%) in diagnosis of stage IV. Conclusion: MSCT is a valuable tool for detection, staging, surveillance, and post-treatment evaluation of gastric neoplasm.
https://ejhm.journals.ekb.eg/article_39916_80e0536821a22c8a69ac8288ad3b1cd5.pdf
Multi-detector Computed Tomography
Gastric Cancers
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
3
3718
3723
10.21608/ejhm.2019.39918
39918
Original Article
Evaluation of Flanged Haptics Intrascleral Sutureless Intraocular Lens Fixation
Younis Alsaeid Abd-Elhafez
1
Ali Ahmed Ali Ghali
2
Ahmed El Sayed Hodib
3
Ahmed Anwer Sadat Ali
ahmedophth89@gmail.com
4
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University
Background: successful intraocular lens (IOL) placement in patients undergoing cataract surgery has become synonymous with the IOL being placed in the capsular bag. Purpose: to evaluate the flanged haptic sutureless intrascleral intraocular lens fixation with double needle technique as a method of scleral fixation of posterior chamber IOL (PCIOL) as regard to its stability and safety as well as its complications. Patients and Methods: this is a prospective study, which included 20 eyes of 20 patients with aphakia with no adequate capsular support. Results: post-operatively the best corrected visual acuity (BCVA) was improved to reach up to 0.8 decimal unit. Intra-operatively, haptic breakage was reported in 3 cases where the IOLs were explanted and new IOLs were implanted and sclerally fixated. The post-operative complications included iris capture in 2 cases (10%), haptic deformation in 2 cases (10%), exposure in 5 cases (25%) and slippage in 2 cases (10%), corneal edema in 6 cases (30%), IOL decentration in 4 cases (20%) one of them was significantly decentered and needed for reoperation where one point fixation by a stitch of the slipped haptic , spontaneous IOL dislocation in 2 cases (10%) 1 month and 3 months post-operatively, both required re operation where the slipped IOL was explanted and new one is re implanted and sclerally fixated. There were no incidents of post-operative ciliary body injury, retinal tear or detachment or endophthalmitis. Conclusions: the flanged haptics intrascleral sutureless IOL fixation with double needle technique can be done for aphakic cases with no adequate capsular support.
https://ejhm.journals.ekb.eg/article_39918_67ac9ba59468a321a32684f4534134cb.pdf
Aphakia
Flanged haptics
Sutureless
Scleral fixation
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
3
3724
3735
10.21608/ejhm.2019.39921
39921
Original Article
Role of CT Gastric Volumetric Study in Sleeve Gastrectomy
Abd Ellah Nazzer Yassin Mohamed
1
Mohamed Salah Elfeshawy
2
Emad Abdelsalam Abdelkader Sokker
emad.sokkar@yahoo.com
3
Department of Radio-diagnosis, Faculty of Medicine, Al-Azhar University
Department of Radio-diagnosis, Faculty of Medicine, Al-Azhar University
Department of Radio-diagnosis, Faculty of Medicine, Al-Azhar University
Background: obesity continues to be a major public health problem, as defined by a body mass index (BMI) ≥30 kg/m2 . Obesity has been associated with an increased hazard ratio for all-cause mortality, as well as significant medical co-morbidity. Indeed, obesity is not only a chronic medical condition but should be regarded as a bona fide disease state. Objective: the study aimed at correlation between the operative gastric volume reduction and body weight reduction after surgery. Patients and Methods: our study included 30 cases; all were overweight/obese individuals. There were 20 females and 10 males. All patients underwent MSCT abdomen with oral contrast. Post processing in form of multi-planner reformatting and 3D reconstruction was performed to all cases before and 3 months after sleeve gastrectomy. Results: collection and correlation of preoperative and postoperative data, revealed that the percentage of operative gastric volume reduction ranged between 76% and 98% with mean value of about 84%, while the percentage of body weight reduction ranged between 7% and 24% with a mean value of about 15%. The correlation between the body weight and gastric volume measured preoperative in the studied patients was found to be insignificant, which means that the stomach volume doesn’t have a direct impact on body weight. Conclusion: MSCT volumetric study of the stomach is the gold standard imaging technique for evaluation of the gastric size in the preoperative and postoperative states in the context of bariatric sleeve gastric surgery.
https://ejhm.journals.ekb.eg/article_39921_85e1da46f8c2db2cc71819ebd657d550.pdf
CT Gastric Volumetric
obese
sleeve gastrectomy
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
3
3736
3740
10.21608/ejhm.2019.40451
40451
Original Article
Use of Fecal Calprotectin as A Predictor of Spontaneous Bacterial Peritonitis in Post Hepatitis C Cirrhotic Egyptian Patients
Atef Abou Elfotouh Ibrahim
1
Mohammed Salah Ali Hussein
2
Zakarya Mohamed Zakarya Shady
3
Mahmoud Mohammed Mohammed Metwally
4
Abdelrahman Saad Mohamed Amer
abdosaad123@gmail.com
5
Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Background: patients with liver cirrhosis have an increased risk of infections mainly spontaneous bacterial peritonitis, which is present in about 15% of patients with cirrhosis and ascites. This is believed to be mainly due to bacterial translocation (BT) although accurate mechanisms of BT are unknown, SIBO, gut dysmotility, increased intestinal permeability and impaired defense mechanisms are regarded as major risk factors for BT. Objective: to assess the value of fecal calprotectin (FC) as a predictor of SBP in cirrhotic Egyptian patients. Patients and Methods: this study included 75 subjects; they were divided into two groups: 25 cirrhotic subjects with ascites and no SBP as control group and 50 with liver cirrhosis and ascites and an evident SBP, all patients were subjected to full history taking, complete clinical examination and routine laboratory investigations and microbiological analysis of ascitic fluid, stool samples were collected for measuring FC by ELISA. Results: FC showed a highly significant difference (p<0.001) with the median FC in SBP case group higher than median FC of cirrhotic control group and both groups above average normal range, also a colleration emerged between elevated FC and previous history of hepatic encephalopathy in case group. Conclusion: FC was significantly elevated in cirrhotic patients dependant on the severity of liver disease as assessed by Child pugh score and a significant colleration emerged between elevated FC and complications of liver cirrhosis as SBP; So FCC can be used as a useful marker for early prediction and diagnosis of SBP in patient with liver cirrhosis.
https://ejhm.journals.ekb.eg/article_40451_b97cd9c461d15606b5f24929f72e9902.pdf
fecal calprotectin
Spontaneous Bacterial Peritonitis
Hepatitis C cirrhotic
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
3
3741
3748
10.21608/ejhm.2019.40452
40452
Original Article
Preconditioning Risk Factors Affecting Survival and Remission of Adult Egyptian Patients with Hematological Malignancies Undergoing Hematopoietic Stem Cell Transplantation
Fathy Ghamry Abd El-Razek
1
Ezzat Abd El-Rahman El-Etraby
2
Essam Abd El-Wahed Hassan
3
Amro Mohamed Sedky El Ghammaz
4
Mohammed Abd El-Akher Mohammed
5
Department of Internal Medicine, Faculty of Medicine, Al-Azhar University
Department of Internal Medicine, Faculty of Medicine, Al-Azhar University
Department of Internal Medicine, Faculty of Medicine, Al-Azhar University
Department of Internal Medicine, Faculty of Medicine, Al-Azhar University
Department of Internal Medicine, Faculty of Medicine, Al-Azhar University
malignant and non-malignant hematologic conditions and in the treatment of various solid tumors. Since the 1970s, steady progress has been made and HSCT is now regarded as a routine, rather than an experimental, approach in the treatment of a number of conditions, which would have proven fatal earlier on. Objective: Our study aimed to determine the most important preconditioning prognostic factors affecting the overall survival (OS), disease free survival (DFS) and relapse rate (RR) of adult Egyptians with hematological neoplasms who are treated with HSCT, whether autologous or allogeneic, and in turn minimizing the morbidity and mortality of those patients and improving their quality of life. Patients and methods: The study evaluated 98 adult patients with different hematological malignancies who underwent HSCT (whether autologous or allogeneic) at Stem Cell Transplantation Unit of Ain-Shams University from January 2014 to December 2018. Results: In our study, in the group of allogenic transplantation, There was a statistically significance at overall survival with number of chemotherapy cycles with P =0.028. Regarding post HSCT relapse and post HSCT mortality 11 patients (37.9%) died in the group that received ≤4 cycles of chemotherapy and 16 patients (55.2%) died in the group that received > 4 cycles of chemotherapy. Conclusion: Five-year overall and progression-free survival rose for allogeneic and autologous HSCT after the decade of their introduction
https://ejhm.journals.ekb.eg/article_40452_7b473ba01927a51803db6477641afd60.pdf
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
3
3749
3757
10.21608/ejhm.2019.40639
40639
Original Article
Effect of YAG Laser Posterior Capsulotomy on Central Macular Thickness in Pseudophakic Patients
Younis E. Abd-Elhafez
1
Mohamed Mohamed-Aly Ibrahim
2
Mahmoud A. Elsherbiny
elsherbinymahmoud2@gmail.com
3
Ophthalmology Department, Faculty of Medicine, Al-Azhar University, Egypt
Ophthalmology Department, Faculty of Medicine, Al-Azhar University, Egypt
Ophthalmology Department, Faculty of Medicine, Al-Azhar University, Egypt
Background: posterior capsular opacification (PCO), also known as ‘secondary cataract’ or ‘after cataract’, develops a few months to a few years over the clear posterior capsule after an uncomplicated cataract surgery. Purpose: evaluation the impact of Neodymium-doped Yttrium Aluminum-Garnet (Nd: YAG) laser capsulotomy on central macular thickness (CMT) by optical coherence tomography (OCT). Patients and Methods: the present study examined 50 eyes (24 males, 26 females) with an average age of 63.58±7.7 which was pseudophakic and had PCO, preoperative evaluation included history taking, ophthalmological examination and OCT was done. All patients underwent YAG laser posterior capsulotomy and CMT assessed at 3 days, 1 week, 1 month and 3 months by OCT. Results: there was significant improvement of BCVA (LogMAR) post laser capsulotomy (P< 0.001), IOP statistically significant increased (P< 0.001) at the first postoperative 3 days, 1 week, 1 month with mean ±SD of 16.46±2.54 mmHg 17.50±2.67 mmHg ,15.50±2.39 mmHg respectively when compared to preoperative values 13.0±1.67 mmHg. At 3 months there was minimal change (P=0.02). As regard CMT values at 1 week post laser (mean ±SD of 270.92±24.88) was highly significant increased (P< 0.001) and values at 3 months (mean ±SD of 248.70±21.66) showed nonsignificant difference (P=0.285) when compared to pre laser values (mean ±SD of 245.58±23.30). Conclusion: typical treatment of the PCO is YAG laser capsulotomy, IOP elevation is the most prevalent complication so antiglaucoma drugs is recommended and IOP return to normal values in the follow up period.
https://ejhm.journals.ekb.eg/article_40639_fc8cca2011a1a4eef8a6e6eee5be48f1.pdf
Posterior Capsule Opacification (PCO)
ND: YAG laser
Central Macular Thickness (CMT)
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
3
3758
3763
10.21608/ejhm.2019.40640
40640
Original Article
Evaluation of Pedicled Medial Thigh Perforator Flap and Its Application in Loco-Regional Soft Tissue Reconstruction
Wael M. Ayad
1
Mohamed A. Autifi
2
Abdel-Nasser M. Khallaf
3
Ahmed A. Aborawash
ahmedfyounes143@yahoo.com
4
The Departments of Plastic & Reconstructive Surgery, Al-Azhar University Hospitals and El-Sahel Teaching Hospital
The Departments of Plastic & Reconstructive Surgery, Al-Azhar University Hospitals and El-Sahel Teaching Hospital
The Departments of Plastic & Reconstructive Surgery, Al-Azhar University Hospitals and El-Sahel Teaching Hospital
The Departments of Plastic & Reconstructive Surgery, Al-Azhar University Hospitals and El-Sahel Teaching Hospital
Introduction: perineoscrotal defects represent a challenging problem in reconstructive surgery. Scrotal skin loss can occur following trauma, Fournier’s gangrene, post tumor excision, burns, etc. There are many techniques described in the literature for reconstruction of defects of scrotal skin. The pedicled medial thigh (PMT) perforator flap is a valuable reconstructive option. In its pedicled form, the experience is currently limited to a few case reports. Objective: the purpose of this study was to describe clinical applications of the pedicled medial thigh (PMT) perforator flap for reconstruction of loco-regional soft tissue defects. Patients and Methods: between June 2018 and June 2019, an experimental cadaveric study including two cadavers with four lower limbs was done in Al-Azhar University, Faculty of Medicine, Department of Anatomy and Embryology. A prospective cross-sectional study in which ten male patients with soft tissue defects or lesions that requires excision and reconstruction in perineum and scrotum received MTP flaps. All flaps were unilateral and the flap sizes ranged from 9-12 cm to 12-26 cm. Results: all flaps survived well, with the exception of partial wound dehiscence in two patients that was managed conservatively by frequent dressings and healed by 2ry intention. Conclusion: the medial thigh fasciocutaneous perforator flap offers a good option for Perineoscrotal defects. The flap provides a single stage, stable, well vascularized soft tissue coverage with no significant major complications, short hospital stay, appropriate range of motion, faster return to normal lifestyle and accepted aesthetic appearance.
https://ejhm.journals.ekb.eg/article_40640_193c5ec59ed2706d35f13a79fee5b03f.pdf
Pedicled Medial Thigh Perforator Flap
Application in Loco-Regional Soft Tissue Reconstruction
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
3
3764
3773
10.21608/ejhm.2019.40641
40641
Original Article
Endoscopic Management of Supratentorial Ventricular Tumors
Osama El Ghannam
1
Ahmed El Narsh
2
Hamdy Beheiry
3
Mohamed Fathy Kamel Ziady
ahmedyounes143@yahoo.com
4
Department of Neurosurgery, Faculty of Medicine – Al-Azhar University
Department of Neurosurgery, Faculty of Medicine – Al-Azhar University
Department of Neurosurgery, Faculty of Medicine – Al-Azhar University
Department of Neurosurgery, Faculty of Medicine – Al-Azhar University
Background: Intraventricular tumors are ideal indications for neuroendoscopic surgery. Because intraventricular tumors often cause cerebrospinal fluid (CSF) pathway obstruction, resulting in ventricular dilation and sufficient space for maneuvering with the endoscopes is available. Objective: The aim of this study was retrospectively and antrospectively evaluation of the role and outcome of use of endoscope in intraventricular tumors in term of: 1-Diagnostic of the deep lesions. 2- Management of increased intra-cranial pressure (ICP). 3-Excision of tumor depends on the type. Patients and Methods: This prospective and retrospective study was carried on 30 patients who sought medical advice for intra ventricular tumor from 2015 to 2019 in Al-Hussein University Hospital. Tumors are removed or biopsied with or without ETV and septum pellucidostomy. Results: According to our study, we found that endoscopic removal of intraventricular tumors has low rate of complications. There were 25 cases with no complications (83.3%) and better outcome. There were 15 cases (50%) very good outcome and 10 cases (33.3%) were good outcome, as there was minimal dissection and brain retraction. Conclusion: Regarding endoscopic treatment of intra ventricular tumors, there are many advantages of the endoscopic approach as low rate of complications, minimal dissection, better outcome, brain retraction, rapid access to the target and excellent visualization of the lesion and surrounding structures. Endoscopic approach also has the ability of treatment of the associated hydrocephalus at the same session with low rate of failure or recurrence.
https://ejhm.journals.ekb.eg/article_40641_13ac65dd933d9a0cacaf33572ec36155.pdf
Endoscopic Management
Supratentorial ventricular tumors
ETV
SCF
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
3
3774
3778
10.21608/ejhm.2019.40642
40642
Original Article
Risk Factors of Post PCNL Systemic Inflamatory Response Syndrome (SIRS)
Mohamed Kamal
1
Atef Ahmed Hamdy
2
Abdullah Mohamed
3
Urology Department, Al-Azhar University, Cairo, Egypt
Urology Department, Al-Azhar University, Cairo, Egypt
Urology Department, Al-Azhar University, Cairo, Egypt
Background: urolithiasis is one of the most common benign urologic diseases, with a nearly 10% of lifetime incidence. In addition, the prevalence of urolithiasis has been rising through the decade worldwide. Objective: To determine the parameters and contributing factors that are associated with SIRS following PCNL. Materials and Methods: an observational retrospective case control study, the medical records of all patients who underwent PCNL for renal stones in-between 10/2017 and 4/2019 (320 patients) at Al-Hussein and Sayed Galal, AlAzhar University Hospitals had been reviewed. The demographic and perioperative data of these patients had been collected. Results: the study comprised 307 patients, the mean age of the studied patients was 40.9±15.8 years (range: 2.5 to 70 years). The mean BMI was 26±3 (range: 18 to 35). There were 193(62.9%) males and 114(37.1%) females. Twenty two patients had bilateral renal stone. In 170(55%) cases the targeted stone was in left side and the rest was in the right one. Forty eight (15.6%) cases developed SIRS post-operative. The age, gender, residual stones, hepatitis and diabetes were found to be independent risk factors for SIRS. Conclusions: good preoperative assessment and strict control of DM and haptic diseases before the procedure, try to render the patient stone free intraoperative as much we can and strict follow up to these categories of patients postoperatively to detect inflammatory response and infectious complications as early as possible.
https://ejhm.journals.ekb.eg/article_40642_694d931a7575b1d5e0b158ec13392bf7.pdf
SIRS
infectious complications
percutaneous nephrolithotomy
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
3
3779
3790
10.21608/ejhm.2019.40643
40643
Original Article
Aesthetic External Dacryocystorhinostomy
Sayed Abbas Sayed Mahfouz
1
Ahmed Mahmoud Amin
2
Kareem Bakr Elessawy
3
Mohammed Mahmoud Hamed Mahmoud
m.m.hamed2013@gmail.com
4
Department of Ophthalmology, Faculty of Medicine – Al-Azhar University
Department of Ophthalmology, Faculty of Medicine – Al-Azhar University
Department of Ophthalmology, Faculty of Medicine – Cairo University
Department of Ophthalmology, Faculty of Medicine – Al-Azhar University
Background: acquired obstruction of the lacrimal excretory outflow system whether functional, structural or both will produce the symptoms of epiphora, mucopurulent discharge, pain, dacryocystitis and even cellulitis, promoting the patient to seek the ophthalmologist for evaluation and treatment. Objective: comparative study between conventional external DCR with postoperative scar modulating treatment, external DCR via subciliary incision and DCR via transconjunctival approach evaluating their functional outcome and final cosmetic scar. Patients and Methods: study cases were non-randomized 30 eyes in patients who inclusion and exclusion criteria are applied for them and dacryocystorhinostomy operation was done. Transconjunctival approach was done for 10 eyes, subciliary approach was done for 10 eyes while conventional approach with scar modulating treatment was done for last 10 eyes. Results: Aesthetic outcome of our study showed improvement in postoperative conventional approach scar with using scar modulatory treatment postoperatively and the results were 30% invisible, 50% minimally visible and 20% moderately visible after three months follow up. Also, subciliary approach study showed a significant improvement in scar outcome which was 60% invisible and 40% minimally visible. Conclusion: in spite of all the new innovations and competition, external DCR remains the gold standard and the most successful surgery in the management of complete NLDO.
https://ejhm.journals.ekb.eg/article_40643_e3b01e695c70620af76428723915b606.pdf
Ex-DCR
Eye
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
3
3791
3796
10.21608/ejhm.2019.41340
41340
Original Article
Transpedicular Screw Fixation for Degenerative Lumbar Spine Stenosis with Segmental Instability
El-Sayed El-Mor
1
Adel Ragab
2
Mohammed Elsayed Mansour
neurosugery151988@gmail.com
3
Neurosurgery Faculty of Medicine-Al-Azhar University
Neurosurgery Faculty of Medicine-Al-Azhar University
Neurosurgery Faculty of Medicine-Al-Azhar University
Objectives: Evaluation of the Transpedicular Screw Fixation as a surgical treatment for the degenerative lumber spin stenosis with segmental instability. Methods: A prospective, uncontrolled and interventional study conducted on thirty patients with low back pain and associated sciatica and claudication due to degenerative spinal stenosis and instability between March 2017-August 2018. Pain assessment, dynamic x rays and MRI was done perioperatively. Results: By comparison of pre- and post-operative translational motion, it has been found that more cases tend to be “fixed in plane” with high statistically significant testing (p=0.00677) by using Wilcoxon signed rank. In the same line, angular motion was compared perioperatively with the same test above, it has been found that vertebral line is more fixed as regard angular motion with high statistically significant result (p=0.0074). By comparing both variables to test the existence of good operative results with presence of “changed” vertebral alignment from instable to stable. It has been found that good results were statistically significant associated with changed alignment from moving to unmovable spinal segment (p < 0.0001). Conclusion: Posterolateral pedicle screws insertion for degenerative lumbar spine is a good option for restoration of sagittal balance, decompression of canal stenosis and needs no demanding experience or learning curve to serve patients with lumbar spine stenosis and instability.
https://ejhm.journals.ekb.eg/article_41340_28f92f2536f1be4b111e25da1d7e6bdf.pdf
degenerative lumbar
segmental instability
screw fixation
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
3
3797
3800
10.21608/ejhm.2019.41342
41342
Original Article
Effect of Low Temperature Dialysis on The Functional Activity of Complement Activation Pathways during Hemodialysis Procedure
Mohammed Nabil Raafat Farhat
1
Mohammed Elsaed Alshorbagy
2
Ahmed Mohamed abd-Elfattah Al Ashkar
3
Mahmoud El-Sayed Lotfy Hassan
dr.lot64@gmail.com
4
Departments of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Departments of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Departments of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Departments of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Background: low dialysate temperature dialysis has been used successfully in treatment of intradyalytic hypotension and resistant pruritus. In both conditions complement activation was proposed as one pathological mechanisms for their development. to our knowledge, no study has been done to assess the effect of low dialysate temperature on the individual complement activation pathway. Objective: to assess the effect of low dialysate temperature on complement activation pathways. Patients and Methods: this case control study included 20 patients, on regular hemodialysis at Alhusein University Hospital. Results: the mean age of our patients was 48.8±10 years, 11 males and 9 females, their mean BMI was 22±4 kg/m2 , their mean blood pressure 120/80± 20/20, all patients received hemodialysis via arterio-venous fistula. The main cause of hemodialysis is chronic renal failure due to hypertension in 8 patients, glomerulonephritis in 4 patients, polycystic kidney in 2 patients, hyperurecemic nephropathy in 2 patients, analgesic abuser in 1 patient, and chronic pyelonephritis in 1 patient. Conclusion: cold hemodialysis is associated with activation of complement system.
https://ejhm.journals.ekb.eg/article_41342_c45530d98754104d09098a832e4f7591.pdf
Hemodialysis
lactin pathway
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
3
3801
3806
10.21608/ejhm.2019.41343
41343
Original Article
Hydrocelectomy through Inguinal Approach in Adults
Adel Mohamed Abdel Halim Lashen
1
Mohamed Abdel-all Nafea
2
Mohamed Ahmed Mohamed Elsayed
drmbasiony1989surg@gmail.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: hydrocele is the most common cause of painless scrotal swelling. The incidence in adult males is approximately 1%, although prevalence varies according to country. Objective: to compare between the two groups? as regards the volume of the hydrocele sac, operative time, postoperative morbidity, length of hospital stay, and time of return to daily life. Patients and Methods: this prospective study was conducted on 40 patients with a diagnosis of unilateral (idiopathic) primary vaginal hydrocele during the period from October 2010 to October 2011. All patients were admitted to the Department of General Surgery, El-Hussein University Hospital, and underwent hydrocelectomy. Results: the age of the patients in the inguinal approach group ranged from 17 to 52 years (mean 30.75±10.67), whereas the patients included in the scrotal approach group had an age range of 16–48 years (mean 29.35±8.93). The difference in mean age between the two groups was statistically insignificant. The mean volume of the hydrocele sac was 196± 30.28 ml (range, 155–250 ml) in the inguinal approach group and 197.75±26.72 ml (range, 150–260 ml) in the scrotal approach group. The difference in mean volume of hydrocele between the two groups was statistically not significant. Conclusion: hydrocelectomy using the inguinal approach in adults is associated with low or no postoperative morbidity, no discomfort, short hospital stay, and early return to normal life. It is easily applied and allows management of any associated lesions in the inguinal canal.
https://ejhm.journals.ekb.eg/article_41343_d43a0d655133cc24dbccaf9117b00291.pdf
Hydrocelectomy
Vaginalis
adults
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
3
3807
3815
10.21608/ejhm.2019.41490
41490
Original Article
Holmium YAG Laser Ureterolithotripsy versus Extracorporeal Shock Wave Lithotripsy in Management of Proximal Ureteric Stones; Prospective Randomized Study
Hussein Hosny Mahmoud Farag
1
Mohammed Abdallah Hendawy
2
Mohammed Shukry Hussein
dr_gladiator2020@yahoo.com
3
Department of Urology; Faculty of Medicine; Al-Azhar University; Cairo
Department of Urology; Faculty of Medicine; Al-Azhar University; Cairo
Department of Urology; Faculty of Medicine; Al-Azhar University; Cairo
Background: Shockwave Lithotripsy (SWL) and ureteroscopy using Holmium Laser are effective and minimally invasive procedures for treating proximal ureteric stones ≤ 1.5 cm. However, there is still a debate of which one is more suitable for the proximal ureteric stones. Different studies have reported a variety of outcomes of SWL and ureteroscopy, as the both treatments use advanced instruments, they offer few complications and good outcomes among urologists. Objective: To evaluate the safety and efficacy of ureteroscopy using Holmium YAG LASER for proximal ureteric stone ≤ 1.5cm compared to SWL. Patients and Methods: It was a randomized prospective trial comparing ureteroscopy with HO: YAG Laser to (SWL) in managing proximal ureteric stones, done in the period from April 2018 to April 2019. It included 40 patients with upper ureteral stones and were randomly divided into two groups: Group A: 20 patients treated by ESWL. Group B: 20 patients treated by ureteroscopy using LASER lithotripsy. Results: There was no significant difference between the two groups regarding patients and stones criteria as maximal diameter, HU and position opposite vertebrae, degree of hydronephrosis and overall success rate. Conclusion: ESWL and Ho-YAG laser lithotripsy are comparable in managing proximal ureteric stones in term of safety and efficacy. URS has the advantage of higher SFR from the first session and prolonged radiation exposure time. ESWL has the advantage of no need of anesthesia and no hospital stay as it was done as outpatient and this should be considered when counseling the patient with proximal ureteric stone.
https://ejhm.journals.ekb.eg/article_41490_0429a225e68ba4f0ee038b7ab5343c65.pdf
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
3
3816
3823
10.21608/ejhm.2019.41491
41491
Original Article
Evaluation of Efficiency of Endoscopic trans-thoracic Sympathectomy for Primary Palmar Hyperhidrosis
El-Sayed Ahmed Moustafa
1
Mahmoud Abd Allah Abdel Razik
2
Mohammed Ibrahim El-Metwally Agwa
drmohamedagwa2010@gmail.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
Backgound: Primary hyperhidrosis is a condition of unknown etiology characterized by excessive sweating, typically on the palms of the hands, on the soles of the feet, and in the arms. The sweating response is increased by emotional stimuli, temperature, or elevated anxiety level or even spontaneously with no apparent cause. Objictive: The aim of the study is to evaluate the safety, efficacy and early and late complications of bilateral simultaneous endoscopic thoracic sympathectomy in treatment of primary hyperhidrosis. Patients and methods: Thirty patients with palmar hyperhidrosis grade 3 and 4 HDSS amenable for thoracoscopic sympathectomy were primarily managed. The study compromise 12 males and 18 females; the mean age at intervention was 20 (range 12-30) years. All were evaluated preoperatively with detailed history, full physical examination and the required investigations to confirm the diagnosis and to assess the fitness for surgery. Consent was then taken after discussing everything with the parents. Results: Immediately after sympathectomy, all patients were completely free from palm sweating (100%), in relation to the side operated upon. Three patients out of the 27 patients (11%) with associated plantar hyperhidrosis showed improvement of their plantar sweating immediately after endoscopic trans-thoracic sympathectomy (ETS), but the sweating recurred during the follow up period. Conclusion: in view of the low morbidity and zero mortality rate of this surgical technique, we recommend it as a method of treatment for palmar hyperhidrosis. Thoracic sympathectomy eliminates palmar hyperhidrosis with minimal recurrence
https://ejhm.journals.ekb.eg/article_41491_ef78a129d0ce580133c4686fa097c8cd.pdf
Endoscopic trans-thoracic Sympathectomy
Primary Palmar Hyperhidrosis
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
3
3824
3827
10.21608/ejhm.2019.41344
41344
Original Article
Cardiopulmonary Affection in Patients with Systemic Lupus Erythematosus
Mohammed Mahmoud Nussier
1
Mohamed Elwan Sayed
2
Hosni Abd-Elkareem Younus
3
Department of Internal Medicine, Assuit Faculty of Medicine, Al-Azhar University, Egypt
Department of Rheumatology and Rehabilitation, Assuit Faculty of Medicine, Al-Azhar University, Egypt
Department of Internal Medicine, Assuit Faculty of Medicine, Al-Azhar University, Egypt
Background; Systemic lupus erythematosus (SLE) is a systemic autoimmune disease that can affect any part of the body. Early detection and quantification of pathological changes are important for assessing the benefits of cardiopulmonary prevention in SLE management. Objective: The aim was to study the effect of SLE on cardiopulmonary system, and its early detection. Patients and Methods: Fifty patients were selected from those attending the outpatient clinics and inpatients who were admitted to Internal Medicine Department of Al-Azhar Assuit University Hospital, from May 2017 to May 2018, and fulfilled the American College of Rheumatology (ACR) 1982 revised criteria for classification of SLE. All patients were subjected to complete history taking, clinical examination, routine investigations, transthoracic echocardiography (Echo) and computed tomography (CT) of the chest. Results: The most common echo finding was pericardial effusion seen in 20 patients (40%), followed by mitral regurgitation in 14 patients (28%), mitral valve prolapse was seen in 13 patients (26%).The most common CT chest findings was ground glass opacity seen in 15 patients (30%) followed by pleural effusion seen in 14 patients (28%) and pleural thickening in 10 patients (20%). There was non- significant correlation between EF% and SLE Disease Activity Index (SLEDAI), but a negative significant correlation between disease duration and EF% (p=0.02). Conclusion: All SLE patients even who have clinically inactive disease should be screened for the presence of structural cardiac and chest abnormalities. Echocardiography and CT chest can be helpful as a noninvasive diagnostic tool for early detection of such abnormalities
https://ejhm.journals.ekb.eg/article_41344_4a8062c8e09b434d89cc40f90b48e75f.pdf
Cardiac changes
pulmonary changes
Systemic lupus erythematosus
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
3
3828
3834
10.21608/ejhm.2019.41345
41345
Original Article
Assessment of The Level of Protein C in Children with Nephrotic Syndrome
Magdy Zaky El Ghannam
1
Ahmed Abd El Moez Ali
2
Mohamed Ibrahim El Samanoudy
3
Ayman Ramadan Kamel
kamelayman896@gmail.com
4
Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University
Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University
Departments of Pediatric and Neonates, Faculty of Medicine, Al-Azhar University
Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University
Background: thromboembolic events remain one of the most serious complications in patients with nephrotic syndrome and this thrombotic tendency could be related to deficiency in natural coagulation inhibitors. Objective: the aim of our study was to estimate P-C quantity &quality in the blood of nephrotic patients for the possible role that it might play in the pathogenesis of thromboembolic complications in these patients & trial to find correlations between P-C & some hemostatic parameters. Patient and Methods: this study was carried out on 60 children (age: 3-13years) were diagnosed as nephrotic patients. They were classified as follow: G1- comprised of 20 cases in relapse, G2- comprised of 20 cases in remission (the same cases of relapse), G3- comprised of 20 healthy children as control group. Results: Our study showed very high significant increase in P-C, both in activity and concentration in relapse but in remission its level decreased towards the normal level but still slightly increased and this increase is statistically nonsignificant. As regard serum albumin and serum total protein, the both were very highly significantly increased in relapse and remission as compared to the control. As regard PT and PTT were found to be highly significant decreased in relapse as compared to the control group. Conclusion: from the foregoing we can concluded that, Increase level of P-C in N.S. denoted that it has no role in thromboembolic complications and Increase level of P-C in N.S may afford some protection against the thrombotic diathesis by counteracting hypercoagulability state.
https://ejhm.journals.ekb.eg/article_41345_d018c2f6635c0105db0a017ff461c6e6.pdf
Protein C
children
nephrotic syndrome