ORIGINAL_ARTICLE
Role of Magnetic Resonance Urography in Diagnosis of Pediatric Obstructive Uropathy: A Surgeon Perspective
Background: Obstructive uropathy is a group of different pathologies. Congenital obstructive uropathy represents a major cause of renal failure in infants and children. Urinary tract obstruction is defined as any condition that impairs urinary drainage from the pelvicalyceal system and leads to increased pressure and reduced urine flow rate.
Objective: The aim of this study was to assess the role of combined static and dynamic Magnetic Resonance Urography in the management of pediatric obstructive uropathy and to compare it with our basic investigations.
Patients and Methods: This study was conducted on the pediatric patients presented to Pediatric Surgery Department in cooperation with Radiology Department, Ain Shams University Hospitals, presented with upper urinary tract dilatation detected by ultrasonograghy.
Results: There was a high agreement between MRU and our standard imaging data as regard detection of urinary tract obstruction giving the MRU no superiority to the basic imaging in this field. Combined MRU showed the highest accuracy among other investigations in identification of the level of obstruction. Dynamic MRU and renal scintigraphy in our study yielded similar results for identification of split renal function.
Conclusion: This study provides evidence that combined static and dynamic MRU is a promising technique that allows anatomical and functional evaluation of obstructed kidneys to be used as a single modality for the comprehensive evaluation of urinary tract obstruction.
https://ejhm.journals.ekb.eg/article_12356_dc1c077b35c9743237f455ceb45914e6.pdf
2018-10-01
5961
5969
10.21608/ejhm.2018.12356
MRU
Obstructive Uropathy
Sameh AbdelHay
AbdelHamid
1
Department of Pediatric Surgery Ain Shams University, Cairo, Egypt
AUTHOR
Khaled AbouelFotouh
Ahmed
2
Department of Radiology Faculty of Medicine, Ain Shams University, Cairo, Egypt
AUTHOR
ORIGINAL_ARTICLE
Futures and the outcome of treatment of poisoned children and adolescents admitted to emergency units in different areas of Saudi Arabia
Background: poisoning is a major problem in the pediatric and adolescents population. Poisoning is a main reason for children’s admission to emergency units. Medications are the most common poisonous agent in children. Objective: to describe the, futures, and the outcome of treatment of poisoned children admitted to emergency units in different areas of Saudi Arabia. Patients and Methods: in this study, analysis of a retrospective data was done. Data were collected from mothers from different cities in KSA, during the period from 1st January to 31 March 2018. Cases of childhood or adolescents poisoning that were experienced by those mothers within the period were included. A structured close-ended online questionnaire was distributed to collect the relevant data. Results: the study included 96 cases. More than third (35.4%) of children aged 4-8 years, < 4 years constituted 24.0% and adolescents were 19.8%. Males were more than females (57.3% vs. 42.7%). Mode of poisoning was accidental in 91.8% and intended in 5.2%. As regards mood of administration of poisoned substance, 86. 5% were by ingestion, 7.3% by inhalation and 6.2% by contact of eyes or skin. The type of poison was spoiled food in 55.2%, cleaning compounds, such as chlorine and others in 12.5%, drugs in 7.3%, insecticide in 6.2%, poisonous herbs in 4.2%, narcotic substance in 1% and other substances in13.5%. Symptoms of poisoning was severe diarrhea ,vomiting and excessive sweating by the same percent 31.2%, severe abdominal pain in 14.6%, breathing difficulties in 13.5%, redness of the eyes in 12.5%, fainting in 8.35 and convulsions in 2.1%. As regards outcome of treatment, 93.8% of the cases were improved and cured completely and the overall mortality rate was 3.1%. Conclusion: Accidental childhood and adolescents poisoning in KSA is just like in many other regions. there is thus, the need for public awareness on the proper storage of harmful materials and the need for immediate hospitalization if accidental ingestion occurs. We strongly recommended for regulatory policies on safe keeping drugs to reduce the morbidity and mortality associated with accidental poisoning.
https://ejhm.journals.ekb.eg/article_12361_c665ca7ae1b9e641e21a1cbb23307964.pdf
2018-10-01
5970
5975
10.21608/ejhm.2018.12361
accidental poisoning
childhood
Adolescents
Outcome
Maha Mukhlef R.
Alanazi
mahamukhlef@gmail.com
1
Faculty of Medicine, Northern Border University, Arar
LEAD_AUTHOR
Turki Habib
AlShammari
2
Faculty of Medicine, Imam Abdulrahman Bin Faisal University, Riyadh,
AUTHOR
Muhannad Mohammed
Alshehri
3
Faculty of Medicine, Imam Abdulrahman Bin Faisal University, Riyadh
AUTHOR
Talal Habib
AlShammari
4
Faculty of Medicine, Imam Abdulrahman Bin Faisal University, Riyadh
AUTHOR
Abdullah Ahmad
Alaradi
5
Faculty of Medicine, Imam Abdulrahman Bin Faisal University, Riyadh,
AUTHOR
Sami Najeeb
Alsagre
6
Faculty of Medicine, Northern Border University, Arar
AUTHOR
Haifa Saeed
Alrumeh
7
Faculty of Medicine, Taibah University, Madinah
AUTHOR
Mohammed Saeed Abdullah
Alqahtani
8
Faculty of Medicine, King Khaled University, Abha, KSA
AUTHOR
ORIGINAL_ARTICLE
The role of prophylactic radiotherapy in prevention of brain metastasis
Despite of these side effects, many studies concluded that the benefits of prophylactic brain radiation in prevention and delaying the spread of cancer overcome its harmful effects. This review aimed to evaluate the literature assessing the role of prophylactic radiotherapy in prevention of metastasis to the brain tissues, measure its incidence and the overall survival rates in patient with lung cancer to provide evidence-based data
Methods:
Electronic search was performed in Medline using Pubmed resulted in 107 eligible studies. The titles and abstracts of all these articles, was screened and based on this reading studies excluded due to irrelevancy or duplication.
Results:
Search of the literature identified total of 107 studies, after exclusion of irrelevant, duplicated and review studies, five studies were included in the review as they met the inclusion criteria. The included studies pointed to assess the effect of prophylactic radiotherapy in avoidance of brain metastasis. All included studies were randomized controlled trials. Total numbers of 1399 patients were recruited in the included studies. Age of patients range from 39 up to 84 years old or more. Small-cell lung cancer was the primary cancer in three of the included studies. One of the included studies assessed patients with non-small cell lung cancer and one study included patients with small cell anaplastic bronchogenic carcinoma.
Conclusions:
The use of prophylactic radiotherapy is effective in reduction of incidence of brain metastasis, but it had no role in rising of the overall survival.
https://ejhm.journals.ekb.eg/article_12364_dda6d0b579e9806cebbaabe036a32935.pdf
2018-10-01
5976
5981
10.21608/ejhm.2018.12364
Brain
Tumor
Radiation
Radiotherapy
Prophylaxis
Jnadi Mohammed Jaber
Madkhali
jnady888@gmail.com
1
Faculty of Medicine, Jazan University, KSA
LEAD_AUTHOR
Khalil Ibrahim Ali
Kariri
2
Faculty of Medicine, Jazan University, KSA
AUTHOR
Ammar Abdullah Othman
Hakami
3
Faculty of Medicine, Jazan University, KSA
AUTHOR
Jubran Mohammed Ali
Abiri
4
Faculty of Medicine, Jazan University, KSA
AUTHOR
Alhassan Mahdi Ali
Kariri
5
Faculty of Medicine, Jazan University, KSA
AUTHOR
Ali Mahdi Ali
Kariri
6
Faculty of Medicine, Jazan University, KSA
AUTHOR
ORIGINAL_ARTICLE
Primipara Mothers who delivered vaginally or by cesarean section, is there an impact on the sexual function?
Background: The strength of the muscles of the pelvic floor and other supporting structures of the pelvic organs are affected by various events that occur during a woman's lifetime. Pregnancy and childbirth have a pronounced influence on maternal anatomy and physiology. Aim of the Work: The aim of the study was to investigate the impact of the mode of delivery on the sexual function (arousal-pleasure-orgasm-desire) -among a representative sample of Egyptian primiparae. Subjects and Methods: This cross-sectional observational comparative study was conducted at Ain Shams University Maternity Hospital during the period between November 2017and July 2018 on 260 women who had single uncomplicated delivery within a duration of not less than 6 months and not more than 2 years from recruitment of the study. Results: Pain was significantly positively correlated to the age [r=0.319, p=0.013] and social class [r=0.276, p=0.028]. Both satisfaction and the overall sexual function score was also significantly positively correlated to social class[r=0.275, p=0.032; r=0.237, p=0.048; respectively]. Pelvic floor muscle strength was poorly correlated to sexual function. Conclusions: The study revealed a significant difference in pelvic floor muscle strength between women who delivered vaginally and those who delivered by Cesarean section. However, there was no significant difference in sexual function between women who delivered vaginally and those who delivered by Cesarean section. Pelvic floor muscle strength was poorly correlated to sexual function. Recommendations: Cesarean section on demand should not be considered as prophylaxis against sexual dysfunction. A larger, nation-wide based study should be performed for assessment of sexual dysfunction among women of different age groups and parities.
https://ejhm.journals.ekb.eg/article_12366_b248978e431bd08f8f409ac1e1468a11.pdf
2018-10-01
5982
5991
10.21608/ejhm.2018.12366
primipara
vaginal delivery
cesarean section
sexual function
Mohamed M.
Al-Sherbiny
1
Department of Obstetrics and Gynecology
AUTHOR
Rehab M.
Abdelrahman
2
Department of Obstetrics and Gynecology
AUTHOR
Amr A.
Riad
3
Department of Obstetrics and Gynecology
AUTHOR
Ahmed M. Adel
Abdelgawad
4
Department of Psychiatry Faculty of Medicine, Ain Shams University
AUTHOR
Mahmoud M.
Elsayed
5
Department of Obstetrics and Gynecology
AUTHOR
ORIGINAL_ARTICLE
Comparative evaluation of hemodynamic stability and recovery during conscious sedation by dexmedetomidine with fentanyl versus ketamine with fentanyl in dilatation and curettage
Background: Conscious sedation is a technique of providing analgesia, sedation and anxiolysis while ensuring rapid recovery without side effects. Conscious sedation is administered with the dual goals of rapidly and safely establishing satisfactory procedural condition for the performance of therapeutic or diagnostic procedures while ensuring rapid, predictable recovery with minimal post-operative sequels. Dexmedetomidine is a highly selective alpha-2 agonist that provides anxiolysis and cooperative sedation without respiratory depression. It inhibits the release of norepinephrine via actions on the alpha2A (α-2A) adrenoceptors located in the locus ceruleus and the spinal cord, resulting in sedation and analgesia via sympatholysis.
Objective: It was to study the effect of dexemdetomidine with fentanyl versus ketamine with fentanyl on hemodynamic stability and recovery during conscious sedation in dilatation and curettage procedure. The comparison included the vital data and recovery time. The effect of the drugs on hemodynamics and monitoring the occurrence of any complication were also done.
Patients and Methods: In our study, 50 patients were randomly divided into 2 equal groups; group DF received dexmedtomidine loading dose 1 μg/kg over 10 min and followed by 0.5 μg/kg/hr infusion till completion of surgery and group KF received ketamine 0.5 mg/kg slow intravenous Bolus.
Results: Dexmedetomidine is a safe drug with good hemodynamic and recovery time, also exerts sedative and analgesic effects without respiratory depression, unlike most analgesic/sedative drugs, such as ketamine, opioids, benzodiazepines, and propofol.
Conclusion: This study demonstrates that dexmedetomidine is a safe drug with good hemodynamic and recovery profile. Dexmedetomidine better preserved MBP and SpO2.
https://ejhm.journals.ekb.eg/article_12367_507b06cef1f913dd12c69359f969635d.pdf
2018-10-01
5992
5997
10.21608/ejhm.2018.12367
Dexmedetomidine
Ketamine
Fentanyl
Gehan Fouad
kamel
1
Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University
AUTHOR
Rania Magdy
Ali
2
Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University
AUTHOR
Ali Elsayed Ali
Ismail
3
Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University
AUTHOR
Beshoy Eshak Aziz
Hanna
beshoyaziz310@gmail.com
4
Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University
LEAD_AUTHOR
ORIGINAL_ARTICLE
Histologic Features of Uterine Septum
Aim of the Work: this study aimed todetect the assessment of the histological features of the uterine septum as regard the proportion of muscle fibers in relation to fibrous tissue to decide the best management whether incision or excision.Patients and Methods: this study was carried out on 16 women with uterine septum in childbearing period complaining of either infertility or recurrent miscarriage fulfilling the inclusion criteria, attending to Ain Shams University Maternity Hospital between May 2017 and April 2018. The septum was incised or excised by scissors or by resectoscope and then specimen was taken from the middle of the septum sample (A) and another specimen from the uterine wall sample (B). The retraction of the septal tissue on both sides was observed. This study included 16 specimens of uterine septum (A) and 16 specimens from uterine wall (B). Histopathological examination was done. Results: there was a statistical significant difference between the uterine septum and uterine wall regarding amount of fibrous tissue, number of cells in the connective tissue, amount of muscle tissue, amount of capillaries and number of vessels with muscle wall (P < 0.05). Poor retraction of the septal tissue was found in the muscular septum in contrast to good retraction that found in the fibrous septum. Conclusion: poor retraction of the septal tissue was found in the muscular septum in contrast to good retraction that found in fibrous septum.
https://ejhm.journals.ekb.eg/article_12369_88a3d8b4879d2a1cd162228e9c7d059f.pdf
2018-10-01
5998
6003
10.21608/ejhm.2018.12369
Histologic Features
uterine Septum
septal tissue retraction
Mohamed Ibrahim Mohamed
Amer
1
Obstetrics and Gynecology Department, Faculty of Medicine, Ain Shams University
AUTHOR
Walid ElBasuony
Mohammed
2
Obstetrics and Gynecology Department, Faculty of Medicine, Ain Shams University
AUTHOR
Ahmed Hefny Abdo Abdo
Hefny
3
Obstetrics and Gynecology Department, Faculty of Medicine, Ain Shams University
AUTHOR
Laila Nabegh Mohammed
Nageeb
4
Pathology Department, Faculty of Medicine, Ain Shams University
AUTHOR
ORIGINAL_ARTICLE
The Effect of Adding Dexmedetomidine or Fentanyl to Levobupivacaine for Ultrasound-guided Supraclavicular brachial plexus block in Upper Extremity Sugeries
Background: Supraclavicular brachial plexus block is one of the most effective anesthetic procedures in operations for the upper extremity. It has gained importance as regional anesthetic technique for surgical, diagnostic and therapeutic purpose in interventional pain management.
Aim: We aimed to study the effect of adding dexamedetomidine or fentanyl to levobupivacaine in ultrasound guided supraclavicular brachial plexus block in upper extremity surgeries as regard to onset and duration of sensory and motor block and postoperative pain.
Methods and Material: The study was carried out in Tanta University Hospital on 90 patients of 18-60 years old with ASA physical status I/II scheduled for elective surgery of upper hand. Patients were divided into three equal groups. Group A: was given 30 ml of 0.5% levobupivacaine with fentanyl 100 µg. Group B: was given 30 ml of 0.5% levobupivacaine with dexamedetomidine 100 µg. Group C: was given 30 ml of 0.5% levobupivacaine with 1ml normal saline. The following data were measured for each patient: hemodynamic status (HR, MAP), onset of sensory and motor block, and duration of sensory and motor block, visual analogue score (VAS) and incidence of complications.
Results: Our results showed that no significant difference between three groups according to hemodynamic changes, while there was significant prolongation in duration of sensory and motor block, significant decrease in VAS score in group B compared to group A and C.
Conclusions: We concluded that the addition of dexmedetomidine was better than fentanyl when both used as adjuvants to levobupivacaine in ultrasound guided brachial plexus block as demonstrated by prolongation of duration of sensory block, improved quality of postoperative analgesia and provide of desirable sedation
https://ejhm.journals.ekb.eg/article_12372_5eabdf07457cba79b949c9a40a03fe29.pdf
2018-10-01
6004
6009
10.21608/ejhm.2018.12372
Supraclavicular brachial plexus–dexmedetomidine-levobupivacaine – upper extremity surgeries
Eissa R.E, Abo-Elnassr
L.M
1
Anesthesiology and Surgical ICU Department, Faculty of Medicine, Tanta University
AUTHOR
Amin S.M.and Mohamed
R.M
2
Anesthesiology and Surgical ICU Department, Faculty of Medicine, Tanta University
AUTHOR
ORIGINAL_ARTICLE
Lidocaine for Pain Control during Intrauterine Contraceptive Device Insertion: A Randomized Clinical Trial
Background: Intrauterine contraceptive device (IUCD) is one of the most common contraception methods. In a survey of female Fellows of the American College of Obstetricians and Gynecologists, the prevalence of personal IUCD use was >20-fold higher than among women in the general population. In statistical terms, The IUCD is used by approximately 15% of reproductive-aged women in developing countries and 8% in developed countries.
Aim of work: To compare the safety and efficacy of different local lidocaine preparations (spray, cream and injection) for reducing pain associated with IUCD insertion.
Patients and Methods: This is a prospective randomized clinical trial. The study was conducted at Ain Shams University Maternity hospital at family planning outpatient clinic during the period between December 2017 and June 2018.
Results: Results proved that lidocaine 10% spray application to the cervix during IUCD insertion effectively reduce pain felt during stages of IUCD insertion and is good option for reduction of pain associated with IUCD insertion in compared with lidocaine injection or cream.
Conclusion: Our study demonstrated that local lidocaine spray 10% is effective in control of pain associated with IUCD insertion when compared with lidocaine cream or injection because its application is easy and rapid, while lidocaine injection can also reduce pain but injection itself is painful that makes it unfavorable method.
https://ejhm.journals.ekb.eg/article_12375_a82df2df74a1b2453a8ad20eca19ec27.pdf
2018-10-01
6010
6020
10.21608/ejhm.2018.12375
Lidocaine – Intrauterine Contraceptive Device Insertion- Levonorgestrel Intrauterine System
Hassan Awwad
Bayoumy
1
Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University
AUTHOR
Gihan El Sayed
El-Hawwary
bluesky201070@yahoo.com
2
Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University
LEAD_AUTHOR
Hadeer Abd El-Shafy
Fouad
3
Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University
AUTHOR
ORIGINAL_ARTICLE
Assessment of Pulmonary Artery Pressure in Chronic Obstructive Pulmonary Disease Patients without Resting Hypoxemia
Background: Chronic obstructive pulmonary disease (COPD) is a disease state characterized by progressive airflow limitation and is associated with an abnormal inflammatory response of the lungs to noxious particles or gases, primarily caused by cigarette smoking. Pulmonary hypertension primarily occurs in COPD patients with severe hypoxemia and fortunately it is typically mild. Hypoxemia increases pulmonary artery pressure (PAP) through hypoxic pulmonary vasoconstriction and vascular remodeling, but there is a correlation between lung function parameters and PAP, suggesting that factors other than airway obstruction and/or loss of alveolar surface may play a role in its etiology.
Objective: The aim of the work was to Identify other factors other than resting hypoxemia contributing to pulmonary hypertension in COPD patients.
Patients and Methods: This study was a prospective study including 80 cases referred to Ain Shams University Hospitals presented with COPD defined using the standard criteria for chronic bronchitis. All patients underwent spirometry with pre and post bronchodilator treatment and trans-thoracic echocardiography.
Results: The results showed that there was significant correlation between right ventricular systolic pressure (RVSP) values and each of the following; age, duration of smoking and degree of airway obstruction which were all contributing to pulmonary hypertension in COPD patients. Among 80 patients, 18 had elevated RVSP value. The mean age of those 18 patients was 58.8 ± 7.78 years while in those with normal RVSP 54.15±10.56 years. Those 18 patients had mean FEV1 percentage of predicted 44.5 ± 12.1% while in those with normal RVSP value 48.72±1.62%. Among those 18 patients 16 had history of smoking for >20 years representing 88.9%. Multivariate analysis showed that among all the studied parameters in our study, degree of obstruction determined by measured FEV1 percentage of predicted is an independent predictor for pulmonary hypertension in stable COPD patients.
Conclusion: It could be concluded that pulmonary hypertension occurs frequently in stable COPD outpatients without resting hypoxemia and that age, duration of smoking and low pre-bronchodilator FEV1 are all risk factors for pulmonary hypertension. And that degree of airway obstruction is an independent predictor for pulmonary hypertension in stable COPD patients.
https://ejhm.journals.ekb.eg/article_12378_804919788d7d5ca700b18b8de7ab7a2a.pdf
2018-10-01
6021
6027
10.21608/ejhm.2018.12378
Pulmonary arterial hypertension
forced expiratory volume in the first second
Right ventricular systolic pressure
Muhammed Ali Mahmoud
Farrag
1
Department of Chest Diseases,Faculty of Medicine, Ain Shams University, Cairo, Egypt
AUTHOR
Mohamed Ali
ElSayed
2
Department of Chest Diseases,Faculty of Medicine, Ain Shams University, Cairo, Egypt
AUTHOR
Alaa Gamal Youssef
El Mashad
alaaelmashad@hotmail.com
3
Department of Chest Diseases,Faculty of Medicine, Ain Shams University, Cairo, Egypt
LEAD_AUTHOR
Ahmed Mohamed
El Mahmoudy
4
Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
AUTHOR
ORIGINAL_ARTICLE
Evaluation of the Effect of Diet Therapy in the Management and Prevention of Acne Vulgaris
Background: Acne is a widespread and complex skin disease among developed nations, affecting nearly all young adults between the ages of 15 to 17 years. It is a chronic inflammatory skin disorder resulting in psychological stress. Historically, the relationship between diet and acne is controversial. As a result, significant studies have been done to evaluate this relationship. Assessment of these literatures will help to provide better outcomes for the patients.
Objective:This study aims to: 1- Measuring effect of diet and nutritional substances in the management and prevention of acne vulgaris. 2- Providing a reference paper analyzing all the clinical studies in this field. 3- Analyzing the last progression has been reached.
Methods: PubMed database was used for articles selection. We included all relevant articles to our review with the following topics (("Acne Vulgaris/diet therapy"[Mesh]) AND ("Acne Vulgaris/prevention and control"[Mesh])) AND ("Acne Vulgaris/therapy"[Mesh]). We excluded other articles which are not related to this field. The data will be extracted according to specific form in which it is going to be reviewed by group members to assess the dietary effect of nutritional substance on acne vulgaris.
Conclusion: We concluded that there are studies that showed promising results among patients and proved that associations do exist.Nevertheless, further studies with bigger sample and better protocols are needed to establish a concrete evidence-based relationship.
https://ejhm.journals.ekb.eg/article_12382_6286d74e060f896bc31ebc385d69df9a.pdf
2018-10-01
6028
6034
10.21608/ejhm.2018.12382
Diet Therapy
Management
prevention
Acne vulgaris
Sultan Mousa
Bakr
1
Prince Mohammad Bin Naser Hospital
AUTHOR
Alshafie Ali
Yahya A
2
National Guard Hospital
AUTHOR
Mohammed Abdulkhaleq
Farea
3
Hadramout University College of Medicine
AUTHOR
Bakr Abobakr
Albrakati
4
Umm Al-Qura University
AUTHOR
Tharaa Waleed
Rambo
5
Umm Al-Qura University
AUTHOR
Fatimah Mustafa
AlShakhs
6
Imam Abdulrahman Bin Faisal University
AUTHOR
Aldhafeer Eman
Saad A
7
Imam Abdulrahman Bin Faisal University
AUTHOR
Rawan Adel
shafaay
8
Almareefa College
AUTHOR
Mahabbat Nadin
Anam A
9
King Saud Bin Abdulaziz University For Health Sciences
AUTHOR
Njoud Ibrahim
Al-Nodali
10
University of Hail
AUTHOR
Yara Mahdi
BinSaleh
11
Alfaisal University
AUTHOR
ORIGINAL_ARTICLE
Risk Factors, Post-operative Complications and outcome of management of Hip Fracture in Arar, Northern Saudi Arabia
Background: Hip fractures are defined as any fracture of the femur between the articular cartilages of the hip joint to 5 cm below the distal point of the lesser trochanter. Hip fracture is a worldwide public health problem that primarily affects osteoporotic individuals and the elderly. Up to 30 % of the elderly patients with a hip fracture die within the first year. Objective: to show the risk factors and post-operative complications of hip fracture in cases attending orthopedic department of Arar Central Hospital in Arar city. Methods: a cross sectional study conducted during the period from 1 December 2017 to 31 March 2018. A predesigned questionnaire was used for data collection, and included inquiries about sociodemographic data of the studied patients, performing muscular exercise, osteoporosis, diminished vision and disorders in equilibrium, causes of fracture, type and site of fracture, occurrence of complications of surgery, postoperative care and the final outcome of treatment. Results: Most (70.1%) of the studied population aged 22-59 years, males constituted 59.8%. Causes of hip fracture were accident in 66.7% and fall in 25.0%. Among hip fracture cases, 43.9% were obese, 13.1% have osteoporosis, and 17.8% have disorders in equilibrium. Males reported insignificant higher percentage of hip fracture than females (25.0% Vs. 18.6%). Osteoporosis, diminished vision, chronic diseases, continuous use of medications and smoking showed significant relation with hip fracture (P<0.05). While BMI, disorders in equilibrium and performing muscular exercise showed insignificant relation. Complications after surgery was osteomyelitis in 12.6%, early fixation failure in 4.2%, wound infections in 8.4% and hospital acquires pneumonia in 4.2%. Only two thirds of the cases were completely cured. Conclusion: in our study population in Arar city, males reported insignificant higher percentage of hip fracture than females. Osteoporosis, diminished vision, chronic illnesses, continuous use of medications and smoking were significant risk factors of hip fracture. Complications after surgery was included, osteomyelitis, early fixation failure, wound infections and hospital acquire pneumonia. Only two thirds of the cases were completely cured, the rest of cases showed disability and movement limitation.
https://ejhm.journals.ekb.eg/article_12387_2b1e245882b74329a870617b17f34039.pdf
2018-10-01
603
6041
10.21608/ejhm.2018.12387
Hip Fractures
risk factors
surgical complications
Outcome
Saud Rteamy R
Alanazi
1
Faculty of Medicine, Northern Border University, KSA
AUTHOR
Malik Azhar
Hussain
2
Assistant professor of surgery, College of Medicine, Northern Border University, Arar, Saudi Arabia
AUTHOR
Hamdan Ayed H
Albathali
3
Faculty of Medicine, Northern Border University, KSA
AUTHOR
Fatimah Khalifah A
Alshammari
4
Faculty of Medicine, Northern Border University, KSA
AUTHOR
Zaid Qati F
Alshammari
5
Faculty of Medicine, Northern Border University, KSA
AUTHOR
Adel Turki D
ALenez
6
Faculty of Medicine, Northern Border University, KSA
AUTHOR
Muaz Bilal Abdulhameed
Wali
7
Faculty of Medicine, Northern Border University, KSA
AUTHOR
Razan Fahad S
Alotayfi
8
Faculty of Medicine, Northern Border University, KSA
AUTHOR
Khalid Nadi M
Alanazi
9
Faculty of Medicine, Northern Border University, KSA
AUTHOR
Bader Arar Shadad
Alruwaili
10
Faculty of Medicine, Northern Border University, KSA
AUTHOR
Abdalla Mohamed Bakr
Ali
apdo3332008@gmail.com
11
Faculty of Medicine, Sohag University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Comparative Study on the Effect of Silver Nanoparticles versus Silver Sulfadiazine in Diabetic Wound Healing in Albino Rat: a Histological Study
Background: the impairment of wound healing in the diabetic patients is an important clinical problem affecting millions of patients worldwide. This significant health care problem still lacks effective therapy. The ideal wound dressing is resistant to external forces and pathogens. It reduces patient discomfort and achieves good cosmetic results. Aim of the work: this study aimed to compare the effect of silver nanoparticlesversus silver sulfadiazine on diabetic wound healing in the adult albino rat. Material and Methods: twenty adult female albino rats were included in this study. The animals were categorized into four groups, 5 rats each: group I (control). Group II (untreated diabetic wound): diabetic rats that left untreated for 15 days of wound excision. GroupIII: diabetic rats in which silver sulfadiazine cream was applied on the wound daily for 15 days after thin skin excision. GroupIV: diabetic rats in which nanosilver-ointment was applied on the wound daily for 15 days after thin skin excision. At the end of the experiment, the specimens were taken and processed for histologicaland immunohistochemical studies. Morphometric and statistical studies were carried out. Results: examination of thin skin sections of nanosilver treated group revealed continuous epidermis with differentiated keratinocytes with proliferating basal layer. The dermis showed increased collagen deposition, decreased p53 and increased VEGF expression compared to SSD treated group. Conclusion: silver nanoparticlescould be more effective than silver sulfadiazine in treatment of the diabetic wound.
https://ejhm.journals.ekb.eg/article_12498_1d10932e97edacc394d5f5b405014c43.pdf
2018-09-04
6042
6051
10.21608/ejhm.2018.12498
silver nanoparticles
silver sulfadiazine
diabetes
wound
Heba Mohamed
Fawzy
1
Histology and Cell Biology Department, Faculty of Medicine, Ain Shams University
LEAD_AUTHOR
Amany
El Shawarby
2
Histology and Cell Biology Department, Faculty of Medicine, Ain Shams University
AUTHOR
Nagwa Kostandy
Kalleny
3
Histology and Cell Biology Department, Faculty of Medicine, Ain Shams University
AUTHOR
Safaa M.
Shaker
4
Histology and Cell Biology Department, Faculty of Medicine, Ain Shams University
AUTHOR
ORIGINAL_ARTICLE
Amniotic Fluid Changes and Doppler Studies in Unexplained Oligohydramnios before and after Intravenous Maternal Hydration
Background: role of intravenous hydration is well documented for the treatment of oligohydramnios. The present study concentrated on the efficacy of intravenous hydration in cases of unexplained oligohydramnios.Aim of the study: this study aimed to evaluate the effect of intravenous maternal hydration (hypotonic and isotonic fluid) in pregnancies with third-trimester oligohydramnios on amniotic fluid index and uteroplacental perfusion and fetal blood flow. Patients and Methods: this study was conducted in the Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Egypt, during the period from January 2017 to January 2018. A total of 60 pregnant women were included and parameters like age, parity, BMI, amniotic fluid index, urine specific gravity, hematocrit value, umbilical artery pulsatility index and uterine artery pulsatility index before and after maternal hydration were noted and compared. Results: intravenous maternal infusion of (1/2) normal saline (0.45%) at a rate of 1000 ml/hr for two hours has statistically difference in the mean amniotic fluid index ,in mean urine specific gravity, in mean umbilical artery pulsatility index and in mean uterine artery pulsatility index immediately after hydration,72 hr and one week after hydration (p<0.05). Conclusions: maternal intravenous hydration with hypotonic fluid can be used in the treatment of oligohydramnios
https://ejhm.journals.ekb.eg/article_12502_3f29ee6b4d654a7984ed9e2f5b7264ef.pdf
2018-09-04
6052
6063
10.21608/ejhm.2018.12502
amniotic fluid index
maternal hydration
oligohydramnios
Abd El Moneim M.
Zakaria
1
Department of Obstetrics and Gynecology,Faculty of Medicine Al-Azhar University
AUTHOR
Abd El Monsef A.
Sedek
2
Department of Obstetrics and Gynecology, Elmenshawy General Hospital
AUTHOR
Nader A.
Abohassan
rare2010@yahoo.com
3
Department of Obstetrics and Gynecology,Faculty of Medicine Al-Azhar University
LEAD_AUTHOR
ORIGINAL_ARTICLE
Assessment of Diclofenac Sodium Infusion for Management of Post-Spinal Shivering
Background: shivering is a common problem faced by an anesthesiologist during intraoperative as well as in postoperative period. It is a frequent, unpleasant, and undesirable complication occurring after sub-arachnoid block (SAB), secondary to vasodilatation as a result of sympathetic blockade. The incidence of shivering has been reported to be about 36-85% after spinal anesthesia. The present study was designed to compare the efficacy of diclofenac sodium and pethidine on reducing postoperative shivering following sub-arachnoid block. Objectives: the aim of this study was to investigate the ability of intravenous infusion of diclofenac sodium (1mg/kg maximally 75mg) to treat established post-spinal shivering. Patients and Methods: after approval from departmental ethics committee in Ain shams university and written informed consent from the patient, a randomized study was conducted on ninety adult patients with American society of anesthesiologists (ASA) physical status I, II and III aged from 18 to 65 years. The study was conducted from September 2017 to February 2018. The study was a randomized, prospective, double-blind, placebo-controlled study. All patients were informed about the study design and objectives as well as tools and techniques. Informed consent was signed by every patient prior to inclusion in the study. Results: after approval of the department of anesthesiology, intensive care and pain management at Ain Shams University ethical committee, this randomized study was conducted on ninety patients who were scheduled to have surgery with spinal anesthesia. The design of the study included three groups, each constitutes of 30 patients (n= 30). Conclusion: the data showed that pethidine infusion was more effective than diclofenac sodium infusion in management of shivering after spinal anesthesia. However diclofenac sodium was better than placebo in non-significant way. Keywords: Diclofenac Sodium Infusion, Post-Spinal Shivering, pethidine infusion INTRODUCTION Shivering is a frequently occurring post-anesthesia complication. It occurs after both general and regional anesthesia. It is estimated to follow more than 40% of all cases receive anesthesia. Shivering is defined as involuntary, spontaneous, oscillatory muscular activity. It is one of main cause of patient discomfort in the immediate postoperative period. Oxygen consumption increases with the intense of shivering. It may resemble a mild exercise but in some severe cases oxygen consumption may rise to 600%. Post-anesthesia shivering may be caused by different factors. It is considered a physiological response to core hypothermia that accompanies anesthesia. Core hypothermia is attributed mainly to redistribution of warm core blood to cold peripheral compartment after peripheral vasodilatation that starts immediately after induction of anesthesia. Other factors help hypothermia include cold room temperature and intravenous fluids used intraoperatively. Other factors that may lead to shivering include transfusion reactions, bacteremia and sepsis and drug reaction(1). The incidence of shivering has been reported to be about 36-85% after SAB. Shivering has detrimental effects like interference in monitoring of pulse rate, blood-pressure (BP), and ECG, increase in oxygen consumption, catecholamine secretion, carbon dioxide production, metabolic rate increase by 400%, increase intraocular pressure (IOP), Intra-cranial pressure (ICP), and lactic acid
https://ejhm.journals.ekb.eg/article_12508_10172753dba3502d0f504b19f01feea3.pdf
2018-09-04
6064
6069
10.21608/ejhm.2018.12508
Sherif Sayed
Sultan
1
Anesthesia, Intensive Care and Pain Management Department, Faculty of Medicine, Ain Shams University
AUTHOR
Ashraf Elsayed
Elagamy
2
Anesthesia, Intensive Care and Pain Management Department, Faculty of Medicine, Ain Shams University
AUTHOR
Mayada Ahmed
Ibrahim
3
Anesthesia, Intensive Care and Pain Management Department, Faculty of Medicine, Ain Shams University
AUTHOR
Mina Magdy
Fakhry
fakhryeeee@gmail.com
4
Anesthesia, Intensive Care and Pain Management Department, Faculty of Medicine, Ain Shams University
LEAD_AUTHOR
ORIGINAL_ARTICLE
Values of Chest Ultrasound and Blood Platelet in Diagnosis and Assessment the Severity of Community Acquired Pneumonia
Background: over the past 15 to 20 years, lung ultrasound has developed as an important modality for the bedside diagnosis of pneumonia both in the Emergency department and intensive care unit (ICU) settings, Platelets play a crucial role in antimicrobial host defenses and the coagulate system, it is hypothesized that an abnormal platelet count may be an important marker to assess severity of disease in patients with community acquired pneumonia (CAP). Aim of the Work: the aim of this study was to evaluate the role of chest ultrasound and blood platelet in diagnosis and assessment the severity of community acquired pneumonia. Patients and Methods: this was a prospective study carried out at Chest Department and Respiratory ICU at El-Hussein University hospital in the period from September 2017 to June 2018. The study included 50 cases of CAP; 29 cases male and 21 cases female with mean age (48.32+15.62 years) admitted at the Chest Department and Respiratory ICU were enrolled in this study after obtaining informed consent. Results: the results of this study revealed that the transthoracic ultrasound can easily detect signs of consolidation and assess the success of pneumonia correlation with CURB 65 SCOR and blood platelet. Conclusion: thoracic ultrasound is a simple, bedside test used for diagnosis of pneumonia can differentiate between simple pneumonia and post stenotic pneumonia, atelectasis and mass. However, it is operator dependent and needs training.
https://ejhm.journals.ekb.eg/article_12513_20f93a3400724095f034764d82e1952e.pdf
2018-09-04
6070
6074
10.21608/ejhm.2018.12513
Thoracic Ultrasound
CURB 65 Scor
Blood Platelet
Hussein Abd El-Fattah
Mohammed
1
Departments of Chest Diseases ,Faculty of Medicine, Al-Azhar University
AUTHOR
Fareed Shawky
Basiony
2
Departments of Chest Diseases ,Faculty of Medicine, Al-Azhar University
AUTHOR
Ahmed Younes Younes
Younes
shafehy100@gmail.com
3
Departments of Chest Diseases ,Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
ORIGINAL_ARTICLE
Retrospective Analysis of Clinico-Epidimological Factors in Prostatic Cancer
Background: Prostate cancer is the second most common cancer in men and the seventh leading cause of male cancer death worldwide. It is a highly heterogenous disease with great variability in its clinical course. Treatment options vary depending on age, stage, and grade of cancer, as well as other medical conditions. Aim of study: In this retrospective study we aimed to provide clinico-epidemiological characteristics of prostate cancer and to present different treatment modalities with respect to OS, DFS and PFS. Patients and Methods: Male patients with localized or metastatic prostate cancer presented to Ain Shams University Hospitals in the period from January 2010, to December 2015. In our study, we reviewed medical records of 101 patients including demographic data and clinic-pathological factors were reported, including age, sex, performance status (ECOG), co-morbidities, personal habits, tumor characteristics, surgery, radical treatment, metastatic treatment, treatment response and survival rates were collected. Results: Our population under study had a median age of 69 years (range: 42-85), majority of our patients (94%) had good ECOG performance status (≤ 2), (44.6%) of the patients were presented to us with metastatic disease, most common symptoms at presentation were prostatism in 72.8% of patients and bony aches in 18.8%. The mean Gleason score among studied population was mean 7.37. 44.6% of the patients were metastatic at time of presentation. Median overall survival in studied population was 31 months, median PFS of the studied group was 17 months and the median DFS 29 months. Conclusion: We provide an overview of patients with prostate cancer in a single tertiary institution in Cairo and it was found that lack of patient awareness in most patients leads to their late presentation at time of diagnosis.
https://ejhm.journals.ekb.eg/article_12518_a1a52d9dc4bc8892d8eeb116d17e0511.pdf
2018-09-04
6075
6081
10.21608/ejhm.2018.12518
Prostate Cancer
Diagnosis
Enzalutamide
salvage
Egypt
Atef Youssef
Reyad
1
Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Ain Shams University
AUTHOR
Mai Mohamed
Ezz El Din
2
Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Ain Shams University
AUTHOR
Nesreen Ahmed
Mosalam
3
Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Ain Shams University
AUTHOR
Walaa Hatem
El Damhogy
walaa_hatem87@outlook.sa
4
Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Ain Shams University
LEAD_AUTHOR
ORIGINAL_ARTICLE
Effect of Maternal Anemia on Fetal Doppler Indices during the Last Trimester of Pregnancy
Background: Anemia is one of the most commonly encountered medical disorders during pregnancy. In developing countries it is a cause of serious concern as, besides many other adverse effects on the mother and the fetus it contributes significantly to high maternal mortality. According to United Nation declaration 1997, anemia is a major public health problem that needs total elimination. It is estimated that globally two billion people suffer from anemia or iron deficiency.Maternal anemia is frequently associated with premature delivery, reduced neonatal weight, infant iron deficiency, neonatal death, and low APGAR scores at 1 min. It is also suspected to reduce the oxygen supply to the growing fetus, leading to the redistribution of fetal blood flow. Objective: The aim of this study was to evaluate the effect of maternal anemia on fetal Doppler indices namely umbilical artery and middle cerebral artery in the last trimester of pregnancy. Patients and Methods: This study was designed as a prospective case control clinical trial carried out in Obstetric outpatient clinics and inpatient ward, Ain Shams University Maternity Hospital on 200 patients. The patients must follow these criteria, gestational age between 28-40 weeks of singleton pregnancy (calculated by their last menstrual period or by earlier ultrasound), fetus is alive and normal fetal ultrasound parameters. Results: The umbilical artery resistance index show a significant increase in moderate severe anemic patients more than control group, umbilical artery pulsatility index show a significant increase in severe anemic group more than the other 3 groups, umbilical artery systolic/diastolic ratio show a significant increase in severe anemic more than the other groups. Finally the umbilical artery cerebral/umbilical artery resistance ratio show a significant increase in severe anemic more than the other groups. Conclusion: GA at delivery in in different groups was matched. i.e. there was no statistical significant difference between different studied groups regarding GA at delivery (P > 0.05). Neonatal ICU admission were 2(4%), 2(4%), 4(8%) and 9(18%) in different groups respectively. There was statistical significant difference between different studied groups regarding Neonatal ICU admission (P < 0.05).
https://ejhm.journals.ekb.eg/article_12519_6c823143d496277f444868334baa4019.pdf
2018-09-04
6082
6089
10.21608/ejhm.2018.12519
red blood cells
hemoglobin concentration
Cerebral/umbilical artery resistance ratio
Abdel-Megeed Ismail
Abdel-Megeed
1
Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University
AUTHOR
Amr Ahmed Mahmoud
Riad
2
Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University
AUTHOR
Shaimaa Mahmoud Mohamed Morsi
Elsherif
drshaymaa1987@yahoo.com
3
Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University
LEAD_AUTHOR
ORIGINAL_ARTICLE
Role of Diffusion Mri In Differentiation Between The Common Pediatric Posterior Fossa Brain Tumors.
Background: Diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) map provide information on MRI about the cellularity of the tumor and have an important role in the pre-operative differentiation of different tumor types. Objective: The aim of this work is to assess the role of diffusion MRI in differentiation between the most frequently encountered pediatric posterior fossa brain tumors. Materials and methods: Twenty-four patients were prospectively included in this study. They were referred from the Neurosurgery Department. All of them were suspected to have posterior fossa SOL according to the contrast enhanced CT. All patients were subjected to conventional MRI followed by diffusion MR imaging and calculation of the ADC values. Results: Twenty-four children (15 females) were included in the study. Their ages ranged between one and fifteen years old with a mean age of six years. Low-and high-grade tumors could be differentiated by using both absolute ADC values and ratios. Low-grade tumors showed statistically significantly higher ADC values (1.69±0.15 vs. 0.80±0.23) and ratios for tumor versus normal cerebellum (2.17±0.30 vs. 1.14±0.33) and tumor versus brain stem (1.88±0.35 vs. 1.06±0.24).The probability of error at 0.05 was considered significant, while at 0.01 and 0.001 was considered highly significant. Absolute ADC values and cerebellar and brainstem ratios were significantly higher in low-grade astrocytomas than in MBs. Overlap was found between ADC values of ATRTs and MBs.The sensitivity and specificity of a cutoff ADC value of > 1.083 x 10-3mm2/s for differentiation of pilocytic astrocytomas from MBs and ependymomas were 100%.The sensitivity and specificity of a cutoff ADC value of ≤ 0.847 x 10-3mm2/s for differentiation of medulloblastomas from PAs and ependymomas were 100%.The sensitivity and specificity of a cutoff ADC value of ≤ 1.083 x 10-3mm2/s and > 0.847 x 10-3mm2/s for ependymomas were 100%. Conclusion: The calculation of ADC value in the solid enhancing portion of a tumor is a simple and reliable technique for preoperative differentiation of the most common posterior fossa tumors.
https://ejhm.journals.ekb.eg/article_12521_33b3bf7decaba5be430fbd36886e231e.pdf
2018-09-04
6090
6096
10.21608/ejhm.2018.12521
DWI
ADC
Posterior Fossa Tumors
HanaaAbdelkader
Ahmeda
1
Radiology Department, Faculty of Medicine, Ain Shams University
AUTHOR
Eman A. F.
Darwisha
2
Radiology Department, Faculty of Medicine, Ain Shams University
AUTHOR
Osama Mohamed
abo-bakrkhattabb
khattabosama@yahoo.com
3
Radiology Department, Basioun Central Hospital,Basioun, Gharbia
LEAD_AUTHOR
ORIGINAL_ARTICLE
Preoperative Prediction of Difficulty of Laparoscopic Cholecystectomy
Background: laparoscopic cholecystectomy (LC), one of the most commonly performed surgical procedures worldwide, is accepted as the gold standard in the treatment of symptomatic gallstones for its minimal invasiveness, less pain and early recovery. Purpose: to predict the difficulty of laparoscopic cholecystectomy in patients according to the recently published scoring system and to add more items to it. Patients and Methods: this is a prospective cohort study. This study took place in Ain Shams University Hospital and Manshiet El Bakry Public Hospital, General Surgery Unit, Surgery Department; the study involved 120 patients admitted with calcular cholecystitis, arranged for laparoscopic cholecystectomy. Results: in our study we found that age, sex and ultrasonographic data were significant predictive factors for assessment preoperatively difficult cases that will be operated upon. We found 14 patients above 50 years who scored to be difficult and very difficult were at outcome difficult, only three patients converted to open surgery over fifty. Conclusion: According to sex males has been described to be associated with difficult LC as in our study that confirmed that as 14 males who participated in our study 10 of them were predicted to have a difficult surgery and 3 expected to be very difficult. Post-surgery 100% of males turned out to have a difficult procedure. Also according to other factors, such as history of acute attacks that increase risk and difficulty due to adhesions at Calot`s triangle and risk of cystic artery and bile spillage, were increased during dissection.
https://ejhm.journals.ekb.eg/article_12525_aec11d4a03967262aef005f60684e284.pdf
2018-09-04
6097
6102
10.21608/ejhm.2018.12525
Laparoscopic cholecystectomy
Acute Cholecystitis
Pancreatic Duct
Hanna Habib
Hanna
1
Department of General Surgery, Faculty of Medicine, Ain Shams University
AUTHOR
Mohamed Ibrahim
Mohamed
2
Department of General Surgery, Faculty of Medicine, Ain Shams University
AUTHOR
Amir Milad
Nazier
amir-1001@hotmail.com
3
Department of General Surgery, Faculty of Medicine, Ain Shams University
LEAD_AUTHOR
ORIGINAL_ARTICLE
Timothy Grass Pollen Sensitization in Asthmatic Egyptian Children
Background: Allergic diseases are considered a major problem for healthcare systems in both developed and developing countries. Longitudinal epidemiologic studies have shown an increased prevalence of sensitization to common allergens, and increased prevalence of asthma, atopic dermatitis, food allergy, and allergic rhinitis in children. The increase in allergies is a phenomenon that is being observed in all fast-developing countries. For a long time, science has taken as a starting point that solely a genetic predisposition is a precondition for the development of an allergy. Today, knowledge of environmental factors that can alter genes or the transcription of genes in the cells, has improved. Aim of the Work: We aimed to investigate the rate of sensitization to Timothy grass pollen in a group of asthmatic Egyptian children in relation to other markers of disease expression. Our ultimate objective was to add information to the map of aeroallergen sensitization in our country. Patients and Methods: This analytical cross sectional study was conducted on children with bronchial asthma following up at the Pediatric Allergy and Immunology Clinic, Children's Hospital, Ain Shams University in the period from September 2017 to March 2018. The sample included 100 asthmatic patients who were enrolled consecutively. Patients were classified into intermittent and persistent Asthma according to the 2009 VA/DoD asthma management guidelines. Results: The current study revealed a high frequency of Timothy grass pollen (TGP) sensitization representing 61% of the studied sample. The diameter of wheal in sensitized children ranged between 3-7 mm with a median (IQR) of 4 (3- 4). None of our subjects had wheal diameter ≥ 8 mm, which denotes severe reaction. In our study, Patients with persistent asthma were more prone to be TGP sensitized (80.3%) than those with intermittent asthma (19.7%). Sensitized children with persistent asthma showed larger wheal diameter (median= 4 mm, range: 4-7 mm) than those with intermittent asthma who showed smaller diameter (median= 3.5 mm, range: 3-4 mm). Conclusion: Sensitization to TGP might point a persistent phenotype of pediatric asthma and may be linked to severity and need to step up and/or add on therapeutic options.
https://ejhm.journals.ekb.eg/article_12729_43028d3b0e074af776c3b86f9334d637.pdf
2018-10-01
6103
6108
10.21608/ejhm.2018.12729
Timothy Grass Pollen Sensitization
Asthmatic Egyptian Children
Elham Mohammad
Hossny
1
Department of Pediatrics, Faculty of Medicine, Ain Shams University
AUTHOR
Hanan Mohamed
Abd El Lateef
2
Department of Pediatrics, Faculty of Medicine, Ain Shams University
AUTHOR
Ahmed Abd El-Hamid Abd El-Hamid
Youssef
ahmedabdelhamidrihan@gmail.com
3
Department of Pediatrics, Faculty of Medicine, Ain Shams University
LEAD_AUTHOR
ORIGINAL_ARTICLE
Preoperative Pregabalin Prolongs Duration of Spinal Anesthesia and Reduces Early Postoperative Pain
Background: Various adjuvants have been used to prolong spinal anesthesia, with the additional advantages of delaying the onset of postoperative pain and reducing postoperative analgesic requirements. Pregabalin is an R-aminobutyric acid analog that binds to the α2-δ subunit of presynaptic voltage-gated calcium channels.
Objective: The aim of this work is to evaluate the efficacy of a single dose of pregabalin in terms of spinal blockade duration and its potential opioid-sparing effect during the first 24 hours postoperatively
Patients and Methods: There were limitations to the present study. First, since only 1 dosage of pregabalin was evaluated, we could not determine the most effective dosage. Second, clinically meaningful improvements in recovery were not assessed. Adequate postoperative pain control provides early postsurgical mobilization, shortened hospitalization, and increased patient satisfaction. Third, preoperative pain and anxiety scores were not recorded. Pregabalin might affect the preoperative pain, mood, and anxiety scores, and these factors can be related to the postoperative pain score.
Results: The mechanisms by which pregabalin premedication prolongs motor and sensory blocks using local anesthetics in spinal anesthesia are not fully understood. There may be several reasons for the prolongation of spinal anesthesia. Gabapentinoids are an r-aminobutyric acid analog that binds to α2-δ subunit of presynaptic voltage-gated calcium channels, and this inhibition decreases postsynaptic excitability by reducing potassium-evoked excitatory transmitter release. These medications provide antiepileptic, anxiolytic, and analgesic features by modulating both GABAergic neurotransmission and calcium influx. Gabapentinoid compounds produce a significant and clinically important improvement in preoperative anxiety scores. Since patients may be anxious in the perioperative period, the anxiolytic effects and euphorigenic effects of pregabalin may be beneficial.
https://ejhm.journals.ekb.eg/article_12730_40599051d78a9dbebb6f1dc404a7f692.pdf
2018-10-01
6109
6114
10.21608/ejhm.2018.12730
Gabapentin
Neuropathic pain
adjuvant antiepileptic drug
Galal Adel Abd-Elrehim
El-Kady
1
Department of Anesthesia, Intensive Care and Pain Management, Ain Shams University
AUTHOR
Safaa Ishak
Ghaly
2
Department of Anesthesia, Intensive Care and Pain Management, Ain Shams University
AUTHOR
Amin Mohammed
El-Ansary
3
Department of Anesthesia, Intensive Care and Pain Management, Ain Shams University
AUTHOR
Ahmed Mohamed
Ismail
ahmedchelse1341991@gmail.com
4
Department of Anesthesia, Intensive Care and Pain Management, Ain Shams University
LEAD_AUTHOR
ORIGINAL_ARTICLE
Non-absorbable versus absorbable tacks in transabdominal preperitoneal laparoscopic repair of inguinal hernia
Background: Groin hernia repair is considered to be one of the most commonly performed operations by general surgeons however, there is no "gold standard" operation for treatment of inguinal hernias. The optimal surgical approach must be selected individually for the patient, considering patient age, hernia size, unilaterality or bilaterality, primary or recurrent status, and type of anesthesia, occupation, and leisure activities. The laparoscopic revolution has increased the debate about the safest and most effective inguinal hernia repair. This revolution has broadened our understanding of inguinal anatomy and hernia repair. At the least, surgeons should be aware of the current indications and contraindications for laparoscopic inguinal hernia repair, because some hernias should have a laparoscopic repair. To increase versatility, surgeons should consider becoming skilled at both techniques, with the understanding that outcomes are optimal if one is committed to achieving expertise in laparoscopic repair.
Objectives: Our objective in this study is to compare the outcome of mesh fixation using non-absorbable tacks versus absorbable tacks in transabdominal preperitoneal (TAPP) laparoscopic repair of inguinal hernia regarding their efficacy and postoperative complications to improve the outcome of patients undergoing surgery for inguinal hernia in Ain Shams University Hospitals.
Patients and methods: The present study is a prospective, randomized comparative study that was conducted in Ain Shams University Hospitals in Egypt, and included sixty (60) patients who had inguinal hernia. The patients were divided into two groups each group including 30 patients. In the first group (Group A) titanium non-absorbable tacks were used and in the other group (Group B) absorbable tacks were used. The patients underwent a trans-abdominal preperitoneal (TAPP) laparoscopic repair of inguinal hernia using prolene mesh. The study was conducted from July 2016 to July 2017, with 12 months of follow-up post-operatively until July 2018.
Results: The mean age of the patients was 36.93 ± 10.23 (19-55) and the mean BMI was 24.83 ± 2.79 (19-32). There was no significant difference between 2 groups as regard preoperative comorbidities. Patients presented mainly with swelling in the groin region 71.67%. Right sided hernia was 46.7% and bilateral hernia was 15%. There was no difference between 2 groups as regard the operative time (p-value=0.056) and intraoperative complications: bleeding (p-value=0.150) and bladder injury (p-value=0.313). Post-operative complications, postoperative hospital stay, time needed to return to normal activity and the recurrence were all alike between the 2 groups. Pain analysis was done four times, and revealed no significant difference between the 2 groups at any time of follow-up.
Conclusion: Both non-absorbable tacks and absorbable tacks used in mesh fixation are similarly effective in terms of operative time, the incidence of recurrence, complications and pain at least in the first year of follow up, but it may be less painful after one year after the complete absorption of the absorbable tacks but this needs further investigations and studies containing more patients and with follow-up for longer time.
https://ejhm.journals.ekb.eg/article_12731_46a856ec628a5761067bfec36d6eff10.pdf
2018-10-01
6115
6121
10.21608/ejhm.2018.12731
laparoscopic hernia repair
Transabdominal preperitoneal hernia repair
Non-absorbable tacks
Titanium tacks
Absorbable tacks
Postoperative pa
Ayman Abd-Allah
Abd-Rabu
1
General Surgery Department, Faculty of Medicine, Ain Shams University
AUTHOR
Mahmoud Saad
Farahat
2
General Surgery Department, Faculty of Medicine, Ain Shams University
AUTHOR
Haitham Mostafa
Elmaleh
3
General Surgery Department, Faculty of Medicine, Ain Shams University
AUTHOR
Dina Hany
Ahmed
4
General Surgery Department, Faculty of Medicine, Ain Shams University
AUTHOR
Ehab Mohammed Ali
Fadl
ehab.fadl@yahoo.com
5
General Surgery Department, Faculty of Medicine, Ain Shams University
LEAD_AUTHOR
ORIGINAL_ARTICLE
Uncomplicated Laparoscopic Cholecystectomy to Drain or not to Drain
Background: gallstones are present in about 10% to 15% of adult population. Between 1% and 4% of these adults become symptomatic every year.Laparoscopic cholecystectomy first performed by philippe Mouret in Lyon, Francein the late 80s, has gained acceptance at the standard of care for patients requiring cholecystectomy. Laparoscopic cholecystectomy provides a safe and effective treatment for most patients with symptomatic gall stones. Laparoscopic cholecystectomy for acute cholecystitis is mainly performed after the acute cholecystitis episode subside because of the fear of higher morbidity and need for conversion from laparoscopic to open cholecystectomy.
Aim of the Work: the need for routine abdominal drainage in uncomplicated laparoscopic cholecystectomy. Benefits and harms of intra abdominal drains in uncomplicated laparoscopic cholecystectomy.
Patients and Methods: the study included 50 patients from Al Azhar University Hospital and with chronic calcular cholecystitis in period from February 2016 to June 2018. They were randomly assigned into one of the two study groups: Group I: with tubal drains; Group II: without drains. The later group wasn’t selected except after making sure that a drain is not required by the operating surgeon. Patients were selected on the basis of the following criteria.?? Ethical approval from local ethical committee of surgery department was obtained.
Results: data obtained from the present study were selected statistically analysis computed using SPSS. Continuous data were expressed in the form of mean + SD while categorical data were expressed in the form of count and percent. Comparison of continuous data was performed utilizing student t test, while categorical data were done using chi-square test. P value less than 0.05 was considered statistically significant. In group A (with drain) according to the sex is arranged as 7 male patients and 18 female patients, according to the age is arranged between 23-60 years and according to BMI is arranged between 18-30 (kg/m2) in group B (no drain) according to the sex is arranged as 5 male patients and 20 female, according to the age is arranged between 25-60 years and according to the BMI is arranged between 20-35(kg/m2). No statistically significant differences between the two studied groups according to domographic data.
Conclusion: use of drain didn't result in reduction of postoperative complications. It was also associated with prolonged operative time, higher pain levels and longer hospital stay.
https://ejhm.journals.ekb.eg/article_12732_80219e7311dbb8df8c25872a5b98daae.pdf
2018-10-01
6122
6127
10.21608/ejhm.2018.12732
Uncomplicated Laparoscopic Cholecystectomy
pneumoperitoneum
Selim Said Abdel-Rahman
EL-Nemr
1
General Surgery Department, Faculty of Medicine, Al-Azhar University
AUTHOR
Ahmed Mohamed
El-Sayed
2
General Surgery Department, Faculty of Medicine, Al-Azhar University
AUTHOR
Abdel-Galeel Kamal Abdel-Galeel
Elwany
surgelwany41@gmail.com
3
General Surgery Department, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
ORIGINAL_ARTICLE
Role of diffusion weighted and perfusion weighted imaging in characterization of ovarian tumours
Background: ovarian cancer is the second most common gynecological cancer and the fifth most common cancer in women. Proper management depends on proper preoperative assessment with the help of clinical examination, laboratory tests and different imaging modalities. Radiological evaluation includes ultrasonography (US), computed tomography (CT) and recently magnetic resonance imaging (MRI). Diffusion weighted imaging (DWI) has been established as a useful functional imaging tool in neurologic applications for a number of years, but recent technical advances now allow its use in abdominal and pelvic applications.
Purpose: it was to evaluate the role of diffusion weighted and perfusion weighted MRI imaging in the characterization of ovarian tumours and differentiation between benign and malignant tumours.
Patients and Methods: this study was performed on 24 patients. All patients had US finding of solid or complex adnexal lesions.
Results: DWI & dynamic MRI are significant promising tool factors for characterization of ovarian tumours and differentiation between benign & malignant lesions with high sensitivity, specificity. The sensitivity, specificity and accuracy of detection of the nature of the lesions. Have been increases after adding of DWI & DCE-MRI to the conventional imaging.
Conclusion: Adding of DWI & DCE-MRI to the conventional MRI improves the sensitivity and specificity of diagnosis and allows confident diagnosis and differentiation between benign and malignant lesions.
https://ejhm.journals.ekb.eg/article_12733_d756a372399daec6e5233a749c97c44d.pdf
2018-10-01
6128
6135
Ovarian tumours
MRI
DWI
ADC
DCE
TTP
MRE%
SI max
Randa Hussein
Abdallah
1
Radiodiagnosis Department, Ain Shams University, Cairo, Egypt
AUTHOR
Nermeen Nasry
Halim
2
Radiodiagnosis Department, Ain Shams University, Cairo, Egypt
AUTHOR
Eman Sameh
Hussein
eman_smh@yahoo.com
3
Radiodiagnosis Department, Ain Shams University, Cairo, Egypt
LEAD_AUTHOR
Eman Ahmed
Fouad
4
Radiodiagnosis Department, Ain Shams University, Cairo, Egypt
AUTHOR
ORIGINAL_ARTICLE
Role of Endovenous Laser Ablation versus Radiofrequency Ablation for Primary Varicose Veins
Background: varicose veins, a common problem with effects on quality of life, account for a significant cost burden on the health care system. They are enlarged, tortuous, subcutaneous veins that commonly occur in the legs. Varicose veins are caused by faulty valves and decreased elasticity in the vein walls, which allow blood to backflow and pool. This is known as venous reflux. The affected veins enlarge and appear as green, dark blue or purple protrusions just below the skin’s surface.
Objective: in this study we aimed to compare short term outcomes and postoperative short term complications between EVLA and RFA.
Patients and Methods: this is an observational prospective study. It was carried out in General Surgery department and Vascular Surgery unit at Ain Shams Hospitals and in Kahraba hospital for Research and Treatment.
Results: there was no significant difference between radiofrequency powered segmental ablation and endovenous laser ablation according to demographic data.
Conclusion: there was no significant difference between radiofrequency powered segmental ablation and endovenous laser ablation according to demographic data.
https://ejhm.journals.ekb.eg/article_12734_1710cec085534d78a19d2be2aa330675.pdf
2018-10-01
6136
6142
10.21608/ejhm.2018.12734
varicose veins
endovenous laser therapy
Radiofrequency
Hesham Adel Alaa El-Diin
Alaa El-Diin
1
Department of General Surgery, Faculty of medicine, Ain Shams University
AUTHOR
Hesham Mohamed
Omraan
2
Department of General Surgery, Faculty of medicine, Ain Shams University
AUTHOR
Mohamed Ahmed Abd El-Moniem
Hagag
hagagmohamed369@gmail.com
3
Department of General Surgery, Faculty of medicine, Ain Shams University
LEAD_AUTHOR
Amr Nabil
Kamel
4
Department of Vascular Surgery, Faculty of medicine, Ain Shams University
AUTHOR
ORIGINAL_ARTICLE
A prospective study of the latero-central glandular pedicle technique as an oncoplastic procedure for medial quadrants breast masses:oncological safety and clinical outcomes
Background: breast cancer, according to national cancer institute, is the most common site of cancer in women in Egypt as it accounts for about 38.8% of total malignancies among Egyptian females; it is an important cause of mortality among women. For many women with stage 1 or 2 breast cancer, the combination of partial mastectomy and radiation therapy – together referred to as breast- conserving therapy is preferable to total mastectomy because breast conserving surgery survival rates is equivalent to those after mastectomy while preserving the breast. Aim of the work: this study aimed to focus on the latero-central glandular pedicle technique as an oncoplastic procedure for management of medial breast cancer and to assess the technique clinically regarding oncological safety, surgical outcomes and patient satisfaction. Methods: this was a prospective analytical study that included 15 patients aiming to clinically assess the centro-lateral oncoplastic technique for both inner quadrants of breast cancer regarding oncological safety and patient satisfaction. This study was conducted at Ain-Shams University Hospitals. Approval of the Ethical Committee and written informed consent from all participants was obtained. Results: in our study we were able to conduct an excellent cosmetic outcome for a relatively large tumor excisions with 66% of the cases (10 patients) falling in excellent and very good score groups with mean cosmetic outcome score 4.26. Another 20% (3 cases) which fall in good and fair score groups as those two patients noticed asymmetry of the two breasts in front of the mirror as they refused bilateral breast reduction mastopexy. None of our cases have had a poor or an ugly score. Conclusion: the combination of plastic surgery techniques with breast oncology surgery gives the surgeon a new tool for treatment of breast cancer. This approach has enabled us to increase the number and extend the indications of breast conserving surgery with wider margins offering safer oncologic control with more satisfactory cosmetic outcome.
https://ejhm.journals.ekb.eg/article_12735_4ce52fdb8626421415c8e3e69cf3be91.pdf
2018-10-01
6143
6148
10.21608/ejhm.2018.12735
Ayman Ahmed
Talaat
1
General Surgery Department, Faculty of Medicine, Ain Shams University
AUTHOR
Ahmad Gamal El Din
Osman
2
General Surgery Department, Faculty of Medicine, Ain Shams University
AUTHOR
Niveen Fathy
Al Mahmoudy
3
General Surgery Department, Faculty of Medicine, Ain Shams University
AUTHOR
Mohammed Mostafa
Ali
4
General Surgery Department, Faculty of Medicine, Ain Shams University
AUTHOR
ORIGINAL_ARTICLE
Correlation between Axial Length and Macular Thickness in Myopia
Background: Myopia is the most common error of refraction and, in many countries; complications related to high myopia are a major cause of blindness. The prevalence of myopia has been reported as high as 70–90% in some Asian countries, 30–40% in Europe and the United States, and 10–20% in Africa. Myopia, which is measured in diopters, has also been classified by degree. Low myopia usually describes myopia of −3.00 diopters or less. Medium myopia usually describes myopia between −3.00 and −6.00 diopters. High myopia usually describes myopia of −6.00 or more. Roughly 30% of myopes have high myopia.
Aim of the Work: To correlate macular thickness in the different degrees of axial myopia.
Subjects and Methods: Cross sectional study assessing 40 myopic eyes of 22 subjects. They were subdivided according to axial length into two groups: Group A (low myopes) 20 myopic eyes with their axial length between 24-26.5mm.Group B (high myopes) 20 myopic eyes with their axial length above 26.5mm. Cases were selected from the outpatient clinic of the Al-Azhar University Hospitals. All were above eighteen years of age. Each patient was subjected to a full clinical examination, refraction, axial length assessment by IOL master and macular thickness determined by Swept source OCT.
Results: The study revealed a highly significant negative correlation between axial length and macular thickness in all quadrants except foveal thickness which is non-significant positive correlation (an increase in thickness with increasing axial length). Macular thickness was significantly less in high myopes than low myopes except in the fovea. The spherical equivalent was significantly negatively correlated with increasing axial length.
Conclusion: In this study macular thickness in myopes was correlated with axial length. A significant negative correlation was found between increasing axial length and macular thickness in all quadrants of the macula except for the fovea. As the degree of myopia increased the average overall thickness of the macula decreased. No significant correlation was found between the foveal thickness and axial length.
https://ejhm.journals.ekb.eg/article_12736_33025a9099833f7c25a3a6dc580da9f6.pdf
2018-10-01
6149
6156
10.21608/ejhm.2018.12736
Myopia
Axial length
Macular Thickness
OCT
Mahmoud A.
Rabea
1
Department of ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Sayed M.
Al sayed
2
Department of ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Mohammad H.
Abdel Zaher
drmohamadhanafy2@gmail.com
3
Department of ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
LEAD_AUTHOR
ORIGINAL_ARTICLE
Tranexamic Acid for Prevention of Postpartum Hemorrhage after Vaginal Delivery
Objective: To assess the efficacy of tranexamic acid in reduction of blood loss and pervention of postpartum hemorrhage after vaginal delivary. Methods: This is a multicentric prospective randomized double blind placebo controlled trial. 200 pregnant women were randomized to receive either 60 mg/kg of tranexamic acid (TA) (n=100) or placebo (n=100) intravenously in the second stage of labour. Postpartum blood loss was collected and measured accurately from placental delivery to 2 hours postpartum and adverse effects of were observed. Results: The mean estimated postpartum blood loss was significantly lower in women treated with tranexamic acid compared to women in the placebo group ( 442.50 ± 128.55 versus 555.75 ± 191.88, respectively; p < 0.001), and the proportion of women in the tranexamic acid group who had an estimated blood loss ≥ 500 mL was significantly lower than in the placebo group( 3 [3 %] versus 9 [9%],relative risk [RR]=0.30; 97% confidence interval [CI] 0.11 to 0.78;P<0.05). Maternal and neonatal outcomes did not differ significantly between both groups. Conclusion: The addition of tranexamic acid to the active management of third stage of labor after normal vaginal delivery is effective as a prophylaxis against post-partum hemorrhage. It can significantly reduce blood loss during and after delivery.
https://ejhm.journals.ekb.eg/article_12737_04cd12270aa91f24021230b11f8df64a.pdf
2018-10-01
6157
6164
10.21608/ejhm.2018.12737
Tranexamic acid
postpartum haemorrhage
blood loss
Esmail Talaat
El-Garhy
1
Department of Obstetrics and Gynaecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Ashraf Hamdy
Mohamed
2
Department of Obstetrics and Gynaecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Ashraf
Elshahat
3
Department of Obstetrics and Gynaecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Ibrahim
Abu Elmagd
4
Department of Obstetrics and Gynaecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
AUTHOR
Mohamed Awad Allah
Hamed
moda6366@gmail.com
5
Department of Obstetrics and Gynaecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
LEAD_AUTHOR
ORIGINAL_ARTICLE
Multifocal Electroretinogram changes after intravitreal injection of Anti VEGF for Diabetic Macular Edema in correlation to visual acuity and optical coherence tomography
Back ground: compared to laser photocoagulation, intra vitreal injection of anti-vascular endothelial growth factors (Anti VEGFs) have more desirable results and less complication. Study of this issue by multifocal electroretinogram (mf-ERG) revealed significant improvement in macular function associated with decreased retinal thickness using optical coherence tomography (OCT) and improvement of best corrected visual acuity (BCVA). Aim of the Work: to study the role of multifocal Electroretinogram in the follow up of diabetic macular edema after intravitreal injection of Anti vascular endothelial growth factors (Anti-VEGFs) and study its correlation to visual acuity and optical coherence tomography changes. Patients and Methods: a non-randomized prospective study was carried out from February 2018 to August 2018 on thirty eyes of patients with diffuse or focal DME without macular ischemia. The patients were selected from the outpatient ophthalmology clinic of Al-Hussein University hospital. The patients were injected intravitreally by anti VEGF Ranibizumab 0.5 mg / 0.05 mL at baseline, 1 and 2 months. In this study we assessed pre and post-injection BCVA, IOP measurement by applanation tonometer, OCT and multifocal ERG changes over 3 months. Results: log MAR BCVA improved from (0.88±0.12) preoperatively to (0.53±0.18) at the end of the 3rd month, with P-value <0.001. Central subfield thickness 1 mm improved from (408.73±79.40 µm) preoperatively to (224.33±32.49 µm) at the end of the 3rd month, while para and peri-foveal thickness improved from (402±46.52 µm) preoperatively to (286.30±32.67 µm) at the end of the 3rd month, with Pvalue <0.001. P1 amplitude in ring 1 using MF-ERG improved from (33.08±10.59 nv/deg2) preoperatively to (58.30±32.67 nv/deg2) at the end of the 3rd month, with P-value<0.001. P1 amplitude in ring 2 using MF-ERG improved from (18.82±5.01 nv/deg2) preoperatively to (26.36±3.006 nv/deg2) at the end of the 3rd month, with P-value in the 1st month <0.05, while in the 3rd month <0.001. P1 implicit time in ring 1 using MF-ERG improved from (78.65±12.37 ms) preoperatively to (63.78±15.73 ms) at the end of the 3rd month, with P-value in the 1st month <0.05, while in the 3rd month <0.001. P1 implicit time in ring 2 using MF-ERG improved from (48.81±6.44 ms) to (44.39±4.06 ms) at the end of the 3rd month, with P-value in the 1st and 3rd months <0.05. Complications during follow up of patients especially 1 week after injection were relatively uncommon, including mild subconjunctival haemorrhage in 1 eye (3.3%) and transient increase of IOP in 4 eyes (13.33%). Conclusion: intravitreal injection of Anti-VEGFs especially Ranibizumab resulted in improvement of macular function in study patients with diabetic macular edema. Postoperative improvement in visual acuity was accompanied by decreased retinal thickness measured by OCT and improvement of P1 amplitude in the central ring measured by MF-ERG.
https://ejhm.journals.ekb.eg/article_12739_f73774c3f663f225ebfab32c2ebb22e6.pdf
2018-10-01
6165
6175
10.21608/ejhm.2018.12739
anti-VEGF
Multifocal Electroretinography
Diabetic Macular Edema
Magdy
E. Tawakol
1
Department of ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Hossam Eldin
A. Ziada
2
Department of ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Amr R.
Mahmoud
amrradi053@gmail.com
3
Department of ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
LEAD_AUTHOR
ORIGINAL_ARTICLE
Vardenafil versus Tamsulosin as a Medical Expulsive Therapy for Distal Ureteral Stones
Background:urolithiasis is one of the most common diseases of the urinary tract. The lifetime prevalence of urinary stones is around 1% to 15% and the peak age of incidence is at 30 years. Men are affected 2 to 3 times more often than women. Ureteral stones account for 20% of the calculi in urolithiasis and about 70% of ureteral stones are present in the distal third of the ureter at the time of presentation. Aim of the work: this study aimed to compare the efficacy and safety of vardenafil (5mg twice daily) vs tamsulosin (0.4mg once daily) as a medical expulsive therapy in the management of distal ureteric stones (DUS) in terms of stone expulsion rate, stone expulsion time, number of pain episodes, analgesic use and side effects related to medical therapy. Patients and Methods: this was a prospective randomized comparative study conducted on 50 patients admitted through the outpatient Urology Clinic in Ain shams University Hospitals and Nasser Institute Hospital between February 2018 and August 2018. The patients were randomized using a closed envelope method. The patients were categorized into 2 main groups 25 patients each. Results: this study showed non significant stone expulsion rates and faster expulsion times in favor of vardenafil when compared to tamsulosin. Conclusion: both of the medications demonstrated a good safety and tolerability profile for medical expulsive therapy in patients with lower ureteric stones.
https://ejhm.journals.ekb.eg/article_12738_3081220743daeba10c382771945504f2.pdf
2018-10-01
6176
6181
10.21608/ejhm.2018.12738
vardenafil
Tamsulosin
distal ureteral stones
Amr Fekry
Elshorbagy
1
Department of Urology, Faculty of Medicine, Ain Shams University
AUTHOR
, Karim Omar
El Saeed
2
Department of Urology, Faculty of Medicine, Ain Shams University
AUTHOR
Mohammed
Mohammed
mohamedzaghlolokla@gmail.com
3
Department of Urology, Faculty of Medicine, Ain Shams University
LEAD_AUTHOR