ORIGINAL_ARTICLE
Serum Chemerin Level as Biomarker for Renal Dysfunction in Type II Diabetes
Background: Type 2 diabetes mellitus is the most common form of diabetes. Millions of patients worldwide have been diagnosed as type 2 diabetes and many more are unaware they are at high risk. It represents a major public health threat and constitutes an important contributor to the predicted decline in life expectancy. Objective: The aim of the present work was to evaluate serum chemerin level and its association with kidney functions in patients with type 2 diabetes mellitus. Patients and methods: This case control study was conducted at Clinical Pathology Departments of Al-Azhar University Hospitals. It was carried out on 80 subjects of matched age and sex divided as 60 type 2 diabetic patients and 20 apparently healthy volunteers (hospital staff) serving as control group. Results: In a correlation study between serum chemerin and other studied parameter in diabetic patients, a significant positive correlation was found between serum levels of chemerin, FBS, ACR, serum creatinine, serum urea, fasting insulin, HOMA-IR index and BMI. On the other hand, a highly significant negative correlation between serum chemerin and eGFR was observed in patients' group. Furthermore, we evaluated the diagnostic performance of chemerin for discriminating patients with macroalbuminuria from those without. The best diagnostic cutoff for chemerin was 100.1 ng/mL. This had a diagnostic sensitivity of 85%, specificity 75%, negative predictive value 63%, positive predictive value 90.9%. The area under the curve (AUC) was 78.3%. Conclusion: These findings suggested that serum chemerin can be used as a predictive marker for diabetic nephropathy.
https://ejhm.journals.ekb.eg/article_49549_7b15c4d072df0bc860f9ecfeb1ad2050.pdf
2019-10-01
5081
5088
10.21608/ejhm.2019.49549
Serum chemerin
Renal dysfunction
Type 2 diabetes mellitus
Ahmed Mohammed Abdel- Rahman
Tahoun
1
Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University
AUTHOR
Ahmed
Abdou El lawah
2
Department of Internal Medicine, Faculty of Medicine, Al-Azhar University
AUTHOR
Magdy Abdel-kareim
EL dahshan
3
Department of Internal Medicine, Faculty of Medicine, Al-Azhar University
AUTHOR
Ahmed Mohammed El sayed
Shalaby
drahmedshalaby1981@yahoo.com
4
Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
ORIGINAL_ARTICLE
The Role of Midkine in Breast Cancer
Background: Breast cancer (BC) is the most frequently diagnosed life-threatening cancer in women and the second leading cause of cancer death among women worldwide. The present conventional clinicopathological factors remain insufficient to evaluate the substantial prognosis of this disease. Midkine is a heparin-binding growth factor. It is upregulated in many types of cancer. Aim of the work: The aim of this study was to through light on the role of serum midkine level in breast cancer patients and its relation to the conventional tumor marker CA 15-3. Subject and method: This study was conducted on 40 newly diagnosed breast cancer patients (Group I) and 20 apparently healthy control subjects (Group II). Complete history, clinical examination, mammography and histopathological examination of breast cancer with immunohistochemical study were performed. Serum midkine level was assessed by double antibody sandwich assay technique(ELISA) by using human midkine ELISA kit also CA 15-3 level was assessed by using an automatic immune assay analyzer (TOSOH AIA system). Results: The present study revealed a statistically significant difference between breast cancer patients (Group I) and healthy control (Group II) regarding serum midkine level. Serum midkine level showed a statistically significant difference with stage of breast cancer, menopausal status and CA 15-3 serum level. There was no statistically significant difference regarding age, family history of breast cancer, parity, breastfeeding and history of oral contraceptive pills (OCPs) intake. Conclusions: This study showed that midkine might be a diagnostic and prognostic biomarker for breast cancer.
https://ejhm.journals.ekb.eg/article_49550_d329f2105c890027aa8eeba976bf17fe.pdf
2019-10-01
5089
5095
10.21608/ejhm.2019.49550
breast cancer
Midkine
ELISA
Immunoassay
CA 15-3
Walaa M.
Hadida
walaa.hadida@gmail.com
1
Department of Clinical Pathology, Faculty of Medicine – Tanta University
LEAD_AUTHOR
Dina A.
Ali
2
Department of Clinical Pathology, Faculty of Medicine – Tanta University
AUTHOR
Ayman A.
ELnemr
3
Department of Surgical Oncology Faculty of Medicine – Tanta University
AUTHOR
Hanaa E.
Nofal
4
Department of Clinical Pathology, Faculty of Medicine – Tanta University
AUTHOR
ORIGINAL_ARTICLE
Anti-Mullerian Hormone as A new Marker for Diagnosis of Poly Cystic Ovary Syndrome
Background: Polycystic ovary syndrome (PCOS) is a complex disease characterized by various endocrine disorders that are the potential cause of anovulation and hyperandrogenism. This heterogeneous syndrome affects about 5– 10% of reproductive-age female population and it can be considered the most common endocrine disorder affecting women during reproductive life. PCOS is a multifactorial polygenic disease. Genes that regulate steroidogenesis and folliculogenesis are interested. Hence, AMH measurement has been found to offer a relatively high specificity and sensitivity as a diagnostic marker. Objectives: The study aimed to assess the accuracy of AMH in the prediction of PCOS in patients admitted to Elsayed Galal and El Hussein University Hospital. Subjects and methods: This was a retrospective study that was done on 130 women, divided into two groups, group I include 100 PCOS patients and group II, 30 control subject. Results: The results of this study showed that there was no significant difference between the two groups regarding age, while there was a significant increase in BMI in patients more than in control. The level of LH showed a significant increase in patients more than in the control. The level of FSH showed a significant decrease in patients less than in the control. The Testosterone showed a significant increase in patients more than in the control. The androstenedione showed a significant increase in patients more than in the control group. The AMH showed a highly significant increase in patients more than in the control and in turn the number of follicles in group II (patients) was significantly higher than in the control. The sensitivity of AMH in diagnosis PCOS was 98.0, specificity was 80.0% and the total accuracy was 93.0 at the cutoff of point 0.911. Conclusion: Additional advantages of AMH as diagnostic tool are that it is biological, objective, quantitative marker not affected by day of menses or OCP intake. So in future, more studies should be undertaken to validate its role as diagnostic tool for PCOS.
https://ejhm.journals.ekb.eg/article_50261_4096c27a2878469496343690e3ee31cb.pdf
2019-10-01
5096
5100
10.21608/ejhm.2019.50261
Anti Mullerian Hormone
Diagnosis
Poly Cystic Syndrome
Abdel Monieum Mohamed
Zakaria
1
Department of Obstetrics and Gynecology, Faculty of Medicine Al-Azhar University
AUTHOR
Ahmed
Osama
2
Department of Obstetrics and Gynecology, Faculty of Medicine Al-Azhar University
AUTHOR
Ahmed Kamal Mohamed
Abo Sheashea
3
Department of Obstetrics and Gynecology, Faculty of Medicine Al-Azhar University
AUTHOR
ORIGINAL_ARTICLE
Role of Speech-Language Pathologist in Pediatric Corrosive Ingestion in Zagazig University Children Hospital
Background: Pediatric corrosive ingestion injuries represent a significant proportion of total ingestion injury annually. Medical and surgical advancements over the past five decades led to significant reductions in mortality. Optimal treatment of children with ingestion injuries requires a multi-skilled team approach. Objective: The aim of the work was to assess the effects of corrosive ingestion in children and to determine the role of speech-language pathologist. Patients and methods: This cross section study was conducted on 52 patients with corrosive ingestion. The patients were admitted at Zagazig University Children Hospitals from February 2018 to February 2019. Results: Our results showed that there was high significant relation between impaired oral intake and period of admission, PICU admission, days to initiate oral feeding and grade of mucosal injury. Also, there was high significant relation between fluid, semisolid and solid dysphagia and oropharyngeal mucosal injury. Also, there was a high significant relation between oesphageal mucosa grading of injury and oropharyngeal mucosal injury. Conclusion: Children admitted to hospital with severe ingestion injury to the oral cavity, oropharynx and esophagus had significant and sustained delay in the recovery of effective PO intake milestones, with many requiring ongoing gavage feeding at hospital discharge.
https://ejhm.journals.ekb.eg/article_50262_f37cc9ce14a5ef9b751b925c870931bf.pdf
2019-10-01
5101
5108
10.21608/ejhm.2019.50262
Speech-Language Pathologist
Pediatric Corrosive Ingestion
Hatem Mohammed
Hussein
1
Department of Pediatrics, Faculty of Medicine, Zagazig University
AUTHOR
Hossam Fathy
El-saadany
2
Department of Pediatrics, Faculty of Medicine, Zagazig University
AUTHOR
Elham Magdy
Hafiz
3
Department of Phoniatrics, Faculty of Medicine, Zagazig University
AUTHOR
Mahmoud Gamal-eldeen Mohamed
Mohamed
m.g.abasy@gmail.com
4
Department of Pediatrics, Faculty of Medicine, Zagazig University
LEAD_AUTHOR
ORIGINAL_ARTICLE
Pregnancy Outcome in Women with Previous One Cesarean Section, Experience from Kingdom of Saudi Arabia
Objectives: The aim of this study is to determine the outcome of pregnancy in women with previous one cesarean section as successful trial of scar and vaginal delivery, and repeated caesarian section. Methodology: This is a retrospective cohort hospital-based study was conducted in Maternity and Children Hospital AlHASA. Included booked women and non-booked pregnant women and had previous one cesarean section. Data were collected from delivery room log book and medical files when more details were required. Those who were eligible for the study were 299 women who underwent comprehensive analysis. Main results: The successful vaginal delivery was (73.9%). No reported cases of maternal mortality or morbidity. However, there were tender scar with no dehiscence or rupture uterus (4 %). No neonatal mortality, however, 6% of the CS were indicated by fetal distress. There was statistically significant association between gestational age and fetal weight (P < 0.01) and between the gestational age and Apgar score (P < 0.01). Significant results was found between outcome and previous successful vaginal birth after cesarean (VBAC) (P < 0.001) and with spontaneous vaginal deliveries (P Value 0.004) and between previous cause of C-Section and the outcome was highly significant (P < 0.001). Conclusion: In this study the maternal and fetal outcome of VBAC were quite satisfactory. Policy maker can use the findings of this study to develop strategy to decrease the cesarean section rate. Safe practice that enhances VBAC success rate without increasing mortality and morbidity should be evaluated
https://ejhm.journals.ekb.eg/article_50257_13306d64bf280da25692c336e3319b10.pdf
2019-10-01
5109
5113
10.21608/ejhm.2019.50257
VBAC
maternal
fetal
Outcome
Saudi Arabia
Fatimah
Alkhamis
drfatimah7070@hotmail.com
1
Department of Obstetrics and Gynecology, Faculty of Medicine, King Faisal University, Saudi Arabia
LEAD_AUTHOR
ORIGINAL_ARTICLE
The Relationship between Childhood Trauma and Schizophrenia Symptoms Severity at Zagazig University Hospitals
Background: Childhood trauma is an environmental and risk modifying factor for schizophrenia. Aim of the work: The objective of the present work is to evaluate the incidence of childhood trauma among schizophrenic patients and how this impacts the clinical features of the disorder. Subjects and Methods: It is a crosssectional study conducted from January 2019 to June 2019 at the Psychiatry Department, Zagazig University hospitals where the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) Arabic version was used to verify the diagnosis of randomly chosen 104 schizophrenic patients meeting the inclusion criteria. Positive and Negative Syndrome Scale (PANSS) for the assessment of positive, negative and general psychopathology connected with schizophrenia. Adverse Childhood Experiences International Questionnaire (ACE-IQ) Arabic version to assess adverse childhood experience. The study was approved by the medical ethics committee of Zagazig University Hospitals and a written informed consent is obtained from all patients. Results: The prevalence of childhood trauma in schizophrenic patients is (85.6 %), (42.3%) of them had ≥3 types of trauma. Childhood trauma was associated with low education level and rural residence. There was a statistically significant positive correlation between childhood trauma and positive symptoms of schizophrenia in which (ACE total score ≥ 3 traumas) were associated with severe positive symptoms. Conclusion: Childhood trauma is prevalent in patients with schizophrenia. Childhood trauma patients are associated with more severe positive symptoms, especially in patients with 3 or more traumas. Patients with childhood trauma were associated with early schizophrenia onset.
https://ejhm.journals.ekb.eg/article_50258_5a993409f184c4deecd8ded622a21666.pdf
2019-10-01
5114
5120
10.21608/ejhm.2019.50258
Childhood trauma
Schizophrenia
Symptom severity
Asaad AbdElrahman
Shalanda
1
Department of Psychiatry, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Amira Mohamed
Youssef
2
Department of Psychiatry, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Rehab Saeed
Mahdy
3
Department of Psychiatry, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Alaa Elsayed Mohamed
Zayed
alaaelsayedzayed@gmail.com
4
Department of Psychiatry, Faculty of Medicine, Zagazig University, Egypt
LEAD_AUTHOR
ORIGINAL_ARTICLE
Endoscopic Endonasal Approach for Craniopharyngiomas
Background: Craniopharyngiomas are challenging tumors that most frequently occur in the sellar or suprasellar regions. The endoscopic endonasal transsphenoidal approach is a minimal-invasive technique for managing craniopharyngiomas. Objective: The aim of this study was to evaluate endoscopic endonasal trans-sphenoidal approach in management of craniopharyngioma as regard the indications, operative difficulties, post-operative complications and outcomes. Patients and methods: An analytical prospective study conducted on 10 Craniopharyngioma patients treated via endoscopic endonasal, trans-sphenoid approach in Al-Azhar University Hospitals. Follow up of patients done clinically and radiologically over 6 months. Results: The study included 10 patients, 2 (20%) males and 8 (80%) females. Ages ranged from 19 to 60 years (mean age 39.5 years). Gross total resection was achieved in 7 patients (70%). The most common surgical complications in our series were diabetes insipidus (DI) and cerebrospinal fluid (CSF) leakage in 5 patients (50%) and 3 patients (30%) respectively. None of our patients suffered from worsening of endocrinological or visual outcome postoperatively. Conclusion: To conclude that endoscopic endonasal approach (EEA) is an effective surgical treatment for removal of craniopharyngiomas in terms of surgical outcome and tumor control.
https://ejhm.journals.ekb.eg/article_50259_b8dd653ec1e389cf2cd4d3f9067c7185.pdf
2019-10-01
5121
5127
10.21608/ejhm.2019.50259
Craniopharyngioma
Endoscopy
Skull base surgery
Endoscopic Endonasal Approach
Transsphenoidal surgery
Hamdy M.
Behairy
1
Neurosurgery Department, Faculty of Medicine, Al-Azhar University, Cairo
AUTHOR
Adel R.
Almelesy
2
Neurosurgery Department, Faculty of Medicine, Al-Azhar University, Cairo
AUTHOR
Mohamed M.
Daoush
drdaoush2015@gmail.com
3
Neurosurgery Department, Shebin El Kom Teaching Hospital, Egypt
LEAD_AUTHOR
ORIGINAL_ARTICLE
Endovascular Treatment of Un-Ruptured Cerebral Aneurysms (Experience by Neurologist)
Saccular intracranial aneurysms are localized enlargement lesions of the vasculature, most commonly sited at bifurcation points in the circle of Willis. Un-ruptured intracranial aneurysms (UIA) are a common finding, occurring in about 2% of the population, making them very probable to be seen by most practitioners, and present a challenge in the recommendations for optimum management and screening. Most aneurysms do not rupture and patients harboring these lesions often remain asymptomatic. Material and Methods: we recruited 12 patients with un-ruptured intracranial aneurysms that was treated by endovascular intervention and evaluated clinically and angiographically before procedure and 3-6 months after procedure Results: the mean age of the patients was 51.42±11.23 ranging age 23 – 69 years. 6 were females and 6 were males. 5 patients (41.7 %) were hypertensive which was the commonest risk factor in those patients, 6 patients (50%) had ICA (Internal Carotid Artery) aneurysm. Conclusion: endovascular therapy of intracranial aneurysms is a safe and effective method of therapy with less morbidity and mortality rates.
https://ejhm.journals.ekb.eg/article_50260_46807c94f45cedbff27a5d618314d268.pdf
2019-10-01
5128
5131
10.21608/ejhm.2019.50260
un-ruptured aneurysm
coiling
Eman
Khedr
1
Department of Neuropsychiatry, Faculty of Medicine, Assiut University, Assuit, Egypt and the Academic Director of Neuropsychiatry Department, Faculty of Medicine, Aswan University, Aswan
AUTHOR
Ahmed
Bassiony
2
Department of Neuropsychiatry, Faculty of Medicine, Ain shams University, Cairo
AUTHOR
Hany
Zaky-Eldin
3
Department of Neuropsychiatry, Faculty of Medicine, Ain shams University, Cairo
AUTHOR
Bastawy
Fawal
4
Department of Neuropsychiatry, Faculty of Medicine, Aswan University, Aswan, Egypt
AUTHOR
Ahmed
Shoyb
ahmed.shoyb@yahoo.com
5
Department of Neuropsychiatry, Faculty of Medicine, Aswan University, Aswan, Egypt
LEAD_AUTHOR
ORIGINAL_ARTICLE
To Evert or not to Evert Tunica Vaginalis during Low Inguinal Approach Varicocelectomy
Background: Varicocele is the most common correctable etiology found in infertile men. The aim of all surgical methods that treating varicocele is to increase the potential for future fertility. Objective: The aim of work was to evaluate the outcome of varicocelectomy through the low inguinal approach as a compare of eversion or non-eversion of the tunica vaginalis. Patients and methods: This prospective study included a total of 40 patients with a diagnosis of primary testicular varicocele and underwent low approach varicocelectomy, attending at Department of General Surgery, El-Hussein University Hospital. The patients were divided into two groups: group I included 20 patients with everted tunica and group II included 20 patients without everted tunica. Results: show that eversion of tunica vaginalis proved statistically to be effective in avoidance of hydrocele formation after varicocelectomy as there is no case developed hydrocele during the follow up period and as effective as microsurgical varicocelectomy. Conclusion: It could be concluded that for reduction of the incidence of hydrocele after varicocelectomy, eversion of tunica vaginalis can be afforded as adjunctive in operation theatre performing sub inguinal varicocelectomy without the aid of an operating microscope.
https://ejhm.journals.ekb.eg/article_52401_fd933e979df6e343e82cacf4f67894e4.pdf
2019-10-01
5132
5137
10.21608/ejhm.2019.52401
varicocelectomy
hydrocele
Shawky Mohammed
Deabes
1
Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Mohamed Abdel-all
Nafea
2
Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Ahmed Soliman
Ibrahim
ahmed.sol.ib.88@gmail.com
3
Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
LEAD_AUTHOR
ORIGINAL_ARTICLE
Management of Abdominal Complications of Ventriculoperitoneal and Thecoperitoneal Shunts
Background: The overall incidence of hydrocephalus in the general population is not known since the condition occurs in association with a large number of childhood and adult intracranial diseases. It is obvious that the reported incidence of infantile hydrocephalus, namely 3 to 4 per 1000 live birth is grossly understated. Objective: The aim of this study was to study various complications of the ventriculoperitoneal shunt and their management. Patients and methods: This a prospective study, a total of assessed 20 patients of complicated shunt operations for hydrocephalus in single group, the age of the patients varied from two months to seventeen years?; there were ten males and ten female patients, at Al-Azhar University Hospitals between March 2017 and June 2018. Results: Treatment of shunt obstruction was done by shunt revision using a new catheter which was easy with excellent results in absence of infections. 65% of the cases with shunt infection occurred during the first six months after initial shunt insertion. Treatment of patients with shunt infection was done by shunt removal, CSF drainage and combined intravenous and intraventricular antibiotics according to culture and sensitivity. Shunt insertion was done after negative three successive CSF cultures and lower CSF protein level. The cure rate was 62.5% in cases of shunt infections using the above-mentioned regimen. Conclusion: The complication due to non-infective causes is easy to manage and usually requires a short stay of the patient in the hospital.
https://ejhm.journals.ekb.eg/article_52402_cc67d136fc836943a5849882b8653b5c.pdf
2019-10-01
5138
5142
10.21608/ejhm.2019.52402
Abdominal Complications of Ventriculoperitoneal
Thecoperitoneal Shunts
Megahed Mohamed Ali
El-Shafei
1
Departments of General Surgery, Faculty of Medicine, Al-Azhar University
AUTHOR
Abd El Kafi
Sharaf El Din
2
Departments of General Neurosurgery, Faculty of Medicine, Al-Azhar University
AUTHOR
Abd El Fattah Morsi Saied
Mohammed
3
Departments of General Surgery, Faculty of Medicine, Al-Azhar University
AUTHOR
Islam Abd Elhaleem
Matter
islammatter221183@gmail.com
4
Departments of General Surgery, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
ORIGINAL_ARTICLE
Curcumin Phytosome Ameliorates Aluminum Chloride-Induced Nephrotoxicity in Rats
Aim of the work: aluminum chloride (AlCl3) toxicity to animals and human increased in the last decade. Thereby, this study evaluated the potential ameliorative role of curcumin phytosome (CP) on AlCl3-induced nephrotoxicity. Material and methods: rats were allocated into four groups (n=6), Control group; CP group: rats orally administered with CP (200 mg/kg b.wt.) for 21 days; AlCl3 group, intraperitoneally injected with three doses of AlCl3 (30 mg/kg/b.wt.) every five days; group AlCl3 and CP, rats received CP for 7 days prior to AlCl3 and then received CP concurrently with AlCl3 for another 14 days. Results: AlCl3 acquaintance significantly increased levels of creatinine, urea, uric acid, LPO and NO as well as reduced renal GSH, SOD and GPx activity in comparison with the control group. These biochemical variations linked with histological renal atrophy and morphological lesions in the glomeruli and the different renal tubules. All these biomarkers in addition to the histopathological changes of injured kidneys were distinctly reversed after treatment with CP. CP is effective in mitigating the nephrotoxicity evoked by AlCl3 through restoring the oxidant/antioxidant equilibrium. The pathway of renal ameliorative effect of curcumin phytosome may be related to its ability to decrease MDA and other ROS and increase of antioxidants activity.
https://ejhm.journals.ekb.eg/article_52403_34c31936ce42c3dc3f9297773c6989f2.pdf
2019-10-01
5143
5147
10.21608/ejhm.2019.52403
aluminum chloride
Nephrotoxicity
curcumin phytosome
antioxidants
Mohammed A.
Al Kahtani
dr.malkahtani@gmail.com
1
Biology Department, Science College, King Khalid University, Abha, Saudi Arabia
LEAD_AUTHOR
ORIGINAL_ARTICLE
Ocular Manifestations of Rheumatoid Arthritis and Complications of Hydroxychloroquine Treatment
Background: Rheumatoid arthritis (RA) is the most common autoimmune disease. Ocular manifestations of RA vary and are mainly keratoconjunctivitis sicca, episcleritis, scleritis and keratitis. Antimalarial drugs [hydroxychloroquine (HCQ) and chloroquine (CQ)] have been used for the treatment of RA. Objective: The aim of this study was to study the ocular manifestations of rheumatoid arthritis and the complications of the use of hydroxychloroquine in treatment. Patients and methods: A prospective study that was conducted at Al-Zahraa University Hospital. The study included a total of 80 eyes of 40 patients. Patients were divided into two groups: Group (1) 20 RA patients not using HCQ treatment and group (2) 20 RA patients using HCQ treatment. All patients underwent complete ophthalmic examination including SD-OCT. Results: the most ocular manifestations found in patients were keratoconjunctivitis sicca (KCS) 93.8%, scleritis and episcleritis 2.5%, acute anterior uveitis (AAU) and sclerosing keratitis 1.3%. Regarding SD-OCT finding comparing between the two groups, we found signs of early HCQ retinopathy in patients of group 2 in the form of parafoveal and perifoveal thining compared to group 1. Conclusion: RA is associated with many extra-articular manifestations, HCQ and CQ used in treatment of RA have significant efficacy and safety, but with long duration of using can cause retinopathy, and follow up of patients is necessary to detect early retinopathy.
https://ejhm.journals.ekb.eg/article_52404_caf6abb3afda8c07aae3610df14d238a.pdf
2019-10-01
5148
5154
10.21608/ejhm.2019.52404
Rheumatoid Arthritis
ocular manifestations
hydroxychloroquine
retinopathy
Zeinab Sayed
Hasan
1
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Sanaa Ahmed
Mohamed
2
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Fatma Essam
Abdelmohsen
dr.fatma.esam@gmail.com
3
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
LEAD_AUTHOR
ORIGINAL_ARTICLE
A Two Years Follow Up of a Surgical Treatment and Reconstruction Using Platelet Rich Fibrin for Central Giant Cell Granuloma of The Mandible _ A Case Report
Background: Central giant cell granuloma (CGCG) is a benign aggressive destructive osteolytic lesion of osteoclastic origin. The central giant cell granuloma is often found in the mandible, anterior to the first molars. It most commonly occurs in patients under the age of 30, with a clear female prevalence. Objectives: The aim of this report was to present a case of CGCG of the mandible and to describe the effect of platelet rich fibrin along with the surgical treatment on such aggressive lesions. Patients and methods: A 29 years old man referred from Hafer Albaten General Hospital to our Department of Oral and Maxillofacial Surgery with a chief complaint of painless swelling on the left lower back jaw region for 6 months. An unusual treatment modality had been carried out in Department of Oral and Maxillofacial Surgery at Alrass General Hospital. Aggressive curettage along with peripheral osteotomy has been done followed by reconstruction with Platelet rich fibrin (PRF) as an autologous grafting material. Results: A Three months, six months, One year and Two years follow up revealed a good healing of the osseous lesion with no signs of recurrence. Conclusion: Curettage of the tumor mass, followed by the removal of the peripheral bony margins results in a low recurrence rate and good prognosis.
https://ejhm.journals.ekb.eg/article_52405_8e96ae31c7947734fb63b42740011ad1.pdf
2019-10-01
5155
5160
10.21608/ejhm.2019.52405
Central Giant Cell Granuloma
Platelet rich fibrin
Autologous graft
Reconstructive surgery
Tarek
kasem
1
Dental Department, AlRass general hospital, Qassim, Kingdom of Saudi Arabia.
AUTHOR
Salma
Albati
salmaalbuty93@gmail.com
2
Dental Department, AlRass general hospital, Qassim, Kingdom of Saudi Arabia.
AUTHOR
Jihad
Alokaily
3
Dental Department, AlRass general hospital, Qassim, Kingdom of Saudi Arabia.
AUTHOR
Ali
Alsalim
4
Dental Department, AlRass general hospital, Qassim, Kingdom of Saudi Arabia.
AUTHOR
ORIGINAL_ARTICLE
The Relationship between Vitamin D Deficiency and NAFLD in Sample of Egyptian Type 2 Diabetic Patients
Background: vitamin D deficiency has a strong association with insulin resistance and NAFLD. Objective: to assess vitamin D levels in patients having type2 diabetes with NAFLD and to study its relationship with insulin resistance. Patients and methods: a case–control study conducted on 50 subjects who were divided into 2 groups: 35 patients having T2DM and NAFLD (group 1) and 15 healthy subjects served as control (group 2). Fasting plasma glucose (FBG), 2 hour post prandial (2hrpp), and fasting plasma insulin (FPI) were measured with calculation of HOMA-IR. Fasting lipids, Hb A1c, calcium, phosphorus, urea, creatinine, serum alanine aminotranseferase (ALT), aspartate aminotransaminase (AST) were also measured. BMI was calculated, serum 25 (OH)D was measured with ELISA and abdominal ultrasonography was done for all participant. Results: the study showed lower level of vitamin D in patients with T2DM and NAFLD 10.6 (5.5-21.3) as compared to control group 31 (27-39.7). While non-significant difference was found between male and female regarding 25(OH) D level and HOMA-IR. There was significant negative correlation between vitamin D level and HOMA-IR. Conclusion: Vitamin D level was associated with presence of NAFLD. There was strong relation between vitamin D level and insulin resistance as vitamin D deficiency was associated with higher levels of HOMA-IR. Obesity may be related to low vitamin D level, but no difference in VD level between males and females was found.
https://ejhm.journals.ekb.eg/article_52406_85bbabd82c44e50fa77228d1c101a930.pdf
2019-10-01
5161
5166
10.21608/ejhm.2019.52406
Vitamin D
NAFLD
T2DM
Hanaa Taha
Kandeel
1
Department of Endocrinology and Metabolism, Faculty of Medicine for Girls, AL-Azhar University
AUTHOR
Doaa Mohammed
Sayed
2
Department of Endocrinology and Metabolism, Faculty of Medicine for Girls, AL-Azhar University
AUTHOR
Esraa Hatem
Ahmed
3
Department of Endocrinology and Metabolism, Faculty of Medicine for Girls, AL-Azhar University
AUTHOR
ORIGINAL_ARTICLE
A Novel Three Drug Rigemen (Moxifloxacin –Omeprazole - Nitazoxanide) in Comparison to Traditional Triple Therapy for Treatment and Eradication of Naïve and Resistant H. Pylori Infection in Dyspeptic Patients
Background: Helicobacter pylori is one of the most common, medically prominent infection worldwide and one of the major causative factor of peptic ulcer disease. So, eradication of H. pylori is effective in healing ulcers, reducing the ulcer recurrence and eliminating the need for maintenance therapy. Objective: The aim of the work was to compare between the efficacy of traditional triple therapy and Moxifloxacin-based triple therapy in treatment of H. pylori infection and to evaluate the efficacy of moxifloxacin-based regimens as a rescue regimen for H. pylori eradication in resistant patients. Patients and methods: This study was carried out on 100 Helicobacter pylori (H. pylori)-infected patients (within the period between septemper, 2018 to May, 2019) who were enrolled from Hepatology, Gastroenterology & Tropical Medicine Department, Al Azhar University Hospitals (El-Hussein and BAB El-Shaarea). Results: Helicobacter pylori eradication results in group III as evaluated by monoclonal H. Pylori stool Ag, 6 weeks post therapeutic regimens reported that eradication rate was 76.9% (20 patients). Regarding post treatment clinical data in group III, 42.3% of patients remained having symptoms and 57.7% had acheived symptomatic improvement. Also, the best results were recorded for H.pylori eradication (90%) in group II who received moxifloxacin based triple therapy compared to group I (with eradication rate 62.9%) who received traditional triple therapy regimen. Thus the better results (76.9%) were achieved in group III (resistant patients from group I). Conclusion: The present results could state that moxifloxacin can overcome traditional triple therapy resistance.
https://ejhm.journals.ekb.eg/article_52407_b98e88227fbc068f7e6eced0a7ef3bc5.pdf
2019-10-01
5167
5172
10.21608/ejhm.2019.52407
H.Pylori
Moxifloxacin
Omeprazole
Nitazoxanide
Traditional triple therapy
Ahmed Abd El Aleem
Ahmed
1
Department of Tropical Medicine, Faculty of Medicine, El-Azhar University
AUTHOR
Mohammed Zakaria Abu
Amer
2
Department of Tropical Medicine, Faculty of Medicine, El-Azhar University
AUTHOR
Mahmoud Mostafa
Abd El Hamid
dr7oodasamar@gmail.com
3
Department of Tropical Medicine, Faculty of Medicine, El-Azhar University
LEAD_AUTHOR
ORIGINAL_ARTICLE
Assessment of Myocardial Viability After Acute ST- Elevated Myocardial Infarction Using Stress Speckle Tracking Echocardiography and Cardiac MRI
Background: Speckle-tracking echocardiography has emerged as a unique technique for accurately evaluating myocardial function by analyzing the motion of speckles identified. Speckle-tracking measured under stress may offer an opportunity to improve the detection of dynamic regional abnormalities and myocardial viability. Objective: The aim of the current study was to evaluate stress speckle tracking to detect myocardial viability in comparison to cardiac MRI in post-STEMI patients. Patients and methods: 74 patients were prospectively enrolled in 18-month’s study. Dobutamine stress echocardiography was performed 4 days post-infarction accompanied with automated functional imaging analysis of left ventricle during rest and then during low dose stress. All patients underwent a follow up stress echocardiography at 3 months with speckle tracking analysis. Cardiac MRI took place concomitantly at 4 days post-infarction and 3 months. Results: Investigating strain rate obtained with stress speckle tracking after revascularization predicted the extent of myocardial scar, determined by contrast-enhanced magnetic resonance imaging. A good correlation was found between the global strain and total infarct size (R 0.75, p< 0.001). Furthermore, a clear inverse relationship was found between the segmental strain and the transmural extent of infarction in each segment. Meanwhile it provided 81.82% sensitivity and 82.6% specificity to detect transmural from non-transmural infarction at a cut-off value of -10.15. Conclusion: Strain rate obtained from speckle tracking during stress is a novel method of detecting myocardial viability after STEMI. Moreover, it carries a promising role in post-myocardial infarction risk stratification with a reasonable prediction of reversible cardiac-related hospital re-admission.
https://ejhm.journals.ekb.eg/article_53303_658a197717279fb39949d7290d55eb63.pdf
2019-10-01
5173
5182
10.21608/ejhm.2019.53303
STEMI
Stress Echocardiography
speckle tracking
Cardio-MRI
Ahmed
Saleh
salehcardio@hotmail.com
1
*Cardiology unit, Research Institute of Ophthalmology, Ministry of Scientific Research and Technology, Al-Azhar University, Cairo, Egypt
LEAD_AUTHOR
Ali
El-Amin
2
Cardiology department, Al-Azhar University, Cairo, Egypt
AUTHOR
Mohamed
El-Baz
3
Cardiology department, Al-Azhar University, Cairo, Egypt
AUTHOR
Hany
Negm
4
*Cardiology unit, Research Institute of Ophthalmology, Ministry of Scientific Research and Technology, Al-Azhar University, Cairo, Egypt
AUTHOR
ORIGINAL_ARTICLE
Study of Thyroid Dysfunction in Postpartum Psychosis
Background Becoming a mother of newborn involves adaptation to may changes socially and physiologically. Some risk factors are responsible for the development of postpartum psychosis including postpartum hormonal changes. Objectives: was to study the role of thyroid dysfunction in development of early postpartum psychosis among a sample of Egyptian women. Subjects and Methods: A total of 60 female patients with postpartum psychosis during the first four weeks after delivery not suffering from any previous psychiatric disorders (Case Group) and 30 female patients within the first four weeks after delivery not suffering any psychiatric disorders (Control Group) were subjected to clinical psychiatric assessment using structured psychiatric interview of DSM -V, BPRS, HDRS and measuring plasma level of thyroid hormones e.g., free triiodothyronine, free tetra-iodothyronine and thyroid stimulating hormone. Results: There were higher significant difference regarding thyroid dysfunction in patients with postpartum psychosis than in controls. Patients with postpartum psychosis with thyroid dysfunction have a higher significant score on BPRS and HDRS than patients with postpartum psychosis without thyroid dysfunction. Conclusion: There is significant association between thyroid dysfunction in first four weeks after delivery and postpartum psychosis.
https://ejhm.journals.ekb.eg/article_53304_6d4c61ed67e6fdda57c7f2b97f052ac1.pdf
2019-10-01
5183
5186
10.21608/ejhm.2019.53304
Thyroid dysfunction
Postpartum psychosis
ORIGINAL_ARTICLE
Phenomenology of Postpartum Psychosis
Background For centuries, physicians have observed a temporal relation between the occurrence of female-specific reproductive events and the symptoms of illness that traditionally have been classified as "mental". Objectives: study of phenomenology of postpartum psychosis. Methods: 60 female patients with postpartum psychosis during the first four weeks after delivery (patients group) and 30 female patents within the first four weeks after delivery not suffering any psychiatric disorders (Control group). The two groups were subjected to clinical psychiatric assessment using structured psychiatric interview of DSM -V, BPRS, HDRS and EPDS. Results: Postpartum psychosis was more in younger females than older and in primipara than multipara. The onset of symptoms of postpartum psychosis was more common in first week after delivery (mean 6.11 days), sleep disturbance, irritability and hypomanic symptoms are the most early symptoms of postpartum psychosis followed by anxiety, confusion and somatic complain. Mood congruent psychotic feature significantly more than mood non-congruent psychotic feature. Conclusion: postpartum psychosis is more common in younger and primipara females with onset of symptoms in first in first week after delivery. Sleep disturbance, irritability and hypomanic symptoms are the earliest symptoms of postpartum psychosis
https://ejhm.journals.ekb.eg/article_54164_7e36ecac158668bc7615567a74b4cf12.pdf
2019-10-01
5187
5190
10.21608/ejhm.2019.54164
Phenomenology of postpartum psychosis
Eman M.
Khedr
1
Department of Neuropsychiatry Faculty of Medicine, Asuit University
AUTHOR
Ehab S.
Ramadan
2
Department of neuropsychiatry, Faculty of Medicine, Tanta University
AUTHOR
Mostafa A.
Bastawy
3
Department of neuropsychiatry, Faculty of Medicine, Aswan University
AUTHOR
M. Nemr
Osman
nemrmohamed@yahoo.co.uk
4
Department of neuropsychiatry, Faculty of Medicine, Aswan University
LEAD_AUTHOR
ORIGINAL_ARTICLE
Study of The Effect of Bisphenol A and Anise Oil on Some Sexual Hormones in Male Albino Rats and Illustration of The Effects of Aphanizomenon Flos-Aquae on Their Actions
Background: Xenoestrogens are compounds like estrogens in effect but not in structure which are mimicking the action of endogenous estrogen and activate estrogen receptor. Phytoestrogens are naturally occurring non-steroidal plant chemicals that can act like the female hormone estrogen. Aphanizomenon Flos-aquae (AFA) is a blue-green microalgal species which has antioxidant properties. Objective: The aim of the study was to clarify the effects of both Bisphenol A (BPA) and anise oil (phytoestrogen) together on some sexual hormonal pattern in male albino rats and illustration of the adverse effects of AFA on their actions. Materials and methods: Thirty male albino rats were used. They were divided into three groups: Group I: control (untreated group), Group II: rats treated with BPA and Anise oil and Group III: rats treated with BPA and Anise oil in addition to AFA. Blood samples were collected for different biochemical investigations. Results: The biochemical results showed highly significant increase (p<0.01) in the activities of ALT, AST, urea, creatinine, FSH, prolactin and lipid profile (total cholesterol, triglycerides, HDL-C, VLDL, LDL/HDL & TC/HDL). While, there was a highly significant decrease (p < 0.01) in LDL-C, total protein, albumin, Globulin, testosterone and LH. These results returned back to the normal values after receiving the AFA as compared to normal group. Conclusion: It could be concluded that phytoestrogen and xenoestrogen have undesirable effects and it is recommended to minimize the utilization of these compounds to protect people from its hazardous effects.
https://ejhm.journals.ekb.eg/article_54173_0ef343e6452e22b98dcfda031b2378a7.pdf
2019-10-01
5191
5198
10.21608/ejhm.2019.54173
BPA
Anise oil
AFA
Hormonal assay
biochemical parameters
Eman G.E.
Helal
emanhelal@hotmail.com
1
Zoology Department, Faculty of Science (Girls), Al-Azhar University
LEAD_AUTHOR
Mohamed A.
Abdelaziz
2
Physiology Department, Faculty of Medicine, Al-Azhar university
AUTHOR
Hewaida A.E.
Fadel
3
Department of Nutritional Chemistry& Metabolism, National Nutrition Institute, Cairo, Egypt
AUTHOR
Abeer
Zakaria
4
Zoology Department, Faculty of Science (Girls), Al-Azhar University
AUTHOR
ORIGINAL_ARTICLE
Assessment of Extent and Severity of Coronary Artery Stenosis Using CT Coronary Angiography Among Prediabetic Patients
Background and aims: Prediabetes is associated with an increased risk of developing diabetes and cardiovascular disease. Our objective was to assess the extent and severity of coronary artery diseases (CAD) among prediabetic patients using multi-slice computed tomography (MSCT) coronary angiography. Subjects and methods: Our population included 60 patients with mean age 56.2 ±10.5 years presented by typical chest pain with fasting blood glucose (FPG) < 126 mg/dL and HbA1c ≤ 6.4% and at least one CV risk factor. Any patients with prior history of CV disease or clinical evidence of advanced renal disease were excluded from this study. The extent and severity of coronary artery stenosis were assessed using MSCT coronary angiography. The patients were divided into two groups, prediabetic group (GI) and non-diabetic group (GII). Prediabetes was defined as an HbA1c value of 5.7-6.4%. Results: Prediabetic group had significantly higher number of diseased vessels with higher number of patients having MVD compared to non-diabetic group. HbA1C and FPG were found as independent predictors for both extent and severity of diseased coronary arteries. Conclusion: CAD was more advanced in prediabetic patients compared to non-diabetic patients. Moreover, non-diabetic levels of glucose metabolism evidenced by impaired FBG and increased levels of HbA1C were helpful to predict increased risk for the extent and severity of CAD among our study population.
https://ejhm.journals.ekb.eg/article_54174_fe2d41d8c9eefd177a48a5605f133a4d.pdf
2019-10-01
5199
5206
10.21608/ejhm.2019.54174
Prediabetes
HbA1c
Coronary Artery Disease
MSCT coronary angiography
Eman
Elkholy
emanelkholy23@gmail.com
1
Mahalla Cardiac Center
LEAD_AUTHOR
Layla
Ahmed
2
Department of Cardiology, Faculty of Medicine (for Girls), Al-Azhar University, Cairo, Egypt
AUTHOR
Rehab M.
Hamdy
3
Department of Cardiology, Faculty of Medicine (for Girls), Al-Azhar University, Cairo, Egypt
AUTHOR
Ahmed
Magdy
4
Kobry El-Kobba Military Hospital
AUTHOR
ORIGINAL_ARTICLE
Factors Correlated with Post Endoscopic Retrograde Cholangiopancreatography Hyperamylasemia: A Single Center Study
Background and aim of the work: Identifying patient at risk for post ERCP hyperamylasemia which may progress to pancreatitis is essential to minimize morbidity and mortality by suitable procedural or pharmacological intervention. In this study hyperamylasemia following ERCP were recorded and correlated with different patient or procedure related risk factors. Patients and methods: The data of all patients who met the inclusion criteria of the study and underwent endoscopic retrograde cholangiopancreatography (ERCP) in Al-Hada Armed Force Hospital, Taif, Saudi Arabia from January 2015 to March 2016, were collected through a review of their hospital and data base records. Results: There were 138 patients (86 females and 52 males) with mean age of 63.7±15.3 years. Hyperamylasemia was developed in 29.7% of them; 16.8% were recorded as asymptomatic hyperamylasemia and post ERCP pancreatitis in the remaining 13%. Multivariate analysis confirmed that, the gender, precut sphincterotomy and pancreatic duct cannulation were significant risk factors for development of non symptomatic hyperamylasemia and confirmed also the significance of precut sphincterotomy and pancreatic duct cannulation for post ERCP pancreatitis. Conclusion: This study confirmed the correlation of precut sphincterotomy and pancreatic duct cannulation with post ERCP hyperamylasemia and pancreatitis and in such conditions preventive measures are recommended.
https://ejhm.journals.ekb.eg/article_55413_fea73d115a8318ff9e4d35efd1149184.pdf
2019-10-01
5207
5209
10.21608/ejhm.2019.55413
post ERCP
Hyperamylasemia
pancreatitis
risk factors
Bilal O
Al-Jiffry
1
Department of surgery, Taif University Saudi Arabia
AUTHOR
ORIGINAL_ARTICLE
Infant Weaning Knowledge and Practice among Mothers Attending Maternal and Child Healthcare Center in Tor-Sinai City
Background: Weaning has been one of the most wrongly practiced processes in the developmental stages of the children. Objective: The aim of the work was improving knowledge and practice of mothers regarding weaning diet. Subjects and methods: Across sectional study was performed on 323 mothers attended maternal and childcare center in Tour Sinai City. Structured questionnaire was used included sociodemographic data, knowledge and practice regarding infant weaning. Results: revealed that the mothers belonging to the age group 20-35 (84.8%), secondary education (39.6%), with current occupation (60.1%), and with enough income (79.9%) were classified as medium social class. Level of mothers' knowledge and practice was moderate (50-70%) and there was highly statistical significance association (P<0.001**) between social class and level of mothers’ knowledge and practice. Social class was the only significant factor affecting knowledge and practice where moderate knowledge was noticed in medium social class, moderate practice was associated with high social class. There was statistically significant positive correlation between total score of knowledge and total score of practice. Conclusion: Knowledge and practice among the participants were of moderate level and social class was the only factor affecting it.
https://ejhm.journals.ekb.eg/article_55414_33610fd7beebf60df3723aaedd45371c.pdf
2019-10-01
5219
5227
10.21608/ejhm.2019.55414
Weaning
Knowledge
Practice
Assessment
Doaa Mohammed
Saeed
dr.dms.online@gmail.com
1
Departments of Family Medicine, Faculty of Medicine, Zagazig University, Egypt
LEAD_AUTHOR
Soad Abd Elsalm
Shedeed
2
Department of Pediatrics, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Amira E.
Abdelsalam
3
Department of Community Medicine, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Rasha Mohamed
Bahaa Eldien
4
Departments of Family Medicine, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Management of Lumbar Spondylolysis
Background: Spondylolysis is a fatigue fracture which occur in the pars interarticularis due to repetitive mechanical stresses on the lumbar spine. Objective: This work was aimed to discuss the different methods in management of spondylolysis, regarding the conservative treatment and surgical procedures. Patients and methods: This study included 30 cases with spondylolysis at Al-Azhar University Hospitals. 13 cases were operated upon in El-Sayed Galal Hospital of Al-Azhar University and 12 cases were operated upon in El-Hussin Hospital of Al-Azhar University with 5 cases were managed by conservative treatment between August 2017 and July 2019. Follow up was done for average one year. Results: The improvement of radiculopathy in our study was ranging into 3 category: Fair improvement (2 cases, 20%) with conservative treatment, Good improvement (2 cases, 20%) with decompression and fixation, and Excellent improvement (6 cases, 60%) also with decompression and fixation, so there was a statistical significant relation between both strategy (p-value=0.007), which indicate that the spondylolysis with radicular pain is better managed by decompression and fixation. In our study, we used the Visual Analogue Scale (VAS) in the all cases pre management and post management to assess the outcome. In our study, there was a significant change in Mean VAS score with mean VAS pre-management 7.1, mean VAS post management 2.6 and mean difference in VAS 4.5. Indicating a significant improvement of pain intensity (P<0.001). Conclusion: Spondylolysis is common in young females at L5 pars and presented with LBP in most cases. Different surgical procedure is safe and effective in management than conservative treatment.
https://ejhm.journals.ekb.eg/article_55415_7ce560fefba90ff01e91394f370d53b2.pdf
2019-10-01
5228
5234
10.21608/ejhm.2019.55415
Management
Lumbar spondylolysis
Ibrahem Gameel
Ewaiss
1
Department of Neurosurgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Mostafa
Abo-El kheir
2
Department of Neurosurgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Ibrahim Mohammed Ibrahim
Al-Abd
3
Department of Neurosurgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
ORIGINAL_ARTICLE
Mobility Safety in Chronic Elderly Stroke: Evaluation and Assessment A Narrative Review of the Current Literature and Future Directions
Purpose: Safe ambulation is a multidisciplinary approach of combined skills of medical, nursing, and physical therapy staff to achieve safe outcomes within in- and outpatient settings. The purpose of this literature review is an in-depth evaluation of the available research on factors contribute to mobility falls in chronic ambulatory stroke survivors as a vascular brain pathology with senseromotor consequences especially in geriatric population. Most importantly, the review proposes guidelines for a comprehensive assessment tool combining the major threats assessed of mobility safety in integrated approach. Material and Methods: This narrative review searched in PubMed/MEDLINE was presented in four sections: (Section one) represents the gait motor impairment, (section two) represents the gait motor recovery (section three) addresses walking speed and how it relate to community ambulation and (section four) represents the major threats to mobility safety in chronic stroke survivors. Results: The three major factors that are related to mobility-related fall risk are vision, fast walking and cognitive functions. The literature point to no conclusions regarding the mobility safety benchmarks assessment in an integrated approach. Conclusion: Our literature review shows a complete lack of a comprehensive well-tested clinical assessment tool for measuring mobility safety in stroke. The review propose future research using Dynamic Visual Acuity test as an integrated assessment methodology to assess mobility safety in chronic ambulatory stroke survivors.
https://ejhm.journals.ekb.eg/article_55485_3db0cc10293d678d2aaeab2c4f75cacd.pdf
2019-10-01
5235
5241
10.21608/ejhm.2019.55485
Stroke mobility, safety
Dynamic visual acuity
Bani Ahmed
Ali A.
ali.baniahmed@gmail.com
1
Department of Physical Therapy, Faculty of Applied Medical Sciences, University of Tabuk
LEAD_AUTHOR
ORIGINAL_ARTICLE
Selective Intraoperative Transcystic Cholangiogaraphy in Laparoscopic Cholecystectomy, 3 Years' Experience
Background: Use of intraoperative cholangiography (IOC), a contrast-based examination of the biliary system during laparoscopic cholecystectomy (LC) still represents a valuable approach to illustrate biliary duct anatomy, diagnose obstruction and avoid complications. Objective: The aim of work was to detect the advantages of IOC when used in selected cases during LC in diagnosis of biliary obstruction and prevention of biliary injuries. Patients and methods: 29 patients with specific criteria were included in the study to perform LC and IOC after preoperative magnetic resonance cholangio pancreatogaraphy (MRCP). Follow-up was done by clinical examination, serum bilirubin and U/S for one year. Collected data had been statistically analyzed. Results: IOC resulted in significant increase in mean surgical time with longer time in cases with pericholecystic fluid and mucocele. IOC still has a higher specificity, sensitivity and positive predictive value (PPV) (100, 87.5&100% respectively) over MRCP (65, 77.8&50% respectively) in prediction of choledocholithiasis. U/S, MRCP & IOC had high negative predictive values (NPV), good negative tests. History of obstructive jaundice had a low sensitivity, specificity and PPV (71.5, 63.6&38.5) but had a high NPV (87.5%) in detection of choledocholithiasis. Normal IOC saved 8 patients with history of obstructive jaundice from unnecessary endoscopic retrograde cholangiopancreatography (ERCP). No biliary injuries had been reported. Conclusion: selective IOC in high risk patients is useful in detection of choledocholithiasis, avoidance of ERCP in patients with non-specific common bile duct (CBD) dilatation and prevention of biliary injuries in cases with high risk for injury.
https://ejhm.journals.ekb.eg/article_55486_d8312bcacb6888c6898d9c367dd5cf63.pdf
2019-10-01
5242
5248
10.21608/ejhm.2019.55486
Laparoscopic cholecystectomy
MRCP
selective intraoperative cholangiogram
biliary injuries
Ayman Helmy
Ibrahim
aymanmohamedmed.b@azhar.edu.eg
1
Departments of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
LEAD_AUTHOR
ORIGINAL_ARTICLE
The Efficacy of Ultrasonography in Prediction of the Degree of Placental Accretion among Cases of Placenta Previa
Background: Placenta previa and previous cesarean section are the two most important known risk factors for abnormally invasive placenta (AIP). AIP can be predicted as early as in the first trimester, and almost always confirmed in the second and third trimesters via Grayscale ultrasonography, with or without color Doppler has been used widely for antenatal screening and diagnosis of AIP. Objectives: To evaluate the accuracy of ultrasound in the diagnosis of placenta accreta and its variants, and to assess the impact of prenatal diagnosis in our population. Patients and Methods: A total of 60 women with placenta previa were enrolled prospectively. All those patients presented during the period of December 2017 till December 2018 to Ghamra Military and Sayed Galal Obstetrics outpatient clinic during their follow up visits in the 2nd and 3rd trimesters and underwent ultrasound examinations. Results: A number of ultrasound criteria can be used for in diagnosis of placenta accreta, as this study showing their high accuracy, they include loss of retroplacental clear zone, presence of abnormal placental lacunae, myometrial thinning, bladder wall interruption and uterovesical hypervascularity. On the other hand, both loss of retroplacental clear zone and abnormal placental lacunae could predict which patient will mostly have CS hysterectomy. Conclusion: It could be concluded that gray scale and color Doppler ultrasound have good performance in the diagnosis of AIP and that prenatal diagnosis improves maternal outcome.
https://ejhm.journals.ekb.eg/article_55487_d10237e2d47581954fd1e5f94364d156.pdf
2019-10-01
5249
5257
10.21608/ejhm.2019.55487
Cesarean section – Co-morbidities – Efficacy– Operative findings – Placenta accreta – Ultrasound
Esmail Mohamed Talaat
El Garhy
1
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Abd El Fatah Mohamed
El Senity
2
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Ahmed Gaber Ahmed
Rizk
prosso_2000@yahoo.com
3
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
LEAD_AUTHOR
ORIGINAL_ARTICLE
Hypolipidemic Effects of Aphanizomenon flos-aquae and Slimquick on Cardiac Muscle Fibers of the Adult Male Albino Rats
Background: hyperlipidemia is a group of heterogeneous disorders characterized by an elevation of lipids in the blood stream. It accounts for the high danger of coronary heart disease and atherosclerosis which is known as a silent killer. Objectives: The aim of work was to evaluate the possible protective effects of Aphanizomenon flos-aquae (AFA) as a natural hypolipidemic product on the cardiac muscle of adult male albino rats, in comparison with Slimquick as a synthetic hypolipidemic drug and their ability to treat hyperlipidemia or to prevent it. Material and methods: fifty six male albino rats (Rattus albinus) were used and categorized into eight groups (7rats/group) .The 1st group (C) rats were used as a control, the 2nd group (H) rats were treated with high fat diet (HFD) (2% cholesterol) to induce hyperlipidemia for 4 weeks only then scarified, the 3rd group (A) rats were orally administrated with AFA only for 4 weeks(94.5 mg/kg body weight /day), the 4th group (H+A1) rats were treated with HFD enriched with 2% cholesterol for 2 weeks to induce hyperlipidemia and the other 2 weeks were fed on the same HFD plus AFA extract administration, the 5th group (H+A2) rats were treated with HFD diet enriched with 2% cholesterol for 4 weeks to induce hyperlipidemia and then they were fed on normal basal diet (BD) plus AFA extract administration for another 2 weeks, the 6th group (S) rats were orally administrated with Slimquick only for 4 weeks (5 mg orlistat/rat/day), the 7th group (H+S1) rats were treated with HFD diet enriched with 2% cholesterol for 2 weeks to induce hyperlipidemia and the other 2 weeks rats were fed on the same HFD plus Slimquick extract administration, the 8 th group (H+S2) rats were treated with HFD diet enriched with 2% cholesterol for 4 weeks to induce hyperlipidemia and then they were fed on normal basal diet (BD) plus Slimquick extract administration for another 2 weeks. Results: the biochemical parameters showed a highly significant increase in the mean value of LDH and CK in the cardiac muscle fibers of the high fat diet group. Many histopathological and histochemical changes were detected in the cardiac muscles of the high fat diet group. Meanwhile, treatment with AFA or Slimquick ameliorated the biochemical parameters, histological and histochemical results; but using AFA extract arrived to decrease the strong changes which were observed in the cardiac muscle fibers of the high fat diet group more than that observed with Slimquick. Conclusion: Aphanizomenon flos-aquae extract as a natural product and Slimquick as a synthetic drug ameliorated the biochemical, histopathological and histochemical changes in the cardiac muscle of the hyperlipidemic rats. Aphanizomenon flos-aquae extract proved to be a better hypolipidemic agent than Slimquick.
https://ejhm.journals.ekb.eg/article_55488_63ae4bfa57bffc2e393aef655bec67b4.pdf
2019-10-01
5258
5275
10.21608/ejhm.2019.55488
Aphanizomenon flos-aquae (AFA)
Slimquick
Orlistat
male Albino rats
hyperlipidemia
LDH
CK
Hemmat M.
Abdelhafez
dr.hematmansour@yahoo.com
1
Department of Zoology, Faculty of Science (for Girls), Al-Azhar University, Cairo, Egypt
LEAD_AUTHOR
Fatma Ahmed
Eid
2
Department of Zoology, Faculty of Science, Al-Azhar University, Cairo, Egypt
AUTHOR
Samir Attia
Zahkouk
3
Department of Zoology, Faculty of Science, Al-Azhar University, Cairo, Egypt
AUTHOR
Amira M. Salah EL-Din Ahmed
El-Wahsh
4
Department of Zoology, Faculty of Science (for Girls), Al-Azhar University, Cairo, Egypt
AUTHOR
ORIGINAL_ARTICLE
Evaluation of Serum Interleukin-6 Level in Vitiligo Patients before and after Phototherapy
Background: Vitiligo is an acquired pigmentary disorder of the skin, resulting from a loss of functioning epidermal melanocytes. Multiple pathogenetic factors have been proposed, including the neural theory, genetic predisposition and impaired anti-oxidative defense. Objective: To evaluate the role of interleukin-6 in pathogenesis of vitiligo and the effect Narrow band-UVB on IL-6 serum levels. Patients and Methods: The study included 30 patients with vitiligo and 30 healthy controls. Each was submitted to thorough history taking, complete general, dermatological examinations including VASI score, and assessment of serum interleukin-6 before and after 16 sessions of NB-UVB. Results: Results of this study showed no statistical significant difference between patients and control as regard age and gender. Our study revealed a statistically significant difference between levels of IL-6 in patients group before and after therapy. Conclusion: Knowing exactly the role of IL-6 is important not only to clarify the pathogenesis of this disease, but also to improve the clinical course of vitiligo (i.e., disease stabilization and/or repigmentation) and the quality-of-life of patients.
https://ejhm.journals.ekb.eg/article_55489_1c3cd951fb772c8126013ed9f14065cb.pdf
2019-10-01
5276
5278
10.21608/ejhm.2019.55489
Broadband (narowband)UVB
systemic corticosteroids
erythrocyte sedimentation rate
Amr Mohamed
Zaki
1
Department of Dermatology and Venereology, Faculty of Medicine - Al Azhar University
AUTHOR
Hassan Mamdouh
Abd El Aziz
2
Department of Dermatology and Venereology, Faculty of Medicine - Al Azhar University
AUTHOR
Mamdouh Atiah
Mohamed
3
Department of Clinical Pathology, Faculty of Medicine - Al Azhar University
AUTHOR
Ahmed Ayman Mohamed
Abd El Hamed
ahmed.ayman4391190@gmail.com
4
Department of Dermatology and Venereology, Faculty of Medicine - Al Azhar University
LEAD_AUTHOR
ORIGINAL_ARTICLE
Surgical Approach to Hysterectomy for Benign Gynecological Diseases
Background: Hysterectomy is one of the most commonly performed surgeries worldwide. Indication for hysterectomy is most often benign, which includes conditions such as prolapse, abnormal uterine bleeding, fibroids and pelvic pain. Hysterectomy can be performed vaginally, abdominally or laparoscopically. Objective: The aim of work was to determine the frequency of use, evaluate and compare the most appropriate surgical method and assess the effectiveness and safety of the three approaches for hysterectomy: Abdominal hysterectomy (AH), vaginal hysterectomy (VH) and laparoscopic hysterectomy (LH) for women with benign gynecological conditions. Patients and Methods: This Prospective case control study was conducted on 75 women with benign disease of uterus with failed medical management or not amenable to medical management attending at Obstetrics and Gynecology Department, Al-Azhar University Hospitals. Patients were divided into three groups (25 cases each) for either technique of hysterectomy depending on the gynecological lesion that indicated the surgical procedure. Results: In the present study there was no statistically significant difference between the abdominal and laparoscopic groups as regard patients age, parity, BMI, previous CS, and previous pelvic surgeries. In our study fibroid represented the most common indication for abdominal hysterectomy (40%), vaginal hysterectomy (36 %) and Laparoscopic hysterectomy (48%). Conclusion: It could be concluded that laparoscopic hysterectomy has minimally invasive and is related to a low intra and postoperative complication rate, and even when there is a history of abdomino-pelvic surgery.
https://ejhm.journals.ekb.eg/article_55490_cf4c798328bce226400a7f4765b8a823.pdf
2019-10-01
5279
5286
10.21608/ejhm.2019.55490
Abdominal hysterectomy
laparoscopic hysterectomy
vaginal hysterectomy
Samir Abdalla
Ali
1
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Mohamed Mohamed
Farahat
2
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Mahmoud Ahmed Mohamed
ElShafei
dr_mahmoudelshafei@yahoo.com
3
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
LEAD_AUTHOR
ORIGINAL_ARTICLE
Incidental Thyroid Carcinoma Diagnosed after Total Thyroidectomy for Benign Thyroid Diseases: A Prospective Observational Study
Background: The term “incidental” denotes malignant tumors of the thyroid gland detected postoperative in surgical specimens resected for benign disease. As cancer, thyroid is the commonest endocrine malignancy and their incidence increases over the past 15-20 years. In Egypt, it represents 2.2% of total cancers. It constitutes 30% of endocrine malignancies and 12-49% of head and neck tumors. Objective: The aim of this study was to determine the incidence and histological features of incidental cancers in patients who had total thyroidectomy for benign thyroid diseases. Patients and Methods: This Study is a prospective, empirical study carried out at Al-Zahraa University Hospital during the period from April, 2016 to April, 2018. The study included 100 cases had total thyroidectomy of previously diagnosed benign thyroid diseases and fulfilled the inclusion criteria. Results: In this study, 100 patients underwent total thyroidectomy. The female (n=86) to male (n=14) ratio was 6.14: 1 and the age ranged from 19 to 69 years. The incidental carcinoma in this study found in 12 (12%) patients. The frequency of papillary carcinoma was 9 % of all thyroid diseases and 75% of the incidental thyroid cancer (ITC) (9/12). Also, frequency of follicular carcinoma was 1.4% of all thyroid diseases (three cases) and 16.66% of the ITC. Conclusion: The non-irrelevant incidence of ITC, the eventuality of multifocal and bilaterality and the possible occurrence of relapse support that total thyroidectomy without residuum is a valuable option for treating benign thyroid conditions.
https://ejhm.journals.ekb.eg/article_55491_8080660084934d7dd33542ebb9452b16.pdf
2019-10-01
5287
5292
10.21608/ejhm.2019.55491
Fine-needle aspiration cytology
Occult
Thyroid swelling
Incidental
Total Thyroidectomy
Ahmed Fayez
Othman
ahmedfayez_666@yahoo.com
1
General Surgery, Faculty of Medicine for Boys, Al-Azhar University
LEAD_AUTHOR
Bosat Elwany
Bosat
2
Department of General Surgery, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
AUTHOR
Hamed Ahmad
Elbadawy
3
Department of General Surgery, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
AUTHOR