Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
53
1
2013
10
01
Low Dose Nicotinamide as an Adjunctive Therapy to Calcium Carbonate for Control of Hyperphosphatemia in Hemodialysis Patients
752
762
EN
Magdy
El-Sharkawy
Ain Shams University, Nephrology Department, Faculty of medicine, Cairo Egypt
Mostafa
kamel
Ain Shams University, Nephrology Department, Faculty of medicine, Cairo Egypt
Ahmed
Ramadan
Ain Shams University, Nephrology Department, Faculty of medicine, Cairo Egypt
Manal
El-Hamamsy
Clinical Pharmacy department, Faculty of Pharmacy, Cairo, Egypt
Shaimaa
Allam
Clinical Pharmacy department, Faculty of Pharmacy, Cairo, Egypt
10.12816/0001636
<strong>Abstract</strong><br /> <strong>Background: </strong>Hyperphosphatemia remains a common problem in patients on maintenance dialysis and contributes to the development of secondary hyperparathyroidism. Current therapies for the treatment of hyperphosphatemia are frequently insufficient to achieve the recommended K/DOQI goal of maintaining serum phosphorus level between 3.5 and 5.5 mg/dl. Niacinamide inhibits intestinal sodium/ phosphorus co transporters and reduces serum phosphorus level in some clinical studies. So, we aimed to evaluate the safety and the efficacy of nicotinamide as adjunctive therapy to calcium carbonate (as calcium based phosphate binder) in hemodialysis patients.<br /> <strong>Methods: </strong>Sixty hemodialysis patients with serum phosphorus level ≥ 5.0 mg/dl were randomly assigned to 8 weeks of the study. Patients were divided into two groups:<strong>(</strong><strong>group I) </strong><strong>(control group): </strong>30 cases calcium carbonate only and <strong>(group II)</strong><strong> (study group): </strong>30 cases received a combination of calcium carbonate and nicotinamide. Nicotinamide dose was started as 500mg/day and increased on 8<sup>th</sup> day to 1000 mg/day. <strong>Results:</strong><em>In the <strong>study group</strong> (nicotinamide group):</em> serum phosphorus level fell significantly <em>(p<0.001),</em> calcium × phosphorus product dropped significantly <em>(p<0.001),</em> with a significant elevation of serum calcium <em>(p<0.05).</em> <em>In the <strong>control group</strong>:</em> there was insignificant change in former parameters <em>(p values>0.05</em>). Intact parathyroid hormone, uric acid, platelet count, total cholesterol, hemoglobin, ASAT, and ALAT and lipid profile remained insignificantly changed <strong><em>in both groups</em></strong>. Diarrhea, flushing and skin rash were the major adverse effects seen with nicotinamide therapy resulting in early withdrawal of 4 patients from the study. <strong>Conclusion: </strong>In hemodialysis patients, nicotinamide in single dose of 1000 mg daily can effectively reduce serum phosphorus level when administered with calcium carbonate (as phosphate binder) with less potential side effects reported.<br /> <strong> </strong><br /> <strong> </strong>
Nicotinamide- Hyperphosphatemia- Hemodialysis
https://ejhm.journals.ekb.eg/article_15827.html
https://ejhm.journals.ekb.eg/article_15827_575a7efc809639640750c648ee19a004.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
53
1
2013
10
01
The Effect of Lupinus albus and Hyphaene thebaica on Chromosomal Aberrations and Histopathological Changes of Liver and Pancreas in Streptozotocin-induced Diabetic Rats
763
769
EN
Amany A
Tohamy
Department of Zoology and Entomology, Faculty of Science, Helwan University
Rasha S
Mohammed
Department of Zoology and Entomology, Faculty of Science, Helwan University
Mohga S
Abdalla
Department of Chemistry, Faculty of Science, Helwan University
Adel K
Ibrahim
Department of Clinical Pathology, Veterinary Medicine, Cairo University
Khaled F
Mahran
Department of Clinical Pathology, Veterinary Medicine, Cairo University
Kawkab A
Ahmed
Department of Pathology, Veterinary Medicine, Cairo University.
10.12816/0001637
<strong>Background: </strong>The folk medicine in Egypt has described several kinds of Egyptian herbs and plant prescriptions, belonging to various families to be concerned with the treatment of diabetes mellitus<strong>.</strong>The present study focuses on evaluating the chromosomal aberration in somatic cells of STZ-diabetic rats treated with <em>Lupinus albus </em>(termis) and <em>Hyphaene thebaica </em>(doum) as well as their effect on liver and pancreas histopathology.<br /> <strong>Material and methods:</strong> STZ was injected intraperitoneally at a single dose of 50 mg/kg to induce diabetes. Termis seeds suspension (75 mg/100 g b.wt.) was daily orally administered, doum fruit suspension was daily orally administered (1g/kg b.wt.) and also gliclazide, reference drug, was administered at a dose equivalent to the therapeutic dose of rat. After four weeks of administration, bone-marrow metaphases were prepared for examining chromosomal aberration. These were followed by statistical analysis. Liver and pancreas were dissected, processed and stained with H&E for investigating histopathological changes. <br /> <strong>Results: </strong>The results of chromosomal analysis showed that, diabetic rats had a highly significant increase of chromosomal aberrations compared to that of normal healthy control. Animals which were treated with <em>Lupinus albus</em> and <em>Hyphaene thebaica</em> showed significant improvements in the frequencies of chromosomal aberrations. Also, treatment of diabetic rats with termis and doum revealed marked improvement in liver and pancreas histopathology. <br /> <br /> <strong>Conclusion: </strong> It is concluded that diabetes is much harmful on the histological picture of liver and pancreas and on chromosomal aberration frequencies in the animal body, whilst the administration of termis or doum reduced these harmful effects of diabetes.<br /> <strong> </strong>
Lupinus albus,Hyphaene thebaica,Gliclazide,streptozotocin,diabetic rat
https://ejhm.journals.ekb.eg/article_15828.html
https://ejhm.journals.ekb.eg/article_15828_594290d39464add08c02ea9131451b3e.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
53
1
2013
10
01
Effect of Curcumin on Some Heavy Metals Induced Renal and Testicular Injuries in Male Rats
770
781
EN
Tamer, M. M.
Saad
Medical and Radiation Research Dept., Nuclear Materials Authority, Cairo, Egypt
10.12816/0001638
<strong>Back ground </strong>Toxic heavy metals in water, air and soil are global problems that are a growing threat to humanity. Heavy metals are widely distributed in the environment and some of them occur in food, water, air and tissues even in the absence of occupational exposure. The antioxidant and protective influences of curcumin on a mixture of some heavy metals (Pb, Hg and Cd) induced renal and testicular injuries in male rats were detected.<br /> <em> </em>Curcumin, a yellow pigment from <em>Curcuma longa</em>, is a major component of turmeric and is commonly used as a spice and food-coloring material. It exhibits anti-inflammatory, anti-tumor, and antioxidant properties.<br /> <strong>Aim</strong> The present study aims to evaluate the antioxidative activities and protective role of curcumin against some heavy metals induced renal and testicular injuries in male rats.<br /> <strong>Material and Method </strong><br /> Male Swiss albino rats were orally administrated by curcumin (150 mg/kg B.W.) using suitable stomach tube (eight weeks) before receiving mixture of heavy metals (Pd, Hg and Cd) in drinking water for two weeks. Levels of plasma creatinine, urea, uric acid and serum testosterone concentration were measured, glutathione content and superoxide dismutase activities in kidney and testis tissues were estimated and also histological examinations for kidney and testis tissue were detected. <br /> <strong>Results</strong><br /> The results revealed that mixture of heavy metals lead to significant increase in the level of plasma creatinine, urea and uric acid, Meanwhile, significant decrease in serum testosterone concentration. Glutathione content and superoxide dismutase activities in kidney and testis tissues were significantly decrease by using a mixture of heavy metals. But groups administrated with curcumin before administrated with mixture of heavy metals, exerted noticeable amelioration against their damage in most of the biochemical and histological tested parameters.<br /> <strong> </strong>
Ionizing radiation,Curcumin,antioxidant,Liver and kidney tissues
https://ejhm.journals.ekb.eg/article_15829.html
https://ejhm.journals.ekb.eg/article_15829_7f49bdd5869c780db8ab0e70a7117084.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
53
1
2013
10
01
Self Perception of Community Dwelling Elderly toward Aging in Shubra El Khima City
782
788
EN
Ahmed K
Mortagy
Geriatrics and Gerontology department, Faculty of Medicine, Ain shams university, Cairo, Egypt
Tamer M
Farid
Geriatrics and Gerontology department, Faculty of Medicine, Ain shams university, Cairo, Egypt
Ekramy E
Abdul Rahman
Geriatrics and Gerontology department, Faculty of Medicine, Ain shams university, Cairo, Egypt
Asmaa F
Abdellah
Geriatrics and Gerontology department, Faculty of Medicine, Ain shams university, Cairo, Egypt
Hoda I
Fahim
Community department; Faculty of Medicine, Ain shams university, Cairo, Egypt
10.12816/0001639
<strong>Background:</strong> Elderly with positive self-perception of aging tend to engage in additional health behaviors related to prevention and report better functional health and live longer.
<strong>Objectives</strong>: The aim of the study is to assess the self-image of community dwelling elderly toward aging in shubra el khima city.
<strong>Design:</strong> A cross sectional study.
<strong>Participants</strong>: Four Hundred of community dwelling elderly<strong><span style="text-decoration: underline;">.</span> Settings: </strong>shubra el khima city.
<strong>Measurements</strong>: Minimental status examination (MMSE-30)<strong>, </strong>Geriatric Depression scale (GDS-15), Direct interview by researcher to fulfill a structured battery of questionnaire formed of several subscales from seven different questionnaires investigating self perception of aging by participating individual:Age Stereotypes Scale, Quality of Life Scale, Satisfaction with Life Scale (SWLS), Positive and Negative Affect Schedule (PANAS), Lawton’s Philadelphia Geriatric Center (PGC) Morale Scale, Subjective Age Scale, Ryff'sPsychological Well Being Scales.
<strong>Results:</strong> Older people feel younger than they actually are generally are satisfied with their aging, have high levels of positive affect and low level of negative affect and have higher morale, have positive age stereotype, have positive self-acceptance (good psychological well-being) and positive purpose in life. The three most important things for a good quality of life among studied participants were in order: good health followed by having good pension and good relationship with family members or friends. <strong>Conclusion: </strong>elderly in shubra el khima city have positive self-perception of aging.
<strong> </strong>
self perception of aging- elderly-age stereotype-quality of life-PANAS-morale-psychological well being
https://ejhm.journals.ekb.eg/article_15830.html
https://ejhm.journals.ekb.eg/article_15830_e49e0979633595079552f948b7195dae.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
53
1
2013
10
01
The Effect of Lupinus Albus (Termis) and Hyphaene Thebaica (Doum) on Some Biochemical Parameters in Streptozotocin-Induced Diabetic Rats
789
794
EN
Amany A
Tohamy
Department of zoology and entomology, Faculty of science, Helwan University
Rasha S
Mohammed
Department of zoology and entomology, Faculty of science, Helwan University
Mohga S
Abdalla
Department of chemistry, Faculty of science, Helwan University
Adel K
Ibrahim
Department of clinical pathology, Veterinary Medicine, Cairo University.
Khaled F
Mahran
Department of clinical pathology, Veterinary Medicine, Cairo University.
10.12816/0001640
<strong>Background:</strong> Several plants have been used as dietary adjuvant and in treating the number of diseases because of their perceived effectiveness, minimal side effects in clinical experience and relatively low costs.The present study focuses on evaluating the effect of <em>Lupinus albus</em> (termis) and <em>Hyphaene thebaica</em> (doum) on STZ-diabetic rats at the level of some biochemical parameters <strong>Material and methods:</strong> STZ was injected intraperitoneally at a single dose of 50 mg/kg to induce diabetes. Termis seeds suspension (75 mg/100 g b.wt.) was daily orally administered. Doum palm fruit suspension was daily orally administered (1g/kg b.wt.) and also gliclazide (reference drug) was administered of a dose equivalent to the therapeutic dose of rat. After four weeks of administration, blood samples were collected for biochemical measurement. <strong>Results: </strong>Blood glucose level was significantly increased. Diabetes increased serum total lipids, cholesterol, triglycerides and LDL but serum HDL wasdecreased. Also activities of serum enzymes ASAT, ALAT, ALP, GGT and LDH were elevated. However, <em>L. albus </em>and<em> H. thebaica </em>improved the level of mostly all biochemical parameters.
<strong>Conclusion: </strong> It is concluded that termis and doum may be dietary adjuvant in reducing the harmful of diabetes.
<strong> </strong>
<strong> </strong>
<strong> </strong>
Lupinus albus Hyphaene thebaica,Gliclazide,streptozotocin,diabetic rat
https://ejhm.journals.ekb.eg/article_15831.html
https://ejhm.journals.ekb.eg/article_15831_59229b441cc66e82e6e915fdd445857d.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
53
1
2013
10
01
Depression as a Predictor of Length of Hospital Stay in Elderly Patients Admitted to Ain Shams University Hospitals
795
798
EN
Sherine M.
Elbanouby
Geriatrics and Gerontology department, Faculty of Medicine, Ain shams university, Cairo, Egypt
sherine_banouby@hotmail.com
Sarah A.
Hamza
Geriatrics and Gerontology department, Faculty of Medicine, Ain shams university, Cairo, Egypt
Samia A.
Abdel Rahman
Geriatrics and Gerontology department, Faculty of Medicine, Ain shams university, Cairo, Egypt
Ahmed Kamel
Mortagy
Geriatrics and Gerontology department, Faculty of Medicine, Ain shams university, Cairo, Egypt
10.12816/0001641
<strong>Background:</strong> Depression among the physically ill is common and frequently under-diagnosed. Elderly patients with depressive symptoms are at higher risk of hospital admission for non psychiatric conditions and are more likely to have longer hospital stays and worse hospital outcomes, compared with non depressed patients.
<strong>Objectives:</strong> The aim of this study was to find out if depression can be considered a predictor of prolonged hospital stay in elderly patients.
<strong>Design:</strong> A prospective cohort study. Participants: 205 consecutive patients 60 years and over both males and females. <strong>Settings:</strong> Ain shams university hospitals. <strong>Measurements:</strong> All participants were assessed using comprehensive geriatric assessment including Geriatric depression scale (GDS) and the length of stay was registered. <strong>Results:</strong> Depressed patients had longer length of hospital stay compared to non depressed patients and the least length of hospital stay was for cases with no risk on GDS scale compared to other groups and the difference is highly significant statistically (p=<strong><</strong>0.001).
<strong>Conclusion:</strong> length of hospital stay is significantly longer among depressed elderly.
<strong> </strong>
Depression –Length of hospital stay– Elderly
https://ejhm.journals.ekb.eg/article_15832.html
https://ejhm.journals.ekb.eg/article_15832_90c06927936e39b28b368e4001b5b788.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
53
1
2013
10
01
Effect of Vitamin C and/or Vitamin E on Kidney, Liver and brain Functions of Streptozotocin-Induced Diabetic Rats
799
808
EN
Ghada Z A
Soliman
National Nutrition Institute, Cairo, Egypt
amr_soliman2005@yahoo.com
10.12816/0001642
<strong>Introduction:</strong> Diabetes Mellitus is one of the main threats to human health in the 21<sup>st</sup> century. <strong>Purpose:</strong> To evaluate the effect of vitamin C and/or vitamin E on liver, kidney and brain function of streptozoticin induced-diabetic rats.<strong> Study Design:</strong> One hundred and twenty male adult Sprague Dawley rats were divided into 6 groups (20 rats each), normal control, STZ-induced diabetic rat, STZ-induced diabetic rats treated with: antidiabetic drugs; vitamin C; vitamin E; vitamin C+E. <strong>Material and Methods:</strong> Blood samples were collected from all groups, Urea, creatinine, uric acid, total protein, Alanine/ aspartate transaminase and vitamin E were measured in plasma. <strong>Results: </strong>Urea, creatinine, uric acid, ALT, AST, vitamin E, LDH (in brain and liver) and MDA (brain) were significantly increased in STZ-induced diabetic rats. Treatment with vitamin C and/or E decrease significantly the increased level of the tested parameters and this may be due to the scavenging free radicals properties of vitamin C and/or E which prevents damage induced by hyperglycaemia; Also may be because vitamin C and/or vitamin E decreased lipid peroxidation and augmented the activities of antioxidant enzymes. <strong>Conclusion:</strong> Vitamin C and/or E may thus be a useful adjuvant therapy in the management of diabetes mellitus but it is better to use combination of the two vitamins rather than in single supplements to prevent the perturb antioxidant–proxidant balance.
<strong> </strong>
Diabetes mellitus,liver and kidney function,Vitamin E,Uric acid
https://ejhm.journals.ekb.eg/article_15833.html
https://ejhm.journals.ekb.eg/article_15833_f9cde2b7c0a39c6f2a2b9665b9d3f502.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
53
1
2013
10
01
Effect of Rosmarinus Officinalis on Lipid Profile of Streptozotocin-induced Diabetic Rats
809
815
EN
Ghada Z A
Soliman
Associate Professor of Biochemistry,
National Nutrition Institute, Cairo, Egypt
amr_soliman2005@yahoo.com
10.12816/0001643
<strong>Introduction:</strong> Diabetes mellitus (DM) is considered as one of the main threats to human health in the 21<span style="text-decoration: underline;"><sup>st</sup></span> century. The use of herbs as medicines has increased all over the world, gaining popularity and played an important role in disease treatment especially in diabetes mellitus. <strong>Aim:</strong> The present research was designed to evaluate the effects of dried rosemary leaves powder on blood sugar and lipid profile of streptozotocin-induced diabetic rats.
<strong>Material and methods: </strong>One hundred (100) male Sprague Dawly rats aged 3 months, weighing 184±11 g, divided into 5 groups (20 rats/group) as follow:G 1: Normal Control; G 2: STZ-induced Diabetics; G 3: STZ-induced Diabetic+ Glibenclamide; G 4: STZ-induced Diabetic+ Dried rosemary leaves powder; G: Normal Control+ Dried rosemary leaves powder. At the end of the experiments (6 weeks, 45 days), rats were fasted overnight, and then sacrificed under ethyl ether and blood was taken for further biochemical analysis.
<strong>Results:</strong> The body weight and High density lipoprotein were decreased significantly in STZ-induced diabetic group of rats when compared to normal control rats. Diabetes induced by STZ resulted in a significant elevation in the levels of fasting blood glucose (FBG), glycosylated haemoglobin (HbA1c), lipid profile (Cholesterol, low, very low density lipoprotein cholesterol) and triacylglycerol. Treatment of STZ-induced diabetic rats with dried rosemary leaves powder reduced the elevated blood glucose, HbA1c, triacylglycerol, cholesterol and LDL-C by 53.97, 24.56, 45.43, 39.31 and 33.89 % respectively in respect to untreated STZ-induced diabetic group. Dried rosemary powder leaves have no significant influence on body weight, plasma glucose level and lipid profile of normal rats.
<strong>Conclusion:</strong> The results of this experiment may indicate that the dried rosemary leaves powder has a beneficial effect as an anti-diabetic agent and its complications as well as improving lipid metabolism in diabetics with no effect on normal rats.
<strong> </strong>
Rosmarinus officinalis,antidiabetic,Antihyperlipidemic
https://ejhm.journals.ekb.eg/article_15834.html
https://ejhm.journals.ekb.eg/article_15834_7a00695e16fc772b332952d0f5ebf6aa.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
53
1
2013
10
01
Role of PET/CT in Management of Chest Tumors
816
826
EN
Heba
Nabil
Nasser Institute Hospital for Research and Treatment, Cairo, Egypt
Karima M
Maher
Radiodiagnosis Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Sameh AR
Mahdy
Radiodiagnosis Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Hossam M
Sakr
Radiodiagnosis Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Khalid
Abdel Karim
Clinical Oncology Depatment, Faculty of Medicine, Ain Shams University, Cairo, Egypt
10.12816/0001644
<strong>ABSTRACT</strong><br /> <strong>OBJECTIVE</strong>: to identify the role of PET-CT in management of chest tumors.<br /> <strong>PATIENTS AND METHODS</strong>: Whole body PET/CT study was performed on 32 patients of variable primary & secondary chest tumors who were under evaluation for primary or secondary chest tumors by recent CT, referred for staging before treatment and / or follow up after treatment.<br /> <strong>RESULTS:</strong> Our findings indicate that FDG PET/CT has an important impact on diagnosis & management of chest tumors , as it delineated the metabolic activity of the disease in 19 patients (59.4 %), outlined the metabolic activity of the tumoral residue in 6 patients (18.75%) , differentiated between tumoral residue & post irradiation pneumonitis in 1 patient (3.1%), followed up the therapeutic response in 4 patients (12.5 %), differentiated between residual mass & post therapeutic fibrosis in 1 patient (3.1%) and delineated the metabolic activity of the disease for preparing for BMT in 1 patient (3.1%) and so had an impact on the management of chest tumor patients.<br /> <strong>CONCLUSION:</strong> By recognizing the relevant radiologic and metabolic behavior of chest tumors, understanding the appropriateness of staging disease with the TNM classification system, and being familiar with potential imaging pitfalls, PET/CT can make an important contribution to diagnosis, treatment and outcome in chest tumor patients.<br /> <strong> </strong>
PET/CT – Chest Tumors – Management
https://ejhm.journals.ekb.eg/article_15835.html
https://ejhm.journals.ekb.eg/article_15835_13cf43d4eace7aa7859443545d337753.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
53
1
2013
10
01
Risk Factors for Coronary Artery Disease in Egyptian Women
827
836
EN
Bahnasawy
MH
Zoology department, Faculty of science, Damietta University, Egypt
Habbak
LZ
Zoology department, Faculty of science, Damietta University, Egypt
Al-Maie
MM
Zoology department, Faculty of science, Damietta University, Egypt
Al-Ashry
MA
Intensive care unit, Damietta chest hospital, Damietta, Egypt
10.12816/0001645
<strong>Introduction:</strong> Coronary artery disease (CAD) is a major public health problem both in developed and in developing countries. The disease is multifactorial and many predisposing risk factors are responsible for this disease. The present study was performed to determine the prevalence of CAD risk factors among Egyptian women at Damietta governorate.
<strong>Patients and methods</strong>: The study was based on investigation of 113 randomly chosen women who had CAD. Demographic data, risk factors were determined by taking history, physical examination and laboratory tests.
<strong>Results: </strong>The results indicated that the age of the patients ranged from 24 to 82 years with a mean of 55.95±11.04 years. The mean total cholesterol, LDL-C and HDL-C were 233.17, 150.77 and 44.80 respectively. The blood sugar ranged from 75 to 488. Risk factors analysis revealed a significant higher prevalence of obesity and overweight (96.46%), hypertension (83.19%), total cholesterol (78.76%), physical inactivity (70.8%), stress (69.03%), diabetes mellitus (57.52%) and family history of CAD (46.9%).
<strong>Conclusion: </strong>This study provides useful information about the health characteristics of the Egyptian women at Damietta governorate and indicates that the development of health education programs and early chick-up is necessary to prevent the risk factors of this disease.
<strong> </strong>
Coronary – risk factors – Damietta,Women
https://ejhm.journals.ekb.eg/article_15836.html
https://ejhm.journals.ekb.eg/article_15836_7076362b04222699739d4dc535cb9134.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
53
1
2013
10
01
Adverse Effects of Digoxin, as Xenoestrogen, on Some Hormonal and Biochemical Patterns of Male Albino Rats
837
845
EN
Eman G.E.
Helal
Department of Zoology, Faculty of Science, Al-Azhar University (Girls)
Maha G.
Soliman
Department of Zoology, Faculty of Science, Al-Azhar University (Girls)
Nadia A.
Abdel-Kawi
Department of Zoology, Faculty of Science, Al-Azhar University (Girls)
Mohamed M.M.
Badawi
Department of Biochemistry, National organization for Drug Control and Research
Nashwa M. G.
Abozaid
Department of Biochemistry, National organization for Drug Control and Research
Hany Nady
Yousef
Department of Biological and Geological Sciences, Faculty of Education, Ain Shams University
10.12816/0001646
<strong>Background: </strong>Xenoestrogens are widely used environmental chemicals that have recently been under scrutiny because of their possible role as endocrine disrupters. Among them is digoxin that is commonly used in the treatment of heart failure and atrial dysrhythmias. Digoxin is a cardiac glycoside derived from the foxglove plant,<em> Digitalis lanata</em> and suspected to act as estrogen in living organisms.
<strong>Aim of the work</strong>: The purpose of the current study was to elucidate the sexual hormonal and biochemical patterns of male albino rats under the effect of digoxin treatment.
<strong>Material and Methods: </strong>Forty six male albino rats (100-120g) were divided into three groups (16 rats for each). Half of the groups were treated daily for 15 days and the other half for 30 days. Control group: Animals without any treatment. Digoxin L group: orally received digoxin at low dose equivalent of 0.0045mg/200g.b.wt. Digoxin H group: administered digoxin orally at high dose equivalent of 0.0135mg/200g.b.wt. At the end of the experimental periods, blood was collected and serum was separated for estimation the levels of prolactin (PRL), FSH, LH, total testosterone (total T), aspartate amino transferase (AST), alanine amino transferase (ALT), alkaline phosphatase (ALP), urea, creatinine, total proteins, albumin, total lipids, total cholesterol (total-chol), Triglycerides (TG), low density lipoprotein cholesterol (LDL-chol) and high density lipoprotein cholesterol (HDL-chol).
<strong>Results: </strong>Results showed marked elevation in PRL and FSH levels and significant reduction in LH and total T levels in all treated groups compared to the corresponding controls. Serum enzyme activities (ALT, AST and ALP) and levels of urea, creatinine, total lipids, total-chol, TG and LDL-chol were obviously elevated in all the treated groups as compared to control groups. Marked decline was recorded in the values of total proteins, albumin, A/G ratio and HDL-chol in all the treated groups at the end of the two time intervals of treatment compared to controls. Regarding serum globulin level, treatment of rats with the low dose of digoxin for 15 days induced significant reduction in this parameter, while globulin returned back to its normal level after 30 days of treatment. On the other hand, the high dose of digoxin caused significant decline in serum globulin concentrations at the two time intervals of treatment. Most of the recorded changes in hormonal and biochemical parameters exhibited dose and time-dependent manner.
<strong>Conclusion: </strong>The results of the current research confirmed that digoxin disrupts the sexual hormonal pattern and biochemical parameters. So, we recommend replacing of this drug by others without estrogenic activity, particularly if it is indicated at a high dose or for a long period of time.
<strong> </strong>
Xenoestrogens,digoxin,Hormones,biochemical parameters
https://ejhm.journals.ekb.eg/article_15837.html
https://ejhm.journals.ekb.eg/article_15837_1f683aadf130faf064fd2796a4ccd884.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
53
1
2013
10
01
Role of Tumor Necrosis Factor Alpha, Ghrelin, Evoked Potentials in Hepatic Encephalopathy
846
854
EN
Wafaa M.
Elzefzafy
Departments of Tropical Medicine, Neurology Faculty of Medicine for Girls, Al-AzharUniversity
Abeer
AboulEla
Departments of Tropical Medicine, Neurology Faculty of Medicine for Girls, Al-AzharUniversity
Manal H.
Maabady
Departments of Tropical Medicine, Neurology Faculty of Medicine for Girls, Al-AzharUniversity
Radwa S.
Shahin
Clinical Pathology Faculty of Medicine for Girls, Al-AzharUniversity
10.12816/0001647
<strong>Background</strong>: Hepatic encephalopathy has a negative effect on patient health-related quality of life. Apart from increased blood ammonia, alterations in various other substances (Tumor necrosis Factor- Alpha (TNF-α), Ghrelin)have been implicated in the pathogenesis of hepatic encephalopathy (HE). Ghrelin and TNF-alpha have numerous metabolic actions.
<strong>Aim of the work:</strong> was to estimate the role of TNF -α, Ghrelin and Evoked Potentials changes in patients with hepatic encephalopathy, and their relation to grades of hepatic encephalopathy <strong>Methods:</strong> We measured serum levels of TNF -α, Ghrelin in 40 patients with liver cirrhosis (20 with hepatic encephalopathy & 20 without encephalopathy) and 10 healthy controls. All subjects underwent to neurophysiological test: p300,visual and auditory evoked potentials.
<strong>Results</strong>: The results of this study showed highly significant increase in TNF -α, Ghrelin & levels in both groups when compared to the control group with a significant increase in the cirrhotic encephalopathic group. Also significant correlation between TNF-α, Ghrelin & grading of encephalopathy was found. Delay in latency and decrease amplitude of VEP, p 300 and ABR were significant in cirrhotic patients with hepatic encephalopathy.
<strong>Conclusion</strong>: TNF -α, Ghrelin levels are sensitive indicators of the severity of liver disease. Patients with liver cirrhosis can be followed up by measurement of these serum markers which might predict the development of encephalopathy. The increasing levels of Ghrelin & TNF-α is more prominent in cirrhosis with encephalopathy. The presence of nutritional and metabolic abnormalities, including malnutrition in cirrhosis, at least partly, elucidates high Ghrelin level. The applied neurophysiological tests are a simple, suitable and objective method for differentiating the degrees of encephalopathy and for identifying the preclinical stage of encephalopathy because abnormalities in these tests may prompt the clinician to initiate treatment.
<strong> </strong>
TNF,ghrelin,evoked potentials,hepatic encephalopathy
https://ejhm.journals.ekb.eg/article_15838.html
https://ejhm.journals.ekb.eg/article_15838_a4f6171377322efa8482fc94edec0eab.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
53
1
2013
10
01
Treatment of Cisplatin Induced Kidney Injury in Rats by Bone Marrow- derived Mesenchymal Stem Cells
855
868
EN
Habbak
L.Z
Zoology Department, Faculty of Science, Damietta University, Egypt.
Bahnasawy
M.H
Zoology Department, Faculty of Science, Damietta University, Egypt.
Zatar
S.M
Zoology Department, Faculty of Science, Damietta University, Egypt.
Sobh
M.A
Urology and Nephrology Center, Mansoura University, Egypt
Amin
M.M
Pathology Department, Faculty of Medicine, Mansoura University, Egypt
10.12816/0001648
<strong>Background</strong>: Cisplatin is one of the most important antineoplastic drugs used in the treatment of many cancers; however the main dose-limiting side effect of cisplatin is nephrotoxicity. It has multiple cellular targets and modes of action that lead to nephrotoxicity. The present study aims to test whether bone marrow-derived mesenchymal stem cells (BM-MSCs) may play a therapeutic role in the treatment of nephrotoxicity. <br /> <strong>Material and methods</strong>: Adult male Sprague Dawley rats (SD), were divided into four groups. The first group was injected (i.p) with <strong>1ml</strong> normal saline alone and kept as control, the second group was injected (i.p) with <strong>1ml</strong> normal saline containing <strong>5mg/kg</strong> cisplatin, the third group was injected (i.p) with <strong>1ml</strong> normal saline containing <strong>5mg/kg</strong> cisplatin and <strong>0.5</strong> <strong>ml </strong>of culture media containing <strong>5 x10<sup>6</sup></strong> BM-MSCs into the tail vein in the first day post cisplatin injection and the fourth group was injected with <strong>1ml</strong> normal saline containing <strong>5mg/kg</strong> cisplatin and <strong>0.5</strong> <strong>ml</strong> of culture media into the tail vein in the first day post cisplatin injection.<br /> <strong>Results:</strong>Serum creatinine, blood urea nitrogen, creatinine clearance and malonadialdehyde were decreased in the kidney that received BM-MSCs while; superoxide dismutase and glutathione were increased to reach the normal values. Infusion of BM-MSCs ameliorated the renal dysfunction and enhanced tissue injury caused by cisplatin.<br /> <strong>Conclusion: </strong>The present study shows BM-MSCs can exert a protective effect on cisplatin nephrotoxicity and suggests that BM-MSCs might be a new therapeutic approach for patients with kidney injury.<br /> <strong> </strong>
Cisplatin,kidney,Nephrotoxicity,stem cells
https://ejhm.journals.ekb.eg/article_15839.html
https://ejhm.journals.ekb.eg/article_15839_d72af35f71d691c92af507eda1a46137.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
53
1
2013
10
01
Prescrotal Orchiopexy for the Palpable Undescended Testicle (UDT): Initial Experience and Comparison with The Standard Inguinal Approach
869
873
EN
Suoub
M.
Section of Urology medical school, Mu’tah University, Karak Teaching Hospital, Jordan
Fadi
Sawaqed
Section of Urology medical school, Mu’tah University, Karak Teaching Hospital, Jordan
Sayel
Al-Khitan
Section of Urology medical school, Mu’tah University, Karak Teaching Hospital, Jordan
Yaser
El-Hout
Section of Urology medical school, Mu’tah University, Karak Teaching Hospital, Jordan
10.12816/0001649
<strong>Objective</strong>: To review our initial experience with prescrotal orchipexy, to illustrate this surgical approach, and to compare it with the standard two incision inguinal approach.
<strong>Material and Methods</strong>: This is a single institution retrospective comparative review of 135 patients (pts) who underwent orchiopexy for UDT over 4 years. Pts undergoing the standard inguinal orchiopexy were compared to those undergoing the emerging single-incision prescrotal approach in regards to operative time, complications and cosmesis.
<strong>Results:</strong> The study was completed on 96 pts who met the inclusion criteria. Group A (72 pts, 75%) underwent the standard two-incision inguinal orchiopexy while Group B (24 pts, 25%) underwent the single-incision prescrotal orchiopexy. Average age at surgery was 3.2 years, with a mean follow up of 13 months. Average operative time was 56 minutes for Group A and 32 minutes for Group B, by using SPSS significant P value difference (p < 0.05) was calculated . All patients from the two groups had uneventful postoperative period with one pt in Group A who had a scrotal wound infection. None of the pts in Group B need conversion to the inguinal approach. At last follow-up, all patients in both groups had testicles in the scrotum with no atrophy. While the cosmetic appearance in Group A was acceptable, cosmesis in Group B was superior.
<strong>Conclusion</strong>: Prescrotal orchipexy is a safe alternative to the standard inguinal orchiopexy for the palpable UDT. Our study demonstrates similar outcome, shorter operative time and superior cosmesis.
<strong> </strong>
undescended testicle,single incision,orchiopexy
https://ejhm.journals.ekb.eg/article_15840.html
https://ejhm.journals.ekb.eg/article_15840_e34ab10b3ff99cef6a9eac5ac45e3272.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
53
1
2013
10
01
The Relation of Retinol-Binding Protein 4 (RBP4) With Insulin Resistance in Hemodialysis Patients
874
882
EN
Eman I.
Sarhan
Ain Shams University,faculty of medicine,Internal Medicine&Nephrology
Ahmed A.
Abdelnaby
Ain Shams University,faculty of medicine,Internal Medicine&Nephrology
Hyam M.
Aref
Ain Shams University,faculty of medicine,Internal Medicine&Nephrology
Yasser M.
El Shahawy
Ain Shams University,faculty of medicine,Internal Medicine&Nephrology
Mohammed R.
Halawa
Ain Shams University,faculty of medicine Internal Medicine&Endocrinology
Nahla M.
Teama
Ain Shams University,faculty of medicine Internal Medicine
10.12816/0001650
<strong>Background:</strong> Insulin resistance (IR) is one of the important causes of abnormal glucose homeostasis in CKD even in the absence of overt diabetes mellitus. Retinol-binding protein 4 (RBP4) is a lipocalin superfamily molecule that is synthesized primarily by hepatocytes and adipocytes. CKD may contribute to the increased survival and retention of RBP4 in the circulation. RBP has recently been proposed as a novel adipokine involved in the metabolism of glucose.
<strong>Objective: </strong>
To evaluate Retinol Binding Protein 4 in stage 5 Chronic kidney disease patients on regular hemodialysis and its contribution to insulin resistance in those patients.
<strong>Patients &Methods:</strong>
The patients divided into 2 groups:
<strong>Group I: </strong>Patients group consist of 50 ESRD patients on regular hemodialysis; they were 20 females (40.0%) and 30 males (60.0%) with age ranged from 19 years to 52 years and with mean±SD (38.08±7.1 years).
<strong>Group II: </strong>Control group consists of 50 normal subjects; 26 females (52%) and 24 males (48%) with age ranged from 21 years to 51 years and with mean±SD (35.38±8.77 years).
<strong>Results: </strong>comparison between group I and group II show that there was highly significant increase in RBP4 (p 0.000) while no statistically significant difference found between the two studied groups regarding HOMA (p 0.260).
<strong>Conclusion:</strong>no correlation betweenRBP4 and HOMA in hemodialysis patients.
<strong> </strong>
Insulin Resistance,Retinol binding protein
https://ejhm.journals.ekb.eg/article_15841.html
https://ejhm.journals.ekb.eg/article_15841_fa9df7faa21e66eb46562ebcd5af8b11.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
53
1
2013
10
01
Histological Studies on Skeletal Muscles of Albino Rats under the Effect of Atorvastatin
883
903
EN
Hassan S. A.
El Dawi
Histology Departments, Faculty of Medicine (Cairo and Damietta),
Al-Azhar University
Gamal S.
Elgharabawy
Histology Departments, Faculty of Medicine (Cairo and Damietta),
Al-Azhar University
Ezz El-Dein
El Sharkawy
Histology Departments, Faculty of Medicine (Cairo and Damietta),
Al-Azhar University
Abd El Ghany A.
Moustafa
Histology Departments, Faculty of Medicine (Cairo and Damietta),
Al-Azhar University
Ibraheim M.
Amr
Histology Departments, Faculty of Medicine (Cairo and Damietta),
Al-Azhar University
Osama I. R.
Bayomy
Histology Departments, Faculty of Medicine (Cairo and Damietta),
Al-Azhar University
10.12816/0001651
<strong>Introduction</strong>:The purpose of this study was to evaluate the effect of atorvastatin on the structure of skeletal muscles in male albino rats and the possibility of recovery of any changes in the muscles.
<strong>Drug used:</strong> Atorvastatin (Lipitor 20mg) tablets<strong>.</strong>The daily single oral dose was 1.6 mg /kg body weight.
<strong>Experimental animals: </strong>Twenty five adult local strain male albino rats with average weight of 160 gm were chosen, divided into five equal groups and fed on ordinary rat diet<strong>:</strong> Group <strong>I</strong> (control group), Group <strong>II</strong> treated with atorvastatin (1.6 mg/kg/b.wt/day) for two weeks, Group <strong>III</strong> treated with atorvastatin for two weeks then stopped receiving treatment for two weeks (recovery group <strong>1</strong>), Group <strong>IV</strong> treated with atorvastatin for four weeks and Group <strong>V</strong> treated with atorvastatin for four weeks then stopped receiving treatment for four weeks (recovery group <strong>II</strong>).
<strong>Results:</strong> Administration of atorvastatin for long duration resulted in some sort of myotoxic structural changes and apoptosis as evident by deformity in the mitochondria , lack of striation , degeneration of nuclei and splitting of muscle fibres in the adult male albino rat skeletal muscle.
<strong>Conclusions:</strong>Atorvastatin (statin) has many adverse effects on the skeletal muscle tissues with treatmant for long duration (Group IV). So, patients should avoid the possible side effects.
<strong> </strong>
albino rats,Atorvastatin drug,skeletal muscles
https://ejhm.journals.ekb.eg/article_15842.html
https://ejhm.journals.ekb.eg/article_15842_19f90c658d2f9fc037ea3d503ab532f5.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
53
1
2013
10
01
The Relationship between Serum Leptin Level and Bone Mineral Denisty in Postmenopausal Osteoporotic Women
904
908
EN
Fahmy
Emam
Physical Medicine, Rheumatology and Rehabilitation
Sobhia Ali
Mahmoud
Physical Medicine, Rheumatology and Rehabilitation
Amany Mohammed
El-Said
Clinical Pathology ,Faculty of medicine for girls, Al-Azhar University
Mona Mokhatr
El-Metwally
Clinical Pathology ,Faculty of medicine for girls, Al-Azhar University
10.12816/0001652
Postmenopausal osteoporosis is a heterogeneous disorder characterized by a progressive loss of bone tissue that begins after menopause and leads to fracture within 15-20 years from the cessation of the ovarian function.Human leptin is a protein of 167 amino acids. It is manufactured primarily in the adipocytes of white adipose tissue, and the level of circulating leptin is proportional to the total amount of fat in the body.Leptin’s effects on bone are mediated via a central neuroendocrine signaling pathway, as well as directly on bone marrow stem cells to enhance their differentiation to osteoblasts and inhibit their differentiation to adipocytes.
<strong>Aim of the Study: </strong>to detect the relation between serum leptin level, total lipid profile and bone mineral denisty in postmenopausal osteoporotic women.
<strong>Subjects and Methods: </strong>The study was carried on 40 postmenopausalfemales. According to Dual Emergy X-ray absorptiometry (DEXA), the subjects were divided into group A, Tt-score <span style="text-decoration: underline;"><</span>-2.5, group B, t-score <-1, leptin and lipid profile were measured for all subjects.
<strong>Conclusion:</strong>The current study has provided evidence that bone mineral density is influced by serum leptin level in postmenopausal osteoporotic women and positive correlation between serum leptin level and bone mineral density was found.
<strong>Recommendation: </strong>Serum leptin level measurement could be used as a simple and non invasive method for screening programs for osteoporosis in postmenopausal women but the accuracy of this test still needs furtherer studies.
<strong>Abbreviation:</strong> Ob gene : Obese gene; BMD : Bone Mineral Density;
NOF: National Osteoporosis Foundation; M-CSF : Monocyte colony stimulating factor;
BMI: Body mass index; DEXA: Dual-energy X-ray absorptiometry
serum leplin, Bone Mineral Denisty,Postmenopausal Osteoporotic
https://ejhm.journals.ekb.eg/article_15843.html
https://ejhm.journals.ekb.eg/article_15843_f0b5ae47f3b995e4954ec6ba2b9b5afd.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
53
1
2013
10
01
Bioleaching of Rare Earth Elements and Uranium From Sinai Soil, Egypt Using Actinomycetes
909
917
EN
Maha Amin
Hewedy
College of Women for Arts, Science and Education, Ain Shams University Cairo, Egypt
Abeer Ahmed
Rushdy
College of Women for Arts, Science and Education, Ain Shams University Cairo, Egypt
Noha Mohammed
Kamal
College of Women for Arts, Science and Education, Ain Shams University Cairo, Egypt
10.12816/0001653
The use of microorganisms in the recovery of Rare Earth Elements (REEs) and Uranium (U) from low grade ores provides an appropriate eco-friendly alternative to chemical methods used in extraction and/or removal of metals from soils, with a higher efficiency, less destruction to the environment, and lower cost from a commercial view especially given that high-grade mineral resources that can be used in the chemical extraction of metals are being depleted. The feasibility of using actinomycetes to recover REEsand Ufrom a low-grade ore occurring in an Egyptian soil in Wadi Abu Thor, Sinai, Egypt, was investigated. The most effective isolate in REEs-bioleaching was <em>Streptomyces fungicidicus</em> YH04, while the most effective isolate in U-bioleaching was <em>Streptomyces aureofaciens</em> 3001(1).<em> Streptomyces fungicidicus</em> YH04 bioleached 37.13% of the REEs present in the sample, while <em>S. aureofaciens </em>3001(1) bioleached of 12.56% of the U present in the sample. The isolated strains of actinomycetes can be used to extract REEs and U by better, more economic and less polluting bioleaching processes instead of the chemical processes which are in common use today.
Actinomycetes,Streptomyces,Rare earth elements,Uranium,Bioleaching
https://ejhm.journals.ekb.eg/article_15844.html
https://ejhm.journals.ekb.eg/article_15844_0c545b96acbc735d5f8eb56ee1755b64.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
53
1
2013
10
01
A Study of the Effect of Angiotensin Converting Enzyme Inhibitors and Thiazides on Bone Mineral Density in Hypertensive Elderly
918
922
EN
Ahmed K
Mortagy
Geriatrics and Gerontology department, Faculty of Medicine, Ain shams university, Cairo, Egypt
Sara A
Hamza
Geriatrics and Gerontology department, Faculty of Medicine, Ain shams university, Cairo, Egypt
Hoda MF
Wahba
Geriatrics and Gerontology department, Faculty of Medicine, Ain shams university, Cairo, Egypt
Nermien N
Adly
Geriatrics and Gerontology department, Faculty of Medicine, Ain shams university, Cairo, Egypt
Asmaa M
Nabiel
Geriatrics and Gerontology department, Faculty of Medicine, Ain shams university, Cairo, Egypt
10.12816/001654
<strong>Background:</strong> Hypertension and osteoporosis are two major age-related disorders. Several studies have shown greater Bone Mineral Density (BMD) in people receiving thiazides diuretics compared with controls. The benefit of Angiotensin Converting Enzyme Inhibitors (ACEIs) to improve bone metabolism has been supported by some clinical studies. Therefore, these drugs might be a part of the therapeutic regime for osteoporotic hypertensive elderly. <strong>Objective:</strong> to compare between the effect of ACEIs and thiazides on BMD when used separated or combined in hypertensive elderly.
<strong>Patients&method:</strong> A retrospective comparative study recruiting 171 participants who were aged 60 years and above from the outpatient clinics of Ain shams University Hospitals. The participants were divided into three groups: Group I: 57 participants receiving thiazides, Group II: 57 participants receiving combined ACEIs and thiazides, Group III: 57 participants receiving ACEIs. Each group was subdivided into two subgroups; older and younger than the median age (65years) of participants. Patients with systemic diseases or on drugs that affect BMD were excluded from the study. All participants were subjected to: BMD measurement at lumbar spine (L2-L4) and left femur neck using Dual-energy x-ray absorptiometry (DEXA) [lunar DPX DEXA system].
<strong>Results</strong>: As regard lumbar (L2-L4) BMD T-score ,there was no significant difference found between the groups as a whole sample (P-value 0.383), nor the age subgroups ,when subdivided into two subgroups older than the median age (65 years old)(P-value 0.832) and from 65 years old and younger (P- value0.259) (the same was found as regard z-score). As regard BMD of the Left Femur Neck T-score there was no significant difference found neither between the groups as a whole sample (P-value 0.921), nor among the age subgroups when subdivided into two subgroups older and younger (p-value 0.889), (the same was found as regard z-score). <strong>conclusion:</strong> the current study found no evidence that there is a difference between thiazides therapy and ACEIs therapy as regard their effect on BMD in elderly hypertensive patients when used separated or combined.
<strong> </strong>
ACEIs,Thiazides,BMD
https://ejhm.journals.ekb.eg/article_15845.html
https://ejhm.journals.ekb.eg/article_15845_fe7b03394023a80aeb619aae258207e6.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
53
1
2013
10
01
Role of MR Spectroscopy in Characterization of Breast Masses
923
934
EN
Sherif T
Gamal El Din
Department of Radiodiagnosis, Ain Shams University.
Mohammed A
Darwish
Department of Radiodiagnosis, Ain Shams University.
Ahmed M
Monib
Department of Radiodiagnosis, Ain Shams University.
Togan T
Abd El Aziz
Department of Radiodiagnosis, Ain Shams University.
10.12816/0001655
<strong>Introduction: </strong>Dynamic contrast enhanced magnetic resonance imaging “MRI” is not 100 percent accurate in distinguishing benign from malignant lesions, resulting in a large number of breast biopsy procedures recommended on the basis of imaging findings. Proton magnetic resonance spectroscopy “¹H MRS” can provide chemical information about a lesion by measuring the levels of choline compounds, which are markers of an active tumor. In most cases, the results indicate whether the lesion is cancerous without need for biopsy. In addition to being used in breast cancer diagnosis, in vivo ¹H MRS has also been used to monitor breast cancer response to chemotherapy as well as in differentiating between scar tissue and recurrent cancer after breast-conserving therapy.
<strong>Aim of the work:</strong> To evaluate the diagnostic performance of magnetic resonance spectroscopy “MRS” in characterization of breast masses with histopathologic findings or follow up used as the reference standard.
<strong>Methods:</strong> The studied group included 50 female patients referred for MRI breast for workup of a suspicious clinical, mammographic, or sonographic abnormality. ¹H MRS was added to the routine study. Results of the contrast enhanced bilateral breast MRI and ¹H MRS of the 50 patients were all reported and compared with the histo-pathological results of surgery or biopsy and with the results of follow up of lesions that were not surgically removed or biopsied.
<strong> Results: </strong>there was a highly significant relation between ¹H MRS and histopathological. Follow Up results with p value = 0.005. The sensitivity, specificity, positive and negative predictive values of ¹H MRS for characterization of suspicious breast lesions in patients included in the study, were 90%, 93.3%, 90%, and 93.3% respectively.
<strong>Conclusion: </strong>¹H MRS is a short non-invasive scan that can be inserted easily into standard clinical breast MRI protocols as a potential adjunct that can be added routinely to conventional breast MRI. Detection of choline peak with estimation of the choline signal to noise ratio “SNR” can accurately differentiate benign from malignant breast lesions with high sensitivity and specificity especially when its results are combined with the results of the standard dynamic MRI scan.
<strong> </strong>
MRI,H MRS,spectroscopy,Breast Masses
https://ejhm.journals.ekb.eg/article_15846.html
https://ejhm.journals.ekb.eg/article_15846_59f1e2862326ce4275f0461c69f269a9.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
53
1
2013
10
01
Role of Diffusion MRI & Dynamic Contrast-enhanced MRI in Assessment of Hepatocellular Carcinoma after Trans-arterial Chemoembolization
935
946
EN
Fatma S.El-dien
Mohammed
Radiodiagnosis Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Hanaa Abd Elkader
Abd Elhamed
Radiodiagnosis Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Yosra Abdelzaher
Ibrahim
Radiodiagnosis Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Ali Haggag Ali
Noreldien
Radiodiagnosis Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
10.12816/0001656
<strong>Abstract</strong>:<strong>Purpose</strong>: to assess the effectiveness of diffusion & Dynamic contrast enhanced MRI in imaging of hepatocellular carcinoma after chemoembolization.<br /> <strong>Patients and Methods</strong>: between November 2011 & September 2013, 30 patients were treated with chemoembolization in our interventional radiology unit. All patients underwent pretreatment MRI within 10 days before chemoembolization & post-treatment MRI after one month from treatment. The arterial enhancement as well as the mean Apparent Diffusion Coefficient (ADC) of the focal lesion was prospectively assessed & the percent change in both was assessed. The significance of differences between ADC values of complete & partially responding lesions was calculated.<br /> <strong>Results</strong>: Thirty male patients, ranging in age between 51 & 73 years who met the inclusion criteria were prospectively studied. According to the results of this study, there was a statistically significant difference between patients with partial response & those with complete response as regard the percent change in the mean ADC value of the focal lesion after treatment with P-value less than 0.001. There was significant positive correlation between the percent change in the mean ADC value & the percent change in the diameter of the enhancing tumor tissue after treatment. The percent change in the mean ADC value among patients with complete response was higher than that among patients with partial response with P-value less than 0.001. The best predictive cut off value for differentiation between complete & partial response was 24 % increase in the mean ADC value, with 99 % sensitivity, 84 % specificity, 90 % positive predictive value, 99 % negative predictive value & 86 % accuracy. The % change of the mean ADC value is considered better positive than negative predictor for response to treatment. On the otherhand, there was no statistically significant difference between patients with complete & partial response as regard the mean ADC of the focal lesion before chemoembolization.<br /> <strong>Conclusion</strong>: After chemoembolization, completely responding HCC lesions exhibited more increases in the mean ADC than partially responding lesions. Pretreatment mean ADC values were not predictive of response to chemoembolization<br /> <strong> </strong>
Hepatocellular carcinoma,chemoembolization,Diffusion,dynamic MRI
https://ejhm.journals.ekb.eg/article_15847.html
https://ejhm.journals.ekb.eg/article_15847_5077844e98819153ecedaed4eb91dabb.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
53
1
2013
10
01
Effect of Insulin-sensitizer Drug (Metformin) on Some Physiological Parameters in Some Infertile Obese Egyptian Women Undergoing ICSI
947
959
EN
Eman G.E.
Helal
Zoology Department, Faculty of Science, Al-Azhar University (Girls)
Samia M.
Abd El-Wahab
Zoology Department, Faculty of Science, Al-Azhar University (Girls)
Aziza M. Aly
Mansour
International Islamic Center for Population Studies and Research, Al-Azhar University
Mervat M.
Mahmood
International Islamic Center for Population Studies and Research, Al-Azhar University
Amira B.
Mehaney
International Islamic Center for Population Studies and Research, Al-Azhar University
10.12816/0001657
<strong>Background: </strong>Egyptian infertileobese women with polycystic ovary syndrome (PCOS) were markedly increased in ART Unit for infertility treatment undergoing ICSI. In a trial to enhance the ovulation, fertilization response and pregnancy outcome treated patients with Metformin as insulinsensitizing drug, 3 months before ICSI processing.<br /> The aim of this study was to evaluate the effect of Metformin on the hormonal profile, lipid and lipoprotein profile and insulin resistance in obese PCOS patients undergoing ICSI.<br /> <strong>Setting: </strong>This study was conducted at International Islamic Center for Population Studies and Research, Assisted Reproduction Unit, Al-Azhar University during the period between 2009 and 2011.<br /> <strong>Design: </strong>A prospective randomized study.<br /> <strong>Patient and Methods:</strong> A total of 75 patients with obese PCOS were randomized to receive oral Metformin for three months. For each patient, FBS and Hb, hormonal profile included FSH, LH, FSH/LH ratio, E<sub>2</sub> and PRL, lipid and lipoprotein profile included total cholesterol, LDL, HDL and triglycerides evaluation were performed at baseline and after 3 months of treatment.<br /> <strong>Results:</strong> There was a significant decrease in the FBS in cases treated with Metformin when compared with control or obese PCOS, no significant differences were noticed in the level of Hb% in both groups. Total lipids, triglycerides and total cholesterol were decreased significantly compared with obese PCOS group. Significant decrease was also observed in respect to LDL in cases of Metformin than cases of obese PCOS. Significant increase in the level of HDL was recorded. Significant decrease was detected in FSH, LH and FSH/LH ratio in Metformin treated group while no difference was observed in prolactin or estradiol hormonal profiles. Observed improvement was detected in the number of received HMG ampoules, mature oocytes, number of grade A embryos and in pregnancy outcome.<br /> <strong>Conclusion:</strong> Metformin as lowering insulin resistance, improving the response in obese PCOS women undergoing ICSI, by enhance their resistance sensitivity in transadipose tissue leads to improvement the function of gonads and hormonal and lipids profile .This improvement was detected by decreased total cost for ICSI, lowering the number of both given stimulation ampoules and mature collected oocytes and finally the percent of successful pregnancy rate.<br /> <strong><span style="text-decoration: underline;"> </span></strong>
PCOs,obese,Metformin,ICSI,Lipid profile,physiological parameters
https://ejhm.journals.ekb.eg/article_15848.html
https://ejhm.journals.ekb.eg/article_15848_a4b696cb28b7aa24f2a1a40ed9c7069c.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
53
1
2013
10
01
Biochemical Diagnosis of Peroxisomal Disorders by GC/MS: Egyptian Patients with X-linked Adrenoleukodystrophy
960
966
EN
Ekram
Fateen
Biochemical Genetics Department, Human Genetics and Genome Research Division, National Research Centre.
Amr
Gouda
Biochemical Genetics Department, Human Genetics and Genome Research Division, National Research Centre.
Mona
Ibrahim
Biochemical Genetics Department, Human Genetics and Genome Research Division, National Research Centre.
10.12816/0001658
<strong>Background: </strong>Peroxisomes are organelles responsible mainly for metabolism of lipids and peroxides. Lack of peroxisomes or dysfunction in any of their normal functions is the cellular basis for human peroxisomal disorders (PDs).<strong> </strong>
<strong>Aim of the Work: </strong>diagnosis of peroxisomal disorders among a high risk group of Egyptian patients using gas chromatography mass spectrometry<strong>.</strong>
<strong>Subjects and Methods:</strong> Forty six patients suspected to have peroxisomal disorders were included in this study. Their ages ranged from 2 to 20 years. They were referred to The Biochemical Genetics Department, National Research Centre from all over Egypt. Forty one (89%) were males while five were females (11%). Parental consanguinity was positive in 28 cases (61% out of 46). Very long chain fatty acids were quantified after extraction from plasma of all cases using gas chromatography/mass spectrometry (GC/MS) technique.
<strong>Results: </strong>The present study included 46 cases suspected clinically to have one of the peroxisomal disorders; four of them (8.7%) proved to have X-linked adrenoleukodystrophy by quantitative determination of the very long chain fatty acids after extraction from their plasma. The other 42 cases showed normal profile for very long chain fatty acids.
<strong>Conclusion: </strong>
This study showed that GC/MS analysis for VLCFA discriminates patients from controls, representing a non-invasive, reliable, specific and sensitive method for the diagnosis of peroxisomal disorders.
https://ejhm.journals.ekb.eg/article_15849.html
https://ejhm.journals.ekb.eg/article_15849_b76048dd90e38c2d0554573268c55d99.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
53
1
2013
10
01
Unexplained Somatic Symptoms due toDepression and/or Subclinical Hypothyroidism
967
975
EN
Hala El Said
Sayyah
Assistant professor of psychiatry, BeniSuef University, Egypt
Maha Mahmoud
El Shafei
Lecturer of internal Medicine, Mansoura University, Egypt
Rania Hussein
Mohamed
Lecturer of psychiatry, Al-Azhar University ( For Girls ),Egypt.
10.12816/0001659
<strong>Background:</strong> Unexplained somatic symptoms are common presentation of many diseases including subclinical hypothyroidism and depression. Subclinical hypothyroidism (mild thyroid failure) represents an early stage of thyroid disease that will commonly progress to overt hypothyroidism.
<strong>Objectives: </strong>To assess the presence of depression and subclinical hypothyroidism (mild thyroid failure) in patients presenting with unexplained somatic symptoms aiming for better care provided to those patients. Special care should be provided to females as they are more likely to be affected by both conditions.
<strong>Method: </strong>Patients were collected conveniently from those attended internal medicine clinic during the period from January to August 2013 complaining from multiple unexplained somatic symptoms. Patients with clinical hypothyroidism or anemia or other cause of their presenting somatic complaints were excluded from the study. Remaining 48 patients were having only unexplained somatic symptoms which proved after investigation to have subclinical hypothyroidism with high TSH while their T4 were normal. Then they were screened for depression byPatient Health Questionnaire 9 (PHQ-9), fatigue severity scale (FSS), Somatic Symptom Inventory (SSI), and Sheehan Disability Scale (SDS) for measurement of functional impairment.
<strong>Results:</strong> Females (n=36) represent 75% of cases while males (n=12) represent only 25% of cases. FSS was significantly higher in females than males (t=2.373, p=0.023). Fatigue is the most common presenting symptom among all patients (n=21, 43.7%) followed by weight gain (n=16, 33.3%)
and lastly generalized aches (n=11, 22.9%). More females presented with fatigue (n=15, 72.7%) than males (n=6, 28.6%). Females are earlier than males to seek medical advice. Only 19 patients (39.6%) were presented early and females were majority of them (n=17, 89.5%). There were positive correlations between severity of depression and (physical symptoms severity, fatigue, and degree of functional disability). There were significant negative correlations between T4 serum level and (depression severity and degree of functional disability).
<strong>Conclusion: </strong>Mild thyroid failure frequently progresses to overt hypothyroidism. It may clearly be associated with somatic symptoms, depression, memory and cognitive impairment. It is common more in females than males regardless their age. Early detection & treatment of mild thyroid failure and depression has been reported to be cost-effective and can prevent further functional impairment.
<strong> </strong>
https://ejhm.journals.ekb.eg/article_15850.html
https://ejhm.journals.ekb.eg/article_15850_6382c22d69f7b7535ee281dfa553aa2b.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
53
1
2013
10
01
Wheezy Chest in Children: Findings and Outcome
976
987
EN
Abdelaziz, A.
El-Sadek
Public Health and Community Medicine . Faculty of Medicine - Al Azher University
Khaled
Zaed
Pediatrics Departments. Faculty of Medicine - Al Azher University
10.12816/0001660
<strong>Background</strong>: wheezy chest is a serious public health problem throughout the world, affecting people of all ages and were recognized as leading cause of morbidity and mortality in the under-five children in developing countries. The disease places a burden on the health services in term of admission to hospitals and health centers.
<strong>Objectives</strong>: to identify some epidemiological aspects and fate of hospitalized cases of wheezy chest.
<strong>Material and Methods</strong>: A descriptive study was used to the study 385 children with wheezy chest among those admitted to el-Husen university hospital, Cairo, from January to December 2012 using a pre-designed questionnaire to collect data from mothers of the admitted children. The children recruited were those < 12 years coming with respiratory distress for one year. The variables included are age, sex, education, income, crowding index, symptoms presented. Laboratory findings and x ray were done to some cases when needed in the clinical pathology and x ray departments at hospital in the routine investigation of such cases. Administrative and ethical issues as patient consent and confidentiality were followed in all steps of the study. The data were analyzed by SPSS program version 18. Descriptive and analytic statistics were done. The lowest accepted level of significance was 0.05 or less.
<strong>Results</strong>: The highest affected age was infants (54%), males (53.7%), and of low income families (69.6%). Cough, dyspnea and tachypnea are the most frequent clinical findings (82.3%). Most investigations were normal, and more than half of cases have positive CRP. High percent had bronchovascular marking plus pneumonic patches and hyper-inflated chest in about 34.1% and 36.5% respectively. Most of admitted cases stayed at hospital for 10 days on average. High percent of the studied cases have respiratory distress (41.2%), wheezes (30.6%) and also recurrent wheezy chest (20.0%). The studied cases diagnosed as acute bronchiolitis (27.1%), bronchial asthma (18.8%) and bronchopneumonia (34.1%). The fates of cases were: improved with no complications (72.9%), improved with nebulizer (23.5%) and no case fatality recorded. Bronchopneumonia recorded highest CRP readings than the other acute respiratory infections.
<strong>Conclusions and recommendations</strong>: wheezy chest is a major cause of hospitalization of male infant of poor families. Cough, dyspnoea and tachypnea were major findings. Wheezy chest were recognized as pneumonia, acute bronchiolitis, and bronchial asthma with better outcome. We recommend admission of severe cases of wheezy chest, and the wheezy chest with other health problems (liable for complications) to minimize over use of beds.
<strong> </strong>
wheezy chest,cough,Dyspnea,Outcome
https://ejhm.journals.ekb.eg/article_15851.html
https://ejhm.journals.ekb.eg/article_15851_7a5cc600d38c33de5ddbd695803e9b93.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
53
1
2013
10
01
Chest Pain in Pediatric Patients Referred to Pediatric Cardiology Clinic
988
990
EN
Majdi
Jaafreh
Pediatric cardiologist, Queen Alia Heart Institute, Amman, Jordan
mjaafreh@gmail.com
10.12816/0001661
<strong>Objectives: </strong>To evaluate causes of chest pain in children referred to pediatric cardiology clinic and the need for echocardiography in these patient.<br /> <strong>METHODS: </strong>A prospective study conducted in Prince Ali Hospital, in the southern of Jordan, between Nov. 2010 till Nov. 2012. Clinical history and physical examination done. Electrocardiogram, chest X-ray, and echocardiogram for all patients, and a 24-hour Holter monitoring, if needed.<strong><br /> RESULTS: </strong>A total of 145 children were referred to pediatric cardiology clinic.
Musculoskeletal causes were the most common accounting for (36.6%), idiopathic chest pain (31%), respiratory causes (15%), gastrointestinal causes (4.1%) and miscellaneous disorders (6.9%), while cardiac causes found in 9 patients (6.2%), echocardiography was positive in 4 patients (2.8%).<strong> <br /> CONCLUSIONS: </strong>The study reveals that cardiac etiologies for childhood chest pain account for a small percentage, and these can be excluded by a complete history and physical examination. Therefore, echocardiogram may not be necessary, and shouldn't be part of routine evaluation of children with chest pain<strong>.</strong>
<strong> </strong>
Chest Pain,Pediatric Patients,Echocardiography
https://ejhm.journals.ekb.eg/article_15852.html
https://ejhm.journals.ekb.eg/article_15852_e5ec0095f6ac99ab865fe644415056d4.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
53
1
2013
10
01
Effect of Lifestyle Modification in Hypertensive Patients in Greater Cairo
991
1006
EN
Fargally
M
Public Health and Community Medicine Department, Faculty of Medicine, Al-Azhar University Cairo
Elsadek
A
Public Health and Community Medicine Department, Faculty of Medicine, Al-Azhar University Cairo
Abdelhady
AS
Public Health and Community Medicine Department, Faculty of Medicine, Al-Azhar University Assiut
Ghandor
A
Public Health and Community Medicine Department, Faculty of Medicine, Al-Azhar University Damietta branch
10.12816/0001662
<strong>Introduction: </strong>The World Health Organization has estimated that hypertension causes one in every eight deaths, making it as the third leading killer in the world. In Egypt, 2004, hypertension reached about 26.3% of whole population. Lifestyle modifications have an important role in the management of patients with hypertension; when used effectively.
<strong>Objective:</strong> to assess efficacy of lifestyle modifications on hypertensive patients, and also assessing their compliance towards lifestyle modifications advice<strong>.</strong>
<strong>Subjects and Methods: </strong>An intervention study was carried out on 448 hypertensive patients recruited among those attending 5 accredited health centers in greater Cairo from May 2007 to March 2008. Patients were divided into 2 groups: case group (240 patient) & control one (248 patient). Both groups were examined for baseline data: blood pressure, obesity parameters & lipid profile & fulfilled a pre-coded questionnaire containing the relevant variables. Then only intervention group was submitted for 3 months to an educational program about lifestyle modifications, while control group received routine outpatient services & asked to maintain their usual lifestyle including dietary & exercise habits. After 3 months both groups were re-examined for the same baseline data done before 3 months. Administrative and ethical issues were followed in all stages of the study, and appropriate statistical design and tests of significance were performed.
<strong>Results: </strong>The results of this study showed the following findings: Applying of a Comprehensive lifestyle modifications program including regular physical activity, reducing salt intake, weight reduction …etc. had a direct beneficial effect on lowering both systolic and diastolic blood pressure, weight & lipid profile of the studied cases. Low rate of regular physical exercises practicing by the studied cases was detected before the intervention .There was a good compliance of the studied cases towards practicing regular physical activities, consuming little salty & starchy foods, excess vegetables, fruits, fish & using plant oil in cooking, while they were un-compliant as regards drinking coffee or tea, consuming eggs ,sweets & quitting smoking.
<strong>Conclusion & Recommendations: </strong>the study concluded that modifying life style lowers level of blood pressure, lipid profile and minimizes the use of Anti-hypertensive, and recommended: increasing the awareness of hypertensive patients about lifestyle modifications program and its importance to control their high blood pressure through health providers or health educators. Ensure more focusing on lifestyle modifications as preventive and curative measures for hypertension in medical curricula. Further research based on evidence based guidelines to improve health related quality of life of hypertensive patients should be encouraged.
https://ejhm.journals.ekb.eg/article_15853.html
https://ejhm.journals.ekb.eg/article_15853_efe88ce162399287d6df6988b9dbf818.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
53
1
2013
10
01
The Trans-radial Approach for Diagnostic Coronary Angiography and Interventions. Our Experience at Queen Alia Heart Institute / Amman – Jordan.
1007
1013
EN
Walid
Sawalha
Queen Alia Heart Institute – King Hussein Medical Centre Amman – Jordan
sawalha_md@yahoo.com
Ashraf Ahmad
Abu Alsamen
Queen Alia Heart Institute – King Hussein Medical Centre Amman – Jordan
Laith Saad
Obaidat
Queen Alia Heart Institute – King Hussein Medical Centre Amman – Jordan
Ramzi Abdelmajeed
Alhyari
Queen Alia Heart Institute – King Hussein Medical Centre Amman – Jordan
10.12816/0001663
The aim of our study was to assess our experience of coronary angiography and intervention via the radial artery in comparison to the standard approach from the femoral artery at Queen Alia Heart Institute.
<strong>Method;</strong>
This was a prospective study conducted from September 2010 till August 2013. This was a single operator experience. All adult patients undergoing coronary angiography or intervention were enrolled into this study. It was left to the operator’s discretion to decide which patient is for trans-radial access. Demographic data, risk factors for coronary artery disease (CAD), the amount of contrast used, fluoroscopy time, and the diagnosis were collected. We also looked at the time taken for mobilization of patients following procedure, the incidence of pain from the site, any local complications and hospital stay. The data was compared to a similar number of patients who had coronary angiography via the femoral artery.
<strong>Results</strong>;
We looked at 456 patients. There were 346 males (76%) and 110 females (24%). Their age ranged from 29 – 76 years with a mean of 53.5 (± 10.5) years. The right radial artery was used in almost all cases (454 patients, and the left radial in 2 patients). The prevalence of diabetes was 48.5%, hypertension 59.2%, family history of premature CAD 28%, hyperlipidaemia in 30% and 44% were smokers. These figures were the same for patients who had the procedure via the trans-femoral artery done during the study period.
Successful angiography was feasible in 449 patients (98.46%). Diagnostic angiography was done in 319 patients (71%), while coronary intervention was done in 130 patients (29%). Total procedural time averaged 41 (± SD = 22) minutes for trans-radial compared to 40 (± 23) for trans-femoral approach (P non significant). Fluoroscopy time was 15 (± 10) minutes for the former compared to 18 (± 13) minutes for the later approach (P non significant). The amount of contrast used was 180 (± 64) ml for trans-radial compared to 192 (± 73 ml) for the trans-femoral approach (P non-significant). On average patients in the trans-radial group had less access site complications with early mobility and earlier discharge.
<strong>Conclusion;</strong>
Coronary angiography and intervention via the radial artery has a high success rate with no difference in terms of procedure time, amount of contrast or fluoroscopy time. It has demonstrable advantages in terms of local site complications, early mobility and discharge leading to better patient’s satisfaction.
<strong> </strong>
Coronary angiography,radial artery,morbidity,Queen Alia Heart Institute
https://ejhm.journals.ekb.eg/article_15854.html
https://ejhm.journals.ekb.eg/article_15854_a3759471a1437f7d72eb2d1b3bf461f0.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
53
1
2013
10
01
Effect of Noise and Crowding Related Stress on Serum Level of TSH and Thyroid Hormones in Female Albino Rats.
1014
1018
EN
Eman G. E.
Helal
Zoology Department, Faculty of Science, Al-Azhar University (girls)
Samia M.
Abd El-Wahab
Zoology Department, Faculty of Science, Al-Azhar University (girls)
Neama M.
Taha
Zoology Department, Faculty of Science, Al-Azhar University (girls)
10.12816/0001664
<strong>Background: </strong>Noise and crowdingare the most stressful factors for human beings.
This study is aimed to clarify their effect on some thyroid hormones and the amelioration effect of sulprid .
<strong>Material and Methods: </strong>Thirty six female rats were divided into four groups (6/each):
1-control, 2-treated with sulpiride drug, 3- rat exposed to noise (90db/3hper day for 45 days) 4-Noise plus drug, 5 – rat exposed to crowded exposure and 6- crowded plus drug.
<strong>Results:</strong> Noise and crowding stresses caused a significant increase only of T3 and T4 while there was a significant decrease in TSH. Sulpiride drug was ameliorated these parameters.
<strong> </strong>
<strong> </strong>
Noise,crowding,Sulpiride drug,Grave's disease Albino rats,physiological parameters
https://ejhm.journals.ekb.eg/article_15855.html
https://ejhm.journals.ekb.eg/article_15855_6a3263653d8202e189cad5ad9cbf2de5.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
53
1
2013
10
01
Risk Assessment of Physical Health Hazards in Al-Azhar University Hospital in New Damietta, Egypt
1019
1035
EN
Alaa
Abdel-Wahed
Indusrial Medicine,
Faculty of Medicine, Al-Azhar University
Raed Mohammed
Alazab
Indusrial Medicine,
Faculty of Medicine, Al-Azhar University
Waheed Hussien
Elsaidy
Indusrial Medicine,
Faculty of Medicine, Al-Azhar University
Mohammed El-Hady
Imam
Departments of Community ,Faculty of Medicine, Al-Azhar University
Ahmed Ali
Ghandour
Departments of Community ,Faculty of Medicine, Al-Azhar University
10.12816/0001665
<strong>Introduction</strong>: Personnel working in hospitals are exposed to many occupational hazards that may threaten their health and safety. Physical hazards that are encountered in hospital working environment include temperature, illumination, noise, electrical injuries, and radiation.
<strong>Objectives</strong>: The objectives of this study were to identify physical health hazards in all departments of Al-Azhar University Hospital in new Damietta,to measure risk level of these hazards, and to recognize safety measures in these departments.
<strong>Study Site</strong>: The study was conducted in Al-Azhar University Hospital in Damietta Governorate.<strong> Study Subjects</strong>: All personnel (328) working in the hospital were recruited.
<strong>Study Methods</strong>: Interview forms; a workplace inspection checklist, assess physical health hazards in the hospital and a modified checklist (workplace safety and health risk management, assess leadership commitment towards workplace safety and health). Risk assessment matrix was used to describe the risk level. Also, environmental measurements of noise, temperature, relative humidity, and lighting were taken in all departments including auxiliary service offices.
<strong>Results</strong>: Majority of the staffs reported stairways were free of obstacles, emergency lighting worked properly, and temperature was suitable. Minority of the staffs reported stairways were slippery, they were informed on hazards of noise and non-ionizing radiation, and they were given radiation safety training. Measurements of physical agents revealed noise levels were above standard of the WHO in all wards and above slandered of OSHA as in laundry, kitchen, etc. Range of noise level was from 58 dB in renal dialysis unit to 88 dB in kitchen. Lighting level was from 290 to 1150 Lux, temperature level was from 25 to 31°C, relative humidity level was from 45 to 59%, and heat index was low in all departments except kitchen and boiler room, it was moderate. Risk level of electrical and fire hazards was medium 22 (B), while other hazards were of low risk level; 01, 11, and 12 (A). Leadership commitment towards safety and health in the hospital was only 14.3%.
<strong>Recommendations</strong>: Workplace environment should be monitored and evaluated. Environmental and behavioral interventions are indicated for all personnel to prevent undue exposures. Noise monitoring and noise engineering and administrative control should be established. Increase leadership commitment towards workplace safety and health. Training programs on health and safety issues should be conducted to all healthcare workers. Lastly, further studies in different hospitals in Egypt are needed to investigate this health problem.
<strong> </strong>
occupational physical hazards,Damietta
https://ejhm.journals.ekb.eg/article_15858.html
https://ejhm.journals.ekb.eg/article_15858_eea8cc72694def1363aa290907ab8628.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
53
1
2013
10
01
The Potency of Some Natural Products on Dimethyl Benz(A)antheracene(DMBA) Induced Hepatotoxicity in Rats
1036
1048
EN
Wafaa
El Kholy
Zoology department ,Faculty of Science,Mansoura University, Egypt
Hanaa
Serag
Zoology department ,Faculty of Science,Mansoura University, Egypt
Asharf
zakaria
Zoology department ,Faculty of Science,Mansoura University, Egypt
Aziza
El Metwaly
Zoology department ,Faculty of Science,Mansoura University, Egypt
10.12816/0001666
<strong>Aim of the work:</strong>the present study was carried out to investigate the possible ameliorating effects of three herbs: hops(H) 1.5g/kg diet , rosemary(R) 5g/kg diet and cat's claw (C C) 1.7g/kg diet on hepatic toxicity induced by 7,12-Dimethyl benz(A)antheracene , a hydrocarbon involves various negative consequence for human health and ecosystems conversation .<strong>Results</strong>:in this work,48 female rats at 50 day of age were divided into 8 groups; control ,hops(H), rosemary(R), cat<sup>'</sup>s claw(CC),DMBA, DMBA+H,DMBA+R and DMBA+CC groups.Results:the results indicated that a single intraperitonial (i.p) dose of DMBA (30mg/Kg b.W) caused significant decrease in the percentage of body weight gain, but an increase in the hepatosomatic index. In addition , the results illustrated an increase in the liver malondialdehyde (MDA) contents and hydrogen peroxide levels (H<sub>2</sub>O<sub>2</sub>) accompanied by significant decrease in reduced glutathione (GSH) content and superoxide dismutase (SOD) and glutathione-S-transferase (GST) activities.The results, also reported significant decrease in serum total proteins, total albumin , globulin and liver total protein but serum total bilirubin was significantly elevated in the DMBA intoxicated group. Furthermore, aspartate aminotransaminase (ASAT), alanine aminotransaminase (ALAT) , γ-glutamyltransferase (GGT) and alkaline phosphatase (ALP) activities were significantly increased in serum but significantly decreased in the liver.
On the other hand, intake of hops, rosemary and cat<sup>'</sup>s claw minimize the disturbances observed in most of the tested parameter's resulted from DMBA administration and improve the liver functions mostly in the following order, rosemary ˃ hops ˃ cat's claw. <strong>Conclusion</strong>: it can be concluded that intake of such herbs (hops , rosemary, cat<sup>'</sup>s claw)may be effective in reducing DMBA toxicity.
<strong> </strong>
natural products,Hepatotoxicity,Rats
https://ejhm.journals.ekb.eg/article_15860.html
https://ejhm.journals.ekb.eg/article_15860_4d16dc335cf13e23b6d1b3385503805d.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
53
1
2013
10
01
Hematological and Immunological Studies on the Effect of Hepatitis B Virus Vaccination in Hepatitis and Non-Hepatitis, Iron Chelating Dependent or Independent Egyptian Thalassemia Patients
1049
1063
EN
Eman G.
Helal
Al-Azhar University, Faculty of Science (Girls)
Noran
Abu- Ouf
Al-Azhar University, Faculty of Science (Girls)
Ali F.M.
El-Sayed
Virology Sector Research Unit, VACSERA. Egypt.
Nahla G.
Mohamed
Virology Sector Research Unit, VACSERA. Egypt.
Mona A.M.
Ahmed
Virology Sector Research Unit, VACSERA. Egypt.
10.21608/ejhm.2013.15862
<strong>Background: </strong>Regular transfusion in thalassemia major patients increases life expectancy and improves quality of life. Blood transfusion is the main sources for viral transmission to Thalassemia patients. So, detection of viral antigens using more than one technique must be adopted. Iron and its binding proteins have immune regulatory properties and shifting of immune regulatory balance by iron excess or deficiency may produce severe deleterious physiological effects. Thus, the aim of this study was to assess the efficacy of immunization and determine the immune response of beta-thalassemia patients. Also, to evaluate the effects of iron overload chelating therapy and hepatitis B virus (HBV) vaccination on some immunological and hematological parameters in hepatitis and non hepatitis Egyptian thalassemia patients.
<strong>Methods:</strong> Forty homozygote Thalassemia patients attending blood bank, therapeutic unite, Holding company for Biological production and Vaccine, VACSERA were chosen for this study (age range 4-30years, mean 14 years, 18 females 46% and 22 males 54%).
<strong>Results: </strong> There was no significant correlation between HBs Ab level in control and non vaccinated groups that include Thalassemia, hepatitis, non hepatitis, either iron chelating therapy dependent or independent patients. In the same time, there was no significant correlation between Ab level in vaccinated control and Thalassemia groups. HbF and HbA2 % showed significant and highly significant increases respectively, in most of groups especially, Thalassemia, hepatitis and iron chelating independent, vaccinated or non vaccinated groups. While HbA may be present in small amount or completely absent. RBCs count, Hb%, Hematocrit and MCV values were decreased significantly in all patient's groups vaccinated or non vaccinated compared to control group, while MCH and MCHC were not changed in patient' groups compared to control group. Platelets count was increased significantly in most patient' groups (except non vaccinated, Thalassemia, hepatitis, iron chelating dependent) compared to control group. Also, WBCs count was increased significantly in most groups (except non vaccinated, Thalassemia, hepatitis or non hepatitis, iron chelating dependent or independent) in comparison with the control group. All patients (hepatitis, vaccinated or non vaccinated) had high significant increase in gamma globulins compared to control group.
<strong>Conclusion: </strong>Hematological and immunological measurements for hepatitis Thalassemia patients are important to monitor and treat the disease.
<strong> </strong>
Blood transfusion,Thalassemia patients,iron excess,HBs,gamma globulins
https://ejhm.journals.ekb.eg/article_15862.html
https://ejhm.journals.ekb.eg/article_15862_cca49480ff8f4f3a741757e8a3615f6a.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
53
1
2013
10
01
Therapeutic Efficacy of Conventional Treatment Combined with Manuka Honey in the Treatment of Patients with Diabetic Foot Ulcers: A Randomized Controlled Study
1064
1071
EN
Mohamed
Al Saeed
Department of Surgery, Taif University and Head of Surgical Department of king Abdul Aziz Specialist Hospital, Taif, Saudi Arabia
alsaeed@yahoo.com
10.12816/0001668
<strong>Background and aim of the work: </strong>Foot ulcers are a major problem of diabetes for which conventional treatment modalities alone have had limited success in promoting complete wound closure; however, there are large amounts of evidences that exist for the effectiveness of manuka honey as a wound dressing especially in diabetic foot. The aim of this study was to compare the efficacy of Manuka honey combined with conventional modalities to that of conventional treatment alone in the treatment of diabetic foot ulcers.
<strong>Patients and Methods:</strong> This was a prospective double-blind, randomized clinical trial conducted at the King Abdul Aziz Specialist Hospital in Taif, Saudi Arabia. Fifty-nine patients, enrolled from January 2011 to January 2013, were randomized to receive conventional treatment plus manukahoney impregnated dressings (honey treatment group) or conventional treatment alone (control group). Outcomes were; time to eradicate infection, length of hospital stay, percentage of completely healed ulcers after six weeks and six months.
<strong>Results: </strong>The mean time to eradicate infection and the hospital stay were significantly reduced in the honey treatment group compared to control group (51.1% and 53.8% respectively, P<0.05). Percentages of ulcers that were completely healed were significantly greater in the honey group than the control group, at six weeks (61.3% vs. 11.5%; P <0.05) and at six months (87.1% vs. 42.3%; P<0.05). There were less toe amputations in the honey-treated group (9.7% vs. 34.6%; P<0.05)<strong>.</strong>
<strong>Conclusion: </strong>Combination of conventional treatment with manuka honey impregnated dressings is superior to conventional treatment alone in controlling wound infection, promoting the complete healing of diabetic foot ulcers, and decreasing the rate of minor amputations.
<strong> </strong>
Manuka,Honey,Diabetic foot,Taif,Saudi Arabia
https://ejhm.journals.ekb.eg/article_15864.html
https://ejhm.journals.ekb.eg/article_15864_392c08d14d2e0a02088903652fddc1ad.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
53
1
2013
10
01
Protective Effect of Nigella Sativa Against Diabetic Complications on The Liver in White Male Rats
1072
1082
EN
Nassar Ayoub
Abdellatif
Department of Anatomy, Faculty of Clinical Pharmacy, Taif University, Saudi Arabia andFaculty of medicine, Sohag University, Egypt.
nassarayoub@yahoo.com
10.12816/0001669
Aim of the work: The effect of diabetes on the liver is associated with histological changes. The aim of the present study was to evaluate the histological changes following administration of nigella sativa (NS) in the streptozotocin (STZ) induced diabetes mellitus in rats.<br /> Materials and Methods: Thirty six male white rats (n=36), weighing (180–230 g) were taken for this study. The animals were divided into 3 groups: 1- Normal control group. 2- Diabetic group. 3- Diabetic group treated by Nigella Sativa (N.S) oil. Diabetes was induced in the experimental rats via intraperitoneal injection of streptozotocin (45 mg/kg body weight) in a single dose. The fasting blood glucose was estimated, 5ml\kg of body weight of N. sativa oil was given orally for three weeks. After an overnight fast, the animals were sacrificed. The livers were identified, weighed and observed for any gross appearance and color changes and tissues were preserved for histopathological studies using hematoxylin & eosin (H&E) and periodic acid Schiff (PAS) stains.<br /> Results: In streptozotocin treated animals, the body weight was significantly decreased compared to normal rats, while treating diabetic rats with <em>N. sativa </em>oil showed significant increases in the body weight. Administration of nigella sativa oil to diabetic rats resulted in a<br /> significant decrease in blood glucose after three weeks compared to untreated diabetic rats. In untreated diabetic group, there was a significant decrease in the liver glycogen. Light microscopic examination of the liver of diabetic rats revealed profound histological changes. Nigella sativa consumption could reverse most of these histological and biochemical changes in the liver of the diabetic group owing to its hypoglycemic and antioxidant effect.<br /> Conclusion: The Nigella Sativa due to its antioxidant role may be helpful in reversing the changes in the liver in diabetes mellitus.<br />
Liver,Diabetes mellitus,streptozotocin,Streptozotocin diabetes,Nigella Sativa
https://ejhm.journals.ekb.eg/article_15865.html
https://ejhm.journals.ekb.eg/article_15865_a75cc1f0f2043f7bd948ff1d3d9d9338.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
53
1
2013
10
01
Effect of Noise Stress on Lung and Heart of the Adult Albino Rats and the Possible Protective Role of Sulpiride.
1083
1105
EN
Tamer M. M.
Abu-Amara
Histology&Cytology Department,College of Medicine, Al-Azhar University, Egypt
tamer4567@yahoo.com
Gamal S.
Elgharabawi
Histology&Cytology Department,College of Medicine, Al-Azhar University, Egypt
Moustafa E. E.
Motawee
Histology&Cytology Department,College of Medicine, Al-Azhar University, Egypt
Salah E.
Mourad
Anatomy Department, College of Medicine, Al-Azhar University, Egypt
Neama M.
Taha
Physiology Department, College of Medicine, Umm Al-Qura University, KSA.
10.12816/0001670
Exposure to noise stress is associated with increased respiratory system morbidity; however the underlying mechanisms are unclear. Thus there is a need for more study about this harmful effect. Sulpiride had been shown to have a protective role against noise stress on other systems but this role did not studied well on respiratory system.<br /> <strong>Aim of the work: </strong>To investigate using histological, histochemical and morphometric methods the possible harmful effects of noise on adult female albino rats' lung, heart and the possible protective role of combined sulpiride treatment.<br /> <strong>Material and Methods: </strong>The present study was carried out on 24 adult female albino rats which were randomly divided into <strong>Group 1(C, untreated negative control), Group 2 (N, noise exposed or positive control) </strong>where rats were exposed to noise “>90 decibel/3h/day” for 1 month<strong>, Group 3(D, sulpiride treated) </strong>where rats were exposed to sulpiride “0.028 mg/B.W./day” and <strong>Group 4 (N+D, noise+ sulpiride exposed). </strong>Paraffin sections were prepared for histological, histochemical and morphometric study. Also statistical analysis was done.<br /> <strong>Results</strong>: Rats exposed to noise only or sulpiride only showed highly significant damaging changes on lung such as thickening in the interalveolar septa and obliteration of the alveoli, inflammatory cells infiltration within the pulmonary interstitium, peribronchiolar infiltration and fibrosis, thickening of the pulmonary blood vessels walls, interstitial collagen fibres deposition and apoptotic cellular changes. On the level of heart, highly significant decrease in the diameters of the myocardial muscle fibres with focal areas of necrosis and apoptotic changes was detected. Also, increased collagen fibres deposition was marked in sulpiride group. When noise and sulpiride treatment was combined, the damaging effects were maximized on the lung and to a lesser extent on the heart.<br /> <strong>Conclusion</strong>: These results provide evidence that noise stress cause obvious lung and heart tissue damages. No protective role for sulpiride was proofed. This is as using sulpiride alone or in combination with noise showed marked damaging effects on the lung and heart tissues.<br /> <strong> </strong>
Noise,Sulpiride,albino rats,lung,heart,Stress,Histology and Histochemsitry
https://ejhm.journals.ekb.eg/article_15866.html
https://ejhm.journals.ekb.eg/article_15866_0a5dbdb2b44c73aef19a7d0c5c7e8417.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
53
1
2013
10
01
Achieving Targets in Secondary Prevention of Hyperlipidaemia in Patients with Coronary Artery Disease.
1106
1109
EN
Dr Walid
Sawalha
Queen Alia Heart Institute – King Hussein Medical Centre Amman – Jordan
Dr Ashraf Ahmad
Abu Alsamen
Queen Alia Heart Institute – King Hussein Medical Centre Amman – Jordan
Dr Laith Saad
Obaidat
Queen Alia Heart Institute – King Hussein Medical Centre Amman – Jordan
Dr Ramzi Abdelmajeed
Alhyari
Queen Alia Heart Institute – King Hussein Medical Centre Amman – Jordan
10.12816/0001671
<strong>Abstract</strong>
<strong>Aim:</strong>
We set our study to assess how good are we at achieving targets of lipid profile in patients with coronary artery disease at Queen Alia Heart Institute – King Hussein Medical Centre Amman – Jordan.
Method:
This was a retrospective analysis of the lipid profile of patients who are being followed up for coronary artery disease at Queen Alia Heart Institute. Lipid profile (total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides) of patients who are legible for secondary prevention was collected and compared to the targets set by the Adult Treatment Panel (ATP) III guidelines. Demographic data and risk factors for coronary artery disease (CAD) were collected. The type and dose of lipid lowering drug was recorded.
Results;
Lipid profiles of 1250 patients were looked at. Their age ranged from 29 – 76 years with a mean age of 59.6 years (±12.8). 27% of our study were females. The mean age for females was 64.2 years (±11.4) and for males was 57.4 years (±13.1). The prevalence of diabetes was 48.5%, hypertension 59.2%, hyperlipidaemia in 30%, family history of premature CAD 28% and 44% were smokers. Target total cholesterol was achieved in 67% of patients, and target LDL in 54% and HDL in 49% of patients. Almost all patients were on statins or fibrates (94%). 52% were on Simvastatin (84% of them on 20mg) and 38% on Atorvastatin (88% of them on 20mg).
<strong>Conclusion</strong><span style="text-decoration: underline;">;</span>
Target lipid profile in our patients has only been moderately achieved in patients with coronary artery disease. Only modest doses of statins are used. More efforts with better follow up is needed.
<strong> </strong>
Coronary Artery Disease,Lipid profile,Jordan
https://ejhm.journals.ekb.eg/article_15867.html
https://ejhm.journals.ekb.eg/article_15867_35c90e28b098b3b494788ed9081b7dc7.pdf