2024-03-28T23:03:04Z
https://ejhm.journals.ekb.eg/?_action=export&rf=summon&issue=3318
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2015
59
1
Optimization of Coronary Sinus Lead Position in Cardiac Resynchronization Therapy guided by Three Dimensional Echocardiography
Maha Mohamed Mohamed
Khalifa
Ali Ahmed
El Abd
Mohamed Amin
Abd El Hamid
John Kamel
Zarif
Tarek Rashid
Mohamed
Haitham Abd El Fattah
Badran
Background:Cardiac resynchronization therapy (CRT) is now an established effective treatment for patients with advanced heart failure.
One approach to improve CRT outcome may be determination of the degree of dsynchrony before CRT as a predictor for CRT response. Conversely, the focus may be on an improved positioning of CRT left ventricular (LV) lead.
AIM of the study: We aimed at our study to define the rule of three-dimensional echocardiography in determining the optimal site of LV pacing lead.
Patients and Methods: The current study was conducted on 30 patients with heart failure who had received CRT in Ain Shams University Hospitals in the period from 2012 to 2014.
All patients were subjected to thorough history taking, complete general and local examination, conventional 2D echo and 3D echo analysis. The latest wall to reach the minimal volume was determined. The patients were classified after CRT insertion into group A with concordance between the delayed LV area and LV lead position and group B with discordance between them. Our patients were followed up for 6 months duration.
Results: Our findings demonstrated that the response to CRT resulted in improvement of NYHA class (p-value 0.04), LV EF by 2D and 3D echocardiography (P value <0.001 for both) with significant increase in LV 3D SV (p value 0.001), and significant reduction of LA diameter (p-value 0.03), LVESD diameter, 2D and 2D LVESV (P value 0.026, 0.026 respectively), however there was no any statistically significant difference between both groups.
Conclusions: No additional benefit of selecting LV lead position pre CRT insertion to be concordant with the latest myocardial segment in reaching the minimal systolic volume assessed by 3D echocardiography
CRT
LV lead
3D echo
Dyssynchrony
2015
04
01
167
171
https://ejhm.journals.ekb.eg/article_15407_59d9833455bc7f57bd8e59a148e0f547.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2015
59
1
Evaluation of DNA Damage in vivo by Comet Assay and Chromosomal Aberrations for Pyrethroid Insecticide and the Antimutagenic Role of Curcumin
Fouad
Abdel Rheim
Awad Abbas
Ragab
Fatma .M.
Hammam
Hossam El-Din
Hamdy
Background: Esfenvelerate a synthetic pyrethroid insecticide, is widely used in the home environment and in agriculture because of its high activity against a broad spectrum of insect pests and its low animal toxicity .Objective of this study was to evaluate the genotoxicity of esfenvelerate and the possible protective role of curcumin against this genotoxicity. Material and methods:Forty male albino rats were divided into 8 groups of 5 rats each: G1 served as control and G2 served as positive control received (100mg/kg curcumin ), G3,G4 and G5 were orally administrated with (1/20 LD50, 1/40 LD50 and 1/60 LD50 of esfenvelerate ) respectively and the last three groups(G6,G7and G8) were received the same doses of pesticide plus 100mg /kg curcumin for 28 days daily. Animals were sacrificed and bone marrow samples were collected for chromosomal aberration assay test and liver samples were used for DNA damage detection by comet assay. Results:chromosome aberration assay revealed that all the tested doses induced chromosomal aberrations (CA) such as centromeric gaps, chromatid gaps, chromatid deletion, dicentric chromosome, and ring chromosome. The alkaline comet assay showed significantly increased tail moment, tail length and tailed DNA % in liver cells of animals treated with esfenvelerate alone compared to control group. On the other hand, oral curcumin significantly ameliorated the genotoxicity induced by esfenvelrat. All these results clarified the efficacy of curcumin in amelioration of chromosomal aberrations of structures as well as DNA damage which may result from its antioxidant properties.
pyrethroid insecticide
Comet assay
chromosomal aberrations
Curcumin
2015
04
01
172
181
https://ejhm.journals.ekb.eg/article_15409_a4dd2f03c92c468459681667b5ec68e3.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2015
59
1
Role of Multi-detector CT in Assessment of Patients Suspected with Chronic Inflammatory Bowel Disease
Ahmed Mohamed
Monib
Sherif Hamed
Abu Gamrah
Amira Mokhtar
Bayomi
Background:Crohn’s disease and ulcerative colitis evolve with a relapsing and remitting course. Determination of inflammatory state is crucial for the assessment of disease activity and for tailoring therapy .Computed tomography enterography (CTE) has become a main modality for the evaluation of inflammatory bowel disease (IBD). It simultaneously offers visualization of the small bowel and extra intestinal status, which is helpful for diagnosing IBD. Crohn disease has long segmental enhancing wall thickening related with the eccentric longitudinal distribution. In addition, mural stratification, fibrofatty proliferation, positive comb sign by increased mesenteric vascularity and internal/perianal fistula are characteristics of Crohn disease and can be identified on CTE. Each of CTE findings for the IBDs is helpful for differential diagnosis. The main disadvantage of this technique is the requisite radiation exposure of patients, particularly in young patients. However, recent development of advanced CT techniques is promising for radiation dose reduction without compromising diagnostic image quality
crohn’s disease
ulcerative colitis
inflammatory bowel disease
Computed tomography enterography
multi detector computed tomography
2015
04
01
182
190
https://ejhm.journals.ekb.eg/article_15410_15b3add0a0601abfddd2c3313b16362b.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2015
59
1
Risk Factors and Effects of Infestation with Pediculosis Capitis and Scabies among Primary School Students in Cairo, Egypt
Essam A.
El-Moselhy
Hassan M.
Hassan
Ayman S.
Abdelhady
Alaa
Abdel-Wahed
Abd-Elnaser S.
Mohammed
Background: Pediculosis capitis (PC) and scabies are an important public health problem in childhood. They have a worldwide distribution. Also, they have many effects on the infested students. Objectives: To define the prevalence of PC and scabies, to find out the socio-demographic, environment, and health care behavior risk factors, and to determine the effects on the studied students in Cairo, Egypt. Subjects and Methods: A cross-section, analytical study design was chosen to conduct this work. Three primary schools were the field of this study. Total number of the students was 1987. The students were clinically examined; for each infested case with PC and/ or scabies a control student was chosen. Results: Prevalence of PC and scabies was 10.2% and 3.4%, respectively. These infestations were more common significantly among students in the public school. Significant social risk factors of infested students were the low level of head of the family education, occupation, and social status. Also, significant personal hygiene risk factors were poor hair, body, and environment hygiene. While significant health care behavior risk factors were student never received skin examination, no early consultation for skin diseases, and no compliance with therapy. Also; female gender, the last birth order child, had previous infestation with PC, had sibling(s) with PC, and had parents with history of infestation with PC were significant risk factors. On the other hand; male gender, the last birth order child, had previous infestation with scabies, had sibling(s) with scabies, and had parents with history of infestation with scabies were significant risk factors. Further, the PC cases with crowding index >1, had no sun access, had shared water supply and bathing facilities, co-sleeping, had no short cut hair, and sharing hair brushes were significant risk factors. On the other hand, the scabitcs with crowding index >1, had no sun access, had shared water supply and bathing facilities, and co-sleeping were significant risk factors. Lastly, presences of psychiatric, sleep, and peers’ relations disturbances were significantly more common among the infested students. Conclusions: Many risk factors of PC and scabies can be manipulated, so these infestations can be prevented, so many health hazards on the students could be prevented. Recommendations: Improving students' hygiene, health education, and regular dermatological screening and treatment of students are important essentiality. Also, dermatological health component should be integrated in school health program. Lastly, further studies in different rural and urban areas in Egypt are recommended.
Pediculosis capitis
scabies
prevalence
risk factors
Primary Schools
2015
04
01
191
207
https://ejhm.journals.ekb.eg/article_15412_0d6cd4862d00093fc668945b4eb7f94c.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2015
59
1
Adiponectin Levels as a Marker of Inflammation in Pulmonary Tuberculosis
Gamal M.
Elnemr
Manal A.
Elnashar
Nesriene M.
Elmargoushy
Nihad A.
Elnashar
Mohamed A.
Elnashar
Background: tuberculosis (TB) is a multisystem disease with myriad presentations and manifestations that may be pulmonary or extra-pulmonary. It is the most common cause of infectious diseases related mortality worldwide. Mechanisms underlying host defense to TB infection are poorly understood. Adiponectin is a protein produced exclusively in adipose tissue; it is lower in obese subjects than their lean counterparts. Another adipocyte hormone is leptin which is higher with fat mass and body mass index (BMI). Wasting is a known feature of TB with a decrease in BMI. Patients with pulmonary TB disease often suffer from weight loss and BMI and leptin are known to be inversely correlated with adiponectin. Thus, increased adiponectin may be a promising marker for severity of the disease independent of the BMI and leptin.
Aims of the work: the work aimed to evaluate the levels of serum adiponectin in patients with pulmonary TB in both active and latent TB patients as a diagnostic marker for tuberculous inflammation. Also, levels of serum leptin and measured BMI were evaluated and compared to make a relationship among active TB, latent TB, and healthy control groups.
Subjects and Methods: the subjects were divided into 3 equal groups. The 1st group included 25 patients with active pulmonary TB. The 2nd group included 25 patients with latent TB after 6 months of diagnosis. The 3rd group included 25 healthy control volunteers. Serum levels of adiponectin and leptin were measured and BMI values were calculated to all groups.
Results: Serum adiponectin levels in patients with active pulmonary TB were very highly significantly increased compared to both latent TB patients and healthy subjects (P<0.0001), while serum adiponectin levels in patients with latent pulmonary TB were only significantly increased compared to the healthy subjects (P<0.05). On the other hand, serum leptin levels in patients with active pulmonary TB were very highly significantly decreased compared to both latent TB patients and healthy subjects (P<0.0001), while serum leptin levels in patients with latent pulmonary TB were only significantly decreased compared to the healthy subjects (P<0.05). Also, BMI in patients with active pulmonary TB were very highly significantly decreased compared to both latent TB patients and healthy subjects (P<0.001), while BMI in patients with latent pulmonary TB were only significantly decreased compared to the healthy subjects (P<0.05).
Conclusion: the higher levels of adiponectin with lower levels of leptin in association with lower BMI measurements might indicate activity and severity of the TB disease. On the other hand, the lower levels of adiponectin with higher levels of leptin in association with higher BMI measurements might indicate stability and latency of the TB disease. Thus, increased adiponectin in the serum of pulmonary TB patients may be promising markers for severity of the disease independent of the BMI and leptin levels.
TB patients
leptin
adiponectin
Body Mass Index
2015
04
01
208
213
https://ejhm.journals.ekb.eg/article_15413_eeff07c03355162cec5e881794057a21.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2015
59
1
Chronic Diseases and Outcome in Critically Ill Elderly Admitted to ICU
Moatassem Salah
Amer
Randa Reda
Mabrouk
Tamer Mohamed
Farid
Mohamed Shawky
Khater
Rania Mohamed Abd elhamed
Alakad
Mohamed Mortada Mohamed
Goda
Background: Elderly patients are a significant and increasing proportion of ICU patients. With advancing age, the comorbidities critically ill elderly patients have substantial mortality. The early recognition of patients at high risk of mortality is needed to plan care in advance and to control healthcare costs. Aim: To find out the relation between chronic diseases and outcome in critically ill elderlyadmitted to ICU. Study design: A prospective study. Participants: seventy elderly patients aged 60 years and above. Method: This study was performed in Geriatric ICU in Ain Shams University Hospitals including 70 critically ill elderly patients admitted for 24 hours or more. Each patient was subjected to on admission clinical assessment including detailed history taking, in addition to laboratory investigations. Results: The results of our study showed that ischemic heart disease was the only chronic diseases that had significant statistical effect on mortality in critically ill elderly admitted to ICU with p. value= 0.002. Conclusion: In the current study we found that mortality was associated with history of ischemic heart disease.
Intensive Care Units
ICU mortality
Elderly
Chronic Diseases
2015
04
01
214
216
https://ejhm.journals.ekb.eg/article_15414_5daea9e3dd2d57c585f220a2d7c58a09.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2015
59
1
Effect of Prenatal Exposure to Bisphenol A on the Endometrium of Albino Rats: a Histological and an Immuno-histochemical Study
Essam Eldin A.
Salama
Ali H.
Ali
Tarek A.
El Ghamrawy
Mohamed S.
Farag
Lotfy S.
Mohamed
Aim of the work: bisphenol A (BPA) is a synthetic monomer that is polymerized to manufacture polycarbonate plastic products and resins, including those used in food packaging and dental sealants. It is used in the manufacture of a great variety of products including: compact disks, food can linings, plastic windows, car parts, adhesives, protective coatings and powder paints. This work aimed to study the effect of prenatal exposure to BPA on the endometrium of female rats.
Materials and methods: thirty adult female albino rats were divided into three groups: rats in group 1 served as a control (G1) and received an equal amount of sesame oil to those of the treated groups; those in group 2 (G2) were administered by gavage 5.0 μg BPA/kg/day (low-dose group); the third group (G3) received 50 μg BPA/kg/day (high-dose group). The female offspring of each group were weaned at day 21 and maintained until 3 months old. The uteri were dissected for the histological and immuno-histochemical examination.
Results: low-dose group showed degeneration of the epithelial lining of the endometrium with focal patches of increased epithelial cell layers. The high dose group revealed cytoplasmic hydropic degeneration and pyknotic nuclei of the epithelial cells. Estrogen receptors showed a significant decrease of positive cells in low dose treated group and this decrease markedly accentuated in the high dose one. Positive nuclei for Ki-67 were markedly increased with increasing doses of BPA.
Conclusion: BPA showed obvious endometrial degenerative and proliferative histological changes. Therefore, the use of this substance in food packaging materials and in the manufacture of substances liable to come into contact with food and drink should be phased out.
2015
04
01
217
226
https://ejhm.journals.ekb.eg/article_15417_cf8380d3d6f1914216133628c0b1015a.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2015
59
1
Effect of Platelet-Rich Plasma Intra Articular Injection on Patients with Primary Knee Osteoarthritis
Nadia Abdel Salam
Elkadery
Mohammed Aly
Elwy
Eman Mahmoud
Ghaniema
Ahmed Ibrahim
Hammad
Hossam Moussa
Sakr
Background: Osteoarthritis (OA) is the most common type of arthritis. It is a degenerative joint disease. OA is usually defined according to radiographic changes. Conventional radiographs (CR) were considered the most relevant outcome measure to assess the progression of OA in clinical trials and epidemiological studies. Many modalities are used in treatment of knee OA. There is a distinct need for new procedures that are cost effective by reducing the need for pharmaceutical and surgical management, while targeting the biochemical process of OA. Platelet-rich plasma (PRP) is one of these new procedures. PRP was found to increase hyaluronic acid (HA) concentration, stabilizing angiogenesis in patients with osteoarthritic knees.
Aim of the study: Was to assess the value of intra articular injection of autologous platelet rich plasma in management of knee osteoarthritis.
Patients and methods: This study was conducted on 40 patients with primary knee osteoarthritis, divided into 2 groups; study group treated with 3 injections of PRP, and control group treated with single dosed high-molecular weight HA. Clinical assessment and visual analogue scale (VAS) scoring were done pretreatment and 3 months post treatment.
Results: Clinical improvement and reduction of VAS in both groups which is significant at the study group. Conclusion: PRP injection could be considered as a simple, safe, effective and non-palliative treatment that may promote cartilage healing in knee osteoarthritis as it improve the clinical condition and the function of the joint. Hence, it may represent a useful addition to the available therapeutic options for knee osteoarthritis.
knee
osteoarthritis
platelet-rich plasma
2015
04
01
227
232
https://ejhm.journals.ekb.eg/article_15419_54012757a994c6b0b864192357b7fcf7.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2015
59
1
The Therapeutic Role ofProximol and Lasilactone in Rat Model of Renal Stress
Shadia Ali
Radwan
Yasser A.
Khadrawy
Samia Mohamed
Sakr
Enas S.
Abdel-Bakey
Background
High salt intake induces renal-stress. The present study was carried out to examine the therapeutic effects of proximol(Halfa bar extract), lasilactonedrug(Spironolactone+Furosemide) and their combination on renal-stressed rats.
Material and Methods:Thirty five male rats were used and divided into five groups. The first group served as negative control and received fresh tap water orally for four weeks. The animals in the other four groups drank hypertonic saline solution (2% NaCl) as a sole source of drinking water for four weeks to induce the animal model of renal stress. Then the renal-stressed rats were further divided into: positive control, renal-stressed rats treated daily with proximol (7.8 mg/kg b.wt), renal-stressed rats treated daily with lasilactone (3.9 mg/kg b.wt), and renal- stressed rats treated daily with a combination of proximol and lasilactone for four weeks. The levels of aldosterone, sodium, potassium, calcium, urea, uric acid and creatinine were measured in the sera of rats. Nitric oxide (NO), reduced glutathione (GSH) and lipid peroxidation (MDA) levels were also measured in the homogenate of renal tissue.
Results:In the renal-stressed group, there was a significant increase in levels of aldosterone, sodium, calcium, urea, uric acid, NO and MDA and a significant decrease in potassium and GSH as compared to control group. Although the treatment of renal stressed rats with proximol, lasilactone and their combination reduced the increased level of aldosterone induced in renal stressed rats, aldosterone level was still higher than the control value. In addition, the treatment with proximol, lasilactone and their combination restored the significant increase in sodium, NO and lipid peroxidation to non significant changes as compared to control group. Also the decreased levels of GSH induced in renal-stressed rats returned to non significant changes. However, potassium decreased significantly below the control and the model groups with the combined treatment. Furthermore, treatment with proximol, lasilactone and their combination reduced the elevated levels of uric acid and urea induced by hypertonic saline solution to control- like values in the case of uric acid and to a significant decrease in the case of urea.
Conclusion:In conclusion, proximol, lasilactone and their combination have an effective role in ameliorating the changes in the levels of aldosterone, serum electrolytes, oxidative stress and consequently the disturbance in kidney functions in renal-stressed rats induced by hypertonic saline solution.
renal-stressed rats
proximol
lasilactone
aldosterone
electrolytes
Oxidative Stress
2015
04
01
233
243
https://ejhm.journals.ekb.eg/article_15421_1e414ff1838852c1b2bc2ece4ed5f7dd.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2015
59
1
Teratogenic Effect of Carbamazepine Administration in Pregnant Rats
Inass
El-Gaafarawi
Magdy
Abouel-Magd
Background: Carbamazepine "CBZ" (Tegretol) is an anticonvulsant and mood stabilizing drug used primarily in the treatment of epilepsy and bipolar disorder, as well as trigeminal neuralgia. It has been assigned to pregnancy category D by the U.S Food and Drug Administration (FDA). CBZ can cause fetal harm when administered to pregnant women. Epidemiological data suggested that there may be an association between the use of CBZ during pregnancy and congenital malformations, specifically spina bifida and developmental disorders. The possible malformation-specific risks with CBZ use during pregnancy need to be considered, so the present work was conducted to evaluate the genotoxicity of two doses of CBZ (3.6 mg and 10.8 mg/ 100g body weight/ day) in pregnant female rats and their fetuses. Chromosomal aberration in bone marrow cells and histopathological examination of liver and kidney of pregnant rats were also determined. Materials and Methods: Fourty five pregnant Sprague Dawley rats were randomly divided into the groups. The first was administered oral doses of distilled water and served as control. The other two groups were administered oral doses of CBZ suspended in distilled water equivalent to 3.6 mg and 10.8 mg/100g body weight/day respectively for 15 day from the 6th day to the 20th day of gestation. Females were sacrificed on the 20th day of gestation. Results: Administration of CBZ 3.6 mg and 10.8 mg /100g body weight to pregnant rats from the 6th till the 20thday of gestation. Decreased fetal body weight, crown-rump length, increased resorbed and dead fetuses were observed compared to the control ones. Moreover, CBZ-high dose group(10.8mg/100g) causedmalformations that could be described as severe growth retardation. At the same time, bone marrow metaphases of CBZ-treated pregnant rats revealed structural chromosomal aberrations. Whereas, histopathological examination of liver and kidney of pregnant rats treated with both doses of CBZshowed cellular alterations.Conclusion:It has been found that usage of antiepileptic CBZ during gestational period may create risk, associated with maternal toxicity, hepato- and nephrotoxicity and chromosomal aberrations in pregnant rats, with intrauterine growth retardation which was manifested by low body weight, length reduction and malformations. These alterations were dose dependent. The benefits of taking CBZ must be weighed against the potential risks to boththe developing fetus and the mother.
carbamazepine
pregnant rats
fetus malformations
Chromosomal aberration
histopathology of liver and kidney
2015
04
01
244
257
https://ejhm.journals.ekb.eg/article_15422_6095c54b60620de389edef9e3ca7e897.pdf