2024-03-29T10:11:12Z
https://ejhm.journals.ekb.eg/?_action=export&rf=summon&issue=3478
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2012
48
1
Enhancement of Urinary Bladder Carcinogenesis by the Role of Chronic Bacterial Infection-induced Inflammation (Imunnohistochemical and Biochemical studies)
Gabri
MS
Ashmawy
AM
Ibrahim
MA
Hosny
RM
Background: Bacterial infections traditionally have not been considered major causes of cancer. Recently, however, bacteria have been linked to cancer by two mechanisms: induction of chronic inflammation and production of carcinogenic bacterial metabolites. The most specific example of the inflammatory mechanism of carcinogenesis is Escherichia coliinfection. E. coli has been epidemiologically linked to urothelial carcinoma of the urinary bladder by its propensity to cause lifelong inflammation. This inflammation is in turn thought to cause cancer by inducing cell proliferation and production of mutagenic free radicals and N-nitroso compounds.
Material and methods: After each 3, 6 and 9 months of daily oral administration ofdibutyl amine (DBA) plus sodium nitrate (nitrosamine precursors) in drinking water, curcuma in grinding diet and bladder injection with E. coli, rats were sacrificed. The excited bladder were dissected, processed and stained with H&E and anti-Ki67 immunohistochemical stains. This was followed by Elisa for caspse-3 and statistical analysis.
Results: The current results indicated that E. coli infection in the bladder tissues increases the carcinogenic ability of nitrosamine precursors through caused marked alteration in the form hyperplastic, dysplastic and metaplastic urothelium. Also, there was a statistically significant increase in ki67 immunoreactivity in urothelium. However, a statistically significant decrease in the concentration of caspase-3 in bladder tissue consequently caused the process of carcinogenesis. All these changes were less marked after curcuma treatment when compared with the group that not treated with curcuma.
Conclusion: Bacterial infection of the urinary bladder may play a major additive and possible role in bladder carcinogenesis. Rhizome of curcuma may have a protective action during induction of urinary bladder tumors.
Bladder carcinogenesis
E. coli
curcuma – DBA
Ki67-Immunohistochemistry
Caspase-3
2012
07
01
334
347
https://ejhm.journals.ekb.eg/article_16238_b199f87944b6a812e67606d2be453be7.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2012
48
1
Long Coronary Lesions Requiring Long Stents >20 mm. Analysis And Outcome In Patients Treated At Queen Alia Heart Institute
Marwan Adib
Al-Nimri
Objective: To determine the outcome after using long coronary stents >20 mm for long coronary lesions among patients treated at Queen Alia Heart Institute.
Methods: This is a descriptive, and a retrospective non randomized study which was conducted at Queen Alia Heart Institute on 900 adult patients who underwent coronary angiography and intervention for either stable or unstable angina pectoris during the period between 2006 to 2011. Those patients had coronary intervention using a single long stent for each long lesion (>20 mm). Their follow up was analyzed and the outcome of these long stents was studied for in stent restenosis or in stent total occlusion in each specific coronary artery. A specially designed form was used to record the following data in the involved patients: age, gender, size and type of coronary stent (drug eluting or bare metal), the presence of diabetes mellitus, hypertension or hypercholesterolemia, and the status of the left ventricle.
Results: The total number of patients who had long coronary stent intervention was 900 cases. Four hundred eighty patients (53.3%) had restudy cardiac catheterization within 6-8 months, which showed instent restenosis or instent total occlusion in 90 patients. Males constituted the majority (88.9%) of the affected patients. Smoking was the commonest (83.3%) factor associated with instent restenosis followed by Diabetes Mellitus (61.1%). About half the cases of long instent restenosis was found in left anterior descending artery, whereas right coronary artery and circumflex artery had almost equal ratios: 23.3% and 22.2% respectively. Long instent restenosis was commoner (33.3%) in ostial lesions and was the least (14.5%) in mid segment lesions. Bare metal stents were associated with the majority (77.8%) of cases of instent restenosis. About two thirds of the affected patients had small caliber stents (2.5 and 2.75 mm diameter).
Conclusion: Instent restenosis or instent total occlusion in long coronary stents is a well recognized and not uncommon clinical entity. Men are more commonly affected than women. Ostial left anterior descending artery is more affected than other coronaries. Smoking, Diabetes Mellitus and the use of bare metal stents of small sized caliber (≤ 2.75 mm) were common in our study patient population and associated with increased incidence of long instent restenosis.
long coronary lesions
Instent restenosis
2012
07
01
348
356
https://ejhm.journals.ekb.eg/article_16239_db1ac752897d880f078ec69cf2abee32.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2012
48
1
Effect Of Some Aflatoxins On A Lymphatic Organ (Spleen) Of Male Albino Rats (Histopathological Study)
Nahed Ahmed
Omar
Background:The present study was planned to compare between two kinds of aflatoxins ( AFB2 and AF Mix) on spleen of male albino rats. Fifty young male albino rats ,each weighing 50g, were fed on diets containing aflatoxins at concentration of 1.0 ppm either of AFB2 or AF mix. for 2, 4, 6 weeks followed by a withdrawal period of 2 weeks. Material and Methods:- Rats were randomly divided into 3 groups: the 1st group of 10 rats was fed on the standard diet. The 2nd and the 3rd groups of 20 rats each were maintained on the standard diet plus either AFB2 or AF mix. respectively. Ten animals from the latter 2 groups as withdrawal period. Pieces of spleen were subjected to histological procedures and the obtained sections (6 µm thick) were stained with the haematoxylin and eosin, also, mercuric bromophenol blue stain for total protein were used in this study. Results:- Marked histopathological alterations were observed in the studied sections under the influence of AFB2 and AF mix. It was found that AFB2 induced more alterations. The most common changes were lymphocytic degeneration, fatty changes with numerous hemorrhagic areas. The two weeks withdrawal period showed a partial recovery of the developed changes. Conclusion:- This study indicated that AFB2 has a toxic effect on spleen than the equivalent level of AF mix. .Great caution must be followed to prevent the possible contamination of our food with such mycotoxins.
Aflatoxins – Spleen – Histopathology
2012
07
01
357
367
https://ejhm.journals.ekb.eg/article_16240_bf45e2d399c4f34a313e867a4220360e.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2012
48
1
The Current Status of Usage of Complementary Cardiovascular Devices in Cardiac Catheterization Laboratory in Queen Alia Heart Institute (QAHI)
Marwan
AlNimri
Cardiac catheterization laboratories are experiencing phenomenal change, as their volume increases and cases become more complex. In the search for the perfect angiographic result, interventional cardiologists have explored numerous therapeutic complementary devices that are used in the cath labs to facilitate achieving this elusive prize.
Unfortunately, these adjunctive interventional devices are lacking in the majority of cath labs all around developing countries including those in Middle East /North Africa region (MENA region). In fact, most of coronary interventions here became restricted to implantation of bare metal stents or drug-eluted stents with or without simple balloon predilatation or post-dilatation. Thelimited adoption of complementary devices reflects concerns of the high costs for these devices, un-suitability for their re-sterilization, having their own learning curve with compelling continuous need for high level oftraining.
In this review, we will summarize the evidence base concerningmost of the important therapeutic complementary cardio-vascular interventional devices and comment on challenges facing the more widespreadadoption of their use in MENA region .Hopefully, this objective analysis would help fostering their further growth and penetration into the markets, making them part of daily practice.
Complementary Cardiovascular Devices
Cardiac Catheterization Laboratory
2012
07
01
368
382
https://ejhm.journals.ekb.eg/article_16241_f694a53f9da7e7e531dc88eac1df31b5.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2012
48
1
Doxorubicin-induced cardiotoxicity in mice; protection by silymarin
Heba Abdelnasser
Aniss
Camelia
AdLy
Ashraf El Metwally
Said
Ibrahim Helmy
El Sayed
Background: despite its vast utility in clinical oncology, the use of doxorubicin is limited by a potentially fatal cardiomyopathy and congestive heart failure. Free radical formation and antioxidants depletion are mechanisms proposed for this cardiomyopathy. The aim of this study is to compare the potential antioxidative protective effect of silymarin on doxorubicin-induced cardiotoxicity in experimental mice. Materials and methods: four groups (ten animals in each group) of experimental mice were used as follows: Group 1, mice received only saline (intraperitoneally) and served as a negative control group; Group 2, mice received doxorubicin (intraperitoneally, 5 mg/kg body weight) in three equal injections over a period of two weeks for a cumulative dose of 15 mg/kg body weight; Group 3, mice orally administrated silymarin (200 mg/day/kg body weight) respectively, through an intragastric feeding tube over a period of three weeks; Group 4, mice treated orally with silymarin plus intraperitoneally doxorubicin administration with the same protocol of groups 3 and 4. Serum lactate dehydrogenase (LDH), creatine phosphokinase (CPK), aspartate aminotransferase (ASAT), alanine aminotransferase (ALAT), malondialdehyde (MDA), total nitric oxide (NO), cardiac reduced glutathione (GSH), superoxide dismutase (SOD), glutathione peroxidase (GPx) and catalase (CAT) were measured in all tested groups. Results: doxorubicin elevated the activities of LDH, CPK, AST, ALT, MDA and NO in the cardiac tissue. Cardiac antioxidant enzymes activities SOD and CAT also increased while GPx activity was decreased. Pre-co-treatment with silymarin prevented the changes induced by doxorubicin administration. These findings demonstrate the cardio-protective effect of silymarin on cardiac antioxidant status during doxorubicin induced cardiac damage in mice. Conclusion: silymarin could be recommended for further investigation as potentially new indication for clinical application.
Doxorubicin
cardiotoxicity
Silymarin
Antioxidant enzymes
Oxidative Stress
2012
07
01
383
395
https://ejhm.journals.ekb.eg/article_16242_25a8f412e73867018c8bcc7b820250b1.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2012
48
1
The Evidence For Soybean Products As Cancer Preventive Agents
Mohamed E.M.
Zowail
Eman H. S.
Khater a
anaa F. M.
Waer
Hala A.
El-mancy
Aim of the work: The evidence for specific soybean-derived compounds having a suppressive effect on carcinogenesis in animal model systems is created, the anti-carcinogenic potential of soybean was studied against colon cancer. Colon cancer has been induced by dimethylhydrazine (DMH). Material and methods: The DMH was dissolved in physiologic saline and the animals were given subcutaneous injections once weekly for 16 weeks. The possible preventive effects of soybean on Dimethylhydrazine-induced colon tumors in male Sprague Dawley rats was investigated. Albino rats were divided into four groups. control group, control soybean powder group, DMH-treated colon cancer group and the fourth group treated with soybean powder+DMH. Results: In the studied groups the colon was examined macroscopilly to calculate the number of polyps appeared in each colon. The histological and ultrastructural studies included the alternations in different component of the colon. The macroscopical examination showed that the group which was given the soybean alone showed no polyps. On the other hand the group that was given the carcinogenic agent alone expressed a high number of polyps. The histological and ultrastructural studies showed that colon cell structure of carcinogenic treated animal groups underwent cell proliferation, focal cell damage with certain nuclear changes, abundance of fibrous tissue and lymphocytic infiltration, while the group given soybean as a preventive agent expressing less number of colon polyps, and induced a moderate changes of different degrees. Conclusion: It is clear that soy bean component showed a good protective effect against the colon cancer.
Soybean
Cancer
2012
07
01
394
406
https://ejhm.journals.ekb.eg/article_16243_8aad86bf6a1a87ceb164173b5a2b6149.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2012
48
1
The Use of the Median Raphe of Gastrocnemius to Augment the Repair of Achilles Tendon Rupture
Abdullah Ali
Al-Zahrany
Background and Objectives:
Rupture of the Achilles tendon is a common injury among athletes and even sedentary individuals. Presence of a gap between the two ends of the disrupted tendon makes the treatment difficult, however, augmented repair techniques are used in defective Achilles tendon ruptures and provide excellent functional results in active individuals, but it carries an incidence of wound complications like tendon adhesion to the skin. In this study we present an augmentation technique for Achilles tendon rupture that would prevent tendon adhesion to the skin.
Material and methods:This prospective study was conducted in King Abdul-Aziz Specialist Hospital, Taif, Saudi Arabia from March 2009 to March 2011 on 12 male patients with defective Achilles tendon ruptures. We used an apponeurotic strip from the median raphe of gastrocnemius, and twisted 180 degrees on itself from medial sides, to allow its smooth external surface to lie next to the skin and cover the rupture site, and the plantaris tendon was incorporated in the repair site.
Results: Twelve male patients with a mean age of 37 years (27-55) were diagnosed as having a ruptured Achilles tendon. Ten patients had been injured during sports activities the other two cases occurred during walking. The mean duration of ruptures before surgery was (20 days) ranging from 3 to 40 days. The mean follow up was 22 months (11- 35) There were no re-ruptures. Three patients had skin necrosis and managed by debridement followed by secondary sutures and satisfactory healing was achieved. There were no tendon adhesion to the skin and the skin over the tendon was movable. All patients returned to their activity after 6- 14 months (mean 8 months).
Conclusion: augmented operative repair of Achilles tendon ruptures is a reliable treatment method for active patients and the repair is preferred to prevent tendon adhesion to the skin.
Gastrocnemius
Repair of Achilles Tendon Rupture
2012
07
01
407
413
https://ejhm.journals.ekb.eg/article_16244_e230f6c4e9587bb8ae5b9e308b6fcbcf.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2012
48
1
Effect of Grape Seed Extract on Oxidative Damages in Gamma Irradiated Rats
Abdelgawad.A.
Fahmi
M.A.
El- Desouky
Neama M.
El-Fatih
Wissam.A.
Mohamed
Back ground: Ionizing radiation is known to produce deleterious effects in the living organisms.
Aim of the work: The aim of this study is to evaluate the possible protective effect of the chemical constituents of grape seed extract on oxidative stress induced by gamma rays.
Materials & Methods: Rats were subjected to 8 Gy fractionated doses of gamma radiation, grape seed extract 100 mg/kg body weights were daily administrated before and within radiation exposure.All parameters were investigated at 1st and 14th days post last radiation exposure.
Results: The results revealed that administration of grape seed extract to irradiated rats significantly ameliorates the changes induced in antioxidant system. TBARS (lipid peroxidation index) were significantly decreased when compared with their equivalent values in irradiated rats.
In conclusion, the administration of grape seed extract to irradiated rats might provide substantial protection against oxidative damages due to its free radical scavenging and antioxidant properties of its ingredients. It could be suggested that, grape seed extract may have a potential benefits to people receiving radiotherapy.
Grape seed extract
γ-irradiation
Oxidative Stress
mitochondria
and Antioxidant Enzymes
2012
07
01
414
428
https://ejhm.journals.ekb.eg/article_16245_bc8b9b78a7196bbfaac391b82c7a1001.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2012
48
1
Management of Severe Hallux Valgus Using Combined Proximal Closing Osteotomy with a Distal Soft Tissue Reconstruction
Abdullah Ali
Al-Zahrany
Background: many surgical procedures were described for correction of hallux valgus and the type of operation is based upon; foot length, width and redressibility of the transverse arch, hallux valgus evaluation of possibility of its passive redression and radiographic examination of foot.
Aim of the work: To evaluate the results of hallux valgus surgery combining the distal soft tissue reconstruction (DSTR) or modified McBride procedure and proximal closing wedge osteotomy of the first metatarsal base.
Patients and methods: This prospective study, was performed in King Abdul-Aziz Hospital, Taif, Saudi Arabia. The study was approved by the local committee of human research, and all patients gave written informed consent to participation. Ten patients (8 women and 2 men) with mean age of 28 years (18-40 years) were included in the study with 16 surgeries. The mean postoperative follow-up was 36 months (28 – 48). The operative technique performed in these patients was a combination of DSTR with closing osteotomy of the first metatarsal base.
Results: The mean pre-operative intermetatarsal 1-2 angle (IMA) revealed by radiographs was surgically corrected from 20.3 degrees at the baseline to the mean degree of 7.9. The mean pre-surgical hallux valgus angle (HVA) was 44.9 degrees proved by radiographs was surgically improved to 11.7 degrees, and 3 years after operation it reached 12.3 degrees (mean). Ninety percent of patients were satisfied with their surgical results and cosmetic improvements were achieved in 93.7 % (15/16 feet in 9 patients).
Conclusion: The combination of wedge osteotomy of the first metatarsal base and the distal soft tissue reconstruction (DSTR) or modified McBride procedure is suitable in the treatment of young patients having severe forms of hallux valgus and minimum arthritic changes in metatarsophalangeal joint with increased IM.
Severe Hallux Valgus
Combined Proximal Closing Osteotomy
Distal Soft Tissue Reconstruction
2012
07
01
429
438
https://ejhm.journals.ekb.eg/article_16246_56e7934d0028be4def22d3b283a7ae60.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2012
48
1
Dual Effect of Sacral and Lower Limb Neuromodulation in Urge Incontinence
Marwa M. Eid
MD
Basant M.
Elnady
Fatma M.
Abdel Aty MD
Dalia
Desouky MD
Purpose: To investigate the effect of posterior tibial nerve electrical stimulation (PTN) andsacral surface therapeutic electrical stimulation (SSTES) in the treatment of overactive bladder.
Patient and method: Sixty patients were included in this study. Their ages ranged from 14-62 years. They were divided into two equal groups.
Procedures: Group(A)received 12weeks of treatment with sacral surface electrode and posterior tibial nerve electrical 15 min three times /week for12 weeks while group (B)received pelvic floor exercises for 15 minutes 3times/week for 12 weeks.
Results: this study revealed that the bladder volume at first desire to void for group (A)as well as for group(B); showed no statistical significant difference, bladder stability in (A)group showed a highly statistical significant improvement with a percentage 48.69% while for group(B) non significant and by comparing both groups post-treatment, there was a statistical significant difference between groups with high percentage of improvement of the bladder stability in group(A) more than group(B). Maximum flow rate was significantly improved post-treatment, for group (A) with a percentage of improvement 25.2% while, for group (B)it was with a percentage of improvement 12.37%, and by comparing both groups post-treatment there was a statistical significant improvement in group(A) more than in group (B).
Conclusion PTN and sacral surface therapeutic electrical stimulation (SSTES) produced objective improvements include urodynamic changes specially bladder stability, and maximum flow rate.
Urge incontinence
Neuromodulation
Dual
sacral
lower limb
2012
07
01
439
451
https://ejhm.journals.ekb.eg/article_16247_64841e5b562a08e357328a41a33cc0e4.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2012
48
1
Cytological And Histochemical Studies On Rat Liver And Pancreas During Progression Of Streptozotocin Induced Diabetes And Possible Protection Using Certain Natural Antioxidants
Hanaa F.
Waer
Seham A.
Helmy
Background: Diabetes mellitus is a major endocrine disorder and growing health problem in most countries. Diabetes manifested by experimental animal models exhibits high oxidative stress due to persistent and chronic hyperglycemia which increases the generation of free radicals, streptozotocin (STZ) provides an animal model of type 1 diabetes. Thereby depleting the activities of antioxidative defense systems with alteration of antioxidant activities of enzymes such as green tea and curcumin . Aim : Biochemical histological and histochemical investigations were carried on to revel the effect of STZ on the liver and pancreas cells. Natural antioxidants were used as a new way for ameliorating diabetic effect on the cells Material and methods: Diabetes was induced by a single intraperitoneal injection of freshly prepared STZ dissolved in 0.05M of sodium citrate buffer, pH = 4.6, (STZ; 45 mg/kg B.wt.).Three days after degeneration of beta cells, diabetes was induced in all animals. After induction of diabetes, diabetic and normal animals were kept in metabolic cages separately. Green tea (EGCG) and curcumin are used as natural antioxidants to improve the disorders and structural changes induced by STZ. Cellular and histochemical investigations were carried on the changes induced in the pancreatic and hepatic tissues.Body weight, level of serum glucose and insulin were calculated in the control and treated groups. For detecting the degeneration of both hepatocytes and pancreatic cells of diabetic rats, tissue samples from diabetic and treated rats were collected and pathologically examined. Results: The present investigations reveled that there was a detectable amelioration on the injures induced by STZ on both hepatocytes and pancreatic cells using green tea or curcumin with a detectable dose level. Also it can be observed that the ameliorated effect induced was a time dependant. Conformation of these results from histochemical detection of polysaccharides and DNA contents were detected by PAS and Feulgen reactions. Conclusion: Curcumin and green tea look to have a powerful effect against diabetic cell injury induced in both rat liver and pancreas. The ameliorating effect seem to be time dependant.
biochemistry
Liver
pancreas
Pathology
STZ
histochemistry
2012
07
01
452
471
https://ejhm.journals.ekb.eg/article_16248_72d4a4ea5a5c613787c001003a857916.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2012
48
1
Correlation of DNA damage in type 2 diabetes to glycemic control
Sohair I
Salem
Safinaz E
El-Toukhy
Gamila S M
El-Saeed
Maha
El-Wassef
Background: Diabetes is associated with excessive production of reactive oxygen species (ROS) which can damage cellular macromolecules. The aim of the study was to detect oxidative DNA damage in type 2 diabetic patients and to correlate it with glycemic control.
Aim of work: to assess the percentage of DNA damage in patients with type 2 diabetes and the relation with glycemic control and lipid profile.
Patients and methods: The present work included 28 diabetic patients as well as 25 age and sex matched healthy volunteers served as control. Single cell gel electrophoresis (SCGE) was used to assess DNA damage in 28 patients with type 2 diabetes and 25 age and sex matched healthy controls. Moreover, glycemic as well as lipid profiles were also estimated in those subjects.
Results: The percent of DNA damage of peripheral blood mononuclear cells was higher in diabetic patients (45.1±9.2) compared to healthy controls (3.70± 0.85) (p<0.001). The percent of DNA damage correlated positively with BMI, fasting blood glucose, HbA1C, serum cholesterol, serum triglycerides, HDL cholesterol and LDL cholesterol (p<0.001) . However, there was no significant difference in percent of DNA damage between hypertensive patients (36.2 ±4.6) and non hypertensive patients (37.2±4.6). Pearson correlation analysis showed a significant positive correlation between DNA damage and body mass index, glycated hemoglobin, total cholesterol, triglycerides and low density lipoprotein cholesterol.
Conclusion: Type 2 diabetic patients have more oxidative DNA damage than normal controls and this damage increase with poor diabetic control, obesity and hyperlipidemia. Thus, DNA damage in the peripheral blood of diabetic patients assessed by comet assay can be applied as a new and non expensive technique for monitoring patients with type-2 diabetes.
diabetes
DNA damage
2012
07
01
472
482
https://ejhm.journals.ekb.eg/article_16249_ccae2a2e6c7debe16f579fb7edfc6843.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2012
48
1
Effect of Ginkgo biloba Leaves Aqueous Extract on Carbon Tetrachloride Induced Acute hepatotoxicity in rats
Hala A.H.
Khattab
Bachground: Oxidative stress plays a pivotal role in the pathogenesis and progression of various liver diseases. Ginkgo biloba leaves extract (GbE) have been proved to be an effective antioxidant, thereby can contribute to the prevention and treatment of diseases associated with oxidative stress.The present study aimed to investigate the hepatoprotective effect of GbE on acute liver injury induced using carbon tetrachloride (CCl4) in rats.
Material and Methods: Hepatotoxicity was induced in male rats by intraperitoneal (i.p) injection of CCl4 1mL/ kg body weight (b.w.) for every 72 h for 14 days, GbE was administered orally at a dose of 150 mg/kg b.w., daily started two weeks prior to CCl4 injection and continued until the end of the experiment.
Results: CCl4 caused acute liver damage in rats, as evidenced by significant increase serum enzymes activities of aspartate and alanine aminotransferase (ALT & AST) and alkaline phosphatase (ALP), and hepatic malondialdehyde (MDA), as well as significant decrease in weight gain percent, serum total protein (TP), high-density lipoprotein cholesterol (HDL-C), and hepatic reduced glutathione (GSH). Pretreatment with GbE prior to CCl4 injection elicited hepatoprotetcive activity by significant decreased the activities of liver enzymes and hepatic MDA, and significant increased the levels of TP, and hepatic GSH, as well as induced significant ameliorated in weight gain percent and lipid profileparameters as compared with CCl4 group. Histopathological examination of the liver tissues of CCl4 group represented the presence of hepatic necrosis associated with cells infiltration and vacuolar degeneration of hepatocytes, while the pretreatment with GbE overcome these changes, the majority of the cells tend to be normal.
Conclusion: The present findings indicated that the hepatoprotective effect of GbE against CCl4-induced oxidative damage may be due to its potent antioxidant activity. Therefore, GbE could be of potential help as a medicament or food supplement for alleviation of liver toxicity.
Ginkgo biloba – aqueous extract
male rats
Carbon tetrachloride
liver enzymes
lipid parameters
Malondialdehyde
reduced glutathione
Hepatoprotective
2012
07
01
483
495
https://ejhm.journals.ekb.eg/article_16250_470981dd7894758efc42de9e986cc96f.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2012
48
1
Portal Vein Thrombosis after Splenectomy
Mohamed
Al Saeed
Backgroundand Aim of the work: Splenectomy is a common operation but it carries the danger of many postoperative complications. One of the most important complications is the portal vein thrombosis (PVT), which may be fatal due to development of bowel ischemia and severe portal hypertension. Due to the effect of hypobaric hypoxia and higher liability for thrombosis encountered in high altitude areas, PVT may represent an actual problem in Taif province. The aim of this retrospective study is to detect the incidence, pattern of presentation, laboratory, radiological and results of treatment of cases of PVT following splenectomy.
Methods: In this study, we reviewed all cases of splenectomy performed in King Abdul Aziz Specialist Hospital, Taif, Saudi Arabia from January 2007 to January 2012. Cases of PVT following splenectomy were analyzed for incidence, pattern of presentation, laboratory, radiological and results of treatment.
Results: This study involved 50 patients (40 males and 10 females) admitted in the surgical department of King Abdul Aziz Specialist Hospital, Taif, Saudi Arabia from January 2007 to January 2012. Eight cases of Portal vein thrombosis (16%) out of 50 splenectomies were identified. These 8 patients included: 4/10 of the patients (40%) suffering from myeloproliferative (MP), 3 of them (75%) had spleen weight greater than 3,000 g, 3/12 (25%) of the hemolytic anemia patients, and 1/10 of the patients (10%) operated upon for Hypersplenism. All patients had splenomegaly with mean weight of 1540 Gms (range 460 to 3850 g). Presenting symptoms included; anorexia in 7/8 cases (87.5%), abdominal pain in 6 (75%), and in all cases there was elevation in D-Dimer level, leukocyte and platelet counts. All diagnoses were made by contrast-enhanced computed tomography scan, and anticoagulation was initiated immediately. One/8 patients (12.5%) died from progressive liver cell failure; the others are alive with no clinical sequalae at a mean follow up of 27 months.
CONCLUSIONS: PVT is a relatively common complication of splenectomy in patients with Splenomegaly, especially in Taif and related districts in which there is already a higher incidence of thrombotic disorders. The surgeon has to be with high index of suspicion, for early diagnosis by contrast-enhanced computed tomography, and prompt anticoagulation for successful outcome.
Portal Vein
Splenectomy
Thrombosis
2012
07
01
496
503
https://ejhm.journals.ekb.eg/article_16251_80647efaaabdd73c7691b7bce5f5ab46.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2012
48
1
The Use of Hypertonic Saline in Management of Hemorrhagic Shock
Mohamed
Al Saeed
Background: The most appropriate solution for volume replacement in hemorrhagic shock is controversial, however, hypertonic saline (HTS) solutions have recently gained widespread acceptance.
Aim of the work: to study the use of hypertonic saline with the resuscitation fluids in patients with hemorrhagic shock to evaluate the impact of this solution on the extent of early bacterial translocation and blood pressure.
Material and method: Forty patients were involved in this prospective study with class II & III hemorrhagic shock. They were randomized into 2 groups, each of 20 patients. Initial resuscitation in group I was done by using Lactated Ringer's (LR) solution with or without blood according to the patient requirements and in the second group of patients (group II), HTS 7.5% with dose of 4 ml /kg body weight was added to the resuscitation fluids. Regular monitoring of vital signs was done and blood samples were withdrawn 1, 30, and 90 minutes after commencement of the resuscitation and sent for blood culture for both aerobic and anaerobic growths.
Results: The mean arterial blood pressure in the group I before resuscitation was found to be about 65mm Hg and the mean was raised to 105 mm Hg after 2 hours of resuscitation with LR ± blood. The mean amount of LR used in this group to resuscitate the patients was found to be 40 ml/kg body weight. In group II, the mean arterial blood pressure was found to be 62 mm Hg and it was efficiently controlled by HTS, LR ± blood and the mean arterial blood pressure 2 hours after commencement of resuscitation was elevated to 124 mm Hg. The mean amount of LR used in this group to resuscitate the patients was found to be 18 ml/kg body weight. The blood cultures were positive in 5% of the patients of group II and in 40% of patients of group I. Escherichia coli were the most commonly isolated organism.
Conclusion: hypertonic saline was found to be effective for decreasing the rate of early bacterial translocation to blood and also for more efficient restoring of the mean arterial pressure in patients with hemorrhagic shock.
Hypertonic saline
bacterial translocation
hemorrhagic shock
2012
07
01
504
510
https://ejhm.journals.ekb.eg/article_16252_aad3fc0ba5494ef7447fd20327e0c80a.pdf