2024-03-29T09:21:41Z
https://ejhm.journals.ekb.eg/?_action=export&rf=summon&issue=3501
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2011
45
1
Prophylactic role of combined treatment with wheat germ oil and ginseng against radiation injury in male rats
S.M.
Abdel Fattah
Th. M.
Fahim
N.M.
El-Fatih
Background: This study was designed to investigate the possible ameliorating effect of combined treatment of rats with wheat germ oil [a rich source of vitamin E, octacosanol, policosanol and the essential fatty acids (linoleic and linolenic)] and the antioxidant properties of panax quinquefolium ginseng on radiation-induced oxidative body damage.
Materials and Methods: Animals received wheat germ oil by gavage at a dose of 80 mg/kg body wt and panax ginseng was intraperitioneally injected with 100 mg/kg body wt for 10 successive days pre as well as during irradiation and supplementation was extended during the period of radiation exposure of rats to fractionated doses 8 Gy (4 x2Gy).
Results: Experimental investigations were performed at 7th and 10th days after the last dose of irradiation revealed that whole body γ-irradiation of rats produced a significant rise in the activities of serum markers for liver damage as aspartate aminotransferase (ASAT), alaninetransaminase (ALAT), ammonia and buytryl cholinestase associated with decrease in the serum content of total protein, albumin (A), golublin (G) and A/G ratio indicating acute hepato-toxicity, at the 7th and 10th days post-irradiation. Also, radiation-induced biochemical disorders manifested by significant elvation in serum creatinine and urea levels. Serum lipid profile as total cholesterol (TC), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C) and low density lipoprotein-cholestrol (LDL-C) levels were significantly higher than normal control rats associated with significant decrease in HDL/LDL ratio. Radiation induced an elevation of lipid peroxidation measured as thiobarbituric acid reactive substance (TARS) in plasma and liver. The rats that received combined treatment with wheat germ oil and panax ginseng supplement showed significantly less severe damage and remarkable improvement in all of the measured parameters when compared to irradiated rats. According to the results obtained it could be concluded that combined treatment with whole germ oil and panax ginseng might be a useful candidate against radiation-induced oxidative stress and metabolic disorders without any toxicity.
γ-irradiation
Wheat germ oil
Panax ginseng
Liver Injury
2011
10
01
403
415
https://ejhm.journals.ekb.eg/article_16367_e1376e394f7950b26fdc12575332ac3f.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2011
45
1
The Role of Prophylactic Antibiotics in the Management of Post Surgical wound Infection
Hanaa
Abu Ria
Bosat
Olwani
Altahr
Abed Alhamid
Introduction: Prophylactic antibiotics have been shown to be effective in reducing the incidence of febrile morbidity associated with surgical operations. Surgical site infections (SSI’s) account for approximately 15% of nosocomial infections and are associated with prolonged hospital stays and increased costs.
Objective: To improve the outcome and to reduce the time stay at the hospital.
To determine the independent risk factors for post surgical infection.
To decrease the incidence of post surgical wound infection.
Study Design: An intervention randomized study.
Aim of the work: To evaluate the efficacy of prophylactic antibiotics in reducing the incidence of post surgical wound infection.
Place and Duration: Department of Obstetrics and Gynecology,
Department of Surgery and Department of urology, Faculty of Medicine
Al-Azhar University from January to June 2011.
Patient and Method: Three hundred patients undergoing surgical operations were enrolled in this study and classified into two groups:
Group1:150 patients received parental prophylactic antibiotics, 1st dose at the time of induction of anesthesia, 2nd dose after 12hs from the surgery.
Group2: 150 patients received oral antibiotics for five days postoperative.
Results: In this study ,Total 300 patients were enrolled,6 patients from group 1 developed wound infection(4%),39 patients from group 2 developed wound infection(26%) ,with prolonged stay at the hospital,2.3 days in group1, and 4.9 days in group 2.
Conclusion:
The use of prophylactic antibiotics therapy is satisfactory in our surgical
environment, this practice would be efficient, cost effective and prevent
the emergence of nosocomial infection in developing countries.
Surgical Sit Infections (SSI’s) – Prophylactic antibiotic
2011
10
01
416
423
https://ejhm.journals.ekb.eg/article_16368_2f53f0f55e2bd998943551176dd68415.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2011
45
1
Neutropenia in chronic hepatitis C during Interferon and Ribavirin Therapy.
Saadia
Farid
Hala
Morad
Samya
Sweilam.
Background: Neutropenia is a condition characterized by an abnormally low number of a type of white blood cells called Neutrophils, up to 25 % of people who take pegylated interferon, ribavirin and an HCV protease inhibitor experience Neutropenia.
Aim of the work: The study will be intended to analyze neutrophil counts and associated conditions of the liver and spleen , platelet count, liver enzymes and infections, during Interferon and Ribavirin therapy.
Patients and methods: One hundred forty two patients with chronic hepatitis C virus infection, their age between (18-59) years, selected from the National Hepatology and Tropical Medicine Research Institute were included in this study, during Interferon and Ribavirin therapy.
All the patients were subjected to the following history, through clinical examination, abdominal ultrasonography and collection of blood samples for routine investigations, CBCs and serological assay for ALT, Bilirubin.
Resuls: Our results revealed presence of 32.4 % anaemia, 18.3 % Thrombocytopenia, 16.9 % elevated ALT, 2.8 % elevated bilirubine, 16.9 % coarse liver, 25.4 % hepatomegaly, 16.2 % splenomegaly, and 16.9 % of cases complained different shapes of infection, associated with Neutropenia in patients of chronic hepatitis C during interferon and ribavirin therapy.
Conclusion: Our study concluded that the prevalence of Neutropenia in chronic hepatitis C virus infection patients 23.8 % during interferon and ribavirin therapy but it is not usually associated with infection.
Recommendations: Neutropenia is a complicated process that requires expert guidance from a medical provider.
Neutropenia
Chronic hepatitis C
side effect of interferon and ribavirin therapy
2011
10
01
424
433
https://ejhm.journals.ekb.eg/article_16370_6d2f9fff05b00d7118d2d9d2003db454.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2011
45
1
A Combination anti-HBV regimen using lamivudine and other agents in treatment of resistant chronic hepatitis B
Saadia
Farid
Samya
sweilam
Background: Several difficulties remain in formulating treatment for chronic hepatitis B (CHB), 350 million people are chronically infected with HBV, Chronic infection with hepatitis B virus accounts for an enormous burden of disease worldwide, including up to half of all cases of cirrhosis, end stage liver disease , and hepatocellular carcinoma.
Aim of the work: To maximize the elimination of the viral infection while minimizing or preventing damage to the liver cells and tissues and development of viral resistance to more antivirals.
Patients and Methods: Eighty eight patients of chronic hepatitis B virus infection with resistance to lamivudine treatment as proved by quantitative PCR (more than 200 IU/ ml). Their age between (20-60) years, (85 males, and 3 females) were selected from the National Hepatology and Tropical Medicine Research Institute and were included in this study. The included patients were two groups, the first group 42 patients , were receiving Lamivudine, plus (Baraclude) Entecavir (tablet 0.5mg / day) treatment at the time of assessment. The second group 46 patients were receiving ( Hepsera tablet 10 mg / day ) Adefovir dipivoxil plus lamivudine (tablet).
All the patients were subjected to the following : thorough history and clinical examination, abdominal ultrasonography and collection of blood samples for routine liver and kidney function investigations and serological assay for HBsAg, HBsAb, HBeAg, HBeAb, HBcAb quantitative HBV DNA (PCR).
Results: Our results revealed significant differences between the two groups of patients of CHBV infection, resistant to Lamivudine drug, the first group were higher in response to a combination between Lamivudine + (Baraclude) Entecavir, than the second group who were receiving Lamivudine + (Hepsera) Adefovir dipivoxil combination therapy.
Conclusion: Our study concluded that the clinical benefit is apparent with high percentage after a combination regimen using Lamivudine + Entecavir than a combination regimen using Lamivudine + Adefovir dipivoxil for the treatment of resistant chronic hepatitis B virus who were treated with Lamivudine only before.
Recommendations: Optimal management of chronic hepatitis B,that may require
long-term and sometimes lifelong treatment to maintain its clinical benefit is challenging. It is important to initiate treatment with a drug that has the least potential for induction of drug resistance as sequential monotherapy which may result in selection of multidrug resistant HBV mutatants.
A combination anti-HBV
Antiviral drug resistance
Nucleos(t)ide analogues
Lamivudine
Entecavir
Adefovir dipivoxil
2011
10
01
434
442
https://ejhm.journals.ekb.eg/article_16372_ab77ee0370086bd427abab744c6f6793.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2011
45
1
Effects of Aging and Anti-Aging Hormones on The Kidney, The Thyroid Functions and The Histology of The Testis of Male Albino Rats
Shadia Ali
Radwan
Samia Mohamed
Sakr
Mohamed Salah
Al-Shinnawy
Enas Saleh
Abdel-Bakey
Introduction
The present study was carried out to evaluate the effect of aging and anti-aging hormones on the kidney, the thyroid and the testis of aged male albino rats from the physiological and histological points of view.
Material & Methods
Thirty five male rats were used in the present study. They were allocated into five groups. The first group (5months old) served as control group and the other remaining groups are (18 months old). The second group 1 ml/kg b.w. corn oil intramuscular injection through a period of two weeks .The third group received 2mg/kg b.w. of melatonin hormone orally daily for two weeks. The fourth group received 0.57 mg/kg b.w. of testosterone hormone via intramuscular injection through two weeks. The fifth group received the same dose of both hormones (Melatonin & Testosterone) for two weeks. Some biochemical parameters of the kidney, the thyroid and histological structure of the testis were examined.
Results
The untreated aged group showed insignificant change in urea level with highly significant decrease in creatinine, T3 and T4 hormones levels.The melatonin treated group showed significant decrease in urea level with highly significant decrease in creatinine, T3 and T4 hormones. The testosterone treated group showed highly significant increase in urea, T3 and T4 hormones and highly significant decrease in creatinine level. Whereas, fifth group showed significant decrease in urea accompanied with a highly significant decrease in creatinine and highly significant increase in T3 with a significant increase in T4.
The histological changes induced by aging and anti-aging hormones included intertubular haemorrhage, odematous areas present between the seminiferous tubules. The interstitial tissue was degenerated. The degenerated seminiferous tubules revealed maturation arrest in late-stage spermatides.
Conclusion
In conclusion, aging and anti-aging hormones administration into adult male rats exerts a clear effect on the kidney and the thyroid functions and on the testicular structure. On the other hand, amelioration in T3 &T4 serum level was found in anti-aging treated rats compared with untreated aged rats.
aging
Anti-aging Hormones
Melatonin
testosterone
biochemical parameters
testis
histology
male Albino rats
2011
10
01
443
456
https://ejhm.journals.ekb.eg/article_16374_111252c312890df05a3afb20cc278d66.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2011
45
1
Comparison of Lipopolysaccharide binding protein and C-reactive protein gene expression levels in a Rat model of induced Atherosclerosis
Kholoud S.
Ramadan
Rasha E.
Hassan
Abd El Rahman B.
Abd El Ghaffar
Asmaa A.
Deghedy
Introduction:
Atherosclerosis is an inflammatory disease characterized by the accumulation of lipids within arterial walls that eventually go on to form plaques, which can cause narrowing, hardening, and/or complete blockage of arteries. This study was designed to examine the cholesterol feeding induction of cardiovascular diseases exemplified by atherosclerosis in rat and induction of CRP, LBP, SAP and P4H on the transcriptional activity of the inflammation / related gene expression by a semi-quantitative RT-PCR in liver and heart tissues, and make comparison between CRP and LBP as biomarker for atherosclerosis.
Material & Methods:
Experimental Rats were fed with cholesterol diet (2.5% pure (wt/wt) cholesterol, 1% cholic acid and 5% oil) and sacrificed after 18 weeks of feeding.
Results:
Histopathological examination for heart showed fatty cells deposition in atherogenic rats. Expression pattern of CRP, LBP, SAP & P4H genes were investigated, in liver and heart, these genes were highly expressed while some of them showed no expression pattern in heart tissues.
cardiovascular diseases
Atherosclerosis
C-reactive protein
Lipopolysaccharide binding protein
Serum amyloid P component & Prolyl-4-Hydorxylase
2011
10
01
457
476
https://ejhm.journals.ekb.eg/article_16375_bbd7350b51759b382ef456fcf45f03f4.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2011
45
1
The immunological and histopathological changes of Tramadol, Tramadol/Acetaminophen and Acetaminophen in male Albino rats “Comparative study”
Hanan Mostafa
Rabei
Background:
Tramadol is a synthetic opioid analgesic. It is commonly prescribed for moderate to severe pain, becoming abused more popular among teens in most countries. Paracetamol as anti-inflammatory drugs (acetaminophen) (APAP) is widely used as an analgesic and antipyretic agent. Meanwhile, tramadol/acetaminophen (tramacet) is effective in acute or chronic moderate-to-moderately severe pain. In comparative study, the current investigation threw the light on the effect of over doses of tramadol and/or APAP on the immune function and hepatocytes in adult maleSprague-Dawley rats.
Material and methods:
Treated rats received oral doses of each drug for 15 consecutive days and after last treatment, they kept three days later for withdrawal studies. The rats were divided into four treatment groups, in the first group, rats received saline and used as control. The second, third and fourth groups treated with tramadol (45 mg/kg), tramadol/APAP (45/450 mg/kg), APAP (450 mg/kg) respectively, once a-day at the first week and ending with 90, 90/900, 900 mg/kg at the second week. Rats were sacrificed at the end of the first, second weeks and three days of last treatment.
Results:
Daily doses of tramadol and /or APAP exposure in rats decreased the cellularity of spleen. Moreover, phagocytic and killing of S. aureus by PMN and macrophage cells caused a highly significant decrease in treated groups. IFN-γ was reduced in a statistically different treated group of rats. Serum IL-10 was unaffected by any of the treatment regimens but increased only in tramadol/APAP treated rats. Spleen histology exhibited mild pathological alteration with different injures between treated groups. Splenic white pulp accompanied by ill deformed which reflected the reduction of white pulp zones, thickened vasculature in the splenic net work, fibrous trabeculae become prominent feature, where splenic red pulp occupied large areas of the splenic network with predominant edema and megakaryocytes. On the other hand, the effect of tramadol and/or APAP induced DNA alterations of hepatocytes in dose dependent pattern as elucidated by dendrogramatic analysis. Liver histopathological changes of treated groups included vacuolated hepatocytes, dilated sinusoid with proliferated Kupffer cells; atrophied hepatocytes with nuclei reduced in size and darkly stained. Many areas of hepatocytes showed loss of architecture, congested central vein, expanded portal area with edema and inflammatory reaction.
Conclusion:
It could be concluded that the effect of tramadol/APAP induced anti-inflammatory cytokines than tramadol and APAP alone. Tramadol and/or APAP may display severe pathological consequences of hepatocytes. These hepatic lesions may be caused impairment of the liver function.
tramadol
Tramadol/Acetaminophen
acetaminophen
Cytokines
phagocytosis
Histopathology of spleen and liver
DNA fragmentation
albino rat
2011
10
01
477
503
https://ejhm.journals.ekb.eg/article_16376_07905470b246a9b6aa953e6c25ca8be4.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2011
45
1
Early Detection of Hepatocellular Carcinoma on top of Liver Cirrhosis: The Fas Receptor and Ligand System
Olfat
Hammam
Manal
Zahran
Ola
Mahmoud
Sohair
Aly
Karim
Hosny
Amira
Helmy
Amgad
Anas
Hepatocyte aberrations, accumulation of chromosomal damage and possibly initiation of hepatic carcinogenesis is thought to be caused by the continued viral replication and the persistent attempt by a less than optimal immune response to eliminate hepatitis C virus (HCV) infected cells. The identification of the “death factors" including Fas and its Ligand (Fas-L) as a major regulator of both apoptosis and immune function has provided insight into an attractive mechanism of tumor escape from immune clearance.
Aim: To assess the hepatic expression of Fas/Fas-L, the Fas receptor (Fas-R) expression on lymphocyte, and serum soluble Fas (sFas) in an attempt to analyze the role of Fas receptor/ligand system in the multistep process of fibrosis/carcinogenesis and the possible use of the serum marker as possible candidate biomarkers for an early detection of hepatocellular carcinoma (HCC).
Material and Method:
The current study included 100 samples from cases at Theodor Bilharz Research Institute and Kasr Al Aini Hospital in Egypt. There were 90 cases of chronic hepatitis C (CHC) infection (and negative hepatitis B virus infection). There were 30 cases without liver cirrhosis, 30 cases with liver cirrhosis and 30 cases with HCC. 10 liver biopsies were taken from healthy livers as normal controls. Histopathologic study and immunohistochemistry for detection of hepatic Fas and Fas-L expression were determined for all cases. Electron microscopy (EM) and immunoelectron microscopy (IEM) examination for detection of Fas-R expression on lymphocytes were also done. sFas, liver function tests, serologic markers for viral hepatitis, and serum alpha-fetoprotein level (alpha-FP) were done.
Results:
The sFas in both HCC and CHC with cirrhosis patients were significantly higher than those of normal controls and CHC without cirrhosis (P<0.01), but there was no significant difference between the cirrhosis and HCC patients. Positive hepatic expression of both Fas and Fas-L were significantly increased in the diseased groups (p<0. 01) compared to the control specimens. A progressive Fas and FasL increase from CHC without cirrhosis to CHC with cirrhosis followed by a decline from the latter to HCC. Apoptotic Fas and Fas-L proteins expression was significantly increased with the necroinflammatory activity and the advancement of fibrosis. There was a non-significant negative correlation between sFas and hepatic Fas. In addition a significant over expression of Fas-R on separated lymphocytes was associated with a higher frequency of apoptotic cell death as detected by EM examination.
Conclusion:
The Fas receptor/ligand system was significantly involved in the process of liver cirrhosis converting into HCC. Down-regulation of Fas expression, up-regulation of Fas-L expression in hepatocytes and elevation of serum sFas level were important in tumor evasion from immune surveillance and in hepatic carcinogenesis.
Hepatocellular carcinoma
Cirrhosis
Fas
Fas ligand
hepatitis C
2011
10
01
504
521
https://ejhm.journals.ekb.eg/article_16379_a852ef5ca4eefdae36d8571117d94163.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2011
45
1
Effect of Cichorium intybus L. on fatty liver induced by oxytetracycline in albino rats.
Eman G.E.
Helal
Samia M.
Abd El-Wahab
Ghada A.
Zedan
Atef M.Moussa
Sharaf
Background: Fatty liver is now one of the most common diseases in Egypt. People prefer to use the medicinal plants instead of using chemical compounds because they are cheap and have few side effects compared to chemical compounds.The current investigation was carried out to examine the possible potential therapeutic and protective effects of Cichorium intybus (chicory) against oxytetracyclin-induced fatty liver in an attempt to understand its mechanism of action, which may pave the way for possible therapeutic applications.
Material and Methods: Albino rats were divided into two major groups, 15 rats for each. The first group was divided into three sub-groups: a) control, b) fatty liver group; that was injected intraperitonealy with oxytetracycline (120mg/kg) for three consecutive days resulting in steatosis and c) chicory treated group; which was treated with chicory water extract (70 mg/kg) for 30 days after fatty liver induction . All animals were scarified after 33 days of the beginning of the experiment. The second group was divided into three subgroups: a) control, b) fatty liver group; that was injected intraperitonealy with oxytetracycline (120mg/kg) for three consecutive days and c) drug protection group; which received chicory for 15 days before induction of fatty liver, then sacrificed after induction of fatty liver (3 days). Blood samples were collected for biochemical analysis. Liver specimens were obtained and fixed in 10% formalin for histological study.
Results: Fatty liver groups showed high significant increase in serum glucose, cholesterol, triglycerides, LDL cholesterol, ALAT, ASAT, GGT, LDH, urea, creatinine and A/G ratio while total protein, albumin, globulin and HDL cholesterol were significantly decreased compared to control group. These biochemical changes were accompanied with histopathological alterations in fatty liver tissue. The treatment with chicory ameliorated most of the evaluated biochemical parameters and improved the induced degenerative histopathological changes. The pre-treatment with chicory before the induction of fatty liver gave some protection against factors that experimentally induced fatty liver.
Conclusion: Chicory as diet additive is recommend for fatty liver patients or those people who have hyperlipidemic family history.
Fatty Liver
Chicory
Lipid profile
albino rats
physiological parameters
histopathology
2011
10
01
522
535
https://ejhm.journals.ekb.eg/article_16381_7cb056f047bb82dd9165630953cf3d46.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2011
45
1
Amelioration of aluminium - intake oxidative stress by some antioxidants in male albino rats
Ahkam M.
El-Gendy
Aluminum is potentially toxic to humans. The Agency for Toxics Substances and Disease Registry (ATSDR) reported that aluminum accumulates mainly in the bone, liver, testes, kidneys and brain. The goal of the present study was to assess in rats the pro-oxidant effects induced by Al3+ exposure, as well as the protective role of exogenous melatonin (M), vitamin E (vit. E) or N-acetylcystiene (NAC). The effect of aluminium (Al) alone or combined with antioxidants (M), (vit. E) or (NAC) on some physiological parameters and antioxidants in male albino rats were studied.
Material and methods:
The animals were assigned to 5 groups: control (group I); Al3+–intake (53.5 mg AlCl3/litre drinking water , group II) ; 5 mg melatonin/kg b.wt. plus AlCl3 (group III); , or vitamin E(100 mg/kg b.w.) plus AlCl3 (group IV)or 100mg N-acetylcystien plus AlCl3 (group V). Rats were orally administered their respective doses daily for 30 days. At the end of the treatment period, blood was obtained. Thereafter, brain, liver, kidney and testes were removed. These tissues were processed to examine oxidative stress markers: reduced glutathione (GSH), superoxide dismutase (SOD), glutathione peroxidase (GSHpx) and lipid peroxidation end products {malondialdhyde(MDA) + 4- hydroxynonenal (4- HNE)}. Samples of these tissues were also used to determine Al3+ concentrations.
Results :
In Al- toxicated group ,serum glucose and total cholesterol levels, liver enzyme activities (ASAT and ALAT), as well as, lipid peroxidation end products {malondialdhyde (MDA) + 4- hydroxynonenal (4- HNE)} were elevated significantly in the brain , liver ,kidney and testes tissues when compared with control group. On the other hand, serum triglycerides and tissue (liver, kidney and testes) intracellular antioxidants glutathione (GSH) and superoxide dismutase (SOD) and liver glutathione peroxidase (GSHpx) activity decreased significantly. Brain GSH also decreased but SOD showed no significant changes. Melatonin, vit. E and NAC improved the levels of the different changed parameters when combined with Al. The most improved correction was recorded when Al3+ combined with vit. E followed by M ,then NAC. Serum Al3+ levels were increased in Al3+ treated group as well as groups exposed to Al3+ combined with vit. E, M or NAC when compared with control group. Al3+ could not be detected in tissues by atomic spectrophotometer (aluminium metal concentrations were below the limit of detection by AAS).
Conclusion:
The results show that Al3+ exposure promotes oxidative stress in different tissues while melatonin, vitamin E and N-acetylcystiene exert antioxidant actions in Al3+-treated animals. The protective effects of these antioxidants against cellular damage caused by Al3+-induced oxidative stress, together with its low toxicity, make them worthy of investigation as potential supplements to be included in the treatment of neurological disorders in which the oxidative effects must be minimized as well as protection against liver, kidney and testes damage by Al- exposure.
Dietary vitamin E supplementation may offer further protection.
aluminium
Melatonin
Vitamin E
N-acetylcystiene
antioxidants
Lipid peroxidation
MDA
2011
10
01
536
546
https://ejhm.journals.ekb.eg/article_16384_305997bbbd47e7362b2af5b003bf1eea.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2011
45
1
Maternal obesity and its adverse impact on labor outcome
Inas Mahmoud
Hamdy
Objective: to study the impact of maternal obesity on the outcome of labour. Setting: Al zahraa University hospital.Design: prospective randomized control study.Patients: a total of (80) pregnant women were included in this study from April 2009 to March 2010. Patients and Methods:According to the BMI the patients were classified into two groups. Group (I): (Control Group):Included (30) patients with (body mass index) (BMI) ranging from 20 to 25 kg/m2.Group (II): (Obese Group): Included (50) patients with (BMI) ranging from 25 to 30kg/m2. Each patient were subjected to full clinical examination (General) Abdominal and pelvic) U/S pelviabdominal examination that is to confirm the inclusion and exclusion criteria of the study. Results : A significant differences was noticed between 2 groups as regard the BMI. The current study showed significant difference in cases subjected to induction of labour with p-value < 0.001. Also significant difference between control group and obese group regarding failed induction, failure to progress 1st stage, 2nd stage, shoulder dystocia with p-value < 0.01.Case of C.S showed the highest significant diff. with P-value < 0.0001 .In the present study no sig. diff. between cases of both groups as regard 3rd stage complication, 4th stage (PPH) and blood transfusion with P-value 0.658, 0.684 and 0.658 respectively. A high significant diff. between the two groups as regard case of macrosomia, Apgar score < 7 1st minute, and birth injury with p-value < 0.01. A significant diff. were showed between the cases of both groups as regard the incubation with p-value > 0.05.No significant diff. were noticed between the 2 groups as regard the cases with Apgar score < 7 at 5 minutes with p-value 0.06. A positive correlation coefficient between the BMI (25-29), (29-33) kg/m2 with the case of induction of labour, failure to progress 1st stage, shoulder dystoca, cesarean section and fetal low Apgar score. While a negative correlation was recorded between the BMI of the control group and all the adverse outcomes. Conclusion:Obesity of the gravid women is a sensitive predictor of the adverse outcome during pregnancy, labour, and post partum. Researches are needed into effective, applicable and acceptable community -based program for obese women planning a pregnancy.
Maternal obesity. labor
2011
10
01
547
553
https://ejhm.journals.ekb.eg/article_16386_c201a177f91b92a255a3cf2a597f9f94.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2011
45
1
The predictive value of studying the Uterine & umbilical artery
Naemat M. Hafei El Din
Shiry
Inas Mahmoud
Hamdy
Objective: to assess the value of uterine artery and umbilical artery resistance indices changes in predicting cases of PTD
Setting: The study was carried on gravid women attending AI zahraa University Hospital between February 2009 to September 2010.
Design: A prospective study on gravid women picked up at 24 week gestation during ANC . They were subjected to Doppler velocimetry study of the Umbalical & Uterine artery blood flow to measure the resistive indices changes on going GA.
Patients & Methods: Participants were 24 weeks pregnant with a singleton pregnancy, Participants were seen at three study visits: at recruitment, at, 28 weeks gestation; and finally at 34 weeks gestation. Patients who later developed PTL formed the study group n=28.
The control group were the women who completed 40 weeks gestation at the time of delivery. For each patient seen at the three visits Doppler velocimetry ultrasound study of the umbilical and uterine were performed to assess the RI indices changes.
Results: The current study revealed a high significant difference in the RI value of the umblical artery starting from 28 weeks visit to be (0.74), (0.61) in the study group and control group respectively with p-value (0.001) also a highly significant diff. were noticed at the 34 weeks visit to be( 0.65),(0.49) in the study group and control group respectively with p-value (0.0001). As regard the uterine artery RI the study group showed a highly significant difference at 28 weeks visit when compared to the value of the control group with p-value( 0.001) in the same manner the RI value at 34 weeks visit showed a highly significant difference between both groups with p-value(0.0001).In the current study the mean RI for both uterine and umbilical arteries decreased steadily across all study visits from 24 weeks to 34 weeks gestation. In linear regression models, the relationships of both uterine and umbilical artery RI with gestational age were significantly different between study group and control group. The mean umbilical artery RI and uterine artery RI indices decreased significantly more slowly across gestation for study group than for control group. In univariate analyses, a 2.9 fold increase in risk for PTD was associated with a 0.1 unit increase in uterine artery RI across gestation; while a 3.4 fold increase in risk for PTD was associated with a 0.1 unit increase in umbilical artery RI across gestation.
Conclusion: The RI indices values in the umblical artery and uterine artery showed a significant slowly decrease along gestational age among gravid patients developed preterm labour so that they could be predictive for PTL.
(Naemat – Inas- UT.&UMB-RI)
2011
10
01
554
560
https://ejhm.journals.ekb.eg/article_16388_a9b4ea3997ddeead901c94f96e0483e5.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2011
45
1
Embryonic Heart Rate correlation with pregnancy outcome in women with first trimester bleeding
Naemat Mohamed H.ELDin
Shiry
Objective : To assess the correlation between fetal heart rate and the fate of pregnancy in women with first trimester bleeding.
Methods :
This prospective observational study included 281 consecutive women with first trimester bleeding and Singleton pregnancies. The embryonic heart rate measured at the time of first trans-vaginal scan as per protocol in our university hospital for the evaluation of pregnancy. The heart rate was classified as slow if it was fewer than 110 beats per minute. The primary outcome measure is the occurrence of spontaneous early pregnancy loss prior to 12 weeks. Other outcome measures included the occurrence of late pregnancy loss (prior to 24 weeks), gestational age at birth, and fetal weight at birth.
Results :
Embryonic heart rate at less than 110 bpm was associated with a high likelihood of pregnancy loss. The sensitivity, specificity, positive and negative predictive value, and accuracy were 43.1%, 86%, 40.7%, 87.2%, and 78.2%, respectively. The OR (95% CI) of first-trimester pregnancy.
Conclusion:
embryonic heart rate can be an independent predictor of the outcome of pregnancy in women with intrauterine pregnancy complaining of first trimester bleeding.
2011
10
01
561
569
https://ejhm.journals.ekb.eg/article_16389_043c6b9327fbb87524e18c1bd2727ed9.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2011
45
1
Association between Helicobacter Pylori infection and autoimmune hypothyroidism in Egyptian population
Fatma Kamel
Hammad
Zeinab Abd El-Baset
Hassan
Dina Mohammed
Abaza
Hesham Mohamed
Abou El-Soud
Sabila Gomma
Mosua
Ahmed Ahmed
Saad
Autoimmune hypothyroidism commonly affecting females is one of the commonest causes of thyroid disease in adults. Among the various autoantibody tests applied in research and clinical practice, the determination of thyroid microsomal antibodies (TPO) and thyroglobulin antibodies (TG Ab) still retains its strong value in the screening for thyroid autoimmunity. Helicobacter pylori (H. pylori) infection plays an important role in the pathogenesis of chronic gastritis, peptic ulcer disease, MALT (Mucosa Associated lymphocyte T) Lymphoma and gastric cancer.
Aim of the work:
The aim of this work was to study the relationship between H.pylori infection and autoimmune hypothyroidism in Egyptian population.
Subjects and Methods:
This study was carried out on 147 Egyptian persons divided into 3 groups: Hypothyroid Group: Included 49 patients with autoimmune hypothyroidsm and positive antithyroid antibodies with no history of dyspeptic symptoms or peptic ulcer. H.pylori positive Group: Included 50 patients with dyspeptic symptoms or peptic ulcer with H.pylori positive antibodies with no history of any thyroid disease. Control Group: Included 48 apparently healthy persons serving as control. Serum Free T3, Free T4 and TSH were done for all subjects together with Antimicrosomal antibodies (TPO-Ab), Antithyroglobulin antibodies (TG-Ab) and Helicobacter Pylori antibodies (H. pylori Ab).
Result
There was no significant difference between all groups as regards age. Also there was significant difference between Hypothyroid and H.pylori positive groups as regarding TSH and Free T3, TG-Ab, TPO-Ab and H. pylori Ab. There is also significant difference between Hypothyroid and control groups regarding TSH, free T3, TG-Ab, TPO-Ab, and H. pylori Ab. There is significant difference between H.pylori positive and control groups regarding FT3 and H. pylori AB. Hypothyroid Group was divided according to the presence of H. pylori Ab into –ve &+ve H. pylori Ab subgroups. There was significant difference between the –ve and +ve subgroups as regard TSH, free T4 and TG-Ab. H.pylori positive Group was divided according to the presence of TG Ab & TPO Ab into–ve and +ve subgroups. There was significant difference between the –ve and +ve cases in TSH, free T4, Free T3, and H.Pylori
Antibody.
Positive correlation was found between H pylori Ab titer and age, TSH, TG-Ab and TPO-Ab titers. There was also negative correlation between H. pylori Ab titer and free T4. There is no correlation between H. pylori Ab titer and free T3. (Correlation is referred to all subjects of the study = 147).
Conclusion
This study revealed that patients with positive TG & TPO antibodies, showed (+ve) H. pylori Ab, with significant high titer in their sera. The patients with positive H. Pylori Ab showed high serum titer of TG-Ab. In our study H. pylori-Ab correlates to thyroid function tests and thyroid antibodies.
Thyroid peroxidase
thyroglobulin
Helicobacter pylori
Antibody
2011
10
01
570
584
https://ejhm.journals.ekb.eg/article_16395_64b0b1ed284b24cb4b0c78e908a8ef7b.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2011
45
1
The Relation between Asthma, Body Fat Distribution and Serum Adiponectin in Obese Egyptian Children.
Dina M
Abaza
Amany E.
El Arab
Ensaf K.
Mohamed
Hoda E.
El Arab
Childhood obesity is an emerging global public health challenge. That is because the prevalence of obesity among children and adolescents has increased greatly in all parts of the world. A number of studies have reported an inverse relation between respiratory function and various indices of obesity or fat distribution (El-Baz et al., 2009). Adiponectin, an antiinflammatory adipocytokine, circulates at lower levels in the obese, which is thought to contribute to obesity-related inflammatory disease as bronchial asthma ( Medoff et al., 2009).
Aim of the work
The aim of this work was to assess the correlation between the bronchial asthma, obesity, fat distribution and serum adiponectin in obese Egyptian children.
Subjects and Methods
The present study included a group of obese fifty (50) children (25 boys & 25 girls) without the co morbidities of the metabolic syndrome; aged 7-18 years, mean age (14.2±3.9). Obesity without the co morbidities of the metabolic syndrome was defined as a BMI above the 85th percentiles according to BMI Charts of Egyptian Growth Charts for boys and girls from 2-21 years (2002). They were compared to thirty (30) lean sex and age matched controls mean age (14.1±4.8) (15 boys & 15 girls) with BMI between the 10th and 75th percentile. Anthropometric measurements (body weight, BMI, WC and fat mass% by DEXA) were done for all children together with pulmonary function test and assessment of serum adiponectin levels.
Results
Weight, Waist circumference (WC), Body mass index (BMI), fat mass% and adiponectin were significant higher in obese compared to non obese groups (p<0.001 for all). Parameters of pulmonary function was significant lower in obese compared to non obese groups as regard forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow maximum (PEF) and forced midexpiratory flow 25%(FEF25%) (p<0.01 for all). while no significant difference was found between both groups as regard FEV1\FVC ratio and forced midexpiratory flow rate( FEF25-75% )(p>0.05 for both).
A negative association of BMI with parameters of pulmonary function was found but only FEV1, FVC & FEF 25% were statistically significant(p<0.01 for all). As regard WC it was negatively correlated with FEV1, FVC and FEF 25 %( p<0.01 for all) but no correlation was found with other parameters of pulmonary functions (p>0.05). In the present study a negative correlation was found between fat mass % and parameters of pulmonary function but none of them was statistically significant (p>0.05 for all).
A negative significant correlation was found between adiponectin and age in obese group (p>0.05) .As regard anthropometric parameters in obese group a significant negative correlation was found between adiponectin and BMI, WC & fat mass %(p<0.01 for all) while no correlation was found with body weight(p>0.05). As regard of pulmonary function parameters a negative significant correlation was found between serum adiponectin and FVC and PEF %( p<0.01 for both) while a negative correlation was found between adiponectin and FEF 25% but this correlation was statistically insignificant (p>0.05), While no correlation was found with FEV1\FVC ratio (p>0.05).
Conclusion:
The increasing prevalence of overweight and obesity among Egyptian children may be an important contributor to the increasing incidence and prevalence of asthma. Adiponectin may be one of the signals linking obesity with asthma.
adiponectin
Obesity
children
BMI
WC
fat mass%
Pulmonary Function Test
2011
10
01
585
594
https://ejhm.journals.ekb.eg/article_16399_51b2a19ca523a66482bf35165b5d175c.pdf