Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200261120151001Validation of New D-Dimer Cutoff Values to Increase its Diagnostic Utility as Biochemical Marker in Acute Venous Thromboembolic Disease3633701484710.12816/0017688ENDalal NemenqaniCollege of Medicine, Taif University, Saudi ArabiaManal H FayekFaculty of Medicine, Ain Shams UniversitySoha Ahmad AFaculty of Medicine, Ain Shams UniversityHala ElnasharCollege of Medicine, Taif University, Saudi ArabiaHaneen AsaadCollege of Medicine, Taif University, Saudi ArabiaJournal Article20180926<strong>Background:</strong> Diagnosis of venous thromboembolic disease (deep venous thrombosis and pulmonary embolism) is often inaccurate because signs and symptoms are nonspecific. Numerous clinical management trials using D-dimer which is one of the coagulation markers have shown that it has a sufficient specificity to assist in the diagnosis of venous thromboembolic disease.
<strong>Aim of the work:</strong>This study was done to validate the utility of D-dimer as a diagnostic biomarker for DVT using a higher cutoff values which may improve the test specificity.
<strong>Material and method:</strong> In this retrospective chart review study, we reviewed the hospital records of all patients for whom D-dimer assay was done in King Abdul Aziz Specialist Hospital, Al Taif - Saudi Arabia from January 2011 to October 2013. The study involved 141 individuals; 25 who were proved to be normal were chosen to serve as control group (Group I), 61 patients who were positive for DVT by duplex scanning (Group II) and 55 patients who had symptoms of DVT but showed negative results on duplex ultrasound(group III).
<strong>Results:</strong> The demographic data revealed statistically insignificant difference between all studied groups. No significant differences were detected between the studied groups, except for hemoglobin level which was significantly lower in patients of groups II and III than in control group. However, highly significant differences were detected between different studied groups as regards D-dimer. Analysis of the receiver operator characteristic (ROC) curve to establish the cutoff level of the studied marker in the diagnosis of DVT, verified that D-dimer value of 0.92 mg/L can accurately differentiate patients who were positive for DVT on duplex scanning from control group. Level of 2.81 mg/L for D-dimer was considered as a cutoff point that can differentiate patients who were duplex negative and free from thrombosis from those who eventually developed thrombosis.
<strong>Conclusion:</strong> This study suggests the importance of the use of modified D-dimer cut-off values that can safely differentiate patients who are free from venous thromboembolic disease from others who are positive for the disease sparing patients the unnecessary risks of anticoagulation. In addition it can detect the patients who will eventually develop thrombosis regardless their primary duplex ultrasound scanning results, so, they could receive anticoagulation treatment.
<strong> </strong>https://ejhm.journals.ekb.eg/article_14847_5ee0ec3a13d578e5592b2f85d12bfa9a.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200261120151001A Multi-Level Noncontiguous Vertebral Tuberculosis in Taif Province, Saudi Arabia: ASingle Center Study.3713761484810.12816/0017689ENAbdullah Ali Al-ZahranyDepartment of orthopedics, College of Medicine ,Taif UniversityJournal Article20180926<strong>Background and aim of the study: </strong>Multilevel noncontiguous spinal tuberculosis is an atypical form of the spinal tuberculosis, which leaves not less than two adjacent vertebrae intact between the two foci. The aim of this study is to record the incidence, pattern of presentation, risk factors; and diagnostic tools of multi-level noncontiguous vertebral tuberculosis in a single center (King Abdul Aziz Specialist Hospital) Taif, Saudi Arabia.
<strong>Patients and method: </strong>In this retrospective chart review study, we reviewed the records and data of all patients presented to King Abdul Aziz Specialist Hospital, Taif, Saudi Arabia from January 2009 to January 2014 and their diagnosis were proved to be spinal tuberculosis.
<strong>Results</strong>: the study included76 patients with spinal tuberculosis; multilevel noncontiguous tuberculosis was detected in 18.4% and a single spinal lesion was identified in the other 81.6%of patients. There was no statistically significant difference between the 2 groups regarding their demographic, clinical, and their laboratory findings except for the hepatitis B virus (HBV) positivity and elevated serum transaminases which were significantly higher in the multilevel non contagious group of patients. Plain film detected multiple non contagious lesions in 64.3% of patients, and in 35.7%of them, they were first diagnosed as single lesion but MRI detected the multiplicity. The thoracic and lumbar vertebrae were involved in 85.7% of the multilevel lesions and in the other 14.3% of patients the cervical and lumbar involvement was detected. In the single focus group the thoracic and thoracolumbar vertebrae were involved in 75.8% of cases. Diagnosis was confirmed by culture and histopathology.
<strong>Conclusion</strong>: This study suggested a strong relation between hepatitis B and spinal tuberculosis, specially the multilevel non contagious form, however, till similar results of larger series of patients are obtained, the orthopedic surgeon must be with high index of suspicion in patients with spinal tuberculosis to detect multiplicity by MRI and any co infection with hepatitis B virus.
<strong> </strong>https://ejhm.journals.ekb.eg/article_14848_35588e6446b73cd93701981f07cf351d.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200261120151001Synchronous Colorectal Neoplasias: A Single Hospital Study3773821485010.12816/0017690ENDalal NemenqaniDepartment of Pathology, College of Medicine ,Taif UniversityJournal Article20180926<strong>Background and the aim of the study:</strong> The presence of more than one primary tumor in the colon at time of presentation is diagnosed as colorectal synchronous neoplasias (SN) and the largest one is considered the index tumor. The aim of this study is to identify the magnitude of synchronous colorectal neoplasias and its relation to different variables as pattern of presentation, age, gender and histopathology in addition to evaluation of different methods of diagnosis in patients presented to King Abdul Aziz Specialist Hospital, Taif, Saudi Arabia.
<strong>Patients and methods:</strong> This is a retrospective chart review study. The hospital records and the files of all patients diagnosed to have colonic neoplasms were reviewed from January 2008 to August 2014.
<strong>Results:</strong> The study involved 87 patients, 53 males and 34 females. Ten of the 87 patients (6 males and 4 females) had synchronous colonic neoplasms (11.5%). Intestinal obstruction was the presenting symptom in 4/10 patients (40%, Vs 35.6% in patient with single lesion), rectal bleeding in 4/10 patients (40%) and in 20% mass in right lower quadrant was the presenting symptom. In obstructed patients, SN was diagnosed after examination of the operative specimen, however; intra-operative palpation detected multiple colonic polypi in one patient and intra-operative colonoscopy detected SN in another 2 patients. In the non obstructed patients preoperative colonoscopy and biopsy diagnosed multiple lesions in 5/6 of the patients (83.3%). Pre and intra- operative colonoscopy helped to guide accurately the extent of resection in 83.3% of non obstructed patients and in 75% of obstructed patients respectively. Mean period of follow up was 3. 4±0.8 years.
<strong>Conclusion</strong>: The incidence of SN is significantly higher in this study than that recorded in English literature, so a larger study involving all regions of Saudi Arabia is strongly recommended as the presence of SN worsens the prognosis entailing modification of the treatment options. Thorough pathological examination is mandatory of any doubtful colonic lesions, and the study verified the effectiveness of preoperative colonoscopy in patients with non obstructed colorectal cancer and intra-operative colonoscopy in obstructed patients for visualization and biopsy of these lesions.
<strong> </strong>https://ejhm.journals.ekb.eg/article_14850_55edb24537ae31daae463044818746cb.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200261120151001A Study on The Preventive Effect of Mulberry (Morus alba l.) Fruits in Rats Exposed to Gamma Radiation3833881485210.12816/0017691ENAmal A. A. AmmarMedical and Radiation Research Department,Nuclear Materials Authority,Cairo, EgyptJournal Article20180926<strong>Background: </strong>Ionizing radiation is known to generate reactive oxygen species. This study was carried out to investigate the efficacy of mulberry fruit against γ-irradiation induced oxidative stress in rats. <strong>Materials and methods: </strong>Male albino rats were divided into four groups, Group (I): (control group) rats fed on balanced diet for 4 weeks, Group (II): rats fed on balanced diet contained 5% mulberry fruits powder (MFP), Group (III): rats were exposed at the 1st week of the experiment to fractionated γ-irradiation dose of 8 Gy administered as 2 Gy, every other day and fed on balanced diet for 4 weeks, and Group (IV): irradiated rats fed on balanced diet contained 5% mulberry fruits powder, at the end of the experiment, animals from each group were sacrificed, 24 hrs post the last dose of treatment, six rats from each group were sacrificed. Blood samples were taken and analyzed for Lipid peroxides as malondialdehyde (MDA) level, Xanthine Oxidoreductase system (XO and XDH), Glutathione (GSH) content, Superoxide dismutase (SOD), catalase (CAT), Aspartate Transaminase (AST), Alanine Transaminase (ALT), Gamma Glutamyl Transferase (GGT), Alkaline Phosphatase (ALP) activities and total bilirubin in rats.<strong> Results: </strong>The results showed that, irradiation induced high significant decrease in hepatic Glutathione contents (GSH), Xanthine Dehydrogenase (XDH), Superoxides Dismutase (SOD) and Catalase (CAT) activity. Moreover, a remarkable increase in the Malondialdehyde (MDA) concentration, xanthine oxidase activity (XO), the activity of some liver enzymes was observed in γ-irradiated rats. In contrast, administration of Mulberry Fruit Powder (MFP) to γ-irradiated rats was found to offer protection against γ-irradiation induced oxidative stress, by elevating the activity of antioxidant enzymes, enhancing liver function. All results in this study suggested that mulberry fruit had high potential to be developed as radio protective agent.
<strong>Conclusion: </strong>Therefore, MFP could have a beneficial role in modulating oxidative stress by improving the natural antioxidant mechanism<em>.</em>
<strong> </strong>https://ejhm.journals.ekb.eg/article_14852_07172da658aaef3c4c3c065623c94e83.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200261120151001IFN-Stimulated Genes Upregulation Pattern in Chronic Hepatitis C3894051485810.12816/0017692ENSaadia FaridDepartments of Tropical Medicine,National Hepatology and Tropical Medicine Research Institute and
Faculty of Medicine, Cairo UniversityAmal AhmedDepartments of Biochemistry ,National Hepatology and Tropical Medicine Research Institute and
Faculty of Medicine, Cairo UniversitySamya SweilamDepartments of Medical Biochemistry National Hepatology and Tropical Medicine Research Institute and
Faculty of Medicine, Cairo UniversityLaila RashedJournal Article20180926<strong>Background: </strong>The development of effective tools for the large-scale analysis of gene expression has provided new insights into the involvement of gene networks and regular pathways in various disease processes. The chemokine receptor CXCR3 is a G protein-coupled receptor found predominantly on T cells that is activated by three ligands as follow: CXCL9 (Mig), CXCL10 (IP-10) and CXCL11 (I-TAC), and play a key role in immune and inflammatory responses by promoting recruitment and activation of different subpopulations of leukocytes. <strong>Aim of the work: </strong>The study is a logical functional approach for the development of serum markers chemokines that bind to CXC chemokine receptor 3 to determine whether they play a role in the future of immune system to clear HCV, these chemokines: CXCL9, CXCL10 and CXCL11. <strong>Patients and methods: </strong>131 male and female patients with chronic hepatitis C virus (CHCV) infection, their age ranges between 22 and 55 years, selected from the National Hepatology and Tropical Medicine Research Institute. The included patients were divided to two groups, the first group: 80 patients were investigated for the predictive values of CXCL9,10,11 and CXCR3 chemokines in peripheral blood mononuclear cells (PBMCs), the second group were fifty one patients analyzed for the expression of surface markers on CD8+T cells. Twenty healthy individuals were included to serve as controls for each group. All the patients and controls were subjected to the following: history, clinical examination, abdominal ultrasonography and collection of blood samples for routine laboratory investigation and serological assay. <strong>Results: </strong>Chemokine CXCL9, CXCL10, CXCL11 and their receptor CXCR3 expression levels are induced in PBMCs during CHCV infection, associated with increased the expression levels of CD8+T cells in CHCV patients. <strong>Conclusion: </strong>The interaction between chemokines and their receptors is essential in recruiting HCV-specific T cells to control the infection. <strong>Recommendations: </strong>The regulationof chemokines and their receptors could be a future potential therapeutic target to decrease liver inflammation and to increase specific T cell migration to the infected liver, the blocking of chemokines and chemokine receptor engagement is a therapeutic strategy that should be explored in the near future for non-responders to current anti-HCV therapy.
<strong> </strong>https://ejhm.journals.ekb.eg/article_14858_479097d86dcf632f080cd6198eed3438.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200261120151001Immunohistochemical Studies in Mice Liver Immunized by Attenuated Schistosoma Mansoni Schistosomules by Gamma Radiation4064141486110.12816/0017683ENMona Mohamed AminHealth Radiation Research Dept., National Centre for Radiation Research and Technology (NCRRT)Eman Naser HafezHealth Radiation Research Dept., National Centre for Radiation Research and Technology (NCRRT)Elham Said MareiHealth Radiation Research Dept., National Centre for Radiation Research and Technology (NCRRT)Journal Article20180926<strong>Background</strong>: Schistosomiasis is an important cause of hepatic fibrosis in man. As etiological therapy alone is not enough to treat hepatic fibrosis, finding other strategies that can control the disease is important. Considering the dominant role of vaccination, research on gamma radiation-attenuated vaccine has become a new focus and has very promising value.
<strong>Aim of the work: </strong>The objective of this study was to detect the effect of vaccination with attenuating dose of gamma radiation of schistosomules in controlling immunohistochemical changes in mice model of human schistosomiasis mansoni. <strong>Materials and methods: </strong>Forty mice were divided into four groups (ten each). Group A served as normal control, group B was infected by subcutaneous (S. C.) injection with 100 <em>S. mansoni</em> cercariae/mouse (infected control), group C was vaccinated by (S.C.) injection with 500 schistosomulae irradiated with 20 Krad gamma-radiation (vaccine control) and group D was vaccinated by (S.C.) injection with the same dose of irradiated schistosomules and then challenged after 4 weeks by S.C. injection with 100 <em>S. mansoni</em> cercariae. Expression of α-smooth muscle actin (α SMA), desmin, collagen type-1 and transforming growth factor-beta1 (TGF-β1) in the extracellular matrix (ECM) using immunohistochemistry were done.
<strong>Results: </strong>exhibited in infected control group B marked expression of α-SMA, desmin, collagen type-1 and TGF-β1. These changes were moderate in vaccinated-control group C while few changes were detected in vaccinated-challenged group D.
<strong>Conclusion:</strong>It was concluded that using 20 Krad-gamma irradiated schistosomules as vaccine is effective in controlling liver pathology and reduces immunohistochemical changes.
<strong> </strong>https://ejhm.journals.ekb.eg/article_14861_23238d636c26f063f6641f706dc50c65.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200261120151001Protective Effect of Olive Oil Against Teratogenecity Induced by Mancozeb in Albino Rats4154241486510.12816/0017694ENNahas A.AMammalian and Aquatic Toxicology Dep., Central Agricultural of Pesticides Lab. (CAPL), Agricultural Research CenterEnas A. AbbasBiochemistry Dept., Animal Health Research Institute, Agricultural Research CenterJournal Article20180926<strong>Aim</strong>: this study aimed to investigate the protective effect of extra-virgin olive oil (EVOO) against teratogenicity of the fungicide mancozeb. <strong>Methods</strong>: after pregnancy confirmation, 32 pregnant rats were divided into 4-groups (n=8). The 1<sup>st</sup> group orally administered tap water (-ve control), the 2<sup>nd</sup> group (+ve control) was administered EVOO (0.5ml/dam) from the1<sup>st</sup> to 20<sup>th</sup> day of pregnancy. The 3<sup>rd</sup> and the 4<sup>th</sup> groups were administered 200 mg/kg mancozeb during the period of organogenesis, from the 6<sup>th</sup> to 15<sup>th</sup> day of pregnancy. The 4<sup>th</sup> group received the mentioned dose of EVOO prior to the pesticide administration. Cesarean section was performed on day 20 of pregnancy and the maternal and fetal parameters were recorded. <strong>Results</strong>: mancozeb induced maternal toxicity manifested as lower body weight gain of dams, increased number of late resorption sites/litter in comparison with the control group and mancozeb group pretreated with EVOO. Mancozeb evoked a decrease in fetal body weight, altered sex ratio (M/F) as well as increased incidence of fetal external, visceral and skeletal abnormalities. Treatment with virgin oil reduced the congenital malformations.
<strong>Conclusively,</strong> the present study elucidates the protective role of EVOO as a result of antioxidant activity which scavenges the reactive oxygen species which induced cytotoxicity and increased prenatal mortalities.
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https://ejhm.journals.ekb.eg/article_14865_506931f9e4dcd657ad2d75477935a241.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200261120151001Immunohistopathological Studies on Rats Injected with CCl4 and Treated with Propolis and Honey Bee4254361486710.12816/0017695ENNahed A OmarZoology Dep., Faculty of Science, Damietta University, New Damietta City, Damietta, EgyptaKadry A. ElbakryaZoology Dep., Faculty of Science, Damietta University, New Damietta City, Damietta, EgyptaShaymaa M. NasraZoology Dep., Faculty of Science, Damietta University, New Damietta City, Damietta, EgyptaHoda M. ElemshatybGastroenterology Center Mansoura UniversityJournal Article20180926<strong>Background</strong>: liver and kidney play a pivotal role in metabolism of nutrients, drugs, hormones, metabolic waste products and thereby maintaining body homeostasis. The present study was conducted to demonstrate the protective effects of honey and propolis on liver and kidney tissues of rats injected with CCl<sub>4</sub>.
<strong>Material and method</strong>: rats were divided into 4 groups (10 rats in each group). N<strong>ormal control group: </strong>received standard food and water; <strong>CCl<sub>4</sub> group:</strong> injected with <strong>CCl<sub>4</sub></strong>0.5 ml/kg b. wt. mixed in olive oil(v/v) twice a weekfor six weeks; <strong>CCl<sub>4</sub> & honey group</strong>: injected with CCl<sub>4</sub> 0.5 ml/kg b. wt. mixed in olive oil(v/v) twice a week for six weeks and 10% honey in drinking water. <strong>CCl<sub>4</sub> & Propolis</strong>: injected with CCl<sub>4</sub> 0.5 ml/kg b. wt. mixed in olive oil(v/v) twice a week for six weeks and 200 ml/kg b.wt/rat/day of propolis. After 6 weeks, rats were anesthetized, then liver and kidney organs were collected, washed in normal saline, fixed in 10% formalin, then processed for the histopathological and immunohistochemical examinations.
<strong>Result</strong>s: marked histopathological alterations were observed in CCl<sub>4</sub> group, the most common changes were cloudy swelling of hepatocytes, fatty changes, clear vacuolation of renal cells and congested blood vessels. Treatment with honey or propolis improved the histopathological changes induced by CCl4 in liver and kidney tissues of rats.
<strong>Conclusion</strong>: the present study indicated that CCl<sub>4 </sub>has a toxic effect on liver and kidney tissues, but administration of honey and propolis can protect rats against form the toxic effect of CCl<sub>4</sub>.
<strong> </strong>https://ejhm.journals.ekb.eg/article_14867_2525a1e7cbb724d5f13a751e1bbb61b7.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200261120151001Serum Vitamin D Deficiency and Risk of Schizophrenia: A Case Control Study4374441486910.12816/0017696ENReda IsmailPsychiatry Department, Faculty of Medicine, Al-AzharUniversity,EgyptTaghreed ElShafeiPsychiatry Department, Faculty of Medicine, Al-AzharUniversity,EgyptRania HusseinPsychiatry Department, Faculty of Medicine, Al-AzharUniversity,EgyptIman K. RamadanCommunity Medicine Department, Faculty of Medicine, King Abdul Aziz University and Al-Azhar UniversityJournal Article20180926<strong>Background: </strong>Schizophrenia is a mental illness with symptoms like delusions and hallucinations. A recent study concluded that individuals with vitamin D deficiency are twice more likely to have schizophrenia than optimum level vitamin D people.
<strong>Objective: </strong>To measure schizophrenic patients` serum vitamin D concentration and compare it to healthy controls(non schizophrenics), and to investigate the relationship between serum schizophrenia and related potential risk factors.
<strong>Subjects and Methods: </strong>Twenty patients with schizophrenia were recruited and compared to 20 controls with no major psychopathology using age and sex matched case control study. The <strong>SCID-1</strong>(semi-structured interview for making major DSM-IV Axis 1 diagnoses), was administered and the blood samples were withdrawn after patient consent on the same day.
<strong>Results: </strong>Schizophrenic patients showed a significantly lower mean vitamin D level (14.8±4.5 IU) compared to control group (19.6±3.3 IU) (P<0.001). Higher vitamin D level participants were nearly 80% less likely to have schizophrenia compared to low level ones. Being older and female were 80%and 40% less likely to have schizophrenia respectively. Individuals with large body mass index were 1.2 times more likely to have schizophrenia compared to normal body weight. Smokers were 10% less likely to be schizophrenic compared to non-smoker participants.
<strong>Conclusions: </strong>Patients with schizophrenia showed lower serum vitamin D level compared to healthy controls. Further studies are needed to explore the role of vitamin D in the pathogenesis of schizophrenia.
<strong> </strong>https://ejhm.journals.ekb.eg/article_14869_fe26ea86a5d22f9ab6804e4d0bed3502.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200261120151001Potential Effect of Aloe barbadensis and Salvadora persica (Miswak) Mixture Sap as a Contraceptive Therapy in Female Mice4454501487110.12816/0017697ENEman G. HelalZoology Department, Faculty of Science for Girls, Al-Azhar University, EgyptHanan A. JambiFood and Nutrition Department, Faculty of Home Economic, King Abdulaziz University, Saudi Arabia.Gamal M. ElnemrDepartment of Medical and Radiological Researches, Nuclear Materials Authority, Egypt, and Department of Internal Medicine, Faculty of Medicine, Taif University, Saudi Arabia.Hoda M. Abu-TalebBiostatistics and Demography Medical Statistician, Department of Environment Research, Theodor Bilharz Research institute, Cairo, Egypt.Journal Article20180926<strong>Background:</strong> Evaluation of herbs has been in progress worldwide for several decades to identify effective and safe substances for fertility regulation. This approach proved to be a good alternative to synthetic drugs as the chemicals of plant origin have limited side effects. Various medicinal plant extracts were investigated for their antifertility activity in female animal models.
<strong>Aim of the work:</strong> This study was designed to investigate the toxic effects of <em>Aloe barbadensis</em> and <em>Salvadora persica</em> (<em>Miswak</em>) <em>Mixture</em> <em>sap</em> and to assess them as a contraceptive therapy.
<strong>Material and Methods: </strong>Twenty female adult albino rats (Sprague dawley strain) were used in this study. Rats were divided into two groups (10 rats in each group); Group I (control untreated group) and Group II (mix treated group). <em>Mixture</em> of <em>Aloe barbadensis</em> and <em>Miswak sap</em> was orally administered (7 mg of <em>Miswak</em> + 7 mg of <em>Aloe</em> per 100 gram body weight) for 30 ± 2 days, where females were in the diestrus phase). All animals were decapitated after 30 days and blood samples were analyzed for estrogen, progesterone, tumor markers CA-15.3 and CA-125, kidney and liver functions, proteins profile and lipids profile.
<strong>Results:</strong> The mean serum level of estrogen was significantly increased (<em>p</em><0.01), while that of progesterone was significantly decreased (<em>p</em>≤0.01), in the <em>Aloe barbadensis and Miswak </em>group when compared to the control group. No significant difference was found between the treated and control groups for the serum level of tumor markers CA-15.3 and CA-125. Also, no significant difference was found between the two groups regarding kidney and liver function tests and proteins profile. The results also showed marked significant decline (<em>p</em><0.01) in levels of the serum total lipids, total cholesterol, triglycerides, and LDL-cholesterol (LDL-C) in the treated group when compared to the control group. While, there was a significant elevation in HDL-cholesterol (HDL-C) level in the mix group when compared to the control group.
<strong>Conclusion: </strong>It could be concluded that <em>Aloe barbadensis and Miswak extract</em> can be used as a safe contraceptive therapy that can increase the estrogen level due to its phytoestrogen components such as beta sitosterol, without deleterious effects on the vital organs (liver and kidneys).
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<strong> </strong>https://ejhm.journals.ekb.eg/article_14871_7deaff9a078c68a229b10368fa9ec2eb.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200261120151001Iodine Status of Primary School Children in Different Egyptian Environments4514581487210.12816/0018750ENHanaa H ElsayedDepartment of Biochemistry of Nutrition and MetabolismMohamed K Abd El-RahmanDepartment of Biochemistry of Nutrition and MetabolismAfaf ATawwfikDepartment of Field Studies and Survey
National Nutrition Institute Cairo- Egypt.Journal Article20180926<strong>Background</strong>: iodine deficiency is the main cause of potentially preventable mental retardation in childhood. It is still prevalent in large parts of the world. Mild iodine deficiency can affect cognitive development of the child. Aim of study investigated iodine status of primary school children and consumption of iodized salt. <strong>Subjects and methods</strong>: this study included 2105 households, urine analysis for 1879 primary school children aged (6 - 12 years) from urban and rural sites (975 and 904), seven governorates in Egypt (Behera, Menoufia, Dakahlia, Beni Suif, Minya, Wadi Jedid and South Sinai). <strong>Results</strong>: showed that more than 50% of household used iodized salt. In addition, they were adding iodized salt (65.8%) during the process of cooking food. Beni Suif recorded the highest prevalence of mild iodine deficiency in both urban and rural sites. <strong>Conclusion</strong>: iodized salt program in the seven governments faces some problem/barriers for use of iodized salt at household level. Government has required the use of iodized salt in processed foods. <strong>Recommendation</strong>: Surveillance systems need to be strengthened to monitor both low and excessive intakes of iodine to improve the iodine nutritional status of the population without risks of iodine excess or deficiency.
https://ejhm.journals.ekb.eg/article_14872_0dac2b9028bf9d1fe80705c530d87cec.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200261120151001In Situ Hybridization and Light and Electron Microscopes of Cervical Squamous Cell Carcinoma Infected with Human Papillomavirus4594781487410.12816/0018751ENMonir A. El-GanzuriZoology department, Faculty of Science, Ain Shams UniversityAli KhalifaBiochemistry department and Head of Oncology Diagnostic unit .
Faculty of Medicine, Ain Shams UniversityThanaa HelalPathology department, Faculty of Medicine, Ain Shams UniversityNanice Nabil RizkZoology department, Faculty of Science, Ain Shams UniversityNora A. Al-JalaudDepartment of Biology,Faculty of Science,Dammam University,Saudi ArabiaJournal Article20180926<strong>Aim of the work</strong>-In Egypt cervical carcinoma is ranked as a number 6 of all malignant tumors. There is growing evidence that the human papillomavirus (HPV) is associated with the development of cervical cancer. <strong>Patients and Methods</strong>-The present study hunted HPV in Egyptian biopsies of cervical cancer by using in situ hybridization (ISH) technique .Light microscopy and ultra-structural features accompanied by squamous cell carcinoma (SCC) of the cervix were monitored. <strong>Results</strong>-The ultra structural study revealed viral particles in some epithelial cell nuclei and cytoplasm in the moderately-differentiated squamous cell carcinoma. These were suggested to be Herpes Simplex Virus (HSV<strong>). Conclusion</strong>-The potential relation between HPV and HSV in the incidence of Cervical Squamous Cell Carcinoma is discussed.
<strong> </strong>https://ejhm.journals.ekb.eg/article_14874_208c27298f2c567083800f5900dcff4b.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200261120151001Urinary Markers for Early Detection of Diabetic Nephropathy in Type 1 Diabetes Mellitus47948814875:10.12816/0018752ENShawkia S. Abd El-HalimFaculty of Art and Science – Qilwa – El-Baha University.Awatif M. Abd El-MaksoudNutritional Requirements and Growth Department, National Nutrition Institute, CairoMohammed A. Abdel-RahmanZoology Department, Faculty of Science, Suez Canal University, IsmailiaEl-sayed H. El-TamanyChemistry Department, Faculty of Science, Suez Canal University, IsmailiaMohammed H. El-HefnawyPediatric Department, National Diabetes and Endocrinology Institute, Cairo, EgyptAmal H. Abd El-RazekNutritional biochemistry Department, National Nutrition Institute, CairoJournal Article20180926 <strong>Background</strong>: diabetic nephropathy (DN) is a serious complication of diabetic mellitus associated with increased risk of morbidity and mortality. Diagnostic markers to detect DN at early stage are important as early intervention can slow loss of kidney functions and improve patient outcomes. N-acetyl-β-d-glucosaminidase (NAG) is a lysosomal enzyme, present in high concentrations in renal proximal tubular cells, Gamma-glutamyltransferase (GGT) is an enzyme which located along the proximal tubular brush border, Malondialdehyde (MDA) is a highly toxic product, formed in part by lipid oxidation derived free radicals, Reactive carbonyl derivatives (RCD<sub>S</sub>) is an oxidative stress marker in urine, as a measure of the oxidative modification of proteins and bete-2-microglobulin is filtered by the glomerulus, absorbed and catabolized by the proximal tubules. The aim of this study is to investigate the urinary outcome of these markers as early detectors of diabetic nephropathy in type 1 diabetic children.
<strong>Subjects and methods</strong>: This case-control study included 67 children with type 1 diabetes mellitus (33 male; 34 female), age (<strong>11.03±1.05</strong> years) and thirty one age (<strong>10.58±1.11 years</strong>) and sex (13 male; 18 female) matched healthy children (13 male; 18 female). Type 1 diabetic children were further subdivided into microalbuminuric and normoalbuminuric subgroups according to microalbuminuria concentration (30 mg/ g creatinine). Age, sex, diabetic duration and the current daily insulin dose, and family history of diabetes, weight, height, body mass index, systolic and diastolic blood pressure were recorded. Fasting plasma glucose, glycated hemoglobin, blood urea nitrogen, plasma creatinine, urinary creatinine, micoalbumin, N-acetyl-B-D glucosaminidase (NAG), Gama glutamyl transferase (GGT), Beta-2-microglobulin, Malondialdehyde (MDA) and Reactive carbonyl groups (RCDS<sub>S</sub>) were measured in all subjects.
<strong>Results</strong>: a significant increase in tubular injury markers of diabetes (NAG, GGT, beta-2-microglobulin) and oxidative stress parameters (MDA, RCDS<sub>S</sub>) as compared to control subjects was found. Microalbuminuric subjects showed a significant elevatation in the urinary markers including NAG, GGT, beta-2-microglobulin, MDA, RCDS<sub>S</sub> as compared to normoalbuminuric subjects. The studied urinary tubular enzymes (NAG, GGT), oxidative stress markers (MDA, RCDS<sub>S</sub>) and Beta-2- microglobulin showed positive correlations with one another. <strong>Conclusion</strong>: The results of this study introduced the possibility of depending on tubular enzymes (NAG, GGT), oxidative stress markers (MDA, RCDS<sub>S</sub>) and β<sub>2</sub> microglobulin as early, reliable, and sensitive predictors for diabetic nephropathy. The NAG activity index proved to be the most sensitive biomarker, then beta-2- microglobulin for early discovering the tubule cells damage.
<strong> </strong>https://ejhm.journals.ekb.eg/article_14875_4ad57165fea24d59f5b1b1771b9a9cda.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200261120151001Role of Alpha Lipoic Acid on Metabolic Hepatosteatosis: An Experimental, Biochemical, and Microscopic Study4894981487610.21608/ejhm.2018.14876ENAwatief A. EdriesCollege of Medicine, Taif, Saudi ArabiaAhmed H. El-RashedyDepartment of Pathology, College of Medicine, Al-Azhar University, Assuit, EgyptMohamed WagihDepartment of Pathology, College of Medicine, Beni- Suef University, Beni-Suef EgyptM.H. WahdanDepartment of Anatomy, College of Medicine, Cairo University, EgyptJournal Article20180926<strong>Background and aim of work: </strong>metabolic hepatosteatosis is a common serious prevalent condition in KSA. The current study investigated alpha lipoic acid (ALA) effects on hepatic lipid accumulation in severely fatty rats and secondarily on blood lipid profile.<br /> <strong> Materials and methods:</strong> sixty male Zucker rats were selectively used half of which (Lean) weighed 200±25g & others weighed 375±30g. Fatty animals were allowed free access to food and water for one week before experiment. The animals were divided into lean untreated (group I), lean ALA – managed (group II), fatty untreated (group III) and fatty ALA – managed (group IV) (fifteen animals per each group). ALA was taken orally (20 mg/kg/day) for six months. Animals were sacrificed and weighed (BW). Their liver was weighed (LW) and its portion was sliced to study its lipid content. Right tibia length (TL) was measured and LW: TL ratio was calculated.<br /> <strong>Results:</strong> ZF ALA-untreated rats showed high LW: TL ratio. ALA therapy significantly reduced BW, TL, LW and LW: TL ratio in managed ZF rats compared to untreated ones while it didn't affect these parameters significantly in lean (ZL) rats. ZF rats exhibited significant hepatosteatosis evidenced by excessive liver triglyceride (TG) and total cholesterol (TC) contents and microscopically by large cytoplasmic vacuoles. Interestingly, 6-months' ALA therapy in ZF caused significantly diminished serum triglycerides and cholesterol levels as well as diminished hepatic triglycerides and TC component in addition to decreased its lipid vacuoles compared to untreated ZF rats. The results were insignificantly changed between managed and untreated lean groups.<br /> <strong>Conclusion:</strong> our findings support effectiveness of ALA therapy in excessive hepatosteatosis and in hyperlipidemia via improving abnormal lipid metabolism.<br /> <strong> </strong>https://ejhm.journals.ekb.eg/article_14876_6b80adc5a9272a3ee1b8b1e4a44633e0.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200261120151001The Effect of Clarithromycin Administration on Pregnant Albino Rats during the Cleavage Period of Gestation and on Their Embryos4995131487710.12816/0018754ENAsmaa M. KandilPharmacology Dep., National Organization for Drug Control and Research (NODCAR).Gabri M.SZoology and Entomology department, Faculty of Science, Helwan UniversityMaiada MoustafaZoology and Entomology department, Faculty of Science, Helwan UniversityNehad MohamedZoology and Entomology department, Faculty of Science, Helwan UniversityJournal Article20180926<strong> Background:</strong> Clarithromycin is a macrolide antibiotic used to treat common infections including respiratory tract, skin and <em>Helicobacter pylori</em>. This work investigates whether the administration of clarithromycin to pregnant females during the cleavage phase of gestation was associated with a risk of miscarriages and offspring morphological malformation and skeletal anomalies, histological changes and DNA fragmentation of embryos and liver of pregnant rats.
Two major groups of pregnant albino rats were used. The animals of the control group received distilled water from the 1<sup>st</sup> to 7<sup>th</sup> days of gestation.One subgroup (C1) was sacrificed on the 8<sup>th </sup>day; and the other (C2) was sacrificed on the 20<sup>th </sup>day of gestation. The treated group was drenched 45 mg/kg clarithromycin (therapeutic dose) suspension from 1<sup>st</sup> to 7<sup>th </sup>day of gestation. The first subgroup (T1) was sacrificed on the 8<sup>th</sup> day and the other (T2) was sacrificed on the 20<sup>th</sup> day of gestation.
<strong>Results:</strong> The obtained results showed a decrease in maternal body weight gain, increase in the rate of abortion, resorption and growth retardation of fetuses and some malformation in the skeletal system of the treated group. Histopathological studies of pregnant and fetal rats revealed congestion and dilatation of the central vein, fatty degeneration of the hepatocytes and severe DNA fragmentation.
<strong> </strong>https://ejhm.journals.ekb.eg/article_14877_debf904a5448fdab85837dbf39b5f681.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200261120151001Comparison of Efficacy of Continuous Erythropoietin Receptor Activator (CERA) In Chronic Kidney Disease Patients versus Patients on Hemodialysis, Single Center Experience.5145211487810.12816/0018755ENAyman Aly SeddikDepartment of Medicine, Faculty of Medicine Ain Shams University, Cairo, Egypt and Nephrology Department, Dubai Hospital, Dubai Health Authority.Journal Article20180926<strong>Background :</strong> prior to the availability of recombinant human erythropoietin (r-EPO, epoetin), patients on dialysis frequently demanded blood transfusions and excessive iron therapy, exposing them to the risks of iron overload, transmission of viral hepatitis, and sensitization, which reduced the chances of successful transplantation . Recombinant human erythropoietin has been used for more than 20 years for the treatment of renal anemia, Epoetin-Alfa and -beta representing the common traditional preparations. By the modification of the molecule's carbohydrate moiety or structure a longer duration of erythropoietin receptor stimulation was achieved. The continuous erythropoietin receptor activator C.E.R.A. once or twice a month was found sufficient to achieve serum hemoglobin target levels.
This study was aimed to identify the efficacy of C.E.R.A (Methoxy polyethylene glycol-epoetin beta in achieving and maintenance of hemoglobin level in patients with chronic kidney disease and patients on regular Hemodialysis therapy.
<strong>Patients and methods</strong>: 145 patients with either CKD stage 4 & 5 (e GFR < 45 ml/min) on follow up in nephrology outpatient department or on regular Hemodialysis in nephrology unit Dubai hospital. In this center, the CERA approved by the local pharmacy authority was used for treatment of anemia in chronic kidney disease monthly dose of (100 mg for 70 kg patient) and adjusted according to monthly HB level during the trial period for reaching and maintaining target HB level of 11-12.5 g/dl.
<strong>Results</strong> : Patients on HD 78 patients (53.8%) and CKD patients 67 patients the mean HB level at the end of study period showed statistically significant rise in whole patient cohort with HB START (8.882 ±1.272 g/dl) and at the end of 24month (11.119±1017 g/dl) With <em>P-value</em> (< 0.001). HB at start was (9.013±1.298 g/dl) and (8.769±1.246) g/dl for CKD and HD respectively slightly higher in CKD group however without statistical difference (P-value 0.250). HB level at the 24 month period (end of trial period) was found statically higher in HD group (11.305±1.197g/dl) than CKD group (10.903±1.116g/dl) again without statistical significance <em>P-value</em> (0.038).
<strong>Conclusion:</strong> It could be concluded that the long acting erythropoietin stimulating therapy using continuous erythrpoeitin receptor activator ( CERA ) as once monthly dose is effective and safe in maintaining target HB level in both CKD patients and patients on maintenance hemodialysis and there was no recorded side effects of its use either by intravenous or subcutaneous use.
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<strong> </strong>https://ejhm.journals.ekb.eg/article_14878_f406d13e619ccf0870cf62d2aeb83c24.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200261120151001Efficacy of Intravenous Vitamin-D Selective Receptor Activator (Paricalcitol) In Management of Secondary Hyperparathyroidism in Hemodialysis Patients, Single Center Experience5225281487910.12816/0018756ENAyman Aly SeddikDepartment of Medicine, Faculty of Medicine Ain Shams University, Cairo, Egypt and Nephrology Department, Dubai Hospital, Dubai Health Authority.Journal Article20180926<strong>Background</strong>: secondary hyperparathyroidism (SHPT), a complication of chronic kidney disease (CKD) and is characterized by not only increased serum levels of intact parathyroid hormone (iPTH), but also may cause skeletal and cardiovascular complications. Deficiency of calcitriol (1, 25-hydroxy vitamin D) caused by impaired renal function, a main factor in the pathogenesis and pathophysiology of secondary hyperparathyroidism (SHPT) is associated with poor outcomes in hemodialysis patients. Therapy with vitamin D receptor (VDR) activators, including calcitriol or the selective VDR activator paricalcitol, has been associated with improved survival in patients with CKD on hemodialysis.
<strong>PATIENTS AND METHODS:</strong> single center cross over observational study of 28 patients on regular Hemodialysis in nephrology unit in Dubai hospital, the patient stopped all vitamin-D supplementations and calcium containing phosphate binder for 2 weeks prior to initiation and for the whole study period, non calcium based phosphate binder was continued. Initial dose of selective VDRA (PARICALCITOL) is 0.04 to 0.1 mcg/kg body weight (average total dose 2.8 – 7 mcg) administered as a bolus dose post hemodialysis twice to three times per week according to initial parathyroid hormone level Titration weekly dose (micrograms) calculated by dividing most recent i-PTH level (pg/ml)/80.
<strong>RESULTS :</strong> analyzing the data at start and end of trial period 48 weeks showed that there was significant reduction of serum I-PTH from (491.210±144.690 pg/dl ) at start of the trial to (142.610 ±41.519pg/dl) at 48 weeks with <em>P- value (<0.001)</em> . Serum calcium increased from ( 8.343± 0.654mg/dl ) at the start of the study to (8.629±0.534mg/dl ) at 48 weeks but without statistical significance <em>P- value (0.006), </em>same occurred with serum phosphatewhich showed insignificant rise with phosphate level at start of the test( 7.264±1.695mg/dl) and at 48 weeks (7.279±1.800mg/dl) with <em>P-value( 0.975).</em>
<strong>CONCLUSION:</strong> It could be concluded that use of intravenous vitamin D selective receptor activator (Paricalcitol) is effective in reducing serum I-PTH level in hemodialysis patients. Serum Ca++ and phosphorus levels were statistically insignificant.
<strong> </strong>https://ejhm.journals.ekb.eg/article_14879_8f8d3a2003c9177c922be508ad662450.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200261120151001Effects of Recovery Period and Tamoxifen on Bisphenol A Treated Female Albino Rats5295341488010.12816/0018757ENEman G. E. HelalDepartment of Zoology, Faculty of Science (Girls), Al-Azhar University, Cairo, EgyptGamal M. ElnemrDepartment of Medical and Radiological Researches, Nuclear Materials Authority, Egypt,Mohamed A. Abdel-AzeizDepartment of Physiology, Faculty of Medicine, Al-Azhar University, Cairo, EgyptDoaa I. A. GewilyDepartment of Zoology, Faculty of Science (Girls), Al-Azhar University, Cairo, Egypt.Journal Article20180926<strong>Background: </strong>Bisphenol-A (BPA) is an organic synthetic polycarbonate compound [(CH<sub>3</sub>)<sub>2 </sub>C(C<sub>6</sub>H<sub>4</sub>OH)<sub>2</sub>] which is widely incorporated into many plastic industries worldwide. BPA is an endocrine disruptor that exhibits hormone-like properties which may promote adverse effects in humans, triggering estrogenic signals in target tissues, which raise concern about its suitability in some consumer products and food containers. Since 2008, several governments have investigated BPA safety, which prompted some retailers to withdraw polycarbonate products. A 2010 report from the United States (US) Food and Drug Administration (FDA) identified possible hazards of BPA to fetuses, infants, and young children. However, the FDA has ended its authorization of the use of BPA in baby bottles and infant formula packaging, based on market abandonment, not safety.
<strong>Aim of the work:</strong> This study aimed to investigate the antitoxic effects of the anti-estrogen drug Tamoxifen (Nolvadex) and the recovery period on the female albino rats which received BPA.
<strong>Materials and Methods: </strong>This study was performed on forty female albino rats with an average body weight of 140-160 grams. The animals were divided into four groups (10 rats per cage); <strong>Group I</strong> (Control untreated for 30 days), <strong>Group II </strong>(BPA treated for 15 days, then sacrificed), <strong>Group III</strong> (BPA treated first for 15 days, then left to a recovery period of another 15 days), and <strong>Group IV</strong> (BPA treated first for 15 days, then treated with the anti-estrogen drug Nolvadex for another 15 days). The following analyses were done to all groups; ALT (alanine amino-transferase), AST (aspartate amino-transferase), GGT (gamma glutamyl-transferase), total proteins, albumin, globulins, A/G ratio [i.e., liver function tests], creatinine, uric acid, A/C (albumin/creatinine) ratio [i.e., renal function tests], total lipids, total cholesterol, LDL-C (low density lipoprotein cholesterol), HDL-C (high density lipoprotein cholesterol), and triglycerides [i.e., lipids profile].
<strong>Results: </strong>In the BPA treated group II the biochemical results showed highly significant increase (<em>P</em><0.01) in the enzymatic activities of ALT, AST, and GGT with concomitant increase in globulins (<em>P</em><0.05), creatinine, uric acid, total lipids, total cholesterol, LDL-C, and triglycerides levels when compared to the control group. On the other hand, there was highly significant decrease (<em>P</em><0.01) in total proteins, albumin, A/G (albumin/globulin) ratio, A/C (albumin/creatinine) ratio, and HDL-C levels when compared to the control group. These results turned back to normal control values after stopping the use of BPA alone (Group III) or stopping BPA and treatment with the anti-estrogen drug Nolvadex in the recovery period, except for ALT which was elevated (<em>P</em><0.05) with Nolvadex (Group IV).<strong> Conclusion: </strong>It could be concluded that BPA has dangerous toxic effects on the liver and kidney functions as well as on the lipids profile. Moreover, the recovery period (i.e., 15 days without treatment) is better than the use of the anti-estrogens (as Tamoxifen) which have no antitoxic effects to BPA, but caused hepatic toxicity instead which is noted by an increase in ALT levels. So, we recommend minimizing utilization of this compound (BPA) to protect people from its hazardous effects.
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https://ejhm.journals.ekb.eg/article_14880_ebd8a6196e520741d5ae92707afe9726.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200261120151001Problematic Internet Use Among Al-Azhar University Students in Cairo5355471488110.12816/0018758ENZeinab El-Sayed HammourAssistant ProfessorHeba Mohamed Abd-ElgalilLecturer of Public Health, Community and Preventive Medicine,
Faculty of Medicine, Al-Azhar UniversityMohamed M. Abo Alabbaslecturer of Psychiatry, Al-Azhar University, DomiatJournal Article20180926<strong>Background: </strong>the Internet has become an important tool for social interaction, information, and entertainment. Studies have shown that the percentage of students using the Internet has increased dramatically. However, as the Internet has moved into homes, schools, Internet cafes, and businesses, there has been a rapidly growing public awareness of the potential adverse effects arising from excessive, maladaptive or addictive Internet usage, which are a condition also known by terms such as problematic Internet use (PIU), Internet dependence and pathological Internet use.
<strong>Aim of the study:</strong> 1- To determine the general characteristics of Internet users among Al-Azhar under graduate university students in Cairo. 2- To explore the problematic Internet use (PIU) among under graduate university students based on the Internet activities . 3- To investigate the difference between males and females regarding PIU<strong>. Materials and methods: </strong>a cross sectional study was conducted on a sample of 600 undergraduate university students including both scientific and literary collages of Al-Azhar Universities for girls and boys in Cairo. This sample was chosen randomly through on line questionnaire. All participants voluntarily participated in the present study to identify the extent of problematic Internet use among university students. On line self-administered questionnaire that designed to include different items.
<strong>Results: </strong>female students had significantly lower PIU levels on alldimensions (i.e., social comfort, loneliness/depression, diminished impulse control anddistraction) than those of males. Furthermore, the results reveal that the students who use internet frequently (3-6 hours/day) and those who use it for entertainment (e.g., game), chat, news (policy or sports news) and social networking purposes have significantly higher PIU levels on all dimensions than the students who use it for less than 3 hours/day or for scientific purposes. Moreover, multiple regression analyses reveal that gender and time spent online daily are significant predictors of PIU and its all dimension except for diminished impulse control only time spent online daily is the predictor. <strong>Conclusion:</strong> males are more at risk than females in terms of problematic Internet use. The effect of duration of daily internet use on cognitions about PIU was found to be significant in all analyses. <strong>Recommendation: </strong>the students should be informed about the association between long use of internet /day and PIU to protect them from negative consequences PIU.
<strong> </strong>https://ejhm.journals.ekb.eg/article_14881_e8420254df63916866a113424debce75.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200261120151001Is There A Place for Plasma Osteaopontin as Key Mediator in Patients With Diabetic Nephropathy?5485631488210.12816/0018759ENWafaa Mohi El-Deen Abd El-FatahDepartment Of Medical BiochemistryMona Abd El-Raof Abd El-KaderDepartment Of Internal Medicine Faculty of
Medicine for Girls Al-Azhar UniversityJournal Article20180926<strong>Background: </strong>micro- and macro-vasculopathies, such as nephropathy and coronary artery disease (CAD), respectively, are common in diabetes and constitute the major causes of death for in these patients. Pro-inflammatory cytokines play a critical role in the pathogenesis of diabetic complications through various biochemical and cellular pathways. Osteopontin (OPN) has been identified as a key regulator of many metabolic and inflammatory diseases including obesity, diabete and diabetic nephropathy. <strong>The aim of this study</strong> was to evaluate plasma level of osteopontin in different stages of diabetic nephropathy in type II DM, and to correlate it with the stage of nephropathy and with other measured parameters. <strong>Patients and methods:</strong>the study was conducted on 58 patients with diabetic nephropathy as well as 15 apparently healthy subjects as a control group. Patients were classified into 2 main groups according to the level of glycosylated hemoglobin (H<sub>b</sub>A<sub>1c</sub>) <strong>Group I:</strong> controlled type II DM (H<sub>b</sub>A<sub>1c</sub> 5.55%-7.6%). <strong>Group II:</strong> uncontrolled type II DM (H<sub>b</sub>A<sub>1c</sub> 7.6 %).Each group was subdivided into two subgroups (A and B) according to the presence of microalbuminuriaor macroalbuminuria (degree of nephropathy). In addition to, <strong>Group III:</strong> DM type II with end stage renal disease (serum creatinine ≥ 5mg/dl) and just starting hemodialysis (1-3 sessions Only) plasma osteopontin was measured by ELISA. Results of the study revealed significant increase of serum osteopontin in all studied groups
<strong>Results:</strong> compared to normal control subjects (P<0.001).There was a statistically positive correlation between serum osteopontin versus all variables in group I and II; except HBA1C in group I, and FBS in group II. But, no statistical correlation change between serum osteopontin versus all variables in group III (P>0.05).Cut ROC curve of osteopontin levels of all cases of diabetic nephropathy indicates high validity of OPN to detect positive cases of diabetic nephropathy with accuracy of 100%, andOPN is considered a high validity test in prediction of end-stage renal disease (ESRD) more than prediction of microalbumnuria. <strong> Conclusion</strong>: plasma level of osteopontin increases with the progression of diabetic nephropathy and osteopontin may be useful as a biomarker to trace disease progression as well as a potential diagnostic biomarker for the prediction of diabetic ESRD.
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<strong> </strong>https://ejhm.journals.ekb.eg/article_14882_66a2fce23448f88234bca6d2e2edb28f.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200261120151001Closure of the Cystic Duct Comparison Ultrasonic Harmonic Scalpel versus Clip Application in Laparoscopic Cholecystectomy5645691493410.12816/0018760ENHazem Ahmed M. BadrGeneral Surgery Department, Faculty of Medicine for Girls Al-Aazhar UniversityJournal Article20180927<strong>Background: </strong>Laparoscopic cholecystectomy (LC) is usually performed using titanium clips (TC) for occlusion of the cystic duct and cystic artery. The use of Harmonic scalpel (HS) in LC has been reported.<br /> <strong>Aim:</strong> This study aimed to compare effect of HS and clips application for closure of the cystic duct and artery in patients undergoing LC. <strong>Patients and Methods: </strong>Totally 50 patients were operated using LC technique from April 2010 to April 2012. Patients were retrospectively, divided into 2 groups according to the instruments used for division of the cystic artery and duct as well as for dissection of the liver bed. On the one hand, group 1 consisted of 30 patients who were all treated with the ultrasonic harmonic scalpel as the sole instrument used in the whole procedure. On the other hand, group 2 comprised 20 patients in whom dissection and coagulation were performed using monopolar coagulation, and occlusion of the artery and duct with clips. The operative time, postoperative hospital stay, morbidity, and mortality for each group were analyzed and compared with each other. <strong>Results: </strong>The 2 groups were comparable for age, sex, indication for cholecystectomy, and combined procedures. Patients were randomly treated either with the ultrasonic HS or with clips. Postoperative hospital stay of all patients in the group 1 and group2 was 2 days. Superficial wound infection seen in one patient (2%) in group 2 which was treated by oral antibiotics. During the follow-up period, one port-site hernia was detected in one patient (2%) in group 2. One case (2%) of peritoneal fluid collection seen in (group 1) and treated with percutaneous drainage was found.<br /> <strong>Conclusions:</strong> The use of harmonic scalpel was accepted as a reasonable alternative for closure of cystic ducts < 4 mm in diameter. This Study has shown that the HS is an effective and safe tool for the closure of both the cystic duct and artery in patients who undergo LC.<br /> https://ejhm.journals.ekb.eg/article_14934_996b10abbe6c592ceefd57d2a3da3dfd.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200261120151001Histological and Immunohistochemical Study on the Effect of Bisphenol A on the Retina of Female Albino Rat5705741493510.12816/0018761ENHassan B NDepartment of Zoology, Faculty of Science, Helwan UniversityAlazzouni A SDepartment of Zoology, Faculty of Science, Helwan UniversityAl Jalaud N ADepartment of Biology, Faculty of Science, Dammam University, Saudi ArabiaHassan M EDepartment of Ophthalmology, Faculty of Medicine, Al Azhar UniversityJournal Article20180927<strong>Background:</strong> Bisphenol A (BPA) is a well-known endocrine disruptor used to manufacture polycarbonate plastics and epoxy resins. Exposure of rats to low doses of BPA results in histopathological effects in their retina.<br /> <strong>Objectives:</strong> We used histological and immunohistlogical techniques for determining retina pathological changes in response to low doses of BPA and the modulating effect of both vitamin A and stem enhancer.<br /> <strong>Methods: </strong>Twenty female albino rats orally administered with 20mg BPA /kgb.wt/day for 45 days and then divided to groups and treated with vitamin A and stem enhancer. Both eyes were examined histologically and immunohistochemicaly to determine the histopathological changes in retinal layers.<br /> <strong>Results:</strong> A remarkable degenerative histopathological changes in the ganglion cell layer and inner nuclear layer appeared with bis phenol treated rats and a clear improvement was seen after treatment with both vitamin A and stem cell enhancer.<br /> <strong>Conclusions:</strong> Both of vitamin A and stem enhancer have ameliorative effect on the degenerative changes in the retinal layers and damaged estrogen receptors by the action of bisphenol A. <br /> <strong> </strong>https://ejhm.journals.ekb.eg/article_14935_4b6cb2a6539b0160da74360d856126f5.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200261120151001Histological Study and DNA Changes in the Kidneys of Rat Fetuses Maternally Treated with Clarithromycin5755901494310.12816/0018762ENAsmaa M. KandilaPharmacology Department, National Organization for Drug Control and Research, Giza, EgyptGabri M. SZoology and Entomology Department, Faculty of Science, Helwan University, Cairo, EgyptAbdel Razik H. FarragPathology Department, Medical Research Division National Research Centre, Cairo, EgyptBasma N. HassanZoology and Entomology Department, Faculty of Science, Helwan University, Cairo, EgyptDoaa Ezz-Eldin I. SZoology and Entomology Department, Faculty of Science, Helwan University, Cairo, EgyptJournal Article20180927<strong>Introduction</strong>: macrolide antibiotics are a class of potent and well established antimicrobials that also possess anti-inflammatory and/or immunomodulatory properties. Because of their size, lower levels of macrolides are able to reach the developing fetuses.
<strong>Materials and method:</strong> the pregnant rats were orally administered with clarithromycin at early and late gestational periods. The 20 day-old fetuses were dissected for excision of the kidney. Half of the kidney was processed and stained with H & E, PAS, Masson’s trichrome and Feulgen techniques then followed by morphometric measurements and statistical study. The other half of the kidney was preserved for DNA fragmentation assay.<strong>Results</strong>: This study revealed that clarithromycin administration to pregnant rats showed different histopathological, histochemical and DNA changes in the kidneys of their fetuses.
<strong>Conclusion</strong>: Administration of the antimicrobial agent; clarithromycin at early and late gestational periods exhibits nephrotoxicity in the developing fetuses.
<strong> </strong>https://ejhm.journals.ekb.eg/article_14943_3844268bd2533501fb0384d11f977686.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200261120180927Histological and Immunohistochemical Studies on the Kidneys of Pregnant Rats Treated with Clarithromycin5916141495410.12816/0018763ENAbdel Razik H. FarragaPathology Department, Medical Research Division National Research Centre, Cairo, EgyptGabri MSZoology and Entomology Department, Faculty of Science, Helwan University, Cairo, EgyptAsmaa M. KandilPharmacology Department, National Organization for Drug Control and Research, Giza, EgyptBasma N. HassanZoology and Entomology Department, Faculty of Science, Helwan University, Cairo, EgyptDoaa Ezz-Eldin I. S.Zoology and Entomology Department, Faculty of Science, Helwan University, Cairo, EgyptJournal Article20180927<strong>Background</strong>: clarithromycin is a semisynthetic macrolide antibiotic, exhibits broad-spectrum activity against gram-positive and gram-negative aerobes. Macrolides are bacteriostatic antibiotics that inhibit protein biosynthesis via reversible binding to the bacterial 50S ribosomal subunit. Macrolides are able to cross placenta and reach the fetus.<br /> <strong>Aim of the work</strong>: the present study is focused on evaluating the effects of antimicrobial drug, clarithromycin on the kidneys of pregnant rats.<br /> <strong>Material and methods:</strong> clarithromycin is orally given to the treated groups of the pregnant rats once daily at different periods of gestation by gastric tube at a dose of 45 mg/kg/day. The excised kidneys were dissected, processed and stained with H & E, PAS, Masson’s trichrome, Feulgen reaction and anti-CD68 immunohistochemical stain then followed by morphometric measurements and statistical analysis. The kidneys were also preserved for DNA fragmentation assay.<br /> <strong>Results</strong>: this study revealed that clarithromycin administration especially to pregnant rats showed different histopathological and histochemical changes in kidney tissues and cellular DNA. Also immunohistochemical anti-inflammatory marker CD68 showed positive reactivity in all treated groups. <br /> <strong>Conclusion</strong>: The presence of histopathological and histochemical changes revealed nephrotoxicity in the pregnant rats after administration of the antimicrobial drug, clarithromycin.<br /> <strong> </strong>https://ejhm.journals.ekb.eg/article_14954_ea2917a5846e58ee4285cbb0b8495391.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200261120180927Effect of Altitude on Vascular Endothelial Growth Factor Levels with Validation of its Prognostic Significance in Patients with Non-Small Cell Lung Carcinoma6156191495810.12816/0018764ENMajed Al MourgiDepartment of Thoracic Surgery, College of Medicine, Taif UniversityJournal Article20180927<strong>Background and aim of the work:</strong> Recent studies revealed that hypobaric hypoxia stimulates release of vascular endothelial growth factor (VEGF) and other studies found that high levels of this angiogenic factor are correlated with poor prognosis in patients with non-small cell lung cancer (NSCLC). In this study we will measure the serum levels of VEGF in both healthy individuals and in patients with operable non small cell lung carcinoma living in hypobaric oxygen environment (Taif) and validate the prognostic significance of its pretreatment level in those patients.
<strong>Patients and methods: </strong>Thirty one patients with operable (stage I, II and III A) non-small cell lung cancer (the patient group) and 15 healthy volunteers with matched gender and age (control group) were enrolled in this study from January 2010 to March 2015. The pretreatment level of VEGF was measured in patients in addition of its level in controls. All patients had the same diagnostic and therapeutic protocols. Mean follow up of patients was 30.4±7.8 months.
<strong>Results: </strong>Themean level of VEGF was high in control group, however, it was significantly lower than that in patient group (P value 0.041). The median survival of stage I patients was 13 months, stage II was 9 months, and of stage III A was 6 months. Univariate analysis showed a significant correlation between survival and pretreatment level of VEGF in patients with small lung cancer.
<strong>Conclusions:</strong> Our results revealed that hypobaric hypoxia significantly increases the circulating levels of VEGF in healthy individuals without remarkable effect on its level in patients with NSCLC. Our study verified also that the pretreatment mean serum level of VEGF showed a highly significant increase in NSCLC patients than that in control group and it was significantly correlated with patient survival in levels above 618 pg/ml.https://ejhm.journals.ekb.eg/article_14958_82638f1c8a3c85f3752ad954e684758f.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200261120180927Effect of Endotoxemia on Cardiac Disease in High & Low Flux Hemodialysis Patients6206301496210.12816/0018765ENMona HosnyInternal Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, EgyptHesham ElsayedInternal Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, EgyptKhaled Abo SeifInternal Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, EgyptHowayda Abd ElhamidInternal Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, EgyptAshraf ElmobdyInternal Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, EgyptJournal Article20180927 <strong>Background : </strong> endotoxemia can be the missing link between ESRD and cardiac disease , the first cause of death in hemodialysis patients .
<strong>Patients and methods : </strong>patients were recruited from Ain Shams University Hospitals , hemodialysis units .120 patients on prevalent HD were enrolled in the study : 31 cardiac patients on high flux HD ( group A) , 29 cardiac patients on low flux HD (group B), 32 non – cardiac high flux HD ( group C), and 28 non – cardiac low flux HD ( group D) . For all patients we measured : Hb , URR , serum albumin , HsCRP, predialysis and postdialysisa endotoxin , endotoxin delta change, echocardiography , and ECG . <strong>Results : </strong>we found that cardiac high flux and low flux groups had higher endotoxemia levels than non – cardiac high flux and low flux groups .<strong>Conclusion : </strong>High flux hemodialysis patients had higher accumulated endotoxin than low flux hemodialysis patients, within either cardiac or non - cardiac groups .
<strong> </strong>https://ejhm.journals.ekb.eg/article_14962_6512fe6a0e8526f97f42067cd5b6c276.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200261120180927Toxicological Effects of Generated Radiations on the Eye among Computer Users6316421496610.12816/0018766ENNadia I. MohammadForensic Medicine and Clinical Toxicology DepartmentOmaima I. Abo-ElkheirCommunity and Occupational Medicine DepartmentRehab A. MasoudForensic Medicine and Clinical Toxicology DepartmentNeveen A. IbrahimForensic Medicine and Clinical Toxicology DepartmentHosny H. MohammedOphthalmology Department, Faculty of Medicine - Al Azhar University, Cairo, EgyptJournal Article20180927<strong>Background:</strong> Nowadays computers being used in every aspect of life in both developed and developing countries. These electronic devices generate a form of non-ionizing electromagnetic radiation which exerts negative influence on human health. Eyes are particularly vulnerable; thus computer vision syndrome or dry eye disease is the most frequent health problems among computer users. This study <strong>aims to </strong>assess toxic effects of computer generated radiation on eyes among a sample of Egyptian computer users. <strong>Subjects and Methods: </strong>this is a cross-sectional study conducted on 100 volunteers from both sexes who worked daily on a computer. All participants were subjected to a self-filling questionnaire including questions about personal information, work and workplace related information as well as, Ocular Surface Disease Index (OSDI) with 12 questions about symptoms of eye and vision problems.<strong> Results: </strong>this study revealed that more than three fourths (79.0%) of the studied computer workers suffered from symptoms of dry eye disease, 40.5% of them had severe eye affection, 26.6 % had moderate and 32.9 % had mild eye affection. Those with severe eye affection of participants with dry eye disease were using the computer for a mean duration of 10.3 ± 2.4 hour/day and 70.9 % of them not taking regular rest during computer work. Wearing visual aids showed a significant association with dry eye disease (P = 0.002).<strong>Conclusion: </strong>the majority of participants had symptoms of dry eye disease. The most vulnerable persons were those who wearing medical glasses or lenses and use the computer for around 10 h / day without regular rest. Occurrence of eye dryness was relevant to the presence of fan and air conditioner in the workplace. These results indicated the valuable role and the essential need for visual assessment of computer workers for early and proper diagnosis of dry eye disease in order to minimize its impact on their productivity and quality of lifehttps://ejhm.journals.ekb.eg/article_14966_79698ec85b3d48c360442e7b8885a43d.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200261120180927Essential Hypertension among Egyptian Adults6436521497210.12816/0018767ENWalaa F ElbazDepartment of Internal Medicine Faculty of Medicine for Girls, Al Azhar University, Cairo, EgyptSomaia S M EissaDepartment of Internal Medicine Faculty of Medicine for Girls, Al Azhar University, Cairo, EgyptRehab A. MohamedDepartment of Internal Medicine Faculty of Medicine for Girls, Al Azhar University, Cairo, EgyptNaeima K AlyDepartment of Clinical Pathology Faculty of Medicine for Girls, Al Azhar University, Cairo, EgyptBassem M Abdel HadyDepartment of Cardiology Faculty of Medicine for Girls, Al Azhar University, Cairo, EgyptTaghreed M RedaJournal Article20180927<strong>Background</strong>: hypertensive diseases represent a major disease burden in Egypt. The prevalence of hypertension in Egypt in 2008 among adults of age ≥ 25 was 17.6%. In 60% of patients, hypertension is usually associated with cardiovascular risk factors. This leads to increased cardiovascular morbidity and mortality. Management of hypertension in Egypt is not easy because of treatment costs and inefficient primary health care system. There is a need for developing national hypertension guidelines to improve the rates of awareness, treatment and control of hypertension with the final goal of preventing and decreasing mortality and morbidity.
<strong>Aim of work: </strong>to assess the essential hypertension status among the Egyptian adult population of age≥ 25 and to study the modifiable social and environmental risk factors, health consequences, and assess the cardiovascular and non-cardiovascular complications to help disease prevention and limitation of complications.
<strong>Patients and methods:</strong> this study was conducted on 312 patients of age ≥ 25 with essential hypertension. All patient were subjected to full medical history and physical examination that including measurement of blood pressure (BP) and fundus examination. Anthropometric measurements including height, weight, waist circumferences, and hip circumferences were also measured. Waist to hip ratio and body mass index (BMI) were calculated. Laboratory investigations were performed including complete blood count (CBC), fasting blood glucose, measurement of creatinine, uric acid and lipid profile. Microalbuminuria was also assessed. Other investigations including electrocardiogram and echocardiograph were done.
<strong>Results</strong>: Male patients were 134(42.9%), while females were 178(57.1%). Their ages ranged from 30 to 85 years with a mean ±SD of 55.16±9.4years.Dyslipidemia was found in 152 (49%) patients. Left ventricular diastolic dysfunction (LVDD) was represented in160 (51%) patients. Uncontrolled BP was represented in (73%), (66%) and (55%) of non-educated, mild to moderate educated and high educated patients respectively. Retinopathy was found in 121 (38.8%) patients, 76 (60%) patients were hypertensive diabetic and 45 (24%) patients were hypertensive non-diabetic. Albumin in urine was present in 20%of patients.
<strong>Conclusion:</strong> strategies that enhance public awareness of hypertension and increase access to affordable medications are urgently needed. Prevention of hypertension needs both a population strategy and an intensive strategy focused on individuals at high risk. The complications of hypertension can be prevented by adequate blood pressure control with screening programs to identify the population at risk
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<strong> </strong>https://ejhm.journals.ekb.eg/article_14972_31b710df1d77a36d46e3afc3df795fb6.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200261120180927Prevalence and Risk Factors of Overt- and Occult Hepatitis C Virus Infection among Chronic Kidney Disease Patients under Regular Hemodialysis in Egypt6536691498710.12816/0018768ENEssam A. El-MoselhyDepartments of Community and Occupational Medicine Faculty of Medicine, Al-AzharAyman Abd El-AzizInternal Medicine Faculty of Medicine, Al-AzharSalwa A. AtlamDepartments of Community and Occupational Medicine Faculty of Medicine Tanta UniversityRaed H. MnsourTropical Medicine Faculty of Medicine, Al-Azhar UniversityHesham H. AminClinical Pathology Faculty of Medicine, Al-Azhar UniversityTarek H. KabilMedical Microbiology & Immunology Faculty of Medicine, Al-Azhar UniversityAyman S. El-KhateebDepartments of Community and Occupational Medicine El-Menia UniversityJournal Article20180927<strong>Background: </strong>hepatitis C virus (HCV) infection is a major health problem. It is more prevalent among chronic kidney disease (CKD) patients. Occult HCV infection, a new, entity has been described.
<strong>Aims: </strong>to find out prevalence of occult HCV infection among CKD patients under regular hemodialysis (RHD) and to define epidemiology of HCV infection among them.
<strong>Patients and Methods: </strong>a sample of 100 CKD patients under RHD was recruited. A questionnaire form was used to collect data. HCV-RNA was tested in serum to detect overt HCV infection patients. HCV-RNA was tested in peripheral blood mononuclear cells of undetected HCV-RNA patients’ serum to determine those with occult HCV infection. Rest of the patients was considered HCV free. Biochemical tests were done to all patients.
<strong>Results: </strong>prevalence of overt and occult HCV infection among CKD patients under RHD was 34.0% and 27.3%, respectively. Liver and renal function tests were significantly higher among the overt and occult HCV patients compared to negative HCV patients. Liver function tests were significantly lower among the occult compared to overt HCV patients. Overt HCV patients had significant risk factors compared to negative HCV patients; age group 40-59 years (OR=9.34) and rural residence (OR=3.14). Also, significant clinical risk factors were the overweight, history of blood transfusion ≥5 times/year, history of nonmedical bloody manipulations, and history of IV drug abuse (OR=3.23, 5.96, 8.28, 7.08, respectively). Occult HCV patients had significant risk factors compared to negative HCV patients; age group ≥60 years and rural residence (OR=6.25 and 6.73, respectively). Significant clinical risk factor was the history of nonmedical bloody manipulations (OR=11.5).
<strong>Conclusions and Recommendations: </strong>prevalence of overt- and occult HCV infection is high in CKD patients under RHD; this has important clinical and public health implications. There are many significant socio-demographic and clinical risk factors for these infections. A close monitoring of the HD patients and testing them for HCV-RNA in PBMCs yearly to adopted a proper management. Also, more studies on bigger number of patients are required to understand real epidemiology of this health problem.
<strong> </strong>https://ejhm.journals.ekb.eg/article_14987_bf0782400c386ca6665d79d9195c9388.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200261120180927Ameliorative Effect of Olive Leaf Extract on the Fetal Lung Tissue of Diabetic Pregnant Rats6706841498810.12816/0018769ENMervat A. Abd RabouBiology Department, Faculty of Science, Al-Jouf University, Saudi ArabiaFawzya A. Al-GhamdiZoology Department, Faculty of Science, Abdul-Aziz University, Saudi ArabiaNehal A. Abu ElnagaZoology Department, Faculty of Science, Al-Azhar University, CairoJournal Article20180927<strong>Aim of the work-</strong> Diabetes mellitus is a common metabolic disease not only affecting the individual, but also imposes adverse effects on the offsprings. Besides increasing congenital malformations, maternal diabetes is suggested to be associated with early pregnancy loss, altered sex ratio in the offspring and long-term postnatal diseases. Antidiabetic plants are used as supportive therapy in the treatment of diabetes during pregnancy, so the present study aims to investigate the protective effect of olive leaf extract on the fetal lung of the diabetic pregnant rats.
<strong>Material and methods - </strong>Forty pregnant albino rats were used and categorized after mating into four groups; group 1: control group(<strong>C</strong>), group 2: rats treated with olive leaf extract during the period of pregnancy (<strong>O</strong>) (1 ml/100gm. b. wt), group 3: streptozotocin induced diabetic rats (<strong>D</strong>)(STZ 35 mg/kg b.wt), group 4: diabetic rats treated with olive leaf extract (<strong>D+O</strong>) (as in groups 2&3). The pregnant females of different groups were dissected during the 19 <strong><em><sup>th</sup></em></strong> day of pregnancy. Lung samples of fetuses were taken for the histological and histochemical studies.
<strong>Results</strong>- Histopathological and histochemical observations of fetal lung tissue showed that the olive leaf extract succeeded to minimize the drastic changes which were observed in the fetal lung of diabetic rats. <strong>Conclusion</strong>- It is recommended that the use of the olive leaf extract has the ability to minimize the adverse effects in the fetal lung tissue of diabetic rats.
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<strong> </strong>https://ejhm.journals.ekb.eg/article_14988_958743a28f1afd3c83e8281dc7cf4a0d.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200261120180927Therapeutic Effects of Olive Leaf Extract or Bone Marrow Mesenchymal Stem Cells against Lung Damage Induced In Male Albino Rats Exposed To Gamma Radiation6856991499010.12816/0018770ENAmr Mahmoud Abd El-HadyFaculty of Applied Medical Sciences, Misr University for Science and Technology (MUST), 6th October, Cairo, Egypt.Nora Abdulaziz AlJalaudDepartment of Biology, Faculty of Science, University of Dammam, Saudi ArabiaJournal Article20180927<strong>Aim of the work</strong>- This study aimed to investigate the histological and histochemical changes in the lung tissue of male albino rats post exposure to gamma radiation and the possible therapeutic effect of both olive leaf extract and bone marrow mesenchymal stem cells.
<strong>Matrerial and methods-</strong>The current study was carried out on 40 adult male albino rats (<em>Sprague dawely</em> strain); they were divided equally into 5 groups (C group: control rats; O group : rats treated with olive leaves extract( 15 mg /kg body weight/daily) ; R group: rats exposed to a single dose of gamma-radiation(3 Gy); RO group: rats of this group treated with olive extract 15 mg /kg body weight/daily one week before and one week after irradiation; RS group: rats of this group irradiated with 3Gy then treated with bone marrow mesenchymal stem cells ( BMSCs) 3×10<sup>6</sup> cells/ml suspension through caudal vein about 5h post radiation exposure. Histopathological and histochemical changes were studied.
<strong>Results</strong>-Rats exposed to gamma radiation showed numerous histological and histochemical changes, these changes were ameliorated by using either olive leaf extract or bone marrow mesenchymal stem cells. BMSCs showed more obvious therapeutic effect than olive leaf extract.
<strong>Conclusion-</strong>The present work showed that olive leaf extract or bone marrow mesenchymal stem cells (BMSCs) have lung tissue radiotherapeutic effects against whole body gamma radiation in male albino rats.
<strong> </strong>https://ejhm.journals.ekb.eg/article_14990_de6db7a72377fddff063c7800a903544.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200261120180927Evaluation of Role of Glibenclamide and Aphanizomenon flos-aquae Extract on Lymph Node and Spleen of Diabetic Rats7007201499610.12816/0018771ENHemmat M. AbdelhafezZoology Department, Faculty of Science, Al-Azhar UniversityTamer M. M. Abu-AmaraHistology&Cytology Department, Faculty of Medicine, Al-Azhar UniversitySara M. El-debsiZoology Department, Faculty of Science, Al-Azhar UniversityJournal Article20180927<strong>Background:d</strong>iabetes mellitus is a metabolic disorder in the endocrine system with a common biochemical manifestation, thus hyper-glycemia is a disturbed carbohydrate metabolism. This work aimed to evaluate the role of antidiabetic and hypoglycemic drug glibenclamide as a chemical agent and <em>Aphanizomenon flos- aquae</em> extract as a natural agent on lymphoid organs such as lymph nodes and spleen in the diabetic (type-2) white male albino rats.<br /> <strong>Material and methods –</strong>Fifty male albino rats were used and categorized into five groups; group 1: control (<strong>C</strong>), group 2:Alloxan induced diabetic rats (<strong>D</strong>) (150 mg/kg b. wt); group 3:diabetic rats treated with daonil (<strong>D+Do</strong>)(daonil 5 mg/kg b.wt/day); group 4:<em>Aphanizomenon flos-aquae</em> extract (<strong>AFA</strong>)(94.5mg/kg b.wt/day) and group 5:diabetic rats treated with <em>Aphanizomenon flos -aquae</em> extract(94.5mg/kg b.wt/day) (<strong>AFA+D</strong>). All groups were dissected after 30 days of treatment. Lymph nodes and spleen samples were taken for histological and histochemical studies. Blood samples were taken for measurement of serum glucose and serum insulin level.<strong> Results</strong>- Diabetic male rats showed very highly significant increase in the serum glucose level, while non significant increase was recorded in the other treated groups in comparison with the control group.Diabetic male rats showed highly significant decrease in the serum insulin level as compared to the control group. Conversely, treatment of diabetic rats with daonil showed a significant increase in the levels of serum insulin. On the other hand non significant increase in the serum insulin was observed in <strong>AFA or AFA+D</strong> groups in comparison with the control group. Many histopathological and histochemical changes were observed in the lymph nodes and spleen of the diabetic rats, but using <strong>AFA</strong> extract succeeded to minimize the drastic changes which were observed in the lymph nodes and spleen of the diabetic rats more than that observed with glibenclamide. <strong>Conclusion</strong>- glibenclamide (daonil) as asynthetic drug and <em>Aphanizomenon flos-aquae</em> extract as a natural product ameliorated biochemical, histopathological and histochemical changes in the lymph nodes and splenic tissues of the diabetic rats.<em>Aphanizomenon flos-aquae</em> extract proved to be antidiabetic agent better than daonil drug and its antidiabetic action may be due to its anti-inflammatory, antioxidant and hypoglycemic action.<br /> <strong> </strong>https://ejhm.journals.ekb.eg/article_14996_cca6cba38e0756da242588cfb3ced35b.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200261120180927Histological, Histochemical and Immunohistological Comparative Study between Ranitidine and Rebamipide in Gastric Mucosal Protection after Dexamethasone Induced Injury in Adult Male Albino Rats7217441499810.12816/0018772ENAyman F. ElsharawyHistology& Cell Biology Department, Faculty of Medicine, Al-Azhar University, EgyptWagih M. AbdelhayHistology& Cell Biology Department, Faculty of Medicine, Al-Azhar University, EgyptMohammed A. EisaHistology& Cell Biology Department, Faculty of Medicine, Al-Azhar University, EgyptAl-Sayed A. Abd-ElrahmanHuman Anatomy Department, Faculty of Medicine, Al-Azhar University, EgyptWail M. Gad ElrabHuman Anatomy Department, Faculty of Medicine, Al-Azhar University, EgyptAdel I. Abd ElazizPharmacology Department, Faculty of Medicine, Al-Azhar University, EgyptJournal Article20180927<strong>Background:</strong> Gastritis can be caused by many factors, one of them is drugs, and among these drugs is dexamethasone that has many uses in medicine. Dexamethasone prevent synthesis of gastric mucous barrier by surface epithelial cells, so the stomach wall will be injured by digestive enzymes and stomach HCl. Treatment of gastritis can be done by antisecretory drugs like H<sub>2</sub> receptors blocker as ranitidine or by drugs that stimulate prostaglandins synthesize by surface epithelial cells of gastric mucosa to form the mucous barrier like rebamipide.<br /> <strong>Aim of the work</strong>: Comparison between ranitidine and rebamipide to detect which mechanism is better in gastric mucosal protection after dexamethasone administration.<br /> <strong>Material and methods</strong>: Twenty male albino rats were included in this study, they were divided into four groups, control group, dexamethasone administrated group, dexamethasone and ranitidine administrated group, dexamethasone and rebamipide administrated group, each group contained five rats.<br /> The examined samples were stained with hematoxylin & eosin stain, PAS & Alcian blue stains and TdT reaction, all of the results were statistically analyzed.<br /> <strong>Results:</strong> The result showed improvement of the gastric mucosa by using both of ranitidine and rebamipide as protective agents against injury induced by dexamethasone but the improvement was better in the group that was administrated rebamipide as indicated by better number of healthy cells, low numbers of damaged cells and better formed mucous barrier.<strong>Conclusion</strong>: The drug that stimulates mucous barrier formation is better than antisecretory drug in gastric mucosa protection.<br /> <strong> </strong>https://ejhm.journals.ekb.eg/article_14998_a8d0fd9802f5bc3943f617215290f28f.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200261120180927Relation between IL-1 β and IL1-ra in Pathogenesis of Febrile Convulsions7157231499910.12816/0018773ENSeham ElsaidNeurology department Faculty of Medicine for Girls, AL-Azhar UniversityManal HafezNeurology department Faculty of Medicine for Girls, AL-Azhar UniversityEman Saif EldeenNeurology department Faculty of Medicine for Girls, AL-Azhar UniversityHanan A EL-HagrasyClinical pathology Faculty of Medicine for Girls, AL-Azhar UniversityJournal Article20180927<span>Background: </span><span>febrile seizures are the most common form of childhood seizures. Fever is induced by proinflammatory cytokines during infection. The cytokine network may contribute to the generation of febrile seizures in children. Interleukin beta (IL-</span><span>1 β) an</span><span>d Interleukin receptor antagonist (IL-1ra) have been implicated in the pathogenesis of febrile seizures.<br /> </span><span>Aim of the work: </span><span>was to estimate the role of IL-</span><span>1 β and IL</span><span>-1ra in febrile convulsions and their relation to pathogenesis of febrile convulsions. </span>
<span>Methods: </span><span>serum interleukin I beta (IL-</span><span>1 β) and interleukin 1 receptor antagonist (IL</span><span>-1ra) were measured by ELISA technique in twenty five children with febrile seizure and twenty five age matched controls children with febrile illness without convulsion within 24 hours from onset of fever . </span>
<span>Results: </span><span>serum IL-</span><span>1 β and IL</span><span>- 1ra levels were significantly higher in febrile seizure patients than in fever in controls. Serum IL-</span><span>1 β and </span><span>IL- 1ra levels were highly significant higher in complex febrile seizures than in simple febrile seizures. Serum levels of IL-</span><span>1 β and IL</span><span>- 1ra were significantly positive correlated with duration of seizure in patients group. </span>
<span>Conclusions: </span><span>serum levels of IL-</span><span>1 β and IL 1ra were significantly higher in febrile seizure children. Our </span><span>study suggest that the inflammatory cytokine may play role in the generation of febrile seizures in children. These information may allow the development of anti- inflammatory therapy targeting these cytokines to prevent febrile seizures or subsequent epileptogenesis </span>https://ejhm.journals.ekb.eg/article_14999_fcc2550b8b61cd30b8034bf345904b76.pdf