Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001Role of EUS-FNA and Percutaneous US-FNA in diagnosis of pancreatic head lesions, Egyptian Experience51152016195ENHussein OkashaInternal Medicine Department, Faculty of Medicine, Cairo UniversityMohamed A. HassaneinTropical Medicine Department, National Hepatology and Tropical Medicine Research Institute, Cairo, EgyptHany M. KhattabPathology Department, Faculty of Medicine, Cairo UniversityMohamed NaguibInternal Medicine Department, Faculty of Medicine, Cairo UniversityJournal Article20181009<strong>Background:</strong> pancreatic carcinoma is one of the leading cancer morbidity and mortality worldwide. Endoscopic Ultrasound (EUS) provides good direct visualization of the pancreas and EUS-FNA raises the accuracy for diagnosing pancreatic malignancies. US-FNA is another established method for diagnosing pancreatic malignancies.
<strong>Aim:</strong> to determine the Role of Percutaneous US-FNA and EUS-FNA in diagnosis of pancreatic lesions.
<strong>Subjects & Methods</strong>: 131 patients with pancreatic masses were included in the study and sub-classified into 2 groups according to the imaging tool used, US-FNA (group I) and EUS-FNA (group II).
<strong>Results:</strong> using the appropriate statistical tools, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy were calculated for both groups. It was 88.2%, 93.9%, 96.8%, 97.5% and 90.1% respectively in group I. It was 77.8%, 100%, 100%, 75% and 86.7% respectively in group II.
<strong>Conclusion</strong>: US-FNA/EUS-FNA are safe reliable tools for diagnosis of pancreatic lesions.
<strong> </strong>https://ejhm.journals.ekb.eg/article_16195_ff5e63becfe38629bd1df1271bccef20.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001Protective Effects and Its Relative Mechanisms of Low Dose Ionizing Radiation on pancreatic cells of Male Diabetic Rat’s5215381619610.21608/ejhm.2012.16196ENHanaa F. WaerAtomic Energy Authority. National Center For Radiation Research and Technology, Biology Department - (King Khalid University Faculty of Science – University Center for Girls)Rabab M. MahmoudAtomic Energy Authority. National Center For Radiation Research and Technology, Biology Department - (King Khalid University Faculty of Science – University Center for Girls)Seham A. HelmySuez Canal University, Faculty of Veterinary Medicine, Department of Cytology and HistologyJournal Article20181009<strong>Back ground & Aim of the work:</strong> Diabetes mellitus (DM) is a chronic metabolic disorder brings great danger to human health. Low-dose-rate radiation modulates various biological responses including carcinogenesis, immunological responses and diabetes. This study examined the effect of low doses of irradiation on the pathological and ultrastructural progression of type I diabetes in rats inducted by Streptozotocin.<br /> <strong>Material and Methods</strong>: The present study was done on 80 healthy adult albino male rats 9 weeks age, in the weight range from (150–200 gm). Rats were grouped to 4 groups they were cared according to the Guiding Principle in the Care and Use of Animals. Diabetes was induced by a single intraperitoneal injection of freshly prepared Streptozotocin (STZ- 45 mg/kg b.w.).<br /> Whole body gamma irradiation was performed using Caesium -137. Animals were exposed to fractionated dose levels of 0.5 Gy/week of γ-radiation for 3 and 6 weeks. The body weight, blood glucose and insulin levels were measured after 3 and 6 weeks. Small blocks of pancreatic tissues of different groups were removed and prepared for pathological and ultrastructure examination.<br /> <strong>Results</strong><strong>:</strong> An elevated level of glucose and decreased level of insulin in blood were first detected at 3 and 6 weeks of age in the STZ treated rats. There was significant and remarkable tendency of gaining normal levels of both blood glucose and blood insulin by irradiation exposure especially after 6 weeks of irradiation. Both suppression of cell death and cellular injury induced by STZ were also observed by EM examination in 3 week and 6 weeks.<br /> <strong>Conclusion</strong><strong>:</strong> The present results indicated that treatment with 0.5 Gy γ rays suppresses progression of type I diabetes in STZ rats.<br /> <strong> </strong>https://ejhm.journals.ekb.eg/article_16196_798d74802ad2483a7f9fbb0a17a8d63a.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001EFFECT OF CAMEL MILK ON ALLOXAN-INDUCED DIABETIC RATS5395541619710.21608/ejhm.2012.16197ENEman G. E. HelalDepartments of Zoology –Faculty of Science-Al-Azhar University (Physiology)Samia M. Abd-ElwahabDepartments of Zoology –Faculty of Science-Al-Azhar University ( Histology )Anwaar Alkamel MohammadDepartment of Medical Science- Faculty of dentistry Sinai UniversityJournal Article20181009<strong>Back ground</strong><strong>:</strong> Diabetes is a chronic metabolic disease which affects large number of population all over the world. Such disease is associated with many complications which may leads finally to patient's mortality. Camel milk supplementation reduces the insulin requirement in Type I diabetic patients. So this study was planned to evaluate the effect of camel milk as hypoglycemic agent.
<strong>Material and method</strong><strong>:</strong> Thirty male adult albino rats were used to investigate the effect of camel milk (CM) treating diabetic rats. Rats were divided into three equal groups, control, diabetic non treated and diabetic CM treated groups. After thirty days of treatment all rats of each group were sacrificed. The body weight of each rat was determined at the beginning and the end of each period. Blood glucose, serum insulin, lipid and protein profiles, liver and kidney functions, blood picture and liver glycogen were determined for each rat at the end of each period. Pancreatic samples were obtained and processed for microscopic and quantitative evaluation after staining the prepared sections with both Heamatoxylin and eosin as well as special stain for demonstration of the different pancreatic cells in the Islet of Langerhans.
<strong>Results:</strong> The obtained results showed that the induced diabetes was diagnosed by laboratory assessment to body weight loss, hyperglycemia, and hypoinsulinemia, significant increase in liver and kidney functions, lipid and protein profiles and decreased liver glycogen content. While, CM treatment led to a significant improvement in all these parameter except liver function. Microscopically there was definite vaculation, degeneration, karyolysis and pyknosis of beta pancreatic cells in diabetic group while the other pancreatic cells were not affected (alpha and delta cells). The use of CM treatment of this study greatly improves such cellular changes.
<strong>Conclusion</strong><strong>: </strong> it was recommended that the use of the CM as a hypoglycemic agent may be of good results besides repeating such study with the use of variable doses may be helpful in better evaluation for the required doses.
<strong> </strong>https://ejhm.journals.ekb.eg/article_16197_c50d6aebee842e050c7b6771117cdbee.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001LOW BIRTH WEIGHTS: I- MATERNAL RISK FACTORS – A HOSPITAL- BASED STUDY IN CAIRO CITY, EGYPT5555721619810.21608/ejhm.2012.16198ENESSAM A. EL-MOSELHYCommunity Medicine Faculty of Medicine, Al-Azhar UniversityHAMED O. KHALIFACommunity Medicine Faculty of Medicine, Al-Azhar UniversityIBRAHIM SAAD NADAIndustrial Health & Occupational Medicine Faculty of Medicine, Al-Azhar UniversityKHADRA I. MOHAMMADObstetrics & Gynecology, Faculty of Medicine, Al-Azhar UniversityJournal Article20181009Background: Low birth weight (LBW) is an important public health problem. The problem is prevalent world-wide and has negative impacts. So, its prevention is a major challenge.
Objective: To determine maternal risk factors of LBW in Cairo city.
Design: A case-control, hospital-based, study design.
Subjects: Mothers of 270 LBW neonates were recruited in this study. A control group of mothers of an equal number of normal birth weight (NBW) neonates was chosen.
Methods: The mothers of LBW and NBW neonates were interviewed using a specially designed questionnaire. All mothers had been subjected to full examinations. The neonates were weighted and examined after labor.
Results: Low education, unskilled occupation, and husband unavailability are significant sociodemographic risk factors of LBW; OR=1.75, 1.62, and 2.21, respectively. Mother’s height (≤145 cm), BMI (<18 kg/m²), history of previous abortion, and maternal family history of LBW are significant personal characteristic risk factors of LBW; OR=3.26, 5.11, 3.27, and 3.23, respectively. The significant obstetric risk factors are congenital malformations, weight gain during pregnancy ≤6 kg, multiple gestations, bleeding at first/second trimester, presence of complications during delivery, gestation age <37 weeks, and birth spacing <2 years; OR=13.61, 7.61, 7.15, 5.92, 3.93, 3.17, and 2.84, respectively. Absence of antenatal care, inadequate healthy diet intake, physical hard activities, exposure to tobacco smoke, and living nearby heavy air pollution are significant health care behavioral and life-style risk factors of LBW; OR=2.49, 2.72, 2.96, 3.64, and 4.8, respectively. Anemia, hypertension, and history of recurrent chronic/specific infections are significant medical risk factors of LBW; OR=2.68, 4.35 and 4.84, respectively. Anorexia nervosa/stress, oligo/polyhydramnios, and gestational hypertension are significant gynecological/obstetric conditions risk factors; OR=3.53, 3.32, 3.23, and 3.36, respectively. Lastly, the most important risk factors of LBW as weighted by partial F-test are multiple gestations, neonate congenital malformations, weight gain during pregnancy ≤6 kg, maternal BMI <18 kg/m², gestation age <37 weeks, and mother’s weight at early pregnancy ≤45 kg, (F test=2.9, 2.7, 2.6, 2.3, 2.2, and 2.2, respectively).
Recommendations: There is a need for improving the quality and utilization of ANC services, nutritional education, birth spacing, and avoidance exposure to tobacco smoke. Also, increasing promotion of reproductive health services in relation to safe motherhood at community level in order to reduce risk factors of LBW is needed. Lastly, further population based studies are needed in different areas in Egypt.
https://ejhm.journals.ekb.eg/article_16198_3b8324519509df98902f07d9bf935451.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001Molecular characterization of glutathione S-transferase, endothelial nitric oxide synthase and Vitamin D receptor genes in breast cancer cases5735881619910.21608/ejhm.2012.16199ENRizk El-BazGenetics Unit, Children Hospital, Mansoura University, EgyptAzza IsmailPhysiology Department, Faculty of Science, Mansoura University, EgyptMaher AmerPhysiology Department, Faculty of Science, Mansoura University, EgyptMai ElshahatClinical Oncology & Radiology, Mansoura University, EgyptAmira KazamelPhysiology Department, Faculty of Science, Mansoura University, EgyptAhmad SettinGenetics Unit, Children Hospital, Mansoura University, EgyptJournal Article20181009<strong>Background:</strong> Enzymes of the Glutathione S-transferase system (GST) modulate the effects of exposure to several cytotoxic and genotoxic agents. Nitric oxide (NO) is constitutively synthesized in the endothelium by endothelial nitric oxide synthase (eNOS) and acts as a pleiotropic regulator involved in carcinogenesis. Vitamin D levelsmay influence breast cancer development. The vitamin D receptor(VDR) is a crucial mediator for the cellular effects of vitaminD and additionally interacts with other cell-signaling pathwaysthat influence cancer development.
<strong>Objectives:</strong> To check for the association of polymorphisms of GST, eNOS3 and VDR genes with the susceptibility and severity of breast cancer in Egyptian cases.
<strong>Subjects</strong>: This work included 100 cases with breast cancer and 100 healthy individuals. The mean age of cases was 48.31±11.40 years. They included 100 females.
<strong>Methods:</strong> DNA was amplified using PCR-RFLP for detection of polymorphisms related to eNOS3 and VDR , also DNA was amplified using PCR-SSP for detection of polymorphisms related to GST and calculating the odds ratios and their 95% confidence intervals.
<strong>Results:</strong> Total cases showed high significant frequency of eNOS3<sup>-786</sup> CC (P<0.05, OR=18.58) genotypes, GSTT1(null) (OR = 2.68; CI 95%=1.51-4.75; p=0.001). These were considered risk genotypes for disease susceptibility. On the other hand, total cases showed low significant frequency with homozygosity for eNOS3<sup>-786</sup> TT (P=0.01) and the GSTT1 gene was present in 42.0% of the cancers and in 66.0% of controls (OR = 0.37; CI 95%= 0.21-0.66; p=0.001). These may be considered low risk genotypes. No significant difference in frequencies of null and present genotypes of GSTM1 and VDR FOKI in total cases compared to controls.
<strong>Conclusions:</strong> Polymorphisms related to eNOS3<sup>-786</sup>, GSTT1 and VDR FOKI genes may be considered genetic markers for BC among Egyptian cases. This may have potential impact on family counselling as well as future management plans.
<strong> </strong>https://ejhm.journals.ekb.eg/article_16199_798323e929bd576f5b4139f6bd40d130.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001Routinely Use of computed tomography (CT) scanning in patients with abdominal pain at emergency Department at King Hussein medical center. (KHMC)5895951620010.21608/ejhm.2012.16200ENAbdallah AL- MheratEmergency Department, King Hussein Medical Center
Royal Medical Services,Journal Article20181009<strong>Objective</strong>: To evaluate use of abdominal computed tomography in patients with abdominal pain and accuracy of diagnosis, in patients who attend the Emergency Department at KHMC.
<strong>Method:</strong> We conducted a retrospective descriptive case series of consecutive patients who received an abdominal CT scan for abdominal pain. The setting was an Emergency Department at King Hussein Medical Center, from January to September. 2011. All patients who presented to Emergency Department at King Hussein Medical Center with Abdominal pain and who received a CT scan in the ED were included. All CT scans were reviewed by a radiology specialist and all patients examined by an Emergency physicians.
<strong>RESULTS:</strong> The number of patients that attended the emergency Department of King Hussein Medical Center during period of study with abdominal pain was (2060).
930 (45, 1%) of those Patients underwent Abdominal CT scan for abdominal pain. Then the patients were categorized into groups according to abdominal CT scan findings.
Group A: 570 (61, 2%) patients with Abnormal Abdominal CT Scan.
Group B: 360 (38, 7%) patients with Normal Abdominal CT Scan.
The patients with Abnormal CT scan (Group A) were classified into two subgroups:
Subgroup I: (330) (57, 8%) patients had urinary tract stones.
Subgroup I I: (240) (42, 1%) Patients with variable conditions.
<strong>Conclusions:</strong> The study showed that the Use of abdominal computed tomography for Abdominal pain in emergency Department may reduce mortality and Hospitals admissions, but the use of abdominal computed tomography as a routine diagnostic tool in patients with abdominal pain is unrecompensed, unless there is an indication. The Clinical assessment remains the most important first step in evaluating patients with an Abdominal Pain to decide on when to use CT scans in patients with abdominal pain.
<strong> </strong>https://ejhm.journals.ekb.eg/article_16200_a934b2332e3aa25ace7d857e6f520864.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001Immune Response to Hepatitis B Vaccine in Health-Care Workers5966031620110.21608/ejhm.2012.16201ENMaha M. HusseinInternal Medicine department Ain Shams UniversityManal M. HusseinClinical Pathology Department Ain Shams UniversityJournal Article20181009Health care workers (HCWs) constitute a high-risk population of HBV infection. There are limited data on the efficacy of vaccination in HCWs in Egypt.
<strong>The aim </strong>of this study was to evaluate the immune response to hepatitis B recombinant vaccine in HCWs in our hospital.
<strong>Methods: </strong>100 HCWs who completed three doses of intramuscular immunization with recombinant DNA hepatitis B vaccine (Engerix-B) at different time periods during the last 5 years were examined for hepatitis B surface antigen (HBs Ag), anti hepatitis B surface antibodies (anti HBs Abs) and hepatitis B core antibodies (HBc Abs).
<strong>Results</strong>: 96% of HCWs showed seroconversion (anti HBs ≥ 10 IU/L); 92% good responders (anti HBs > 100 IU/L) and 4% weak responders (anti HBs = 10-100 IU/L). The HBsAg and HBc Ab were never detected among the entire responders. Younger age had higher anti HBs titer than older HCWs. The non responders were 4%; two of them had evidence of chronic hepatitis B infection.
<strong>Conclusion</strong><strong>: </strong>Vaccination against HBV in HCWs in Egypt is cost effective and achieved good response rate. Screening for Hepatitis B infection before vaccination should be considered to detect those with undiagnosed infection.
<strong> </strong>https://ejhm.journals.ekb.eg/article_16201_fa0cc4ec0263c1e5e7d58733042f683c.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001EFFCT OF LONG-TERM TREATMENT OF INSULIN ON GROWTH PERFOMANCE, LIPID METABOLISM AND ELECTROLYE IN TILAPIA FIORIDA6046141620210.21608/ejhm.2012.16202ENAbdel-Salam Mohamed Ibraik OhaidaZoology Department. Faculty of Science. University of Misurata LibyaJournal Article20181009<strong>Material & methods:</strong> Forty Fish, <em>Tilapia florida.</em> were injected with insulin (20 IU/Kg body weight) for different periods. Single dose for 24h and repeated doses (dose every 48 h for 30, 45 and 55 days) were used in this experiment. Body gain, condition factor (CF), hepatosomatic index (HSI) and gut weight were calculated . Levels of total lipids, triglycerides and cholesterol were determined in serum, liver and myotomal muscle. Also, sodium and potassium levels were estimated in both serum and muscle but inorganic phosphorus was determined only in serum.
<strong>Results:</strong> Insulin injection increased significantly body gain (P<0.05) and gut weight (P<0.01). While hepatosomatic index was significantly decreased (P<0.01) in insulin treated group at 30 and 45 days of the experimental periods. The prolonged administration of insulin in <em>Tilapia florida</em> showed a continued effect on the stimulation of lipogenic in the myotomal muscle as well as in the liver triglycerides synthesis. The lowering effect of insulin on liver content of triglycerides but not in the serum.
<strong>Conclusion:</strong> So, it has been suggested that insulin might promote the triglyceride synthesis in liver to be removed as rapidly as synthesized to lipid stores in the body. The increasing effect of insulin on serum and muscle potassium level probably reflect role of such hormone in osmoregulation in this fish.
<strong> </strong>https://ejhm.journals.ekb.eg/article_16202_60ef5b9a93dc26e31fadabd14ef58449.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001A Key Regulator For Iron Homeostasis in chronic hepatitis C.6156271620310.21608/ejhm.2012.16203ENSaadia FaridDepartment Of Tropical Medicine and Medical Biochemistry.
National Hepatology and Tropical Medicine Research Institute and Cairo University Faculty of MedicineSameh MohamedDepartment Of Tropical Medicine and Medical Biochemistry.
National Hepatology and Tropical Medicine Research Institute and Cairo University Faculty of MedicineLila RashidDepartment Of Tropical Medicine and Medical Biochemistry.
National Hepatology and Tropical Medicine Research Institute and Cairo University Faculty of MedicineDina SbryDepartment Of Tropical Medicine and Medical Biochemistry.
National Hepatology and Tropical Medicine Research Institute and Cairo University Faculty of MedicineJournal Article20181009<strong>Background: </strong>Hepcidin is a small, cysteine-rich cationic peptide produced by hepatocytes. There is a single human hepcidin gene; whose essential role in iron homeostasis was confirmed by identifying homozygous frameshift or nonsense mutations in affected individuals with severe Juvenile hemochromatosis. IL-6 may be the mediator of hepcidin induction by inflammation. Hypoferremia is a common response to systemic infections or generalized inflammatory disorders, anemia of chronic disease occurs in patients with acute and chronic immune activation and represents an important clinical problem.
<strong>Aim of the work: </strong>The study will attempt to determine the hepatic hepcidin expression levels in patients with chronic hepatitis C virus infection.
<strong>Patients and methods: </strong>Fifty patients with chronic hepatitis C virus infection (CHCV), their age between (20- 55) years, selected from the National Hepatology and Tropical Medicine Research Institute were included in this study, before interferon and Ribavirin therapy, and ten healthy individuals were included to serve as controls. All the patients and controls were subjected to the following history, clinical examination, abdominal ultrasonography and collection of blood samples for routine laboratory investigations. CBCs and serological assay for serum ferritin, iron, transferrin (s-TFR) levels, Liver biopsy for hepcidin mRNA levels and iron deposits in liver by (PCR) polymerase chain reaction. All subjects gave written informed consent for enrolment in the study, which was approved by the Research Ethical Committee of the General Organization for Teaching Hospitals and Institutes. Liver biopsy was taken from healthy subjects during abdominal surgery.
<strong>Results: </strong>Our results revealedthat hepatic hepcidin expression is considered highly valid marker in case of CHCV infection.
<strong>Conclusion: </strong>Our study concluded thatthere’s a highly significant inverse correlation between hepcidin versus liver iron, serum iron and serum transferrin but there’s no significant correlation versus ferritin.
<strong> </strong>
<strong>Recommendations: </strong>Hepcidin measuring and manipulating hepcidin levels will, in the future, have a role in diagnosing and treating any number of iron related disorders.Hepcidin itself has antimicrobial properties of uncertain importance so that careful clinical trials will be required to define appropriate indications of hepcidin antagonists.
<strong> </strong>https://ejhm.journals.ekb.eg/article_16203_61bdfc1a146196995339559a265cc55e.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001The Possible Protective Role of Bone Marrow Transplantation against Alternations Induced by Gamma Radiations on Fetal Gastrointestinal Tract of Pregnant Albino Rats6286601620410.21608/ejhm.2012.16204ENNahed Mohamed Mansour EmamBiological and Geological Dept., Faculty of Education, Suez Canal University, Ismailia, EgyptJournal Article20181009<strong>Aim of the work</strong>:It is well recognized that radiation can be carcinogenic for a wide variety of tumors, especially, in breast, thyroid, and bone marrow which appear to be radiosensitive.<br /> Bone marrow cells (BM) suppress immune cell responses and have beneficial effects in various inflammatory-related immune disorders. The present study is designed to evaluate the possible role of bone marrow to restore certain histopathological and histochemical changes in the fetal gastrointestinal tract of pregnant rats which exposed to gamma rays. <strong>Material and Methods</strong>: The experimental animals were divided into five groups:<br /> 1-Control pregnant rats.<br /> 2- Group of pregnant rats irradiated with γ-rays on day 7 of gestation.<br /> 3- Group of pregnant rats irradiated with γ-rays on day 14 of gestation.<br /> 4- Group of pregnant rats irradiated with γ-rays on day 7 of gestation and treated with BM one hour post- exposure<br /> . <strong>5</strong>-group of pregnant rats irradiated with γ-rays on day 14 of gestation and treated with BM one hour post-exposure. All the previous groups were sacrificed on day 20 of gestation (1 day prior delivery).<br /> <strong>Results</strong>: Exposure of pregnant rats to γ-rays on day 7 or day 14 of gestation showed many pathological and histochemical changes in the fetal gastrointestinal tract. These changes were more pronounced on day 14 of gestation. The changes include increased proliferation in the mucosal layer, increased signs of lymphocytic infiltration and pyknotic nuclei in addition to highly distorted circular muscle fibers. Also, altered collagen, total protein, polysaccharides contents were noted post-irradiation. Bone marrow transplantation post-irradiation improved the tissue architecture which restored it's normal histological and histochemical pictures.<br /> <strong>Conclusion</strong>: It can be concluded that bone marrow transplantation post-irradiation showed somewhat a considerable ability to overcome radiation injuries or damages from the histological and histochemical point of view on day 7 or 14 of gestation in the studied previous fetal tissues although the healing was incomplete on day 7 or 14 of gestation when compared with the control groups.<br /> <br /> <strong> </strong><br /> <strong> </strong>https://ejhm.journals.ekb.eg/article_16204_f5ea9af14104c84c394d57678e42833a.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001Assessment of the Respiratory Muscles Function in Chronic Obstructive Pulmonary Disease patients6616711620510.21608/ejhm.2012.16205ENManal R. HafezChest Department Faculty of Medicine for Girls Al-Azhar UniversityRawda M. ElsheikhCommunity& Occupational Medicine Department
Faculty of Medicine for Girls Al-Azhar UniversityJournal Article20181009Chronic Obstructive Pulmonary Disease (COPD) is a public health problem worldwide. It is a polygenic disease and a classical example of gene-environment interaction. Of the many inhalational exposures that may be encountered over a lifetime, only tobacco smoke and occupational dusts and chemicals (vapors, irritants, and fumes) are known to cause COPD on their own. Maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) may be impaired in patients with COPD.
<strong>Aim of the study</strong><strong>: </strong>to assess respiratory muscle function in male COPD patients by measuring MIP and MEP values and to identify possible correlation between MIP and MEP and the anthropometric parameters as well as degree of airflow obstruction among COPD patients.
<strong>Subjects and methods</strong><strong>: </strong>A case-control study was carried out on 50 COPD male patients and 50 of age and sex matched healthy subjects as a control group. All participants were subjected to assessment of respiratory muscle (RM) strength by MIP and MEP, pulmonary function tests {flow/volume spirometry, and MVV}, as well as the functional exercise capacity (6MWT) and the anthropometric measurements.
<strong>Results</strong><strong>:</strong> the values of MIP and MEP in COPD cases were lower than those of the control group with a statistically significant difference. In COPD cases the MIP and MEP were positively correlated with VC%, FEV<sub>1</sub>\FVC, FEV<sub>1</sub>%, FVC%, PEF%, MVV%, and 6MWD (p<0.00). Furthermore, COPD patients were subdivided according to the presence of respiratory muscle (RM) affection into two subgroups: <strong>Group A (</strong>patients with RM affection) and <strong>Group B (</strong>patients without RM affection). There was a significant difference between the two subgroups concerning smoking index , disease duration, VC% , FVC% ,FEV<sub>1</sub>\FVC, FEV<sub>1</sub>%, PEF%, MVV%, and 6MWD (P< 0.05).
<strong>Conclusion:</strong> RM is affected in patients with COPD. Measurement of MIP and MEP indicates the state of RM which is related to smoking index, disease duration, and spirometric-indices (VC%, FVC%, FEV<sub>1</sub>\FVC, FEV<sub>1</sub>%, PEF%, and MVV %).
<strong>Recommendation</strong>: Health care workers involved in the diagnosis and management of COPD patients especially those with severe airflow obstruction should consider the possibility of RM deterioration and should have an access to RM function assessment.
<strong> </strong>https://ejhm.journals.ekb.eg/article_16205_2dbea17d8a77e40104d8ae8b42782321.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001Echographic evaluation of optic disc excavation6726771620610.21608/ejhm.2012.16206ENFatma A. AtwaOphthalmology Department, Faculty of Medicine (for Girls), Al-Azhar University, Cairo, Egypt.Mona Mohamad A. FaragOphthalmology Department, Faculty of Medicine (for Girls), Al-Azhar University, Cairo, Egypt.Mona N. MansourOphthalmology Department, Faculty of Medicine (for Girls), Al-Azhar University, Cairo, Egypt.Journal Article20181009<strong>Purpose</strong><strong>: </strong>To evaluate the role of high resolution B-scan echography in differentiating the causes of optic disc excavation.
<strong>Methods</strong><strong>:</strong> A prospective study was conducted on 30 subjects presenting to Al-Zahraa University Hospital (2009 – 2011) with optic nerve excavation. Of these patients 10 with coloboma, 10 with cup-shaped posterior staphyloma and 10 with glaucomatous optic nerve cupping were identified. Horizontal and vertical approaches for optic disc excavations were evaluated using B-scan echography. Specific echographic criteria for excavation configurations were successfully estimated.
<strong>Results & conclusion</strong><strong>:</strong> High-resolution contact B-scan echography may provide useful differentiation for optic disc excavations in eyes with opaque media.
<strong> </strong>https://ejhm.journals.ekb.eg/article_16206_d528608d396ade993229f69e34263b9e.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001EFFECT OF OBESITY AND DIETARY FACTORS ON BONE MINERAL DENSITY LEVELS AMONG FEMALE STUDENTS IN UMM AL-QURA UNIVERSITY6786901620710.21608/ejhm.2012.16207ENHassan M. BukharDept. of Clinical Nutrition in the Faculty of Applied Medical Sciences, Umm al-Qura University Makkah, KSAIbrahim Saad NadaLaboratory Department, Faculty of Applied Medical Sciences, Umm al Qura University, Makkah, Saudi ArabiaEslam A. HeaderDepartment of Nutrition and Food Science Faculty of Home Economics Minufiya University, Egypt.Journal Article20181009<strong>Background:</strong> Nutrition is one of the most important factors influencing human health. Also, nutrition plays a role in the etiology of osteoporosis disease. This disease is a serious metabolic bone disorder that often results in hip fracture and is usually asymptomatic in its initial stages.
<strong>Objective:</strong> Assess the prevalence of osteoporosis among female university students.
<strong>Methods</strong><strong>: </strong>A cross sectional study was carried out during the period from 1/1/2010 to 30/6/2010 among a random sample of (257) university female students were chosen from Umm Al Qura of Makkah. The age of sample from 19-24 years old. Data were collected through an interview with case by using a special questionnaire; bone mineral density (BMD) and body composition have also been measured.
<strong>Results: </strong>Osteoporosis was present in 7% of cases while, osteopenia was current in 32.3% of cases. Moreover there was a highly positive significant relationship at level (1%) between osteoporosis induced and each of body fat %, fat weight, and BMI.
<strong>Conclusion: </strong>The prevalence of osteoporosis among university students was positively and significantly associated (p<0.001) with increased body fat. The study results suggested that inevitable decrease in body fatness and weight with less consumption of carbonated beverages, taking into consideration variety and balanced diets and increasing nutrition education programs will improve bone health and nutritional status.
<strong> </strong>https://ejhm.journals.ekb.eg/article_16207_ef8e84a4b7b9e5fa305a24d3642d2a61.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001EFFECT OF YOGHURT PILLARED WITH PROPOLIS ON HYPERGLYCEMIC RATS6917041620810.21608/ejhm.2012.16208ENHassan M. BukhariClinical Nutrition Department, Faculty of Applied Medical Sciences, Umm al Qura University Makkah, Saudi ArabiaAbdelghany H. AbdelghanyDepartment of Anatomy and Embryology Faculty of Medicine, Alexandria University, EgyptIbrahim Saad NadaLaboratory Department, Faculty of Applied Medical Sciences, Umm al Qura University, Makkah, Saudi ArabiaEslam A. HeaderNutrition and Food Science Department, Faculty of Home Economics Minufiya University, Egypt.Journal Article20181009Dietary supplementation of yoghurt with plants rich in antioxidants such as propolis which is an adhesive resinous material collected by honey bees is recently recommended. This study aimed at investigating the protective effect against the hyperglycemia and hyperlipidemia. The study showed that yoghurt with propolis had a hypoglycemic effect together with reduction of the serum levels of cholesterol, low density and very low density lipoproteins with elevation of high density lipoproteins. The atherosclerosis indices were affected with reduction of low density lipoproteins-cholesterol/high density lipoproteins-cholesterol and elevation of the high density lipoprotein-cholesterol/total cholesterol. This was attributed to the reduction of glucose absorption and inhibition of α-glucosidase together with the antioxidant activity with regain of the pancreatic β-cell function. The hypolipidemic effect and consequently protective effect against atherosclerosis was attributed to the binding, breakdown and reduction of absorption of cholesterol together with the antioxidant activity of both yoghurt and propolis. Down regulation of the expression of the angiogenic gene factors which have a role in the pathogenesis of atherosclerosis may play a role.
Thus, this dietary supplementation may be manufactured and used for its value in reducing hyperglycemia and hyperlipidemia in cases of diabetes mellitus.
<strong> </strong>https://ejhm.journals.ekb.eg/article_16208_8a0699ad2b68eb6101b777b48d916de1.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001Effect of Morin against Gentamicin-Induced Nephrotoxicity in Young Male Rats7057171620910.21608/ejhm.2012.16209ENHala A.H. KhattabNutrition and Food Science Dept., Faculty of Home Economics, Helwan UniversityJournal Article20181009<strong>Background:</strong> Morin, a bioflavonoid with antioxidant properties, is a constituent of many herbs and fruits that are used as herbal medicines. It exhibits many biological activities and possibly even has protective effects against chronic diseases. The present study was conducted to determine the protective effect of morin against gentamicin-induced nephrotoxicity in young male rats.
<strong>Material and Methods:</strong> Young male rats (n=24) were divided into four groups as follow; (1): control group, (2): gentamicin (GM) group; rats injected intraperitioneally (i.p.) with GM at a dose of 100 mg /kg body weight (b.w.) for five consecutive days to induced nephrotoxicity, (3): morin group; rats administered morin daily at a dose of 30 mg/ kg b. w. via gavage, and (4) GM group pretreated with morin; rats were orally received morin at the same dose and route in group (3) up to two weeks followed by injected i.p. with GM as in group (2). Separated serum samples were used for determination of protein metabolism parameters, kidney functions, malondialdehyde (MDA), and ionic sodium (Na<sup>+</sup>) and potassium (K<sup>+</sup>).
<strong>Results: </strong>GM injection induced marked nephrotoxicity as evidenced by significant elevation in serum levels of albumin, creatinine, urea, uric acid, MDA and K<sup>+</sup>, with significant reduction in serum levels of total protein, Na<sup>+</sup> and albumin/creatinine ratio (ACR). Pretreatment with morin protected the rats from GM- induced nephrotoxicity as evidenced by significant improvement of these investigated parameters. Histological examination of renal tissues showed marked glomerular thickening, vacuolations of the wall of blood vessels associated with necrobiotic changes in GM injected group, meanwhile there were amelioration in rats group received morin pre-GM injection.
<strong>Conclusion:</strong> Morin exert potential antioxidant activity and offer nephroprotective effect against GM- induced nephrotoxicity in young rats.
<strong> </strong>https://ejhm.journals.ekb.eg/article_16209_804f4fbd59878d051ab0df4a077c42d4.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001Anxiety and depression among patients with Bronchial asthma, chronic obstructive pulmonary disease and diffuse parenchymatous lung diseases7187311621010.21608/ejhm.2012.16210ENTaghreed S. FaragChest Diseases Department , Faculty of Medicine for Girls Al-Azhar UniversityManal R. HafezChest Diseases Department , Faculty of Medicine for Girls Al-Azhar UniversityTaghreed ElshafiePsychiatric Diseases Department , Faculty of Medicine for Girls Al-Azhar UniversityOmaima I. Abo-ElkheirCommunity & Occupational Medicine Department, Faculty of Medicine for Girls Al-Azhar UniversityJournal Article20181009<strong>Background:</strong> Psychosocial stressors, such as death of a spouse or divorce are closely related to relapses and aggravations of respiratory disease pointing to a link between psychological factors and chronic pulmonary disease. Patients with chronic obstructive pulmonary disease (COPD) cannot cope adequately with everyday needs. This inadequacy may lead to heightened anxiety and depression, which in turn may worsen the everyday inadequacy. It has been reported that this is probably a factor that leads bronchial asthma (BA) and COPD patients to frequent hospital admissions, lower treatment adherence and even intensive care unit hospitalizations<strong>.</strong>
<strong>Study objectives:</strong> to assess anxiety and depressive symptoms among a sample of Egyptian patients with chronic obstructive pulmonary disease (COPD), bronchial asthma (BA), and diffuse parenchymatous lung diseases (DPLD).
<strong>Subjects & methods</strong>: A cross-sectional study conducted over a one year period on a sample of 258 Egyptian patients with chronic breathing disorders who attending the outpatient chest clinic at Al-Zahraa University Hospital. All patients diagnosed as having COPD, BA or DPLD were enrolled into the study. Anxiety and depression were assessed by using the Hospital anxiety and depression scale (HADS) and the Beck Depression Inventory (BDI).
<strong>Results:</strong> Psychiatric disorders were most prevalent among DPLD cases (80.0%), followed by COPD patients (74.0%), while BA group showed the least reported cases (38.8%) with psychiatric disorders, with a statistically significant difference among the studied groups (P-value < 0.05).Depression was prevalent among 60.1% (155/258) of the studied cases, of them 23.2% had severe depression, followed by 38.7 % had moderate depression and 38.1% had mild depression. DPLD cases had the highest proportion of severe depression (31.8), COPD cases had the highest proportion of moderate depression (52.4) and BA group had the highest proportion of mild depression (68.4%), with a statistically significant difference among the studied groups (P-value < 0.05).<strong>Conclusion:</strong> results of this study revealed that mixed anxiety depression disorders, depression and anxiety were common co-morbidities among the studied sample of the Egyptian patients with DPLD, COPD and those with BA.<strong> Recommendations:</strong> physicians should take into consideration the assessment of psychiatric co-morbidities among cases with DPLD, COPD and BA.
<strong>Key words: </strong>
<strong> </strong>https://ejhm.journals.ekb.eg/article_16210_f137ae0732fa9482e085755fb8218929.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001ROLE OF MULTISLICE COMPUTED TOMOGRAPHY IN PATIENTS PRESENTING WITH HEMOPTYSIS7327501621110.21608/ejhm.2012.16211ENAmr M IsmaeelRadiodiagnosis department, Faculty of Medicine, Ain Shams UniversityMohamed A NassefRadiodiagnosis department, Faculty of Medicine, Ain Shams UniversityMaha F AzmyRadiodiagnosis department, Faculty of Medicine, Ain Shams UniversityMagdy M KhalilRadiodiagnosis department, Faculty of Medicine, Ain Shams UniversityJournal Article20181009We described the role of MDCT with its new applications for determining the cause and site of bleeding, and to determine the additional benefit of MDCT angiographic technique in identifying the site of bleeding and its vascular origin.
<strong>PATIENTS AND METHODS:</strong> 50 patients suffering from hemoptysis were evaluated by MDCT with its new applications & MDCT angiographic technique.
<strong>RESULTS</strong>: MDCT revealed excellent diagnostic method for hemoptysis.
<strong>CONCLUSION:</strong> MDCT is considered a primary noninvasive imaging modality in the evaluation of patients with hemoptysis. It also serves as a guide for other diagnostic or therapeutic procedures.
<strong> </strong>https://ejhm.journals.ekb.eg/article_16211_41fb0e1bdf1a57507120286e9f83e499.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001Role of MRI in Characterization of Occult Breast Lesions in High Risk Population7517701621210.21608/ejhm.2012.16212ENCaroline AY HabiRadiodiagnosis department, Faculty of Medicine, Ain Shams UniversityHisham MA MansourRadiodiagnosis department, Faculty of Medicine, Ain Shams UniversityMohsen G HassanRadiodiagnosis department, Faculty of Medicine, Ain Shams UniversityAyman M IbrahimS.Radiodiagnosis department, Faculty of Medicine, Ain Shams UniversityJournal Article20181009<strong>OBJECTIVE:<em> </em></strong>To evaluate the diagnostic validity of breast MRI in discriminating benign from malignant lesions in women with occult breast lesions who are at a high risk of developing breast cancer, with histopathologic findings and/or follow up used as the reference standard.
<strong>PATIENTS AND METHODS:</strong> Contrast-enhanced bilateral breast MRI was performed on 100 women at high risk of developing breast cancer with indeterminate imaging findings by mammography and/or ultrasonography. Lesions detected by MRI that could represent potential malignancies in both breasts were evaluated. Morphologic assessment and kinetic analysis (contrast enhancement and time/intensity curves) were performed on each lesion using dedicated postprocessing and display software. Functional MR toolswere used in about 60% of casesto help in the differential diagnosis between malignant and benign of suspicious lesions detected at conventional MRI.
<strong> RESULTS</strong>: Among 100 patients included in the study12% of the patients were finally diagnosed as free of any pathology, 56% had benign findings, while 31% of the patients were malignant. (24 IDC, 4 Invasive Lobular Carcinoma, 1 Medullary carcinoma, 1 Mucinous carcinoma and 1 DCIS.) The sensitivity, specificity, positive and negative predictive values of CE-MRI, were 100%, 93%, 86%, and 100% respectively. Overall accuracy of MRI breast was 95%. <strong>CONCLUSION:</strong> Breast MRI is highly effective in detection and characterization of occult breast lesions in high risk population, with excellent sensitivity and high specificity. Development of functional MRI tools contributed to the improving validity of this modality
<strong> </strong>https://ejhm.journals.ekb.eg/article_16212_dac998373181e448b31c6abfa6e7297e.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001The Beneficial Effect Of Trifolium Flower Extracts On Paracetamol- Intoxicated Male Rats7717801621310.21608/ejhm.2012.16213ENAhkam M. El-GendyZoology Dep. Faculty of science (Girls' branch), Al-Azhar University, Cairo, Egypt.Journal Article20181009Acetaminophen known as paracetamol (P) overdose can cause severe hepatotoxicity and even liver failure and hepatic centrilobular necrosis in experimental animals and humans.
<strong>Material and methods: </strong>
The male rats (n=36) were allocated into 6 groups (each group n=6 rats). Group I was kept as control. All animals in groups II-VI were given paracetamol at 2 g /kg bw by gastric gavage on days 3 post Trifolium alixanderanum(<em>T alixanderanum</em>) flower extracts (TEs) or N-acetylcystiene (NAC) treatments. Group III, IV and V were treated for three days by hexane extract (THE + P), ethanol extract (TEE + P) and water extract (TWE + P). Group VI received 100 mg/kg bw of antidote N-acetylcystiene (NAC + P).
<strong>Results</strong>:
Paracetamol induced a significant rise in Liver weight and hepatosomatic index, serum aspartate amino transferase (ASAT), alanine amino transferase (ALAT), alkaline phosphatase (ALP), total bilirubin (T bili), liver lipid peroxides (MDA+ 4-HDNE) with a reduction of liver glutathione (GSH), glutathione peroxidase (GSHpx) and superoxide dismutase (SOD) enzymes activities. The plant extracts showed a remarkable hepatoprotective and antioxidant activity against paracetamol induced hepatotoxicity as judged from the serum marker enzymes and antioxidant levels in liver tissues.
<strong>Conclusion</strong>:
The present investigation indicated that paracetamol damaged liver cells and TEs prevented this damage when compared with control group.<em>Trifolium</em> flower hexane extract was the most effective superior to TEE, TWE and NAC.
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https://ejhm.journals.ekb.eg/article_16213_be8430b55c76a42de22f014fadbd7452.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001Changes Of P21 And Bcl-2 During Induction Of Bladder Inflammation And/Or Bladder Carcinogenesis7817921621410.21608/ejhm.2012.16214ENA.A. SayedM.Sc candidate, Faculty of Science, Cairo UniversityM.A. El-DesokyDepartment of Chemistry,BiochemistryDivision, Faculty of Science, Cairo UniversityS. ShaarawyDepartment of Medical Biochemistry,NCI , Cairo UniversityA.M. AshmawyDepartment of Medical Biochemistry,NCI , Cairo UniversityJournal Article20181009The effect of E.coli infection in association with dibutylamine and sodium nitrate in induction of bladder inflammation and /or bladder carcinogenesis were investigated in 150 male albino rats, divided into five groups, as follows: The first group(<strong>G1</strong>) infected by E. coli , The second group (<strong>G2</strong>), given nitrosamine precursors in the diet , The third group(<strong>G3</strong>) infected by E. coli and given nitrosamine precursors in the diet ,The fourth group(<strong>G4</strong>) infected by E. coli , given nitrosamine precursors in the diet and received standard diet containing 1% Curcumin powder mixed in the diet and the fifth group (<strong>G5</strong>) , served as control group .
<strong>Results</strong>:
The worst histopathological changes are in G3 . A highly significant decrease in the mean cell lysate level of p21was found in different studied groups(<strong>G1,G2&G3</strong>) especially in<strong>(G3)</strong> where P values in these groups when compared to control group were (P < 0.0001) . In curcumin treated group(<strong>G4</strong>), there were downregulation in the mean cell lysate level of p21 gene when compared to control group but higher than other studied groups (<strong>G1,G2&G3</strong>) . A highly significant increase in the mean serum level of Bcl-2 was found in different studied groups(<strong>G1,G2&G3</strong>) especially in<strong>(G3)</strong> where P values in these groups (<strong>G1,G2,G3</strong>) when compared to control group were (P < 0.0001). (<strong>G4</strong>) showed higher Bcl-2 serum level when compared to control group, this difference was insignificant but this level is lower than other studied groups (<strong>G1,G2&G3</strong>) .
<strong>Conclusion</strong>:
The results in the present study indicate that both <em>P21</em> and Bcl-2 can be used as biological markers in the diagnosis of bladder cancer . Curcumin have the ability to overcome the decrease in p21WAF1/CIP1 protein and the increase of Bcl-2 protein and reduce the induction of carcinogenic effect .
<strong> </strong>https://ejhm.journals.ekb.eg/article_16214_7fd0b1e8753ad9c4c253ab76d0084005.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001Role of Multidetector Computerized Tomography in Coronary In-Stent Restenosis7938001621510.21608/ejhm.2012.16215ENWaleed S El-SharkaweRdiodiagnosis department, Faculty of Medicine, Ain Shams UniversitySahar M El-FikyRdiodiagnosis department, Faculty of Medicine, Ain Shams UniversityKhalid A ShoukryRdiodiagnosis department, Faculty of Medicine, Ain Shams UniversityRania A Maarouf.Rdiodiagnosis department, Faculty of Medicine, Ain Shams UniversityJournal Article20181009We described the role of multi detector computerized tomography in the detection and exclusion of coronary in-stent re-stenosis compared with the conventional coronary angiography.
<strong>PATIENTS AND METHODS:</strong> 30 patients pretreated with coronary stenting and complaining of angina like symptoms underwent dual source coronary angiography one day before performing conventional coronary angiography.
<strong>RESULTS:</strong> 47 stents were examined 43 of them were assessable by DSCT-CA and the calculated sensitivity, specificity, negative predictive value, positive predictive value and overall accuracy of all assessable stents were 100%, 90%, 100%, 81% and 93%, respectively. When analyzing the results for stents ≤2.75mm in diameters the results were less encouraging, The calculated sensitivity, specificity, negative predictive value, positive predictive value and overall accuracy of all assessable stents were 100%, 70%, 100%, 40% and 75%, respectively.
<strong>CONCLUSION: </strong>With the high sensitivity and negative predictive value -reaching up to 100%- with dual source CT scanners, it could be used confidently to rule out in-stent re-stenosis. However, due to the frequent false positive results, careful patient selection should be done.
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<strong> </strong>https://ejhm.journals.ekb.eg/article_16215_9c392eed85589a7bbb1bfed1b06f920e.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001Eleven years experience with the use of Contegra8018091621610.21608/ejhm.2012.16216ENJournal Article20181009The implantation of the Bovine Jugular Vein (Contegra) in the repair of many congenital heart defects (CHD) had gained a worldwide acceptance. We report our experience in using it over eleven years.<br /> <strong>Methods:</strong><br /> During the period from February 2000- December 2011, we implanted the Contegra in 268 patients with different congenital heart defects at the position ventricle-Pulmonary artery (RV/LV-PA).<br /> There were 178 males and 90 females in an age ranging between 2 months- 33 years mean of 5.6 yrs.<br /> Echocardiography was performed postoperatively at 3days, 3months, 6months then every year looking for pressure gradient (PG) across the valve, regurgitation and calcification.<br /> The primary endpoints of operative mortality and morbidity and secondary endpoints of follow-up haemodynamic performance including severe stenosis, regurgitation and need for reintervention are presented. <br /> <strong>Results:</strong><br /> The follow up of patients were 100% in 1 yr, 98% in 2 yrs; 82% in 3yrs and 57% in 4 yrs, 40% in 5yrs, 35% in 6 yrs, 20% continued to show up from year 7 to year 11.<br /> The performance of the conduit was as follow: Unchanged pressure gradient (PG) or < 15 mmHg over 2yrs in 98%, PG 15 – 25 mmHg over 3yrs in 25%, PG 25 -35mmHg over 4yrs in 18%, PG 35 – 45mmHg over 5yrs in 14%, and by the end of 11 yrs 10% of pts had PG >55 mmHg, and were scheduled for redo surgery. The rest of the patients were having minor changes in the pressure gradients over variable periods of follow up.<br /> The younger the child at the time of implantation, the higher the chance to develop pressure gradient over the conduit over years.<br /> There were no conduit related adverse events, there were 32 deaths; 12 early deaths (4.5%), late 20 deaths, not related to conduit implantation.<br /> Operative morbidity was 11.2%.<br /> There were mild regurgitation at the valve in 32 cases (12%); moderate regurgitation in 9 cases (3.4%) and severe regurgitation in 6 cases (2.2%) at variable periods of follow up, calcifications were detected by X-ray and sonography in 37 cases (13.8%)<br /> Reintervention by redo surgical procedure in 33 cases (12.3%)<br /> <strong>Conclusion </strong><br /> The Contegra conduit is s a reliable extra-cardiac conduit for primary and redo- RVOT reconstruction over eleven years of follow up.<br /> <br /> https://ejhm.journals.ekb.eg/article_16216_69270c2c1ad99b669699dd8928899e58.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001Hepatic DNA Damage and Abnormality in Serum Protein Pattern Due to Long Term Use of Tramadol in Rats8108261621710.21608/ejhm.2012.16217ENLaila Abd El KawyNarcotic Department, the National Center for Social and Criminological Research, Cairo, EgyptJournal Article20181009Tramadol is a widely used analgesic that stimulates the μ opioid receptor and inhibits serotonin and noradrenalin reuptake. In this study, we investigate the effect of chronic administration of 200 and 400mg of tramal for 15,30 ,45 days followed by withdrawal periods(w15) on protein activity in male rats as manifested by changes in electrophoretic serum protein patterns and gene expression manifested by DNA damage, measured by Comet Assay .
<strong>Materials and methods:</strong>
100 male Wistar rats (100-150 g) were included and divided into three groups, control group (n = 20), Tramal(I) group (n = 40), received the drug orally at doses of 200mg/kg/day for 15,30,45 days of the study, respectively(10 rats for each subgroup).TR45 group was followed by 15 withdrawal period(W15) ,Tramal(II) group (n = 40), received the drug orally at doses of400mg/kg/day for 15,30,45 days of the study, respectively. TR45 group was followed by 15 withdrawal period (W15).
<strong>Results</strong>:
Results exhibited major changes in the protein pattern which included changes in the molecular weight of the control bands and the relative percentage of protein fraction as well as the total number of bands, as a result of disappearance of some original bands and appearance of other new one. Serum protein fraction revealed an increase in total number of protein fractions being in Tr200mg (14 and 16 bands), whileTR400mg revealed a decrease in total number of bands (except TR15 which exhibited an increase in bands (14). The changes were observed all over the treated groups as well as in the withdrawal groups In this study, the alkaline version of the comet assay has been used to determine the effect of tramal administration (200 and 400mg/Kg) on peroxide-initiated free radical-mediated DNA damage in rat liver cells. Indeed, levels of strand breaks in rat liver cell exposed to tramal400mg/Kg were significantly higher than in cells exposed to 200mg/Kg, especially after a long administration period (TR45 days). The intensity of the comet tail relative to the head reflects the number of DNA breaks. The rates of tailed cells detected by the comet assay increased significantly when the rats were exposed to 200 and 400mg/kg of tramal compared with control (however, the tail length did not differ significantly between the same groups). The intensity of the comet tail relative to the head reflects the number of DNA breaks.
<strong> </strong>
<strong>Conclusions:</strong>
Our findings pointed out the risk of increased lipid peroxidation, hepatic DNA damage and abnormality in serum protein pattern due to long term use of tramadol, although opioids are reported to be effective in pain management, their toxic effects should be kept in mind.
<strong> </strong>https://ejhm.journals.ekb.eg/article_16217_153001d89f0039d9f59e201707dffa63.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001Haemostatic activation in acute coronary syndrome patients in relation to physical exercise8278381621810.21608/ejhm.2012.16218ENAmany H. MansourDepartment of Clinical Pathology Faculty of Medicine, Mansoura University ), EgyptMaha RagabDepartments of internal Medicine Faculty of Medicine, Mansoura University ), EgyptRokiah AnwerDepartments of internal Medicine Faculty of Medicine, Mansoura University ), EgyptMaha M. Abd El MohsenFaculty of Medicine, Mansoura University and Department of Clinical Pathology AL-Azhar University Egypt.Mostafa M. ShaabanFaculty of Medicine, Mansoura University and Department of Clinical Pathology AL-Azhar University Egypt.Journal Article20181009<strong>Backgound: </strong>Thrombosis is regarded to be a key factor in the development of acute coronary syndromes in patients with coronary artery disease (CAD), Platelets are known to play a fundamental role in acute coronary syndromes(ACS). After atherosclerotic plaque rupture, platelets can form pathogenic, occlusive thrombi leading to acute ischemic events. The precise mechanisms of platelet activation in acute coronary syndromes are still under investigation. Physical activity could regulate the development of ACS via effects on platelet function. Several studies have shown that acute physical exercise increases platelet reactivity, typically assessed by aggregation assays, in both healthy individuals and in patients with cardiovascular disease. The aim of this study was to investigated the effect of moderate and strenuous exercise on arterial thrombus formation.
Subjects and Methods: Assay of some hemostatic marker as Platelet activation , thrombin generation (TF(pg/ml),TAT_ µ g/l and dimerand tPA concentration ) von Willebrand factor<span style="text-decoration: underline;">,</span>platelet aggregation tests,Coronary Angiography. haemostatic parameters in patients with ACS correlated with other clinical parameters under physical exercise .
Results: Patients with ACS showed higher values for fibrinogen , tPA , TAT_ , as indicators for a thrombin synthesis, and a marker for prothrombotic conditions, was elevated in patients with ACS,. Von Willebrand factor and D-dimer showed no statistical significant differences during rest., Exercise increased hemostatic parameters in an strenuous physical exercise in ACS Patients( < 0.05). Exercise also increased plasma levels of fibrinogen and von Willebrand factor ,but there was an increase in the generation of T-AT complexes,. (<em>P</em> < 0.05). Exercise did not affect platelet aggregation regardless of its intensity when triggered by the agonists ADP or collagen.
<strong>Conclusion:</strong> Strenuous but not moderate exercise increases the thrombotic tendency in healthy sedentary male volunteers
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.https://ejhm.journals.ekb.eg/article_16218_f4273151db8d2e5f84b560b94e3cdfc8.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001Ecological studies on the diversity of terrestrial poisonous snakes "Proteroglyphous” of Jazan region Kingdom of Saudi Arabia (Reptilia: Ophidia)8398561621910.21608/ejhm.2012.16219ENMostafa F. MasoodDepartment of biology, Faculty of Science, Jazan University, Kingdom
Saudi ArabiaJournal Article20181009The present work was carried out in Jazan region. The region of Jazan in being in the South-Western part of Saudi Arabia between longitudes 42<sup>0</sup> and 43.8<sup>0</sup> and latitudes 5, 16<sup>o</sup> and 17<sup>o</sup>, and is bounded on the south and east of the Republic of Yemen, Asir area in the north and the Red Sea in the west.
The results showed that there are four families of poisonous snakes "Proteroglyphous" living in Jazan region. They are: Family Atractaspididae, Elapidae, Viperidae and Hydrophiidae . This work aimed to unveil ecological problems and throw light on diversity of poisonous snakes in Jazan region and the danger of these species to human life. Despite the fact that these snakes may be harmful to human life in some cases, it may also be useful to him in many aspects of life. Since there are no enough studies on the animal species in the region, this study came to identify the diversity of this animal group. There is no doubt that the study of these species and identifying them will provide some solutions that could make this group as an endless source of biodiversity and at the same time, this study provides information on the feasibility of protection of this species in this region. Discussion of ecological and geographical affinities of this taxa and taxonomic keys of different types in order to facilitate the process of identification will be provided.
https://ejhm.journals.ekb.eg/article_16219_7ab998a22f0c9c5d7b53aa54c95bc700.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001Effect of Cholesterol and /or Methionine on the Testis of Rats8578781622010.21608/ejhm.2012.16220ENNehal Ali Moustafa Abu ElnagaZoology Department, Faculty of Science, Al-Azhar UniversityJournal Article20181009<strong>Aim of the work</strong>-Methionine is essential for maintaining proper growth and development in mammals. Also, cholesterol enriched diets significantly increase cholesterol level in body tissues. The present study aims to investigate the effects of dietary cholesterol and /or methionine on the histological and some histochemical changes in the testis and epididymis of the male rats.<strong> Material and methods</strong>- sixty adult male rats (5-7 weeks old) were used in this study and divided into 6 groups. Group 1 served as the control group (C). The following 5 treated groups administered the diets for four months. Group 2 treated with a diet enriched with 2% cholesterol, group 3 received 0.5% methionine, group 4 received 2% methionine, group 4 treated with 2% cholesterol and 0.5% methionine, group 5 received 2% cholesterol and 2% methionine.<strong>Results</strong>- Testes isolated from rats fed excessive amount of cholesterol showed disturbance in spermatogenesis and the epididymal structure with altered total protein, polysaccharides and collagen fibers. Dietary low doses of methionine with or without cholesterol improved spermatogenesis and architecture of the epididymis, but addition of high dose of methionine caused many drastic changes in the testis and the epididymis.<strong>Conclusion-</strong>Low dose ofmethionine (0.5%) showed ameliorative effect against adverse effects of cholesterol ,but the high dose (2%) showed less protective effect.<br /> <strong> </strong>https://ejhm.journals.ekb.eg/article_16220_a653fdc3497fd00e5661b6de0208eca9.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001Epilepsy cases: fMRI and MR tractography as qualitative and quantitative tools for proper localization and pre-operative planning.8798901622210.21608/ejhm.2012.16222ENAhmed Abdelmoniem GaberDepartement of Biological Anthropology National Research CentreEman A. GeneidiDepartement of Biological Anthropology National Research CentreMohamed KhMitkeesDepartement of Biological Anthropology National Research CentreAzza M. Sarry El DinRadiodiagnosis , Neurology and Neurosurgery, Faculty of Medicine, Ain Shams UniversityWael Abdelhalim RedaRadiodiagnosis , Neurology and Neurosurgery, Faculty of Medicine, Ain Shams UniversityYasser A AbbasRadiodiagnosis , Neurology and Neurosurgery, Faculty of Medicine, Ain Shams UniversityJournal Article20181009<strong>Introduction</strong>: Functional MRI is a relatively new noninvasive brain imaging technique that has been used for neuroscience research applications since the early 1990s. This technique relies on the blood oxygenation level dependent (BOLD) effect. Diffusion tensor magnetic resonance imaging (DTI) is a noninvasive technique that can be used to assess the integrity of cerebral tissue.
<strong>Methods</strong>: We evaluated 16 patients with unilateral MTLE. We did MRI for language and memory areas for localization and lateralization of the dominating cortical areas concerned with language and memory. Diffusion-weighted images along twelve different directions with a b value of 1000 s/mm2. A 1.5-T scanner was used to acquire those examinations. For DTI we compared the mean diffusivity (MD) and fractional anisotropy (FA) from symmetrical voxels by sampling the basal ganglia, thalamus, hippocampus and parahippocampus regions bilaterally. We compared measurements with the EEG, high-resolution MR imaging, as well as clinical data. For MR tractography, various tracts were traced including the Meyer’s loop.
<strong>Results</strong>: Among the study group only 5 patients with partial epilepsy out of 16 are promising candidates for surgery representing only 31.25 % among the study population 68.75% of our study population were excluded according to our quantitative and qualitative tools.
<strong>Conclusion</strong>: Combined fMRI with MR tractography are valuable qualitativeand quantitative tools for proper localization and lateralization of the eloquent areas including memory, language areas and Meyer’s loop in the selection of promising epilepsy surgery candidates and for pre-operative planning.
<strong> </strong>https://ejhm.journals.ekb.eg/article_16222_7314fc0e9832351917520cc910a01ef7.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001Screening For Vitamin D Deficiency In Females In Madina Region; Saudi Arabia. Vitamin D Deficiency In A Sunny Environment8918951622410.21608/ejhm.2012.16224ENEman NagibInternal Medicine department-Ain ShamsMahmoud A. AbulmagdEndocrinology department-BanhaJournal Article20181009<strong>Background And Objective</strong>: Poor sunlight exposure leads to vitamin D deficiency even in the sunniest places. So screening for vitamin D deficiency in outpatient clinics and inhospital setting in King Fahad Hospital , Al Madina Al Monwara.
METHODS: Screening for vitamin D deficiency by assessment of serum 25(OH)D with radioimmunoassay in 60 female patients aged 18 – 40 years. Serum calcium, phosphorous and alkaline phosphatase were assessed, too.
<strong>Results:</strong> 6 female patients (10%) showed significant vitamin D deficiency with 25(OH) D < 20 ng/ml. However 54 female patients (90%) showed severe vitamin D deficiency with 25 (OH) D < 10 ng/ml.
<strong>Conclusion:</strong> Vitamin D deficiency is very common in Saudia Arabia especially females due to poor sunlight exposure. So being underrecognized and undertreated, vitamin D deficiency represents an important health problem in MADINA REGION, KSA.
https://ejhm.journals.ekb.eg/article_16224_b43a46a3d8f976b363ed85dc209b8655.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001Physiological Effect Of Peri winkle (C.roseus) On Diabetic Albino Rat8969101622610.21608/ejhm.2012.16226ENEman G.E. HelalDepartments of Zoology –Faculty of Science-Al-Azhar UniversitySamia M. Abd-ElwahabDepartments of Zoology –Faculty of Science-Al-Azhar UniversityAtef M. MoussaDepartment of Physiology-Faculty of Medicine-Al-Azhar UniversityAnwaar A. MohammadDepartment of Medical Science- Faculty of Dentistry Sinai UniversityJournal Article20181009<strong>Back ground:</strong> Diabetes mellitus (DM) is a major health problem worldwide in recent time. Asia and Africa are the most viable areas where the disease is feared to raise 2–3 folds. Many herbal products have been recommended for the treatment of DM in ancient literature of Ayurveda in India and other worldwide.
<strong>Material and method:</strong> Thirty male adult albino rats were used to investigate the effect of <em>Catharanthus rosea</em> (<em>C</em>.<em>roseus</em>) on diabetic rats. Rats were divided into three equal groups, control, diabetic non treated and diabetic <em>C.roseus</em> treated groups. After thirty days of treatment all rats of each group were sacrificed. The body weight of each rat was determined at the beginning and the end of each period. Blood glucose, serum insulin, lipid and protein profiles, liver and kidney functions, blood picture and liver glycogen were determined for each rat at the end of each period. Pancreatic samples were obtained and processed for microscopic and quantitative evaluation after staining the prepared sections with heamatoxylin and eosin as well as special stain for demonstration of the different pancreatic cells in the islets of Langerhans.
<strong>Results:</strong> The obtained results showed that the diabetic rats were diagnosed by laboratory assessment to body weight loss, hyperglycemia, and hypoinsulinemia, significant increase in liver and kidney functions, lipid and protein profiles and decreased liver glycogen content. While, <em>C.roseus</em> treatment led to a significant improvement in these parameters except liver function. Microscopically there was definite vaculation, degeneration, karyolysis and pyknosis of beta pancreatic cells in the diabetic group, while other pancreatic cells were not affected (alpha and delta cells). The use of <em>C.roseus</em> treatment of this study greatly improves such cellular changes.
<strong>Conclusion:</strong> It was recommended that the use of the water extract of <em>C. roseus</em> levies as a hypoglycemic agent may offer a new hope to the diabetics in future. It's well recommended to use variable doses and different periods of treatment to evaluate the best dose and period.
<strong> </strong>https://ejhm.journals.ekb.eg/article_16226_2c4a4b15b4721c86c9e4be703b791a84.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001EVALUATION THE EFFECT OF SILDENAFIL CITRATE (SC OR VIAGRA) ON SENILE ALBINO RAT TESTIS (HISTOLOGICAL AND BIOCHEMICAL STUDY)9119321622710.21608/ejhm.2012.16227ENEzz-Eldin E-AbdallaHistology Department, Faculty of Medicine Al-Azhar University (Damietta)Abd-Elghany A. MoustafaHistology Department, Faculty of Medicine Al-Azhar University (Damietta)Ibrahim M. AmrHistology Department, Faculty of Medicine Al-Azhar University (Damietta)Zienab M. GebalyHistology Department,
Faculty of Medicine for girls Al-Azhar University (Cairo)Journal Article20181009Sildenafil citrate (SC or Viagra) is an oral medication widely used to treat erectile dysfunction and maintains a sufficient erection for satisfactory sexual performance. The side effects of sildenafil citrate have been reported.<br /> <strong>Aim of the work</strong>: The present study was designed to investigate the effect of sildenafil citrate in the therapeutic dose in different regimes.<br /> <strong>Materials and methods</strong>: This study included forty senile male albino rats divided into four equal groups. Group (A) was used as a control group (did not receive any treatment). Group (B) receive the therapeutic dose of Viagra (1.5 mg suspended in 1.5 ml distilled water) orally using a gastric gavage as daily dose for one week. Group (C) received the therapeutic dose of Viagra 3 times / week for two weeks. Group (D) received the therapeutic dose of Viagra each week for 4 weeks. Half of the treated rats of the different groups were sacrificed, other half were sacrificed after two weeks from the last dose as recovery groups (RB, RC and RD). The testes were dissected and blocked in paraffin. Hematoxylin and Eosin (HX&E) and Periodic acid Schiff stain (PAS) were applied and serum testosterone levels in the different groups were evaluated.<br /> <strong>Results</strong>: The present study showed that the therapeutic dose of sildenafil caused several histological findings in the germinal epithelial of the rat testes including degeneration , detachment of the spermatogenic cells especially the primary spermatocytes with addition thickening of the basement membranes of the seminiferous tubules and increased interstitial Leydig cells. The serum testosterone of the treated rats showed increased level of testosterone especially in group D. The recovery rats showed relative improvement of parameter toward normal.<br /> <strong>Conclusion: </strong>Sildenafilproduce morphological and histological alterations in the testes.<br /> <strong> </strong>https://ejhm.journals.ekb.eg/article_16227_7a623f6f196e5ae8082424674f0a9cc0.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001Effect of Sitagliptin "a Dipeptidyl Peptidase-4 (DPP-4) Inhibitor" on the Endocrine Part of the Pancreas in Experimentally induced Diabetes in Adult Albino Rat; A Light Microscopic and Biochemical Studies9339451622810.21608/ejhm.2012.16228ENTamer M. M. Abu-AmaraAl-Azhar University- Histology Departments (Boys-Girls)Zeinab M. GebalyAl-Azhar University- Histology Departments (Boys-Girls)Journal Article20181009Sitagliptin is highly selective dipeptidyl peptidase-4 (DPP-4) inhibitor that is considered as one of the new oral therapies for management of type II diabetes. Because of the sitagliptin unknown effects on the endocrine part of the pancreas, especially on the cellular levels, this study was done to evaluate its effect on the endocrine part of the pancreas in experimentally-induced type II diabetic in adult albino rats.
<strong>Material and Methods: </strong>The present study was carried out on 30 adult male albino rats which were divided into; <strong>Group I (untreated control group), Group II (diabetic group)</strong>, where type II diabetes had been induced via alloxan intake<strong>)</strong> and <strong>group III (treated group), </strong>where 0.14 mg/100 mg B.W. sitagliptin was given orally per day for 3 weeks after induction of type-2 diabetes.
The specimens were prepared for light microscopic examination. In parallel, the related biomedical parameters such as serum glucose and serum insulin levels had been estimated, statistically analyzed and compared between the three groups.
<strong>Results</strong>: Sections of pancreas taken from diabetic rats showed morphological changes in islets of Langerhans cells in the form of pyknotic nuclei, cytoplasmic vacuolation, poor differentiation and abnormal shape and size of the cells. These morphological changes had been partially recovered in diabetic rats treated with sitagliptin. Also, the hyperglycemia and hypoinsulinemia that was detected in the control diabetic group had been nearly returned to normal after sitagliptin treatment.
<strong>Conclusion</strong>: Sitagliptin drug has improved islet functions on both morphological and biomedical parameters in type II diabetic rats and can be taken into consideration as one of the new oral anti-diabetic drugs on the human level that need to be more investigated.
<strong> </strong>https://ejhm.journals.ekb.eg/article_16228_000b51d614085b7d853990b4b863647f.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001Serum 25 Hydroxy Vitamin D Levels In Adult Asthmatic Patients9469521622910.21608/ejhm.2012.16229ENMostafa M. ShaabanClinical Pathology Department, Faculty of Medicine, Al-Azhar UniversityManal HashemInternal Medicine Department, Faculty of Medicine, Zagazig UniversityJournal Article20181009<strong>Purpose:</strong> Patients with chronic lung disease as asthma appear to be at increased risk for vitamin D deficiency for reasons that are not clear.
<strong>Methods: </strong>A cross sectional study including 75 asthmatic adults aged older than 18 years and 75 adults healthy control aged older than 18 years (35 males and 40 females for both groups) assessing the relationship between serum 25 hydroxy vitamin D levels and lung function.
<strong>Result: </strong>In our study only (12٫31%) of our asthmatic adults had sufficient vitamin D levels ( ≥ 30 ng/ml) , wherase (85%) of healthy control subjects expressed sufficient levels. Vitamin D deficiency (<20 ng/ml) was observed in 59 (78.66%) asthmatic patients (17.28 ±2.4 ng/ml). Deficiency was not observed in controls (33.67±6.3). In asthmatic patients Serum 25(OH) vitamin D was positively correlated with forced expiratory volume in 1 second % <strong> </strong> ( FEV1 %) predicted &forced expiratory/forced vital capacity ratio ( FEV1//FVC)(P=<0.05 for all). There was no significant association between serum vitamin D level and eosinophil count.
<strong>Conclusion:</strong> Reduced vitamin D levels are highly prevalent in adult asthmatic patients and are associated with impaired pulmonary functions
https://ejhm.journals.ekb.eg/article_16229_efe102de643aec0ada1e2fc77dd2c095.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001Assessment of Serum Concentrations of Vitamin D in Young Male Patients with Tuberculosis9539591623010.21608/ejhm.2012.16230ENAmani Ezz Al ArabChest DiseaseDina AbazaEndocrinology Al Azhar University For GirlsAzza Al SebayeClinical Pathology Zagazig UniversityJournal Article20181009Tuberculosis is highly prevalent worldwide, accounting for nearly two million deaths annually. Vitamin D influences the immune response to tuberculosis, and vitamin D deficiency has been associated with increased tuberculosis risk in different populations <em>(Bedoya and Ronnenberg, 2009).</em>
<strong>The aim of this study</strong> has been to determine the possibility of an association between tuberculosis and low serum vitamin D concentration in young male patientsand to monitor the changes in vitamin D levels after TB treatment.
<strong>Material and Methods</strong>: Twenty five (25) Patients aged 20-40 with newly diagnosed TB were enrolled in this study. They were divided into eleven (11) cases on first line TB treatment for 2-3 months and fourteen (14) cases before starting TB treatment. Twenty five (25) age and sex matched healthy volunteers were enrolled as controls. For all groups body mass index (BMI) was calculated. Also serum calcium (Ca⁺),25-hydroxyvitamin D (25-OHD) and 1-25-hydroxyvitamin D (1-25-OHD) levels were measured and compared.
<strong>Results </strong>There was significant difference between groups as regard BMI, serum Ca⁺, 25-OHD and1-25-OHD (p<0.0001 for all groups). In the TB group both25-OHD and1-25-OHD were lower in patients who were underTB treatment compared to patients who didn't received treatment (p<0.001).
<strong>Conclusion: </strong>Low serum vitamin D concentrations may be a consequence of TB disease. The possibility that low serum 25-OHD and1-25-(OH)² D concentrations may predispose to tuberculosis infection cannot, be excluded. Antituberculous treatment has been shown to reduce serum 25-OHD and1-25-(OH)²vitD, which may increase the risk of vitamin D deficiency.
https://ejhm.journals.ekb.eg/article_16230_e341ae7ff1149f014eddd624fa5415b8.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001Evaluation of Serum Complement C3 and C4 Levels as biomarkers for Systemic Lupus Erythromatosus9609751623110.21608/ejhm.2012.16231ENFayez Muhammad ShaldoumDepartment of Zoology, Faculty of Science, University of El-Azhar, Cairo, EgyptYousra Refaey Abdo MohammedDepartment of Radiology, Faculty of Dental Medicine, University of El-Azhar, Cairo, EgyptNaglaa Mohamed El WakeelDepartment of Radiology, Faculty of Dental Medicine, University of El-Azhar, Cairo, EgyptAbeer Saad GawishDepartment of Radiology, Faculty of Dental Medicine, University of El-Azhar, Cairo, EgyptJournal Article20181009<strong>Background</strong>: Systemic Lupus Erthematosis (SLE) is a chronic autoimmune disorder that affects multiple organ systems and also affects the skin and oral mucosa, with the exact cause is unknown. Many hypotheses try to explain the role of the complement C3, C4 in the pathogenesis of SLE. The aim of this study is to determine levels of serum complement C3 and C4 in patient with SLE, so that we may explain its role in diagnosis and pathogenesis of the disease.
<strong>Methods</strong>: Twenty patients were informed from outcome patients of Dermatology Unit in El-Azhar University suffering from SLE. All the patients included in this study fulfilled 4 or more of the American Rheumatism Association classification Criteria for SLE. Blood samples from These 20 SLE patients (18 females and 2 males) aged from 20 to 45 years old were collected. Complement C3 and C4 were measured using radial immunodiffusion plates system technique. Clinical parameters such as Erythrocyte Sedimentation Rate (ESR), Total Protein (TPR), Serum Creatinine and Antinuclear Antibody (ANA) of those patients were considered in order to compare and explain the data obtained for the levels of C3 and C4. The data were collected and statistically analyzed.
<strong>Results</strong>: Most of patients were female 90% and only 10% male. Of all patients, 60% have low level of serum C4, 40% have normal level of serum C4, 25% have abnormal level of serum C3, and 75% have normal level of serum C3.Statistical analysis of the data on the correlation between C4, and disease activity revealed significant (<strong>P</strong><strong>></strong><strong> 0.05</strong>) correlation, however no significant correlation was found between C3 and disease activity. Analysis on the correlation between C3 and C4 with TPR, S. creatinne, and ESR, showed no significant correlation. No significant relationship was also found between C3 and C4.All patients have had high TPR, S. creatinne and ESR. All patients have had positive ANA which is an important marker of SLE as an auto immune disease.
<strong>Conclusions</strong>: Patients showed different degrees of oral and systemic manifestations, which exacerbate and become acute with decreased level of complement C4 and instability of C3 level. Accordingly, the low level of C4 was associated with the development and exacerbation of SLE. Increased C3 levels is solely due to activity through the alternative pathway in SLE patients
<strong> </strong>https://ejhm.journals.ekb.eg/article_16231_65ce1b1392a80ae9862d85c096f63d1d.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001دور سم النحل في تعديل التغيرات الوظيفية التي يحدثها تثبيط نشاط الغدة الدرقية المستحث بالکاربيمازول في الجرذان البيضاء الحوامل9769861623210.21608/ejhm.2012.16232ENهناء ابوجبلکلية العلوم والدراسات ا لإنسانية بالخرج ،جامعة سلمان بن عبد العزيزمها مؤمنهکلية العلوم ،قسم الأحياء ،جامعة الأميرة نوره بنت عبدالرحمنحنان المعلاکلية العلوم ،قسم الأحياء ،جامعة الأميرة نوره بنت عبدالرحمنJournal Article20181009 <strong>الهدف من البحث:</strong> استخدمت في هذه الدراسة الجرذان البيضاء من جنس <em>Wistar wistar</em> وکان عددها 60 من إناث الجرذان البيضاء الناضجةMature Female Albino Rats و30 من ذکور الجرذان البيضاء Male Albino Rats(من اجل التزاوج) ، ولقد تم التأکد من الحمل بإجراء المسحة المهبلية ، وتم تقسيم حيوانات التجارب إلى مجموعتين رئيسيتين : المجموعة الأولى وهي المجموعة التجريبية الضابطة حيث تم حقن الجرذان الحوامل لهذة المجموعة بالماء المقطر (المادة المذيبة لسم النحل وعقار الکاربيمازول) في التجويف البريتوني بمقدار 1 مل/200جم من وزن الجسم من اليوم الأول وحتى اليوم الثامن عشر من الحمل ، أما المجموعة الثانية فهي مجموعة الحيوانات المعاملة والتي قسمت إلى ثلاث مجموعات وهي المجموعة الأولي والمعاملة بعقار الکاربيمازول عن طريق الفم وهذه قسمت إلى مجموعتين مجموعة معاملة بجرعة 2 مجم/200 جم من وزن الجسم والأخرى بجرعة 3 مجم /200جم من وزن الجسم ، أما المجموعة الثانية من الحيوانات المعاملة هي المجموعة المعاملة بسم النحل في التجويف البريتوني بجرعة مقدارها 0.6 مجم/200جم من وزن الجسم في الأيام 2،3،4،7،8،9،10،11،12،15،16 ، أما المجموعة الثالثة فهي مجموعة العلاج والتي عوملت فيها الحيوانات بسم النحل بعد ساعة من الحقن بالکاربيمازول في الأيام المحددة کما هو موضح مسبقاً ، ولقد أوضحت نتائج الدراسات الوظيفية الخاصة بمکونات الدم في الأمهات الحوامل أن معاملة الأمهات الحوامل بالکاربيمازول بجرعتيه أدت إلى حدوث انخفاض ذو دلالة إحصائية ( 0.01>(p وکذلک ذو دلالة إحصائية( 0.001>p) في محتوى البروتين الکلي في المصل (على التوالي) وحدوث انخفاضذو دلالة إحصائية (0.001>p) في محتوى الألبيومين وکذلک مستوى هرموني T4&T3 في المصل مقارنة بالمجموعة الطبيعية، وظهر ارتفاع معنوي عالي جداً 0.001>p في محتوى الجلوبيولين في المصل وکذلک ظهر هذا الإرتفاع في معدل نشاط انزيمي ASAT&ALAT بالمقارنة مع المجموعة الطبيعية ، ولکن بعد العلاج بسم النحل حدث تحسن ملحوظ وواضح في المعايير الوظيفية السابقة .
https://ejhm.journals.ekb.eg/article_16232_778cf4ceef7c8ed6dcb76d2e55c699bd.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001Role of Protective Effect of L-Carnitine against Acute Acetaminophen Induced Hepatic Toxicity in Adult Albino Rats98710041623310.21608/ejhm.2012.16233ENZeinab M. GebalyHistology department, Faculty of Medicine (Girls branch),Gamal M. Aboul HassanAnatomy department, Faculty of Medicine (Assiut Branch) Alazhar UniversityJournal Article20181009<strong>Background:</strong> Acetaminophen, a widely used analgesic and antipyretic is known to cause hepatic injury in humans and experimental animals when administered in high doses. It was reported that toxic effects of acetaminophen are due to oxidative reactions that take place during its metabolism. L-carnitine is a cofactor in the transfer of long-chain fatty acid allowing to the beta-oxidation of fatty acid in the mitochondria. It is a known antioxidant with protective effects against lipid peroxidation. This study aimed to investigate the possible beneficial effect of L-carnitine as an antioxidant agent against acetaminophen induced hepatic toxicity in rats.<br /> <strong>Material and Methods:</strong> Four rat groups (N=7 in each group). Group I is the control, group II received 500 mg/kg/ body weight of L-carnitine for 7 days by oral route, group III received 640/kg/ bw of acetaminophen by oral route, group IV acute acetaminophen group pretreated with L-carnitine for 7 days by gastric tube gavage tube. The liver of all rats were removed for investigation using light and electro microscopic studies.<br /> <strong><em>Results</em></strong>: Acetaminophen caused massive centrilobular necrosis and massive degenerative changes. The electron-microscopic study showed few mitochondria, increased fat droplets and scanty smooth endoplasmic reticulum (SER), rough endoplasmic reticulum (RER).These changes were reduced by L-carnitine pretreatment.<br /> <strong><em> Conclusion</em></strong>: those results suggest that acetaminophen results damage in the liver as an acute effect and L-carnitine ameliorated the adverse effects of acetaminophen via its antioxidant role.<br /> <strong> </strong>https://ejhm.journals.ekb.eg/article_16233_0272f32bea26002aa8fc5e9e367a6efe.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001Histopathological changes in some organs of Japanese quail after different levels of jojoba meal100510251623410.21608/ejhm.2012.16234ENAbd El-Hakim , N.F.Anim. Prod. Depart., Faculty of Agric., Al-Azhar Univ.Abou-Khashaba, H.A.Poult. Nutrit. Res. Depart., Animal Prod. Res. Instit., Agri. Res. Center, Giza, EgyptEl-Sayed S. AtiaPoult. Nutrit. Res. Depart., Animal Prod. Res. Instit., Agri. Res. Center, Giza, EgyptJournal Article20181009<strong>Aim of the work</strong>-The present study was conducted to investigate the effect of different jojoba meal as a replace of soybean protein and to detect the histopathological changes in some organs of Japanese quail (one week old) for 5 weeks.<br /> <strong>Material and methods</strong>-The present study included two experiments, the first aimed to investigate the incorporation of treated jojoba meal seed (bentonite + autoclaving + fungus) in Japanese quail diets as replacer to soybean meal protein and to detect the histopathological changes in some organs of the Japanese quail .The treated jojoba meal was incorporated in the experimental diets to replace 0 (control); 4 (T<sub>1</sub>); 8 (T<sub>2</sub>) and 12% (T<sub>3</sub>) of soybean meal protein. The second experiment, dietary treatment included the control diet (The same control of experiment I) and groups 2 (UT<sub>1</sub>), 3(UT<sub>2</sub>), 4 (UT<sub>3</sub>), 5 (UT<sub>4</sub>), which were supplied with untreated jojoba meal at 0.0, 0.2, 0.4, 0.6 and 0.8% levels, respectively<br /> <strong> Results</strong>- Observations of the present study showed that liver of T<sub>2</sub> group revealed ruptured endothelial lining of the central vein, and T<sub>3</sub> group showed elongated walls of the bile ducts. Ileum of T<sub>2</sub> group showed highly thickened muscle layer and ileum of T<sub>3</sub> group showed distorted tissue. Kidney of T<sub>2</sub> group showed congested inters tubular spaces and T<sub>3</sub> group showed normal convoluted tubules with congested and dilated blood vessels. Testis of T<sub>2</sub> & T<sub>3</sub> groups showed hypocellularity of cells of the spermatognic layers with absence of mature sperms. Ovary of T<sub>3</sub> group showed somewhat normal mature ovum with reduced internal content.<br /> Results of experiment II showed that the liver tissue was normal.Ileum of birds of UT<sub>3</sub> and UT<sub>4</sub> groups showed somewhat normal appearance. Kidney of UT<sub>3</sub> group showed that some cells of the convoluted tubules were faintly stained with hemorrhagic areas. Testis of UT<sub>3</sub> and UT<sub>4</sub> groups showed decreased Leydig cells with absence of mature sperms and increased number of primary spermatocytes. Ovary of UT<sub>3</sub> group showed reduced stroma, and those of UT<sub>4</sub> showed highly reduced storma in the cortex and medulla of the ovary with malformed mature follicles and irregular membranes, but somewhat normal growing follicles.<br /> <strong>Conclusion-</strong>It isclear that 4 %(At the level 1.55) of the treated jojoba meal and 0.4 % untreated meal give the best results.<br /> <strong> </strong>https://ejhm.journals.ekb.eg/article_16234_fbddc455068f3b5edf15811f68141213.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200249120121001Study of Serum Adiponectin level in Obese and Non-obese Asthmatic Patients102610341623510.21608/ejhm.2012.16235ENMagdy Mohammad OmarChest Department - Faculty of Medicine Benha UniversityAhmad Abdelsadek MohammadChest Department - Faculty of Medicine Benha UniversitySahar M. AliMicrobiology and Immunology department , Faculty of Medicine ,Menufiya UniversityJournal Article20181009<strong>Background :</strong> Asthma is a worldwide problem, with an estimated 300 million affected individuals. Although central (visceral) adipocytes are the most important source ofadiponectin (APN), there is a tendency for reduced serumadiponectin concentration among obese subjects suggesting that decreased APN levels may contribute to the increased inflammatory state as in asthma.
<strong> Aim of the work: </strong>The aim of this work was to determine whether serum concentration of adiponectin changed in asthmatic patients during acute attack and in remission or not.
<strong>Subjects and Methods:</strong> Fifty five subjects were included in this study from Chest department, Benha university hospital .40 patients with bronchial asthma(20 obese and 20 nonobese) and 15 age related healthy subject(7 obese and 8 nonobese<strong>)</strong> as a control. All asthmatic patients and control group were divided into non-obese and obese according to their body mass index(BMI) Those with BMI < 25& >18.5 were considered non-obese, Those with BMI> 30 were considered obese .Those with BMI . 25 and. 30 were considered overweight and were not included in this study (NIH/NHLBI, 1998). All subjects were submitted to the following, Full history taking ,Complete physical examination(General & Local),Plain x-ray chest P-A & left lateral views ,Complete blood count , Erythrocyte sedimentation rate, Liver and kidney function tests, Fasting and post prandial blood sugar, Ventilatory function tests , Venous blood samples were taken for Adiponectin level measurement.
<strong>Results : </strong>Serum adiponectin(μg/ml) in obese control subjects (3.25 ± 0.65 μg/ml) was highly significant lower than that in nonobese control subjects(10.51 ± 1.55μg/ml), (P-value < 0.001). Also serum adiponectin revealed highly significant decrease in obese asthmatics during attack (1.58 ± 0.724 μg /ml) than in obese asthmatics during remission (2.08 ± 0.74 μg /ml) and that in obese control subjects (3.25 ± 0.65 μg /ml), (P-value < 0.001).Serum adiponectin(μg/ml) was significantly higher in nonobese asthmatics during remission (9.49 ± 2.49 μg /ml) than in nonobese asthmatics during attack (7.89 ± 2.7 μg /ml) and both was lower than that in nonobese control subjects , (p-value < 0.05 ).Serum adiponectin (μg /ml) was highly significant lower in obese asthmatics during attack (1.58 ±0.72 μg/ml) than in obese asthmatics during remission(2.08 ± 0.74 μg /ml), (P-value < 0.001) and highly significant higher in nonobese asthmatics during attack (7.89 ± 2.7 ìg/ml) than in nonobese asthmatics during remission (9.49 ± 2.49 μg /ml), (P-value < 0.001).
<strong>Conclusion: </strong>Serum adiponectin was significantly decreased in asthmatic patients (obese and nonobese) than control subjects also serum adiponectin level was significantly lower during attack than in remission.
<strong> </strong>https://ejhm.journals.ekb.eg/article_16235_b28a97f5380eca93e26e1ff6343ee2b9.pdf