Knowledge and Attitude Practice (KAP) of Rickets Disease among Mothers in KSA
Fahad Saleh
Alsuwat
Taif University
author
Nouf
Jafer Alzahrani
Taif University
author
Mohammed Ateih Awwad
Alsofyani
Taif University
author
Reem Mohammed
Alshamrani
King Abdulaziz University
author
Nadia Abaidullah
Ahmed
Imam Abdulrahman Bin Faisal University
author
Samia Mohammad
Babi
National Ribat University
author
Abdulrahman Talal
Qasim
Taif University
author
Emad Ruddah M.
Alsofyani
Taif University
author
text
article
2018
eng
Background: Rickets is one of the emerging diseases around the world and its records have been frequently increased among Saudi children. Objective: Our aim of the study was to discuss and improve the knowledge and the awareness of mothers in the Kingdom of Saudi Arabia about rickets disease and its environmental and nutritional risk factors. Methods: We conducted this cross-sectional retrospective Study at the maternal Children Hospital in Taif, Saudi Arabia. Data were collected using a pre-specified questionnaire after obtaining the patients consent. SPSS software was used to analyze the data. Results: We included 150 mothers with their children. There were 146 (97.3%) of the children with vitamin D deficiency. Conclusion: In Saudi Arabia, there is a need for campaigns that spread awareness among mothers and young adult females about the importance of vitamin D, diets containing adequate levels of it as well the risk factors that cause its deficiency.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
72
v.
6
no.
2018
4582
4585
https://ejhm.journals.ekb.eg/article_9784_d7fd8eaa9ae87a997e1faf241b438405.pdf
dx.doi.org/10.21608/ejhm.2018.9784
Vaginal Misoprostol for Cervical Priming Before Outpatient Hysteroscopy: A Randomized Controlled Trial
Anis Mansour Nagib
Younis
Department of Obstetrics and Gynecology, Faculty of Medicine, Ain shams University, Cairo, Egypt
author
Mohamed Ibrahim
Amer
Department of Obstetrics and Gynecology, Faculty of Medicine, Ain shams University, Cairo, Egypt
author
Malames
Faisal
Department of Obstetrics and Gynecology, Faculty of Medicine, Ain shams University, Cairo, Egypt
author
text
article
2018
eng
Background: Misoprostol has generally shown good efficacy in promoting cervical softness and facilitating hysteroscopic procedures. Objective: To evaluate the efficacy and safety of vaginal misoprostol for cervical priming before diagnostic outpatient hysteroscopy (OH) without anesthesia. Patients and Methods: Design: Double-blind randomized controlled trial. Setting: University teaching hospital. Patient(s): Ninety patients requiring diagnostic OH for investigation of infertility or abnormal uterine bleeding in the reproductive age. Intervention(s): Patients were randomly allocated into two equal groups (n= 45). In group I, 200 mcg misoprostol was inserted into the posterior vaginal fornix 3 hours before OH; in group II (control), 250 mg metronidazole as placebo was inserted into the posterior vaginal fornix by investigator. A rigid 30 4-mm hysteroscope was used in the vaginoscopic technique. Main Outcome Measure(s): Ease of cervical entry (Likert scale), procedural time, patient acceptability (Likert scale), and pain scoring (visual analog scale). Result(s): Vaginal misoprostol significantly facilitated the procedure; cervical entry was easier, procedural time was shorter, patient acceptability was higher, and pain scoring was lower in group I compared with group II. Side effects of misoprostol were infrequent, minor, and transient. No complications were reported. Conclusion(s): The regimen of 200 mcg vaginal misoprostol administered 3 hours before diagnostic OH is a simple, effective, and safe method of cervical priming to facilitate the procedure without anesthesia.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
72
v.
6
no.
2018
4586
4592
https://ejhm.journals.ekb.eg/article_9785_5f270fa54bade4f67ba4f5e2827b67cb.pdf
dx.doi.org/10.21608/ejhm.2018.9785
Primary Parotid Gland Sarcoidosis - Case Report
Kholood S
Assiri
The Department of ORL-HNS, Khamis Mushayt General Hospital, Aseer, Kingdom of Saudi Arabia
author
Mohammad S.
Al-Ahmari
The Department of ORL-HNS, Khamis Mushayt General Hospital, Aseer, Kingdom of Saudi Arabia
author
text
article
2018
eng
Background: Sarcoidosisis rare disorder worldwide and in Saudi Arabia. Extrapulmonary involvement are noticed as primary presentation seen in patients with sarcoidosis and can present at the same time as pulmonary sarcoidosis. Methods: A notolaryngology view of case report following a 44-year-old female presented with right painless parotid swelling for four months who was managed in Otolaryngology-Head and Neck Surgery (ORL-HNS) Clinic of Khamis Mushayt General Hospital and referred to rheumatology for evaluation and management and follow up for one year who completely cured. Conclusion: Primary parotid sarcoidosis is an uncommon disease. The diagnosis has been obtained from the surgical excision of the lesion.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
72
v.
6
no.
2018
4593
4595
https://ejhm.journals.ekb.eg/article_9786_47d135407e4443e764235eaec5d3e3e8.pdf
dx.doi.org/10.21608/ejhm.2018.9786
Fetomaternal Outcome in Severe Preeclamptic Women Undergoing Emergency Cesarean Section with Spinal or General Anesthesia
Mohamed Anwar Mohamed
Oreef
Department of Obstetrics & Gynecology, Faculty of Medicine, Al- Azhar University
author
Tarek Mohamed
Ramadan
Department of Obstetrics & Gynecology, Faculty of Medicine, Al- Azhar University
author
Adel Aly
Elboghdady
Department of Obstetrics & Gynecology, Faculty of Medicine, Al- Azhar University
author
text
article
2018
eng
Background: Preeclampsia (PE) is a hypertensive disease specific to pregnancy and it complicates 5–10 % of all pregnancies and it is a major cause of maternal, fetal, and neonatal morbidity and mortality worldwide. Preeclampsia is defined as new-onset hypertension (systolic blood pressure 140 mm Hg or diastolic blood pressure 90 mm Hg) and new-onset proteinuria after 20 weeks of gestation in previously normotensive patients. Objective: The aim of this work is to show the fetomaternal outcome of severe preeclampsia in women undergoing emergency cesarean section with either spinal or general anesthesia. Which better? Patients and Methods: This study was conducted at El Sayed Galal and El Hussein University Hospitals. 180 pregnant women with severe preeclampsia admitted to the operating room for emergency cesarean section were included and divided into 2 groups: Group I: 150 patients underwent cesarean section under spinal anesthesia. Group II: 30 patients underwent cesarean section under general anesthesia. This study was prospective observational study. The patients fulfilled our inclusion criteria and signed a well informed consent to declare their agreement to be in this study as agreed upon by the ethical committee. Results: The mean values of DBP were significantly higher in group II than in group I (p <0.05). The incidence of maternal complications was significantly higher in group II more than group I, especially in vomiting, high blood pressure and convulsion (p <0.05). There was a significant increase in neonatal weight in group I more than group II (p <0.05). Regarding preterm, there was a significant increase in preterm cases in group II (60%) more than group I (38%) (p <0.05). Regarding APGAR score at 1 and 5 min, it was found that there was a significant increase in APGAR score in group I more than group II at both 1 minute and 5 minutes (p <0.05). The mean values of neonatal heart rate were significantly higher in group II than in group I (p <0.05). The mean values of neonatal respiratory rate were significantly higher in group I than in group II (p <0.05). Regarding breast feeding after cesarean section (hrs.), there was a significant increase in the duration after cesarean section till the breast feeding in group II more than group I (p < 0.05). Regarding neonatal mortality, there was a significant increase in mortality in group II (16.7%) more than group I (2.7%), (p <0.05). Conclusion: This means that spinal anesthesia is a safer alternative to general anesthesia in severe preeclampsia with less postoperative morbidity and mortality regarding both mothers and babies. These findings agreed with many previous studies worldwide.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
72
v.
6
no.
2018
4596
4601
https://ejhm.journals.ekb.eg/article_9787_53ac31fec0099dfeec3a24dbfed0b262.pdf
dx.doi.org/10.21608/ejhm.2018.9787
Prevalence of Access Recirculation in Prevalent Arterio-Venous (A-V) Fistula Hemodialysis Patients and Its Effect on Hemodialysis Adequacy
Michael Mamdouh
Fakhry
Internal Medicine Department, Ain Shams University
author
Lina
Khedr
Internal Medicine Department, Ain Shams University
author
Essam
Nour El Din
Internal Medicine Department, Ain Shams University
author
text
article
2018
eng
Background: Assessment of access recirculation (AR) is crucial to dialysis efficiency and there is thus a need for a method yielding a highly accurate, fast, easy and economical measurement that can be applied in any dialysis clinic. Non-urea based dilutional methods are more accurate than urea based methods and avoid problems with cardiopulmonary recirculation, but they require expensive specialized devices, which limit their applicability. Patients and Methods: We used simple dilutional method of AR based on the determination of serum potassium [K+] in two samples. A prospective study was performed in a Dialysis Unit at El Sahel Teaching hospital, Cairo, on End stage kidney disease patients on regular Hemodialysis through a functioning Arterio-venous fistula. Results: Access recirculation was found in 42% of studied patients. There were Highly Significant positive correlation between access recirculation, pre / post dialysis blood urea, basal k, and parathyroid hormone level. In addition, there were highly significant negative correlation between AR, Urea reduction ratio and KT/V. Conclusion and Recommendations: Potassium dilution method is one of the most simple, specific, and economical way to measure access recirculation and can easily be performed in any dialysis unit. We recommend more research should be done about hemodialysis adequacy, access recirculation and how to improve it.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
72
v.
6
no.
2018
4602
4609
https://ejhm.journals.ekb.eg/article_9788_6ddf345faf9dd6327e33c91b20826739.pdf
dx.doi.org/10.21608/ejhm.2018.9788
Effect of Psidium guajava leaf extract, glibenclamide and their combination on rat model of diabetes induced by streptozotocin
Shadia Ali
Radwan
Department of Biological and Geological Sciences, Faculty of Education, Ain Shams University
author
Omnia Nasr Abdelrhman
Mohamed
Department of Biological and Geological Sciences, Faculty of Education, Ain Shams University
author
Yasser A.
Khadrawy
Department of Medical Physiology, Medical Division, National Research Center
author
Gamal Abdel-Aty
Hafez
Department of pathology, Faculty of medicine- Suez Canal University
author
text
article
2018
eng
Aim: The present aim is to evaluate the anti-diabetic effect of aqueous extract of guava (Psidium guajava) leaf using rat model of diabetes induced by streptozotocin. In addition, the effect of this extract on liver and kidney functions induced in rat model of diabetes were investigated. Material and Methods: Rats were divided randomly into: control group, rat model of diabetes induced by streptozotocin, rat model of diabetes treated with aqueous extract of guava leaf, rat model of diabetes treated with glibenclamide and rat model of diabetes treated with aqueous extract of guava leaf plus glibenclamide. Result: In the present rat model of diabetes a significant decrease in the serum insulin level and a significant increase in glucose level were detected. Streptozotocin induced a significant increase in the activities of AST, ALT, ALP and a significant increase in the levels of bilirubin, urea, creatinine and uric acid. In addition histopathological and immunological changes were detected in the pancreatic tissue. The present data revealed that aqueous extract of guava leaf improved the reduced insulin level and the high glucose level induced by streptozotocin. This was associated with an improvement in the changes in the liver and kidney functions. Loss of body weight gain induced by streptozotocin was alleviated by guava leaf extract, glibenclamide or both. Conclusion: According to the present findings it could be concluded that the aqueous extract of guava leaf has a potent anti-hyperglycemic effect on rat model of diabetes induced by streptozotocin with hepatic and renal protective effects.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
72
v.
6
no.
2018
4610
4619
https://ejhm.journals.ekb.eg/article_9789_5aacc37806c1765063776c9c1aa4508a.pdf
dx.doi.org/10.21608/ejhm.2018.9789
Comparative Study between Cervical Laminectomy and Cervical Laminectomy with Fixation on Clinical Outcome and Spine Stability in Patients with Degenerative Cervical Myelopathy
Adel Nabeeh Mohamed
Abdalla
Department of Neurosurgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt
author
Mohamed Wael
Sameer
Department of Neurosurgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt
author
Amr Mohamed
Nageeb El-Shehaby
Department of Neurosurgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt
author
Mohamed
Abdalla El-Werdany
Department of Neurosurgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt
author
Mohammed Abdelaty Mohamed
Abdalla
Department of Neurosurgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt
author
text
article
2018
eng
Background: Degenerative Cervical Myelopathy (DCM) is an age-related disease of the cervical spine and represents one of the most common causes of spinal cord dysfunction. Surgical intervention is the cornerstone of management in symptomatic cases,but the approach of choice is always debatable. Purpose: Was to compare between mutltilevel cervical laminectomy,and multilevel cervical laminectomy with lateral mass fixation in patients with cervical spondylotic myelopathy regarding the functional clinical outcome and cervical spine normal sagittal alignment. Patients and Methods: This work is a prospective study of two groups of randomly selected patients. The first group (n= 20) underwent cervical laminectomy while the second group (n=18) underwent cervical laminectomy with lateral mass fixation. Patients were followed up for 12 months duration using functional modified Japanese orthopedic association (mJAO)score, andmeasurement of C2-C7 cobb`s angle to evaluate post-operative cervical sagittal alignment. Results: Results revealed that both approaches have better post-operative functional outcome with no significant changes on the normal cervical lordosis. Results alsoshowed no statistically significant difference in clinical outcome between the 2 groups after one year follow up. Conclusion: Both simple multilevel posterior cervical laminectomy and posterior cervical laminectomy with lateral mass fixation are associated with improvement in the functional outcome in CSM patients with no changes in normal cervical lordotic sagittal alignment in at least 12 months follow up duration.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
72
v.
6
no.
2018
4620
4624
https://ejhm.journals.ekb.eg/article_9790_5760cb9fc59df2bf3ae30a22ff33c6d8.pdf
dx.doi.org/10.21608/ejhm.2018.9790
The Prevalence of Iron Deficiency Anemia and its Associated Risk Factors among a Sample of Females in Riyadh, Saudi Arabia
Abdullah Mansour
Alswailem
Almareefa colleges
author
Sulaiman Mohammed
Alahmad
Almareefa colleges
author
Muath Ali
Alshehri
Almareefa colleges
author
text
article
2018
eng
Objectives: To assess the prevalence of iron deficient anemia (IDA) within Saudi Arabian females and to examine the risk factors leading to the IDA. Methods: A cross-sectional study on 683 healthy females aged between 18 and 40 years was performed within April 2016. Data on the participants’ socio-demographics, diet, health, anthropometry, and hematological and biochemical iron status indices were gathered. Univariate and multivariate logistic regression analysis were used in order to reveal the IDA risk factors. Results: A total of 683 non-pregnant women aged between 18-40 years were included in the analysis. The prevalence of IDA was 41.6%. In the multivariate regression analysis; inadequate iron and vitamin C intakes, infrequent (≤2 times per week) consumption of red meat and fish, menstruation disorder eg: (Twice or more per month), (more than 8 days), (blood clotting and heavy blood flow),blood disorder and previous blood transfusion, past personal history of IDA and familial history of IDA were significantly associated with increased odds of IDA. Conclusion: To reduce IDA in Saudi Arabian women, the country needs a multifaceted approach that incorporates iron supplementation, food fortification, rich dietary iron sources and by raising awareness of the food and drinks which facilitate or hinder the bioavailability of iron.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
72
v.
6
no.
2018
4625
4629
https://ejhm.journals.ekb.eg/article_9791_fedc404797383e6ae16c9e9928f6737c.pdf
dx.doi.org/10.21608/ejhm.2018.9791
Prognostic Impact of Factor V Leiden in Systemic Lupus Erythematosus Pediatric Patients
Noha S.A.
Abdelhalim
Department of Clinical Pathology, Ain Shams University
author
Sahar S.
Abd Elmaksoud
Department of Clinical Pathology, Ain Shams University
author
Doaa A.G.
Eissa
Department of Clinical Pathology, Ain Shams University
author
Hanan M.
AbdEl Lateef
Department of Pediatric Immunology, Ain Shams University
author
text
article
2018
eng
Objective: This research aimed to study the presence of factor V gene G1691A mutation (Factor V Leiden) in SLE pediatric patients with and without complications and to investigate the association between the presence of Factor V Leiden and lupus complications mainly lupus nephiritis in these patients. Subjects and Methods: This study was conducted on 50 Egyptian pediatric patients (48 females and 2 males) who were all diagnosed as SLE according to the American College of Rheumatology criteria. They were enrolled from the Immunological Clinics at Ain shams University Pediatric Hospital and were divided into two groups: Group 1 (control group) of matched age and sex: Including 25 newly diagnosed uncomplicated SLE patients e.g.: arthritis, musculoskeletal and cutaneous lupus. Group 2 (patients group): Including 25 SLE complicated patient e.g.: nephritis, neurolupus, thrombotic manifestation, cardities and antiphospholipid antibody syndrome. The complications observed in patient group was further classified into lupus nephritis alone or lupus nephritis with other complications (21 patients) or patients with complications other than lupus nephritis (4 patients). Results: All patients included in this study were subjected after taking their parents' consent to full history taking laying stress on history of complications mainly lupus nephritis. In addition, laboratory investigations which include CBC, tests for confirmation of SLE as ANA, anti dsDNA, C3, lupus anticoagulant, anticardiolipin IgG and IgM and renal function tests as serum creatinine and 24hrs urinary proteinsm were done. The Factor V gene mutation was determined by the method of PCR-based DNA analysis in both control and patient groups. In control group, there was 1 out of 25 patients having the Factor V Leiden mutation; who had a heterozygous pattern. The prevalence of Factor V Leiden in patients group showed 2 out of 25 patients, both of them had a heterozygous pattern of the gene mutation. Conclusion: This study couldn't demonstrate any correlation between the presence of Factor V Leiden mutation and the presence of complications in SLE patients as there was no statistical significant difference (P >0.05).
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
72
v.
6
no.
2018
4630
4636
https://ejhm.journals.ekb.eg/article_9792_6f8961cd4bce97d67d62c592b4bd768f.pdf
dx.doi.org/10.21608/ejhm.2018.9792
Molecular Detection of Human Herpes Viruses 1, 2, 3 and 6 in the Cerebrospinal Fluid of Patients with Central Nervous System Infections
Magda Salah El Dine
Gabr
Clinical Pathology Department – Faculty of medicine – Ain Shams University
author
Nevine Nabil
Kassem
Clinical Pathology Department – Faculty of medicine – Ain Shams University
author
Samia Abdou
Girgis
Clinical Pathology Department – Faculty of medicine – Ain Shams University
author
Rania Mohamed
Abd-El Halim
Clinical Pathology Department – Faculty of medicine – Ain Shams University
author
Yasmeen Mohammad Mahmood
Ali
Clinical Pathology Department – Faculty of medicine – Ain Shams University
author
text
article
2018
eng
Background: Infections of central nervous system (CNS), such as encephalitis, meningitis, and meningoencephalitis are potentially life-threatening syndromes. They are caused by a diverse array of infectious causes. Despite being relatively uncommon, the morbidity, mortality, and costs are substantial. Of major importance are the herpes simplex virus (HSV)-2 and varicella zoster virus (VZV) in meningitis, and HSV-1 in encephalitis. Human herpes virus 6 (HHV-6) infection can induce severe encephalitis cases, particularly in immunocompromised. Human herpes viruses (HHVs) can cause CNS disease following primary infection, reactivation or recurrence. Purpose: To estimate the frequency of four common neurotropic herpes viruses: HHV-1 (HSV-1), HHV-2 (HSV-2), HHV-3 (VZV) and HHV-6 as causative agents for viral encephalitis and aseptic meningitis. Patients and Methods: The study was conducted on sixty five (65) CSF samples selected from the CSF of patients clinically diagnosed with acute encephalitis or meningitis. The samples belonged to 39(60.0%) males and 26(40.0%) females. Their ages ranged from 12 days to 62 years old. All CSF samples included in the study were subjected to white cell count, estimation of the level of protein and glucose, direct macroscopic and microscopic examination and culture on blood, chocolate and MacConkey agar plates. All samples had a CSF leukocytic count ≥ 5 cells/ mm3 and all were negative for bacterial culture. Real time PCR for the following viruses: HHV-1 (HSV-1), HHV-2 (HSV-2), HHV-3 (VZV) and HHV-6 was done for each sample. Results: The results of the PCR showed that twenty six (40%) were positive: twenty two (34%) were positive for a single infection; HSV-1 was positive in seven (10.8%), HSV-2 in eight (12.3%), VZV in one (1.5%) and HHV-6 in six (9.2%) of the cases. Four (6.2%) samples showed co-infection with two viruses. VZV was common in all cases of co-infection, together with HSV-2 in two (3%), HSV-1 in one (1.5%) and HHV-6 in one (1.5%). Thirty nine cases (60.0%) were negative for the four viruses. Conclusion: The four herpes viruses (HSV-1, HSV-2, VZV and HHV-6) tested by PCR are causative agents in 40% of the tested cases of CNS infections. The most frequently detected virus by PCR was HSV-2 followed by HSV-1. In case of encephalitis, the most frequently detected virus was HSV-1, while HSV-2 was the most frequent in case of aseptic meningitis. VZV was common in all cases of co-infections.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
72
v.
6
no.
2018
4637
4643
https://ejhm.journals.ekb.eg/article_9793_bebc797d2ca6d125ffac5f701816993b.pdf
dx.doi.org/10.21608/ejhm.2018.9793
Randomized controlled trial comparing pregnancy outcome using artificial versus letrozole stimulated cycle in cryo preserved embryo transfer
Ahmed S.
Tahoon
Department of Obstetrics and Gynecology, Faculty of Medicine, Al Azhar University
author
Hassan A.
Abdrabo
Department of Obstetrics and Gynecology, Faculty of Medicine, Al Azhar University
author
Mohammed K.
Mustafa
Department of Obstetrics and Gynecology, Faculty of Medicine, Al Azhar University
author
text
article
2018
eng
Background: Intracytoplasmic sperm injection (ICSI) is a procedure performed in the IVF embryo laboratory after the eggs have been retrieved from the ovaries and involves placing a single sperm directly inside the egg. It is indicated for cases which involve very low sperm counts or motility. Aim of the Work: To compare the outcome of pregnancy using artificial and letrozol stimulated cycle in cryo preserved embryo transfer. Patients and Methods: This randomized controlled trial was conducted on 190 patients attending the clinic submitted for embryo transfer of cryo embryos. All cycles were performed at international Islamic Center for population Studies and Research Assisted Reproduction Unit (ART unit IICPSR) at Al-Azhar University and evidence based centers. Results: Pregnancy rate was significantly higher in letrozole (53.2%) compared to the artificial group (40.6%). Furthermore, first trimester abortion rate was non-significantly lower in letrozole group. Conclusion: ovulation induction with letrozole during endometrial preparation for cryopreserved ET has a significantly higher ongoing pregnancy rate than artificial cycle. The reported ongoing pregnancy rate in letrozole arm was encouraging and may provide an alternative mean to artificial cycles in endometrial preparation in FET.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
72
v.
6
no.
2018
4644
4649
https://ejhm.journals.ekb.eg/article_9794_1d3c19b224a38dcffde7c9fbaf58b99c.pdf
dx.doi.org/10.21608/ejhm.2018.9794
Role of Automated Breast Ultrasound System (ABUS) as Screening Tool in Comparison To Mammogram in Detect of Different Breast Lesions
Marwan A.
Mohammed
Department of Radiodiagnosis, Faculty of Medicine, Ain Shams University
author
Hanan M.
Arafa
Department of Radiodiagnosis, Faculty of Medicine, Ain Shams University
author
Ahmed M.
Bassiouny
Department of Radiodiagnosis, Faculty of Medicine, Ain Shams University
author
text
article
2018
eng
Background: Mammography is an effective randomized controlled trial-proven method for reducing mortality due to breast cancer. However, the sensitivity of mammography depends on breast density. The current supplemental screening options include breast ultrasonography (US) and magnetic resonance imaging (MRI). Automated breast ultrasound system (ABUS) is an option proposed to overcome the time-consuming and costly nature of handheld, physician-performed whole-breast US (WBUS). Objectives: To evaluate the utility of automated breast ultrasound system (ABUS) in detection of different breast lesions especially in dense breast in comparison to mammogram. Patients and Method: It is prospective study included 25 women outreached for digital mammography or handheld ultrasound examination at the general Egyptian hospitals. Women have no specific age group. Results: The use of ABUS with the mammogram shows significant increased frequency of detection of positive benign lesions in ACR class C and D in comparison to class A and B and insignificance malignant lesions detection. Conclusion: ABUS reflects a promising modality in breast imaging however appears to be on a par with mammogram in terms of diagnostic quality.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
72
v.
6
no.
2018
4650
4653
https://ejhm.journals.ekb.eg/article_9795_9f1714a1d55948858ecb8dffc3698ab7.pdf
dx.doi.org/10.21608/ejhm.2018.9795
Orthopedic Injuries in Poly- Traumatized Patients in Age Group of 15-45 Years
Ahmad Saladdin
Sultan
Emergency Medicine, Scientific Council of Emergency Medicine
author
Muddather AA.
Mohammed
Emergency Medicine, Scientific Council of Emergency Medicine
author
Omar MS.
Younus
Emergency Medicine, Scientific Council of Emergency Medicine
author
text
article
2018
eng
Background: Orthopedic injuries in polytraumatised patient are common and affect the management in such patients. Aim of the Work: The purpose of this study was to assess the pattern and nature of orthopedic injuries in polytraumatised patient who sustain different mechanism of injury and to analyze the management of these injuries in the E.D. It is a descriptive study carried out at E.D. of Al-Jamhory teaching hospital. Patients and Methods: The study included all polytraumatised patient aged 15-45 years admitted to the E.D. OF Al-Jamhory teaching hospital after being injured in different mechanism of injury (MCV, FFH, Bullet injury, ... etc). Management carried out according to ATLS and to specific patient needs, 64 patient included in this study by using a special form for the study, patients ages were ranging from 15-45 years with subdivided to subgroups (15-25), (26-35), (36-45) and studied separately from the mechanism of injury and injured part of the body point of view. Results: Total number of causalities was 64 their mean age was 20 years, out of them 59 were male and 5 females, the most mechanism of injury were MVC 32(50%), transportation time was with average of 30 minutes, upper limbs affected equally to lower limbs, closed orthopedic injuries were common than open injuries, head injuries were noted to be the bulk associated injuries with the most serious and fatal outcome. Conclusions: Orthopedic injuries have a major impact on the management of polytraumatized patients. Males were the active sex group in our society and had much more affected in polytrauma than females with the main mechanism of injury of MVC.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
72
v.
6
no.
2018
4654
4659
https://ejhm.journals.ekb.eg/article_9796_99dde211978aa61b6b7f02b993a1c640.pdf
dx.doi.org/10.21608/ejhm.2018.9796
Association between Potentially Inappropriate Prescription (PIP) and Health Outcome Among Geriatric Home Residents
Alaa I.
Saeed
Department of Geriatrics and Gerontology, Faculty of Medicine, Ain Shams University
author
Moatassem S.
Amer
Department of Geriatrics and Gerontology, Faculty of Medicine, Ain Shams University
author
Rania M.
Elakkad
Department of Geriatrics and Gerontology, Faculty of Medicine, Ain Shams University
author
text
article
2018
eng
Background: Appropriate prescribing of medications in elderly especially with advancing age is a major clinical and economic issue. Therefore, health care and appropriate use of medications with advancing age is one of the major challenges facing health care systems. Potentially inappropriate prescriptions (PIP) are defined by the presence of a risk of prescribed drugs that overweighs their benefit. Especially, when there are safer alternatives and include misuse of medications, prescription of drugs with significant drug–drug or drug– disease interactions and the negligence of beneficial medications. Aim of the Study: To assess the association between potentially inappropriate prescription and health outcome among a sample of Egyptian elderly patients in geriatric homes in Cairo. Methods: A cross-sectional study. A random sample of 120 geriatric home residents in Cairo. Demographic data were collected and comprehensive geriatric assessment was done for each participant including history taking, clinical examination, psychological, mental, functional, risk of falls and nutritional assessment. Assessment of potentially inappropriate prescription using STOPP criteria. Results: The present study showed that among the 120 participants; the prevalence of PIP using STOPP criteria was 27(22.5%) of them were taking one or more PIP, 24 (20%) were taking one PIP and 3 (2.5%) were taking 2 PIP, 12 (44.4%) of the studied participants having visual impairment were using PIP regarding STOPP criteria; 7 (25.9%) of the studied participants having hearing impairment were using PIP as detected by STOPP criteria, so there was significant relation between PIP and patients who had visual and hearing impairments, there was a significant relation between PIP among the studied group using STOPP criteria regarding functional assessment (Instrumental activity of daily living (IADL) with p-value equal (0.031), and there was no significant relation with cognitive, psychological, risk of falls and nutritional assessment and there was no significant relation with other health outcome. Conclusion: Potentially inappropriate prescription using STOPP criteria was found to be statistically significant with hearing, visual impairment and regarding functional assessment (IADL) only. No significant association with other health outcome.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
72
v.
6
no.
2018
4660
4665
https://ejhm.journals.ekb.eg/article_9797_e3e2787fa174bd522c33db6a1793c3d6.pdf
dx.doi.org/10.21608/ejhm.2018.9797
The Effect Of Eicosapentanoic Acid Administration On Clinical Outcome Of Patients With Major Depression: A Pilot Study
El Baz
A.H.
Department of Clinical Pharmacy, Faculty of pharmacy,Ahram Canadian University
author
Zaki
M.A
Department of Clinical Pharmacy, Faculty of pharmacy,Ahram Canadian University
author
El Wakeel
L.M.
Department of Clinical Pharmacy, Faculty of Pharmacy, Ain Shams University
author
El-Shafie
T. M
Department of Psychiatry, Faculty of Medicine, Al Azhar University
author
text
article
2018
eng
Background: Major depressive disorder (MDD) is a common brain disorder that affects approximately 10% of the world population and leads to significant disability. The current study was aimed to evaluate the impact of Omega3 PUFAs administration on the clinical outcome of patients with depression. Patients and Methods: This prospective, randomized controlled study included a total of Forty-two patients who diagnosed with depression according to a strict inclusion and exclusion criteria, attending at the outpatient clinics of the Department of Psychiatry, Al-Zahraa University Hospital, Cairo, Egypt. Approval of the Ethical Research Committee of Faculty of Pharmacy, Ain Shams University (registration number 61), and a written informed consent from all the subjects were obtained. This study was conducted between February 2015 till August 2016. patients were randomly assigned to either; Group1; (intervention n=21); received the prescribed antidepressant + omega3 (2100mg) for 8 weeks, or Group 2; (control, n=21); received the prescribed antidepressant only for 8 weeks. Baseline evaluation and 8-week assessment included; patient demographic- data collection, history taking and clinical assessment of DSM-5 criteria & HAM-D score. Laboratory assessment included; complete blood picture (CBC), prothrombin time (PT), activated partial thromboplastin time (aPTT). Patients were followed up regularly every 2 weeks for 8 weeks for the occurrence of side effects due to antidepressants/ Omega 3 and compliance with medications. Results: The 2 groups were comparable at baseline. The test group showed a significant improvement in the HAMD score from baseline values and versus the control. There was no significant difference in the reported side effects between the 2 groups. Conclusion: Omega -3 PUFAs administration at a dose of 2100 (EPA1350 mg/ , DHA 600 mg/ 150 mg other omega 3 FA) for 8 weeks, improved depression symptoms and was well tolerated.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
72
v.
6
no.
2018
4666
4672
https://ejhm.journals.ekb.eg/article_9798_865acc0ad9cd8d1170804ea9bdd66401.pdf
dx.doi.org/10.21608/ejhm.2018.9798
A Study of Endometrial Perfusion in Unexplained Infertility
Ahmad Mohammed Nour-Eldin
Hashad
Obstetrics & Gynecology Department, Ain Shams University
author
Heba Abdel Naby Kamal
Elkholy
Cairo University
author
Mohamed Kamal
Etman
Ultrasound Special Care Unit for the Fetus
author
Ibrahim Mohamed
Ibrahim
Obstetrics & Gynecology Department, Ain Shams University
author
text
article
2018
eng
Background: Infertility in itself represents a wide spectrum of disorders explaining the inability to conceive. Series of investigations are required to depict the potential cause of infertility, yet there exist a small percentage (10 -25%) of couples in which no obvious cause is delineated. these groups of patients are classified as ‘unexplained infertility. The endometrium has dynamic features: cyclical growth, desquamation and regeneration. Its main function is to provide the possibility of the time-limited support of implantation of the embryo for further development. Most part of the menstrual cycle, the endometrium is resistant to the embryo but acquires special receptive properties in a limited space and time interval of the luteal phase, known as the ‘‘implantation window’’. Aim: The aim of this study was to evaluate the uterine perfusion, particularly the endometrial blood flow in women with unexplained infertility. Methodology: The patients recruited from women presenting to the outpatient clinic at Ain Shams University Maternity Hospital seeking fertility compared to other fertile group coming to hospital with non specific gynecological problems or for routine checkup at the same period. The study conducted on two groups of women: Group1(study group) 40 women with unexplained infertility, Group 2 (control group) 20 fertile women who had normal physical and pelvic examination, regular menstrual cycles, didn't have intrauterine device or oral contraceptive, and gave a birth year ago. Results: As regard the mean, the resistance index in the study group was 0.69 ranged from 0.39 to 0.96, while the resistance index in the control group was 0.61 ranged from 0.58 to 0. 73 and the difference between both groups was statistically significant pulsatility index in the study group was 1.3 ranged from 0.51 to 1.99 while the pulsatility index in the control group was 1.16 ranged from 0.88 to 1.7 and this difference between both groups was statistically significant. From the results of our study we could say that uterine perfusion, particularly the endometrial blood flow in women with unexplained infertility different from that in fertile women. Recommendation: We recommend further study on large numbers of women and the possible role of perfusion enhancer's drugs in improving utero-ovarian circulation as a treatment of unexplained infertility.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
72
v.
6
no.
2018
4673
4680
https://ejhm.journals.ekb.eg/article_9839_6422334af916755c0f2c680735af3770.pdf
dx.doi.org/10.21608/ejhm.2018.9839
Measurement of knee cartilage thickness in young adults by musculoskeletal ultrasound in relation to serum vitamin D level
Khaled O.
Zaiton
Department of Physical medicine & Rheumatology and Rehabilitation, AL-Ahrar educational hospital, Zagazig, Egypt
author
Ashraf I.
Khalifa
Department of Physical medicine & Rheumatology and Rehabilitation
author
Mohamed M.
Abdelkreem
Department of Physical medicine & Rheumatology and Rehabilitation
author
Mohamed A.
Hashesh
Department of clinical pathology, Faculty of Medicine, Al-Azhar University, Cairo
author
text
article
2018
eng
Background: Osteoarthritis (OA) is a degenerative joint disease involving the cartilage and many of it's surrounding tissues. In addition to damage and loss of articular cartilage, there is remodeling of subarticular bone, osteophyte formation, ligamentous laxity, weakening of periarticular muscles and in some cases, synovial inflammation.Musculoskeletal Ultrasound (MSUS) is a newer imaging technique in musculoskeletal system for diagnosis and monitoring of treatment. A potential association between serum vitamin D levels and knee OA symptoms may occur through effect on cartilage metabolism, bone metabolism or both. Aim of the Work: This study was done tomeasure of knee cartilage thickness in young adults by musculoskeletal ultrasound in relation to serum 25(OH) vitamin D level. Patients and Methods: This study was carried on 75 individuals chosen from out-patient's clinics of physical medicine and rheumatology department at AL-Hussein hospitals of AL-Azhar University after their agreement to inform a consent for this research. They are divided into 2 groups: Group (1) includes 50 patients suffering of knee pain, their age ranged from 20-35 years with a mean of 29.5± 4.4, 43 females and 7 males. Group (2) includes 25 apparent healthy volunteers matched for age and sex as group 1. Results: Musculoskeletal Ultrasonography is a very important tool in detection of early OA in patients with vitamin D deficiency and Comparison between MRI and musculoskeletal ultrasound showed high concordance in the findings of cartilage changes of early OA patients. Conclusion: Vitamin D deficiency and insufficiency is correlated with thinning of femoral cartilage thickness and higher risk of early knee OA.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
72
v.
6
no.
2018
4681
4685
https://ejhm.journals.ekb.eg/article_9840_8eb72fdc6361c9285596df9ea430a145.pdf
dx.doi.org/10.21608/ejhm.2018.9840
Clinical Significance of Lymphoid Enhancer-Binding Factor 1 (LEF-1) Expression in Acute Myeloid Leukemia
Nahela Ahmed
Shalaby
Department of Clinical Pathology Faculty of Medicine, Ain Shams University, Cairo, Egypt
author
Doaa Ahmed Gamal
Eissa
Department of Clinical Pathology Faculty of Medicine, Ain Shams University, Cairo, Egypt
author
Botheina Ahmed Thabet
Farweez
Department of Clinical Pathology Faculty of Medicine, Ain Shams University, Cairo, Egypt
author
Shaimaa Abdelmalik
Pessar
Department of Clinical Pathology Faculty of Medicine, Ain Shams University, Cairo, Egypt
author
Raghda El Sayed Abdel Monem
Galal
Department of Clinical Pathology Faculty of Medicine, Ain Shams University, Cairo, Egypt
author
text
article
2018
eng
Background: Lymphoid enhancer-binding factor-1 (LEF1) is a member of the LEF/T-cell factor family of transcription factors and a key mediator of the Wingless-type (Wnt) pathway. It mediates Wnt signals through recruiting β-catenin and its co-activators to Wnt response elements of target genes. It plays crucial roles in normal hematopoiesis, not only in the development of B and T lymphocytes but also in granulopoiesis. Objectives: The aim of this study was to evaluate of LEF1 expression levels in patients with AML and correlate this expression with clinical data. Methodology: The present study was conducted on 30 de novo adult AML patients and 10 age and sex-matched controls with non-malignant hematological disorders (e.g.: hypersplenism, megaloblastic anemia, immune thrombocytopenic purpura) who attended Hematology/Oncology unit of Ain-Shams University Hospitals during the period from May 2017 till January 2018, after taking the approval of the Scientific and Ethical Committee of Ain- Shams University. LEF1 expression levels were measured by quantitative real-time PCR. Results: The present study showed that there was highly statistically significant association between patients and control group in LEF1 expression level. There was positive significant correlation between LEF1 expression level and Hb level and PLT count. While negative significant correlation was found with age, TLC count and peripheral blood blast %. No correlation was found with bone marrow blasts %. There was statistically significant difference between LEF1 expression level and both hepatosplenomegaly. No statistically significant difference was found between LEF1 expression level and Sex or lymphadenopathy. Conclusion: Our study has shown that Lymphoid Enhancer-Binding Factor 1 (LEF-1) is over expressed in AML patients. LEF1 expression might be involved in the process of disease progression, and possibly can serve as a molecular parameter for risk assessment and/or monitoring of treatment in AML patients. Thus, molecular assessment of LEF1 expression at diagnosis may be of value to add to the prognostic work of AML patients.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
72
v.
6
no.
2018
4686
4692
https://ejhm.journals.ekb.eg/article_9841_daaf555f7210e6bc71439ba41cdad075.pdf
dx.doi.org/10.21608/ejhm.2018.9841
Assessment of Awareness of Medical Students Toward Paralytic Ileus After Colon Surgery
Abrar Saad
Alshareef
Ibn Sina National College-Jeddah-kingdom of Saudi Arabia
author
Anwar Mohammed Omer
Basri
Ibn Sina National College-Jeddah-kingdom of Saudi Arabia
author
Bashaer Ibrahim
Ahmed
Ibn Sina National College-Jeddah-kingdom of Saudi Arabia
author
Areen Jibreel
Khamaj
Ibn Sina National College-Jeddah-kingdom of Saudi Arabia
author
text
article
2018
eng
Background: Protocols for bowel management have been used adequately among postoperative patients to maintain the normal GIT function and prevention of ileus among critically ill patients. Objectives: Evaluating the knowledge, attitude and practice (KAP) of medical students about paralytic ileus after colon surgery at Kingdom of Saudi Arabia (KSA). Methods: It is a randomized cross sectional study that was conducted during the period from March 2018 to June 2018, at Saudi Arabia among 320 medical students at the 5 thacademicyear.The study was based on a questionnaire sheet with an interview that included questions about knowledge, attitude and practice pattern of the students about paralytic ileus after surgery. Results: The study included 320 medical students from different universities at the stage of fifth academic year. All of the included subjects had good knowledge about the definition of ileus, its symptoms and the initial treatment with intravenous fluids. Most of them have adequate knowledge about effect of epidural anesthesia on the duration of ileus (82.5%), the complications of ileus (67.5%), the paralysis of the bowel (86.3%) and the diagnostic importance of CT (87.8%). The attitude of most of the participants was good toward the importance of good nursing and efficient doctors to overcome the risks of postoperative ileus, the efficiency of bowel protocols and increasing the knowledge of the staff is adequate for prevention of ileus. The practice pattern was found to be adequate among the majority of participants as 81 % would take care while using analgesics and sedatives and 90% would encourage movement of patient when possible. All of the subjects had adequate practice toward managing dietary nutrition, constipation and diarrhea. Conclusion: The level of knowledge was adequate among most of the students which resulted in proper attitude and practicing pattern that encourage educating the health staff about ileus and how to be efficient in managing the bowel protocols.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
72
v.
6
no.
2018
4693
4696
https://ejhm.journals.ekb.eg/article_9842_8315bb310c26d1f648b35a5f326e0210.pdf
dx.doi.org/10.21608/ejhm.2018.9842
Decline of Tobacco Smoking Among Medical Specialists at A Spanish University Hospital
Mohamed Farouk
Allam
Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
author
Alberto Molina
Cabildo
Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Cordoba, Cordoba, Spain
author
Carmen Díaz
Molina
Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Cordoba, Cordoba, Spain
author
text
article
2018
eng
Background: Several epidemiological studies have shown that the prevalence of tobacco smoking in the Spanish healthcare centres is relatively high. Objective: to assess the current situation of tobacco smoking among medical specialists of Reina Sofia University Hospital (Cordoba, Spain). As a secondary objective we intended to calculate the indirect costs of smoking among medical specialists during the working hours. Materials and Methods: Descriptive cross-sectional study of the medical specialists of Reina Sofia University Hospital. Our survey was conducted using an interview questionnaire that included the following variables: age, sex, medical specialty, smoking habits, tobacco smoking during work hours, time spent on each cigarette, intention to quit smoking and the possibility to participate in a smoking cessation program. Results: A total of 143 medical specialists; 64 women and 79 men were interviewed. About 14% of participants were former smokers and 10.5% were current smokers, of whom 67% wanted to quit smoking. About 73% of smokers consumed tobacco during the working hours. Most of smokers consumed 2 cigarettes during the working hours. About 60% of smokers would use a permanent aid program to quit smoking. The hours lost by the smoking habits of medical specialists cause an annual loss of 143.512,96 euros. Conclusions: The study results show that currently there is an increasing awareness of health professionals about the harmful effects of smoking: former smokers have increased, and most of smokers want to quit. Also, they would use a permanent aid program to quit smoking.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
72
v.
6
no.
2018
4697
4701
https://ejhm.journals.ekb.eg/article_9843_00007797e60bdeec39d4ad05ed71ae7a.pdf
dx.doi.org/10.21608/ejhm.2018.9843
Role of Duplex Ultrasonography in Correlation With CT Angiography In Assessment Of Vascular Complications In Recipients Post Liver Transplantation
Hala Mohamed Abdel Hamid
Badawy
Radio-Diagnosis Department, Faculty of Medicine, Ain Shams University
author
Sherif Abu
Gamrah
Radio-Diagnosis Department, Faculty of Medicine, Ain Shams University
author
Ahmed Hassan
Soliman
Radio-Diagnosis Department, Faculty of Medicine, Ain Shams University
author
Marwa Adel
Shabaan
Radio-Diagnosis Department, Faculty of Medicine, Misr University for Science and Technology
author
text
article
2018
eng
Background: Liver transplantation is currently accepted as a first line treatment for patients with end-stage acute or chronic liver diseases. Graft survival and overall patient survival have steadily improved since the first transplants were performed in the early 1960s, but a significant percentage of transplants develop complications related to vascular and biliary insufficiency. Graft ischemia after liver transplantation is associated with a high incidence of morbidity and mortality. Aim of the Work: to evaluate the sensitivity and specificity of Duplex ultrasound in detection most of vascular complication after liver transplantation in correlation with CTA. Patients and Methods: The study was done from Aug. 2017 until Aug. 2018, where 50-55 cases who underwent living donor liver transplantation with post-operative complications. The cases were done at Ain Shams University Hospital and other private hospitals. All cases where admitted to post-transplanting intensive care unit in the postoperative period where a routine full laboratory and radiological assessment were done. The laboratory assessment included full liver function tests, kidney function tests, complete blood picture, and C-Reactive Protein. Immunosuppressant level and bilirubin level in drains had also done. Results: The patient age ranges from 36 to 53 years with the mean age of 45 years. Most cases have cases had hepatitis C related cirrhosis (90%). One case had veno-occlusive disease related cirrhosis (Budd Chiari syndrome). About 95% of cases were suffering from end stage liver disease. The results we have reached are that Doppler U/S sensitivity in diagnosis of these complications is 83.8% and CTA sensitivity is about 100%. Conclusion: It could be concluded that colour duplex is the investigations of choice in postoperative liver transplantation. They can be used as routine steps in the assessment of liver transplant graft postoperatively in recipient patient as early as possible within the first 3 days after operation and used as a late follow up, as they are noninvasive, safe, cheap, and accurate. Routine use of gray-scale US and color duplex showed to minimize the impact of postoperative complications and maximize both graft and recipient patient survival and if any complications suspected, it can be confirmed by CTA
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
72
v.
6
no.
2018
4702
4706
https://ejhm.journals.ekb.eg/article_9844_c06a9eef84898bafa2bd56046d013406.pdf
dx.doi.org/10.21608/ejhm.2018.9844
Comparative Study Between Sublingual and Vaginal Misoprostol for Induction of Labor in Post Term Pregnant Patients with Unfavourable Cervix
Hossam Sobhy Mohamad
Bayomi
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
Ismail M.
El-Garhy
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
Ashraf Hamdy
Mohamad
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
text
article
2018
eng
Background: Pharmacological studies suggest that sublingual route might be the optimal route of administration for PGE1 analogue misoprostol because the avoidance of the first pass hepatic circulation would yield bioavailability like that achieved with the vaginal route along with an earlier onset of action and a prolonged activity.
Objective: The aim of this study was to compare the efficacy and the safety of vaginal misoprostol with sublingual misoprostol for induction of labor in post-term pregnancy.
Subjects and Methods: This study included 50 cases, each with a singleton post-term pregnancy and a live fetus requiring induction of labor were allocated to sublingual and vaginal administration of misoprostol. Outcome measures related to labor and maternal and fetal side effects were compared between the 2 groups and evaluated using Chi square test.
Results: The sublingual route of misoprostol was associated with a reduced risk of failed induction, reduced time from initiation to induction, reduced induction to delivery interval and a higher incidence of maternal and fetal side effects. However, the differences were not statistically significant.
Conclusion: The sublingual route of administration of misoprostol is comparable in efficacy and safety to the vaginal route for induction.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
72
v.
6
no.
2018
4707
4711
https://ejhm.journals.ekb.eg/article_9845_4eeda4d0d77b8ba28ddba06216e24645.pdf
dx.doi.org/10.21608/ejhm.2018.9845
Effect of Alienation on Academic Achievement Performance of Medical Students of King Faisal University
Abdullah Ibrahim
Alamoudi
College of Medicine, King Faisal University
author
Abdullatif Waleed Al
Arfaj
College of Medicine, King Faisal University
author
Abdullah Habib
Almeshari
College of Medicine, King Faisal University
author
Abdulatif
Alom
College of Medicine, King Faisal University
author
Azam Abdulwahab
ALQuraini
College of Medicine, King Faisal University
author
Qussi Jaffer
Al-Rebh
College of Medicine, King Faisal University
author
Essam
Abdelbary
College of Medicine, King Faisal University
author
text
article
2018
eng
Background: Alienation is a term used to describe student estrangement in the learning process. It is also defined as a state or experience of being isolated from a group or an activity to which one should belong, or in which one should be involved. The aim of this research is to find out if there is a real effect on alienated students in their academic achievement through biostatical correlation
Materials and Methods: This study was conducted at the college of medicine of King Faisal University in Al-hasa throughout the period between March and May 2015. The study included 79 students, 59 of them were male, and 20 were female. The alienated students were 20 out of 79 with a percentage of 25.3%. Four of which were females while 16 were males with a ratio of 1:4.
Results and Discussion: After the analysis of the results of the study, it’s turn out that there is no statistical relationship between alienation & academic achievement. That was an unexpected result, and opposite to old stereotypes about alienation, which believed that academic achievement is affected or influenced by alienation.
Summary and Conclusion: This study is about alienation and its effects on the medical student's academic achievements and performance. It argues whether alienation has good or bad consequences on the medical student’s academic achievements. The results are impressive, because many people think that alienated students are performing academically better than the other students. However, that is false. Both alienated and non-alienated students are performing at the same level and have the same caliber of academic achievements.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
72
v.
6
no.
2018
4712
4714
https://ejhm.journals.ekb.eg/article_9846_663966a0ac445e5bcd372125e015dbbc.pdf
dx.doi.org/10.21608/ejhm.2018.9846
Incisional Hernia Repair with Abdominoplasty
Ahmed R
Nassem
Department of General Surgery, Faculty of Medicine, Ain Shams University
author
Hesham H
Wagdi
Department of General Surgery, Faculty of Medicine, Ain Shams University
author
Mostafa A
Mohamed
Department of General Surgery, Faculty of Medicine, Ain Shams University
author
Mohamed A Aboul
Naga
Department of General Surgery, Faculty of Medicine, Ain Shams University
author
text
article
2018
eng
Background: Abdominoplasty is considered by many general surgeons as only an aesthetic technique. It has shown to provide great benefits for patients: (1) removal of excessive skin, which promotes better local hygiene and reduces incidence of skin infections; (2) strengthening of muscular bending (better muscular tone, corporal position, and then de-ambulation); (3) stabilization of the lumbar spine level (by changing the angle of lumbar lordosis and sacral inclination, improving the chronic low back pain), scar removal and, finally, a better perception of their bodies (higher selfesteem, satisfaction and quality of life), less anxiety and better personal relationships. All these changes are always desirable for all patients. Aim of the Work: The main objective of our study is to assess the outcome of the combined procedure of abdominoplasty and incisional hernioplasty, compared to incisional hernioplasty alone. Patients and Methods: This randomized comparative study was carried out on fourty patients having incisional hernias in General Surgery and Plastic Surgery Departments in Ain Shams University and AL Salam Specialized Hospital. Hernias are included in this study and divided into two groups, each group formed of 20 patients. First group (group A) with patients underwent hernioplasty alone and the other group (group B) with patients underwent combined hernioplasty with abdominoplasty. Patients are explained that they have the right to refuse joining to the research or withdraw at any time without affecting their chances to receive the optimal treatment at any time. Patients are explained the significant risks and the problems specific to them as well as the likely outcome if complications occurred and the relevant treatment options as well as the risks of not having the procedure. Results: According to size of hernia hernioplastywas 4.20 and abdominoplasty was 5.45. According to type of suture PDS loop hernioplasty was15.0%, abdominoplasty was 75.0% and Prolene hernioplasty was 85% abdominoplasty was 25%. Conclusion: Abdominoplasty can be performed in combination with hernia repair in patients with incisional hernias, especially when associated with large sized defects or divercation of recti. Simultaneous techniques can be safely performed with the same morbidity and recurrences, but with major quality of life improvement and superiority over hernioplasty alone.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
72
v.
6
no.
2018
4715
4724
https://ejhm.journals.ekb.eg/article_9847_94ba0e32c3b75c685d1957b50cfec889.pdf
dx.doi.org/10.21608/ejhm.2018.9847
Misunderstanding of Parents about using of Anti-Biotic in Upper Respiratory Tract Infection in Riyadh, Saudi Arabia
Fatimah Adam
Alaswad
Ras Tanura General Hospital, Ras Tanura, Saudi Arabia
author
Faisal Mubarak
AlZahrani
Almaarefa Colleges, Riyadh, Saudi Arabia
author
Faisal Abdullah
Alomani
Almaarefa Colleges, Riyadh, Saudi Arabia
author
Nawaf Mohammed
Alwohaibi
Almaarefa Colleges, Riyadh, Saudi Arabia
author
Ali Ahmed
Almaimouni
Almaarefa Colleges, Riyadh, Saudi Arabia
author
Abdullah Abdulrahman
Almannaa
Almaarefa Colleges, Riyadh, Saudi Arabia
author
Abdullah Abdulrahman
Bin Saeed
Almaarefa Colleges, Riyadh, Saudi Arabia
author
Abdulaziz Abdullah
Alzwaid
Almaarefa Colleges, Riyadh, Saudi Arabia
author
Rakan Abdulrahman
Aladwanie
Almaarefa Colleges, Riyadh, Saudi Arabia
author
text
article
2018
eng
Background: Misuse of antibiotics has become a global public health issue for several reasons, one of which is the rapid development of antibiotic resistance that leads to high morbidity and mortality.
Objectives: Objective of this study was to study the misconceptions of parents of primary school children in Riyadh about the use of antibiotics for upper respiratory tract (URT) symptoms; and also study perceptions, attitudes, and behavior toward antibiotic use and identifies the factors affecting this.
Methods: Analytic cross-sectional study of parents in one large city: Riyadh, Saudi Arabia. Study population were parents of children studying in these schools and were selected multistage sampling and proportional to population size (PPS).
Results: The questionnaire was distributed to 1306 parents. The response rate was 78.9%, 56.6% respondents were mothers with a mean age of 40 ± 7. Sixty seven percent of the parents admitted to self-prescription once or more, and the most common reason for self-prescribing, was because they thought the child was not ill enough to be taken to hospital (41.8%). This was followed by 37.7% who used “leftovers”. Regarding the attitude toward antibiotic prescription, 62.5% agreed that children should not be given an antibiotic when they have fever and nasal congestion. In addition, 63.5% agreed that they should give their child antibiotic for ear or throat pain. Around two thirds agreed that upper respiratory tract infection (URTI) was caused by a virus. Those who obtained their information from primary health care centers and general practitioners had the lowest median of total knowledge score, and the highest knowledge was for those who obtained information from websites and the social media. Multiple linear regressions revealed that parents whose incomes were high, had high education, had children in private schools were more likely to have good knowledge and highly favorable attitudes and practices toward antibiotic use.
Conclusion: Thirteen percent had an excellent knowledge, and 52.7% had an intermediate level of knowledge. Of those with excellent knowledge, 58.6% still expected to get antibiotic prescription from a physician for URTI.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
72
v.
6
no.
2018
4725
4731
https://ejhm.journals.ekb.eg/article_9848_be9f606301e2f55e5d6dc953f0af400a.pdf
dx.doi.org/10.21608/ejhm.2018.9848
Visual Outcomes after Topography-Guided Femtosecond LASIK in Virgin Eyes
Ahmed Hassan
Assaf
Ophthalmology Department, Faculty of Medicine, Ain Shams University
author
Sameh Hany
AbdEl Rahman
Ophthalmology Department, Faculty of Medicine, Ain Shams University
author
Mahmoud Abd El Meguid
AbdEl Latif
Ophthalmology Department, Faculty of Medicine, Ain Shams University
author
Mai Mohammad Zaki
Afifi
Ophthalmology Department, Faculty of Medicine, Ain Shams University
author
text
article
2018
eng
Background: Laser vision correction has been established over the last 2 decades as a safe and effective intervention, with Laser-assisted in situ keratomileusis (LASIK), being one of the main techniques practiced globally. Femtosecond laser-assisted LASIK has become a popularized modification over the last decade and over the standard LASIK technique utilizing mechanical microkeratomes. A spherical ablation profiles performed by “wave front optimized” have been employed to reduce spherical aberration associated with myopic corrections.
Aim of the Work: To evaluate the quality and efficacy of topography-guided femtosecond lasik in virgin eyes with myopia, hypermetropia and astigmatism.
Patients and Methods: This comparative prospective study was conducted on 60 eyes of 30 Egyptian patients with comparing preoperative and postoperative outcomes. Eyes with myopia (-1.0 up to -8.0 diopters) or hypermetropia (+1.0 up to +5.0 diopters) or astigmatism (up to 5.0 diopters) or less. Eyes with central corneal thickness (CCT) of 500 microns or more. Eyes at risk for developing post-refractive corneal ectasia, such as keratoconus, keratoconus suspect, previous refractive surgery, corneal dystrophy, corneal guttae or opacities, any previous eye surgery e.g.:pseudophakic patients, retinal detachment surgery, all eyes were normal for example no cataract, no glaucoma, no retinal pathology and no previous trauma.
Results: Our study was performed on sixty eyes of thirty Egyptian patients. Sixty eyes of thirty patients underwent LASIK using T-CAT. Seventeen patients were females and thirteen were males. The average age of the patients was 24.8 year ±5.45 standard deviation (SD). The average spherical error was -3.09 D ±2.33 SD. The average cylinder error was -1.02 D ±1.02 SD.
Conclusion: The results showed that there were statistically significant differences between preoperative BCVA and postoperative UCVA with a good safety and efficacy profile with T-CAT lasik as no patient loss even one line and 80% of cases gaining at least one line postoperative. The surgery was associated with higher values of high order aberrations after surgery than before surgery.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
72
v.
6
no.
2018
4732
4736
https://ejhm.journals.ekb.eg/article_9849_6fcf28cb068939f277ceac8887a59516.pdf
dx.doi.org/10.21608/ejhm.2018.9849
Predictors of admission in patients with acute Bronchiolitis
Muddather A.
Mohammed
Lecturer, Senior specialist, Mosul Teaching Hospital, Iraq
author
Mazen H. Khalid, Faraj A.
Faraj
Senior Specialist, Alkhansaa Teaching Hospital Mosul, Iraq
author
Ahmad Saladdin
Sultan
Senior Specialist, Alkhansaa Teaching Hospital Mosul, Iraq
author
text
article
2018
eng
Background: Acute viral bronchiolitis represents the most common lower respiratory tract infection in infants and young children less than 24 months and is associated with substantial morbidity and mortality. Respiratory syncytial virus is the most frequently identified virus, but many other viruses may also cause acute bronchiolitis. Most children with bronchiolitis have a self-limiting mild disease and can be safely managed at home with careful attention to feeding and respiratory status. Criteria for referral and admission vary between hospitals as do clinical practice in the management of acute viral bronchiolitis, Supportive care, including administration of oxygen and fluids, is the cornerstone of current treatment. Aim: To identify the epidemiological profile of babies less than 2 years with bronchiolitis, clinical characteristics of babies with bronchiolitis in respect to the main symptoms, signs and clinical presentations and the factors that affect disposition of the patient with acute bronchiolitis. Patient and Method: Design: A prospective observational case series study. Setting: Emergency unit in Al-Khansaa Teaching Hospital. Study period: one-year (1/October/ 2012 – 30/September/ 2013) Sample size: 84 patients were enrolled in this study. Inclusion criteria: 1-first attack of acute wheeze due to bronchiolitis.2-age 2years or younger. Exclusion criteria: 1. patients with more than one attack wheezes.2. wheezes due to other cause (pneumonia).3.age more than 2 years. Result: A Total of 84 patients with 1st attack wheeze in less than 2 years identified. The main age was 8.2±5.77months, and the peak age was 6 months.53 (63.1%) male, and 31(36.9%) female and ratio of 1.7:1.and the majority were mature babies, came from urban area more than rural area. The comparison done concentrated on symptoms, signs, and radiological findings between babies younger and older than 6months age and studied either to hospital or not and concentrated these findings had role as an indicator for admission on heart rate, respiratory rate and SPO2, The results indicated that poor feeding, irritability, runny nose, cough and shortness of breath all of these symptoms consider a good indicators for admission in both age groups. Severe retraction, rhonchi, and temperature more than 38.1 C, all of these physical findings consider good indicators of admission in both age groups. While fine rales and cyanosis are good indicators in babies younger than 6 months only. Radiological findings had no role in assessing admission of the patients to hospital. Respiratory rate (tachypnea)>60 bpm, and SPO2<94 are consider a significant indicator in both age groups, while heart rate >160 BPM consider significant indicator only in babies older than 6 months of age. Of all 84 patients admitted to emergency unit, only 63(75%) of them were admitted to hospital and the remaining were discharged. Conclusion: Indications of admission can be assessed by many symptoms (poor feeding, irritability, runny nose, cough, and SOB) and physical signs (Rhonchi, severe retraction, temperature >38.1 c, RR>60bpm, and SPO2<94), so We recommended carrying out serial checking SPO2 by pulse oximetry, and to conduct arterial or capillary blood gas analysis for the severely ill patients to assess the severity of the disease and its complications and treatment procedures.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
72
v.
6
no.
2018
4737
4745
https://ejhm.journals.ekb.eg/article_9850_65899eb1d2ee4187c2ab57a043090eb8.pdf
dx.doi.org/10.21608/ejhm.2018.9850
Expression of CD73 and CD39 on Peripheral Blood Leukocytes in Type II Diabetes Patients
Soha Ezz El-Arab
Abdel Wahab
Departments of Clinical Pathology, Faculty of Medicine, Ain Shams University
author
Deena Samir
Eissa
Departments of Clinical Pathology, Faculty of Medicine, Ain Shams University
author
Christine Atef
Habib
Departments of Clinical Pathology, Faculty of Medicine, Ain Shams University
author
Mona Mohamed
Abdelsalam
Departments of Endocrinology & Metabolism, Faculty of Medicine, Ain Shams University
author
text
article
2018
eng
Background: Type II diabetes mellitus (T2D) is one of the most common chronic metabolic diseases. It is associated with a state of chronic inflammation resulting in both microvascular and macrovascular complications. The adinosinergic axis plays an important anti-inflammatory protective role through conversion of ATP (produced as a result of inflammation) into adenosine (a potent anti-inflammatory mediator) through CD39 and CD73. Various peripheral blood leucocytes hold CD39 and CD73 with different degrees.
Objective: To determine the expression of CD73 and CD39 on different peripheral blood leukocytes including Treg cells to uncover their inflammatory modulation role in T2D subjects in comparison to normal control ones. The level of their expression will be correlated with various anthropometric and biochemical parameters in diabetic patients.
Materials and Methods: Venous blood was collected on EDTA anticoagulated tubes from 45 T2D patients; 15 with early T2D and 30 with complicated T2D with both microvascular and macrovascular complications. Twenty-five normal subjects, with no family history of T2D, were included. Immunophenotyping of the samples were performed on Navios Flow cytometer (Coulter Electronics, USA), using phycoerythrin (PE)-labelled CD39 antibodies, fluorescein isothiocyanate (FITC)-labelled CD4 antibodies, peridinin-chlorophyll-protein complex: CY5.5 conjugate (PerCP-CY5.5)-labelled CD73 and allophycocyanin conjugate (APC)-labelled CD25.
Results: CD39 expression was highest in early cases of T2D in comparison to least expression in complicated T2D on peripheral blood total lymphocytes, CD4+ lymphocytes and CD4+CD25+ lymphocytes.
Conclusions: The increased expression of CD39 in early non-complicated cases of T2D indicates a state of low-level chronic inflammation owing to their role in production of adenosine; a potent anti-inflammatory mediator. This is reversed when CD39 expression in peripheral blood leucocytes is assessed in complicated T2D patients, which emphasise their role in protecting the patients from diabetic complications.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
72
v.
6
no.
2018
4746
4752
https://ejhm.journals.ekb.eg/article_9851_03b654eae475845c9bf2c36c703fb23b.pdf
dx.doi.org/10.21608/ejhm.2018.9851
Analgesic Efficacy and Outcome of Lumber Epidural Analgesia versus ultrasound guided Trasversus Abdominis Plane block In Laparoscopic Sleeve Gastrectomy
Marwa M.
Salem
Department of Anesthesia, Intensive care and Pain Management, Faculty of Medicine – Ain Shams University
author
Mohamed S.
Abd-El Aziz
Department of Anesthesia, Intensive care and Pain Management, Faculty of Medicine – Ain Shams University
author
Sherif S.
Wahba
Department of Anesthesia, Intensive care and Pain Management, Faculty of Medicine – Ain Shams University
author
Sanaa F.
Mahmoud
Department of Anesthesia, Intensive care and Pain Management, Faculty of Medicine – Ain Shams University
author
Moustafa M.
Sery
Department of Anesthesia, Intensive care and Pain Management, Faculty of Medicine – Ain Shams University
author
text
article
2018
eng
Background: The transversus abdominis plane (TAP) block provide effective postoperative analgesia in lower abdominal surgery. Subcostal TAP block as a new technique to provide analgesia for the supraumbilical abdomen. Traditionally, pain relief for these patients is provided by epidural analgesia or IV opioid analgesia. Although epidural analgesia is currently the “gold standard” for postoperative pain treatment, associated complications and contraindications may limit its use. IV opioid analgesia may cause opioid-related side effects and be associated with inadequate analgesia. Aim of the Work: This study aimed at clinically evaluating and statistically comparing between lumber epidural versus transversus abdominus plane block as postoperative Analgesia for laparoscopic sleeve gastrectomy. Also, our goal was to figure out the most possible effective technique for this kind of procedure with most benefits and least side effects. Patients and Methods: This single blinded randomized clinical trial was carried out at Ain Shams University hospitals on 60 adult Bariatric patients undergoing elective Laparoscopic sleeve Gastrectomy, aged 20 to 50 years, ASA I-II, BMI equal or less than 45 Kg/m2. Results: Patients in the Lumber Epidural group had significantly less pain score when compared to the other TAP group (p-value < 0.001). And, they had longer time to first request rescue analgesia (nalbuphin) (P = 0.0013). Also, total dose of nalbuphin consumption was less in Lumber Epidural group than TAP group (P < 0.001). Conclusion: This study concluded that TAP block was effective in pain relief after Laparoscopic sleeve gastrectomy, however, Lumber Epidural was superior in pain relief, less narcotic consumption and overall more patient satisfaction.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
72
v.
6
no.
2018
4753
4760
https://ejhm.journals.ekb.eg/article_9852_f69d2959071e8d40e1048585dc5b711a.pdf
dx.doi.org/10.21608/ejhm.2018.9852
Differential Incidence of Eyelid Margin Cysts in ASU Outpatients
Mayar Mohammad Salaheldin
Faheem
Department of Ophthalmology, Faculty of Medicine, Ain Shams University
author
Sherif Elwan, Azza Mohamed Ahmed
Said
Department of Ophthalmology, Faculty of Medicine, Ain Shams University
author
Ossama Tarek
Nada
Department of Ophthalmology, Faculty of Medicine, Ain Shams University
author
text
article
2018
eng
Background: Wide varieties of lesions affecting the eyelid are encountered within routine Ophthalmology practice. These lesions are numerous due to the unique anatomical features of the eyelid as the whole skin structures, appendages, muscle, modified glands, and conjunctival mucous membrane are represented in the eyelid. The eyelid comprises different types of glands that clinically correlate with the development of eyelid cysts; Sebaceous glands (Meibomian glands and glands of Zeis), aporcine glands (glands of Moll) and eccrine sweat glands.
Objectives: To report the incidence of the different etiologies of eyelid margin cysts in Ain Shams University (ASU) Hospital, General Ophthalmology Outpatients Clinic.
Patients and Methods: It included all patients who presented to the General Ophthalmology Outpatient Clinic, 6 days per week for one month (November 2017) complaining of eyelid margin lesions, found cystic on slit lamp examination, of all ages.
Results: The total number of patients recorded was 45 patients presenting with eyelid margin cysts, out of 1920 patients visiting the General Ophthalmology Outpatient Clinic during the month of November 2017 with an incidence of 2.34%. Seven types of cysts were found namely; External Hordeolum (8.9%), Internal Hordeolum (15.6%), Chalazion (28.9%), Sebaceous Cyst (11.1%), Cyst of Zeis Gland (13.3%), Apocrine Hidrocystoma (11.1%) and Eccrine Hidrocystoma (11.1%).
Conclusion: Eyelid margin cysts should be studied and categorized as a separate entity from eyelid lesion due to the unique anatomy of the eyelid margin. The incidence was calculated to be 2.34% during this study that was relatively short lived. Chalazion was the most common lesion encountered but that was solely by clinical diagnosis.
Recommendations: It is recommended to continue this study for a longer duration to be more comparable with the other studies and it should be enriched by histopathological diagnosis aside the clinical one.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
72
v.
6
no.
2018
4761
4764
https://ejhm.journals.ekb.eg/article_9853_5d30b4e3e0f4db0535415a6ebc51fbe3.pdf
dx.doi.org/10.21608/ejhm.2018.9853