Assessment of Knowledge, Perception and Impacts of Acne Vulgaris among Saudi Community
Huda Ibrahim
Alrwebah
King Saud Bin Abdulaziz University for Health Sciences
author
Shaza Omar
Alorabi
King Abdulaziz University
author
Turki Mobark
Alenzi
Northern Border University
author
Lama Mohammed
Al Saud
King Saud Bin Abdulaziz University for Health Sciences
author
Wafa Ibrahim
AlSaab
Princess Nourah bint Abdulrhman university
author
text
article
2017
eng
Background:Acne vulgaris is one of the most common dermatological diseases that affect young people. The etiology of acne vulgaris is dependent on genetic factors and environmental and psychological stressthat impact the quality of life.
Objectives:Evaluating the knowledge, perception and impact of Acne vulgaris Among Saudi Community and its association with demographics of included subjects.
Methods: A questionnaire based on cross-sectional study was distributed among 452 adult populations from KSAfor assessment of demographics of included subjects, knowledge and awareness of acne risk factors, health belief and preventive behavior.
Results: Most subjects were aged 46-69 years old. Most of participants were females, married and highly educated. The prevalence of acne was 12%. Genetics and psychological stressors were the most important risk factors for acne. The level of knowledge was about acne and its risk factors were found to be good in 62% of subjects. The level of knowledge was significantly associated with higher education and female gender. The most common reported psychological effects of acne were embracement and depression.
Conclusion: A high level of awareness about acne was found among most of the participants and it was significantly associated with female gender and higher education levels. The prevalence of acne was low (12%) however it cannot be
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
68
v.
2
no.
2017
1088
1093
https://ejhm.journals.ekb.eg/article_13372_48a2949f2f5d3336827ea934849ef84a.pdf
dx.doi.org/10.12816/0039034
Multi Drug Resistant Bacteria and Its Antibiotic Susceptibility at Percutanous Endoscopic Gastrostomy (PEG) Tube Site of Long Term Care Facility Elderly Residents
Reem Mohamed Sabry
EL Bedewy
Geriatrics and Gerontology Department, Ain Shams University, Egypt
author
text
article
2017
eng
Background: Percutaneous endoscopic gastrostomy (PEG) is the preferred route of feeding and
nutritional support in patients with a functional gastrointestinal system who require long-term enteral nutrition. The objective of this descriptive study was to detect the commonest multidrug resistant bacteria and its antibiotic sensitivity at PEG tube site of elderly residents at long term care facility (LTCF). Forty two long term care facility elderly residents bedridden were having multi drug resistant organisms at percutaneous endoscopic gastrostomy tube site. Informed consent taken from each patient or from his/her guardian, also Ethical committee approval was obtained. Demographic data were collected and comorbidities were established. Culture and sensitivity was done for pus samples from PEG tube site (stoma) and documented multidrug resistant organisms with antibiotic susceptibility to a range of different antibiotic groups. All samples were processed as per standard techniques and bacteria identified by standard biochemical tests. IBM SPSS statistics (version 24, IBM corp., USA, 2016) was used for data analysis. The age ranges from 60 to 79 years with mean 69.19 +/- 7.01 years. 47.6 % of residents in the age group 60-66 y while 52.4% of residents are in the age group 67-80 y. Males were 57.1% while females were 42.9 %, The predominant resistant detected organism in this sample was Klebsiella (57.1%) while E coli accounts for 28.6% and Proteus is 14.3%. The study revealed that klebsiella was highly statistically significant sensitive to Cefepime (CPM), Imipenam (IMP), Ciprofloxacin (CP), and Colistin (CT) and statistically significant resistant to Trimethoprim/Sulfamethoxazole (TS), and tobramycin (tobra.) Whereas Proteus was highly statistically significant resistant to Cefepime (CPM), Colistin (CT), Imipenam (IMP) and highly statistically significant sensitive to Ciprofloxacin (CP), Trimethoprim/Sulfamethoxazole (TS), tobramycin (tobra.). E Coli was found to be highly statistically significant intermediately sensitive to Cefepime (CPM), Colistin (CT), and Tobramycin and highly statistically significant resistant to Ciprofloxacin (CP), Trimethoprim/Sulfamethoxazole (TS). Further studies are recommended on larger numbers of elderly patients to confirm significant findings in this study, try to explain these findings, and make use of them in clinical practice.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
68
v.
2
no.
2017
1094
1100
https://ejhm.journals.ekb.eg/article_13373_99086a74050a52e30934236fd9886285.pdf
dx.doi.org/10.12816/0039035
Prevalence of Risk Factors for Coronary Heart Disease among Patients Presented in Cardiology Clinic at King Abdul-Aziz Hospital and Oncology Center – Jeddah
Asma Saad
Al Ahmari
King Khalid University
author
Wafaa Mohammed
Alsbhani
Ibn Sina National College For Medical Studies
author
Mona Ahmed
Al Hamad
Safwa General Hospital
author
Sukayna Adil
Al Hamad
Abqaiq Hospital
author
Duoaa Mohammad
Sakabomi
October 6 University
author
Saja Mohammad
Aljehani
King Abdul Aziz University
author
Molook Shebeeb
Alotibi
King Saud University
author
text
article
2017
eng
Background: Coronary heart disease is the leading cause of death in Saudi Arabia. We designed this study with the objective to determine the prevalence of risk factors of this disease within patients diagnosed with CHD.
Aim: our aim is to observe the current prevalence of risk factors of coronary heart disease (CHD), with respect to the lifestyle. We will attempt to identify the possible causes of such habits. Patients and Method: a cross-sectional study among 300 Saudi patients, with known coronary heart disease, was conducted with help of a questionnaire. The study was conducted at the cardiology department of King Abdul Aziz Hospital & Oncology Center in the city of Jeddah. Results: the prevalence of CHD was higher in the male gender by a ratio of 2:1. Also, the prevalence increases with age, the highest being found in age group over 75 years old which is 8 times higher than was observed in age group 35-44 years. 72.5% females and 52.6% males of these atherosclerotic patients was either overweight or obese. The same trend is seen in negative habits of 10 years duration, such as lack of exercise as high as 75.6 % in males and 81.3% in females. Intake of fatty/fast food was found to be 64.85% in both sexes. Intake of sweet/ sugary food was also high, and unfortunately consumption of fruits and vegetables was low. The current smoking trend is 45.9% in men and 21.95% in women. Conclusion: The risk factors assessed in the study were gender, age, obesity, smoking history, physical inactivity, and eating habits. Unfortunately, physical inactivity, bad eating habits, and smoking were found to be very common. The patients must be encouraged to practice healthy lifestyle modifications to reduce morbidity and mortality.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
68
v.
2
no.
2017
1101
1106
https://ejhm.journals.ekb.eg/article_13374_27657e9f29054eee11d37898822e53d0.pdf
dx.doi.org/10.12816/0039036
Management of Chronic Osteomyelitis Following Gunshot Injuries: A Systematic Review of Literature
Esam E.
Abuharba
Orthopedic Department, Faculty of Medicine, Ain Shams University-Egypt
author
Amr M.
Abdelhady
Orthopedic Department, Faculty of Medicine, Ain Shams University-Egypt
author
Saleh G.
Mansour
Orthopedic Department, Faculty of Medicine, Ain Shams University-Egypt
author
text
article
2017
eng
Background: Chronic osteomyelitis of long bones are common in daily clinical practice, however, the treatment of these diseases has still been a challenge and difficult for orthopedic surgeons. Gunshot injuries lead to damage to bone and soft tissues that can complicate with bacterial invasion and cause bone infection. Many ways can overcome of bone infection, surgical debridement, bone fixation and antibiotic are used in management of chronic osteomyelitis. The objective of this systematic review was to review available studies reporting in management of chronic osteomyelitis following gunshot injuries and compare the methods used into the treatment.
Methods: A comprehensive literature search was performed from the electronic databases Medline, PubMed, Google scholar, and Cochrane collaboration between 1995 and 2016. References were analyzed from included studies, inclusion criteria included (1) English literatures, (2) Humans clinical trials, (3) Orthopedic Journals only, (3) Definitive treatment strategy for management chronic osteomyelitis. In total, 5 articles were included in the systematic review.
Results: A total of 278 patients from 5 studies were included in this systematic review. The mean age of the patients is all studies were 33.84 year, the ratio male to female is 6:1. The most of patients were classified as Gaustilio type lllB and CiernyMader type lllB. The result of all different studies shows a good outcome in 260 patients but 7 patients had poor outcome who were still had bone infection and one patient end by amputation. Radiographic X-ray did postoperative follow up every two weeks. The mean follow up duration was 40 months and all patients responsible for keep the fixator clean.
Conclusion: Our systematic review showed that the patients with chronic osteomyelitis were treated by surgical debridement and bone fixation had a good result. But, this research lost the randomized trials methods, risk factors of patients, compare control groups and good statistical analysis. Without any direct comparison of treatment modalities, it is difficult to determine which individual treatment option is the most efficacious.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
68
v.
2
no.
2017
1107
1116
https://ejhm.journals.ekb.eg/article_13375_416caac43e8db795d79b84e06a0ddd11.pdf
dx.doi.org/10.12816/0039037
Glucocorticoids Induced End Organs Damage in Patients with Systemic Lupus Erythematosus
Mohammed Afify
Abd-El-Atty
Rheumatology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
author
Eman Ahmed
Hafez
Rheumatology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
author
Noha Hussien
Shedid
Rheumatology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
author
Dalia Abdel Hamid
El Sherbiny
Rheumatology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
author
text
article
2017
eng
Background: Systemic lupus erythematosus (SLE) is a systemic autoimmune disease that affects multiple organs and requires long term treatment with GCs. GC-related end organ damage in SLE appears in the form of: osteoporosis, Avascular Necrosis (AVN), cataracts, diabetes (DM) and cardiovascular disease.
Aim of the work: the present work was to assess the prevalence of the complications in SLE patients who were treated with GCs for long periods and with moderate to severe cumulative steroid doses.
Patients and Methods: This study was done on 50 SLE patients who fulfilled the SLICC criteria for diagnosis of SLE. All patients subjected to full history taking, clinical examination, slit-lamp examination to assess cataract, laboratory investigations (ESR, CRP, FBS, 2-H PP, CBC, C3, C4 and anti-dsDNA), DEXA scan, MRI scan (when needed), SLEDAI score and SLICC score assessments. All data were collected, tabulated and statistically analyzed. Results: Regarding the frequency of steroid induced complications, 38% were osteopenic, while 18% were osteoporotic patients. 10% had AVN. 18% had cataract. 14% had DM. There was very strong relationship between steroid duration and the frequency of DM and cataract. But in osteopenia, osteoporosis and AVN, there were weak relationship regarding steroid duration. There was very strong relationship between cumulative steroid dose and the frequency of DM, cataract, osteoporosis and AVN. There was no relationship between age and osteoporosis and AVN but in cataract and DM, there was strong relationship. There was no relationship between sex and complications (DM, cataract, osteopenia, osteoporosis and AVN). There was no relationship between disease activity (measured by SLEDAI score) and frequency of steroid complications (DM, cataract, osteopenia, osteoporosis and AVN). There was strong relationship between end organ damage (measured by SLICC damage index) and frequency of steroid complications (DM, cataract, osteoporosis and AVN). Conclusion: Steroid intake (duration and dose) were major risk factors for developing end organ damage in SLE patients.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
68
v.
2
no.
2017
1117
1125
https://ejhm.journals.ekb.eg/article_13376_ca72980f087c12a8c523a110651ba77d.pdf
dx.doi.org/10.12816/0039038
Quality of life in Heamodialysis Patients with Residual Renal Function
Basset El-Shaarawy
Abdel-Azim
Internal Medicine and Nephrology Department, Ain Shams Faculty of Medicine
author
Abdel-Rhman Nabil
Khedr
Internal Medicine and Nephrology Department, Ain Shams Faculty of Medicine
author
Safaa Ahmed
Abdel-Hamid
Internal Medicine and Nephrology Department, Ain Shams Faculty of Medicine
author
text
article
2017
eng
Background: patients undergoing maintenance heamodialysis (HD) have a progressively loss of residual renal function (RRF), Short-term morbidity and mortality are significantly higher in patients lost RRF,and these patients frequently die before the development of long –term complications of dialysis. HD patients without preserved RRF have greater hospitalization rate, more significant malnutrition and health related quality of life. Aim: the aim of the present study was to assess impact of RRF on QoL in chronic HD patients and to study clinical and laboratory characteristics of these patients.
Patients and Methods: this cross sectional study was carried out on 40 adult clinical stable regular HD Patients. They were divided into 2 groups according to the presence or absence of RRF.Group 1 included 20 HDpatients with RRF (defined as urine volume >200 ml/24 h) and group 2 included 20 patients without RRF (defined as urine volume <200 ml/24 h).
Results: patients with preserved RRF had a positive significant correlation between QoL scores, male gender ,younger age, employment, higher BMI (p=0.006), higher hemoglobin (p=0.036), higher predialysis serum creatinine (p=0.033), less complication during HD sessions hypotenstion (p=0.003), hypertenstion(p=0.003), vomiting (p=0.017), cramps(p=0.010)and Less use of Phosphate binders and Erythropoietin dose (p=0.020).
Conclusion: HD patients with preserved RRF had better QoL scores compared to patients without RRF.Efforts to preserve RRF in HD patients could improve outcomes and should be encouraged.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
68
v.
2
no.
2017
1126
1134
https://ejhm.journals.ekb.eg/article_13377_795485aab90171d7c96c387b3a9f39f4.pdf
dx.doi.org/10.12816/0039039
Role of High Resolution Computed Tomography in Diagnosis of Interstitial Lung Diseases in Patients with Collagen Diseases
Marina Mikhail Fouad
Hanna
Radiology Department, Faculty of Medicine, Ain shams University
author
Ahmad Mostafa
Mohamed
Radiology Department, Faculty of Medicine, Ain shams University
author
Ahmed Mohamed
Osman
Radiology Department, Faculty of Medicine, Ain shams University
author
text
article
2017
eng
Aim of the work: a descriptive study including analysis of HRCT chest done for patients known to have collagen diseases for diagnosis and classification of interstitial lung diseases.
Patients and methods: forty five patients were included in our study (23 rheumatoid arthritis, 14 systemic lupus erythematosis and 8 scleroderma). This was a retrospective study that included patients with collagen diseases either outpatients or referred from the Rheumatology Departement at Ain Shams University Hospitals to the Radiodiagnosis Department for HRCT chest examination.
HRCT chest images were interpreted for identification of lung interstitium architectural abnormalities associated with collagen diseases and they were statistically analyzed. Results: The mean age of the selected patients was about 42 years old. Parenchymal involvement was noted in 30 cases that represented 66.6% of included cases in the study, 15 cases had normal HRCT of the chest representing 33.4% of the cases. Conclusion: HRCT of the chest has a reasonable role in the diagnosis of interstitial lung diseases and has the ability to be classify according to the pattern of involvement, distribution and extent of the disease as well as to estimate the severity and help in prognosis of the disease process.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
68
v.
2
no.
2017
1135
1140
https://ejhm.journals.ekb.eg/article_13378_ac362081be879476ba7c4e7c47a16d56.pdf
dx.doi.org/10.12816/0039040
Stem Cell Therapy in Glaucoma
Hany M.
El-ibiary
Department of ophthalmology. Faculty of medicine. Ain shams university
author
Lamia S.
Elewa
Department of ophthalmology. Faculty of medicine. Ain shams university
author
Maha M.
Ibrahim
Department of ophthalmology. Faculty of medicine. Ain shams university
author
Eman M.
Wady
Department of ophthalmology. Faculty of medicine. Ain shams university
author
text
article
2017
eng
Glaucoma is a chronic, degenerative optic neuropathy, which cause progressive damage to the optic nerve, retinal ganglion cell (RGC) death and characteristic damage to the visual field. Current glaucoma therapeutics lower intraocular pressure (IOP) but they do not repair the damaged optic nerve or reverse vision loss. So, new treatment strategies are in demand. Stem cell therapy presents a new intervention that holds great promise for reversing vision loss. There are at least 3 potential targets for stem cell therapy in glaucoma: the retinal ganglion cells , the optic nerve head, and the trabecular meshwork. Stem cells also have a neuroprotective effect in glaucoma by improving retinal ganglion cell survival. There are many obstacles in using stem cells in glaucoma as the regulation of differentiation, integration, host immune response, tumorigenesis and ethical concerns.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
68
v.
2
no.
2017
1141
1145
https://ejhm.journals.ekb.eg/article_13379_1f485d07c6e14c1e041df61f1e229a23.pdf
dx.doi.org/10.12816/0039041
Systematic Review: Osteochondral Allograft in Treatment of Knee Articular Cartilage Injuries
Ahmad Mohamed
Elsaeed
Department of Orthopedics, Faculty of Medicine, Ain Shams University
author
Ashraf Mohamed
Elseddawy
Department of Orthopedics, Faculty of Medicine, Ain Shams University.
author
Mohammed Elmowafy
Abdelwahed
Department of Orthopedics, Faculty of Medicine, Ain Shams University
author
text
article
2017
eng
Purpose: The objectives of this study were designed to conduct a systematic review of clinical outcomes after osteochondral allograft transplantation in the knee and to identify patients, defects, and graft-specific prognostic factors.
Methods: We searched PubMed, Medline, EMBASE, and the Cochrane Central Register of Controlled Trials. Studies that evaluated clinical outcomes in patients after osteochondral allograft transplantation for chondral defects in the knee were included.
Results: There were 11 eligible studies resulting in 550 knees with a mean follow-up of 150 months (range, 30 to 261 months). The overall follow-up rate was 93%. The mean age was 31 years (range, 15 to 52 years), and 478 patients (63%) were men. With regard to etiology, the most common indications for transplantation included post-traumatic (38%), osteochondritis dissecans (31%), osteonecrosis from all causes (12%), AVN (1%) and idiopathic (9%). 63% of patients had concomitant procedures, and the mean defect size across studies was 6.3 cm2. The overall satisfaction rate was 93%.
Conclusions: Osteochondral allograft transplantation for focal and diffuse chondral defects results in predictably favorable outcomes and high satisfaction rates. Patients with osteochondritis dissecans, traumatic and idiopathic etiologies have more favorable outcomes as younger patients with unipolar lesions and short symptom duration. Future studies should include comparative control groups and use established outcome instruments that will allow for pooling of data across studies.
The level of Evidence: Level IV, a systematic review of Level IV studies.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
68
v.
2
no.
2017
1146
1154
https://ejhm.journals.ekb.eg/article_13380_d70acdb659a8d0e79e13b5572d88f298.pdf
dx.doi.org/10.12816/0039042
Effect of Autologous Fibrin Gel and Platelet Rich Plasma Activated by Ozone Versus Those Activated by Calcium Chloride on Wound Healing and Prevention of Infection in High Risk Cesarean Sections: Randomized Controlled Study
Marwa
Wanas
Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
author
Waleed
Khalaf
Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
author
Mohamed
Elmandooh
Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
author
text
article
2017
eng
Background: Cesarean delivery, one of the most common major surgical procedures performed worldwide used for 15% of births around the world and it continues to increase in frequency. It is an important contributor to surgical site complications such as infection, hematoma and dehiscence. Platelet Rich Plasma (PRP) is a volume fraction of blood having a high concentration of platelets above the baseline. This product is a rich source of growth factors. PRP can be activated by CaCl2 or medical Ozone. The induction of growth factors found in PRP by ozone can support and potentiate their action.
Aim: The purpose of this study is to compare the effect of application of autologous Fibrin Gel and Platelet Rich Plasma (PRP) activated by medical Ozone (Ozonated PRP) versus those activated by CaCl2 on wound healing and prevention of infection in high risk cesarean sections.
Design: 90 high risk pregnant females undergoing cesarean section were selected randomly according to inclusion criteria and divided into 3 groups each contains 30 patients. Group Ca received Autologous PRP and Fibrin gel activated by CaCl2 at the wound site. Group O received Autologous PRP and Fibrin gel activated by Medical Ozone at the wound site while group P (control) did not receive any of them. All patients were examined for wound complications and healing progress on day 1, day 7 and day 21 postoperative by visual analogue scale (VAS), REEDA scale and Vancouver Scar System (VSS).
Results: the results revealed statistically significance decrease in pain by VAS in group Ozone compared to group P on day 7 and 21. For REEDA also group O showed significant decrease compared to group Calcl on day 1 and 7 while compared to group P was also decreased on day 1, 7 and 21. Group Cacl was significantly decreased compared to group P on day 7 and 21 only. Regarding VSS both group O and group Cacl were significantly decreased compared to group P on all days.
Conclusion: this study gives evidence that applying autologous platelet rich plasma (PRP) promote wound healing and when activated by Ozone gives better results and helps prevention of infection in cesarean section of high risk patients.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
68
v.
2
no.
2017
1155
1161
https://ejhm.journals.ekb.eg/article_13381_5fb0b3766d91616ed2c9bf5deb2af484.pdf
dx.doi.org/10.12816/0039043
Calcium in the Management of Atonic Postpartum Hemorrhage
Abd El-Samie
M
Department of obstetrics and gynecology- Al-Azhar University-Assiut
author
Abd El- Hamid
A
Department of obstetrics and gynecology- Al-Azhar University-Assiut
author
El-Ashmawy
A
Department of obstetrics and gynecology- Al-Azhar University-Assiut
author
Ahmed
B
Department of obstetrics and gynecology- Al-Azhar University-Assiut
author
text
article
2017
eng
Objective: was to compare the role of methergine, misoprostol and calcium in the management of atonic postpartum hemorrhage. Design: Randomized Controlled Trial. Setting: This study was conducted in obstetrics and gynecology department of Al-azhar University Hospital, Assiut.
Patients: 300 women with PPH were included in the study.
Intervention: 300 women, each received 5 IU of oxytocin as prophylaxis then divided into three groups:
Group A (N=100): women with atonic PPH took methergine, Group B (N=100): women with atonic PPH took misoprostol and Group C (N=100): women with atonic PPH took calcium.
Outcome measures: The primary outcome was change in hemoglobin concentration before and after intervention.
Results: There was no significant difference between the three study groups as regard mean hemoglobin level before and after treatment. However, a significant difference was present as regard mean change (drop) in hemoglobin level after treatment, with misoprostol group showing the highest drop in Hb% (2.07 ±0.8) compared to calcium group (1.7 ±0.8) and methergine group (1.3 ±0.5).
Conclusion: Methergine is more effective in controlling the amount of blood loss during delivery giving a better chance in treatment of atonic postpartum hemorrhage followed with calcium then misoprostol. Although of that calcium is good alternative to methergine with low side effects so can be used safely and effectively when methergine is contriandicated.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
68
v.
2
no.
2017
1162
1168
https://ejhm.journals.ekb.eg/article_13382_30b83657dabe7f89e8387f9332548df5.pdf
dx.doi.org/10.12816/0039044
Reassessment of Cases of Uncontrolled Bronchial Asthma in Port-Said Chest Hospital
Mohamed Ali
Farrag
Department of Chest Diseases, Faculty of Medicine - Ain-Shams University
author
Eman Ramzy
Al Adawy
Department of Chest Diseases, Faculty of Medicine - Ain-Shams University
author
Michael Moris
Farid
Department of Chest Diseases, Faculty of Medicine - Ain-Shams University
author
text
article
2017
eng
Background: bronchial asthma is a heterogeneous disease characterized by chronic airway inflammation. It is defined by the history of respiratory symptoms such as wheeze, shortness of breath, chest tightness and cough that vary over time and in intensity, together with variable expiratory airflow limitation. This definition was reached by consensus, based on consideration of the characteristics that are typical of asthma and that distinguish it from other respiratory conditions. The causes of poorly controlled asthma may lie in any of four major areas: diagnosis, medications, provoking agents, and presence of co-morbid conditions.
Aim of the work: this study aimed to assess causes of improper control of bronchial asthma among patients in Port-Said Chest Hospital.
Patients and Methods: this retrospective study was done on 100 uncontrolled asthmatic patients selected from outpatient clinic or inpatient wards in Port-Said Chest Hospital, over a period from January to May 2016.
Results: non-compliance and uncontrolled co-morbidities were the most common presented causes of uncontrolled asthma (55% for each), however ttt improper represented 32% of cases. Other less common causes were infection, offending drug, improper diagnosis, wrong technique and resistant asthma.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
68
v.
2
no.
2017
1169
1175
https://ejhm.journals.ekb.eg/article_13383_c61bd13529b532d12751073973996a36.pdf
dx.doi.org/10.12816/0039045
The Role of Diffusion Weighted MRI in The Differentiation between Benign and Malignant Hepatic Focal Lesion
Amr Mahmoud
Abdelsamed
Department of Radiodiagnosis, Faculty of Medicine - Ain Shams University
author
Remon Zaher
Elia
Department of Radiodiagnosis, Faculty of Medicine - Ain Shams University
author
Mohammed Uday
Hatim
Department of Radiodiagnosis, Faculty of Medicine - Ain Shams University
author
text
article
2017
eng
Background: early detection and diagnosis of hepatic focal lesions are an important step in clinical work, which would allow effective surgical or mini-invasive therapy. With the advances in magnetic resonance imaging (MR) technology, diffusion-weighted magnetic resonance imaging (DWI) is now widely used as a standard imaging sequence in clinical work and shows its potential benefit in evaluation of the focal hepatic lesions.
Aim of the work: the use of MR Diffusion imaging with both low and high B values to detect and differentiate between benign and malignant hepatic focal lesion.
Methodology: the present study included 30 patients. They were El-Demerdash hospital patients with hepatic focal lesions. Patients underwent US or CT before MR examination.
Results: thirty patients were included in this study, 20 males and 10 females. The patient’s age was ranging from 33 to 60 years. There were 24 primary hepatic focal lesions, (36.7% HCC, 3.3% focal nodular hyperplasia, 3.3% cysts, 13.3% hemangiomas, 6.7% cholangiocarcinoma, 16.7% regeneration nodule) and 6 metastatic lesions.
Conclusion: we hope to use DWI to be helpful in the characterization of focal liver lesions, especially if the lesions show non classic appearance of contrast enhancement in Triphasic CT study and in patients with renal insufficiency with inability to use contrast enhancement.
Recommendations: in our opinion, DWI is a useful adjunct to routine liver imaging (i.e. used as an additional sequence to the standard protocol study and not as a unique imaging series); it is fast, requires no intravenous contrast and is non-invasive. The radiologist has to be aware of the potential pitfalls and limitations of the technique. In patients who cannot receive gadolinium-based contrast agents, DW MR imaging has the potential to be a reasonable alternative technique to contrast-enhanced imaging. We suggest the following strategy for evaluating DWI features of FLLs. We believe that most of the FLLs can be practically classified as benign or malignant by using this scheme.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
68
v.
2
no.
2017
1176
1183
https://ejhm.journals.ekb.eg/article_13384_b95b7c85a62b962da707843f5cfe8224.pdf
dx.doi.org/10.12816/0039046
The Future of Glaucoma Treatment Ripasudil
Zafer F.
Ismaiel
Department of ophthalmology, Ain Shams University, college of medicine, Cairo, Egypt
author
Mahmoud A.
Abdel Hamed
Department of ophthalmology, Ain Shams University, college of medicine, Cairo, Egypt
author
Samah M.
Fawzy
Department of ophthalmology, Ain Shams University, college of medicine, Cairo, Egypt
author
Nada E.
Amer
Department of ophthalmology, Ain Shams University, college of medicine, Cairo, Egypt
author
text
article
2017
eng
Glaucoma is a leading cause for worldwide blindness and is characterized by progressive optic nerve damage. The etiology of glaucoma is unknown, but elevated intraocular pressure (IOP) and advanced age have been identified as risk factors. IOP reduction is the only known treatment for glaucoma. Recently, drugs that inhibit Rho associated protein kinase (ROCK) have been studied in animals and people for their ability to lower IOP and potentially treat POAG. ROCK inhibitors lower IOP through a trabecular mechanism and may represent a new therapeutic approach for the treatment of glaucoma. Ripasudil is the first Rho-kinase inhibitor ophthalmic solution developed for the treatment of glaucoma and ocular hypertension in Japan 2014. ROCK inhibition not only reduces intraocular pressure (IOP) but also increases ocular blood flow.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
68
v.
2
no.
2017
1184
1188
https://ejhm.journals.ekb.eg/article_13385_fcbc1900364ace3c70847f1fafe54104.pdf
dx.doi.org/10.12816/0039047
Assessment of Decidual Natural Killer Cells CD56+ Population in Placental Bed in Fetal Growth Restriction
Mohammad Alaa Mohi El-Din
El-Ghannam
Department of Obstetrics & Gynecology, Faculty of Medicine, Ain Shams University,
author
Mohamed ElMandooh
Mohamed
Department of Obstetrics & Gynecology, Faculty of Medicine, Ain Shams University,
author
Mohammed Saeed El-Din
El-Safty
Department of Obstetrics & Gynecology, Faculty of Medicine, Ain Shams University
author
Noha Mahmoud
Kasim
Department of Obstetrics & Gynecology, Faculty of Medicine, Ain Shams University
author
Nahla Mohamed
Awad
Early Cancer Detection Unite at Ain Shams University Hospitals, Cairo, Egypt
author
text
article
2017
eng
Aim: this study to compare the density of decidual natural killer cells (CD56) in deciduas of placental bed in patients with Intrauterine Growth Retardation (IUGR) and women with normal pregnancy.
Patients and Methods: in the study 23 pregnant women were recruited and divided into 2 groups: The study group (A): included 14 patient females which diagnosed as IUGR by ultrasound of the third trimester and the control group (B): included 14 normal females at third trimester with no antenatal complications recruited from the antenatal care clinics. All patients underwent elective cesarean delivery. Decidual biopsies were taken during the operation. An immunohistochemical staining for decidual natural killer cells (dNK, CD56+bright) and a semi quantitative scoring were done.
Results: In this study it was found that the Immunohistochemical scores and dNK cell population density is statistically higher in controls compare with IUGR group (P<0.01)
Conclusions: findings reinforce the concept of pregnancy as a controlled systemic inflammatory state that if altered can have adverse consequences for the mother and the fetus.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
68
v.
2
no.
2017
1189
1195
https://ejhm.journals.ekb.eg/article_13386_7751ad45dba5aa70c670b7b363f23af1.pdf
dx.doi.org/10.12816/0039048
Role of Non-Contrast MRI in Diagnosis of Pulmonary Embolism
Iman Sherif Ahmad
Mohamed
Radiology Department, Faculty of medicine, Ain Shams University, Cairo, Egypt
author
Laila Ahmad
Abdurrahman
Radiology Department, Faculty of medicine, Ain Shams University, Cairo, Egypt
author
Ahmed Mohamed
Osman
Radiology Department, Faculty of medicine, Ain Shams University, Cairo, Egypt
author
text
article
2017
eng
Background: Pulmonary embolism patients with contraindication to radiation exposure and contrast injection. Objective: comparative study between the non -contrast Magnetic Resonance Pulmonary Angiography (MR PA) and the Computed Tomography Angiography (CTA) in diagnosis of pulmonary embolism (PE). Patients and methods: twenty-one patients were included in our study. All patients were admitted and/or referred to Ain Shams University Hospital Departments, Kasr El Ainy Hospital and private centers confirmed to have pulmonary embolism (PE) by CTA. All patients underwent CTA and non-contrast MR-PA in the same day or within three consecutive days. The radiological examinations were interpreted by two different radiologists. The results were compared and statistically analyzed. Results: The mean age of the selected patients was about 49.43years old. 16 cases showed positive PE in both MR-PA and CTA. The 5 cases showed negative results in both. Conclusion: The non-contrast MR-PA has a reasonable sensitivity and specificity in the diagnosis of PE especially in major branches. So, it can be used as an alternative to the CTA especially when the CTA and the use of gadolinium are contraindicated.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
68
v.
2
no.
2017
1196
1201
https://ejhm.journals.ekb.eg/article_13387_5596f59aece4abba16fdfbd3c154d0c0.pdf
dx.doi.org/10.12816/0039049
MRI Evaluation of Lumbar Disc Degenerative Disease
Noha Mohamed
Osman
Radiodiagnosis Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
author
Fady Mamdouh
Fawzy
Radiodiagnosis Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
author
Hanady Mohammed
Lateef
Radiodiagnosis Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
author
text
article
2017
eng
Aim of the work: lumbar disc degenerative disease is most leading cause of back pain, it is the most common cause of disability at age above 45 years and 2nd most common reason for primary care physician visit. Magnetic Resonance Imaging (MRI) is the standard imaging modality for detecting disc pathology due to its advantage of lack of radiation, multi planar imaging capability, excellent spinal soft-tissue contrast and precise localization of intervertebral discs’ changes. this study aimed to evaluate the characterization, extent and changes associated with the degenerative lumbar disc disease by Magnetic Resonance Imaging. Study Design: cross-sectional and observational study.
Study Sample: forty consecutive and clinically examined patients with lower back pain suggestive of lumbar disc disease. Material and Methods: 40 patients with age group between 17 and 80 years with low back pain were diagnosed on 1.5 Tesla MRI machine. The following MRI findings were noted: lumbar lordosis preserved or not, ligamentum flavum hypertrophy, facet joint arthrosis or osteophytes formation and Endplate (modic) changes, decreased disc height as compared to the upper and lower vertebral levels and loss of signals, disc bulge at different levels, Disc protrusion and disc extrusion was observed.
Result: most of patient showed lossof lumbar lordosis, facet joint arthrosis, ligamentum flavum hypertrophy, Endplate (modic) changes, and osteophytes formation. Disc dehydration which is one of the earliest features of aging and disc degeneration was present in (42%) patients with the most dehydrated disc seen at L4/L5 and L5/S1. Patients with degenerative disc disease had the following disc contour abnormalities. Disc bulges (26.5%) and herniations (10.5%). Herniations were further reported as broad based herniations (9.5%), extrusions (19.0%) and the protrusions (71.4%). The most common site for bulges and herniations was L4/L5 (33.6%) and (57.1%) respectively. The most common complication of bulges and herniations was impingement of exiting nerve roots (40%) and compression of exiting nerve roots and cauda equina (47.6%) respectively.
Conclusion: lumbar disc degeneration is the most common cause of low back pain. It is the most common cause of disability at age above 45 years. Plain radiograph can be helpful, but MRI is the standard imaging modality for detecting disc pathology due to its advantage of lack of radiation, multi planar imaging capability, excellent spinal soft-tissue contrast and precise localization of intervertebral discs changes.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
68
v.
2
no.
2017
1202
1207
https://ejhm.journals.ekb.eg/article_13388_36c135af6436ff12fd43baea8f83f8e6.pdf
dx.doi.org/10.12816/0039050
Urea and Creatinine Levels in Vaginal Fluid as A Predicator for Length of Latency Period in Prelabour Membranes Rupture
Daniel Onsi
Anis
Obstetrics and Gynecology Department, Faculty of Medicine, Ain shams University
author
Rasha Mahmoud Medhat
Abd El-Hady
Obstetrics and Gynecology Department, Faculty of Medicine, Ain shams University
author
Mohamed El-Mandooh
Mohamed
Obstetrics and Gynecology Department, Faculty of Medicine, Ain shams University
author
Amr Mohamed
El-Husseni
Obstetrics and Gynecology Department, Faculty of Medicine, Ain shams University
author
text
article
2017
eng
Background: The diagnosis of equivocal cases of prelabour rupture of membranes (PROM) with traditional methods has been unreliable therefore various biochemical markers have been sought to confirm the same, this study aims to determine the relation between the concentration of urea and creatinine in vaginal fluid and length of latency period in women with PROM between 32 and 35 weeks gestation.
Methods: sixty patients were included in our study with PROM of their singleton pregnancies, their gestational age ranged between 32- 35 gestational weeks by reliable menstrual history and confirmed by pelvi-abdominal ultrasound. All samples were obtained within 6 hours after membranes rupture before vaginal examination and the administration of any drugs All women will be put under observation for 48 hours and time of onset of delivery will be documented, the onset of labor will be diagnosed by either: frequent uterine contractions more than 2 contractions in 10 minutes or CTG showing frequent contractions.
Results: The current study was conducted on a total number of 60 pregnant women, 20-35 year old; pregnant between 32 and 35weeks. Our study demonstrated that patients with higher levels of vaginal fluid urea and creatinine concentrations had earlier onset of labor. Patients with vaginal fluid urea and creatinine concentrations above cut-off levels (urea ≥26.0 (mg/dL), creatinine ≥0.64 (mg/dL)) went into labor early within a 48 hours latency period. This suggests vaginal urea and creatinine levels measurement in the prediction of early delivery.
Conclusion: Measurement of urea and creatinine in vaginal fluid is a cheap and rapid method with high sensitivity and specificity for the delivery interval after PROM. Therefore, these methods can be integrated as non-invasive tests for the predication of delivery interval after PROM.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
68
v.
2
no.
2017
1208
1214
https://ejhm.journals.ekb.eg/article_13389_05c46fd96ae6f74a8266855c3f3c0bf6.pdf
dx.doi.org/10.12816/0039051
Asthma Control Assessment Using Asthma Control Test Among Pediatric Patients Attending a Tertiary Care Hospital in Saudi Arabia
Bandar
Alsahn
King Saud Bin Abdulaziz for Health Science
author
Abdulaziz
Alzahrani
King Saud Bin Abdulaziz for Health Science
author
Othman
Alsahmi
King Saud Bin Abdulaziz for Health Science
author
Abdullah
Alqudhybi
King Saud Bin Abdulaziz for Health Science
author
Abdullah
Alshamrani
Department of Pediatric, Prince Sultan Medical Military
author
text
article
2017
eng
Background: There are not enough data on the epidemiology of asthma in pediatric patients. The goal of the study was toassess the level of asthma control using the childhood Asthma Control Test (c-ACT).
Methods: This cross-sectional descriptive study was conducted in the outpatient pulmonary clinic at King Fahad Medical City in Riyadh.Pediatric patients who were diagnosed with bronchial asthma by their primary treating physician were recruited over a one-year period. Patients completed the c-ACT and questionnaires, which were associated with the quality of asthma control.
Results: Two hundred and ninety-two asthmatic patients (n = 292) were enrolled, and 35.3% of these patients were female. The estimated prevalence of uncontrolled asthma at the time of the study was 45.2%. Factors that were significant in asthma control were female gender (P-value = 0.041), winter months (P-value = 0.01), allergic rhinitis (P-value = 0.036), and eczema (P-value = 0.039). However, the degree of asthma control did not appear to be related to the place of residence, the type of clinic visited, pet ownership, receipt of an influenza vaccine, or medication use.
Conclusion: This study identified evidence for the high prevalence of uncontrolled asthma in pediatric patients in out-patient clinics and several factors that may contribute to poor asthma control. Physicians should be aware of seasonality and of treating patients with comorbid eczema and allergic rhinitis.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
68
v.
2
no.
2017
1215
1223
https://ejhm.journals.ekb.eg/article_13390_1603b51224139b2ca9532a614a88dced.pdf
dx.doi.org/10.12816/0039052
Role of Trans-catheter Ovarian Vein Embolization in The Management of Symptomatic Chronic Pelvic Congestion in Females
Mai Shaaban
Abd El-Galil
Radiology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
author
Ahmed Mohamed
Bassiouny
Radiology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
author
Karim Ahmed
Abd El-Tawab
Radiology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
author
Hossam Abd El-Kader
Moursy
Radiology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
author
text
article
2017
eng
Background: Trans-catheter ovarian vein embolization has a role in the management of symptomatic chronic pelvic congestion in females.
Objective: Toassess the technical success and short term clinical efficacy of trans-catheter ovarian vein embolization as a treatment for symptomatic pelvic congestion syndrome in women.
Methodology: Some of the cases are done at interventional radiology unit Ain Shams University and some of them are taken from literatures.
Conclusion: Ovarian vein embolization has a great role in the management of symptomatic pelvic congestion syndrome in women.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
68
v.
2
no.
2017
1224
1228
https://ejhm.journals.ekb.eg/article_13391_d4d64577bfba38dfef37c108e7e77008.pdf
dx.doi.org/10.12816/0039053
MRI Features of Posterior Reversible Encephalopathy Syndrome
Abdul-Qader Isam
Abdul-Hameed
Radiology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
author
Salwa Taha Ahmed
Isma'il
Radiology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
author
Shaimaa Abdelsattar
Mohammad
Radiology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
author
text
article
2017
eng
Background and Purpose: Posterior Reversible Encephalopathy Syndrome (PRES) represents a clinico-radiological constellation of neurological symptoms and radiological features. The syndrome tends radiologically to be present with certain features and patterns. Our aim in this study is to investigate the PRES radiological features by which it does present in our community and to correlate the findings clinically. Methods: The MR images obtained for the 17 patients included in the study were analyzed for the PRES features and patterns. Fluid Attenuation Inversion Recovery (FLAIR) sequence was the mainly used sequence for assessment. Diffusion images with their apparent diffusion coefficient maps, T2* images, and Angiography were also utilized for further assessment and characterization. Results: Most of the cases demonstrated a bilateral involvement (94%). The regional distribution supra-tentorially included parietal and occipital affection in 94%, frontal lobe affection in 76%, and a temporal lobe affection in 71%. Infra-tentorial involvement was noted in 41% of the cases. Pattern percentages were slightly different from those available in the literature with the Holo-hemispheric Watershed pattern being the most common (35%). Conclusion: The originally described PRES features are present in the majority of the studied cases. The identified PRES patterns may reflect underlying clinical or pathological correlations, and hence can vary across communities.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
68
v.
2
no.
2017
1229
1235
https://ejhm.journals.ekb.eg/article_13392_53159294a93db80d42723594e4a310c7.pdf
dx.doi.org/10.12816/0039054
Malignant Breast Tumors: Role of MRI in Predicting Histopathological Grading
Hossam Moussa
Sakr
Department of Radiodiagnosis, Faculty of Medicine - Ain Shams University, *Thi-Qar University
author
Allam Elsayed
Allam
Department of Radiodiagnosis, Faculty of Medicine - Ain Shams University, *Thi-Qar University
author
Zinah Nashee
Hasan
Department of Radiodiagnosis, Faculty of Medicine - Ain Shams University, *Thi-Qar University
author
text
article
2017
eng
Introduction: Magnetic Resonance Imaging (MRI) is an established supplemental technique to mammography and ultrasonography for evaluation of breast lesions. Diffusion-weighted MR imaging (DWI) has recently been integrated into the standard breast MRI in addition to images obtained from dynamic contrast enhanced MRI. DWI is quantified using the Apparent Diffusion Coefficient (ADC) value which is the measurement of the mean diffusivity of water in tissues along three orthogonal directions.
Aim of the Work: The aim of this study was to investigate the relationship between DWI findings (represented by ADC values) and the dynamic contrast enhanced MRI findings (including functional parameters and morphological criteria) with the histopathological grade of malignant breast tumors.
Methodology: 25 Patients (age >30 years) were enrolled in this study. All patients were referred either from the screening clinic or the outpatient clinic of Eldemerdash Hospital with clinically suspicious findings and the abnormality was detected by mammography and/or ultrasound. Included masses are those with BI-RADS 5 category on imaging, with no previous biopsy or treatment. There was no knowledge about the histopathological diagnosis at the time of initial evaluation. Exclusion criteria were breast masses with diagnosed or proved benign features. All patients were scheduled for dynamic MRI with diffusion weighted imaging in addition to the conventional MR imaging.
Results: Histopathological analysis revealed all 25 lesions to be invasive ductal carcinomas not otherwise specified. Grading of included carcinomas was as follows: 3 lesions (12.0%) were grade I, 14 lesions (56.0%) were grade II and 8 lesions (32.0%) were grade III.
Conclusion: That makes DWI the best non-invasive tool available to predict grades of breast carcinoma. However, further larger and more detailed studies are still needed to fully understand the role MR imaging in distinguishing different histological grades of breast cancer.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
68
v.
2
no.
2017
1236
1245
https://ejhm.journals.ekb.eg/article_13393_9587f2a34b59277bd0814123ed62fe0d.pdf
dx.doi.org/10.12816/0039055
Surgical Wound Infection
Ebtesam Mohammed
Alahmari
King Khalid Univerity, Abha, Saudi Arabia
author
Roaa Fahad
Alshabanah
King Khalid Univerity, Abha, Saudi Arabia
author
Tahani Saeed
Almohayya
King Khalid Univerity, Abha, Saudi Arabia
author
Norah Ibraheem
Almanie
King Khalid Univerity, Abha, Saudi Arabia
author
Reem Ali
Almanie
King Khalid Univerity, Abha, Saudi Arabia
author
Amal Nasser
Alqahtani
King Khalid Univerity, Abha, Saudi Arabia
author
Sarah Saeed
Alshahrani
King Khalid Univerity, Abha, Saudi Arabia
author
Amjaad Saleh
Aljelban
King Khalid Univerity, Abha, Saudi Arabia
author
text
article
2017
eng
Surgical wound infections prompt antagonistic patient results, including delayed hospitalization and demise. Wound infection happens with every entry point, however demonstrated procedures exist to diminish the hazard of surgical injury diseases. Specifically, enhanced adherence to prove that based deterrent measures identified with fitting antimicrobial prophylaxis can diminish the rate of surgical wound infection. Various patient-related and technique related components impact the danger of surgical injury disease, and henceforth counteractive action requires a package approach, with deliberate consideration regarding numerous hazard factors, to diminish the hazard of bacterial pollution and enhance the patient's defences. Forceful surgical debridement and successful antimicrobial treatment are expected to enhance the treatment of surgical wound infections.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
68
v.
2
no.
2017
1246
1251
https://ejhm.journals.ekb.eg/article_13394_2bd061ae3f0d1ce1702b3eadc7e3929d.pdf
dx.doi.org/10.12816/0039056
Assessment of The Prevalence of Pelvic Floor Disorders in Both Vaginal and Cesarean Deliveries and Their Impact on The Quality of Life
Osama Saleh Hassan
El Kady
Obstetrics and Gynecology department, Faculty of Medicine, Ain Shams University
author
Tarek Fathy
Tamara
Obstetrics and Gynecology department, Faculty of Medicine, Ain Shams University
author
Haitham Abd El Mohsen
Sabaa
Obstetrics and Gynecology department, Faculty of Medicine, Ain Shams University
author
Alaa Hafez Mohamed Shawky
Hafez
Obstetrics and Gynecology Department, El Mataria Teaching Hospital
author
text
article
2017
eng
Background: Pelvic floor disorders (PFDs) occurring in women comprises a broad range of clinical scenarios such as pelvic organ prolapse (POP) and stress urinary incontinence (SUI).
Aim of the work: The objectives of the present study were to estimate differences in the prevalence of pelvic floor disorders (POP & SUI) in Egyptian women by mode of delivery and their impact on patients’ quality of life using assessment questionnaire.
Materials and Methods: This observational (non-interventional) cohort study was conducted on 464 parous women from the gynecologic out-patient clinic of Ain Shams Maternity University Hospital for measuring the prevalence of POP and UI regards the mode of delivery in women delivered 5 years back or more and its impact on the quality of their lives. Pelvic organ support was assessed using the Pelvic Organ Prolapse Quantification method (POP-Q), and pelvic floor symptoms were evaluated using assessment questionnaire.
Results: Our study found that compared to Cesarean Section (CS; 32.8%), vaginal delivery (VD) was associated with statistically significant increase in the occurrence (43.5%) and severity (Moderate-to-severe UI [39.6% in VD vs. 10.5% in CS]) of UI especially SUI (VD vs. CS: 62.4% vs. 51.3%). Vaginal delivery was associated with more than double the occurrence of POP (19.4% vs. 8.2% in CS), and more than triple the concomitant occurrence of both POP and SUI (9.9% vs. 2.6% in CS).
Conclusion: There is a positive correlation between the mode of delivery - as an independent factor - and the prevalence of pelvic floor disorders (both pelvic organs prolapse & urinary incontinence) in parous women.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
68
v.
2
no.
2017
1252
1256
https://ejhm.journals.ekb.eg/article_13395_0caf0a19f52203735a0cc37bdae222e8.pdf
dx.doi.org/10.12816/0039057
Acute Coronary Syndrome in a 56-year-old Female with Sedentary Lifestyle: A Case Report
Mohammed Adel
Basyuni
Umm AlQurra University
author
text
article
2017
eng
Background: the average amount physical activity of women in Saudi Arabia predisposes them to ischemic heart disease, in an otherwise completely healthy individual.
Aim: To emphasize the significance of lack of physical activity alone on cardiovascular health.
Case report: this case report describes an acute onset of severe coronary syndrome of a middle aged Saudi woman with no other cardiac risk factors. Treadmill test was positive for inferolateral ischemia. CT angiography revealed occluded arteries in five different locations. A PCI was performed after three months to achieve complete vascularization.
Conclusion: normal lifestyle of women in Saudi Arabia should be considered very sedentary and a major risk factor of ischemic heart diseases.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
68
v.
2
no.
2017
1257
1259
https://ejhm.journals.ekb.eg/article_13396_fb1fce36826969b1c1e4979eb87e7946.pdf
dx.doi.org/10.12816/0039058
The Diagnostic Value of Combined Conventional MRI and Diffusion Weighted MRI in Diagnosis of Non-Palpable Undescended Testes
Aisha Dabnon
Abd Alnabie
Faculty of Medicine, Ain Shams University
author
text
article
2017
eng
Background: MRI is noninvasive imaging tool, does not involve ionizing radiation and yields multiplanar images but it is sometimes less efficient in locating intra-abdominal functioning testicles and it fails to locate most of the atrophied testicles. Additional MRI assessments, as fat-suppressed T2WI and DWI are useful methods to improve the accuracy and sensitivity of diagnosis of non-palpable testes.
Objective of the Study: is to assess the value of adding diffusion-weighted sequences (DWI) to routine magnetic resonance imaging (MRI) in identifying and locating nonpalpable undescended testes.
Results: a combination of DWI and conventional MRI including Fat-supp. T2WI sequence is the most accurate means of detecting and localizing non-palpable undescended testes. The findings of DWI complement the information on the location of undescended testes obtained with conventional MRI. In addition, DWI is helpful in detection of testicular viability or atrophy properly before the operation.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
68
v.
2
no.
2017
1260
1271
https://ejhm.journals.ekb.eg/article_13397_0eed8c766215cfa9e06b80c1fc5df93a.pdf
dx.doi.org/10.12816/0039059
Procalcitonin as A Diagnostic and Prognostic Marker of Sepsis in Critically Ill Patients in Intensive Care Unit
Fatema H.
Ashour
Anaesthesia department, AL-Azhar University, Cairo, Egypt
author
Hend M.
Maghraby
Internal medicine department, AL-Azhar University, Cairo, Egypt
author
Asmaa S.
Hassan
Clinical pathology department, AL-Azhar University, Cairo, Egypt
author
text
article
2017
eng
Background: Sepsis is a leading cause of mortality in critically ill patients. However, differentiating sepsis from non-infectious triggers of the systemic inflammatory response syndrome (SIRS) is difficult. Procalcitonin is useful biomarker of systemic inflammatory response to infection. Its level rises in response to a proinflammatory stimulus, especially of bacterial origin and not rise significantly with viral or non infectious inflammation. Objectives: The aim of this study was to determine the relation of procalcitonin (PCT) level with the development of organ failure and mortality in critically ill septic ICU patients
Patients and Methods: The current study was conducted on 60critically ill adult septic patients aged between 18-60 years old of both sex with anticipated stay of >48 hours. All patients were assessed clinically with haemodynamic and full laboratory monitoring, CRP, a PCT level and SOFA score were calculated in the1st and the 4th day of admission.Results: There was significant increase in PCT level between three groups and no significant difference between groups as regard CRP. According to SOFA score there was significant difference between three groups. There was a positive correlation between PCT level and SOFA Score (r = 0.924, P = 0.001) while there was no correlation between CRP and SOFA score (r = -0.233, P = 0.091).
Conclusion: PCT is a good diagnostic and prognostic marker of sepsis. PCT shows a closer correlation than that of CRP with the severity of infection and organ dysfunction.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
68
v.
2
no.
2017
1272
1278
https://ejhm.journals.ekb.eg/article_13613_6c9864a604185503cdaba6c0436cee2a.pdf
dx.doi.org/10.12816/0039060
Comparison of Sensitivity and Specificity of DWIBS and Contrast Enhanced T1Wi Sequences in Characterization of Suspicious Mammography Lesions
May
El-Samahy
Radiology Department, Faculty of Medicine, Ain-Shams University
author
Haytham Mohamed
Nasser
Radiology Department, Faculty of Medicine, Ain-Shams University
author
Sherine Kadry
Amin
Radiology Department, Faculty of Medicine, Ain-Shams University
author
text
article
2017
eng
Background: Diffusion Weighted Imaging with Back-ground Suppression is a new technique which uses the same concept of diffusion weighted imaging yet has the privilege of back-ground suppression and acquisition at a wider range of b-values hence increasing sensitivity and specificity.
Objective: to determine the accuracy of DWIBS MR imaging in comparison to the DEC MR imaging in characterizing suspicious mammography lesions.
Patients and Methods: twenty patients were included in the study, all with suspicious breast lesions from Ain-Shams University mammography clinic. A cross-sectional study was held where all the patients under-went MRI breast protocol which included DCE and DWIBS sequences. The MRI of all the patients was read by two expert radiologists blinded to each other's opinion. Biopsy was then done for histo-pathological correlation. The results were statistically analyzed.
Results: seventy percent of the patients included in our study had malignant lesions and 30% had benign lesions. Both DWIBS and DCE showed comparable efficacy of 90% and 95% respectively.
Conclusion: DWIBS can be used as an adjunct to DCE breast MRI improving its sensitivity and specificity. It can as well be used instead of DCE sequences in cases of renal impairment.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
68
v.
2
no.
2017
1279
1283
https://ejhm.journals.ekb.eg/article_13614_59f814ba852e91a08955fbf39d919193.pdf
dx.doi.org/10.12816/0039061
Skin Adhesive Tape versus Non- Absorbable Sutures in Repair of Laparoscopic Incision
Moustafa Ibrahim
Ibrahim
Department of Obstetrics and Gynecology, Faculty of Medicine-Ain Shams University
author
Amr Ahmed
Riad
Department of Obstetrics and Gynecology, Faculty of Medicine-Ain Shams University
author
Safaa Ragab
Ahmed
Department of Obstetrics and Gynecology, Faculty of Medicine-Ain Shams University
author
text
article
2017
eng
Background: Every year several million women have to undergo gynecological surgery. As a result of that they acquire an abdominal scar. Nowadays women of all ages place extreme importance on the appearance of the scar in addition to the symptoms of pain, tenderness and itching. An aesthetically poor scar can have a negative impact on the overall quality of life causing considerable distress, loss of self-esteem and unhappiness. The appearance of the scar is of significant importance and is often the only reminder of surgery. Aim of the Study: to compare between skin adhesive tape (steri-strips) and non-absorbable suture in closure of abdominal laparoscopic port sites.
Patients and methods: The current prospective case control study was conducted at Ain Shams University maternity hospital .the participating women were randomly allocated into two arms .Arm (A): women had laparoscopic port sites closed with skin adhesive tape. Arm (B): women had laparoscopic port sites closed withnon- absorbable sutures.
Results: A total of 142 women were included. The overall incidence of pain was 0.1%and 0.2%, redness was 8.5% and 23.9%,hotness was 2.8% and 12.7%, discharge was 1.4% and 4.2%, impaired healing was 1.4% and 5.6% and satisfaction was 94.4%and 63.4% in arm A and B respectively.
Conclusion: using skin adhesive tape (Steri Strep®) in closure of abdominal laparoscopic port sitesis associated with a decreased risk of wound complications and increased rate of patient satisfaction.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
68
v.
2
no.
2017
1284
1288
https://ejhm.journals.ekb.eg/article_13615_a9cb14eee973f3c365a7b8e8cdf1d6b9.pdf
dx.doi.org/10.12816/0039062
Diabetic Foot Awareness among Diabetic Patients in Saudi Arabia
Mesale A
Algshanen
Najran University, College of Medicine
author
Mohammed F
Almuhanna
Wroclaw Medical University
author
Ahmed M
Almuhanna
King Saud University
author
Faisal F
Alghobaish
Ministry of Health
author
Omer S
bari
Batterjee Medical College
author
Naif A
Alajji
King Saud University
author
Hussain J
Alabdullah
Wroclaw Medical University
author
Saad H
Aldosari
Khalid M Alotaibi
author
Salman I
Alomran
Prince Sattam University
author
Muayyad
Abualjadayel
UQU University, College of Medicine
author
Ahmed A
Almeshari
King Fasial Universty
author
Meshal A
Almustafa
King Fasial Universty
author
Fahad S
Alqahtani
King Saud University
author
Mohammed D
Alzamanan
Najran University, College of Medicine
author
Khalid M
Alotaibi
King Saud University
author
Mahdi Y
Alzamanan
Najran University, College of Medicine
author
text
article
2017
eng
Aim of the work: diabetic foot disease(DFD) is diabetic patient's foot affection by ulcers which are accompanied by peripheral vascular disease and/or diabetic neuropathy of the lower limb. Prevalence of diabetic ulcer is ranging from 2%-10%. High rate of lower limb amputation in DFD (More than 15%) and survival rate for undertaken amputation patient are short. Ninety diabetic amputations are performed monthly in Saudi Arabia capital of Riyadh. Identification of DFD and diabetic patient's awareness of DFD and how to take care of it will reduce the incidence of more complications like amputation. This study aimed to evaluate knowledge, education, attitude and practice with diabetic foot among diabetic patients all over Saudi Arabia. Patients and Method: cross-sectional study directed among the diabetic clinic visitors in Primary Health Care Centers (PHCs s). Selection of 55 PHCs was done by random sampling. Ten diabetic patients were randomly selected from each PHCs and collecting of data was done by interviews. Research questionnaire contains three parts; first part is asking about demographic data; second part is about data that are focusing on diabetes and its related questions and last part is the main part which asking about diabetic foot. Results: 519 diabetic patients were participated in this study. Only 180 participants were complaining of diabetic complications (34.7%). Most of participants (55.1%) get high score 7-8 out of 8 questions in Knowledge. Although, there were 166 persons (32%) who couldn’t reach full score in attitude evaluation. There was a large percentage of our participants (69%) had very low score 0-2 out of 6 in assessment of previous education of diabetic foot. More than half of participants (56.5%) had score 6-10 out of 15 in evaluation of practice with diabetic foot. Conclusion: diabetic foot in Saudi Arabia is existing, even amputations and other diabetic foot complications were also present. Diabetic patients have good knowledge and attitude toward diabetic foot. Education about diabetic foot and practice is still weak.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
68
v.
2
no.
2017
1289
1290
https://ejhm.journals.ekb.eg/article_13641_eff05cb22360460a2c91a9c13f689e6f.pdf
dx.doi.org/10.12816/0039063
Role of MRI CSF Flowmetry in Evaluation of Hydrocephalus in Pediatric Patients
Abeer Maghawry
Abdelhameed
Radiology Department, Faculty of Medicine, Ain Shams University
author
Eman Ahmed Fouad
Darweesh
Radiology Department, Faculty of Medicine, Ain Shams University
author
Marwa Hosni
Bedair
Radiology Department, Faculty of Medicine, Ain Shams University
author
text
article
2017
eng
Background: phase contrast MR imaging is a rapid, simple and non-invasive technique which is sensitive to even small CSF flows, and can be used to evaluate CSF flow both qualitatively and quantitatively. Cine phase contrast MR images show CSF flow in a dynamic, more easily appreciable, and in a more pleasing manner, allowing the delineation of obstruction, if present, along the portions of CSF pathway where obstruction is common (foramen of Monro, acqueduct of Sylvius)
Patients and Methods: the study includes 20 patients from the pediatric population with ventriculomegaly (diagnosed by a radiological report) referred from Ain Shams Pediatric Hospital, Neurosurgery department at Ain Sahms University, clinic, and outpatients. Control group of 20 pediatric patients of matched age group underwent CSF flow study to obtain normal reference values. These patients had no hydrocephalus and came to our institute to undergo MRI for other neurological causes. CSF flowmetry was added to their study after obtaining oral informed consent from their parents.
Results: our study included 20 patients, 8 males and 12 females, with age range 2 months - 12 years and average age 3.5 years old. All patients included were diagnosed with hydrocephalus by a previous radiological report. All patients underwent conventional MRI brain and CSF flowmetry. Patients were given diagnosis based on findings of conventional MR images, and were categorized into groups according to their underlying etiologies. 9 patients had aqueductal stenosis, 4 patients had atrophy, 2 patients had communicating hydrocephalus, 2 patients had Arnold Chiari malformation, 1 patient had Dandy-Walker variant, 1 patient had obstruction at foramen of Monro, and 1 had obstruction at foramen of Magendi. CSF flowmetry was added to evaluate the cause of hydrocephalus.
Conclusion: phase contrast MR imaging is a rapid, simple and non-invasive technique which is sensitive to even small CSF flows, and can be used to evaluate CSF flow both qualitatively and quantitatively, and could be used in conjunction with conventional MRI in assessment of cases of hydrocephalus.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
68
v.
2
no.
2017
1291
1296
https://ejhm.journals.ekb.eg/article_13642_11942afcfa2ebf9532e55485c065ae2c.pdf
dx.doi.org/10.12816/0039064
Effective Phacoemulsification Time in Femto Cataract in Comparison to Conventional Cataract
Ahmed Hassan
Assaf
Department of Ophthalmology, Faculty of Medicine, Ain Shams University
author
Rania Gamal El Din
Zaki
Department of Ophthalmology, Faculty of Medicine, Ain Shams University
author
Yasmine Maher
Mohammed
Department of Ophthalmology, Faculty of Medicine, Ain Shams University
author
Marwa Mustafa
Mahmoud
Department of Ophthalmology, Faculty of Medicine, Ain Shams University
author
text
article
2017
eng
Background: Cataract surgery is one of the most commonly performed surgery in the world and the number of individuals with cataracts is predicted to reach 30 million by the year 20201. This number will continue to grow as the population ages. more and more patients pursue surgery at the early stage of cataract in order not to endure visual impairment. Phacoemulsification is the standard surgery procedure for cataract in the developed countries. In recent years, femtosecond laser (FSL) has been introduced into phacoemulsification cataract surgery to perform corneal incisions, capsulorhexis, and nuclear fragmentation. Numerous clinical studies have reported that using FSL to perform nuclear fragmentation before phacoemulsification significantly reduces the amount of ultrasound energy and effective phacoemulsification time (EPT) required in the surgery.
Purpose: The goal of the present study is to assess the effect of FSL on effective phaco time in comparison to conventional phacoemusification procedure. Patients andMethods: a comparative study included 40 patients with senile cataract (nuclear cataract grade III or more) based on lens opacification classification system III (LOCSIII). The patients were subdivided into 2 groups; group (A) included 20 patients with senile cataract underwent Femtosecond laser-assisted phacoemulsification (CATALYS FSL system (Abbott Medical Optics)) and group (B) included 20 patients with senile cataract underwent conventional phacoemulsification ( INFINTI phacoemulsification platform (Alcon)). Effective phaco time had monitored and recorded in all patients.
Results:As regarding conventional phaco group, mean EPT was 19.80±24.33 and in femto group, mean EPT was 1.05±1.28 with (p-value 0.001) which show highly significant difference between the two groups.
Conclusion: Femto-second laser assisted cataract surgery reduce effective phacoemulsification time for grade 3 or more of nuclear cataract in comparison to manual procedure.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
68
v.
2
no.
2017
1297
1300
https://ejhm.journals.ekb.eg/article_13644_c57fffa99b810e9ce4d720109208dbc4.pdf
dx.doi.org/10.12816/0039065