Predictive Factors for the High Perianal Fistula Recurrence After Placement of Seton
Mohammed Sobhy
Taema
Department of General Surgery, Faculty of Medicine - Al-Azhar University
author
Abd El Fattah Morsi
Saied
Department of General Surgery, Faculty of Medicine - Al-Azhar University
author
Mustafa Mohammed Ahmed
EL Sheikh
Department of General Surgery, Faculty of Medicine - Al-Azhar University
author
text
article
2019
eng
Background: The placement of seton is one of the common sphincter-saving procedures for high fistula-in-ano (FIA). It has been described since Hippocrates who first used horse hair as a seton for the treatment of anal fistula. Objective: The aim of this study is to investigate the predictive factors for recurrence and to evaluate the efficacy and complications of seton treatment for high transsphincteric perianal fistula. Patients and methods: Our study was a prospective study, on a sample size of 50 patients (43 males and 7 females) of high perianal fistula, carried out in Bab-Alsharia University Hospital. Results: In our study 66.7 % of recurrent cases had history of previous fistula surgery. Fecal incontinence was recorded in 3/50 (6%) patients in our study. Factors associated with higher rates of fecal incontinence (FI) after fistula surgery included high transsphincteric or suprasphincteric fistula, horse-shoe fistula, female patients, and patients older than 45 years. Conclusion: Factors that significantly predicted the recurrence of FIA were previous fistula surgery, anterior anal fistula, and presence of secondary tracks or branches as with supralevator extension, and horse-shoe fistula. Female patients and horse-shoe fistula were the significant risk factors for developing FI after the placement of seton.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
77
v.
5
no.
2019
5514
5519
https://ejhm.journals.ekb.eg/article_60261_428ff22c9105009789391ca7932200e3.pdf
dx.doi.org/10.21608/ejhm.2019.60261
Effect of Both Phytoestrogen and Xenoestrogen on Some Sexual Hormones in Male Albino Rats and Illustration of The Effect of Arctium Lappa L (A. Lappa) on Their Actions
Eman G.E.
Helal
Zoology Department, Faculty of Science, Al- Azhar University (Girls)
author
Nora Abdulaziz
Aljalaud
Biology Department Collage of Science Imam Abdulrahman Bin Fasial University
author
Mohamed A.
Abdelaziz
Physiology Department, Faculty of Medicine, Al-Azhar University
author
Abeer
Zakaria
Zoology Department, Faculty of Science, Al- Azhar University (Girls)
author
text
article
2019
eng
Background: Xenoestrogens are chemically distinct industrial products potentially able to disrupt the endocrine system by mimicking the action of endogenous steroid hormones. Phytoestrogens are naturally occurring non-steroidal plant chemicals that can act like the female hormone estrogen. Arctium lappa (burdock) root has traditionally been recommended as an aphrodisiac agent. Objective: The aim of the study was to clarify the effect of both bisphenol-A (BPA) and anise oil together on some sexual hormones and illustration the effect of A. lappa on their actions. Materials and methods: The study was conducted on thirty male albino rats. The animals were divided into three groups: Group I, control untreated group, Group II, rats treated with bisphenol-A and anise oil and Group III, rats treated with BPA and anise oil in addition to A. lappa. Blood samples were collected to estimate biochemical parameters. Results: The biochemical results showed highly significant increase (p < 0.01) in the activities of ALT, AST, urea, creatinine, FSH, prolactin, total cholesterol, triglycerides, LDLC, VLDL, LDL/HDL and TC/HDL levels. While, there was highly significant decrease (p < 0.01) in HDLC, total protein, albumin, globulin, testosterone and, LH. All these results turned back to the normal values after receiving the A. lappa as compared to normal group. Conclusion: it could be concluded that phytoestrogen and xenoestrogen have undesirable effects and it's recommended to minimize the utilization of these compound to protect people from its hazardous effects.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
77
v.
5
no.
2019
5520
5527
https://ejhm.journals.ekb.eg/article_60262_a945dd7bc714915c575a5112a0ee4bfb.pdf
dx.doi.org/10.21608/ejhm.2019.60262
The Association between Helicobacter Pylori Infection and Hyperemesis Gravidarum
Attia Mohammad
Attia
Department of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University
author
Abd-Elaleem Abd-Elaleem
Elgendy
Department of Clinical Pathology,
Faculty of Medicine, Al-Azhar University
author
Osama Gamal
Mohammad
Department of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University
author
text
article
2019
eng
Background: Hyperemesis gravidarum is the severe form of nausea and vomiting of pregnancy. The reported incidence of Hyperemesis gravidarum is about 0.5-2.0%. For the diagnosis of hyperemesis gravidarum there must be presence of three or more vomiting episodes during the day, weight loss of over 5% and ketonuria. Studies have recently suggested that there is an association between emesis gravidarum and hyperemesis gravidarum with Helicobacter pylori infection. Serologically positive H. pylori infection has been demonstrated in hyperemesis patients. Objective: To detect if there is association between hyperemesis gravidarum and infection with helicobacter pylori. Methods: The study included 200 women that were classified into two groups. Group (1) 100 women with hyperemesis gravidarum and group (2) 100 women with usual antenatal care. Serum H. pylori titre was measured for detection of seropositivity incidence in both groups. Results: Regarding H. pylori IgG titre, there was significant difference between study group and control group. Conclusion: This study concluded that there is significant correlation between Helicobacter pylori infection and occurrence of emesis gravidarum.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
77
v.
5
no.
2019
5528
5533
https://ejhm.journals.ekb.eg/article_60263_09c4196b53526d4fd564a390e33e3ff9.pdf
dx.doi.org/10.21608/ejhm.2019.60263
Epidemiological Typing of Methicillin Resistant Staphylococcus aureus Isolated from Surgical Site Infection Following Caesarean Section in an Egyptian University Hospital
Asmaa M.
El-Nasser
Department of Medical Microbiology & Immunology, Faculty of
Medicine for Girls, Al-Azhar University, Cairo, Egypt.
author
Azza Hassan
El Salakawy
Department of Medical Microbiology & Immunology, Faculty of
Medicine for Girls, Al-Azhar University, Cairo, Egypt.
author
Azza Ahmed
Mira
Department of Medical Microbiology & Immunology, Faculty of
Medicine for Girls, Al-Azhar University, Cairo, Egypt.
author
Daad Fathallah
Ibrahim
Department of Medical Microbiology & Immunology, Faculty of
Medicine for Girls, Al-Azhar University, Cairo, Egypt.
author
Hala Fathy
El-Sharaky
Department of Obstetrics & Gynecology, Faculty of
Medicine for Girls, Al-Azhar University, Cairo, Egypt.
author
text
article
2019
eng
Background: Surgical site infection (SSIs) is one of the most common healthcare-associated infections. It comprises a great risk to hospitalized patients in terms of morbidity, mortality and economic cost. Objectives: To identify the causative organism(s) responsible for surgical site infection following Cesarean section and to trace the source of that infection. Patients & methods: A total of 623 clinical samples and swabs were collected from Obstetrics & Gynecology Department at Al-Zahraa University Hospital. The study included 300 patients with provisional diagnosis of SSI from whom, wound swabs were taken, in addition to 23 swabs from medical staff and 300 environmental samples. Samples were subjected to conventional bacteriological identification, biochemical reactions, antibiogram and genotyping by Random Amplified Polymorphic DNA (RAPD) assay of the dominated isolates. Results: Out of 300 wound swabs from patients with SSI following CS surgery, 62 (20.7%) yielded aerobic microbial growth. Eighty three out of 323 swabs (26%) collected from health care workers (HCWs) & environment were positive on culture. The most common organism isolated from both sources (clinical & environmental specimens) was Methicillin resistant Staphylococcus aureus (MRSA) isolates 35/623 (5.6%). Genotyping of MRSA isolates revealed 20 distinct Random Amplified Polymorphic DNA (RAPD) patterns, indicating high rate of genetic heterogeneity among MRSA isolates. Conclusion: There were clonally related MRSA isolates obtained from operating room and from patients, indicating that the operating room was accused as a source of infection.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
77
v.
5
no.
2019
5534
5541
https://ejhm.journals.ekb.eg/article_60861_62213cd8dfcda704de783f03d2045d25.pdf
dx.doi.org/10.21608/ejhm.2019.60861
Three-Dimensional Endometrial Volume and Power Doppler Angiography for Prediction of Endometrial Carcinoma in Woman with Postmenopausal Bleeding
Esmael Mohammed Talaat
Elgarhy
Obstetrics and Gynecology Department, Faculty of Medicine, Al-Azhar University
author
Mohammed Abd El-Kreem
Kassem
Obstetrics and Gynecology Department, Medical Military Academy
author
Mahmoud Abd El-Ghaffar Morsi
Alzayat
Obstetrics and Gynecology Department, Faculty of Medicine, Al-Azhar University
author
text
article
2019
eng
Background: A woman is considered menopausal after cessation of menstruation for one year. The goal of evaluations of postmenopausal bleeding (PMB) is to achieve the diagnosis with greatest accuracy, the least risk and expense for the patient. Transvaginal ultrasound (TVS) is imaging technique of choice for first line investigation of endometrial abnormalities as a possible cause of abnormal uterine bleeding, malignant and benign endometrial patterns can often be determined by TVS which can help diagnosis. Objectives: This study aims to assess the accuracy of endometrial volume and vascularization index assessed by three-dimensional ultrasound in prediction of endometrial carcinoma in woman with postmenopausal bleeding. Patients and Methods: This study was conducted in Ghamra Military Hospital on 100 women with postmenopausal bleeding. Results: Our results revealed that both endometrial thickness, volume, and 3D-PDA indices may discriminate between endometrial cancer and benign conditions in women with postmenopausal bleeding. All parameters of our study were not significant in diagnosis of cancer in women with postmenopausal bleeding. Conclusion: The diagnostic performance of the measurement of the size of the endometrium by three-dimensional ultrasound with respect to the distinction between benign and malignant endometriosis was higher when compared to the measurement of the thickness of the endometrium with 2D ultrasound.The Doppler flow indicators have three-dimensional power as good diagnostic tools in predicting endometrial cancer But it cannot rule out the presence of malignant tumors endometriosis.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
77
v.
5
no.
2019
5542
5548
https://ejhm.journals.ekb.eg/article_60863_89a7872d115cfee267046b56ba91821b.pdf
dx.doi.org/10.21608/ejhm.2019.60863
Correlation of Serum Markers and Ultrasound Markers in the Prediction of Threatened Miscarriage Outcome
Ali El-Shabrawy
Ali
Department of Obstetrics and Gynecology, Faculty of Medicine, Zagazig University
author
Hala Elsayed
Mowafy
Department of Obstetrics and Gynecology, Faculty of Medicine, Zagazig University
author
Mustafa Taha
Abd El-Fattah
Department of Obstetrics and Gynecology, Faculty of Medicine, Zagazig University
author
Ibrahim Ali Ibrahim
El-Gohary
Department of
Obstetrics and Gynecology Mit Ghamr General Hospital, Egypt
author
text
article
2019
eng
Background: First-trimester bleeding is one of the most common obstetric complications, occurring in 25% of all pregnancies. The clinical diagnosis of threatened miscarriage is presumed when bloody vaginal discharge or bleeding appears through a closed cervical os during the first half of pregnancy. Objective: The aim of the present study was to investigate the relationship between sonographic findings, progesterone level and serum CA-125 in women presenting with symptoms of threatened abortion and first trimesteric pregnancy outcome. Subjects and Methods: This a case-control study included a total of 120 pregnant women between 7- and 13- weeks’ gestation in which a singleton embryo with evident cardiac activity was initially documented completed the study, attending at Gynecological and Obstetric Department in Zagazig University Hospital and Mit Ghamr General Hospital. This study was conducted between July 2016 to February 2018. Results: There was no significant difference among groups in CRL and GSD but YSD was significantly higher among cases. CA 125 was significantly higher in actual miscarriage with a level 47.9IU/ml (±31.52) between those who had actual miscarriage before 13 weeks and 17.4IU/ml (±10.67)between those who continued pregnancy after 13 weeks while progesterone showed level 11.1ng/ml (±10.38)between those who aborted before 13 weeks and a level of 11.6ng/ml (±6.19) between those who continued. GSD and YSD significantly higher in actual miscarriage as the mean was 51.4mm (±18.56) and 6.73mm (±0.6) respectively for those who aborted and 38.52mm and 6.11mm respectively for those who continued pregnancy. Conclusion: The use of ultrasound and maternal serum CA-125in the first trimester represents non-invasive, early and fast methods that can be considered as a good predictor for the outcome of pregnancy in cases with threatened abortion.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
77
v.
5
no.
2019
5549
5555
https://ejhm.journals.ekb.eg/article_60865_d58d57fb54c261d92dc889d6943ced2e.pdf
dx.doi.org/10.21608/ejhm.2019.60865
Comparative Study between Intralesional Injection of Vitamin D3 and Candida Albicans Antigen in Treatment of Plantar Warts
Mohamed Abd-Elmonem
Abd-Elaal
Department of Dermatology, Venereology and Andrology, Faculty of Medicine
author
Hassan Mamdouh
Abd-Elaziz
Department of Dermatology, Venereology and Andrology, Faculty of Medicine
author
Karim Atwa
Ahmed
Department of Dermatology, Venereology and Andrology, Faculty of Medicine,
author
text
article
2019
eng
Background: Numerous therapeutic modalities have been used either singly or in combination to treat recalcitrant warts. However, a single treatment that is entirely effective in all patients is not yet explored. This might be attributed to the absence of specific antiviral medications against human papilloma virus (HPV) infection. Objective: The aim of this work was to compare efficacy of intralesional vitamin D3 in treatment of plantar warts in comparison to candida albicans antigen. Patients and methods: This study included a total of 40 patients suffering from plantar warts, attending at Dermatology and Andrology Outpatient Clinic, Dermatology Department, Al-Azhar University Hospitals. The included subjects were randomly divided into two groups; Group A (Candida antigen group) consisted of 20 patients, subjected to intralesional injection of candida albicans antigen and Group B: (Vitamin D3 group) consisted of 20 patients, subjected to intralesional injection of Vitamin D3. Results: Results revealed that there were no statistically significant correlations between age, sex of patients, duration of treated warts and clinical response in both treatment groups. However, a statistically significant correlation existed between the number of treated warts and response in Vitamin D group. Complete response occurred in patients with low number of warts. At the end, our results showed that there was no statistically significant correlation in complete response between candida antigen and vitaminD3. Both treatments show comparable efficacy and safety in treatment of plantar warts. Conclusion: Treatment of multiple warts by intralesional injection of candida antigen or vitamin D3 is safe and effective, with good cure rates, excellent safety profile and minimal recurrences.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
77
v.
5
no.
2019
5556
5562
https://ejhm.journals.ekb.eg/article_60867_1baa5fc9cca7d25c3bd2fba95cddea99.pdf
dx.doi.org/10.21608/ejhm.2019.60867
Prognostic Value of Insulin-Like Growth Factor 1 in Hodgkin Lymphoma
Fathy Ghamry Abd El Razek
Elghamry
Department of Internal Medicine, Faculty of Medicine – Al-Azhar University
author
Essam Abdelwahed
Hassan
Department of Internal Medicine and Clinical Hematology, Faculty of Medicine – Al-Azhar University
author
Mamdouh Attia
Mohamed
Department of Clinical Pathology, Faculty of Medicine – Al-Azhar University
author
Hosameldeen Salah
Shabana
Department of Internal Medicine, Faculty of Medicine – Al-Azhar University
author
Mostafa Ahmed Mostafa
Sabrh
Department of Internal Medicine, Faculty of Medicine – Al-Azhar University
author
text
article
2019
eng
Background: Hodgkin’slymphoma (HL) (formerly, Hodgkin disease) is a potentially curable lymphoma with distinct histology, biologic behavior, and clinical characteristics. The disease is defined in terms of its microscopic appearance (histology) and the expression of cell surface markers (immunophenotype). Objective: In this study we aim to evaluate the serum level of IGF-1 as prognostic factor in patients with Hodgkin lymphoma and its impact in outcome of treatment. Patients and methods: This study was conducted in the Internal Medicine Department of Al-Azhar University, during the period from January 2018 to December 2018. It was carried on 60 patients diagnosed with HL. All patients had a confirmed histopathological examination as HL before inclusion in the study. Patients were classified into (3 equal groups) according to (Ann Arbor staging classification scheme): Group -1: 20 patients with HL in stage I &II. Group -2: 20 patients with HL in stage III. Group -3: 20 patients with HL in stage IV. An approval of the study was obtained from Al-Azhar University academic and ethical committee. Every patient signed an informed written consent for acceptance of the operation. Results: In our study, patients with HL had significantly higher levels of IGF-1 in advanced stages than limited stages. Since serum levels of IGF-1 is a potent proliferative agent affecting almost every cell type and a powerful antiapoptotic agent affecting apoptotic responses to a variety of agents of numerous cell types. These two effects result in a state of hyperproliferation. Such an imbalance between cell proliferation and death. Also, our study showed the higher level of IGF-1, the good response to aggressive chemotherapy. Conclusion: IGF-1 may be a prognostic factor in HL and may be useful for the identification of a subgroup of patients who may benefit from aggressive chemotherapy
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
77
v.
5
no.
2019
5563
5569
https://ejhm.journals.ekb.eg/article_60870_789f8068fbb8ef08ff912a46b2246c03.pdf
dx.doi.org/10.21608/ejhm.2019.60870
Outcome of Pedicular Fixation of Unstable Dorsolumbar Fractures
Mohammad Salah Eldein
Abd Elhafez
Department of Orthopedics and Traumatology, Faculty of Medicine – Al-Azhar University
author
Mohammad Ibrahim
Abulsoud
Department of Orthopedics and Traumatology, Faculty of Medicine – Al-Azhar University
author
Mahmoud Moursy Saleem
Moursy
Department of Orthopedics and Traumatology, Faculty of Medicine – Al-Azhar University
author
text
article
2019
eng
Background: The spine is made of 33 individual bones stacked one on top of the other. This spinal column provides the main support for your body, allowing you to stand upright, bend, and twist as well as protecting the spinal cord from injury. Objective: The aim of this study was to evaluate the post-operative clinical outcome of transpedicular screw and rod fixation in unstable thoracolumbar fractures by using Mc Nab’s criteria in patients collected from Sohag General Hospital and Sohag University Hospital. Patients and methods: A prospective study included patients admitted to Orthopedic and Traumatology Department of Sohag General Hospital suffering from unstable fracture of thoracolumbar area. The study was conducted on twenty patients suffering from thoracolumbar fractures attending to Department of Orthopedics and Traumatology, Sohag University Hospitals, Sohag General Hospital and Al-Azhar University Hospitals from June 2018 till December 2018. Results: In comparison between cases, which conserved and those operated as regard vertebral height loss, angle of kyphosis, oswestry disability index and visual analogue score, we found that p value was not significant in these parameters and its value was 0.15, 0.46, 0.15, and 0.88 respectively. Which means that decision making correlated to patient score. As regards type of operative fixation done, there were non-significant comparison between type of fixation done and the mentioned parameters. All changes in the parameters explain that these parameters correlate with TLICS and prove the validity of this classification. Conclusion: Posterior short segment pedicle screw fixation is good and enough for treatment of thoracolumber fractures (burst fracture) when neurological condition of the patients is intact.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
77
v.
5
no.
2019
5570
5578
https://ejhm.journals.ekb.eg/article_60871_8890f02f3c491cfcfbda729db0970760.pdf
dx.doi.org/10.21608/ejhm.2019.60871
Urinary Level of Tumor Necrosis Factor Alpha in Patients with Type –2 Diabetic Nephropathy
Youssef Khalel
Ahmed
Departments of Internal Medicine, Faculty of Medicine, Al-Azhar University,
Cairo, Egypt
author
Amin Mahmoud Amin
Hegazy
Departments of Internal Medicine, Faculty of Medicine, Al-Azhar University,
Cairo, Egypt
author
Mohammed Abdel-Hamed
Keder
Clinical Pathology, Faculty of Medicine, Al-Azhar University,
Cairo, Egypt
author
Mohamed Ahmed Mohamed
Moustafa
Departments of Internal Medicine, Faculty of Medicine, Al-Azhar University,
Cairo, Egypt
author
text
article
2019
eng
Background: Diabetic nephropathy is the principal cause of end stage renal disease (ESRD) in the Western world, with renal disease as a major cause of morbidity and mortality in the diabetic population. Inflammation is a potential factor in the development and progression of DN and recent data indicate that diabetes includes an inflammatory component which may contribute to diabetic complications. Objectives: Aiming to investigate possible correlation between the presence and degree of albuminuria and urinary tumor necrosis factor-alpha as a marker of inflammation in diabetic nephropathy in type 2 diabetes mellitus. Patients and Methods: This study was conducted at El-Hussein University Hospital on 60 patients with type-2 diabetes mellitus and 20 healthy volunteers for the matched age and sex. Diabetic patients were divided into 3 groups according to the degree of proteinuria. Controls: 20 healthy controls, Group A: 20 type 2 diabetic patients without albuminuria, Group B: 20 type 2 diabetic patients with microalbuminuria. Group C: 20 type 2 diabetic patients with macro-albuminuria. Results: urinary TNF-alpha and serum hs-CRP were significantly higher in diabetic than controls. It was also significantly higher in patients with macroalbuminuria than those with microalbuminuria and normoalbuminuria. There was significant positive correlation between urinary TNF-α and urine protein excretion in diabetic patients as well as age, CRP, duration of diabetes and glycemic control. Conclusion: urinary TNF-α is independently and significantly correlated with the presence and degree of albuminuria in diabetic nephropathy in type 2 diabetes mellitus. This suggests that TNF-α play a significant role in the pathogenesis and progression of renal injury in diabetes.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
77
v.
5
no.
2019
5579
5588
https://ejhm.journals.ekb.eg/article_61456_b360abc4d614562880965c4ab561d25e.pdf
dx.doi.org/10.21608/ejhm.2019.61456
Intradermal Sterile Water Injection versus Epidural Bupivacaine in Painless First Stage of Labor
Saeed Mohammed
Faied
Anesthesiology and Intensive Care Department, Faculty of Medicine, Al-Azhar University
author
Abdalla Mohammed
Abdalla
Anesthesiology and Intensive Care Department, Faculty of Medicine, Al-Azhar University
author
Ahmed Youssef Mohammed
Youssef
Anesthesiology and Intensive Care Department, Faculty of Medicine, Al-Azhar University
author
text
article
2019
eng
Background: Many women have moderate to severe low back pain during labor. It has been shown that injection of sterile water can reduce the pain of 1ststage. This method is very cheap, easy to learn and can be used as alternative method for reducing the labor pain. Objectives: The aim of this study was to compare the effectiveness, women satisfaction safety and safety of intradermal sterile water injection and epidural bupivacaine in decreasing the pain of1st stage of labor. Patients and Methods: After approval of Institutional Ethical Committee and obtaining written informed consent from eligible parturient women, 120 healthy parturient divided into 3 groups. 1st group epidural bupivacaine plus fentanyl, Initiated with 10 ml of bupivacaine 0.125% with 2 micrograms/ ml of fentanyl and maintained with 10 ml/ h of the same mixture. 2nd group intradermal injection of sterile water 0.1 ml, while 3rd group intradermal injection of 0.1 ml normal saline. Results: The study reported good pain relief in epidural and sterile water group compared to normal saline group. Pain relief was comparable in both the epidural and sterile water group. Complications were more demonstrated in epidural compared to the sterile water and the normal saline groups. A good maternal satisfaction in epidural and sterile water group with no satisfaction in the normal saline group. Conclusion: The evidence from this study suggests that sterile water injections are safe and effective method for relieving pain of the 1st stage of labor similar to epidural bupivacaine analgesia.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
77
v.
5
no.
2019
5589
5596
https://ejhm.journals.ekb.eg/article_61470_6af444b86184ea5f04acfb74640ac3fe.pdf
dx.doi.org/10.21608/ejhm.2019.61470
Comparative Study between Circum-areolar Skin Reduction and Standard Long Scar Techniques for Treatment of Severe Degrees of Gynaecomastia after Massive Weight Loss
Ismael Mahmoud
Selim
Plastic and Burn surgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
author
Fawzy Ahmad
Hamza
Plastic and Burn surgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
author
Mustafa Sayed Ahmed
Meky
Plastic and Burn surgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
author
text
article
2019
eng
Background: Reshaping of the male chest following massive weight loss is challenging and there are many techniques for its management. Aim: This study was to compare circum-areolar skin reduction for the treatment of severe gynaecomastia in massive weight loss patients with other standard long scar techniques. Patients and methods: Patients with massive weight loss whom their redundant and ptosed breast and patients whom their weight was stable for at least 6 months before surgical intervention for the treatment of gynaecomastia. Those patients were included in the study. Patients were subjected to either circum-areolar or other long standard scar techniques in 2 equal groups. Patients were evaluated subjectively and objectively. Results: As for patient’s satisfaction, there was statistically significant higher satisfaction (p=0.039) among patients submitted to circum-areolar approach regarding the overall chest contour (80% vs 50%) and nipple-areola complex aesthetics (90% vs 60%). Objective assessment showed better outcome for circum-areolar scar in cases of moderate skin laxity and minimal glandular tissue, while other long standard scars could be appropriate with patients having massive skin laxity and marked glandular atrophy. Conclusion: Circum-areolar skin reduction technique is an effective, safe, and promising approach in the management of gynaecomastia after massive weight loss, which is an accomplished advancement relative to other standard long scar techniques. Circum-areolar skin reduction technique is the best for the patients with moderate skin redundancy where it preserved glandular tissue and no presence of side or back rolls. While, long scar techniques are favorable in patients with severe skin redundancy and atrophied glandular tissue with side or back rolls.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
77
v.
5
no.
2019
5597
5610
https://ejhm.journals.ekb.eg/article_61474_9483c7810e62888fcd6e95ec562800bf.pdf
dx.doi.org/10.21608/ejhm.2019.61474
Optical Coherence Tomography Angiography Compared to Fluorescein Angiography in Central Retinal Vein Occlusion
Khaled
Selim
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University
author
Mostafa
Mahmoud
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University
author
Ali Maher Ibrahim
El-Shaarawy
Memorial Institute of Ophthalmic Research
author
text
article
2019
eng
Background: Retinal vein occlusion is the second most common cause of retinal vascular disease worldwide after diabetic retinopathy. Objective: It is a prospective comparative study to evaluate the optical coherence tomography angiography appearance of superficial and deep capillary plexa in eyes with central retinal vein occlusion in comparison to conventional finding in fluorescein angiography. The study was approved by the medical ethics committee of Al-Azhar University Hospitals and a written informed consent is obtained from all patients. Patients and Methods: A total of 19 eyes of 17 patients (with a known clinical diagnosis of CRVO; any stage, any type), were recruited. All patients underwent standard ophthalmological examination together with multimodal imaging procedures including; color fundus photography, fluorescein angiography and optical coherence tomography angiography. Quantitative flow analysis of the SCP has been performed for selected 15 images of 15 eyes with CRVO versus a single eye of a normal control. Results: Optical coherence tomography angiography can qualitatively demonstrate all the macular complications of CRVO including; ischemia, capillary dilation, microaneurysms, collateral vessels, edema and intraretinal hemorrhages, with superiority to fluorescein angiography especially in the presence of retinal hemorrhages and retinal edema. OCTA with the help of the co-registered en face OCT images, can demonstrate laser scars, at the level of the choriocapillaris and can help in detecting disc edema. Statistical analysis of the incidence of the different pathological findings in CRVO, has revealed more severe affection of the deep capillary plexus than the superficial one. Conclusion: OCTA allows stratigraphic analysis of the retinal and choroidal vasculatures. It also allows performing quantitative flow analysis of the retinal vasculature providing an easily interpretable noninvasive objective tool for the management and monitoring the progression of CRVO.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
77
v.
5
no.
2019
5611
5620
https://ejhm.journals.ekb.eg/article_62142_4d95f863b28cea5ec75de65ebf644c53.pdf
dx.doi.org/10.21608/ejhm.2019.62142
Comparative study between El-Ganzouri airway risk index alone and in combination with upper airway ultrasound in preoperative airway assessment
Mohamed Amr
Abo Sabaa
Department of Anesthesiology and Intensive Care, Faculty of Medicine, Al-Azhar University
author
Gamal Farouk
Amer
Department of Anesthesiology and Intensive Care, Faculty of Medicine, Al-Azhar University
author
Abd Elwehab Abd Alsatar
Saleh
Department of Anesthesiology and Intensive Care, Faculty of Medicine, Al-Azhar University
author
Mohamed Abd ElrahmanAbd Elkader
Elbakery
Department of Anesthesiology and Intensive Care, Faculty of Medicine, Al-Azhar University
author
text
article
2019
eng
Background: The upper airway is an extraordinarily complex anatomical region. Anticipating and preparing for difficulty in airway management is crucial to avoid airway catastrophes. Objective: Aim of our study was to evaluate the combination of El-Ganzouri airway risk index (EGRI) with the ultrasound of the airway (measuring the hyomental distance and distance from epiglottis to midpoint between the two vocal cords) as a fast, easy and noninvasive method in the examination of the airway and prediction of difficult airway. Patients and methods: Preoperative airway assessment will be carried out for 60 adult patients randomly allocated in Al-Azhar University Hospitals. Results: The hyomental distance at cutoff point of 5.6 cm, (below which the intubation difficulty is high), sensitivity and specificity of Cormack-Lehane grade with hyomental distance in study group was75.0% and 94.4% respectively with accuracy of 85%. For the epiglottis to vocal cord distance the cut off value of ≤ 1.2 (below which the intubation difficulty is high) the sensitivity of epiglottis to vocal cord distance was 75.0% and the specificity was 100% with accuracy of 92%. Conclusion: We concluded that combination of EGRI with epiglottis to vocal cord distance and hyomental distance is a very sensitive and specific tool for prediction of difficult airway and may be superior to standard methods of assessment.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
77
v.
5
no.
2019
5621
5632
https://ejhm.journals.ekb.eg/article_62144_7f184b6d53ce89477555f6ec192361c9.pdf
dx.doi.org/10.21608/ejhm.2019.62144
Assessment of remodeling index and its relation to coronary heart disease in patients with types 2 diabetes by MDCT coronary angiography
Mansour Mohamed Mostafa
Aref
Department of Cardiology, Faculty of Medicine – Al-Azhar University
author
Samy Hassan
Nouh
Department of Cardiology, Faculty of Medicine – Al-Azhar University
author
Sameh Mosad
Ibrahem
Department of Cardiology, Faculty of Medicine – Al-Azhar University
author
Wael Anwar
Hasseb
Department of Cardiology, Faculty of Medicine – Al-Azhar University
author
Ahmed Mohamed Mansour Eltantawy
Mansour
Department of Cardiology, Faculty of Medicine – Al-Azhar University
author
text
article
2019
eng
Background: Cardiovascular diseases (CVDs) are the primary cause of mortality worldwide with 17.3 million deaths per year and an estimation of 23.6 million in 2030, placing it as a relevant issue for the public health system. Objectives: This study aimed to assess the Remodeling Index (RI) and its relation to coronary heart disease in patient with type 2 diabetes mellitus (T2DM) by multi-slice coronary CT angiography (MSCTA). Patients and methods: This prospective observational study was conducted in Cardiology Department and Radiology Department in El-Agouza, Academy, Nasr City Police Hospital. The study included 250 patients with coronary remodeling of which 200 patients with type 2 diabetes (group I) and 50 are non-diabetics (group II) matched in age and sex with the patients’ group I (P > 0.05). All patients referred for MSCT coronary angiography. Results: As regard remodeling index of the two groups were 1.11 ± 0.34 and 0.81 ± 0.29 in groups (I) and (II), respectively. They showed a statistically highly significant difference between the two groups (p < 0.001). The level of < 75th percentile was found in 74% and 100% of patients in groups (I) & (II), respectively, while level of >75th percentile was found in 26% of group (I) and not found in group (II) and they showed a statistically very highly significant difference (p < 0.001). Conclusion: Patients with T2DM are susceptible to premature CAD with more calcified and non-calcified plaques. Early prevention program using computed tomography angiography might be helpful in identifying diabetic patients with subclinical atherosclerosis.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
77
v.
5
no.
2019
5633
5642
https://ejhm.journals.ekb.eg/article_62407_75d4cef0123558b449c88a951e623aeb.pdf
dx.doi.org/10.21608/ejhm.2019.62407
Study of Left Ventricular Function in Patients with Acute Myocardial Infarction and Neutrophilia
Ahmed Kamal
Matawaa
Department of Cardiology, Faculty of Medicine Al-Azhar University, Cairo, Egypt
author
Mohsen Ali
Salama
Department of Cardiology, Faculty of Medicine Al-Azhar University, Cairo, Egypt
author
Mamdouh Attia
Mohamed
Department of Clinical Pathology, Faculty of Medicine Al-Azhar University, Cairo, Egypt
author
Abd El-Aziz Rizk
Hasan
Department of Cardiology, Faculty of Medicine Al-Azhar University, Cairo, Egypt
author
Mohamad Fawzy Abo-El-Naga
Abd El-Rahman
Department of Cardiology, Faculty of Medicine Al-Azhar University, Cairo, Egypt
author
text
article
2019
eng
Background: Acute myocardial infarction is frequently associated with leukocytosis and elevated neutrophil count. Neutrophilia may occur in response to myocardial necrosis which is a potent acute phase stimulus that is associated with a local and systemic inflammatory response. Objective: The aim of this study was to evaluate the left ventricular systolic function in patients with STsegment elevated myocardial infarction and neutrophilia. Patients and Methods: This prospective study included fifty patients with acute ST-segment elevated myocardial infarction at Cardiology Department, Al-Azhar university Hospitals within the period between January 2016 and June 2018. The patients were divided into two groups: Group (A): Thirty patients with neutrophilia. Group (B): twenty patients without neutrophilia. Results: Patient's ECG in 1st period showed that all patients had positive ECG in both groups while at 2nd and 3 rd periods all patients had negative ECG in both groups with statistically significant differences between 1st period and other period (2nd and 3rd period) where P <0.001 at all. According to neutrophil count there was statistically significant difference between the studied groups in all period where P<0.001 at all period. There was statistically significant difference between the studied groups where P<0.001 at baseline and after 48 hours as regard to EF and FS. There was statistically significant difference between the studied groups according to patients RWMA where P<0.001 at baseline and P= 0.002 after 48 hours. Conclusion: Patients with STEMI associated with neutrophilia are significantly associated with early development of congestive heart failure.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
77
v.
5
no.
2019
5643
5654
https://ejhm.journals.ekb.eg/article_62412_cf4a9eb975ac6f18158a6edc04b87129.pdf
dx.doi.org/10.21608/ejhm.2019.62412
Evaluation of Efficacy of Standard Treatment of Non-Purulent Cellulitis
Abdalla Abd Al-Hamid
Sallam
Department of General Surgery, Faculty of Medicine, Al-Azhar
University, Cairo, Egypt
author
Mohammed Rashed
Abd Al-Hamid
Department of Clinical Pathology, Faculty of Medicine, Al-Azhar
University, Cairo, Egypt
author
Mohammed Abd Al-Aale Yusuf Ali
Nafie
Department of General Surgery, Faculty of Medicine, Al-Azhar
University, Cairo, Egypt
author
Abdalla Mohammed Al-Hady
Abd Al-Aziz
Department of General Surgery, Faculty of Medicine, Al-Azhar
University, Cairo, Egypt
author
text
article
2019
eng
Backgound: Cellulitis is commonly used to indicate a nonnecrotizing inflammation of the skin and subcutaneous tissues, a process usually related to acute infection that does not involve the fascia or muscles. Cellulitis is characterized by localized pain, swelling, tenderness, erythema, and warmth, cellulitis has been classically considered to be an infection without formation of abscess (nonpurulent), purulent drainage, or ulceration. Objective: The aim of the current work was to evaluate the efficacy of standard treatment for cases of cellulitis and identify other treatment options if needed in local community. Patients and methods: This prospective study was conducted at Department of General Surgery, Al-Azhar university hospitals (Al-Hussin & Said Galal hospitals). This study carried out on 100 consecutive patients with non-purulent cellulitis from 23/2/2017 to 1/5/2018 to allow a minimum follow-up period of at least 4 months for the last case follow upon. Clinical response to dicloxacillin, amoxicillin, and cephalexin was evaluated. Results: Age, sex, presentation, sit of non purulent cellulitis and result were recorded. Cellulitis was found to be more common in geriatric patients and slightly more in females. Most patients had lower limb cellulitis, and only little patients had an additional sit as orbit, hand and genitalia. 83 cases have good clinical response and 17 cases have poor clinical response within 7 days to dicloxacillin, amoxicillin, and cephalexin. Conclusion: Dicloxacillin, amoxicillin, or cephalexin are effective in most cases of cellulitis with gram positive organisms as Streptococcal and staphylococcal species.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
77
v.
5
no.
2019
5655
5661
https://ejhm.journals.ekb.eg/article_62414_6ca3e9c74f91b0f2ac8a93531c13ce32.pdf
dx.doi.org/10.21608/ejhm.2019.62414
Quality of Life after Different Types of Ileal Diversions Following Radical Cystectomy
Mahmoud Abdel Hameed
Mahmoud
Urology Department, Faculty of Medicine, Al Azhar University
author
Mohamed Abd Allah
Hindawy
Urology Department, Faculty of Medicine, Al Azhar University
author
El Sayed Mohamed
Hathout
Urology Department, Faculty of Medicine, Al Azhar University
author
text
article
2019
eng
Background: Radical cystectomy remains the gold standard in treatment of muscle invasive bladder cancer. Objective: To evaluate the quality of life (QOL) for patients underwent ileal conduit (IC) versus orthotopic ileal neobladder (INB) urinary diversions (UD) after one year post radical cystectomy (RC). Patients and methods: Our study was a retrospective study that included patients with MIBC who underwent RC and UD from January 2014 to Julie 2018 that passed one-year post RC. There were two groups of patients as follows: IC and INB groups. QOL was evaluated by the Functional Assessment of Cancer Therapy– Bladder Cancer (FACT-BL). The erectile function (EF) was assessed by the International Index of Erectile Function-5 (IIEF-5) questionnaire. Results: Overall, 125 patients underwent RC with UD were screened for eligibility. Twenty patients (16%) died, 11 patients (8.8%) failed to reach to them, 6 patients (4.8%) underwent other UD and 2 patients (1.6%) refused participation in this study thus 86 patients (68.8%) were eligible for the study and were analyzed. The mean patient’s age was 61.6 ± 6.3 in both groups (p value 0.199). There were significant differences between both groups in physical, social, emotional, functional, additional concerns, urinary and GIT symptoms that were significantly better in INB group (p value < 0.001). There was no significant difference between both groups regarding the EF. Conclusions: the INB is better than the IC UD in most of QOL domains, which include physical, social, emotional, functional, additional concerns, urinary and GIT symptoms. But sexual function remains equal bad in both groups.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
77
v.
5
no.
2019
5662
5667
https://ejhm.journals.ekb.eg/article_62417_34e39ad75bd4ec3a4f1c78e301d9b5ca.pdf
dx.doi.org/10.21608/ejhm.2019.62417
Recent Advances and Surgical Applications of Monoclonal Antibodies
Selim
Elnemr
Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
Ahmed Abd El Aal
Sultan
Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
Samh Massoud Saad
Nassar
Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
text
article
2019
eng
Background: Monoclonal antibodies plays an important role in surgical disease practice specially cancers, Crohn's Disease and ulcerative colitits. Monoclonal antibodies is a type of biological therapy that utilizes a person’s natural immune defense system to fight diseases. Monoclonal antibodies for cancers is essentially the stimulation of immune system via a variety of reagents such as vaccines infusion of T cells or cytokines. These reagents reacted through one of several mechanisms: 1- By stimulating the antitumor response either by increasing the number of effector cells or be production one or more soluble mediators such as lymphokines. 2- By decreasing suppressors mechanisms. 3- By altering tumor cells to increase their immunogenicity and make them more susceptible to immunological defenses. 4- By improving tolerance to cytotoxic drugs or radiotherapy such as stimulating bone marrow function with granulocyte colony stimulating factor (G- CSF). Monoclonal antibodies is a type of immunotherapy but there is another types of immunotherapy such as nonspecific immunotherapies and cancer vaccines mechanism of monoclonal antibodies in surgical disease. Objective: This work was aimed to study the role of monoclonal antibodies in surgical disease as a new tool to surgical armamentarium. Conclusion: It could be concluded from this study that monoclonal antibodies helps the body to fight disease and infection. Monoclonal antibodies are used to treat many types of carcinoma and cancers.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
77
v.
5
no.
2019
5668
5676
https://ejhm.journals.ekb.eg/article_62667_fa5169aadfbdcb37e13d1fc989127bf2.pdf
dx.doi.org/10.21608/ejhm.2019.62667
Adult Hepatoblastoma: an Update
Bilal O
Al-Jiffry
Department of surgery, Taif University
author
text
article
2019
eng
Abstract: Diagnostic and therapeutic protocols of adult hepatoblastoma are lacking because it is a rare condition, though, the pediatric one is the commonest hepatic tumor in children. The present study aimed at revision of the English literature of the published case reports and the systematic reviews of this rare tumor to elucidate the recent trends and update the etiological, pathological, diagnostic, and therapeutic concerns of hepatoblastoma in adult.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
77
v.
5
no.
2019
5677
5680
https://ejhm.journals.ekb.eg/article_62669_d65b2601f2b055d0caa2f8058e96425a.pdf
dx.doi.org/10.21608/ejhm.2019.62669
Association between Neutrophil to Lymphocyte Ratio and Inflammatory Markers in Hemodialysis Patients
Hafez Ahmed
Abd El-Hafeez
Department of Internal Medicine, Faculty of Medicine, Al-Azhar University
author
Ahmed Mohammed
Al-Alashkar
Department of Internal Medicine, Faculty of Medicine, Al-Azhar University
author
Nagah Mohamed Abo
Mohamed
Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University
author
Mohammed Ibrahim Khalil
Zoheir
Department of Internal Medicine, Faculty of Medicine, Al-Azhar University
author
text
article
2019
eng
Background: End stage renal disease patients on regular hemodialysis patients have higher rate of mortality and morbidity compared to the general population. Objective: This study aimed to study the association between neutrophil-to-lymphocytic ratio and other inflammatory markers (IL-6, high sensitive CRP, PLR, etc) in hemodialysis patients. Patients and methods: This study was designed to assess inflammation in hemodialysis patients and study the association between high sensitive CRP (hs-CRP) and the other inflammatory markers in those patients. Initially, forty two patients with end stage renal disease (ESRD), on regular hemodialysis in dialysis unit, Internal Medicine Department, AL-Hussien Hospital, Faculty of Medicine, Al-Azhar University-Egypt. Results: We calculated the cut off point for IL-6 that best indicates the presence of inflammation in hemodialysis patients, we found that it was value more than 30 ng/l with sensitivity 96.6, specificity 69.2%, with AUC: 00.77 and P < 0.004. Moreover, we calculated the cutoff point for PLR that is consistent with presence of inflammation in hemodialysis patients, we found that it was more than 180.2 with sensitivity 82.2%, specificity 92.3% with AUC .087 and p value equals 0.0001. In addition to calculating the cut off point for NLR that best indicates the presence of inflammation, we found that it was ≥1.6 with sensitivity 93.1%, specificity 92.3%, with AUC: 0.92 and P < 0.001. Conclusion: We can assess cardiovascular condition of our hemodialysis patients along with their morbidity and mortality with measuring these inflammatory markers which are nonexpensive and has high sensitivity and specificity.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
77
v.
5
no.
2019
5681
5689
https://ejhm.journals.ekb.eg/article_62671_1a687d7af0e9ba9200058fb52a93a827.pdf
dx.doi.org/10.21608/ejhm.2019.62671
A Comparative Study of the Results of Three cm versus Six Cm Distance from Pyloric Sphincter in Sleeve Gastrectomy
Ahmed
Maher
Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
Magdy Mahmoud
Mostafa
Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
Mohammad Arafat
Abd El-Maksoud
Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
text
article
2019
eng
Background: Obesity is excessive fat accumulation. Now, laparoscopic sleeve gastrectomy (LSG) is gaining popularity as a primary, staged and provisional operation for its proven safety and simplicity. Complete removal of the gastric fundus makes adequate weight loss and plays a key role in reducing co-morbidities, ghrelin production, and eliminate inlet of the stomach to become small enough so that the patient will feel full quickly. Objective: The aim of this study was to assess the results of resecting the stomach 6-cm versus 3-cm from the pylorus regarding weight loss, reflux development, nausea and vomiting Patients and Methods: This randomly selected prospective study included a total of 30 morbidly obese patients, attending at Department of General Surgery, Bab El-Shaaria, and Al-Azhar University Hospital for doing sleeve gastrectomy. According to the starting point of stomach resection, the included subjects were randomly divided into two groups; each was 15 patients. Group (A) started 3 cm from the pylorus towards the gastro-esophageal junction and Group (B) started 6 cm from the pylorus. These patients followed up over a period of 2 years for postoperative nausea; vomiting and reflux symptoms and their weight loss. Results: group A patients (3 cm groups) were >14 times at a higher risk to have minor complications in the form of nausea; vomiting and reflux compared to group B patients (6 cm groups) without any difference between both groups regarding BMI changes over a period of six months. Conclusion: It could be concluded that leaving an antral pouch of 6 cm size while performing this procedure is recommended for better outcome with minor complications.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
77
v.
5
no.
2019
5690
5697
https://ejhm.journals.ekb.eg/article_63224_e2c7ecbbb7c4473da0b8aad4cccb1a45.pdf
dx.doi.org/10.21608/ejhm.2019.63224
Posterolateral Approach for Dorsal Spine Fractures
Ahmed
Salem
Department of Neurological Surgery, Faculty of Medicine, Al-Azhar University
author
Ahmed
El-Narsh
Department of
Neurological Surgery, Faculty of Medicine, Minia University
author
Ma’mon
Abo-Shosha
Department of Neurological Surgery, Faculty of Medicine, Al-Azhar University
author
Mohamed Abd El-Hameed Abd ElKader
El-Heeny
Department of Neurological Surgery, Faculty of Medicine, Al-Azhar University
author
text
article
2019
eng
Background: Despite the great evolution in neurosurgical techniques, management of fractures of the thoracic spine still represent a major conflict in neurosurgery due to the different causes leading to fracture and the different methods available for management. The thoracolumbar region anatomically from D11-L2 which loss the stabilization effect of the rib cage. The spinous processes are more horizontal, which provides increase mobility. Objective: The aim of this study is to evaluate the efficacy and success of posterolateral approach for treatment of dorsal spine fractures surgically. Patients and methods: This was a prospective study of 30 patients of both sexes having all types fractures in the dorsal region (whether traumatic or pathologic) managed in the period between October 2015 and September 2017 in Neurosurgery Department Minia and Al-Azhar University hospitals. The study was approved by the medical ethics committee of Minia and Al-Azhar University Hospitals and a written informed consent was obtained from all patients. Results: Among the 30 patients, 14 of them managed by transpedicular screws fixation, 11 patients managed by costotransversectomy with pedicular screws fixation, and 3 patients managed by costotransversectomy with pedicular screws fixation and interbody cage insertion while one case managed by LECA with pedicular screws fixation and another one case with LECA with both pedicular screws and interbody cage insertion. Among the 30 patients managed 25 of them improved and 5 patients did not show any improvement during management. Conclusion: The ideal methodology in managing fractures should be meticulous pre-operative, operative, and postoperative management. The preoperative management should entail detailed and through clinical neurological evaluation to point out the presence of preoperative neurological deficit and their extent.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
77
v.
5
no.
2019
5698
5709
https://ejhm.journals.ekb.eg/article_63225_7183676cae471e2a00857e9b8d4a6fc6.pdf
dx.doi.org/10.21608/ejhm.2019.63225
Orbital Volume Evaluation post Orbital Fractures Restoration
Ahmed Sabry
Ahmed
Department of Plastic Surgery - Faculty of medicine – Al Azhar University
author
Tarek Mahmoud
El-Banoby
Department of Plastic Surgery - Faculty of medicine – Al Azhar University
author
Amr Ahmed AL-Sayed
Shoaib
Department of Plastic Surgery - Faculty of medicine – Al Azhar University
author
text
article
2019
eng
Background: The orbits are bony structures of the skull that house the globe , extra ocular muscles (EOM), nerves, blood vessels, lacrimal apparatus and adipose tissue. Each orbit protect the globe, while the supportive tissues therein allow the globe to move in three dimensions (horizontal –verticalrotational). Objectives: Evaluation of orbital volume after orbital fractures reconstruction by software orbital volume measurement using CT scan. Patients and methods: This study was conducted on 20 patients with a unilateral orbital blowout fracture treated surgically at Department of Plastic and Reconstructive Surgery in AL-Azhar University Hospitals from October 2018. To October 2019 and followed for 3 months were identified and included in this study. Results: 5% of patients had positive limitation of EOM and 90% of patients were good Pt. acceptance post-operative. 5% of patients were dystopia post-operative, all of patients had no infection, enophthalmouse or extrusion. Conclusion: We must exert great effort to prevent occurrence of these injuries through a joint cooperation with civil society through the dissemination of culture and means of safety on the highways. Rules and basics of craniofacial osteosynthesis must be known to craniofacial surgeon starting from wiring osteosynthesis.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
77
v.
5
no.
2019
5710
5717
https://ejhm.journals.ekb.eg/article_63226_edd497078496e65d91e31caa813b30ff.pdf
dx.doi.org/10.21608/ejhm.2019.63226
Internet Addiction and Internet Gaming Disorder and Associated Insomnia among a Sample of Al-Azhar University Students, Clinical Study
Mohamed Abdel Fattah Soliman
Al Gammal
Department of Psychiatry, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
Mohamed Mohamed Ali
Elsheikh
Department of Psychiatry, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
Abdelrahman Ahmed Elrefaey
Abozahra
Department of Psychiatry, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
text
article
2019
eng
Objective: The aim of this cross-sectional study was to examine and compare the prevalence of internet addiction and internet gaming disorder with examination of related sleep problems. Also identifying risk factors associated with them . Patients and methods: Data were collected from 60 students of Al-Azhar University. From randomly selected 6 different faculties. We found a high prevalence rate of Internet Addiction (IA) among them. This prevalence was higher than Internet Gaming Disorder (IGD) prevalence. Both of IA and IGD are inversely correlated to sleep quality. Theoretical faculties are at higher risk for IA and IGD. Middle Socioeconomic status (SES) of adolescents’ parents is related to IA but not related to IGD. The study was approved by the medical ethics committee of Al-Azhar University Hospitals and a written informed consent was obtained from all patients. Results: According to the results of the Internet Addiction Test (IAT), 46.7% of the sample had moderate internet addiction, 3.3% had severe internet addiction and 40% had mild internet addiction. According to results of (IGD) Scale 50% were at risk to develop Internet Gaming Disorder (IGD)&13.6% were disordered. According to Pittsburgh Sleep Quality Index (PSQI), (60%) of the participants were suffering from poor sleep Quality. Conclusion: The current study has revealed a high prevalence rate of Internet Addiction (IA) among Al-Azhar university students. This prevalence was higher than Internet Gaming Disorder (IGD) prevalence. Both of IA and IGD are inversely correlated to sleep quality.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
77
v.
5
no.
2019
5718
5726
https://ejhm.journals.ekb.eg/article_63227_e6f6a3fb9b20c57af411ea08c020e984.pdf
dx.doi.org/10.21608/ejhm.2019.63227
Local and Regional Flaps in Thumb Reconstruction
Wael Mohamed
Ayad
Department of Plastic Surgery - Faculty of medicine – Al-Azhar university
author
Essam Ali
Taman
Department of Plastic Surgery - Faculty of medicine – Al-Azhar university
author
Mohammed Fathi
Elsaid
Department of Plastic Surgery - Faculty of medicine – Al-Azhar university
author
text
article
2019
eng
Background: The thumb represents a critical role in overall hand function particularly by pinching and grasping thus, representing about 40% of actual hand function. Objective: Evaluation of different local and regional flaps in thumb reconstruction regarding function, sensation and aesthetic outcome. Patients and methods: The study included 20 patients with thumb defect admitted to Al-Azhar University Hospital in New Damietta for prospective cohort study. Results: Homodigital island flap was used in two cases (10 %), this type of flap proved to have excellent cosmetic and sensory results very close to FDMA flap, with privilege over FDMA flap in large defects where Homodigital flap proved to be better and provided adequate skin coverage. The flap was reliable, with good vascular and sensory supply, and provided thumb reconstruction in a single stage. 8 cases (40%) by volar advancement flap. Moberg flap was used in 8 cases. The flap was reliable, with good vascular and sensory supply, and provided thumb reconstruction in a single stage. This flap was found to be sufficient to cover no more than the distal one third of the distal phalanx of the thumb. Minimal flexion limitation at the interphalangeal joint occurred then returned to normal in all patients. Postoperatively, no flap loss occurred. Conclusion: V-Y, The Moberg`s flap, cross finger flap, the first dorsal metacarpal artery flap and homo-digital island flap. The volar advancement flap (Moberg’s Flap) is the simplest and easier sensate flap used for reconstruction of thumb defects in distal third of distal phalanx less than one centimeter.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
77
v.
5
no.
2019
5727
5732
https://ejhm.journals.ekb.eg/article_63228_2946b0dbe3edf62b5ddd24eddf6b681f.pdf
dx.doi.org/10.21608/ejhm.2019.63228
The Ameliorative Potential of Saffron Against the Histological and Immunohistochemical Changes in Kidney of Albino Mice Due to Streptozotocin-Induced Diabetes Mellitus
Samir A.
Nassar
Zoology Department, Faculty of Science, Zagazig University, Egypt
author
Amal M.
Hashim
Zoology Department, Faculty of Science, Zagazig University, Egypt
author
Nahla H.
Al-Shaer
Zoology Department, Faculty of Science, Zagazig University, Egypt
author
Sahar M.
Abd El-Salam
Zoology Department, Faculty of Science, Zagazig University, Egypt
author
text
article
2019
eng
Background: multiple-organ failure is the chief inducer of death in diabetes mellitus and hyperglycaemiainduced oxidative stress is responsible for serious complications including nephropathy. Medicinal plants with antioxidant activity may ameliorate oxidative status and improve the histological and immunohistochemical lesions resulted in chronic hyperglycemia in diabetes. Aim of the work: this study aimed to assess the beneficial effects of aqueous saffron extract (ASE) in streptozotocin (STZ)-induced diabetic mice by investigating the histopathological and immunohistochemical pattern in kidney tissues of different experimental groups. Material and Methods: fasted mice were intraperitoneally (IP) injected by a single dose of a STZ (60 mg/kg body weight). After 24 hours, animals with fasting blood glucose over than 300 mg/dl were considered diabetic. The experimental groups were; control (1), saffron (2), diabetic (3) and diabetic + saffron (4). The treatment was started on the same day of STZ administration with oral gavage of ASE (80 mg/kg body weight) along with drinking water. At the end of the experimental period (45 days), fasting blood glucose was measured by blood strips using an Accu-Chick Performa device (Germany). Furthermore; histopathological and immunohistochemical studies were performed. Results: Results showed that ASE significantly decreased blood glucose level and caspase-3 immunoexpression in treated diabetic mice as compared to untreated diabetic ones. Moreover, ASE improved the histopathological pattern to show a less injury. Conclusion: administration of ASE showed significant ameliorative effects on the biochemical, histopathological and immunohistochemical parameters in kidney tissues of treated diabetic mice.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
77
v.
5
no.
2019
5733
5741
https://ejhm.journals.ekb.eg/article_63229_91fd146b7f7bdd24b0cc48b359cf370e.pdf
dx.doi.org/10.21608/ejhm.2019.63229
Cognitive Functions in Breastfed versus Artificially Fed in Preschool Children
Sara Hamed
Ibrahim
Pediatrics Department, Faculty of Medicine for girls -
Al–Azhar University
author
Somaya Mohamed
Abd El –Ghany
Pediatrics Department, Faculty of Medicine for girls -
Al–Azhar University
author
Tagreed Mohamed
El Shafie
Psychiatry Department, Faculty of Medicine for girls -
Al–Azhar University
author
Marwa
El Hady
Pediatrics Department, Faculty of Medicine for girls -
Al–Azhar University
author
text
article
2019
eng
Background: Breastfeeding has been widely researched and reviewed in relation to cognitive performance in children, but early reviews have not provided compelling evidence linking breastfeeding to cognitive development Objective: To assess the effect of breastfeeding duration and exclusivity on the cognitive development of a group of preschool Egyptian children. Methods: The current study was a cross sectional comparative study that included 90 apparently healthy preschool Egyptian children aged 3 - <6 years who were classified into three equal groups according to their type of feeding in early infancy. Assessment of neurocognitive function and IQ was done using the following 3 tests: Stanford-Binet test 5th edition Arabic version (2003), Kaufman Assessment Battery for Children (2004), Illinois Test of Psycholinguistic Abilities (ITPA) (2001). Results: There was significant increase in IQ detected by kauffaman test in breastfed group than either mixed or artificially fed, while no significant difference was found in IQ between mixed and artificial fed groups. There was significant increase in psycholinguistic age in breastfed group in comparison to artificially fed groups, while no significant difference was found between breastfed and mixed fed or mixed fed and artificially fed groups. Children who were breastfed had better scores in Total IQ than either artificially or mixed fed. Also, there was significant increase in total IQ scores in mixed than artificially fed groups. A significant positive relation was found between the total duration of breastfeeding and Binet total IQ score. Conclusion: The effect of breastfeeding is dose-dependent, the longer the duration of breastfeeding, the more is the benefit, the strongest effect for cognitive function in breastfed children was more prominent in psycholinguistic age.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
77
v.
5
no.
2019
5742
5751
https://ejhm.journals.ekb.eg/article_63230_96339130e472b11398618fa63bf39d9d.pdf
dx.doi.org/10.21608/ejhm.2019.63230
Evaluation of Autologous Platelet Rich Fibrin in Cleft Palate Repair
Soliman Mohammed
Soliman
Department of Pediatric Surgery, Faculty
of Medicine, Al-Azhar University
author
Abdelaziz Yehya
Mahmoud
Department of Pediatric Surgery, Faculty
of Medicine, Al-Azhar University
author
Ahmed Abdelaal
Elsayed
Department of General Surgery, Faculty
of Medicine, Al-Azhar University
author
Mahmoud Abdellatif
Hashish
Department of Clinical Pathology, Faculty
of Medicine, Al-Azhar University
author
Mohammed Fawzy Saleh
Mohammed
Department of Pediatric Surgery, Faculty
of Medicine, Al-Azhar University
author
text
article
2019
eng
Background: Clefts of the lip and/or palate (CLP) are common birth defects of complex etiology. Management of this problem is somehow challenging depending on many factors. The main goal of treatment is mostly functional for the sake of creating normal feeding pattern, acquaintance of normal hearing and hence normal speech development. These goals carry a great impact on social and psychological status of the patient and his family. The repair of cleft palates ideally involves an interdisciplinary team contributing together to achieve this mission. Objective: Evaluation of the role of platelet-rich Fibrin (PRF) on wound healing following primary cleft palate repair. Patients and Methods: It was a prospective study done at the Department of Pediatric Surgery, Al-Azhar University, Cairo, Egypt. A total of forty patients (both sexes) were selected randomly and performed surgery using PRF which was placed during surgical procedure using two flap palatoplasty between the nasal and the oral mucosa. Then, the patients were followed up for six months to evaluate its efficacy in wound healing by monitoring incidence of fistula. All cases in the study group showed complete healing with no fistula or wound dehiscence all over the follow up period except one patient developed oronasal fistula. Results: In this study, post-operative bleeding tendency decreased in patients with preoperative injection of local anesthetic with vasoconstrictor agent and the extent of the surgical field. We measured the amount of bleeding with number of gauzes used by the parents to collect blood from the patients' mouth. Actually, it was blood mixed with saliva in addition to the remaining serum from the PRF. Conclusion: The use of PRF showed satisfying healing for most of the cases under study along the whole follow up period.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
77
v.
5
no.
2019
5752
5758
https://ejhm.journals.ekb.eg/article_63231_eea2c59b517b9aeae499715ee9b7db3f.pdf
dx.doi.org/10.21608/ejhm.2019.63231
Corneal Hysteresis before and after Corneal Collagen Cross Linking for Keratoconus
Magdy Ezz-Eldin
Tawakol
Department of Ophthalmology - Faculty of Medicine, Al Azhar University
author
Abd El-Magid M.
Tag El-Din
Department of Ophthalmology - Faculty of Medicine, Al Azhar University
author
Amr Gamal
Hassan
Department of Ophthalmology - Faculty of Medicine, Al Azhar University
author
text
article
2019
eng
Background: Corneal collagen cross-linking (CXL) has been used as a treatment option in patients with either keratoconus or iatrogenic corneal ectasia after LASIK. The purpose of corneal cross-linking is to stabilize the corneal stroma and to delay the progression of these two pathologic entities. Objective: The aim of this study is to compare the corneal hysteresis before and after corneal collagen cross-linking using riboflavin and ultraviolet-A light by the epithelial-off technique for treatment of keratoconus. Patients and methods: This study is a single-centre prospective interventional study. It was conducted between April 2018 to December 2018 and included 30 eyes of 18 patients with a mean age 27.08 years (range from 17- 30). They were 12 female eyes and 18 male eyes; all underwent corneal collagen cross-linking using riboflavin and ultraviolet-A light at Kobry El Kobba Military Specialized Eye Hospital. Results: All patients were evaluated preoperatively for their uncorrected corrected visual acuity (UCVA), best corrected visual acuity (BCVA), k-reading, spherical equivalent and pachymetry (using Pentacam), and corneal biomechanical properties (using ocular response analyzer (ORA). The mean age was 27.08±7.86 years, and postoperative follow up was at 1 and 4 months. The mean CH was 7.93±1.79 mmHg preoperatively, 8.27±1.22 mmHg at 1 month, 8.99±1.24 mmHg at 4 months, which show a statistically significant increase in the mean CH pre- and postoperatively, while CRF the other parameter, show a highly statistically significant decrease pre- and postoperatively. Conclusion: CXL is a promising new treatment modality for keratoconus patients and may affect corneal biomechanics.
The Egyptian Journal of Hospital Medicine
Pan Arab League of Continuous Medical Education
1687-2002
77
v.
5
no.
2019
5759
5765
https://ejhm.journals.ekb.eg/article_63232_17b790aa0ce35bd373c26d300d76f16d.pdf
dx.doi.org/10.21608/ejhm.2019.63232