@article { author = {}, title = {The Effect of Diet and Nutritional Supplements in the Management, Prevention, and Control of Inflammatory Bowel Disease: A Simple Literature Review}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {72}, number = {1}, pages = {3676-3679}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: Inflammatory bowel disease (IBD) is known for its episodic relentless course of gastrointestinal symptoms. There are two major clinically defined forms of inflammatory bowel disease (IBD), Crohn’s disease (CD) and Ulcerative colitis (UC). It’s associated with chronic remittent or progressive inflammatory conditions that may affect the entire gastrointestinal tract and the colonic mucosa, respectively. A lot of literatures have been done to assess the role of diet in IBD management, prevention, and control, as a result, we will review the articles that investigated the diet role in IBD, and clarify the new progress that have been done, which will help the patients and the physicians in managing, and prevention of the acute attacks. Objectives: In this paper we aimed to present the role of diet and nutritional substances in the management and prevention of inflammatory bowel disease. Methods: PubMed database was used for articles selection, and the following keys used in the mesh ("Crohn Disease"[Mesh]) AND ("Colitis, Ulcerative/diet therapy"[Mesh] OR "Colitis, Ulcerative/prevention and control"[Mesh] OR "Colitis, Ulcerative/therapy"[Mesh]) AND "Inflammatory Bowel Diseases"[Mesh]. Conclusion: patients with IBD should increase their fiber intake in their diet, and take vitamin D supplement. Also, introduction of eicosapentaenoic acid (EPA) in a free fatty acid form (EPA-FFA) into their diet is helpful. However, the overall benefit of diet in this prevalent disease still need more research looking into the variable dietary regimens that can be given in this special population. }, keywords = {Keywords: Diet,nutritional supplements,Management,prevention,control,inflammatory bowel disease}, url = {https://ejhm.journals.ekb.eg/article_8184.html}, eprint = {https://ejhm.journals.ekb.eg/article_8184_36295dc33af456dda7c87649ada4029c.pdf} } @article { author = {}, title = {Evaluation of Coronary Artery Disease among Population with Fatty Liver Disease Using Multi-Slice Computed Tomography}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {72}, number = {1}, pages = {3680-3687}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: Fatty liver disease (FLD) is a common disorder with an increasing prevalence. It is considered to be an important syndrome associated with several cardiovascular risk factors and to be a component of metabolic syndrome. Several studies found significant association of fatty liver and coronary artery disease (CAD). Aim of the Work: was to evaluate the presence and the severity of coronary artery disease among FLD population and to evaluate the association of FLD and CAD using Multi-Slice Computed Tomography (MSCT) and the possibility of considering FLD as a predictor for CAD. Patients and Methods: The study was conducted in Radiological Department of Ain-Shams Hospital and other private centers. It focused on evaluating 30 patients, who were referred to perform CT coronary angiography. These patients were examined in the period between 1st of Oct. 2017 and 1st of Apr. 2018. The target sample was patients with fatty liver who underwent CT coronary angiography for recent chest pain. Fatty liver was diagnosed using non-contrast CT when calculated attenuation value of the liver is less than spleen by 10 UH. The coronary arteries were assessed using CT angiography, significant CAD was defined as a stenosis of more than 50% in at least one major coronary artery. Results: fatty liver developed coronary atherosclerosis were 17 (56.7%) and this was statistically significant P= 0.017. Patients with fatty liver developed significant CAD were 9 (30.0%) and this was statistically insignificant P=0.266. Conclusion: Fatty liver disease may be considered as a predictor for coronary atherosclerosis and based on this, more individuals from the general population with subclinical CAD could be detected at earlier stages when fatty liver is identified. Presence of fatty liver may help in cardiovascular risk stratification and assessment. Recommendations: It will be worthwhile to study whether improving FLD will ultimately prevent the development of CAD. }, keywords = {Keywords: coronary artery disease,fatty liver disease, multi-slice CT,Atherosclerosis}, url = {https://ejhm.journals.ekb.eg/article_8185.html}, eprint = {https://ejhm.journals.ekb.eg/article_8185_50474b66db0ab8a97e97aaec201f98d6.pdf} } @article { author = {}, title = {Refractive Errors among Northern Border University Medical Students}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {72}, number = {1}, pages = {3692-3696}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: Uncorrected refractive error is the most common cause of vision impairment worldwide, and the WHO identified uncorrected refractive error as one of the priorities for the program of Vision 2020. Aim: Aim of this study was to determine the prevalence of refractive errors (REs) among medical students of Northern Border University. Subjects and Methods: A cross-sectional study was conducted on 167 students. A structured close-ended questionnaire was distributed for data collection and checking REs amongst them in the period between December 2017 and January 2018. All volunteering participants underwent ophthalmic examination including autorefractometer examination. Results: Our study showed that 67.1% of participants suffered from REs. 53.9% had myopia, 6.6% hyperopia and 6.6% had astigmatism. 47.9% of cases of refractive errors have myopia, 5.4% hyperopia, 1.8% astigmatism, 4.2% have both myopia and astigmatism, 0.6% have both hyperopia and a stigmatism, 0.6% have all myopia, hyperopia and astigmatism. Both eyes were affected in 46.7% of cases, left eye was affected in 6.6% and right eye was affected in 7.2% of cases. Conclusion: the prevalence of REs among investigated students was 67.1%, which is one of the highest rates reported. There has to be a concern for a regular checkup starting from early ages as a preventive measure against REs through increasing knowledge, concerning REs particular for medical students as future health care professionals.}, keywords = {Keywords: Refractive errors,Medical students,Myopia,Astigmatism,hypermetropia,Northern Border University,Arar,KSA}, url = {https://ejhm.journals.ekb.eg/article_8187.html}, eprint = {https://ejhm.journals.ekb.eg/article_8187_eca25782fa619bf5b96a9d6aeb20f2e6.pdf} } @article { author = {}, title = {Spina bifida in Infants and Children in Arar, Northern Saudi Arabia}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {72}, number = {1}, pages = {3697-3702}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: Neural tube defects (NTDs) are the most common birth defect of the central nervous system. Spina bifida (SB) is a common birth defect resulting from incomplete closure of the neural tube during the first month of pregnancy and that is associated with significant clinical complications that can affect survival and the quality of life for affected individuals. Objective: The study objective was to estimate the prevalence, types, manifestations, diagnosis, complications as well as treatment outcomes of of Spina bifida in all neonates born in Maternity and Children hospital in Arar city, Northern Saudi Arabia. Methods: This is a descriptive study involved all neonates born in Maternity and Children hospital in Arar city, Northern Saudi Arabia, KSA, during the period from 1 January to 31 December 2017. Data was collected by retrospective analysis of the recorded data and filling a pre designed questionnaire, which include questions designed to fulfill the study objectives. Results: The total number of spina bifida cases borne in maternity and children hospital in Arar city, Northern Saudi Arabia during the year 2017 was 14 cases with a prevalence of 0.51%; 8(57.1%) were females and 6(42.9%) were males. Consanguinity between parents found in 57.1% of cases, and folic acid deficiency during pregnancy reported in 78.6%. The site of spina bifida was lumbosacral in 57.1% and lumber 42.9%. The type was Spina bifida occulta 57.1%, Myelomeningocele 28.6% and Myeloschisis 14.3%. Weakness of legs, urinary incontinence 35.7%, hip dislocation, deformity of the body 21.4% and paralysis were the reported complications. Conclusion: The prevalence of spina bifida in Arar, KSAwas 5.1per 1,000 live births. Majority of the reported cases were females, Spina bifida occulta was the most common then myelomeningocele and myeloschisis. The site was lumbosacral and lumber. }, keywords = {Keywords: Spina bifida,Arar,Northen KSA,prevalence,types,site,Complications,Treatment}, url = {https://ejhm.journals.ekb.eg/article_8188.html}, eprint = {https://ejhm.journals.ekb.eg/article_8188_36349c914cc74d9f17c9bbe10ea55c21.pdf} } @article { author = {}, title = {The Pattern of Utilization and Outcome of Complementary and Alternative Medicine among Primary Health Care Attendees in Tabuk, KSA}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {72}, number = {1}, pages = {3703-3711}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: Despite all the marvelous advancements in modern medicine, traditional medicine (TM) has always been practiced. Aim of the work: We aimed to assess Patterns of utilization and outcome of complementary and alternative medicine among primary health care attendees in Tabuk, KSA. Subjects and Methods: This cross-sectional study conducted among 345 patients attending the primary health care centers (PHC) in Tabuk, Saudi Arabia during the period from January 2015 to January 2016. Participants were selected from 29 centers by a stratified selection method. A structured questionnaire was used to collect socio-demographic data, going to a non-medical practitioner (TH) for advice about a health problem within the last year, the reason for that, type of TH provided prescription/advice, outcome, and personal satisfaction. The Statistical Package for Social Sciences (SPSS) was used for data analysis. The Chi-square and Fischer exact tests were used to examine the associations and differences between two categorical variables. Results: Participants (57.1% males), 62.9% had a history of visiting a Traditional Healer, Visiting a traditional healer was commoner among females (72.3% versus 55.8%, p=0.002)No significant statistical differences were found regarding other characteristics. Ineffective medical management was the reason in 55.3%, while the firm belief in TH that it was the reason behind 36.9%. Medical treatment was the most frequent (50.7%) followed by Zikr (25.8%), 87.6% said the visits were affordable, and 70% of visitors improved. Conclusion: Traditional medicine practice was prevalent in Tabuk, Saudi Arabia and was most prevalent among females. No significant differences were found between traditional medicine visitors and their counterparts regarding other characteristics. }, keywords = {Keywords: Complementary medicine,pattern,Tabuk,Saudi Arabia}, url = {https://ejhm.journals.ekb.eg/article_8189.html}, eprint = {https://ejhm.journals.ekb.eg/article_8189_002dc7f447222c6e98f463fc745dc84e.pdf} } @article { author = {Elhennawi, Fatma Mohammed and Alzankalony, Yasser Abdelmaguid and Abdellatif, Mona Kamal and Tawfik Ibrahim, Abeer Mohamed}, title = {Role of Anterior Segment Optical Coherence Tomography in The Diagnosis of Subclinical Keratoconus in Comparison with The Pentacam}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {72}, number = {1}, pages = {3712-3715}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: The most common ectatic disorder is keratoconus which is characterized by bilateral and progressive corneal thinning. Role of the pentacam has been well established for screening form fruste keratoconus in ophthalmology practice. While for anterior segment OCT it can detect the characteristic abnormal corneal thinning in patients with keratoconus using its pachymetry maps. Aim of the Work: was to detect how much anterior segment OCT can approach the pentacam’s well established efficacy in diagnosis of early keratoconus among the highly myopic astigmatic patients. Patients and Methods: This prospective, non-randomized population study followed the tenets of the Declaration of Helsinki, and the protocol was reviewed and approved by the Ophthalmology Department of Ain Shams University. An informed consent was signed by the patients before inclusion. We selected 40 eyes of twenty-three healthy young volunteers with high myopic astigmatism for the study from patients who attended the outpatient clinic of Maghraby Eye Hospital at the period of November and December 2017. Results: This study included 40 eyes of healthy young adults (22 females, 18 males) with high myopic astigmatism (-4.038 D± 1.194). The mean age ± SD was 24.1 ± 5.702 (range: 16-31 years). Statistically highly significant differences were observed in all measured cases between Pentacam and Anterior Segment OCT (p <0.01). So the OCT corneal pachymetry mapping seems promising for evaluating corneas as in cases of early keratoconus. Conclusion: The OCT corneal pachymetry mapping with its fast acquisition time seems promising for evaluating highly astigmatic corneas, as in early keratoconus. }, keywords = {Keywords: Anterior Segment Optical Coherence Tomography,Subclinical Keratoconus,pentacam}, url = {https://ejhm.journals.ekb.eg/article_8190.html}, eprint = {https://ejhm.journals.ekb.eg/article_8190_244466174f039c4aece3dde7a9edcf27.pdf} } @article { author = {}, title = {Severe Tracheomalacia Secondary to Double Aortic Arch. Any Role in Posterior Aortopexy? A Case report}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {72}, number = {1}, pages = {3516-3520}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Tracheomalacia is the abnormal collapse of the tracheal lumen and is common after cardiac compression. In the severe types, tracheomalacia can lead to significant morbidity, especially if encountered in a critical area, such as the distal part of the trachea, immediately above the tracheal bifurcation. We report a case that did not improve after cardiac surgery with persistent airway narrowing of more than 90%, requiring ventilatory support for a year. The case was difficult to manage, but the patient eventually showed a significant improvement after a posterior aortopexy that helped a lot in weaning him off the ventilator with a residual persistent audible wheeze and recurrent chest exacerbation. The diagnostic and therapeutic options for the case will be discussed. }, keywords = {}, url = {https://ejhm.journals.ekb.eg/article_8191.html}, eprint = {https://ejhm.journals.ekb.eg/article_8191_b600f6ffdd0f8c97fd15d48fa18e85c3.pdf} } @article { author = {}, title = {Potential Risk Factors of Intestinal Parasitic Infection in AlAhssa, Saudi Arabia}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {72}, number = {1}, pages = {3521-3525}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: Intestinal parasitic infections (IPIs) are endemic worldwide and have been described as constituting the greatest single worldwide cause of illness and disease. Low income, poor personal hygiene, environmental sanitation, and limited access to clean water are the factors associated with spread IPIs. Therefore, the purpose of this study was to determine the community awareness to IPIs and their related risk factors among people in Al- Ahssa. Subjects and Methods: A cross- section study was conducted in April 2014. A random sample of 120 participants was included. Data collection was gathered through the questionnaire form which includes inquires about social-demographic data, personal hygiene and habits. Results: Results showed that 92.7% of the participants were lacking awareness of IPIs. The proportions of participants who wash fruits and vegetables with only water before eating were 80% and 94% of them used to eat in restaurants at variable frequencies which was considered as a high risk factor for acquiring IPIs. However, the percentages of participants practice good hand washing before eating and after toilet were 67.7% and 90%, respectively which indicates lower risk. Conclusions: There is a need for campaigns to create awareness regarding the importance of prevention against the intestinal parasitic infection, and improve delivery of hygiene and health information. }, keywords = {Keywords: Risk factors of intestinal parasites,Hygiene,Saudi Arabia}, url = {https://ejhm.journals.ekb.eg/article_8192.html}, eprint = {https://ejhm.journals.ekb.eg/article_8192_a78068776ea6842afccf944f4e442015.pdf} } @article { author = {}, title = {Assessment of Cases of Acute Tramadol Toxicity as Regards Clinical, Laboratory and Management Procedures in Some University Hospitals in Cairo}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {72}, number = {1}, pages = {3732-3740}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Tramadol, a widely used opioid in recent years, is a centrally acting analgesic drug that has been used clinically for the last two decades to treat pain in humans. Tramadol also has antitussive activity. Tramadol is a centrally acting analgesic which is extensively used in the management of moderate to severe pain. It slightly affects opioid receptors and inhibits the reuptake of norepinephrine and serotonin in the CNS. The aim of this study was to evaluate the clinical manifestations, the laboratory findings, the different lines of treatment and the outcome of cases presented with acute toxicity by tramadol overdoses. This study was carried out at Al-Azhar University Emergency Hospitals in Cairo (El-Hussein And Bab El-Shaaria University Hospitals) and Ain Shams University Hospitals on one hundred subjects in the period from July 2016 to February 2018. Toxicological screening was done for every patient by rapid lateral flow chromatographic immunoassay for detection of tramadol and its principal metabolites in human urine by special kits at a cut off level of 1000 ng/ml. In this study, 95% of studied cases fully recovered and 5% died. }, keywords = {tramadol,substance of abuse,urine screening}, url = {https://ejhm.journals.ekb.eg/article_8194.html}, eprint = {https://ejhm.journals.ekb.eg/article_8194_fde92a9bf91df67cd2a7609105ceabec.pdf} } @article { author = {}, title = {Comparative Study between Laparoscopic Assisted versus Open Left Sided Hemicolectomy and Sigmoidectomy for Cancer Colon}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {72}, number = {1}, pages = {3741-3748}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: Traditionally, open procedure through exploratory incisions remains the gold standard approach for treating colorectal (CRC). Laparoscopic colectomy was proved to be a better alternative to the open approach. Though in some studies, it was found that the length of the operation tends to be somehow longer. However, in experienced hands it has comparable oncologic outcomes. Moreover, the laparoscopic approach is associated with less postoperative pain, faster return of bowel activity, earlier resumption of oral intake and lesser hospital stay. Aim of the Study: to study and evaluate the effectiveness of laparoscopic left hemicolectomy and sigmoidectomy compared to the open left sided colectomy and sigmoidectomy for malignancy regarding operative time, length of hospital stay, return of bowel function, resumption of oral intake, postoperative pain perception, general postoperative complications, surgical site infections and early recurrence. Patients and methods: This comparative study has been conducted in El-Demerdash hospital, Ain Shams University - Cairo, Egypt and has included 60 patients where half of the patients underwent open left hemicolectomy or sigmoidectomy and the other half underwent laparoscopic left hemicolectomy or simoidectomy. We performed both procedures during the period between 1st of January 2016 and 1st of January 2017 with 12 months of follow- up post-operatively. Results: In our study, the laparoscopic operation was associated with less hospital stay, earlier return of bowel activity, earlier resumption of oral intake without the use of the regular anti-emetics with better pain control and perception postoperatively. Moreover, it was associated with less surgical site infections and general complications including the respiratory ones than the open operation. We had similar anastomotic leak rates and early recurrence rate between both operations. Finally, the laparoscopic operation was associated with more operative time compared to the open operation. Conclusion: Laparoscopic left hemicolectomy and sigmoidectomy are oncologically sound when compared to the open left hemicolectomy and sigmoidectomy for treating left sided and sigmoid cancers. Moreover the laparoscopic approach yielded better outcomes regarding the postoperative recovery compared to the open approach. Recommendation: A further high volume study is needed to assess the long term effects of both procedures in our hospital. }, keywords = {laparoscopic assisted,open left-sided hemicolectomy,sigmoidectomy,Cancer Colon}, url = {https://ejhm.journals.ekb.eg/article_8195.html}, eprint = {https://ejhm.journals.ekb.eg/article_8195_13d218a722cbceb05fda1f28b1e6e80e.pdf} } @article { author = {}, title = {Efficacy and Safety of Colistin for Treatment of Multidrug-Resistant Acinetobacter Baumannii}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {72}, number = {1}, pages = {3749-3752}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: Antibiotic resistance of Acinetobacter baumannii causes various communicable diseases and increases the risks of admission to intensive care units (ICUs) with high morbidity and mortality rates. Objectives: Evaluating the efficacy of colistin usage guidelines and recommendations among critically ill patient infected by a multidrug-resistant Acinetobacter baumannii. Methods: An observational cross sectional study that was performed during the period from June to August 2017 among 127 critically ill patients who were treated with colistin for multidrug-resistant Acinetobacter baumannii using bacterial culture and proper identification methods. Evaluations of CRP, bacterial culture, BUN and serum creatinine level were routinely done pre- and post-treatment. Results: The method of administrating colistin was through intravenous infusion among all the patients and the most common indication of colistin usage were pneumonia followed by UTI. All the patients were susceptible to colistin and shown a negative bacterial cultures among most of the patients. The creatinine level was elevated (>2 mg/dL) showing nephrotoxicity among 11% of the patient. No allergic, neurological effects or mortality rates were observed in the study. Conclusion: The findings of the recent study revealed that colistin is the best therapeutic treatment for A. baumannii in KSA hospitals due to their broad-spectrum activity that may make them the most important choice for serious communicable and hospital acquired infections. Proper monitoring of the side-effects of colistin especially nephrotoxic effects through routine evaluation of creatinine level to detect the renal injury and adjusting the doses or combination of colistin low dose with other antibiotics. }, keywords = {Keywords: Colistin,Acinetobacter baumannii (A. baumannii),resistance,Monitoring,Critically Ill,KSA}, url = {https://ejhm.journals.ekb.eg/article_8235.html}, eprint = {https://ejhm.journals.ekb.eg/article_8235_9dbe62aa23b397f916523b97ada52456.pdf} } @article { author = {}, title = {Insulin versus Metformin in Treatment of Gestational Diabetes Mellitus (Randomized Controlled Clinical Trial)}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {72}, number = {1}, pages = {3753-3761}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: the use of anti-diabetic drugs to control gestational diabetes was controversial. Some studies suggested a possible link between the use of oral anti-diabetics and fetal anomalies, fetal macrosomia and neonatal hypoglycemia whereas others have demonstrated no such relationship. Metformin is a biguanide hypoglycemic agent that reduces hepatic gluconeogenesis and increases peripheral insulin sensitivity. Although it crosses placenta, metformin appears to be safe in pregnancy. Aim of the Work: this study aimed to assess the efficacy of metformin in controlling maternal blood glucose level compared to insulin in women with GDM. Patients and Methods: this randomized controlled trial was conducted on 116 patients with GDM recruited from the outpatient clinic of Ain Shams University Maternity Hospital (ASMH), Cairo, Egypt from February, 2016 to January, 2017. Results: macrosomic baby was significantly less frequent among metformin group than among insulin group (p= 0.047). Conclusion: metformin has efficacy as that of insulin in glycemic control of GDM and has the following beneficial effects: reduction the rate of shoulder dystocia, reduction the rate of cesarean section and reduction the rate of macrosomia more than insulin. Recommendations: metformin is recommended as an alternative to insulin therapy in control of blood glucose in patient with GDM when diet therapy and exercise fail to reduce blood glucose values sufficiently. The time for metformin as an alternative treatment to insulin has come; however, it should be prescribed after careful consideration of these patient characteristics to minimize the need for supplemental insulin.}, keywords = {}, url = {https://ejhm.journals.ekb.eg/article_8236.html}, eprint = {https://ejhm.journals.ekb.eg/article_8236_ffe51b277376bc3513789fcfed45478b.pdf} } @article { author = {}, title = {Magnetic Resonance Imaging of Suspicious Ovarian Lesions}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {72}, number = {1}, pages = {3762-3765}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: Characterization of an ovarian lesion represents a diagnostic challenge; the optimal assessment of an adnexal mass requires a multidisciplinary approach, based on physical examination, laboratory tests and imaging techniques. Diagnostic imaging plays a crucial role in detection, characterization and staging of adnexal masses. Magnetic Resonance Imaging (MRI) is an essential problem solving tool to determine the site of origin of a pelvic mass and then to characterize an adnexal mass, especially in patients with indeterminate lesions. Aim of the Work: The aim of the study is to evaluate role of MRI as a powerful and noninvasive technique which may effectively characterize and differentiate between various suspicious ovarian lesions. Patients and Methods: The current study is a prospective analysis that evaluated 26 female patients with 36 suspicious ovarian lesions. The study was conducted at Radiology Department of El-Demerdash hospital. The patients were previously evaluated by ultrasound examination in the period from November 2017 to April 2018. The patients’ age ranged from 12 to 65 years old (mean age 41± 15 SD). 4 patients presented by abdominal swelling (15%), 8 were complaining of chronic pelvic pain (30.7%), 10 came with menstrual irregularities (38%) and 4 (15%) cases were accidentally discovered during US examination. Results: This study included 36 ovarian lesions in 26 patients (8 cases had bilateral masses). The age in cases with benign lesions ranged from 12 to 65 years (Mean age 37.31 ± 16.214 SD), While the age in cases with malignant lesions; ranged from 14 to 61 years. (Mean age 44.38±14.015 SD) . Conclusion: As an advanced technique, dynamic contrast-enhanced MRI (DCE-MRI) plays an important role in tumor detection and characterization, subtyping, prediction of prognosis, treatment monitoring, and drug development. }, keywords = {Magnetic Resonance Imaging,Suspicious Ovarian Lesions}, url = {https://ejhm.journals.ekb.eg/article_8237.html}, eprint = {https://ejhm.journals.ekb.eg/article_8237_ee8b2b4570129f98f3b499782083eeb0.pdf} } @article { author = {}, title = {Combined Maternal Serum C3 Activation and Uterine Artery Doppler at 14-20 Weeks as Predictors for Pre-Eclampsia in Primigravida}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {72}, number = {1}, pages = {3766-3775}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: Preeclampsia is a multisystem disorder of pregnancy, which complicates 3%-5% of pregnancies in the western world. It is a major cause of maternal morbidity and mortality worldwide. The cardinal clinical features of the condition are hypertension and proteinuria occurring after 20 weeks gestation in women who were not previously known to be hypertensive. Objective: This study was aimed to assess the efficacy of C3 estimation and measurement of bilateral uterine artery Doppler before 20 weeks of pregnancy for prediction of preeclampsia in primigravida. Methods: The study was performed at the Antenatal Care Unit, Obstetrics and Gynecology Department, Sayed Galal Hospital, Al Azhar University on 131 pregnant women at 14-20 gestational weeks during period from July 2017 to December 2017 gestation attending. Results: On follow up the population of the study 131 pregnant women had completed the study that were classified to 119 (90.8%) with no pre-eclampsia and 12 (9.2%) developed preeclampsia, As regards the Patients characteristics there was no statistical significant difference between the two groups as regard age, height, weight, gestational age, SBP and DPB at enrollment (p-value>0.05). There was a significant difference regarding BMI as (p value < 0.05), with more increasing BMI and decreasing gestational age at delivery in preeclampsia group in comparison with the no preeclampsia group. As regards the C3, there was statistically highly significant difference between the two groups regarding serum C3 level as p value <0.05, with lower levels of C3 serum levels in preeclampsia group. Receiver operator characteristics (ROC) curves were constructed for estimating the association between pre-eclampsia and serum C3 level. A significant association was found with serum C3 level being a significant predictor with lower values in cases with pre-eclampsia than in normal cases [area under the curve (AUC) = 0.935, 95% CI (0.878 to 0.9711.35), best cut off (≤53.1), sensitivity of 83.3%, specificity of 100% positive predictive value (PPV) of 100% and negative predictive value (NPV) of 98.3%. Conclusion: This study demonstrates that lower level of maternal serum C3 in the early second trimester (14-20 weeks gestation) and abnormal increasing in uterine artery indices (PI and RI) are associated with developing pre-eclampsia several months later in pregnancy. }, keywords = {Predictors for Pre-eclampsia in Primigravida,Maternal Serum C3 Activation,uterine artery Doppler}, url = {https://ejhm.journals.ekb.eg/article_8238.html}, eprint = {https://ejhm.journals.ekb.eg/article_8238_b0601bb023197638bacd130699c139a4.pdf} } @article { author = {}, title = {Knowledge, Attitude and Practice towards Hepatitis B Virus among Medical Students in Tabuk City, Saudi Arabia}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {72}, number = {1}, pages = {3776-3780}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: Medical students are at high risk of hepatitis B during their training, and are expected to be future doctors to acquire proper knowledge and attitude about the virus. The aim of the work: The present study aimed at assessing knowledge, attitude, and practice regarding hepatitis B virus among Saudi medical students. Materials and Methods: This cross-sectional study conducted among147clinical phase medical students during the period from may 2017 to April 2017. A self-administered questionnaire (five components and 46 choice questions with yes/no or yes/no/don't know) was used to assess knowledge (16 queries), attitude (18 items), symptoms and signs (6 questions), prevention (4 questions), and treatment (two issues) . The Statistical Package for Social Sciences (IBM, SPSS, version 20, New York) was used for data analysis. The data were presented as percentages and mean± SD unless otherwise specified. A P-value of <0.05 was considered significant. Results: Out of 147 medical students (51% males), their age was 22.90±1.2 years, the student's overall knowledge was 70.54±26.51%, the knowledge regarding symptoms and complications was 83.9±9.11%, while the prevention, treatment, and attitude scores were 67.17±20.96%, 51.7±32.66%, and 53.52±26.11% respectively. Conclusion: The students in Tabuk had a negative attitude towards hepatitis B virus in spite of the fair knowledge, their knowledge regarding the virus prevention and treatment were suboptimal. }, keywords = {Hepatitis B virus,Knowledge,Attitude,Practice,Medical students,Saudi Arabia}, url = {https://ejhm.journals.ekb.eg/article_8239.html}, eprint = {https://ejhm.journals.ekb.eg/article_8239_ce51a1233672dd349bb004053c66118d.pdf} } @article { author = {}, title = {Evaluation of Left Ventricular Systolic Function by Two-Dimentional Speckle Tracking Echocardiography in Patients With Chronic Obstructive Pulmonary Disease (COPD)}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {72}, number = {1}, pages = {3781-3789}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: Chronic obstructive pulmonary disease (COPD) is characterized by chronic airflow limitation. In addition, COPD presents significant extra-pulmonary effects and is associated with important co-morbidities. The main causes of morbidity and mortality among COPD patients are cardiovascular disease (CVD), lung cancer and osteoporosis. Subclinical changes in LV systolic function that cannot be detected by conventional LV ejection fraction (EF) can be identified by speckle tracking echocardiography for quantification of myocardial strain and is a superior predictor of outcomes to EF. There are different mechanisms that COPD affect LV function as physiologcal stress, ventricular interdependence, chronic hypoxia and left ventricular hypertrophy. Aim of the Work: to evaluate LV systolic function by means of two-dimentional speckle tracking echocardiography (2D-STE) in patients with COPD and no evidence of CVD. Patients and Methods: This prospective study was carried out on 50 subjects of both sexes, who were presented to El Hussein University Hospital. Subjects were categorized into two groups; 20 healthy subjects as (control) group and 30 patients with (COPD) group. Results: The results of the study showed that there were statistically highly significant correlations of FEV1% with GLS, PAPs and smoking pack years (p < 0.001) and significant correlations of FEV1% with PO2 and oxygen saturation (p < 0.05). In addition, there were statistically significant correlations of global longitudinal strain (GLS) with tricuspid annular plane systolic excursion (TAPSI) and PO2 (p < 0.05) and PAPs and smoking pack years (p < 0.001). According to the comparison between both COPD subgroups, group (B) COPD subjects showed higher significant correlation with GLS, FEV1, FEV1/ FVC, PAPs and smoking pack year than group (A) COPD. Therefore, COPD severity is significantly correlated with GLS. Conclusion: 2D-STE is a novel, fast and non invasive technique so, clinicians can use 2D-STE to predict risk of cardiovascular morbidity in COPD patients. Recommednations: It is recommended to perform larger- scaled study in multi-centers to assess role of 2D-STE in diagnosis LV dysfunction in COPD patients. Other diagnostic modalities as cardiac (MRI) can be helpful for assessment of LV function. }, keywords = {ventricular systolic function,2D speckl tracking echocardiography,COPD}, url = {https://ejhm.journals.ekb.eg/article_8240.html}, eprint = {https://ejhm.journals.ekb.eg/article_8240_b4b81c344624112e2a71641f70e11c93.pdf} } @article { author = {}, title = {Pulmonary Alveolar Microlithiasis in Saudi Child: A Case Report}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {72}, number = {1}, pages = {3790-3793}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: Pulmonary alveolar microlithiasis (PAM) is a rare but not uncommon disease; it showed worldwide distribution either familial or sporadic, the most reported cases in Europe, especially in Turkey. The presence of round shaped little bodies containing concentric calcareous lamellas in pulmonary alveolus is the hallmark of the disease. With this study, we report a case of PAM in Arabic descent, a Saudi child, who represented the most characteristics of the disease in dissociation between definite radiological pattern of the lungs and relatively poor clinical symptoms. Case Presentation: A-9-year-old Arabic female, presented with occasional nonproductive cough for one year, the patient suspected milliary TB and received antituberculous therapy. Examination: Revealed well pleasant child with finger clubbing and clear chest. The patient followed for two years, with marginal deterioration in her general condition. Conclusion: Here, we reported a sporadic case of PAM in Saudi child that presented with nonspecific clinical picture, which resulted in misdiagnosis and consequently improper management. The case proves the slowly progression of the disease. }, keywords = {Pulmonary alveolar microlithiasis. PAM,Saudi origin,Pediatrics}, url = {https://ejhm.journals.ekb.eg/article_8241.html}, eprint = {https://ejhm.journals.ekb.eg/article_8241_4fbb44ccbe6eed9c965aa94622c92e3f.pdf} } @article { author = {}, title = {Using Pregabalin for Prevention of Post Anesthesia Shivering}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {72}, number = {1}, pages = {3794-3805}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2018.8249}, abstract = {s}, keywords = {s}, url = {https://ejhm.journals.ekb.eg/article_8249.html}, eprint = {https://ejhm.journals.ekb.eg/article_8249_ab0229b3d061c49b21740764d2fca61b.pdf} } @article { author = {Abdallah, Hany Mustafa and Sayed, Mohamed Samir and Ibrahim Saif, Ahmed Mohsen}, title = {Evaluation of Staging Accuracy of Dynamic MRI in Urinary Bladder Cancer}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {72}, number = {1}, pages = {3806-3811}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: Urinary Bladder cancer is the second most common neoplasm of the urinary tract worldwide. It accounts for 6-8 % of malignancy in men and 2-3% in women with the highest incidence rates in North American and Europe as well as areas with endemic schistosomiasias in Africa and the middle east. Purpose: To show the staging accuracy of Dynamic MRI in urinary bladder carcinoma. Patients and Methods: This is a Prospective randomized clinical study, study setting: Radiology and Urology Departments, Faculty of Medicine, Ain Shams University, study period: 6 months from August 2017 till February 2018. Results: This study conducted on 20 patients (17 male and 3 females) with age ranged from 42 – 78 years and with mean±SD of 55.95±9.01 years. 4/20 patients (20.0%) were presented to TURT procedure while 16/20 patients (80.0%) were presented to radical cystectomy. Conclusion: In this study, despite small differences between the results of the MRI and pathology, Dynamic MRI was found to be an accurate modality for assessment of tumor staging, and its routine use in bladder cancer staging can lead to significant improvement of diagnostic accuracy of the staging and treatment planning and hence improvement of the prognosis of the patients and their survival rates. Furthermore, the use of Dynamic MRI systems with higher magnetic field and imaging techniques standardized with higher resolution could further enhance the accuracy of the method. Further studies with larger sample size may also help to validate the results of this study. }, keywords = {Keywords: Dynamic MRI,Urinary Bladder Cancer,Conventional Computed Tomography}, url = {https://ejhm.journals.ekb.eg/article_8246.html}, eprint = {https://ejhm.journals.ekb.eg/article_8246_c4612e8b8c9255a055947bd710ef1ae5.pdf} } @article { author = {}, title = {Variation in Morphology of Soft Palate Using Cone-Beam Computed Tomography in Sakaka Population}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {72}, number = {1}, pages = {3812-3815}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Objective: The aim of the present study was to investigate the variation in morphology of soft palate in age groups and gender using CBCT in Sakaka population. Study design: The study sample consisted of 240 CBCT scans aged between 15 and 45 years. The velar morphology on CBCT was examined and grouped into six types. The results obtained were subjected to statistical analysis to find out the association between variants of the soft palate with gender and different age groups. Results: The most frequent type of soft palate was Rat tail shaped. (46.25%) followed by Leaf shape, 18.75% Butt shape, 13.33% and Handle shape, 10%. S-shape7.5% and Crook shape, was 4.1%. There was no significant difference between Males and Females. Conclusions: The knowledge of a varied spectrum of velar morphology and the variants of the soft palate assist in the better understanding of the velopharyngeal closure and craniofacial anomalies. }, keywords = {soft palate,Morphology,cone -beam computed tomography}, url = {https://ejhm.journals.ekb.eg/article_8247.html}, eprint = {https://ejhm.journals.ekb.eg/article_8247_ab0269b9df4641c800c2832b4edbc7c3.pdf} } @article { author = {}, title = {Congenital Diaphragmatic Hernia Management and Outcomes: A Simple Literature Review}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {72}, number = {1}, pages = {3816-3822}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: Congenital diaphragmatic hernia (CDH) is considered as one of the most common congenital anomalies. As a result, significant literatures have been done to assess the different management procedures and outcomes of each. Assessment of these literatures will support in providing better outcomes for the patients. Objective: Aim of the study : Assessment of different management plans of CDH, and the outcomes related. In addition to providing scientific references for analyzing all the clinical studies in this field. Methods: PubMed database was used for articles selection. We included all relevant articles to our review with the following topics: Congenital Diaphragmatic Hernia, Management, Outcomes, Morbidity, and Mortality. We excluded other articles which are not related to this field. The data were extracted according to specific form to be reviewed by group members to assess the different procedures, and the outcomes. Conclusion: Congenital Diaphragmatic Hernia has high complexity regarding its management. Prenatal screening is important because early diagnosis is helpful either in family education about the condition and its prognosis or in the decision regarding prenatal intervention. Smoking and alcohol intake are modifiable risk factors of CDH and their complications like prematurity, which is associated with high incidence of morbidity and mortality. Resolution and improvement of pulmonary hypertension either with or without treatment in the first 2-3 weeks was a major indicator of good prognosis of the case. Minimally invasive techniques showed lower rate of complications than open surgeries either prenatally like FETO or postnatally like thoracoscopic CDH repair. In addition, Hernia repair after decannulation from ECMO showed lower bleeding complications than repair on ECMO. }, keywords = {}, url = {https://ejhm.journals.ekb.eg/article_8253.html}, eprint = {https://ejhm.journals.ekb.eg/article_8253_7512f03c44834550027745769b99cfef.pdf} } @article { author = {}, title = {Results of Laparoscopic Varicocelectomy}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {72}, number = {1}, pages = {3823-3826}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: varicoceles are one of the most commonly identified scrotal diseases. their prevalence in the normal adult male population is 15-20% &they are thought to be the most common treatable cause of male factor infertility. a variety of surgical & non-surgical approaches have been advocated for varicocelectomy. objective: to make a follow-up for the results of laparoscopic varicocelectomy after 3 & 6 months. Patients and methods: a total of twenty male patients, presented with history of primary infertility or pain or both and have varicocele (30% left-sided & 70% bilateral), were included in the study. laparoscopic varicocelectomy was done between march 2016 and december 2017.we made a follow-up after 3 & 6 months by clinical examination, semen analysis & colored-doppler ultrasonography. Results: mean operation time was 40 min. (range 22-58 min.). the hospital stay was one day for all patients. return to normal activities was from 2-3 days. 25% of patients have postoperative scrotal emphysema. 20% of patients had recurrence & 10% had hydrocele. there was no postoperative testicular atrophy in any of the patients. during the follow-up period (6 months), there was improvement in the seminal fluid parameters in 85% of patients. Conclusion: although sooner return to work, less postoperative pain, more accessibility to both sides from small incisions are achieved by laparoscopic varicocelectomy, recurrence & hydrocele are more frequent than with the open method. }, keywords = {hydrocele,Laparoscopy,Male infertility,Recurrence,Varicocele}, url = {https://ejhm.journals.ekb.eg/article_8254.html}, eprint = {https://ejhm.journals.ekb.eg/article_8254_3e62b92a821b394a7a8a634c9ed8d62e.pdf} } @article { author = {}, title = {Prophylactic Carbetocin during Elective Caesarean Section in High Risk group for Atonic Postpartum Hemorrhage}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {72}, number = {1}, pages = {3827-3834}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: Postpartum hemorrhage (PPH) is defined as a blood loss more than 500 ml and serious PPH as a blood loss more than 1,000 ml. PPH is a serious condition remaining the single main cause of maternal morbidity and mortality. Postpartum hemorrhage (PPH) accounts for nearly one-quarter of all maternal deaths worldwide and was the second most frequent cause of maternal death in the UK for the 2000–2002 trienniums. The most frequent cause of PPH is uterine a tony, contributing up to 80 % of the PPH cases. Although two-thirds of the PPH cases occur in women without predisposing factors, there are several risk factors for PPH such as previous PPH, preeclampsia, coagulopathy, multiple gestation and antepartum hemorrhage. Also cesarean section (CS) is a recognized risk factor for PPH and its prevalence is increasing .The administration of oxytocics after the delivery of the neonate reduces the like hood of PPH and 5 IU oxytocin by slow intravenous injection is currently recommended in the UK for all cesarean sections. However, the use of additional oxytocic medication is common to arrest bleeding, or prophylactically if there are risk factors for PPH. Oxytocin is currently the uterotonic of first choice. It has proven to decrease the incidence of PPH by 40 % and has a rapid onset of action and a good safety profile . A disadvantage of oxytocin is its short half life of 4–10 min, regularly requiring a continuous intravenous infusion or repeated intramuscular injections. Objectives: was.to evaluate role of carbetocine either i.v or intramyometriam in preventing postpartum haemorrhge. Patients and methods: this was Randomized controlled double blind study was held at sayed galal hospital department of obstetrics and gynecology between April 2016 to October 2017 . Results: We observe fall in rate of atonic postpartum haemorrhage after administration of carbetocin either i.v. or intramyometriaum . we found diferrance in blood pressure between two group weher increase og blood pressure in group received carbetocine i.v. .Also we found difference between two group need for additional dose which increase in goup that received carbetocine intramyometraim. Conclusion: Adminstration of carbetocine either i.v. or intramyometriaum decrease rate of atonic post partum haemorrhage in high risk group for atonic postpartum haemorrhage. }, keywords = {Prophylactic Carbetocin during,Elective Caesarean,Atonic Postpartum Hemorrhage}, url = {https://ejhm.journals.ekb.eg/article_8255.html}, eprint = {https://ejhm.journals.ekb.eg/article_8255_5011464f06dc9cf1963b3d1715320efd.pdf} } @article { author = {}, title = {Serum Zinc Level in Children with Acute Lower Respiratory Tract Infection}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {72}, number = {1}, pages = {3835-3838}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: Pediatric respiratory disease remains an important cause of morbidity in both the developing and the developed world. Pneumonias and inflammatory process develops in alveoli and interstitium as a response to infection- causing factors such as bacteria and viruses. Since pneumonia in infancy is difficult to discriminate from acute bronchiolitis, the term acute lower respiratory tract infection (ALRTI) inclusive of these both diseases is used. Zincis a micronutrient with important roles in growth and in the immune, nervous and reproductive systems. Regular dietary intake of zinc is necessary because the human body cannot produce zinc and does not have an adequate mechanism for storing or releasing it. Objective: was to evaluate serum zinc level in children with ALRTI. Patients and Methods: Serum zinc level in children with ALRTI. 80 patients (subdivided into 3 groups according to severity of infection) compared to 20 normal individuals were included in this study. Results: there was highly statistical significant difference between all patients and control groups as regard serum zinc level (mean of serum vitamin D level in patients and control groups were 56.413 ±29.474 and 90.135 ± 17.345 respectively, p=<0.0001). Conclusion: Zinc deficiency occurs in the majority of recurrent respiratory infection in children and therefore a decreased serum zinc level is considered an additional risk factor for recurrent respiratory infection. }, keywords = {Zinc Level,children,Lower Respiratory Tract Infection}, url = {https://ejhm.journals.ekb.eg/article_8256.html}, eprint = {https://ejhm.journals.ekb.eg/article_8256_ea0da5b4be9f33123b6060e516c9098c.pdf} } @article { author = {}, title = {Clinical Intervention for Maternal Near Miss Cases in El Galaa Teaching Hospital}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {72}, number = {1}, pages = {3839-3845}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: Near miss cases share many characteristics with maternal deaths and can directly inform about obstacles that had to be overcome after the onset of an acute complication, hence providing valuable information on obstetric care. This allows for corrective action to be taken on identified problems to reduce related mortality and long-term morbidity. Objective: The purpose of this study was to determine the efficacy of possible interventions (in the form of monthly clinical audit for new near miss cases and feedback strategy) in reducing maternal near miss cases in El Galaa Teaching Hospital in Egypt and improving WHO indicators of maternal health. Methods: The study was conducted over 3 stages: Stage I (Formative Stage): Is a retrospective study of maternal near miss cases over 1 year period, based on WHO criteria from 1/1/2016 to 1/1/2017. Stage II (Intervention stage): This incorporated a monthly clinical audit for new near-miss cases and feedback strategy, using WHO case report forms, as well as engagement of opinion leaders for 1 year from 1/1/2017 to 1/1 2018 with 2 to 3 cases discussed monthly. Stage III (Assessment Stage): Evaluating the clinical performance and frequency of near miss cases after intervention. Results: In this study, the majority of women with potentially life threatening conditions were referred from private obstetrician clinic, private hospitals and Ministry of Health to El Galaa hospital. The majority of Maternal near miss cases (67.9%) gave birth by Caesarean section, this was because of the severity of these patients' obstetric conditions usually requires urgent action. The main life threatening conditions among women in this study were hypertensive disorders of pregnancy 41% (24% Pre-eclampsia, 15% Eclampsia, 2% chronic hypertension). Conclusion: Our intervention (near miss clinical audit) helped to improve the performance and quality of care provided to women with complications during pregnancy, as reflected on the maternal health outcome indicators. Therefore we recommend incorporating clinical audit process in all health facilities. The Maternal mortality index and Maternal near miss mortality ratio, two of the indicators recommended by WHO, can be used to monitor and assess the performance and health care level. Health managers and policy makers should use maternal health outcome indicators for allocation of resources and prioritization of investments. }, keywords = {Maternal near miss – Maternal mortality – Maternal morbidity}, url = {https://ejhm.journals.ekb.eg/article_8257.html}, eprint = {https://ejhm.journals.ekb.eg/article_8257_41f593c7e74adfdd4b986309edae530f.pdf} } @article { author = {}, title = {Awareness of Jouf University Medical Students about Brucellosis}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {72}, number = {1}, pages = {3846-3849}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Background: Brucellosis can be well-defined as a bacterial zoonotic infection conveyed to humans by direct interaction with infected animals or its food products such as meat, cheese, and unpasteurized milk mainly domesticated ruminants and swine. Objective: Determination of the students’ knowledge about Brucellosis. Methods: Medical students of Jouf University asked to complete a questionnaire capture about their knowledge on the etiology, clinical feature, complications, prognosis and prevention of brucellosis. Results: The overall results showed that there is a lack in awareness about brucellosis among the students. Conclusion: The medical training institutions should give special consideration to brucellosis in their teaching curricula. }, keywords = {Awareness,Brucellosis,Medical Practitioners}, url = {https://ejhm.journals.ekb.eg/article_8259.html}, eprint = {https://ejhm.journals.ekb.eg/article_8259_2aa7a530eee73c0ae7eefc1b4f4deae2.pdf} } @article { author = {}, title = {Growth Kinetics and Metronidazole Sensitivity of Blastocystis Sp. Isolated from Colorectal Carcinoma (CRC) and Non-CRC Patients}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {72}, number = {1}, pages = {3850-3856}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Blastocystis sp. is the most common protist detected in human fecal samples in numerous studies globally. Extreme debate regarding Blastocystis sp. pathogenicity exists. Some studies have speculated a possible correlation between Blastocystis and CRC. No previous study has investigated the presence of non-genotypic differences in Blastocystis sp. isolated from CRC and non-CRC patients. The present work aimed to investigate the growth kinetics (G.K) and metronidazole (MTZ) sensitivity in Blastocystis isolates from CRC and apparent non-CRC whether symptomatic and asymptomatic Blastocystis carriers. Seven isolates from CRC patients and 6 from symptomatic and 6 from asymptomatic non-CRC carriers were cultured in Locke's Egg (LE) medium supplemented with bovine serum and antibiotic mixture and incubated at 37◦ C. Mean viable organisms counts of each isolate were counted every 24 hours in medium to follow their GK and after exposure to different MTZ concentrations to perform drug sensitivity assay. In vitro growth kinetics of CRC and Non-CRC symptomatic isolates were nearly similar with higher peaks attained at 72 hours incubation than by the slower growing non-CRC-asymptomatic isolates. MTZ-sensitivity of CRC isolates was nearly similar to that of non-CRC asymptomatic isolates, both were significantly more sensitive than the symptomatic isolates especially at high drug concentration of 200 μg/ml of the medium. }, keywords = {Blastocystis sp,Colorectal carcinoma,Symptomatic,Asymptomatic,growth kinetics,metronidazole sensitivity}, url = {https://ejhm.journals.ekb.eg/article_8260.html}, eprint = {https://ejhm.journals.ekb.eg/article_8260_34676fdbafb04b4b447ae10c3f9d414b.pdf} } @article { author = {}, title = {Patients’ Satisfaction with Health Care Services in Southern Saudi Arabia}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {72}, number = {1}, pages = {3857-3860}, year = {2018}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {}, abstract = {Objective: To evaluate the level of patients’ satisfaction in primary health care centers and tertiary hospitals in Al- Baha, Saudi Arabia. Methods: A cross sectional study was carried out during March 2018 using a questionnaire that has combined (outpatient and inpatient) measures to include admitted patients and clinics’ attendants. After explaining the study nature and purpose, an individual consent was obtained from all the participants prior to filling the questionnaire. The data were analyzed using a computer program (SPSS, version 21.00). Results: 303 responses were analyzed, of which (50.8%) were males, (93.1%) were aged from 15 to 45 years, about two thirds (65.3%) were single, (79.9%) were income-satisfied, and the majority (69.6%) has completed or still studying at the university, which indicates a high educational level among our sample. (82.8%) were satisfied about nurses’ treatment, (90.1%) were satisfied about doctors’ treatment, and around (79.6%) were satisfied about the cleanliness, quietness, and design of the facility. Conclusion:The satisfaction among our sample is considered high and indicates a good care provided by health facilities in Al-Baha region, Saudi Arabia. Male gender and higher educational level were associated with higher levels of satisfaction. The least satisfactory factor was regarding communication; therefore, we recommend implanting programs concerning communication skills for health care providers. }, keywords = {Satisfaction,hospital,Al-Baha,Saudi Arabia}, url = {https://ejhm.journals.ekb.eg/article_8262.html}, eprint = {https://ejhm.journals.ekb.eg/article_8262_53df998c6ef06efe63626be41f42ebfd.pdf} }