@article { author = {El Makkawy, Fatma Sabry and Ezzo, Azza Mohammed and Ouda, Enass Abd El-Aty and Al-Kassas, Azza El-Said Mahmoud}, title = {Pharmacological Effects of Gemfibrozil on Some Isolated Smooth Muscle Preparations Of Experimental Animals}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {66}, number = {1}, pages = {1-17}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0034628}, abstract = {Background: Gemfibrozil is a member of fibrates (gemfibrozil, fenofibrate, ceprofibrate, and benzafibrate) which is employed for treatment of dyslipidemia particularly hypertriglyceridemiae through its action on peroxisome proliflator activated receptors (PPAR-α). Objective: The aim of this work was to study the site of action and pharmacololgical effects of different doses of gemfibrozil on some isolated smooth muscles preparations of experimental animals. Materials and Methods: The experiments were conducted on  isolated jejunum of rabbits, isolated spiral tracheal and urinary bladder strips of guinea pigs. Results: I- On isolated rabbit jejunum, gemfibrozil produced a dose-dependent reduction on the amplitude of jejunal contractions. The inhibitory effect of gemfibrozil was not abolished after complete blockade of alpha and beta adrenergic receptors, while it was completely abolished after inhibition of nitric oxide synthase by N-methyl L-arginine. On the other hand the stimulatory effects of nicotine small dose, acetylcholine, calcium gluconate, histamine and serotonin were not abolished after administration of gemfibrozil. II- On isolated tracheal spiral strips of ginea pigs, gemfibrozil produced a dose- dependent relaxation on the basal tone and a dose-dependent reduction on the amplitude of acetylcholine-induced tracheal contractions of the tracheal strips. The inhibitory effect of gemfibrozil was completely abolished after inhibition of nitric oxide synthase by N-methyl L-arginine. Gemfibrozil completely abolished also serotonin-induced contraction, while it has no effect on histamine or calcium-induced tracheal contractions. III- On isolated urinary bladder strips of guinea pigs, gemfibrozil produced a dose-dependent reduction on the amplitude of urinary bladder contractions. The inhibitory effect of gemfibrozil was not abolished after complete blockade of beta adrenergic receptors, while it was completely abolished after inhibition of nitric oxide synthase by N-methyl L-arginine. On the other hand the stimulatory effects of acetylcholine and serotonin were not abolished after administration of gemfibrozil. Conclusion: Gemfibrozil (antidyslipidemic, PPAR-α agonist) reduced jejunal and urinary bladder contractions and has a relaxant effect on tracheal basal tone. So it has a beneficial effect in obstructive airway diseases and cases of urgency and frequency of micturation and urinary incontinence. However, it may be used cauciously in cases of ,GIT disturbances as constipation and prostatic hypertrophy.  }, keywords = {Gemfibrozil,isolated smooth muscle,jejumum of rabbits,tracheal strip,and urinary bladder strips of guinea pigs}, url = {https://ejhm.journals.ekb.eg/article_14478.html}, eprint = {https://ejhm.journals.ekb.eg/article_14478_132c6acf5b76a841a6d4e9bcd4fe3eed.pdf} } @article { author = {Alebshehy, Raouf and Ohas, Josephine}, title = {A Critique of Proposed Strategies for Tackling Female Obesity in Egypt}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {66}, number = {1}, pages = {18-27}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0034629}, abstract = {Background: obesity is a huge health problem in Egypt. Its prevalence is the double among Egyptian females as compared to males. It is estimated that 75% of females over the age of thirty are overweight or obese.  However, 95% of Egyptian females are not taking any measures to control their weight; additionally there is no national program to address the problem. Methods: following specific appraisal criteria, this research article provides a critical appraisal of strategies that could help in addressing the problem of obesity among females. This article includes an appraisal of interventions of promoting healthy lifestyle changes; healthy diet and physical activity. It also provides an appraisal of using social media, primary healthcare clinics, and pharmacies as delivery strategies of the proposed interventions. Findings: the research article reveals the feasibility of the proposed strategies based on the criteria of effectiveness, cost-effectiveness, organizational feasibility, and gender appropriateness.  }, keywords = {female obesity,interventions,delivery strategies}, url = {https://ejhm.journals.ekb.eg/article_14481.html}, eprint = {https://ejhm.journals.ekb.eg/article_14481_1d5ca236f560a7bab3586bb327150c95.pdf} } @article { author = {Samn, Alaa Abdel-Aziz Mohamed}, title = {A Molecular and Microscopically Studies of Calicophoron Microbothrium}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {66}, number = {1}, pages = {28-39}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0034630}, abstract = {Background: Paramphistomiasis is a parasitic disease of livestock animals and humans, which causes heavy economic black lashes especially in countries with advanced animal industry   Aim of Study: the current study aimed to add more information about Calicophoron microbothrium (C. microbothrium) and clarify its biological role and how its miracidia infecte the molluscan intermediate host.  In addition, a briefdescription to Bullins truncates; the morphological, structural and chronological characteristics of the various intermolluscan stages of the parasite are studied in detail. Moreover, the present work showed the effective role of physical parameters (light, temperature, salinity and gas-phase (aerobic versus anaerobic)) on egg development and hatching and the biological activities of cercaria and metacercaria.  Beside these routine techniques, PCR also was used as more advanced and accurate diagnostic technique based on the detection of nucleic acid. Where, 34 larvae and adult worms of Calicophoron microbothrium were isolated from naturally infected buffaloes. The results of the present study will facilitate the identification of this despise secular group of digeneans although its bad effect not only affect animal industry but also human health. Furthermore, the current research clears the weak points in its life cycle to aperient settling this parasite.  }, keywords = {Calicophoron microbothrium,Bullins truncates,paramphistome,biology,histology,Mas–PCR technique}, url = {https://ejhm.journals.ekb.eg/article_14482.html}, eprint = {https://ejhm.journals.ekb.eg/article_14482_319e4db29751fc67cace18447c695251.pdf} } @article { author = {Shaldoum, Fayez M. and Ahmed, Wafaa Fayez and Hamza, Hanan Taher and Shahin, Mohammed Sedik}, title = {Comparative Study on Copper, Zinc, Magnesium and Iron in Hydatid Cyst Fluid (Supernatant and Residue) in Sheep and Camel in Egypt}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {66}, number = {1}, pages = {40-45}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0034631}, abstract = {Aim: this study included comparative biochemical composition of micro-minerals, including Cu, Zn, Mg and Fe in hydatid cyst fluid (supernatant and residue) from liver of infected sheep and lung of infected camels. Materials and Methods: Organs with hydatid cysts were collected from El-Basateen abattoirs, Cairo, Egypt, during the period from Nov. 2014 to Dec. 2015. Flame ionization by Atomic absorption spectroscopy was used for measuring the micro-minerals concentration. Results: the current study showed: significant difference in Mg, Cu and Fe micro-minerals between cyst’ supernatant (S Sh) and residue (R Sh) of infected sheep (p<0.001, p<0.05); significant difference in only Cu micro-mineral between S Sh and cyst residue (R C) of camels (p<0.001); significant difference in both Fe and Zn micro-mineral between cyst supernatant of infected camels (S C) and S Sh (p<0.05); significant difference in both Mg and Fe between R Sh and R C (p<0.01); significant difference in Mg, Fe and Zn between R Sh and S C (p<0.01, p<0.001) and significant difference in Fe and Zn between S C and R C (p<0.001, p<0.01). Cu was the highest while Mg was the lowest concentration of all tested minerals in both S Sh and S C but Fe was the highest and Zn was the lowest concentration of all tested minerals in both R Sh and R C.  Conclusions: in the current work, the parasite that was located in both sheep and camel is characterized by having high levels of Copper in the cyst fluid and of iron in the scolecies. Binding a scolecidal drug with either copper or iron may enhance its efficacy.  }, keywords = {copper,zinc,Magnesium,iron,Hydatid cyst,sheep,camel,Egypt}, url = {https://ejhm.journals.ekb.eg/article_14484.html}, eprint = {https://ejhm.journals.ekb.eg/article_14484_4bf23cf8d8cf1e04bca6ec175f6fa849.pdf} } @article { author = {Al-Azhari, Shabaan Salah and Negm, Mohamed Salem and El-Awdy, Mostafa Mostafa Kamel and Galal, Al-Shazly Gaber Mohamed}, title = {Evaluation of Ledipasvir plus Sofosbuvir for Treatment of Compensated and Decompensated HCV Cirrhotic Patients}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {66}, number = {1}, pages = {46-51}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0034632}, abstract = {Background:unlike human immunodeficiency virus (HIV) and hepatitis B virus (HBV), hepatitis C virus (HCV) infection is a curable disease. Current direct acting antiviral agent (DAA) targets are focused on HCV NS3/4A protein (protease), NS5B protein (polymerase) and NS5A protein. The first generation of DAAs includes boceprevir and telaprevir, which are protease inhibitors and were approved for clinical use in 2011. The cure rate for genotype 1 patients increased from 45% to 70% when boceprevir or telaprevir was added to standard PEG-IFN/ribavirin. More effective and less toxic second generation DAAs supplanted these drugs by 2013. The second generation of DAAs includes sofosbuvir, simeprevir and fixed combination medicines containing ledipasvir plus sofosbuvir and Viekira Pak. These drugs increase cure rates to over 90% without the need for interferon and effectively treat all HCV genotypes. With these drugs the “cure HCV” goal has become a reality. The aim of this study was to assess of ledipasvir plus sofosbuvir as treatment of HCV infection in patients with advanced liver disease including cirrhotic patients with child B and C.   Patients and methods:in this prospective study, seventy five HCV PCR positive patients were classified into three groups according to child score. Each group included twenty five patients. All patients received ledipasvir plus sofosbuvir for six months. For all patients thorough medical history, clinical examination, kidney function tests, liver function tests, complete blood count, pelvi-abdominal ultrasound, HCVantibodies, hepatitis C viral RNA, quantitative, HbsAg, alpha fetoprotein as baseline screening. HCV PCR done for all patients at end of treatment and three months later to detect sustained virological response (SVR12). Patients with combined HCV and HBV infection, hepatic or extrahepatic malignancies and late child C were excluded.         Results: showed that no statistical significant difference were detected in patients of group A as regard liver function tests before and after treatment and SVR12 achieved by 96%. Patients of group B showed significant statistical difference as regard liver function tests before and after treatment with SVR12 achieved by 88%. In patients of group C there were significant statistical difference in liver function tests with SVR12 achieved by 80%. Also there were clinical improvement in patients of group B and C after end of treatment. Conclusion:it could be concluded that there will be a dramatic improvement in HCV therapy followed the introduction of oral medicines that directly inhibiting the replication cycle of HCV. The combination pill contains a fixed-dose of ledipasvir 90 mg and sofosbuvir 400 mg, two direct-acting antiviral agents against HCV. Ledipasvir is an inhibitor of the NS5A protein, which is required for HCV replication. Sofosbuvir inhibits the HCV NS5B RNA-dependent RNA polymerase, which is also required for viral replication. Sofosbuvir is a nucleotide prodrug that undergoes intracellular metabolism to form a pharmacologically active triphosphate that can incorporate into the HCV RNA. Ledipasvir plus sofosbuvir can be used safely in treatment of compensated and decompensated post hepatitis C liver cirrhosis. SVR12 can be achieved by 96% in patients with early cirrhosis (child A), 88% in patients with child B cirrhosis and 80% in patients with child C with subsequent improvement in liver functions.  }, keywords = {Ledipasvir plus sofosbvir,Advanced liver disease,HCV infection,Direct acting antivirals}, url = {https://ejhm.journals.ekb.eg/article_14486.html}, eprint = {https://ejhm.journals.ekb.eg/article_14486_cd690fbd1330963a9d15ae7ae30c412e.pdf} } @article { author = {Abdelrazik, Mostafa M. and El Sawy, Ezz El Din and Fahmy, Ahmed M. and Rafik, Fouad}, title = {Correlation between Dyslipidiemia and The Severity of Coronary Artery Disease Using SYNTAX Scoring System}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {66}, number = {1}, pages = {52-56}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0034633}, abstract = {Background: the relationship between hyperlipidiemia and an increased risk of coronary heart disease has been well documented and has served as a motivating factor for research into lipoproteins structure, function and metabolism. Many epidemiological studies have revealed that chronically elevated lipid and cholesterol levels are associated with an increased incidence of atherosclerosis. Dyslipidemia together with hypertension and diabetes is major modifiable risk factors for atherosclerotic disease and the subsequent development of cardiovascular events. Dyslipidemia is known to be an independent predictor for cardiovascular events, other risk factors including family history, hypertension, tobacco use, age, sex and diabetes also have been found to be associated with an increased risk of coronary artery disease (CAD). This cross-sectional study was aimed to investigate the association of Dyslipidemia as an atherosclerosis predictor and its relationship to the severity of CAD using SYNTAX score. Patients and Methods: the current study included 535 patients who presented during 2015 with chest pain to Dar Al Fouad Hospital, experiencing symptoms of CAD or evidence of CAD by noninvasive testing were enrolled, a fasting blood sample was extracted and assessed for lipids profile. Patients underwent  coronary angiography either using femoral or radial approach, and the resulting angiographic study was used to calculate the SYNTAX score of each patient. Patients were divided in to two group i.e. CAD and Non-CAD group. The CAD group was further divided into three sub-groups according to the SYNTAX score into low risk, intermediate risk and high risk group. Results: in this study, triglycerides, total cholesterol and LDL-C levels were positively associated with  sever CAD and higher number of diseased vessels. Higher HCL-C levels were also found in subjects with normal coronaries. Conclusion: there was no significant proportionate, linear relation between the SYNTAX score and the levels of triglycerides, total cholesterol or LDL-C  }, keywords = {Atherosclerosis,SYNTAX score,dyslipidemia,CAD,Non-CAD}, url = {https://ejhm.journals.ekb.eg/article_14488.html}, eprint = {https://ejhm.journals.ekb.eg/article_14488_cef2a9ba0e35a2be5ab435ddc83936f0.pdf} } @article { author = {Alwan, Yasser Mohammed Shukri and Alayed, Ibrahim S and Albarakati, Mohammed Hassan and Alaryni, Mohammed Abdulaziz and Abu Kashaba, Ghufran Abdulrahman and Alkateeb, Amina Saad and Adham, Salma Walid Mohammed}, title = {Assessing Awareness about Diabetes Mellitus among Attendees of Primary Health Care Centers, Makkah, Saudi Arabia}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {66}, number = {1}, pages = {57-65}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0034634}, abstract = {Background: diabetes is well studied in Saudi Arabia; however, there seems to be little research in the area of awareness, education and health care delivery. Objectives: to assess the awareness about diabetes mellitus among attendees of primary health care centers, Makkah, Saudi Arabia. Subjects and Methods: a cross-sectional study was conducted among a representative random sample of adult attendees of primary health care centers (diabetic and non-diabetics), Makkah Al-Mokkaramah, the kingdom of Saudi Arabia during the study period (1-31 November, 2016). An Arabic self-administered questionnaire was used for data collection. It includes 31 questions with sections of demographic data, community awareness regarding diabetes definition, risk factors, signs and symptoms, and complications community awareness regarding diabetes prevention. Results: the study included 662 adult patients. Approximately one-third of them (32.2%) aged 60 years or more. Females represent 51.1% of them. More than one-fifth of them (21%) were university graduated whereas 6.3% were illiterates. Prevalence of diabetes among the participants was 33.7% and majority of them (97.9%) had family history of diabetes. The most frequent sources were mass media (57.4%), health sector (29.9%) and educational sector (10.6%). Overall sufficient awareness regarding diabetes mellitus was reported among majority of the participants (91.2%). Among studied factors, only marital status and income were significantly associated with sufficient awareness. Conclusion: population in Makkah AL-Mokkaramah has enough knowledge of the general knowledge of diabetes regarding risk factors, symptoms, etc. However, they are not very well aware of the diabetes associated secondary complications.  }, keywords = {Awareness,Diabetes mellitus,Complications,Saudi Arabia}, url = {https://ejhm.journals.ekb.eg/article_14490.html}, eprint = {https://ejhm.journals.ekb.eg/article_14490_59c3243fec4be7740fcbba77e4594b40.pdf} } @article { author = {Saber, Samy and Tito, Wondwosen and Said, Rashad and Mengistou, Seyoum and Alqahtani, Abdulaziz}, title = {Amphibians as Bioindicators of the Health of Some Wetlands in Ethiopia}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {66}, number = {1}, pages = {66-73}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0034635}, abstract = {Background: Ethiopia has a variety of wetlands which provide enormous socio-economic and environmental values. Most of these wetlands are under severe pressure and degradation. Maintaining the health of wetlands is recognized as crucial for protecting biodiversity, ecosystem function, and human health. In order to properly protect and conserve wetlands, it is essential to collect baseline data and establish monitoring programs which can detect change in the health of the wetland over time. One common method for monitoring includes using bioindicators as amphibians. Materials and Methods: the current study was conducted to assess the health in two areas in Ethiopia, Abijata - Shalla Lakes and Awash National Parks using amphibians as bio-indicators and to predict any changes on the natural environments and resources in the study area. Results: in Abijata area, less species richness, lower total population index and higher fluctuating asymmetry were observed compared to the second area (Hot spring area) which means that it is more threatened. }, keywords = {diversity,Developmental instability,Malformation,Abijata-Shalla,Awash}, url = {https://ejhm.journals.ekb.eg/article_14494.html}, eprint = {https://ejhm.journals.ekb.eg/article_14494_ddd9ec975e4cc0b49e602e2a7cd76ec7.pdf} } @article { author = {Almalki, Abdullah Talal and Albalawi, Faisel Ahmed}, title = {Predictors of Diabetes Mellitus Type 2 Control}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {66}, number = {1}, pages = {74-80}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0034636}, abstract = {Background: successful treatment of patients with type 2 diabetes mellitus (DM) is achieved by having a HbA1C of<7%. Objectives: to determine the factors that affect successful control of diabetes mellitus type 2 at Diabetic centre, King Khalid hospital, Ministry of Health, Tabuk, KSA. Subjects and Methods: a cross-sectional study was carried out at Diabetic centre, King Khalid hospital, Ministry of Health, Tabuk, KSA. A representative sample of adult diabetes mellitus type 2 patients (18-60 years) both sexes, who attend diabetic center clinics during month of November 2016 were included. Self-administer questionnaire was used for data collection. Last HBA1c level was addressed. Results: almost one-third of the participants (n=342), aged between 41 and 50 years (35.1%) whereas 11.4% aged over 50 years. Male patients represent 65.8% of them. The duration of diabetes was more than 10 years in 45.6%. Diabetic complications were reported by 26% of diabetic patients. Regarding diabetes therapy, a combination of oral hypoglycemic and insulin was reported by 21.1% of them while insulin alone and oral hypoglycemic alone were reported by 42.1% and 36.8% of the participants, respectively. It is evident that DM was controlled among only 32.5% of the diabetic patients (HBA1C was less than 7%) while it was uncontrolled among almost two-thirds of them (67.5%). Logistic regression analysis revealed that patients aged between 41 and 50 years were at lower risk compared to those aged 20-30 years (OR=0.13, p=0.008). Females were less likely compared to males to have uncontrolled diabetes (OR=0.25, p=0.007). Patients having more than three children were at higher risk for uncontrolled diabetes opposed to those without children (OR=11.19, p=0.003). Patients having income ranged between 10001 and 15000 were more protective than whose income was ≤5000 SR/month to develop uncontrolled diabetes (OR=0.22, p=0.007). Patients without diabetic complications were less likely to have uncontrolled diabetes compared to those with complications (OR=0.24, p=0.004). Patients treated with either insulin alone or a combination of insulin and oral hypoglycemic (OHGs) were at higher risk for uncontrolled diabetes compared to those treated with OHGs alone (OR=3.51 and 3.07, p=0.007 and 0.027. respectively). Patient who never compliant with diabetic diet were more prone to uncontrolled diabetes (OR=15.09, p<0.001). Conclusion: the study revealed relatively high prevalence of poor glycemic control as expressed by HbA1c≥7%. There is a strong need for public education programs and for promoting public awareness about control of blood glucose level in Saudi Arabia.  }, keywords = {Diabetes type 2,control,HbA1c,predictors}, url = {https://ejhm.journals.ekb.eg/article_14495.html}, eprint = {https://ejhm.journals.ekb.eg/article_14495_27b303c7416de4929c5e4b99a656305c.pdf} } @article { author = {Sarhan, Moustafa and Mostafa, Ahmed and Elbehiry, Serag Eldin and el Reheem, Abdelbaset M. A. Abd and Saber, Samy A.}, title = {Intersexual Variation in Tail Length, Venom Composition, Toxicity, and Anticancer Activity of Cerastes cerastes (Viperidae)}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {66}, number = {1}, pages = {81-90}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0034637}, abstract = {Background: The medically important desert-horned or Egyptian sand viper (Cerastes cerastes) is one of the most familiar snakes of the great deserts of North Africa and the Middle East. It is a poisonous and widely distributed snake in Africa and inhabits the sandy deserts of Egypt. Male and female specimens of C. cerastes have been compared from different aspects. Results:  Morphologically, tail length relative to snout-vent length was compared. Males significantly showed longer tails than do females. From the venom aspect, males showed a significant (p<0.005) higher concentration of protein in the venom (133mg/ml) compared to females (106 mg/ml). Female venom was significantly more toxic than male, with a median lethal dose (LD50) in mice of 0.6μg venom protein/gm body weight whereas LD50 for males was 0.7 μg/gm. Protein analyses by means of electrophoretic technique revealed differences in venom composition between males and females. We have detected individual variability and highlighted sex-specific protein similarities and differences among snake venoms. SDS-polyacrylamide gel electrophoresis showed protein bands of 42 and 39 kDa specific to male venoms while bands of 46 and 44 kDa are specific to female venoms. Moreover, we evaluated the antitumor efficacy of male and female snake venoms in liver (HEPG-2), breast (MCF-7), colon (HTC-116) and normal cell lines and IC50 was calculated. Interestingly, both male and female venoms had anti proliferative effects on the tumor cell lines with different potency. Female venom had a higher cytotoxicity against colon cells (IC50=0.006 µg/ml) than male venom (IC50= 0.019µg /ml). In contrast, male venom had a higher cytotoxicity against breast cells (IC50=0.005 µg/ml) than female venom (IC50=0.024µg /ml). These results indicate that males and females of C. cerastes produce venoms with different composition and activity, which may have epidemiological implications.  }, keywords = {Cerastes cerastes,venom composition,toxicity,Anticancer activity,intersexual variation}, url = {https://ejhm.journals.ekb.eg/article_14497.html}, eprint = {https://ejhm.journals.ekb.eg/article_14497_8733d6232831723678453c5113a7ab74.pdf} } @article { author = {Shahat, Samir A. and Sallam, Ahmed M. and Gad, Hesham M. and Abdallah, Mohammed H.}, title = {Copro-Antigen versus Classical Microscopy as Diagnostic Tool for Giardia Lamblia Infection in Egyptian Patients}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {66}, number = {1}, pages = {90-93}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0034638}, abstract = {Background: Giardia lamblia, a flagellate protozoa, is a one of the most common causes of non-viral (parasitic) diarrheal illness in humans. Laboratory diagnosis mainly consists of direct microscopic examination of stool specimen for trophozoites and cysts. However, due to intermittent fecal excretion of the parasite, the patient may be misdiagnosed, continue excreting the parasite and infecting others. Therefore, other methods of diagnosis should be looked for, which overcome the drawbacks of microscopy when used alone for diagnosis. The present study aimed to evaluate the efficacy of copro-antigen detection by ELISA test in comparison to direct microscopy in the diagnosis of G. lamblia in stool specimens from patients with diarrhea and other gastrointestinal symptoms. Patients and methods: stool samples were collected form 250 child included in the present study (150 symptomatic and 100 apparently healthy as a control group) aged between 1-10 years old, and subjected for direct microscopic examination and ELISA test for copro-antigen detection. Results: out of 250 stool samples, 53 specimens (21.2%) were positive for Giardia by direct microscopy, while 68 specimens (27.2%) were positive by ELISA test. Conclusion: ELISA test for copro-antigen detection in stool samples is a rapid and effective method with high sensitivity and specificity for diagnosis of giardiasis in stool specimens even when the parasitic count is low, thus reducing the chances of missing even in the asymptomatic cases.  }, keywords = {Direct microscopy,Giardia lamblia,RIDASCREEN Giardia (ELISA) test}, url = {https://ejhm.journals.ekb.eg/article_14501.html}, eprint = {https://ejhm.journals.ekb.eg/article_14501_d5cfbcbe7b6abbc9048390db7f4b9064.pdf} } @article { author = {Aalshareef, Esraa Ahmed and Alzahidy, Zina Abdulkareem and Hawsawi, Marwa Thani and Basalama, Mohamed Salem and Al-Thobaiti, Ayat Ibrahim and Alzahrani, Shuruq Hassan and Baghdadi, Tamer Hassan and Awad, Hamza Ahmed and Alsulami, Afnan Hameed Breek and Aljuhine, Faisal Hamdan and Alkhraiji, Abdullah Ibrahim and AlKhateeb, Amina Saad and Alwan, Yasser Mohammed Shukri}, title = {Study Factors Affecting Academic Achievement among Female Students at Ibn Sina National College}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {66}, number = {1}, pages = {94-102}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0034639}, abstract = {Background: A good social environment is a key strategy to improve the level of education and achievement in medical college students. However, survey data from Jeddah, Saudi Arabia have indicated that a large number of medical students are affected negatively by their social status. This article comparatively explores the impact of four main factors: Social class/Background, Students’ Personality, Health Status, and Psychological health on their achievement. Data were collected as part of a program of qualitative and quantitative research investigating the prevalence of bad environment effect on the psychological level of the students. Objectives:  To study the four main factors Social class/Background, Students’ Personality, Health Status, and Psychological health affecting academic achievement among Female Students at Ibn Sina National College. Methods: The study was conducted among 1315 female students attending colleges of Ibn Sina-Jeddah-Saudi Arabia between 1st of April – 31th of May 2016.  An open-ended questionnaire was developed to cover the objectives. Conclusion: After assessment of the factors and variables across the targeted sites about the academic achievement were often conclude that overall achievement were very good regardless the factor.  }, keywords = {social factors,increase academic achievement}, url = {https://ejhm.journals.ekb.eg/article_14505.html}, eprint = {https://ejhm.journals.ekb.eg/article_14505_05651dfd5440548c240b4b9f49dafc92.pdf} } @article { author = {Al Qahtani, Adel Saeed and Almetrek, Metrek Ali}, title = {Knowledge, Attitudes and Practice of Nurses in Renal Dialysis Units Regarding Infection Control in Abha City – Saudi Arabia, 2015}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {66}, number = {1}, pages = {103-114}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0034640}, abstract = {Background: patients on hemodialysis are at risk of nosocomial infections especially Hepatitis C Virus (HCV) and Hepatitis B Virus (HBV). Nurses’ adherence to infection control procedures is instrumental to control the transmission of the virus among patients. The identification of gaps in knowledge, attitudes and practices (KAP) of nurses aims at tailoring related training programs. Aim: the study was conducted to determine the knowledge, attitudes and practices of nurses working in dialysis units regarding standard recommendations of infection control. Methods: a cross-sectional study was conducted between December 2014 and January 2015 targeting all nurses in three dialyses units affiliated to the Ministry of Health in Abha city. Data was collected using a self-administered questionnaire to assess nurses’ KAP and an observation checklist to report on the environmental aspects. Results: one hundred and nine nurses were included with a response rate of 94.78%. Most of them were Saudi nationals (62.39%) and holding a diploma (78.90%).  The percentage score was 60.18+17.51 for knowledge, 85.59+8.09 for attitudes and 92.11+7.98 for practice. Nurses’ practice was high despite the deficiency in knowledge. Gaps in practice were identified including not always adherent to hand washing (15% to 18%), use of eyewear when blood splash is likely (31.19%), simultaneous care for positive and negative patients (24.77%), passing needles from hand to hand (29.36%) and recapping needles after use (25.69%). Multivariate linear regression analysis revealed that attitudes towards infection control, attempt to access infection control guidelines, on job training and being non-Saudi independently predicted higher practice scores. Conclusion: nurses’ knowledge is deficient but their performance is significantly related to their attitudes. Nurses tend to be adherent to certain infection control practices than the others. Training in infection control should address the gaps in performance with emphasize on creating favorable attitude.    }, keywords = {Hepatitis C virus,Knowledge,Attitude,Practices,Nurses,Renal dialysis}, url = {https://ejhm.journals.ekb.eg/article_14506.html}, eprint = {https://ejhm.journals.ekb.eg/article_14506_1e6579c410bbfff302857420c4a5a9f4.pdf} } @article { author = {Shams El-Din, Salwa A}, title = {Role of Liver and Cardiac Enzymes as Markers of Parasite Load and Recovery after Treatment in Experimental Murine Toxocariasis}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {66}, number = {1}, pages = {115-122}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0034641}, abstract = {Background: Toxocara is mainly a parasite of animals. The disease is caused mainly due to accidental ingestion of Toxocara canis embryonated eggs and to a lesser extent T.cati eggs. Till now, there is no marker of severity of infection or treatment in toxocariasis. Aim of the study: The current work aimed at studying the role of liver enzyme aspartate transaminase (AST) and cardiac enzyme creatine kinase-MB isoenzyme (CK-MB) as markers of severity infection and treatment of toxocariasis in correspondence to serum immunoglobulin with study of histological cardiac effects of toxocariasis. Materials and Methods: Laboratory mice were divided into groups infected with different doses of Toxocara eggs. Sera were collected from each group before and after treatment for measurement of AST and CK-MB, as well as ELISA for anti-Toxocara immunoglobulin IgG. T test, ANOVA test and Pearson correlation tests were used to assess the results. Results: CK-MB was elevated significantly with infection and reduced significantly after treatment. The serum level of CK-MB also correlated significantly and positively with parasite load. Conclusion: CK-MB can be used together with anti-Toxocara IgG in diagnosis and CK-MB can be a  good markers of treatment and parasite load in toxocariasis.     }, keywords = {Toxocara- IgG- Liver enzymes-cardiac enzymes}, url = {https://ejhm.journals.ekb.eg/article_14508.html}, eprint = {https://ejhm.journals.ekb.eg/article_14508_4ecad4555277416e4ce8cf3b9b2403c5.pdf} } @article { author = {Rafik, Mona Mohamed and Zakaria, Nahla Mohamed and Ghareeb, Hala and Mohamed, Nesrine Aly and Mohsen, Ghada Maged}, title = {Dendritic Cells in Hepatitis C Virus Infection}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {66}, number = {1}, pages = {123-126}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0034642}, abstract = {Background: The global prevalence of chronic hepatitis C is estimated at 2.8%. There is markedly higher prevalence in the Middle East about 14.7% in Egypt. Dendritic cells (DCs) are one of the major Antigen presenting cells in the body. They bridge innate and adaptive immunity and impact priming of HCV-specific immune responses. The current study was aimed to investigate the DC activation status, and their role in interaction with natural killer (NK) cells utilizing different setups with healthy NK and HCV+ DC, HCV+ NK and healthy DC, healthy DC and healthy NK and finally HCV+ NK and HCV+ DC in the presence of HCV peptides and a ratio of 5 NK: 1DC. Results: DC-NK interaction in chronic HCV infection is mainly affected by the affection of DCs by HCV leading to a maturation defect (decreased expression of HLA DR, CD 86 and CD 83). Healthy NK cells were able to stimulate the maturation of DCs particularly with core peptide whereas NS3-4 had no effect. When DCs were healthy, all peptides were able to produce significant maturation of DCs even when co-cultured with HCV+ NK cells. Co-cultured HCV+ NK cells and HCV+ DCs showed significantly higher apoptosis of both cells. This could be attributed to the immature moDCs more with chronic HCV infection due to the fact that immature DCs typically under express HLA-class I molecules that would protect from NK-mediated lysis. Conclusion:   Cross-talk between DCs and NK cells plays an important role in the induction of both the innate and adaptive immune systems. HCV infection was found to impair the maturation of DCs. Thus consequently affecting its antigen presentation and T cell allostimulatory capacity and rendering them more liable to NK mediated lysis which could explain the persistence of infection and chronicity.    }, keywords = {dendritic cells and natural killer crosstalk,dendritic cells and natural killer cells in HCV,dendritic cells and natural killer cells co-culture}, url = {https://ejhm.journals.ekb.eg/article_14510.html}, eprint = {https://ejhm.journals.ekb.eg/article_14510_15b0da2032b260281cdeb3dccc3b2567.pdf} } @article { author = {Saadeldin, Kouka Abdelwahab and Aljafar, Mohammad Mustafa and Alghamdi, Abdulwahab Abdullah and Alsawidan, Morshed Ali and Almalki, Ali Hassan and Alateeq, Fahad Sulaiman and Alsudairi, Abdulaziz Abdulsalam}, title = {The Synergetic Effect of Alternative Medicine with Acyclovir in the Treatment and Control of Herpes Labialis; HSV1}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {66}, number = {1}, pages = {127-139}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0034643}, abstract = {Background: herpes simplex is a common viral infection of the skin or mucous membranes. The lesions caused by this infection are often painful, burning, or pruritic, and tend to recur in most patients. Short term treatment with acyclovir can accelerate the healing of an acute outbreak, and continuous acyclovir therapy is often prescribed for people with frequent recurrences. While this drug can reduce the recurrence rate by 60-90 percent, it can also cause a wide array of side effects, including renal failure, hepatitis, and anaphylaxis. Safe and effective alternatives are therefore needed. Aim of the Study: is to examine and provide evidence on the potent effect of alternative medicine in Herpes treatment and recurrence prevention. Patients and methods: 60 Patients were divided into 3 major groups according to the severity of the infection with 7 subgroups split according to the treatment protocol. Results: among 60 patients with varies severity, recurrence of outbreaks was significantly reduced when a combined therapy was used while 0-10 percent outbreak recurrence rate was observed for a year when alternative therapy was used alone for mild cases. Conclusion: there is evidence that certain dietary modifications and the use of alternative medicine can be significantly useful for treating active Herpes simplex lesions and preventing recurrences.  }, keywords = {HSV1,Herpes Labialis,alternative medicine,Acyclovir}, url = {https://ejhm.journals.ekb.eg/article_14511.html}, eprint = {https://ejhm.journals.ekb.eg/article_14511_27f59838b616b6fcab10f6dfc5b5ac50.pdf} } @article { author = {Farag, Gamal Abdel-Shafy and Al-Awadi, Mohammed Seddiq}, title = {Surgical Fixation Compared with Conservative Treatment of Flail Chest Injuries}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {66}, number = {1}, pages = {140-145}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0034644}, abstract = {Background: although the surgical treatment of flail chest has been practiced for many decades, it is still controversial. Aim: to compare between conservative treatment and surgical management intervention for flail chest. Patients and Methods: The present research is a prospective study; included 71 patients with flail chest, admitted at Al-Azhar University hospital, New Dameitta. The patients were divided into 2 groups according to the treatment they received; 33 patients in surgical fixation group and 38 in conservative management group. The basic patients' clinical characteristics, associated comorbidities, detailed intervention, laboratory investigations, and outcome were obtained. The outcome included total ventilator days, length of stay (LOS) in the intensive care unit (ICU), rate of pulmonary complications, postoperative pain, development of chronic pain, and mortality. Results: patients in surgical group had statistically significant low APACHE II score after two weeks postadmission (7.48±1.17 vs. 9.36±1.02) and higher postoperative FEV1 (1.62±0.06 vs. 1.41±0.02). Duration of mechanical ventilation was significantly shorter in surgical group (5.25±1.76 vs. 11.81±2.57 days). Total duration of ICU stay was significantly shorter in surgical group (6.12±1.55 vs. 13.86±2.40 days). No chest deformity was reported in surgical group compared to 34.2% in conservative group; and the respiratory complications were significantly lower in surgical group (30.3% vs. 73.3%). At 6 months, no significant difference between surgical and conservative groups as regard to performing usual activity (18.2% vs. 15.8%) or return to job (45.5% vs. 34.2%). However, the chronic pain was significantly low in surgical group (21.1% vs. 36.8%). No mortality was reported. Conclusion:  surgical internal fixation was found to be superior to conservative treatment for flail chest.  }, keywords = {Flail chest,fracture rib,surgery, conservative treatment,internal fixation}, url = {https://ejhm.journals.ekb.eg/article_14513.html}, eprint = {https://ejhm.journals.ekb.eg/article_14513_d7a1bf7b221629ea4546eeace52ad3c6.pdf} } @article { author = {Binjahlan, Yousef Ehab Jan, Murad Mahmood and Binjahlan, Murad Mahmood and Alqurashi, Abdulrahman Ghazi and Alqurashi, Ghayda ghazi and Zirari, Mohammed Ahmed and Alturkistani, Feher Mohammed and Tolah, Mohannad Talal and Khedrawi, Almoutazbillah Abdurahman}, title = {Assessment of Knowledge, Attitude and Practice toward Down Syndrome in Jeddah City, Saudi Arabia 2016}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {66}, number = {1}, pages = {146-151}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0034645}, abstract = {Background: Down syndrome (DS) is a chromosomal disorder that results in intellectual disability and growth problems. The worldwide incidence of this syndrome is 1 in 1000 births and increases exponentially with the maternal age. People with DS usually have reduced life expectancy and suffer from mental retardation, heart problems, Alzheimer’s disease among other complications. However, the severity of the disease differs from patient to patient. Perceptions of the disease and the public attitudes towards people with Down syndrome are very important in the inclusion of these people in the community and the supporting families. Objectives: to assess the level of awareness, attitude and practice toward Down syndrome in Jeddah city to identify barriers. Methods: a cross-sectional analytical questionnaire-based study among the general population of Jeddah city. Results: a total of 360 subjects answered the questionnaires. The mean age was 36 years, it ranged from 16 to 70, with 45.2% females and 43.7% male respondents. Of these, 67% had attended college, 5% had a postgraduate degree, 23.5% had completed high school, and 3.1% had basic school. The majority of participants had a high level of monthly income (38%).  The majority of subjects included in the research were (59.6%) married and (51.3%) were unemployed. Most subjects (338) had poor knowledge about Down syndrome and there was no association between the knowledge and demographics of participants except for education at the higher levels of education, the more significant association with good knowledge. Conclusion: The results of the present study reveal that the knowledge about the Down syndrome was poor among the studied population. Also, education significantly impacts the knowledge of Down syndrome, thus there is a need for providing the population and patients with the necessary information to improve their Down syndrome awareness.  }, keywords = {Down syndrome,awareness spreading}, url = {https://ejhm.journals.ekb.eg/article_14516.html}, eprint = {https://ejhm.journals.ekb.eg/article_14516_913ba937db7b546913a861a1dadc6a4b.pdf} } @article { author = {Alqahtani, Youssef Ali and Alqahtani, Saleh M. and Alfaifi, Jaber Ahmed and Alghamdi, Abdullah Abdulaziz and Alrufaidy, Omar Mohammad}, title = {Autoimmune Hepatitis in Children: A Case Report}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {66}, number = {1}, pages = {152-155}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0034646}, abstract = {Background: Autoimmune hepatitis (AIH) is considered rare, and it is even rarer in the pediatric population. AIH in the pediatric population is categorized into type 1 and 2, which are differentiated by their autoantibody profiles. Case report: 5 years old Saudi boy presented with history of jaundice, fever and dark urine for 5 days with previous similar history at the age of 3 years. Examination revealed that he was conscious, looks pale and jaundiced but not in respiratory distress and well hydrated. Abdominal examination showed hepatosplenomegaly. Anti-nuclear antibodies (ANA), antismooth muscle antibodies and anti-neutrophilantibodies were positive whereas anti platelet antibodies and anti-mitochondrial antibodies were negative. Hepatitis serology was negative. Magnetic resonant cholangiopancreatogram (MRCP) showed diffuse periportal edema, likely related to liver cirrhosis. Liver biopsy was suggesting end stage biliary cirrhosis. Diagnosis was end stage cirrhosis with biliary features secondary to autoimmune process. The patient was treated with prednisolone, ursodeoxycholic acid, Vitamin K, omeprazol and iron. He was discharged and listed on the liver transplant clinic. Conclusion: This case report highlights and alerts physicians that AIH should always be considered in paediatric patients presenting with chronic liver disease.  }, keywords = {Autoimmune hepatitis,childhood,IgG,Saudi Arabia}, url = {https://ejhm.journals.ekb.eg/article_14518.html}, eprint = {https://ejhm.journals.ekb.eg/article_14518_9ced72a9f67cbcf73508cad548224917.pdf} } @article { author = {Al-Dhubaib, Abdulaziz and Al-Mulhim, Saqqer and Al-Ghamdi, Mohammed and Al-Ghamdi, Zeead and Elhag, Atef}, title = {PURPLE GLOVE SYNDROME IS NOT ALWAYS PURPLE AT THE INITIAL PRESENTATION: A Case Report and Literature Review}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {66}, number = {1}, pages = {156-158}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0034647}, abstract = {Background: Purple glove syndrome (PGS) is a rare complication of intravenous phenytoin use that typically presents with pain, edema, and discoloration at the injection site that spreads to the distal limb. Case Presentation: A 25-year-old female patient presented to Kind Fahad University hospital’s emergency department (ER) following a seizure episode, on admission to the hospital she was found to have profound tonic-clonic seizures, flexed limbs, uprolling eyes and frothy secretion from her mouth. The patient received IV fluid 0.9 NS and diazepam 5 mg IV injection followed by Phenytoin 1g was IV administrated on 100cc NS over 3 hours with a dose of 50 mg IV/min, and was admitted to the medicine service. Soon, the patient felt pain, swelling, Erythema and abnormal movement from the site of the IV cannula over the left forearm while Phenytoin was being injected, however no purple discoloration was detected and the patient was diagnosed with purple Glove syndrome (PGS). Accordingly, Phenytoin was held and replaced by carbamazepine for Seizure control, Brain MRI and EEG were ordered simultaneously. Patient symptoms were alleviated 2 days later and was ready for discharge. Follow-up visits were scheduled until the patient was fully recovered and aware of the implications of Phenytoin on her case. Conclusion: Since PGS is a rare complication of IV phenytoin therapy, it’s not common to link the clinical symptoms of PGS to Phenytoin adverse reactions at the first prognosis especially when discoloration - which is a profound symptom of PGS -is missing.  The risk of PGS for this patient may have been abated at the very early stage by decreasing the phenytoin infusion rate from 50 mg/min to less than 25 mg/min.  }, keywords = {Phenytoin,PGs,Seizures,extravasation,adverse reactions}, url = {https://ejhm.journals.ekb.eg/article_14520.html}, eprint = {https://ejhm.journals.ekb.eg/article_14520_23c5190fbe16d7f4a7cfdb4e9392854a.pdf} } @article { author = {Alroqaiba, Nawaf Abdullah and Althomali, Khalid Mohammad and Saeed, Ekram Ibrahim and Alhaj, Ibrahim Mahmoud and Alkatheri, Maha Nageeb and Alrifaie, Razan Isam and Al Aidarous, Abrar Sheikh Faisal and Rabie, Nejoud Bassam and Abdullah, Reham Abdulrahman}, title = {A Call for Spreading Awareness among Parents and Gynecologists on the Danger of Genital Herpes on Neonates - Department of Medicine and Dermatology- King Abdulaziz Hospital and Oncology Center, Jeddah, Saudi Arabia}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {66}, number = {1}, pages = {159-165}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0034648}, abstract = {Background: genital Herpes infection is caused by HSV 1 and HSV2 Virus. It causes distressing symptoms in a significant number of adolescents and adults with over 40 million people sufferers from recurrent HSV genital ulcer disease causes significant disease globally and it is potentially fatal when transmitted to neonates and most maternal infections with risk of transmission are asymptomatic. Aim of the Study: highlighting the crucial rule of parents’ education and awareness on the prevention and management of HSV in neonates (NHSV). Patients and methods: 112 females and 34 males HSV2 seropositive patients were assigned to fill a questionnaire on their awareness about HSV2 infection and symptoms and its effect on potential neonates. In parallel, there was a questionnaire for the assigned gynecologists to assess the counseling process of the mothers about the history of previous infection. Data was compared to the patients’ medical chart and past delivery of defected and treated neonates. Results: Patients whom were aware with the dangerous effect of the infection of virus had no mortality in their neonatal and had the good treatment for them. Conclusion: Couple educational and Awareness campaigns on genital Herpes infection have become a compelling need in order to avoid neonates mortality and help in designing preventive measures for neonates morbidity.  }, keywords = {Genital Herpes,HSV2,NHSV,Acyclovir,Neonates morbidity,Pregnant women}, url = {https://ejhm.journals.ekb.eg/article_14523.html}, eprint = {https://ejhm.journals.ekb.eg/article_14523_5c9513c37fa1ace53f190c456bd144ea.pdf} } @article { author = {AlGorashi, Wail Omar and Al Zahidy, Zina Abdulkareem and Sharton, Amal Mohamed and Turki, Sara Abdullah and Aljiffry, Aisha Omar and Al-jehani, Alaa Khalid and Saber, Rasis Khalid}, title = {Prevalence of Internal Hernia Post Laparoscopic Surgery}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {66}, number = {1}, pages = {166-169}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0034649}, abstract = {Background: Laparoscopic approach for colorectal resections is now very popular. Internal small bowel herniation (SBH) through a mesenteric defect has been recorded especially if the mesentery is not repaired. Although it’s rare, it is a severe complication. Lack of postoperative adhesions is one advantage of minimally invasive surgery but it’s also responsible for a higher incidence of internal hernias. These patients often present with intermittent abdominal pain or small bowel obstruction with completely normal contrast radiographs. Laparoscopic surgery is a minimally invasive approach with good treatment outcomes and is currently the standard surgery for colorectal cancer in Saudi Arabia. Objective: the aim of our study was to evaluate the incidence and outcome of internal hernias after laparoscopic procedure in King Abdul-Aziz Hospital & Oncology Center. Patients and methods: a total of 372 patients underwent laparoscopic colon resection surgery for colon cancer during the study period from August 2015 to October 2016 in King Abdul-Aziz Hospital & oncology center. Results: our result found that internal hernia was reported 48 times.  }, keywords = {Internal hernias,closed colon cancer resection surgery}, url = {https://ejhm.journals.ekb.eg/article_14525.html}, eprint = {https://ejhm.journals.ekb.eg/article_14525_a99f6baba8409171e7512c0ba8df6b57.pdf} } @article { author = {El-Moselhy, Essam A. and Abo-Rahma, Alyaa H. and Moftah, Farag M. and Darwish, Manal M.}, title = {Trends and Determinants of Contraceptive Use among Young (15-24 Year) Married Women: A Secondary Analysis Based on the 2008 and 2014 Egypt Demographic and Health Surveys}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {66}, number = {1}, pages = {170-187}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0034650}, abstract = {Background: young females in Egypt still face a number of challenges regarding their reproductive health (RH) despite efforts to enhance it. Importance of young women’s reproductive choices arises from the concept that early childbearing can impair their health and their productive participation in community. Aim: the paper aimed to explore the key determinant of the contraceptive (CC) use amongst young married females in Egypt using the 2008 and 2014 Egypt Demographic and Health Survey (EDHS) with a comprehensive look at the CC use changes occurred in the study period 2008-2014. Subjects and Methods: data from the 2008 and 2014 EDHS were secondary analyzed. Variables were selected to assess their effect on CC use. Multivariable regression analyses were performed. Odds ratio was computed. Results: overall contraceptive prevalence (CP) decreased from 53.7% in 2008 to 51.2% in 2014. Traditional methods were responsible for this decrease. Younger age, being from rural Upper Egypt, husband desire for more children, no visit to health facility were the most important risk factors for not using any CC method among Egyptian young married females in 2008. Added to these factors; low women autonomy, no exposure to family planning message, in the poster and women justifying husband violence in 2014. However, region lost its significance as a determinant in 2014. Conclusions: our results discovered the determinants that modulate the CC use behavior among Egyptian young married females.  }, keywords = {Contraceptive use,Trend,determinants,young married females,Egypt Demographic Health Survey}, url = {https://ejhm.journals.ekb.eg/article_14526.html}, eprint = {https://ejhm.journals.ekb.eg/article_14526_09c253735623f26387767af012529b4f.pdf} } @article { author = {Alharbi, Eman Hassan and Yamani, Logeen Khalid and Taiyeb, Aisha Esam and Tobaig, Saad Mahmoud and Zawawi, Mawaddah Mohammed and Shahrour, Alhassan Mohamed and Alqurashi, Sara Abdulelah}, title = {Seroprevalence and Potential Root Cause of Toxoplasmosis in Primary Children; A Study Conducted at King Abdulaziz Hospital}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {66}, number = {1}, pages = {188-192}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0034651}, abstract = {Background: Toxoplasmosis is a zoonosis with a high prevalence throughout the world. Toxoplasma gondii infection is frequently asymptomatic. Primary school children are particularly vulnerable to toxoplasmosis due to their habits of playing in water, soil, eating various raw foods, or contact with pets, including dogs, cats, and birds and hence they are an ideal target group to investigate T. gondii prevalence. Data collected from this age group can thus be used to assess whether T. gondii threatens the health of school-aged children, and also as a reference for evaluating the need for community interventions. The aim of this study was to determine the prevalence rate of anti-toxoplasmosis IgG and IgM in Primary School children and to detect agents that increase prevalence of the disease.  Materials and methods: 328 primary children (219 females and 109 males) were screened for T. gondii antibodies with ELISA along with a questionnaire conducted to all children and parents/guardians to obtain data for relevant eating and social habits. Among the risk factors tested, including contact with cats and soil, consumption of raw meat and vegetables, and drinking unboiled milk. Results: the seroprevalence of anti-Toxoplasma IgG & IgM was found to be 12 % (40 out of 328) and 2.4 % (8 out of 328), respectively while combined anti Toxoplasma IgG & IgM antibodies were found in 1.5 % of the children (5 out of 328). Infection acquisition rate was directly proportional to age and it was of interest that the most significant risk factor was not the petting of cats but the ingestion of raw meat. The seroprevalence of T. gondii IgG & IgM by ELISA among primary children in this region of Saudi Arabia is considerable with few identifiable significant risk factors reported. Conclusion: effective measures should be taken to prevent and control T. gondii infection in primary school children, the results of this study showed that in order to increase awareness of the disease in the community especially for girls and their parents on common root causes such as raw meat and vegetable is necessary. Policy makers also need to initiate prevention and control programs to not only primary children but also pregnant women and immunocompromised patients in particular because they are more severely affected by T. gondii infection.      }, keywords = {Primary School Children,toxoplasma gondii,seroprevalence,Saudi Arabia}, url = {https://ejhm.journals.ekb.eg/article_14528.html}, eprint = {https://ejhm.journals.ekb.eg/article_14528_ab98f22b41fef2c531e1b0f254164d5c.pdf} } @article { author = {Albahlool, Abdulrahman M and Alshotairy, Hatim Ahmed and Abdullah, Reham Abdulrahman A and Mogharbel, Bayan Fouad and fageeha, Sultan tariq S and Malky, Ameen Mohammed}, title = {Assessment of Knowledge, Attitude and Practice toward Acne Vulgaris among Community in Jeddah City, 2016}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {66}, number = {1}, pages = {193-197}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0034652}, abstract = {Background: acne vulgaris is the most common skin condition seen by the dermatologists. It is a chronic inflammatory disease of pilosebaceous unit characterized by seborrhea, comedones, papules, pustules, nodules, cysts and in some cases scars and keloids, which persist for rest of the life. Objectives: the present work aimed at evaluating the level of awareness, Attitude And Practice toward acne vulgaris in Jeddah city . Methods: a cross sectional analytical questionnaire based study was carried out  among the general population in Jeddah city. This study started in the year (2016) and composed  of 461 subjects. The mean age of citizens was 28,82. To assess citizens’ demographic factors and beliefs about acne vulgaris, consenting citizens completed an anonymous online questionnaire. The data was entered and analyzed using SPSS version 20. Results: The sample is consisted of 65,8% women and 34,2% men. Among the respondents 7,7% reported suffering from acne vulgaris and 13,6% confirmed having a history of acne vulgaris illness in their family. The results of the study showed that 153 (34,8%) subjects had weak knowledge related to the disease, 260 (59,1%) subjects had average level of knowledge while only 27 (6,1%) subjects had good knowledge regarding acne vulgaris. There was a statistical significant association between gender, educational level and the level of awareness about acne vulgaris. Conclusion: acne vulgaris is a disease that is potentially controllable but that cannot be cured. Education still be important overall the treatment of the patients.  }, keywords = {acne ,prophylactic measures,treatment plan}, url = {https://ejhm.journals.ekb.eg/article_14529.html}, eprint = {https://ejhm.journals.ekb.eg/article_14529_ae424e96d2cba286a95d206373ecba6d.pdf} } @article { author = {aljefri, Bilal and Almalki, Shahd Abdulaziz}, title = {Postoperative Recurrence of Huge Hydatid Cyct Bilal aljefri and Shahd Abdulaziz Almalki}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {66}, number = {1}, pages = {198-201}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0034653}, abstract = {Background:hydatid disease (Echinococcus granulosus), is a parasite disease infestation in humans most commonly occurs in the liver. It has high recurrence rate. Surgery remains the mainstay of treatment for HD and aims to eliminate the parasite, promoting the rapid disappearance of any residual cavity and preventing complications and recurrence . ‏Case study:our patient  is a case of recurrent huge hydatid cyst which infested in the liver of 39-year-old female, medically free, in 2009 she underwent evacuation of hydatid cyst with partial removal of the cyst wall. ‏7 years later (2016) she presented to ER with abdominal mass increasing in size with time, associated with dull, aching pain and vomiting, with jaundice and itching, there was no fever, no change in bowel habit, no change in urine and stool color. A full investigation done, abdominal CT showed large oval shaped intraperitoneal cystic lesion with a diameter about 20 cm * 15 cm. ‏The patient received anti-parasitic medications for 2 weeks before the operation. The operation of complete cyst excision (cystectomy) was done. ‏We recommend a total or partial pericystectomy as the most appropriate procedure for the management of primary hydatid cyst and also for recurrent hydatid cyst with pre- and post-operative courses of anti-parasitic drugs should be considered which helped in reducing the intraoperative spillage of viable cysts and to decrease the recurrence rate post-operatively, and the patient has to avoid the risk factors and transmission ways of the parasite.  }, keywords = {Hydatid cyst,Echinococcosis}, url = {https://ejhm.journals.ekb.eg/article_14530.html}, eprint = {https://ejhm.journals.ekb.eg/article_14530_ece18b9e4405e42ba8e503536c8eea02.pdf} } @article { author = {Altajori, Nura N. and Elshrek, Yousef M.}, title = {Review Article: Risk Factors for Non-communicable Diseases in Libya}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {66}, number = {1}, pages = {202-214}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0034654}, abstract = {This review article highlights the current situation of some non-communicable diseases in Libya and factors contributing to its prevalence such as obesity, diabetes, cardiovascular diseases (CVD), high blood pressure and cancer. Obesity is a global epidemic resulting in major morbidity and premature death. Between 26-41% among adult Libyan women and 11–21 % among adult Libyan men (about 64% of Libyan adults are either overweight or obese), obesity progressively increasing with age, and two times more common among Libyan women than men. Hypertension is a common co-morbidity of diabetes, affecting 20-60% of people with diabetes. Hypertension is also a major risk factor for CVD as well as microvascular complications such as retinopathy and nephropathy. About 68.4% of Libyan males and 48.4 % of Libyan females who suffer from high blood pressure are under treatment. The average rate of those who suffer from diabetes mellitus among Libyans reached between 11 – 23.3 % for both sexes. The main causes of death are cardiovascular diseases (43%), cancer (14%), chronic respiratory diseases (4%), diabetes (5%), other Non-communicable diseases (NCDs) (12%), communicable maternal perinatal and nutritional conditions (10%), and road traffic injuries (12%). The prevalence of risk factors for non-communicable diseases has risen as a result of changing lifestyles. More than 30% of the adult male population smokes regularly. Approximately, 1.2 percent of the population is blind, mainly due to cataract. Trachoma remains endemic in some pockets in the country. Road traffic crashes, which result in 6 deaths per day and even higher figures for disability, account for a significant burden of disease.    }, keywords = {Libya,Non-communicable diseases,Obesity,diabetes,Cancer,blood pressure}, url = {https://ejhm.journals.ekb.eg/article_14531.html}, eprint = {https://ejhm.journals.ekb.eg/article_14531_817c1d3a9f423e24f9196cf573572017.pdf} } @article { author = {Ibrahim, Mohamed and Yousefjan, Yousef Ehab and Alzahrani, Ibrahim Saeed bin Sadan and Torkostani, Fisal Mahmood B and Baawadh, Abdullah Ali and Alattas, Abdullah Alawi .H.}, title = {A Meta-Analysis Study on Intraoperative Awareness with Recall and Need for Proper Guidelines}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {66}, number = {1}, pages = {215-220}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0034655}, abstract = {      The main objective of the article is to provide the necessary awareness on decision making in order to support better patient care. The awareness is through advisory technique with more emphasis on practical application. The article has analysis of the opinions from experts on synthesis. More so, there is provision of better ways to clinical data feasibility, open forum consultations and surveys from experts on anesthesia. The main emphasize of the article is decision making in improvement of the patient care. Although advisories are important, the aim should always be decision making and the article focuses on practice in order to improve medical knowledge. The article gives an outline on additional measures to be taken to improve the medical practice according to Anesthesiology. The article emphasizes the advisory from the anesthesiologists and all the supporting physicians. In addition, there is also provision of advisory to individuals who administer general anesthesia. Review of the article on Metal-Analysis study has identified many characteristics of patients who have been associated with the risk of little awareness. The review has explained the procedures to be followed when dealing with situations of higher risks on intraoperative awareness. The anesthetic techniques on intraoperative awareness are also included in the preoperative awareness.  }, keywords = {intraoperative awareness}, url = {https://ejhm.journals.ekb.eg/article_14533.html}, eprint = {https://ejhm.journals.ekb.eg/article_14533_833a3c5e77bfd91f509c14ddbe946f1e.pdf} } @article { author = {Abouhamda, Ayman and Jan, Yousef and Alturkstani, Majid and Alsaadi, Fouad and Garah, Rami and Alaqel, Sara and Al Thobaiti, Fawaz}, title = {Interval Appendectomy Operative vs. Non-Operative Management of Appendicitis in Saudi Arabia}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {66}, number = {1}, pages = {221-226}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0034656}, abstract = {The goal of this review is to analyze the perfect mechanism for managing acute appendicitis. Both surgical and non-operative approaches are in contention as the best remedies for the appendix complications. To draw a better comparative analysis, the strengths and weaknesses of each proposed mechanism are analyzed. In the Kingdom of Saudi Arabia (KSA), both immediate and interval surgical procedure remain debatable as best remedies for acute appendicitis. To determine the suitability of both immediate and interval appendectomy against non-operative management in KSA, vast literature is analyzed to portray the strengths of each medical maneuver. Background: The primary objective of appendicitis management is to ensure early diagnosis and prevent operative management, which is risky and costly [1]. However, this goal has remained elusive due to delayed diagnosis, a characteristic that is prevalent for most people. In an analysis concerning the changing trends of appendicitis management over the past 30 years, surgery is not the only remedy for appendicitis patients [2]. Some individuals, as exhibited by numerous studies, have been able to recover without the need for surgical procedures, currently conceptualized as appendectomy. However, concentrating on the analysis by a number of scholars, it becomes evident that some delayed attention to symptoms, mainly due to patient’s ignorance, makes appendectomy inevitable. As such, the most common cause of abdominal surgical emergency is appendicitis [3]. Narrowing down to the ground situation in America, not much difference is exhibited. Appendectomy remains the most significant tool at the physicians disposal when faced with relatable appendicitis dilemmas. By the time patients seek medical attention, it is already late, an aspect that motivates physicians to put into use prompt surgical procedures. The growing attention to appendicitis management is proportional to its prevalence rate. Appendicitis accounts for approximately 40,000 hospital admissions each year in England [2]. Similarly, early studies performed by English medical scholars indicated that close to 150 people from England and Wales die from acute appendicitis [4]. The prevalence rate of appendix complications is approximately seven to eight percent of the global population. Regardless of the advanced diagnostic and surgical technology, morbidity of the complication is 10%, and the mortality rate is between 1% and 5%. Despite its high prevalence, acute appendicitis is decreasing the in the US and the European region while proportionally increasing in the developing countries, mainly due to changing lifestyles [5,6,7].Consequently, a histopathological study on KSA in 2015 revealed that diagnosis rate of acute appendicitis was 52% while acute suppurative, acute gangrenous appendicitis and acute perforated appendicitis remained at 28%, 12.5% and 2% respectively [8]. However, it is important to acknowledge that the study was limited to one geographical area, but scientifically, the figures represent a consistent pattern. Significantly, the prevalence rate of subhepatic acute appendicitis accounted for 0.054% of Saudi Arabia’s hospital population [9]. With much research being carried on the best way of handling appendicitis, this next segment of the review covers a summary of current research’s perception concerning the effective medical procedure (operative vs. non-operative). The summary section is not conclusive but rather shows a sample of analyses approaching the best way of handling appendix complications in the general population.       Methods:A review of the literature was made using the most common electronic sources including: electronic database, EMBASE, MEDLINE search using  }, keywords = {Appenedectomy interval,Appendicitis,Appendiceal mass,Phlegmon and Saudi Arabia. The major outcomes gained were related with the different approaches associated with appendicitis}, url = {https://ejhm.journals.ekb.eg/article_14534.html}, eprint = {https://ejhm.journals.ekb.eg/article_14534_84dc03d0f6cd65edbbb3d70c3451b107.pdf} } @article { author = {Alhassani, Hani Helal Khader and Al-Ghamdi, Khalid Mohamad Gormallh and Allehaiby, Ahmad Hameed and Mohammed, Moataz Abdulhalim and Rawah, Maram Adnan and Alzahrani, Saleh Jamaan and Banjar, Alyaa Mohammed Rafie A}, title = {Systematic Review and Evidence Based Guidance on the Surgical Antibiotic Guidelines Adherence}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {66}, number = {1}, pages = {227-233}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0034657}, abstract = {Background: antibiotic administration is an essential element for any surgical operation success, even if a prior infection was not detected. This is due to the fact that antimicrobial agents do not only act as therapy to treat preexisting infection but also as a prophylaxis which is given preoperatively to reduce the incidence of surgical site infection and as an adjunct to operative treatment which is given in the setting of operative management of infections such as secondary peritonitis or necrotizing fasciitis. Prophylactic antibiotics are also used as primary therapy when operation is not performed, such as for cellulitis, or postoperative pneumonia which indicates the significance of surgical antibiotic prophylaxis and the great importance of adhering to the right treatment protocol and guidelines. Aim of the Study: a systematic review was performed to evaluate the adherence to clinical guidelines for surgical antibiotic prophylaxis. Methods: of which fifteen studies were retrieved that fulfilled most of the inclusion requirements of being randomized controlled clinical trials. Results: 952 articles were retrieved from database, of which 15 studies were selected for selected for synthesis. 5 outcome of interest were identified, on top of which were the administration of antibiotic at the correct time and adequate discontinuation of antibiotic which ranged from 0.3% to 100%.          Conclusion: the assessed studies addressed a gap in the adherence to guidelines for surgical antibiotic prophylaxis and more rigor approaches to leverage the guidelines.  }, keywords = {Surgical Site Infection,SSI,Prophylaxis,antibiotic,systematic review,Guideline adherence}, url = {https://ejhm.journals.ekb.eg/article_14536.html}, eprint = {https://ejhm.journals.ekb.eg/article_14536_9e5806898cb8f884e4a013c4ada72bfa.pdf} } @article { author = {N A, AbdelSattar and AM, Seif and EA, ELHadidi and N R, Mohamed and MA, Abu El Naga and AD, Abdelhakam}, title = {Clinical Utility of PCA3 Assay in Patients with Suspicious Prostate Cancer}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {66}, number = {1}, pages = {234-236}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0034658}, abstract = {  Background: this study evaluated the clinical utility of the PCA3 assay in guiding initial biopsy decisions in prostate cancer. Subjects and Methods: this study was conducted on fifty patients selected from the Urology Department at Ain Shams University Hospitals and scheduled for prostate biopsy after digital rectal examination first catch urine was collected. PCA3 scores were determined using RT-PCR and compared to biopsy outcome. The diagnostic accuracy of PCA3 was compared to total prostate specific antigen and %free prostate specific antigen.Results: the best cutoff for PCA3 was 4.6 folds (RQ). This cutoff had a diagnostic sensitivity of 94.7%, specificity 95% and area under the curve (AUC) was 0.978. Total PSA at the cutoff 10 ng/mL had a diagnostic sensitivity 68%, specificity 70% and AUC was 0.766. At cut off 19%, f/t PSA ratio had a diagnostic sensitivity 38%, diagnostic specificity 90 %, and AUC was 0.529. Conclusions: the PCA3 assay can aid in guiding biopsy decisions. It is superior to total prostate specific antigen and %free prostate specific antigen in predicting initial biopsy outcome, and may be indicative of prostate cancer aggressiveness.  }, keywords = {Prostate Cancer,PCA3,PSA,BPH}, url = {https://ejhm.journals.ekb.eg/article_14538.html}, eprint = {https://ejhm.journals.ekb.eg/article_14538_2132d74a4ac9e58aa1a91ef2040cca1a.pdf} } @article { author = {El-Moselhy, Essam A. and Hagrass, Sabah A. and Mohammed, Abd-Elnaser S. and Abd-Alrhman, Throwt M. and Alnabawy, Aly A. and Mosalam, Ahmed}, title = {Psychosocial Impact and Quality of Life among Adult Egyptian Patients with Psoriatic Arthritis}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {66}, number = {1}, pages = {237-247}, year = {2017}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0034659}, abstract = {Background: psoriatic arthritis (PsA) is a chronic, inflammatory, progressive joint disease. It has much psychosocial impact and affects quality of life (QOL) of the patients. Aim of the study: to determine the psychosocial impact of PsA on the patients and to define QOL of them. Patients and Methods: the study was conducted on 50 PsA patients, 68 psoriasis (Ps) patients, and 100 controls. A case-control, clinic-based study design was used in this research. An interviewing form and Middle Sex Hospital Questionnaire were used to survey the characteristics of the patients and controls. Severity of PsA was determined clinically. Also, the medical outcomes study 36-item short form (SF-36) was used to assess impact of the disease on the patient’s QOL. Results: most (92.0%) of PsA patients had psychiatric symptoms. The disease had interfered with most of patients' personal feelings and relationships, daily activities, school/work, and leisure/sport. Majority (88.0%) of the patients had stigma feeling. Also, 40.0% and 60.0% of PsA patients had severe and mild forms, respectively. The differences between two forms of PsA regarding interference with school/work and presence of suicidal ideation were significant. The difference regarding presence of familial psychological stress was significant. The highly affected SF-36 domain scores were general health and physical limitation. The eight mean domain scores were significantly lower among PsA patients than controls. The mean domain scores of physical functioning, physical limitation, social functioning, emotional limitation, and mental health were significantly lower among patients with severe PsA than those with mild PsA. The eight mean domain scores were significantly lower among PsA patients than those with only Ps. Conclusions: the physical and psychosocial aspects of PsA may interact and influence one another. So, PsA has a great effect on the patients’ QOL; disrupting physical and psychosocial aspects, and interfering with daily activities, school/work, and leisure/sport. QOL scores were significantly lower among PsA than only Ps patients.    }, keywords = {Psoriatic arthritis,adults,Impacts,Psychosocial,familial,Medical care,QOL}, url = {https://ejhm.journals.ekb.eg/article_14539.html}, eprint = {https://ejhm.journals.ekb.eg/article_14539_997a21587784849a966a18c945077d8f.pdf} }