@article { author = {El Gendy, Naima A. and M. S, Tawfik and Nour, Asma M.}, title = {Effect of Electron beam on Prepared HAP-Gel Composition}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {55}, number = {1}, pages = {129-136}, year = {2014}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0004497}, abstract = {Background: Polyvinyl alcohol liquid PVAl was used as the organic carrier for Hydroxylapatite-gel (Hap-gel) composite. PVAl has the ability to form a nano- hydroxylapatite polyvinyl alcohol composite gel which has a wide range of uses in different environmental and medical applications. Prepared Hap-gel is known to have a very similar composition to human bone and is used as a substitute for bones in compound fractures and artificial dentures.   Matreia and Methods: In this work prepared HAP- gel was exposed to a high ionizing radiation electron beam (5 kilo Gray) and an aqueous solution containing aluminum ions (Al+). Some investigations were done to illustrate the effect of radiation exposure and aluminum contamination on prepared Hap-gel.   Results: Energy dispersive X-ray analysis (EDx) showed that  the electron beam used caused an obvious increase in the calcium ions (Ca++) content of the prepared Hap-gel from 60% to 65.69 % with a prominent decrease in phosphorus ions (P +) content from 40 %  to 34.31 % in addition to an increase in the Ca/P ratio from 1.5 to 1.91. Exposure of the pre-irradiated Hap-gel samples to aluminium ions (Al+) resulted in a noticeable decrease in Ca++ content from 65.69 atomic % to 32.14 % atomic % and a further noticeable decrease in P+ content from 34.31 % atomic % to 13 atomic % as well    as an increase in the Ca/P ratio from 1.91 to 2.47. The levels for the original prepared Hap-gel were Ca++; 60 atomic % and P+; 40 atomic %. It was deduced that exposure of the Hap-gel to Al+ had a further damaging effect on the pre-irradiated Hap-gel composition in addition to the damaging effect that the electron beam used induced on the samples.    Conclusions: it could be concluded that electron beams  and  Al+ have an injurious effect on human bone tissue taking into consideration the similarity in composition between Hap-gel and bones. Therefore, this study could be beneficial in the field of osteoporosis research and assist the understanding of the effects of radiation such as that of electron beams and some pollutants such as aluminium present in running water on the health of human bone tissue.      }, keywords = {Hap-gel,calcium,phosphorus,aluminium,electron beam}, url = {https://ejhm.journals.ekb.eg/article_15774.html}, eprint = {https://ejhm.journals.ekb.eg/article_15774_11a0bc19839fae5bd38f9a07be2aeaf4.pdf} } @article { author = {Amer, Moatassem S. and Farid, Tamer M. and Abdel-rahman, Ekrami E. and EL-maleh, Deena M. and Omar, Omar H. and Mabrouk, Randa A.}, title = {Relationship between Coronary Risk Factors, C-Reactive Protein, Bone Mineral Density and Carotid Circulation Among Frail Elderly}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {55}, number = {1}, pages = {137-141}, year = {2014}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0004498}, abstract = {Background: Frailty may now be regarded as a geriatric syndrome of decreased reserve and resistance to stressors, resulting from cumulative declines across multiple physiologic systems, causing vulnerability to adverse health outcomes including falls, hospitalisation, institutionalisation and mortality. The inflammatory mediators as C-reactive protein have been associated with the development of the geriatric frailty. Several studies have pointed out increased level of homocystiene in frail elderly Increasing frailty was associated with lower bone mineral density, as both bone mass and muscle strength decrease during ageing and this has also been associated with higher risk of osteoporotic fractures in frail elderly. Objective: To compare frail and non-frail elderly regarding Bone mineral density, carotid circulation and serum levels of Homocysteine, coronary risk factors and CRP.  Methods: 104 elderly patients, who were assigned to 2 groups.  Group A (52 frail participants): diagnosed by Fried’s criteria as applied by Avila-Funes et al., 2008. Group B (52 non-frail participants).All participants were subjected to the following: through history, physical examination, ADL, IADL assessment, MMSE ,GDS, laboratory investigations including; CRP, homocystiene and total lipid profile, measurement of bone mineral density by DEXA and carotid intima-media thickness by carotid duplex. Results: There was no statistically significant difference in age, sex, among both groups.Frail participants had higher ADL  and IADL dependence, higher incidence of depression,  cognitive impairment and osteoprosis.They also had higher levels of homocystiene , CRP , CIMT and lower levels of HDL cholesterol. Conclusion: Osteoporosis is more prevalent among frail elderly also frailty is associated with more ADL & IADL dependence, higher GDS scores & lower MMSE score in addition to higher mean level of homocystiene, CRP & triglycerides in addition to low serum HDL & higher CIMT.  }, keywords = {Frailty,comprehensive geriatric assessment,coronary risk factors,Osteoporosis}, url = {https://ejhm.journals.ekb.eg/article_15777.html}, eprint = {https://ejhm.journals.ekb.eg/article_15777_5779a09cf50fde72b6e0e20c0e209ff8.pdf} } @article { author = {Atwa, Fatma A. and Farag, Mona M.A. and Mansour, Mona N. and Albadry, Abeer F.}, title = {Hallermann-Streiff syndrome A case report from Egypt}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {55}, number = {1}, pages = {142-145}, year = {2014}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0004499}, abstract = {Abstract Hallermann-Streiff syndrome (HSS) is a rare genetic disorder that is primarily characterized by distinctive malformations of the skull and facial (craniofacial) region; sparse hair (hypotrichosis); eye abnormalities; dental defects; degenerative skin changes (atrophy), particularly in the scalp and nasal regions; and proportionate short stature. Here we describe a case with HSS.  }, keywords = {Hallermann-Streiff syndrome,congenital cataract,Microphthalmos}, url = {https://ejhm.journals.ekb.eg/article_15778.html}, eprint = {https://ejhm.journals.ekb.eg/article_15778_076dca883cf78656f40183e9237f8d53.pdf} } @article { author = {Al-Shinnawy, Mohamed S. and Hassan, Ahmed R. and Ismail, Dalia A. and Shahin, Mohamed A.}, title = {The Potential Protective and Therapeutic Effects of Aloe Vera Juice on Malathion Induced Hepatotoxicity in Rabbits}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {55}, number = {1}, pages = {146-158}, year = {2014}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0004500}, abstract = {Background: the potential protective and therapeutic effects of Aloe vera juice against malathion induced hepatotoxicity were evaluated in this study.  Material and methods: one hundred twelve young male rabbits were used ; they were allocated into two sets of experiments included rabbits treated for short (7 days) and long (21 days) periods. Animals of the first set (short period of treatment) were divided into eight groups; each consisted of four treated groups and four control groups (each treated group had its own control). The animals of the first group were orally dosed with Aloe vera juice (0.84 ml/kg b. wt.). Rabbits of the second group were orally dosed with malathion (5 mg/kg b. wt.).  The third group animals were dosed orally with malathion concomitant with Aloe vera juice (this group served as the protective group). Animals of the fourth group were dosed orally with malathion; for 7 days followed by Aloe vera juice for the same period (this group served as the therapeutic group). The design of the second set (long period of treatment) was exactly similar to that of the short period experiments (divided into eight groups; four treated and four control groups) except the duration of treatment which extended to 21 days. Animals of the control groups of Aloe vera treated rabbits were dosed with distilled water, and those of malathion treated animals were dosed with the solvent of the insecticide. All the animals were sacrificed, blood samples were collected and the serum was used to determine the levels of hepatic enzyme markers: lactate dehydrogenase (LDH), aspartate aminotransferase (ASAT), alanine aminotransferase (ALAT) and alkaline phosphatase (ALP) as well as the total bilirubin.  Results: the results revealed that treatment of rabbits with malathion caused marked increase in the serum activity of LDH, ASAT, ALAT and ALP in treated rabbits. Administration of Aloe vera juice (in the protective and therapeutic groups) was found to be effective in lowering the elevated activities of these enzymes to approximate near normal levels for both the short and long periods of treatment, especially in the activity of LDH, ASAT and ALP. The present results suggested that Aloe vera juice has ameliorative effects against hepatotoxicity produced by malathion in the treated rabbits.  }, keywords = {Hepatotoxicity,Aloe vera juice,malathion,liver function,Rabbits}, url = {https://ejhm.journals.ekb.eg/article_15779.html}, eprint = {https://ejhm.journals.ekb.eg/article_15779_d1629740011dce052eefd9f2a488a00a.pdf} } @article { author = {Mustafa M, Maher K. and Hamoury M, Mufeed K. and Hassan R, Salma S.}, title = {Wilms’ Tumor in Children : A Single Institution 10-Year Experience}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {55}, number = {1}, pages = {159-164}, year = {2014}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0004501}, abstract = {Objective: To evaluate the disease characteristics and treatment outcome of children with wilms’ tumor at King Hussein Medical Center over a period of 10 years. Methods: We conducted a retrospective  review of the medical files of children ( < 14 years ) with wilms’ tumor who were managed at King Hussein Medical Center -Jordan in the interval between June, 2000 until June, 2010 . Patients’ and disease characteristics, treatment modalities and outcome were analyzed. Staging and histopathological classification were preformed according to the system of the National Wilms Tumor Study Group (NWTSG). Descriptive analysis using frequencies was used to describe the study variables. Results: A total of 61 patients (54.1% female) with wilms’ tumor with a median age of 40 months were identified. Their ages ranged between seven months and 7.8 years.  The stage frequencies  of our cases were : stage I ( 27.9 % ) , stage II (34.4 % ) , stage III ( 16.4 % ) , stage IV ( 11.5 %) and stage V ( 9.8 %) . The 3- year relapse-free survival rate was 100%, 81%, 70%, 57.1% and 83.3% for stages I , II , III , IV and V, respectively. Favorable histology accounted for 86.9 % (53 cases) of our patients . The 3-year relapse-free survival rate was 84.9% for the favorable histology and 62.5% for the anaplastic histology .The 3- year relapse-free survival rate for the entire group was 82%.  Conclusion: Combined modality management including surgery , chemotherapy and radiotherapy resulted in satisfactory loco-regional and systemic control and  better  relapse-free  survival in pediatric patients with wilms’ tumor . Stage and histopathologic classification of the disease were  important as prognostic factors.  }, keywords = {wilms’ tumor,Staging,histology,Favorable,anaplastic}, url = {https://ejhm.journals.ekb.eg/article_15780.html}, eprint = {https://ejhm.journals.ekb.eg/article_15780_17cbd1b21e9ec790ab82a6c0ba256439.pdf} } @article { author = {Hablas, Wael R and El- Nabarawy, Salwa K and Ibrahim, Nadia F and Radwan, Noha M}, title = {Prevalence of Glucose-6-Phosphate Dehydrogenase and Thyroid Hormones Deficiency in Neonatal Jaundice}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {55}, number = {1}, pages = {165-174}, year = {2014}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0004502}, abstract = {G6PD deficiency is the most common inherited metabolic disorder and clinically significant red cell enzyme defect in man. Severe neonatal jaundice proved to be the most common clinical manifestation and a globally important most dangerous consequence of G6PD deficiency. Prolonged jaundice is sometimes associated with congenital hypothyroidism. So the early characterization of G6PD activity and thyroid hormone levels provides an etiological diagnosis for neonatal jaundice as well as the opportunity to give the newborn's family information concerning hemolytic crisis prevention and an early management in case of hypothyroidism.  Aim: This study was conducted in an attempt to evaluate the prevalence of G6PD deficiency and hypothyroidism in relation to neonatal physiological hyperbilirubinemia.  Subjects and Methods: The study included 50 neonates aged between 6 hr – 5 days, forty infants had jaundice and the other ten (control), were healthy neonates, matching the same age. All infants of the study were subjected to C-RP test, routine hematological evaluation, and serum total bilirubin levels, quantitative red blood cells G6PD assay and thyroid hormone levels. Results: All the fifty cases of both jaundiced and healthy neonates were negative for C-RP test indicating that the 40 cases had physiological jaundice .The study revealed that G6PD enzyme was lower than normal level in 2 cases (5%). TSH level was found to be higher than normal in 13 jaundiced neonates out of 40 (33%). Seven jaundiced neonates (18%) had T4 hormone lower than normal while all the 40 jaundiced cases had normal T3 level. Correlation of the total bilirubin was significant with TSH and T3 at 0.05 levels, while there was no significance with both T4 and G6PD. Conclusion: statistically there was no correlation between bilirubin and both G6PD enzyme and thyroid hormones, but the incidence of hypothyroidism in this study was high (18%) and the incidence of G6PD deficiency was (5%). This indicates a role of G6PD deficiency and hypothyroidism in developing neonatal jaundice among neonates. So, early neonatal screening program is recommended for early management.    }, keywords = {Neonatal Jaundice,G6PD deficiency,thyroid hormones}, url = {https://ejhm.journals.ekb.eg/article_15782.html}, eprint = {https://ejhm.journals.ekb.eg/article_15782_f1e7938f5603ec614b680b42cfe04cb5.pdf} } @article { author = {Fathy, Hanan A. and M.S, Tawfik and Khalifa, Nawal M.}, title = {Effect of Microcytic Hypochromic Anemia and Parasitic Infestations on Stature in Adolescents}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {55}, number = {1}, pages = {175-183}, year = {2014}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0004503}, abstract = {  Bakground: Microcytic hypochromic anemia is the commonest form of iron deficiency anemia in adolescents. The occurrence of this type of anemia among adolescents is around 27% in developing countries. Clinical management should be based on a full knowledge of the prevalence of this disease in the age group mentioned.   Subjects and Methods: The present study reported the distribution of this type of anemia across age, anthropometric guides, and parasitic infestations in a sample of 300 adolescents attending various schools in Giza region, Egypt. Red blood cell size and iron concentration were assessed by mean corpuscular volume, hemoglobin levels, serum ferritin and total iron binding capacity from a venous blood sample. The adolescent was considered to have the microcytic form of anemia when their mean corpuscular volume was below 80 femtoliters (fL). An adolescent with hypochromic anemia was defined as any subject with hemoglobin (Hb) below the WHO cutoff for age and sex: 12.0 g/dl for girls and for boys aged 12.5–14.99 years and 13.0 g/dl for boys aged ≥ 15 years. Also, hypochromic anemia included every subject having either serum iron < 50 µg/dL, or a serum total iron binding capacity (TIBC) > 400 µg/dL.   Results: The incidence of microcytic hypochromic anemia in this study was 53%.  There were highly statistically significant differences between anemic and non-anemic groups as regards age and height (P <0.05). Anemic adolescents also had significantly lower values for weight (P < 0.01), BMI (P < 0.01) and hemoglobin concentration (P<0.01) compared to non-anemic adolescents. Also, microcytic hypochromic anemia was more common in adolescents who did not have lunch regularly. Adolescents with current parasitic infestations showed a higher frequency of anemia compared to those who did not. There were no statistically significant differences between adolescents with parasitic infestation and adolescents without parasitic infestation as regards age, weight, height and BMI (P >0.05). Signs of pallor were more common in adolescents suffering from microcytic hypochromic anemia. Subjects with a history of chronic conditions such as cardiac diseases, renal failure or cancer had a significantly higher incidence of anemia than adolescents who did not.   Conclusion: It was concluded that the anemic group of adolescents enrolled in the study were susceptible to growth retardation. This type of anemia is more common in adolescents who do not have lunch, have a chronic disease or a parasitic infestation.  }, keywords = {Stature,microcytic hypochromic anemia,Parasitic Infestation,school adolescents}, url = {https://ejhm.journals.ekb.eg/article_15784.html}, eprint = {https://ejhm.journals.ekb.eg/article_15784_3bf6618df2aa316243613f8d34435bf0.pdf} } @article { author = {M.S, Tawfik}, title = {Serum Leptin Hormone as an Indicator of Bad Prognosis in Colon Cancer Patients}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {55}, number = {1}, pages = {184-196}, year = {2014}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0004504}, abstract = {Background: Leptin has been linked to the pathology of several types of cancers related to obesity, particularly colon cancer. This could be related to leptin’ s influence on the equilibrium of specific intracellular mechanisms that control cellular growth, differentiation, apoptosis, neovascularization and invasiveness thus participating in the pathophysiology of colon cancer growth and metastasis. Additionally, ghrelin is a gut peptide secreted from the fundus of gastric mucosa and adiponectin is an adipocytokine released from adipose tissue and their low levels in obese subjects have been linked to an increased risk of development of colon cancer. Subjects and methods: Forty (40) patients were enrolled from Cairo University hospitals and included in this study beside the control group which comprised 20 age and sex-matched healthy subjects. Patients were divided into two groups: Group 1: Included 20 patients suffering from colon cancer (stage II-A) without lymph node involvement or distant metastasis. Group 2: Included 20 patients suffering from colon cancer (stage III-C) with lymph node involvement but no distant metastasis. Serum Leptin, ghrelin and adiponectin were measured in all patients using a radioimmunoassy technique. Results: Serum leptin levels were significantly higher in colon cancer patients compared to that of control subjects (p<0.001). Serum leptin levels were also significantly higher in stage II-A patients as compared to stage III-C (p<0.001). Serum ghrelin and adiponectin levels were found to be significantly lower in colon cancer patients compared to the control subjects (p<0.001).  Moreover, serum ghrelin and adiponectin levels were found to be significantly lower in patients belonging to stage III-C compared to stage II-A (p<0.001).  A negative correlation was noted between seum leptin levels and both serum ghrelin and adiponectin levels in colon cancer patients enrolled. Conclution: Serum leptin levels could serve as a good prognostic marker in colon cancer patients in addition to serum ghrelin and adiponectin levels to predict the severity and the development of colon cancer metastasis.  }, keywords = {Serum leptin,serum ghrelin,serum adiponectin,Colon cancer,lymph node,matastasis}, url = {https://ejhm.journals.ekb.eg/article_15785.html}, eprint = {https://ejhm.journals.ekb.eg/article_15785_39d1b321c1b790b6d40e0e6931d52320.pdf} } @article { author = {Al-Momany, Nairooz H. and Abo-Ashour, Nibal M. and Al-Hwadi, Maysoon L. and Al-farhan, Mahdi H. and Al-Edwan, Fardose N.}, title = {Pregabalin Efficacy and Tolerability: A Clinical Point of View}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {55}, number = {1}, pages = {197-203}, year = {2014}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0004505}, abstract = {Antiepileptic drugs have been used in pain management since the 1960s. Pregabalin is a recently developed antiepileptic drug also used in management of chronic neuropathic pain conditions. The aim of this observational prospective study was to assess the analgesic efficacy and associated adverse events of pregabalin in treated patients with neuropathic pain. The source of medication was the free samples that have been provided by the company for evaluation. Methods Neurologists and Endocrinologists at king Hussein Medical Center prescribed Pregabalin for selected patients (no. =50) who were diagnosed to have neuropathic pain according to pre-formulated questionnaire that was developed by researchers. The majority of patients received Pregabalin 150mg as a starting dose, 300 mg as a maintenance dose for three months. then the magnitude of pain was assessed first after  one week of treatment, if the patient had pain relief after one week and maintained on treatment further assessment was performed at intervals of one, two and three months. Then for each patient the average score of pain relief was calculated (0=worst value, 10=best value).patients were also encouraged to report any adverse effect during treatment period.  Results   A total of 50 patients with neuropathic pain were included. During the course of the study 17 patients terminated treatment during the first week (but were replaced by other 15 patients) either due to lack of efficacy (12%, n=6) or due to intolerable adverse effects (22%, n= 11). For the remaining patients the average score of pain relief was 2.8 ±1.2. The average score of pain reduction was higher among patients with diabetic neuropathy (3.4) than with other types of neuropathic pain (2.2). The most frequently reported adverse effects were dizziness, fatigue, somnolence, and gastrointestinal disturbances. Conclusion   Pregabalin is effective in reducing diabetic neuropathy and to a lesser extent than other types of neuropathic pain. (But) However intolerable adverse effects still face a problem. Further studies comparing its efficacy and tolerability with other neuropathic treatment choices are needed.  }, keywords = {Pregabalin,Neuropathic pain,Diabetic neuropathy,postherpetic neuralgia}, url = {https://ejhm.journals.ekb.eg/article_15786.html}, eprint = {https://ejhm.journals.ekb.eg/article_15786_f221d944baea807fdd63e9f3a3608040.pdf} } @article { author = {Zaahkouk, Samir Attia Mohamed and Hedifa, Hesham Fathy and Ibrahim, Seham Omar Mohamed and Hammam, Amira Ahmed}, title = {Expression of Heparanase Gene in Egyptian Acute Leukemia Patients}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {55}, number = {1}, pages = {204-217}, year = {2014}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0004506}, abstract = {Background: Heparanase is an endoglycosidase that degrades heparin sulfate, the main polysaccharide constituent of the extracellular matrix and basement membrane. Expression of the heparanase gene is associated with the invasive, angiogenic, and metastatic potential of diverse malignant tumors and cell lines.                                                                              Aim of the study: to investigate possible relation/correlation between Heparanase gene expression and quantitation in pediatric Acute leukemia patients and clinicopathologic variables as well as patients outcome in an attempt to determine it′s prognostic value and the possibility of using it as a new target for treatment. Patients and methods: Forty pediatric acute leukemia patients (20 acute myeloid leukemia (AML)&20 acute lymphoblastic leukemia(ALL) as well as 11 normal volunteers were analyzed for the expression and level of Heparanase gene using real time quantitative reverse transcriptase polymerase chain reaction (RTQ-PCR) to investigate a possible relation, association, or correlation with the clinical and laboratory features of patients at diagnosis, and patient outcome after treatment and follow up.                                                                       Results: Comparing the 3 groups as regards the Heparanase gene level there was high statistical significant difference (p<0.001) being maximum in AML and minimum in controls, with mean Relative quantitation (RQ) level 2336.2± 10405.2 in AML ,median 8.0 and range (3.1-46543.0) , while mean RQ in ALL was 1.7±1.0 ,median 1.7 and range (0.1-3.1) and in controls mean was 0.8±0.3, median 0.8 and range (0.4-1.4).Comparison between each 2 groups as regards heparanase level was of high statistically significant difference, p value being (p<0.001) when comparing AML/ALL and AML/controls and (p=0.035) when comparing ALL/controls. Cut off value for heparanase gene was calculated using Roc curve and was found to be 1.413 with 80% sensitivity and 100% specificity. According to this cut off level, 20/20 (100%) AML cases were heparanase positive, 12/20(60%) (ALL) cases were heparanase positive and 8/20 ALL patients were negative, while all controls (100%) were negative. This was of high statistical significance (p<0.001). Comparing the overall survival (OS) of AML/ALL there was no statistically significant difference (p=0.2916), while comparing the disease free survival (DFS) of AML/ALL was of statistical significant difference (0.0312). Comparing the final status of the disease (complete remission(CR)/ progressive disease(PD) or death) as regards the heparanase gene level RQ , showed a high statistical significant difference (p<0.005) with the level being higher in patients with PD/death. There was no significant correlation between all group and heparanase gene level as regards age, TLC, hemoglobin, platelets and peripheral blood blasts (p=0.353,0.704,0.844,0.54 and 0.097) respectively, while there was significant negative correlation on comparing bone marrow blast% and heparanase gene level (r=-0.408 and p=0.09). Conclusion: Heparanse gene is expressed in acute leukemia being higher in AML than ALL and controls. Patients with higher heparanase gene showed poorer outcome. These findings suggest that heparanase gene may be a novel significant therapeutic target for acute leukemia.    }, keywords = {Heparanase gene,Acute leukemia,RTQ-PCR}, url = {https://ejhm.journals.ekb.eg/article_15787.html}, eprint = {https://ejhm.journals.ekb.eg/article_15787_09e8b3961583b0114de38b398d869dee.pdf} } @article { author = {El- Nabarawy, Salwa K}, title = {Oxidative Damage in Embryo and Placenta of Streptozotocin-induced Diabetic Rats Salwa K El- Nabarawy}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {55}, number = {1}, pages = {218-227}, year = {2014}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0004507}, abstract = {Background: Maternal type 1 diabetes is associated with an increased risk for fetal malformations. The mechanism by which diabetes caused teratogenic disorders is not fully known. Previous studies have demonstrated that many teratogenic diabetic cases were related to free radical oxygen species. This study was conducted to evaluate the effect of maternal diabetes on both embryo and placenta by estimating theoxidative and DNA damage in embryo and placenta of diabetic mellitus- induced rats. The possible role of olive leaves extract of Olea europaea ( O. europaea ) plant in repairing the damage was also assessed.  Material and Methods:.  Diabetes mellitus was induced by streptozotocin (STZ) by a single intraperitoneal injection (35 mg/kg b wt). O.europaea leaves water extract was administered orally (550 mg/ 100g b wt/ day) for 5days before pregnancy and18 days after. Malondealdehyde (MDA) level, glutathione peroxidase (Gpx) and superoxide dismutase (SOD) activities and glycogen concentration were measured in term embryo and placenta homogenates of diabetic and control rats. Moreover, the evaluation of DNA damage was carried out by the Alkaline Comet Assay usingembryos and placentas taken from STZ-induced diabetic and control pregnant rats. Results: the results showed an elevation in MDA level of the diabetic groups of both embryo and placenta compared to that of the control. This was accompanied by reduction in Gpx and SOD activities indicating oxidative damage.      Glycogen level was reduced in diabetic groups of embryo and placenta. Both oxidative and hyperglycemic status were improved in the groups treated with olive leaves water extract. The percentage of tail DNA and tail moment values were also higher in both embryo and placenta of the diabetic -induced rats. DNA damage seems to be partly ameliorated in groups treated with O. europaea leaveswater extract. Conclusion: This study indicated that maternal hyperglycemic condition in diabetic- induced pregnant rats could generate oxidative and DNA damage to embryo and placenta that could be ameliorated by oral doses of olive leaves water extract.  }, keywords = {Diabetes mellitus,hyperglycemia,Oxidative Stress,embryo,placenta,DNA damage,Alkaline CometAssay,Olive leaves}, url = {https://ejhm.journals.ekb.eg/article_15788.html}, eprint = {https://ejhm.journals.ekb.eg/article_15788_84785519b904bdfbd8c1d2a9035340fa.pdf} } @article { author = {Habahbeh, Zeyad}, title = {Juvenile DermatomyositisKing Hussein Medical Center Experience}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {55}, number = {1}, pages = {228-238}, year = {2014}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0004508}, abstract = {Background: Juvenile dermatomyositis (JDM) is an uncommon, often chronic, and potentially serious childhood systemic autoimmune vasculopathy affecting primarily skin and muscles. It is characterized by pathognomonic rash, and symmetrical proximal muscle weakness. Objective: In this retrospective study, we reviewed the clinical, laboratory profiles, treatment and outcome of Jordanian children diagnosed with JDM in the past 8 years in a tertiary facility in Amman, Jordan. Methods: Sixteen (16) JDM patients, diagnosed based on criteria of Bohan and Peter, and have attended the pediatric rheumatology clinic in King Hussein Medical Center, from January 2006 to September 2013, were recruited. Their medical records were studied for clinical and biochemical profile, radiological and electrophysiological data were studied as well. Treatment and outcome were also reviewed. Results: Our cohort includes 16 patients, 9(56 %) males, and 7 (44%) females (M: F 1.3:1), their age ranges between 2 to 9 years, with average age at diagnosis of 5.4 years. Time to diagnosis varies from 2 months to 12 months, and averages at 4.6 months. Proximal muscle weakness was present at time of diagnosis in 14(87.5 %) cases. Cutaneous signs in form of either poikiloderma in malar distribution, Gottron’s sign and /or heliotrope sign were apparent in all the 16(100%) patients at time of diagnosis, periungual erythema was evident in 10(63%) patients while abnormal nailbed capillaries pattern was only reported in 6(38%) cases. Skin and soft tissue calcification, crusting and ulceration were seen in 3(19 %) patients. Serum Lactate dehydrogenase, (LDH) was elevated in 94% and creatininine phosphokinase (CPK) in 88%. Elevated SGOT (AST) was seen in almost all subjects, while ESR was high in 14 (87.5%) patients. All patients treated with corticosteroids and methotrexate (MTX). Two (12.5%) patients died in our series, complete remission was achieved in 4(25%) of patients, while partial remission was seen in 8 (50%) of patients in our cohort. Conclusion: JDM is a rare disease that has the potential to cause physical disability, poor functional outcome, and death if not recognized early and treated properly. We focused in our study, on importance of early referral, and aggressive therapy in improving outcome, aiming to increase awareness of families and general pediatricians.    }, keywords = {Juvenile dermatomyositis,Myopathy,Calcinosis,Heliotrope sign}, url = {https://ejhm.journals.ekb.eg/article_15789.html}, eprint = {https://ejhm.journals.ekb.eg/article_15789_0fc51ea826ca75b4f312f665e87cc2f5.pdf} } @article { author = {Amer, Moatassem S and Hamza, Sarah A and el Rahman, Ekramy E Abd and Hamed, Heba M and Zaki, Osama K and Saad, Wessam E}, title = {Relation between Smoking and Cognition in Egyptian Elderly}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {55}, number = {1}, pages = {239-244}, year = {2014}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0004509}, abstract = {Background:  In spite of numerous studies published in the past few years on the topic, the effect of smoking on Alzheimer's disease and dementia remains uncertain. Case–control studies have largely suggested that smoking lowers the risk of AD, whereas prospective studies have shown that smoking increases this risk or has no effect on the probability of developing AD. Objectives: The aim of this study is to compare the prevalence of Smoking in elderly with cognitive impairment and elderly with non-cognitive impairment. Design: A Case control study. Participants: 88 participants aged 60 years and above. They were selected from Ain Shams University Hospital from inpatient wards and outpatient clinics. The studied sample was divided into 3 groups: Group A (32 elderly patients with Alzheimer's disease), Group B (32 elderly patients with Mild cognitive impairment) and Group C (24 controls with normal cognitive function). Measurements: Comprehensive geriatric assessment, including detailed history, physical examination, and also cognitive assessment using Montreal Cognitive Assessment (MOCA) and Mini mental status examination (MMSE). Results:As regards smoking there was a highly statistical significant difference between the 3 groups as non-smokers were more prevalent in Alzheimer's disease and Mild cognitive impairment groups in comparison to control group with (p-value= 0.001). Conclusion: There was a highly significant negative association between smoking and cognitive impairment.    }, keywords = {Alzheimer's disease – Mild cognitive impairment – Smoking – Elderly}, url = {https://ejhm.journals.ekb.eg/article_15790.html}, eprint = {https://ejhm.journals.ekb.eg/article_15790_3714774b0e9a574b881fbe5632e06c25.pdf} } @article { author = {Helal, Eman G. E. and Abou-Aouf, Noran Ahmed and Taha, Neama M.}, title = {Effect of Noise and Crowding Related Stress on Serum Level of Cortisol ACTH, Epinephrine and Insulin in Female Albino Rats}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {55}, number = {1}, pages = {245-250}, year = {2014}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0004510}, abstract = {Background: Noise and crowdingare the most stressful factors for human beings. Study aimed to clarify their effect on cortisol, ACTH, epinephrine, insulin and the amelioration effect of Sulpiride. Material and Methods: Thirty six female rats were divided into six groups (6/each): 1- Rats served ascontrol, 2- Rats treated with Sulpiride drug, 3- Rats exposed to noise (90db, 3hr. per day) for 45 days. 4- Rats exposed to noise and treated with sulpiride drug, 5- Rats exposed to crowding. 6- Rats exposed to noise and treated with Sulpiride drug. Results: Noise and crowding stresses caused a significant increase of cortisol, ACTH and epinephrine while there was a significant decrease in insulin hormone. Sulpiride drug   ameliorated these parameters. Conclusion: it is useful to use Sulpiride drug with   people who are exposing to noise and  crowding stress.  }, keywords = {Noise,crowding,Sulpiride drug,physiological parameters,Cortisol,ACTH,Epinephrine,Insulin}, url = {https://ejhm.journals.ekb.eg/article_15791.html}, eprint = {https://ejhm.journals.ekb.eg/article_15791_a6543d00a78fb04b516037b9e7377430.pdf} } @article { author = {El-Banna, Rokia Abd ElShafy Soliman and Sarry El-Din, Azza Mohamed and Ali, Walaa Yousef Mohamed and Eid, Fatma Ahmed}, title = {The Prevalence of Vitamin D Deficiency in Ancient Egyptian Population from Baharia Oasis, the Greco Roman Period.}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {55}, number = {1}, pages = {251-256}, year = {2014}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0004511}, abstract = {Background: Vitamin D deficiency is considered to be the most common nutritional deficiency and also one of the most common undiagnosed medical conditions in the world. Vitamin D is naturally present only in minor amounts in most foods; the great majority is synthesized by the action of ultraviolet light on chemical precursors in the skin. The manifestation of vitamin D deficiency in sub adults is referred to as rickets, and in adults, osteomalacia . Rickets and osteomalacia are the sub adult and adult expressions of a disease in which the underlying problem is a failure to mineralize bone protein (osteoid). The most common cause of this disease is a physiological deficiency in vitamin D. The associated problems include deformed bones. Material and Methods: This study  aimed to investigate the skeletal remains of ancient Egyptians from Baharia Oasis population for lesions indicative of vitamin D deficiency (rickets and osteomalacia). The material consisted of 1075 commingled bones (38 sub adults and1037 adults). They were recovered from Baharia oasis. Results: The results showed that, there was no evidence of rickets in sub adult group. The prevalence of osteomalacia in adult Baharia populations was 7.4% ; all were adult males. This result could indicate that this population was subjected to sunlight all over the year and their diet was rich of calcium and phosphorus. Conclusion: These few cases that were found may be due to mechanical stress during wine and textile production.  }, keywords = {rickets,Osteomalacia,Ancient Egyptians,Greco-Roman Period}, url = {https://ejhm.journals.ekb.eg/article_15792.html}, eprint = {https://ejhm.journals.ekb.eg/article_15792_3b3e6bec6a99bbbfa1ef3bf6b0e8e06e.pdf} } @article { author = {Abdel Rahman, Tomader Taha and Abdel Guaad, Marwa Abdelazeem and Mortagy, Ahmed Kamel}, title = {Assessment of Executive Functions in Chronic Hepatitis C Virus Infected Patients}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {55}, number = {1}, pages = {257-260}, year = {2014}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.12816/0004512}, abstract = {Background: Chronic infection with HCV is one of the most important causes of chronic liver disease, which can progress to cirrhosis and hepatocellular carcinoma (HCC). It is well established that advanced forms of the disease are accompanied by overt and global cognitive deficits (hepatic encephalopathy) but now there is a growing evidence that the alterations in cerebral function in patients with chronic HCV infection may appear long before the development of severe liver cirrhosis, it has been hypothesized that it is related to a direct effect of HCV on the brain; or the neurotoxic effect of HCV-related systemic inflammation. Aim: The purpose of the study was to assess the possible existence of executive dysfunction in chronic HCV infected patients without cirrhosis. Study design: case control study. Participants: 100 elderly patients aged 60 years and above, 50 patients are HCV positive (cases) and 50 patients are HCV negative (controls) both groups have no liver cirrhosis. Methods: All participants were subjected to the following: Diagnosis of HCV by detection of HCV ab using ELISA technique, non invasive assessment of liver cirrhosis using abdominal ultrasound, and evaluation of executive functions using 5 neuropsychological tests (block design, digit span backwards, animal verbal fluency, clock drawing, and EXIT 25). Results: The study showed that there is a significant difference between cases and controls regarding Exit 25 and Digit span backwards tests scores indicating affection of the phonological loop component of working memory among HCV positive patients. Conclusion: Executive functions are affected in patients with chronic HCV infection without liver cirrhosis.  }, keywords = {executive functions,HCV,no cirrhosis}, url = {https://ejhm.journals.ekb.eg/article_15793.html}, eprint = {https://ejhm.journals.ekb.eg/article_15793_9cb886e09cf00178bc181122eba9bd00.pdf} }