@article { author = {Tawfik, Tarek Mohamed and Hasan, Mohamed Saeed Mohamed and Aref, Mohamed Ibrahim and Marie, Mohamed Samy Ibrahim}, title = {Serum Tumor Necrosis Factor-α (TNF-α) with Erectile Dysfunction in Psoriatic Patients}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {75}, number = {1}, pages = {1907-1912}, year = {2019}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2019.29112}, abstract = {Background: Erectile dysfunction (ED) is a common disorder leading to serious, negative impact on the quality of the patient's life and self-esteem. Its occurrence rate increases with psoriatic patients, as it is a systemic disease intervenes with endothelial dysfunction. A link is described among systemic inflammation and endothelial dysfunction (Psoriasis), and ED. Objective: Estimate of the serum level of tumor necrosis factor-α (TNF-α) in erectile dysfunction patients with psoriasis and patients with erectile dysfunction without psoriasis. Subjects and Methods: This study was conducted over a period of one year starting from February 2018 until February 2019. The study was consented by the Ethics Committee of Al-Azhar Faculty of Medicine. A sample of 90 men (30 men psoriatic patients with ED and 30 men with ED complaints and 30 healthy men of matched age as controls) were conscripted from the Dermatology and Andrology Outpatient Clinics at Al-Hussien and Bab AlShariah University Hospitals. ED presence and severity were tested by the five-item version of the International Index of Erectile Function questionnaire (IIEF-5). Psoriatic patients were evaluated by PASI score. All subjects had thorough medical history and full physical examination. The serum level of TNF-α was measured for all cases and healthy controls using specific enzyme-linked immunosorbent assay (ELISA) technique. All men volunteered to partake in this study were married and have only one sexual partner. Results: In this study, serum TNF- levels were indicatively elevated in psoriatic patients with ED compared to ED patients only. In addition, the difference reached highly statistical significance between psoriatic patients with ED and healthy controls. The elevation correlates with duration of the disease, and family history. Levels of TNF-α were further increased when ED was associated with psoriasis advocating a more severe course of ED in these patients. }, keywords = {Erectile dysfunction,tumor necrosis factor-α,Psoriasis}, url = {https://ejhm.journals.ekb.eg/article_29112.html}, eprint = {https://ejhm.journals.ekb.eg/article_29112_7c41628e825e8034c847fc2fc80a0f42.pdf} } @article { author = {Yassein, Ismael Ahmed and Elzehad, Ehab Abd El Maboud and Mohamed, Yasser Mohamed Ali}, title = {High Tibial Opening Wedge Osteotomy in Osteoarthritis with Varus Knee}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {75}, number = {1}, pages = {1913-1917}, year = {2019}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2019.29113}, abstract = {Background: High tibial osteotomy was first described in 1958 as a successful treatment for moderate to severe unicompartmental, degenerative arthritis of the knee associated with angular deformity. Malalignment is frequently associated with knee arthrosis and can influence the mechanical load through either the medial or the lateral compartment. Aim of the work: Investigation of the clinical and radiographic results of opening-wedge high tibial osteotomy and fixated by locked compression plate, when used to as surgical treatment of osteoarthritis and varus deformity. Patients and methods: The study took place at Al Azhar University Hospital {Elhussein and Bab EL Sharia}. It was a prospective study on 20 consecutive patients who had knee osteoarthritis and varus knee deformity. They were treated by surgical intervention by opening wedge high tibial osteotomy applied by T – locked plate, between September 2016 to April 2019. The procedures are carried out under spinal anesthesia. Results: There was a significant improvement in the pain level after surgery when compared to before surgery. Postoperatively, 16 patients (80%) were found to have no pain. Pre-operatively 19 patients (95%) had full range of knee motion, and only one patient had hyperextension. Post-operatively, all patients had maintained their full knee extension. Postoperatively, 60% of the patients showed normal alignment, 10% valgus (mean: 1° valgus) and 30% still varus (mean: 2.33° varus, range: 1-4°). Conclusion: The patients in this study were satisfied with the results. Younger patients planning for HTO should be advised about the benefits and risks of the procedure, specifically mentioning kneeling and scar formation.}, keywords = {High Tibial Opening Wedge Osteotomy,osteoarthritis,Varus Knee}, url = {https://ejhm.journals.ekb.eg/article_29113.html}, eprint = {https://ejhm.journals.ekb.eg/article_29113_fbecf87839c82a14838d94fa3797fdb0.pdf} } @article { author = {Helal, Eman G.E. and Abd-El-Aziz, Mohamed A. and Ahmed, Shaimaa S.}, title = {Effect of Anise (Pimpinella Anisum L.) as Phytoestrogen on Some Sex Hormones and Biochemical Parameters}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {75}, number = {1}, pages = {1918-1922}, year = {2019}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2019.29114}, abstract = {Background: Phytoestrogen is a plant derived compound which have estrogenic effect similar to estrogen. Aim of work: The present study was carried out to investigate some pharmacological and biochemical effects of anise oil on male albino rats. Materials and methods: twelve animals were divided randomly into two groups. Group A: Control. Group B: treated rats. The treated rats were given an oral dose of 1 ml/kg body weight/day anise oil once daily for one month. At the end of the experiment, blood samples were collected for biochemical analysis. Results: The anise oil induced highly significant decrease (p<0.01) in TC, TG, LDL, VLDL, LDL/HDL. In addition, significant increase (p<0.05) in HDL and highly significantly decreased in FSH, LH, testosterone and sperm count compared to normal control group. Conclusion: This study showed that high levels of anise intake cause hormonal disturbance and decrease sperm count.}, keywords = {Anise oil,Lipid profile,albino rats,Sperm count,physiological parameters}, url = {https://ejhm.journals.ekb.eg/article_29114.html}, eprint = {https://ejhm.journals.ekb.eg/article_29114_7ce6d7c6f9029e776e6746d2b9192234.pdf} } @article { author = {Alhejaily, Mohammed Ahmed and Alatawi, Ahmad Awadh and Alatawi, Meshal Saleh and Mrighani, Hyder Osman}, title = {Evaluation of Knowledge, Attitude and Practice of Epistaxis among the General Population of Tabuk City, Saudi Arabia}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {75}, number = {1}, pages = {1923-1931}, year = {2019}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2019.29115}, abstract = {Background: epistaxis is a fairly common problem, which has been reported to be occurring in about 60% of the population. It defined as a bleeding from nose or nasal cavity and it is considered as one of the most common emergencies presenting in Ear, Nose and Throat (ENT) Department and Accident and Emergency Department worldwide. Objectives: this study aimed to assess the knowledge, awareness and practice of the general population of Tabuk City, KSA towards epistaxis, its causes, and management. Materials and Methods: a cross sectional study was conducted on 540 participants of age less than 20 years to 51 and older in Saudi Arabia. Data were collected by using a pre-designed online questionnaire, which was distributed among the general population of Tabuk City, Saudi Arabia. Results: this study included 540 participants, 71.9% females and 28.1% males. Most of the participants (50.4%) were from 21 to 30 years. Epistaxis was found in 45.2% of them. Among participants, 34.8% knew that chronic diseases cause epistaxis, 42.2% stated that drugs cause epistaxis and 68.9% knew that excess nose manipulation caused epistaxis. Tilting the head forward was the best position to stop epistaxis which reported by 45.2% and 42.2% reported cartilage as a part of nose should be pressed on to stop epistaxis. There were no significant correlations between educational level and different knowledges of the causes and how to deal with epistaxis case (p>0.05). However, we found that there was a significant correlation with the action should be done if the epistaxis continues (p=0.001), the best position to stop epistaxis (p= 0.02) and nose manipulation as a cause of epistaxis (p=0.01). Conclusion: our results showed that high percent of the participants were suffering from nasal bleeding (Epistaxis) in Saudi Arabia. And there was good a knowledge about causes of epistaxis and how to deal with epistaxis cases.}, keywords = {epistaxis,Bleeding,Knowledge,Awareness,Saudi Arabia}, url = {https://ejhm.journals.ekb.eg/article_29115.html}, eprint = {https://ejhm.journals.ekb.eg/article_29115_da382a571c63bb0da6348edb239ae44e.pdf} } @article { author = {Sayed, Suzan S. and Elkholy, Maha M.S. and Ismail, Eman M. and Abdulkareem, Ebtsam S.}, title = {Patterns of Presentation of Lung Cancer in Aswan University Hospital}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {75}, number = {1}, pages = {1932-1936}, year = {2019}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2019.29116}, abstract = {Background: globally, lung cancer is the most common cancer among males in terms of both incidence and mortality and among females has the third highest incidence, and comes after breast cancer in mortality. Aim of the Work: to recognize the lung cancer presentation pattern in Aswan University Hospital involving different clinical, radiological and bronchoscopic pattern. Patients and Methods: this retrospective study included 30 patients with lung cancer in Aswan University Hospital, all these data were recorded; complete clinical examination, full laboratory investigations, imaging modalities, bronchoscopy and histopathological analysis of tissue samples. Results: the mean age in lung cancer patients was (59.33 ± 8.6) years, mass lesion and collapse were the main radiological presentations and endobronchial mass lesion was the main presenting bronchoscopic finding. Conclusion: endobronchial mass was the most frequent bronchoscopic finding in lung cancer patients in our study.}, keywords = {Lung Cancer,Smoking,Bronchoscopy}, url = {https://ejhm.journals.ekb.eg/article_29116.html}, eprint = {https://ejhm.journals.ekb.eg/article_29116_d57b1d0ee1c57c3a39173444e7a2c6d9.pdf} } @article { author = {Kamel, Esam Omar and Abdel Hady, Alsayed Abdel Rahman and Abd-Elrahman, Al-Sayed Al-Hady and Diab, Mahmoud Mohamed}, title = {Evaluation of Role of Captopril and Erdosteine in Protection of The Lung against Bleomycin-Induced Injury in Rats}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {75}, number = {1}, pages = {1937-1945}, year = {2019}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2019.29117}, abstract = {Background:bleomycin (BLM) is a chemotherapeutic agent having a wide use in the clinical field. Its most serious side effect is the life-threatening pulmonary toxicity.Objective:this study aimed to evaluate the role of captopril and erdosteine (ERD) in lung protection against BLM-induced injury in rats. Material and Methods:thirty-two rats were categorized into 4 equal groups. Group I: rats received distilled water. Group II: rats injected intaperitonealy with 0.5 mg of BLM sulphate dissolved in 0.5 ml saline twice weekly for 4 weeks. Group III: rats received BLM in a dose as in group II &ERD by a dose of 10 mg/kg/day orally, 2 days before BLM administration. Group IV: rats received BLM in a dose as in group IIand captopril with a dose of 5 mg∕kg orally for 4 weeks, 2 days before BLM administration. Results: rats treated with BLM revealed disturbance of lung structure. There were marked cellular infiltration and thickening in alveolar septa with wide variation in the diameter of alveoli. Blood vesselswere congested. Extravasation of blood into interalveolar septa was observed. Large number of vacuolated cuboidal cells was noticed. Large amounts of collagen fibers around the bronchioles and few collagen fibers in the interalveolar septa were detected. Sections of rats treated with BLM and ERD showed apparently normal lung structure but, some collapsed alveoli with thick septa were still noticed. Sections treated with BLM and captopril showed lesser structural improvement than ERD-treated sections.Conclusion: administration of captopril and ERD partially improved BLM-induced pulmonary fibrosis in rats.}, keywords = {lung,alveoli,fibrosis,Bleomycin,captopril,Erdosteine}, url = {https://ejhm.journals.ekb.eg/article_29117.html}, eprint = {https://ejhm.journals.ekb.eg/article_29117_44fa3fc5ffe2584ba762f081c61dc396.pdf} } @article { author = {Ali, Said Ahmed and Fayad, Said Mohamed and Saad, Nasr Abd Alaziz Mohamed and Abd Allatif, Mohammad Abd AlHady}, title = {A Comparison between Volume-Controlled Ventilation and Pressure-Controlled Ventilation in Providing Better Oxygenation in Obese Patients Undergoing Laparoscopic Cholecystectomy}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {75}, number = {1}, pages = {1946-1952}, year = {2019}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2019.29166}, abstract = {Background: The main goal of mechanical ventilation is the maintenance of adequate oxygenation and ventilation. There is no guidelines on the mechanical ventilation in obese patients. This study aims to compare the effect of pressure controlled ventilation PCV vs. volume controlled ventilation VCV on oxygenation parameters in obese patients undergoing laparoscopic cholecystectomy. Methods: 70 obese patient of ASA physical status II, Body Mass Index of 30–40 kg/m2, scheduled for laparoscopic cholecystectomy were included in this prospective randomized study. All patients received VCV. Fifteen minutes after creation of pneumoperitoneum, they were randomized to receive either VCV (Group V) or PCV (Group P). The ventilatory parameters were adjusted accordingly to maintain the end‑ tidal CO2 between 30 and 40 mmHg. Primary outcome variable was mean airway pressures. Secondary outcomes were PO2/FiO2 ratio, dead space to tidal volume ratio and alveolar arterial oxygen tension gradient before and after creation of pneumoperitoneum. Results: Patients in group P showed a statistically significant (P < 0.05) higher level of PaO2/FiO2 ratio and mean airway pressure and lower value of PAO2–PaO2, dead space to tidal volume ratio and peak airway pressure than those in group V. Conclusion: PCV is a more efficient mode of ventilation in comparison with VCV mode regarding oxygenation in obese patients undergoing laparoscopic cholecystectomy.}, keywords = {Volume-Controlled Ventilation,Pressure-Controlled Ventilation,Obese Patients Undergoing,Laparoscopic cholecystectomy}, url = {https://ejhm.journals.ekb.eg/article_29166.html}, eprint = {https://ejhm.journals.ekb.eg/article_29166_3c693ec8eabe916d996dd6386bd31924.pdf} } @article { author = {Farhan, Abd El Sattar Mohammed and Elboghdady, Adel Aly and Elsayyad, Mohammed Emad}, title = {Assessment of Different Methods of Ovulation Induction on Endometrial and Ovarian Blood Flow by Transvaginal Ultrasound Doppler}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {75}, number = {1}, pages = {1953-1962}, year = {2019}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2019.29167}, abstract = {The study was performed in a prospective randomized fashion in order to compare the value of tansvaginal ultrasound, and the value of combined colour Doppler imaging of uterine, ovarian blood flow and transvaginal folliculometry in assessment of ovulation induction of infertile women. Ovulation rate was taken as the gold standard for assessment of ovulation induction result Analysis of the results provided the following information: A) Better sensitivity & specificity of colour Doppler indices in detection of ovulation. B) Better timing of human chorionic gonadotrophin administration & better ovulation rate when colour Doppler was used in cycle monitoring. It can be concluded from the results of this study that combined use of transvaginal sonography& colour Doppler imaging is more reliable in assessment of ovulation & is more useful in monitoring of follicular growth and vascularity in clomiphene citrate induced cycles than the use of transvaginal ultrasound alone. The study opens a new field of ongoing research on the valuable application of colour Doppler studies in the management of gynecologic infertility due to ovarian cause.}, keywords = {transvaginal ultrasound,colour Doppler,ovulation induction clomiphene citrate}, url = {https://ejhm.journals.ekb.eg/article_29167.html}, eprint = {https://ejhm.journals.ekb.eg/article_29167_878a41600bf0508b234d60205afc2f1d.pdf} } @article { author = {Hussein, Mohammed Salah and Mahmoud, Asem Ashraf and Ibrahim, Abdel Rahman and Bakeer, Mohammed Saied and Hussein, Safaa Abd Elsalam and Mahmoud, Abdelhalim Assem and Eldahshan, Tarek}, title = {Ceruloplasmin as a Predictor for Responsiveness to Direct Antiviral Drugs in Treatment of Chronic HCV Infection}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {75}, number = {1}, pages = {1963-1968}, year = {2019}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2019.29168}, abstract = {Background: Hepatitis C virus (HCV) is one of the major globally cause of death and morbidity. The appearance of direct-acting antiviral agents (DAAs), which specifically target HCV proteins, has provided insights into the current situation Ceruloplasmin (Cp), where its serum levels tend to be high in myocardial infarction, neoplastic and inflammatory conditions. Objective: The aim of the current work was to evaluate the prognostic value of serum ceruloplasmin in chronic hepatitis C before and after treatment by direct-acting antiviral agents and possibility of using it as a marker for hepatitis C virus treatment response. Patients and methods: This intervention prospective study was conducted on one hundred subjects attending at the Hepatology Clinic at the Hepatology Clinic at Algalaa Military Hospital and Kopri Elkopa Military Hospital and Al-Hussein university Hospital, from December 2016 till June 2017. The associations between serum Ceruloplasmin levels in chronic HCV patients before receiving DAAS and three months after was investigated. Results: showed that serum Ceruloplasmin levels were slightly higher after receiving DAAS and so it can be used as a marker for responsiveness to direct acting antiviral drugs. Conclusion: It could be concluded that ceruloplasmin can be used as a marker for responsiveness to direct acting antiviral drugs}, keywords = {Ceruloplasmin,Hepatitis C virus,Direct acting antiviral agents}, url = {https://ejhm.journals.ekb.eg/article_29168.html}, eprint = {https://ejhm.journals.ekb.eg/article_29168_164cc55b4f57823741d434e27fa6f8f6.pdf} } @article { author = {Ahmed, Mohammed Abd Elmoneim and Yassin, Abd Ellah Nazeer and Dawood, Yahia Mohammed and Abd Elwahab, Ahmed Ragab}, title = {Correlation Between Role of Preoperative Computerized Tomography and Intraoperative Findings in Revision Myringoplasty}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {75}, number = {1}, pages = {1969-1975}, year = {2019}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2019.29169}, abstract = {Background: The goals of tympanic membrane repair in tubotympanic chronic suppurative otitis media are to close the perforation, remove the disease, and improve hearing of the patient. Myringoplasty is an operation used to repair a perforation of the tympanic membrane and this improves the patient hearing and decreases susceptibility of infection. Objective: To correlate the radiological findings of preoperative CT with intra-operative findings in revision myringoplasty. Patients and Methods: This study included 30 patients suffering from safe type of chronic suppurative otitis media with central tympanic membrane perforations. 23 patients were subjected to underlay revision myringoplasty and 7 patients were subjected to cortical mastoidectomy based on the preoperative CT findings. Diagnosis of the disease was established by clinical, otoscopic, microscopic and endoscopic examination. All patients were studied prospectively. Preoperative history taking, ENT examination, general examination, and assessment of hearing were performed for all cases. All patients complained of history of ear discharge and deterioration of hearing. Surgery was done; operative details were recorded and postoperative follow up was done. Results: This study showed that CT scan temporal bone is 100% accurate in assessment of ossicular chain, aditus ad antrum patency and mastoid pneumatization. While, CT accuracy in assessment of middle ear spaces, middle ear mucosa and fibrous adhesions is 76.7%. Conclusion: Comparing these results with those of other researches using similar techniques, revealed that they are almost similar regarding the accuracy of CT scanning and success rate.}, keywords = {Chronic otitis media,Tympanic Membrane,chronic suppurative otitis media}, url = {https://ejhm.journals.ekb.eg/article_29169.html}, eprint = {https://ejhm.journals.ekb.eg/article_29169_a2d07e6d58f914d447e82544476f6577.pdf} } @article { author = {Helal, Eman G.E. and Abdelaziz, Mohamed A. and Taha, Neama M. and El-Gama, Mariam S.}, title = {The Influence of Acesulfame-K and Aspartame on Some Physiological Parameters in Male Albino Rats}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {75}, number = {1}, pages = {1976-1981}, year = {2019}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2019.29170}, abstract = {Background: the easiest method of reducing calories is to replace the high caloric food products with sweetened ones. Aim of the work: this study aimed to determine the effects of acesulfame-k or aspartame on some physiological parameters in male albino rats. Materials and methods: we used thirty male albino rats of local strain weighing from 100 to120 gm. The period of the experiment was 30 days. The animals were divided into three groups; Group 1: control, Group 2: rats received acesulfame-k (15 mg/kg/day) and group 3: rats received aspartame (50 mg/kg/day). Results: there was an increase in serum glucose and insulin level in rats that received aspartame. In addition, there was increase in ASAT and ALAT activities, serum creatinine, serum urea and lipid profile except HDL-C in both treated groups as compared to the control group. Meanwhile, there was a drop in serum testosterone level and serum T3&T4 levels in aspartame group as well as in total protein, albumin and albumin/globulin ratio in both treated groups as compared to control group. Conclusion: aspartame has more dangerous effects than acesulfame-k.}, keywords = {acesulfame-k,Aspartame,ASAT,ALAT,T3,T4,testosterone,Insulin}, url = {https://ejhm.journals.ekb.eg/article_29170.html}, eprint = {https://ejhm.journals.ekb.eg/article_29170_f97eb955b37386b808f2955b4dda89e7.pdf} } @article { author = {Soliman, Amany A. and Hussein, Adel S. and Ahmed, Ahmed G.}, title = {Assessment and Management of Asymptomatic Bacteriuria in Pregnancy}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {75}, number = {1}, pages = {1982-1986}, year = {2019}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2019.29171}, abstract = {Background: Asymptomatic bacteriuria in pregnancy is defined as the presence of a significant amount of bacterial growth in a urine culture taken from a urine sample and the absence of symptoms of urinary infection such as pain or urgency.Asymptomatic urinary tract infection is an important risk factor for developing acute symptomatic infection later in pregnancy, and it was also associated with a preterm labor, intra-uterine growth retardation and low birth weight infants. Objective: This prospective study was aimed to assess the incidence, causative organisms, response to medication and follow-up for recurrence of asymptomatic bacteriuria in pregnant and non-pregnant women in a randomized pattern with maximum safety procedures to both mother and fetus. Patient and Methods: This study included 100 pregnant and 50 non-pregnant women were screened for the prevalence of asymptomatic bacteriuria from March 2016 to May 2017 at AL-Zahraa University Hospital and Cairo Fatemic Hospital. All the subjects were clinically identified to have no signs and symptoms of urinary tract infection. The age ranges of the study and control groups were between 18-30 years. All were subjected to bacteriological screening of mid-stream (MSU). Results: Revealed that 4/100(14%) and 6/50(12%) were positive for asymptomatic bacteriuria in the study and control groups respectively. The most prevalent organism was the E. coli (71.4%,83.3%) in both groups respectively. Conclusion: All pregnant women should be screened for bacteriuria and subsequently treated with appropriate antibiotic therapy. Acute cystitis and pyelonephritis should be aggressively treated during pregnancy.}, keywords = {Asymptomatic bacteriuria- culture and sensitivity- urinary tract infection}, url = {https://ejhm.journals.ekb.eg/article_29171.html}, eprint = {https://ejhm.journals.ekb.eg/article_29171_28ce52d099c8c7a9bebb2a3aced488cb.pdf} } @article { author = {Safwat, Hesham Mohamed and Abulsoud, Mohamed Ebrahim and Abdelazim, Abdelazim Elsayed}, title = {Internal Fixation of Proximal Humerus Fracture by PHILOS Plate}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {75}, number = {1}, pages = {1987-1995}, year = {2019}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2019.29172}, abstract = {Background: Fractures of the proximal humerus are relatively common, accounting for about 5% to 9% of all fractions. Majority of undisplaced proximal humeral fractures can be treated with a sling immobilization and physical therapy. However, approximately 20% of displaced proximal humeral fractures require surgery. Objective: The aim of the current study was to assess the expected outcomes and complication rate of proximal humerus fractures treated with Proximal Humerus Internal Locking System (PHILOS) plating. Patients and Methods: This prospective study included a total of 15 patients with fracture of the proximal humerus attending at Department of Orthopedic Surgery, Al-Azhar University Hospitals. This study was conducted between January 2018 to October 2018. All cases were surgically managed by fracture fixation procedures (PHILOS). The follow up period of the cases is 6 months. Results: From analysis of the literature concerning the use of PHILOS plates, our results were satisfying in terms of functional recovery, with Constant Scores 73.67 that range between (48%–94%). Data from our survey show that most of patients were satisfied. We have noticed that limited functional recovery was usually caused by incorrect or delayed rehabilitation. The complication rate in our study (26.66%) is comparable to the literature, where the most recent studies report complication rates between 32 and 50%. Conclusion: More accurate length measurement and shorter screw selection should prevent primary screw perforation.}, keywords = {range of motion,PHILOS}, url = {https://ejhm.journals.ekb.eg/article_29172.html}, eprint = {https://ejhm.journals.ekb.eg/article_29172_aeec61e8b0bd10492ac19b7906e7ab11.pdf} } @article { author = {El-Ganainy, Hadeer Fahmy Ramadan and El-Mashad, Abd El-Rahman Mohamed and Shihab, Nihal Salah and Abu-Hamama, Ashraf Mohamed}, title = {Risk Factors for Neonatal Mortality in Neonatal Intensive Care Units in Tanta City}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {75}, number = {1}, pages = {1996-2006}, year = {2019}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2019.29332}, abstract = {Background: Neonatal period is the weakest period of life as it causes high rates of morbidity and mortality due to various diseases, especially in preterm infants and those with low birth weight. Aim of the present study: assessment of the risk factors and incidence of neonatal mortality in neonatal intensive care units in Tanta city. Subjects and Methods: Multi-centric prospective Cohort study that was conduct in Neonatal Intensive Care Units in Tanta city (5 public centers and 10 private centers). The duration was 6 months from August 2017 to January 2018. Results: Incidence of neonatal mortality among the studied sample during a period of six months was 27.7%. The most common cause of neonatal deaths was prematurity (39.4%). Cesarean section was the highest maternal risk factors (64.3%) among the study sample. Positive consanguinity was found in 52% and had statistically significant on neonatal mortality. There was no statistically significant difference between survived and expired neonates, while gestational age and birth weight were statistically significant. Neonatal mortality was higher between lower gestational age and lower birth weight. Conclusion: Neonatal mortality rates were found to be significantly high in prematurity, low gestational age, low birth weight, cesarean section and positive consanguinity. Improvement of health care qualities is needed to control the preventable risk factors and decrease neonatal morality.}, keywords = {neonatal mortality,Neonatal Intensive Care Units}, url = {https://ejhm.journals.ekb.eg/article_29332.html}, eprint = {https://ejhm.journals.ekb.eg/article_29332_334aad57165c5b80e3efea0d3d136dc8.pdf} } @article { author = {Elkholy, Shimaa Moawad Hamed and Abd-ElRazek, Ahmed Mohamed and ElBendary, Amal Said and Harkan, Ahmed Ibrahim}, title = {Serum Vascular Endothelial Growth Factor Levels in Asthmatic Children}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {75}, number = {1}, pages = {2007-2012}, year = {2019}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2019.29398}, abstract = {Background: Bronchial asthma is a heterogeneous disease, which is usually characterized by chronic airway inflammation. Asthma is a global problem with 300 million affected individuals. Angiogenesis has been recognized as an essential step in the development and maintenance of airway inflammation and tissue remodeling. Vascular endothelial growth factor plays a key role in both the physiological and pathophysiological forms of angiogenesis. Aim of the present study was to measure serum levels of vascular endothelial growth factor in asthmatic children to assess its relation with asthma severity. Subjects and Methods: This study was conducted on two groups, group A: 30 asthmatic children and group B: 20 healthy children of matched age and sex. Serum vascular endothelial growth factor (VEGF) levels were measured by ELISA. Results: There was no significant difference between asthmatic and control groups as regard age, sex and weight. There was significant increase in serum VEGF levels in asthmatic group than control group. There was negative correlation between VEGF serum levels and pulmonary function tests. There was positive correlation between serum VEGF levels and asthma severity. Conclusion: There were higher levels of serum VEGF in asthmatic patients than healthy control. Serum VEGF was higher in those with moderate and severe asthma than those with mild disease.}, keywords = {vascular endothelial growth factor,Asthmatic Children}, url = {https://ejhm.journals.ekb.eg/article_29398.html}, eprint = {https://ejhm.journals.ekb.eg/article_29398_ff688f938332255cc597ba90cb69ea52.pdf} } @article { author = {Dardyr, Mohamed El-Moddather Ahmed and Saliem, Emad Abdel Aal and Sabra, Hossam Ahmed}, title = {Evaluation of Vitreoretinal Changes after Nd: YAG Laser Posterior Capsulotomy}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {75}, number = {1}, pages = {2013-2019}, year = {2019}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2019.29333}, abstract = {Objective: To evaluate the vitreoretinal changes after Neodymium-Yttrium-Aluminum-Garnet (Nd: YAG) laser posterior capsulotomy in patients with posterior capsular opacification after cataract extraction. Patients and Methods: 60 pseudophakic eyes of 50 patients with opacified posterior capsule after uncomplicated cataract surgery treated by Nd: YAG laser posterior capsulotomy. Patients were divided according to the preoperative refractive state of the eye into three groups (Myopic, Hypermetropic, and Emmetropic). Vitreoretinal assessment was done pre and post YAG capsulotomy. Results: The mean best corrected visual acuity (BCVA) had improved after YAG laser posterior capsulotomy in all groups (p < 0.001). Although there was no significant correlation between the refractive state of the eye and changes in CMT measured by optical coherence tomography (OCT) (p < 0.096), however, there was a statistically significant increase in CMT before and one week after YAG posterior capsulotomy (p < 0.001) without any detectable clinical effect on the BCVA. Conclusion: Nd: YAG laser posterior capsulotomy is the standard treatment for posterior capsular opacification [PCO] and gives rise to rapid improvement in visual acuity relieving the symptoms of blurring, photophobia, and glare.}, keywords = {Capsular Opacification,Vitreoretinal changes,Nd: YAG laser posterior Capsulotomy}, url = {https://ejhm.journals.ekb.eg/article_29333.html}, eprint = {https://ejhm.journals.ekb.eg/article_29333_e2f5b9e68192c164e3f35c96f765069d.pdf} } @article { author = {Anwar, Mohamed Hesham Hassan and Abu Shady, Yousef and Abdel-Aziz, Bassem Ragab and Ashour, AbdelHalim Esmail Esmail}, title = {Doppler Characteristics of Subendometrium and Uterine Hemodynamic Changes in Patients with Copper Intrauterine Device-induced Bleeding}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {75}, number = {1}, pages = {2020-2025}, year = {2019}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2019.29334}, abstract = {Background: The intrauterine contraceptive device is one of the most frequently used method of contraception allover the world. The most important adverse effects related to copper intrauterine contraceptive device use are excessive uterine bleeding and menstrual pain which are responsible for 5-15% removal rate of IUD during the first year of its insertion. Objectives: The aim of the present study is to evaluate subendometrial blood flow in cases of menorrhagia after copper IUCD insertion in comparison to cases using IUCD and not complaining of abnormal uterine bleeding. Patients and Methods: This study included 200 women; divided into two groups. Group I; included 100 women using copper intrauterine device and complaining of menorrhagia, Group II; included 100 women using copper IUD and not complaining of abnormal uterine bleeding. Results: As regard to Doppler findings, it was noted that PI, RI of uterine arteries were significantly lower in group I in comparison to group II (p value <0.001), and by power Doppler energy women in group I with menorrhagia had a significant increase in subendometrial blood flow according to the subendometrial signal area percentage in comparison with women in group II using copper IUD and not complaining of abnormal uterine bleeding (control group). Conclusion: The results of our study revealed that uterine artery and subendometrial blood flow were increased in women with copper IUD induced menorrhagia in comparison to women with copper IUD and not complaining of abnormal uterine bleeding}, keywords = {Doppler,Subendometrium,Uterine Hemodynamic,Copper Intrauterine Device-induced Bleeding}, url = {https://ejhm.journals.ekb.eg/article_29334.html}, eprint = {https://ejhm.journals.ekb.eg/article_29334_d1e75aa4ca63fe49734852fbb3a22f14.pdf} } @article { author = {Fawzy, Olfat A. and Mahmoud, Eman and Attia, leaW M. and Ibrahim, Ahmed M.}, title = {One Year Randomized Study of L-Thyroxin Treatment in Women with Subclinical Hypothyroidism}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {75}, number = {1}, pages = {2026-2035}, year = {2019}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2019.29941}, abstract = {Introduction: Subclinical hypothyroidism (SCH) is a laboratory finding which may be asymptomatic or associated with signs and symptoms of hypothyroidism. However, benefits of L-Thyroxin (LT4) treatment are not well established. Aim of the Work: The aim of the study was to evaluate the impact of treatment of SCH on thyroid clinical scores, bone mineral density (BMD), cardiac function and health related quality of life (HR-QOL). Subjects and Methods: a total number of 65 women, who were diagnosed with SCH, constituted the study subjects. They were within the age range of 40-70 years. They were randomly divided into two groups (group I, included 25 patients who were treated with L Thyroxin (L-T4), and group II included 40 women with SCH who were not treated and kept under follow up for one year. Effects of L-T4 treatment on BMI, cardiac function, BMD, lipid profile, thyroid clinical score and HR-QOL were assessed. Results: After one year; regarding body mass index (BMI), Group II had significantly higher BMI (p=0.006) though the percentage change of BMI after one year was comparable in the two groups. Total thyroid clinical score and the total HR-QOL score were significantly lower in Group I compared to group II (p < 0.001). Regarding thyroid hormone profile; free T4 was significantly higher and thyroid stimulating hormone (TSH) was significantly lower in-group I compared to group II (p=0.033 & p < 0.001 respectively). Conclusion: LT4 treatment for women with SCH was found to improve total clinical thyroid score, HR-QOL, systolic and diastolic dysfunction besides lowering TC, LDL and TG levels. However, there was evidence of bone loss in patients with SCH treated with L-T4. Thus, decision to treat or not should be individualized according to the patient’s risk benefit ratio assessment.}, keywords = {subclinical hypothyroidism,Thyroid Clinical Score,Diastolic Dysfunction,Health related quality of life}, url = {https://ejhm.journals.ekb.eg/article_29941.html}, eprint = {https://ejhm.journals.ekb.eg/article_29941_e1427e2e6b19685ad516bd80919849b5.pdf} } @article { author = {Mohammed, Asmaa A. and Abdelrahman, Heba M. and Aly, Mona M.}, title = {Evaluation of Choroidal Changes During Pregnancy}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {75}, number = {1}, pages = {2036-2042}, year = {2019}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2019.29335}, abstract = {Background: During pregnancy, various physiological changes occur in almost all organs of the body including the eyes. Increased blood volume and cardiac output results in ocular blood flow increase. Consequently, the choroid is a highly vascular tissue; any local or systemic pathology affecting the vasculature could also affect the choroid. Objective: The aim of the study was to report and evaluate choroidal changes in healthy pregnant women, pregnant women with gestational diabetes mellitus (GDM), and pregnant women with gestational hypertension (GH) and to compare the measured parameters with those of healthy non-pregnant women. Patients and Methods: This prospective comparative study comprised 180 eyes of 90 women divided into 4 groups; Group 1(control): 30 healthy non-pregnant females, Group 2 (Low risk pregnancy): 30 healthy pregnant females ≥ 24 weeks of gestation, Group 3 and 4 (high risk pregnancy): each consisted of 15 pregnant females ≥ 24 weeks of gestation with GDM or GH. All four groups were age-matched. Choroidal thickness (CT) was measured using enhanced depth imaging spectral domain optical coherence tomography at seven different locations. Results: CT increased significantly in healthy pregnant females (third trimester) compared to control group and decreased significantly in high risk pregnant females compared to healthy pregnant and non-pregnant females. Conclusion: Reporting changes in CT during pregnancy may give valuable data to interpret pregnancy-related ocular pathologies.}, keywords = {choroidal thickness,Pregnancy,enhanced depth imaging optical coherence tomography}, url = {https://ejhm.journals.ekb.eg/article_29335.html}, eprint = {https://ejhm.journals.ekb.eg/article_29335_ca09af1c4d8b36ef130fdb8538acc0de.pdf} } @article { author = {Hammouda, Ismail and Sedeek, Mahmoud and Fadel, Ahmed Ali}, title = {Closed Reduction and Percutaneous Pinning in Management of Epiphyseal Injury of Distal Radius in Children}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {75}, number = {1}, pages = {2043-2047}, year = {2019}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2019.29336}, abstract = {Background: The goals of management of a displaced epiphyseal fracture of distal radius are to recover full function in a cosmetically normal wrist and elbow and avoidance of complication. The commonly accepted treatment in children is fracture reduction and percutaneous pin fixation. Objectives: Study of the results of treatment of displaced epiphyseal fractures of distal radius in children by closed reduction and percutaneous fixation by K-wires. Materials and Methods: Twenty-five children were treated by this method. Most of them were displaced dorsal and the others were displaced volar according to the directional displacement. The cases were examined clinically and radiologically at first. Twenty cases were operated in the same day and five cases were delayed because of sever edema. Results: the results were assessed both functionally and cosmetically according to evaluation of elbow, wrist function, pronation and supination and residual deformity. The overall results obtained were satisfactory with treatment by closed reduction and percutaneous pinning. Conclusion: we suggest that children who initially have a completely displaced fracture of the distal radius should be manipulated under general anesthesia and recommend that percutaneous K-wire fixation be used to ensure stabilization and avoid redisplacement, even when a perfect closed reduction has been achieved.}, keywords = {Percutaneous Pinning,Epiphyseal Injury,Distal Radius}, url = {https://ejhm.journals.ekb.eg/article_29336.html}, eprint = {https://ejhm.journals.ekb.eg/article_29336_a9f403c443f66c7244fe9c48efeba007.pdf} } @article { author = {Abdel Mawla, Tamer Sayed Mohamed and Abdel Hameed, Asmaa Mizar and Zaky, Sherif Hamed and El Khashab, Khaled Ahmed}, title = {Fragmented QRS and Ventricular Arrhythmias in Coroary Artery Disease Patients}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {75}, number = {1}, pages = {2048-2053}, year = {2019}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2019.29713}, abstract = {Background: Fragmented QRS represents myocardial scar and will be associated with ventricular dysfunction and occurrence of congestive heart failure. In CAD, fQRS represents prior occurrence of myocardial infarction and will have a risk of subsequent occurrence of ischemic events. Objective: in our study we aimed to determine whether fragmented QRS (fQRS) is associated with increased incidence of ventricular arrhythmias in patients with coronary artery disease (CAD) or not . Patients and Methods: one hundred patients with CAD were included. Patients were divided into two groups according to presence or absence of fQRS on admission ECG. Group 1 (n=50) was defined as a fQRS (+ve) and group 2 (n=50) was defined as a fQRS (-ve). All patients were subjected to full history taking, complete physical examination, ECG, echocardiography and laboratory investigations. Results: There was higher incidence of fQRS in hypertensive patients (72%). FQRS was found to be associated with increased incidence of ventricular arrhythmias, 52% in group 1 versus 24% in group II. EF % was significantly lower in group I than in group 2 with p value 0.03. Fragmented QRS was an independent predictor of all-cause mortality with p value 0.02. Conclusion: fQRS on the resting surface electrocardiogram is a simple, fast and inexpensive modality of noninvasive investigation for evaluation of CAD patients. Patients who have known CAD present with a fQRS have an increased rate of ventricular tachyarrhythmias, death risk, and low ejection fraction.}, keywords = {fragmented QRS,Coronary Artery Disease,Ventricular arrhythmia,mortality}, url = {https://ejhm.journals.ekb.eg/article_29713.html}, eprint = {https://ejhm.journals.ekb.eg/article_29713_5ff412fb19f14ac21141338136ea2291.pdf} } @article { author = {Elgarhy, Ismael Mohammed and Rammah, Ahmed Mohammed and Bakry, Mohammed Mohammed Saber}, title = {Comparison of ICSI Outcomes in Patients with Hydrosalpinx Pretreated with Either Laparoscopic Tubal Disconnection or Hysteroscopic Tubal Occlusion}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {75}, number = {1}, pages = {2054-2058}, year = {2019}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2019.29714}, abstract = {The aim of the study was to compare the efficacy of hysteroscopic tubal electrocoagulation versus laparoscopic tubal disconnection for management of hydrosalpinx related infertility among patients undergoing ICSI. The sample of the study was 100 patients. Half of the patients underwent hysteroscopic tubal electocoagulation who have laparoscopic contraindications, while the other half underwent laparoscopic tubal disconnection. After tubal occlusion was done, an ICSI cycle was startedwith assessment of chemical pregnancy rate. The rate of positive chemical pregnancy was 50 % in hysteroscopic group and 58% in laparoscopic group, so hysteroscopic tubal electrocoagulation was found to be a successful treatment for hydrosalpinges before ICSI when laparoscopy is contraindicated with chemical pregnancy rate comparable to laparoscopic tubal disconnection.}, keywords = {Hydrosalpinx,Hysteroscopy,Infertility,Invitrofertilization,Laparoscopy}, url = {https://ejhm.journals.ekb.eg/article_29714.html}, eprint = {https://ejhm.journals.ekb.eg/article_29714_3ec16db194be550e63a8bada564c2176.pdf} } @article { author = {El-Zayat, Tarek Mohamed and Elfeshawy, Mohamed Salah and Khashaba, Ahmed Hassan and Abd El-Raouf, Mohamed Ezzat}, title = {Role of CT and MRI in Assessment of Temporal Bone Pre and Post Cochlear Implantation}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {75}, number = {1}, pages = {2059-2063}, year = {2019}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2019.29724}, abstract = {Background: MDCT and MRI plays a critical role in evaluation and management of different causes of hearing loss which require many therapeutic techniques including cochlear implantation. MDCT has proven its efficacy in the postoperative imaging of cochlear implant patients. CT confirms the intracochlear position of the implant. It has also been shown that malpositioning and kinking can be detected by CT imaging. Aim of the Work: To evaluate the role of various imaging modalities (CT and MRI) in pre and postoperative evaluation of cochlear implant candidates. Patients and Methods: The study included a total of 20 patients referred to the Radiodiagnosis Department from the E.N.T Department in EL-Galaa Military Hospital. The patients had bilateral severe to profound sensorineural hearing loss (SNHL). CT and MRI were done for assessment of the cochlear state prior to the cochlear implantation operation. Postoperative CT was done to underline the position of implanted electrode. Results: The study was performed on 8 males (40%) and 12 females (60%). Only 17 patients (85%) underwent cochlear implantation, the other 3 cases (15%) were diagnosed as Michel deformity, Cochlear hypoplasia and Labyrinthine ossificans. Full electrode array insertion was reported in all cases underwent of cochlear implantation. Conclusion: Preoperative CT and MRI assessment is critical for determining implant candidacy. Postoperative CT confirms the intracochlear position of the implant}, keywords = {CT,MRI,temporal bone,petrous,Cochlear implantation,Preoperative,Postoperative}, url = {https://ejhm.journals.ekb.eg/article_29724.html}, eprint = {https://ejhm.journals.ekb.eg/article_29724_26fa9c575f50928dab1e84bae8287c2b.pdf} } @article { author = {Rezk, Abdelaziz and Sarhan, Mohamed and Elmoghl, Ahmed}, title = {Highly-Sensitive C-reactive Protein Level and its Association with Intermediate and High Syntax Score in cases of Acute Coronary Syndrome}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {75}, number = {1}, pages = {2064-2070}, year = {2019}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2019.29715}, abstract = {Background: Highly-Sensitive C-reactive Protein (hs-CRP) levels are associated with short- and long-term mortality in patients with acute coronary syndrome (ACS). Aim: We investigated if baseline hs-CRP levels are correlated with burden of coronary atherosclerosis assessed by SYNTAX score (SXScore). Subjects and methods: We investigated 200 patients with ACS who underwent coronary angiography. The patients were divided into groups based on their SXScore: low SXScore (≤ 22), and intermediate-high SXScore (≥ 23). Results: Patients in the intermediate-high SXScore group had higher serum hs-CRP levels in comparison to low SXScore group (4.61 ±1.54 mg/dL versus 2.37 ± 0.66 mg/dL, P < 0.001). The mean age of patients and prevalence of diabetes in the intermediate-high SXScore group were statistically insignificantly than in the low SXScore group. Left ventricular ejection fraction (LVEF) was significantly lower in the patients with an intermediate-high SXScore (41±9 %) compared to low SXScore tertiles (50±8 %) (P< 0.001). There was significant correlation between the hs-crp levels and the syntax score. The correlation coefficient (r) = 0.567, also p value was significant p=0.0001. Consecutively hs-CRP at a cut-off point of ≥ 2.5mg/L was highly sensitive (97%) and specific (41%) and was a strongly independent predictor of a high SXScore in patients with ACS. Where accuracy of test was (acc= 0.94). Conclusion: It is believed that serum levels of hs-CRP on admission in patients with ACS thought to be a strong predictor of the severity and complexity of coronary atherosclerosis together with multivessel disease, and LVEF.}, keywords = {Inflammation,Severity of atherosclerosis,Coronary Artery Disease}, url = {https://ejhm.journals.ekb.eg/article_29715.html}, eprint = {https://ejhm.journals.ekb.eg/article_29715_358c1cf5023a2ca9cc111aa55cd36e5d.pdf} } @article { author = {Mostafa, Mostafa M. and Mostafa, Magdy M. and Hablas, Wael R. and El-Kordy, Mohammed A.}, title = {Comparative Study between Effect of Sleeve Gastrectomy and Mini-Gastric Bypass on Weight Loss and Improvement of Co-Morbidities}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {75}, number = {1}, pages = {2071-2080}, year = {2019}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2019.29718}, abstract = {Background: sleeve gastrectomy (SG) is one of the most popular procedures in the world. SG is a technically less complex procedure with short learning curve and effective weight loss, but it suffers from two outstanding disadvantages including high risk of weight regain and gastro- esophageal reflux disease (GERD). Mini-gastric bypass (MGB), also known as single anastomosis gastric bypass or omega gastric bypass, is a newly emerged procedure. Due to safe and simple process as well as effective outcomes, MGB has quickly become one of the most popular procedures in many countries. Patients & Methods: the study included 60morbidly obese patients that were assigned to two equal groups as regards to the operation they underwent either Laparoscopic MGB or Laparoscopic SG. The primary outcome measured was change in weight and BMI. The secondary outcome was improvement of other co-morbidities like DM and lipid profile. Patients were followed up to 12 months after operation. Results & Conclusion: after prospectively comparing the two procedures for a year, almost both procedures have near same effect on loss of weight and resolving or better control on co-morbidities as DM, and HTN. However, MGB patients in need for multi-vitamins and minerals costing more than 1500 Egyptian pounds per month. The statistical differences observed as regards to BMI, LDL and HDL are still clinically insignificant. So, the recommendation for Egyptian patient whatever their morbid obesity scale is Sleeve Gastrectomy except for patient complaining of GERD, they should undergo MGB, as the results showed better resolution for their complain postoperatively.}, keywords = {}, url = {https://ejhm.journals.ekb.eg/article_29718.html}, eprint = {https://ejhm.journals.ekb.eg/article_29718_cf572394fd165b12306e755fb1e5877c.pdf} } @article { author = {Khalifa, Abd-Alsameea Hassan and Farahat, Mohamed Mohamed Ibrahim and Mohamed, Ahmed Fadel Abdel Hameed}, title = {The Effects of Vitamin D Supplement on Prevention of Recurrence of Preeclampsia in Pregnant Women with a History of Preeclampsia}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {75}, number = {1}, pages = {2081-2088}, year = {2019}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2019.29719}, abstract = {Background: Many studies hypothesized a strong relation between vitamin D level during pregnancy and the frequency of recurrent preeclampsia (PE). Objectives: The aim of the current study was to determine the effect of vitamin D supplement on reducing the probability of recurrent preeclampsia in pregnant women with history of preeclampsia. Patients and Methods: The study population included 50 women having a history of preeclampsia in previous pregnancies. They were referred to the obstetrical clinic in Diarb Negm Centeral Hospital in Diarb Negm City, for prenatal care. Women were classified into two groups, the first one (I) received 25-hydroxy vitamin D supplements and the other (II) received placebo. Results: Eight patients had pre-eclampsia in group II (34.8%) while in group I only 4 patients had preeclampsia (16%) (p=0.133). There were no significant statistical differences between the two groups according to pre-eclampsia incidence. The mean vitamin D level was 25.72 ± 7.69 and 28.33 ± 7.40 among patients without and with preeclampsia respectively. (p=0.309) there were no significant relation between the preeclampsia incidence and vitamin D level. Conclusion: vitamin D supplement may not have a role in prevention of preeclampsia recurrence.}, keywords = {preeclampsia,Vitamin D,Eclampsia}, url = {https://ejhm.journals.ekb.eg/article_29719.html}, eprint = {https://ejhm.journals.ekb.eg/article_29719_9795f8f9eff1d077e860a3833196c3d6.pdf} } @article { author = {Kornah, Bahaa Ali and Negm, Mohamed Abd Elmoneam and Megahed, Mohamed Ahmed Mustafa}, title = {Short Term Outcomes of Non-Surfacing Patelloplasty in Primary Total Knee Arthroplasty}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {75}, number = {1}, pages = {2089-2091}, year = {2019}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2019.29720}, abstract = {Background: The management of the patella during primary total knee arthroplasty (TKA) is controversial. The most common methods of treating the patella in TKA are patellar resurfacing and non-surfacing patelloplasty. Objectives: The aim of this study was to assess short term outcomes of non-surfacing patelloplasty in primary total knee arthroplasty. Patient and methods: This study included a total of twenty patients who had primary total knee arthroplasty for degenerative or inflammatory arthritis accompanied with moderate to severe patellofemoral arthritis attending at Al-Azhar University Hospitals. Patelloplasty was done in the form of excision of peripatellar synovial tissues, osteophytectomy and denervation of patellar rim using electro-cautery and smoothing of the articular surface by oscillating saw. Results: All patients were examined using a new patellofemoral scoring system,after one year follow up after total knee arthroplasty (TKA) the end result was: 14 patients were very satisfied, while 5 patients had mild to moderate anterior knee pain, tolerated by analgesics on demand and physiotherapy. Only one case had severe pain and secondary resurfacing was done about 6 months postoperatively, the patient was satisfied, and the pain became mild. Discussion: Total knee arthroplasty (TKA) is one of the most commonly performed operations in adult reconstructive surgery. The management of the patella in primary TKA remains controversial. The approaches available for patellar management in TKA are non-resurfacing patelloplasty, and selective resurfacing. Conclusion: It is recommended to do patelloplasty without resurfacing of the patella as this technique has fewer hazards and complications.}, keywords = {anterior knee pain,patellar denervation,patelloplasty,total knee arthroplasty}, url = {https://ejhm.journals.ekb.eg/article_29720.html}, eprint = {https://ejhm.journals.ekb.eg/article_29720_9ed2d2e127cac27392cfd9b7fd39595f.pdf} } @article { author = {El-Sakka, Safaa Shebl and Hussein, Mervat Ismail and El-Barbary, Amal Mohamad and Rehan, Fahema Saad}, title = {The Effect of Shock Wave Therapy as a New Modality for Treatment of Primary Knee Osteoarthritis}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {75}, number = {1}, pages = {2092-2097}, year = {2019}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2019.29721}, abstract = {Background: osteoarthritis, the most common form of arthritis, is a chronic disease characterized by slow degradation of cartilage, pain, and increasing disability. Objective: to study the effect of shock wave therapy in treatment of primary knee osteoarthritis. Patients and Methods: thirty patients with primary knee osteoarthritis were classified equally into 2 groups according to the line of treatment; Group I received extra-corporeal shock wave therapy and Group II received continuous ultrasonic waves. Patients were evaluated for pain using visual analogue scale, active range of motion, and physical and functional assessment. Bilateral anteroposterior weight bearing radiographs were done for all patients before treatment and degree of osteoarthritis was assessed by Kallgren and Lawrence Radiographic criteria. Results: there was significant improvement in group I more than group II (as regard to pain assessed by visual analogue scale (VAS) after treatment (p=0.039) and in follow up (p <0.001). There was significant improvement in morning stiffness in both groups with insignificant difference between both them. Regarding active range of motion (ROM), there was significant improvement in flexion in both groups with significant difference between both groups before and after treatment (p =0.001) and in follow up (p <0.001). Regarding chair stand test, there was significant improvement in both groups with in significant difference between them. Regarding stair climb test (SCT), there was significant improvement in both groups with insignificant difference between them. Conclusions: shock wave had an effect in treatment of primary knee OA as a new modality for improving clinical and functional performance.}, keywords = {Primary knee osteoarthritis,shock wave therapy,therapeutic ultrasound}, url = {https://ejhm.journals.ekb.eg/article_29721.html}, eprint = {https://ejhm.journals.ekb.eg/article_29721_f2616ff770d6aa18413f9d255a061030.pdf} } @article { author = {Youssef, Mohamed Ahmed and Dawoud, Mohamed Fathy and Abdelaziz, Lamiss Mohamed and Elsheikh, Mostafa Hussein}, title = {Comparative Study of Positron Emission Tomography /Computed Tomography and Whole-Body Bone Scanning for Detecting Bone Metastasis in Patients with Breast Cancer}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {75}, number = {1}, pages = {2098-2104}, year = {2019}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2019.29722}, abstract = {Objective: the aim of this study was to compare the role of PET/CT & bone scintigraphy in detection of bone metastasis in patients with breast cancer. Patients and methods: The present study included 30 patients with breast cancer. Their ages ranged between 25years and 65 years with mean age of 45 years old. All patients were subjected to full history taking, clinical breast examination, histopathology investigation, 99mTc-MDP Whole body bone scan, whole body positron emission tomography / computed tomography (FDG- PET/CT). Results: on patient-based analysis in this study thirty patients were examined with bone scintigraphy and FDGPET/CT. only 24 (80%) were detected by FDG-PET/CT had metastasis compared by only 18 (60%) patients detected by bone scintigraphy. On lesion-based analysis in this study 71 lesions detected by FDG-PET/CT (positive 50 lesions (70.42%) - negative 21 lesions (29.58%), compared by 62 lesions detected by bone scintigraphy (positive 43 lesions (69.35%) – negative 19 lesions (30.65%). Conclusion: whole-body FDG-PET/CT is more sensitive and equally specific for the detection of bone metastases compared with bone scintigraphy. Both bone scintigraphy and FDG-PET/CT give false-positive results due to various common benign bone processes which are the most disadvantages of both modalities.}, keywords = {PET/CT,Bone scintigraphy,bone metastasis,breast cancer}, url = {https://ejhm.journals.ekb.eg/article_29722.html}, eprint = {https://ejhm.journals.ekb.eg/article_29722_7bba2df5acb0ea879c6422ef2870d597.pdf} } @article { author = {El Nemr, Selim and Reda, Mahmoud and Hashish, Mahmoud and Amir, Hossam}, title = {Assessment of Hypocalcemia Following Total Thyroidectomy for Benign Thyroid Lesions: To Be Continued or Not?}, journal = {The Egyptian Journal of Hospital Medicine}, volume = {75}, number = {1}, pages = {2105-2111}, year = {2019}, publisher = {Pan Arab League of Continuous Medical Education}, issn = {1687-2002}, eissn = {2090-7125}, doi = {10.21608/ejhm.2019.29725}, abstract = {Background: Thyroidectomy is one of the most common operations performed worldwide by various surgeons whether general or endocrine surgeons. The rate of complications following thyroidectomy has been progressively decreasing yet it still carries significant morbidity if preoperative preparation and patient as well as procedure selection were not optimized. Objective: This study was designed to evaluate the problem of hypoparathyroidism following thyroid surgery and to assess the use of parathyroid hormone (PTH) level to predict patients with risk of postoperative hypocalcemia. Through this study, it was sought that we could reach a recommendation to rely on the routine technique of total thyroidectomy and utilization of PTH assay to allow for a safe and timely discharge of patients with normocalcemia and for the early identification of patients requiring treatment of post thyroidectomy hypocalcemia. Patients and Methods: This prospective study included 50 patients from two different hospitals undergoing total thyroidectomy to evaluate the efficacy of postoperative serum PTH and calcium (Ca) levels as an early and accurate predictor of post-thyroidectomy hypocalcemia. Ionized serum calcium as well as PTH were measured for each patient preoperatively, intraoperatively (just after skin closure), at every day postoperative when patient admitted and after one month in patients with hypocalcemia. Results: Our results showed an overall incidence of 18% of hypocalcemia after total thyroidectomy. Of them, only 6% developed symptomatic hypocalcemia. Transient hypocalcemia occurred in 4% of patients while permanent hypocalcemia affected 2%. Conclusion: Serum calcium concentrations have been the basis of identification of post-operative hypocalcemia, however this has been replaced by PTH levels being more sensitive and specific to the early prediction of transient as well as permanent hypocalcemia. Postoperative PTH; also known as quick PTH assay, level of < 12 pg/ml was found to have an overall accuracy of 98% in early prediction of permanent hypocalcemia in our study.}, keywords = {Hypocalcemia Post Total Thyroidectomy,Benign Thyroid Lesions}, url = {https://ejhm.journals.ekb.eg/article_29725.html}, eprint = {https://ejhm.journals.ekb.eg/article_29725_c524d56baed0d5faab6e20d093eff1cd.pdf} }