eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
39
1
140
153
10.21608/ejhm.2018.16958
16958
Original Article
HISTOLOGICAL AND ENZYME HISTOCHEMICAL STUDIES ON THE TRANSITIONAL
Nora Ahmed Obaid Al-kaabi
1
Dep. Of Biology, College of Science for Girls, Dammam University, Dammam, Saudi Arabia
The present work was carried out using twenty mature Epinephelus tauvina (Perciforms: Serranidae) collected from Arabian Gulf coast at Dammam City. Fishes of this species are known to undergo sex change during certain stage of their life cycle. Histological and enzyme histochemical studies were performed on gonads of the collected fishes. The examination of the gonads of E. tauvina revealed the presence of three developmental phases during the sex change process. These were: Female, early transition phase and late transition phase each one may subdivide into two stages. In female phase several developmental stages of the oocytes were recognized. At the beginning of early transition phase perinucleolar mature oocytes began degeneration while late transition phase characterized by rapid proliferation of spermatogenic cells. The histochemical studies demonstrated that alkaline phosphatase enzyme gave intense reaction in granulosa cells of mature oocytes while acid phosphatase gave an intense reaction in the interstitial cells and atretic follicles but ∆5 –3β hydroxysteroid dehydrogenase enzyme gave intense reaction to special cells in capsule of gonads.
https://ejhm.journals.ekb.eg/article_16958_9f7c16877e8d5e7dbb6dd939faec715c.pdf
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
39
1
154
163
10.21608/ejhm.2018.16959
16959
Original Article
Association of factor V Leiden mutation with deep vein thrombosis among Egyptian cases
Sherif H. Abdeen
1
Rizk El-Baz
2
Ahmad Settin
3
Wessam El-Gazar
4
Zoology Department, Faculty of Science, Mansoura University
Genetics Unit, Faculty of Medicine, Mansoura University
Genetics Unit, Faculty of Medicine, Mansoura University
Zoology Department, Faculty of Science, Mansoura University
Background: Deep vein thrombosis (DVT) is a blood clot in a major vein, usually in the legs and/or pelvis. If part of the thrombus breaks off, it becomes an embolism, which can travel through the heart and block the arteries to the lungs. Factor V Leiden (FVL) is a common genetic risk factor for hereditary hypercoagulability disorder in several populations. The present study investigates the association of FVL mutation with DVT among Egyptian cases.
Patients & methods: The study included 44 cases (16 males and 28 females) with an age range of 20 to 80 years in addition to 211 healthy unrelated controls of matched age and sex. A multiplex allele-specific PCR amplification was conducted for assignment of FVL gene mutation (G1691A).
Results: Cases having the mutant allele A (AA and AG genotypes) were significantly higher than controls (38.6% vs. 18.5%; P < 0.05, OR= 2.78 and CI 95%, 1.380–5.589). Conclusion: These results concluded that FVL mutation has a high frequency and positive association with the occurrence of deep vein thrombosis among Egyptian cases.
https://ejhm.journals.ekb.eg/article_16959_abdfc719a82fc687ed4ee7c2c31bcb94.pdf
factor V Leiden mutation
Deep Vein Thrombosis
Egyptian population
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
39
1
164
180
10.21608/ejhm.2018.16960
16960
Original Article
LARYNGEAL CANCER:QUALITY OF LIFE AMONG PATIENTS UNDERWENT TOTAL LARYNGECTOMY
E. A. EL-MOSELHY
1
T. M. FARGHALY
2
Y. M. SALEH
3
Departments of Community Medicine and Ear, Nose & Throat Faculty of Medicine - Al-Azhar University
Departments of Community Medicine and Ear, Nose & Throat Faculty of Medicine - Al-Azhar University
Departments of Community Medicine and Ear, Nose & Throat Faculty of Medicine - Al-Azhar University
Introduction: Laryngeal cancer is an important health problem causing negative effects on patients’ quality of life (QOL). Objectives: The aim of this research is to study QOL of the patients with laryngeal cancer who underwent TL, laryngectomees, and to study impact of early speech restoration on QOL of these patients. Subjects and methods: A case-control, hospital- based study design was used. A total number of 90 laryngectomees and a control group of the same number were enrolled in this research. Results: The laryngectomees had a significantly poorer self-reported health-related QOL domain scores than the controls on all eight Short Form (SF)-36 domains (P=0.000). Also, the laryngectomees with primary/secondary tracheoesophageal puncture (TEP) had significantly poorer self-reported health-related QOL domain scores than the controls on all eight SF-36 domains (P=0.000). Further, patients with primary TEP had significantly higher self-reported health-related QOL domain scores than the patients with secondary TEP on the social functioning, emotional limitation and mental health domain scores of SF-36 QOL with statistically significant differences (P=0.003, 0.006 and 0.019; respectively). Conclusions: Voice restoration is an important essentiality for the laryngectomees. Primary TEP is preferred over secondary TEP. Recommendations: More studies are needed on large number of patients to understand the impact of the laryngeal cancer and consequent of its therapy on QOL of these patients on short and long term.
https://ejhm.journals.ekb.eg/article_16960_0e7dd4255c269bc479222064ac765ec3.pdf
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
39
1
181
188
10.21608/ejhm.2018.16961
16961
Original Article
Topical corticosteroid drops in the management of dry eye
Mohamed A. Bragheeth
1
Mohamed I El-Kasaby
2
Division of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Division of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
To evaluate the efficacy and safety of topical corticosteroid drops for treatment of moderate to severe dry eye cases.
Methods:
Fifty eyes of 25 dry eye patients, who were unresponsive to artificial tears only, were treated with 0.1% fluorometholone eye drops for one week. Subjective symptoms scoring, evaluation of conjunctival hyperemia, tears break-up time (BUT), vital staining scores, and Schirmer test 1 were performed before starting steroid drops and at 1 week and 1 month after treatment.
Results:
All the patients had fewer symptoms as early as one week after topical steroid drops use. Objective tests were improved in all dry eye patients 1 month after treatment, and the difference was significant. Hyperemia of the conjunctiva was relieved obviously one month after treatment (P<0.05). The mean value of BUT increased from (5.13±1.82 sec.) before treatment to (6.57±1.85 sec.) at one month. The mean value of Schirmer test I was (4.63±0.94) mm/5 min. increased to (7.12±1.83) mm/5 min one month after topical steroid drops use (P<0.05). No complications were observed.
Conclusion:
Short course of topical corticosteroid drops can rapidly and effectively relieve the symptoms and signs of moderate or severe dry eye.
https://ejhm.journals.ekb.eg/article_16961_6930b897d60c5b06815c6810c78a6eed.pdf
Steroid drops and dry eye
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
39
1
189
196
10.21608/ejhm.2018.16962
16962
Original Article
Transdermal Nitroglycerin Enhances Lidocaine And Neostigmine for Intravenous Anesthesia in Patients Undergoing Hand Surgery. A Prospective Randomized Double Blind Placebo Control Study.
Osama Farouk
1
Jamal Shahin
2
Amr Mokhtar
3
Hassan Abudaleh
4
Mohammed Abdelkawy
5
King Abdulaziz Naval Base Hospital, Jubail, KSA.
King Abdulaziz Naval Base Hospital, Jubail, KSA.
King Abdulaziz Naval Base Hospital, Jubail, KSA.
Department of Anesthesia and the Department of Orthopedics
Department of Anesthesia and the Department of Orthopedics
In a prospective randomized blind study, we investigated the effects of adding transdermal nitroglycerine for lidocaine and neostigmine for intravenous regional anesthesia in adult patients undergoing hand surgery.
Patients and Methods
Sixty patients (ASA grade I, aged 20-60 years) of both sexes were enrolled. The patients were randomly allocated to receive either 40ml of 0.5% lidocaine plus a transdermal placebo patch (control group n=15), 40ml of 0.5% lidocaine with 0.5mg of neostigmine plus a transdermal placebo patch (Neostigmine group, n=15), 40ml of 0.8% lidocaine plus a transdermal nitroglycerine patch (Nitroglycerine group, n=15) or 40ml of 0.5% lidocaine with 0.5mg of neostigmine plus a transdermal nitroglycerine patch (Neostigmine - Nitroglycerine group, n=15). All routine hemodynamic parameters and O2 saturation were monitored, surgical time, sensory and motor block onset times, sensory and motor block recovery times and time to first analgesic requirement were measured. Operative conditions and quality of anesthesia were also recorded.
Results
Sensory and motor block onset times were shorter in the neostigmine – nitroglycerine group compared with all other groups (p<0.05). Sensory block recovery time was significantly prolonged and the quality of anesthesia was better in the neostigmine – nitroglycerine group compared with all other groups (p<0.05).
Conclusion
We found that the addition of 0.5mg neostigmine to 40ml of 0.5% lidocaine for intravenous regional anesthesia with a 5mg transdermal nitroglycerine patch improved the operating conditions and quality of anesthesia and prolonged postoperative relief with no adverse effects.
https://ejhm.journals.ekb.eg/article_16962_f20b4bd95dcfb1daac3ced134b9cd1b0.pdf
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
39
1
197
207
10.21608/ejhm.2018.16963
16963
Original Article
Chronic Hepatitis C Virus (HCV)-associated Cryoglobulinemia and its possible impact on the skin in Egyptian Patients
Amin Mohamed Abd El Baki
1
Mohamed A. Ezzel Arab
2
Nabil Abd El Mageed
3
Tropical Medicine Department, National Hepatology and Tropical Medicine Research Institute
Internal Medicine Department, National Hepatology and Tropical Medicine Research Institute
Dermatology Department,National Hepatology and Tropical Medicine Research Institute.
Background: Chronic hepatitis C virus (HCV) infection may have extremely variable clinical consequences
and is more than just a liver disease; it has been associated with numerous extra-hepatic manifestations (EHM). According to various international studies Mixed Cryoglobulinemia (MC) was found to be the most common EHM, however its local prevalence in Egyptian HCV patients was not clearly studied. The aim of our study was to investigate the frequency of cryoglobulinaemia in sera of chronic HCV patients and their association with clinical symptoms especially, vasculitis.
Method: One hundred patients with chronic HCV infection attending the outpatient clinic of the National
Hepatology and Tropical Medicine Research Institute were interviewed. Patients with decompensated liver disease, on interferon therapy, having end-stage renal disease or coexisting viral infection like hepatitis B surface antigen positive patients were all excluded from the research. All patients were subjected to general and dermatological examination for liver affection signs; cryoglobulinemia related clinical manifestations and/or associated dermatoses. Cryoglobulins, CBC, LFT. AFP, ALP, KFT, ANA and RF were assessed.
Results: Overall 15% of 100 patients were positive for presence of cryoglobulins in their sera. We found
a relatively high incidence of clinical symptoms commonly accompanying cryoglobulinemic cases in the form of Purpura, Arthralgia, Generalized weakness, Peripheral Neuropathy and Reynaud’s phenomenon with prevalence of 26.67%, 46.67%, 53.33%, 40% and 6.67% respectively. Our data also demonstrated that 46.67% (7) of our 15 cryopositive patients had concomitant skin manifestations in the form of Pruritus 40% (6) and Vasculitis 26.67% (4) (P=0.004) which was significant in comparison with prevalence of vasculitis in all patients 4.7% (4 patients). Generalized weakness and fatigue, which is the most prevalent symptoms related to Chronic Hepatitis C (CHC) patients whether positive or negative for cryoglobulinemia, were present in 52% of all patients. Other associated dermatological diseases in all patients were Lichen Planus, Psoraiasis, Urticaria, Necrolytic Acral Erythema (NAE) and Vitiligo with prevalence of (1%), (1%), (5%), (1%) and (2%) respectively. The most common dermatological disease was pruritus 36% (36) of all patients and 40% (6) in cryopositive patients. Regarding liver condition there was no significant correlation between presence of cryoglobulins and biochemical parameters. However, we found a significant correlation between presence of cryoglobulinemia and presence of ANA in sera of HCV patients with incidence of 40%) in
https://ejhm.journals.ekb.eg/article_16963_ca534cec3db27b80bb12f651385ae657.pdf
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
39
1
208
217
10.21608/ejhm.2018.16964
16964
Original Article
Clinical value of screening serum squamous cell carcinoma antigen (SCCA) for HCC
MohamedA. EzzelArab
1
MohammadA. Hassanein
2
Mohamed Hassany
3
SalahEldeenM. Ahmad
4
AminM. AbdElBaki
5
NashwaA. AbdEl Moniem
6
Internal Medicine Department Department -National Hepatology And Tropical Medicine Research Institute,Cairo,Egypt
Tropical Medicine Department Department -National Hepatology And Tropical Medicine Research Institute,Cairo,Egypt
Tropical Medicine Department Department -National Hepatology And Tropical Medicine Research Institute,Cairo,Egypt
Tropical Medicine Department Department -National Hepatology And Tropical Medicine Research Institute,Cairo,Egypt
Tropical Medicine Department Department -National Hepatology And Tropical Medicine Research Institute,Cairo,Egypt
Clinical Pathology Department -National Hepatology And Tropical Medicine Research
Background:Hepatocellularcarcinoma(HCC)isthefifthmostcommonmalignancyinthe world.InEgypt,HCCwasreportedtoaccountforabout4.7%ofchronicliverdisease(CLD) patients.Squamouscellcarcinomaantigen(SCCA)hasbeenreportedtobestronglyexpressed inHCCtissuehamperingitsextensiveuseinclinicalpractice.
Aim:Studythevalueofserumsquamouscellcarcinomaantigen(SCCA)forscreeningof HCC.
Materials&Method:Thestudycomprisedoftwogroups.GroupAincluded60patientswith HCCdiagnosticallyconfirmedbyspiralCT,elevatedalfa-fetoprotein(AFP),and/orliverbiopsy .GroupBCLDpatientsdiagnosedonclinical,laboratory,andultrasonographicalinvestigations; groupBsuclassifiedintothreecategoriesaccordingtoCHILD-PUGHscoreincluded30 patients,matchedforsexandage.Allgroupsweresubjectedtothoroughhistorytaking,full clinicalexamination,andlaboratoryinvestigationsincludingliverfunctions,viralmarkers,and AFPandSCCAestimationusingELISAtechnique.
Results:ThisstudyrevealedahighlysignificantdifferencebetweenpatientswithHCCand CLDregardingserumSCCAlevelsbeinghigheringroupA(10.35±20.677)thangroup B(1.64±2.462)(p=0.02).SCCAlevelwaselevatedinpatientswithHCCwithnormalAFPlevels representingitsusefulroleinearlydetectionandfollow-upofpatientstreatedforHCC.The cut-offvaluewasestablishedat2ng/mlwithsensitivityof80%andspecificityof70%).
Conclusion:SCCAcouldrepresentausefultoolasamarkerfordetectionofHCC.
https://ejhm.journals.ekb.eg/article_16964_02dfa32385b5c60121f8c99d504f60f3.pdf
Hepatocellularcarcinoma
squamouscellcarcinomaantigen
tumormarkers
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
39
1
218
222
10.21608/ejhm.2018.16965
16965
Original Article
Young adult with liver cirrhosis, portal vein thrombosis, a reported case of α-1anti-trypsin deficiency.
Sameh Seif
1
Mohamed A. Ezzel Arab
2
Mohammad A .Hassanein
3
Mohamed El Kassas
4
Selim Wadie
5
Khalid Zalata
6
Helmy El Gazzar
7
Mohamed Hassany
8
Amin Abdel Baki
9
Tropical Medicine Department National Hepatology and Tropical Medicine Research Institute (NHTMRI), Cairo, Egypt.
Internal Medicine Department, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt.
Tropical Medicine Department National Hepatology and Tropical Medicine Research Institute (NHTMRI), Cairo, Egypt.
Tropical Medicine Department National Hepatology and Tropical Medicine Research Institute (NHTMRI), Cairo, Egypt.
Radiology Department, National Hepatology And Tropical Medicine Research Institute, Cairo, Egypt.
Pathology Department, Faculty of Medicine, Mansoura University, Egypt
Clinical Pathology Department, Hearing and Speech Institute, Egypt
Tropical Medicine Department National Hepatology and Tropical Medicine Research Institute (NHTMRI), Cairo, Egypt.
Tropical Medicine Department National Hepatology and Tropical Medicine Research Institute (NHTMRI), Cairo, Egypt.
Alpha-1antitrypsinisaproteinwith inhibitorycapabilityovertheproteolytic enzymeelastase.Sinceitsfirstdescription in1963,over100differenta1ATalleles havebeendescribed(FolchE.,etal, 2007).Themajorclinicalmanifestationsof a1ATdeficiencyrelatetothefunctionofa 1ATandwhereitismade.A1ATserves asaninhibitorofneutrophilelastase(NE), apowerful,destructiveproteolyticenzyme storedinneutrophils(CarrellR.W,etal., 1982)(JanoffA,.1985).Theliveristhe majorsiteofa1ATgeneexpression, releasing2gofa1ATintothecirculation daily.A1ATdiffusesintomostorgans, whereitprotectsextracellularstructures fromattackbyNEreleasedbyactivatedor disintegratingneutrophils.Thelower respiratorytractisparticularlyvulnerableto deficiencyofa1AT,whichnormally represents>90%oftheanti-NEprotective screenofthealveolarwalls(GadekJ.E.,et al.,1981)(Wewers,M.D.,etal.,1987) .WhenserumaIATlevelsare<11um, thereisinsufficientaIATtoprotectthe lowerrespiratorytractfromitsburdenof NE,permittingprogressivedestructionof thealveoli,whichculminatesin emphysema(Wewers,M.D.,etal.,1987). Thepathogenesisoftheliverdiseaseisless wellunderstood,butrelatestothefactthat hepatocytesarethemajorsiteofalAT synthesis,andthatcertainmutationsofthe
a1ATgenecausederangementsinthe intracellularprocessingofaIAT, culminatinginhepatocyteinjury (ErricksonS.,1986).Themostsevereform ofdeficiencyisthehomozygousexpression oftheZalleleorPI*ZZ,whenthis expressionoccurs,itaccountsfor95%of casesofseverea1ATdeficiency.The threeorgansmostcommonlyaffectedbya 1ATarethelungs,liverandskin.a1AT deficiencyisthemostfrequently recognizedgeneticriskfactorforchronic obstructivepulmonarydisease(COPD). Eventhoughitremainsunderdiagnosed,its importancecontinuestogrowinthefieldof solidorgantransplantation,accountingfor 8-9%ofalllungtransplants.A1ATisthe mostcommonmetabolicliverdisease requiringlivertransplantationinchildren.
Thepresenceofcirrhosisinalpha-1- antitrypsindeficiencyislow,approximately 2.2/100,000forZZhomozygotes.The male-to-femaleratiowas2to1.Inone- thirdofthepatientsalcoholcouldhave beenaco-adjuvantoraggravatingfactorin theliverdisease(FolchE.,etal,2007).
Wedescribeauniquecaseofa27year-old manwitha1AT,presentedwithliver cirrhosisportalveinthrombosis&multiple bonydeformities.
https://ejhm.journals.ekb.eg/article_16965_77333be1313403051a28de1173f7aa95.pdf
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
39
1
223
228
10.21608/ejhm.2018.16966
16966
Original Article
THE EFFECTS OF EXPOSURE TO ORGANOPHOSPHOROUS COMPOUNDS ON SOME ASPECTS OF CARBOHYDRATE METABOLISM IN Tilapia zillii
Abdel-Salam Mohamed Ibraik Ohaida
1
Nuha Mahmoud A. Akrawee
2
Zoology Department. Faculty of Science. University of 7 October Misurata
High Institute of Medical Technology, Misurata
The Effect of organophosphorous insecticides compounds (Malathion and Fenitrothion) on certain aspects of carbohydrate metabolism in the freshwater fish Tilapia zillii exposed to 1/3 LC50 of both insecticides for 96 hours was studied. Organophosphorous compounds were found to affect some parameters of carbohydrate metabolism. Muscle and liver glycogen decreased significantly accompanied with significant increase of the plasma glucose and the specific activity of phosphorylase enzyme in both liver and muscles. The activity of Succinate dehydrogenase (SDH), lactate dehydrogenase (LDH) and malate dehydrogenase (MDH) showed a significant decrease in liver and muscle tissues. Alanine transferase (ALT) and Aspartate transferase (AST) in liver and muscles also showed a significant decrease. Significant alterations in the content of metabolites and enzyme activity under malathion and fenitrothion toxicity seemed to suggest marked shift from aerobic to anaerobic condition.
https://ejhm.journals.ekb.eg/article_16966_6e802dae54a684c7fad2060000442dad.pdf
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
39
1
229
248
10.21608/ejhm.2018.16967
16967
Original Article
Histological and ultrastructural studies on the effect of Cleome droserifolia plant from Sinai on the liver and kidney tissues of rats
Nahed Mohamed Mansour Emam
1
Biological and geological Department, Faculty of Education, Suez Canal University. Ismailia Egypt.
Sinai regions are characterized by the presence of large number of medicinal plants that are highly used in folk treatments but only a small number of these plants have received scientific and medical evaluation to assess their efficacy. Among these plants, Cleome droserifolia plant, which is commonly used in the Egyptian folk medicine for treatment of many diseases. The present study was planned to examine the safety of using an extract of Cleome droserifolia plant. This study focuses on the histopathological and ultrastructural changes induced by the plant extract in liver and kidney of the experimental rats. Cleome droserifolia treatment produced cellular swelling, cytoplasmic granulation with necrotic cells in addition to appearance of patches of depleted glycogen within the hepatic cytoplasm. The glomeruli were hypertrophied with thickening of Bowman's capsule and the renal tubules exhibited damaged epithelial lining cells in addition to the appearance of numerous lysosomes. Such changes in the present study may be due to the toxic effect or accumulation of one or more of the active pharmacological compounds of the plant in the liver or kidney tissues of the treated rats. It is recommended that future studies and chemical analytical techniques are required to separate and purify the main components from the plant responsible for safety and quality assurances for good practices of the plant.
https://ejhm.journals.ekb.eg/article_16967_4014dd73a095e7049ef9d694135b32a7.pdf
Cleome
droserifolia
Liver
kidney
Histological
Ultrastructural
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
39
1
249
259
10.21608/ejhm.2018.16968
16968
Original Article
Laryngeal Nerves Monitoring Versus Non-monitoring in Thyroid Surgery
Mohammed Fatehy Zidan
1
Ahmed Abdou Moustafa
2
Departments of ENT and Surgery Faculty of Medicine for Girls, Al-Azhar University
Departments of ENT and Surgery Faculty of Medicine for Girls, Al-Azhar University
Background and objectives: Thyroid surgery is the most common cause of recurrent nerve (RLN) injury. Deliberate identification of the RLN minimizes the risk of injury. When the nerve is identified and dissected, the reported RLN injury rate during thyroidectomy is 0-2.1%. Continuous intra-operative nerve monitoring during surgery remains a controversial issue. The basic technique involves a skin surface electrode or muscle electrode used to make electromyography (EMG) recordings, which have an audible alarm to alert the surgeon if passive (e.g.stretch during traction) or active nerve stimulation has occurred. We aim to evaluate the use of intra-operative nerve monitoring (IONM) to preserve the laryngeal nerves that may be at risk for injury during thyroid surgery and show the merits of using electrophysiologic laryngeal nerve monitoring during thyroid surgery.
Patients and methods: This study was conducted as a prospective study on 28 patients whom are thyroidectomy candidates; we elected 14 thyroidectomy candidates in whom we don’t use NIM during surgery (Control group_A). These patients were chosen to be evenly matched with another 14 thyroidectomy candidates to monitor the recurrent laryngeal (RLN) and external branch of superior laryngeal (EBSLN) throughout thyroidectomy procedures (NIM group_ B) to compare the laryngeal nerves risk of injury with and without the use of nerve monitor.
Results: Four patients (2 patients in-group A and 2 patients in-group B) were dysphonic after operation. Laryngoscopy revealed unilateral recurrent laryngeal nerve palsy in all except one bilateral in group A. There were no significant differences in RLN paralysis, paresis, or total injury rates between both groups. The number of patients in the presented study was limited to draw a statistical conclusion for significance.
Conclusions: The routine application of IONM cannot prevent or reduce recurrent laryngeal nerve injury. However the study signifies the trend towards the use of INOM in expectedly difficult cases and in revision surgery with distorted anatomical relationships and fibrous adhesions.
https://ejhm.journals.ekb.eg/article_16968_f23db107d29c6d0b7c31f56ad111cd29.pdf
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
39
1
260
267
10.21608/ejhm.2018.16969
16969
Original Article
Anticarbohydrate antibodies in patients with inflammatory bowel disease.
Mohammed Fakhraldeen
1
Huseen Saad Mostafa
2
Lecturer of internal medicine, Faculty of medicine, Mansoura University
Consultant clinical pathology, King Fahd hospital, Riyadh, Saudi Arabia
Evaluating antilaminaribioside carbohydrate antibodies (ALCA), antimannobioside carbohydrate antibodies (AMCA) and anti-Saccharomyces cerevisiae antibodies (ASCA), in patients with inflammatory bowel disease (IBD).
Subjects and methods:
268 serum samples were used; 115 Crohn’s disease (CD), 83 ulcerative colitis, and 70 healthy control samples. All samples were evaluated using enzyme-linked immunosorbent assay for the following four anticarbohydrate antibodies: ACCA, ALCA, AMCA, and ASCA.
Results:
In patients with Crohn’s disease the prevalence of the anticarbohydrate antibodies was: ASCA 69%, AMCA 32%, ACCA 28% and ALCA 24% with the highest prevalence being for ASCA (P-value<0.0001) while in patients with ulcerative colitis the prevalence was: ACCA 46%, AMCA 35%, ALCA 23% and ASCA 15% with the highest prevalence being for ACCA (P- value<0.001).
Conclusion:
Anticarbohydrate antibodies are significantly present in patients with IBD. The use of a panel of anticarbohydrate antibodies may provide additional help in distinguishing IBD from non-IBD disease patterns and narrow the range of differential diagnosis in these patients.
https://ejhm.journals.ekb.eg/article_16969_0166f703297c867fc636494c4517262f.pdf
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
39
1
268
274
10.21608/ejhm.2018.16970
16970
Original Article
Adiponectin multimers in patients with Barrett’s Oesophagus
Mohammed Fakhraldeen
1
Huseen Saad Mostafa
2
Ghada Ali Abdulwahab
3
Faculty of medicine, Mansoura University
King Fahd hospital, Riadh ,Saudi Arabia
King Fahd hospital, Riadh, Saudi Arabia
Barrett’s oesophagus is associated with abdominal obesity. Adiponectin is a peptide that is secreted from adipocytes and circulates in three multimeric forms: low molecular weight (LMW), middle molecular weight (MMW), and high molecular weight (HMW). The anti- inflammatory effects of adiponectin are specific to individual multimers, with the LMW being most anti-inflammatory. We investigated the possibility that circulating levels of adiponectin and its multimers would be associated with the risk of Barrett’s oesophagus.
Subjects and methods
This study comprised patients diagnosed to have Barrett’s oesophagus, and control subjects diagnosed to have gastrooesophageal reflux disease (GORD), all were diagnosed in the gastroenterology and endoscopy unit, King Fahd hospital, Riyadh, Saudi Arabia. Plasma adiponectin levels and its multimers were evaluated for patients with Barrett’s oesophagus and controls with GORD.
Results
There were 120 cases of Barrett’s oesophagus and 250 GORD controls. Total adiponectin was not significantly associated with Barrett’s oesophagus; low levels of LMW adiponectin and low LMW/total ratio were significantly present in patients with Barrett’s oesophagus.
Conclusion
Low levels of LMW adiponectin are significantly associated with Barrett’s oesophagus.
https://ejhm.journals.ekb.eg/article_16970_4f765304a4b3e7806bc70b020b1ff983.pdf
Barrett’s oesophagus
GORD
abdominal obesity
adiponectin
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
39
1
275
280
10.21608/ejhm.2018.16971
16971
Original Article
Allergic bronchopulmonary aspergillosis among patients with bronchial asthma
Al-Najada M
1
Al-Nadi K
2
Sharara AM
3
Department of chest disease, King Hussein Medical Centre, amman -jordan
Department of chest disease, King Hussein Medical Centre, amman -jordan
Department of chest disease, King Hussein Medical Centre, amman -jordan
Objective
To determine the different presentations encountered upon diagnosis of ABPA among patients with bronchial asthma and the two-year-follow-up results.
Patients and method
All patients with bronchial asthma and ABPA were included in the study .Specially formulated sheet was done include age, gender, duration of bronchial asthma ,new clinical,radiological,and laboratory findings suggestive of ABPA and two year follow up of them. Diagnosis of ABPA was based on Rosenberg-Patterson criteria.
Result
Fifteen patients with ABPA 3.9% out of 385 patients with bronchial asthma were included in our study, (5males)and (10 females) there mean age was 28.8 years , and mean duration of asthma was 8.9 years, and they represent all stages of asthma severity. Fleeting shadows mainly in the upper lobes were the most common radiological findings observed in nine patients (60%), five patients (33.3%) had proximal bronchiectasis detected by high resolution chest ct-scan, one of our patients had collapsed consolidation. All patients had moderate to severe eosinophilia and positive immediate skin test for aspergillus.
Conclusion
As the prevalence of ABPA is not uncommon among patients with bronchial asthma regardless the severity and the level control of asthma, high index of suspicious for ABPA should be maintained when followed up any patient with bronchial asthma.
https://ejhm.journals.ekb.eg/article_16971_23dd448e780a5dc057f8749a5768d4c5.pdf
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
39
1
281
287
10.21608/ejhm.2018.16972
16972
Original Article
Statin Therapy and Serum Testosterone in Men with Type 2 Diabetes
Mohammed Fakhraldeen
1
Huseen Saad Mostafa
2
Faculty of medicine, Mansoura University
King Fahd hospital, Riyadh, Saudi Arabia
There is a high prevalence of hypogonadism in men with type 2 diabetes. Statins could potentially decrease testosterone levels by reducing the availability of cholesterol for androgen synthesis. In this study we compared testosterone levels and hypogonadal symptoms with statin use in men with type 2 diabetes.
PATIENTS AND METHODS
Total testosterone, sex hormone–binding globulin (SHBG), and estradiol were measured by an enzyme-linked immunosorbent assay. Bioavailable testosterone was measured by the modified ammonium sulfate precipitation method. Free testosterone was calculated using Vermeulen's formula. Symptoms of hypogonadism were assessed using the Androgen Deficiency in the Aging Male questionnaire.
RESULTS
Statins were associated with lower total testosterone and a trend toward lower SHBG compared with untreated patients. Bioavailable testosterone, free testosterone, estradiol, and hypogonadal symptoms were not affected. Atorvastatin was associated with reduced total testosterone and a trend toward reduced SHBG compared with no treatment, and there was a dose-response effect with the lowest levels of total testosterone seen in men treated with ≥20 mg atorvastatin .Simvastatin use was not associated with significant reductions in testosterone or SHBG levels.
CONCLUSION
Assessing androgen status using total testosterone in men with type 2 diabetes treated with statins, particularly atorvastatin, may potentially lead to diagnostic error. Levels of bioavailable testosterone or free testosterone are recommended for the assessment of hypogonadism in this group if total testosterone levels are borderline.
https://ejhm.journals.ekb.eg/article_16972_9b084d6dfd84977c38a7ae6389ffc2ab.pdf
Type 2 DM
testosterone
Hypogonadism
statin therapy
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2018-04-01
39
1
288
294
10.21608/ejhm.2018.16973
16973
Original Article
Egyptian Mother-to-fetus transmission of Parvovirus B-19 in the first trimester abortions
Abo-Elkhier AAK
1
Abdel-Wahab KSE
2
Clinical Pathology Department, El-Sahel Teaching Hospital, Ministry of Health.
Virology Laboratory, Microbiology Department, Faculty of Medicine, Al-Azhar University, Branch for Females
Parvovirus B-19 infection is a common mild illness in adulthood and usually subclinical in childhood. Serious illness can be caused by this virus in certain circumstances. When a pregnant female contracts parvovirus B-19 complications may affect the fetus and/or the newly born. A study of 240 parturient mothers was carried out to assess the possible role of this virus in abortion. Detection of virus-DNA in fetal tissues by PCR confirmed mother-fetus transmission.
Introduction
Parvovirus B-19 (Pattison and Patou, 1996) is a single strand DNA virus of small size that infects humans usually by inhalation, but can be transmitted by blood, blood products, plasma and bone marrow transfusion (Siegl and Cassinolty, 1988). In immunocompetent persons subclinical infection is predominant. The clinical infection of children is erythema infectiosum and of adults are polyarthritis, transient aplastic crisis, and pure red cell aplasia. Infected adult pregnant females in their first trimester, may transmit parvovirus B19 to their fetus where infection of the fetal heart leads to non- immune hydrops fetalis, and erythrocyte progenitor cell suppression. Parvovirus B19 infects placental endothelia with high titer output that enables the virus to cross the placenta barrier to the fetus where it grows in liver, bone marrow, heart and skin. Multi-organ infection may progress to abortion, still birth or postnatal death (Enders et al. 2004 and Yong et al. 2004). Parvovirus B-19 may cause chronic infection (Frickhofen and Young 1989 and Koch & Adler 1990).
Parvovirus B19 serological and molecular tests are used to diagnose infection. IgM anti-parvo B19 is a marker of early immune
response in acute infection. IgG anti Parvovirus B19 is a marker of past exposure. The enzyme-linked immunosorbent assay (ELISA) test is used to assay these antibodies in patient’s sera but not in fetal blood due to the immature immune system response. Detection of Parvovirus B19 – DNA by polymerase chain reaction (PCR) is used to evaluate qualitatively or quantitatively viral DNA. Viremia titer is up to 1011 to 1013 genome equivalents/ml). There are variations in Parvovirus B19 PCR results, because of the choices of primer sites, the PCR procedure (Anderson et al., 1985) and the existence of virus variants (Heegaard et al., 2001; Servant et al., 2002; Saldanha et al., 2002; Hokynar et al., 2004). In our study we selected Parvovirus B19 VP1 gene primers for PCR according to Koch and Adler (1990).
Aim of Study
To assess mother to fetus transmission of parvovirus B-19 when pregnant mothers are hospitalized for spontaneous abortion in the first trimester.
https://ejhm.journals.ekb.eg/article_16973_2fffb2fab358014a8b1013993ceb8162.pdf