eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-01-01
74
4
705
720
10.21608/ejhm.2019.24068
24068
Original Article
Comparative Study between Treatment of Lumbar Disc Herniation with Intra Discal Ozone and Transforaminal Steroid Injection versus Steroid Injection only
Abd El Shafy Ahmed Haseeb
1
Abd El Hameed Abd El Hares
2
Khaled Mohamed Abd El Moez
3
Ashraf Ismail Mustafa
4
Osama Eid Ahmed Ahmed
osmaead@gmail.com
5
Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, AlAzhar University
Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, AlAzhar University
Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, AlAzhar University
Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, AlAzhar University
Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, AlAzhar University
Background: Oxygen-ozone therapy is a minimally invasive treatment for lumbar disc herniation that exploits the biochemical properties of a gas mixture of oxygen and ozone. Objective: The purpose of our study was to prospectively evaluate the clinical effectiveness of oxygenozone therapy and compared the therapeutic outcome of injection of oxygen-ozone combined steroid with injection of steroid alone at different follow-up period. Patients and Methods: One hundred patients were included for this study from al-Agouza Physical Medicine, Rheumatology and Rehabilitation center. From March 2014 to April 2016, we treated 100 patients (42 men, 58 women; age range, 23–65 years) with lumbar disk herniation (L3-4, 23 patients; L4-5, 61 patients; L5-S1, 75 patients) and radicular pain. The mean duration of radicular pain at the time of treatment was 8 weeks. Result: Satisfactory clinical outcomes were obtained in both groups after two weeks, three months and at 6 months. Treatment was successful in patients in group I and patients in group II. The difference between group I and group II was insignificant. Conclusion: O2–O3 seems to play a role in pain relief, and we suggest the administration of the O2– O3 mixture combined with transforaminal steroid injection as a first-choice treatment before recourse to surgery or when surgery is not possible.
https://ejhm.journals.ekb.eg/article_24068_825c87e4e5a63c2f18a97ca2db22dd58.pdf
Lumbar Disc Herniation
Intra Discal Ozone
Transforaminal Steroid
steroid injection
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-01-01
74
4
721
725
10.21608/ejhm.2019.24069
24069
Original Article
Corneal Endothelial and Central Corneal Thickness Changes after non Complicated Uneventful Phacoemulsification
Mohamed A. El Masry
1
Abdelghany I. Abdelghany
2
Mohamed R. Elrefaei
dr.m.elrefaei@gmail.com
3
Ophthalmology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Ophthalmology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Ophthalmology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Aim of the work: this study aimed to evaluate the central corneal thickness and the corneal endothelium by specular microscopy in torsional phacoemulsification versus longitudinal phacoemulsification. Methods: in our study we did a comparative analysis of the changes in endothelial cells of the cornea (Central cell density and cell loss) and central corneal thickness after cataract extraction surgeries by torsional phacoemulsification versus longitudinal phacoemulsification. In our study thirty eyes of thirty patients were chosen from Ophthalmology clinic at Bab Al-Shaariah University Hospital for uneventful phacoemulsification surgeries (15 eyes of 15 patiens for torsional phaco and 15 eyes of 15 patients for longitudinal phaco). The types and densities of cataract were determined as cortical, posterior supcapsular (PSC), nuclear I, nuclear II and nuclear III. Divide and Conquer technique was used for phacoemulsification using (Infiniti, Ozil technology, Alcon) phaco machine. A noncontact specular microscope Topcon SP-1P (Topcon Corporation, Japan) was used to evaluate the central endothelial cell density (CD) and central corneal thickness (CCT). Results: The mean U/S time was lower in the torsional group than in the longitudinal group (p< 0.05). On comparing between the torsional Phaco and longitudinal phaco groups, the longitudinal phaco group had higher average central corneal thickness (p > 0.05) and higher average corneal endothelial cell losses at 2 weeks postoperative (p > 0.05). Conclusions: our study suggested a better efficiency by the torsional mode rather than the longitudinal mode.
https://ejhm.journals.ekb.eg/article_24069_3d6ffc0cc7c93243ef72f631de7933e2.pdf
Corneal Endothelial
Central Corneal Thickness
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-01-01
74
4
726
734
10.21608/ejhm.2019.24073
24073
Original Article
Evaluation of Psychological and Sexual Effects of Female Genital Mutilation (Circumcision)
Zakaria Mahran Obaid
1
Ahmed Wahhed-Allah Amer
2
Mohammed Abdel Fatah El Mahdy
3
Amira Elmaadawy Barakat Mohammed
dr_miro89@yahoo.com
4
Departments of Dermatology, Venereology & Andrology, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
Departments of Dermatology, Venereology & Andrology, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
Departments of Psychiatry, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
Departments of Dermatology, Venereology & Andrology, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
Background: female genital mutilation (FGM), also known as female circumcision (FC), but more recently as female genital mutilation/cutting (FGM/C) according to the World Health Organization (WHO), has occurred in many forms in all societies. The psychosocial consequences include post-traumatic stress disorder (PTSD), anxiety disorders, panic disorders, depression and suppression of feeling and thinking, and sometimes attempted suicide. Objective: To evaluate sexual and psychological effects of female genital mutilation. Patients and Methods: The two groups were compared as regard many demographic data such as age, level of education, associated chronic diseases and previous gynecological history. The results revealed no significant difference between the two groups in the educational level. The females in the two groups also showed significant difference in their agreement with the process and subsequently in their future decision in performing circumcision for their daughters. Other demographic data included in this study revealed no difference between the studied groups. Results: The study used different questionnaires and scores to compare the sexual satisfaction and psychological effects of the females in the study. For assessment of sexual satisfaction, Female Sexual Function Index (FSFI) questionnaire translated into Arabic was used and showed no significant difference between the two groups except for only a single domain" lubrication". Conclusion: Concerning the psychiatric analysis of the two groups, Anxiety Hamilton score and Depression Beck score were used and showed no statistically significant difference between the two groups in the two scores. Also 19% of the females in the group of FGM showed positive symptoms for post-traumatic stress disorder (PTSD).
https://ejhm.journals.ekb.eg/article_24073_3c63c559fd33d6b7915c4c854582ef81.pdf
Post-traumatic stress disorder
female genital mutilation
female circumcision
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-01-01
74
4
735
743
10.21608/ejhm.2019.24083
24083
Original Article
Surgical Outcomes of Right Anterolateral Minithoracotomy versus Median Sternotomy in Atrial Septal Defect
Hossam ElSayed Abd Al-Fattah
1
Mohammed Eldesoky Sharaa
2
Mohammed Abd Al-Fattah
3
Department of Cardiothoracic Surgery, Faculty of Medicine, Al-Azhar University
Department of Cardiothoracic Surgery, Faculty of Medicine, Al-Azhar University
Department of Cardiothoracic Surgery, Faculty of Medicine, Al-Azhar University
Background: the atrial septal defect repair has been traditionally approached through a median sternotomy. However, significant advances in surgical optics, instrumentation, tissue tele manipulation and perfusion technology have allowed for atrial septal defect repair to be performed by using progressively smaller incisions including the minithoracotomy. Aim of the study: this study aimed to compare the surgical outcome of right anterolateral minithoracotomy versus median sternotomy in atrial septal defect repair. Methods: this study was done in Department of Cardiothoracic Surgery at Elhussen Hospital, Al-Azhar University, after approval of the local ethical committee in the period between July 2017 till July 2018. 30 patients with ASD required ASD repair were included in this study for operative and short term postoperative results to evaluate the impact of two approaches of repair on quality of life of patients who survived the operation was studied. Results: The patients in both groups were similar in age preoperative comorbidities and ejection fraction but more female s were in Right anterolateral mini -thoracotomy group. There was a highly statistically significant prolonged pump-run time in the thoracotomy group than the sternotomy group with p-value ¼ 0.0 0 4. Interestingly, in the thoracotomy group, mechanical ventilation time (hours) was shorter with p-value ¼ 0.0 02. There were similar blood transfusion rate, chest tube drainage, intensive care unit stay and hospital length of stay. However, more wound infection was found in the sternotomy group which was statistically significant (p-value ¼ 0.035). There were no patients requiring conversion to full sternotomy, no residual defect across the atrial septum and all patients were alive on a month follow-up of the hospit al discharge. Conclusion: right antero-lateral mini-thoracotomy technique for atrial septal defect anomaly closure was safe and reliable technique as sternotomy incision. Apart from its restricted operating field and longer pump-run time, it kept the sternal integrity, it had better esthetic incision, it reduced wound infection and the need for analgesia. Moreover, it is associated with an early recovery and short ICU stay.
https://ejhm.journals.ekb.eg/article_24083_4e9f82650e515b74135a4eaeb2aac4fb.pdf
Atrial Septal Defect
right anterolateral thoracotomy
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-01-01
74
4
744
751
10.21608/ejhm.2019.24084
24084
Original Article
Toxic effects of chronic exposure to dyes among workers of synthetic textile industries
Ahmed F.M. Mohammed
abf114@yahoo.com
1
Magdy M. Sherif
2
Ashraf I. Hasan
3
Bahyeldein E. Makrahy
4
Nabil E. Hasan
5
Forensic Medicine and Clinical Toxicology, Internal Medicine Department, Faculty of Medicine, Al-Azhar University
Forensic Medicine and Clinical Toxicology, Internal Medicine Department, Faculty of Medicine, Al-Azhar University
Forensic Medicine and Clinical Toxicology, Internal Medicine Department, Faculty of Medicine, Al-Azhar University
Clinical Pathology Department, Faculty of Medicine, Al-Azhar University
Clinical Pathology Department, Faculty of Medicine, Al-Azhar University
Background: textile industry is one of the major industries in Egypt. However, the working environment is associated with potential health hazards. Aim of the work: to study the toxic effects of different types of dyes among workers in textile industries and its effect on their respiratory, renal, and immunological systems. Subjects and methods: this study was conducted on 50 male workers exposed to textile dyeing of different ages, selected from all textile plants with dyeing industry at Borg Al-Arab City compared with 50 males, who were not exposed to textile dye as a control group. Results: both groups were comparable as patient age, while smoking was significantly increased in exposed group (38.0% vs 14.0%). Reported symptoms such as itching, abdominal pain, etc. and respiratory symptoms were significantly increased in exposed group. There was significant increase of AST, ALT, total bilirubin and alkaline phosphatase, urea and serum creatinine in study when compared to control group. Furthermore, there was statistically significant decrease of respiratory function percentage of predicted in study group, and there was statistically significant increase of serum lead concentration in study when compared to the control group (17.18±2.35 vs 6.74±2.29 respectively). In addition, there was significant increase of IgM and IgG in study group. Conclusion: workers in textile industry were significantly exposed to health hazards especially on respiratory system. However, multi-organ affection is the role with increased oxidative stress.
https://ejhm.journals.ekb.eg/article_24084_3feea7c682871e3778a5d43df7a5b005.pdf
textile
Reactive oxygen species
respiratory
dyes
Oxidative Stress
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-01-01
74
4
752
763
10.21608/ejhm.2019.24166
24166
Original Article
Adherence of surgeons to surgical prophylaxis guidelines
Ibrahim M. Alshehri
1
Ibraheem M. Albishry
2
Khuwailid R. Alharthi
3
Bader A. Al Qarni
4
Inpatient Pharmacy Supervisor, Rabigh General Hospital, Jeddah
Rabigh General Hospital, Pharm.,D
King Abdullah Hospital, Bishah, BPharm, Pharm.
Al-Thagar General Hospital, Jeddah, BPharm, Pharm.
Background: surgical site infections (SSIs) are microbial contamination of the surgical wound during a period of one month that could result in major post-operative morbidity and mortality rates. Objectives: this study aimed to identify the adhesion of surgeons to antibiotics prophylaxis guidelines at Kingdom of Saudi Arabia (KSA). Methods: this study included 180 adult subjects who were scheduled to undergo major surgeries in the hospital. The data of the patients were collected from the surgical wards and day care unit. Results: most of the included surgeons showed no error during pre, intra and post operative duration as give the required antibiotics and didn’t give the non-require antibiotics. The preoperative adherence of surgeons as most of the surgeons (73.9%) followed the prophylactic measures that included correct choice, indications, dosage and duration. Most of the surgeons (76.1%) followed the prophylactic measures including correct choice, indications, dosage and duration during intra-operative period. The majority of the surgeons (75%) followed the prophylactic measures including correct choice, indications, dosage and duration during post-surgical duration. Conclusion: The level of surgeon’s adherence to antibiotic prophylactic guidelines was efficient among most of surgeons regarding the proper choice of antibiotic, duration, timing and indication. However, these results differ from other available studies, this study showed a good sign for application of antibiotic prophylactic measures in KSA hospitals. Further studies should be conducted to increase the knowledge and adherence of surgeons all over KSA.
https://ejhm.journals.ekb.eg/article_24166_7e1617727073ddcd9c01d1b7e266df31.pdf
adherence
prophylactic measures
antibiotic prophylaxis guidelines
surgeons
KSA
2018
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-01-01
74
4
764
770
10.21608/ejhm.2019.24167
24167
Original Article
Double Guidewire Technique versus Transpancreatic Sphincterotomy for Difficult Biliary Cannulation
Mohie Eldin Mohamed Amer
1
Mohamed Abdel Rasheed Abdel Khalik Allam
2
Mohamed Hamza Al-Sisi
abo_hamaza2751@yahoo.com
3
Department of Tropical Medicine, Faculty of Medicine, Al-Azhar University
Department of Tropical Medicine, Faculty of Medicine, Al-Azhar University
Department of Tropical Medicine, Faculty of Medicine, Al-Azhar University
Background: The standard biliary cannulation technique has been reported to fail in approximately 5– 20% of cases so, several supplementary techniques have been recommended to facilitate access to the common bile duct (CBD); Double-guidewire technique (DGT) and transpancreaticsphincterotomy (TPS) are effective method in cases of standard biliary cannulation failure. Objective: To compare the outcomes between DGT and TPS in patients with difficult biliary cannulation regarding the procedure duration, success rate and complications. Patients and Methods: This was a randomized study conducted in Al-Hussein University Hospital, Endoscopy Unit in the period between May, 2016 to October, 2017. A total of 40 patients, who bile duct cannulation was not possible and selective pancreatic duct cannulation was achieved were randomized into DGT (n = 19) and TPS (n = 21) groups. DGT or TPS was done for selective biliary cannulation. We measured the technical success rates of biliary cannulation, median cannulation time, and procedure related complications. Results: The distribution of patients after randomization was balanced, and both groups were comparable in baseline characteristics. There was no significant difference between both groups regarding age and sex distribution, clinical presentation, laboratory findings and sonographic findings. Successful cannulation rate and mean cannulation times in DGT and TPS groups were 94.7% vs 95.2% and 20.1 ± 8.7min vs 21.5 ± 7.8min, P = 0.602, respectively. There was no significant difference between the two groups. Conclusion: When free bile duct cannulation was difficult and selective pancreatic duct cannulation was achieved, DGT and TPS facilitated biliary cannulation and showed similar success rates. However, post-procedure pancreatitis and Cholangitis were significantly higher in the DGT group.
https://ejhm.journals.ekb.eg/article_24167_7bcd008696b4723913920b635d6161cc.pdf
ERCP, Endoscopic Retrograde Cholangiopancreatography, DGT, TPS
Transpancreaticsphincterotomy
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-01-01
74
4
771
774
10.21608/ejhm.2019.24169
24169
Original Article
Predictive Factors for Failed Endoscopic Retrograde Cholangiopancreatography
Hassan Abd El-Hafiez
1
Mohamed Abdel Rasheed
2
Mohamed Ismail Fadel
isia992018@yahoo.com
3
Tropical Medicine Department, Al Azhar University
Tropical Medicine Department, Al Azhar University
Tropical Medicine Department, Al Azhar University
Background: failure during cannulation renders the endoscopic retrograde cholangiopancreatography (ERCP) unsuccessful and gives rise to various consequences, including cholangitis and pancreatitis, which may require interventions, such as percutaneous transhepatic cholangiography (PTC) and surgery, with higher morbidities. Aim of the Work: we aimed to establish predictive factors for ERCP failure. Patients and Methods: a total of 103 ERCP procedures were done from October 2016 to October 2017 in the endoscopy unit at AL Hussein university hospital. Patients were divided according to ERCP results into 2 groups; group I consists of 93 cases of successful ERCP procedure (90.2%) and group II consists of 10 cases of failed ERCP procedure (9.7%). After clear written consent, full clinical, sonographic and laboratory evaluation were done for all patients. Results: patients with history of previous abdominal surgery and\or CBD stricture had a significant higher rate of ERCP failure. Duodenal diverticula, papillary mass and gastric outlet obstruction were significantly higher in failed ERCP group. Conclusion: any patient with history of previous abdominal surgery, CBD stricture and benign or malignant tumors should be investigated before ERCP with non-invasive image as magnetic resonant cholangiopancreatography (MRCP) or Endoscopic ultrasound (EUS).
https://ejhm.journals.ekb.eg/article_24169_9dd48d7d84f066b65aa229b7157981bd.pdf
Endoscopic retrograde cholangiopancreatography
Magnetic Resonant Cholangiopancreatography and Endoscopic Ultrasound
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-01-01
74
4
775
781
10.21608/ejhm.2019.24171
24171
Original Article
The Role of Ultrasound versus Hysteroscopy in Assessment of Cesarean Section Scar in Non Pregnant Females
Islam Ibrahim Abdel-Aziz El-Ewiny
drislamelewiny@gmail.com
1
Farid Ahmed Kassab
2
Kamel Nour el-Dean Abdul-Jaleel
3
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-azhar University, Cairo, Egypt
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-azhar University, Cairo, Egypt
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-azhar University, Cairo, Egypt
Background: cesarean section is one of the most commonly performed surgical procedures in obstetric practice. It has become increasingly important to study the sequelae of this procedure on the future reproductive capacity. Special investigations are required for assessment of CS scar integrity to avoid its dehiscence or rupture during pregnancy or labor. Objectives: to compare between the accuracy of ultrasound and hysteroscopy in visualization of the site of Cesarean section scar in non-pregnant females and also to determine and comment on thickness, vascularity, continuity and ballooning of the scar. Patients and Methods: in a comparative cross-sectional study, 50 women with previous cesarean section attending the Ob/Gyne outpatient clinic complaining of infertility or recurrent pregnancy loss. They had been examined by transvaginal ultrasound (TVS), then by hysteroscopy to evaluate and compare their accuracy in assessment of the scar. Results: it was found that hysteroscopy can't comment on scar thickness but transvaginal ultrasound can do it in all patients of the study with a mean value 1.57 mm. There is a statistically significant correlation between the use of ultrasound and hysteroscopy in determination of the site, continuity and vascularity of scar, while there is a statistically insignificant correlation between ultrasound and hysteroscopy in determination of the balloning of the scar. Conclusion: ultrasound is more accurate than hysteroscopy in evaluating scar thickness and detection of scar defect.
https://ejhm.journals.ekb.eg/article_24171_c13d5ee8b1be46c1b8476019025bfc7a.pdf
Cesarean section scar
Ultrasonography
Hysteroscopy
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-01-01
74
4
782
788
10.21608/ejhm.2019.24172
24172
Original Article
Evaluation of the Effect of Diabetes Mellitus on Corneal Biomechanics
Abd Elmagid Mohamed Tag Eldin
1
Abdulmoez Haddad Ahmed
2
Amr Khalil Abdelmonem
3
Ophthalmology department, Faculty of Medicine, Al-Azhar University
Ophthalmology department, Faculty of Medicine, Al-Azhar University
Ophthalmology department, Faculty of Medicine, Al-Azhar University
Background: the cornea exhibits viscoelastic properties, which give it the quality of hysteresis. Corneal hysteresis is an important indicator of the biomechanical properties of the cornea. Aim: to compare the biomechanical properties of the cornea in patients having diabetes mellitus and age matched normal individuals as regards to corneal hysteresis (CH), corneal resistance factor (CRF), Corneal compensated IOP (IOPcc) and Goldman- correlated IOP (IOPg). Patients and Methods: A total of 200 eyes of 100 patients were enrolled in our study. Patients were selected from Ophthalmology outpatient clinics in Minia Health Insurance Hospital – Ophthalmology department. The type of our study is a case-control one. Patients were divided into two equal groups: Group A: included 50 patients (100 eyes) of age matched normal individuals. Group B: included 50 patients (100 eyes) having type 2 diabetes mellitus. Results: mean CH in control group was 9.8±1.3 mm Hg in comparison to mean CH in diabetic group which was 11.9±1.4 mm Hg, which was statistically significantly higher in diabetic patients when compared to control group, (P value = 0.<001). Conclusion: the corneal biomechanics in diabetic group are significantly higher compared with those of the control group.
https://ejhm.journals.ekb.eg/article_24172_139d8bfc4c743cf690267b87946775fe.pdf
cornea
Corneal Hysteresis
corneal resistance factor
intra-ocular pressure
Diabetes mellitus
corneal compensated intra-ocular pressure
Goldman correlated intra-ocular pressue
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-01-01
74
4
789
796
10.21608/ejhm.2019.24356
24356
Original Article
The Clinical Characteristics and Treatment Response of Patients with Low Grade Non-Hodgkin Lymphoma
Ahmed Yosry El-Agamawi
1
Mohammed El-Sayed Mansy
2
Mohamed Omar Ahmed
dr.omar_77@yahoo.com
3
Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Background: as the histopathologic diagnosis of Non-Hodgkin Lymphoma (NHL) has become more sophisticated with the use of immunologic and genetic techniques, the understanding and treatment of many of the previously described pathologic subtypes have changed. Aim of the Work: was to review the clinicopathologic characteristics of the NHL patients, to assess the treatment response to the different treatment modalities available at our center and to analyze the correlation between patient’s characteristics, treatment modality and the achieved response.
Patients and Methods: the current work was a retrospective study reviewing the data of patients with pathologically confirmed diagnosis of low-grade NHL referred to Al Hussein university Hospital, Department of Clinical Oncology, Faculty of Medicine, Al-Azhar University during the period between January 2012 till December 2016.
Results: more than half the study group (57.2%) had the age between 41 and 60 years. Only 14.2% of the study group was younger than 40 years and 28.6% were older than 60 years. There was no difference between patients with CLL and patients with Low grade NHL as regards the age distribution. NHL in this study was equal among both males and females in both above 40 and below 40 age groups, unlike what was mentioned before which stated that NHL is more common in males than in females.
Conclusion: only 31 patients were evaluable for survival analysis with median follow up period of 15 months. Median disease-free survival (DFS) was 12 months (95% CI 0-72.9).
https://ejhm.journals.ekb.eg/article_24356_f9cf2c5e072ff49c78f529f5a9647958.pdf
Clinical Characteristics
Non-Hodgkin lymphoma
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-01-01
74
4
797
801
10.21608/ejhm.2019.24357
24357
Original Article
The Incidence and Predictors of Renal artery Stenosis in Patients Referred for Coronary Angiography
Mohamed Osama Fathy Kayed
1
Haytham Mahmoud Hassan
2
Mostafa Elsayed Abd ElGhany
3
Adham Mohamed Abd Elkader
dr.adham.abdelkader@gmail.com
4
Department of Cardiology, Faculty of Medicine. Al-Azhar University
Department of Community and occupational medicine, Faculty of Medicine. Al-Azhar University
Department of Cardiology, Faculty of Medicine. Al-Azhar University
Department of Cardiology, Matrouh Specialized Cardiothoracic and Interventional Catheterization Center, Egypt
Background: Renal artery stenosis (RAS) and coronary artery disease (CAD) are two manifestations of a same pathogenesis which is atherosclerosis.. RAS is a leading factor of secondary hypertension, ischemic nephropathy and end stage renal disease (ESRD). Aim of work: This study was aimed to detect the incidence and predictors of renal artery stenosis in patients referred for elective coronary angiography. Patients and Methods: In this study we included 100 patients who underwent coronary and renal angiography.The mean age was 56.6 + 7.9 years, 60 males (60%), 40 females (40%), 60 diabetic (60%), 58 hypertensive (58%), 41 smokers (41%), 62 dyslipidemic (62%), 27 patients with family history of ischemic heart disease (27%), and patient with normal coronaries 12 (12 %). Our study consisted of 2 groups; 87 (87%) patients with normal renal arteries (group 1) and 13 (13%) patients with renal artery stenosis (group 2). Results: The incidence of RAS was 13% and the incidence of significant RAS (>50% stenosis) was 7%. The significant difference between the two groups was in the terms of hypertension (p-value 0.014), female gender (p-value 0.021), multivessel (> 2 vessels) coronary artery disease (p-value 0.046), normal coronaries had a significant negative association with RAS (p-value 0.027) and there was a significant relationship between atherosclerotic involvement of Left anterior descending artery (LAD), Diagonal, and right coronary artery (RCA) with RAS (p-value 0.037, 0.041 and 0.042). Conclusion: It could be concluded that predictors of RAS were hypertension, multivessel coronary artery disease (> 2 vessels) and female gender.
https://ejhm.journals.ekb.eg/article_24357_ba5e0dfc8f3c1a6cb123f064a79daf1f.pdf
Coronary angiography
renal artery stenosis
renal angiography
Atherosclerosis
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-01-01
74
4
802
808
10.21608/ejhm.2019.24358
24358
Original Article
Awareness of heat-related illnesses in population of Saudi Arabia
Mohammad Aljumaan
1
Faisal Alhawaj
2
Saleh Alkhalifa
s.khalifa013@gmail.com
3
Najebah Alhussain
4
Ali Alhashim
5
Layan Alahmadi
6
Fatimah Alkhunaizi
7
Saleh Aljarudi
8
Emergency Department, Imam Abdulrahman Bin Faisal University, Eastern Provence, Saudi Arabia
Emergency Department, Imam Abdulrahman Bin Faisal University, Eastern Provence, Saudi Arabia
Emergency Department, Imam Abdulrahman Bin Faisal University, Eastern Provence, Saudi Arabia
Emergency Department, Imam Abdulrahman Bin Faisal University, Eastern Provence, Saudi Arabia
Emergency Department, Imam Abdulrahman Bin Faisal University, Eastern Provence, Saudi Arabia
Emergency Department, Imam Abdulrahman Bin Faisal University, Eastern Provence, Saudi Arabia
Emergency Department, Imam Abdulrahman Bin Faisal University, Eastern Provence, Saudi Arabia
Emergency Department, Imam Abdulrahman Bin Faisal University, Eastern Provence, Saudi Arabia
Background: heat stroke is a preventable severe condition of heat-related illnesses; it is an emergency condition affecting millions of people around the world. Heat related illnesses ranged from mild heat exhaustion to life-threatening heat stroke. Early detection and treatment of heat-related illnesses crucial to avoid mortality and morbidity. The aim of this study was to evaluate awareness of heat illnesses, its symptoms, treatment and prevention among the population of Saudi Arabia. Methodology: a cross-sectional study carried out an online survey, Saudi Arabia, between, 1 November 2017 and 23 June 2018. Data were collected by using a valid multiple-choice question (MCQ). Survey questions included the possible thought causes and risk factors of both heat stroke and heat exhaustion. Result: a total of 865 participants, the majority were Saudi citizens (806). Age and gender were almost equal. 281 were involved in the medical fields. Conclusion: this study assessed the awareness of heat stroke and heat exhaustion among the health staff and medical students in different aspect of heat-related illness (Mainly heat stroke and heat exhaustion) and compared it to the level of awareness of general population in some aspect of heat-related illnesses. Almost, two third of medical personnel differentiate heat stroke definition when it was listed among other heat-related illnesses.in the other hand, knowledge of heat exhaustion definition was markedly lower among both health staff and non-health staff.44.6% of the participants chose all cooling methods as appropriate treatment of heat stroke. 71.1% knows that heat stroke had more devastating outcomes if not managed properly and rapidly than heat exhaustion.34% of the medical personnel thought avoiding hot spots was the best way to prevent heat-related illnesses; a similar number of the non-medical (31%) also thought the same. Awareness of heat-related illnesses and differentiation between them in relation to the definition, sign, symptoms, diagnosis, and treatment is not satisfactory.
https://ejhm.journals.ekb.eg/article_24358_43722792f608410e1d6a92c4a3a2eef9.pdf
Heat stroke
heat exhaustion
heat-related illness
awareness of heat-related illness
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-01-01
74
4
809
819
10.21608/ejhm.2019.24359
24359
Original Article
Comparative Study between Submucosal Diathermy and Endoscopic Partial Turbinectomy in Hypertrophied Inferior Turbinate
Wael Hassan Aboulwafa
1
Abd Elaziz Kamal Saad
2
Ayman Yehia Abbas
3
Mohammed Abed Elewa
drmohamedabed@gmail.com
4
Tarek Abd Elkarem Eldahshan
5
Otolaryngology dept., Faculty of Medicine, AL-Azhar University
Otolaryngology dept., Faculty of Medicine, AL-Azhar University
Otolaryngology dept., Faculty of Medicine, AL-Azhar University
Otolaryngology dept., Faculty of Medicine, AL-Azhar University
Clinical Pathology dept., Faculty of Medicine, AL-Azhar University
Background:Chronic nasal obstruction is a common subjective complaint seen by otolaryngologists; turbinate hypertrophy is one of its causes. There are various treatment options for enlarged turbinates, the method of treatment depends on the size of the enlarged turbinates.
Objective:To evaluate the effectiveness of submucosal diathermy of inferior turbinate versus endoscopic partial turbinectomy in patients with inferior turbinate hypertrophy.
Patients and methods:A total of sixty patients of different age groups and both sexes were involved in the study. Patients were divided in two groups; group (I), which included 30 patients, had submucosal diathermy of both inferior turbinates and group (II); which included 30 patients had surgical endoscopic partial turbinectomy of both inferior turbinates. Patients were followed up for 6 months postoperatively and nasal obstruction was analyzed according to (NOSE) scale.
Results: there were no significant differences between both groups in nasal score mean at pre-operative, 1 week and 1 month (post-operative), however, group (II) had significantly (p<0.01) lower nasal score mean at 6 months compared to group (I),. In addition, there were a significant post-operative improvement in nasal obstruction in both used techniques at 1 week and 1 month. However, this significant improvement continued to 6 months in group II While, a type of recurrence was happened in group I at 6 months.
Conclusion: both of the used surgical techniques were found to be effective in reducing nasal obstruction but endoscopic partial turbinectomy was more effective in reducing nasal obstruction for longer duration.
https://ejhm.journals.ekb.eg/article_24359_a4987a602f4932abe12a407ea3c11eda.pdf
submucosal diathermy
Endoscopic Turbinectomy
HypertrophyInferior Turbinate
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-01-01
74
4
820
826
10.21608/ejhm.2019.24360
24360
Original Article
The outcome of Antegrade Cerebral Perfusion during Deep Hypothermic Circulatory Arrest in Pediatric Arch Surgery
Hyam Refaat Tantawi
1
Mohamed Abdel Hafez
2
Pediatric department , Ain Shams University, Faculty of Medicine –Cairo University
Cardiothoracic department, Faculty of Medicine –Cairo University
Background: Techniques for the surgical correction of aortic aneurysms have steadily improved since the first described successful repair, Despite these improvements, postoperative neurological complications remain a major factor in determining an adverse outcome.Complex aortic arch reconstruction in neonates and children is performed typically under deep hypothermic circulatory arrest. Aim: The study aimed at examining the effect of clinical impact, particularly neurologic complications, of deep hypothermic circulatory arrest in pediatric arch surgery and to summarize the early outcomes. Patients and method: One-handed and fourteen underwent full-term babies were enrolled in the present study .The maximum age was 20 weeks, arch surgery included Norwood, arch reconstruction for hypoplastic arch and interrupted aortic arch. Healthy neurological status preoperative was included between January 2011 and October 2015. The medical records were reviewed for preoperative diagnosis of patients which included age at the time of operation, sex and diagnosis of the patients. Operative details including type of the operation, duration of cross-clamp and deep hypothermic circulatory arrest timing were documented. The deep hypothermic circulatory arrest was conducted at 20 ℃. Postoperative outcomes, neurological complications including seizers, cerebral infarct, and duration of hospital stay were recorded. Results: The study noted that the incidence of postoperative complications such as seizure & bleeding was markedly 5.3%& 1.8% of the studied pediatric patients. Conclusion: The results concluded that the aortic arch reconstruction with Antegrade cerebral perfusion during the deep hypothermic circulatory arrest was accompanied by a lower risk of neurological complications. Recommendations: Long-term neurodevelopmental follow-up of these children is required to evaluate the late outcomes of Antegrade cerebral perfusion.
https://ejhm.journals.ekb.eg/article_24360_0349335b1e4a8ce5c6710dbea3657f05.pdf
Aortic Arch Surgery
Antegrade Cerebral Perfusion
Deep Hypothermic Circulatory Arrest
Neurological complications
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-01-01
74
4
827
841
10.21608/ejhm.2019.25262
25262
Original Article
Health Needs of Patients with Cholelithiasis Undergoing Laparoscopic Cholecystectomy
Sanaa Mohamed Alaa Eldin
1
Amna Yehia saad
2
Samira Saad Ali Abo El baka
3
Medical -Surgical Nursing Department, Faculty of Nursing, Alexandria University.
Medical -Surgical Nursing Department, Faculty of Nursing, Alexandria University.
Medical -Surgical Nursing Department, Faculty of Nursing, Alexandria University.
Background: Laparoscopic cholecystectomy is standard procedure for management of gallbladder stone. Gallstones (cholelithiasis) are the most common cause of biliary tract disease in adults. The educative role of nurse is integral part of the care that is essential to patient satisfaction and positive outcomes.
Objective:Identify health needs of patients with cholelithiasis who were undergoing laparoscopic cholecystectomy.
Patients and Methods: A convenient sample of 100 adult patients with cholelithiasis who were undergoing laparoscopic cholecystectomy. Health needs of patients with cholelithiasis who were undergoing laparoscopic cholecystectomy included structured interview schedule was used to collect the data for the present study. It included two parts about socio-demographic and clinical data, knowledge related to nature of the disease, pre- operative preparation, post-operative care and self- care following discharge.
Results:the present study revealed that the majority of the studied patients had poor level of knowledge. There was statistically significant positive correlation between patients' level of knowledge and age, educational level, nurses as a source of knowledge and advices as well as physician and the nurse as a preferred source of knowledge.
Conclusion:It was concluded that the studied patients had poor level of knowledge regarding disease nature, pre-operative care, post-operative care and complications and self-care following discharge.
https://ejhm.journals.ekb.eg/article_25262_b9e6d27e02e5cf4fa6861bc8162d3dd5.pdf
health needs
Cholelithiasis
Laparoscopic cholecystectomy
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-01-01
74
4
842
852
10.21608/ejhm.2019.25263
25263
Original Article
Transcranial Ultrasound in Comparison to MRI in Evaluation of Hypoxic Ischemic Injury in Neonates
Abd El-Aziz Kamal Aun
1
Hassan Ali Hassan
2
Wafik Ibrahim Ali
3
Maged Mohamed Ali Ataky
dr.maged_mohamed_ali@hotmail.com
4
Department of Radiodiagnosis, Al-Azhar University
Department of Radiodiagnosis, Al-Azhar University
Department of Radiodiagnosis, Al-Azhar University
Department of Radiodiagnosis, Al-Azhar University
Background: Hypoxic-ischemic injury is the most common cause of encephalopathy in newborns.
Objectives: The goal of our study was to demonstrate the role of transcranial ultrasound (TCUS) compared to MRI in assessment of neonatal encephalopathy.
Patients and methods: Consecutive thirty sex neonates with hypoxic-ischemic encephalopathy (HIE) were included. All cases had undergone MR imaging as well as transcranial ultrasound study of the brain. The study was conducted between May 2015 and September 2017. They were collected from the Neonatology Intensive Care Unit at Elsayed Galal and El-Demerdash University Hospitals.
Results: Our study found that stages I and II showed mild to moderate HIE presented with peripheral pattern and white matter injuries while stage III revealed severe HIE presented with central pattern of injury (BGT). In addition, our study reported that all patients with stage III of HIE showed severe central pattern on MRI.
Conclusion: MRI imaging is considered a sensitive technique in detecting different MR patterns of encephalopathy in newborns. MRI placed other imaging modalities in diagnostic assessment and early predictor of future development of neurological abnormalities in neonates with encephalopathy.
https://ejhm.journals.ekb.eg/article_25263_bb573b9d3bf7065a0c9e36acdb8a23e4.pdf
HII
TCUS
MRI
WD
Neonates
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-01-01
74
4
853
857
10.21608/ejhm.2019.25264
25264
Original Article
Conservative Treatment versus Elective Repair of Umbilical Hernia in Patients with Liver Cirrhosis and Ascites
Ashraf Abdel El-hamid Abd El-monem
1
Mohammed Abbas
2
Mahmoud Ramadan Abdelaziz El-halawany
dr7alawany@gmail.com
3
Department of General Surgery, Faculty of Medicine, Al-Azhar University
Department of General Surgery, Faculty of Medicine, Al-Azhar University
Department of General Surgery, Faculty of Medicine, Al-Azhar University
Background: management of umbilical hernia in patients with liver cirrhosis remains controversial. The general surgical opinion is that umbilical hernia in patients with liver cirrhosis and ascites has high operative risks and high recurrence rates after elective repair. Conservative treatment, however, can also have severe complications resulting in emergency repair. In these patients such operations carry an even greater risk of complications than compared to elective operations.
Objective: Aiming at comparing between conservative treatment and elective repair of umbilical hernia in patients with liver cirrhosis and ascites.
Patients and Methods: a randomized prospective interventional study Our series was carried out on 40 consecutive patients at General Surgery department, Al-Azhar University hospital; Bab Elshaeria, Cairo, Egypt in the period from June 2017 till September 2018. The patients were divided into 20 patients (group A) undergo surgical repair and 20 patients (group B) undergo conservative treatment. Mean follow up was 6 months.
Results: elective repair of umbilical hernia in patients with liver cirrhosis and ascites had fewer complications than conservative treatment.
Conclusion: Our study showed that elective repair of umbilical hernia in cirrhotic and ascetic patients had less complication than conservative treatment.
https://ejhm.journals.ekb.eg/article_25264_110693234d20752aef911e72c8ea8dcd.pdf
conservative treatment
Elective Repair
Umbilical Hernia
Liver cirrhosis
ascites
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-01-01
74
4
858
866
10.21608/ejhm.2019.25265
25265
Original Article
Comparative study between fixed and flexible GnRH antagonist protocol versus GnRH agonist long protocol in polycystic ovarian disease patients treated with IVF
Hany Maged Abd-Elaal
1
Farid Ahmed Kassab
2
Osama Deif
3
Ismael Abd-Elazeem Mira
4
Mohamed Mohamed Mohamed Essawy
5
Obstetrics and Gynecology department, Faculty of Medicine, Al-Azhar University
Obstetrics and Gynecology department, Faculty of Medicine, Al-Azhar University
Obstetrics and Gynecology department, Faculty of Medicine, Al-Azhar University
Obstetrics and Gynecology department, Faculty of Medicine, Al-Azhar University
Obstetrics and Gynecology Department, Beni-Suef General Hospital, Ministry of Health, Egypt.
The objective of the present study was to compare and evaluate the effectiveness and safety of GnRH agonist long protocol compared with the GnRH antagonist (fixed and flexible) protocols in polycystic ovary syndrome (PCOS) patients undergoing in vitro fertilization (IVF)/ intracytoplasmic sperm injection (ICSI) cycles. This study was carried out on 60 patients with polycystic ovarian disease undergoing ICSI, their age ranged from (20 to 40 years). The cases were selected from The International Center for Population Study and Research (ICPS), Al-Azhar University. Eligible patients who accepted to take part in the study were randomized into 3 study group: Group A: 20 patients were included in agonist protocol, Group B: 20 patients were included in fixed antagonist protocol and Group C: 20 patients were included in flexible antagonist protocol. The results obtained from this study indicated no statistically significant differences regarding the pregnancy rates or regarding the developing of ovarian hyperstimulation syndrome (OHSS) complication in the studied population; so larger studies with larger sample size and longer duration are needed to clarify the roles of different IVF protocols.
https://ejhm.journals.ekb.eg/article_25265_748a316d0219437319197c8ec2625b41.pdf
gonadotropin-releasing hormone agonist
gonadotropin-releasing hormone antagonist
in vitro fertilization
Polycystic Ovarian Syndrome
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-01-01
74
4
867
872
10.21608/ejhm.2019.25266
25266
Original Article
Comparative Study between Single-Level Anterior Cervical Discectomy and Fusion using Cage and Plate or Cage Alone
Youssef Barakat
1
Alaa Rashad
2
Mokhtar Ragab
3
Mohamed Ibrahim Abd Elrahman
drmohamedelhossieny@gmail.com
4
Departments of Neurosurgery, Faculty of Medicine, Al-Azhar University
Departments of Neurosurgery, Faculty of Medicine, Al-Azhar University
Departments of Radiology, Faculty of Medicine, Al-Azhar University
Departments of Neurosurgery, Faculty of Medicine, Al-Azhar University
Background: anterior cervical discectomy and interbody fusion (ACDF) is a well-accepted management option for the treatment of persistent cervical radiculopathy or myelopathy due to cervical disc prolapse. Typically a fusion is performed to stabilize the segment, maintain foraminal height.
Objective: to prospectively analyze the effect of one-level ACDF, comparing stand-alone cages and cage-with-plate fixation constructs with respect to clinical outcomes and radiologic changes.
Patients and Methods: a total of 20 patients who underwent one-level for cervical disc disease and who completed 6 months of follow-up were included in this study. The patients were grouped into ACDF-Cage-only and ACDF-Cage-with-plate groups. The following parameters were assessed using radiographs: subsidence, adjacent disc space narrowing, clinical outcomes were assessed using the Odom's criteria.
Results: in the comparison of one-level ACDF-cage-only and ACDF-cage-with-plate groups, at the 3-and 6-months follow-up: Regarding the functional outcome in the plate group 6 (60%) patients had excellent outcome, 2 (20%) patients had good outcome, 1 (10%) had satisfactory and 1 (10%) had poor outcome, while in the cage group 7 (70%) patients had excellent outcome, 110%) had good outcome, 1 (10%) had satisfactory and 1 (10%) had poor outcome.
Conclusion: our results showed that for single-level cases, plate fixation had no additional benefit versus cage-only, although the cage-with-plate fixation group had a lower incidence of cage sinking than did the cage-only group. We conclude that physicians should be aware of these possible advantages and disadvantages associated with using cervical plates in one-level ACDF.
https://ejhm.journals.ekb.eg/article_25266_76dcc7d9da0cd3d5da9ddb76d27b87c3.pdf
Diskectomy
Cervical vertebrae
spinal fusion
Bone Plate
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-01-01
74
4
873
884
10.21608/ejhm.2019.25267
25267
Original Article
The possible protective effect of vitamin E on adult albino rat’s testes exposed to electromagnetic field emitted from a conventional cellular phone
Mahmoud Ibrahim EL-Naggar
1
Alaa EL-Din Sayed EL-Sagheer
2
Ashraf El- Sayed Ebaid
3
Anatomy and Embryology department, Faculty of Medicine, Al- Azhar University
Anatomy and Embryology department, Faculty of Medicine, Al- Azhar University
Anatomy and Embryology department, Faculty of Medicine, Al- Azhar University
Aim of the work: i to discuss the possible protective effect of vitamin E as a model of powerful antioxidant on the testes of adult albino rates exposed for electromagnetic field (EMF) emitted from cellular phone. This study also detected and described signs of morphological and behavior changes that can appear on the rats. Materials and Methods: The present study was carried out on 120 healthy adult albino rats. The rats were divided into 3 main groups. Group I (control group): consisted of 40 rats. These rats were kept in the animal house away from any source of EMF. Group II (radiation group): consisted of 40 rats that were exposed to EMF emitted from mobile phone for 60 days. Group III (radiation and vitamin group): consisted of 40 rats, those were exposed to EMF emitted from mobile phone for 60 days and simultaneously they received vitamin E, orally. Results: Electromagnetic field exposed rats showed testicular alterations, which were ameliorated by using vitamin E.
https://ejhm.journals.ekb.eg/article_25267_3aed9b7784acb4b443cec598ca185523.pdf
mobile phones
Electromagnetic Field
Vitamin E
testis
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-01-01
74
4
885
889
10.21608/ejhm.2019.25268
25268
Original Article
Assessment of Impact of Insight on Medication Adherence in Schizophrenic Patients
Abd Elhady E. Hassan
1
Ali Abd E. Elnabawy
2
Mohamed M. A. Eldeeb
3
Ahmed S. M. Essa
4
Departments of Psychiatry and Neurology – Faculty of Medicine – Al-Azhar University.
Departments of Psychiatry and Neurology – Faculty of Medicine – Al-Azhar University.
Departments of Psychiatry and Neurology – Faculty of Medicine – Al-Azhar University.
Departments of Psychiatry and Neurology – Faculty of Medicine – Al-Azhar University.
BACKGROUND:Many patients with schizophrenia have impaired insight and low medication adherence. Poor adherence is one of the leading problems affecting the effectiveness of treatment in schizophrenia. It is an identified factor for relapse and hospitalizations with major social and economic consequences.
OBJECTIVE:The aim of this study was to study the relation between insight and medication adherence and other factors that may affect both of them.
SUBJECT AND METHODS:A total number of 50 schizophrenic outpatients “DSM 5” aged > 18 years old who were attending the hospital for regular follow up were included in this study. From the selected patients full medical history was obtained including: name, age, gender, occupation, educational status, history of the psychiatric disease, duration, medical treatment and times of hospitalization. Cultural and social standard and degree of family support was also collected. Patients’ insight was measured by the Schedule for Assessment of Insight-Expanded Version (SAI–E) translated into Arabic by Marwa Abdelgawad. The degree of medication adherence was measured by using Medication Adherence Rating Scale (MARS).
RESULTS:There was no significant correlation between patients’ insight and patients’ ages, duration of illness and hospitalization times with p-value: 0.69, 0.61 and 0.07 respectively. In addition, there was no significant association between medication adherence and age, duration of illness, number of hospitalization, gender, social level and family support with p-value: 0.575, 0.678, 0.566, 0.945, 0.091 and 0.360 respectively. Our results showed a strong positive correlation between insight and medication adherence with p-value: < 0.0001.
CONCLUSION: Insight and adherence were found to be closely related, low insight was associated with poor adherence in patients with schizophrenia. Moreover, these results should be used to establish a strategy for improving the prognosis of chronic schizophrenia.
https://ejhm.journals.ekb.eg/article_25268_6507e8283aa37f874192d09b90935423.pdf
Medication Adherence
Insight
Neurocognition
Schizophrenia
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-01-01
74
4
890
898
10.21608/ejhm.2019.25269
25269
Original Article
Reproductive outcomes following Hysteroscopic Removal of endometrial polyps of different location, number, and size in patients with infertility
Ismaeel Mira
1
Abdelmonsef Abdelhamed Sedek
2
Hazem Shaban Eldesoky
hzemshaman@gmail.com
3
Department of Obstetrics and Gynecology, Faculty of Medicine - Al-Azhar University
Department of Obstetrics and Gynecology, Faculty of Medicine - Al-Azhar University
Department of Obstetrics and Gynecology, Faculty of Medicine - Al-Azhar University
Bɑсkgrouոd: Һystеrosсopiс rеsесtioո is ɑ rеlɑtivеly sɑfе ɑոd simplе proсеdurе wһiсһ еffесtivеly rеmovеs polyps; һowеvеr, еոdomеtriɑl polyps сɑո rесur. Studiеs һɑvе suggеstеd rесurrеոсе rɑtеs of up to 46%, ɑոd tһеrеforе it is importɑոt to idеոtify risk fɑсtors ɑssoсiɑtеd witһ rесurrеոсе.
Objесtivе: To ɑssеss tһе prеgոɑոсy rɑtе ɑftеr һystеrosсopiс polypесtomy iո iոfеrtility pɑtiеոts witһ еոdomеtriɑl polyps to сompɑrе prеgոɑոсy rɑtе ɑmoոg subgroups witһ polyps of diffеrеոt loсɑtioոs, ոumbеr ɑոd sizе.
Pɑtiеոts ɑոd Mеtһods: These Prospесtivе Сoһort Study oո 60 сɑsеs were сoոduсtеd ɑt tһе dеpɑrtmеոt of obstеtriсs & gyոесology Sɑyеd Gɑlɑl Uոivеrɑity һospitɑl bеtwееո Mɑy 2017 ɑոd ɑpril 2018. Pɑtiеոts witһ uոеxplɑiոеd iոfеrtility. two groups.
Rеsults: Iո our study wе сompɑrе tһе prеgոɑոсy rɑtе ɑссordiոg to polyp сһɑrɑсtеristiсs suсһ ɑs loсɑtioո, sizе ɑոd ոumbеr. ɑlso wе study tһе rеproduсtivе outсomе of һystеrosсopy iո two groups: 1st group witһout iոtrɑutеriոе lеsioո. 2 - 2ոd group witһ еոdomеtriɑl polyps. ɑոd wе fouոd tһɑt: tһеrе is ոo stɑtistiсɑlly dеfеrеոсе bеtwееո tһе two groups tһе p-vɑluе is 0.40654. Wе fouոd ɑ ոoո sigոifiсɑոt positivе сorrеlɑtioոs bеtwееո Prеgոɑոсy outсomе ɑոd ոumbеr of polyps witһ p-vɑluе 0.71, ɑ ոoո sigոifiсɑոt positivе сorrеlɑtioոs bеtwееո Prеgոɑոсy outсomе ɑոd sizе of polyps witһ p-vɑluе 0.456 ɑոd ɑ ոoո sigոifiсɑոt ոеgɑtivе сorrеlɑtioոs bеtwееո Prеgոɑոсy outсomе ɑոd sitе of polyps.
Conclusion: Wе fouոd tһɑt tһеrе is ոo stɑtisticɑlly dеfеrеոcе bеtwееո tһе two groups. Wе fouոd ɑ ոoո sigոificɑոt positivе corrеlɑtioոs bеtwееո Prеgոɑոcy outcomе ɑոd ոumbеr of polyps, , sizе of polyps ɑոd ,sitе of polyps
https://ejhm.journals.ekb.eg/article_25269_5a92a7f24a1446b9a5eaeba67520881e.pdf
iոfirtility
еոdomеtriɑl polyp
һystеrosсopy
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-01-01
74
4
899
904
10.21608/ejhm.2019.25556
25556
Original Article
Does Dopamine Agonist Hormonal Therapy for Macro-Prolactinoma Affect Future Surgery?
Mohamed Raafat Kandeel
kandeelneurosurgery@gmail.com
1
Magdy A. Elhawary
2
Osama Elghannam
3
Department of Neurosurgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Department of Neurosurgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Department of Neurosurgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Background: Controversy regarding first line therapy for macro-prolactinoma patients had been of debate for many decades. Several reports suggested that dopaminergic agents (DAs) medications are accused for prolactinoma fibrosis. Whether fibrosis has positive or negative influence on the management of prolactinomas is still unclear.
Aim of the work: was to compare the intraoperative tumor consistency, intraoperative difficulties and complications both pre- and post-operative between macro-prolactinoma patients who received DA medications and who did not receive prior to surgery.
Patients and Methods: Twenty-five macro-prolactinoma patients who underwent primary pituitary surgery, sub-labial trans-sphenoidal microscopic removal, of macro-prolactinoma grouped into two groups. Group 1 included patients who were treated by DA medication, combined therapy with Bromocreptine and Cabergoline, prior to surgery for at least 3 months. Group 2 included patients who didn’t receive any preoperative DA medications. We compared the intra-operative texture of the tumor, intraoperative and post-operative complications together with the extent of surgical excision and hormonal remission achieved.
Results: No significant statistical difference as regards intra-operative tumor consistency in relation to preoperative hormonal treatment. The rate of intra-operative and post-operative complications has no relation to the pre-operative hormonal therapy by DAs nor to the intraoperative tumor consistency. The only factor that affect the extent of surgical excision is the pre-operative tumor size graded by KNOSP classification and this extent of surgical excision has direct implication on the post-operative hormonal remission rate.
Conclusion: It could be concluded that there is no risk of more tumor fibrosis nor increase in the complication rate due to DA medication prior to surgery. So, using dopamine agonist as the primary treatment for prolactinoma while Surgical excision is deferred for cases of failure or intolerance of side effects of the the hormonal therapy.
https://ejhm.journals.ekb.eg/article_25556_7d2c8bdd27c0146a28945d1bc415aedc.pdf
pituitary adenoma
Macroprolactinoma
Dopamine agonists
Bromocreptine
Cabergoline
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-01-01
74
4
905
913
10.21608/ejhm.2019.25558
25558
Original Article
Comparative study of total dose infusion of iron and intramuscular iron administration in treatment of severe iron deficiency anemia during pregnancy
Fahd Abd El Aal Al Omda
1
Abd El Raaof Abd El Raaof Abo Nar
2
Waleed El Sayed Al Naggar
3
Mohamed Abdullah Al Sayed Al-Morsi
mhmdnmtallh165@gmail.com
4
Department of Obstetrics and Gynecology, Faculty of Medicine- Al-Azhar University
Department of Clinical Pathology, Faculty of Medicine- Al-Azhar University
Department of Obstetrics and Gynecology, Faculty of Medicine- Al-Azhar University
Department of Obstetrics and Gynecology, Faculty of Medicine- Al-Azhar University
Background: Iron deficiency anemia is the most common type of anemia among pregnant women, especially in developing countries. Indeed, a majority of women in the reproductive age group in the developing countries are anemic even before conception; pregnancy only tends to intensify it further.
Objective: to compare the effectiveness and safety of intramuscular and intravenous iron therapy in pregnant women with severe iron deficiency anemia.
Patients and Methods: This study is an interventional randomized study, comparing the effect of intravenous and intramuscular iron therapy on pregnant women with severe anemia. Allocation of patients in either group (I.V & I.M) was sealed and enveloped. The study was conducted at the Department of Obstetrics and Gynecology of General Helwan Hospital.
Results: The results of our study proved that the intravenous iron, showed high effectiveness in the treatment of iron deficiency anemia during pregnancy. Nearly no side effects were detected and thus, it can be considered as a useful and alternative formulation for the treatment of iron deficiency.
Conclusion: The present study proved that the severity of iron deficiency anemia affects the maternal outcome by increasing the risk of postpartum hemorrhage and also affects the fetal outcome by increasing the risk of preterm delivery and low birth weight.
https://ejhm.journals.ekb.eg/article_25558_ecb680df13c8c381b40e1af57ce43e00.pdf
Adenosine triphosphate
Complete Blood Count
Hemoglobin
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-01-01
74
4
914
923
10.21608/ejhm.2019.25560
25560
Original Article
Diabetic macular edema: posterior subtenons versus intravitreal injection of steroids
Ashraf Mohammed Gad Elkareem
silicon2030@gmail.com
1
Ophthalmology department, Faculty of medicine, Al-Azhar University, Asyut Branch, Egypt.
Background: Diabetic retinopathy (DR) with diabetic macular edema (DME) is one of the most common complications of diabetes and can lead to visual loss in young individuals. Purpose: to evaluate the efficacy of posterior subtenon versus intravitreal triamcinolone injection for treatment of diffuse diabetic macular edema. Patients and methods: seventy six eyes of 64 patients having diffuse diabetic macular edema were included and divided into two groups; Intravitreal triamcinolon acetonide group (IVTA group) included 40 eyes of 30 diabetic individuals, injected with 4 mg (0.1ml) IVTA. Posterior subtenon triamcinolon acetonide group (STTA group) consists of 36 eyes of 34 diabetic persons injected with 40 mg (1ml) in the posterior subtenon space. The central subfield macular thickness (CMT) measured with optical coherence tomography (OCT) before injection, 3 and 6 months post-injection was evaluated. Visual acuity as Log MAR, intraocular pressure (IOP) and any complications associated with both techniques ware assessed. Results: the baseline log MAR VA was significantly improved in both groups at one, three, and six months post-injection .The IVTA and STTA groups had significant reduction in CMT three and six months after steroid injection. The mean IOP was 16.6±1.3 mmHg and 15.4±1.1mmHg at the end of follow up in IVTA and STTA groups respectively. Conclusion: both intavitreal and subtenons routes of steroid injection are good alternatives for the treatment of diabetic macular edema, but the intravitreal route has a more pronounced effect while the subtenons route is safer.
https://ejhm.journals.ekb.eg/article_25560_8b4b1cf61090c6ab92c7eafe817b10a6.pdf
Diabetes mellitus
Diabetic Macular Edema
diabetic retinopathy, posterior subtenon
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-01-01
74
4
924
933
10.21608/ejhm.2019.25561
25561
Original Article
Orthotopic ileal and sigmoid neobladder after radical cystectomy: functional results: A prospective study and retrospective study
Saied A.A. Mostafa
1
Ismail M. Khalaf
2
Ali M.H. Farag
3
Hassan A. Abdel-Baky
4
Mostafa M.M. Shakweer
5
Tarek M. Omran
6
Departments of Urology, Faculty of Medicine, Al-Azhar University, Egypt
Departments of Urology, Faculty of Medicine, Al-Azhar University, Egypt
Departments of Urology, Faculty of Medicine, Al-Azhar University, Egypt
Departments of Urology, Faculty of Medicine, Al-Azhar University, Egypt
Departments of Radiology, Faculty of Medicine, Al-Azhar University, Egypt
Departments of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Egypt
Background: bladder cancer is common among genitourinary tract. Radical cystectomy with urinary diversion is the widely accepted treatment. However, no consensus exists regarding the best orthotopic neobladder creation intestinal segment.
Aim of the work: to evaluate functional and oncological outcome of ileal and sigmoid orthotopic urinary diversion.
Patients and methods: The study included two groups of 40 patients in each group (ileal and sigmoid groups). Each group was further divided in two twenty subgroups; prospective and retrospective. Ileal group operated in Urology and Nephrology centre (UNC) and Al-Azhar University hospital (Damietta), while patients in sigmoid group were operated in Al-Azhar University hospital (Cairo). All underwent full history taking, clinical examination, and laboratory investigations. Then, postoperatively, all were followed up for 6 months. In each postoperative follow up visit, patients were assessed clinical, radiological, urodynamic study and by laboratory investigations and patients’ quality of life were evaluated.
Results: In ileal orthotopic diversion, early postoperative complications were bleeding (2.5%), urine leakage (2.5%) and wound infection (25%). Diurnal continence was achieved in 90%, while nocturnal continence was achieved in 70%. The early postoperative complications were urine leakage (2.5%), obstruction (2.5%), and ileus (12.5%). The late complications were DVT (2.5%) and intestinal obstruction (5.0%). In addition, 2.5% were died from disease. Tumor recurrence was pelvic in 7.5%, distant (hepatic) in 2.5%. Only 25% of patients were potent and urine culture revealed E-coli in 40.0%. In the sigmoid orthotopic diversion group, the early postoperative complications were urine leakage (17.5%), obstruction (2.5%), ileus (7.5%), bleeding (2.5%), DVT (2.5%) and faecal leak (2.5%). Late complications were pouch stones (10.0%), stricture urethra (12.5%), ureterocolic stricture (7.5%), pouch stones plus stricture urethra in 5.0%, DVT (2.5%), intestinal obstruction (10.0%) and hematemesis in 2.5%. In addition, 12.5% were died. Tumor recurrence was pelvic in 25.0%. Only 7.5% of patients were potent and urine culture revealed E-coli in 35.0%. Diurnal continence was reported in 92.5%, while nocturnal continence was reported in 60%.
Conclusion: both sigmoid and ileal orthotopic neobladder provided a satisfactory outcome. Sigmoid neobladder was associated with lower rate of complications and better functional outcome. However, there were many late-term complications detected in this group.
https://ejhm.journals.ekb.eg/article_25561_fd5f00ec86a7061e890c972537a97103.pdf
Bladder cancer
urinary diversion
orthotopic neobladder
sigmoid
Ileum
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-01-01
74
4
934
941
10.21608/ejhm.2019.25562
25562
Original Article
Gestational Trophoblastic Neoplasia
Mahmoud Ibrahim M. Shahin
mahmoudshahin.s3@gmail.com
1
Wael Helmy El Sheshtawy
2
Mohsen Salah El-Din Zikri
3
Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Al-Azhar University
Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Al-Azhar University
Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Al-Azhar University
Background: gestational trophoblastic neoplasia forms a wide variety of rare conditions arising from abnormal proliferation of the trophoblastic cells in the placental microvilli. They consist of vesicular mole “partial and complete”, invasive mole, placental site trophoblastic tumor (PSTT), epithelioid trophoblastic tumor (ETT) and choriocarcinoma. They can be classified into premalignant forms which include vesicular mole and malignant forms which include the rest. Aim of the Work: this study aimed tostudy the epidemiological and clinical data, as well as treatment regimes and their outcome included response and related toxicity among patients with gestational trophoblastic neoplasia treated in this study.Patients and Methods: in this retrospective study, medical records of all patients with GTN presented to Oncology Department, Al-Hussein University Hospital in the period from January 2007 to June 2017 was retrieved from the archives and medical data was reviewed and analyzed. Results: median age of patient was 37.5 (Range 20-55), molar pregnancy was the most common pathological type (40%), followed by invasive mole (31.4%), while choriocarcinoma was diagnosed in 25.7% and only 2.9% of patients had placental site trophoblastic disease. According to FIGO score; 26 patients (74.3%) showed low risk and 9 patients (25.7%) showed high risk. In low risk patients, 30.8% of patients were kept under follow up while, (69.2%) received chemotherapy, 61.1% of them achieved complete remission on methotrexate as first line chemotherapy, while the rest 38.9% achieved complete response on EMA-CO or dactinomycin as 2nd line chemotherapy. Methotrexate wasn’t effective in high risk patients, while EMA-CO had much better response achieving (66.7%) complete response rate, with 2 cases of early death in those patients. Conclusion: this retrospective study represented a single center experience and had relatively small number of cases. A large multicenter prospective trial is recommended.
https://ejhm.journals.ekb.eg/article_25562_5685bb301d7c016ecd74e4773e4ce1a4.pdf
trophoblastic
neoplasia
microvilli
epithelioid trophoblastic
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-01-01
74
4
942
948
10.21608/ejhm.2019.25563
25563
Original Article
Immunohistochemical expression of ERG and P63 in some prostatic lesions
Al-Sayed Mohamed Ibrahim
1
Hussein Abdel-Moneim Hasan
2
Al-Moatazbellah Mahmoud El-Sayed
dr_moatazsaid@yahoo.com
3
Department of Pathology, Faculty of Medicine, Al-Azhar University
Department of Pathology, Faculty of Medicine, Al-Azhar University
Department of Pathology, Faculty of Medicine, Al-Azhar University
Background: prostate cancer (PCa) ranks second among the most common types of solid tumors and the sixth among the leading causes of cancer deaths in men worldwide. In Egypt, prostatic cancer formed the majority of male genital cancer (60.7%) at the NCI in the last 10 years. Aim of the work: the present study aimed to detect the immunohistochemical expression of ERG and p63 (as abasal cell marker) in benign prostatic lesions and prostatic carcinoma and to investigate the potential use of ERG and p63 expression levels to discriminate prostatic carcinoma from other lesions and to investigate the association of immunohistochemical expression of ERG with the other prognostic parameters of prostatic carcinoma such as age, plasma PSA level and pathological Gleason score. Methods: fifty prostate lesions, which were collected from the surgical files of the Pathology Department of Al-Azhar University Hospital and from a private lab. Clinicopathological and histological features were taken from patients files and confirmed by H&E examination. Immunohistochemical study was done by using two markers ERG and P63. Results: expression of ERG was restricted to malignant tissue (Prostatic carcinoma) and was negative in BPH and PIN specimens (P. < 0.001) ERG is highly specific but less sensitive marker (40 % of PCa were negative). Expression of ERG revealed inverted significant correlation with Gleason grade and plasma PSA level (P < 0.05). P63 is highly specific and sensitive marker for non-carcinomatous prostatic lesions. Conclusion: ERG showed strong nuclear endothelial expression in all lesions.
https://ejhm.journals.ekb.eg/article_25563_ed3e4265bb80f03fc0d4a6b880a1fe42.pdf
ERG
P63
PSA
Prostate Cancer
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-01-01
74
4
949
956
10.21608/ejhm.2019.25565
25565
Original Article
The Role of Nuclear Factor Kappa B Rs28362491 Single Nucleotide Gene Polymorphism in Recurrent Embryo Implantation Failure
Khalid Tahseen Ahmed Gabr
dr_kh_g20252000@yahoo.com
1
Abd EL-Mohsen Mousa Shaheen
2
Ashraf Taha Abd-Elmouttaleb
3
Adel Elsayed Ibrahim
4
Department of Medical Biochemistry, International Islamic Center for Population Studies and Research, Faculty of Medicine, Al-Azhar University
Department of Medical Biochemistry, International Islamic Center for Population Studies and Research, Faculty of Medicine, Al-Azhar University
Department of Assisted Reproductive Unit, International Islamic Center for Population Studies and Research, Faculty of Medicine, Al-Azhar University
Department of Assisted Reproductive Unit, International Islamic Center for Population Studies and Research, Faculty of Medicine, Al-Azhar University
Background: Embryo implantation is a very intricate process, which is controlled by a number of complex molecules like hormones, cytokines, growth factors and their cross talk at feto-maternal interface. The transcription factor nuclear factor kappa B (NF-κB) induces the expression of various pro-inflammatory genes, including those encoding cytokines and chemokines, and also participates in inflammasome regulation. Aim of the present study:was to investigate the possible associations between NF-κB rs28362491 single nucleotide gene polymorphism and susceptibility to repeated implantation failure (RIF). Subjects and Methods: This study was conducted on 120 subjects subdivided into 2 groups: 60 women with successful implantation asacontrol group (Group I), and 60 womendiagnosed withRIF(Group II). They were subjected to full history taking, clinical examination and investigated for molecular testing of the NF-κB -94 ins/del ATTG (rs28362491) polymorphism by lymphocyte separation and extraction of DNA for polymerase chain reaction (PCR) together with determination of serum concentration of day 3 follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol II (E2), prolactin and thyroid stimulating hormone (TSH) concentrations by an automated quantitative enzyme-linked fluorescent immunoassay (ELFA). Results: A significant difference in the genotype distribution of the NF-κB rs28362491 between those with RIF and controls. Specifically, subjects with RIF had a significantly higher frequency of the NF-κB rs28362491 del allele than that of controls. Conclusion: This study showed a significant association between rs28362491 in the promoter region of the NF-κB gene and RIF. NF-κB appears to be a triggering factor of orchestrated gene regulation during embryo implantation.
https://ejhm.journals.ekb.eg/article_25565_db7463aeb92c0eb5f9c72d3f173c6863.pdf
Recurrent embryo Implantation Failure
Nuclear factor kappa B
single nucleotide gene polymorphism