eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
2
3392
3396
10.21608/ejhm.2019.37899
37899
Original Article
Role of Pelvic and Para-Aortic Lymphadenectomy in Advanced Ovarian Epithelial Cancer
Ahmed Mohamed Aydarous
ahmedaydarous343@gmail.com
1
Hamed Ahmed Al Azoony
2
Eid Rizk El Gammal
3
Ibrahim Hassan Mohamed
4
Mohamed Foad Abd Elmoty
5
Mohamed Rashed Abdel Hamid
6
Surgical Oncology Unit, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Surgical Oncology Unit, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Surgical Oncology Unit, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Surgical Oncology Unit, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Surgical Oncology Unit, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Surgical Oncology Unit, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Background: the role of detection and removal of retroperitoneal lymph nodes in patients with advanced ovarian cancer disease is unclear. Aim of the work: this study was aimed to evaluate the therapeutic role of pelvic and paraaortic lymphadenectomy in patients with advanced epithelial ovarian cancer. Patients and Methods: this study was designed as a prospective randomized controlled trial. Thirty patients were divided into two equal groups; 15 patients underwent optimum cytoreduction and in the other 15 patient retroperitoneal lymphadenectomy was added. Results: the mean number of nodes removed was 26, and the mean number of positive nodes was 6. There was significant difference between the two groups of the study when considering operation time (Mean 122 min. Vs. 192 min.). Also there is significant difference between the two groups of the study when considering hospital stay in days (Mean 8 days Vs. 13 days). There was significant difference between the two group of the study when considering the blood loos and need for blood transfusion (26% Vs. 80%). There was no significant difference between the two groups of the study when considering recurrence (73.3% Vs. 60%). Conclusion: Our results show improvement towards decrease the recurrence in the lymphadenectomy group but with non-significant results.
https://ejhm.journals.ekb.eg/article_37899_f86f62b30ba813b8486f7937caf8d867.pdf
Advanced epithelial ovarian cancer
Prognostic factors
Survival
Therapeutic role pelvic and aortic lymphadenectomy
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
2
3397
3400
10.21608/ejhm.2019.37901
37901
Original Article
Estimation of Autophage Function for Clearance of Hyperlipidemia with Concern of Anti-Rheumatoid Drugs
Mohamed Ibraheim Aref
1
Mahmoud Mohammed Mohammed Metwally
2
Ahmed Ewas Abd El Wahab
owieso2014@gmail.com
3
Department of Clinical Pathology, Faculty of Medicine – Al-Azhar University
Department of Clinical Pathology, Faculty of Medicine – Al-Azhar University
Department of Clinical Pathology, Faculty of Medicine – Al-Azhar University
Background: Dyslipidemia is the common complication in rheumatoid arthritis (RA) patient, and subsequently increased CVD risk. Dyslipidemia is the net result between positive intake of lipids and clearance by autophage. Objective: The aim of this work is to evaluate the effect of autophages function as clearance of dyslipidemia in two different lines of active RA treatment. Patients and methods: This study was carried out at Agouza Police Hospital. It was analysis of data from one hundred and twenty individuals who were admitted to the hospital. Their age ranged from 40-65 years. They were 84 females (70%) and 36 males (30%) healthy and patient with rheumatoid arthritis attending the outpatient clinic and the inpatient of the Department of Rheumatology. Results: There was significant increase of cholesterol in group 2, 3, and 4. There was significant increase of LDL in group 2 and 4 while it decreased in group 3 which showed significant increase in HDL. There was significant increase of disease activity (DAS-28) in group 2, 3, and 4. The autophage function showed significant increase in all groups and this could be secondary increase of phagocytosis through the action of cytokines and defect of digestion secondary to therapeutic drugs. Conclusion: Methotrexate is immunosuppressive drug could be the one of the famous immunosuppressive drugs in RA that is completely responsible for dyslipidemia.
https://ejhm.journals.ekb.eg/article_37901_cc926accedfe70833b95665c1a41b743.pdf
Autophage Function
Clearance Hyperlipidemia
Concern of Anti-Rheumatoid Drugs
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
2
3401
3406
10.21608/ejhm.2019.37902
37902
Original Article
Comparison of Intra-articular versus Intravenous Application of Tranexamic Acid in Total Knee Arthroplasty: A Prospective Randomized Study
Bahaa Kornah
1
Galal Mohamed Mansour
2
Mohamed Tawfiq Ibrahim Mohamed
mohaned.tawfiq.ibrahim@gmail.com
3
Orthopedic Surgery Department, Faculty of Medicine, Al-Azhar University
Orthopedic Surgery Department, Faculty of Medicine, Al-Azhar University
Orthopedic Surgery Department, Faculty of Medicine, Al-Azhar University
Background: Total knee arthroplasty (TKA) is commonly performed for the advanced knee joint disease. Considerable postoperative blood loss, however, is an unavoidable occurrence because of extensive soft-tissue release, and the large area of cancellous bone osteotomy associated with the procedure. In addition, knee flexion and extension activities that begin the day after the operation adds to the problem. Aim of the Work: to compare between the intravenous the intraarticular tranexamic acid (TXA) administration in total knee arthroplasty surgery. Patients and Methods: It is a prospective double-blinded randomized controlled study. This prospective, two-arm, parallel-group study was conducted at El-Hussein University Hospital and El-Agouza Hospital on 20 patients who underwent total knee arthroplasty and fulfilled all assumed inclusion and exclusion criteria. Results: The average total blood loss amount in the drain after 48 hrs. in the 1st group was 365±74.722 while in the 2 nd group it was 575±88.976. This indicates a significant decrease in blood loss amount in the 1st group (intraarticular TXA group) than the 2 nd group (intravenous TXA group). Also, it was found that the decrease in hemoglobin (Hb) level is less in the 1st group than in the 2nd group which indicates less postoperative anemia. Conclusion: Concerning intraarticular administration of TXA seemed to be effective much more than intravenous injection in terms of blood loss amount and transfusion frequency.
https://ejhm.journals.ekb.eg/article_37902_edfa4ee2548f335bb04c361f2d73fb5b.pdf
Blood Loss– Tranexamic Acid –Total Knee Arthroplasty
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
2
3407
3413
10.21608/ejhm.2019.37904
37904
Original Article
Neuropsychiatric Manifestations of Multiple Sclerosis in Egyptian Patients
Mahmoud Mohamed Abdel Sayed
1
Ahmad Farag Ibrahim
2
Ahmed El said Hassan Mohamed
ahmedega2312@gmail.com
3
Neurology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Neurology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Neurology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Background: Multiple sclerosis (MS) is a chronic inflammatory central nervous system (CNS) disease, arising from a complex interaction of both environmental and genetic factors. MS affects individuals during the most productive time of their lives, and directly limits their work capacity, leading to major social and economic consequences. Objectives: The aim of the current work was to study neuropsychiatric manifestations in multiple sclerosis patients and to understand their correlation with the degree of clinical disability. Patients and Methods: A cross-sectional randomized study included a total of 40 consecutive M.S. patients (26 female and 14 males with mean age ± SD 32.60 ± 10.01) attended at MS Outpatient Clinics of Al-Azhar University Hospitals (Al Hussein and Bab Elshierya) and 20 controls during the period from January 2018 until February 2019. Results: The present study showed that there was a highly significant difference between patients and controls groups regarding Beck scale score for depression (p =0.005). There was 52.5% of MS patients had depression (while 25% of control subjects had depression). The study showed that there was significant positive correlation between beck scale score and EDSS scale score for disability a (p value =0.048 r=0.315). There was a highly significant difference between patients and control group regarding Hamilton scale score for anxiety as (P-value = 0.002). Conclusion: An understanding of neuropsychiatric disorders in MS is important for all professionals involved in the care of people with MS. These disorders affect about half of patients.
https://ejhm.journals.ekb.eg/article_37904_23557794b453b4125b02caf6f8353b59.pdf
Neuropsychiatric Manifestations
Multiple sclerosis
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
2
3414
3418
10.21608/ejhm.2019.37920
37920
Original Article
Comparative study between Sustained Low Efficiency Hemodialysis and Online Hemodiafiltration in Critically Ill patients with Acute Kidney Injury
Mostafa Abdel Fattah El-Ballat
1
Mohamed Saeed El-Shorbagy
2
Mohamed Ahmed El-Sayed
3
Abdel Aziz Refaat Abdel Aziz
abdelaziz.refaat@gmail.com
4
Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Background: acute kidney injury (AKI) has arisen as a global public health problem and associated with high morbidity and mortality where the AKI mortality is more than 50%. It is a serious complication frequently occurred in ICU In hospitalized patients, 15% of them developed AKI and around 40% of AKI patients were referred to ICU. Objective: The aim of this study was to compare between effect of Sustained Low Efficiency Hemodialysis and Online Hemodiafiltration in Critically Ill patients with Acute Kidney Injury. Patients and Methods: This prospective study included a total of forty (age and sex matched) patients with Acute Kidney Injury (AKI) who were critically ill, attending at Nephrology Unit, Bab El-Shaareya, Al-Azhar University Hospitals. The patients were divided into 2 groups; Group (A): 20 patients on Sustained Low Efficiency Hemodialysis (SLED) and Group (B): 20 patients on Online Hemodiafiltration (OLHDF) Results: there was no significant difference between the two groups as regard Intradialytic hypotension (2 patients (10 %) in group 1 and 5 patients in group 2 (25%) p-value = 0.2). There was no significant difference between the two groups as regard weaning from ventilator (4 patients (40%) in group 1 and 3 patients in group 2 (42.8%) p-value = 0.5). Conclusion: Online haemodiafiltration (OL-HDF) showed to be better than IHD-LI in many aspects but there was no statistically significant difference in mortality, allowing us to recommend as first choice OL-HDF of treatment proposed for critically ill patients with acute kidney injury.
https://ejhm.journals.ekb.eg/article_37920_3cbf0f92ceb6f393a27074b04a084daa.pdf
Sustained Low Efficiency Hemodialysis
Online Hemodiafiltration
Acute kidney injury
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
2
3419
3424
10.21608/ejhm.2019.37907
37907
Original Article
Effect of Ligation of Inferior Thyroid Artery Main Trunk vs. its Branches on Post Thyroidectomy Hypocalcaemia
Mohamed A. Rahman Al Kordy
1
Emad Ads El Ewesy
2
Ahmed Jamal Nasr Hassan
tantawy_wael@yahoo.com
3
Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Background: more than a century ago, thyroid surgery was a somewhat frightening operation, with a reported mortality rate of 40%. Nowadays, thyroidectomy is one of the most commonly performed surgical procedures. Hypocalcaemia is well recognized phenomenon following thyroidectomy; it has been a matter of interest in the past 100 years. Objective: to compare the effect of ligation of inferior thyroid artery main trunk versus its individual branches on postoperative hypocalcaemia. Patients and Methods: thirty patients with indication for thyroidectomy were randomly allocated into two groups; 15 patients each. Group A (15 patients) where the main trunk of inferior thyroid artery was ligated, while in group B (15 patients) the individual branches were ligated. Results: the results of this work showed that the incidence of post thyroidectomy hypocalcaemia, although was statistically significant in some comparisons of calcium and PTH, yet most of the levels were within the normal range, either pre or postoperatively with no clinical effects. Conclusion: ligation of the main trunk of inferior thyroid artery, although have a statistical significant on the parathyroid function and hypocalcaemia postoperatively, good surgical technique to identify and preserve the parathyroids, is the most important factor which may affect the postoperative hypocalcaemia.
https://ejhm.journals.ekb.eg/article_37907_07c15c175f249c27e72b66cc1e42cfad.pdf
Inferior Thyroid Artery
ligation
Thyroidectomy
hypocalcaemia
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
2
3425
3431
10.21608/ejhm.2019.37909
37909
Original Article
Three-column Internal Fixation System for Comminuted Fracture of the Tibial Plateau
Ali Mohammed El Gioushy
1
Galal Mansour Hegazy
2
Ahmed Ashour El Sherief
3
Department of Orthopedic Surgery, Faculty of Medicine, Al-Azhar University, Egypt
Department of Orthopedic Surgery, Faculty of Medicine, Al-Azhar University, Egypt
Department of Orthopedic Surgery, Faculty of Medicine, Al-Azhar University, Egypt
Background: the tibia is the major weight-bearing bone of the lower leg. The proximal portion of the bone, the tibial plateau, forms the lower surface of the knee joint and it consists of two condyles – medial and lateral – separated by the tibial spines, The articular surface of the medial plateau is concave, whereas that of the lateral plateau is convex. The knee is a complex dynamic joint that is subjected to many forces during normal activities, so intact articular surface of tibial plateau is one of important factors to keep the geometry and alignment of the knee joint to act in harmony to perform its crucial function as a flexible weight bearing joint. Objective: the aim was to describe the operative procedures and clinical outcomes of internal fixation of tibial plateau to treat comminuted fractures of the tibial plateau according a new three-column classification. Conclusion: using anatomical locking plates on tibial plateau is an effective and safe tool to treat complex three-column fractures of tibial plateau and is more convenient than common plate.
https://ejhm.journals.ekb.eg/article_37909_687edd8db906484cfe106e9fdb102b2e.pdf
Internal Fixation System
Comminuted
Tibial Plateau
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
2
3432
3436
10.21608/ejhm.2019.37922
37922
Original Article
Estimation of Serum Zinc Levels in Children with Short Stature
Hosny Mohammed Ahmed Elmasry
1
Abd El-Monem Mohammed Hassan
2
Mohammed Ahmed Besher
3
Mostafa Mahmoud Abd El-Moiz
4
Department of Pediatrics, Faculty of Medicine - Al-Azhar University
Department of Pediatrics, Faculty of Medicine - Al-Azhar University
Department of Pediatrics, Faculty of Medicine - Al-Azhar University
Department of Pediatrics, Faculty of Medicine - Al-Azhar University
Background: Factors affecting malnutrition in toddlers include genetics, hormones, gender, infectious diseases, and chronic diseases. Nutritional factors that cause stunting include low intake of energy, protein, and micronutrients such as iron, vitamin A, and zinc. Objective: the aim of this study was to estimate the relation between serum zinc levels and short stature among children. Patients and methods: our study included 50 children with short stature (Group I), and 30 children with normal stature as a control group (Group II). Any children with possible genetic, endocrinological cause of short stature, severe nutritional insufficiency, age beyond the 2-10 years range or having any chronic illness or infections were excluded from the study. Results: we found non-significant relations between serum zinc and demographic characteristics among group I cases. Also, we found non-significant relations between serum zinc and anthropometric measures (weight, BMI and head circumference) among group I cases. On the other hand, we found a positive and significant relation between serum zinc level and both of height and height percentile. Also, pallor was associated with significantly lower levels of serum zinc. We found non-significant relations between serum zinc and laboratory investigations among group I cases. The only exception was the moderate positive highly significant correlation between HB and serum zinc level. Conclusion: our study concluded that lower serum zinc level is associated with short stature among preschool children, and is also associated with more anemia, and lower WBCs count.
https://ejhm.journals.ekb.eg/article_37922_c8455db374ff7e04d6573ff8a3c9b37d.pdf
zinc
children
Short stature
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
2
3437
3445
10.21608/ejhm.2019.37927
37927
Original Article
Evaluation of Transforaminal Lumbar Interbody Fusion and Posterolateral Lumbar Fusion In Treatment Of Degenerative Lumbar Disorders With Instrumentation
El- Sayd Abd El-Rahman El-Mor
1
Mamoun Mohammed Abo Shosha
2
Mokhtar Ragab
3
Mohammed Saad El-Din Radwan
4
Ashraf Abbas Abd Al Karim
ashraf_med2010@yahoo.com
5
Department of Neurosurgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Department of Neurosurgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Department of Radiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Department of Neurosurgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Background: degenerative lumbar disorders affect millions of people causing low back pain, which can restrict mobility and daily activities. Lumbar fusion operations are used as a treatment of degenerative lumbar disorders. However, the better choice among fusion techniques is still controversial. Objective: to compare the clinical and radiological outcome of Transforaminal Lumbar Interbody Fusion (TLIF) and Posterolateral fusion (PLF) in the treatment of degenerative lumbar spine stenosis and degenerative spondylolisthesis. Patients and Methods: a prospective study was conducted on 40 patients with degenerative lumbar spondylolisthesis and degenerative lumbar spine stenosis. Twenty patients underwent transforaminal lumbar interbody fusion and 20 patients underwent posterolateral fusion. Patients were followed up using the visual analogue scale (VAS) for back and leg pain and Oswestry Disability Index (ODI). Final fusion assessment was done according to Bridwell criteria. Results: ODI and VAS of leg and back pain improved in the two groups with no significant differences between the two groups whether after six or twelve months of follow up. TLIF group shows a high grade of fusion according to Bridwell grading criteria for spinal fusion and significantly better than the PLF group of patients either in six-month follow up (p=0.045) or twelve-month follow up (p=0.04). Conclusion: both TLIF and PLF provide improvement of disability and pain in patients with degenerative lumbar disorders. TLIF is superior to PLF with regard to achieving radiographic fusion. There is no significant clinical or functional outcome to support the use of TLIF over PLF in the treatment of degenerative lumbar disorders.
https://ejhm.journals.ekb.eg/article_37927_19a16c5f5f6d47e9be263eeea4721e2d.pdf
TLIF
PLF
spinal fusion
Degenerative lumbar disorders
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
2
3446
3453
10.21608/ejhm.2019.37930
37930
Original Article
Role of Magnetic Resonance Imaging in Assessment of Anterior Cruciate Ligament Post-Grafting Cases in Terms of Graft Integrity and Complications
Eisha Ramadan Mohammed
1
Nadia Abd El Sater Metwally
2
Anne Abdelaziz Saeed Elaidy
anneladidy@gmail.com
3
Department of Diagnostic Radiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Department of Diagnostic Radiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Department of Diagnostic Radiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Background: because of the high incidence of anterior cruciate ligament (ACL) injuries among the population, these have been the subject of many recent studies. It is the most commonly reconstructed ligament in the knee. Its clinical evaluation is difficult. MRI is reliably and accurately used to assess ACL-R complications. Objective: this work is an attempt to spot light the diagnostic value of MR imaging in assessment of anterior cruciate ligament reconstruction graft for distinction of its various common complications. Patients and methods: this prospective study was conducted on 50 patients with postoperative knee reconstruction of ACL. The study was done between the duration of (April 2014 to February 2019) in an MRI unit of a private radiology center. All cases were referred from the orthopedic department of New Cairo Hospital. Results: according to our results, 33 (66%) cases showed osteoarthritic changes, suggesting that the development of osteoarthritis is one of the common complications of ACL reconstruction, however it can’t be considered the commonest complication as it can be explained by the associated risk factor as meniscal or chondral lesion. Thus osteoarthritic changes can be considered is one of the most common associated findings of ACL reconstruction and ACL reconstruction can be a risk factor for development of osteoarthritis. Conclusion: MRI of the knee is indispensable and the preferred modality in evaluating the integrity of the ACL graft and can be reliably and accurately used in diagnosing complications associated with ACL reconstruction.
https://ejhm.journals.ekb.eg/article_37930_d81fc1ef9d6485675058a4e6421eed07.pdf
MRI
ACL
CT
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
2
3454
3459
10.21608/ejhm.2019.37932
37932
Original Article
Role of Laparoscopy in Management of Non-Palpable Undescended Testis in Children
Mohamed M. AbdElsalam
dr_medo_mas_4040@yahoo.com
1
Khalid M. Elshimy
2
Akram M. Elbatarny
3
Mahmoud A. Elafifi
4
Pediatric Surgery Department. Faculty of Medicine. Tanta University
Pediatric Surgery Department. Faculty of Medicine. Tanta University
Pediatric Surgery Department. Faculty of Medicine. Tanta University
Pediatric Surgery Department. Faculty of Medicine. Tanta University
Background: Several techniques have been described for treatment of intra-abdominal testis including microsurgical autotransplantation, primary laparoscopic orchiopexy (VILO), one- and two-stage laparoscopic Fowler–Stephens procedures, and staged laparoscopic traction orchiopexy (Shehata technique). Aim of the work: To evaluate the role of laparoscopy in the treatment of non-palpable undescended testis. Patients and methods: This study was carried out in the Pediatric Surgery Unit, Tanta University Hospitals, during the period from April 2017 to October 2018, on 37 cryptorchid boys with 40 non-palpable testes. The mean age of the patients was 3.46 ± SD 3.1 years. Laparoscopic exploration was done for all cases, and if testes were found intraabdominally, with rough measurement of the length oftesticular vessels (TV), decision was taken either to do VILO or Shehata technique. Results: Out of 40 testes, 17 testes (42.5%) were vanishing, 3 intra-abdominal testes (7.5%) with long TV enough to undergo VILO, and 20 intra-abdominal testes (50%) with short testicular vessels underwent Shehata technique. Follow up for 3 -12 months postoperatively showed that all 3 testes underwent VILO were normal in size and vascularity. While the 20 testes underwentShehata technique, 19/20 (95%) testes were normal in size, while small testis was detected in 1/20 testis (5%). Conclusion: VILO has excellent results in management ofintra-abdominal testes with sufficient TV length while Shehata technique has excellent results in management ofintra-abdominal testis with short TV
https://ejhm.journals.ekb.eg/article_37932_973b8251074d01769861f3525a594b53.pdf
Laparoscopy
intra abdominalt estis
primary laparoscopic orchiopexy
Fowler–Stephens procedures
Shehata technique
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
2
3460
3467
10.21608/ejhm.2019.37933
37933
Original Article
A Study of CT Versus MR Arthrography in Detection of Acetabular Cartilage Defects and Labral Tears
Eman Gaber Mohamed Al-Saadawy
1
Ashraf Mohammed Enite
2
Ahmed Mahmoud Sayed
amboeyad@gmail.com
3
Radiodiagnosis Department, Faculty of Medicine, Al-Azhar University for Girls, Cairo, Egypt
Radiodiagnosis Department, Faculty of Medicine, Al-Azhar University for Girls, Cairo, Egypt
Radiodiagnosis Department, Faculty of Medicine, Al-Azhar University for Girls, Cairo, Egypt
Background: the most important role of imaging in the preoperative period is to reveal labro-cartilaginous lesions in patients with chronic hip pain and suggested FAI. MRI particularly 3T MRI has a good ability to detect labral and chondral pathologies in FAI. Objective: to evaluate CT hip arthrography in the detection of acetabularlabral lesions and articular cartilage defects in comparison with MR arthrography in patients with chronic intractable hip pain. Patients and Methods: this is a cross sectional study in Cairo Scan Radiology center and Al-Azhar University hospital over 5 years period. The study included 61 patients who were referred for identification of source of chronic hip pain or assessing previous hip arthroscopic intervention. All cases were subjected to evaluation by both MDCT and MR arthrography. Confirmation of diagnosis was primarily based upon MR arthrography findings. Result: sixty-one patients were included in this study. Of them, 51 patients have been proved to have intra articular pathology; 31 males (61%) and 20 females (39%). Femoro-acetabular deformities were readily detectable via CT arthrography. Compared to MRA, CT arthrography had a sensitivity and specificity of 90.7% and 100% in detection of acetbularlabral lesions, 95% and 100% specificity in detection of femoral and acetabularchondral lesions, and 86% and 100% specificity in the detection of other intra articular pathologies, respectively. Conclusion: multidetector CT arthrography is an efficient alternative to MR arthrography in the evaluation of internal derangements of the hip.
https://ejhm.journals.ekb.eg/article_37933_5e65de3fc9c86d1065dfd32402e7536c.pdf
Labral tear
Cartilage loss
Para-labral cysts and ossification
CTA and MRA
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
2
3475
3482
10.21608/ejhm.2019.37935
37935
Original Article
Fixation of Fractures of Ulnar Styloid Associated with Distal Radius Fractures by K wires "Tension Band"
Adnan Abd-aleem El sebaey
1
Galal Mohamed Mansour
2
Sobhy Taher Sobhy Daoud
dr_daoud86@yahoo.com
3
Department of Orthopaedic Surgery, Faculty of Medicine, Al-Azhar University
Department of Orthopaedic Surgery, Faculty of Medicine, Al-Azhar University
Department of Orthopaedic Surgery, Faculty of Medicine, Al-Azhar University
Background: fracture of the distal radius is the most common type of fracture in the upper extremity. Because the radius plays a fundamental role in the stability of the wrist joint, preservation of ligamentous function of the wrist and the biomechanics of radiocarpal and radioulnar joints, anatomical reduction and correction of articular surface incongruity decreases the potential of degeneration and accelerates post-injury rehabilitation. Objective: the aim of this study is targeting fixation of ulnar styloid fracture associated with distal radius fracture by K wires" Tension Band" and detecting the effect of these fractures on final wrist outcome. Patients and Methods: ten cases with fracture of ulnar styloid were managed over the last year from July 2017 to march 2018. Case selection was according to: 1- Base fracture of ulnar styloid (Type 2). 2- Involvement more than 50% of the height of ulnar styloid. Results: our study showed that one patient developed non-union, one patient developed infection, two patients with injury to dorsal cutaneous branch of ulnar nerve and one patient developed DRUJ instability. According to Mayo Clinic Wrist Score; one patient achieved excellent Mayo Score, two with good score, five with satisfactory score and two with poor score. Conclusion: although Open reduction and internal fixation is recommended in case of base fracture if there is displacement more than 2mm or if there is associated DRUJ instability as it is associated with high union rate and less rate of DRUJ instability
https://ejhm.journals.ekb.eg/article_37935_5d5bb6caa2d32183f14c4f866d15bcf2.pdf
Ulnar Styloid
DRUJ
K wires
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
2
3483
3493
10.21608/ejhm.2019.37936
37936
Original Article
Retrospective Evaluation of The Result of Fixation of Lateral Humeral Condyle Fractures by K-Wires versus Cannulated Screws in Children
Adnan A. Alim Alsebaie
1
Mohamed A. Monam Negm
2
Mostafa Mahmoud Mohamed Kudaih
kodeah.mm@gmail.com
3
Department of Orthopedic Surgery, Faculty of Medicine – Al-Azhar University
Department of Orthopedic Surgery, Faculty of Medicine – Al-Azhar University
Department of Orthopedic Surgery, Faculty of Medicine – Al-Azhar University
Background: fractures of the lateral condyle of the humerus represent the second most common type of fracture of the elbow in children. Although this injury is seen at all ages, it is predominately observed in children aged between 5 and 10 years. Objective: the purpose of this study is retrospective evaluation of the results of fixation of lateral humeral condyle by K-wires versus cannulated screws in children by assessment of: 1-Time to full union. 2-Range of motion.3- Percentage of complications. 4-According to Hardacre criteria. Patients and methods: a retrospective study for evaluation of the result of fixation of lateral humeral condyle fractures in children by K-wires vs cannulated screws. Our series was conducted in Al-Azher University Hospitals. 20 patients with humeral condyle fractures were treated by K-wires and cannulated screws. Results: in group A patients presented by complications as following: extension lag 1 (10%), delayed union (healing at 3–6 months) 1 (10%), revision 1 (loss of reduction at the 3rd day of operation and required revision using pin fixation) (10%), fish tail deformity 0 (0%) and 7 (70%) had no complications. While in group B: extension lag 1 (10%), delayed union 2 (20%), nonunion 1 (10%) (Not healed at greater than 6 months and reoperated using bone graft and pin fixation), revision 0 (0%), fish tail deformity 1 (10%), pin tract infection 1 (10%) and 4 (40%) had no complications. Conclusion: our study supports that screw fixation may be a viable option, with no nonunions and fewer complications than pin fixation.
https://ejhm.journals.ekb.eg/article_37936_c8eff8852e7946d7f06aea22ed1c36d7.pdf
Fixation of lateral humeral condyle fractures
K-wires
Cannulated screws in children
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
2
3494
3499
10.21608/ejhm.2019.37937
37937
Original Article
Phytoestrogens Soymilk and Fenugreek Oil Perturb Lipid and Hormonal Profile and Other Physiological Parameters of Male Albino Rats
Eman G.E. Helal
emanhelal@hotmail.com
1
Hewaida, A.E. Fadal
2
Gavin C. Ikechukwu
3
Mohamed A. Abd-El-Aziz
4
Shaimaa S. Ahmed
5
Zoology Department, Faculty of Science, Al-Azhar University (Girls)
Physiology and Nutritional Chemistry, National Nutrition Institute, Cairo, Egypt
Biochemistry Department, College of Natural Sciences, Michael Okpara University of Agriculture, Umudike, Nigeria
Physiology Department, Faculty of Medicine, Al-Azhar University (Boys), Cairo, Egypt
Zoology Department, Faculty of Science, Al-Azhar University (Girls)
Background: phytoestrogens are a diverse group of plant-derived compounds that structurally or functionally mimic mammalian estrogens. They have been investigated at the epidemiological, clinical and molecular levels to determine their potential health benefits. Aim: the present study was carried out to investigate some biochemical effects of fenugreek oil and soymilk on male albino rats. Materials and Methods: eighteen (18) animals were divided randomly into three groups with 6 animals per group. Group “1” received normal saline 1 mL/kg body weight orally for four weeks. Group “2” rats were treated with oral dose of soymilk 1 ml/kg body weight/day once daily for four weeks, while rats in group “3” were treated with oral dose of fenugreek 1 ml/kg body weight/day once daily for four weeks. Blood samples were collected on the last day of the experiment for biochemical analysis. Results: the fenugreek oil and soymilk induced highly significant decrease (p<0.01) in total cholesterol, triacylglycerol, low-density lipoprotein, very low-density lipoprotein, low-density lipoprotein high-density lipoprotein ratio (LDL/HDL) and a significant increase (p<0.05) in high-density lipoprotein. The results also showed highly significant decrease in follicle stimulating hormone, luteinizing hormone, testosterone and sperm count compared to normal control group. Conclusion: the results of this study suggest that high levels of fenugreek and soymilk intake can cause hormonal disturbance and decrease sperm count.
https://ejhm.journals.ekb.eg/article_37937_313d8403cead76608ae063068e2583e8.pdf
Fenugreek oil
Soymilk
Lipid profile
Phytoestrogen
hormonal profile
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
2
3500
3515
10.21608/ejhm.2019.38653
38653
Original Article
Comparative Histological and Immunohistochemical Study on The Effect of Curcumin and Atorvastatin in Induced Atherosclerosis in Aorta and Cardiac Muscle of Male Rabbits
Sheriff Aly Saleh
1
Gamal Soliman Algharabawy
2
Mohamed Ghazy Attia Hablas
drgazy78@gmail.com
3
Department of Histology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Department of Histology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Department of Histology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
Background: curcumin has many pharmacological effects including antioxidant, anti-inflammation, eliminating free radicals, anti-tumor, lipid regulation and anti-coagulation. Objectives: to compare the histological effects of curcumin and atorvastatin in experimental induced atherosclerosis in the rabbit’s aorta and heart. Subjects and Methodology: thoracic aorta sections were prepared and stained by Hx&E, orcein, Masson's trichrome and immuonohistochemical staning using CD34. Cardiac sections were prepared and stained by Hx&E, Masson's trichrome stain and immuonohistochemical staning using troponin T. Morphometrical study included, the thickness of both tunica intima and media of thoracic aorta , area % of the elastic fibers contents of both tunica intima and media in thorathic aorta, and the area %of the immune reaction of CD34 in thoracic aorta . Results: the atherosclerotic group showed a significant increase in the thickness of both tunicae intima& media when compared with the control group. There was a significant decrease in elastic fibers content and significant increase in the mean area % of the immune reaction of CD34 versus control. In atorvastatin treated group: there was a significant increase in comparison to control group, while there was a significant decrease in comparison to atherosclerotic group. There was significant decrease in elastic fibers content and significant increase in the mean area % of the immune reaction of CD34 in comparison to control group. In curcumin treated group: the thickness of both tunica intima and media showed a significant increase in comparison to control group. Conclusion: curcumin has potential role in treatment of atherosclerosis and myocardial infarction.
https://ejhm.journals.ekb.eg/article_38653_f6fe7f7e821bb4a6fc48a81bc8c91e4d.pdf
Atherosclerosis
Atorvastatin
Curcumin
Aorta
cardiac muscle
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
2
3516
3522
10.21608/ejhm.2019.38654
38654
Original Article
A Comparison between Both Mineralocorticoid Receptor Antagonist Agents (Eplerenone and Spironolactone) in Prognosis of Heart Failure with Reduced Ejection Fraction (HFrEF)
Mohamed Ayman Mostafa Saleh
1
Ramadan Ghaleb Mohammed
2
Ayman Maher Asham Ibrahim
3
Mena Mekhail Solhy
menamekha88@gmail.com
4
Department of Cardiology, Faculty of Medicine, Aswan University
Department of Cardiology, Faculty of Medicine, Aswan University
Department of Cardiology, Faculty of Medicine, Aswan University
Department of Cardiology, Faculty of Medicine, Aswan University
Background: heart is the target organ for Aldosterone, spironolactone and eplerenone (mineralocorticoid receptor antagonists) inhibits the aldosterone extraction through the heart in patients with congestive heart failure (CHF). Objective: to evaluate prognostic impact of both MRA (spironolactone and eplerenone) on heart failure and compare between both agents in incidence of side effect (gynecomastia and hyperkalemia). Patients and Methods: the study was conducted from March 2016 to September 2016 at Aswan University hospital. Our study population consisted of 100 adult patients, who were proved to have heart failure symptoms, with reduced ejection fraction heart failure divided in two groups. Group A contains 50 patients on spironolactone in addition to other anti-failure treatments according to ESC guidelines. Group B is 50 patients on eplerenone in addition to other anti-failure treatments according to ESC guidelines. Results: follow up had been done after one month for patient clinical status and serum potassium level and development of gynecomastia. Another Follow up was done after 3 months for BNP level, gynecomastia, NYHA classification and body weight. Conclusion: MRA are important line of treatment in HF patients, eplerenone and spironolactone are both have good result in improving BNP level and improving NYHA classifications and patients weight loss.
https://ejhm.journals.ekb.eg/article_38654_364fe41f245ebb408e599578c8e4a7ba.pdf
Mineralocorticoid receptor
Atrial Fibrillation
Congestive Heart Failure
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
2
3523
3529
10.21608/ejhm.2019.38655
38655
Original Article
Metabolic Profile as A Predictor of Coronary Artery Disease Detected by Multislice Computed Tomography in Asymptomatic Type II Diabetic Patients
Islam Shawky Abdel Aziz
1
Mohamed Abou Mandour Mousa
2
Mohamed Saleh Rizk Elwaseef
dr.m.saleh046@gmail.com
3
Department of Cardiology, Faculty of Medicine – Al-Azhar University
Department of Cardiology, Faculty of Medicine – Al-Azhar University
Department of Cardiology, Faculty of Medicine – Al-Azhar University
Background: previous studies have demonstrated that coronary artery calcium score (CACS) assessment combined with risk factors among asymptomatic adults provides prognostic information superior to either method alone, and the combined approach can more accurately guide primary preventive strategies for patients with coronary artery disease (CAD) risk factors. Objective: the purpose of this study was to assess the presence and extent of coronary calcium in symptomatic type 2 diabetic patients with metabolic syndrome by MSCT. Patients and Methods: this was a prospective observational study that was done between January 2018 and December 2018. The study included 150 patients referred to the MSCT Coronary Angiography unite in Mustafa Kamel Military hospital (Alexandria, Egypt) with metabolic syndrome according to IDF. Results: in our study 51 cases (86.4%) of those with serum parathyroid hormone level less than 65 pg/dl had a coronary calcium score (CCS) less than 10 compared to 8 cases (18. 6%) among those with more than 65 pg/dl (p value 0.001), while 0% out of those with normal serum parathyroid hormone less than 65 pg/dl had a CCS more than 200 (p value= 0.001) while 100% cases with CCS more than 200 had serum parathyroid level more than 65 pg/dl. So, the trend toward a high CCS is linked to increasing serum parathyroid hormone level. Conclusion: CAC screening is accurate and valuable modality as a completely non-invasive and relatively timeefficient screening way when avoiding high radiation burden to patients with metabolic syndrome criteria even when asymptomatic.
https://ejhm.journals.ekb.eg/article_38655_534f95dc155653ed1167a04a05b94dd9.pdf
CACS
MetS
CVD
HDL
DMT2
CCS
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
2
3530
3541
10.21608/ejhm.2019.38656
38656
Original Article
Evaluation Study of Different Methods of Refraction in Hyperopic Lasik
Abd El Rahman Fathy Sayed Ahmed
abdo_belal2010@yahoo.com
1
Hassan Abd El Wahab
2
Mahmoud Mohammed Saleh
3
Department of Ophthalmology, Faculty of Medicine-Al Azhar University.
Department of Ophthalmology, Faculty of Medicine-Al Azhar University.
Department of Ophthalmology, Faculty of Medicine-Al Azhar University.
Background: hyperopia, also known as far-sightedness, is a common type of refractive error in which light is focused behind, instead of on, the retina. This causes close objects to be blurry, while far objects may appear normal. Aim: this was evaluation study between different methods of preoperative refraction detection in hyperopic lasik including cycloplegic, manifest and wave front refraction for all patients and according to best-corrected visual acuity we do refractive surgery and analyze postoperative refraction outcome. Patients and Methods: the current study was carried out on thirty-four eyes of eighteen patients. All patients had primary hyperopia with or without hyperopic astigmatism. All patients were informed about the limitations and risks of the procedure. All patients signed an informed consent. Results: In hyperopic spherical group, the mean preoperative spherical equivalent regarding wavefront refraction was + 3.36 ± 1.26 (range + 1.70 to + 5.39 D). 6 months post operatively, it became + 0.35 ± 0.36 (rang + 0.12 to +0.90 D). In hyperopic astigmatic group, the mean preoperative spherical equivalent regarding wave-front refraction was + 3.13 ± 2.08 (range + 1.0 to +5.63D). 6 months post operatively, it became + 0.74 ± 0.43 (range + 0.12 to + 1.63D) and for Cycloplegic auto-refraction, it became + 0.92 ± 0.46 (range + 0.25 to + 1.74D). Conclusion: laser in situ keratomileusis for hyperopia, hyperopic astigmatism is a safe, effective and predictable technique. However, modification in the nomogram is needed in order to achieve good results.
https://ejhm.journals.ekb.eg/article_38656_7c83f5a956fabfbb836365c5902a1069.pdf
Wavefront
hyperopia and manifest refraction
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
2
3542
3549
10.21608/ejhm.2019.38887
38887
Original Article
Role of Nucleic Acid Test (NAT) in Detection of Transfusion Transmitted Viruses in Comparison to Other Methods
Ekram Yassin Ebeid
1
Hoda Abd Ellateif Kholeif
2
Nancy Hassan Hussein
nancy.barbie83@gmail.com
3
Department of Clinical Pathology, Faculty of Medicine - Al-Azhar University
Department of Clinical Pathology, Faculty of Medicine - Al-Azhar University
Department of Clinical Pathology, Faculty of Medicine - Al-Azhar University
Background: over the two last decades, much attention has been given to the prevention of transfusion-transmitted viral infections. Given the potential transmission of viruses during the window period, novel non-serology based approaches such as viral nucleic acid testing (NAT) have been established. Objective: a comparative study of different methods to detect transfusion transmitted viral infections. Materials and methods: this cross-sectional study was conducted at the Egyptian National Blood Transfusion Center (NBTC), Giza. The duration of the research was 2 months from June 2018 to august 2018. In our study 1000 donor samples were tested by ELISA and NAT tests for HBV, HCV and HIV. Results: regarding ELISA tests of the three viruses, only 14 (1.4%) samples were finally HBsAg reactive. Finally, reactive HCVAb were 22 (2.2%) samples, while only 4 (0.4%) samples were HIV Ag-Ab finally reactive. We found highly statistical significant difference between initial and final results of ELISA (p<0.001). Regarding NAT testing of the three viruses. HBV: 5 (0.5%) samples were NAT and ELISA reactive, 1 was NAT yield. HCV: 9 (0.9%) samples were NAT and ELISA reactive. HIV one sample (0.1%) was NAT and ELISA reactive, one (0.1%) was NAT yield. Statistical significant difference was found in comparison between NAT and ELISA in HBV, HCV, and HIV p values <0.001, <0.001, and = 0,008 respectively. Conclusion: we concluded that NAT and ELISA are complementary to each other. NAT is an effective method for safeguarding the blood supply.
https://ejhm.journals.ekb.eg/article_38887_a7ae584c3410cdcfdbaec873b851ea3b.pdf
NAT
Transfusion transmitted viruses
HIV
HCV
HBV
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
2
3550
3555
10.21608/ejhm.2019.38888
38888
Original Article
Optical Coherence Tomography Patterns in Diabetic Macular Edema and Its Impact on Anatomical and Functional Outcome after Intravitreal Injection of Ranibizumab
Ahmed T. Al Sayed
tefa2end@hotmail.com
1
Hassan A. Ali
2
Mostafa M. Mostafa
dr.mostafamosbeh@gmail.com
3
Abdelaleem A. Elgendy
4
Department of ophthalmology and clinical pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Department of ophthalmology and clinical pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Department of ophthalmology and clinical pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Department of ophthalmology and clinical pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Background: to report the anatomical and functional outcome based on patterns of optical coherence tomography (OCT) morphology in diabetic macular edema (DME), following treatment with intravitreal ranibizumab (IVR) injection. Aim of the Work: to evaluate the role of OCT in detecting the patterns of DME and its effect on anatomical and functional outcome after IVR injection. Patients and Methods: this study enrolled 30 eyes of patients with DME. These patients were categorized into 3 groups according to OCT finding, group I- 10 eyes with diffuse retinal thickening (DRT), group II- 10 eyes with cystoid macular edema (CME), group III- 01 eyes with neurosensory detachment (NSD). All patients received a three monthly doses of intravitreal ranibizumab. Best-corrected visual acuity (BCVA) and central macular thickness (CMT) were assessed before and after the treatment (in the 1st, 3rd and 6th month). Results: at month 6, mean BCVA changed with 0.24 ± 0.057 Decimal (P<0.001),0.23± 0.10 Decimal (P<0.001) and 0.11 ± 0.12 Decimal (P=0.019), respectively, for DRT, CME and NSD groups. Mean CMT decreased by119.80 ± 84.58μm (P=0.002) in DRT group, by83.00 ± 65.98μm (P=0.003) in CME group and by 102.30 ± 110.25 μm (P=0.017) in NSD group. The DRT group was associated with superior BCVA improvement and greater reduction in CMT. Conclusion: we found statistically significant improvement of BCVA and CMT in all groups of DME based on OCT pattern at final follow-up with greater reduction in CMT and superior BCVA improvement in DRT group.
https://ejhm.journals.ekb.eg/article_38888_28088250c5d154bbc8b6c6e436b4850a.pdf
Optical Coherence Tomography
Diabetic Macular Edema
intravitreal injection
ranibizumab
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
2
3556
3563
10.21608/ejhm.2019.39161
39161
Original Article
Comparative Study between Heavy-Weight Mesh and Light-Weight Mesh in Ventral Hernia Repair
Mahmoud Mohamed Ibrahim
1
Waleed Raafat Abd Alaaty
2
Osama Ibrahim Abd Alkader
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: Ventral hernia may be spontaneously (primary ventral hernia) or at the site of a previous surgical incision (incisional hernia). Ventral hernias are classified according to their location and etiology, a primary ventral hernia is classified as a (para-) umbilical, epigastric or Spigelian hernia (between the muscles of the abdominal wall). Objective: This work aims to study and compare the use of the heavy-weight mesh and light-weight mesh in ventral hernia repair. Patients and Methods: This study was conducted on patients (male and females) suffering from ventral hernia “primary or incisional” admitted to the General Surgery Department, at Nasser Institute Hospital and Al-Azhar University Hospital during the period from June 2018 to May 2019. Results: Quality of life (QOL) values in the 3rd postoperative month were not statistically significant higher in the LW group than that of the HW group. QOL values of the both groups in the 3rd postoperative month were significantly higher when compared to the baseline (preoperative values). Foreign body sensation was significantly less frequent in the LW group than that of the HW group. Conclusion: The lightweight mesh offers benefits over heavyweight mesh for ventral hernia repair by reducing the incidence of chronic pain and foreign body sensation.
https://ejhm.journals.ekb.eg/article_39161_d7c5b196c0c2cdb130bfde8cd7b053bf.pdf
Heavy-Weight Mesh
Light-Weight Mesh
Ventral Hernia Repair
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
2
3564
3571
10.21608/ejhm.2019.39162
39162
Original Article
Eating Red meat and Symptomatic Lower Urinary Tract Infection among female students at King Abdul-Aziz University in Rabigh, Saudi Arabia
Iman Mohmad Wahby Salem
1
Soad Shaker Ali
2
Fatma Ibrahim Al Bllady
3
Ebtihal Mohammed Saleh Albeshri
4
Family and Community Medicine Department, Faculty of Medicine, Rabigh, KAU and Al-Azhar University
Anatomy Department, Faculty of Medicine, Rabigh, KAU
Internal Medicine Department, Faculty of Medicine, Rabigh, KAU
Undergraduate student, Faculty of Medicine, Rabigh, KAU.
Background: Chronic diseases, such as diabetes, hypertension associated-heart disease; and several different cancers were reported to be linked to high meat consumption. Assessment of urinary nutria-metabolomics was also considered and reported as a novel tool for dietary styles. Increased consumption of red meat was associated with increased risk of bladder diseases and infection. Method: This is a cross-sectional study conducted among the Rabigh colleges’ female students throughout 10 months, for measuring the prevalence of symptomatic lower urinary tract infection (LUTI) at King Abdul-Aziz University, Rabigh, Saudi Arabia, 2019. The questionnaire was distributed among 200 students through their mobile via WhatsApp. It was calculated by the sample size equation, using a mean prevalence of LUTI among teenage female. Result: Among the 230 students who received the questionnaire, the response rate was 66%, so the total current studied sample was 152 female students from different colleges in Rabigh. 75.66% of them in age (15- 24 years), and 24.34% of them were in age (25-30 years), 23.68% of them were married, and 78.29% were eating red meat. UTI prevalence was 25.66%. There was a high percentage (66.7%) of UTI among the young female (15-24 years), the married women (35.9%), the group who don’t drink enough water (69.2%), and 59.0% with a high rate of eating meat (2 times/ week). All these differences were found to be statistically significant (P ≤ 0.05). Conclusion: LUTI symptoms seemed to be related to increased trend towards red meat eating besides other factors e.g. water drinking and marital status.
https://ejhm.journals.ekb.eg/article_39162_1fd8f26ff25fcc538d16ab09f420b5d0.pdf
Eating Red meat
Symptomatic Lower Urinary Tract Infection
Female Students
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
2
3572
3580
10.21608/ejhm.2019.39163
39163
Original Article
Increased Risk of Rheumatoid Arthritis-Related Pulmonary Disease as a Results of Serum Anticitrullinated Protein Antibody Positivity
Samia Abdel-Hamid Abdel-Mageed
1
Eldesoky E. Foda
2
Emam Mohamed Abdel-Azeez
3
Seham Abdallah Elazab
s.abdallah.azab@gmail.com
4
Department of rheumatology and Rehabilitation, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Department of Internal Medicine and Immunology and Allergy Center, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Department of Radiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Department of rheumatology and Rehabilitation, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Background: there is increasing evidence to indicate that autoimmunity as well as inflammatory reactions occur systemically before development of any clinical sign of joint disease in patients with anti–citrullinated protein antibody (ACPA)–positive rheumatoid arthritis (RA). Objective: The aim of the work was to investigate the potential predictive value of anti-ccp3 for interstitial lung disease association with RA and to discriminate RA patient who are at potential risk to develop methotrexate (MTX) induced pulmonary toxicity. Patients and methods: This cross-sectional study included a total of 50 RA patients who were diagnosed according to the 2010 American College of Rheumatology / the European League Against Rheumatism classification criteria for Rheumatoid Arthritis (ACR/EULAR 2010 criteria) for detection of pulmonary manifestations attending at Physical medicine, Rheumatology and Rehabilitation Outpatient Clinics of Al-Azhar University Hospitals. Results: there was statistically significant difference between patients with and without interstitial lung disease (ILD), in high-resolution computed tomography (HRCT) as regards to Tiffeneau-Pinelli index (FEV1/FVC ratio), except for FEV1/FVC between patients with and without ILD in HRCT, forced expiratory volume in first second (FEV1), and forced vital capacity (FVC) are often decreased because of the reduction in lung volume, but the FEV1- to-FVC ratio is maintained or increased in ILD. Conclusion: RA patients without chest symptoms should not be neglected, pulmonary function testing and HRCT should be done routinely to pick up early ILD cases.
https://ejhm.journals.ekb.eg/article_39163_766917227f6dfdb57783d7b0f636e29f.pdf
Rheumatoid Arthritis
pulmonary disease
PCPA
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
2
3581
3588
10.21608/ejhm.2019.39164
39164
Original Article
Subclinical Systolic Myocardial Dysfunction in Diabetic Patients by 2-Dimensional Speckle Tracking
Muhammad Adel Attia
1
Muhammad Saad Reihan
2
Abu Bakr Muhammad Bakr
tantawy_wael@yahoo.com
3
Department of Cardiology, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
Department of Cardiology, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
Department of Cardiology, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
Background: Diabetic cardiomyopathy became a subject of great interest and the evidence for this entity is rapidly emerging as the incidence of heart failure is increasing in those patients even with no hypertension or coronary artery disease (CAD). Objective: The current study was aimed at early detection of subtle left ventricular systolic dysfunction by speckle tracking echocardiography in patients with Diabetes Mellitus with and without hypertension. Patients and methods: This study included a total of 100 asymptomatic poorly controlled diabetic patients with or without hypertension and no structural heart disease and 25 age-matched apparently healthy control subjects attending at Cardiology department, Al-Azhar University Hospital in Damietta. The included subjects were divided into three groups; Group I (control) consisted of 25 apparently healthy subjects, Group II (diabetic normotensive group) consisted of 64 patients and Group III (diabetic hypertensive) consisted of 36 patients. The following were done for all: resting ECG, HbA1c, conventional echo assessment and finally strain imaging with measurement of LV-GLS and LV-GCS. Results: There was a significant inverse correlation between the duration diabetes, BMI and LV-GLS. On the other hand, there was no significant correlation between hypertension or HbA1c and echocardiographic parameters including conventional and strain methods. Patients with higher BMI had more decrease in LV circumferential strain while patients with longer periods of DM and higher values of BMI had a decrease on both global LV longitudinal and circumferential strains. Conclusion: It could be concluded that assessment of left ventricular (LV) systolic function in patients with diabetes mellitus by speckle tracking echocardiographic modalities can detect subtle LV dysfunction earlier than conventional echocardiographic measures.
https://ejhm.journals.ekb.eg/article_39164_2a1913223c54f2ed81faea6e2dfae8ee.pdf
DM
CAD
LV
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
2
3589
3594
10.21608/ejhm.2019.39165
39165
Original Article
Intralesional Vitamin D3 versus Purified Protein Derivatives in The Treatment of Multiple Cutaneous Warts: Comparative Study
Essam Elden M Mohamed
1
Moustafa A El Taieb
2
Gehad A Abd El- sabour
gehada022@gmail.com
3
Venereology and Andrology, Faculty of Medicine, Al-Azhar University, Assuit
Dermatology, Venereology and Andrology, Faculty of Medicine, Aswan University
Dermatology, Venereology and Andrology, Faculty of Medicine, Aswan University
Background: Viral warts are caused by human papillomavirus. Many therapeutic options are available for treating warts. Newer and effective treatments include intralesional immunotherapy, has been tried in the recent times with variable success rates. Objective: The aim of this study was to compare the effect of intralesional vitamin D3 versus purified protein derivative (PPD) in the treatment of multiple cutaneous warts. Methods: A total of 62 patients were included in the study, each patient had at least 3 common warts, one or more of them injected with 0.1 of intralesional PPD, one or more injected with 0.5 of vitamin D3 and one or more were control according to number of warts of each patient and up to 4 sessions. The clinical assessment was done by photographic measurements at baseline, before each treatment session, and after the completion of treatment. Results: In PPD-injected lesions. 43 patients (69.4%) showed complete clearance (100%) and 13 patients (20.9%) showed partial response (25% - 99%). While, in vitamin D3-injected lesions, 22 patients (35.5%) showed complete clearance while 21 patients (33.9%) showed partial response. On comparing between PPD, vitamin D3 and control, both PPD and vit D3 were statistically significant compared to control and PPD was more statistically significant than vit D3 (P3 = 0.019) in effectiveness and less in recurrence rate. Conclusions: PPD and vitamin D3 were found to be effective, well-tolerated modalities of treatment of multiple common warts. Intralesional PPD was more statistically significant in effectiveness and less in recurrence rate than intralesional vitamin D3.
https://ejhm.journals.ekb.eg/article_39165_271a027040f6bea90a2a9d4712958812.pdf
Intralesional
PPD
cutaneous wart
vitamin D3
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
2
3595
3599
10.21608/ejhm.2019.39166
39166
Original Article
Arthroscopic Release of Resistant Tennis Elbow
Faisal Hassan Zayed
1
Ismael Ahmed Yassin
2
Waleed Abd-Allah Salama Al-Attar
waleedelattar4@gmail.com
3
Department of Orthopedic Surgery, Al-Azhar Faculty of Medicine
Department of Orthopedic Surgery, Al-Azhar Faculty of Medicine
Department of Orthopedic Surgery, Al-Azhar university hospital, Cairo
Background: Lateral epicondylitis is a common cause of lateral elbow pain; characterized as an overuse injury of the forearm and the wrist extensors. The elbow arthroscopy has an important role for diagnosing and treating many elbow disorders. Objective: The aim of this study was to evaluate the effectiveness of the arthroscopic intervention as a minimally invasive procedure in management of resistant cases with tennis elbow after failure of conservative treatment. Material and methods: A prospective study included 30 patients with resistant lateral epicondylitis treated with arthroscopic debridement of extensor carpi radialis brevis tendon. This study was carried out in the period between January 2017 and February 2019 at Al Azhar University Hospitals. The patients were evaluated pre-, intraand post-operatively for their elbow function and pain using the following scores: Mayo Elbow Performance Index (MEPI), Disability of the Arm, Shoulder and Hand (DASH), The Nirschl staging score and visual analog scale (VAS) for pain. Result: A total of 30 patients (12 male and 18 female) were included. The mean of MEPI score improved from 71.33 to 92.55, DASH score from 28.53 to 3.18, Nirschl scale improved from 4.13 to 1.47 and pain VAS improved from 5.27 to 1.47. There was a significant difference between from before to after surgery for the four functional scores. 2 patients complicated with ulnar nerve injury. Conclusion: The arthroscopic treatment of tennis elbow was shown to be an effective therapeutic option when appropriately indicated and performed in refractory cases. It also allowed excellent viewing of joint space for diagnosis and treatment of any associated pathological conditions with a minimally invasive procedure.
https://ejhm.journals.ekb.eg/article_39166_625cf423fc346141761f2498bd526b3c.pdf
Lateral epicondylitis
elbow pain
arthroscopic release
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
2
3600
3606
10.21608/ejhm.2019.39167
39167
Original Article
Comparison between Fetal Echocardiography and Neonatal Echocardiography in Diagnosing Congenital Heart Diseases
Ahmed H. Khorshid
khorshid_daniel@hotmail.com
1
Mohammad Ismail Abd El-Khalek Aldeftar
2
Ahmed Al-Habbaa
3
Hassan Abd Elaziz Gaber
4
Ahmed Abd El-Samad Elhewala
5
Mohamed Hesham H. Ezzt
6
Department of Cardiology, Faculty of Medicine – Al-Azhar University
Department of Cardiology, Faculty of Medicine – Al-Azhar University
Department of Cardiology, Faculty of Medicine – Al-Azhar University
Department of Cardiology, Faculty of Medicine – Al-Azhar University
Department of Cardiology, Faculty of Medicine – Zagazig University
Department of Cardiology, Faculty of Medicine – Al-Azhar University
Backgound: Congenital heart defects (CHD) are the most common congenital malformations. It is six times more common than chromosomal abnormalities and four times more common than neural tube defects. Congenital heart disease accounts for approximately 40% of perinatal deaths due to congenital anomalies and more than 20% of deaths in the first month. Objective: This study aimed to compare the accuracy between fetal and neonatal echocardiography in diagnosing congenital heart disease. Patient and methods: This is a retrograde comparative study that included neonates who underwent echocardiography examination and the results were compared with fetal echocardiographic results available in historical records from prenatal care. 60 pregnant women were referred for fetal echocardiography. The included fetuses in the study were 60 fetuses. It was conducted at the Neonatal Echocardiography Unit, Pediatric Department at Zagazig University Hospitals, from July 2016 to March 2018. Results: Our study showed that out of the 60 cases, fetal echocardiography detected 8 cases out of 24 cases diagnosed with CHD (33.3%), while Neonatal echocardiography detected 24 cases out of 24 cases diagnosed with CHD (100%). Conclusion: The present study demonstrated that fetal cardiovascular diseases, either functional or structural, can be accurately identified by prenatal echocardiography.
https://ejhm.journals.ekb.eg/article_39167_c8c7724840f2281ac93e5f6004f6ca29.pdf
Fetal echocardiography
Neonatal echocardiography
Congenital heart diseas
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
2
3607
3617
10.21608/ejhm.2019.39169
39169
Original Article
Hepatotoxicity of Bare and Polyethylene Glycol Coated Iron Oxide Nanoparticles and The Protective Role of Virgin Olive Oil in Male Albino Rats
Marwa El-Soudy Abd El-Maqsood Shakra
drm1432@yahoo.com
1
Rawya Mohammed Salah El-Din
2
Somaya Youssef Mostafa Hamouda
3
Amira Abdel Raouf Mohammed
4
Rehab Abd Allah Abd Al-Rahman
5
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine for Girls, Al-Azhar University, Egypt
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine for Girls, Al-Azhar University, Egypt
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine for Girls, Al-Azhar University, Egypt
Cell Biology Department, National Research Centre in Dokki, Egypt
Histology Department, Faculty of Medicine for Girls, AL-Azhar University, Egypt
Background: Iron oxide nanoparticles (IONPs) are widely used in various biomedical applications. Polyethylene glycol (PEG) is most popular coating option, reduce the aggregation problem of uncoated IONPs and lower toxicity. Liver is a target organ to identify adverse effects of IONPs. Virgin olive oil (VOO) has potent antioxidants and hepatoprotective effects. Aim: The present work aimed to study hepatotoxicity of bare and PEG coated IONPs in male albino rats through biochemical and histopathological study and protective effect of VOO. Materials and Methods: Seventy seven adult male albino rats were divided randomly into 11 groups: control; PEG; VOO; bare IONPs (15 mg/kg b.wt. and 30 mg/kg b.wt.) with and without VOO and PEG coated IONPs (15 mg/kg b.wt. and 30 mg/kg b.wt.) with and without VOO. All groups received the treatment by oral gavage daily for four weeks and then blood samples and livers were collected for biochemical and histopathological examination. Results and Conclusion: Bare and PEG coated IONPs significantly increase AST, ALT, ALP and total bilirubin and significantly decrease total protein. Also, all IONPs treated groups showed significant increase in malondialdehyde (MDA) marker of oxidative stress and significant decrease in SOD and CAT activities (antioxidant markers). All these biochemical changes significantly improved in PEG coated IONPs compared to bare IONPs. Histopathological adverse effects were observed in livers of IONPs treated animals. Significant improvement occurred on coadministration of VOO in these disrupted parameters and improved hepatic tissues damage and function.
https://ejhm.journals.ekb.eg/article_39169_81bae61c3ac082ad157f39910d3f782b.pdf
Iron oxide nanoparticles
polyethylene glycol
Virgin olive oil
Hepatotoxicity