eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
4
3835
3839
10.21608/ejhm.2019.41523
41523
Original Article
The Efficacy of Serum Biomarkers and Ultrasound Parameters in Prediction of Outcome in Threatened Abortion
Hanaa Omer Badr El Dien
1
Asmaa Mahmoud Abd Elwahab
2
Eman Mostafa Abdalla
emanm5387@gmail.com
3
Department of Obstetrics and Gynecology, of Medicine, Al-Azhar University
Department of Obstetrics and Gynecology, of Medicine, Al-Azhar University
Department of Obstetrics and Gynecology, of Medicine, Al-Azhar University
Background: miscarriage, also known as a spontaneous loss of pregnancy before the fetus reaches viability. Objectives: the aim of this study is to evaluate the association between ultrasonographic findings and maternal serum biomarkers levels and prediction of pregnancy outcome in threatened miscarriage. Patients and Methods: a prospective observational study was conducted at Al-Zahraa University Hospital through the period from April 2018 to May 2019 involving 76 women in their first trimester threatened abortion. Results: there was a statistically significant difference between group 1 and group 2 regarding cancer antigen (CA) 125, β-hCG, progesterone, yolk sac diameter (YSD), fetal heart rate (FHR) and crown-rump length (CRL). The sensitivity, specificity, PPV and NPV of CA 125 at 37.2 IU/ml were 86.0, 84.3, 84.6 and 85.7, respectively, for β-hCG at 19447 IU/ml were 80.6, 78.0, 78.4 and 79.8, respectively, for progesterone at 12.3 ng/ml were 90.1, 88.0, 88.2 and 89.8, respectively, and for FHR at 122 b pm were 96.1, 94.1 respectively. Conclusion: combining of measurement of serum progesterone at a level of 12.3 ng/ml to FHR at 122 bpm represent noninvasive, early, fast and excellent predictor of pregnancy outcome in women with threatened abortion.
https://ejhm.journals.ekb.eg/article_41523_756481f8fc44a1f72f771588938285c3.pdf
CA125
β-hCG, Progesterone
Fetal heart rate, CRL, GSD, YSD, Threatened abortion
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
4
3840
3845
10.21608/ejhm.2019.41524
41524
Original Article
Assessment of Macular Thickness Using OCT in Patients with Diabetic Retinopathy in Relation to HbA1c
Mohammed Ahmed Wahdan
1
Ahmad Elsayed Hodieb
2
Mohammad Hassan Elsayed ElBaz
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
Background: diabetic retinopathy (DR) is the specific micro vascular complication of diabetes mellitus (DM) and affects 1 of 3 with DM. DR remains a leading cause of vision loss in working adult population. Patients with severe levels of DR are reported to have poor quality of life and reduced physical, emotional and social wellbeing. Objectives: to evaluate the relation of macular thickness to HbA1c in patients with diabetic retinopathy. Patients and Methods: this study included 30 eyes of 16 patients with a diagnosis of diabetic retinopathy (DR). Patients were recruited from Retinal Clinic in Bab El-Shearyah University hospital and asked to participate in this study. This study was designed as an observational, cross-sectional and non-coherent study in the period from 12/2018 to 5/2019. Results: the controlled HbA1c group and uncontrolled HbA1c group were comparable in age, sex, type of diabetes mellitus and best corrected visual acuity, but controlled HbA1c group had shorter duration of diabetes mellitus and lower glycosylated haemoglobin level than uncontrolled HbA1c group. Six (40.0%) patients of controlled HbA1c group were hypertensive patients and 11(73.3%) patients of uncontrolled HbA1c group were hypertensive patients. Conclusion: intensive glycemic control might affect retinal vasculature and decrease ischemia and affect the development and progression of diabetic retinopathy.
https://ejhm.journals.ekb.eg/article_41524_62a45db29d3fd19b23d024b3775f96bd.pdf
Macular Thickness
OCT
diabetic retinopathy
HbA1c
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
4
3846
3852
10.21608/ejhm.2019.41556
41556
Original Article
Comparative Study of Open Reduction Internal Fixation with Proximal Humerus Interlocking System and Closed Reduction and Pinning with K –Wire in Proximal Humeral Fracture
Younes Akel
1
Mohammed El Nahas
2
Saddam Rabei Ali Shafei
shafei.saddam@gmail.com
3
Orthopaedic Surgery Department, Faculty of Medicine, Al Azhar University
Orthopaedic Surgery Department, Faculty of Medicine, Al Azhar University
Orthopaedic Surgery Department, Faculty of Medicine, Al Azhar University
Background: Treatment of proximal humerus fractures may be conservative or operative. Each procedure has some limitations and complications. A major disadvantage of conservative treatment is failure to obtain early mobilization, which results in a high rate of shoulder stiffness and pain and malunion or nonunion is likely with certain fracture types. Objective: To compare functional outcomes and complications after open reduction and internal fixation of proximal humerus fractures (type 2 and 3 Neer classification) by proximal humeral internal locking osteosynthesis system (PHILOS) versus percutaneous fixation with K- wires.Patients and methods: Our study was conducted upon 20 Patients (M=7, F=13) in elderly group with two parts (10 patients) and three parts (10 patients) proximal humerus fractures according to Neer's classification patients was randomized to either (group 1) who were treated by open reduction and internal fixation with PHILOS plate and (group 2) who were treated with percutenous K- wire fixation. Results: The mean follow up UCLA score was 30 points (range from 26 to 34) points in (group 1) and 31 points (range from 27 to 35) points in (group 2), values varied depending upon the fracture type with worst in 3 parts fractures. Conclusion: we obtained satisfactory results in both groups with each procedure having its advantages and short comings. We found that fixation with percutaneous K-wires presented an efficient treatment option with the advantages of minimal invasions and soft tissue dissection and PHILO'S plate fixation provided stable fixation with minimal implants problems and enabled early range of motion exercise to achieve acceptable functional results.
https://ejhm.journals.ekb.eg/article_41556_f25673a95c81e9e9b8fc0d3ea6fbbd50.pdf
Proximal humeral
fracture
PHILOS plate
percutaneous K-wires
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
4
3853
3858
10.21608/ejhm.2019.41559
41559
Original Article
Measurement of Psychological Stress in A Group of Journalists Working in One of The Private Journalism Institutes in Egypt
Mohammad Abdelwahid Riyad
1
Mohammad Elsayed Ramadan
2
Ramadan Abd-Al-Azeem Alkhadrawy
3
Department of Neuropsychiatry, Faculty of Medicine, Al-Azhar University
Department of Neuropsychiatry, Faculty of Medicine, Al-Azhar University
Department of Neuropsychiatry, Faculty of Medicine, Al-Azhar University
Background: mental health problems are rising in number and severity between journalists & media field workers. Keeping mental well-being of media field workers is a must that is so hard to be achieved by most societies. Objective: This research aims to study the prevalence of stress &associated psychological disorders (depression- anxiety) and their association with some factors. Patients and Methods: a cross-sectional-questionnaire based study was conducted among journalists working in one of the private journals in Egypt. Depression, Anxiety and Stress Scale-42 (DASS-42) was used to assess stress & associated psychological disorders along with a socio-demographic questionnaire designed by the researcher. A total of 100 journalists participated in the study, they compose about 83% of the whole journalists working in the organization, Overall, the prevalence of stress, anxiety and depression was 61%, 57%, and 64% among studied sample respectively. Results: higher stress scores were significantly associated with lower age group& lower job satisfaction. Higher anxiety scores were significantly associated with demanding psychological support from family and friends & exposure to work-related trauma. Higher depression score was associated with lower job satisfaction &using smoking as stress relief. Conclusion: high percentage of journalists was suffered from stress, anxiety and depression. The associated factors include lower age, low job satisfactionlevel, smoking, and exposure to work-related trauma. Further studies need to be conducted to identify other associated factors related to working as a journalist.
https://ejhm.journals.ekb.eg/article_41559_eeb1a95cbb8d8a121546a732b00fab2c.pdf
psychological stress
journalists working
Egypt
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
4
3859
3866
10.21608/ejhm.2019.41560
41560
Original Article
Assessment of CD56+ CD69+ Natural Killer Cells in the Peripheral Blood of Women with Repeated Implantation Failure (RIF) undergoing an Intra Cytoplasmic Sperm Injection (ICSI) Cycle
Yahia Abd El-Salam Wafa
1
Salah El-Beltagy
2
Osama Mohammed Deif
3
Mohammed Moustafa Abd El Hameed
medocology@hotmail.com
4
Departments of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
Departments of Clinical Pathology, Faculty of Medicine, Al-Azhar University
Departments of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
Departments of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
Background: infertility is an increasing medical and social problem. Delayed childbearing exposes couples to increased risk of causes of infertility including endometriosis, pelvic infection, and poor egg and sperm quality. Many infertile couples turn to in-vitro fertilization (IVF). Objective: to analyze and compare between the peripheral blood NK cells (CD56+ CD69+ ) in women with repeated ICSI failure. Patients and Methods: the current study is a case control study. One hundred women were included and divided into two groups: The study group included 50 women with history of unexplained infertility and repeated implantation failure in their ICSI attempts and a control group which included 50 normal, non-pregnant and fertile women. Results: the current study revealed that there was a highly statistically significant difference between control and case groups regarding CD3- CD56+dim NK percentage with a p-value <0.0001. The current study revealed that there was a statistically significant difference between control and case groups regarding CD3- CD56+dim CD69+ NK cells percentages with a p-value 0.001. Conclusion: there was a highly statistically significant difference between control and case groups regarding CD3- CD56+dim NK percentage. Also the study showed that total CD56+dim NK had a very good predictive value as it had a sensitivity of 80.0%, a specificity of 66.7%, a PPV of 73.3% and a NPV of 78.8%.
https://ejhm.journals.ekb.eg/article_41560_013ecef0e18384331df716f9517b8469.pdf
CD56+ CD69+
Natural Killer Cells
IVF
RIF
ICSI
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
4
3867
3873
10.21608/ejhm.2019.41563
41563
Original Article
Comparative Study between Loop Saphenous Vein and Prosthetic Thigh Vascular Access Graft for Haemodialysis
Mohamed Abdel Hamid Abdel Rahman
1
Ashraf Mohamed Ewida
2
Ayaman Abd El-Hamid Farag
dr_aymanelsamalosy@yahoo.com
3
Department of Vascular Surgery, Faculty of Medicine, Al-Azhar University
Department of Vascular Surgery, Faculty of Medicine, Al-Azhar University
Department of Vascular Surgery, Faculty of Medicine, Al-Azhar University
Background: renal disease is an international problem with a high mortality and morbidity especially in the lowincome countries. Haemodialysis can help patients, but with multiple complications and challenges associated with the procedure. One of these challenges is exhausted veins in the upper limb. Aim of the work: this study aimed to compare using of great saphenous vein bridge fistula versus prosthetic vascular graft, for creating bridge between superficial femoral artery and vein, for the purpose of regular haemodialysis. Patients and Methods: 40 chronic renal failure patients were included. Patients were subjected to full history, clinical examination, investigations and Doppler/duplex scanning for both arterial and venous systems. Follow up was done immediately at the first postoperative day then at one week, 3 weeks, 3 months, 6 months, 9 months and after one year as regards patency, functioning of the graft as well as complications. Results: early death within 30 days of surgery did not occur. Thrombosis was more frequent in PTFE AV graft loop group while all insufficient graft flow (< 200 mL/minute) cases were in SVI group. The numbers of puncture site complications were similar; however, bleeding was more frequent in PTFE group (p = 0.011). None of the patients showed clinical signs or symptoms of graft infection Conclusions: autogenous arteriovenous fistula reveals better primary patency rate than that of prosthetic arteriovenous graft with statistically significant results (p = 0.04). Autogenous arteriovenous fistula showed statistically better secondary patency rate (p = 0.001).
https://ejhm.journals.ekb.eg/article_41563_8d7cdf66b983288e8940e71775e190ae.pdf
renal failure
haemodialysis
Graft
Fistula
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
4
3874
3881
10.21608/ejhm.2019.41566
41566
Original Article
Evaluation of Subclinical Left Ventricular Systolic Dysfunction Using Two Dimensional Speckle Tracking Echocardiography in Patients with Psoriasis
Attia Morsy Skokr
1
Ahmed Rashad Elshahed
2
Youssef Fathy Nosir
3
Muhammad Abdullah AbdelSallam
crazy.doctor1990@gmail.com
4
Departments of Cardiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Departments of Dermatology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Departments of Cardiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Departments of Cardiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Background: dermatologists as well as cardiologists have been studying cardiologic complications of psoriasis for many years. The reason for an increased cardiovascular morbidity in psoriasis seems to be the chronic systemic inflammatory process. Aim of the Work: to evaluate and detect subclinical LV dysfunction by 2D speckle tracking echocardiography in psoriatic patients. Patients and Methods: we selected 100 psoriatic patients (group 1) subclassified them into two equal subgroups; subgroup (1a) involved 50 psoriatic patients recently diagnosed and on topical treatment and subgroup (1b) included 50 psoriatic patients on systemic treatment. The study also included 30 apparently healthy individuals’ age and sex matched with the patients’ group represents the control group. Results: in comparison with healthy subjects, patients with psoriasis were found to have lower LV function using 2‐ D speckle tracking. The 2-D speckle method appears to be useful in the detection of LV systolic dysfunction in patients with psoriasis ،A statistically significant difference was found between sub-groups according to duration of Disease (years), psoriatic arthritis, PASI score and high sensitive CRP. Conclusion: the 2‐ D speckle tracking method appears to be useful in the detection of LV systolic dysfunction in patients with psoriasis. Subclinical left ventricular systolic dysfunction in psoriasis is linked with the inflammatory up-regulation, and enhanced pro-fibrotic activity may be involved in this process. These putative mechanisms may be responsible for the observed higher incidence of heart failure in this disease condition and should be considered as a potential target for preventive and therapeutic measures.
https://ejhm.journals.ekb.eg/article_41566_d8d11bc452d2950ac614dd0c07798e43.pdf
subclinical LV dysfunction
2D speckle tracking echocardiography
Psoriasis
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
4
3882
3890
10.21608/ejhm.2019.41768
41768
Original Article
Results of Treatment of Oblique and Spiral Phalangeal Fractures of the Hand by Mini Lag Screws
Rashed Emam Rashed
1
Galal Mansour Hegazy
2
Hazem Saeed Abd Allah Abusamada
abusamada525@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: Fractures of the hand represent a considerable burden upon the society in terms of medical costs and reduced workplace productivity. Aim of the work: The study aimed to evaluate the clinical outcome of patients with oblique and spiral phalangeal fracture managed with mini-screws fixation. Patients and Methods: A total of 20 patients presented with oblique and spiral phalangeal fractures were treated by mini-screw fixation and were followed for a minimum of 6 months. The mean age of the patients was 33 years, ranging from 19 to 46 years. Eleven cases were males and nine were females. Results: The functional results were graded as excellent in 14 patients (70%), good in two patients (10%), fair in two patient (10%), and poor in two patients (10%). The excellent and good results were considered as satisfactory, while the unsatisfactory included the fair and poor results. Thus, satisfactory results were found in 16 patients (80%), and the unsatisfactory ones were found in four patients only (20%). Conclusion: Mini screw fixation offers an effective, simple and reliable method for treatment of oblique and spiral fracture with low incidence of complication.
https://ejhm.journals.ekb.eg/article_41768_2223a02573caba72f510538cef979776.pdf
Oblique and Spiral Phalangeal Fractures
Mini Lag Screws
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
4
3891
3900
10.21608/ejhm.2019.41567
41567
Original Article
In Vitro Evaluation of Anticancer Potential of Echispyramidum Venom (Viperidae) and Related Genetic and Apoptotic Profile Alterations
Gomaa H. Mahmoud
ghamed2013@yahoo.com
1
Samy A. Saber
2
Abir A. El-Fiky El-Fiky
3
Aly F. Mohamed
4
Department of Zoology, Faculty of Science (Boys branch), Al-Azhar University
Department of Zoology, Faculty of Science (Boys branch), Al-Azhar University
ANDI COE in Antivenom Research
R&D Sector VACSERA
Background: cancer is basically a disease of uncontrolled cell division. Its development and progression are usually linked to a series of changes in the activity of cell cycle regulators. Objective: the present study aimed to investigate the anticancer potential of Echispyramidum venom against HepG2 and HCT 116 cancer cell lines in comparison with the Cisplatin as positive control. Patients and Methods: cell viability performed using MTT assay was cell type and concentration dependent was inversely proportional with the tow substances (Echispyramidum) venom as well as Cisplatin had IC50 of 11.8 and 112.7 µg/mL and 13.4 and 71.2 µg/mL developed in HCT116 and HepG2 cell lines respectively. Results: both of Echispyramidum venom and Cisplatin showed DNA accumulation at the Pre-G1 and G2/ M Phases of cell cycle. Apoptotic profile of treated cells showed up regulation of apoptotic genes (P53, Bax and Casp-3) and down regulation of anti-apoptotic gene (Bcl-2) in a significant way compared with untreated cell control. Also, apoptotic profile was assured via cellular changes detected microscopically in H&E stained cells. Microscopic examination showed apoptotic and slightly necrotic features in case of venoms while Cisplatin induced a number of apoptotic bodies and necrotic cell colonies. Conclusion: it can be concluded that Echispyramidum venom has a clear anticancer potential to human liver and colorectal cancer cells that was proven through the cell cycle arrest profile, induced apoptosis detected via detection of the levels of expression of pro and anti-apoptotic genes, as well as histological alteration detected.
https://ejhm.journals.ekb.eg/article_41567_8cc4dc7583947398520a765a2416f3ee.pdf
Echispyramidumvenom
liver cancer
colorectal cancer
Cisplatin
Cytotoxicity
apoptosis
Anticancer
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
4
3901
3906
10.21608/ejhm.2019.41569
41569
Original Article
Assessment of Left Ventricular Remodeling Index in Hypertensive Patients Using Two- and Three-Dimensional Transthoracic Echocardiography
Mohammad H. Ezzat
1
Kamal A. Marghany
2
Mohammed A. Abd Elghany
dr.mohammedatef1990@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: Hypertensive heart disease (HHD) and coronary artery disease (CAD) generally develop left ventricular remodeling. Therefore, it is of great importance for how to assess HHD and CAD’s left ventricular remodeling which can influence vital diagnosis, therapeutic decisions and prognosis. Aim of the Work: to assess left ventricular remodeling index in HTN patients compared to normal patients using 2D and 3D transthoracic echocardiography. Patients and Methods: This study included 120 subjects at Cardiology Department, Faculty of Medicine, Al-Azhar University during the period from October 2018 to June 2019. They were divided into two groups: Group A (Patient group): which included (100) hypertensive patient. Group B (Control group): which included (20) age and sex matched apparently healthy individuals. Results: There were no significant differences in age and sex inter-group. LVRI detected by RT3DE and 2DE showed significant differences inter-group (1.72±0.04 vs 1.94±0.07, 1.73±0.04 vs 2.17±0.05); and significant differences in patient (1.94±0.07 vs 2.17±0.05), but no significant differences in control group (1.72±0.04 vs 1.73±0.04). Correlation analysis indicated that there was a good positive correlation between LVRI detected by RT3DE and 2DE in control and patient groups (r=0.91, 0.79, all P<0.001). Conclusion: LVRI derived from RT3DE can provide more superiority to LVRI derived from 2DE as an index for evaluating left ventricular remodelling.
https://ejhm.journals.ekb.eg/article_41569_c24491e10266064637d6a27b395e3157.pdf
Left Ventricular Remodeling Index
Hypertension
Two- and Three-dimensional Transthoracic echocardiography
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
4
3907
3911
10.21608/ejhm.2019.41570
41570
Original Article
Intravitreal Ranibizumab Alone or Ranibizumab Combined with Thermal Laser Therapy for Diffuse Diabetic Macular Edema
Ashraf Gad Elkareem
silicon2030@gmail.com
1
Ophthalmology department, Faculty of Medicine, Al-Azhar University, Assiut branch
Background: Diffuse diabetic macular edema (dDME) is one of the most frequent squeal of diabetes mellitus and deteriorates visual acuity in the working group of population. Purpose: to compare the effectiveness of intravitreal ranibizumab alone or ranibizumab combined with thermal laser therapy for treatment of diffuse diabetic macular edema. Patients and methods:forty five eyes of 45 patients suffering from diffuse diabetic macular edema were requriuted and classified into two groups; intravitreal ranibizumab alone group (IR group) included 24eyes of 24 diabetic persons, injected with 0.5 mg ranibizumab (0.1ml) at baseline, 1st month, and 3rd month. A twenty-one eye of 21 diabetic patients was injected with 0.5 mg ranibizumab at baseline, 1st month, and 3rd month followed with macular grid argon laser photocoagulation three weeks after the 1st injection (combined group). Visual acuity as log MAR value, central macular thickness (CMT) measured with optical coherence tomography (OCT), and intraocular pressure (IOP) were assessed at baseline, 3 and 6 months post-injection. Results: the baseline log MAR visual acuity and macular thickness significantly improved in both groups at three, and six months post-injection. However, the combined group showed more improvement with stable results at the end of follow up period of six months. The mean IOP was 14.1±1.3 mmHg and 13.9±1.4mmHg at the end of follow up in IR and combined groups respectively. Conclusion: both groups achieved improvement of visual acuity and reduction of the macular thickness but the effect was more pronounced and long-lasting in the combined therapy group.
https://ejhm.journals.ekb.eg/article_41570_5f517be404c8bf8d8a946376c5b9d594.pdf
ranibizumab
Diabetic Macular Edema
argon laser
diabetic retinopathy
Diabetes mellitus
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
4
3912
3918
10.21608/ejhm.2019.41573
41573
Original Article
Forgotten Double-J Ureteral Stents: Prevalence, Risk factors and Complications
Gamal Eid Gamal El-Kholy
gamalelkholy2007@yahoo.com
1
Hassan kotb Mohamed Keritna
2
Tarek Abdallah Mohamed salem
3
Department of Urology, Faculty of Medicine, Al-Azhar University
Department of Urology, Faculty of Medicine, Al-Azhar University
Department of Urology, Faculty of Medicine, Al-Azhar University
Background: Ureteral JJ stents (DJS) are a common part of urological practice and are used for the management of upper urinary tract obstruction and ureteral surgery, despite their advantages; ureteral stents are not without possible morbidity. Objective: This study aimed to record the prevalence and possible reasons behind neglected DJS and its complications. The difficulties associated with their removal and risk factors correlate with these difficulties. Patients and Methods: A cohort study including 517 patients presented with fixed DJS presenting to Department of Urology, Al-Azhar University Hospitals; Cairo; Egypt. With neglected DJS (indwelling for more than 6 months). We noted the complications of neglected stents (urinary tract infection, gross hematuria, encrustation, migration and stent fragmentation), the treatment modalities and risk factors for these complications. Results: From the entire patients, 239 (46.2%) had a neglected stent with mean stenting duration 11.11 ± 8.6 months. A total of 26.8% of patients received urine acidification, 26.4% were stone formers, 32.2% presented with urinary tract infection (UTI) and 33% had gross hematuria. Encrustations on the stent were recorded in 17.2% of patients and fragmented stent in 4.6% and 2.5% migrated stent up. The stent was removed by cystoscopy in 201 cases (84.1%). Other cases needed combined endoscopic and/or open surgical procedures. Lack of urinary acidification was a significant risk factor for UTI and complex interventions for stent removal (P = 0.013 and 0.017, respectively). Stent fragmentation were more likely with longer duration of stenting (P = > 0.001). Conclusion: Neglected DJS are associated with significant morbidity, urine acidifications is protecting against complications.
https://ejhm.journals.ekb.eg/article_41573_86d892077c962d7c58b23a5cfea1d4da.pdf
DJS
encrustations
Urinary acidification
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
4
3919
3923
10.21608/ejhm.2019.41574
41574
Original Article
Evaluation of Serum Level of Calprotectin in Patients with Psoriasis and Its Relation to The Clinical Severity of The Disease
Amr Mohamed Zaki
1
Mohamed Abdelmawgoud Amer
2
Nagah Mohamed A. Mohamed
3
Mohamed Ahmed El-saeed Abdelkhalik
mohamedshazly1135@gmail.com
4
Departments of Dermatology & Venereology, Faculty of Medicine, Al-Azhar University
Departments of Dermatology & Venereology, Faculty of Medicine, Al-Azhar University
Departments of Clinical Pathology & Immunology, Faculty of Medicine, Al-Azhar University
Departments of Dermatology & Venereology, Faculty of Medicine, Al-Azhar University
Background: Psoriasis is a common chronic immune mediated papulosquamous disease. Its prevalence around 2-3% of the general population,and is characterized by an exaggerated proliferation of keratinocytes secondary to an activated immune system. Objective: the aim of this work was to investigate the relationship between serum Calprotectin and psoriasis vulgaris and to correlate with disease severity. Patients and Methods: the present study was conducted on 50 patients with psoriasis (group A) and 30 healthy control subjects (group B). Both groups were subjected to full history taking, clinical examination and estimation of serum level of calprotectin using ELISA technique. PASI score was used to assess disease severity in group A. Results: calprotectin level was significantly higher in cases group than in control group. A positive statistical correlation between the calprotectin level and the disease severity (PASI score) was observed but not with age, sex, nor duration of disease. Conclusion: calprotectin can be used as a marker of psoriasis severity and progression. Calprotectin may play a role in the pathogenesis of psoriasis.
https://ejhm.journals.ekb.eg/article_41574_34eccb6288adcc75bee70f5ea7aba053.pdf
Calprotectin
Psoriasis
autoimmune diseases
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
4
3924
3932
10.21608/ejhm.2019.41575
41575
Original Article
Assessment of RV Systolic Function by Two-Dimensional Speckle Tracking Echocardiography in Patients with Preeclampsia before and after Labor
Mohamed H. Hassan
1
Abd EL Hamid I. Abd EL Hamid
2
Ahmed O. Abdel-Motaal
3
Hazem A. Mahmoud
ramyhazem94@gmail.com
4
Department of Cardiology, Faculty of Medicine, Al-Azhar University, Cairo
Department of Cardiology, Faculty of Medicine, Al-Azhar University, Cairo
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo.
Department of Cardiology, Faculty of Medicine, Al-Azhar University, Cairo
Background: preeclampsia (PE) is one of the most common causes of maternal mortality and morbidity worldwide. Although cardiovascular (CV) risk is increased after PE, a direct causative relationship has not yet been determined. Aim of the Work: to evaluate and detect subclinical RV dysfunction by 2D speckle tracking echocardiography in preeclamptic patients before and after labor. Patients and Methods: 60 pregnant women were selected for this sectional comparative study which was conducted at Cardiology Department, Faculty of Medicine, Al-Azhar University during the period from October 2018 to June 2019. Results: comparison between before labor and 6 weeks after labor of the right ventricle of the preeclamptic patients showed that tricuspid annular plane systolic excursion (TAPSE) was 22.33 ±3.08 and 26.48 ±2.20, respectively with change of 4.15 (18.6%), with a statistically highly significant difference (p <0.001), end-systolic pulmonary arterial pressure (ESPAP) was 14.65 ±1.63 mmHg and 8.35 ±1.76 mmHg, respectively with change of -6.3 (43%), it showed a statistically highly significant difference (p <0.001), fractional area change (FAC) was 50.55 ±2.25 and 53.40 ±1.66, respectively with change of 2.85 (5.6%), it showed a statistically highly significant difference (p <0.001), right ventricular index of myocardial performance (RIMP) was 41.45 ±2.11 and 33.28 ±2.34, respectively with change of -8.17 (19.7%). Conclusions: two-dimensional speckle echocardiography proved to be acceptable, and applicable for assessing rightsided heart function in patients with preeclampsia. Using this image modality demonstrated significant differences in right ventricular measurements to overcome further morbidity and mortality of those patients
https://ejhm.journals.ekb.eg/article_41575_664c3e92250caaa34b2400812b85466a.pdf
RV systolic function
Two-Dimensional Speckle Tracking Echocardiography
preeclampsia labor
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
4
3933
3939
10.21608/ejhm.2019.41910
41910
Original Article
Value of Duke Treadmill Score in Setting Priority of Patients for Coronary Angiography
Mohsen Ali Salama
1
Mohamed Saad Elgamaal
2
Aymen Elsaeed Sadek
3
Ahmed Yehia Hafez
yehiaahmedyehia2018@gmail.com
4
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
Background: exercise treadmill test remains a good test in identification of coronary artery disease(CAD). The Duke Treadmill Score (DTS), shown to predict CAD better than ST segment deviation alone. Aim of the work: To determine the potential of DTS in setting priority of patients for coronary angiography. Patients and methods: This was a prospective study that was done from July 2017 to October 2018 and included 150 patients referred to Damannhour Teaching Hospital for evaluation of chest pain. Patients underwent: history, clinical examination, ECGs, Echocardiography, Treadmill exercise ECG with calculation of DTS then coronary angiography that was correlated with DTS and other variables. Results: There were 59 patients(39.3%)with high DTS and 91patients (60.7%) with intermediate DTS. For the intermediate Duke's risk group the result of coronary angiography distributed on normal (26.4%), single vessel disease (33%), two vessel disease (22%), and three vessels disease or left main disease (18.7%). For high Duke's risk group the result of coronary angiography showed mainly three vessels disease or left main disease (54.2%), two vessels disease (27.1%), single vessel disease (6.8%) and normal vessel (11.9%), The P value was<0.001.Adding patient's risk factors to intermediate DTS group were statistically significant in the diagnosis of CAD ,the P value was<0.001. Conclusion: The DTS is a good predictor for CAD. Intermediate risk DTS group exercise test results should be managed individually according to clinical data.
https://ejhm.journals.ekb.eg/article_41910_654d830f9e6fdb2ecb0c2cefa77fb366.pdf
Coronary Artery Disease
Exercise ECG Stress testing
Duke Treadmill Score
Coronary angiography
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
4
3940
3949
10.21608/ejhm.2019.41911
41911
Original Article
Role of Cardiac MRI in assessment Non-Ischemic Cardiomyopathy
Mostafa Fadel Sonbol
1
Mahmoud Ibrahim Elshamy
2
Anas Mohamed Sabry Elhadary
anaselhadary55@gmail.com
3
Department of Radio-diagnosis, Faculty of Medicine, Al-Azhar University
Department of Radio-diagnosis, Faculty of Medicine, Al-Azhar University
Department of Radio-diagnosis, Faculty of Medicine, Al-Azhar University
Background: cardiomyopathies encompass a broad spectrum of myocardial conditions which can affect the heart as a primary disease process or as part of a systemic disorder, evolving toward heart failure or cardiovascular death. Objective: this study aimed to identify the role and diagnostic potential of cardiac magnetic resonance imaging to diagnose and differentiate various types of cardiomyopathy. Patients and Methods: this study included 50 patients with suspected different types of non-ischemic cardiomyopathies referred from outpatient clinic of Cardiology at Al-Hussein University hospital from November 2018 to July 2019. Results: all patients showed mild to moderate mitral regurge (100% of cases), tricuspid regurge was seen in 3 cases (75% of cases) and aortic regurge was seen in 4 cases (50 % of cases). The most value of MRI study of these patients was to differentiate whether if heart failure is related to 1ry dilated cardiomyopathy or other causes such as ischemia as they have different management in each group. Conclusion: CMR is a valuable (minimally or non-invasive) imaging technique in patients with suspected or known to have non-ischemic cardiomyopathies. It helps to identify the underlying cause, predict prognosis and responsiveness to therapy and affect management as well follow-up and most recently as primary prevention diagnostic tool.
https://ejhm.journals.ekb.eg/article_41911_d2e0940c39c7bc1df0169c2f1ea2152d.pdf
MRI
CMR
Ischemic Cardiomyopathy
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
4
3950
3956
10.21608/ejhm.2019.41912
41912
Original Article
Role of CT and MRI in Diagnosis of Pericardial Diseases
Ahmed Abd Al-Fattah Aborashed
1
Mohamed Ismail Ahmed
2
Abdullah Mohamed Wali Ali
abdullahwali033@gmail.com
3
Department of Radio-diagnosis, Faculty of Medicine – Al-Azhar University
Department of Radio-diagnosis, Faculty of Medicine – Al-Azhar University
Department of Radio-diagnosis, Faculty of Medicine – Al-Azhar University
Background: Pericardial disease is an important cause of morbidity and mortality in patients with cardiovascular disease. Although the pericardium is usually sufficiently thick to be identified on CCT and CMR, visualization at the most common site of pericardial defects, the lateral, posterior, and inferior left ventricular wall, can be poor because of a paucity of fat. Objective: The aim of this study was to evaluate the role of CT & MRI in the diagnosis of pericardial diseases. Patients and Methods: 30 patients with cardiac abnormalities were included. All patients’ data of preoperative were reported. Range of age was 15-59 years. 20 patients were male and 10 patients were female. Results: In our study MR imaging showed accuracy of 93% for differentiation between constrictive pericarditis and restrictive cardiomyopathy on the basis of depiction of thickened pericardium. In our study on MR images, an intact pericardial line may be observed if an adjacent tumor extends to the pericardium but not through it. Tumors that have invaded the pericardium may be recognized by focal obliteration of the pericardial line and the presence of pericardial effusion. Hemorrhagic pericardial effusions secondary to metastases usually have high signal intensity on SE images. Conclusion: CT and MR imaging should be used when findings at echocardiography are difficult to interpret or conflict with clinical findings.
https://ejhm.journals.ekb.eg/article_41912_8d110c462b5760d6f4dad11f00c91ae1.pdf
CT
MRI
Pericardial diseases
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
4
3957
3962
10.21608/ejhm.2019.41913
41913
Original Article
Bleeding time after magnesium sulphate infusion in cases of preeclampsia
Ismaeil Mohamed Abd El- Azeim Mira
1
Abd El- Monsef Abd El- Hamed Sedek
2
Ahmed Fathy Abd EL- Aziz
3
Ahmed Ayman Marey
hamada_mar3e@yahoo.com
4
Departments of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Departments of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Departments of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Departments of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Background: preeclampsia is a pregnancy-associated multisystem disorder that affects 3-5% of all pregnancies . It remains a leading cause of maternal and neonatal morbidity and mortality in the world . Magnesium sulphate is the drug of choice in the management of impending eclampsia and eclampsia. Magnesium sulphate has an anticoagulating effect, which has been used early in preeclampsia to delay the advance of the disease . This action however, is considered as a disadvantage, because it can prolong the bleeding time.The prolongation of bleeding time may preceipitate postpartum haemorrhage. Objective: the objective of this study was to observe the effects of magnesium sulphate on bleeding time in patients with preeclampsia. Patients and Methods: a study was conducted between April 2018 and February 2019. Fiffty patients with preeclampsia were included in the study. Bleeding time was measured through modified Ivy method. These measures were recorded before, immediately and 24 hours after discontinuation of magnesium sulphate. Results: after magnesium sulphate therapy; bleeding time is increased , haemoglobin level and haematocrit level are decreased. Conclusion: bleeding time in patients with severe preeclampsia was prolonged with magnesium sulphate infusion This is clinically important because it worsens the present conition and causes possible complications.
https://ejhm.journals.ekb.eg/article_41913_f2e560f1b45ce8979cd149ef30aeb51d.pdf
C-reactive protein
Gestational diabetes
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
4
3963
3967
10.21608/ejhm.2019.41909
41909
Original Article
Outcome of Extracorporeal Shockwave Lithotripsy in Congenital Malformed Kidneys
Mahmoud Nader Abdelrazik Ahmad
mahmoudnader607@gmail.com
1
Hussein Abdallah Galal
2
Ayman Kotb Koritinah
3
Department of Urology, Faculty of Medicine, Al-Azhar University
Department of Urology, Faculty of Medicine, Al-Azhar University
Department of Urology, Faculty of Medicine, Al-Azhar University
Background: urolithiasis has an important role in the structure of the urological pathology, due to its high incidence, frequency of recurrence and complications it may cause, it reduces the medium life span from 5 to 20% of the patients. The management of kidney stones with congenital kidney anomalies and abnormal variations continue to pose challenges to urologists. Objective: to evaluate the stone free rate and complication rate of renal Extracorporeal Shockwave Lithotripsy (SWL) in patients with congenitally malformed kidney and the predictors of SWL outcome will be determined. Patients and Methods: this is a retrospective study that has been conducted in Al-Hussein and Bab El-Shaarya University hospitals in Cairo, Egypt. It includes 50 patients with renal calculi in congenitally malformed kidney, all patients underwent SWL treatment in Al-Hussein and Bab El-Shaarya University hospitals using Dornier compact sigma lithotripser and Dornier lithotripser SII from January 2013 to January 2019. Results: of the total SWL procedures performed to 50 patients with average age 46.3 year and average size of the stone was 15.38 mm, the stone free rate was 74 %, The complication rate was 6%, 1 patient complicated by acute pyelonephritis, 1 patient complicated by perinephric hematoma and 1 patient complicated by steinstrasse. Conclusion: SWL has become the favored treatment for management of kidney stones with congenital renal malformations due to high stone free rate and low incidence of complication.
https://ejhm.journals.ekb.eg/article_41909_cae5ad18a1d0d519399c457bd438f9b5.pdf
Extracorporeal Shockwave Lithotripsy
Lithiasis
renal malformations
Stone-free
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
4
3968
3976
10.21608/ejhm.2019.41914
41914
Original Article
Role of CT Guided Celiac Plexus Block for Intractable Abdominal Pain
Amr Mahmoud Zayed
1
Mahmoud Ibrahim Elshamy
2
Amr Alaa Ramadan El sakka
amr_elsakka_2010@yahoo.com
3
Department of Radiodiagnosis, Faculty of Medicine – Al-Azhar University
Department of Radiodiagnosis, Faculty of Medicine – Al-Azhar University
Department of Radiodiagnosis, Faculty of Medicine – Al-Azhar University
Background: Over the last decades, the incidence of pancreatic cancer has increased. It is the seventh most common cause of cancer deaths especially in the developed world. Objective: This study aims to evaluate the efficacy of computed tomography (CT) guided celiac plexus neurolysis (CPN) to relieve intractable abdominal pain caused mainly by abdominal malignancy. Patients and Methods: This prospective study included 20 adult patients; some of them were referred from Oncology Department and others were from outpatient clinic. Patients had abdominal pain owing to abdominal cancer during the period from October 2018 to May 2019 in Al-Hussien and Bab-Alsheria Hospitals, Al- Azhar University. Results: CT-guided celiac plexus block was successfully carried out for the patients. 13 of them (65%) were males and 7 (35%) were females, with mean age of 57.05 years. Abdominal pain in the 20 patients was owing to infiltrative or metastatic hepatocellular carcinoma in ten (50%) patients, pancreatic cancer in six (30%) patients, lymphoma in two (10%) patients, gastric cancer in one (5%) patient, and metastatic lung in cancer one (5%) patient. Conclusion: The current study disclosed the incremental value of the CT-guided CPN via using different techniques with injection of 20–40 mL of 95% of ethanol neurolytic solution as an ideal palliative treatment for eradication of severe pain mainly caused by unresectable pancreatic cancer.
https://ejhm.journals.ekb.eg/article_41914_b9872e94c4666ca4b7e8c6589c9642eb.pdf
CT
celiac plexus block
intractable abdominal pain
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
4
3977
3981
10.21608/ejhm.2019.41915
41915
Original Article
Effect of Treatment of Hepatitis C by Directly Acting Antivirals (DAA) on Chronic Hepatitis C, B Coinfected Patients
Afify F.A. Ahmed
1
Neveen G. Elantouny
2
Amal A. Zidan
3
Mohamed M.H. El Rasad
4
Internal Medicine Department, Faculty of Medicine, Zagazig University
Internal Medicine Department, Faculty of Medicine, Zagazig University
Clinical Pathology Department, Faculty of Medicine, Zagazig University
Clinical Pathology Department, Faculty of Medicine, Zagazig University
Background: Persons with hepatitis C virus (HCV) who are co-infected with hepatitis B virus (HBV) may be at risk for reactivation of HBV infection during or following HCV treatment. HBV and HCV share similar modes of transmission, and co-infection with the two viruses does occur. Objectives: This study aimed to evaluate the effect of HCV anti-viral treatment (DAAS) on HBV in HCV and HBV Coinfected patients. Patients and methods: The study was performed in Internal Medicine Department (Outpatient Clinic and the Inpatient Ward), Mahalla Hepatology Teaching Hospital, Gharbia, Egypt during the period from August 2016 to November 2017 on 20 HCV and HBV co-infected patients ranged from 18-70 years old. Results: The age of patients ranging from 26 to 65 years old (median 44). Male represent 55% and female represent 45% which showed male predominance. Patients were treated by different types by Hcv antiviral treatment (DAAS) like (SOF+DAC), (SOF+SIM), (SOF+DAC+RBV). At baseline, 12 patients had detectable HBV viral load, 5 Patients had positive (HBsAg) and undetectable HBV viral load and 3 patients had negative (HBsAg) and undetectable HBV viral load. Total number of HBV reactivated cases were 12 patients, 3 of them reactivated by increasing HBV DNA, and 5 of them reactivated by both increasing HBVDNA and ALT flare. Conclusion: HBV reactivation is a severe, life-threatening consequence of chemotherapy and immunotherapy in patients with chronic hepatitis B infection. Reactivation may be associated with DAA therapy in patients with HCV/HBV co-infection. HBV reactivation can be prevented through the use of pretreatment screening and anti-HBV prophylactic treatment.
https://ejhm.journals.ekb.eg/article_41915_d526bc71e23630aef1e2bb50dcda5cb5.pdf
hepatitis C
Direct acting antiviral
Chronic hepatitis C
Chronic hepatitis B
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
4
3982
3992
10.21608/ejhm.2019.41916
41916
Original Article
The Role of MR Arthrography in Evaluation of Femoroacetabular Impingement Syndrome
Mohamad Farouk Agag
1
Mahmoud Ibrahim Elshamy
2
Anas Abd Alaziz Ahmad
anossof@gmail.com
3
Department of Radio-diagnosis, Faculty of Medicine – Al-Azhar University
Department of Radio-diagnosis, Faculty of Medicine – Al-Azhar University
Department of Radio-diagnosis, Faculty of Medicine – Al-Azhar University
Background: Femoroacetabular impingement (FAI) is defined as an abnormal femoral acetabular contact that occurs within the normal range of motion caused by alterations of the acetabulum and/or the femoral head or neck. Objective: The purpose of this study was to compare the diagnostic performance of MR arthrography (MRA) with arthroscopic correlation for detecting labral tears and articular cartilage abnormalities. Materials and Methods: MRA was performed in 29 patients (16 males, 13 females with symptomatic FAI. The MRI images assessed for presence of labral tears, chondral lesions and osseous abnormalities. Arthroscopic correlation was obtained in all cases. Results: The sensitivity, specificity, PPV, and NPV of MRA for detecting labral tears were 87.5 %, 71.4%, 91.3% and 62.5%, respectively. The sensitivity, specificity, PPV, and NPV of MRA for detecting chondral damage were 76.5%, 91.7%, 86.7% and 78.6% respectively. Conclusion: MRA appears to be an accurate imaging modality in the evaluation of labral tears. MRA is less accurate in the diagnosis of cartilage abnormalities in the hip.
https://ejhm.journals.ekb.eg/article_41916_630791b35455fe357c4c075123848269.pdf
MR arthrography
Hip – FAI
Labral tears
Chondral lesions
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
4
3992
3996
10.21608/ejhm.2019.41917
41917
Original Article
Pregnancy Rates after Laproscopic Adhesiolysis of Post Ceasarean Adhesions
Fayza Alaa El-Din Ghorab
elsherbinyortho@gmail.com
1
Hesham Abdel-Aziz Salem
2
Ahmed Tawfik Morsy
3
Ayman Shehata Dawood
4
Department of Obstetrics and Gynecology, Faculty of Medicine, Tanta University
Department of Obstetrics and Gynecology, Faculty of Medicine, Tanta University
Department of Obstetrics and Gynecology, Faculty of Medicine, Tanta University
Department of Obstetrics and Gynecology, Faculty of Medicine, Tanta University
Background: although cesarean delivery is a relatively simple procedure, it is associated with some long-term sequelae such as peritoneal adhesions that may result in infertility, chronic pelvic pain, or bowel obstruction. Objective: it was to evaluate the efficacy of laproscopic adhesiolysis for post caesarean adhesions evidenced by the pregnancy rates. Patients and Methods: this study was a single armed clinical trial study, which was done at Obstetrics and Gynecology Department of Tanta University Hospital in the period from October 2017 to March 2018. Fifty patients with secondary infertility after previous caesarean delivery were included. Three patients dropped off follow up. Results: pregnancy rate in studied patients, 22 (47%) patients got pregnant, while 25 (53%) patients had no pregnancy Conclusions: there is high incidence of pelvic adhesions in patients with an unexplained secondary infertility following a caesarean delivery, which is mainly periadenxial type. There is a significant increase in pregnancy rate after laproscopic adhesiolysis.
https://ejhm.journals.ekb.eg/article_41917_46211bc73c64863d78cef4dbf5993e5b.pdf
Caesarean section
Adhesions
Laproscopy
Pregnancy
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
4
3997
4006
10.21608/ejhm.2019.42125
42125
Original Article
Comparative Study between Ultrasound Guided Pectoral Nerves Block and Thoracic Paravertebral Block as Postoperative Analgesia in Breast Surgeries
Mohamed Amr Abo-Sabaa
1
Ali Abdallah El kumity
2
Yasser Abdallah Ahmed Amr
yasseramr2016@yahoo.com
3
Department of Anesthesiology and Intensive Care, Faculty of Medicine - Al-Azhar University
Department of Anesthesiology and Intensive Care, Faculty of Medicine - Al-Azhar University
Department of Anesthesiology and Intensive Care, Faculty of Medicine - Al-Azhar University
Background: Breast surgery is an exceedingly common procedure and is associated with an increased incidence of acute and chronic pain in 25–60% of cases. Regional anesthesia techniques may improve postoperative analgesia for patients undergoing breast surgery. Objective: This study aimed to compare the efficacy and safety of an ultrasound-guided Pecs II block versus TPVB for postoperative analgesia after breast surgeries. Patients and Methods: The present study was conducted on sixty female patients ASA I-II, their ages ranged from 18- 65 years old scheduled for unilateral breast surgery. The patients were allocated randomly into two groups (n=30) according to type of regional anesthesia administrated. (PECS block or TPVB). Results: The results demonstrated that PECS block caused hemodynamic stability, decreased the intensity of postoperative pain, reduced postoperative analgesic requirement, prolonged the time needed for first request of analgesia and decreased PONV. Therefore it can be considered as quite safe procedure and effective as well for intraoperative and postoperative pain control in breast surgeries. Conclusion: PECS blocks can produce excellent pain relief during the first twelve postoperative hours. They hold great promise due to their simplicity, easy-to-learn techniques and relative lack of contraindications and complications. It maintained hemodynamic stability. Also, it produced low pain scores and less total (morphine) consumption in the early postoperative period after unilateral breast cancer surgery.
https://ejhm.journals.ekb.eg/article_42125_040ef9758bc29e5ac066a3568b510db5.pdf
Arterial blood pressure
Non-steroidal anti-inflammatory drugs
Paravertebral block. Ultrasound
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
4
4007
4012
10.21608/ejhm.2019.42126
42126
Original Article
Antiproliferative Effect of Metformin on the Endometrium in cases of perimenopausal bleeding
Ismaeil Mohammed Elgarhy
1
Noha Sabry
2
Ahmed Mohmmed elfeky
ahmedabdelmohsen20009@gmail.com
3
Department of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University
Department of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University
Department of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University
Background: based on numerous epidemiologic and experimental studies it has been speculated that unopposed estrogen has a central role in development of endometrial benign, premalignant and malignant lesions. Endometrial cancer is the most common malignancy of the female genital tract, and the fourth most common cancer in women in developed countries. EC is the seventh most common cancer in women worldwide. Objective: To examine the effect of metformin on disordered proliferative endometrium and simple endometrial hyperplasia in comparison with progesterone to assess metformin clinical usefulness in these situations. Patients and Methods: All patients who referred for abnormal uterine bleeding (perimenopausal) and underwent endometrial office biopsy or D&C in our hospital and their tissue diagnosis was disordered proliferative endometrium (DPE) or simple hyperplasia (SH) were included in this study. Past medical history gathered from patients’ interview records and patients with history of metformin sensitivity, renal failure, anorexia, anemia, skin rashes, diabetes mellitus, gynecologic neoplastic disorders and patients on estrogen or progesterone were excluded. Patients who fitted with including criteria were categorized in two groups in randomized fashion. Results: Our findings in this study revealed that metformin could be effective as well as progesterone in resolving of benign enodometrial proliferative lesions. Conclusion: The current study showed that treatment of the patients with abnormal endometrial proliferation (DPE and SH) with metformin induced endometrial atrophy and prevents abnormal cell growth and prevents perimenopausal bleeding subsequently.
https://ejhm.journals.ekb.eg/article_42126_829766de46d1e00cab5bc94790b5ff3c.pdf
Endometrial cancer
medroxyprogesterone acetate
insulin-like growth factors
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
4
4013
4016
10.21608/ejhm.2019.42127
42127
Original Article
Injection in Facet Joint Arthropathy
Eissa Ragheb
1
Mohamed Negm
2
Abd El Rahman Abdalla
abdo1ortho@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: Facet syndrome is an articular disorder related to the lumbar facet joints and their innervations, and produces both local and radiating pain. Objective: The purpose of this study was to evaluate the outcome of steroid injection in treatment of facet joint arthropathy. Patient and Methods: This study was held on 23 patients suffered from chronic low back pain due to facet arthropathy at Al-Azhar University and Alharam Specialized Hospitals. There were 11 males and 12 females with mean age 46.27 years (28 to 60 years). History, clinical examination, x-ray, MRIs were done to all patients. Results: Pain was evaluated by VAS. The mean VAS pre injection was 8.1 ± 0.83 ranging from 6:10. Immediately post injection, the mean was decreased to 3.7 ± 0.85 ranging from 2:5. Six weeks after injection the mean was decreased to 3.6 ± 0.98 ranging from 2:5. Twelve weeks after injection the mean was elevated to 5.3 ± 0.91 ranging from 4 to 6. The mean ODI improved from 36.5 ± 6.9 to 21.1 ± 4.2 three months post injection. Conclusion: intra-articular facet joint injection is crucial in the diagnosis and treatment of facet joint syndrome. It is an easy to perform and effective treatment for temporary pain relief. The pain relief is sustained longer in patients with grade G2 and G3 of facet joints
https://ejhm.journals.ekb.eg/article_42127_2401ee2178cc02312c9b0a2fa0f00059.pdf
facet joint
intra-articular injection
facet arthropathy
steroids
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
4
4017
4020
10.21608/ejhm.2019.42128
42128
Original Article
Comparative Study between Surgical Bypass and Angioplasty in Treatment of Superficial Femoral Artery Occlusion
AbdEl-Fattah Aly Ismail Aly
1
Ahmed Mohammed Abdul-Rahman Tahoun
2
Elsayed Basiony Moghazy Abu-Eliazid
3
Ahmed Attia Shaaban Soliman
surgeon.attia2018@gmail.com
4
Vascular Surgery Department, Faculty of Medicine, Al-Azhar University
Vascular Surgery Department, Faculty of Medicine, Al-Azhar University
Vascular Surgery Department, Faculty of Medicine, Al-Azhar University
Vascular Surgery Department, Faculty of Medicine, Al-Azhar University
Background: Critical limb ischemia is the most advanced stage of peripheral arterial occlusive disease. the prognosis is poor, with amputation rates up to 30 % and mortality up to 25 % after 1 year. Aim of the Work: to compare the results of primary bypass versus primary percutaneous transluminal angioplasty (PTA) in symptomatic superficial femoral artery (SFA) occlusive lesions in terms of complications, restenosis, symptom recurrence, re-interventions, major amputation and mortality. Patients and Methods: This prospective randomized comparative study was conducted in the Vascular Surgery Department at Al-Azhar University Hospitals. The study included 30 patients randomized into two groups (15 patients for Bypass surgery and 15 patient for angioplasty) suffering from SFA occlusion. Satisfying all the inclusion criteria mentioned below, after the clearance from the ethical committee was obtained, all patients were included in the study. Results: The present study was conducted on 30 patients, 19 males (63.33%) and 11 females (36.67%). . The early patency rate was 93.33% in the group with ‘Bypass’, and 86.67% in the group with angioplasty. The late limb salvage rate in the group with ‘Bypass was 73.33 % while in the group with PTA was 66.66 %. Mortality occurred in two patients (13.3 %). Conclusion Endovascular intervention is the preferred method of revascularization in many scenarios; surgical revascularization is reserved for specific clinical scenarios and for cases where percutaneous therapy is not feasible or durable.
https://ejhm.journals.ekb.eg/article_42128_7a90ad94e48a77307a8883d4de227b57.pdf
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
4
4021
4028
10.21608/ejhm.2019.42129
42129
Original Article
Effect of Metformin, Pioglitazone and Rosuvastatin on Induced Non-alcoholic Fatty Liver in Rats
Ahmed Labib Abdul-Kafy
1
Hammouda Hassan Sharaf
2
Adel Ibrahim Abdul-Aziz
3
Mohammed Gaber Keshka
tantawy_wael@yahoo.com
4
Department of Pharmacology, Faculty of Medicine, Al-Azhar University, Egypt
Department of Pharmacology, Faculty of Medicine, Al-Azhar University, Egypt
Department of Pharmacology, Faculty of Medicine, Al-Azhar University, Egypt
Department of Pharmacology, Faculty of Medicine, Al-Azhar University, Egypt
Background: non-alcoholic fatty liver disease (NAFLD) is one of the most common liver diseases affecting up to 30% of the general population worldwide. Objective: the aim of this work was to study the effects of metformin, pioglitazone and rosuvastatin on serum lipids cholesterol and triglycerides (TG), liver enzymes aspartate aminotransferase (AST) and alanine aminotransferase (ALT), random blood sugar (RBS), oxidative stress malondialdehyde (MDA), and histopathological changes in induced non-alcoholic fatty liver in rats. Patients and Methods: fifty male albino rats weighing 100-120 grams of local strain were used. Animals were purchased from Nile Pharmaceutical Company. They were kept in suitable cages at room temperature with the natural light-dark cycle. They were maintained on a standard diet of commercial rat chow and free tap water. They were kept for 10 days for adaptation to the new environment before the start of the experiment. Results: triglycerides decreased significantly in all treated groups as compared to hypercholesterolemic control group. ALT decreased significantly in all treated groups as compared to hypercholesterolemic control group. AST decreased significantly in all treated groups as compared to hypercholesterolemic control group. Blood glucose decreased significantly in Metformin and Rosuvastatin treated groups as compared to hypercholesterolemic control group. Conclusion: the three drugs could be utilized as a treatment option to guard against fat deposition in the liver or progression of steatosis to fibrosis and cirrhosis. However, further studies are required to examine the molecular mechanisms underlying the beneficial effect of the insulin sensitizers in NAFLD patients.
https://ejhm.journals.ekb.eg/article_42129_dbe217d3797c649eb88cf01d25e3be1b.pdf
Metformin
Pioglitazone
Rosuvastatin
Non-alcoholic
Fatty Liver in Rats
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
4
4029
4033
10.21608/ejhm.2019.42130
42130
Original Article
The Use of Trastuzumab in Metastatic Breast Cancer
Shawky El-Hadad
1
Hassan Khalid
2
Ahmed El-Agamawi
3
Mohsen Salah El-Dien Zekry
4
Hanan El-Shahat El-Morsi
5
Clinical Oncology Department, Cairo University
Clinical Oncology Department, Al-Azhar University
Clinical Oncology Department, Al-Azhar University
Clinical Oncology Department, Al-Azhar University
Clinical Oncology Department, Al-Azhar University
Background: Breast cancer is the most common malignancy in women in US and the second cause of cancer death. It comprises 14 % of all new cancers, and 6.8 % of all cancers deaths. Objectives: To evaluate the value of targeted therapy (trastuzumab) in HER-2 positive metastatic breast cancer patients previously treated with anthracycline in the adjuvant setting, in terms of related toxicities, objective response, overall survival, and progression free survival. Patients and Methods: This study included 80 patients with history of primary carcinoma of the breast with HER2neu positive and evidence of metastases. Half the cases received a combination of trastuzumab plus paclitaxel aiming to treat their disease compared with other group, which received paclitaxel alone to asses the effect of trastuzumab. Results: Adding trastuzumab to paclitaxel showed significant positive impact on treatment, objective response, progression-free survival (PFS) and overall survival (OS). In the attempt to evaluate the variable prognostic importance, such as positive family history, performance status, disease grade and tumor size all showed significant impact on objective response, PFS and OS. Conclusion: The metastatic form of the breast cancer is of dismal prognosis. Targeted therapy created a new avenue in the management of this grim disease. This study show that adding trastuzumab to paclitaxel had significantly improved the objective response, PFS and OS.
https://ejhm.journals.ekb.eg/article_42130_d7f31e7155e5499a3eee69e3a442bf71.pdf
Trastuzumab
Metastatic breast cancer
eng
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
2019-07-01
76
4
4034
4038
10.21608/ejhm.2019.42131
42131
Original Article
Effect of Smartphone Addiction on Neck Function among Undergraduate Physical Therapist Students
Rania N. Karkusha
1
Dalia M. Mosaad
2
Basant S. Abdel Kader
pasantsaed@gmail.com
3
Basic Science Department, Faculty of Physical Therapy, Cairo University
Basic Science Department, Faculty of Physical Therapy, Cairo University
Basic Science Department, Faculty of Physical Therapy, Misr University for Science and Technology
Background: the prevalence of gadget was increased between university students. They use it for entertainment rather than learning. The long use of smartphone would be risk factor to musculoskeletal disorder, early neck pain, neck problems and poor work habits that load cervical region. Purpose: this study was conducted to study the effect of smartphone addiction on cervical range of motion and neck function among undergraduate students in the faculties of physical therapy. Design: Cross-sectional one–shot, controlled observational study. Methods: one hundred students selected from different physical therapy colleges in Cairo and Giza using short version of smartphone addiction scale (SAS sv). For selection, the students were assigned into two groups; Group A, consisted of 62 students who were non–addicted smartphone users and Group B, consisted of 38 students who were addicted smartphone users. Cervical range of motion (ROM) assessed by CROM and Copenhagen neck function disability index was used to assess neck function. Result: There were no statistical significant differences between both groups regarding BMI., regard to the cervical range of motion there were statistical significant differences between both group in all direction (flexion, left lateral flexion, right lateral flexion, left rotation and right rotation) except extension and Copenhagen neck functional disability index was significantly higher among smartphone addicted group. Conclusion: Smartphone addiction affects cervical range of motion and neck function so, it is recommended that physical therapy students should not use smartphone in addicted manner to prevent long term neck disability. Ergonomics advises for smartphone use will be preventive therapy programmers.
https://ejhm.journals.ekb.eg/article_42131_ce0f33e2542618e6c1cc69d36a8a22b4.pdf
smartphone addiction
neck function
undergraduate students in the college of physical therapy