ORIGINAL_ARTICLE
Assessment of Vitamin D Level in Patients with Recurrent Renal Calcium Stones
Background: a higher concentration of the active vitamin D metabolite colic calciferol 1,25-dihydroxyvitamin D3 is associated with increased urinary calcium excretion, which could lead to increase the risk of stone formation. Objectives: To assess vitamin D level in patients with recurrent renal calcium (Ca) stones. Patients and methods: This study was conducted in Urology Department at Menoufia University Hospital during the period from March 2018 to December 2019. 96 patients were included in this study divided into two groups. The first group (group 1) consisted of 76 patients with renal Ca stone and the second group (group 2) consisted of 20 cases without renal stone. Patients who were included in this study seeking for treatment of recurrent renal stone that proved to be Ca stone by CT KUB or stone analysis. Results: there was no statistically significant difference between the two groups regarding vitamin D level, there was no statistically significant difference between different types of calcium stone in relation to vitamin D levels (P= 0.981). There was no statistically significant correlation between vitamin D levels with age (P=0.300), Hounsfield unites of stone (P=0.650) or serum creatinine (P=0.690). Conclusion: There was no statistically significant difference between studied groups regarding vitamin D level. Further studies are needed to determine whether there is any untoward consequence of a concomitant rise in intestinal absorption and urinary excretion of calcium associated with vit D supplementation in idiopathic stone formers.
https://ejhm.journals.ekb.eg/article_127706_d480beb638a82195423c41d2788385ae.pdf
2020-10-01
2130
2109
10.21608/ejhm.2020.127706
Calcium stone
Vitamin D
Recurrent
Renal Stone
Urinary excretion
Mohamed Marzook
Abd El-maksoud
1
Urology Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
AUTHOR
Mohamed Adel
Abozead
mohamed.abozead.1985@gmail.com
2
Urology Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
LEAD_AUTHOR
Mohamed Sayed
ELgharbawy
3
Urology Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
AUTHOR
Abd- Elalim Mohamed
El-Doray
4
Urology Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
AUTHOR
ORIGINAL_ARTICLE
Surgical Treatment of Pediatric Proximal Humeral Fracture by Percutaneous Pinning
Background: Proximal humeral fracture pattern varies based on the mechanism of injury and the patient’s age at the time of the injury. The purpose of this study was to prove short-term clinical and radiographic results of closed reduction and percutaneous pinning in displaced proximal humeral fractures in pediatric by K-wire. Subjects and Methods: This was clinical trial study included 18 children with proximal humeral fracture; their age ranged from 8 to 15 years with mean age 11.88 ± 2.08 with closed proximal humeral fracture between November 2019 and June 2020 at Zagazig University Hospital by closed reduction and percutaneous pinning under image intensifier using Kirschner-wires. Results: This study showed that 12 cases had no complication (66.7%), 3 cases had stiffness (16.7%), 2 cases had superficial infection (11.1%) and 1 case had loss of reduction (5.6%) and treated by K-wire removal, arm sling stabilizer. Two cases of superficial infection did not necessitate early removal of K-wires. All of them were treated with oral antibiotics. Conclusions: Additional K-wires through the lateral cortex give more stability for the severely displaced fractures with rotational or angular instability mainly type 4 fractures.
https://ejhm.journals.ekb.eg/article_127708_885c788e68977014230ecbe6353bf55b.pdf
2020-10-01
2110
2114
10.21608/ejhm.2020.127708
Closed reduction
Kirschner-wires
Proximal Humeral Fracture
Percutaneous Pinning
Omar Abd-Wahab
Kelany
1
Department of Orthopedic Surgery, Faculty of Medicine – Zagazig University, Egypt.
AUTHOR
Waleed Mohammed
Nafea
2
Department of Orthopedic Surgery, Faculty of Medicine – Zagazig University, Egypt.
AUTHOR
Mohamed Ismael AbdelRhman
Kotb
3
Department of Orthopedic Surgery, Faculty of Medicine – Zagazig University, Egypt.
AUTHOR
Mohamed Abdusalam Omar
Idrah
edrahmoha@gmail.com
4
Department of Orthopedic Surgery, Faculty of Medicine – Zagazig University, Egypt.
LEAD_AUTHOR
ORIGINAL_ARTICLE
Patterns of Pulmonary Hypertension in Patients with Chronic Kidney Disease
Background: Pulmonary hypertension (PH) is often associated with high morbidity and mortality and is recently recognized as a common complication secondary to chronic kidney disease (CKD). Epidemiological data for this disorder across the spectrum of CKD is poorly understood. Objective: The aim of the work was to detect patterns of PH in patients with chronic kidney disease (CKD). Patients and methods: This study was carried on 80 patients with CKD who were followed up at outpatient clinics, Aswan University Hospital, Aswan, Egypt. This study was conducted between February 2019 and January 2020. Results: There was highly statistically significant increase in PH (65 %) in dialytic group and (42.5%) in nondialytic group, with mean pulmonary artery systolic pressure (PASP) 41.22 ± 11.32 18 to 25 mm Hg in dialytic group versus 33.37± 9.43 mm Hg in non-dialytic group. Also, positive relationship between PH and increase in duration of CKD, but there is no significant relationship with duration of dialysis treatment, hemoglobin level, calcium and phosphorus. Despite a positive correlation between arteriovenous fistula (AVF) flow and PASP, multivariate analysis did not show a significant relation between them. Conclusion: It could be concluded that pulmonary hypertension is a common finding in CKD patients; the prevalence was highest among patients with end stage renal disease (ESRD) on regular haemodialysis (HD) than those on conservative management. Early detection of PH is important in order to avoid the serious consequences of the disease.
https://ejhm.journals.ekb.eg/article_127711_e5a4147c633475274ce29599fad79df6.pdf
2020-10-01
2114
2119
10.21608/ejhm.2020.127711
pulmonary hypertension
Chronic Kidney Disease
Mohammed Zain El-Din
Hafiz
1
AUTHOR
Hala Abdallah
Mahmoud
2
AUTHOR
Ramadan Ghalib
Mohammed
3
AUTHOR
Mohammed Mahmoud Abd Elwahab
Mohammed
mmawahab92@gmail.com
4
LEAD_AUTHOR
ORIGINAL_ARTICLE
Role of Nailfold Capillaroscopy as A Method of Detection of Atherosclerosis in Systemic Lupus Erythematosus Patients
Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with increased risk of atherosclerosis. Despite the relative youth of lupus patients, they have risk for the development of premature cardiovascular atherosclerotic diseases. Objective: This work aimed to study the detection of atherosclerosis and the cardiovascular risk in SLE patients by nail fold capillaroscopy and the intima media thickness of the carotid artery. Patients and methods: This was a cross sectional study included 60 SLE patients. Patients were collected from the Outpatient Clinic and Inpatient of Internal Medicine and Rheumatology Departments within 6 months. Results: 22 patients (36.7%) had atherosclerosis, with higher SLE disease activity index (SLEDAI) score (p 0.002). 45.5 % of them had severe disease activity and 54.5% had moderate disease activity. Atherosclerotic patients had statistically significant lower capillary density (P 0.001), higher capillary length (P 0.008), capillary width (P < 0.001) and arterial limb diameter (P< 0.001) with higher prevalence of tortuous (P= 0.022), meandering (p=0.014) and disorganized capillaries (P= 0.008). There was statistically significant positive correlation between Intima media thickness (IMT) and disease duration, SLEDAI score, capillary width and arterial limb diameter, while there was statistically significant negative correlation with capillary density. The Arterial limb diameter had highest diagnostic performance in diagnosing atherosclerosis. Conclusion: Atherosclerosis is common in SLE & is associated with higher diseases activity. By capillaroscopy, lower density, longer, wider and disorganized capillaries and tortuous & meandering capillaries were associated with the presence of atherosclerosis.
https://ejhm.journals.ekb.eg/article_127713_80d929ab17678ee04478af4006790f16.pdf
2020-10-01
2121
2128
10.21608/ejhm.2020.127713
Capillaroscopy
Atherosclerosis
SLE
Hanan M
Farouk
1
Department of Internal Medicine and Rheumatology, Faculty of Medicine, Ain Shams University
AUTHOR
Fatma M
Aboud
drfatmaaboud@gmail.com
2
Department of Internal Medicine and Rheumatology, Faculty of Medicine, Ain Shams University
LEAD_AUTHOR
Huda T
Hussein
3
National research center, Cairo, Egypt
AUTHOR
Rasha M
Mohamed
4
Department of Internal Medicine and Rheumatology, Faculty of Medicine, Ain Shams University
AUTHOR
ORIGINAL_ARTICLE
Discrepancy between Stool Culture and Blood Culture in Acute Diarrheal Disease
Background: Acute diarrhea is defined as the passage of stools with abnormal consistency and frequency in a day (e.g. more than three times) which lasts for less than two weeks. Diarrheal diseases are reported as the leading cause of mortality among children aged five years and below. Stool or blood culture tests are very important to determine proper management for diarrheal illness. Objective: to investigate the difference between the role of stool and blood cultures in the diagnosis of acute diarrheal disease and to determine the predictors of positive cultures in patients with diarrheal illness. Subjects and Methods: This prospective cohort study included 77 children. Forty-one of them were males and 36 were females with acute diarrhea with ages between 6months to 5 years who attending Al-Azhar Assiut University Hospital starting from May 2018 until May 2019. Results: The results of the present study demonstrated that Stool culture was positive in 41 cases and blood culture was positive in 8 cases. All cases with positive blood culture were also had a positive stool culture. Twenty-one cases were positive for campylobacter in stool culture and 2 cases of them were pseudomonas positive in blood culture. Twelve cases were salmonella positive in stool culture and 2 cases of them were pseudomonas positive in blood culture. Seven cases were E-coli positive in stool culture and 2 cases of them were E-coli positive and 1cases was positive for pseudomonas in blood culture. Conclusion: The results of this study revealed that stool or blood culture tests are very important to determine proper management for diarrheal illness, Stool culture is more sensitive than blood culture and in severely ill patients, blood culture was required.
https://ejhm.journals.ekb.eg/article_127727_e5ffcf2aeba3b6dae0ec6ace5c14d7bc.pdf
2020-10-01
2129
2132
10.21608/ejhm.2020.127727
Acute Diarrhea
Stool Culture
Blood Culture
Hosny Mohammed Ahmed
Elmasry
1
Pediatric Department, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
AUTHOR
Alaa
Hashim
2
Pediatric Department, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
AUTHOR
Amira Rifaat
Ebrahim
mdamehab411@gmail.com
3
Pediatric Department, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
LEAD_AUTHOR
ORIGINAL_ARTICLE
Prevalence of HCV, HBV and HIV in Institutionalized Mental Illness Patients at Aswan Governorate
Background: HIV, hepatitis B, and hepatitis C are serious infections, but can be treated. The prognosis is much improved by earlier detection and treatment. Prevalence studies have shown that serious mental illness is a risk factor for blood-borne virus infection. Objective: To evaluate the prevalence of blood-borne viral infection in people with psychological disorders attending Aswan Governate. Patients and methods: This across sectional study included 180 patients (150 male, 30 female) with moderate to severe mental illness from the attendants of the Outpatient Clinic of Psychiatric Department, Neuro-Psychiatric Hospital, Aswan Governorate. The study was conducted in the period from May 2019 to November 2019. The etiological diagnosis of the studied group were schizophrenia (males=64, females=9), depression (males=30, females=9) and general anxiety disorder (males=16, females=6). Results: As regard HCV Abs, 157 patients (87.2%) were negative and 23 patients (12.8%) were positive in the studied patients. As regards HBs Ag, there were 162 negative patients (90%) and 18 positive patients (10%) in the studied patients. As regards HIV Abs, there were 170 negative patients (94.4%) and 10 positive patients (5.6%) in the studied patients. There was no statistical significant relation between sex and virology markers in all studied patients (p-value > 0.05). Conclusion: People with serious mental illness are at risk of blood-borne viral infections. Serious mental illness is unlikely to be a sole risk factor and risk of blood-borne viral infection is probably multifactorial and is associated with low socioeconomic status, drug and alcohol misuse, ethnic origin, and sex.
https://ejhm.journals.ekb.eg/article_127728_d9f195160743e785aa127546b1990cb0.pdf
2020-10-01
2133
2138
10.21608/ejhm.2020.127728
depression
general anxiety disorder
hepatitis B
hepatitis C
mental illness and schizophrenia
Atef Mohammed
Mahmmoud
1
Department of Hepatogastroentrology and Infectious Diseases, Faculty of Medicine, Al-Azhar University, Egypt
LEAD_AUTHOR
Mohammed
Bastawy
2
Department of Hepatogastroentrology and Infectious Diseases, Faculty of Medicine, Al-Azhar University, Egypt
AUTHOR
Sherif Ali
Abdel-Aziz
3
Department of Hepatogastroentrology and Infectious Diseases, Faculty of Medicine, Al-Azhar University, Egypt
AUTHOR
Abd-Allha Mustafa
Jafer
4
Department of Hepatogastroentrology and Infectious Diseases, Faculty of Medicine, Al-Azhar University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Assessment of Body Composition in Patients with Multiple Sclerosis: Institutional-Based Cross-Sectional Study
Background: Multiple sclerosis (MS) is the most common progressive neurologic disease all over the world. MS is an immune-mediated disease and there is contradictory data regarding cardiovascular morbidity and mortality risk factors in MS patients. Objective: To assess the body composition in MS patients, and to explore the associations of anthropometric indices and metabolic risk factors with the phenotypic features of MS. Patients and Methods: a cross-sectional study included 150 patients fulfilling the diagnostic criteria for MS according to the revised McDonald’s criteria 2010, and 145 age and sex-matched healthy controls. Fat mass index (FMI) and free fat mass index (FFMI) were assessed by dual-energy X-Ray absorptiometry (DEXA). Results: This study was conducted on MS patients with phenotypes; RRMS (82%) and SPMS (18%). our results revealed that the distribution of body composition among MS patients was 30 %, overweight was 48% and lean was 22%. Also, MS patients had significantly higher values of systolic and diastolic blood pressure as well as dyslipidemia, obesity indices, and hs-CRP compared to the control group, P-value < 0.001. Interestingly, there were significantly higher values of the expanded disability status scale (EDSS), dyslipidemia, obesity indices, and hypertension in the obese group compared to other groups. Conclusions: MS patients had higher values of dyslipidemia and obesity indices than control groups. Among MS, the prevalence of overweight patients was higher than lean and obese MS patients.
https://ejhm.journals.ekb.eg/article_127950_4242b0a0359f5c401def062ef771b936.pdf
2020-10-01
2139
2145
10.21608/ejhm.2020.127950
Multiple sclerosis
body composition
EDSS
FMI
Nearmeen M.
Rashad
1
Department of Internal Medicine, Faculty of Medicine, Zagazig University, Sharkia, Egypt
AUTHOR
Waleed M. Reda
Ashour
2
Department of Neurology, Faculty of Medicine, Zagazig University, Sharkia, Egypt
AUTHOR
Azza H.
Abd El-Fatah
3
Department of Internal Medicine, Faculty of Medicine, Zagazig University, Sharkia, Egypt
AUTHOR
ORIGINAL_ARTICLE
Correlation between Site of Placenta and Umbilical Cord Hematocrit Value
Background: Placenta Previa (PP) is characterized as the unusual implantation of placental tissue over or adjoining the inside cervical os. The commonness of PP is at around 5 for every 1000 pregnancies. It represents roughly 20% of all antepartum drain, front PP was seen as related with unfavorable maternal results including over the top blood misfortune, gigantic transfusion, placenta accreta and hysterectomy. Objective: The purpose of our study was to decide the connection between the site of placenta in pregnant women and the hematocrit (Hct) estimation of umbilical cord blood (CB) of the newborn. Patient and method: This case-control study was carried out at Obstetrics and Gynecology Department, Zagazig University Hospitals and El-Menshawy General Hospital in Tanta during the period from May 2018 to May 2019. The study included 32 pregnant women with various placental site. They were classified into two groups; group 1: women determined to have placenta previa as front or back placenta previa. Group II: women without placenta previa at a similar gestational age as (bunch II). Placenta position was classified as foremost, back and fundal placenta. Results: there was high huge distinction between hemoglobin levels when activity in the placenta previa gathering. Additionally, there was high distinction between the placenta previa gathering and the control group in respect to fetal haematocrit esteem, which was higher among placenta previa gathering. Regarding fetal hematocrit and placenta site, our examination demonstrated that there was high solid critical connection between the placental site and haematocrit esteem. Conclusion: Placental area can decide pregnancy outcome.
https://ejhm.journals.ekb.eg/article_127952_872837e07a38ddb68f0c5a4d77ef8d08.pdf
2020-10-01
2146
2151
10.21608/ejhm.2020.127952
placenta
Placenta Previa (PP)
hematocrit
Neonate
Anwar Ezzat
Ismail
1
Department of Obstetrics and Gynecology, Faculty of Medicine –Zagazig University, Faculty of Medicine, Egypt
AUTHOR
Amal Mohamed
El-Anwar
2
Department of Obstetrics and Gynecology, Faculty of Medicine –Zagazig University, Faculty of Medicine, Egypt
AUTHOR
Waleed Mohammed
Etman
3
Department of Obstetrics and Gynecology, Faculty of Medicine –Zagazig University, Faculty of Medicine, Egypt
AUTHOR
Amany Mohamed Taha
Emara
dr.amany_emara@yahoo.com
4
Department of Obstetrics and Gynecology, Faculty of Medicine –Zagazig University, Faculty of Medicine, Egypt
LEAD_AUTHOR
ORIGINAL_ARTICLE
Prevalence of Polycystic Ovarian Syndrome in Young Adult Unmarried Females Attending Zagazig University Hospital Outpatient Clinic
Background: Polycystic ovary syndrome (PCOS) is one of the most prevalent endocrine and metabolic disorders in women of childbearing age. Objective: To determine the frequency of Polycystic ovarian syndrome (PCOS) among young unmarried females to increase awareness of PCOS and to promote effective early medical interventions and healthy lives for women. Methods: This was a prospective cross-sectional study in which 180 unmarried females between 16 to 24 years old attending gynecology and dermatology outpatient clinic suffering from menstrual abnormalities or symptoms of hyperandrogenism to estimate the prevalence rate of polycystic ovarian syndrome from May to November 2018. According to diagnostic criteria of the NIH, Rotterdam, and the AE-PCOS. Menstrual irregularities (MI) were identified,
and clinical hyperandrogenism was evaluated by self-assessment of hirsutism using the modified Ferriman–Gallwey score. Blood analysis was done for measurement of prolactin, thyroid-stimulating hormone, and androgen hormones. Results: This study revealed Prevalence rate of PCOS is 55.6% among all presented cases, oligomenorrhea, acne, and hirsutism were the most common complaint in this study. Also, this study showed that there is an association between PCOS and sedentary life, and unhealthy food habits. There was a significant difference between PCOS and non-PCOS in LH and prolactin levels. There is a disturbed LH \FSH ratio (2:1 or more). It also shows that there was a significant difference between PCOS and non-PCOS in ovarian volume.
Conclusions: Lifestyle modification as healthy food and exercise play important role in the prevention of PCOS.
https://ejhm.journals.ekb.eg/article_127954_78b0307e994277735acd7821c1801447.pdf
2020-10-01
2152
2159
10.21608/ejhm.2020.127954
polycystic ovary syndrome (PCOS)
Hyperandrogenism (HA)
Hirsutism
Menstrual Irregularities (MI)
Soha Galal
Siam
1
Department Obstetrics and Gynecology, Faculty of Medicine, Zagazig University, Sharkia, Egypt.
AUTHOR
Badeea Seliem
Soliman
2
Department Obstetrics and Gynecology, Faculty of Medicine, Zagazig University, Sharkia, Egypt.
AUTHOR
Mohammed Ramadan
Ali
3
Department Obstetrics and Gynecology, Faculty of Medicine, Zagazig University, Sharkia, Egypt.
AUTHOR
Omnia Abdallah Mohamed
Abdallah
abdallahomnia37@gmail.com
4
Department Obstetrics and Gynecology, Faculty of Medicine, Zagazig University, Sharkia, Egypt.
LEAD_AUTHOR
ORIGINAL_ARTICLE
The role of Therapeutic Repetitive Transcranial Magnetic Stimulation in Treatment of Sleep Disorders in Parkinson’s disease Patients
Background: Parkinson’s disease (PD) is the most common movement disorder and represents the second most common degenerative disease of the central nervous system. Objective: To measure the effect of repetitive transcranial magnetic stimulation (rTMS) as therapeutic treatment on sleep disorders in patients with Parkinson’s disease (PD). Patients and methods: This double-blinded study included 20 PD patients (10 received real rTMs and 10 received sham rTMs) patients recruited from Inpatient and Outpatient Clinic of Neuropsychiatric Department of Aswan University Hospital. Our patients were divided into 2 groups (10 patients each). Results: As regards the effect of rTMs on PDSS and sleep latency, our study results found no significant change in Parkinson disease sleep scale between both groups but there was significant change in sleep latency that it decreased in the group received real rTMS in comparison with the SHAM group. In addition, there were significant changes in wake stage and rapid eye movement stage that both decreased in response to rTMS while there was no significant changes in non-rapid eye movement stage. Awakening after being asleep on both studied groups showing significant decrease in wake after sleep onset and wake after persistent sleep as both of them decrease wit rTMS. Conclusion: The main finding of this study was that 10 sessions of 20–Hz rTMS applied over both parietal area improved the subjective as well as the objective sleep quality as reflected by a decrease of frequency in arousal from sleep and in Non-REM–1 stage sleep.
https://ejhm.journals.ekb.eg/article_127955_3d36eaa1dbbd8aa5433314b8e811bb95.pdf
2020-10-01
2160
2164
10.21608/ejhm.2020.127955
Parkinson’s disease
Transcranial magnetic stimulation
sleep disorders
Eman Mohamed
Khedr
1
AUTHOR
Suzan Salama
Sayed
2
AUTHOR
Abeer Abd El Hady
Tony
3
AUTHOR
Rana Gamal
Abd El Shakour
ranasholok2020.rg@gmail.com
4
LEAD_AUTHOR
ORIGINAL_ARTICLE
A Study of Vitamin D Supplementation to Patients with Chronic Diseases Admitted to Ain Shams University Hospital
Background: Vitamin D deficiency and insufficiency have become a common problem worldwide. Vitamin D has been associated with all causes of mortality in chronic diseases which are significantly associated with a longer hospital stay and poor outcome. Objectives: We aimed to investigate the role of empirical vitamin D supplementation in hospitalized patients and its relation to the length of stay and outcome of hospitalization.
Study design: Case control study performed on eighty patients admitted to Internal Medicine Department at Ain Shams University Hospital, with acute deterioration of their chronic illness. Two groups of diseases were included, chronic liver diseases (CLD) and congestive heart failure (CHF).
Methods: Twenty patients of each group were given vitamin D 200,000 IU IM within 3 days of admission (Intervention group) and 20 patients of each group (control group) did not receive vitamin D. Patients were sampled for their vitamin D, calcium and phosphorus levels on admission prior to intervention. Results: CLD and CHF Intervention groups had a non-significant correlation between vitamin D supplementation with length of hospital stay and mortality in comparison with control groups (P =1.000) (p=0.823) respectively. On the other hand, we found baseline vitamin D deficiency was an independent predictor of mortality (P value .018). Conclusions: Vitamin D deficiency is significantly associated with longer hospital stay and poor outcome of hospital admission. Beneficial effect of empirical vitamin D supplementation can't be achieved with single dose vitamin D (200,000 IU) on CHF and CLD hospitalized patients.
https://ejhm.journals.ekb.eg/article_127962_d3f6516ecc7ab05867dea07e18d5d9ad.pdf
2020-10-01
2165
2172
10.21608/ejhm.2020.127962
CHF
CLD
Vitamin D supplementation
Ahmed Mohamed
Bahaa El Din
1
Department of Internal Medicine and Endocrinology, Faculty of Medicine –Ain Shams University
AUTHOR
Raef Malak
Botros
2
Department of Internal Medicine and Endocrinology, Faculty of Medicine –Ain Shams University
AUTHOR
Mariam Michel Ayad
Grace
3
Department of Internal Medicine and Endocrinology, Faculty of Medicine –Ain Shams University
AUTHOR
Hany Khairy
Mansour
hanyemad@med.asu.edu.eg
4
Department of Internal Medicine and Endocrinology, Faculty of Medicine –Ain Shams University
LEAD_AUTHOR
ORIGINAL_ARTICLE
Laparoscopy Versus Laparotomy in The Surgical Treatment of Perforated Duodenal Ulcers
Background: There is no clear consensus about whether laparoscopy or laparotomy is more beneficial in managing perforations of duodenal ulcers. Objective: The study was performed to compare between laparotomy and laparoscopic approaches in managing perforations of duodenal ulcers regarding operative time and early operative outcomes. Patient and methods: This randomized comparative prospective study included 84 cases diagnosed with perforated duodenal ulcer, they were divided into two equal groups: laparotomy and laparoscopic groups (42 cases for each). All cases were clinically and radiologically assessed. Operative time was our primary outcome, while secondary outcomes included post-operative pain, analgesic consumption, hospitalization time, and complications of both techniques. Results: No significance in differences were reported between the two groups regarding patient demography. Both smoking history and analgesic use were reported by most cases in both groups. The operative time (p = 0.082) was not significantly different between the two groups. The laparoscopic group showed less pain scores, less morphine needs, earlier oral fluid intake, and short hospitalization time in comparison to the laparotomy group. Also, the wound infection incidence was significantly higher in the laparotomy group. Conclusion: The laparoscopic approach appears to be more safe and efficacious in the surgical treatment of perforations of duodenal ulcers, as it is associated with less peri-operative complications and shorter hospitalization time with a comparable operation time in comparison to laparotomy.
https://ejhm.journals.ekb.eg/article_127963_7909981af34cfb1db512612eafcdb2ec.pdf
2020-10-01
2173
2178
10.21608/ejhm.2020.127963
Perforated duodenal ulcer
Laparoscopy, Laparotomy
Mohamed
Tag El-Din
1
General Surgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
AUTHOR
ORIGINAL_ARTICLE
A Randomized-Trial Study of Corneal Collagen Cross-Linking (CXL) in Progressive-Keratoconus (PK)
Background: Keratoconus is a frequent, familiar, bilateral, non inflammatory, and gradually progressive corneal ectasia, which leads to corneal protrusion, irregular astigmatism, and decrease vision. Currently, the corneal cross-linking (CXL) treatment could attain vision improvement. Aim: To investigate the topographic, refractive, and clinical-out-comes after six months CXL in gradually progressing keratoconic eyes. Patients & Methods: A follow-up, randomized, controlled-trial study was used. In this study, 30eyes with progressive- keratoconus (PK) were recruited in the study. Cross-linking was done and achieved by a solution of 0.1% riboflavin mixture with 20% dextran for 15minutes before and during 30minutes time-period of ultraviolet A (UV-A) irradiation (3Mw\cm2). The obtained data were analysed using IBM SPSS software. Results: Statistically significant improvements were noticed in Sim k (at 6months), Kmin (at 6months), spherical power (at 6momths), cylinder power (at 6momths), spherical equivalent [SE] (at 6months), uncorrected visual acuity (UCVA) (at 6months) and best corrected visual acuity [BCVA] (at 6months) in trial group (15patients) when compared with the controls. Conclusions: At 6months, hopeful, promising improvements were reported in Kmax, UCVA, and BCVA. So, long term studies are requested to survey the efficiency of CXL as well as the safety of the repeated procedures.
https://ejhm.journals.ekb.eg/article_127965_7346154bc1fa5eecd0f5128daaaa78ba.pdf
2020-10-01
2179
2183
10.21608/ejhm.2020.127965
Corneal Collagen cross-linking
Riboflavin
Epithelium-off procedure
Topographics changes
Keratoconus
Hassan Shamselden
Yousef
hassanetal@yahoo.com
1
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
LEAD_AUTHOR
ORIGINAL_ARTICLE
Effect of Chronic Stress on The Testis of The Adult Male Albino Rat and The Role of Ginger
Background: Infertility and its problems are one of the most vital problems that ranges from 10% to 15% among couples. Chronic variable stress (CVS) disrupts normal homeostasis of a variety of body systems and is a major cause of male infertility. Ginger is known to have anti-inflammatory and antioxidant properties via its free radical scavenging activity so it can be used in various experimental models as a protective agent against various toxicants.
Objectives: The current work aimed to study the effect of chronic variable stress on the testis and the possible protective and therapeutic roles of the ginger on this effect. Materials and Methods: thirty-five adult male albino rats were divided into five groups. Group I; control, group II received ginger only, group III subjected to CVS, group IV CVS + pretreated with ginger and group V CVS + post-treated with ginger. All rats were weighted, sacrificed, blood samples collected to asses testosterone hormone, the testis was weighted to calculate gonadosomatic index and processed for light microscopic study. Paraffin sections were stained by hematoxylin and eosin stain.
Immunohistochemical staining for PCNA, caspase-3 and androgen receptor were also performed. Results: CVS induced decreased gonadosomatic index, testosterone hormone level, destructive effects on the testis as decreased spermatogenic cells and sperm count, detachment of the cells, vacuolations and apoptosis. Ginger produced great improvement of these effects which was pronounced in the protected group (IV) than the treated one (V). Conclusion: CVS caused apoptotic changes in testis and ginger had ameliorating effects on these changes.
https://ejhm.journals.ekb.eg/article_127968_95333262ef167e90bc60db6c2ac90c4a.pdf
2020-10-01
2184
2194
10.21608/ejhm.2020.127968
CVS
testicular apoptosis
Ginger
Hadeer Abd El-Mohsen
El-Naggar
hadderelnaggar@yahoo.com
1
Department of Anatomy and Embryology, Anatomy Department, Menoufia University, Menoufia, Egypt
LEAD_AUTHOR
Fatma El-Nabawia A.
El-Safty
2
Department of Anatomy and Embryology, Anatomy Department, Menoufia University, Menoufia, Egypt
AUTHOR
Abeer E.
El-mehi
3
Department of Anatomy and Embryology, Anatomy Department, Menoufia University, Menoufia, Egypt
AUTHOR
Ayman Abdallah
Reafie
4
Department of Anatomy and Embryology, Anatomy Department, Menoufia University, Menoufia, Egypt
AUTHOR
ORIGINAL_ARTICLE
Resistance Index of Uterine and Spiral Arteries as a Predictor of Threatened Miscarriage Outcome
Background: Miscarriage is a common event in the first half of pregnancy. Improvements in Ultrasound and Doppler technology, have led to a better understanding of early pregnancy development. Such a facility may be used in turn to predict pregnancy outcome in threatened miscarriage. Objective: To assess the ability of the Uterine artery RI and Spiral artery RI to predict outcome in cases of Threatened miscarriage Patients and methods: Prospective observational study was conducted in the Department of Obstetrics and Gynecology at Menoufia University Hospital. The study included 90 women with gestational age between 5 – 13 w. divided into three groups; Group (A): involved (30) women diagnosed with threatened miscarriage and was followed up and got aborted before pregnancy completed 24weeks. Group (B): (30) women diagnosed with threatened miscarriage and were followed up and the pregnancy continued till 24weeks. Group (C): 30 women having singleton normal ongoing pregnancy till 24 weeks of gestation as a control group. Results: In this study, the Doppler study of uterine arteries the subchorionic blood flow revealed that (RI) was significantly higher in the miscarried group than both continued and control groups. Conclusion: Uterine artery RI and Subchorionic blood flow RI can predict the fate of pregnancy in cases with threatened miscarriage with high accuracy.
https://ejhm.journals.ekb.eg/article_127970_4828c8ca63782996205081121405d6aa.pdf
2020-10-01
2195
2198
10.21608/ejhm.2020.127970
threatened miscarriage
Doppler
uterine artery
Spiral artery
AlaaEdeen F.
Al Halaby
1
AUTHOR
Mohamed M.
Fahmy
2
AUTHOR
Hany M
Khallaf
3
AUTHOR
Mohamed S
Abdullah
4
AUTHOR
Ahmed M
Nofal
nofal3030@gmail.com
5
LEAD_AUTHOR
ORIGINAL_ARTICLE
The Omentopexy Role in The Prevention of Post-Operative Gastric Sleeve Surgery Complications
Background: Currently, there is still a debate about the omentopexy preventive mechanism of sleeve gastrectomy complications. The current study was conducted to evaluate the omentopexy role on the early outcomes after laparoscopic gastric sleeve surgery. Patients and methods: This prospective randomized study included a total number 172 cases, divided equally into two groups (86 cases for each); the omentopexy (sleeve gastrectomy with omentopexy) and control groups (sleeve gastrectomy only). All cases were subjected for complete pre-operative assessment. Post-operative complications including leakage, bleeding, vomiting, reflux symptoms, and gastric volvulus were recorded. Results: patient characteristics including age, sex or comorbidities did not significantly differ between both groups. However, the duration of operation showed significant prolongation in the omentopexy group (78.33 vs. 62.47 minutes in controls). No difference was significantly noted between both groups regarding posto-perative complications, apart from gastric twist that was not encountered in our study. Despite that, these complications showed a slight increase in controls. The duration of hospitalization did not differ significantly between the study groups (median = 1 day). Conclusion: Omentopexy did not have a significant different impact on the prevention of post-sleeve gastrectomy complications although it is associated with longer operative time. However, it may serve as an extra guard against leakage, bleeding, vomiting, and GERD, manifested by the decreased incidence of these complications with that technique.
https://ejhm.journals.ekb.eg/article_127971_31aa57630225376f91155b0a72dfbcac.pdf
2020-10-01
2199
2204
10.21608/ejhm.2020.127971
sleeve gastrectomy
Omentopexy
Leakage
Bleeding
Mohamed Fathy
Labib
1
General Surgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
AUTHOR
ORIGINAL_ARTICLE
Endoscopic Verses Conventional Septoplasty in the Treatment of Deviated Nasal Septum
Background: Septum deviation is the major cause of nasal obstruction, which is the most common symptom in ENT practice. Surgical correction of the deviated nasal septum has been advanced over the years, from the radical removal of both mucosa and cartilage to submucous cartilage resection with preservation of the mucosa. Objective: To compare the efficacy of the conventional and the endoscopic septoplasty in the management of patients with symptomatic nasal deviation. Patients and methods: This study included 40 patients presented to the Otorhinolaryngology outpatient clinic at Assiut University Hospitals between May 2018 and December 2019, suffering from nasal obstruction due to a significant septal deviation, randomly divided into two groups: Group A: 20 patients underwent endoscopic septoplasty and Group B: 20 patients underwent conventional septoplasty. Results: In this study, no significant difference was detected in the preoperative results of both groups regarding the age, sex and types of septal deformities. So, the preoperative circumstances were similar between both groups. Hence, results of this study showed that these two procedures were suitable to correct septal deformities but the endoscopic septoplasty was superior to the traditional septoplasty in cases with isolated septal spur. Also, it was associated with the minimal re-occurrence rate. Conclusion: Endoscopic septoplasty is a valuable teaching tool, which is efficient in the management of different types of septal deformities.
https://ejhm.journals.ekb.eg/article_127973_2506168022ecd229ef27e31a4e1ac713.pdf
2020-10-01
2205
2210
10.21608/ejhm.2020.127973
Endoscopic
Conventional septoplasty
Deviated nasal septum
Mohamed O.A.
Gad
1
Department of Otolaryngology, Faculty of Medicine - Assiut University
AUTHOR
Mostafa Othman Ramadan
Salama
2
Department of Otolaryngology, Faculty of Medicine - Assiut University
AUTHOR
Mostafa Mahrous
Mahmoud
mostafamahrouss@gmail.com
3
Department of Otolaryngology, Faculty of Medicine - Assiut University
LEAD_AUTHOR
Reham AE
Ibrahim
4
Department of Phoniatrics, Faculty of Medicine - Assiut University
AUTHOR
ORIGINAL_ARTICLE
Role of D-Dimer in Assessment of the Severity of Community Acquired Pneumonia in Children
Background: Pneumonia remains the leading cause of death in children under five worldwide. It accounts for about 1.6 million deaths a year in this age group - 18% of all deaths among children under five. More than 99% of all pneumonia deaths occur in low- and middle-income countries. Objective: To detecting the role of D-dimer in assessment of the severity and prognosis of community acquired pneumonia (CAP) in children. Patients and Methods: This was a cross sectional study carried out in Zagazig University Hospital, Pediatric, Microbiology and Immunology Departments. 143 children with pneumonia aged 6 months to 12 years old were included in the study that was conducted in the period from January 2019 to June 2019. Blood samples were taken from the antecubital vein with an injector and placed into citrated tubes. After they were centrifuged, the samples were evaluated with the quantitative ELISA method. Results: The study showed that plasma D-dimer levels were higher in patients with lobar or multi-lobar pneumonia than in patients with segmental pneumonia. Additionally, the present study revealed a significant area under curve with cutoff > 0.85 and with sensitivity 97% and specificity 95% of D-dimer. Conclusion: Pneumonia severity (CAP) patients showed increased plasma D-dimer levels in absence of an accompanying disease that could increase D-dimer levels.
https://ejhm.journals.ekb.eg/article_131122_983136bc42056990df2021e920f4e0ff.pdf
2020-10-01
2211
2216
10.21608/ejhm.2020.131122
Pneumonia severity
D-Dimer
Community-acquired pneumonia
Hasan El-Banna
Khedr
1
AUTHOR
Dina Mohamed
Shokry
2
AUTHOR
Eman Mohamed
El Behedy
3
AUTHOR
Zeinab El-Sayed Kotb
El-Sayed
4
AUTHOR
ORIGINAL_ARTICLE
Serum Fibroblast Growth Factor 19 As A Predictor and Follow Up of Hepatocellular Carcinoma
Background: Abnormal autocrine fibroblast growth factor 19 (FGF19) productions have been observed in several types of cancers, including hepatocellular carcinoma (HCC), which is considered 3rd cause of cancer deaths worldwide with gradually increased incidence. Objective: To investigate the role of FGF 19 in prediction, diagnosis and follow up of HCC together with alpha feto protein (αFP). Patients and methods: This study was carried in Internal Medicine Department and Clinical Pathology Department, Faculty of Medicine Zagazig University Egypt in the period from October 2017 to October 2020. The study included 150 patients (111 males and 39 females) classified into 3 groups: 50 healthy volunteers as a control, 50 patients with liver cirrhosis documented by examination and investigation and 50 Patients with HCC with variable sizes. All participants in the study were subjected for the following after written consent and approval by their search ethics committee of Zagazig University. Result: The median of FGF19 level between control, liver cirrhosis and HCC was 4, 6 and 10 87 pg/ml respectively with higher sensitivity for detection of small HCC with high significance of α Fp between HCC > cirrhosis > control. Conclusion: FGF19 can be used successfully as a novel biomarker for HCC diagnosis and follow up after treatment together with already existing biomarker α FP.
https://ejhm.journals.ekb.eg/article_131123_e75d59b3da0dc81b98c5b93126db1125.pdf
2020-10-01
2217
2221
10.21608/ejhm.2020.131123
α FP
HCC
FGF 19
Said Abdelbaky
Gad
saidabdelbaky12345@gmail.com
1
Internal Medicine Department Faculty of Medicine, Zagazig University
LEAD_AUTHOR
Ahmed I.
Elagrody
2
Internal Medicine Department Faculty of Medicine, Zagazig University
AUTHOR
ORIGINAL_ARTICLE
Plasma and Urinary Calprotectin Levels in Type 2 Diabetic Patients with Peripheral Arterial Disease
Background: Plasma calprotectin is a persistent biomarker of insulin resistance (IR), gastroenteritis, and cardiovascular disease (CVD). We assessed the role of plasma and urinary calprotectin in type 2 diabetes patients with peripheral arterial disease (PAD), to assess whether calprotectin is a risk factor for developing PAD in type 2 diabetes patients. Aim of the work: To study the association of plasma and urinary calprotectin levels with peripheral arterial disease in type 2 diabetic patients Methods: The current study was conducted on 90 subjects. They were subdivided into 3 groups. Group I: 30 type 2 diabetics with PAD, group II: 30 type 2 diabetics without PAD and group III: 30 healthy control subjects of comparable age and sex. They were subjected to history taking, full clinical examination, anthropometric measurement, plasma and urinary calprotectin levels that were measured by ELISA and ankle brachial index. In addition, HbA1c, fasting serum lipid profile, highly sensitive CRP and CBC were measured. Results: plasma calprotectin level was significantly higher in patients with T2DM with lower extremity peripheral arterial disease (LEPAD) compared to the other 2 groups, urinary calprotectin was significantly higher in all type 2 diabetic subjects compared to healthy control group. Age, current smoking status, duration of diabetes, glycated hemoglobin and plasma calprotectin were independent determinant of peripheral arterial disease in T2DM patients Conclusion: Elevated plasma and urinary calprotectin levels in diabetic patients compared to healthy control suggest the possible role of calprotectin in development of atherosclerosis and peripheral arterial disease and the possibility of its use as a biomarker for diabetic vasculopathy.
https://ejhm.journals.ekb.eg/article_131124_4196519dec5d9dd0ed587a1022bc638c.pdf
2020-10-01
2222
2226
10.21608/ejhm.2020.131124
Plasma and urinary calprotectin
Type 2 diabetes mellitus
Peripheral Arterial Disease
Halawa
M
1
Department of Internal Medicine and Endocrinology, Faculty of Medicine – Ain Shams University, Cairo, Egypt
AUTHOR
Abushady
MM
2
Department of Internal Medicine and Endocrinology, Faculty of Medicine – Ain Shams University, Cairo, Egypt
AUTHOR
Abdelsalam Besibes
MM
3
Department of Internal Medicine and Endocrinology, Faculty of Medicine – Ain Shams University, Cairo, Egypt
AUTHOR
Basabbea
AS
4
Department of Internal Medicine and Endocrinology, Faculty of Medicine – Ain Shams University, Cairo, Egypt
AUTHOR
Mohamed
NR
5
Department of Internal Medicine and Endocrinology, Faculty of Medicine – Ain Shams University, Cairo, Egypt
AUTHOR
ORIGINAL_ARTICLE
Does the Gender Imply A Certain Predilection as Regards the Morphology of Left Atrial Appendage in Egyptians?
Background: Left atrial appendage (LAA) has different shapes, sizes, and relations to different adjacent structures, all of these may be extremely important when interventional procedures related to left atrium are done. There is a growing data about variations in LAA morphology in relation to gender and in different populations. Objective: So in our study we evaluated LAA morphologies and identified the proportion of its different subtypes in Egyptians. Patients and methods: We analyzed retrospectively the data of 101 consecutive Egyptian patients who underwent multidetector computed tomography (MDCT) in our university specialized hospital from August 2019 to February 2020. Results: All images were evaluated for LAA morphology and volume. Windsock morphology existed in 32% of patients followed by chicken wing in 25% of patients. Cauliflower morphology was reported in 23% of patients whereas 20% of patients had cactus morphology. There was a significant gender difference, as female patients had predominantly cauliflower and cactus morphologies (P<0.05). Left atrial appendage volume showed a statistically significant positive correlation with advanced age and significant negative correlation with left ventricular ejection fraction. Conclusion: Egyptians had LAA predominantly windsock morphology in males and cactus morphology in females.
https://ejhm.journals.ekb.eg/article_131125_ea6db593593353201bf8e0d0b71882ef.pdf
2020-10-01
2227
2234
10.21608/ejhm.2020.131125
Egyptians
Left atrial appendage
MDCT
Morphology
Hazem
Mansour
hazemmansour79@gmail.com
1
Department of Cardiology, Faculty of Medicine, Ain Shams University, Egypt
AUTHOR
Ahmed Mohamed
Hassan
2
Department of Cardiology, Faculty of Medicine, Ain Shams University, Egypt
AUTHOR
Ahmed Mohamed
Onsy
3
Department of Cardiology, Faculty of Medicine, Ain Shams University, Egypt
AUTHOR
Azza Alaa
Omran
4
Department of Cardiology, Faculty of Medicine, Ain Shams University, Egypt
AUTHOR
Mona
Rayan
monarayan17@gmail.com
5
Department of Cardiology, Faculty of Medicine, Ain Shams University, Egypt
AUTHOR
Mohamed
Ghazy
6
Department of Cardiology, Faculty of Medicine, Ain Shams University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Long Noncoding RNA MALAT-1 and Mirna-9 Expression Profile Levels in Patients with Diabetic Polyneuropathy (DPN) and Their Correlations with The Severity of Painful DPN
Background: Diabetic polyneuropathy (DPN) is the major microvascular complication of type 2 diabetes mellitus (T2DM). Painful-DPN is a major cause of mortality as well as morbidity. Long non-coding RNAs (lncRNAs) and microRNAs (miRNA) have emerged as critical regulators of many diseases, however, little is known about their expression patterns and functions in T2DM and its complications. Objective: To investigate the expression profile levels of lncRNA MALAT-1 and miRNA-9 in Egyptian patients with T2DM and to explore their associations with clinical and electrophysiological tests of both painful and painless DPN. Patients and Methods: This cross-sectional controlled study enrolled 55 patients with DPN and 40 controls. All participants were subjected to a complete neurological examination and electrophysiological tests involving nerve conduction studies. The expression levels of lncRNA MALAT-1 and miRNA-9 were measured by quantitative real-time polymerase chain reaction (qRT-PCR). Results: The relative expression levels of MALAT-1 and miRNA-9 were significantly upregulated in patients with DPN (0.219±0.061, 0.006454±0.0018, respectively) compared to controls (0.111±0.013, 0.0033±0.004, respectively). Interestingly, the relative expression levels of MALAT-1 and miRNA-9 were significantly upregulated in patients with painful DPN (0.206±0.037, 0.0045±0.0008, respectively) compared to patients with painless DPN 0.219±0.083, 0.0058±0.0017, respectively). Patients with DPN had sensory-motor axonal polyneuropathy which was affecting both lower limbs more than upper limbs. P<0.001*. Conclusions: The relative expression levels of MALAT-1 and miRNA-9 were significantly upregulated in patients with DPN more specifically in patients with painful DPN groups, hence, MALAT-1 and miRNA-9 could be used as useful and reliable diagnostic biomarkers of DPN.
https://ejhm.journals.ekb.eg/article_131126_22b8e1408825631c09a258197329866a.pdf
2020-10-01
2235
2245
10.21608/ejhm.2020.131126
DPN
LNC RNA
MALAT-1
miRNA-9
Nerve conduction studies
Nearmeen M.
Rashad
1
AUTHOR
Hala A.
Fathy
2
AUTHOR
Rehab M.
Atef
3
AUTHOR
Neveen F.
Ibrahim
4
AUTHOR
ORIGINAL_ARTICLE
Comparative Study of Multimodal Analgesia and Morphine Analgesia Concerning the Adverse Effects Following Open-Heart Surgeries
Background: Historically, pain management has been based on opioid analgesics after cardiac surgeries. Opiates, however, have adverse dose-related side effects that have an impact on the recovery of patients. So, evidence-based opioids that spare multimodal analgesia are progressively being used. Objective: To determine if the multimodal opioid-sparing treatment of dexamethasone, gabapentin, ibuprofen, ketorolac, and paracetamol had fewer side effects and was safe following open-heart surgeries compared to morphine. Patients and Methods: This prospective, double-blinded randomized, and controlled clinical study was performed on 60 patients scheduled for elective open-heart surgeries with sternotomy at Sohag University Hospital they were be randomly allocated into two equal groups, 30 patients each in the Cardiothoracic Department, Sohag University. Results: Fewer side effects occurred in patients in the multimodal group than in the morphine group. There was nausea and constipation in patients on the morphine versus multimodal group (21versus 0) with a ratio of 70% (p- value 0.001). Vomiting occurred in patients in the morphine group (12 versus 4) relative to the multimodal group with a ratio of 40% (p < /span>–value 0.020). Postoperative creatinine value showed no statistically significant difference in values between the two groups in all days, with the exception of day zero, showing lower values in the multimodal group creatinine level (0.82 ± 0.25 versus 1.02 ± 0.28 in morphine group (p-value 0.006). Conclusions: The multimodal regimen offered lower side effects than morphine group in patients undergoing cardiac surgery. There dramatically decreased complaint of nausea, vomiting, constipation, and respiratory depression. In terms of renal complication, no safety issues were found with the multimodal regimen.
https://ejhm.journals.ekb.eg/article_131127_806091fc12958570f1eaa94bdce80cad.pdf
2020-10-01
2246
2251
10.21608/ejhm.2020.131127
Multimodal analgesia
Open-heart surgeries
NSAIDs
Gabapentin
morphine
Wesam Abd El Galil
Abu Elwafa
1
Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Sohag University, Sohag, Egypt
AUTHOR
Ahmed El Saied
Abd Ell Rahman
2
Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Sohag University, Sohag, Egypt
AUTHOR
Samar Thabet
Abu Bakre
3
Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Sohag University, Sohag, Egypt
LEAD_AUTHOR
Khaled Abdelfattah Mohamed
Abdelfattah
4
Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Sohag University, Sohag, Egypt
AUTHOR
ORIGINAL_ARTICLE
Association between Hypocapnea and Febrile Seizures
Background: Although a number of susceptibility genes and environmental factors have been identified, precise mechanism that triggers febrile seizures (FS) is still unclear. However, it is known that pH changes have central role in the control of electrical activity in brain, leading to seizures. Brain alkalosis is known to enhance neuronal excitability and promote epileptiform activity. Objective: The aim of this study was to assess the association between febrile seizure and hypocapnea and the role of hypocapnea in the development of febrile seizures. Patients and Methods: The present study was an observational, case-control, study that was conducted on 100 patients who were recruited form Aswan University Hospitals. The patients were divided into the following groups: Group I: 50 children with febrile seizure (defined as: seizures in children in association with fever of 38.0 C or more without definitive evidence of neurological disorders, central nervous system infection, or metabolic abnormalities). Group II: 50 age- and gender-matched children with febrile illness, but without convulsions working as a control group. Results: We found that there was statistically significant difference between patients and control groups in terms of hypocapnea (p < 0.001). Patients were more likely to have hypocapnea at admission. In addition, there were statistically significant differences between patients and control groups in terms of acidosis at admission (p < 0.001) and alkalosis at admission (p < 0.001). Patients were more likely to have acidosis or alkalosis. Conclusion: Hypocapnea is significantly associated with febrile seizures. In our study, we found that children with febrile convulsion had significantly higher rate of hypocapnea than normal controls. In addition, it is apparent that presence of hypocapnea is associated with the type of seizure, but not with the duration of the attack.
https://ejhm.journals.ekb.eg/article_131128_5e869497728fdcdf2f4e5916f5da0e2b.pdf
2020-10-01
2252
2258
10.21608/ejhm.2020.131128
Hypocapnea
febrile seizures
children
Hanan Mohammed
Abd El-Moneim
1
AUTHOR
Bahaa
Hawary
2
AUTHOR
Emad Farah Mohammed
Kholef
3
AUTHOR
Yahia Mohammed Hassan
El Tayeb
4
LEAD_AUTHOR
ORIGINAL_ARTICLE
Diagnostic Value of Lung Ultrasound Versus Chest X-Ray in Surgical ICU Patients Alrefaey K Alrefaey, Ahmed S Marwa, Yassen M Amr, Zaghloul A Amgad
Introduction: Facing the recognized obstacles of chest computerized tomography (CT) and chest x-ray (CXR), lung ultrasound (LUS) is a promising alternative imaging tool gathering the benefits of real-time diagnosis with lower difficulties. This study aims to evaluate the effectiveness of LUS as a diagnostic modality in surgical critical care in contrast to chest x-ray. Patients and Methods: In this study, for each of the 92 included patients, when chest CT is indicated, CXR was requested and the BLUE protocol for LUS examination was initiated simultaneously. LUS data were recorded while analysis of CXR finding was performed by independent radiologist who was unaware of CT or LUS findings. Results: For each patient, 4 lung areas were examined with LUS and compared to CXR. LUS showed higher specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy (DA) of LUS in contrast to chest x-ray. A significantly lower time was required for LUS to reach the diagnosis compared to CXR (10.2± 4 minutes vs. 33±17 minutes respectively, p less than 0.01). Conclusion: LUS is a useful tool in screening and diagnosis detection of various pulmonary problems in surgical ICU; it can be used as daily bedside diagnostic tool for the critically ill patients adding the use of other chest imaging modalities.
https://ejhm.journals.ekb.eg/article_131133_90fbca6567ada2c552204a2069feaa89.pdf
2020-10-01
2259
2264
10.21608/ejhm.2020.131133
lung
Ultrasound
Complications
atelectasis
Alrefaey K
Alrefaey
refa3ey2@yahoo.com
1
Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura University, Egypt
LEAD_AUTHOR
Ahmed S
Marwa
2
Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura University, Egypt
AUTHOR
Yassen M
Amr
3
Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura University, Egypt
AUTHOR
Zaghloul A
Amgad
4
Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Risk Factors of Type 1 Diabetes Mellitus in Children Attending Aswan University Hospital
Background: Type 1 diabetes (T1DM) is a chronic disease caused by immune-mediated destruction of insulin producing beta cells in the pancreas. The destruction of beta cells results in insulin insufficiency, and patients develop life-threatening hyperglycemia that clinically manifests with weight loss, polyuria, and polydipsia. Objective: This study aimed to search for disease prediction and disease prevention. Patients and methods: The present cross-sectional study was conducted at Aswan University Hospital. One hundred children with T1DM were included during the period from April to November 2018. The mean age of the included patients was 7.2 ± 4.3 years and the age at onset of the disease was 4.56 ± 2.9 years. 56% of the patients were males. Results: In our cohort, we found that, in terms of obstetric history, 76% of the mothers delivered by CS and 12% of them had history of preeclampsia. 13% had a history of gestational diabetes. On the other hand, 13% and 29% of the mothers had a history of infectious diseases and use of antibiotics, respectively. There were no statistically significant associations between age group and preeclampsia (p =0.33), gestational diabetes and use of insulin (p =0.67), infectious diseases (p =0.91), use of antibiotic (p =0.26), use of antihypertensives (p =0.22), and mode of delivery (p =0.067). Conclusion: In conclusion, Egyptian children with T1DM had wide range of genetics, environmental, maternal, and neonatal risk factors that may have contributed to the development of T1DM.
https://ejhm.journals.ekb.eg/article_131134_c5bd6422877ee81dbc76ee1b85b273c8.pdf
2020-10-01
2265
2273
10.21608/ejhm.2020.131134
type 1 diabetes mellitus
children
Aswan University Hospital
Asmaa Mohammed
Ismail
1
Department of Pediatrics, Faculty of Medicine, Aswan University
AUTHOR
Ahmed El-Meshwady Ahmed
Mohammed
ahmed.elmeshwady1992@gmail.com
2
Department of Pediatrics, Faculty of Medicine, Aswan University
LEAD_AUTHOR
Hanan Mohammed
Abd El-Moneim
3
Department of Pediatrics, Faculty of Medicine, Aswan University
AUTHOR
ORIGINAL_ARTICLE
Assessment of Health-Related Quality of Life in Children with Rheumatic Heart Disease at Upper Egypt
Background: Many published literatures suggested that RHD can cause stress and anxiety in patients, with increased risks of evolving physical and psychosocial impairments. These include not only pain and fatigue but also difficulties with activities of daily living. Objective: The study aimed to evaluate the HRQOL in children with RHD and delineate the HRQOL domains in various clinical subtypes of RHD. Patients and methods: The present study was a cross-sectional, comparative, study that was conducted on 120 RHD patients who were recruited from Upper Egypt University Hospitals (Aswan, Assiut, and Qena hospitals) for six months. Also, 120 age and sex-matched healthy volunteers were included as the control group. Results: In our cohort, the most common presentation of the included patients was pancarditis with arthritis (33.3%), followed by polyarthritis (31.7%), and fever with pan carditis (20%). One-third of the patients had a history of one hospital admission, and 26.7% had a history of two or more admission. Besides, 65% had swollen, redness, hotness, limitation of movement in the lower limb. All patients were on long-acting penicillin and 10.8% had a history of cardiac surgery. In the present study, the mean serum CRP level was notably high in patients with RHD (mean 114.63 ±113.5mg/dL). Conclusion: Rheumatic heart disease imposed a considerable burden on the quality of life of the Egyptian pediatric population. In our study, we found that Egyptian patients with rheumatic heart disease had significant impairments on the physical, emotional, social, and school functioning, as compared to their counterpart healthy population.
https://ejhm.journals.ekb.eg/article_131135_1b70b425e429142bbb92071cbfdc25c3.pdf
2020-10-01
2274
2284
10.21608/ejhm.2020.131135
Health-Related Quality of Life
children
Rheumatic heart diseases
Upper Egypt
Asmaa Mohammed
Ismail
1
Department of Pediatrics, Faculty of Medicine, Aswan University, Aswan, Egypt
AUTHOR
Hanan Mohammed
Abd El-Moneim
2
Department of Pediatrics, Faculty of Medicine, Aswan University, Aswan, Egypt
AUTHOR
Asmaa Ashraf
Mohammed
3
Department of Pediatrics, Faculty of Medicine, Aswan University, Aswan, Egypt
LEAD_AUTHOR
ORIGINAL_ARTICLE
Chronic Graft-versus-Host Disease: An Immunologic Perspective
Background: Chronic graft-versus-host disease (GVHD) is the leading cause of late, nonrelapse mortality and disability in allogeneic hematopoietic cell transplantation recipients and a major obstacle to improving outcomes. The biology of chronic GVHD remains enigmatic, but understanding the underpinnings of the immunologic mechanisms responsible for the initiation and progression of disease is fundamental to developing effective prevention and treatment strategies. Objectives: The aim of this work is to summarize the most recent available data concerning chronic graft versus host disease from biologic, cytogenic and immunopathogenesis and its role in diagnostics therapeutic.
https://ejhm.journals.ekb.eg/article_131138_f26dd9eda071d537001618e6322d8606.pdf
2020-10-01
2285
2290
10.21608/ejhm.2020.131138
Allogeneic hemopoietic stem cell transplantation
CHRONIC GRAFT VERSUS HOST DISEASE
Alaa E.
Abd El-Hamid
1
Department of Internal Medicine, Faculty of Medicine, Menoufia University
AUTHOR
Enas S.
Zahran
2
Department of Internal Medicine, Faculty of Medicine, Menoufia University
AUTHOR
Mohamed E.
Salim
3
Department of Internal Medicine, Faculty of Medicine, Menoufia University
LEAD_AUTHOR
ORIGINAL_ARTICLE
Laparoscopic Treatment for Secondary Ureteropelvic Junction Obstruction
Background: Pelviureteric junction obstruction (PUJO) is one of the most frequent congenital anomalies of the urinary tract system. It is associated with pain, hydronephrosis, urinary tract infections, and eventually loss of renal function. Objective: To evaluate our institution in laparoscopic management of pelviureteric junction obstruction after failed open or laparoscopic surgery for pyeloplasty. Patients and methods: This study was conducted on 45 patients in two centers, Aswan Urology Department, and Sohage Urology Department. All of them have secondary pelviureteric junction obstruction.
Results: This study included 24 females and 21 males, with the mean age of 30.2 ± 7.5 years (range 21 to 45 years), failed previous repair on the left side was in 29 cases while it was in 16 cases on the right side. Regarding BMI, it ranged from 21 to 30 with mean of 24.9 ± 3.1 kg/m2. The mean time after failure of primary pyeloplasty in both genders was 21.3 ± 8.2 months with a range of 10-38 months. The preoperative total renal function by DTPA was 80.7 ± 26.5. All cases were done laparoscopically without conversion to open surgery with a mean operative time of 154.9 ± 25.4 minutes (range from 80 to 185 minutes). The intra operative etiological finding of previous failure were peripelvic fibrosis and scarring in 34 cases, proximal ureteric stricture in 4, missed lower pole crossing vessels at initial surgery in 5 and a kink at the PUJ associated with redundant pelvis in two patients.
Conclusion: Laparoscopic pyeloplasty is an effective minimal invasive alternative to open surgery in treatment of secondary pelviureteric junction obstruction.
https://ejhm.journals.ekb.eg/article_131139_b7679e6adf5d1cc2f73a3de28bcde2d1.pdf
2020-10-01
2291
2294
10.21608/ejhm.2020.131139
Laparoscopic treatment
Pyeloplasty
Repyeloplasty
secondary
UPJO
Hassaan A.
Gad
hassan.ali@aswu.edu.eg
1
Department of Urology, Faculty of Medicine - Aswan University
LEAD_AUTHOR
M. Zaki
Eldahshoury
2
Department of Urology, Faculty of Medicine - Aswan University
AUTHOR
Mohammed M.
Hussein
3
Department of Urology, Faculty of Medicine - Aswan University
AUTHOR
Ahmed
Hammady
4
Department of Urology, Faculty of Medicine - Sohag University
AUTHOR
ORIGINAL_ARTICLE
Serum leptin level in diabetic patients with erectile dysfunction
Background: Erectile dysfunction (ED) is a common sexual problem affecting men. Diabetes mellitus (DM) is one of the most common comorbidities of ED. Leptin is a 167-amino-acid peptide that is mainly expressed in white adipose tissue but is also found in a variety of tissues. Objective: To estimate serum level of leptin in diabetic patients with ED and correlate level of serum leptin in diabetic patients with severity and origin of ED. Patients and methods: Cross-sectional descriptive study was conducted on 64 individual male; 34 diabetic patients of both types of DM with ED and 30 non diabetic normal erectile function as control. All patients were evaluated clinically by history included IIEF-5 score and examination. Assessment of serum leptin level, HbA1c, cholesterol, triglycerides was done and penile duplex study was done only for diseased patients. Results: Serum leptin significantly increased in cases than control (P <0.001). Also, there was increased in diabetic men vasculogenic ED either arterial, venous or mixed (P =0.047). Serum leptin was correlated with the severity of ED (P =0.046). Conclusion: Leptin may play an important biomarker as a cost-effective method for diagnosis and assessment of severity of vasculogenic ED in DM and as a good predictor for ED occurrence.
https://ejhm.journals.ekb.eg/article_131140_a27ab6c94f49a11e03428fe065820fc5.pdf
2020-10-01
2295
2299
10.21608/ejhm.2020.131140
Diabetes mellitus
Erectile dysfunction
Serum leptin
Moustafa A.
El Taieb
moustafa.eltaib@aswu.edu.eg
1
LEAD_AUTHOR
Eisa M.
Hegazy
2
AUTHOR
Ahmed I.
Ebeed
3
AUTHOR
Mostafa A.
Maher
4
AUTHOR