ORIGINAL_ARTICLE
Comparative Study between Dexmedetomidine Versus Dexamethasone as Adjuvants to Levobupivacaine for Cervical Plexus Block in Patients Undergoing Thyroid Operation. Prospective-Randomized Clinical Trial
Background: Thyroidectomy is the most common endocrine surgical procedure, and many challenges are encountered during the preoperative, intraoperative, and postoperative periods. After thyroidectomy, bilateral superficial cervical block is the most successful option reducing postoperative pain, analgesic needs and post-operative complications such as vomiting.
Objective: Our study aimed to evaluate the analgesic effect, onset time of sensory block, duration time, postoperative visual analogue score (VAS) and complications of adding dexmedetomidine versus dexamethasone to levobupivacaine for cervical plexus block.
Patients and Methods: A prospective-randomized clinical trial study that was conducted at Sohag University between April 2018 and March 2020. The study included fifty patients with (ASA) Class I or II, aged 30 to 60 years were scheduled for euthyroid surgeries (including thyroid adenoma, Hashimoto's goiter, and nodosity thyroiditis)
Results: The addition of dexmedetomidine to levobupivacaine (group D) shortened the sensory block onset time compared to dexamethasone added to the levobupivacaine group (group S) (p < 0.05). The duration of analgesia of cervical plexus block in group (D) was significantly longer than that in group (S) (232.34 versus 303.55 min; p < 0.05). HR level in group (D) was significantly lower than that in group (S) (p < 0.05).
Conclusion: The addition of 1 μg kg−1 dexmedetomidine to levobupivacaine for cervical plexus block (BSCPB) shortened the sensory block onset time and extended the duration of analgesia and increased the quality of analgesia more superior than the addition of dexamethasone.
https://ejhm.journals.ekb.eg/article_175172_050cc33bd6127d52f957817879eab8d2.pdf
2021-07-01
1638
1643
10.21608/ejhm.2021.175172
Cervical plexus block, Levobupivacaine, Dexamethasone
Dexmedetomidine
Ahmed Hamody
Hassan
1
AUTHOR
Islam A.
Amer
2
AUTHOR
Ayman Mohamed
Abdelkareem
aymann8100@gmail.com
3
AUTHOR
ORIGINAL_ARTICLE
Determinants of Quality of Life after Laparoscopic Cholecystectomy
Background: Laparoscopic Cholecystectomy is one of the most common surgical procedures. Quality of life (QOL) is a concept reflecting physical, social, and emotional attitudes. Surgical operation, as a traumatic treatment procedure, could affect QOL of the patients as well as treating them. Therefore, surgeons should try their best to improve patient’s QOL in addition to focus on the more traditional outcomes of mortality, morbidity, and laboratory findings.
Objectives: The aims of the current work were to determine risk factors for calcular cholecystitis and assess the determinants of quality of life after laparoscopic cholecystectomy.
Patients and methods: This cross-sectional study included a total of 200 patients prepared for laparoscopic cholecystectomy, attending at Department of Surgery, Menoufia University Hospital, Egypt. Patients were first introduced and consented for the study at the surgery outpatients’ clinics during the preoperative settings and guided to fill out the chosen questionnaires and filling out other important information. Patients’ understanding and readiness to fill out the questionnaire without help were assessed. Assistance was offered accordingly.
Results: The demographic of the studied population shows predominant female distribution which was about three times their fellow Males. Mean age was 43 years. Presence of comorbidity in 41.5% of patients. There was a statistically significant difference between the preoperative scores and 3 months postoperative in all domains as the total score of Gastrointestinal Quality of Life index (GIQLI) improved by about ten points.
Conclusion: It could be concluded thatwith no doubt laparoscopic cholecystectomy positively affected the Quality of life. Patients subjectively had significant improvement of their symptoms. Some social determinants can predict postoperative outcomes.
https://ejhm.journals.ekb.eg/article_175173_20e586aa17b109ed06e077e1e7a3397b.pdf
2021-07-01
1643
1649
10.21608/ejhm.2021.175173
Laparoscopic cholecystectomy
quality of life
Taghreed Mohamed
Farahat
1
AUTHOR
Hatem Mohamed
Soltan
2
AUTHOR
Hala Mohamed El-Moselhy
Shaheen
3
AUTHOR
Nagwa Nashaat
Hegazy
4
AUTHOR
Heba Ali Rohiem
Elghalban
hebaelghalban@gmail.com
5
LEAD_AUTHOR
ORIGINAL_ARTICLE
Retrospective Statistical Study of Thoracic Trauma Patients in Al-Hussein Hospital, Al-Azhar University
Background: Trauma is reported to be the leading cause of death. Thoracic trauma comprises 10-15% of all traumas. Thoracic trauma directly accounts for approximately 25% of trauma related mortality and is a contributing factor in another 25%. Eastern Mediterranean region had one of the highest rates of trauma mortalities around the world. Objective: to determine chest trauma cases as regards the pattern, etiology, type of chest trauma, management and outcome of chest trauma in Al-Hussein Hospital, Al-Azhar University.
Patients and methods: A retrospective study was done on one hundred patients with traumatic chest injuries admitted to Al-Hussein Hospital, Al-Azhar University and were randomly chosen. Data were collected from patient’s files. Results: The highest incidence of thoracic trauma was found in age groups of 3rd and 4th fourth decades. The cause of trauma was work related; 42%, assault; 31%, road traffic accident; 20% respectively. Forty seven percent of cases had open cardiothoracic injury, 26% had closed lung injury and hemothorax, and 18% had chest cage fracture while 9% had pneumothorax only. Conclusion: Assault related injury was found to be the commonest cause of chest trauma followed by road and motor car accident, which could be explained by characters of population activities in the area surrounding Al-Hussein hospital.
https://ejhm.journals.ekb.eg/article_175174_2c3f1bab7ded54e35e38e281d18be536.pdf
2021-07-01
1650
1654
10.21608/ejhm.2021.175174
Al-Hussein Hospital
Thoracic trauma
Shaban Ragab
Ibrahim
ssukkar444@gmail.com
1
LEAD_AUTHOR
Ahmed Ezzat
Abdelaziz
2
AUTHOR
ORIGINAL_ARTICLE
Diagnostic Performance of Shear Wave Elastography Ultrasound for Identification of Esophageal Varices Needing Treatment in Initially Diagnosed Patients of Compensated Cirrhotic Liver
ABSTRACT
Background: The presence of varices in liver cirrhosis patients is an important risk factor for death and decompensation. Ultrasound elastography can be a noninvasive alternative to estimate portal hypertension severity and to predict varices.
Objective: Our study was performed to evaluate the diagnostic performance of liver stiffness (LS) and splenic stiffness (SS) measured by 2D shear wave elastography (SWE) and correlate it with endoscopic findings for the accuracy of assessment of varices needing treatment (VNT) in compensated liver cirrhosis patients.
Patients and methods: This is a prospective study that included 150 patients who had compensated liver cirrhosis. Two dimensional shear wave elastography measurements for liver and spleen stiffness were obtained and upper gastrointestinal endoscopies for the presence and grade of varices were performed.
Results: We found that as liver or spleen stiffness increases, the more is the increase in the size of the varices with significant positive linear correlation (p value < 0.001). We tried to identify the value of liver/spleen stiffness, which could predict presence of significant varices. Multivariate analysis identified several factors that could be associated with high risk varices, including liver and spleen elastography (p < 0.001).
Conclusion: Shear wave elastography is an effective and noninvasive tool not only for staging of fibrosis, but also for predicting clinically significant portal hypertension.
https://ejhm.journals.ekb.eg/article_175177_26184c0587a941a71db44414265a3ade.pdf
2021-07-01
1655
1661
10.21608/ejhm.2021.175177
Shear Wave Elastography Ultrasound
Esophageal varices
Compensated Cirrhotic Liver
Wael
Abdelghany
1
AUTHOR
Mahmoud M.
Higazi
mahmoud.higazi@minia.edu.eg
2
LEAD_AUTHOR
Elham
Mousa
3
AUTHOR
Mahmoud R.
Mohamed
4
AUTHOR
Wafaa
Abdelhamid
5
AUTHOR
ORIGINAL_ARTICLE
Prognostic Value of Neutrophil /Lymphocyte Ratio in Acute Ischemic Stroke patients Either Received Reperfusion Therapy or Not
Background: Very few studies have investigated the specific relationship between neutrophil-lymphocyte ratio (NLR) and the short-term prognosis of patients with acute ischemic stroke (AIS) and after receiving intravenous thrombolysis. Objectives: To discuss if there is a relationship between neutrophil-lymphocyte ratio and stroke severity in the emergency department and short-term prognosis whether the patient is treated by reperfusion therapy or not to use it as a rapid prognostic marker in acute ischemic stroke patients. Patients and Method: A prospective comparative interventional study was done on 56 patients with acute ischemic stroke at Menoufia University Hospitals. They were selected according to certain inclusion and exclusion criteria. NLR was assessed from the patients’ blood samples. Initial stroke severity was evaluated by Glasgow Coma Score (GCS), National Institutes of Health Stroke Scale (NIHSS) score and modified ranking scale (mRS), then was re-evaluated later after 24 hours of admission and after one month. Results: NLR among ischemic stroke patients with a bad prognosis was significantly higher than that of the patients who had a good prognosis. The optimal cutoff value of NLR for the prediction of unfavorable outcomes was 4.15 with a sensitivity of 100% and a specificity of 88.5%. Conclusion: Elevated NLR on the hospital admission is an easy and strong predictor of poor outcomes in AIS patients either receiving reperfusion therapy or not.
https://ejhm.journals.ekb.eg/article_175179_6896e6742e60bfc5e96fc632bc8743b3.pdf
2021-07-01
1662
1666
10.21608/ejhm.2021.175179
Acute ischemic stroke
Intravenous thrombolysis
Neutrophil-to-lymphocyte ratio
Outcome
Mahmoud Ahmed
Shahin
1
AUTHOR
Mostafa Saleh
Melake
2
AUTHOR
Saad Soliman
Ibrahim
3
AUTHOR
Amira Mohiey El-deen
Hamdey
dr_amira9393@yahoo.com
4
LEAD_AUTHOR
ORIGINAL_ARTICLE
Prevalence and Predictors of Aortic Valve Sclerosis in Chronic Hemodialysis Patients Walid Ahmed Ragab Abdelhamid
ABSTRACT
Background: Aortic valve sclerosis (AVS) is a serious public health issue, particularly among the elderly. It is linked to higher rates of acute cardiovascular events. In addition, cardiovascular diseases are common in chronic hemodialysis patients. Objective: To find out the prevalence of AVS in chronic hemodialysis patients and assess risk factors for AVS in these patients. Patients and Methods: The research involved 58 chronic hemodialysis patients from December 2019 to December 2020. They were categorized into group 1 (22 subjects) who did not have AVS and group 2 (36 subjects) who had AVS. Demographic data were gathered from all patients. Laboratory investigations and echocardiographic examinations were done for all the subjects. Results: Group 2 was older than group 1 (p < /em> = 0.002). In addition, diastolic blood pressure (DBP) was higher in group 1 than in group 2 (p < /em> < 0.003). Furthermore, group 2 exhibited greater serum alkaline phosphatase (ALP) levels than group 1 (p < /em> = 0.011). In contrast, group 2 had lower serum creatinine, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) than group 1 (p < /em>= 0.049, p = 0.038, p = 0.01, and p = 0.01, respectively). On multivariate regression analysis, greater age (p < /em> = 0.014), lower DBP (p < /em> = 0.049), and lower MCH (p = 0.011) were significantly predictive of AVS. Conclusion: 37.9% of hemodialysis patients had AVS in this study and the predictors for AVS included older age, lower DBP, and lower MCH.
https://ejhm.journals.ekb.eg/article_175180_ff2b7bd0d0115d6b3c009e3fe07b36e1.pdf
2021-07-01
1667
1671
10.21608/ejhm.2021.175180
Aortic Valve Sclerosis
Chronic Kidney Disease
Hemodialysis
Mean Corpuscular Hemoglobin
vascular calcification
Walid Ahmed Ragab
Abdelhamid
1
Internal Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
LEAD_AUTHOR
ORIGINAL_ARTICLE
Prevalence of Stress Cardiomyopathy in Polytrauma Patients
Background: Polytrauma is a leading cause of death globally and usually involving young victims. Takotsubo cardiomyopathy (TCM) is a serious clinical presentation of myocardial dysfunction characterized by acute, transient, and reversible heart failure syndrome owing to regional wall abnormalities of the ventricular myocardium associated with ECG changes and rising of myocardial biomarkers in the absence of cardiac condition causing the temporary ventricular dysfunction. Objective: To detect the prevalence of stress cardiomyopathy among polytrauma patients attending to Emergency Hospital Mansoura University. Patients and methods: The current study was a cross sectional study conducted on 500 patients who attended to Emergency Department, Emergency Hospital Mansoura University, suffering from polytrauma within the period from August 2019 to August 2020.
Results: Prevalence of cardiomyopathy among the studied trauma patients was 4.4%. Mode of trauma (either blunt or penetrating) had no effect in the incidence of cardiomyopathy. Sequential organ failure assessment (SOFA) score and revised trauma score (RTS) demonstrated positive correlation with incidence of cardiomyopathy among polytrauma cases (P<0.001). Cardiomyopathy group was associated with marked affection of all echocardiographic parameters (Stroke volume, end diastolic volume, ejection fraction and fractional shortening) except end systolic volume. Cardiomyopathy group was associated with marked increase in ICU admission, ICU length of stay, total length of stay and mortality rate.
Conclusion: Presence of stress cardiomyopathy in trauma cases may be used as an indicator of poor outcomes. Both SOFA and RTS scores were considered as reliable tools used to describe organ dysfunction/failure in polytrauma cases and have a positive correlation with stress cardiomyopathy.
https://ejhm.journals.ekb.eg/article_175182_bebf6d9ace5403d55e50e3269b60a520.pdf
2021-07-01
1672
1676
10.21608/ejhm.2021.175182
ICU
polytrauma
RTS
SOFA
Stress Cardiomyopathy
Samir Mohamed
Attia
1
AUTHOR
Nader El Shahat
Awad
2
AUTHOR
Mohamed Elsaid
Ahmed
3
AUTHOR
Amany Medhat Ezzat
Youssef
4
AUTHOR
ORIGINAL_ARTICLE
Left Atrial Volume as A Parameter of The Ventricular Function in Patient with Non-Valvular Atrial Fibrillation
Background: Remodeling of the left atrium (LA)is a reflection of chronicity of the underlying, often occult cardiovascular disease. The presence of left atrial enlargement indicates clinically significant risk of adverse cardiovascular consequences for the patient. Left atrial volume provides a more sensitive assessment of left atrial enlargement, which is an important predictor of AF, providing incremental information beyond that afforded by the clinical risk factors and conventional M mode LA dimension.
Objective: Assessment of left atrial volume as a parameter of ventricular function in patients with non-valvular atrial fibrillation.
Patients and methods: The study was conducted on convenient sample of 50 patients with non-valvular AF and 50 normal control group who presented to Damietta Cardiology Center Outpatient Echocardiography Laboratory for a resting transthoracic study.The eligible patients were adults aged from 26 to 67 years, who had no history of pacemaker implantation, valvular heart disease (except mild degree), congenital heart disease and ischemic or dilated cardiomyopathy.
Results: our study revealed that there was a strong direct significant graded relationship between the severity of diastolic dysfunction and left atrial volume index (LAVI) in patients of non-valvular AF. There was limited significance regarding Tei index and global longitudinal strain (GLS). Therefore, LAVI can be considered a sensitive and specific echocardiographic indicator for left ventricular diastolic dysfunction. We can consider LAVI the A1c of the heart.
Conclusion: Diastolic dysfunction in non-valvular AF patient can be assessed using LAVI with limited significance of Tei index and GLS. Regarding systolic function in those patients, it can be assessed using GLS as it is considered sensitive index of early systolic dysfunction.
https://ejhm.journals.ekb.eg/article_175728_5bcc9dfb760411022289d442b3cb7ac6.pdf
2021-07-01
1677
1683
10.21608/ejhm.2021.175728
Left atrial volume index
GLS
Ventricular function
Non-valvular atrial fibrillation
Ayman Elsayed
Elbadrany
aymanalbdrany@yahoo.com
1
Department of Cardiology, Faculty of Medicine, Mansoura University, Egypt
LEAD_AUTHOR
Mohamed A. E.
Mostafa
2
Department of Cardiology, Faculty of Medicine, Mansoura University, Egypt
AUTHOR
Ensaf Bassam
Yousef
3
Department of Cardiology, Faculty of Medicine, Mansoura University, Egypt
AUTHOR
Sherif Abd Alsalm
Sakr
4
Department of Cardiology, Faculty of Medicine, Mansoura University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Leg Wound Complications During Hospital Stay When Using Conventional Saphenous Vein Harvest Versus Endoscopic for Coronary Bypass Surgery
Background: Using the endoscope to harvest the saphenous vein as an alternative to conventional method helps in decreasing leg wound related complications.
Objective: The aim of the current work was to detect the leg wound problems while using endoscopic vein harvesting versus conventional method during hospital stay.
Patients and Methods: Fifty patients underwent coronary bypass surgery divided into two groups randomly, conventional, and endoscopic. Data of the patients were collected perioperatively. Patients were followed up during hospital stay which was 5-7 days in average regarding leg wound complications.
Results: Leg wound pain in the postoperative period during hospital stay was significantly higher in the conventional group, leg swelling was lower in endoscopic group, occurrence of hematoma of the leg was higher in endoscopic group.
Conclusion: It could be concluded that harvesting the saphenous vein endoscopically is superior to conventional method regarding leg wound complications in addition to its cosmetic advantage.
https://ejhm.journals.ekb.eg/article_175729_1b0e4655460ccce2eeb6b763e8b7778d.pdf
2021-07-01
1684
1685
10.21608/ejhm.2021.175729
Leg Wound Complications
Conventional Saphenous Harvest
Endoscopic
Coronary Bypass Surgery
Ahmed S.
Mahmoud
1
Department of Cardiothoracic Surgery, Faculty of Medicine, Cairo University
AUTHOR
Fouad M.
Rasekh
2
Department of Cardiothoracic Surgery, Faculty of Medicine, Cairo University
AUTHOR
Hesham Zayed
Saleh
3
Department of Cardiothoracic Surgery, Faculty of Medicine, Cairo University
AUTHOR
ORIGINAL_ARTICLE
The effect of Psoriasis on Female Sexual Function
Background: Psoriasis is one of the most common immune-mediated chronic inflammatory skin disorders. Sexual dysfunction in psoriasis is influenced by factors such as the severity of psoriasis, psoriasis body area and associated physical and/ or psychic comorbidities.
Objective: The study aimed to assess female sexual dysfunction and their correlation with psoriasis severity.
Patients and Methods: The present study was conducted on two groups: patient group that included 30 female patients with psoriasis, with age ranged from 20-60 years old and control group included 20 healthy females, with matched age. The disease severity was graded according to the Psoriasis Area and Severity Index (PASI) score. Female sexual function was assessed by female sexual function Index (FSFI).
Results: The mean of all six FSFI domains were lower in psoriatic group than in control group except pain was increased and with no statistically significant difference between both groups. Orgasm was found to be significantly decreased in female patients with psoriasis than control group. There was a significant negative correlation between female sexual function index (FSFI) and psoriasis severity (PASI). There was a significant negative correlation between age and FSFI among control group. In contrast to psoriasis group, there was no correlation between FSFI and either age or duration of disease.
Conclusion: There was asignificant negative correlation between FSFI and PASI.
https://ejhm.journals.ekb.eg/article_175730_b13bd51d137146f5ea01ab122fa46e02.pdf
2021-07-01
1686
1689
10.21608/ejhm.2021.175730
PASI
FSFI
female sexual dysfunction
Mohammed Mohammed Salem
Selim
mosad8rashed@gmail.com
1
Department of Neurosurgery, Faculty of Medicine, Zagazig University, Sharkia, Egypt
LEAD_AUTHOR
Amany Abdelrahman
Nassar
2
Department of Dermatology, Venereology and Andrology, Faculty of Medicine – Zagazig University, Egypt.
AUTHOR
Al-shimaa Mohammed
Ibrahim
3
Department of Dermatology, Venereology and Andrology, Faculty of Medicine – Zagazig University, Egypt.
AUTHOR
ORIGINAL_ARTICLE
Interrupted versus Continuous Suture Technique for Ventricular Septal Defects Surgical Closure
Background: Ventricular septal defect (VSD) is the most frequent congenital cardiac defect. Conventionally, open-heart surgical repair through cardiopulmonary bypass (CPB) is the primary approach for many years.
Objective: Given the absence of a reliable evidence on the optimal suture technique regarding the efficacy and morbidity, this study aimed to compare the postoperative complication rates and the outcomes of the interrupted and continuous suture techniques for the surgical VSD closure.
Patients and Methods: This retrospective cohort study included 140 consecutive children who underwent surgical closure of congenital VSD of any type with or without associated congenital heart diseases. Patients with associated major cardiac anomalies were excluded. Preoperative, operative, and long-term outcomes data including VSD residual and heart block that needed permanent pacemaker (PPM) were collected from medical files. The closure was performed using interrupted sutures in 76 (54.3%, group 1), and by continuous sutures in 74 (45.7%, group 2) patients.
Results: Three (3.9%) patients in group 1 and four (6.3%) patients in group 2 developed heart block that needed PPM, with no significant difference (p=0.702). Four (5.3%) patients in group 1 compared with two (3.1%) patients in group 2 had clinically and sizable (by echocardiography) significant residual, with no significant differences between both groups (p=0.688).
Conclusion: The present study indicates that interrupted and continuous VSD closure techniques have comparable success and postoperative complication rates. Thus, the optimal suturing technique for VSD closure cannot be standardized, and their predilection depends on the experience and the comfort of the surgeons.
https://ejhm.journals.ekb.eg/article_175731_de9b7e3aede72054f65919532906b48e.pdf
2021-07-01
1690
1695
10.21608/ejhm.2021.175731
Heart block
Residual VSD
surgical closure
Ventricular Septal defect
Rafik
Soliman
rafikfekry@hotmail.com
1
Cardiothoracic Surgery department, Faculty of medicine, Menoufia University
LEAD_AUTHOR
Sherif S.
Salim
2
AUTHOR
Luna S.
Baangood
3
AUTHOR
Abdulhamid
Alnajjar
najjra@mcc.med.sa
4
AUTHOR
Ayman R.
Abdelrehim
5
AUTHOR
ORIGINAL_ARTICLE
Identification of Circulating Tumor Cells and Chemokine Receptor CCR6 as Noninvasive Biomarkers in Egyptian Patients with Hepatocellular Carcinoma
Background: Circulating tumor cells (CTCs) are cancer cells in the circulation that are derived from the original tumor or metastatic foci. Chemokines and their receptors have major roles in hepatocellular carcinoma (HCC) metastasis. They also represent a very promising group of markers to detect CTCs in HCC patients. The CCL20-CCR6 axis promotes cancer proliferation, migration, and tumor remodeling through immune cell control. Objective: This study aimed to identify the role of CTC and CCR6 in hepatocellular carcinoma patients. Patients and methods: The study included 91 subjects; 71 HCC patients and 20 normal individuals. Routine laboratory investigations included CBC, PT and INR, ALT, AST, bilirubin, albumin, alpha fetoprotein, and creatinine in addition to detection of chemokine receptor 6 (CCR6) RNA by real time PCR and CTCs by flow cytometry as CD45¯CK19+ cells were performed for all subjects enrolled in this study. Results: There was significant difference between the studied groups as regards liver function tests. Also, high significant difference was recorded regarding CCR6 RNA expression, CTCs count and hepatic focal lesion detection by ultra sound. No significant difference between both groups regarding kidney function tests. Correlation studies between CTCs and other variables showed positive correlations with liver function tests (ALT, AST, BIL, Alb, AFP, and INR) and negative correlations with albumin and platelets. Conclusion: CCR6 mRNA concentration was significantly increased in HCC patients and its elevation was correlated with CTCs percentage. Therefore, it can be concluded that the combined assessment of CTCs and CCR6 could be considered as noninvasive biomarkers for HCC patients.
https://ejhm.journals.ekb.eg/article_175732_b680f1f04a3d75c8ffe041ae12a4ff8c.pdf
2021-07-01
1698
1702
10.21608/ejhm.2021.175732
Hepatocellular carcinoma
Circulating tumor cells
Chemokine receptor 6
PCR
Flowcytomerter
Mohammed F.
Elshal
1
Molecular Biology Department, Genetic Engineering and Biotechnology Institute, University of Sadat City, Sadat City, Egypt
AUTHOR
Manal O.
Elhamsh
2
Molecular Biology Department, Genetic Engineering and Biotechnology Institute, University of Sadat City, Sadat City, Egypt
AUTHOR
Morad M.
Mahmoud
3
Molecular Biology Department, Genetic Engineering and Biotechnology Institute, University of Sadat City, Sadat City, Egypt
AUTHOR
Neama
Lotfy
neama_lotfy@yahoo.com
4
Assistant professor of clinical pathology, faculty of medicine, Ain Shams university.
LEAD_AUTHOR
ORIGINAL_ARTICLE
Does Farnesoid X receptor (FXR) Have a Role in NAFLD Progression ?
Background: Non-alcoholic fatty liver disease (NAFLD) is the emerging cause of chronic liver disease. In addition, steatosis may lead to failure of obtaining sustained virological response after hepatitis C virus eradication. Therefore, there is a trend to identify effective strategies for managing hepatic steatosis. Farnesoid X receptor (FXR) agonists are reported to play a role in NAFLD treatment. Objective: This study aimed to explore the immunohistochemical expression of FXR in NAFLD spectrum in association with the clinicopathological data. Material and method: This was a retrospective study including 50 cases of NAFLD and 23 cases of normal liver. The NAFLD group was subdivided into 11 cases of NAFL (simple steatosis) and 39 cases of non-alcoholic steatohepatitis (NASH). Results: Hepatocyte FXR nuclear expression was significantly decreased in NASH group (P=0.001) with no significant decrease in NAFL group compared to normal liver (P=0.149). Bile duct FXR expression was significantly lower in NAFL group compared to normal liver (P= 0.009) to reach the lowest level in NASH group (P= 0.017). In NAFLD group, there was an inverse correlation between hepatocyte FXR nuclear expression and the ALT/AST ratio (r=-0.349 and P=0.013). However, hepatocyte FXR nuclear expression was significantly associated with moderate grade of steatosis and severe fibrosis (P= 0.044 and P= 0.033, respectively). Conclusion: Hepatocyte FXR nuclear expression showed a stepwise decrease in its expression from normal to NASH passing with NAFL. Therefore, FXR has a protective role against NAFLD progression. Elevated liver enzymes could be used as a non-invasive method for monitoring FXR agonists' efficacy.
https://ejhm.journals.ekb.eg/article_175733_3fe66ea15415d6ba48b1e567492c96dd.pdf
2021-07-01
1703
1710
10.21608/ejhm.2021.175733
ALT/AST ratio
FXR
NAFLD spectrum
Shereen Fathy
Mahmoud
1
Pathology Department, Faculty of Medicine Menofia University, Egypt
AUTHOR
Dina
Sweed
dina.sweed@liver.menofia.edu.eg
2
Pathology Department, Faculty of Medicine Menofia University, Egypt
AUTHOR
Esraa
Karman
esraa.karman92@gmail.com
3
pathology department, National Liver Institute, Menoufia University
LEAD_AUTHOR
Nancy Youssef
Asaad
4
Pathology Department, Faculty of Medicine Menofia University, Egypt
AUTHOR
Nanis Shawky
Holah
5
Pathology Department, Faculty of Medicine Menofia University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Ultrasound Assessment of Fetal Adrenal Gland in Term and Preterm Labor Cases
Background: Preterm birth (PTB) remains a major cause of perinatal morbidity and mortality worldwide. Compared with term deliveries, early PTB (< 34 weeks' gestation) carries a 7-fold increased risk of neonatal death.
Objective: To compare the Fetal Zone Depth (FZD) of fetal adrenal gland in term and preterm labor cases
Patients and Methods: Thirty-three preterm pregnant women at 29-36 weeks of gestation with single pregnancy and clinical diagnosis of preterm labor and control group of 33 pregnant women at 37-40 weeks with term pregnancy were included in this study. FZD and Total Gland Depth (TGD) of fetal adrenal gland were ultrasonographically measured and FZD/TGD ratios were calculated and compared between the two groups.
Results: No difference was found between the two groups in respect of age and number of pregnancies (P > 0.05). Yet, preterm birth history rupture of membrane, cervical dilatation and mode of delivery were higher in preterm group (P <0.05). Fetal adrenal gland FZD/TGD ratio was statistically significantly higher in preterm group compared to the term group (52% ± 5% vs. 29% ±9%; P <0.001).
Conclusion: The growth in FZ as a fetal adaptation mechanism in increased fetal stress in preterm labor cases was at a significant level. Once supported by more comprehensive studies, we think that this result would be beneficial in the prediction of preterm labor in clinical practice.
https://ejhm.journals.ekb.eg/article_175734_43d019d12d3ffe186d04a4668dd1332d.pdf
2021-07-01
1711
1718
10.21608/ejhm.2021.175734
preterm labor
Adrenal gland
Fetal zone
Ultrasonography
Heba Maged
Abo Shady
1
AUTHOR
Mohamed Ahmed Samy
Kandil
2
AUTHOR
Ashraf Anas
Zytoon
ashradio@gmail.com
3
AUTHOR
Shaimaa Mahmoud
Youssef
shaimaayoussef606@gmail.com
4
LEAD_AUTHOR
ORIGINAL_ARTICLE
Neonatal Sepsis: Single Center Experience
ABSTRACT
Background: Neonatal sepsis is a major cause of morbidity and mortality worldwide, especially when an infant is delivered preterm.
Objectives: The aim of the current work was to evaluate the clinical presentation, etiology, antibiotics use, and mortality in neonatal sepsis cases at King Fahad Medical City. Duration of antibiotics and length of hospital stay were also included.
Patients and Methods: This cross sectional retrospective descriptive, single-institute study included a total of 225 neonates suspected to have neonatal sepsis, attending at tertiary hospital, Department of General Pediatric, King Fahad Medical City, Riyadh, Saudi Arabia. This study was conducted between January 2014 to July 2017. Subjects were hospitalized through Emergency Department and included all neonates underage of 28 days.
Results: Among the included 225 neonates, 134 (59.6%) were male and 91 (40.4%) were female. Most of them Term neonates 203 (90.2%). Fever found to be the most common symptoms 184 patients (81.8%) followed by decrease feeding and activity in 124 (55%) and 101 (44.9%) respectively. Respiratory symptoms like cough, tachypnea, runny nose and cyanosis found in 56 (25%). Empirical antibiotics frequently used were amipicillin 209 (92%) and cefotaxime 185 (82%) with median duration of 4days (range 1-47 days). Blood cultures came positive in 8 patients (3.6%). Coagulase negative staphylococci came in 3 (30%) patients and E.coli in 3 (30%) patients as well.
Conclusion: It could be concluded that large number of neonates admitted as suspected neonatal sepsis in our hospital resolved their symptoms without find identifiable etiology. In those who had identifiable etiology urinary tract infections (UTI) and viral infections were the common etiology. However, blood stream sepsis and meningitis were quite rare.
https://ejhm.journals.ekb.eg/article_175736_566956cc5a4d40b95e0a98355c0d70e4.pdf
2021-07-01
1719
1723
10.21608/ejhm.2021.175736
Neonatal
Sepsis
antibiotics
Mansour
Alzahrani
msgalzahrani@kfmc.med.sa
1
Departments of Pediatric, King Fahad Medical City, Riyadh, Saudi Arabia
LEAD_AUTHOR
Sami
Alrashidi
2
Departments of Pediatric, King Fahad Medical City, Riyadh, Saudi Arabia
AUTHOR
Abdulaziz
Alnujaydi
3
Departments of Pediatric, King Fahad Medical City, Riyadh, Saudi Arabia
AUTHOR
Abdulqudos
Aljenendil
4
Departments of Pediatric, King Fahad Medical City, Riyadh, Saudi Arabia
AUTHOR
Omar
Alomar
5
Departments of Pediatric, King Fahad Medical City, Riyadh, Saudi Arabia
AUTHOR
Abdulaziz
Alareefy
6
Departments of Pediatric, King Fahad Medical City, Riyadh, Saudi Arabia
AUTHOR
Yazeed
Alsubaie
7
Departments of Pediatric, King Fahad Medical City, Riyadh, Saudi Arabia
AUTHOR
Mohammed
Alghoshimi
8
Departments of Pediatric, King Fahad Medical City, Riyadh, Saudi Arabia
AUTHOR
Dayel
Alshahrani
9
Departments of Infectious Diseases, King Fahad Medical City, Riyadh, Saudi Arabia
AUTHOR
ORIGINAL_ARTICLE
The Role of Multi-Slice Computed Tomography for the Assessment of Bronchiectasis
Background: Bronchiectasis is pathological, irreversible dilatation of the bronchi due to destruction of the bronchial wall and the elastic connective tissue. Recurrent infection and inflammation and the resulting chemical and cellular cascade lead to permanent architectural changes in the airways. Bronchiectasis can confer substantial potential morbidity, usually secondary to recurrent infection.
Objective: The aim of the current work was to evaluate the role of Multi-Slice Computed Tomography (MSCT) examination in detection and diagnosis of pulmonary bronchiectasis.
Patients and methods: This study included 60 patients with bronchiectasis detected in their MSCT of the chest referred from the Chest Diseases Hospital to the Radiology Department, Mit Khalaf Hospital Complex, Al-Menoufia.
Results: The most common etiology was post inflammatory bronchiectasis 26 patients (43.3%), followed by traction bronchiectasis 21 patients (35%). The distribution of bronchiectasis in post inflammatory cases was mostly affecting the lower lobes 16 (61.4%) of 26 patients. Regarding traction bronchiectasis, affection was mostly in the upper lobes including 10 (47.4%) of 21 patients. In chronic obstructive pulmonary disease, distribution was mostly in lower lobes with 4 (50%) of 8 patients. In aspiration, distribution was in bilateral lower lobes. In cystic fibrosis, it affected the bilateral upper lobes and in Kartagener syndrome, the distribution was on bilateral lobes. The most common morphological type of bronchiectasis was the cylindrical type which was detected in (25%) of cases followed by the signet ring type with (23.3%) of the cases.
Conclusion: It could be concluded that the role of MSCT in the diagnosis of the pulmonary bronchiectasis is central, accurate and non-invasive.
https://ejhm.journals.ekb.eg/article_175737_9493fee237637e93a515d89c2232674a.pdf
2021-07-01
1724
1730
10.21608/ejhm.2021.175737
Multi-slice computed tomography
Bronchiectasis
Zinab Mostafa Shehata
Bisar
nodamecantabelle@gmail.com
1
Department of Radiodiagnosis, Faculty of Medicine, Menoufia University, Egypt
LEAD_AUTHOR
Zeinab Abd El Aziz
Ali
2
Department of Radiodiagnosis, Faculty of Medicine, Menoufia University, Egypt
AUTHOR
Yasmin Hossney
Hemeda
3
Department of Radiodiagnosis, Faculty of Medicine, Menoufia University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Effects of Varicocele on Serum Testosterone Levels and Changes of Testosterone Levels after Varicocelectomy among Infertile Men: A Prospective Controlled Study
Background: Varicocele repair has been advocated as an option to prevent and treat low serum testosterone, even in men with normal semen quality. The association between clinical varicocele and impaired testosterone production is less clearly understood. Although, the conceptions of the negative impact of clinical varicocele on Leydig cell functions and the beneficial effect of varicocele repair on testosterone production have been proposed for decades.
Objective: To examine the hypotheses that clinical varicoceles affect baseline serum total testosterone levels and to study the effects of varicocelectomy on serum testosterone levels and semen quality in infertile men who suffer from varicocele.
Patients and Methods: This study included 100 patients (50 control and 50 cases) presented to the General Surgery and Endocrine Surgery Unit Outpatient Clinic at Mansoura University Hospitals with clinical varicocele for primary infertility. The study was conducted during the period between 1st April 2020 and end of March 2021.
Results: Regarding preoperative and postoperative testosterone level among the intervention group, there were highly statistically significant increases in total testosterone as well as significant improvement in gonadal functions (significant increase in number of cases with euogonadism) after the operation among the intervention group (P < 0.001). however the percent of improvement was more than among hypogonadal compared to euogonadal.
Conclusion: Varicocelectomy was demonstrated to significantly improve both sperm quality (in terms of volume, count, motility and morphology) as well as serum testosterone in infertile men, especially in cases with hypogonadism.
https://ejhm.journals.ekb.eg/article_176469_12dc9998e7fde6b5a1ec60740ada936a.pdf
2021-07-01
1731
1738
10.21608/ejhm.2021.176469
Varicocele
testosterone
varicocelectomy
Semen Analysis
fertility
Mohamed Ali
Kamar
m.ali9020@yahoo.com
1
Endocrine Surgery Unit, Faculty of Medicine, Mansoura University, Egypt
LEAD_AUTHOR
Tamer Youssef
Mohamed
2
Endocrine Surgery Unit, Faculty of Medicine, Mansoura University, Egypt
AUTHOR
Atef Mohamed Abdel
Latif
3
Endocrine Surgery Unit, Faculty of Medicine, Mansoura University, Egypt
AUTHOR
Ahmed Mohamed
AbdElmodaber
4
Endocrine Surgery Unit, Faculty of Medicine, Mansoura University, Egypt
AUTHOR
ORIGINAL_ARTICLE
The Effects of Educational Interventions on Nurses' Knowledge and Practices in Hemodialysis Unit Regarding Infection Control Practices
Background: Nurses are considered a key element to break the chain of the infection through their adherence to standard precautions. Many factors may hinder nurses’ adherence to these precautions as; shortage of nurses, high number of patient ratio, turn-over of nursing staff, lack of staff training, inadequate supplies, patient urgency, time limits and low patients education level regarding infection control.
Objective: This study aims to evaluate the effects of educational interventions on nurses' knowledge and practices in Hemodialysis Unit regarding infection control practices.
Patients and methods: A quasi-experimental research design (pretest-posttest) was utilized to fulfill the aim of the study. The study was conducted at the Hemodialysis Unit, Alexandria Fever Hospital. All nurses who were involved in providing direct care throughout the three shifts (morning, evening, night), for patients, at the above-mentioned setting, were included in the study (n=30 nurses).
Results: No statistical significant relationships were detected between the studied nurses' knowledge levels and their demographic characteristics after application of the educational interventions. Statistical significant relationships were detected between the nurses' age, level of education, and their practices level after application of the educational interventions. The results of the present study highlighted that nearly two thirds of the studied nurses had "poor" overall knowledge and half of them had "poor" overall practices regarding infection prevention, and control practices before application of the educational interventions.
Conclusion: Educational nursing interventions had significant positive effects on overall percent improvement of nurses’ knowledge, and practice related to infection control in Hemodialysis (HD) Unit Fever Hospital.
https://ejhm.journals.ekb.eg/article_176470_6e8aa48f1a6d10d470d9575274e6e5e0.pdf
2021-07-01
1739
1748
10.21608/ejhm.2021.176470
Educational Interventions
Hemodialysis unit
Infection Control Practices
Nurses' Knowledge and practices
Fatma Korashy
Osman
fatykorashy1234@gmail.com
1
Medical Surgical Nursing Department, Faculty of Nursing, Alexandria University, Egypt
AUTHOR
Haneya Mohamed
El Banna
2
Medical Surgical Nursing Department, Faculty of Nursing, Alexandria University, Egypt
AUTHOR
Amany Youssef
Sharaf
3
Medical Surgical Nursing Department, Faculty of Nursing, Alexandria University, Egypt
AUTHOR
Yasmin Fathy
Mohammed
4
Medical Surgical Nursing Department, Faculty of Nursing, Alexandria University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Exercise-Induced ST Changes in aVR, V5 and V1 in Differentiation between Single and Multi-Vessel Coronary Artery Disease
Background: Angina occurs when there is regional myocardial ischemia causedby inadequate coronary perfusion and is usually but not alwaysinduced by increases in myocardial oxygen requirements.
Objective: The aim of this work was to study the significance of ST changes in aVR, V5, V1 during exercise ECG for diagnosis of single -or multi-vessel coronary artery disease.
Patients and methods: This study had been carried out in the cardiology department, Zagazig University and National Hear Institute during the period from January 2005 to January 2007. This study included 56 patients (40 male +16 female) with chronic stable angina. Results: Comparison was done among groups regarding demographic data, resting ECG data, echocardiographic findings and there were no statistical significant difference among groups. Single vessel disease: LAD: - the ability of the test to detect left anterior descending (LAD) lesion as a single vessel disease has high specificity 87.5%, high +ve predictive value 96%, but low sensitivity 50%. Left circumflex (LCx): the sensitivity of the test to detect LCx lesion as a single vessel disease was 53.4%, specificity 60%, but with low +ve predictive value 44%. RCA: as regard RCA lesion the test has low sensitivity, specificity positive and negative predictive values.
Conclusion: The concomitant appearance of exercise-induced ST-segment elevation in lead V1 and in lead aVR with simultaneous ST-segment depression in lead V5, or the isolated appearance of ST-segment elevation in lead V1 mostly detects single-vessel disease and correlates strongly with significant narrowing of the LAD coronary artery as single-vessel disease, or with significant stenosis of the LAD and LCx coronary arteries as double-vessel disease.
https://ejhm.journals.ekb.eg/article_176471_c1b1f4d5d1de17621b0feb0ba067e4ef.pdf
2021-07-01
1749
1756
10.21608/ejhm.2021.176471
Coronary Artery Disease
ST changes
AVR
V5 and V1
Single - and Multi-Vessel
Ayman Elsayed
Elbadrany
aymanalbdrany@yahoo.com
1
Department of Cardiology, Faculty of Medicine, Zagazig University, Egypt.
AUTHOR
Soliman M.
Ayad
2
Department of Cardiology, Faculty of Medicine, Zagazig University, Egypt.
AUTHOR
Mahmoud D. S.
Elmenshawy
3
Department of Cardiology, Faculty of Medicine, Zagazig University, Egypt.
AUTHOR
Tarek A.
Naguib
4
Department of Cardiology, Faculty of Medicine, Zagazig University, Egypt.
AUTHOR
ORIGINAL_ARTICLE
Ultrasound Guided Foam Sclerotherapy of Lower Limb Varicose Veins: Outcome and Patient Satisfaction
Background: Varicose veins are defined as dilated, tortuous, and elongated superficial veins of the lower limbs with incompetent valves. Sclerotherapy could be a minimally invasive technique that uses an injection of a special chemical (sclerosant) into a varicosity to wreck and scar the inside lining of the vein. Resulting in blockage of the treated vein.
Objective: To explain the efficacy and safety of foam sclerotherapy within the treatment of varicose veins and to see patient’s satisfaction after ultrasound-guided foam sclerotherapy.
Patients and Methods: This study was conducted at Sohag University hospitals to evaluate the efficacy, safety, and patient satisfaction following foam sclerotherapy for varicose veins. There was 60 cases with lower limb varicosities whose mean age was 33.72 years (range 20 – 52). Females represented 62% of cases, while the remaining cases were males.
Results: The cosmetic appearance showed a major improvement (p < 0.001) after our intervention. Pain sensation was significantly decreased after the intervention. Only 25% of cases reported that sensation after 1 week, of which percent decreased all the way down to 3, 3, and seven during the following visits respectively. Saphenofemoral reflux was present in 48% of cases before the intervention, and it decreased all the way down to 7, 3, 3, and seven of cases at the scheduled follow up visits respectively. Complications were reported by 28% of cases. Skin hyperpigmentation was the most common complication (22%), followed by visual disturbances (8%), and thrombophlebitis (7%).
Conclusion: Ultrasound-guided foam sclerotherapy seemed to be a safe and effective procedure for the treatment of chronic venous insufficiency within the selected group of patients.
https://ejhm.journals.ekb.eg/article_176580_3c651f7fb1f565bdb5be75bd761b276c.pdf
2021-07-01
1757
1764
10.21608/ejhm.2021.176580
Radiofrequency ablation
Superficial venous reflux
Ultrasound guided foam sclerotherapy
Waleed Araby Abd Elkhalek
Elmadany
elmadany99@gmail.com
1
LEAD_AUTHOR
Mohamed Tharwat Mahmoud
Solyman
2
AUTHOR
Mohammad Zaki Ali
Mourad
3
AUTHOR
Khaled Mohammad Helmy
El-Kaffas
4
AUTHOR
ORIGINAL_ARTICLE
Study of Red Blood Cell Indices and Biochemical Parameters of Mineral Bone Disorders in Hemodialysis Patients
Background: Chronic kidney disease (CKD) is a worldwide public health problem and a major cause of suffering and having a reduced quality of life for those affected.
Objective: We aimed to study the changes in red blood cell indices and mineral bone metabolism in hemodialysis patients and to explore the correlation between these studied parameters.
Patients and Methods: This is a case control study included 55 adult patients with end stage renal disease on maintenance hemodialysis as well as 55 healthy individuals as a control group. All participants were subjected to laboratory investigations included complete blood count and serum levels of creatinine, urea, total calcium, albumin, phosphate and intact parathyroid hormone (iPTH).
Results: Our study showed thathemoglobin (Hb), hematocrit and red blood cell count were significantly reduced in the hemodialysis patients (P<0.001 for all). Regarding mean corpuscular volume, mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration, no significant differences were found between the hemodialysis patients and the control group (P= 0.362, 0.116, 0.22, respectively). In the hemodialysis group, the albumin-corrected serum calcium level was significantly lower while the serum phosphate and iPTH levels were significantly higher compared to the control group (P<0.001 for all). Hb was inversely correlated with serum iPTH (r=-0.359, P=0.007) and serum phosphate (r=-0.570, P<0.001) in the hemodialysis group and was inversely correlated with serum phosphate (r=-0.495, P<0.001) in the control group.
Conclusion: Hemodialysis patients are at high risk of anemia, hypocalcemia, hyperphosphatemia and hyperparathyroidism. In hemodialysis patients, an association was found between anemia and each of hyperphosphatemia and hyperparathyroidism.
https://ejhm.journals.ekb.eg/article_176583_577317a01ef95e30dfc9c805c685a17a.pdf
2021-07-01
1765
1771
10.21608/ejhm.2021.176583
Anemia
Chronic Kidney Disease
Hemodialysis
Mineral bone disorder
Alhoussein
Abdelaal
alhala1982@gmail.com
1
Zagazig university/Sharkia/Egypt
LEAD_AUTHOR
Alshabrawy M.
Abdelnabi
2
Department of Internal Medicine, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Psoas Compartment Block for Lower Limb Surgeries: A Comparative Study among The Four Lumbar Plexus Localizing Methods
Background: Psoas compartment block (PCB) is a frequently used techniques providing anesthesia for proximal lower limb surgeries. There are many methods of localization of peripheral nerves for regional anesthesiaas loss of resistance (LOR), electric nerve stimulation (ENS), ultrasound-guided (US) and combined ultrasound-guided and electric nerve stimulation (US/ENS). Objective: To compare between these four techniques to find out the method of better outcome and least complications. Patients and Methods: This study was a prospective randomized trial, conducted at Anesthesia and Intensive Care Department, Zagazig University Hospitals during the period from January 2018 to January, 2020. 140 patients undergoing unilateral elective proximal lower limb surgeries were included. Patients were categorized randomly, according to the used method for lumbar plexus localization, into four equal groups (each 35 patients). All groups were compared regarding efficacy and safety. Results: The success rates of PCB in ENS, US and US/ENS groups were higher than that in LOR group with combined US/ENS group was the best group (97.14%). The onset of sensory and motor blocks in ENS, US and US/ENS groups were shorter than that in LOR group. Times to ask for the 1st postoperative analgesia in ENS, US and US/ENS groups were longer than those in LOR group with the consumed amount of morphine for pain relief during the 1st 24 hours postoperatively in ENS, US and US/ENS groups were lower than that in LOR group. Conclusion: Usage of combined ultrasound and electric nerve stimulation was better regarding the outcome and complications.
https://ejhm.journals.ekb.eg/article_176587_d17f9bd9c75b3e334c1c6bb518373449.pdf
2021-07-01
1772
1781
10.21608/ejhm.2021.176587
Electric nerve stimulation
Localizing methods
Psoas compartment block
Ahmed Mohamed Mahmoud
Awadalla
audy1980.aa@gmail.com
1
Anesthesia and Intensive Care, Faculty of Medicine, Zagazig University, Zagazig, Egypt
AUTHOR
Adel Rizk
Botros
2
Anesthesia and Intensive Care, Faculty of Medicine, Zagazig University, Zagazig, Egypt
AUTHOR
Howida Kamal
Abd Ellatif
3
Anesthesia and Intensive Care, Faculty of Medicine, Zagazig University, Zagazig, Egypt
AUTHOR
ORIGINAL_ARTICLE
Is Remnant Donor Volume Less Than 35 % Safe to the Donor in Living Donor Liver Transplantation
Background: In adult (Living donor liver transplantation) LDLT, donor safety is of paramount importance, and ideally, there should not be any donor deaths. Objectives: To assess the prognosis of donor laboratory and clinical data according to the remnant liver volume. Patients and methods: The present study conducted on 200 consecutive cases of living donor liver transplantation over a period of 7 years (2012 and 2018). Patients were divided to two groups according to remnant liver volume (RLV): group (A) 60 patients with 30% to less than 35% RLV, while group (B) 140 patients with RLV more than or equal 35%. Results There were statistically significant difference between both studied group among ALT, total bilirubin and serum albumin. Conclusion: Right lobe donor hepatectomy can be performed with remnant liver volume of less than 35% with low risk on donor.
https://ejhm.journals.ekb.eg/article_177251_1bf42a4e04d2917d3697d7d790944699.pdf
2021-07-01
1782
1785
10.21608/ejhm.2021.177251
Donor complications
Liver transplantation
Right lobe
Mahmoud Abd Al Hady Abd Al Aziz
Abd Al Hady
alnaggar82@yahoo.com
1
Department of Surgery, Faculty of Medicine, Al-Azhar University, Egypt
AUTHOR
Khaled
Amer
2
Department Hepatobiliary and Liver Transplantation, International Medical Center, Egypt
AUTHOR
ORIGINAL_ARTICLE
Chemerin As A Non-Invasive Serum Marker for Non-Alcoholic Fatty Liver Disease
Background: Attempts have been made to recognize noninvasive markers for the identification of non-alcoholic fatty liver disease (NAFLD). Chemerin is a newly defined adipokine linked to insulin resistance and adipogenesis.
Objective: This study intended to evaluate the diagnostic ability of serum chemerin compared with NAFLD fibrosis score as a noninvasive marker for the diagnosis and grading of NAFLD.
Patients and methods: We enrolled 60 NAFLD patients and categorized them into 3 subgroups based on the fatty liver grade by ultrasound. Thirty healthy participants were recruited as a control group. ELISA method was used for serum chemerin levels measurement. Results: Serum chemerin levels were significantly higher in NAFLD cases than controls (p ≤ 0.001). Furthermore, these levels were positively correlated with the fatty liver grade (p ≤ 0.001). Serum chemerin was comparable to NAFLD fibrosis score as regards NAFLD diagnosis (p ≤ 0.001). Patients within the gray zone of NAFLD fibrosis score had a significantly higher serum chemerin levels in comparison to patients under the gray zone (p ≤ 0.001).
Conclusion: Serum chemerin is a promising marker for diagnosing and grading of NAFLD. More research is required to determine its definitive clinical benefit in patients with NAFLD.
https://ejhm.journals.ekb.eg/article_177253_e6759bb711982e2b82dbdd9a97bf6211.pdf
2021-07-01
1786
1790
10.21608/ejhm.2021.177253
Non-alcoholic fatty liver disease
Chemerin
Adipokines
Obesity
NAFLD fibrosis score
Ghada
Mohamed
ghadaabdelrahman@med.asu.edu.eg
1
Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
AUTHOR
Mohamed M
Salama
2
Ghada Abdelrahman Mohamed, Gastroenterology and Hepatology Unit, Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo
AUTHOR
Essam
Byoumy
3
Ghada Abdelrahman Mohamed, Gastroenterology and Hepatology Unit, Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo
AUTHOR
Azza
Mohamed
4
Ghada Abdelrahman Mohamed, Gastroenterology and Hepatology Unit, Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo
AUTHOR
Wesam
Ibrahim
5
Ghada Abdelrahman Mohamed, Gastroenterology and Hepatology Unit, Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo
AUTHOR
Ahmed
El-shafie
6
Ghada Abdelrahman Mohamed, Gastroenterology and Hepatology Unit, Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo
AUTHOR
Mohamed
Abdallah
7
Ghada Abdelrahman Mohamed, Gastroenterology and Hepatology Unit, Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo
AUTHOR
ORIGINAL_ARTICLE
Prevalence and Risk Factors of Helicobacter Pylori Recurrence in Egyptian Patients with Liver Cirrhosis
Background: Helicobacter pylori (H. pylori) is a worldwide gastrointestinal infection. It is a common risk factor for peptic ulcer disease (PUD), chronic gastritis, and stomach cancer. In patients with cirrhosis, there is a significant association between H. pylori infection and severity of gastropathy due to portal hypertension, chronic stomach upset, frequent upper gastrointestinal bleeding as well as hepatic encephalopathy.
Objective: To assess the rate and risk factors of recurrence of H. pylori infection in Egyptian patients with liver cirrhosis after successful eradication therapy. Patients and methods: This study included 500 liver cirrhosis patients who were tested for H. pylori infection. Patients with positive H. pylori infection received proton pump inhibitors (PPI)-based treatment regimen. Successful eradication therapy was assessed 4-8 weeks and repeated over one year after end of treatment using urea breath test (UBT) and stool antigen test (SAT).
Results: The prevalence of H. pylori infection in cirrhotic patients was 58%. There were significantly higher serum levels of ammonia and C-reactive protein (CRP) in H. pylori positive patients as well as significantly more gastritis in endoscopy findings in comparison with H. pylori-negative patients. H. pylori recurrence after successful eradication therapy was observed in 22.1% patients of H. pylori-positive cirrhotic patients. Multivariate analysis showed that higher serum ammonia level & receiving multiple treatment courses to achieve H. pylori eradication were independent risk factors for H. pylori recurrence in cirrhotic patients.
Conclusion: H. pylori infection is prevalent in liver cirrhosis patients with a significant recurrence rate after eradication therapy. High serum ammonia and the need for multiple treatment courses are risk factors for recurrence.
https://ejhm.journals.ekb.eg/article_177254_d0434e5e84132832d5234d7d2fc4348d.pdf
2021-07-01
1791
1794
10.21608/ejhm.2021.177254
Helicobacter pylori
Liver cirrhosis
Eradication therapy
hepatitis C
Ammonia level
Bacterial resistance
Mohamed G.
Hamed
1
Internal Medicine Department, Faculty of Medicine, Zagazig University,Egy
AUTHOR
Mohamed
Bassiony
dr_mbh13303@yahoo.com
2
Internal medicine department, Faculty of medicine, Zagazig university, Zagazig, Egypt
AUTHOR
Ayman F. Elsayed
Mohamed
3
Internal Medicine Department, Faculty of Medicine, Zagazig University,Egypt
AUTHOR
ORIGINAL_ARTICLE
Immunohistochemical Detection of Tumor Necrosis Factor Alpha in Ileocolonic Biopsies of Patients with Inflammatory Bowel Disease
Background: Tumor necrosis factor alpha (TNF-α) is a major proinflammatory cytokine playing paramount role in the pathophysiology of inflammatory bowel disease (IBD). The identification of predictive biomarkers to establish response to treatment is intuitive and still unresolved need. A biomarker of TNF-α sensitivity would avoid unnecessary exposure of the patient to the drug and to its side effects.
Objective: To investigate the relationship between immunohistochemical expression of TNF-α in the biopsies of ileocolonic segments in patients with activity of both ulcerative colitis (UC) and Crohn's disease (CD) and the clinicopathologic parameters and the response to treatment.
Patients and methods: The study was conducted on 41 naïve patients diagnosed as IBD (UC and CD) and 15 normal subjects as a control group. All patients and control underwent full history taking (age, gender and clinical data as weight loss, diarrhea, bleeding, and duration of the disease), complete physical examination, laboratory investigation (Complete blood count (CBC), ESR, C-reactive protein (CRP), fecal calprotectin (FC)), colonoscopy disease localization, upper endoscope with upper GIT symptoms. Biopsies from the terminal ileum and different colon segments were taken for histopathological evaluation and immunohistochemistry was done according to published protocols to all cases and control. Results: Percentage and H-score for TNF-α significantly correlated with clinical severity and need to give additional treatment besides conventional therapy as anti-TNF therapy. Increased TNF-α expression is significantly associated with better response to anti-TNF treatment.
Conclusion: Increased expression of TNF-α in the tissues is associated with the need to give additional treatment besides conventional therapy as anti-TNF therapy and also increased TNF expression is associated with better response to anti-TNF treatment.
https://ejhm.journals.ekb.eg/article_177579_3da9ebc1e7fe1ebfca0ae2c5ea79b0f1.pdf
2021-07-01
1795
1800
10.21608/ejhm.2021.177579
Anti-TNF treatment
inflammatory bowel disease
tumor necrosis factor alpha
Ehab Ahmed
Abdelatti
1
AUTHOR
Alsaid Ibrahim
Alshayeb
2
AUTHOR
Asmaa Gaber
Abdou
3
AUTHOR
Ezzat Mohamed
Abdalla
eabdalla89@yahoo.com
4
AUTHOR
Ezz
El-Arab A.
5
AUTHOR
ORIGINAL_ARTICLE
Management of Pain and Related Disabilities in Primary Fibromyalgia Using Neuromodulator Techniques, Repetitive Transcranial Magnetic Stimulation and Transcranial Direct Current Stimulation
Background: Fibromyalgia syndrome (FMS) is a chronic condition that causes pain, stiffness, and tenderness in muscles, tendons, and joints. It is also characterized by disturbed sleep, fatigue, anxiety, depression, and disturbances in bowel function. Management of FMS is at present very challenging as it contains multiple etiological factors and psychological tendencies; though, a patient-centered approach is essential to deal with this problem.
Objective: To compare the efficacy of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) in improving pain and related disabilities in patients with primary (1ry) FM.
Patients and Methods: Thirty patients with 1ry FM, 18 to 50 years old were randomized into 2 groups. Group I included 15 patients, who received 8 sessions (2/week for 4 consecutive weeks) of high frequency rTMS (10 Hz frequency) and Group II included 15 patients received 8 daily sessions of anodal tDCS (2 mA for 20 minutes) applied over the left primary motor cortex (M1).
Results: Pain visual analogue scale (VAS), the revised Fibromyalgia Impact Questionnaire (FIQR), tender point scale, and Hospital Anxiety and Depression Scale (HADS) showed a significant decrease between baseline and follow-up assessments for both groups. Moreover, a significant change in all assessment scales was observed post-treatment when compared between both groups with more significant improvement in the group that received rTMS.
Conclusion: Both rTMS and anodal tDCS of the left primary motor cortex showed marked improvement in symptoms of pain, functional disabilities and psychological status in patients with 1ry fibromyalgia. Both neuromodulator techniques can be considered as promising alternatives therapeutic options in the management of pain and related disabilities in FM.
https://ejhm.journals.ekb.eg/article_177588_89aca87a34972cee45f04755e098089d.pdf
2021-07-01
1801
1809
10.21608/ejhm.2021.177588
Chronic pain
Fibromyalgia
Neuromodulator techniques
Repetitive transcranial magnetic stimulation
Transcranial direct current stimulation
Mohja A.
EL-Badawy
mohjaelbadawy@gmail.com
1
Department of Physical Medicine, Rheumatology and Rehabilitation, Ain Shams University Hospitals, Cairo, Egypt.
AUTHOR
Mervat A.
Reda
2
AUTHOR
Sahar Y.
Ragab
3
AUTHOR
Dalia M
Ezz-Eldin
4
AUTHOR
ORIGINAL_ARTICLE
Reliability of Optical Coherence Tomography Angiography in Detection of Early Hydroxychloroquine Toxicity
Background: Chloroquine is an antimalarial drug, while hydroxychloroquine is an analogue of chloroquine. Hydroxychloroquine (HCQ) is used to treat autoimmune diseases in addition to malaria. They have toxic effects on retina. Different screening protocols were described to detect HCQ toxicity.
Objective: The aim of the current work was to study the ability of optical coherence tomography angiography (OCTA) to detect early retinal changes that may occur after HCQ treatment in patients with rheumatoid arthritis.
Patient and Methods: This prospective cross-sectional study included a total of 40 eyes of 20 patients who were newly or previously prescribed HCQ for rheumatoid arthritis, recruiting from the Department of Ophthalmology, Al-Zahraa University Hospital. This study was conducted between May 2018 to Dec 2019. OCTA imaging was performed via Angiovue software.
Results: The superficial whole vascular density, superficial parafoveal vascular density, superficial perifoveal vascular density, deep whole vascular density, deep parafoveal vascular density, and deep perifoveal vascular density were thinner in treatment groups compared to the control group (p < 0.05).
Conclusion: OCTA could be a beneficial tool for screening of HCQ retinal affection. It could detect the decrease in the deep capillary plexus at the parafoveal and perifoveal regions in patients who were receiving HCQ treatment.
https://ejhm.journals.ekb.eg/article_177592_9c8492a47c742655a6178bdb2b6e1f31.pdf
2021-07-01
1810
1813
10.21608/ejhm.2021.177592
Hydroxychloroquine toxicity
Optical coherence tomography angiography
Rheumatoid Arthritis
Nesma
Sayed
nesma7@live.com
1
Al Azhar university
AUTHOR
ORIGINAL_ARTICLE
Correlation between Visual Field Changes and Peripapillary Vessel Density in Primary Open Angle Glaucoma
Background: Glaucoma is a progressive optic neuropathy, which is characterized by degeneration of the retinal ganglion cells. The role of optic nerve head (ONH) microvascular network and vascular dysfunction has been investigated in the pathogenesis of glaucoma.
Objective: The aim of the current work was to assess the correlation between visual field changes in primary open angle glaucoma (POAG), and the density of the radial vessels around the optic disc.
Patients and Methods: One hundred eyes of fifty patients were enrolled in this prospective cross-sectional study. Patients were recruited from the Department of Ophthalmology, Al-Zahraa University Hospital from December 2018 to March 2020. They were divided into two groups, control group with normal functional and structural data, and glaucomatous group with POAG.
Results: There were significant differences in all measurements among both groups, including visual field indices, optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) parameters. The changes of peripapillary vessel density (PpVD) had strongly positive correlations with the mean deviation (MD), ganglion cell complex (GCC) thickness and retinal nerve fiber layer (RNFL) thickness, while had negative correlation with pattern standard deviation (PSD) and cup disc (C/D) ratio.
Conclusion: Decreased PpVD was detected in the glaucomatous group. There were statistically significant correlations between visual field changes (changes of both MD and PSD) and PpVD where there were strongly positive correlations with the (MD), and negative correlation with PSD. This can add to the diagnosis of POAG. Also, it provided more information about the microvascular changes in the ONH and peripapillary retina in cases of POAG.
https://ejhm.journals.ekb.eg/article_177598_ce8e5690a895fd77f50dcc058845fbb6.pdf
2021-07-01
1814
1817
10.21608/ejhm.2021.177598
Optical coherence tomography angiography
Ganglion cell complex
Retinal nerve fiber layer
Nesma
Sayed
nesma7@live.com
1
Al Azhar university
AUTHOR
Ahmed Fouad
Ibrahim
2
AUTHOR
Zeinb Sayed
Hassan
3
AUTHOR
ORIGINAL_ARTICLE
The Therapeutic role of Thymoquinone Bioactive Compound as Target Natural Product from Nigella sativa Loaded with Chitosan Nanoparticles on Schistosomiasis
Background: Schistosoma mansoni is a trematode helminth responsible for liver fibrosis or cirrhosis.
Aim of the work: In the present work natural products Thymoquinone loaded with chitosan nanoparticle (TQ/ChNP)) (TQ/ChNP) were used to determine their therapeutic effect on S. mansoni infection.
Materials and methods: A total of 40 healthy Swiss albino mice, 20-25 g in weight, procured from Theodor Bilharz Research Institute (TBRI) Imbaba, Egypt's Schistosome Biological Supply Center (SBSC).
Results: The infected mice treated with TQ/ChNP showed a significant decrease in the total worm burden. Treatment with TQ/ChNP had a highly significant effect on mature worm burden, TQ/ChNP in prophylactic and therapeutic doses significantly increased the mean number of dead ova in comparison to control. TQ/ChNP had a high decrease effect on ova count in intestinal tissue and a moderate reduction on ova count in hepatic tissue. Prophylactic dose gave a high reduction effect on ova count in intestinal tissue. As regards the size of hepatic granuloma, TQ/ChNP had the highest significant reduction on mean granuloma diameter with noticeable improvement of hepatic pathology. TQ/ChNP treated group showed observable improvement of liver pathology with mild degeneration and slight-sized fibrocellular. Conclusion: Based on the outcome of this study, TQ/ChNP proved to have potential bioactivity against S. mansoni adult stages and its potentiality in improving hepatic pathology. Efficacy of TQ/ChNP to postpone progression in chronic liver diseases must be considered as preventive medicine in patients with hepatic disorders.
https://ejhm.journals.ekb.eg/article_177604_e4e1b31a168aee0694525f6ecc9ff78d.pdf
2021-07-01
1818
1826
10.21608/ejhm.2021.177604
S. mansoni infection
Nigella Sativa
(TQ/ChNP)
Chitosan
Oogram
Granuloma formation
Hend M.
El-Menyawy
hendmetwally.2059@azher.edu.eg
1
AUTHOR
Karima M.
Metwally
2
AUTHOR
Ibrahim R.
Aly
3
AUTHOR
Asmaa A.
Abo Elqasem
4
AUTHOR
Alaa A.
Youssef
5
AUTHOR
ORIGINAL_ARTICLE
Value of Multislice Computerized Tomography in Evaluation of Acute Abdomen with A Hidden Cause at Sonography
Background: Our focus is acute abdominal pain in general, but we also discuss a number of frequently encountered urgent diagnoses in patients with acute abdominal pain: appendicitis, diverticulitis, cholecystitis, and bowel obstruction. Although perforated viscus and mesenteric ischemia are less frequently encountered, these are also addressed because imaging is of paramount importance for the timely diagnosis of these abnormalities.
Objective: Evaluation of the diagnostic accuracy of multislice Computerized Tomography (CT) examination in the diagnosis of patients presented with acute abdominal pain with a hidden cause at abdominal Ultrasonography (US) examination.
Patients and methods; the study is a prospective study which included 70 patients referred to the Radiology Department at Sohag University Hospital from the surgical emergency room with Inclusion criteria is a Patient presented with acute abdominal pain and Exclusion criteria is patient with a definite diagnosis of the cause of acute abdominal pain at the abdominal US, medical or traumatic causes of acute abdominal pain.
Results: CT imaging may be called the main method for diagnosing severe abdominal pain. When expense and ionizing radiation toxicity are key considerations, one approach is to conduct US first in all patients with severe abdominal pain, followed by CT in all instances with the non-diagnostic US. CT is much more precise and descriptive in this environment.
Conclusion: At present, CT can be considered the primary imaging technique for patients with acute abdominal pain, with the exception of patients, suspected of having acute cholecystitis. The US is preferable in these patients, but CT is an acceptable alternative.
https://ejhm.journals.ekb.eg/article_177609_ea1f747dcd84194906ffab6070cd574e.pdf
2021-07-01
1827
1831
10.21608/ejhm.2021.177609
Multislice computerized tomography
Acute abdomen
sonography
Mohammad T.
Solyman
1
AUTHOR
Mohammed Z.
Mourad
2
AUTHOR
Nehal G.
Ahmed
nehal.ngg81@gmail.com
3
AUTHOR
Ahmed E.
Mohammed
4
AUTHOR
Sherif S.
Abd Almonem
5
AUTHOR
ORIGINAL_ARTICLE
Comparative Study between Corneal Topographic Changes Following Phacoemulsification and Small Incision Cataract Surgery
Background: Phacoemulsification has become the routine procedure for cataract extraction for most of the surgeons because of its smaller incision and rapid visual rehabilitation. Also, manual small incision cataract surgery (MSICS) with its sutureless relatively smaller incision, compared to conventional extracapsular cataract extraction, has similar advantages to phacoemulsification in addition to its lower risk to corneal endothelium especially in hard cataracts and elder patients.
Objective: To compare the effect of phacoemulsification and small incision cataract surgery on corneal topography in a prospective randomized study.
Patients and methods: 80 eyes were included in this study. Patients were divided into two groups: Group A (40 eyes) underwent phacoemulsification and Group B (40 eyes) underwent MSICS. Both groups were studied preoperatively and postoperatively regarding uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), keratometry, and corneal topography.
Results: There was a significant difference between preoperative and postoperative uncorrected visual acuity (UCVA) during the follow up period (p value < 0.001) among both study groups. There was no significant difference in preoperative as well as postoperative intraocular pressure (IOP) or between preoperative and postoperative IOP values in both study groups. There was significant increase in the mean central corneal thickness during first postoperative week in both studied groups (p value <0.001). In MSICS group there was minimal significant increase in astigmatism within the first weak and first month of follow up (p value 0.041).
Conclusion: Cataract surgery using phacoemulsification or small incision cataract surgery was found to yield excellent visual results with no significant difference as regards to central corneal thickness, keratometric readings, and postoperative astigmatism or perioperative complications.
https://ejhm.journals.ekb.eg/article_177614_49fc54b79750b21a404c61f6e7fdb2b2.pdf
2021-07-01
1832
1838
10.21608/ejhm.2021.177614
Corneal Topographic
Phacoemulsification
Small incision cataract surgery
Asmaa Abu Alhassan
Abd Elrasol
asmaaabualhasan2@gmail.com
1
Department of Ophthalmology, Faculty of Medicine - Aswan University, Egypt
AUTHOR
Tag-Eldin Mohammed
Othman
2
Department of Ophthalmology, Faculty of Medicine - Aswan University, Egypt
AUTHOR
Abdalla Mohamed El Amin
Abdalla
3
Department of Ophthalmology, Faculty of Medicine - Aswan University, Egypt
AUTHOR
Ahmed Fathy
Gabr
4
Department of Ophthalmology, Faculty of Medicine - Aswan University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Suprascapular Nerve Radiofrequency versus Intraarticular Steroid Injection in Chronic Shoulder Pain
Background: Chronic shoulder pain is a frequent clinical condition that often reduces patient’s function and rehabilitation. Objectives: We aimed to compare efficacy of pulsed radiofrequency (PRF) to intra-articular steroid (triamcinolone acetonide) injection in controlling chronic shoulder pain as regard improvement of pain and function in six-month duration. Patients and Methods: We carried out a prospective, randomized, controlled, single-blinded study enrolled 60 patients with shoulder pain randomly divided into 2 groups. Group I: PRF group enrolled 30 patients who were treated by PRF neuromodulation to the suprascapular nerve under fluoroscopy and Group II: steroid group enrolled 30 patients who were treated with intra-articular injection of 5 ml of 2% lidocaine with triamcinolone acetonide 40 mg. Results: In Group 1 (PRF group) we reported statistically significant improvement of VAS, these positive effects lasted at least 6 months and the VAS decreased through 6 months from 6.5 to 3.5. In Group 2 VAS decreased through 6 months from 7 to 3.5. Both groups showed significant Oxford Shoulder Scale (OSS) improvement. Conclusion: Intra articular injection of triamcinolone acetonide is more effective in improvement of chronic shoulder pain and function than PRF.
https://ejhm.journals.ekb.eg/article_177617_3306252fa52cf273c1a0fbacb20017ca.pdf
2021-07-01
1839
1845
10.21608/ejhm.2021.177617
Intra-articular steroid injection
PRF
OSS
Shoulder pain
VAS
Hamdy A.
Youssef
1
AUTHOR
Ossama H.
Salman
2
AUTHOR
Ahmed Y.
Ahmed
3
AUTHOR
Hesham H.
Refae
4
AUTHOR
Ghada Mahmoud
Morsy
gmm_06@yahoo.com
5
LEAD_AUTHOR
ORIGINAL_ARTICLE
New Insights in Role of Cart-T Cell Therapy in Hematological
Background: The Chimeric antigen receptor T cell (CAR-T cell) is a kind of effector T cell that detects and kills cancer cells without the need for major histocompatibility complex components. The entire process of creating CAR-T cells is not well known. Acute lymphoblastic leukemia, chronic lymphocytic leukaemia, lymphoma, and multiple myeloma are among the haematological cancers for which the CAR-T cell has been employed.
Objectives: Chimeric antigen receptor T cell (CAR-T cell) therapy is a novel adoptive immunotherapy where T lymphocytes are engineered with synthetic receptors known as chimeric antigen receptors (CAR).
Data Sources: Electronic articles and Journal articles about role of Cart-T Cell therapy in hematological malignancy. Study Selection: This essay was containing data from many resources such as Google scholar, Elsevier, PMC, PubMed, England Journal, and Blood Journal to facilitate achieving the aim.
Data Extraction: If the studies did not fulfil the inclusion criteria, they were excluded. Study quality assessment included ethical approval was gained, eligibility criteria specified, adequate information and defined assessment measures.
Recent Findings: Fourth-generation CARs include the combination of second-generation CARs with an additional element, such as the tumor-killing cytokine IL-12. This type of CAR has improved tumor eradication by releasing cytokines into the tumor microenvironment and recruiting immune cells without prior conditioning. In addition, it has been used to treat virus infections, metabolic disorders and autoimmune diseases in addition to cancers.
Conclusion: CAR T cell therapy has brought a new hope for the treatment of malignant hematological diseases such as acute lymphoblastic leukemia (ALL), chronic lymphocytic leukemia (CLL), acute myeloid leukemia (AML), non-Hodgkin’s lymphoma (NHL), Hodgkin’s lymphoma (HL) and multiple myeloma (MM).
https://ejhm.journals.ekb.eg/article_177619_187f81e079c33fa56c895138d035a5e4.pdf
2021-07-01
1846
1851
10.21608/ejhm.2021.177619
CART-T cell therapy
Clinical applications
Hematological malignancy
Mohamed A.
Abdel Hafez
1
AUTHOR
Ali M.
El-khouly
2
AUTHOR
Essam A.
Abd Elmohsen
3
AUTHOR
Dina Ragab Mahmoud
Sharaf
dinasharf85@yahoo.com
4
LEAD_AUTHOR
ORIGINAL_ARTICLE
Screening of High-Risk Patient by Uterine Artery Doppler Analysis in The 1st Trimester to Predict Early Onset Pre-Eclampsia
Background: Preeclampsia (PE) is still a major obstetrical problem world-wide. First trimester prediction of PE is of great clinical importance, as it would allow clinicians to focus on high-risk groups and initiate prophylactic medical treatment. The first stage of pre-eclampsia begins in the first trimester by impaired placentation. High-resistant spiral arteries can be detected from the 11th week of gestation by uterine artery (UtA) Doppler examination.
Objective: To assess the relationship between 1st trimester uterine artery pulsatility index (UtA PI) and the development of early onset PE.Patients and Methods: Prospective observational study was performed at Mansoura University Hospital. This study was conducted on 109 pregnant women who attended their routine antenatal care visits at the Outpatient Obstetrics and Gynecology Clinic of Mansoura University Hospital.
Results: There were statistically high significant difference between both groups in the BMI (p = 0.003), and no statistically significant difference as regards the age, gravidity and gestational age (p > 0.05). Statistically significant difference was evident between two groups in the mean values of UtA PI (p = 0.028). The best cutoff value of UtA PI for the prediction of early onset preeclampsia was ≥ 2.03 with accuracy of 0.79, and that of BMI was ≥ 35 with accuracy of 0.93.
Conclusion: This study revealed that first trimester uterine artery Doppler can be used as a reliable screening test for prediction of preeclampsia in high risk women. It is a reliable, noninvasive method of examining uteroplacental perfusion. Abnormal UA Doppler ultrasonography (elevated PI) in 11–14 weeks' gestation can predict pre-eclampsia.
https://ejhm.journals.ekb.eg/article_177620_9a3d61cda2e1f26a2f8d8b6dd5e519db.pdf
2021-07-01
1852
1857
10.21608/ejhm.2021.177620
Early onset pre-eclampsia
High risk patient
Screening
uterine artery Doppler
Hasnaa Mohamed Elfouly
Mohamed
elawadyabdalla88@gmail.com
1
Department of Obstetrics and Gynecology, Faculty of Medicine - Mansoura University, Egypt
LEAD_AUTHOR
Ahmed Mahmoud Moustafa
Badawy
2
Department of Obstetrics and Gynecology, Faculty of Medicine - Mansoura University, Egypt
AUTHOR
Ashraf Ghanem, Khaled Samir
Ismail
3
Department of Obstetrics and Gynecology, Faculty of Medicine - Mansoura University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Evaluating the Impact of Fractional Flow Reserve (FFR) on Decision-Making for Treatment of Borderline Coronary Artery Lesions:
Background: The primary reference criterion for evaluating coronary artery stenosis functional significance is fractional flow reserve (FFR). It helps the interventionist to define appropriate angiographic borderline coronary lesions that should or should not be treated with a stent.
Objective: To evaluate the experience of the cardiology department, MUST University, on the use of FFR and its impact on patients with a borderline coronary lesion as regard revascularization decision-making.
Patients and methods: A retrospective study were done on 86 patients with borderline lesions undergoing coronary angiograms for whom FFR was performed. Three experienced cardiac interventionists re-analyzed their coronary angiography and whether to delay or conduct revascularization with borderline stenotic lesions (40-70 %). A distinction was made between the findings of quantitative coronary angiography (QCA), visual and functional assessment of coronary stenosis severity. Result: Eighty-six patients (51 males and 35 females) with a mean age of 58.60 ± 9.20 were enrolled in the current study. FFR was < 0.80 in 26.74% (23/86) of the patients, and they had coronary angioplasty. Between quantitative evaluation of lesion diameter by FFR and visual measurement, the correlation was -0.645 (P < 0.001). Seven patients (8.139%) had FFR > 0.8 left main (LM) lesion and for the other vessels with severe coronary lesions, stenting was performed.
Conclusion: In patients having borderline coronary artery stenosis, FFR is an important tool for clinical decisions making about procedures of revascularization. FFR results in alteration in the coronary intervention judgment.
https://ejhm.journals.ekb.eg/article_178581_73b5c4a9a8e01a6959649e93084b828a.pdf
2021-07-01
1858
1862
10.21608/ejhm.2021.178581
Coronary angiography
Coronary Stenosis
fractional flow reserve
Ahmed
Elbarbary
dr.barbary_ai@yahoo.com
1
LEAD_AUTHOR
Ghada
Kazamel
2
AUTHOR
Ahmed
Tamara
3
AUTHOR
ORIGINAL_ARTICLE
Locked Dynamic Hip Screw Plate for Elderly Patients with Trochanteric Femur Fracture
Background: Proximal Femoral fractures are common in elderly. Their incidence had increased due to the increased life expectancy and osteoporosis.
Objective: The aim of this study was to evaluate the use oflocked dynamic hip screw plate (LDHS) as a treatment of intertrochanteric femoral fracture in elderly patients.
Patients and Methods: This study was a non-randomized clinical trial including eighteen patients with intertrochanteric femoral fracture fixed with locked dynamic hip screw plate. They came to Orthopedic Department in Zagazig University Hospital and Orthopedic Department in Tripoli Central Hospital over 3 months from July 2020 until September 2020. Patients with sub-trochanteric extension were excluded. There was 10 cases group A1 and eight cases group A2 according to AO Orthopedic Trauma Association (OTA).
Results: Clinical and radiological outcome assessments showed that 77.8% were excellent clinically, 11.1% were good and 11.1% were fair. Regard radiological assessment, 83.3% were excellent, 11.1% were good and 5.6% were fair. As regards complications, 4 cases had groin pain and 1 case had lag screw cut-out and overall complications were in 22.2%.
Conclusion: Locking DHS plate for trochanteric femur fractures is a good option in elderly patients.
https://ejhm.journals.ekb.eg/article_178584_8b7de28c5671467654c0406642354c36.pdf
2021-07-01
1863
1867
10.21608/ejhm.2021.178584
Locked Dynamic hip screw (DHS)
Femur fracture.. Locked Dynamic hip screw (DHS)
elderly patients
Femur fracture.
Mohamed Abdelfattah
Sebaei
1
AUTHOR
Khaled Edris
Abdelrahman
2
AUTHOR
Raouf Elmahdi Omar
Muftah
raoufelmahdi_86@yahoo.com
3
LEAD_AUTHOR
Mahmoud Elsayed Elbadawy
Thabet
4
AUTHOR
ORIGINAL_ARTICLE
Value of Serum Galectin-3 Levels as A Predictor of Thromboembolism in Nonvalvular AF
Background: Galactin is involved in process of cardiac fibrosis. It is not clear if there is an association between serum galactin level and thromboembolism events in atrial fibrillation (AF).
Objective: To investigate whether serum galactin levels can be used as a predictor for thromboembolism in patients with non-valvular AF or not.
Patients and Methods: We conducted a case-control study on 200 participants (100 individuals as a control, 50 patients with AF and thromboembolism and 50 patients with AF but without thromboembolism). We recruited patients from Cardiology Department, Aswan University Hospital who had non valvular AF. Participants were subjected to detailed medical history, clinical examination, electrocardiography, and ELISA test to evaluate serum galactin level. Results: Serum galactin was only predictor for thromboembolic event (OR=2.4, 95% CI = {1.3: 4.3}, P value=0.005) with a sensitivity of 73% and specificity of 65% for the thrombus detection (AUC= 0.80, 95%CI= {0.69-0.89}). Serum galactin has a sensitivity of 81% and specificity of 77% to detect AF incidence (AUC= 0.84, 95%CI= {0.73-0.99}). Serum galactin was correlated to CHADS-VASc score (r= 0.75, p value < 0.001) and LVEF (r= - 0.586, p value <0.001).
Conclusion: Galactin-3 level is a possible predictor for thromboembolism in patients with non-valvular AF. Nevertheless, further studies are still needed to confirm our findings.
https://ejhm.journals.ekb.eg/article_178586_d90857e80e68fab2151739d358348cd9.pdf
2021-07-01
1868
1874
10.21608/ejhm.2021.178586
Non-valvular AF
Thromboembolism
Galactin-3
Saud M.
Elsaughier
1
LEAD_AUTHOR
Mohamed Yassin
Abdelradi
2
AUTHOR
Mohamed Kamal
Slama
3
AUTHOR
Naggeh M.
Mahmoud
4
AUTHOR
Amr Salah
Amin
5
AUTHOR
Amr
Hanafy
dr_amrhanafy@yahoo.com
6
AUTHOR
ORIGINAL_ARTICLE
Study of PTCH1 Gene as a Prognostic Marker to Predict Imatinib Response in CML Patients: a Single Egyptian Center Experience
Background: Chronic myeloid leukemia (CML) is a myeloproliferative illness marked by a reciprocal translocation between chromosomes 9 and 22 [t (9;22) (q34; q11)], forming the Philadelphia chromosome and bringing together the Breakpoint Cluster Region (BCR) and Abelson (ABL1) genes. The protein expressed by this fusion gene is a dysregulated tyrosine kinase that causes alterations in cell proliferation, DNA repair, differentiation, and cell cycle by phosphorylating many downstream proteins. Objectives: To assess PTCH1 gene expression and response of adult patients with chronic myeloid leukemia to imatinib treatment.
Patients and Methods: This is a prospective case-control study that included 55 subjects; 45 patients with chronic phase chronic myeloid leukemia and 10 healthy age and sex-matched controls. The control group presented from the same geographic origin of the patients in the study group. The study was done between June 2015 and July 2017 at the hematology clinic, Ain Shams University Hospital.
Results: PTCH1 gene was more in cases than control with a statistical significance (P-value=0.024). On following up our cases after 6 months treatment with imatinib, patients with desired response to imatinib treatment had a mean of PTCH1 gene expression of 2.41, compared to 3.58 in patients who did not achieve desired response with a statistical significance with p-value = 0.017. Incidence of imatinib failure after 6 months of treatment in patients with high PTCH1 expression is 27.8 % while in those with low expression is 44.4 %.
Conclusion: The study demonstrates that level of PTCH 1 did not affect imatinib response. Therefore, PTCH1 is not a valid biomarker for imatinib resistance in CML patients.
https://ejhm.journals.ekb.eg/article_178590_05545784b46dc944ec1c3a68ae717acc.pdf
2021-07-01
1875
1879
10.21608/ejhm.2021.178590
Chronic Phase
Egyptian CML Patients
Predict Imatinib Response
prognostic marker
PTCH1 Gene
Mohamed Mahmoud
Moussa
1
AUTHOR
Mohamed Tarif
Hamza
2
AUTHOR
Omnia Shoukry Abdel
Fattah
3
AUTHOR
Mary Gamal
Naguib
m.s.wilson.mg@gmail.com
4
LEAD_AUTHOR
ORIGINAL_ARTICLE
Metabolic Changes in Women Using Levonorgestrel Releasing Intrauterine System
Background: The effect of levonorgestrel-releasing intrauterine system (LNG IUS) on metabolic parameters like body mass index, body weight, blood pressure, blood sugar, lipid profile and liver function test is still unclear.
Objective: To assess the possible metabolic effects of the levonorgestrel intrauterine system on serum lipids, body weight and fasting blood glucose level after a period of six months.
Subjects and Methods: A prospective study comprised 50 women attended to the Department of Family Planning in Sadat city Hospital and request intrauterine hormonal contraception during the period from December 2018 to August 2019. Full history, routine, physical examination and special investigations were taking.
Results: There were no statistically significant differences between the studied patients regarding Socio-demographic characteristics before and after 6 months follow up. Menstrual change was the most adverse effects among the studied patients (15 cases, 32.61%), followed by spotting in 6 cases (13.04%) then lower abdominal pain in 5 cases (10.87%). While, weight gain recorded the lowest frequent (2.17%). Regarding overall satisfaction with the method, most of the studied patients had very or somewhat satisfied (32 cases, 69.57%) and 14 cases (30.43%) had neutral or somewhat not satisfied.
Conclusions: Among the Egyptian the LNG-IUS does not have any adverse effects on metabolic parameters, TGs, LDL and blood sugar levels. Most of the studied patients had very or somewhat satisfied with methods and 30.43% had neutral or somewhat not satisfied.
https://ejhm.journals.ekb.eg/article_178593_bb9c5e3a62f610ba5cf9dd1b9d7c6b2a.pdf
2021-07-01
1880
1885
10.21608/ejhm.2021.178593
Body Mass Index
Intrauterine system
Levonorgestrel
Lipid profile
metabolic changes
Mohamed Abdallah
Rezk
1
AUTHOR
Alaa Masoud
AbdElgayed
2
AUTHOR
Shimaa Adel Abdelsalam
Allam
i_wz_u89@yahoo.com
3
LEAD_AUTHOR
Dalia Ibrahim Mohamed
Morsi
4
AUTHOR
Heba Maged
Abo shady
5
AUTHOR
ORIGINAL_ARTICLE
Acquired Left Ventricular to Right Atrial Shunt (Gerbode′s Defect) after Aortic Valve Replacement: Case Report
Background: Left ventricular to right atrial (LV—RA) shunt is an unusual type of ventricular septal defect (VSD). Acquired LV—RA shunts may be due to complications of cardiac operation, endocarditis, trauma or myocardial infarction. A previous cardiac operation is the most common cause. The diagnosis of LV—RA communication is not easy, and it should be remembered in patients who do not recover normally. Diagnosis can be confirmed with ultrasound or magnetic resonance image (MRI) or multi-slice CT. Surgical correction is usually the treatment of choice, but closing the communication percutaneously should be considered as an option.
Objective: Aim of this case presentation was to show the clinical scenario of a rare post-operative complication (after aortic valve replacement).
Patient and methods: Male patient aged 35 years, during hospital admission in the CCU post-operative after aortic valve replacement was complaining of dyspnea, orthopnea, paroxysmal nocturnal dyspnea and by echocardiographic examination revealed Gerbode defect, not improved by modification of medical treatment necessitating cardio-thoracic surgery consultation who recommend conservative treatment and follow up if the patient still symptomatic surgical repair versus percutaneous closure could be done.
Conclusion: Acquired left ventricular to right atrium shunt (Gerbode′s defect) can result from septal trauma after valve replacement, infective endocarditis, or myocardial infarction. In addition to the usual causes of cardiac decompensation following aortic valve surgery, one should consider the possibility of a left-to-right shunt secondary to an iatrogenic left ventricular-right atrial communication, particularly if either septal trauma or extensive valvular calcification was encountered during the surgical procedure.
https://ejhm.journals.ekb.eg/article_178596_f65149de2cb8cfe24a6847f5484881f4.pdf
2021-07-01
1886
1892
10.21608/ejhm.2021.178596
Acquired left ventricular
Right atrial shunt
Gerbode′s defect
aortic valve replacement
Ayman Elsayed
Elbadrany
aymanalbdrany@yahoo.com
1
Department of Cardiology, Faculty of Medicine, Mansoura University, Egypt
LEAD_AUTHOR
ORIGINAL_ARTICLE
Diagnostic Value of Mean Platelet Volume in Prediction of Acute Myocardial Infarction
Background: Acute myocardial infarction (AMI) is one of the main etiologies of death globally. In AMI, platelets were demonstrated to play a main role in thrombotic processes that limit the patency of the recanalized, infarct-related coronary artery and contribute to reperfusion injury. Platelet volume is an important indicator for platelet function and activation.
Objective: The aim of the present study was to evaluate mean platelet volume (MPV) as an early and independent predictor for AMI in patients with acute chest pain.
Patients and methods: This retrospective observational analytical study included a total of 107 patients presenting with acute chest pain presenting to Mansoura Emergency Hospital within the period from January 2019 to January 2020. Of them, 36 cases were diagnosed as stable coronary artery disease and 71 cases were diagnosed as AMI.
Results: There were statistically significant differences among both groups regarding age, female sex and BMI being increased in AMI group. Hypertension, DM and dyslipidemia were significantly increased among AMI cases compared to stable coronary artery disease ones. Stable coronary artery disease cases demonstrated significant increase in platelet count and significant decrease in MPV compared to AMI ones. Hypertension, DM, dyslipidemia, family history of CAD, prior MI, prior PCI and MPV could be used as significant predictors for AMI.
Conclusion: The current study concluded that larger platelet volumes may be used as predictor for AMI as well as ischemic complications.
https://ejhm.journals.ekb.eg/article_178598_2dfede27307b7108aec6cbd1c13ccc16.pdf
2021-07-01
1893
1900
10.21608/ejhm.2021.178598
Diagnostic Value of Mean Platelet Volume
Acute myocardial infarction
Samir Mohamed
Attia
1
AUTHOR
Ahmed Wafa
Soliman
2
AUTHOR
Mohamed El Saeed
Ahmed
3
AUTHOR
Ahmed Mohamed Ahmed
Lasheen
drahmedmaged55@gmail.com
4
LEAD_AUTHOR
ORIGINAL_ARTICLE
Comparison between Caudal Dexmedetomidine and Morphine for Postoperative Analgesia in Pediatric Infraumbilical Surgeries
Background: The usage of caudal opioids extends the length of analgesia substantially, but it often comes with a slew of adverse side effects, including fatigue, vomiting, pruritus, urinary retention, and a chance of respiratory distress later on. Objective: The aim of this analysis was to compare the effects of caudal dexmedetomidine versus morphine in conjunction with bupivacaine in pediatric infraumbilical surgeries. Patients and Methods: This randomized controlled sample involved 90 pediatric patients aged 1 to 7 years old, of American Society of Anesthesiologists (ASA) physical status I-II, of both sexes, who were scheduled for lower abdominal surgeries. Patients were allocated to three equal groups. Group D got a 0.25% bupivacaine + 1 g/kg dexmedetomidine. Group M obtained a 0.25% bupivacaine + 30 g/kg morphine mixture. Group MD: dexmedetomidine 1 g/kg and morphine 30 g/kg with bupivacaine were used in a single dose caudal epidural analgesia. Results: Intraoperative heart rate, mean arterial blood pressure at 20, 25, 30 and 45 min was significantly decreased in group MD than group D and group M while in postoperative period were insignificantly among the three groups at all times of measurement. FLACC was significantly lower in MD group at discharge, 1, 2, 3, 6, 12 and 18 hours. Ramsey sedation score (RSS) at 30 min was significantly decreased in group M than group D and in group MD than group M. Time for 1st analgesia and paracetamol dosage was significantly earlier in group M than group D and group MD. Pruritus and vomiting were significantly lower in group D than other groups. Conclusions: The addition of dexmedetomidine to caudal morphine in pediatric patients produced longer postoperative analgesia, more sedation and with better emergence from anesthesia and hemodynamic stability, with fewer side effects than morphine.
https://ejhm.journals.ekb.eg/article_178601_51c9f11ada7df27caa6c178125d85699.pdf
2021-07-01
1901
1907
10.21608/ejhm.2021.178601
caudal
Dexmedetomidine
morphine
Pediatrics
Mohamed Kamal
Mahmoud
mohkamalhegazy@gmail.com
1
Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Sohag University, Egypt
AUTHOR
Khaled Abdelfattah Mohamed
Abdelfattah
2
Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Sohag University, Egypt
AUTHOR
Hamza Aboalm
Mahmoud
3
Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Sohag University, Egypt
AUTHOR
Ahmed Elsaeed Abd Elrahman
Ali
4
Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Sohag University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Elastic Stable Intramedullary Nailing Femoral Shaft Fractures in Children from Six to Ten Years Age
Background: Diaphyseal fractures of the femur (DFF) are common long-bone injuries in children and adolescents. DFF represent 1.5% of fractures in childhood.
Objective: This study aimed to evaluate the clinical, functional and radiological outcome of femoral shaft fractures, which are managed by elastic stable intramedullary nailing (ESIN) in pediatric age 6-10 years.
Patients and Methods: A prospective clinical randomized trial study was conducted on18 children underwent elastic stable intramedullary nailing (ESIN) for treating femoral shaft fractures at Orthopedic department, Zagazig University Hospitals during the period from April to December 2020. Plain X- rays of the femur Antero-posterior (AP) & Lateral (Lat.) views (from hip to the knee joint) was taken. Results: The time to surgery was 1.39 ± 1.12 days ranging from 1 to 6 days, the time till full union was 9.4 ± 1.76 weeks ranging from 7 to 12 weeks, more than half of the studied group (55.5%) ranged from 7 to 9 weeks and the time of full weight bearing was 9.6 ± 1.7 weeks ranging from 7 to 12 weeks, half of the studied group (50.0%) ranged from 7 to 9 weeks. So, the final outcome was 83.3% had excellent functional outcome, 11.1% of them had satisfactory functional outcome and 5.6% had poor functional outcome. 88.8% didn’t have any complications, 5.6% of them had irritation and 5.6% had superficial infection.
Conclusion: ESIN is the choice treatment for transverse and short oblique shaft fractures in patients aging from 6 to 10 years old.
https://ejhm.journals.ekb.eg/article_178604_f6fb28543521aa75ccc691997a697b0c.pdf
2021-07-01
1908
1913
10.21608/ejhm.2021.178604
Femoral shaft fractures
femur
ESIN
Intramedullary nail
Ahmed Hashim
Amin
1
AUTHOR
Ahmed Mohamed
Nahla
2
AUTHOR
Ahmed Mashhour
Gaber
3
AUTHOR
Millad Mohammed Allafi
Kamsawi
kamsawimillad@gmail.com
4
LEAD_AUTHOR
ORIGINAL_ARTICLE
Intravenous Magnesium Sulfate versus Tramadol in Prevention of Post Spinal Shivering in Geriatric Patients Undergoing Transurethral Resection of Prostate
Background: Postanesthetic shivering is a frequent complication of anesthesia, perhaps even aggravating pain especially during transurethral rsection of prostate (TURP) surgery.
Objective: To compare the efficacy of I.V MgSO4 and tramadol to placebo normal saline on incidence and severity of postspinal shivering in geriatric patients undergoing TURP surgery, when used as prophylaxis.
Patients and methods: This was a comparative prospective study that included 39 geriatric male patients who scheduled for performing an elective TURP surgery under subarachnoid blockade (SAB) at Zagazig University Hospitals. Patients were divided equally into 3 groups: Group C received isotonic saline after spinal anesthesia, group Mg: received I.V MgSO4 in isotonic saline and group T: received I.V tramadol in isotonic saline after spinal anesthesia. All patients were enrolled for examination before and after surgery.
Results: There was no significant difference among the studied groups as regards HR, MAP and Spo2 between the three studied groups. Regarding changes in temperature between the studied groups, C group showed a significant lower temperature time followed by Mg group then T group at different times. There was a significant higher rate of shivering in C group then Mg group and the lowest was T group. Onset of shivering was significantly faster in control then Mg group and longer significantly in Group T.
Conclusions: Prophylactic administration of I.V tramadol in a dose of 0.5 mg/kg immediately after SAB could significantly reduce the incidence and severity of postspinal shivering more than I.V MgSO4 in a dose of 15 mg/kg in geriatric patients undergoing TURP surgery.
https://ejhm.journals.ekb.eg/article_178607_b9ccfaa226d6446bdde5868c16c63a31.pdf
2021-07-01
1914
1919
10.21608/ejhm.2021.178607
tramadol
MgSO4
Post Spinal Shivering
TURP
Fatma Mahmoud
Ahmed
1
AUTHOR
Ashraf Said
Sayed
2
AUTHOR
Hala Ibrahim
Zanfaly
3
AUTHOR
Jamaah Husayn
Qareen
khaledgrain69@gmail.com
4
AUTHOR
ORIGINAL_ARTICLE
Effect of Bisphenol A on the Testis of Offspring of White Albino Rats during Pregnancy and Lactation: (Light and Electron Microscopic Study)
Introduction: The synthetic industrial and biomedical chemicals suspected to threat the health of the living organisms by disrupting their endocrine systems, referred to as endocrine disrupting chemicals (EDCs).
Objective: To study the effects of Bisphenol A (BPA) on the natal and postnatal testis by the light and electron microscope to make sure if it is harmful or not on the development of male reproductive organs in albino rats.
Matrial and Methods: Chemical used: Bisphenol A. The daily single oral dose was (0.3 mg/kg BW./day). Experimental animals: Adult female rats in proestrus cycle were caged overnight with adult males of proven fertility (1 male / 2 females / cage) and produced neonatal male rats.The offspring rats were divided into five main groups: Group I (Control offspring group), Group II (Experimental low dose treated offspring group with Bisphenol A (0.3 mg/kg BW./day) for two weeks, Group III (Experimental high dose treated offspring group; 12 mg/kg b.w/day), Group IV (First recovery group ), Group V (Second recovery group),
Results: Chronic Bisphenol A administration produced testicular toxicity leading to marked serious histological changes of the testis including the spermatogenic cells, spermatids, Sertoli cells and Leydig cells. These testicular changes increased with the high dose intake of BPA indicating its cumulative toxic effects that caused hypospermatogenesis, leading to infertility.
Conclusion: Bisphenol A administration causes testicular toxicity. So, these serious complications on testicular structure should be considered when buying any canned foods or drinks, because it is used nowadays on a large scale allover the world.
https://ejhm.journals.ekb.eg/article_178609_0f5e8647fbe3e8c784422f952d2fc28b.pdf
2021-07-01
1920
1931
10.21608/ejhm.2021.178609
albino rats
BPA
Testis. Histology
Al Sayed A.
Abd Elhady
abdrahmankellany@yahoo.com
1
LEAD_AUTHOR
Mohamed A.
Autifi
2
AUTHOR
Moustafa E.
El Gizawy
3
AUTHOR
Moaaz M.
Yousef
4
AUTHOR
ORIGINAL_ARTICLE
New Modification of Koyanagi Technique Using Dartos Muscle Flap in Management of Proximal Hypospadias
Background: One stage urethroplasty through parameatal foreskin flap (OUPF) available for all types of hypospadias was first described by Tomohiko Koyanagi (1983). High complication rates were reported.
Objective: To evaluate the outcome of Koyanagi technique modification using dartos muscle as a 2nd layer because it has a high vascularity, very thin, easily elevated, and leaves no complications.
Patient and methods: This study was conducted in the Plastic Surgery Department at Menoufia University, during the period of April 2017 to April 2019. Thirty cases for proximal hypospadias were included during this study. After chordee release, urethra was constructed using Koyanagi technique and adding scrotal dartos muscle flap as a 2nd layer.
Results: Patient's age ranged from 1 to 4 years with mean age of 2.83 ± 1.17. All of the 30 cases were with proximal hypospadias and had severe chordee. Early complications were detected as bleeding in 2 patients (6.6%). One patient (3.3%) reported for retention due to obstruction of the inserted catheter. Another case (3.3%) showed wound infection. The reported late complications were fistula in 6 patients (20%), meatal recession in 5 patients (16.6%), meatal stenosis in 3 patients (10%), and diverticulum in one patient (3.3%).
Conclusion: The modified Koyanagi one stage repair of proximal hypospadias is an innovative technique and realize many criteria for expected effective operating results. The use of dartos muscle flap as a cover for the urethroplasty improves the results and minimize complications.
https://ejhm.journals.ekb.eg/article_178612_4f81a14c576b3766de9e0ff3e2bc0207.pdf
2021-07-01
1832
1838
10.21608/ejhm.2021.178612
Dartos muscle flap
Management
Modification of Koyanagi
Proximal Hypospadias
Tarek Abd El Hamed
Keshk
1
Plastic Surgery Department, Faculty of Medicine Menoufia University, Menoufia, Egypt
AUTHOR
Yasser Mohamed Omar
El Sheikh
2
Plastic Surgery Department, Faculty of Medicine Menoufia University, Menoufia, Egypt
AUTHOR
Mahmoud
Abd El Rahman
3
Plastic Surgery Department, Faculty of Medicine Menoufia University, Menoufia, Egypt
AUTHOR
Hanan Ali Ali
Dawod
4
Plastic Surgery Department, Faculty of Medicine Menoufia University, Menoufia, Egypt
AUTHOR
Haytham Shaker Ahmed
Rezq
drhaythamshaker@yahoo.com
5
Plastic Surgery Department, Faculty of Medicine Menoufia University, Menoufia, Egypt
LEAD_AUTHOR
ORIGINAL_ARTICLE
Evaluation of Percutaneous Tendoachilles Tenotomy as an Outpatient Procedure in Clubfoot Treatment by Ponseti Method
Background: Clubfoot is a relatively common congenital foot deformity. Ponseti demonstrated correction of clubfoot in infants using manipulation followed by application of well-molded, long-leg plaster casts. Objective: In the current study, we evaluated the efficacy and safety of percutaneous Achilles tenotomy as an office procedure during the Ponseti technique in the correction of CTEV deformity of the foot. Patients and Methods: This randomized clinical trial study was conducted in the Orthopedic Outpatient Clinic of Zagazig University Hospitals on 12 patients with idiopathic clubfoot managed with the Ponseti technique during the period from April 2020 to September 2020. Results: This study showed, 13 feet had a favorable outcome (8 cases (53.3%) excellent and 5 cases good 33.3%) and 2 feet had fair outcome (13.3); these 2 feet had a relapse (13.3%), one foot relapsed equinus deformity and one adducts foot deformity, The equinus deformity patient responded to repeated tendo-Achilles tenotomy and further Ponseti casting and adductus foot deformity responded to adductor tenotomy and cast. Both two cases obtained satisfactory outcomes after the completion of treatment. Conclusion: Achilles tenotomy as an out-patient procedure using topical and/or local anesthesia is a safe procedure and is an important step in the successful treatment of congenital clubfoot.
https://ejhm.journals.ekb.eg/article_178614_e64b7d31faeebaa479369dc95ebe7fd2.pdf
2021-07-01
1939
1934
10.21608/ejhm.2021.178614
clubfoot
Ponseti method
Achilles tenotomy
Adel Abdelazim Ahmad
Salem
1
AUTHOR
Khaled Edris
Abdelrahman
2
AUTHOR
Mahmoud Elsayed Elbadawy
Thabet
3
AUTHOR
Fahmi Subhi
Alghazawi
algezawy2018@gmail.com
4
LEAD_AUTHOR
ORIGINAL_ARTICLE
Mental Health Outcomes Among Health Care Workers Exposed to Covid-19 Pandemic, Qalyoubia Governorate: Cross-Sectional Survey
Background: The pandemic caused by novel coronavirus disease 2019 (COVID-19) is considered the worst health crisis facing the entire world today. At the topmost of this crisis are the healthcare workers (HCWs) who are working to maintain well-being of all people. COVID-19 pandemic added more and more stress to healthcare workers in particular, depending on their work position. Objective: To assess mental health outcomes among HCWs dealing with confirmed or suspected COVID-19 patients. Methods: This is cross-sectional, hospital-based survey study conducted between Feb 6 and April 28, 2021. A total of 548 HCWs participated in the study. Mental health impact was assessed by using the 9-item Patient Health Questionnaire (PHQ-9), the 7-item Generalized Anxiety Disorder (GAD-7) and the 7-item Insomnia Severity Index (ISI) questionnaires. Multivariable logistic regression analysis was done to determine the risk factors of mental health outcomes. Results: Among the 548 HCWs surveyed; 64.8% were nurses and 50.0% aged from 26-30 years old. About 52.0% worked in Benha University Hospital, 21.2% worked in Toukh Fever Hospital, and 26.8% worked in Qaha Central Hospital. A considerable proportion of HCWs had symptoms of anxiety, depression and insomnia. Nurses, workers aged from 26-30, those working in Qaha Central Hospital and those who had shift hours from 7–10 experienced more severe symptom levels of depression, anxiety, and insomnia. Nurses were associated with severe symptoms of anxiety, depression and insomnia.
Conclusion: The COVID-19 pandemic represents a new working challenge for HCWs and intervention strategies to prevent depression and anxiety to reduce the risk of adverse mental health outcomes are needed.
https://ejhm.journals.ekb.eg/article_178615_286a960fd0654fed5421469eddcaa050.pdf
2021-07-01
1945
1954
10.21608/ejhm.2021.178615
anxiety
COVID-19
depression
(HCWs) Health Care Workers
Mental health
insomnia
Mai Abdullah
Elmahdy
maielmahdy24@yahoo.com
1
Department of Public Health and Community Medicine, Faculty of Medicine, Benha University, Egypt
AUTHOR
Eman Mahmoud
Shebl
2
Department of Public Health and Community Medicine, Faculty of Medicine, Benha University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Ferrous Sulphate Alone Versus Combination of Ferrous Sulphate and Lactoferrin for The Treatment of Iron Deficiency Anemia during Pregnancy and Their Effect on Neonatal Iron Store: A Randomized Clinical Trial
Iron deficiency anemia (IDA) is a frequent medical condition that causes disturbing pregnancies, especially in low-resource nations, and it contributes considerably to morbidity and mortality. As a result, early detection and treatment of IDA are strongly advised.
Objective: This study was conducted to evaluate the effectiveness, safety and acceptability of ferrous sulphate alone in comparison to combination of ferrous sulphate and lactoferrin for the treatment of iron deficiency anemia during pregnancy and their effect on neonatal iron store.
Patients and methods: This randomized prospective cohort study was conducted on 300 pregnant women from the second trimester with IDA who were enrolled and randomly separated on 2 groups; ferrous sulphate group: 150 pregnant women received 150 mg of dried ferrous sulphate capsules. Combined ferrous sulphate and lactoferrin group: 150 pregnant women received combined 200 mg lactoferrin and 30 mg iron once daily for eight consecutive weeks.
Results: Total increase in CBC with combined ferrous sulphate and lactoferrin was higher compared to ferrous sulfate alone (p value < 0.05). Gastrointestinal adverse effects occurred more frequently with ferrous sulphate than the combined ferrous sulphate and lactoferrin (p < 0.05). Neonatal iron store significantly increased in combined ferrous sulphate and lactoferrin than in ferrous sulphate alone (p value < 0.001).
Conclusion: Combined ferrous sulphate and lactoferrin was more effective than ferrous sulfate in pregnant women with IDA, with fewer gastrointestinal adverse effects and better effect on neonatal iron store.
https://ejhm.journals.ekb.eg/article_178616_7cdeeb3afc044939f65fec9743b9146b.pdf
2021-07-01
1955
1960
10.21608/ejhm.2021.178616
Combined ferrous sulphate and lactoferrin
Ferrous Sulphate
iron deficiency anemia
Ibrahim Ali Seif
El-Nasr
ibrahimaliseifelnasr@gmail.com
1
Obstetrics and Gynecology Departments, Faculty of Medicine, Menoufia University Menoufia, Egypt.
LEAD_AUTHOR
Sayed Abdmoneim
Mahmou
2
Obstetrics and Gynecology Departments, Faculty of Medicine, Menoufia University Menoufia, Egypt.
AUTHOR
Eman Mahmoud
Elnaddar
3
Obstetrics and Gynecology Departments, Faculty of Medicine, Menoufia University Menoufia, Egypt.
AUTHOR
Hesham Ali
Ammar
4
Obstetrics and Gynecology Departments, Faculty of Medicine, Menoufia University Menoufia, Egypt.
AUTHOR
ORIGINAL_ARTICLE
The Integrative Role of Magnetic Resonance Cholangiopancreatography and Percutaneous Transhepatic Cholangiography in Malignant Obstructive Jaundice
Background: Magnetic resonance cholangiopancreatography (MRCP) andpercutaneous trans-hepatic cholangiography (PTC) are established techniques for the evaluation of intra-hepatic and extra-hepatic bile ducts in patients with malignant hepato-biliary diseases. PTC has procedure-related complications. MRCP is accurate, non-invasive and safe.
Objective: To evaluate the role of magnetic resonance cholangiopancreatography (MRCP) and percutaneous transhepatic cholangiography (PTC) in the diagnosis of malignant biliary obstruction.
Patients and Methods: This study was conducted on 30 patients (18 males and 12 females) with malignant obstructive jaundice. Their ages ranged between 36 and 85 years with a mean age of 59.9 years. All the 30 examined cases in our study were subjected to MRCP and PTC to detect the diagnosis, the level of obstruction and the degree of obstruction.
Results: Both MRCP and PTC were accurate in the detection of the malignant biliary dilatation and the level of obstruction. MRCP provided adequate information in the diagnosis of the malignant lesions with sensitivity of 86.6% with low sensitivity to detect the degree of obstruction weather complete or partial 12.5% compared to PTC. MRCP detected other related malignant features in 40% of cases. PTC-related complications in 6 out of 30 cases (20%). In 6 patients more than one puncture had to be performed during PTC to delineate the whole biliary system.
Conclusion: MRCP is accurate and non-invasive procedure for the diagnosis of the malignant obstructive jaundice and the level of biliary obstruction reserving PTC for therapeutic procedures and pre-surgical assessment of the degree of obstruction.
https://ejhm.journals.ekb.eg/article_178617_19d6d0ea072a783f729da817e5452d53.pdf
2021-07-01
1961
1971
10.21608/ejhm.2021.178617
Magnetic resonance
Cholangiopancreatography
Percutaneous trans-hepatic
Cholangiography
Malignant obstructive jaundice
Hayam Abdelmonsif
Abdellatif
hayam_drar@yahoo.com
1
Department of Radiodiagnosis, Faculty of Medicine, Menoufia University, Egypt
LEAD_AUTHOR
Omar A.
Hamada
2
AUTHOR
Mohamed S.
Elzawawi
3
AUTHOR
Mohamed A.
Deif
4
AUTHOR
ORIGINAL_ARTICLE
Histopathological Changes in Lesional and Perilesional Vitiligo Skin
Background: Vitiligo is a skin disease with complex, multifactorial pathogenesis. Abnormalities in surrounding keratinocytes may cause melanocyte death due to deprivation of growth factors.
Objective: To evaluate Haematoxylin and Eosin (H&E) histopathological findings in lesional and perilesional vitiliginous skin.
Patients Methods: Lesional skin biopsies were taken from 18 vitiligo patients. Perilesional biopsies were taken from 5 patients. All biopsies were stained with Hematoxylin and Eosin for histopathological assessment.
Results: Detected changes in lesional skin included increased epidermal thickness, epidermal atrophy, focal disruption of dermoepidermal junction and vacuolar degeneration with focal degree. All examined sections showed congested blood vessels and scanty melanin pigment. Dermal perivascular lymphocytic infiltration was present in all cases.
Detected changes in perilesional skin included increased epidermal thickness, epidermal atrophy, plenty of melanin pigment and focal vacuolar alteration. All examined sections showed congested blood vessels and focally disrupted dermoepidermal junction. Dermal perivascular lymphocytic infiltration was present in all sections.
Conclusion: Histopathological changes occur in perilesional as well as lesional vitiligo skin. Therefore, topical or physical treatment for vitiligo should be extended to the surrounding apparently normal skin. This may help in arresting disease course by preventing subclinical or silent lesions from progression to clinically visible lesions.
https://ejhm.journals.ekb.eg/article_178618_4549ad7090e2ed1970ee2a7e0e53ecdb.pdf
2021-07-01
1971
1978
10.21608/ejhm.2021.178618
Hematoxylin and eosin
Lesional
Perilesional
Vitiligo
Ola
Bakry
olabakry8@gmail.com
1
Department of Dermatology, Menoufiya Faculty of Medicine
AUTHOR
Rehab M
Samaka
2
AUTHOR
Wafaa
Shehata
3
AUTHOR
Basma F
Elsawah
4
AUTHOR
Iman
Seleit
5
AUTHOR
ORIGINAL_ARTICLE
Tracheoesophageal Voice Rehabilitation after Total laryngectomy: Primary Versus Secondary Tracheoesophageal Puncture
Background: Voice prosthesis is the current standard for post laryngectomy rehabilitation. Several clinical factors can affect the functional outcomes of voice prosthesis. Various complications are recorded with voice prosthesis.
Objective: This study aimed to compare the results of primary and secondary provox insertion in patients with advanced laryngeal carcinoma undergoing total laryngectomy.
Patients and Methods: Randomized-controlled clinical study included 24 patients with provox voice prosthesis rehabilitation 12 had primary tracheoesophageal puncture and 12 had secondary tracheoesophageal puncture. All patients were evaluated for successful voice restoration and complications rates.
Results: Short-term success rate was 92% in the primary group and 83% in the secondary group. Long-term success rate was 83% in the primary group and 75% in the secondary group. Success rates were higher in the primary group but without statistically significant difference. Complications rate in the primary group was 58.3% and in the secondary group 66.6%. Complications rate was higher in the secondary group but without statistically significant difference. Conclusion: Provox voice prosthesis provides consistent and good voice results, which improve with time. Primary provox insertion had better success rates and fewer complications. Periprosthetic leak is the most common complication.
https://ejhm.journals.ekb.eg/article_178619_faa28456c84d09acc313c22b40b9e149.pdf
2021-07-01
1980
1983
10.21608/ejhm.2021.178619
Total laryngectomy
Voice rehabilitation
Tracheoesophageal puncture
Provox prosthesis
Ibrahim Ahmed
Khaled
1
Department Otorhinolaryngology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
LEAD_AUTHOR
Alaa El-Din Mohammed
El-Feky
2
Department Otorhinolaryngology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
AUTHOR
Tarek Abd-Elmoaty
Omran
3
Department Otorhinolaryngology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
AUTHOR
Khaled Abd-Elshakour
Mohammed
4
Department Otorhinolaryngology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
AUTHOR
Amal Said
Quriba
5
Department Otorhinolaryngology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
AUTHOR
Ali Mohammed
Awad
6
Department Otorhinolaryngology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
AUTHOR
ORIGINAL_ARTICLE
Management of Open Tibial Shaft Fractures in Children with Intramedullary Elastic Nail
Background: Elastic intramedullary nailing is a method of diaphyseal fracture osteosynthesis in children. This technique has many advantages. Namely, there is primary bone union with avoidance of growth plate injury, early weight bearing, and minimally invasive surgery with a short duration of hospitalization. Objective: In this study, we evaluated radiological and functional results of treatment of open tibial shaft fractures in children using intramedullary elastic nail. Patients and Methods: This study was a prospective clinical study that included 24 cases with open tibial fractures treated with intramedullary elastic nail at Zagazig University Hospital (ZUH), Egypt and in Tripoli Central Hospital in Libya from June 2020 until September 2020 with six months follow-up. All patients were assessed radiologically by anteroposterior and lateral plain radiographs of the tibia that included the knee and ankle to limit unnecessary radiation. Results: The majority of studied group were excellent in 19 cases clinically according to Ketenjian and Shelton Criteria and 23 cases were united using radiological assessment. Only two cases had superficial skin infection and just one case had delayed union. Conclusion: Flexible intramedullary nailing is an effective treatment option in patients with open fracture (gustilo type I, II), four to fifteen years age group.
https://ejhm.journals.ekb.eg/article_178621_56967300a5138afffd6325c84aa4717b.pdf
2021-07-01
1984
1988
10.21608/ejhm.2021.178621
Elastic Nail
fracture
Open Tibial
Amr Mohamed
Eladawy
1
AUTHOR
Riad Mansour
Megahed
2
AUTHOR
Abobaker Emrehil Mohamed
Yosef
abobaker.m.yosef@gmail.com
3
LEAD_AUTHOR
Mohamed Ibrahim
Salama
4
AUTHOR
ORIGINAL_ARTICLE
Assessment of Interleukin-34 Serum level In Children with Systemic lupus Erythematosus
Background: Pediatric-onset systemic lupus erythematosus (pSLE) is an autoimmune disease with multiorgan involvement and accounts for 15% to 20% of all systemic lupus erythematosus (SLE) cases. Systemic lupus erythematosus (SLE) is a multifactorial autoimmune disease characterized by variable immune dysregulation, disabling symptoms, and progressive organ damage. Interleukin (IL) -34 is a newly discovered cytokine that has no significant amino acid sequence homology to other cytokines.
Objective: This study aimed to assess interleukin-34 serum level in children with systemic lupus erythematosus.
Patients and Methods: This was a case-control study performed on 39 individuals divided into control group containing 13 healthy children and diseased group containing 26 children, which further subdivided into two diseased groups (one group classified as active SLE group and another group classified as inactive SLE group each group contained 13 children).
Results: In our study the age of the participant children were distributed as 9.46 ± 2.93, 9.07 ± 2.9 and 10.0 ± 3.22 for the control group, inactive and active SLE groups respectively with no significant difference among the studied groups regarding age. But regarding sex, females were majority among all the studied groups with no significant difference between all groups. Our study showed that malar rash was significantly associated with the active lupus nephritis (LN) group.In the current study, we found that serum Interleukin 34 was significantly higher among the active LN group followed by the inactive LN group and the control group was significantly lower.
Conclusion: The serum IL-34 level was significantly elevated in the SLE patients. IL-34 could be a potential disease activity marker, and this study might have revealed new insight for the study of SLE disease activity.
https://ejhm.journals.ekb.eg/article_178623_0353e56dc2353b8cb38a75d3f78c9f73.pdf
2021-07-01
1989
1983
10.21608/ejhm.2021.178623
Metabolic syndrome
Uric acid
Evaluation
Hossam Mostafa
Kamal
1
AUTHOR
Mohammed Mohammed Abd
El salam
2
AUTHOR
Ahmad Mokhtar
Ahmad
3
AUTHOR
Hany Suliman Selem
Awadallah
hanyawadallah1119@gmail.com
4
LEAD_AUTHOR
ORIGINAL_ARTICLE
Validity of Computed Tomography Scoring Model for Prediction of Cervical Nodal Metastasis in Patients with Head and Neck Squamous Cell Carcinoma
Background: Squamous cell carcinoma of the head and neck is a common and often fatal cancer that can emerge from a variety of anatomic locations. An accurate and comprehensive assessment of lymph node metastasis in patients with head and neck squamous cell carcinoma (HNSCC) is necessary in daily practice.
Objective: This study aimed to predict cervical nodal metastasis by using multidetector computed tomography (MDCT) scoring model in patients with HNSCCC.
Patients and Methods: A cross sectional study in Zagazig University Hospital during the period from November 2019 to April 2020, included 76 lymph nodes from thirty patients with HNSCC. We analyzed preoperative CT images of lymph nodes including diameter, ratio of long to short axis diameter, necrosis and T stage of the primary tumor. The reference standard comprised pathologic results. Multivariable logistic regression analysis was performed to evaluate the risk scoring system.
Results: A 9-point risk scoring system (shortest axial diameter, L/S ratio, necrosis and T stage). The most common site was RT buccal region (5 cases), followed by base of tongue (3 cases), followed by RT sided of tongue (cases 5), followed by LT sided of tongue (1 case), followed by tip of nose (1 case), followed by lower lip (4 cases), followed by RT mandibular ramus (3 cases), followed by Epiglottis, true, false vocal cord, aryepiglottic fold (4 cases), followed by LT sided floor of mouth (2 cases), followed by LT external auditory meatus (1 case) and swelling in posterior scalp.
Conclusion: A simple 9 point risk scoring system using CT characteristic of lymph nodes and tumors for HNSCC could be feasible to stratify the risk of cervical lymph node metastasis with high diagnostic accuracy.
https://ejhm.journals.ekb.eg/article_178625_9388ccc5d4dad500121e834180deca1f.pdf
2021-07-01
1994
1999
10.21608/ejhm.2021.178625
Area under curve (AUC)
HNSCC
Long-to-short
Amira Abdelnaby
Abdallah
amiraelazony11@gmail.com
1
Department of Radiodiagnosis, Faculty of Medicine, Zagazig University, Egypt
LEAD_AUTHOR
Dalia Nabil
Khalifa
2
Department of Radiodiagnosis, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Mohammad Abd Alkhalak
Bash
3
Department of Radiodiagnosis, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Ahmed Mohamed
Alsowey
4
Department of Radiodiagnosis, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Corpus Callosum Tractography and its Correlation with Cognitive and Behavioural Changes in Children with Attention-Deficit/Hyperactivity Disorder
Background: Very few studies have investigated the changes in white mater, corpus callosum (CC) specifically, in attention-deficit/hyperactivity disorder (ADHD) patients and its relation to cognitive and behavioral changes in ADHD patients. This study aimed to investigate the correlation between tractography of CC, behavioral and cognitive changes in ADHD patients. Objectives: To detect any morphological changes in corpus callosum in patients with attention-deficit/hyperactivity disorder through diffusion tensor image (tractography) and to elucidate its relation with cognitive and behavioral changes of patients with ADHD.
Patients and Methods: A case-control study was done on 100 children divided into two groups; cases and controls at Menoufia University Hospitals. They were selected according to certain inclusion and exclusion criteria. Diffusion tensor imaging (DTI) of CC was done to both groups. Both behavioral and cognitive functions were assessed in correlation with radiological data.
Results: There were no significant differences between the groups regarding demographic data that included age and sex, while statistically significant difference (p value <0.001*) was detected in IQ in ADHD (mean IQ was 89.62) compared to control (mean IQ: 96.08). The mean FA value (a measure of white matter consistency in DTI) was higher in control group than in ADHD group in all subdivisions of corpus callosum with no significant difference between the two groups except for the isthmus part (p value 0.034) whose fibers were originating from sensory motor cortex denoting defective functioning in mentioned areas.
Conclusion: Diffusion tensor image study of corpus callosum in attention deficit hyperactivity disorder reflected defective inter-hemispheric connectivity mainly sensory motor cortices through isthmus part of corpus callosum.
https://ejhm.journals.ekb.eg/article_178626_5edf230a9130b6cca3553633a3067306.pdf
2021-07-01
2000
2003
10.21608/ejhm.2021.178626
Corpus callosum tractography
Cognitive and behavioural changes
children
Attention-Deficit/Hyperactivity Disorder
Ayman Abdelfattah
El-Hadad
1
AUTHOR
Afaf Zein El-Abedien
Ragab
2
AUTHOR
Mohamed Mohamed
Houseni
3
AUTHOR
Ahmed Nabil
Ramadan
4
AUTHOR
Esraa Mohiey Eldeen
Hamdy
dr.esraa.mohiey@gmail.com
5
AUTHOR
ORIGINAL_ARTICLE
Early Outcomes of Cardiac Surgery in Patients with Liver Cirrhosis
Background: Liver cirrhosis is known to be associated with increased morbidity and mortality in patients undergoing cardiac surgery.
Objective: The purpose of this study was to evaluate the early outcomes of cardiac surgery in patients with liver cirrhosis in our settings, and to assess the performance of the Child-Pugh classification as a predictor of early mortality.
Patients and Methods: A retrospective observational study included 58 patients operated between March 2012 and October 2019. Among these 52 patients required open-heart procedures and 6 were operated without the use of cardiopulmonary bypass. The primary endpoint being examined was early mortality.
Results: The overall mortality was 20.7%. Higher Child-Pugh (CP) class was associated with marked rise in mortality. The mortality rate increased from 10.8% patients in class A of the Child-Pugh, to 25% in class B patients to 80% in class C patients. The need for urgent or emergent procedures was also found to be associated with an increased risk of mortality.
Conclusion: Early results of cardiac surgery in Child-Pugh class A patients although apparently higher than the general population, remain acceptable. The mortality in patients with CP class C is extremely high and almost prohibitive. Non-elective procedures also seemed to be associated with a significant increase in early mortality. This should be borne in mind while assessing surgical risk in cirrhotic patients.
https://ejhm.journals.ekb.eg/article_178628_ab5cb1751a2e041396e1285ced1a584e.pdf
2021-07-01
2004
2007
10.21608/ejhm.2021.178628
cardiac surgery
Liver cirrhosis
Child-Pugh score
Mohamed
Azzam
dr.mohamed.ezzazzam@gmail.com
1
Cardiothoracic Surgery Department, Kasr Al Ainy Faculty of Medicine, Cairo University, Egypt.
AUTHOR
Hussein
Derbala
2
Cardiothoracic Surgery Department, Kasr Al Ainy Faculty of Medicine, Cairo University, Egypt.
AUTHOR
Hesham Zayed
Saleh
3
Cardiothoracic Surgery Department, Kasr Al Ainy Faculty of Medicine, Cairo University, Egypt.
AUTHOR
ORIGINAL_ARTICLE
Impact of Vitamin D Supplementation on Dry Eye in People with Low Serum Vitamin D
Background: Dry eye is a disease (DED) of the tear film and ocular surface, leading to ocular discomforts and pain. The pathophysiology of DED includes tear film instability and ocular surface inflammation. Vitamin D refers to a group of fat-soluble secosteroids responsible for enhancing intestinal absorption of calcium, iron, magnesium, phosphate, and zinc. It is not strictly a vitamin, and may be considered a hormone as its synthesis and activity occur in different locations. Objective: Thisstudy aimed to investigate tear film function in patients with vitamin D deficiency. Patient and methods: A case-control study included 75 eyes of 39 patients who were referred to the Ophthalmologic Clinic, Menoufia University during the period from March 2020 to December 2020. Patients of dry eye underwent tear break up time, Schirmer I test without anesthesia and special tests as well as measurement of serum vitamin D level were assessed. Results: 25-hydroxy vitamin D level of the studied group ranged from 6-18.50 ng/ml with mean value of 8.22 ± 4.814 ng/ml. Also, majority of studied sample (92.3%) had bilateral affected eyes, followed by Gelinya (30%). Schirmer's test, tear film breakup time (TFBUT) and ocular surface disease index (OSDI) were increased significantly when compared the values at baseline and after treatment to be after 10 weeks (P < 0.001). Conclusion: Vitamin D replacement appears to improve ocular surface health in patients with vitamin D deficiency. However, further clinical trials with a large sample size and control group are warranted to define the role of vitamin D. Vitamin D supplementation is an effective and useful treatment for patients with dry eye syndrome (DES) that is refractory to conventional treatment.
https://ejhm.journals.ekb.eg/article_180343_030ad167969b2b66a7fffe31eedf5a04.pdf
2021-07-01
2008
2013
10.21608/ejhm.2021.180343
Dry eye
Schirmer I test
TFBUT
OSDI
Vitamin D
Saber Hamed
El Said
1
AUTHOR
Ahmed Ibrahim
Basiony
2
AUTHOR
Manar Mohammed
Amin
manar.amin.sobih@gmail.com
3
AUTHOR
Shaimaa Kamal
El-deen
4
AUTHOR
ORIGINAL_ARTICLE
Serum Adiponectin Level in Patients with Psoriasis and its Correlation with the Clinical Severity
Background: Psoriasis is a common chronic immune mediated papulosquamous disease that affects 2-3% of the population. The exact cause of psoriasis is still unclear, but it is considered a disease of dysregulated inflammation which is driven and maintained by interaction among multiple components of immune system in genetically predisposed individuals. Adipose tissue is an active endocrine organ contributing to the regulation of multiple metabolic pathways via self-produced bioactive products called adipokine. Adiponectin of adipose origin has the highest circulating concentration among the known adipokines. Adiponectin regulates skin inflammation especially IL-17-related psoriasiform dermatitis. Objective: This study was aimedto estimate the serum level of Adiponectin and detect its correlation with activity of psoriatic patients.
Patients and Methods: This case control study included a total of 50 patients with psoriasis and 50 healthy individuals, attending at Outpatient Clinic, Department of Dermatology, Venereology and Andrology in collaboration with Department of Clinical Pathology, Faculty of Medicine, Zagazig University Hospitals. This study was conducted between November 2019 to November 2020. Psoriasis severity was classified according to psoriatic area and severity index (PASI) score. Serum level of adiponectin was determined by ELISA for both groups.
Results: The results revealed that control group had significantly higher level of adiponectin than psoriasis patients. There was a negative significant correlation between adiponectin and Psoriasis Area and Severity Index (PASI score) (p <0.001**). Sensitivity of adiponectin in diagnosis of psoriasis was 94%, specificity was 90% and accuracy was 92%. Conclusion: Adiponectin measurement in serum of patients with psoriasis provides a tool for monitoring disease activity.
https://ejhm.journals.ekb.eg/article_180344_0163cec600a09eb8e3e7614db29d82f5.pdf
2021-07-01
2014
2019
10.21608/ejhm.2021.180344
Psoriasis
adiponectin
PASI
markers
Adipokines
Aisha Hamza
Gamil
aishahamzawy2014@gmail.com
1
AUTHOR
Mahmoud Yousry
Abdel-Mawla
2
AUTHOR
Naglaa Ali
Khalifa
3
AUTHOR
Mohamed Mahmoud
Nasr
4
AUTHOR
ORIGINAL_ARTICLE
Comparison between Tran abdominal and trans anal one stage pull through in Hirschsprung disease
Background: Hirschsprung’s disease (HD) is one of the commonly studied diseases among pediatric surgeons and researchers. It is also known as intestinal aganglionosis, which is a kind of birth defects mainly expressed as partial or complete absence of ganglion cells of the intestinal tract.
Objective: The aim of the current work was to evaluate the management of children with Hirschsprung's disease by one stage pull-through Soave procedures (transanal and trans-abdominal one stage pull-through) concerning perioperative, short term outcomes and complications.
Patients and methods: This randomized controlled trial study included a total of 32 patients subjected to transanal and transabdominal one stage pull-through procedures for management of Hirschsprung’s disease. Patients were recruited from the Inpatient Clinic, Pediatrics Surgical Department, Assiut University Hospitals. This study was conducted between April 2015 to March 2019 and followed up at our clinics.
Results: Comparison of the rates of late post-operative complications among the studied groups revealed that regarding post-operative incontinence, group A had statistically insignificant (p = 0.723) lower rates (50%) compared with group B (56%). Likewise, rates of adhesive intestinal obstruction were insignificantly (p = 0.310) higher (6.2%) in comparison with group B (0%). There was statistically significant (p = 0.001) longer duration of hospital stay among patients in group A (11.1 ± 6.4days) compared with patients in group B (5.0 ± 1.4 days).
Conclusion: It could be concluded that the advantages of TERPT include a good cosmetic effect, short hospital stays, safe, and less surgical site infection compared to transabdominal procedures.
https://ejhm.journals.ekb.eg/article_180345_63c962c8eec42fdbf20ed9129520d3b6.pdf
2021-07-01
2021
2027
10.21608/ejhm.2021.180345
Hirschsprung Disease
One stage pull-through transanal and trans-abdominal
Mansour Mohammed
Kabbash
1
AUTHOR
Mohammed Abd-Alkader
Osman
2
AUTHOR
Mohammed Youssef
Ahmed
3
AUTHOR
Mohamed
Rabie
4
AUTHOR
Mohammed Kandil
Ibrahim
kandil9595@gmail.com
5
AUTHOR
ORIGINAL_ARTICLE
Serum Neutrophil Gelatinase-Associated Lipocalin and Iron Status in Predialysis Chronic Kidney Disease at Zagazig University
Background: The burden of chronic kidney disease (CKD) is substantial. Anemia is a common feature of CKD.
Objective: The aim was to predict about iron status by serum neutrophil gelatinase-associated lipocalin (NGAL) levels and role of serum NGAL as biomarker of iron deficiency in CKD patients.
Patients and Methods: A prospective, case-control comparative study that was conducted at Nephrology Outpatient Clinic and Internal Medicine Department, Zagazig University Hospitals. Seventy two participants were divided into two groups: Group I included 36 participants with no chronic kidney disease and group II that included 36 chronic kidney disease patients. Laboratory investigations included iron parameters and serum NGAL levels were measured
Results: S. Iron, TIBC, S. Ferritin and calculated T. sat” were statistically analyzed and showed that there was a statistical significant difference between the two studied groups. NGAL level was higher in CKD group than in the non-CKD group. A significant positive correlation between serum NGAL and T sat & serum ferritin and there was a significant negative correlation between NGAL and eGFR, HB and serum iron.
Conclusion: Patients had significantly higher NGAL levels when compared to controls and this means that it had an important role in iron metabolism in those patients. There was statistically significant direct correlation between serum NGAL levels and serum ferritin levels and T. sat and inverse correlation with iron. Serum NGAL could be a good biomarker for iron status in CKD patients but not better than the ordinary used methods “serum ferritin and T. sat”.
https://ejhm.journals.ekb.eg/article_180346_57351f964dbf77f07bbbe841eff414f8.pdf
2021-07-01
2017
2032
10.21608/ejhm.2021.180346
Neutrophil Gelatinase
Associated Lipocalin
iron status
Predialysis
CKD
Halla Mohamed
Allam
1
AUTHOR
Haidy Essam Eldin Ahmed
Zidan
2
AUTHOR
Mohamed Gomaa
Abdelrehim
3
AUTHOR
Amira Mohamed Hamed
Hassan
4
LEAD_AUTHOR
ORIGINAL_ARTICLE
Predictors of Outcome for Non-Operative Management of Localized Intra-Abdominal Infection ''Abscess'': A Prospective Study
Background: Interventional (percutaneous) drainage of abdominal abscesses is a safe and successful method of treatment that avoids many of the disadvantages of traditional surgical drainage. Objective: This study aimed to evaluate factors associated with success or failure for non-operative management of localized intra-abdominal infection ''abscess''. Patients and Methods: This is a prospective single arm descriptive study that has been conducted at Sohag University Hospital from June 2017 to August 2018. This study included 100 patients presented with intra-abdominal localized collection during the period of the study, from June 2017 to August 2018, and presented to Sohag University Hospital, with any sex, age, previous abdominal surgery or clinical presentation. Results: In our studied population, 85 cases of total 100 cases had spontaneous abscesses without any previous abdominal surgeries. 52 cases of them responded successfully to non-operative management while 33 failed. 64 cases of total 100 cases responded successfully to non-operative management, 25 % of them were appendicular/post appendectomy abscesses, 21.88% were liver abscesses, 21.88% were iliopsoas/ iliopsoas and perinephric abscesses. To be noticed that all 14 cases (11 iliopsoas and 3 iliopsoas and perinephric abscesses) responded successfully to non-operative management by 100%. Out of 29 diabetic patients with intra-abdominal abscess, 26 cases of them responded to non-operative management while only 3 cases of them needed surgical intervention. Conclusion: Diabetes mellitus and positive culture of aspirate are predictors for success of non-operative management while high grade fever is predictor for failure.
https://ejhm.journals.ekb.eg/article_180347_816ecdd553c1d64274b2b06d84db6397.pdf
2021-07-01
2033
2039
10.21608/ejhm.2021.180347
Intra-abdominal abscess
Localized intra-abdominal collection
Percutaneous drainage
Pig tail
Sherif Galal
Abdel-Aal Kopesy
sherifgall@yahoo.com
1
Department of General Surgery, Faculty of Medicine, Sohag University, Egypt
AUTHOR
Ahmed Gaber
Mahmoud
2
Department of General Surgery, Faculty of Medicine, Sohag University, Egypt
AUTHOR
Alaa El-Din Hassan
Mohamed
3
Department of General Surgery, Faculty of Medicine, Sohag University, Egypt
AUTHOR
Wael Barakat
Ahmed
4
Department of General Surgery, Faculty of Medicine, Sohag University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Vitamin D Sufficiency Status in a Sample of Egyptian Patients with Different Rheumatological Diseases
Background: Vitamin D is a key hormone in the metabolism of calcium and phosphorus, as well as the creation and maintenance of the mineralized skeleton. It has also been linked to the etiology of autoimmune disorders such as diabetes mellitus type 1 and multiple sclerosis. Vitamin D has been the topic of several difficult investigations in recent years, including its function in the pathophysiology and development of many rheumatological disorders such as rheumatoid arthritis and systemic lupus erythematosus (SLE).
Objective: To investigate Vit D sufficiency status in different rheumatological diseases.
Patients and methods: The current study included 80 patients, divided into 20 patients with rheumatoid arthritis, 20 patients with SLE, 20 patients with osteoarthritis and 20 patients with other miscellaneous rheumatological diseases. The following investigations have been done. 25(OH) vit D, CRP, ESR, ANA, Ca, Po4, rheumatoid factor , C3,C4
Results: 60% of the studied patients had vitamin D deficiency, 33.75 % had vitamin D insufficiency, 6.25% had sufficient vitamin D.Vitamin D was significantly deficient in patients with rheumatoid arthritis compared to other studied rheumatological diseases, Also vitamin D level was significantly deficient with increasing age and Longer duration of the disease (P value < 0.001). Vitamin D was significantly deficient in patients on corticosteroid therapy and smoker patients.
Conclusion: 25(OH) vitamin D was significantly low in Egyptian patients with different rheumatological disease especially rheumatoid arthritis, explaining its role in development of inflammation and autoimmunity. So, 25(OH) vitamin D should be put in consideration in diagnosis and treatment of such patients.
https://ejhm.journals.ekb.eg/article_180349_e7bdc82636252d81c766019b2ed98f1a.pdf
2021-07-01
2040
2045
10.21608/ejhm.2021.180349
Vitamin D
Autoimmune disease
Rheumatoid Arthritis
SLE
osteoarthritis
Nagwa Roshdy
Mohamed
dr_pharos2000@yahoo.com
1
AUTHOR
Raef Malak
Botros
2
AUTHOR
Amr Hassan
Mostafa
3
AUTHOR
ORIGINAL_ARTICLE
Cystatin C and Acute Kidney Injury in Acute Heart Failure; Impact on Hospital Course
Introduction: Acute heart failure (AHF) is a life-threatening disease with a high mortality rate. Cardio-renal syndrome (CRS) has received much attention because of its relation to the poor prognosis of hospitalized patients. In both acute and chronic cardiac disease, kidney impairment is a significant predictor of outcome. Finding a more sensitive renal damage marker is a top priority due to the disadvantage of the existing marker creatinine. Several new acute kidney injury (AKI) biomarkers are being studied. Cystatin Cis a kidney function biomarker that has also been investigated for its use in acute kidney injury early detection.
Aim: was to assess the outcome of using cystatin C as a new AKI biomarker in patients diagnosed with AHF and its effect on hospital stay and in-hospital mortality.
Methods: Cystatin C levels were measured on admission and 48 hours later in 200 hospitalized AHF patients. The amount of increase in cystatin C after 48 hours was measured, as well as the impact of a cystatin C increase on the hospital course.
Results: The mean population age was 66.4 years old, while 49% of the population were females. AKI was detected in 16% of patients with >0.3 mg/L rise in cystatin C within two days of hospital admission, and this led to 3 days (P = 0.01) significant more extended hospital stay while in-hospital mortality was more but could not reach statistical significance (P = 0.239).
Conclusion: In patients with acute heart failure, elevation in Cystatin C within 48 hours of hospital admission is a good detector of early acute kidney injury and has a detrimental impact on their hospital course.
https://ejhm.journals.ekb.eg/article_180350_69415436ff7de97fe439ec65782148c6.pdf
2021-07-01
2046
2051
10.21608/ejhm.2021.180350
Acute heart failure
Cystatin C
acute renal injury
Ahmed
Elbarbary
dr.barbary_ai@yahoo.com
1
LEAD_AUTHOR
Lobna
Refaat
2
AUTHOR
Mohamed
Awadein
3
AUTHOR
Ahmed
Tamara
4
AUTHOR
ORIGINAL_ARTICLE
Albuminuria Independently Determines Intact Parathyroid Hormone in Diabetic Nephropathy with Micro-albuminuria
Background: Diabetes mellitus (DM) is a well-recognised cause of end-stage renal disease (ESRD) through diabetic nephropathy (DN). Elevated intact parathyroid hormone (intact PTH) in DN represents a serious metabolic threat.
Objective: We aimedto detect determinants of intact PTH changes during micro-albuminuria stage of DN.
Patients and Methods: An observational study included 294 patients with type 2 diabetes mellitus (T2D) divided into 2 groups. Case group; 220 patients of DN with micro-albuminuria versus control group; 74 patients without albuminuria. Participants were subjected to history taking, clinical examination and laboratory assessment of glycosylated haemoglobin (HBA1c), serum creatinine, blood urea nitrogen (BUN), urine albumin creatinine ratio (urine ACR), estimated glomerular filtration rate (eGFR), 25(OH) vitamin D, intact PTH, serum ionized calcium, phosphorus and magnesium.
Results: Among 220 patients of mean age 48.7 years and 57.7% male, albuminuria was significantly higher (P<0.001). We found non-significant difference between the study groups in estimated glomerular filtration rate (eGFR) and serum creatinine (P=0.375 and 0.294) respectively. Meanwhile, intact PTH was significantly elevated (P<0.001) in case group. Intact PTH was positively correlated with urine ACR, HBA1c, BUN, and serum creatinine and inversely correlated with eGFR. However, urine ACR was the only independent determinant of intact PTH in diabetic patients with micro-albuminuria (OR: 1.177; 95% CI: 1.074-1.290, P= 0.001).
Conclusion: Interestingly, urine albumin creatinine ratio was the only independent determinant of intact PTH in diabetic patients with micro-albuminuria.
https://ejhm.journals.ekb.eg/article_180351_f2784bc48ff701ea91cfb001a47269f1.pdf
2021-07-01
2052
2056
10.21608/ejhm.2021.180351
diabetic nephropathy
Intact PTH
Micro-Albuminuria
mohammed
gameil
drmaligameil1979@yahoo.com
1
Internal medicine department, Faculty of medicine, Mansoura University, Mansoura, Dakahlia, Egypt.
AUTHOR
Rehab Elsayed
Marzouk
2
AUTHOR
Ahmed Hassan
Elsebaie
3
AUTHOR
Ahmed Ahmed Ahmed
Eldeeb
4
AUTHOR
ORIGINAL_ARTICLE
Serum Malondialdehyde and Vitamin C in Children with Epilepsy
Background: Epilepsy is one of the most common neurological disorders. The prevalence of active epilepsy was estimated to be 6.38 per 1000 persons. Serum malondialdehyde (MDA) is used as a marker to investigate the oxidative damage of lipids in many degenerative human diseases. Vitamin C is important for the proper functioning of the central nervous system.
Objective: To evaluate the association of serum MDA and vitamin C with epilepsy in children.
Methods: This case-control study was carried out in the Pediatric Department at Zagazig University Hospitals during the period from December 2019 to July 2020. This study included 46 children who were divided into 2 groups: Cases group: which included 23 epileptic children. Control group: which included 23 healthy children with age and sex-matched to cases. All the participants were subjected to measuring serum malondialdehyde MDA and Vitamin C.
Results: This study showed that there was a statistically significant increase in serum malondialdehyde (MDA) among the case group than the control group. Also, there was a statistically significant decrease in serum Vitamin C among the case group than the control group.
Conclusion: This study has correlated the increase of lipid peroxidation and defective antioxidant defense and the pathogenesis of epilepsy and we found a significantly elevated level of MDA and a depleted level of vitamin C in epileptic patients than in the healthy control subjects
https://ejhm.journals.ekb.eg/article_180352_3826445faf0cf5a9113973b22c4722e1.pdf
2021-07-01
2057
2059
10.21608/ejhm.2021.180352
Serum Malondialdehyde
vitamin c
Epilepsy
Abdalmalek Milad Ahmed
Abudhir
malek.milad86@gmail.com
1
AUTHOR
Seham Fathy Abdelhamid
Azab
2
AUTHOR
Safaa Hamdy Ahmad
Saleh
3
AUTHOR
Noha Abdelhalim Mohamed
Rezk
4
AUTHOR
ORIGINAL_ARTICLE
Preprocedure Ultrasound-Guided Midline Spinal Anaesthesia versus Conventional Landmarks Technique: Efficacy and Safety
Background: Comparison between spinal anaesthesia with conventional land mark (blind) technique and with preprocedural ultrasonographic guidance technique. Ultrasound (US) can be used effectively and accurately to identify the anatomical landmarks of neuraxial blockade, in order to improve the safety and efficacy of spinal anaesthesia.
Objective: To assess the effectiveness and safety of US to improve the technique of spinal anaesthesia, anddecrease it's complications in comparison to the conventional landmarks technique.
Patients and Methods: The study was performed in Zagazig University Hospital. Hundred and four ASA classes I and II adult cooperative patients of both sexes were scheduled for surgery in the lower part of the body under neuraxial blockade. They were randomly allocated into two equal groups, preprocedure ultrasonography guided spinal anaesthesia (PS) group, and conventional landmark group (CL).
Results: It was found that there was a statistically significant difference between PS and CL groups regarding the number of attempts, number of needle pass (bone hitting), successful dural puncture after the first attempt, and total time for technique performance.
Conclusion: ultrasound guidance improves the success rate of midline spinal anaesthesia. It reduces the number of attempts required, improves the success rate of a single needle pass, and shortens the time to dural puncture. Further trials can be done to establish the role of ultrasound-guided neuraxial block among high-risk groups, such as obese, elderly, and patients with spinal deformity.
https://ejhm.journals.ekb.eg/article_180353_996ffeb756326836ed4f1239610744aa.pdf
2021-07-01
2060
2064
10.21608/ejhm.2021.180353
Spinal anaesthesia landmark technique
Ultrasound
Basmah Ahmed Abdelrahman
Alrobaa
basma.robaa@gmail.com
1
AUTHOR
Mohamed Anwer
Rifky
2
AUTHOR
Mohamed Mowafy
Khattab
3
AUTHOR
Ayman Fathy
Zeid
4
AUTHOR
Ahmed Sobhy
Hegab
5
AUTHOR
ORIGINAL_ARTICLE
Evaluating the Role of Autologous Platelet-Rich-Plasma in The Treatment of Dry Eye Disease
Background: Platelets are irregularly shaped, non-nucleated cytoplasmic bodies derived from fragmentation of megakaryocyte precursors. Objective: This study aimed to evaluate the role of autologous platelet-rich-plasma (PRP) as a monotherapy versus artificial tears (Hyaluronic acid) use for better management of dry eye disease. Patients and Methods: A prospective clinical randomized trial study was conducted on 62 patients with moderate to severe dry eye disease (Schirmer`s test outcomes of 5.5 mm or lower). Patients had been recruited from the Outpatient Clinics of Ophthalmology Department in Zagazig University Hospital during the period from February 2020 to January 2021. They were divided into two equal groups; group A was treated with PRP and group B was treated with artificial tears. Results: There was a significant decrease regarding ocular surface disease index (OSDI) in both groups after treatment, but the improvement was more significantly in PRP group compared to artificial tears group. There was a significant increase in tear break-up time (TBUT) in PRP group only after treatment; although, there was an increase in TBUT in artificial tears group but without statistical significance. There was a significant increase in BCVA in both groups after treatment, but the improvement was more significantly in PRP group compared to artificial tears group. Conclusion: PRP is an interesting alternative therapy in symptomatic dry eye.
https://ejhm.journals.ekb.eg/article_180354_fd85845b730a4f07dc98e5ab036194cd.pdf
2021-07-01
2065
2070
10.21608/ejhm.2021.180354
Dry Eye Disease (DED)
Platelet-Rich-Plasma (PRP)
Tear Break-up Time (TBUT)
Doaa Hatem Farhan
Emam
dodohatemfarhan@gmail.com
1
Ophthalmology Department, Faculty of Medicine, Zagazig University, Egypt.
AUTHOR
Gamal Youssef
El Mashad
2
Ophthalmology Department, Faculty of Medicine, Zagazig University, Egypt.
AUTHOR
Ayman Ahmed
Alkawas
3
Ophthalmology Department, Faculty of Medicine, Zagazig University, Egypt.
AUTHOR
Sherif Mohammed
Sharaf El Deen
4
Ophthalmology Department, Faculty of Medicine, Zagazig University, Egypt.
AUTHOR
ORIGINAL_ARTICLE
Efficacy of Albendazole Mass Treatment Alone Compared to Combined Albendazole – Flubendazole Regimen for Treatment of Resistant Entrobius vermicularis Infection in Children
Background: Enterobius vermicularis is one of the most common parasitic helminths causing infection in children worldwide causing distressing lifestyle and health problems. The empirical use of anthelminthic drugs without medical supervision and low compliance to treatment protocols lead to resistance to therapy.
Objective: To assess the efficacy of albendazole mass treatment alone compared to the combined albendazole-flubendazole regimen for treatment of recurrent and resistant Enterobius vermicularis infection in children and their families.
Subject and Methods: It was a clinical trial that included 130 children 3-12 years old with resistant Enterobius vermicularis infection determined by the following inclusion criteria for treatment resistance. This study was carried out at the Pediatrics outpatient Clinic at Al-Azhar University Hospitals, and the Medical Parasitology Department at Damietta Faculty of Medicine, Al-Azhar University at New Damietta city, Egypt.
Results: 36 out of 65 (55.4%) children in the albendazole treated group and 54 out of 65(83.1%) in the albendazole-flubendazole treated group was cured with significantly higher efficacy for the albendazole-flubendazole regimen. The laboratory data showed improvement in post-treatment phase especially for albendazole- flubendazole treated groups for hemoglobin%, total leukocytic counts, neutrophil and lymphocyte counts that improved by time and a decline in the reported eosinophilia. The clinical data were significantly warning the presence of infection however they did not define the significance of treatment efficacy or resistance.
Conclusion: Enterobiasis is a childhood health problem with potential resistance to regular therapeutic protocols. Using albendazole- flubendazole combined regimen showed promising results in the treated groups superior to albendazole alone against resistant Enterobius vermicularis infection in children. This gives promising results encouraging further evaluation studies.
https://ejhm.journals.ekb.eg/article_180356_8ca0dae8963d02d3ea339ec1a3e1f2d7.pdf
2021-07-01
2071
2077
10.21608/ejhm.2021.180356
Pinworm
Enterobius vermicularis
Flubendazole
albendazole
resistance
Khaled A.
Temsah
drkhaled2008@yahoo.com
1
LEAD_AUTHOR
Doaa A.
Ahmad
2
AUTHOR
Amal A.
El Kholy
3
AUTHOR
Mohamed I.
Elsamanoudy
4
AUTHOR
ORIGINAL_ARTICLE
Clinical Manifestations and Comorbidities of SARS-Cov-2 Infection: A Descriptive Study
Background: Coronavirus disease 2019 (COVID-19) is a clinical syndrome caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Patients with severe illness have an overactive immune system, which can damage organs other than the lungs. Objective: The aim of this study was to assess the prevalence of clinical manifestations and comorbidities in SARS-CoV-2 infected patients. Patients and methods: This retrospective single-center observational study was conducted in the Tertiary Hospital, Internal Medicine Department, Faculty of Medicine, Zagazig University. This retrospective observational study was conducted on consecutive 370 patients with confirmed SARS-CoV-2 infection from May to September 2020.The diagnosis of the cases was confirmed using RT-PCR for detection of the viral RNA. Demographic characteristics, including underlying comorbidities, symptoms, signs, laboratory findings, chest CT scan and treatment measures were reported. Results: According to this retrospective, single-center observational study, which was conducted on consecutive 370 patients with confirmed SARS-CoV-2 infection? The study involved 193 Egyptian males (52.1%) and 177 Egyptian females (47.9%) with COVID-19. The mean age was 40. 2 ±14.74 years. The common symptoms of the COVID-19 patients at the onset of sickness were myalgia [355 (95.9%)], fatigue [291 (78.6%)], headache [235 (63.5%)], fever [247 (66.8%)], cough [213 (57.6.%)], sputum production [201 (54.3%)] and dyspnea [189 (51.1%)].The most prevalent comorbidity were hypertension [142(38.4%)] followed by diabetes [132 (35.6%)]. Conclusion: The commonest clinical manifestations of confirmed cases of COVID-19 were myalgia, fatigue, headache, fever, and cough and the most prevalent comorbidities associated with COVID 19 patients were hypertension and diabetes.
https://ejhm.journals.ekb.eg/article_180358_c5025722a9dab6dc2c6e5bb1acbc940b.pdf
2021-07-01
2078
2083
10.21608/ejhm.2021.180358
SARS-CoV-2
diabetes
comorbidity
Coronavirus
Nearmeen M.
Rashad
1
Department 1 Internal Medicine, Faculty of Medicine, Zagazig University, Sharkia, Egypt
LEAD_AUTHOR
Nevin F.
Ibrahim
2
Department 1 Internal Medicine, Faculty of Medicine, Zagazig University, Sharkia, Egypt
AUTHOR
ORIGINAL_ARTICLE
Correlation between Severity of Coronary Artery Disease and Insulin Resistance in Diabetic Patients
Background: Diabetes mellitus is a well-established risk factor for the development of coronary artery disease (CAD), which is the major cause of premature death in diabetic patients, both in type 1 or type 2 diabetes.
Objective: To examine the relationship between insulin resistance determined by fasting insulin level and complexity of coronary artery lesion in diabetic patients.
Patient and methods: This study enrolled 84 diabetic patients who were presented to the catheter Lab for elective coronary angiography in the period from October 2019 to April 2020. All patients were subjected to full history taking, thorough clinical examination, laboratory investigations (fasting insulin level, HbA1c level, lipid profile and serum creatinine), 12-lead surface ECG, echocardiography examination and coronary angiography. The complexity of the coronary artery lesions was evaluated using Gensini score. Statistical tests were used to analyze the association between the measured fasting insulin levels and Gensini score.
Results:there was a statistically highly significant positive linear correlation between insulin level and Gensini score (P<0.05). The accuracy of for insulin level as a predictor for coronary artery disease equals 96,6% by 96.7% sensitivity and 75% specificity at cut off predictive value <25.8 mIU/L.
Conclusion: Fasting insulin level is a simple test for insulin resistance and significantly correlated with severe CAD so it may have a value as a predictor of severity of CAD and risk stratification of diabetic patients.
https://ejhm.journals.ekb.eg/article_180360_be09dcc94ffcf1a024991012ebf4fcf9.pdf
2021-07-01
2084
2089
10.21608/ejhm.2021.180360
Coronary Artery Disease
Diabetic patients
Insulin Resistance
Rehab I.
Yaseen
1
AUTHOR
Mohammad Y.
Beda
mohammed.yahya84@yahoo.com
2
LEAD_AUTHOR
Fatma A.
Ibrahim
3
AUTHOR
ORIGINAL_ARTICLE
The Relationship between Serum Sclerostin Levels and Carotid Intima Media Thickness in Predialysis Chronic Kidney Disease
Background: The most common cause of increased morbidity and death throughout the chronic kidney disease (CKD) process is atherosclerosis, which advances quickly and is linked to cardiovascular diseases (CVDs). Sclerostin levels in CKD and CVDs have a complicated connection. Objective: We examined the relationship between serum sclerostin levels and atherosclerosis in patients with stage 3, 4, or 5 CKD who were not receiving hemodialysis treatment. Patients and Methods: A total of 125 patients aged >18 years with CKD stage 3, stage 4 and non-dialysis stage 5 were enrolled in the study. Patients with obesity, uncontrolled hypertension, coronary artery disease, with active cancer or liver disease, malignant hematologic disorders, acute renal failure, acute or chronic infections, were excluded. As for the control group; healthy volunteers without any known illness, regular drug use, smoking, alcohol use, and obesity were recruited. Results: Study population was diagnosed as 39.2% with diabetes mellitus and 91.2% of patients with arterial hypertension. 54% of the patients were female. There was a positive correlation between serum sclerostin levels and carotid intima media thickness (CIMT). A negative correlation was found between serum sclerostin levels and GFR and 25-OH vitamin D levels. Sclerostin levels were found to be significantly higher in the group with high CIMT levels. There was no difference in terms of other parameters. Conclusion: Sclerostin levels were significantly higher in patients with abnormal CIMT independent of GFR, calcium, phosphorus and PTH values. This finding suggests that the serum sclerotin level can be used as a CVD marker in patients with CKD.
https://ejhm.journals.ekb.eg/article_180859_5052366f6cbb0d038973805d4013ef25.pdf
2021-07-01
2090
2096
10.21608/ejhm.2021.180859
Carotid Intima Media Thickness
Predialysis Chronic Kidney Disease
Serum Sclerostin Levels
Recep
Demirci
rcpdemirci@windowslive.com
1
LEAD_AUTHOR
Can
Sevinc
dr_cansevinc@yahoo.com
2
AUTHOR
ORIGINAL_ARTICLE
Relationship between Plasma Levels of Vitamin D in Pregnant Women and Development of Gestational Diabetes Mellitus
Background: Gestational diabetes mellitus (GDM) is the leading cause of complications associated with childbirth for both mothers and offspring, and it is considered to be caused by the imbalance between insulin resistance and insulin secretion and contributed maternal hyperglycemia.
This study aimed to assess the relationship between plasma levels of vitamin D in pregnant women and the development of gestational diabetes mellitus.
Patients and Methods: A case-control study was conducted at Gynecology and Obstetrics Department, Zagazig University during the period from August 2020 until April 2021. It included a total of 104 pregnant women. Clinical and obstetrical data were gathered, 25(OH) vitamin D3 total level in ng/ml at week gestation (10-12), (24-26), and (34-36). The blood samples were performed by a Cobas 6000.
Results: There is a strong correlation between vitamin D deficiency with the occurrence of gestational diabetes with a cut-off value of ≤14.1 at (10-12) weeks gestation, sensitivity 100%, specificity 97.83%, NPV 100%, and PPV 93.3%. Conclusions: There is an inverse association of vitamin D status with gestational diabetes risk.
https://ejhm.journals.ekb.eg/article_180861_5ba9dfeaf3d755684402650979ccc04f.pdf
2021-07-01
2097
2102
10.21608/ejhm.2021.180861
plasma
Vitamin D
gestational diabetes mellitus (GDM)
Ali El Shabrawy
Ali
1
AUTHOR
Wael Sabry
Noseir
2
AUTHOR
Mohammed El-Hussiny
El-Kadosi
3
AUTHOR
Raouf Elmahdi Omar
Muftah
raoufelmahdi_86@yahoo.com
4
AUTHOR
ORIGINAL_ARTICLE
Evaluation of Serum Testosterone Level in Patients with Psoriasis and Its Correlation to Severity of the Disease
Background: Psoriasis is a chronic inflammatory, immune-mediated systemic disease with skin manifestations that typically follow a relapsing and remitting course. The most common form, plaque psoriasis, occurs in ∼80–90% of psoriatic patients. Objective: The aim of the current work was to evaluate level of serum testosterone in psoriasis male patients and its relation to severity of the disease.
Patients and methods: This cohort study included a total of 35 psoriatic patients, attending At Outpatient Clinic, Dermatology and Venereology Department, Zagazig University Hospital, Egypt. This study was conducted between January 2020 to October 2020. Serum free and total testosterone and total cholesterol were measured.
Result: About two thirds of the studied group (71.4 %) had normal testosterone level and (28.6 %) had low testosterone level.
Conclusion: Low serum total and free testosterone levels in male psoriasis patients are present and they correlate with disease severity.
https://ejhm.journals.ekb.eg/article_180864_7cda6fcf6e2a103d1a0bc304cccf0017.pdf
2021-07-01
2103
2107
10.21608/ejhm.2021.180864
Psoriasis
testosterone
PASI score
Amira Mohamed
Abdelmonem
dramiramohamed360@gmail.com
1
Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Enayat Mohamed
Atwa
2
Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Ayman El Sayed Ahmed
Yosef
3
Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Supraclavicular Versus Infraclavicular Brachial Plexus Block Using Two Different Techniques: Comparative Study
Background: A perfectly conducted regional anesthetic guided by ultrasound offers much to anesthesiologists.
Objective: This study was aimed to compare supraclavicular block with infraclavicular brachial plexus block for anesthesia in the forearm, hand surgery using two different methods: ultrasound alone or ultrasound together with a nerve stimulator. Patients and Methods: This prospective randomized study was performed on 80 adult patients, aged from 20 to 60 years, with ASA (American Society of Anesthesiology) physical status I and II. Patients were randomized in one of four groups: Supraclavicular block used Ultrasound (n =20), Supraclavicular block used ultrasound with nerve stimulator (n =20), Infraclavicular block used Ultrasound (n =20), Infraclavicular block used ultrasound with nerve stimulator (n =20). The local anesthetic solution used consisted of a 1:1 volume of 0.5 % bupivacaine and 2% lidocaine with 1:200.000 adrenaline. This solution was injected in a dose of 0.5 ml/kg to maximal 40 ml.
The Measured parameters were: Demographic values, the scanning time, the block performance time, the onset time, the degree of pain during block performance, evaluation of sensory and motor block, and complications.
Result: There were no significant differences between groups as regards all measured parameters. Conclusion: It could be concluded that the supraclavicular nerve block showed no significant difference from infraclavicular ultrasound-guided with or without nerve stimulator. It remains controversial whether the adding of the nerve stimulation to the ultrasound is more beneficial in ensuring rapid onset, longer duration of action, and avoiding complications.
https://ejhm.journals.ekb.eg/article_180865_7a45528de1b9c489eeacddcf34604221.pdf
2021-07-01
2108
2114
10.21608/ejhm.2021.180865
Supraclavicular
infraclavicular
brachial plexus
Ultrasound-guided
Nerve stimulator with Ultrasound
Areej Rashad Mohammad
Abdalziz
arig3000@yahoo.com
1
Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Samia Mohammad
Masoud
2
Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Ahmad Abd Elhakem
Balata
3
Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Mona Abd Elhamed
El Harrisi
4
Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Prevalence, risk factors and Impact of Post-transplant Tuberculosis on Live Donor Kidney Transplant Recipients: A Retrospective Study
Background: TB is encountered worldwide more frequently among renal transplant recipients than in the general population. It is reported to be nearly 50 times higher in the renal transplant population because of immunosuppression. TB may arise from unrecognized infection in the allograft or acquisition of new infection after transplantation. Objective: The aim of the current work was to determine prevalence and risk factors for development post-transplant TB, and the impact of post-transplant TB in live donor renal transplantation on both patient and graft survival. Patients and methods: This retrospective cohort study carried out in the Nephrology Unit, Mansoura Urology and Nephrology Centre in Association with Nephrology Unit, Zagazig University Hospitals in the period between January 2020 to December 2020. Included 210 patients out of 3200 kidney transplant recipients (KTRs) who underwent renal transplantation in the period between March 1976 and December 2019, divided into 2 main groups according to development of post-transplant tuberculosis, a group of 70 (KTRs) who developed tuberculosis after transplantation served as a study group and a matched group of 140 (KTRs) who did not develop tuberculosis after transplantation served as control group and evaluation of two groups through risk factor to develop TB, demographical data, clinical, laboratory and radiological evaluation. After that TB group was subdivided into 2 groups according to the site of infection: pulmonary and urinary TB. Results: Body mass index was higher among control group with statistically significant difference. Associated medical disorders as post-transplant diabetes, post-transplant bacterial and CMV infection had higher incidence among TB group. Liver enzymes and calcineurin (CNI) levels showed statistically significant difference among TB group before and during anti tuberculous treatment, in which liver enzymes were elevated while CNI levels were significantly reduced during antituberculous treatment. Post- transplant CMV infection was higher in patients who developed pulmonary TB. Graft and patient survival were comparable among both groups with no significant difference. Conclusions: It could be concluded that post-transplant diabetes, bacterial and CMV infections increase risk of development of post-transplant TB. There was no effect of post-transplant tuberculosis on both patient and graft survival.
https://ejhm.journals.ekb.eg/article_180867_c49c32eeede9d997e13bd6f1727e93d8.pdf
2021-07-01
2115
2123
10.21608/ejhm.2021.180867
Post transplant tuberculosis
Live donor
Kidney transplantation
said
Al-Barshomy
saidbarshomy@yahoo.com
1
internal medicine, zagazig university, egypt
AUTHOR
Samar
Elshahat
2
AUTHOR
Essam Elden Mahmoud
Lotfy
3
AUTHOR
Salwa Mahmoud
El Wasif
4
AUTHOR
ORIGINAL_ARTICLE
Plasma Concentrations of the Trace Elements Copper, Zinc, Lead and Selenium in Children with Autistic Spectrum Disorder at Zagazig University Hospitals
Background: Autistic spectrum disorder (ASD) has a multifactorial etiology involving interactions between genes, environment, and diet. Among the environmental factors that have received significant attention related to ASD are toxic metals, such as lead (Pb). Given the importance of zinc (Zn) and copper (Cu) metabolism for healthy neurological functioning and detoxification of heavy metals. Selenium (Se) is an essential trace element having a very narrow range between deficient, essential, and toxic doses. Objective: To evaluate the association between the level of serum Cu, Zn, Pb, and Se in children with ASD. Patients and Methods: Our case-control study was carried out in the psychiatric and neurology clinic, Pediatric Department, Zagazig University Hospital, during the period 2018 - 2019. It enrolled 42 children, (13 males and 8 females) with autism diagnosed by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) and the Childhood Autism Rating Scales (CARS) (with no other medical disease). The control group enrolled 21 apparently healthy children. Results: There was a statistically significant difference between the studied groups regarding the presence of plasma zinc and selenium (lower in the autistic group). There was a statistically significant difference between the studied groups regarding the presence of copper and plasma lead (higher in the autistic group). There was a statistically significant negative correlation between plasma selenium and lead level. Conclusion: Our results suggested an association between serum Cu, Zn, Pb, and Se in children with ASD.
https://ejhm.journals.ekb.eg/article_180870_87efd06c13b69806762cd84d1a0e5140.pdf
2021-07-01
2124
2129
10.21608/ejhm.2021.180870
trace elements
copper
zinc
Lead
selenium
Autistic Spectrum Disorder
Mohamed Mamdouh Abdelhamed
Gaafar
1
AUTHOR
Hatem Mohamed Elsayed
Hussein
2
AUTHOR
Seham Mahrous Zaki
Nasr
3
AUTHOR
Mohamed Talaat Mohamed Mohamed
Amer
mohamedtalat544@g.mail.com
4
LEAD_AUTHOR
ORIGINAL_ARTICLE
A Persistent left Superior Vena Cava: Case report
Background: Persistent left superior vena cava (PLSVC) is rare but important congenital vascular anomaly. It results when the left superior cardinal vein caudal to the innominate vein fails to regress. It is most commonly observed in isolation but can be associated with other cardiovascular abnormalities including atrial septal defect, bicuspid aortic valve, coarctation of aorta, coronary sinus ostial atresia, and cortriatriatum.
Objective: Aimof this case presentation was to describe a rare case of persistent left superior vena cava that is associated with atrial septal defect and partial anomalous pulmonary venous drainage. Also, how to suspect and then confirm the presence of PLSVC by echocardiographic examination, and to know the role of multi-slice CT and cardiac MRI for detection of other cardiac and extra-cardiac anomalies.
Patients and methods: Male patient aged 32 year complaining of shortness of breath for about 1 year, echocardiographic examination revealed dilated coronary sinus and injection of agitated saline indicated the presence of persistent left superior vena cava. PLSVC may be associated with other anomalies so further evaluation by multi-slice CT was done to confirm the diagnosis of PLSVC as well as sinus venosus ASD and partial anomalous pulmonary venous drainage so surgical consultation was done for surgical correction.
Conclusion: Diagnosis of PLSVC is important, as it is often associated with other anomalies as atrial septal defect and partial anomalous pulmonary venous drainage, which lead to pulmonary hypertension and need surgical correction before the occurrence of pulmonary hypertension.
https://ejhm.journals.ekb.eg/article_180873_80ca62e6c18f2d6b45a3483be63b19ae.pdf
2021-07-01
2130
2136
10.21608/ejhm.2021.180873
PLSVC
CT MRI
Ayman Elsayed
Elbadrany
aymanalbdrany@yahoo.com
1
Department of Cardiology, Faculty of Medicine, Mansoura University, Egypt
LEAD_AUTHOR
ORIGINAL_ARTICLE
Fixation of Displaced Midshaft Clavicular Fracture in Adult by Intramedullary Elastic Rod
Background: Intramedullary elastic rod fixation of midshaft clavicular fracture results in rapid free movement of the shoulder and an earlier return to daily activities than the conservative treatment. In comparison with plate fixation, the procedure is less invasive, with no loss of fracture haematoma, rapid union, and less infection. No major surgery for removal with less injury to surrounded neurovascular structures. A smaller incision is required with superior cosmesis. Objective: To study the short-term results of treatment of displaced fractures of the middle third of the clavicle using percutaneous elastic intramedullary nails
Patient and Methods: This prospective study was carried out on twenty patients with displaced fractures of the middle third of the clavicle presented to the Hospital and treated by percutaneous elastic intramedullary rod between November 2019 and May 2020.
Results: At the end of the follow-up period, the mean score was 89.70 ± 13.55 ranging from 48 to 100 according to the modified Constant and Murley shoulder score. Fourteen patients (70%) had excellent results, four patients (20%) had good results, one patient (5%) had a fair result, and one patient (5%) had a poor result.
Conclusion: Elastic stable intramedullary nailing (ESIN) is an image dependant procedure indicated best for young medically free patients with acute simple 2 part middle third clavicle fracture. Delay in surgery may necessitate open reduction. Hammering is not recommended to avoid dorsolateral cortex perforation.
https://ejhm.journals.ekb.eg/article_180874_730b65912bede8e44d0043916f7c7b9f.pdf
2021-07-01
2137
2143
10.21608/ejhm.2021.180874
Midshaft clavicular fracture
Elastic rod
Minimally invasive fixation
Abdelrhman Ebrahem
Kenan
dr_kenan47@gemail.com
1
LEAD_AUTHOR
Mahmoud Seddik
Hasan
2
AUTHOR
Mohamed Mosa Mohamed
Mahmoud
drmohamedmosa@yahoo.com
3
AUTHOR
ORIGINAL_ARTICLE
Effect of Following Guidelines on Pharmacological Managements in Adult Patients with Type 2 Diabetes on Glycemic Outcomes
Background: The prevalence of diabetes among hospitalized patients is high. One out of 4 hospitalized patients has diabetes; thus, treating hyper- or hypoglycemia represents an everyday challenge in hospitals worldwide.
Objective: This study aimed to assess the level of adherence to current American practice guidelines for inpatient pharmacologic management of type 2 diabetes and its effect on glycemic outcomes.
Patients and Methods: A prospective study was conducted in Internal Medicine Department, Faculty of Medicine, Zagazig University in the period from April 2020 to April 2021. It included 50 patients with type 2 diabetes who were treated with insulin and/or other antihyperglycemic drugs. They were followed up during their hospital stay for hyperglycemic and hypoglycemic episodes. Results: Mean capillary blood glucose measurement (CBGM) throughout three days were higher among Guideline adherence group than Guideline non-adherence group (12.6±1.04 vs. 5.2±1.3) with statistically significant difference p < 0.0001. In addition, 88.0% of Guideline adherence group CBGM was measured four times or more per day. The incidence of hyperglycemic reading (12.0% in Guideline adherence group and 36.0% in Guideline non- adherence group) showed statistically significant difference p= 0.047. Conclusions: There is a good level of adherence to the current American guidelines for inpatient management of type 2 diabetes. The level of adherence is greater with more training and clinical seniority.
https://ejhm.journals.ekb.eg/article_180955_5e1334e4f5a55d537d176c60d268d51a.pdf
2021-07-01
2144
2148
10.21608/ejhm.2021.180955
Diabetes mellitus
Glycemic
guidelines
Type 2 Diabetes
Hamed Abdelaziz
Deraz
1
AUTHOR
Nagwa Mohamed
Shawky
2
AUTHOR
Ahmed Salah
Al Allam
3
AUTHOR
Reem Saad
Abujnah
reem18634@gmail.com
4
LEAD_AUTHOR
ORIGINAL_ARTICLE
Olecranon Apophyseal Fracture and Radial Neck Fracture in a Patient without Osteogenesis Imperfecta: A Case Report
Background: Olecranon apophyseal fractures in children are uncommon. The bulk of these injuries are nondisplaced and therefore can be treated nonoperatively.
Objective: To study the outcome of open reduction and internal fixation of olecranon fracture.
Patients and methods: Our case report of a 9 years old girl who sustained left elbow trauma after falling directly over the elbow. Attended the outpatient clinic of the Department of Orthopedic Surgery, Alnoor Specialist Hospital, Makkah, Saudi Arabia, radiographs showed olecranon and radial neck fractures, olecranon fracture was displaced so we fix it with K-wire and tension band, while the radial neck fracture was treated conservatively.
Results: At the 12 weeks follow-up, she achieved a complete range of motion of the left elbow with good functional outcomes and with no complications. The goal in such complex fractures is to achieve a stable congruent joint with gradual rehabilitation to reach a good functional outcome.
Conclusion: open reduction and internal fixation of the olecranon fracture is the optimal treatment to achieve a complete range of motion and good functional outcome.
https://ejhm.journals.ekb.eg/article_180956_78a68fb4a0bedff9bb439b7c3baa6f6b.pdf
2021-07-01
2149
2152
10.21608/ejhm.2021.180956
Olecranon
Radial neck
Elbow injury
Abdullah A
Alshamrani
dr.a.alshamrani2016@gmail.com
1
Department of Orthopedic Surgery, King Abdulaziz Hospital, Makkah, Saudi Arabia
AUTHOR
ORIGINAL_ARTICLE
Minimizing Myocardial Ischemic Injury by Cool Dialysate in Maintenance Hemodialysis Patients: A Randomized Controlled Trial
Background: Emerging evidence supports a cardiovascular protective role of Cooled Dialysis (CD) in incident Hemodialysis (HD) patients. Whether this benefit can be extended to maintenance HD patients remains to be established.
Objective: The aim of the present study was to assess the impact of CD by lowering Dialysate temperature (dt) 0.5oC below Core Body Temperature (CBT), on minimizing myocardial ischemia in maintenance HD patients (>1 year on HD).
Patients and Methods: from March 2019 to January 2021, we randomized one hundred maintenance HD patients to receive either Cooled Dialysis (dt - 0.5oC below CBT, intervention) or Standard Dialysis (dt= CBT, control) for 12 months. Over the study period, serial measurements of ECG, echocardiography, and myocardial enzymes (CK-MB and Troponin-T) were performed for the whole study population as surrogates for myocardial ischemic injury.
Results: By the end of 12-months, compared to Standard Dialysis (ST) patients, Cooled Dialysis (CD) patients had overall less incidence of new myocardial ischemia (composite surrogate outcomes: ECG, Echo and CK-MB) (p=0.032). In logistic regression analysis, CD was found to be independently protective against myocardial ischemia (OR 0.54, p-value 0.033, CI: 0.3-0.95). Conclusion: In maintenance HD patients, Cooled Dialysis might help decrease myocardial ischemia with a reasonable safety profile. Further studies are warranted to explore these findings.
https://ejhm.journals.ekb.eg/article_180957_a8038184ca0618b5b7723db17f5c792c.pdf
2021-07-01
2153
2164
10.21608/ejhm.2021.180957
Core Body Temperature (CBT)
Cooled dialysate (CD)
Dialysate Temperature (dt)
hemodialysis (HD)
Ischemia-Reperfusion Injury (IRI)
Heba Ahmed M.
Mokhtar
1
AUTHOR
Reda
Biomy
2
AUTHOR
Saddam
Hassan
saddam.ahmed@fmed.bu.edu.eg
3
9, Saad Zaghloul, Kasr Alaini
LEAD_AUTHOR
ORIGINAL_ARTICLE
Monogenic Diabetes, Case Series from Four Arab Countries
Background: Monogenic diabetes results from the inheritance of a mutation in a single gene. It may be dominantly or recessively inherited or may be de novo. Patients and Methods: Five cases were described in a single center in Jeddah, all were products of first cousin marriage. Three infants aged 2-3 months, including two siblings from Egypt and one from Saudi Arabia were found to have diabetes after hospital admission for gastroenteritis. The fourth case (Yemeni) was admitted with anemia and failure to thrive, picked up during routine clinic visit at the age of four months, hyperglycemia was detected during routine hospital workup. The fifth case is a four years old Jordanian child with accidental finding of hyperglycemia during routine workup during admission for pneumonia, with history of gestational diabetes and an affected grandparent. All patients, but the fifth, was started on insulin after collecting samples from patients and parents for molecular genetic testing. Results: The first three patients were diagnosed with Wolcott Rallison, having mis-sense mutation of EIF2AK3 and all expired by almost the age of 6-7 months. Thiamine responsive megaloblastic anemia was confirmed with homozygous SLC19A2 mutation in the Yemeni patient. Last child showed typical profile of fasting hyperglycemia and with the typical family history, was diagnosed on clinical basis as Glucokinase MODY. Conclusion: Awareness with different forms of monogenic diabetes is essential for early diagnosis, especially in countries with high rates of consanguineous marriage. Genetic diagnosis is also mandatory in management, especially in the first
https://ejhm.journals.ekb.eg/article_180958_169a1f089f412270b5385ccc54650630.pdf
2021-07-01
2165
2167
10.21608/ejhm.2021.180958
Glucokinase
Monogenic diabetes
Neonatal diabetes
Wolcott Rallison
Khadiga
Eltonbary
khadigadoc@yahoo.com
1
Pediatric department, Faculty of Medicine, Ain Shams University
LEAD_AUTHOR
ORIGINAL_ARTICLE
Spinal Hemangioma in Pregnancy: A Case Report
Background: Hemangiomas of bone are localized benign tumors composed of fully developed adult blood vessels. Vertebral hemangiomas are present without symptoms in approximately 10% of the population and more common in females. It is usually located in the lower thoracic and lumbar vertebra and are often multifocal. Infrequently these benign lesions may cause local or radicular pain and neurological deficits ranging from myeloradiculopathy to paralysis.
The physiological vascular, hemodynamic and hormonal changes in pregnancy act to enlarge a preexisting hemangioma and most of these changes peak in the third trimester. The most important contributing factor is the increase in venous pressure resulting from mechanical obstruction of blood flow from the paravertebral veins into the inferior vena cava by the gravid uterus.
Objective: To study the outcome of management of a case of spinal hemangioma during pregnancy.
Case report: A 26-years-old pregnant female patient attended the Department of Orthopedic Surgery at the International Medical Center Hospital, Jeddah, Saudi Arabia, suffering from a severe lower limb paresis and loss of sphincteric control and diagnosed with spinal hemangioma. An intervention was done during pregnancy to prevent further complications by decompressing the spinal cord. Post-delivery, the main surgery was performed to prevent the recurrence.
Conclusion: The management of spinal hemangiomas in pregnant women can be done in the following two steps. The First step is short-timed, less bloody intervention to decompress the mass to prevent further damage and complications. The second step is to perform the main surgery post-delivery when the condition permits.
https://ejhm.journals.ekb.eg/article_180959_4fc1918d85b54f8a03dde41502958641.pdf
2021-07-01
2168
2172
10.21608/ejhm.2021.180959
Hemangiomas
spinal
vertebroplasty
Ibrahim Abdullah
Masoudi
dr.imsoudy@gmail.com
1
Department of Orthopedic Surgery, International Medical Center Hospital, Jeddah, Saudi Arabia
LEAD_AUTHOR
Fared Nicholas
Kassab
2
Department of Orthopedic Surgery, International Medical Center Hospital, Jeddah, Saudi Arabia
AUTHOR
ORIGINAL_ARTICLE
Huge Post-Partum Intra-Myometrial Hematoma (Couvelaire Uterus) in A Preserved Uterus in A Case of Placenta Accreta: Case Report
Background: Couvelaire uterus, also known as uteroplacental apoplexy, is a rare but nonfatal condition resulting from extravasation of blood into the uterine musculature and surrounding tissues.
Objective: presentation of a case of huge intramyometrial hematoma (Couvelaire uterus) developed postpartum in a preserved uterus in a case of placenta previa accreta, which is atypical presentation in such cases.
Case Report: 29 years old female patient 38 weeks pregnancy. Pregnancy was terminated by CS due to placenta previa cenralis accreta. During CS, preservation of the uterus was done by application of multiple haphazard haemostatic sutures and bilateral uterine artery ligation. The patient presented by post-partum collapse. Ultrasonographic examination revealed huge intramyometrial hematoma (Cauvlair uterus). Exploration was done with confirmation of the ultrasonographic picture. Subtotal abdominal hysterectomy was done with preservation of both ovaries with uneventful post portative period. Examination revealed huge intramyometrial hematoma (Cauvlair uterus).
Conclusion: Post-partum intramyometrial hematoma (Couvelaire uterus) is atypical presentation in cases of preserved uterus in patients with placenta accreta and it may result from multiple haphazard unorganized haemostatic sutures. Therefore, the obstetricians should be aware of such rare complication for early diagnosis and management.
https://ejhm.journals.ekb.eg/article_180960_c23b09c6b3338aa39a3c17758c87763a.pdf
2021-07-01
2173
2175
10.21608/ejhm.2021.180960
Huge post-partum intramyometrial hematoma
Couvelaire uterus
Preserved uterus
Placenta accrete
Ahmed A.
Khalifa
ahmed.khalifa@med.sohag.edu.eg
1
LEAD_AUTHOR
Elsemary
M.A
2
AUTHOR
Mahmoud Mousa
Ahmed
3
AUTHOR
Mariam M.
Elshamandy
4
AUTHOR
ORIGINAL_ARTICLE
Split Tibialis Anterior Transfer for Correction of Residual Dynamic Metatarsus Adductus Following Ponseti Management of Idiopathic Clubfoot
Background: Clubfoot represents one of the most common congenital orthopedic deformities. It affects 1-2/1000 live births all over the world. Cases of dynamic and severe deformity represent a challenging problem. This is because the conservative management is not effective as well as the surgical options are little.
Objective: Aim of the present study was to evaluate the better management of split tibialis anterior tendon transfer in the treatment of residual clubfoot.
Patients and methods: Eighteen cases (22 feet) with residual dynamic supination deformity following previous Ponseti management underwent split transfer of the anterior tibial tendon. This was a prospective study between March 2020 and February 2021, the cases were collected and the study was carried out at Zagazig University Hospitals.
Results: In our study, the mean age was 41.05 months (ranged from 30 to 59 months). Out of the 18 patients, there were 12 males and 6 females. Four cases (22.2%) were bilaterally affected. While 14 patients (77.8%) were one-side affected (5 left foot affected and 9 right foot affected). Our results showed marked improvement of patients according to Garceau and Palmer’s criteria as the mean pre-operative assessment was 2.5 reaching 3.28 post-operatively. 14 patients (88.9%) were either poor or fair and no single patient was excellent pre-operatively, while postoperatively all patients became either excellent mostly or good.
Conclusion: Anterior tibial tendon transfer is a reasonable method of achieving the objective, either fully or split transfer because both operations have excellent results with low rate of major complications. It's very simple but yet very effective soft-tissue procedure to correct the muscle imbalance of the foot.
https://ejhm.journals.ekb.eg/article_180962_86df4b37f7e97601f74e755e5c36c37a.pdf
2021-07-01
2176
2179
10.21608/ejhm.2021.180962
Split tibialis anterior transfer
Residual dynamic metatarsus adductus
Ponseti management
Idiopathic clubfoot
Emhemmed Faraj Emmhemed
Aboubreeg
emhemmed.faraj@gmail.com
1
Department of Orthopedic Surgery, Faculty of Medicine, Zagazig University, Egypt
LEAD_AUTHOR
Hosam Mohammed Khairy Tawfik
Omar
2
Department of Orthopedic Surgery, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Mohammed AbdElAziz
Gaith
3
Department of Orthopedic Surgery, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Yamen Safwat
AbdElDayem
4
Department of Orthopedic Surgery, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Blunt Chest Trauma; Differences Between Children and Adult in Menoufia University Emergency Hospital
Background: Trauma is a leading cause of mortality globally. Thoracic trauma is a significant cause of morbidity and mortality in both children and adult.
Objective: To compare between children and adult after exposure to a blunt chest trauma according to incidence, mechanism of injury, effect of trauma on lung, pleura and ribs and in hospital mortality rate.
Patients and methods: A prospective, comparative study included patients with blunt chest trauma attending to the Emergency Department, Menoufia University during the period from November 2019 to April 2020.
Results: The outcomes of the study were in the form of incidence, mechanisms of injury, effect of trauma on lung, pleura and ribs and hospital mortality rate in adult and children. There was difference in incidence in studied groups as adult has higher incidence, according to mechanism of injury, motor traffic accident was the main cause of trauma in both groups. Pulmonary contusion was the most common chest injury in both groups but more in children (71%) than in adult (66.7%), chest wall fracture was more in adult (33.3%) than in children (7.1%) and pneumothorax was more in adult (27.3%) than in children (7.1%) exactly as hemothorax. Mortality was observed mainly in adult group (36.4%), while it was (21.4%) in pediatric group.
Conclusion: There were differences between children and adult exposed to blunt chest trauma in incidence, effect of trauma on lung, pleura and ribs, and in mortality
https://ejhm.journals.ekb.eg/article_180964_d0b711d7e71b0d797d0830f2e1df1cf3.pdf
2021-07-01
2180
2183
10.21608/ejhm.2021.180964
Chest Trauma
emergency department
outcomes
blunt
Adult
children
Heba Magdy Ahmed
Ghanima
dhebamagdy@gmail.com
1
LEAD_AUTHOR
Yahia Mohammed
Al khateep
2
AUTHOR
Mahmoud Magdy
AL Abassy
3
AUTHOR
Mohammed Ahmed
El-Hag-Aly
4
AUTHOR
ORIGINAL_ARTICLE
Outcomes of Complete Atrioventricular Septal Defect Surgical Repair in Down Patients
Background: Atrioventricular septal defect (AVSD) is commonly associated with chromosomal abnormalities, especially trisomy 21 or Down syndrome (DS). Surgical repair of complete AVSD (CAVSD) is a complex procedure that carries risks of postoperative morbidity and mortality.
Objective: To evaluate the surgical outcomes and to identify the risk factors for hospital mortality and reoperation after repair of CAVSD in DS patients.
Patients and Methods: This retrospective cohort study included 65 consecutive DS patients who underwent surgical correction for the complete form of AVSD with or without associated congenital heart diseases during the period from 1st January 2014 to the end of June 2020. Patients with associated other major cardiac anomalies were excluded.
Results: In-hospital mortality was documented in 3 (4.6%) patients, whereas 4 (6.2%) patients needed second unplanned operation for valve/shunt correction. Heart block that needed permanent pacemaker insertion was recorded in 3 (4.6%) patients. In-hospital mortality was significantly associated with prolonged cardiopulmonary bypass (CPB) time (p = 0.008) and the development of renal dysfunction that required dialysis or sepsis (p = 0.004). We found a significant association between the need for second unplanned operation and type A CAVSD (p = 0.041) and the presence of preoperative moderate/severe atrioventricular (AV) valve regurgitation as detected in the transesophageal echocardiography (TEE) (p=0.035).
Conclusions: In view of the incidence of the hospital mortality, reoperation, and other postoperative morbidities, we suggest that our outcomes are accepted for surgical repair of CAVSD in DS patients. The CPB time and the development of renal dysfunction that required dialysis and sepsis during the ICU care significantly contributed to the hospital mortality.
https://ejhm.journals.ekb.eg/article_180966_749ca6fce368cd0132582268d83c3ef4.pdf
2021-07-01
2184
2191
10.21608/ejhm.2021.180966
Atrioventricular septal defect
Down syndrome
hospital mortality
outcomes
Reoperation
Rafik
Soliman
rafikfekry@hotmail.com
1
Cardiothoracic Surgery department, Faculty of medicine, Menoufia University
LEAD_AUTHOR
Ayman R.
Abdelrehim
2
AUTHOR
Abdulhamid
Alnajjar
najjra@mcc.med.sa
3
AUTHOR
Syed Aitizaz
FRCS
4
AUTHOR
ORIGINAL_ARTICLE
Early Results of Surgical Treatment of Intra-Articular Calcaneal Fractures Using T-Shaped Plates
Background: Displaced intra-articular calcaneus fractures are still now a controversial topic among orthopedic surgeons. There is no single treatment option to manage all different fractures. Objective: The aim of this study was the assessment and evaluation of providing and maintaining stable fixation by the use of a T-shaped plate for displaced intra-articular calcaneal fractures. Patients and Methods: A randomized controlled study was conducted on18 patients were conducted between the ages of 18 to 50 years in the Orthopedic and Traumatology Department of Zagazig University Hospital from August 2020 to April 2021 including 6 months follow-up periods, all patients with closed D.I.A.C.F with no morbidity. T plates were the method of fixation for all patients.
Results:Mean A.O.F.A.S. hindfoot scale result was 86.61, 88.8% of patients their results were satisfying (excellent and good), and 11.1% of patients their results were unsatisfying (fair). Complications were seen in 27.7% (wound complication, subtalar arthritis, symptomatic hardware, and delayed union).
Conclusion: T-shaped plates can provide stable support and rigid fixation as they maintain proper reduction and alignment to displaced intra-articular calcaneus fractures.
https://ejhm.journals.ekb.eg/article_180967_1ff0fa9563aee099151f20bab7f3acd1.pdf
2021-07-01
2192
2197
10.21608/ejhm.2021.180967
surgical
Calcaneus fracture
T-Shaped Plates
Ahmed Abdulmunem Husayn
Layyas
layas.ahmed87@gmail.com
1
Department of Orthopedic, Faculty of Medicine, Zagazig University, Sharkia, Egypt
LEAD_AUTHOR
Mohsen Mohamed
Abdo Mar&#;e&#;i
2
Department of Orthopedic, Faculty of Medicine, Zagazig University, Sharkia, Egypt
AUTHOR
Reda Hussien
Elkady,
3
Department of Orthopedic, Faculty of Medicine, Zagazig University, Sharkia, Egypt
AUTHOR
Mohamed Abd Elaziz Mohamed
Ghieth
4
Department of Orthopedic, Faculty of Medicine, Zagazig University, Sharkia, Egypt
AUTHOR
ORIGINAL_ARTICLE
Study of Latent Tuberculosis among Type 1 Diabetic Children in Zagazig University Pediatric Hospital
Background: In certain places, tuberculosis (TB) and diabetes mellitus (DM) are strongly linked as frequent comorbidities and might be termed epidemics combined. Objective: The present work aimed to detect relationship between type 1 DM (T1DM) and latent TB. Patients and Methods: This comparative cross-sectional study was conducted over the period from October 2019 to October 2020. It included 81 cases had type 1 DM and 81 healthy children as control group. This study was conducted at Zagazig University Pediatric Hospital. All patients were subjected to the following: Full history taking, full general examination, and investigation (Tuberculin test and chest X ray). Results: In the current study, 42% were male and (58%) were female. In the present work, there was no statistically significant difference between cases group and controls group regarding anthropometric measurements. This study showed that, the percentage of positive tuberculin test was higher among cases group than controls group (32.1%, 7.4%) p value< 0.001. OR estimate for DM on risk of TB was 5.9 (95% CI 2.27 to 15.33). Conclusion: There was no statistically significant difference between diabetic group and control group regarding sex, age, weight, and height. There was no statistically significant difference between diabetic and control group regarding contact with patient with TB and passive smoking. The percentage of positive tuberculin test was higher among diabetic group than control group.
https://ejhm.journals.ekb.eg/article_180970_5b02b9bcf592b14b3c3690b4aeea7ef1.pdf
2021-07-01
2198
2202
10.21608/ejhm.2021.180970
Diabetes mellitus
tuberculosis
Type 1 Diabetic Children
Naglaa Fathy Abd Elrazik
Ibrahim
doc.naglaafathy33@gmail.com
1
AUTHOR
Saad Ahmed
Mansour
2
AUTHOR
Ehab Abd Elhamid
Abd Elsalam
3
AUTHOR
Rehab Ahmed
Rabie
4
AUTHOR
ORIGINAL_ARTICLE
Measurement of Serum Lipid Level in Children with Congenital Heart Diseases
Background: The lipid profile is an important and independent predictor of coronary heart disease is. This process relates to cholesterol concentration, accumulation and deposition of lipids on the arterial wall.
Objective: The aim of this study was the measurement of serum lipid profile (cholesterol, triglycerides, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) in children with congenital heart diseases and to compare the results with those of healthy children. Patients and methods: This case-control study was carried out from July 2020 to December 2020 in Cardiology Unit of Pediatric Department Outpatient Clinic, Zagazig University Hospital on 44 children. Patients were divided into: Group (I): (Case group) included 22 children with congenital heart diseases, and Group (II) (control group) included 22 healthy children.All patients were subjected to dimensional transthoracic echocardiography with color flow Doppler (Vivid 7 dimension apparatus) and Laboratory investigations (total cholesterol, triglycerides, low-density lipoprotein (LDL), high-density lipoprotein (HDL). Results: The most frequent cardiac defect was ASD (22.7%) followed by VSD (13.6%), common A-V canal (9.1%), mitral regurgitation (9.1%), pulmonary regurgitation (9.1%), and PDA (9.1%). 18.2% of the studied patients had cyanotic congenital heart disease (CHD) and 81.8% had non-cyanotic CHD. There was statistically significant differences between the studied groups in lipid profile as case group had higher cholesterol, triglyceride, LDL and lower HDL than control group. Conclusion: We concluded in this study that patients had significantly higher serum lipid levels than age and sex-matched controls in light of these findings.
https://ejhm.journals.ekb.eg/article_180972_6ff78caa6d05efad4c71267af971cc00.pdf
2021-07-01
2203
2207
10.21608/ejhm.2021.180972
Congenital heart disease
lipids
dyslipidemia
Abdulmonam Almokhtar Embark
Omar
1
LEAD_AUTHOR
Amr Megahed
Abouelnaga
2
AUTHOR
Amal Mohamed
Abd El Latef
3
AUTHOR
, Samar Mahmoud Abdelhalim
Sharaf
4
AUTHOR
ORIGINAL_ARTICLE
Effect of Diclofenac Versus Misoprostol on Pain Perception during Intrauterine Contraceptive Device Insertion
Background: The intrauterine device (IUD) is one of the most contraceptive methods with highly effective and safe use. However, insertion through a narrow cervix may be technically difficult and painful.
Objective: This study was performed to compare the effect of vaginal misoprostol and intramuscular diclofenac sodium in decreasing pain and facilitating IUCD insertion.
Patients and Methods: A randomized double-blind controlled trial in Zagazig University Hospital during the period from December 2019 to November 2020. It included sixty-four women who want to insert an IUD. They were classified into four groups on a randomized basis, the first group received two tablets (400 mcg) of misoprostol in the posterior fornix of the vagina 2 hours before IUD insertion and the second group received diclofenac sodium 75 mg ampule intramuscular 2 hours before IUD insertion. The third group received two tablets (400 mcg) of misoprostol in the posterior fornix of the vagina and diclofenac sodium 75 mg ampule intramuscular 2 hours before IUD insertion while the fourth group received placebo. Pain during insertion and difficulty in IUCD insertion were evaluated.
Results: Misoprostol significantly facilitated the insertion of IUD insertion whereas diclofenac sodium lowered the average pain score for all steps of IUD insertion. Side effects were higher in the misoprostol group.
Conclusion: 400 mcg of vaginal misoprostol 2 hours before IUD insertion facilitates the introduction and IM injection of 75 mg diclofenac sodium 2 hours before IUD insertion reduced the pain perception.
https://ejhm.journals.ekb.eg/article_181210_4979c239a0478aa4de5472ba072b080d.pdf
2021-07-01
2208
2212
10.21608/ejhm.2021.181210
IUD
Cervical stenosis
misoprostol
diclofenac sodium
Alaa Ibrahim Mohamed
Nugud
alaaibrahim11690@gmail.com
1
Department of Obstetrics and Gynecology, Faculty of Medicine, Zagazig University, Sharkia, Egypt
LEAD_AUTHOR
Manal Mohamed Mahmoud
Beheiry
2
Department of Obstetrics and Gynecology, Faculty of Medicine, Zagazig University, Sharkia, Egypt
AUTHOR
Hala Elsayed Mohamed
Mowafy
3
Department of Obstetrics and Gynecology, Faculty of Medicine, Zagazig University, Sharkia, Egypt
AUTHOR
Safaa Abdelsalam Ibrahim
Khalil
4
Department of Obstetrics and Gynecology, Faculty of Medicine, Zagazig University, Sharkia, Egypt
AUTHOR
ORIGINAL_ARTICLE
Surgical Treatment of Giant Cell Tumor in Proximal End of Tibia by Curettage and Bone Cement
Background: A giant cell tumor of bone (GCTB) is a primary bone tumor with potential invasion, local recurrence, and low probability of distant metastasis. Surgical treatment stills the most effective treatment for this kind of tumor. The surgery often involves defect reconstruction following tumor removal.
Objective: Aim of the current work was to evaluate the results of surgical treatment of giant cell tumor in proximal end of tibia by curettage and bone cement.
Patients and methods: This study included a total of eighteen adult patients with giant cell tumor of proximal end of tibia, attending at Department of Orthopedic, Zagazig University Hospitals. Patients were treated by curettage and bone cement. This study was conducted between January 2020 to March 2021.
Results: In this study the age was (30.39±6.4) years ranged from 22 to 41 years, half of the group (50.0%) had age less than 28 years and the other half were equal or more than 28 years. Two thirds (66.7%) of the studied group were females and one third (33.3%) of them were males(2:1). Concerning campanacci radiological grading of lesion; most of the studied group (83.3%) had campanacci grade I and grade II (16.7%). The functional outcome by the musculoskeletal tumor society functional scoring system (MSTS) in the present study revealed that two thirds (66.7%) of the studied group didn’t have pain and only (33.3%) of them had intermediate pain.
Conclusion: It could be concluded that patients with GCT of the bone at the proximal end of tibia can be treated satisfactorily with curettage and bone cement packing with lower recurrence rate. Better MSTS functional results were also observed after extended curettage and bone cement.
https://ejhm.journals.ekb.eg/article_181211_f4c325d68f8afa27cbb4133f0464df5f.pdf
2021-07-01
2213
2218
10.21608/ejhm.2021.181211
surgical treatment
Giant Cell Tumor
Tibia by Curettage and Bone Cement
Elsayed Eletawy
Soudy
1
Department of Orthopedic Surgery, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Mohsen Fawzy
Omar
2
Department of Orthopedic Surgery, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Mohammed Basheer Tahir
Wail
mohammedwali2886@gmail.com
3
Department of Orthopedic Surgery, Faculty of Medicine, Zagazig University, Egypt
LEAD_AUTHOR
Mohamed Ismael Abd-Elrhman
Kotb
4
Department of Orthopedic Surgery, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Effect of Muscle Energy Technique Versus Aerobic Exercise on Chronic Cyclic Pelvic Pain
Background: Chronic cyclic pelvic pain is cyclic pain located in the pelvis and the lower abdominal area, persisting for 6 months or more with no obvious pathological cause for their pain and severe enough to interfere with daily activities. Objective: This study was conducted to compare the effect of aerobic exercise versus the effect of muscle energy technique on chronic cyclic pelvic pain.
Patients and Methods: 30 women complaining of increased pelvic pain of unknown cause lasts more than 6 months diagnosed and referred by their gynecologist. They were divided into two equal groups, Group (A) received muscle energy technique; and Group (B) received aerobic exercise. Both groups were assessed before and after the treatment period (8 weeks) for pain degree by visual analog scale (VAS) and assessment of premenstrual, menstrual, and intermenstrual symptoms by menstrual distress questionnaire scale (MDQ).
Results: The results of this study revealed that there was a significant decrease in VAS and MDQ values post-treatment in both groups (A and B) compared with that pretreatment values, when comparing both groups there was a more significant decrease in the post-treatment values of VAS and MDQ of the group (A) compared with that of the group (B). Conclusion: It can be concluded that both muscle energy technique and aerobic exercise will improve chronic cyclic pelvic pain but muscle energy technique resulted in better improvement as compared to aerobic exercise on chronic cyclic pelvic pain.
https://ejhm.journals.ekb.eg/article_181212_79a4d61b2a73fdcca6c8f5919029c273.pdf
2021-07-01
2219
2225
10.21608/ejhm.2021.181212
Muscle energy technique
Aerobic exercises
Pelvic pain
Khadyga Sayed
Abdul Aziz
1
AUTHOR
Hala EL Sayed Mohammad
Mowafy
2
AUTHOR
Marwa Esmael
Hasanin
3
AUTHOR
Noran Hany Hassan Mahmoud
Ghazal
noranghazalrr@gmail.com
4
LEAD_AUTHOR
ORIGINAL_ARTICLE
Urinary Neutrophil Gelatinase-associated Lipocalin: As an Early Marker for Diabetic Nephropathy
Background: Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Diagnostic marker to detect diabetic nephropathy at early stage is important as early intervention can slow the loss of kidney function and reduce adverse outcomes. Neutrophil gelatinase-associated lipocalin (NGAL) is a small (25-kd) protein that belongs to the lipocalin protein family. Urinary NGAL (u-NGAL) levels have been demonstrated to be a very promising marker especially in acute kidney disease.
Objective: To measure urinary neutrophil gelatinase-associated lipocalin (NGAL) as an early marker for diagnosis of diabetic nephropathy in type 2 diabetes mellitus (T2DM) patients.
Patients and Methods: The study was conducted on 84 subjects, from (18- 80 years old), 45 (53.5%) were males and 39 (46.4%) were females, with mean age (58.18 ± 13.98). They were collected from Endocrinology and Nephrology Clinic after a written consent was taken from the patients at Zagazig University Hospital.
Results: Urinary NGAL is higher in diabetic patients compared with non-diabetic controls with high significant difference (p < 0.0001). In our result we found a positive correlation between NGAL and the duration of DM (r =0.279, p=0.027). There was a positive correlation between NGAL level and HbA1C, with significant difference (r =0.778, p =0.000) in patients groups. Our results showed a positive correlation between NGAL and FPG (r= 0.562) (p < 0.001) and 2hPPPG (r=0.687) (p < 0.001). There was a positive correlation between NGAL level and albumin-creatinine ratio (Alb/Cr) with significant difference (r =0.888, p < 0.001) in patients groups.
Conclusion: There was a high significant difference in the level of urinary NGAL in diabetic patients than control subjects. Urine NGAL had a positive correlation with albumin-creatinine ratio, duration of DM, HbA1c.
https://ejhm.journals.ekb.eg/article_181214_d78de399cb5e9a36ca9535c50cd1eb0a.pdf
2021-07-01
2226
2230
10.21608/ejhm.2021.181214
Associated Lipocalin
Neutrophil Gelatinase
T2DM
Diagnosis
Hoda Gouda
Bakr
1
AUTHOR
Khaled Ahmed
Elbana
2
AUTHOR
Abeer Abd Alla
Fekry
3
AUTHOR
Mahmoud Samir
Elkot
doctorelkot1988@gmail.com
4
LEAD_AUTHOR
ORIGINAL_ARTICLE
Association between Neutrophil-To-Lymphocyte and Platelet-To-Lymphocyte Ratios with Chronic Allograft Nephropathy
Background: In several diseases, both neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are reliable indicators of chronic inflammation. Endothelial dysfunction is widely distributed in renal transplant patients and is caused by inflammation and can lead to the malfunction of the graft. Objective: To detect the correlations of NLR and PLR with chronic allograft nephropathy (CAN) in recipients of kidney transplants and determine the cutoff values for the prediction of CAN. Patients and Methods: 68 kidney transplant recipients shared in the study between January 2017 and December 2019. They were two groups. Group 1 (44 subjects) had estimated glomerular filtration rate (eGFR) ≥ 60 ml/m/1.73 m2 and group 2 (24 subjects) had eGFR less than 60 ml/m/1.73 m2. Results: The two groups had similar age and sex distributions. eGFR was shown to be adversely linked to NLR and PLR. The optimal cutoff level of NLR for predicting chronic allograft nephropathy was ≥1.58 and the optimal cutoff level of PLR was ≥109.13. Conclusion: Significant correlations were detected between kidney function tests and each of NLR and PLR. PLR is a more sensitive inflammatory marker to predict chronic allograft nephropathy than NLR with a sensitivity of 83.33 % versus 66.67 %.
https://ejhm.journals.ekb.eg/article_181215_ee090ee192afc8b01e70113ec67594a4.pdf
2021-07-01
2231
2236
10.21608/ejhm.2021.181215
Glomerular Filtration Rate
Graft rejection
Inflammation
Kidney transplantation
Walid Ahmed Ragab
Abdelhamid
1
Internal Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
LEAD_AUTHOR
ORIGINAL_ARTICLE
Effect of Pulmonary Artery Venting in Patients Having Elevated Pulmonary Artery Pressure Undergoing Mitral Valve Surgery, Comparative Study
Background: Despite being controversial, left ventricular venting is still used to facilitate valvular heart surgeries and prevent distention. The classic way to vent the left ventricle is via the right superior pulmonary vein, which has many reported complications.
Objective: We aimed to evaluate the effectiveness of pulmonary artery venting in patients undergoing mitral valve surgery who have elevated pulmonary artery pressure.
Patients and Methods: 100 patients undergoing isolated mitral valve replacement, and having elevated pulmonary artery pressure were recruited in Cairo University Hospitals. They were divided into 2 groups; group 1 had pulmonary artery venting, and group 2 had no plmonary artery venting. Both groups were compared for preoperative, operative and postoperative variables.
Results: Patients were divided into 2 groups; group 1 comprised 51 patients and had pulmonary artery venting, and group 2 comprised 49 patients and had no pulmonary artery venting. Both groups had similar preoperative characteristics, with group 1 having 14 minutes shorter cross clamping time (p value = 0.001), and 0.6 days shorter ICU stay (p value = 0.002), mean hospital stay was 6.4 ± 1.7 in group 1 and 8.7 ± 2.2 in group 2 (p value = 0.001).
Conclusion: Using pulmonary artery venting during open heart surgery for mitral valve replacement, in patients with elevated pulmonary artery pressure is beneficial, facilitates the surgical procedure, and is associated with shorter ICU and hospital stay.
https://ejhm.journals.ekb.eg/article_181216_249b72eed54e93f24906833f9d876770.pdf
2021-07-01
2237
2241
10.21608/ejhm.2021.181216
Mitral valve replacement
Left ventricular venting
ICU stay
surgical outcome
Elevated pulmonar
Ahmed M.
Elwakeel
aelwakeel@kasralainy.edu.eg
1
LEAD_AUTHOR
Sherif
Nasr
2
AUTHOR
Mahmoud
El-wakeel
3
AUTHOR
Ahmed
Asfour
4
AUTHOR
Ihab
Elsharkawy
5
AUTHOR
ORIGINAL_ARTICLE
Value of Serum Copeptin Estimation for the Diagnosis of Diabetic Nephropathy in Type 2 Diabetes Mellitus Patients
Background: Serum copeptin, the terminal part of the arginine vasopressin (AVP), is stable in plasma. The AVP is increased in diabetic patients and may play a role in the development of diabetic kidney disease.
Objective: To evaluate the role of serum copeptin in the diagnosis of diabetic nephropathy in type-2 diabetes mellitus.
Patients and Methods: 40 type-2 diabetes mellitus (T2DM) patients; divided into two groups, (20 with poor glycemic control, and 20 with good glycemic control), in addition to 20 non-diabetic healthy control subjects. The following investigations had been made; HbA1C, FBS, blood urea, serum creatinine and sodium, creatinine clearance (Ccr), glomerular filtration rate (eGFR), urinary protein, and urinary sodium. Serum copeptin levels were measured using an enzyme-linked immunoassay (ELISA).
Results: Serum copeptin levels were significantly higher in (T2DM) patients with poor glycemic control than in (T2DM) patients with good glycemic control compared to the healthy control group. There was a significant positive correlation between serum copeptin and FBS, HbA1C, blood urea, serum creatinine, urinary Na, and 24-hour urinary protein, and a significant negative correlation with serum Na, eGFR, and creatinine clearance. The receiver operating characteristic (ROC) curve for the validity of serum copeptin, as a marker for diabetic nephropathy, at cutoff point 3452 pg/ml, showed 90% sensitivity, and 95% specificity.
Conclusion: Serum copeptin is independently related to markers of kidney injury in T2DM and may be used as a marker for diabetic nephropathy.
https://ejhm.journals.ekb.eg/article_181217_19c096503c861ba791e6ea85543f1538.pdf
2021-07-01
2242
2248
10.21608/ejhm.2021.181217
serum Copeptin
Arginine vasopressin (AVP)
Diabetic kidney disease
said
Al-Barshomy
saidbarshomy@yahoo.com
1
internal medicine, zagazig university, egypt
AUTHOR
Adel A.
Ghorab
2
AUTHOR
Osama A.
Mahmoud
3
AUTHOR
Mohamed
Shahein
4
AUTHOR
Amira A.
Mahmoud
5
AUTHOR
Niveen S.S.
Sakla
6
AUTHOR
ORIGINAL_ARTICLE
Clinical and Laboratory Characteristics of Children with Autism Spectrum Disorder at Sohag University Hospital
Background: Autism Spectrum Disorder (ASD), sometimes referred to as “autism”, is “a chronic disorder whose symptoms include failure to develop normal social relations with other people, impaired development of communicative ability, lack of imaginative ability, and repetitive, stereotyped movements”.
Objective: To assess the clinical and laboratory characteristics as well as risk factors of ASD.
Patients and methods: The study was a retrospective descriptive cohort study and included 1650 autistic patients with AD/ASD referred to the Pediatric Department and Psychiatry Outpatient Clinic at Sohag University Hospital, Egypt, and followed up during the period from June 2019 to May 2020.
Results: Age at presentation ranged from one month to 252 months with a mean ± SD of 44.496 ± 28.435. The results of IQ of the studied patients were available in 241 patients with a range from 25 to 100 with a mean IQ of 62.98. Our CARS data were available in 920 of the studied patients (n=920) and showed a mean of 30.064 with a range from 20 to 60. In our study, the associated risk factors of autism were reported in 332 patients. Hearing problems were found in 25.9%, neonatal asphyxia in 15.9%, phenylketonuria was found in 11.8% of those patients. Epilepsy was found in 7.8%, hyperammonemia in5.3%, cerebral malformation in 5.1%, down syndrome in 3.3%, and tuberous sclerosis in2.8%.
Conclusion: Our study confirmed diagnosis of ASD in children affects patients, family, and the community at large. Knowledge of ASD is crucial for health professionals as its prevalence is increasing globally.
https://ejhm.journals.ekb.eg/article_181218_dd9e5dfae16f466ecef552947b216ac8.pdf
2021-07-01
2249
2255
10.21608/ejhm.2021.181218
Clinical and laboratory characteristic
Autism Spectrum Disorder
Marina Naseralla
Samy
marinaatef_2020@yahoo.com
1
Department of Pediatrics, Faculty of Medicine, Sohag University, Sohag, Egypt
LEAD_AUTHOR
Abdelrahim Abdrabou
Sadek
2
Department of Pediatrics, Faculty of Medicine, Sohag University, Sohag, Egypt
AUTHOR
Amr Ahmed Osman
Amr Ahmed Osman
3
Department of Pediatrics, Faculty of Medicine, Sohag University, Sohag, Egypt
AUTHOR
ORIGINAL_ARTICLE
The Impact of Smoking on Semen Quality and ICSI Outcome in the Obese Men
Background: Male obesity with or without smoking and raised male BMI can markedly harm quality embryo blastocyst development, clinical pregnancy rate, and live birth rate in couples who underwent in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). Male BMI could be an essential factor influencing IVF–ICSI outcome. Objective: This study aimed to investigate the effect of smoking on semen quality, fertilization, embryo quality, and their impact on pregnancy after ICSI in overweight men. Material and methods: The study was performed on 150 cases in the assisted reproductive unit in International Islamic Center for Population Studies and Research, Al-Azhar University. The recruited males were divided into three groups (50/group): Normal control (C), Overweight (OW), and overweight with a smoking (OW&S). Their physiological, biochemical, and semen parameters were investigated for all cases. The fertilization rate, cleavage rate, embryo quality, and pregnancy rate were examined and recorded during and after the ICSI process. Results: Percent of abnormal sperm morphology in the OW&S group showed a very highly significant increase (P<0.01) than the control group. However, for the overweight with smoking (OW&S) and overweight groups (OW), the percentage of the fertilization rate and the high-quality embryos were significantly lower than the values of the control group (P<0.01). The percentage of the low-quality embryo was higher in OW&S and OW groups than in the control group. The lowest rate of positive pregnancy test recorded in overweight with smoking (46%) followed by overweight (60%). Conclusion: the semen parameters and hormonal profile, fertilization rate, embryo quality, and pregnancy rate were significantly lower in smoker men suffering from overweight.
https://ejhm.journals.ekb.eg/article_181219_b0cbe9be386a729b8be208c11d3775a6.pdf
2021-07-01
2256
2261
10.21608/ejhm.2021.181219
ICSI
overweight
semen quality
Smoking
Salha Abd El Fatah
Saad
dr.salhamansoura@gmail.com
1
LEAD_AUTHOR
Nehal Ali
Abu-Elnaga
2
AUTHOR
Amira Badereldin Abdel
Ghany
3
AUTHOR
Ahmed Fathy Alsherbiny
Hassan
4
AUTHOR
ORIGINAL_ARTICLE
Partial Nephrectomy Versus Radical Nephrectomy for Localized Renal Masses: Critical Analysis of Oncological Outcome and Impact on the Renal Function
Background: Management of renal tumors remains a controversial issue especially in small size tumors or special situations as bilateral disease, single kidney, or compromised renal function, nephron-sparing surgery is the case in such situations.
Objective: Comparing oncological outcome and impact on renal function of open radical nephrectomy and open partial nephrectomy for management of renal tumors.
Patients and methods: Our study was conducted as a non-randomized prospective observational study at the Urology Department, Menoufia University Hospital between December 2018 and June 2020. Forty-eight patients with organ-confined renal masses were included in the study. They were divided into two equal groups; (group 1) 24 patients and was treated by PN, and (group 2) 24 patients and was treated by RN.
Results: The mean age of our study is 56.6±13.2. Thirty-two patients were males (66.7%), while females represented 16 (33.3%). Hot ischemia was done for all partial nephrectomy cases with a mean time of ischemia 13.2±4.1. We used different techniques included simple enucleation in 17 patients (70.8%), polar nephrectomy in 4 patients (16.7%), and wedge resection in 3 patients (12.5%). Regarding surgical margin, it was free in 21 patients (87.5%) of PN and positive in 3 patients (12.5%) 2 of them missed follow up and 1 showed no recurrence till now. Our patients showed a smooth postoperative course.
Conclusion: Both techniques (RN&PN) were comparable in terms of oncological outcomes. Patients tolerated both techniques with no major complications, however partial nephrectomy is advised in the localized renal tumors when technically feasible with less probability of complications and good follow-up data regarding the renal function, the oncological outcome is the same as radical surgery.
https://ejhm.journals.ekb.eg/article_181220_0fcb3a95899707a6f903ccf2be4f16f8.pdf
2021-07-01
2262
2269
10.21608/ejhm.2021.181220
Partial Nephrectomy
Radical nephrectomy
renal masses
Mahmoud
Amer
mahmoud.mousa@med.menofia.edu.eg
1
Urology Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
LEAD_AUTHOR
Mohamed
Selim
2
Urology Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
AUTHOR
Mohamed
Elshazly
3
Urology Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
AUTHOR
Sultan
Sultan
4
Urology Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
AUTHOR
ORIGINAL_ARTICLE
Dexmedetomidine versus Dexamethasone as Adjuvants to Bupivacaine for Ultrasound Guided Rectus Sheath Block in Pediatric Abdominal Surgery
Background: The use of ultrasound as a guide for regional anesthesia has become common practice and a new challenge to anesthesiologists. Besides its benefits of reduced complications, it also helps in reducing the total anesthetic dose required with higher block success rates. There is also the advantage of direct observation of the pattern of anesthetic spread.
Objective: To compare between dexamethasone and dexmedetomidine as adjuvants to bupivacaine in rectus sheath block applied during pediatric abdominal surgeries.
Patients and methods: This prospective randomized study was conducted at Mansoura University Children Hospital. We included a total of 60 pediatric patients undergoing elective abdominal surgery. The study was conducted over the period of two years, starting from January 2019 till December 2020.
Results: The mean age of the included patients was 4.7, 4.7, and 4.6 in groups C, D, and Z respectively. Operative time and duration of anesthesia did not show any significant difference between the three groups. The duration of analgesia showed a highly significant difference between the three groups. Group Z showed its superiority as it had a mean analgesic duration of 15.3 hours, followed by Group D which had mean value of 13.02 hours.
Conclusion: Both dexamethasone and dexmedetomidine were efficient adjuvants to local anesthetics as they were associated with significant prolongation of the duration of analgesia, decrease in postoperative analgesia, and better patient satisfaction compared to bupivacaine alone.
https://ejhm.journals.ekb.eg/article_183252_15ee69d39f6826102b0edd94f6d88a7b.pdf
2021-07-01
2270
2278
10.21608/ejhm.2021.183252
Bupivacaine
dexamethasone
Dexmedetomidine
Pediatric Abdominal Surgery
Ultrasound
Ahmed Adel Ahmed
Oriba
adolabashaa@yahoo.com
1
Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura University,Egypt
AUTHOR
Mohamed Younis
Makharita
2
Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura University,Egypt
AUTHOR
Medhat Mikhail
Messeha
3
Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura University,Egypt
AUTHOR
Amer Abd Allah
Atia
4
Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura University,Egypt
AUTHOR
ORIGINAL_ARTICLE
Effect of Genital Tract Infection on Citric Acid in Semen of Infertile Male Patients
Background: Infertility means the failure to achieve a clinical pregnancy after 12 months of regular unprotected sexual intercourse. It affects approximately 15% of couples. The male factor is the main cause of infertility in 20% of cases and contributes in about 50%. There are many etiologies for male factor infertility. Infectious processes contribute to about 15% of such cases. Citric acid has antioxidant and anti-inflammatory functions in tissues damaged by environmental factors. In addition, it favors the synthesis of glycosaminoglycans in various tissues. Citric acid levels are regulated by testosterone, and like fructose can be elevated in oligozoospermic and azoospermic subjects without a convincing clinical explanation.
Objective: To evaluate effect of genital tract infection on level of citric acid in semen of infertile men.
Patients and methods: This study was carried out on 30 infertile male patients. Patients were recruited from the Outpatient Clinic of Andrology Unit in Dermatology & Andrology and STDs Departments, Mansoura University Hospital for one year.
Results: The mean age of the studied group was 29.57 ± 4.22 years. All studied samples were subjected to antimicrobial sensitivity tests. The most sensitive antibiotics were rifampicin, cefoprazone/sulbactam, amoxicillin/clavulanic acid and piperacillin/tazobactam. While the most resistant antibiotics were ciprofloxacin, cephalexin and levofloxacin. The mean of citric acid was significantly increased after receiving antibiotic (16.64 ± 2.24 versus 3.32 ± 1.40 mg/ejaculate before treatment).
Conclusion: Citric acid was significantly increased after receiving antibiotic versus before male genital infection treatment.
https://ejhm.journals.ekb.eg/article_183253_c03872482ad5842fb0f6f5a81f72c596.pdf
2021-07-01
2279
2284
10.21608/ejhm.2021.183253
Sexually transmitted diseases
Genital tract infection
Infertility
spermatogenesis
Doaa Abdel Rahman
Sonbol
1
Department of Dermatology, Andrology and STDs - Faculty of Medicine -Mansoura University, E
AUTHOR
Ahmed Fathy
State
ahmedelkordys4@gmail.com
2
Department of Dermatology, Andrology and STDs - Faculty of Medicine -Mansoura University, Egypt
LEAD_AUTHOR
Samir Mohammad
Elhanbly
3
Department of Dermatology, Andrology and STDs - Faculty of Medicine -Mansoura University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Effect of Alpinia Officinarum Rhizome Extract on Fertility and Sexual Behavior of Adult Male Albino Rats Treated with Sotalol
Background: Infertility in cardiovascular patients is not only attributed to pathogenesis of the disease but, also to the used therapeutic drugs. Beta blockers which are corner stone in treatment of these patients are reported to affect fertility and sexual behavior in patients using them. Alpinia officinarum (A. officinarum) rhizome extracts are widely used for their antioxidant and anti-inflammatory effects to improve oxidative stress which affects organs due to using different drugs or pathogenesis of different diseases.
Objective: The current work aimed to study effect of Alpinia officinarum rhizome extract on improving the reproductive function and sexual behavior of adult male Albino rat treated with Sotalol.
Materials and Methods: Fifty adult male Albino rats were categorized into five groups. Group I control, group II (A. officinarum group) received A. officinarum extract at a dose of 200mg/kg/day in olive oil orally by gastric tube for 21 days, group III (Sotalol group) received Sotalol at a dose of 3mg/kg/day orally by gastric tube for 21 days, group IV (protected group) received the extract then Sotalol and group V (treated group) received Sotalol then the extract. Then fifty adult female rats were used for assessment of sexual behavior through observing mount latency and frequency.
Results: Sotalol induced testicular destruction in the form of shedding of germinal epithelium, hyaline deposition, decreased sperm count with decreased testosterone level, increased oxidative stress in the form of decreased Serum superoxide dismutase (SOD) level and increased Serum malondialdehyde (MDA) level. Deterioration of sexual behavior in the form of increased mount latency and decreased mount frequency was noticed in the Sotalol group. A. officinarum extract produced a great preservation of testicular structure and sexual behavior in the protected group (IV) together with improvement in the treated group (V).
Conclusion: Sotalol induced destructive effects on the testicular structure, function and sexual behavior which were greatly improved by using A. officinarum extract.
https://ejhm.journals.ekb.eg/article_183254_5e024dd8e34384016cfd023cf03616c9.pdf
2021-07-01
2285
2296
10.21608/ejhm.2021.183254
Sotalol
testis
Sexual behavior
A. officinarum extract
Nourhan Mahmoud Abd El-Zaher
Bebars
norabebars48@gmail.com
1
Department Anatomy and Embryology, Anatomy, Faculty of Medicine, Menoufia University, Menoufia, Egypt.
AUTHOR
Mostafa M.
El Habeby
2
Department Anatomy and Embryology, Anatomy, Faculty of Medicine, Menoufia University, Menoufia, Egypt.
AUTHOR
Noha M.
Issa
drnohaissa@yahoo.com
3
Department Anatomy and Embryology, Anatomy, Faculty of Medicine, Menoufia University, Menoufia, Egypt.
AUTHOR
Nermeen M. Noor
El-Dien
4
Department Anatomy and Embryology, Anatomy, Faculty of Medicine, Menoufia University, Menoufia, Egypt.
AUTHOR
ORIGINAL_ARTICLE
Fetal Heart Rate Variability Before and After Antenatal Corticosteroids in Patients at High Risk of Preterm Labor
Background: Premature birth (PTB) occurs in one in ten pregnancies. There are about 13 million PTBs annually worldwide. Antenatal corticosteroids are administered to enhance fetal lung maturation in cases of threatened preterm delivery between 24- and 34-weeks’ gestational age (GA).
Objective: This study aimed to study the cardiotocograp (CTG) before and after antenatal corticosteroids administration in patients at high risk of preterm labor to reduce preterm risks.
Patients and Methods: A prospective cohort study included 52 women who were at risk of premature birth. Each woman received the recommended course of corticosteroids consists of 4 doses of dexamethasone 6 mg for 48 hours (Dexamethasone 8 ml intramuscularly, 12 h apart). CTG examination: Fetal heart rate was monitored with fetal monitor cardiotocogram machine. Cardiotocography strips were interpreted visually.
Results: In our study we recorded decrease in baseline fetal heart rate and increase in fetal heart rate variability (LTV, STV) after dexamethasone course by 24 hours, which were statistically significant. The number of accelerations showed a slight increase, which was significant. Decelerations were not present at all before or after the course. The STV showed a significant change before the course, all participants had moderate STV, but after the course, 8 (15.4%) showed marked variability, which was significant. We found that most of participants (90.4%) had decreased fetal kicks after injection relying on maternal perception.
Conclusion: There was a decrease in baseline fetal heart rate and increase in fetal heart rate variability (LTV, STV) after dexamethasone course by 24 hours, which were statistically significant. The number of accelerations showed a slight increase, which was significant.
https://ejhm.journals.ekb.eg/article_183255_7f50f857217e8aedd4d233053f7028d8.pdf
2021-07-01
2297
2300
10.21608/ejhm.2021.183255
Antenatal corticosteroids
Cardiotocograph
fetal heart rate
preterm labor
Basma Mohamed Safwat Ahmed
Shalaby
drbosy.m92@gmail.com
1
Department of Obstetrics and Gynecology, Faculty of Medicine, Zagazig University, Egypt
LEAD_AUTHOR
Walid Abd Allah
Abd Elsalam
2
Department of Obstetrics and Gynecology, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Amr Kamel
El Fayomy
3
Department of Obstetrics and Gynecology, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Ahmed Ismail
Mohamed
4
Department of Obstetrics and Gynecology, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Indoor Air Quality Assessment in Critical Care Department in One Hospital of The General Organization of Teaching Hospitals and Institutes in Cairo Indoor Air Quality Assessment in Critical Care Department in One Hospital of The General Organization of Teaching Hospitals and Institutes in Cairo
Background: Among hospitals-related health risks, environmental factors play a key-role; this accounting for different rooms’ specific use, patients’ vulnerability and risk of overcrowding. For these reasons, air control in hospitals and in healthcare facilities in general deserves scientific attention.
Objective: Assessing of the quality of indoor air ventilation in critical care department hospitals and its effect on the incidence of hospital acquired infections in order to optimize the ventilation methods in hospitals.
Patients and methods: Our study was performed in Egypt by correlating the examined 70 air samples, from the Intensive Care Unit (ICU), Cardiac Care Unit (CCU) and Neonatal Intensive Care Unit (NICU) in one of the General Organization of Teaching Hospitals and Institute, for presence of bacterial and fungal contamination with the concomitant infection of 70 patients admitted in these units during the period from November 2019 to January 2020.
Results: We had 59 (84.2%) positive air samples in comparison to 21 (30%) positive endotracheal tube (ETT) fluid culture and 19 (27.1%) positive blood cultures in the completely selected air sampling areas and in the selected patients during the included sampling period. This suggested a strong relation between the contamination between the indoor airs either by bacterial or fungal organisms, and between the concomitant presence of the same organism in the ETT fluid samples and to lesser extent in the blood cultures.
Conclusion: This study has fortified the hypothesis that achieving an optimal level of indoor air quality is related to applying the infection control rules, application of approved air filters and strict adherence to hand hygiene.
https://ejhm.journals.ekb.eg/article_184205_c608d8ae26c1952a5e5ea66e51748d0b.pdf
2021-07-01
2301
2307
10.21608/ejhm.2021.184205
Air Quality
Critical care unit
Mohamed Mostafa
Abdelghaffar
1
AUTHOR
Sahar
Abdelfattah
saherabdelfatah55@gmail.com
2
AUTHOR
Neveen
Mahmoud
3
AUTHOR
Hoda
Shoman
4
AUTHOR
ORIGINAL_ARTICLE
Evaluating the Role of Calprotectin in Pathogenesis of Acne Vulgaris in Zagazig University Hospital
Background: Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit. The cardinal pathogenic factors include increased sebum secretion, follicular hyperkeratinization and microbial colonization by Cutibacterium acnes. Calprotectin is released from activated neutrophils, and can be detected in serum or other body fluids.
Aim: The aim of the present study was to clarify if calprotectin plays a role in acne vulgaris pathogenesis.
Subject and Methods: This study is a case control study included 42 patients complaining of acne vulgaris compared with42 apparent healthy individuals matching in age and sex with control group. Human calprotectin level in the serum was measured using enzyme linked immunosorbent assay (ELISA).
Results: The results showed that serum calprotectin level was higher in patients than controls but the difference was statistically insignificant(P=0.12). However, there was statistically significant correlation between serum calprotectin level in severe acne subtype and mild to moderate subtypes (P=0.026). The patients with acute onset had a higher serum calprotectin level than the patients with gradual onset (P=0.42), the difference was statistically insignificant. The male acne patients had higher statistically significant serum calprotectin level than female patients (P=0.03)
Conclusion: Serum calprotectin level was higher in patients with acne vulgaris than controls, and is positively correlated with disease severity, therefore, might help in the evaluation of acne vulgaris severity and can help to evaluate the response to treatment.
https://ejhm.journals.ekb.eg/article_184209_6057f62635677d1c26cff1c628f8a5b2.pdf
2021-07-01
2308
2312
10.21608/ejhm.2021.184209
Acne vulgaris
Calprotectin
Mohamed M.
Nasr
1
AUTHOR
Sharar
Al Mokadem
2
AUTHOR
Samar A
Ahmed
3
AUTHOR
Heba E
AbdElrahman
4
AUTHOR
ORIGINAL_ARTICLE
The Role of Color Doppler Ultrasonography and Magnetic Resonance in the Prenatal Diagnosis of Placenta Accrete
Background: Placenta accrete is a clinical and diagnostic challenge that is being with increasing frequency and may lead to catastrophic blood loss and related complications. Color doppler ultrasonography and magnetic resonance imaging are considered as specific imaging modalities and have very important role in the prenatal diagnosis of placenta accreta. Objectives: The aim of the current work was to evaluate the diagnostic value of color doppler ultrasonography and magnetic resonance imaging in the prenatal assessment of placenta accreta.
Patients and Methods: This study was conducted on 40 pregnant women (from 32 to 40 weeks of pregnancy) with placenta previa and presented with manifestations of suspected placenta accreta. Their age ranged from 19 to 40 years with mean age of 31.8 years. All cases were subjected to ultrasound examination, but MRI was done in 33 cases prior to elective delivery. Results: Cases diagnosed of having placenta accreta were 18 out of 40 cases (45 %). Among those 18 cases; placenta found tobe accreta in 6 patients, increta in 7 patients and percreta in 5 patients. Our study showed high statistical significance between occurrence of Placenta accrete & prior uterine surgeries as a risk factor. Overall accuracy of ultrasound was 88%, while that of MRI was 85%. Ultrasound showed better specificity (86%) than that of MRI (81%), but MRI showed better sensitivity (92%) than that of ultrasound (89%).
Conclusion: It could be concluded that both ultrasound and magnetic resonance have fairly good sensitivity and specificity for prenatal diagnosis of placenta accreta. Color doppler ultrasound remains the first primary screening imaging modality used to evaluate suspected placenta accreta and MRI is suggested as an alternative complementary tool to ultrasound in cases with inconclusive criteria.
https://ejhm.journals.ekb.eg/article_184211_74f664950fb590050383fb4a62434d35.pdf
2021-07-01
2313
2322
10.21608/ejhm.2021.184211
accreta
Color Doppler
placenta
Ultrasonography
Magnetic resonance
Hayam A.
Abdellatif
1
LEAD_AUTHOR
Mona K.
Alashwah
2
AUTHOR
Mohamed S.
Elzawawi
3
AUTHOR
ORIGINAL_ARTICLE
Serum Level of Calprotectin as a Potential Marker of Inflammation in Acne Vulgaris Diagnosis and Severity Estimation
Background: Acne vulgaris (AV) is a common inflammatory skin disease involving dysfunction of the pilosebaceous unit. Many mechanisms for the pathogenesis of acne have been postulated. However, the precise pathogenesis is still uncertain.
Objective: This study aimed to measure serum calprotectin levels in AV and to correlate its level with the activity and severity of the disease.
Patients and methods: A total of 80 subjects were subdivided into two groups; group I included 40 patients complaining of AV with different severity levels, and group II had 40 healthy age and sex‐matched participants as a control group. Serum calprotectin level was measured in both groups by the enzyme‐linked immunosorbent assay (ELISA) method.
Results: Serum calprotectin concentration was statistically significantly (p=0.0001) higher in the patient group when compared to the controls. There was a statistically significant (p = 0.001) difference among subgroups of patients according to disease severity regarding serum calprotectin concentration. There was a high-significant positive correlation between serum calprotectin concentration and disease severity. Calprotectin concentration could be used to diagnose AV with cutoff points higher than 1.03 ng/ml (with 77.5% sensitivity, 80% specificity) and also can detect its severity with cutoff points higher than 1.1 ng/ml with 96.3% sensitivity, 100% specificity to differentiate the mild cases from moderate and severe ones.
Conclusion: Serum calprotectin concentration represents a valuable tool for diagnosing the inflammatory nature and monitoring the disease activity in AV patients.
https://ejhm.journals.ekb.eg/article_184214_31eb994ed94c36833c2e792599e4e7c2.pdf
2021-07-01
2323
2328
10.21608/ejhm.2021.184214
Acne vulgaris
Calprotectin
Mohammed A.
Basha
1
AUTHOR
Rana G.
Abdelmageed
ranaagaamal@gmail.com
2
AUTHOR
Noha Rabie
Bayomy
3
AUTHOR
ORIGINAL_ARTICLE
Relationship of Serum Total Bilirubin with Acute Coronary Syndromes at Sohag University Hospitals
Background: Many evidence has documented that the development of coronary artery disease involves lipid oxidation and formation of oxygen radicals as atherosclerosis and inflammation are associated with formation of oxygen and peroxyl radicals. Bilirubin has proven to be a potent antioxidant under physiological conditions by inhibiting both lipid and protein oxidation.
Objective: This study was aimed to show the relationship between serum total bilirubin and different types of acute coronary syndromes (STEMI, Non-STEMI, unstable angina) in patients admitted at Coronary Care Unit, Sohag University Hospital.
Patients and methods: This cross-sectional study included a total of 100 patients, 64 of them were men presented with acute coronary syndrome, admitted at Coronary Care Unit, Sohag University Hospital. This study was conducted between January 2020 to June 2020.
Results: The mean age was 55.4 years; 64 (64%) were males, 44 (44%) were current smokers, 37 (37%) were HTN, 39 (39%) were DM, 71 (71%) had family history of IHD, 17 (17%) were obese. When the patients were divided into 3 groups (group A, n = 28 "28%", group B, n = 13 "13%", and group C, n = 59 "59%"). Serum total bilirubin was significantly different (group A; Mean ± SD = 0.627 ± 0.241), (group B; Mean ± SD = 0.527 ± 0.173), (group C; Mean ± SD = 0.795 ± 0.367). "P-value = 0.007; highly significant".
Conclusions: It could be concluded that there is an inverse relation of bilirubin with acute coronary syndromes (ACS). These strengths the fact that bilirubin acts as an antioxidant and has cardioprotective action and patients with ACS have lower levels of bilirubin.
https://ejhm.journals.ekb.eg/article_184218_e8728b1a67d18ee36d793f281f19c18f.pdf
2021-07-01
2329
2336
10.21608/ejhm.2021.184218
Hassan Ahmad
Hassanien
1
AUTHOR
Yasser Mohamed
Kamal
2
AUTHOR
Mohamed Hussein
Ahmed
3
AUTHOR
Safaa Ali
Ismail
shmb49@yahoo.com
4
LEAD_AUTHOR
ORIGINAL_ARTICLE
Assessment of SerumYkl-40 and High Sensitivity C-Reactive Protein as Biomarkers of Renal Affection of Children with Type 1 Diabetes
Background: Diabetes describes a group of metabolic disorders characterized and identified by the presence of hyperglycemia in the absence of treatment.
Objective: The aim of this study was early detection of renal affection in children with type 1 diabetes (T1DM) by using serumYkl-40 and high sensitivity C-reactive protein (Hs-CRP) as biomarker.
Patients and methods: This study was a case control study carried out at Pediatric Department, in pediatric endocrine inpatient and outpatient clinic, Zagazig University Hospitals from October 2019 to October 2020. It included 57 participants collected from Pediatric Department in Zagazig University Hospital who were divided into 3 groups; each group included (19) patients.1st group was diabetic group with normoalbuminuria (<30 mg/g creatinine), 2nd group was diabetic group with microalbuminuria (30-299 mg/g creatinine), and the 3rd group was healthy children.
Results : The serumYkl-40 and Hs-CRP were good predictor markers for prediction of renal affection among children with T1DM with (86.8% and 94.7%) ability truly diagnose renal affection, (72.0% and 84.2%) ability to exclude truly negative ones and total (80.7% and 91.2%) accuracy for serumYkl-40 and Hs-CRP respectively.
Conclusion: YKL-40 and Hs-CRP levels could be used as tools to assess the risk of diabetic microangiopathy in the very early stage in T1DM patients.
https://ejhm.journals.ekb.eg/article_184221_d41d8cd98f00b204e9800998ecf8427e.pdf
2021-07-01
2337
2343
10.21608/ejhm.2021.184221
Diabetes mellitus
Diabetic nephropathy (DN)
high sensitivity C-reactive protein
SerumYkl-40
Sabry Abdel Rahman
Tolba
1
AUTHOR
Hadeel Mohammad
Abd-Elrahman
2
AUTHOR
Randa Hussiny
Mohamed
3
AUTHOR
Khaled Abdulhafid Moftah
Hendi
khaledhendi86@gmail.com
4
AUTHOR
ORIGINAL_ARTICLE
Endoscopic Versus Microscopic Canal Wall Up Surgery for Cholesteatoma: A Diffusion-Weighted Magnetic Resonance Imaging Post-Operative Study
Background: Cholesteatoma is a surgical disease for which the primary universally accepted goal is total eradication of cholesteatoma to obtain a safe and dry ear. The second objective is restoration or maintaining the hearing.
Objective: This study was aimed to solve the problem of residual cholesteatoma and decrease the problem of large mastoid cavities and to increase the learning curve of endoscopic ear surgery.
Patients and Methods: non-randomized controlled trial study performed in Otolaryngology, Head and Neck Surgery Departments, Zagazig University Hospitals in the period from February 2018 to February 2021 on 30 patients suffering from middle ear cholesteatoma. Otoendoscopic evaluation were used for detection of the presence of attic perforation, posterosuperior perforation, aural polyps and, whitish shadow behind intact tympanic membrane. All patients were operated under general anesthesia with controlled hypotensive technique.
Results: After 1 year of follow-up in 15 patients using endoscopic approach and 15 patients using microscopic approach, the recidivistic cholesteatoma was found in 6.7% in endoscopic group while it was 20% in microscopic group.
Conclusions: It could be concluded that the use of an endoscope provided important benefits to patients with middle ear cholesteatoma and offer superior visualization than microscope.
https://ejhm.journals.ekb.eg/article_184223_64c837ab56b400471ae4cf8ea9b03a55.pdf
2021-07-01
2344
2349
10.21608/ejhm.2021.184223
Endoscopic
cholesteatoma
microscopic
Ear surgery
Mohamed Kamal
Mobashir
1
AUTHOR
Atef Hamed
Ali
2
AUTHOR
Mostafa Hasan
Hassan
3
AUTHOR
Inas Mohamed Abdel-Aziz
El Fiki
4
AUTHOR
Ahmed Nagy
Hadhoud
a7me_ed@hotmail.com
5
LEAD_AUTHOR
Mohammed Elsayed
Elmaghawry
6
AUTHOR
ORIGINAL_ARTICLE
Role of CD319 Expression as A Diagnostic and Prognostic Marker in Plasma Cell Myeloma Patients
Background: The surface antigen CD319 (SLAMF7) is a marker of normal and malignant plasma cells in plasma cell myeloma. In view of the potential therapeutic use of SLAMF7‐targeting antibodies, such as elotuzumab, the detection of SLAMF7 expression levels on abnormal plasma cells might play an important role in the evaluation of therapy responses. Objective: This study aimed to evaluate role of CD319 marker in diagnosis and prognosis of plasma cell myeloma patients. Patients and Methods: The study was Cohort study conducted on newly diagnosed plasma cell myeloma patients in Clinical Pathology Department and Internal Medicine Department-Hematology Unit at Zagazig University Hospitals in period between February 2019 and February 2021. It included 18 cases diagnosed according to clinical, pathological, morphological and immunophenotypic criteria. Follow up of patients was carried out after 3 months of initiation of treatment to assess response to therapy. Results: This study showed that CD319 (SLAMF7, CRACC, CS1) is a stable marker with high expression mean fluorescence intensity (MFI) on normal and malignant plasma cells. In this study, CD319 is found positive in all plasma cell myeloma (PCM) patients. Low expression of CD319 (if MFI below 128.3) was associated with a significant better response to treatment and good prognosis but high expression of CD319 was accompanied by bad response to treatment. It can be effectively used as a diagnostic and prognostic marker for PCM.
Conclusion: CD319 is found positive in all PCM patients. It can be effectively used as a diagnostic marker for PCM. Low expression of CD319 is associated with a significant better response to treatment and good prognosis. This indicates importance of CD319 as a prognostic marker of PCM.
https://ejhm.journals.ekb.eg/article_184227_8fc4de803b6ea21533e239596332b317.pdf
2021-07-01
2350
2356
10.21608/ejhm.2021.184227
Bone marrow aspiration
CD319
Flow cytometry
Plasma cell myeloma
Saad Sabry
El-Osh
1
AUTHOR
Ayman Fathy
Abd El-Halim
2
AUTHOR
Shaimaa Saeed
Ibrahim
shaimaa.saeed39@yahoo.com
3
LEAD_AUTHOR
Heba Allah Elsayed
Abd El-Rhman
4
AUTHOR
ORIGINAL_ARTICLE
Serological Study of Infection with the Chlamydia - Like Microorganism 'Simkania Negevensis' in Patients Undergoing Hemodialysis
Background: Infection is a common complication of hemodialytic treatment. Many of these infections are due to sepsis, primarily arising from the vascular access site. Simkania negevensis (S. negevensis) is an obligate intracellular bacterium belonging to the family Simkaniaceae in the Chlamydial order, which is able to survive and grow as an amoeba resisting microorganism in trophozoites and cysts of Acanthamoeba and other free-living protozoa, which probably represent its natural reservoirs.
Objective: The study aimed to early diagnose and minimize the risks of Simkania negevensis infection in hemodialysis patients.
Patients and Methods: This cross-sectional study was performed on 78 hemodialysis patients, and they were treated with regular hemodialysis. Patients were subjected to the following: complete history taking, full clinical assessment, laboratory investigation (complete blood count, measurement of serum IgG antibody against S. negevensisin hemodialysis patients and water samples were collected from hemodialysis circuits for detection of the occurrence of S. negevensis infection).
Results: There was no significant difference in the age and gender between the patients undergoing hemodialysis with negative water samples for Simkania compared to hemodialysis with positive water for S. negevensis. Regarding hypertension (HTN) and diabetes mellitus (DM), there was no significant difference between the patients undergoing hemodialysis with negative water samples for Simkania compared to hemodialysis with positive water for S. negevensis. IgG levels are significantly higher in patients during hemodialysis when the water samples were positive for Simkania.
Conclusion: Our study detected the occurrence of S. negevensis in hemodialysis patients. When the patients were undergoing hemodialysis with positive water for Simkania, we detected significant rise of IgG antibodies against S. negevensis. Significant area under curve with significant cutoff >6.1 for IgG with sensitivity 73.3% and specificity 80.0%.
https://ejhm.journals.ekb.eg/article_184231_3b129a8bb3c6f6e7118489a22140c1be.pdf
2021-07-01
2357
2360
10.21608/ejhm.2021.184231
Hemodialysis
Serological Study
Simkania Negevensis
George Emad
Shaker
1
AUTHOR
Rehab Ahmed
Rabie
2
AUTHOR
Ahmed Abo El-Makarem
Hosny
ak6457113@gmail.com
3
LEAD_AUTHOR
Heba Shafeak Abd
El Khalik
4
AUTHOR
ORIGINAL_ARTICLE
Using Ultrasound for Pregnancy Failure in Patients with 1st Trimester Recurrent Pregnancy Loss
Background: Pregnancy loss is the interruption and/or termination of pregnancy, either spontaneously or intentionally, before the fetus develops sufficiently to survive. About 80% of abortions occur in the first 12 weeks of pregnancy.
Objective: To determine the accuracy of U/S parameters in predicting early pregnancy failure in pregnant with history of 1st trimesteric recurrent pregnancy loss.
Patients and methods: This was a prospective study that included 120 pregnant females with history of first trimesteric recurrent pregnancy loss. It was conducted in Obstetrics and Gynecology Department, Menoufia University Hospitals, and Rashid General Hospital, Al-Bahira, Egypt during the period from April 2019 until August 2020.
Results: There is no significant difference between miscarriage group and ongoing pregnancy group regarding risk factors and demographic data (p > 0.05). In addition, crown-rump length (CRL) below 5th percentile for gestational age (GA) category more significantly prevalent in the miscarriage group compared to the ongoing pregnancy group. While, mean gestational sac diameter (MGSD) below 5th percentile for GA, caudal displacement of gestational sac (GS) or irregular GS could predict subsequent miscarriage. Embryonic heart rate/Fetal heart rate (EHR/FHR) below 5th percentile for GA was statistically significantly more prevalent in the miscarriage group than in ongoing pregnancy group. Abnormally large YSD (> 95th percentile for GA), absent yolk sac (YS), floating YS, deformed, irregular or hypo-echoic YS could predict subsequent miscarriage. Uterine artery resistance index (RI), pulsatile index (PI) and systolic/diastolic (S/D) ratio did not differ significantly between the miscarriage group compared to the ongoing pregnancy group across the various gestational ages.
Conclusion: 1st trimester U/S parameters are useful diagnostic tool to prognosis pregnancy outcome among patients with history of recurrent 1st trimester pregnancy loss.
https://ejhm.journals.ekb.eg/article_184236_78f407c898cd01aebb57665c3550f238.pdf
2021-07-01
2361
2365
10.21608/ejhm.2021.184236
aborted cases
Miscarriage
ongoing pregnancy
pregnancy outcome
ultrasonographic predictor
Abdelhaseib salah
Saad
1
AUTHOR
Zakaria Fouad
Sanad
2
AUTHOR
Ahmed Hammouda
Hossameldin
docahmedhamoda@gmail.com
3
AUTHOR
Dalia
Ibrahim
4
AUTHOR
ORIGINAL_ARTICLE
Transcranial Doppler Assessment of Cerebrovascular Reactivity in Migraine Patients
Background: Migraine is considered as a neurovascular coupling disorder where the cerebral vascular reactivity is malfunctioning and measuring hemodynamic changes during migraine without causing more disturbances has always been a challenge. Objective: This study aimed to detect the role of transcranial Doppler ultrasound in assessing the vasomotor reactivity of cerebral blood vessels in migraine patients. Patients and Methods: This case control study included thirty-two migraine patients and thirty-two healthy individuals that were recruited from Neurology Department at Zagazig University Hospital and Neuropsychiatry Department at El-Sahel Teaching Hospital Outpatient Clinics during the period from April to December 2020. We performed Transcranial Doppler (TCD) on all participants and Breath Holding Index (BHI) was measured on both sides from the middle cerebral artery (MCA). Results: There was a significant decrease in breath holding index in patients of migraine. There was a statistical significance decrease in BHI and Maximum flow velocity in the left MCA (Max. FV Lt MCA) among severe patients compared to moderate patients. Conclusion: Migraineurs have significantly lower BHI compared to control group. The noninvasiveness of TCD and the possibility it provides for obtaining instantaneous information about cerebral blood flow changes indicates its usefulness in the study of vascular changes in different types of migraine.
https://ejhm.journals.ekb.eg/article_184239_b691d6cd7badc2657d55ba9e7a977fa8.pdf
2021-07-01
2366
2371
10.21608/ejhm.2021.184239
Cerebrovascular Reactivity
Migraine
Transcranial Doppler
Ultrasound
Sawsan Abdel Aziz
Yousef
1
AUTHOR
Magdy Abdel Hameed
Aidaros
2
AUTHOR
Muhammad Salah
El Sayed
m.s.ngu@hotmail.com
3
AUTHOR
Abdelrahman Ahmed
Fahmy
4
AUTHOR
ORIGINAL_ARTICLE
Evaluation of Platelet Indices as Early Markers for Diagnosis of Neonatal Sepsis
Background: Neonatal septicemia is a clinical syndrome characterized by signs and symptoms of infection with or without accompanying bacteremia in the first month of life. Sepsis is a common complication in the neonatal intensive care unit. It is caused by various organisms invading the blood stream, which may be by bacterial, viral, fungal and protozoal infections. Objective: The aim of this study was to diagnose neonatal sepsis early in order to reduce morbidity and mortality of newborn. Patients and methods: This study was a case-control study that included 132 participants divided into two groups, each group included 66 patients. 1st group included neonatal sepsis and 2nd group was control group without sepsis. They were admitted at Neonatal Unit of Pediatric Department at Zagazig University Hospitals during the period from 11/2019 to 11/2020.Investigations done for all these neonates, and included complete blood count [PLT, PDW, MPV and Platelet-large cell ratio (P-LCR)], CRP, ESR, blood culture, urine culture and chest x-ray. Results: There was statistically significant difference between the septic cases and control group regarding platelets distribution width (PDW) where 87.9% of the septic cases had elevated PDW while 45.5% of control group had elevated PDW. There was statistically significant negative correlation between platelets count with CRP, platelets distribution width, mean platelet volume and P-LCR (increased platelets count is associated with decrease in CRP, platelets distribution width, mean platelet volume and P-LCR) among the control group. Conclusion: Platelet indices, as part of a routine automated cell count, are cheap and readily available tests that can be used as valuable clues in the diagnosis of neonatal sepsis.
https://ejhm.journals.ekb.eg/article_184246_7221e8db577593d5897e8cf81597ed86.pdf
2021-07-01
2372
2377
10.21608/ejhm.2021.184246
Mean platelets volume (MPW)
Neonatal sepsis
Platelet Distribution width (PDW)
Wafaa Fathy
Elsaaed
1
AUTHOR
Asmaa Mohamed Hosny
Esh
2
AUTHOR
Abdulfatah Faraj Bin
Aeshah
fattahbenaisha@gmail.com
3
AUTHOR
Mohamed Ahmed
Arafa
4
AUTHOR
ORIGINAL_ARTICLE
Perineal Body Length as a Predictor of Labor Progress
Background: Trauma to the genital tract does occur in about two thirds of women during the first and subsequent deliveries and the majority of these traumas require suturing. There is a continuous inverse relationship between the rate of episiotomy and the rate of spontaneous trauma. Perineal trauma is associated with a high prevalence of certain health problems. Perineal pain is the most significant with its impact on daily activities.
Objective: The aim was to assess the relationship between the length of perineal body and mode of delivery, need for episiotomy and possibility of perineal and vaginal tears needing repair.
Patients and Methods: This study was conducted at Maternity Hospital, Faculty of Medicine, Zagazig University. All patients were subjected to the following: Complete history taking, complete general examination and antenatal care. Procedure: The perineum was measured as the distance from the fourchette (the mid-point of the posterior edge of the vaginal interoitus at the muco-cutaneous junction) to the center of the anal orifice. Measurement was performed by trained research nurses using standard tape in dorsal lithotomy position.
Results: This study showed that perineal tear, was present among 32.6% of the studied group.This study showed that need for episiotomy was 78.3%.The percentage of perineal tear was statistically lower among cases with perineal length > 4 cm than cases with perineal length < 4 cm (5.9% and 48.3%). The percentage for need of episiotomy was statistically lower among cases with perineal length > 4 cm than cases with perineal length < 4 cm (64.7% and 86.2%). Women with shortened perineal body length (< 4 cm) had a higher chance of a perineal laceration.
Conclusion: Longer perineum is associated with increase in the duration of the second stage of labor. The incidence of episiotomy and perineal tears were increased in patients with a perineal length of <4 cm.
https://ejhm.journals.ekb.eg/article_184252_0fe224866ed49026b73dd611ad6a96cd.pdf
2021-07-01
2378
2382
10.21608/ejhm.2021.184252
Perineal body length
Episiotomy
Perineal tears
Ali El-Shabrawy
Ali
1
AUTHOR
Waleed Abdallah
Abdel-Salam
2
AUTHOR
Ahmed Mohamed El-Sayed
Abdallah
elmodeer90@icloud.com
3
AUTHOR
Alaa Eldin Abdelsalam
Ahmed
4
AUTHOR
Mostafa Abdo
Ahmed
5
AUTHOR
ORIGINAL_ARTICLE
Coronary Sinus Filling Time in Patients with Angina and Normal Coronary Angiography in Zagazig University Hospitals
Background: Dysfunction of the coronary microcirculation may be one of the factors responsible for persistent anginal symptoms. Noninvasive as well as invasive modes for assessing microcirculation have yielded inconsistent results. Aim of work: To determine the usefulness of coronary sinus filling time (CSFT) for assessment of microcirculatory transit time in the coronary circulation.
Subjects and methods: A case-control study carried out in the Cardiology Department, Zagazig University Hospital on 57 patients divided into three groups: Group A included diabetics with angina, Group B included non-diabetics with angina, and Group C included control group. All patients were subjected to complete history taking, general examination and local cardiac examination. 12 Lead ECG, stress ECG (treadmill test), transthoracic echocardiography and coronary angiography were done.
Results: regarding CSFT in group A the mean was 5.247 ± 0.562, in group B the mean was 4.635 ± 0.224 sec and in group C the mean was 3.295 ± 0.525 sec. There were significant difference between group A and control group (P < 0.001), between group B and control group (P < 0.001) and between group A and group B (P < 0.001). There were statistically significant relation between prolongation of coronary sinus filling time and presence of comorbid hypertension (P < 0.001), dyslipidemia (P < 0.05), Family History of CAD (P < 0.001) and obesity (P < 0.05).
Conclusion: The coronary sinus filling time is a useful method for assessment of microcirculatory transit time in the coronary circulation. The prolongation of coronary sinus filling time is significantly associated with the presence of diabetes mellitus.
https://ejhm.journals.ekb.eg/article_184258_1964edbd506eea38841d56567ce84b98.pdf
2021-07-01
2383
2386
10.21608/ejhm.2021.184258
CSFT
Coronary
Angiography
Cardiology
Mohammad Elsayed Mohammad
Ibrahim
dr.mohamed.hadhoud.2020@gmail.com
1
AUTHOR
Tarek Ahmed
Naguib
2
AUTHOR
Tamer M
Mostafa
3
AUTHOR
Hisham Samir
Roshdy
4
AUTHOR
ORIGINAL_ARTICLE
Role of Serum Prolactin as A Cardiovascular Risk in Type 2 Diabetes Mellitus Patients in Zagazig University Hospitals
Background: Type 2 diabetes is a global public health crisis that threatens the economies of all nations, particularly developing countries. Hyperprolactinemia may reflect neuroendocrine stress reaction to acute coronary syndromes, which induces acute endothelial dysfunction, insulin resistance, and induction of vascular immune reactions; thus, prolonged hyperprolactinemia lead to arteriosclerosis, augmentation of arterial stiffness, and hypertension.
Objective: To assess role of prolactin as a cardiovascular risk in type 2 diabetes mellitus patients in Zagazig University Hospitals.
Patients and Methods: This study was performed in Clinical Pathology, Cardiology and Internal Medicine Departments Zagazig University Hospitals in the period between July and October 2019. Approval for study was obtained from research administration and research ethics committee, Faculty of Medicine Zagazig University.
Results: Regarding prolactin level, there was a statistically significant increase on comparing group 1 with group 2, 3 and 4 (P= 0.016, P<0.001, respectively). Also, there was a statistically significant increase on comparing group 2 with group 3 and 4 (p < 0.001), in addition to significant increase on comparing group 3 with 4 (p=0.012). In the present study, serum prolactin increased in patients with acute myocardial infarction (AMI) either in group1 (MI and DM) (mean=26±SD=8.09) or group 2(MI) (mean=16.24± SD =3.37), which points to the possible role of hyperprolactinemia in myocardial infarction. Prolactin was found to be increased as a marker of atherosclerosis so it can be used as biomarker for atherosclerosis or coronary artery disease.
Conclusion: Prolactin can be used as biomarker for coronary artery disease and this is explained by its participation in the process of atherosclerosis. Serum prolactin level increased in acute myocardial infarction.
https://ejhm.journals.ekb.eg/article_184261_61b2daf478d22e414629892561104fc6.pdf
2021-07-01
2387
2390
10.21608/ejhm.2021.184261
cardiovascular risk
prolactin
Type 2 diabetes mellitus
Tamer M
Mostafa
1
AUTHOR
Lamiaa Abd-Elwahab
Mohamed
2
AUTHOR
, Essam El Din Mahmoud Lotfy
Omer
3
AUTHOR
Sherihan Ahmed Mortada
Ibrahim
sherihan_mortada@yahoo.com
4
LEAD_AUTHOR
ORIGINAL_ARTICLE
Epidemiological Study of COVID-19 among Healthcare Workers
Background: Health care workers (HCWs) are crucial to maintaining healthcare services during COVID-19 pandemic. One of the greatest risks to healthcare system is the potentially high rate of infections due to COVID-19 among HCWs. Objective: To summarize the epidemiologic characteristics, clinical features, radiologic findings, laboratory data, and outcomes of health care workers diagnosed with coronavirus disease 2019 (COVID-19) in Sohag University Hospitals. Patients and methods: A retrospective study included 101 HCWs who were proved to have COVID-19. HCWs with COVID-19 were categorized to asymptomatic cases, mild cases which included patients with mild clinical symptoms and normal lung computed tomography (CT), and moderate cases which included patients with mild or moderate clinical features and abnormal lung CT. Results: 89.11% of infected HCWs had no definite history of contact with a confirmed case of COVID-19. A considerable percent of the patients presented with non-respiratory symptoms such as GIT, and neurological symptoms. Patients who had a moderate respiratory illness were significantly older than those who had a mild respiratory illness and were more likely to have diabetes. Home isolation was recommended in most cases (n=73). Several cases (n=24) preferred isolation in university undergraduate houses, and 4 patients were treated at isolation hospital, 2 of them needed oxygen therapy. Conclusion: COVID-19 in HCWs exhibited a wide spectrum of disease severity. Symptom-based screening for COVID-19 in HCWs may underestimate the affected number as there is a considerable percent of asymptomatic cases. For HCWs’ safety, the use of protective personal equipment and adherence to proper hand-hygiene practice are important protective tools during this pandemic. Also, there is a growing need for educational and training programs for all levels of HCWs.
https://ejhm.journals.ekb.eg/article_184264_74fea94d9c33e3758cd1883863cd1bb0.pdf
2021-07-01
2391
2399
10.21608/ejhm.2021.184264
COVID-19
health care worker
Mahmoud Saif-
Al-Islam
happyyear5000@yahoo.com
1
AUTHOR
Hamdy Saad
Mohamed
2
AUTHOR
Ahmad Mokhtar
Abodahab
3
AUTHOR
Doaa Gadallah
Hassanin
4
AUTHOR
Magda Mohamed
Ali
5
AUTHOR
Mustafa A
Younis
6
AUTHOR
Safaa
Khalaf
7
AUTHOR
ORIGINAL_ARTICLE
Diagnosis of Sepsis among Adult Patients with AML Using Scd14
Background: Millions of dead cases are reported every year due to sepsis. Sepsis has been estimated in 1-2 % of hospitalized patients especially leukemic patients. The diagnosis of sepsis remains a clinical challenge. Many studies suggest that presepsin plays a role in diagnosing sepsis, but the results remain controversial.
Objective: To evaluate the potential of presepsin as an early biochemical marker of sepsis in adult acute leukemic patients and to assess the correlation between severity of sepsis and level of presepsin. Comparing between presepsin & CRP in diagnosing bacterial infection in critically ill adult leukemic patients.
Patients and Methods: This study was conducted on 24 patients having acute leukemia after receiving chemotherapy and 24 controls at Medical Oncology and Clinical Pathology Departments, Zagazig University Hospitals during the period from June 2018 to August 2019.
Results: There was statistically significant difference between patients and control regarding presepsin levels. The highest levels of presepsin were in patients with septic shock followed by severe sepsis, sepsis, SIRS then control group. There was statistically significant difference between types of sepsis and presepsin (P value = 0.000). There was statistically significant positive correlation between CRP and presepsin (r = 0.658). AT cut off value of 440 the clinical sensitivity of presepsin was 82.5% and its clinical specificity was 90%, AUC was 0.89. On comparing these results with the normal cut off value of CRP level (6), the clinical sensitivity and specificity were 90% & 61% respectively and AUC was 0.70.
Conclusion: Presepsin can be used as a better indicator to the degree of severity of sepsis than CRP in septic adult leukemic patients.
https://ejhm.journals.ekb.eg/article_184655_646f93218bb96bf30cf95e438e7f1579.pdf
2021-07-01
2400
2404
10.21608/ejhm.2021.184655
presepsin
Systemic inflammatory response syndrome (SIRS)
Rania
Ghonaim
rania_ghonaim@yahoo.com
1
AUTHOR
Rasha
Haggag
2
AUTHOR
Thoraya
Hosny
3
AUTHOR
ORIGINAL_ARTICLE
Study of Vitamin D and Calcium Levels in Patient with Rosacea
Background: Rosacea is a chronic skin condition that primarily affects the central face, and is often characterized by flare-ups and remissions. The increase in serum vitamin D levels is associated with rosacea. Rosacea may be happened due to high level of vitamin D that increases level of cathelicidin, which affect inflammatory process and vascular response. In the other hand Ca level does not have relationship to the cause of rosacea.
Objective: To investigate the relationship between serum vitamin D and calcium levels in patients with rosacea and analyze the association of vitamin D with clinical features.
Patient and methods: This prospective case control study was carried out on thirty patients with rosacea and twenty age and gender matched healthy controls. All enrolled participants were subjected to a full history taking, general and detailed dermatological examination.
Results: Rosacea group showed significantly higher mean vitamin D level when compared to control group (25.5±5.3 versus 17.7±5.2) (p < 0.001). Rosacea cases had 17 with optimal vitamin D levels and 13 with mild to moderate deficiency, while control group cases had 4 with optimal vitamin D level and 16 with mild to moderate deficient vitamin D levels. There was significant (p=0.010) difference between cases and controls regarding vitamin D status. Total and ionized calcium levels did not differ significantly (p= 0.662 and 0.888 respectively) between cases and control groups.
Conclusion: Increased vitamin D levels may lead to the development of rosacea. New findings can be increased the understanding of pathogenesis of rosacea and may lead to development of new treatment options for rosacea.
https://ejhm.journals.ekb.eg/article_184656_b07c77bf80e94dc09dcdd57b6c183b0c.pdf
2021-07-01
2405
2410
10.21608/ejhm.2021.184656
calcium
Rosacea
Vitamin D
Magda Mostafa
Hagag
1
AUTHOR
Noha Rabie
Bayomy
2
AUTHOR
Doha Bakr Mohamed
El-Horish
dohabakr22@yahoo.com
3
AUTHOR
ORIGINAL_ARTICLE
Effects of Levetiracetam and Topiramate Monotherapy on Oral Health in Epileptic Children
Background: Epilepsy is a common neurologic disease in children associated with multipleneurodevelopmental comorbidities or related to adverse drug reactions due to antiepileptic drugs.
Objective: To study the effects of Levetiracetam (LEV) and Topiramate (TPM) monotherapy on oral cavity, to improve oral health care of epileptic children.
Patients and methods: This study was conducted on 60 epileptic children of age group 6 -12 years compared to 30 normal age- and sex-matched controls, 30 children on LEV monotherapy and 30 on TPM monotherapy. All were subjected to full clinical dental examination by a pediatric dental expert.
Results: There was significant increase in plaque index 50% grade 3 in children receiving antiepileptic medications, the decay-missing-filled (DMF) index was significantly more in children than in epileptic children, 43.3 % of children on antiepileptic having grade 1 Gingival index, while grade 2 gingival enlargements were noticed in 43.3% and dental hygiene was missed in 76.7% of children on antiepileptic drugs. Most of the indices were little more with TPM group than LEV group.
Conclusions: Both LEV and TPM affect oral health of epileptic children, which makes regular screening for oral health by a pediatric dental expert necessary to detect early changes and intervene to improve their quality of life.
https://ejhm.journals.ekb.eg/article_184657_81cafd3aaf57d4e4d4f6209197dea2d9.pdf
2021-07-01
2411
2416
10.21608/ejhm.2021.184657
Epilepsy
children
oral health
Antiepileptic drugs
Mennatallah O.
Shata
mennahshata@gmail.com
1
AUTHOR
Hamed M
Shatla
2
AUTHOR
Sherine
Badawy
3
AUTHOR
Mostafa M
Metkees
4
AUTHOR
ORIGINAL_ARTICLE
Evaluation and Management of Syncope in Pediatrics: A prospective Observational study at Sohag University Hospital
Background: Syncope is defined as temporary loss of consciousness and postural tone resulting from an abrupt transient decrease in cerebral blood flow. It is characterized by rapid onset, short duration and spontaneous complete recovery.
Objective: Our study aimed to analyze the frequency of syncope due to cardiac, neurocardiogenic, neurologic, situational, psychiatric, and other causes and make a differential diagnosis of syncope types according to detailed medical history and further investigations with focus on cardiac cause as the most serious type of syncope.
Patients and Methods: 125 pediatric patients were recruited from Arrhythmia Clinic in our Cardiology Unit, Sohag University Hospital. They presented with a primary complaint of syncope aged from 1year to 18 years with a mean age of 6.49 ± 3.77 years.
Results: The most common diagnosis was neurocardiogenic syncope (n=76, 60.8%). Sixty-four cases (84.2%) had recurrent episodes. Epilepsy was found in Thirty-four cases (27.2%) and psychogenic pseudo-syncope affected one female child. There were fourteen cases (11.2%) with cardiac syncope: 8 patients with LQTS, one patient with CPVT, one patient with AVNRT, 2 patients with dilated cardiomyopathy, 1 patients with history of atrioventricular (AV) canal defect closure and one patient with cardiac mass. There was significant relationship between arrhythmia and cardiac syncope (p < 0.001). Exercise-induced syncopes were significantly associated with cardiac origins (p < 0.001). Positive ECG, Holter and echocardiographic findings were statistically significant for cardiac syncope (P < 0.001).
Conclusion: Syncope is a common pediatric complaint. Most cases seen were resulting from benign causes, with only a small percentage because of serious medical conditions. In addition, most syncopal episodes in the pediatric population were diagnosed clinically or with minimally invasive testing, emphasizing the importance of a detailed history and physical examination.
https://ejhm.journals.ekb.eg/article_184658_5ebf331dfca5f1b0261681464b73187f.pdf
2021-07-01
2417
2423
10.21608/ejhm.2021.184658
Pediatric
Cardiac
syncope
Asmaa Ali
Hassan
r.asmaa.3ly@gmail.com
1
AUTHOR
Safaa Hussein
Ali
2
AUTHOR
Shaimaa Mohamed
Mahmoud
3
AUTHOR
ORIGINAL_ARTICLE
Health-Related Quality of Life in School Children with Short Stature in Gharbia Governorate in Egypt
Background: Short stature (SS) in a child is defined as a child 2 or more standard deviations below the mean height for children of that gender and chronological age. Health-related quality of life (HRQOL) reflects physical, psychological, social, cognitive, functional and behavioral dimensions of well-being and functioning as perceived by the person concerned, in a wide range of conditions between excellent and poor health.
Objective: To assess HRQOL for children and adolescents with short stature (SS).
Patients and Methods: In order to assess the HRQOL for SS patients, we studied 392 school children (preparatory and secondary) who meet the diagnosis of SS according to definition of WHO for short stature of child height below or equal 3rd percentile on WHO Growth chart in children of same gender and chronological age . Both sexes were included and age ranged from 12 to 18 years.
Results: According to family history, more than 2/3 of the children with SS had negative consanguinity. 1.5% was with positive family history of a similar condition and 15 % had positive family history of chronic disease. There was significant lower HRQOL in children with SS concerning physical, psychological and environmental World Health Organization Quality of Life (WHOQOL) domains. The psychological domain is the most affected one. A comparison of sex groups (males and females) in relation to different domains among cases but it did not reach statistically significant difference.
Conclusion: Pediatric patients with SS have lower HRQOL. Social domain is the most affected among SS children.
https://ejhm.journals.ekb.eg/article_184659_4bf8e045d798a294bd45d748cdc1bcd8.pdf
2021-07-01
2424
2429
10.21608/ejhm.2021.184659
Short stature
Health-Related Quality of Life
Gharbia Governorate
Seham Fathy
Azab
1
AUTHOR
Ashgan Abdalla
Alghobashy
2
AUTHOR
Ahmed Nagy
Elsafty
ahmedelsafty35@gmail.com
3
AUTHOR
ORIGINAL_ARTICLE
The Role of Atorvastatin in Suppressing Fibroid Related Symptom and Fibroid Size in Perimenopausal Women
Background: Uterine fibroids are the most common benign gynecologic tumors, with a lifetime incidence of approximately 70%. They are associated with multiple symptoms, including heavy uterine bleeding and pelvic pain. Currently used treatments include contraceptive steroids, Gonadotropin-releasing hormone agonist (GnRHa), progesterone modulators, uterine artery embolization (UAE), magnetic resonance imaging-guided focused ultrasound surgery (MRgFUS), and radiofrequency ablation (RFA).
Objective: To evaluate the effect of atorvastatin on decreasing fibroid related symptoms and fibroid size, endometrial thickness and cholesterol level in perimenopausal women.
Patients and methods: Prospective randomized controlled trial that was conducted over a period of 12 months during 2019 and 2021 on 105 patients with symptomatic uterine fibroid in perimenopausal age, admitted to emergency unit and gynecology outpatient clinic at Mansoura University Hospital and after obtaining acceptance from institutional research board faculty of medicine then patients were prospectively recruited and randomized by computer program.
Results: All groups at presentation demonstrated insignificant differences concerning demographic characteristics, gravidity and symptoms of uterine fibroid. Uterine fibroid demonstrated significant reduction in size as well as significant changes following the atorvastatin treatment after 6 months in a dose dependent manner, while endometrial thickness demonstrated insignificant differences as measured by transvaginal ultrasound (TVS). Cholesterol level demonstrated highly statistically significant decrease following atorvastatin treatment in a dose dependent manner.
Conclusion: The current study demonstrated that atorvastatin has promising effects in cases with uterine fibroids as it was associated with a reduction of fibroid size with reduction of fibroid related symptom (menorrhagia, dysmenorrhea).
https://ejhm.journals.ekb.eg/article_184660_ba8cd9753b16c16082b74f887d5b2b4b.pdf
2021-07-01
2430
2434
10.21608/ejhm.2021.184660
Atorvastatin
Perimenopausal Women
uterine fibroids
Ahmed Elsayed Abdel Aleem
Seada
ahmedseada1201011@gmail.com
1
AUTHOR
Yasser Abdel Dayem
Elmorsy
2
AUTHOR
Emad Ahmed
Fayala
3
AUTHOR
Ehsan Mohamed Raghib
Refaie
4
AUTHOR
ORIGINAL_ARTICLE
Thrombocytosis in Children: Clinical and Heamatological Study in Pediatric Department, Sohag University Hospital
Background: Thrombocythemia (ET) is defined as elevation in the platelets count more than 400,000/ µ L in peripheral smear. It is common in infant and children that occurs in 3 to 13% of children. Thrombocytosis is classified into primary/clonal or secondary according to the pathological origin.
Objective: To determine incidence, causes and types of thrombocytosis in children also the correlations between the severity of thrombocytosis and the etiology and platelets indices.
Patients and methods: Prospective, observational study was done in Pediatric Department and Pediatric Out-Patient Clinic, Sohag University Hospital. A total of 117 cases of thrombocytosis were included in this study. All children had thrombocytosis and aged from one month to twelve years old.
Results: Reactive thrombocytosis was observed in 114 cases (97.44%), while primary type was found only in 3 cases (2.56%), 2 of them had chronic myelogenouse leukemia and one case is diagnosed as essential thrombocytosis. Majority of children (96 cases) in our study patients had mild thrombocytosis (82.05%) while moderate thrombocytosis was found in 16 cases and severe thrombocytosis were seen in 5 cases with 13.67% and 4.27% of children respectively. The correlation between platelet number and the mean platelet volume (MPV) showed significant negative correlation (p < 0.001), while the correlation between the platelet number and plateletcrit (PCT) showed significant positive correlation (p < 0.001) but platelet distribution width (PDW) had no correlation with platelet number (P= 0.7).
Conclusion: Among our study platelet indices, the MPV had a significant negative correlation with platelet count and MPV was considered normal in patients with reactive thrombocytosis.
https://ejhm.journals.ekb.eg/article_184663_83dd1572a85d983f7dc8f3f4baf89e8b.pdf
2021-07-01
2435
2441
10.21608/ejhm.2021.184663
Thrombocytosis
Platelet volume
Plateletcrit
Platelet indices
Abd El-Rahman M.
Lotfy
pediatrician.lotfy@gmail.com
1
AUTHOR
Al Zahraa El Sayed
Ahmed
2
AUTHOR
Eman M.
Fahmy
3
AUTHOR
ORIGINAL_ARTICLE
Age Related Effects of Sleep Apnea in Adults: A Polysomnographic Study
Background: Age is a risk factor of obstructive sleep apnea (OSA). It has been shown that OSA progresses over time, full-night polysomnographic sleep study is considered to be the gold standard method for the diagnosis of obstructive sleep apnea syndrome (OSAS).
Objective: This study aims to determine the effect of age on sleep apnea patients.
Patients and Methods: A cross sectional study that included 95 patients conducted at a sleep laboratory in the ENT Department, Sohag University Hospital and in the Clinical Neurophysiology Unit, Cairo University. The study population age range was (20-60). All participants were subjected to personal history taking, detailed sleep history, medical history, general examination, ENT examination, Epworth sleepiness score (ESS), and polysomnography.
Results: Mean age was (43.99 ± 10.96). The male-to-female ratio was 1.7/1.3. Mean BMI was 35.27 ± 7.19. Mallampati score of grade II and III represented the majority of the patients (83.1%). The range of oropharyngeal collapse (tonsil collapse) was ranging from (no collapse-100%), with a mean of (62.31±25.50). The mean value of the Epworth sleep scale score in all patients was 8.09 ± 4.26. The mean of apnea hypopnea index (AHI) was 24.08 ± 28.33. Average O2 was 82.73 ± 31.61. A statistically significant linear correlation was observed between age and BMI, the circumference of the waist and neck, duration of complaints, and collapse of the tonsils (p <0.05).
Conclusion: Prevalence estimates of OSA increased continuously with age. Obesity could play an important role in elderly patients with OSAS and BMI could be a significant variable in determining the severity of OSAS in elderly patients.
https://ejhm.journals.ekb.eg/article_184666_f86a7ddc1cbd78b7c41a6bf50c2e6c3b.pdf
2021-07-01
2442
2446
10.21608/ejhm.2021.184666
Body Mass Index
Obstructive sleep apnea
polysomnography
sleep apnea syndromes
Doaa Mohamed
Gad
1
AUTHOR
Ann Ali
Abd-Elkader
2
AUTHOR
Usama Mohamed
Rashad
3
AUTHOR
Samar Thabet
Abu Bakre
samarthabet@med.sohag.edu.eg
4
AUTHOR
Mostafa Abdel-Moneim
Mohamed
5
AUTHOR
ORIGINAL_ARTICLE
Economic Analysis of HCV Different Screening Algorithms in Egypt
Background: A top ranked public health problems especially in developing countries is hepatitis C virus infection. Being asymptomatic infection, screening has been proposed as a credible public health strategy. Egyptian national guidelines were emphasizing on adopting screening programs nationwide. No economic evaluation studies tackling HCV screening based on risk exposure was conducted in Egypt so far.
Aim: To evaluate the cost effectiveness of screening algorithms among two different population subgroups.
Methods: A Cost-Utility analysis was conducted using a validated decision tree model linked to a Markov Model, to compare the Incremental Cost-Effectiveness Ratio (ICER) of two policy scenarios: No screening versus Screen-and-treat with direct-acting antiviral agents (DAA) ON two Egyptian population subgroups (high risk populations of acquiring HCV infection versus the overall population).
Results: The ICER for implementing screening on high-risk populations was 3895.31 EGY/ QALY, considered cost-effective (below the Egyptian Threshold 46000 EGY/ QALY). Conclusion: The ICER for implementing screening on high-risk populations was cost-effective. Whereas concerning the general population, it is considered cost-saving strategy.
https://ejhm.journals.ekb.eg/article_184667_285c4ae1a5afa052047af1902a598b05.pdf
2021-07-01
2447
2455
10.21608/ejhm.2021.184667
Cost-effectiveness
Economic Evaluation
hepatitis C
Screening
Amal S.
Sedrak
1
AUTHOR
Amany A.
Salem
2
AUTHOR
Mohamed
Hassany
mohamadhassany@yahoo.com
3
AUTHOR
Eman H.
Elsebaie
eman.elsebaei@kasralainy.edu.eg
4
AUTHOR
ORIGINAL_ARTICLE
Treatment of Genu Valgum Deformity in Adolescent by Closed Wedge Femoral Osteotomy
Background: Various types of corrective osteotomies of the distal femur have been described in the literature for genu valgum deformity such as lateral opening wedge, medial closing wedge, dome osteotomy, wedgeless spike osteotomy, and wedgeless “V” osteotomy.
Objectives: We aimed in this study to evaluate the effectiveness of medial closing wedge osteotomy in correction of deformity.
Patients and Methods: This study was done on 32 knees (18 patients) with age ranged from 10 to 18 years with mean average of 15.61 ± 1.28 years. After recording history and physical examination, appropriate radiographs were taken. We did varus distal femoral osteotomy by standard medial subvastus approach then followed the patients clinically and radiographically.
Results: Mean operation time was 139.72 ± 42.4 minutes, with minimum 90 minutes and maximum 170 minutes. The mean time to union of osteotomy was 8.9 weeks (ranged from 7 to 11 weeks). The mean preoperative tibiofemoral angle (TFA) was 16.5° (range: 12°–19°) that improved after surgery to a mean postoperative value of 2.57° (range: 1.3°–4.7°), which was statistically significant (P< 0.001).
Conclusion: Distal femoral varus osteotomy can be a reliable procedure for the treatment of valgus knee deformity. In this procedure, with more tibiofemoral angle correction, more congruence angle correction can be achieved. Therefore, along with genu valgum correction, the patella should be stabilized simultaneously.
https://ejhm.journals.ekb.eg/article_184668_5151bdff64338ef667c9ae1adcfcf756.pdf
2021-07-01
2456
2460
10.21608/ejhm.2021.184668
Genu valgum
pathological
femur
Osteotomy
Mohammed Saeid
Adrees
mohammedsaed.edris.1988@gmail.com
1
AUTHOR
Khaled Mohamad
Hassan
2
AUTHOR
Reda Hussein
Al-kady
3
AUTHOR
Ehab Mohamed
Shehata
4
AUTHOR
ORIGINAL_ARTICLE
COVID-19 Pandemic and Hemodialysis: Disease Parameters and Outcome: Single Center Study
Background: Coronavirus disease 2019 (COVID-19) has significantly affected the provision of medical services. The hemodialysis (HD) facilities together with other medical facilities faced challenges in safely providing clinical care to patients and staff during the pandemic.
Objective: To describe our experience during the COVID-19 pandemic as regard infection, mortality rate, clinical manifestations, illness duration and the efficacy of our local infection control measures in our Hemodialysis Unit, Ain Shams University Hospital, Cairo, Egypt.
Patients and Methods: followed the interim guidance provided by the US Centers for Disease Control and Prevention (CDC) together with the European Renal Association– European Dialysis Transplantation Association (ERA-EDTA) for dealing with the emerging COVID19 pandemic in HD centers. The study included 238 patients on regular HD from Dialysis Unit in Ain Shams University Hospitals. We monitored all patients and staff members for any symptoms or signs of respiratory tract infection and those confirmed to have COVID-19 infection were followed up through their illness.
Results: 42 out of total 238 patients were diagnosed to have COVID19 infection by combination of symptoms, chest imaging and SARS COV PCR. Their mean age was 49.8 ± 8.9 years, 19 were males, the mean ± SD total illness duration for all COVID-19 positive patients was 17 ± 8.7. Patients were further subdivided based on survival into cure group (34 patients) and death group (8 patients). CRP and D-dimer were all significantly higher in death group while O2% were significantly lower in death group compared to cure group.
Conclusion: COVID 19 pandemic still a major health problem worldwide with significant morbidity and mortality among hemodialysis patients.
https://ejhm.journals.ekb.eg/article_184669_e162d887807ed61d56acf1c6e729030c.pdf
2021-07-01
2461
2466
10.21608/ejhm.2021.184669
Ain Shams University Hospital
COVID-19 pandemic
Hemodialysis
Mohamed Saeed
Hassan
1
AUTHOR
Howayda Abdelhamid
Elshinnawy
2
AUTHOR
Sahar Mohamed
Shawky
3
AUTHOR
ahmed
emara
ahmed_emara@med.asu.edu.eg
4
20 makrezy st, misr algadeda (heliopoplis), cairo, Egypt
AUTHOR
Reem Mohsen
Elsharabasy
5
AUTHOR
Mostafa Abdelnasier
Abdelgawad
6
AUTHOR
ORIGINAL_ARTICLE
Serum Level of Preptin in Children with Type-1 Diabetes Mellitus and Its Relation to Diabetic Nephropathy
Background: Type 1 diabetes is one of the most prevalent long-term diseases of childhood globally.
Objective: This study aimed to evaluate a new biomarker such as preptin in patients with type 1 diabetes and to assess its relation to diabetic nephropathy.
Patients and methods: This study was a case-control study that carried on 34 children and adolescents with type 1 diabetes mellitus in addition to 17 healthy children at the Pediatric Endocrinology Unit, Pediatric Department, Zagazig University Hospitals, from June 2020 to April 2021.All patients were subjected to laboratory investigations including fasting blood glucose levels, HbA1c, kidney function tests, lipid profile, serum albumin, urinary albumin, albumin creatinine ratio, glomerular filtration rate (GFR) and serum preptin.
Results: This study showed that age, weight and BMI were significantly higher among group II with no significant difference between group I and II by LSD. Also, there was no significant difference among groups regarding gender or family history of DM.
Conclusion: Serum preptin is significantly lower in patients with diabetic nephropathy compared with diabetic patients without nephropathy and healthy subjects.
https://ejhm.journals.ekb.eg/article_184670_0fbdc67a6482dca92ef1b3e369a1ed63.pdf
2021-07-01
2467
2473
10.21608/ejhm.2021.184670
Preptin
Type-1 Diabetes Mellitus
diabetic nephropathy
Wafaa Fathy Mohamed
Elsaeed
1
AUTHOR
Hadeel Mohamed
Abdel Rahman
2
AUTHOR
Nader Guima
Sasi
narrabty@gmail.com
3
AUTHOR
Haidy Essam Eldin
Zidan
4
AUTHOR
ORIGINAL_ARTICLE
Can Relative Blood Loss and Operative Time Predict Prolonged Length of Stay following Total Joint Arthroplasty? A Retrospective Study from Single Center in Saudi Arabia
Background: Total joint arthroplasty still causes a lot of blood loss, and many patients require blood transfusions thereafter. Blood transfusions can increase the risk of surgical site infection and periprosthetic joint infection, which can lengthen hospital stays and have a negative impact on patient outcomes.
Objective: This study aimed to examine if relative blood loss and operative time could predict the postoperative increased length of stay following total joint arthroplasty.
Patients and methods: A total of 187 procedures done during 2018–2021 were collected. Any revision case or any patient with hematological disorders was excluded. This led to a cohort of 181 procedures. The following data were collected: age, height, weight, body mass index (BMI), sex, procedure, surgery start time, surgery end time, preoperative hemoglobin and hematocrit levels, postoperative hemoglobin and hematocrit levels, number of packed red blood cells (PRBCs) transfused and the volume of each unit, and the length of stay (LOS).
Results: In our study, age (p < /em> = 0.027, odds ratio = 1.076) and relative blood loss (p < /em> = 0.038, odds ratio = 1.036) were predictors of prolonged LOS. Similarly, there was a significant association between age, operative time (p < /em> < 0.01), and blood loss (p < /em> < 0.001) and LOS.
Conclusion: The operative time, relative blood loss, and age were found to significantly affect the LOS. However, no significant association was found between LOS and gender or BMI.
https://ejhm.journals.ekb.eg/article_184671_5eb6f3d5cb15a568f92ac2e622ea8797.pdf
2021-07-01
2474
2479
10.21608/ejhm.2021.184671
blood loss
Total joint arthroplasty
Length of stay
Fahd Ibrahim
Aljuaid
aljuaidfahd@gmail.com
1
Department of Surgery, Faculty of Medicine, Taif University, Taif, Saudi Arabia
AUTHOR
ORIGINAL_ARTICLE
Circulatory Hsa_Circ_0007777 Expression Level as A Predictive Biomarker of Thyroid Dysfunction in Patients with Hashimoto's Thyroiditis
Background: Hashimoto's thyroiditis (HT) is the most common cause of hypothyroidism in iodine-sufficient areas of the world.The pathophysiology of HT is contributed to a combination of genetic susceptibility and environmental factors.
Objective: We aimed in the current study to investigate the relative expression level of hsa_circ_0007777 in patients with or without HT and to assess their associations with thyroid dysfunction.
Patients and Methods: A case-control study included 70 patients with HT and 70 healthy control subjects.Anti-thyroglobulin (anti-TG), anti-thyroid peroxidase (anti-TPO) were measured. Real-Time Quantitative PCR (RT-qPCR) analyses were used to detect the relative expression levels of hsa_circ_0007777.
Results: Hsa_circ_0007777 relative expression level was up regulated in patients with HT in particular patients with clinical hypothyroidism (CHT) and subclinical hypothyroidism (SCHT) compared to the euthyroid group. Andit was correlated positively with TSH, anti-TPO, and anti-TG. Moreover, linear regression analyses test revealed that in HT patients the main independent variables associated with hsa_circ_0007777 relative expression level were anti-TPO and anti-TG.
Conclusion: The relative expression levels of hsa_circ_0007777 were significantly increased in patients with HT more specifically in patients with clinical and subclinical hypothyroidism.
https://ejhm.journals.ekb.eg/article_185503_fca6a63f3aeb026684ed8c93ff874015.pdf
2021-07-01
2480
2485
10.21608/ejhm.2021.185503
hsa_circ_0007777, HT
RT-qPCR, Gene expression, Anti-TPO
Nearmeen M.
Rashad
1
AUTHOR
Marwa H.S
Hussien
2
AUTHOR
Rehab M.
Atef
3
AUTHOR
Shimaa
Abdelmoneem
shimaaabdelmoneem123@gmail.com
4
AUTHOR
Mohamed
Hamed
mohamed1gaber@gmail.com
5
Internal medicine department, faculty of medicine, zagazig university, Zagazig, Egypt
AUTHOR
ORIGINAL_ARTICLE
Role of Visual Field Testing and OCT in Evaluation of Brimonidine as a Neuroprotector in Primary Open Angle Glaucoma
Background: Glaucoma is the leading cause of global irreversible blindness optic neuropathy and retinal ganglion cell (RGC) death are the hallmarks of glaucoma. If intraocular pressure (IOP) is held within “normal” ranges, the disease process and RGC death can still progress in some patients. Neuroprotective therapies for glaucoma should aim to halt RGC loss thus preventing further structural and functional damage of the optic nerve
Objective: The aim of the current work was to study the ability of visual field testing and optical coherence tomography to reveal the neuroprotective role of brimonidine.
Patients and Methods: This prospective randomized controlled trial study included a total of 98 eyes from 50 patients affected by primary open-angle glaucoma (POAG). They were recruited from a larger population of 70 POAG patients, attending at Menofiya University Hospitals.
Results: The use of visual field-testing parameters have revealed that brimonidine had insignificantly halted glaucoma progression: MD (-0.1115 dB and -.2465 dB), VFI (-0.5882 and-1.1471) and PSD (0.1729 and 0.1894). On the other hand, some OCT parameters: average RNFL thickness (-0.7273 u and-2.2121 u), inferior RNFL thickness (-0.735 u and -1.559 u), superior RNFL thickness (-0.6364u and -1.4848 u), rim area (-0.0162 mm2 and-0.0797 mm2), average cup disc ratio (-0.01765 and 0.01824) and vertical cup disc ratio (-0.0167 and 0.0321) for study and control groups respectively, gave promising neuroprotective results for brimonidine.
Conclusion: It could be concluded that the use of visual field-testing parameters (MD, VFI and PSD) has revealed that brimonidine had insignificantly halted glaucoma progression.
https://ejhm.journals.ekb.eg/article_185508_f89c26a2c0451b5597baf56af5025a74.pdf
2021-07-01
2486
2494
10.21608/ejhm.2021.185508
Brimonidine
Primary Open angle glaucoma
Neuroprotec
Moustafa Kamal
Nassar
1
AUTHOR
Hany Ahmed
Khairy
2
AUTHOR
Sameh Mohamed
El Gohary
3
AUTHOR
Ahmed Mohamed Fawzy
Deif
ahmedfawzyeyedr@gmail.com
4
AUTHOR
ORIGINAL_ARTICLE
Effectiveness of Angioplasty in Treatment of Diabetic Foot Patients with Infragenicular Single Stenosis or Occlusion: A Prospective Study
Background: Diabetes is linked to both microvascular and macrovascular complications, such as retinopathy, nephropathy, and neuropathy (microvascular) and ischemic heart disease, peripheral vascular disease, and cerebrovascular disease (macrovascular), resulting in organ and tissue damage in approximately one third to one half of people with diabetes.
Objectives: The aim of the current work was to examine the effectiveness and safety of infragenicular angioplasty in diabetic patients with critical limb ischemia (CLI) due to single stenosis or occlusion.
Patients and Methods: The current study was a prospective cohort investigation that recruited diabetic patient with infragenicular CLI with or without supragenicular lesion at Vascular Surgery Department, Aswan University Hospital. The primary endpoint in our study was the primary patency at the end of sixth month of follow-up.
Results: This study included 20 patients with age ranged between 42 years and 82 years; the majority of patients were males (75%). Eighteen patients (90%) had immediate success; after six months, 14 patients (70%) remained patent.By the end of the sixth month post-revascularization, 15 patients (75%) had limb salvage, while four out of the remaining patients had rest pain relief (80%). Healing of minor ulcers occurred in 80% of the patients, and healing of tissue after debridement or minor amputation occurred in 60% of the patients.
Conclusion: It could be concluded that infragenicular angioplasty exhibited efficacy in the management of CLI due to single stenosis or occlusion in diabetic patients, with acceptable patency rate and safety profile.
https://ejhm.journals.ekb.eg/article_185510_0a2aff6d4e9f75d3d5bd84f5818d83b6.pdf
2021-07-01
2495
2499
10.21608/ejhm.2021.185510
diabetes
Diabetic foot
Limb Ischemia
Infragenicular angioplasty
Ali Mahmoud Mohamed
Galal
a_mando76@yahoo.com
1
AUTHOR
Mohamed Ahmed Mohamed Ismail
Ismail
2
AUTHOR
ORIGINAL_ARTICLE
A Comparative Study between Different Therapeutic Modalities for the Management of Patients with Graves' Disease
Background: The most prevalent cause of thyrotoxicosis is Graves' disease. It can be treated with antithyroid medications (ATD), radioactive iodine (RAI), or a near-total thyroidectomy, among other options. Objective: The aim of the current study was to compare between different therapeutic modalities for the management of patients with Graves disease. Patients and Methods: This Prospective Cohort study included a total of 48 patients with Graves' disease, treated and followed up at the Endocrinology Unit, Department of Internal Medicine, Faculty of Medicine, Zagazig University and both Outpatient Clinics and Medical Departments of Tripoli Medical Center. All patients were subjected to clinical examination of thyroid gland, thyroid function tests (FT3, FT4, TSH) and measurement of thyroid stimulating hormone receptor autoantibodies (TRAb) level. Results: There was statistically significant difference of mean TRAb value before and after treatment in three therapeutic modalities. On other hand, there was marked decreased mean TRAb after treatment with different modalities; difference statistically significant p < 0.05. The decline percent of TRAb values were 97.41%, 93.48%, 82.01% by surgical modalities, GI modalities and GII modalities respectively. Conclusion: It could be concluded that surgery appear to be the useful therapeutic modality associated with significant decrease in TRAb level and inducing remission of graves' disease.
https://ejhm.journals.ekb.eg/article_185512_8fa288eeae9c21f4f0f61d75909565f4.pdf
2021-07-01
2500
2504
10.21608/ejhm.2021.185512
Graves' disease
TRAb
Antithyroid drugs
Radioiodin therapy
Elshorbagy
EA
1
AUTHOR
Najlaa Ali
Khalifa
2
AUTHOR
Mohamed El Hamali Mohamed
Zawia
mahamedzawia@gmail.com
3
AUTHOR
Mohamed M.
Awad
4
AUTHOR
ORIGINAL_ARTICLE
Frequency and Correlation of Serum Uric Acid to Different Stages of Albuminuria in Type II Diabetic Nephropathy
Background: Albuminuria is considered the gold standard of onset and progression of diabetic nephropathy (DN). Higher levels of serum insulin may decrease uric acid clearance by the kidneys leading to hyperuricemia, which has injurious effect on kidneys.
Objective: To evaluate the frequency and relationship of uric acid to different levels of albuminuria in type II diabetes mellitus.
Patients and Method: This cohort study included 56 T2DM patients classified according to stages of DN into: Group I that including 12 patients with normoalbuminuria, group II included 26 patients with microalbuminuria, and group III including 18 patients with macroalbuminuria. All of them were evaluated for serum creatinine and albumin, CBC, ACR, UAE, HbA1c, ESR, Serum TSH and serum uric acid (SUA).
Results: Hyperurecemia frequency was (62.5%) and it had highly statistical significant difference with albuminuria in the three studied groups. There was strong significant positive correlation of SUA with UAE (p < 0.014), Cr (p < 0.037), ACR (p < 0.006), HbA1c (p < 0.017) in macroalbuminuria and UAE (p < 0.042) and ACR (p < 0.043) in microalbuminuria group, and TLC (p < 0.024) in normoalbuminuria group. While there was a significant negative correlation between UA with albumin (p < 0.029) in macroalbuminuria group.
Conclusions: Hyperinsulinemia and chronic inflammation associated with type IIDM leads to hyperuricemia, which had high frequency in our study (62.5%) and carry a hazardous effect on kidney function contributing to progressive increase of albuminuria. So we must search for management of elevated UA in these patients to delay onset & progression of its morbidity.
https://ejhm.journals.ekb.eg/article_185514_379a4af1c76d3754156cd3bc6bdd0d19.pdf
2021-07-01
2505
2509
10.21608/ejhm.2021.185514
Uric acid
type II diabetes mellitus
albuminuria
Egypt
Nafesa M.
Kamal
nanaashraf8979@gmail.com
1
AUTHOR
Eman Magdy
Abdull-Aty
2
AUTHOR
Amal
Zedan
3
AUTHOR
Yasser Abd El Monen
El Hendy
4
AUTHOR
Ibrahim M.
Salem
5
AUTHOR
ORIGINAL_ARTICLE
Sputum Bacteriology in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Background: Acute exacerbation is a common problem in the usual course of chronic obstructive pulmonary disease (COPD). Infections play a chief role in Acute Exacerbation of Chronic Obstructive Lung Disease (AECOPD) that leads to significant morbidity and mortality.
Objective: To assess the bacteriology in COPD exacerbations of hospitalized patients and correlate with clinical and laboratory data of the patients.
Patients and Method: a prospective study was conducted to correlate clinical, laboratory data with sputum culture results of 52 patients, admitted to the Pulmonology Department of Buraidah Central Hospital (BCH) with an AECOPD from 1st January 2018 till 31 August 2018. All collected sputum samples were subjected to standard microbiological procedures.
Results: Growth of pathogenic organisms was seen in 37 (71%) of the 52 sputum samples tested. Gram-positive organisms were found in the majority 20 (54 %). Gram negative microbes accounted for 17 (46%). Streptococcus pneumoniae (24.3 %) was found to be the most common bacterial agent responsible for COPD exacerbations, followed by Klebsiella pneumonia 7 (18.9 %), Haemophilus influenzae (H influenzae) and Staphylococcus aureus; each was 5 (13.5%), Streptococcus pyogenes (Streptococcus pyogenes) 4 (10.8%), Moraxella catarrhalis (M catarrhalis), Pseudomonas aeruginosa, and Methicillin-resistant Staphylococcus aureus (MRSA) each was 2 (5.4%)
Conclusion: Sputum culture is considered a simple and good diagnostic modality to identify bacteria in AECOPD. Antibiogram would assist in developing a local antibiotic strategy and reducing the appearance of resistance stains.
https://ejhm.journals.ekb.eg/article_185519_a235cdf4973a9fe99c519e19706113bf.pdf
2021-07-01
2510
2515
10.21608/ejhm.2021.185519
Antibiogram
Bacteria
Sputum
culture
Mahmoud Ahmed
Arafa
mahmoudarfa1977@gmail.com
1
LEAD_AUTHOR
ORIGINAL_ARTICLE
Evaluation of Intraperitoneal Instillation of Levobupivacaine versus Ultrasound Guided Rectus Sheath Block for Post-Operative Pain Relief Following Laparoscopic Cholecystectomy
Abstract
Background: Laparoscopic cholecystectomy (LC) is not a painless process, with the most acute pain occurring on the day of surgery and the next day. Postoperative pain management methods include intraperitoneal instillation of local anaesthetics and rectus sheath block (RSB), both of which may give excellent pain reduction.
Objectives: The aim of this study was to evaluate the efficacy of intraperitoneal instillation versus rectus sheath block using levobupivacaine for postoperative pain relief after laparoscopic cholecystectomy.
Patients and methods: The study was a prospective randomized double-blind study. Patients were randomized into two groups using a closed envelope technique in sequentially numbered opaque envelopes that was opened by an anesthesiologist not involved in the study.The study was conducted on 50 patients, 25 each for each group. Group I received intraperitoneal instillation of 40 ml 0.25% levobupivacaine. Group II (Rectus sheath block) received bilateral RSB with 40 ml of 0.25% levobupivacaine (20 ml on each side).
Results: There was high statistical significant difference between groups as regard VAS. There was high statistical significant difference between groups as regards patient satisfaction, which was more increased among rectus sheath group. Conclusion: U/S-guided rectus sheath block is effective as analgesic technique as intraperitoneal instillation of levobupivacaine led to more patient satisfaction, lower postoperative pain and lower amount of anaesthetic consumption. Both techniques are simple, safe, and without adverse effects. This study favors the administration of rectus sheath block pre-emptively for postoperative pain relief after laparoscopic cholecystectomy.
2516
https://ejhm.journals.ekb.eg/article_185523_49d7897957b6ad8647065c929401d647.pdf
2021-07-01
2516
2521
10.21608/ejhm.2021.185523
Laparoscopic cholecystectomy
intraperitoneal instillation
Levobupivacaine rectus sheath block
Ahmed A.
Metwally
1
AUTHOR
Nagwa M.
Doha
2
AUTHOR
Amany A.
Sultan
3
AUTHOR
Hend A.
Okasha
hendokasha93@gmail.com
4
AUTHOR
ORIGINAL_ARTICLE
Medical and Surgical Treatment of First Trimester Miscarriage, A Randomized Controlled Trial
Background: Abortion is a common complication of early pregnancy that can have both medical and psychological consequences. Complications following spontaneous or induced abortion are a major cause of maternal morbidity. Objective: To better management and improving outcome of first trimestric miscarriage.
Patients and Methods: A randomized clinical trial study was conducted at obstetric outpatient clinic, Gynecology and Obstetrics Department, Zagazig University during the period from May 2019 until June 2021. The study included 52 women suffering from abortion who were randomized to receive either medical treatment: 800 µg misoprostol prescribed as 400 mg orally and 400 mg vaginally or surgical treatment: evacuation with dilatation and curettage. All patients were followed up with a transvaginal ultrasonography (U/S). Results: The mean of endometrial thickness after treatment was 12.5±2.65 mm and 8.3±1.97 mm in misoprostol and surgical evacuation group respectively, the difference between both groups was statistically significant (p < 0.05). Failed treatment was in 8 (30.7%) patients in misoprostol group and in 2 (7.7%) patients in surgical evacuation group. The difference in failure rate between both groups was significant statistically. Conclusions: A single dose of 800µg misoprostol given as outpatient treatment may be used as first line in management of incomplete abortion.
https://ejhm.journals.ekb.eg/article_185527_8bf9843b76579020d54cd76308d77afc.pdf
2021-07-01
2522
2526
10.21608/ejhm.2021.185527
Abortion
First Trimestric Miscarriage
misoprostol
Amr Ahmed
Abdelrhman
1
AUTHOR
Tarek Abd Elhamid
El Behiedy
2
AUTHOR
Aya El Sayed Mostafa
Mohamed
ayaatty8@gmail.com
3
LEAD_AUTHOR
Mohamed Ramadan
Ali
4
AUTHOR
ORIGINAL_ARTICLE
Transient Constrictive Pericarditis: A Recent 2 Countries Study
Background: Constrictive pericarditis (CP) is a disease of the pericardium that leads to impaired diastolic filling of the heart. The treatment of such a disease entity is known to be purely surgical by pericardiectomy. Patients and methods: This is a prospective, analytical non-randomized study conducted during the period from January 2014 to November 2020. 34 cases of constrictive pericarditis were referred to us for management; 12 of them (35.29%) had a classic picture of definite constrictive pericarditis with areas of calcifications and typical symptoms of constrictive pericarditis (group A). 22 cases (64.71%) had typical symptoms but they responded to medical treatment with complete resolution of the pathology and symptoms (group B). Results: In group A, the mean age was 37 ± 12.3 years. They were treated with pericardiectomy via median sternotomy. 2 cases had persistent symptoms; there was no mortality operative or post-operative. 4 of them were TB positive. In group B, the mean age was 42 ± 14.1years. All were treated medically and resolved totally. All were preceded with influenza like symptoms or chest infection with bilateral pleural effusion and all were TB negative. Biopsies were taken from the pericardium revealing nonspecific reaction. Conclusion: There was an entity of constrictive pericarditis, which is known as transient constrictive pericarditis. It is a different pathology which is mostly autoimmune. It responds to medical treatment. There was no calcification, it might be recurrent and is associated with variable amounts of pericardial effusion and bilateral pleural effusions.
https://ejhm.journals.ekb.eg/article_185532_2dd2480ae137b39f7a1eb4723e0a6a6f.pdf
2021-07-01
2527
2533
10.21608/ejhm.2021.185532
Constrictive pericarditis (CP)
Transient CP
Classic CP
Alaa
Omar
alaaomarcts1@yahoo.com
1
AUTHOR
Ashraf Fawzy
Mahmoud
2
AUTHOR
Omar
Dawoud
3
AUTHOR
Mahmoud
Eldegwy
4
AUTHOR
Abdullah Osama
Mahfouz
5
AUTHOR
ORIGINAL_ARTICLE
Evaluation of Cytomegalo Virus Seropositivity in Haemodialysis Patients and its Relation to Metabolic Syndrome
Background: Chronic haemodialysis patients are at high risk for infection because the process of haemodialysis (HM) requires vascular access for prolonged periods. The humanCytomegalo Virus (CMV) is a DNA virus belonging to the Herpesviridae family, Betaherpsvirnae subfamily and Cytomegalo virus gender, known as Human Herpes Virus Type 5, one of the main causes of morbidity. Acute CMV infection is characterized by system-wide viremia after which latency and lifelong persistence is established in selected cells such as CD34+ monocytes and hematopoietic progenitor cells in humans.
Objective: The work was designed for early detection of CMV infection and metabolic syndrome (MetS) in patients on HD.
Patients and Methods: In this cross-sectional study, 80 patients under regular HD due to end-stage renal disease (ESRD) had participated in the study from HD Unite of Nasr City Health Insurance Hospital in Cairo in the period from June 2019 to December 2019.
Results: In the present study, patients were divided into three groups, first group 78 patients were positive for CMV IgG (97.5%), second group 11 patients were positive for CMV IgM (13.8%) and third group 10 patients were positive for both IgG and IgM (12.3%). In our studythe females have more CMV antibodies. In the present study, patients with metabolic syndrome were 68 (85%). Patients who had MetS and CMV IgG were 68 (100%). The relationship between MetS and CMV IgG is statistically proved.
Conclusion: the importance of early investigation for metabolic syndrome components especially in patients who are immunocompromised like HD patients because of the high prevalence of both chronic CMV infection and reactivation.
https://ejhm.journals.ekb.eg/article_188547_a2059d84030e1cc4b48cf790ed1d7b70.pdf
2021-07-01
2534
2537
10.21608/ejhm.2021.188547
Metabolic syndrome
haemodialysis
Cytomegalo virus
Evaluation
George Emad
Shaker
1
AUTHOR
Heba Shafeak
Abd El Khalik
2
AUTHOR
Rehab Ahmed
Rabie
3
AUTHOR
Ramy Wagdy Ahmed
Abd ElAziz
4
AUTHOR
ORIGINAL_ARTICLE
Evaluation of Lacrimal Sac Diameter in Different Age groups Using Ultrasound Biomicroscopy
Background: Chronic dacryocystitis is the most frequent disorder in the lacrimal drainage system. The disease has been considered to be strongly associated with obstruction of the lacrimal duct, which creates a fertile environment for bacterial colonization and promotes lacrimal sac inflammation.
Objective: The aim of this work was to evaluate lacrimal sac diameter in different age groups using ultrasound biomicroscopy (UBM).
Patients and Methods: Twenty-four eyes of 24 normal individuals. They were divided according to age into 3 groups; group A: age ranging between 30 and 40 years, group B: age ranging between 40 and 50 years and group C: age above 50 years. Lacrimal sac diameter was assessed. Ocular examination and special tests were done for lacrimal drainage system (regurge test and fluorescein dye disappearance test) with imaging of lacrimal passages by ultrasound biomicroscopy.
Results: All patients had no symptoms of epiphora, negative both regurge test and dye disappearance test and clear contents of the lacrimal sac. There was no statistically significant difference between groups regarding either longitudinal or horizontal lacrimal sac diameter. Conclusion: UBM can be used for imaging and measuring lacrimal passages and thus can be useful as an adjunctive to clinical examination and surgical planning in cases with lacrimal system diseases.
https://ejhm.journals.ekb.eg/article_188548_71cb04153a7af84f8a194e8418eabc08.pdf
2021-07-01
2538
2541
10.21608/ejhm.2021.188548
Chronic dacryocystitis
Lacrimal
UBM
Mohamed Ezzat
Abdelfatah
1
AUTHOR
Emad Mohamed
Elhady
2
AUTHOR
Tamer Gamal
Elsayed
3
AUTHOR
Nawal Elsayed Mohamed
Elyamani
4
AUTHOR
ORIGINAL_ARTICLE
Postoperative Parents’ Satisfaction in Cases of Simple Unilateral Cleft Lip Repaired by Millard’s Procedure
Background: Cleft lip is the second most common congenital anomaly (after club foot) accounting for about 13% of all congenital anomalies, and the overall incidence is 1 in 1000 live births. An individual with a disfigurement may be more prone to developing psychological problems. Patient and parent satisfaction is a key indicator of treatment quality. Objective: The purpose of this study was to improve satisfaction after repaired simple unilateral cleft lip by Millard’s procedure. Patients and Methods: This was a prospective cohort study including 24 patients with unilateral cleft lip. The study was performed in the Pediatric Surgery Department, Zagazig University Hospitals. The study was performed in the period from September 2020 to May 2021. All patients were subjected to full history taking, general and local examinations and investigations; including complete blood count and coagulation profile tests. Results: There was statistically significant relation between severity of cleft lip and symmetry at the Cupid’s bow p=0.043 and nasal symmetry p=0.002. It was obvious that incomplete cleft lip had hundred percent good result regarding symmetry at the Cupid’s bow and nose while there was statistically insignificant relation between parents opinion about symmetry and severity of cleft lip p>0.05. Conclusions: Counseling the parents and thereby motivating them and educating them regarding the cleft and the various procedures by which the deformity can be tackled are one of the most important aspects of treatment.
https://ejhm.journals.ekb.eg/article_188549_c75b73966b14fa816a7da5fa55f85142.pdf
2021-07-01
2542
2547
10.21608/ejhm.2021.188549
Millard’s
parents
Unilateral cleft lip
Mohamed
Elekiaby
1
AUTHOR
Tarek
Gobran
2
AUTHOR
Ahmad
Rozik
3
AUTHOR
Wael
Mansy
4
AUTHOR
Omar
Elekiaby
5
AUTHOR
ORIGINAL_ARTICLE
The Effect of Omega 3 Fatty Acids Intake on Drug Resistant Epilepsy (DRE) in Children
Background: Epilepsy is a frequent neurologic disease in children. Epilepsy is one of humanity's oldest diseases, and it is still the most prevalent neurological disorder afflicting people of all ages. It is estimated that 50 million people worldwide suffer from epilepsy at any given moment.
Objectives: To assess the effect of omega 3 supplementation on seizure control in patients with drug resistant epilepsy, and to compare the effect of the use of low-dose omega 3 versus high dose on seizures control of these patients.
Patients and Methods: The study included 44 patients 26 males (59.1%) and 18 females (40.9%) as one patient dropped off during the study. Their mean age was 6.35±3.59 years, they were followed up at Outpatient Pediatric Neurology Clinic, Children’s Hospital, Ain Shams University.
Results: The primary finding in the current study was that there was a statistically significant decrease in seizure frequency after low-dose omega 3 (1 capsule/day, 1000 mg of eicosapentaenoic (EPA) + docosahexaenoic acid (DHA)). The secondary finding in the current study was that there was a statistically significant decrease in severity of seizures after low-dose fish oil (1 capsule/day, 1000 mg of EPA+DHA). The tertiary finding in the current study is that there was no statistically significant decrease in seizure frequency, duration, and severity after high dose omega 3 (2 capsules/ day, 2000 mg EPA +DHA) compared with before using omega 3 at the beginning of the study.
Conclusion: Low dose fish oil (1 capsule/day, total of 1000 mg EPA+DHA) was associated with a 50% reduction in seizure frequency and reduction rate 4.62% in seizure severity compared with before using omega 3 supplementation in patients of drug resistant epilepsy.
https://ejhm.journals.ekb.eg/article_188550_24f10cfaafe9accd852d2c62fd633eae.pdf
2021-07-01
2548
2553
10.21608/ejhm.2021.188550
drug resistant epilepsy
Omega 3 Fatty Acids
Mennatallah O.
Shata
mennahshata@gmail.com
1
AUTHOR
Rasha H
Aly
2
AUTHOR
Manar A
ElHalim
3
AUTHOR
ORIGINAL_ARTICLE
CT Evaluation of Rotational Malalignment after Intertrochanteric Fracture Fixation
ABSTRACT
Background: Intertrochanteric fractures account for 60% of all proximal fractures of femur and most of these fractures occur in patients over 65 years of age and mostly affect females. They are fixed mostly either by proximal femoral nails (PFN) or dynamic hip screw (DHS) post reduction under C- arm images.
Objective: To evaluation by CT the quality of reduction in the horizontal plane.
Patients and methods: Prospective study including 20 patients operated for intertrochanteric fracture femur between April 2019 and December 2019. Thirteen fractures were treated using DHS plate and screw fixation and 7 with PFN. All these patients underwent postoperative CT of the pelvis and knee on the same day of the operation during their hospitalization with measurement of anteversion of the operated and healthy necks of femur compared with a tangent posterior condyles of femur.
Results: There was malalignment greater than 15° on the operated side compared to the unoperated side at 30% of patients.
Conclusion: The rate of rotational malreductions of operated trochanteric fractures is very high; 30%, with a majority of external over rotation occurred during reduction maneuvers. The criteria normally used for reduction of trochanteric fractures are insufficient to prevent rotational malalignment. The increase in the number of C-arm images seems to be an advantageous to avoid these reduction errors during pre- and intraoperative maneuvers.
https://ejhm.journals.ekb.eg/article_188551_3d3b4d0334aafd3dc59269841a4d6ec8.pdf
2021-07-01
2554
2558
10.21608/ejhm.2021.188551
CT
Intertrochanteric Fracture Fixation
Rotational Malalignment
Elshazly Saleh
Mosa
1
AUTHOR
Mosaab Ahmed
Mohamed
mos3ab22333@gmil.com
2
AUTHOR
Ahmed Saleh
Sleem
3
AUTHOR
Hosam
El-Azab
4
AUTHOR
ORIGINAL_ARTICLE
Study of Embolic Cerebral Stroke in Atrial Fibrillation Patients. Severity, Recurrence and Outcome
Background: Patients with AF and concomitant potential cardiac sources of embolism increase the risk of recurrent embolism despite anticoagulation.
Objectives: The aim of this study was to study different cardiac sources of embolism in stroke patients with AF and was to study if the presence of concomitant cardiac sources of embolism in AF stroke patients has impact on stroke severity, recurrence, response to treatment & outcome.
Patients and methods: The study was a prospective clinical study that was conducted on 60 patients admitted to the Intensive Care Unit (ICU), Menoufia University Hospitals.The patients were divided into 2 groups: Group I: Patients with concomitant cardiac sources of embolism. Group II: Patients without concomitant cardiac sources of embolism.
Results: There was significant difference found between the two groups regarding recurrence (P=0.045). We found that Elders, diabetics, patients with dyslipidemia, patients with CVD, severe National Institutes of Health Stroke Scale (NIHSS) score patients and big infarction size were significantly associated with poor stroke outcome.
Conclusion: In conclusion, we found that most of the recurrent ischemic strokes were associated with elders, diabetics, patients with dyslipidemia, patients with CVD, severe NIHSS score patients and big infarction size.
https://ejhm.journals.ekb.eg/article_188552_6804bb0ba14488488b59b7f518cbf2a5.pdf
2021-07-01
2559
2564
10.21608/ejhm.2021.188552
stroke
Atrial Fibrillation
Recurrence
NIHSS score
Infarction
Ashraf M. Mohamed
Mostafa
1
AUTHOR
Yaser I.
Fathy
2
AUTHOR
Mahmoud K.
Ahmed
3
AUTHOR
Khaled H.
Afifi
4
AUTHOR
Naglaa S. Abd El hady
Hammad
naglasamy.ns@gmail.com
5
AUTHOR
ORIGINAL_ARTICLE
Ultrasonographic Optic Nerve Sheath Diameter as A Surrogate Measurement of Intracranial Pressure in Preeclampsia
Background: Preeclampsia affects five to ten percent of pregnant women and accounts for about twelve percent of maternal mortality. It is the third most common cause of maternal mortality worldwide. Papilledema is an indirect and late indicator of raised intracranial pressure (ICP), whereas a pressure rise in optic nerve sheath (and the resulting enlargement of the optic nerve diameter) is a more dynamic process. The retrobulbar optic nerve sheath diameter (ONSD) can be measured at a position 3 mm posterior to the globe, where ultrasound contrast is greatest with more reproducible results.
Objective: To evaluate the correlation between ultrasonographic measurement of ONSD with the degree of severity of preeclampsia.
Patients and methods: This prospective observational study was conducted at Mansoura University Hospital Intensive Care Unit from July 2019 to June 2020. Just after delivery, 175 pregnant females aged between 18 and 45 years old were enrolled for participating in this study. Out of them, 25 females were excluded.
Results: As regarding body weight, there was a significant difference between the control group (79.9±6.36 kg) and preeclamptic without severe feature group (87.7±10.58 kg). The mean body weight in severe preeclampsia group was (91.5 ±14.73kg) which showed no significant difference from that of the non-severe group. ONSD values showed significant difference between the studied groups. The control group had ONSD mean value of 4.85±0.32 mm, mild preeclamptic group had mean value of 6.05±0.096 mm, while severe preeclampsia group had a mean value of 6.76±0.25 mm.
Conclusion: Ultrasonographic measurement of ONSD provides a non-invasive, quick and readily accessible tool for evaluation of raised intracranial pressure (ICP).
https://ejhm.journals.ekb.eg/article_188553_68c8093a873113ca6e9eea398e2138ba.pdf
2021-07-01
2565
2575
10.21608/ejhm.2021.188553
Intracranial pressure
Optic nerve sheath diameter
preeclampsia
ultrasonographic
Ahmed Mohamed Mohamed
Ali El-Din
ahmedalieldin2000@gmail.com
1
AUTHOR
Doaa Galal
Diab
2
AUTHOR
Ibrahim Ibrahim
Abd El-Basir
3
AUTHOR
Amal Rashad
Reyad
4
AUTHOR
ORIGINAL_ARTICLE
Short Term Outcome of Closure or Non-Closure of Peritoneum in Caesarian Section
v*
Background: Cesarean section (CS) can be considered as one of the most frequently performed surgical procedure worldwide, accounting for up to 70% of deliveries, depending on the facility being assessed and the country involved. In Egypt its rate reach about 51.8% from deliveries. Objetive: To compare closure versus non-closure of visceral and parietal peritoneum during primary cesarean section regarding early postoperative outcome.
Patients and Methods: A randomized-controlled study that was conducted at Ismailia General Hospitals during the period from November 2018 to March 2019. Included 142 pregnant women attending Obstetrics and Gynecology Department for primary cesarean section who were divided into two groups. Group I (Control) 71 patients with closure of both the visceral and parietal peritoneum (Study) 71 patients with non-closure of both the visceral and parietal peritoneum. Patients were assessed for intra-operative parameters including operation time. Postoperatively, patients were assessed for pain degree, distention, fever, regain of intestinal sound, wound infection and duration of hospital stay.
Results: There was statistically significant difference between both groups regarding age, BMI, parity, gestational age and type of CS. Non-closure technique of both visceral and parietal peritoneum in CS is associated with shorter operation time, less postoperative pain score, rapid regain of intestinal motility and less duration of hospital stay.
Conclusion: Non-closure of both visceral and parietal peritoneum at CS is associated with less operative time, less postoperative pain and distention and wound infection hence routine closure of peritoneum at CS can be avoided.
https://ejhm.journals.ekb.eg/article_188554_8ec90e348cdf7406617105db314103ec.pdf
2021-07-01
2576
2580
10.21608/ejhm.2021.188554
Peritoneal closure
Caesarian Section
Peritoneum
Ali El-Shabrawy
Ali
1
AUTHOR
Ahmed El-Sayed
Ibrahim
2
AUTHOR
Ahmed Mohamed
Abdel-Aziz
3
AUTHOR
Mustafa Taha
Abdel-fottoh
4
AUTHOR
ORIGINAL_ARTICLE
Efficacy of Cybele Scagel Phonophoresis on Post-Burn Hypertrophic Scar
Background: Hypertrophic scar (HTS) formation after burn remains a major issue for burned patients and is considered a huge problem for clinicians because the hypertrophic scar is painful, reddish, elevated, pruritic, and aesthetically unacceptable. Objective: To evaluate the therapeutic efficacy of Cybele Scagel phonophoresis on the treatment of hypertrophic scar post burn cases. Patients and methods: Thirty patients who had hypertrophic scar after wound closure with ages ranged from 20 to 45 years were selected randomly and divided into two equal groups in number (15 patients each). Group A (study group): received Cybele scagel phonophoresis, 3 sessions per week for 8 weeks (24 sessions), while patients in group B (control group): received topical cybele scagel for 8 weeks. Methods of assessment before and after the study included Modified Vancouver scar scale (VSS) to assess hypertrophic scar characteristics (height, vascularity, pigmentation and pliability) and digital imaging for visual assessment of the scars.
Results: the results of the study showed that between groups comparison, there was no significant difference in VSS between both groups pre-treatment (p > 0.05). Comparison between group A and group B post-treatment revealed a significant decrease in VSS of the group A compared to that of group B (p > 0.05).
Conclusion: It could be concluded that Cybele Scagel phonophoresis is an effective and safe modality that can be used for improving appearance of post burn hypertrophic scar.
https://ejhm.journals.ekb.eg/article_188555_ef72f5944a6448950bc0e642fa1d1589.pdf
2021-07-01
2581
2585
10.21608/ejhm.2021.188555
Post burn hypertrophic Scar
Cybele Scagel
phonophoresis
Modified Vancouver Scale and Digital imaging
Rofaida Mohie Eldeen Ali
Sobh
rofaida.sobh202m@yahoo.com
1
AUTHOR
Haidy Nady
Asham
2
AUTHOR
Sameh Mohammed
El-Taher
3
AUTHOR
Karim Ibrahim
Saafan
4
AUTHOR
ORIGINAL_ARTICLE
Effect of Transcutaneous Electrical Nerve Stimulation on Pruritus in Lichen Planus Patient
ABSTRACT Background: Lichen planus is a chronic inflammatory and immune mediated disease that is usually intensely pruritic, and this symptom does not subside after common antipruritic treatment. Objective: The purpose of the study was to evaluate the therapeutic effect of transcutaneous electrical nerve stimulation on lichen planus patient. Patients and methods: Thirty patients who had lichen planus with age ranged from 20-40 years were selected randomly from El-Saff Hospital, only who agreed to be volunteers participated in the study and were randomized into two groups of equal number, 15 patient for each group. Group (A) received medical medication and transcutaneous electrical nerve stimulation (TENS): frequency 100 Hz, with the duration of each session being 1 h, administered on 3 days/week for 4 weeks and intensity of TENS was according to patient tolerance and Group (B) who only received the same medical medication only. Results: Compared to result before and after TENS treatment, our study showed that there was significant decrease in the results of visual analogue scale (VAS) and Dermatology Life Quality Index (DLQI); but the result of group (A) were superior to that of group (B) when comparing the groups’ results together. Conclusion: TENS was beneficial and had a good effect on pruritus in lichen planus patients.
https://ejhm.journals.ekb.eg/article_188557_a0e1d05590a264a6a1b5fcc9ec0bfa13.pdf
2021-07-01
2586
2590
10.21608/ejhm.2021.188557
lichen planus
pruritus
Transcutaneous electrical nerve stimulation
visual analogue scale
Nessrien
Afifi
1
AUTHOR
Mohammed
Lotfy Elsaie
2
AUTHOR
Marwa Mahdy
Abd EL-Hameed
3
AUTHOR
Ghada Magdy
Abd Elrhim
ghadamagdy1982@gmail.com
4
AUTHOR
ORIGINAL_ARTICLE
Erector Spinae Plane Block: Review Article
Background: Erector Spinae Plane Block (ESPB) belongs to the family of fascial plane blocks in which local anesthetic is injected into a plane between two layers of fascia and subsequently spreads to nerves located within that plane or within adjacent tissue compartments. ESPB has been used in pain management, cervical, thoracic and cardiovascular surgeries.
Objective: The goal of this narrative review article is to go through the pertinent anatomy, explain how the injectant spreads, show several ways to erector spinae plane block, and summarise case studies and clinical trials.
Conclusion: Because the craniocaudal and vertical spread of local anesthetics and sensory block are not well understood or predicted, it appears that, unlike other blocks, the mechanism of erector spinae plane block and spread of local anesthetics will be decided by clinical data.
https://ejhm.journals.ekb.eg/article_188558_ea3350c7bb524e3d32077e6881dc4bc2.pdf
2021-07-01
2591
2598
10.21608/ejhm.2021.188558
Erector spinae plane block
pain management
Ahmed Mahmoud
Azmy
ahmedazmy19692@yahoo.com
1
AUTHOR
Abdelrahman Hassan
Abdelrahman
2
AUTHOR
Fawzy Abbas
Badwy
3
AUTHOR
Wael Alham
Mahmoud
4
AUTHOR
Al Haitham Mohamed
Taha
5
AUTHOR
ORIGINAL_ARTICLE
Quality of Life in Behçet’s Disease in Three Centers Experience
Background: Behçet’s syndrome (BS) is a systemic inflammatory vasculitis of unknown etiology, characinoid by recurrent oral, genital ulcers and uveitis. Its symptoms may affect patients’ quality of life.
Objective: This study aimed to evaluate the quality of life (QoL) in patients with Behçet’s disease (BD) in three centers experience (Menoufia University Hospital, Mansoura University Hospital, and Banha Teaching Hospital)
Patients and methods: A cross sectional study that was carried out on 70 BD patients selected from Rheumatology and Immunology Unit from Menoufia University Hospital, Benha Teaching Hospital, and Mansoura University Hospital from January 2019 till December 2020 on patients who were diagnosed by trained well qualified dermatologists and rheumatologist. All participants were assessed by the SF-36 QoL Scale to evaluate the QoL.
Results: The mean general health score was 12.0 ± 2.09 . The mean limitations of activities score was 10.57± 2.44 . The mean physical health problems score was 2.04 ± 0.97 . The mean emotional health problems score was 1.53 ± 0.90. The mean social activities was 3.94 ± 1.15 . The mean pain was 4.03 ± 1.19 . The mean energy and emotions was 17.63 ± 2.27 , and the mean overall QoL was 51.74 ± 5.03 . Conclusion: QoL scores do not correlated with demographic characteristics such as age, gender, BMI and weight. We also found that disease characteristics such as presence of oral ulcer, genital ulcer, and arthritis and skin lesion do not affect QoL scores.
https://ejhm.journals.ekb.eg/article_188559_272854cffb68964bc4517523e4af735d.pdf
2021-07-01
2599
2604
10.21608/ejhm.2021.188559
Behçet’s syndrome
quality of life
Enas S.
Zahran
1
AUTHOR
Sabry
Shoeib
2
AUTHOR
Mona R
Waly
tokayousef123@gmail.com
3
AUTHOR
Nibal
Mourad
4
AUTHOR
Emad M.
El-Shebiny
5
AUTHOR
ORIGINAL_ARTICLE
Role of Thrombophilia in Neonatal Thrombosis as A Risk Factor
Background: Thrombosis in neonates is rare and usually occurs as a secondary complication of underlying disease, e.g. sepsis or congenital heart disease, or exogenous triggers such as intravascular catheters.
Objective: This study aimed to identify the incidence rates, risk factors and outcomes of neonates with thrombosis admitted to NICU.
Patients and methods: This study was a cohort study conducted in Multiple Neonatal ICU in Sharkia Hospitals in the period from April 2020 to September 2020. The study included 24 neonates, with thrombotic disorders admitted to NICU. The included patients were subjected to careful history taking, clinical and neurological examination and laboratory investigations.
Results: Three patients (12.5%) had wild mutation of factor V gene mutation while 20.8% had wild mutation of prothrombin gene mutation. All patients had MTHFR C6771 mutation. Out of them 16.7% and 83.3% had homozygous and heterozygous types .There was statistically significant relation between presence of factor V G1691 gene mutation and d-dimer, which is significantly higher in wild type mutation.
Conclusion: The most important risk factor for thrombo-embolic events in neonates is placement of central catheters and some perinatal prothrombotic conditions.
https://ejhm.journals.ekb.eg/article_188560_03e1acde84ef01f0c6f8503f6a8cb6dc.pdf
2021-07-01
2605
2611
10.21608/ejhm.2021.188560
Thrombophilia
Neonatal
Thrombosis
Venous thromboembolism (VTE)
Atef Mahammad
Khalil
1
AUTHOR
Ehab Abd Elmenem
Al banna
2
AUTHOR
Zahrah Saleh
Huwas
dr.zohrarahawass@gmail.com
3
AUTHOR
Doaa Metwally
Abd Almonem
4
AUTHOR
ORIGINAL_ARTICLE
Sentinel Lymph Node in Colorectal Carcinoma
Background: Metastasis to the regional lymph nodes is an important prognostic factor in colorectal cancer and nodal evaluation is essential for accurate staging. Sentinel lymph node (SLN) mapping is an additional method for improving colorectal cancer nodal staging.
Objective: To evaluate the identification of SLN sensitivity and accuracy of nodal staging, its upstaging benefits and pattern of nodal metastases in colorectal carcinoma.
Patients and Methods: Lymphatic mapping was performed using patent blue in sixty patients with histopathologic diagnosis of colorectal carcinoma. Enhanced pathologic examination was carried out on (SLNs) using Haematoxylin & Eosin and immunohistochemistry.
Results: The patients studied had an average tumor size 6.6 cm and rectal tumors represented 43.3% of the group. Colon tumors had SLN identification rate of 94.1%, while rectal tumors had 80.8%. Overall, SLN mapping accuracy was 75.4%, sensitivity 66.7% and 33.3% false negative rate. Upstaging rate was 10.5%. No aberrant lymphatic drainage could be detected in our patients.
Conclusion: Intraoperative SLN mapping technique is feasible, safe, accurate, and has no apparent side effects. Implications for long-term survival and prognosis need to be further evaluated in additional studies.
https://ejhm.journals.ekb.eg/article_189444_65d6994356765fee85fb589905745744.pdf
2021-07-01
2612
2618
10.21608/ejhm.2021.189444
Sentinel lymph node (SLN)
Colorectal carcinoma
Lymph node mapping
Abdelhamid Hussein
Ezzat
1
Department of Surgical Oncology, National Cancer Institute, Egypt
AUTHOR
Waleed Mohamed Mohamed
Fadlalla
2
Department of Surgical Oncology, National Cancer Institute, Egypt
AUTHOR
Sherif E.
Sayed
3
Department of Surgical Oncology, Faculty of Medicine, Beni Suef University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Comparison between Continuous Regular Insulin Infusion and Single Dose Subcutaneous Long Acting Insulin Injection in Intensive Care Unit
Background: Stress-induced hyperglycemia is a common metabolic disorder in Intensive Care Unit (ICU) cases (30-60%) in diabetic and non-diabetic patients. It is related to increased rates of mortality and morbidity.
Objective: The aim of the current work was to compare between glycemic control in single dose long-acting subcutaneous insulin glargine injection and standard continuous regular insulin infusion in the same critical case.
Patients and methods: This prospective clinical study period was 72 hours for every patient and conducted on 111 patients aged 20-70 years with targeted blood glucose (BG) level ranging from 100 to 200 mg/dl using a different calculated dose of standard insulin infusion according to conventional sliding scale for the 1st 24hr of the study before conversion into insulin glargine single dose injection with 1-hour washout transition period.
Results: APACHE II score was significantly higher in “Uncontrolled hyperglycemia” group in comparison to “Uncontrolled hypoglycemia” group (P=0.030) but insignificantly different between “Controlled” group and “Uncontrolled hyperglycemia” group and between “Controlled” group and “Uncontrolled hypoglycemia” group. Daily units of insulin and mean BG level at 1st day were significantly lower in “Uncontrolled hypoglycemia” group in comparison to “Controlled” group (P=0.002 and 0.002 respectively) and “Uncontrolled hyperglycemia” group (P=0.004 and 0.006 respectively) but insignificantly different between “Controlled” group and “Uncontrolled hyperglycemia” group. While mean BG level was insignificantly different among the three groups at 2nd day, it was insignificantly different between “Controlled” group and “Uncontrolled hyperglycemia” group at 3rd day.
Conclusion: It could be concluded that the use of 100% conversion single dose of long-acting insulin glargine for control of hyperglycemia in critical ICU patients can be considered as an accepted good alternative to the classic use of continuous regular insulin infusion.
https://ejhm.journals.ekb.eg/article_189446_2ca72a6bf7ba6781a4a3b1240fe15eb7.pdf
2021-07-01
2625
2632
10.21608/ejhm.2021.189446
hyperglycemia
Single-Dose Subcutaneous Long-Acting Insulin
Continuous Regular Insulin Infusion
Intensive Care Unit
Khaled Mohammed
Hassan
1
Department of Anesthesia, Intensive Care and Pain Management Faculty of Medicine, Sohag University, Sohag, Egypt
AUTHOR
Kareem Khaled
Elhossini
kareemelkhayat92@gmail.com
2
Department of Anesthesia, Intensive Care and Pain Management Faculty of Medicine, Sohag University, Sohag, Egypt
LEAD_AUTHOR
Abd Elhady Ahmed Helmy
Abd Elhady
3
Department of Anesthesia, Intensive Care and Pain Management Faculty of Medicine, Sohag University, Sohag, Egypt
AUTHOR
ORIGINAL_ARTICLE
Prediction of Large Esophageal Varices by Ultrasound Doppler and Serum Markers in Portal Hypertensive Cirrhotic Patients in Sharkia
Background: Liver cirrhosis is the most common cause of portal hypertension (PH). Esophageal varices (OV) are the most critical portosystemic shunts that develop secondary to portal hypertension, which is considered a main complication of liver cirrhosis.
Objective: The purpose of this study was to compare the performance of serum marker – based indices and portal vein diameter assessed by ultrasound in patients of portal hypertension due to liver cirrhosis in prediction of large esophageal varices, graded on endoscopy.
Patients and Methods: This cross-sectional study included sixty-six patients with liver cirrhosis who were admitted to Internal Medicine Department, Zagazig University Hospitals for screening the presence of esophageal varices and investigating and/or treating of the patients. The study was performed at a period from September 2019 to February 2020 Diagnosis of liver cirrhosis depended on typical clinical, laboratory, and ultrasound features.
Results: There were statistically significant differences between large and small esophageal varices regarding AST, ALT, INR (higher in patients with large OV), platelet count (higher in patients with small OV).
Conclusions: It could be concluded that Doppler ultrasonography is a non-invasive quantitative technique for the assessment of hemodynamic changes in patients with portal hypertension and appears to be useful in the identification of patients with liver cirrhosis at risk of upper gastrointestinal bleeding.
https://ejhm.journals.ekb.eg/article_189607_65ef5e008350acd9c1479c5a1392ff17.pdf
2021-07-01
2119
2124
10.21608/ejhm.2021.189607
Oesophageal varices
Portal vein diameter
Serum markers
Ultrasound doppler
Portal Hypertensive
Ihab Ahmed Mohammed
Abdallah
ehab43398@gmail.com
1
Department of Internal Medicine, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Yasser Ahmed Fouad
El-Naggar
2
Department of Internal Medicine, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Hesham A.
Attia
3
Department of Internal Medicine, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Efficacy and Safety of Intralesional Triamcinolone Acetonide Injection in The Treatment of Alopecia Areata
Background: Alopecia areata (AA) is a chronic, immune mediated inflammatory disorder of anagen hair follicles leading to relapsing, nonscarring hair loss. Many therapies are available for the treatment of AA, including topical, systemic, and injectable modalities however, these treatment methods produce variable clinical outcomes and there are no currently available treatments that induce and sustain remission. Intralesional injection of corticosteroids (ILCs) is considered relatively simple, effective, and minimally invasive.
Objective: The aim of the work wasto investigate the efficacy and safety of intralesional Triamcinolone acetonide injection in the treatment of AA.
Patients and methods: Thirty-six patients suffering from AA were included in the study. All patients were subjected to complete history taking, general examination and dermatological examination for evaluation of site, size of the patches and type of Alopecia. Confirmation of diagnosis was done by dermoscopy. Evaluation of severity of the disease using SALT scoring system was done. After that, all the patients were treated by ILCs (Triamcinolone acetonide). 5 mg/ml of Triamcinolone acetonide was injected and the Injections were repeated every 4 weeks. Patients were assessed clinically at baseline and every month till the end of the sessions and were asked about their satisfaction on hair growth. Side effects were also monitored every session during and after injection.
Results: Hair growth after Intralesional Triamcinolone Acetonide treatment ranged from 0 to 5. 5.6% of patients showed excellent response, 5.6% showed very good response, 55.6% showed good response, 5.6% showed moderate response, 16.7% showed mild response while four patients showed poor response. Side effects were minimal like pain and atrophy (11.1%).
Conclusion: Intralesional Triamcinolone acetonide injection is safe and effective in the treatment of alopecia areata.
https://ejhm.journals.ekb.eg/article_189608_d41d8cd98f00b204e9800998ecf8427e.pdf
2021-07-01
2633
2636
10.21608/ejhm.2021.189608
Alopecia Areata
Triamcinolone acetonide
Intralesional corticosteroids
SALT scoring
Esraa Wathab
Abdel Fatah
esraa.wesab@su.edu.eg
1
Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Zagazig University, Egypt.
AUTHOR
Ahmed Said
Abdel Shafy
2
Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Zagazig University, Egypt.
AUTHOR
Shrook Abd Elshafy
Khashaba
3
Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Zagazig University, Egypt.
AUTHOR
ORIGINAL_ARTICLE
Clinical Audit of Normal Labour at Nekhel Central Hospital of North Sinai Governorate
Background: Clinical audit is a quality improvement process that seeks to improve patient care and outcomes through systematic review of care against explicit criteria. Where indicated, changes are implemented, and further monitoring is used to confirm improvement in healthcare delivery.
Objective: This study aimed at clinical Auditing of the normal labour in the department of Obstetrics and Gynecology, Nekhel Central hospital of North Sinai Governorate.
Patients and methods: This was a cross-sectional observational study that included 200 pregnant women attending Nekhel Central Hospital for normal vaginal delivery. We compared normal labour management and performance in Nekhel Central Hospital with NICE guidelines. The study was carried out through the period from April 2020 to October 2020.
Results: During the first stage of labour, documentation of frequency of contractions was done in 90% women labour according to NICE guidelines. Also, recording pulse, temperature and blood pressure was done in 100% pregnant women. Observation of frequency of passing urine was done in 87.5% women. 75% women underwent a vaginal examination 4 hourly according to NICE guidelines. During the second stage of labour, documentation of frequency of contractions was done for 90.0% women as NICE guidelines. During the third stage of labour, general physical condition and vaginal blood loss were observed in all cases (100%) and this meet NICE guideline.
Conclusion: There were missing of important aspects of appropriate care in Nekhel Central Hospital especially those related to appropriateness of care givers-patients interaction, safety and completeness of examinations, and appropriateness of postpartum care.
Keywords: Clinical Audit, Normal Labour, Nekhel Central Hospital, North Sinai Governorate.
https://ejhm.journals.ekb.eg/article_189609_6812a7ccbb51763c0d8931fa3c0991f5.pdf
2021-07-01
2636
2644
10.21608/ejhm.2021.189609
Clinical Audit
normal labour
Nekhel Central Hospital
North Sinai Governorate
Asmaa Zakaria Nabieh
Omar
asmaazakaria560@gmail.com
1
Department of Obstetrics and Gynecology, Faculty of Medicine - Al-Azhar University (Assiut), Egypt
AUTHOR
Ayman El Sayed El Ashmawy
El Ashmawy
2
Department of Obstetrics and Gynecology, Faculty of Medicine - Al-Azhar University (Assiut), Egypt
AUTHOR
Ahmed Ali Mohammed
Nasr
3
Department of Obstetrics and Gynecology, Faculty of Medicine - Al-Azhar University (Assiut), Egypt
AUTHOR
ORIGINAL_ARTICLE
The Effect of Intravenous Infusion of Propofol or Aminophylline on Incidence and Severity of Post-dural Puncture Headache in Elective Cesarean Section
Background: Post-dural puncture headache (PDPH) is caused by the persistent leak of cerebrospinal fluid (CSF) from the subarachnoid space. This leakage causes a decrease in the CSF volume and pressure leading to loss of the cushioning effect normally maintained by the intracranial fluid. This results in traction on the intracranial pain-sensitive structures, causing headache. The aim of the present study was to find ways to reduce the incidence and severity of PDPH in parturients undergoing spinal anesthesia for elective cesarean section. Patients and methods: This was a randomized controlled trial study conducted at Zagazig University Hospitals during the period from February to August 2020. It included 200 parturients, planned for elective caesarean section under spinal anesthesia. All parturients were kept nil orally (8 hrs for fatty meals, 6 hrs for light meals and 2 hrs for clear fluids) before the operation. Ranitidine 50 mg I.M was given to all parturients 90 minutes before the operation. Results: The severity, duration of headache was significantly lower in the propofol group compared with the control and aminophylline groups. There was no significant difference between aminophylline and control groups. Conclusion: We can conclude that propofol reduced the severity, the duration and the associated symptoms of post-dural puncture headache compared to aminophylline in parturients undergoing spinal anesthesia for elective cesarean section.
https://ejhm.journals.ekb.eg/article_189610_baa44ba3935b09252188cfe204cedcc7.pdf
2021-07-01
2646
2654
10.21608/ejhm.2021.189610
aminophylline
cesarean section
Post dural puncture headache (PDPH)
propofol
Ahmad Gomaa
Mohamed
histamista2@gmail.com
1
Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine Zagazig University, Egypt
AUTHOR
Mohamed Anwar
Refky
2
Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine Zagazig University, Egypt
AUTHOR
Ekram Fawzy
Sayouh
3
Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine Zagazig University, Egypt
AUTHOR
Sara Mohamed
Abdelnaby
4
Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine Zagazig University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Intra Peritoneal Instillation of Bupivacaine or Bupivacaine plus Magnesium Sulphate or Bupivacaine plus Dexamethasone on Post-Operative Pain after Laparoscopic Cholecystectomy: A Randomized Controlled Study
Background: Laparoscopic cholecystectomy as opposed to open cholecystectomy is currently the most accepted surgical technique for cholelithiasis. Intraperitoneal administration of some drugs can be effective for pain relief after laparoscopic surgery. Intraperitoneal instillation of local anesthetics and opioids is gaining popularity for better pain relief.
Objectives: To compare the effect of adding dexamethasone or magnesium sulphate to bupivacaine on quality and duration of analgesia after intra-peritoneal instillation after laparoscopic cholecystectomy.
Patients and methods: Our prospective study was conducted on sixty patients with ASA physical status I or II. Their ages ranged between 18-60 years scheduled for laparoscopic cholecystectomy under general anesthesia in Menoufia University Hospitals. Patients were randomly divided into three groups, 20 patients each. Patients in group B (bupivacaine group): received 25 ml 0.25% bupivacaine. Group M (Magnesium sulphate group) received 20 ml 0.25% bupivacaine and 5 ml (500 mg) magnesium sulphate.Group D (Dexamethasone group) received 20 ml 0.25% bupivacaine and2 ml (8mg) dexamethasone completed to 25 ml with 3 ml normal saline.
Results: First time of analgesia was significantly longer among magnesium group than dexamethasone group and bupivacaine group (p < 0.05). Nalbuphine consumption in 24 hrs, was higher among bupivacaine group followed by dexamethasone group then magnesium group (p < 0.05). Also, VAS score was significantly higher in bupivacaine group at 4 hour than other groups and, at 6-hour it was higher in dexamethasone group and bupivacaine group with no significant difference but highly significantly more than magnesium. In magnesium group VAS score was low over 24 hours.
Conclusion: Our study found that magnesium sulphate is a good additive than dexamethasone when combined with bupivacaine in intra-peritoneal instillation as it prolonged the duration of analgesia and reduced postoperative pain scores and nalbuphine consumption after laparoscopic cholecystectomy.
https://ejhm.journals.ekb.eg/article_189611_efcaf5ced06bd0932855fafdb3693b2e.pdf
2021-07-01
2655
2662
10.21608/ejhm.2021.189611
Laparoscopic cholecystectomy
Intra-peritoneal instillation
Bupivacaine
Magnesium sulphate
dexamethasone
Alshefaa A.
Zahra
shefaaali20@gmail.com
1
Department of Anesthesiology and Intensive Care Faculty of Medicine, Menoufia University, Menoufia, Egypt
AUTHOR
Khaled M.
Abo-Elenin
2
Department of Anesthesiology and Intensive Care Faculty of Medicine, Menoufia University, Menoufia, Egypt
AUTHOR
Elham M.
El-Fiky
3
Department of Anesthesiology and Intensive Care Faculty of Medicine, Menoufia University, Menoufia, Egypt
AUTHOR
Zeinab A.
Kasemy
4
Department of Anesthesiology and Intensive Care Faculty of Medicine, Menoufia University, Menoufia, Egypt
AUTHOR
Ahmed M.
Helwa
5
Department of Anesthesiology and Intensive Care Faculty of Medicine, Menoufia University, Menoufia, Egypt
AUTHOR
ORIGINAL_ARTICLE
Management of Retrograde Dissection Complicating Thoracic Endovascular Aortic Repair
Background: Retrograde type A aortic dissection is a challenging surgical emergency associated with high morbidity and mortality.
Objective: The aim of this study was to describe our experience with retrograde type A aortic dissection (RAAD) following thoracic endovascular aortic repair (TEVAR) and its surgical management strategy.
Patients and Methods:Our study was conducted between January 2011 and January 2021 at Cairo University Hospitals, and included 100 patients undergoing (TEVAR) to highlight the management of retrograde dissection complicating the procedure. The mean age was 55 ± 9 years and 76% of patients were males. All retrograde dissection patients underwent emergency surgical repair.
Results: The in-hospital mortality was 10% of patients who had RAAD and occurred in one patient who suffered from fatal hematemesis postoperatively. The mean cross clamp time was 93±17 minutes and circulatory arrest time was 25±6 minutes. One patient also suffered from acute renal failure requiring hemodialysis during the postoperative hospital stay.
Conclusions: Retrograde type A aortic dissection is an uncommon but potentially catastrophic complication of TEVAR. Surgical replacement of ascending aorta and a segment of aortic arch involving the entry tear offers an efficient strategy
https://ejhm.journals.ekb.eg/article_189613_413b43f87b462583e517571a5b2663f5.pdf
2021-07-01
2663
2666
10.21608/ejhm.2021.189613
Aortic dissection
Retrograde dissection
TEVAR
Omar
Dawoud
omar_dawoud@cu.edu.eg
1
AUTHOR
Alaa
Omar
alaaomarcts1@yahoo.com
2
AUTHOR
Mina
Wahba
3
AUTHOR
Ahmed
Elsharkawy
4
AUTHOR
ORIGINAL_ARTICLE
A Single Dose Intracameral Triamcinolone Injection Following Phacoemulsification
Background: The most frequent cause of treatable blindness in the world is cataract. The gold standard procedure for cataract surgery is phacoemulsification. Steroids are used to alleviate postoperative inflammation. Steroid administration can be done in a variety of ways. Objective: to evaluate the efficacy, safety and tolerability of 1mg/0.01 triamcinolone acetonide (TA) to control inflammation in eyes undergoing cataract extraction with phacoemulsification.
Patients and methods: It is a prospective non-randomized interventional study. It included 30 patients who are undergoing phacoemulsification surgery. Preoperative evaluation included visual-acuity testing, external-eye examination, slitlamp biomicroscopy, tonometry, and dilated-fundus examination. At the end of the phacoemulsification, triamcinolone (TA) 1mg /0.01 was injected into the anterior chamber. Patients were examined on the first day postoperative, one week one month and 3 months after surgery. Postoperative evaluations included Snellen visual acuity (VA), slit-lamp examination, and IOP measurement. Corneal edema, anterior chamber cells and conjunctival hyperemia were checked.
Results: There was no significant difference in the IOP before and after TA injection. While, there were significant differences in corneal edema, AC cells, conjunctival hyperemia and dryness from first day post- operative and through the study period.
Conclusion: A single dose intracameral triamcinolone injection, instead of topical steroid, was found to be safe, effective and avoids the side effect of topical steroid
https://ejhm.journals.ekb.eg/article_189614_b84d090654eea3f91e2f88afc8e8b4a8.pdf
2021-07-01
2667
2670
10.21608/ejhm.2021.189614
Intracameral injection
Triamcinolone
Postoperative inflammation
Nermien Salah El-Dien Mohammed
El-Haddad
n.el-haddad@azhar.edu.com
1
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Egypt
AUTHOR