ORIGINAL_ARTICLE
Macular Changes after Uneventful Phacoemulsification in High Myopic Patients
Background: Pathologic myopia is one of the leading causes of irreversible visual impairment worldwide, particularly in younger individuals. Objective: to evaluate the influence of uneventful phacoemulsification on macular thickness and macular changes in the postoperative period in high myopic patients. Patients and Methods: This is a prospective study which included 30 eyes in patients with high myopia ≥ -6 D or with axial length≥26mm underwent cataract surgery. Participants did not have any eye disorders exceptformyopia and cataract. Results: Statistically significant improvement was detected in postoperative best corrected visual acuity (BCVA) and intraocular pressure (IOP). As regard BCVA, preoperative mean was 0.116±0.064 and range was from 0.01 to 0.25 Decimal. 1 weak postoperative mean was 0.495±0.145 and range was from 0.32 to 1.00, P-value was <0.01. 1-month postoperative mean was 0.466±0.16 and range was from 0.16 to 1.00, P-value was <0.01. 3 months postoperative mean was 0.401±0.17 and range was from 0.01 to 0.63, P-value was <0.01. As for IOP preoperative mean was 15.73±1.14 mmHg and range was from 13 to 18 mmHg. Postoperative mean was 14.01±0.87 and range was from 12 to 15 mmHg. P-value <0.01. Conclusions: There was no statistically significant macular change after phacoemulsification in high myopic patients. There was statistically significant improvement in the BCVA and IOP control.
https://ejhm.journals.ekb.eg/article_42297_0fac2eb0e1ea409ce7090baa5c3a9341.pdf
2019-07-01
4040
4045
10.21608/ejhm.2019.42297
cystoid macular edema
Epiretinal membrane
Macular Hole
Myopia
Optical Coherence Tomography
Schisis
Vitreomacular Traction
Younis Alsaeid
Abd - Elhafez
1
Ophthalmology Department -Faculty of Medicine, Al -Azhar University
AUTHOR
Mahmoud Mohammed Ahmed
Ali
2
Ophthalmology Department -Faculty of Medicine, Al -Azhar University
AUTHOR
Mohamed Hassan
Elkashef
mohamedelkashef177@gmail.com
3
Ophthalmology Department -Faculty of Medicine, Al -Azhar University
LEAD_AUTHOR
ORIGINAL_ARTICLE
Possible Protective Effect of Ginger Extract and Beetroot Juice Against Cisplatin Induced Testicular and Cytogenetic Toxicity in Adult Male Albino Rats
Background: cisplatin (Cis) is an efficient platinum-derived anticancer drug. It has been successfully used in clinical oncology against diverse types of cancers. Testicular toxicity of cisplatin is of great concern because of increasing number of longer survival of cancer patients treated with cisplatin. Objective: the present study aimed to investigate the possible protective role of ginger extract and red beetroot juice against testicular and cytogenetic toxicity induced by cisplatin. Materials and Methods: sixty adult male albino rats were divided randomly into 6 groups (10 rats each). All groups were received the treatment once daily for 5 weeks, 4 days per week. At the end of experimental period samples were collected and then the levels of malondialdehyde (MDA), reduced glutathione (GSH), catalase (CAT), and testosterone hormone were measured. Results & Conclusion: cisplatin treated animals recorded a significant increase in MDA level and a significant decrease in reduced glutathione (GSH) and catalase activities .Significant improvement occurred on co administration of GE or BRJ to cis treated animals .Significant decrease in serum concentration of testosterone in cis treated animals was recorded ,which improved significantly by co administration of GE or BRJ. A significant reduction in sperm count and motility and a significant increase in sperm head and tail abnormalities were noticed in cis treated animals which improved significantly on co-administration of GE or BRJ. Histopathological lesions which were observed in cis treated animals improved on co-administration of GE or BRJ. Finally BRJ caused more improvement in all theses parameters when compared with GE.
https://ejhm.journals.ekb.eg/article_42298_c5f87b527777a584e18a1162f732b7e0.pdf
2019-07-01
4046
4054
10.21608/ejhm.2019.42298
Cisplatin (Cis)
Cytogenetic
chromosomal aberrations
testes
ginger extract (GE)
beetroot juice (BRJ)
Asmaa A.
Elshiekh
drasmaa.abdo@yahoo.com
1
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine for Girls, Al-Azhar University
LEAD_AUTHOR
Hala R.
Elkolaly
2
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine for Girls, Al-Azhar University
AUTHOR
Noura M.
Tawfeek
3
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine for Girls, Al-Azhar University
AUTHOR
Amira A.
Mohamed
4
Department of Genetic and Cell Biology, National Research Centre, Dokki, Egypt
AUTHOR
Aml A.
Mohamed
5
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine for Girls, Al-Azhar University
AUTHOR
ORIGINAL_ARTICLE
Comparative Study between Medical Thoracoscope and Intrapleural Fibrinolytic Therapy in Complicated Parapneumonic Effusion and Empyema
Background: patients with parapneumonic effusion and empyema must be managed probably to avoid surgery and decortication, the use of medical thoracoscope and instillation of streptokinase intra pleural through intercostal tube consider a modality of dealing with that medical situation. Aim of study: it was to compare the therapeutic yield of medical thoracoscope and intrapleural fibrinolysis by streptokinase in complicated parapneumonic effusion and empyema. Patients and methods: this study was conducted at Endoscopy Unit in Chest Department, Al- Hussin Hospitals, Al-Azhar University and Damanhur Chest Hospital in the period between May 2016 and May 2019. This study included 50 patients with complicated parapneumonic effusion and empyema. They were divided into 2 groups: Group A (25 patients): managed by medical thoracoscopy, Group B (25 patients): managed by intercostal tube drainage (ICT) plus intrapleural instillation of streptokinase as fibrinolytic agent. Results: twenty three (92%) patients improved and 2(8%) failed in group A (thoracoscopic group) and 16(64%) patients improved and 9(36%) not completely improved in group B (Streptokinase group) with significant statistical difference. Conclusion and Conclusion: we conclude that medical thoracoscope is very effective, successful and safe in management of such cases. Also, the use of streptokinase as fibrinolytic is safe and effective but not with the same degree of medical thoracoscope. Patients with parapneumonic effusion and empyema must be managed probably to avoid the risk of surgery and other complications.
https://ejhm.journals.ekb.eg/article_42299_a3ac12528b73a51145d2c6f344fcc96b.pdf
2019-07-01
4055
4061
10.21608/ejhm.2019.42299
Medical thoracoscope
Streptokinase
Parapneumonic effusion
Empyema
Ibrahim Mohammed El-sayed
Radwan
1
Departments of Chest Diseases, Faculty of Medicine, Al- Azhar University, Egypt
AUTHOR
Eisa Ibrahim
Afify
2
Departments of Chest Diseases, Faculty of Medicine, Al- Azhar University, Egypt
AUTHOR
Ahmed Alsaeed
Alsehrawey
3
Departments of Clinical Pathology, Faculty of Medicine, Al- Azhar University, Egypt
AUTHOR
Fawzi Mohamed Abd-Elfatah
Omar
fawzi1984.fo@gmail.com
4
Departments of Chest Diseases, Faculty of Medicine, Al- Azhar University, Egypt
LEAD_AUTHOR
ORIGINAL_ARTICLE
Frequency and Predictors of Extra-articular Manifestations in Patients with Rheumatoid Arthritis
Aim: To evaluate the frequency and the predictors of extra-articular manifestations (EAMs) in rheumatoid arthritis (RA) patients. Patients and Methods: This study included 100 adult rheumatoid arthritis patients. A full medical history and a thorough clinical and rheumatological examinations, along with laboratory and radiological investigations were done. RA disease activity using the modified disease activity score (DAS28), validated Arabic version of the health assessment questionnaire (HAQ-A) and the simplified erosion narrowing score (SENS) were calculated. Results: EAMs were detected in 73 patients (73%) of the RA patients; the most common EAMs were subcutaneous rheumatoid nodules (45%), followed by anemia (43%), ocular affection (23%), pulmonary affection (interstitial lung disease ILD) (15%), neuropathy (10%) while renal and cardiac involvements were (2%) and (1%) respectively. There were statistically significant higher levels of age, disease duration, disease activity (DAS28), severe functional disability (HAQ-A), joint damage (SENS), rheumatoid factor (RF) positivity and CRP levels among RA patients with EAMs than those without EAMs. The multivariate regression analysis of the possible predictors of RA EAMs showed that disease duration (OR 1.8, 95% CI. 1.2-2.9, p=0.006) and disease activity DAS28 (OR 1.6, 95% CI 1.0-2.4, p=0.045) independently affect the occurrence of EAMs in RA patients. Conclusion: Extra-articular manifestations are common among rheumatoid arthritis patients. Disease duration and disease activity were independent predictors of extra-articular manifestations occurrence in rheumatoid arthritis.
https://ejhm.journals.ekb.eg/article_42300_65dad1f591b49a32d8117f032f1db64d.pdf
2019-07-01
4062
4067
10.21608/ejhm.2019.42300
Extra-articular manifestations
Rheumatoid Arthritis
Disease activity score(DAS28)
frequency
predictors
Dalia A.
ElSherbiny
dalia_elsherbiny@hotmail.com
1
Internal Medicine Department, Rheumatology Division, Faculty of Medicine, Ain Shams University, Cairo, Egypt
LEAD_AUTHOR
ORIGINAL_ARTICLE
A Morphometric and Statistical Study for Determination of Sex from Certain Bony Pelvic Parameters in Assiut Governorate by Using Plain X-Ray Films
Background: The identification of sex from human remains is of fundamental importance in forensic medicine and anthropology, especially in criminal investigations as well as in the identification of missing persons and in attempts at reconstructing the lives of ancient populations. Objective: The aim of this study was to assess specific pelvic parameters (Human sacrum and subpubic angle measurements) in Assiut Governorate population by using plain x-ray films. Patients and methods: The study was conducted on 500 plain x-ray films, which were obtained and collected from the Radiology Department- Al-Azhar Faculty of Medicine (Assiut branch), out of which, 250 were males and 250 were females in the age group of 25–70 years belonging to Assiut population to assess the sacral and subpubic angle measurements. Results: Statistically significant increase in the length of sacrum in males compared to females. The sacral length in males varied from 86–120 mm with the mean value of 100.06 ± 9.00 mm, while the sacral length in females varied from 78–120 mm with the mean value of 93.00 ± 9.46 mm. Conclusion: The present study concluded that the subpubic angle is the best criterion for sex determination of pelvis. It was found that 66.4% of males’ bones and 58.4% of females’ bones could be identified by using subpubic angle alone.
https://ejhm.journals.ekb.eg/article_42301_293f8bed73dafad35c00ff36e07b5f1e.pdf
2019-07-01
4068
4076
10.21608/ejhm.2019.42301
sex
Pelvic parameters
human
Plain x-ray films
Sherif Fahmy
Mahmoud
1
Department of Forensic Medicine and Toxicology, Faculty of Medicine, Al-Azhar University
AUTHOR
Nagy Mohammed
Al Fadaly
2
Department of Forensic Medicine and Toxicology, Faculty of Medicine, Al-Azhar University
AUTHOR
Huda Abdel Karim Abdel
Samie
3
Department of Forensic Medicine and Toxicology, Faculty of Medicine, Al-Azhar University
AUTHOR
Gamal El Din Ibrahim
Abdel Halim
4
Department of Forensic Medicine and Toxicology, Faculty of Medicine, Al-Azhar University
AUTHOR
Abdel Rahman Zaki
Abdel Rahman
zaky.abdelrahman@yahoo.com
5
Department of Forensic Medicine and Toxicology, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
ORIGINAL_ARTICLE
Prenatal Diagnostics for Neurosurgical Pathologies
Background: The advance in the prenatal diagnostics, particularly in imaging tools during the pregnancy (ultrasound and magnetic resonance) allowed the early diagnose of many fetal diseases, including the neurological conditions. This progress brought the neurosurgeons the possibility to propose treatments even before birth. Objective: The aim is to study the role and effect of prenatal diagnostics for neurosurgical pathologies as regard to early detection and management. Conclusion: Further progress is necessary to enable fetal neurosurgery in becoming the main technique used in treating fetal neurosurgical diseases. However, we believe that correct prenatal diagnosis and adequate selection of fetuses with myelomeningocele, hydrocephalus, and occipital encephalocele may contribute to the benefits provided by neurosurgical procedures during the fetal period.
https://ejhm.journals.ekb.eg/article_42302_47bbc0352cd6355dbce2ad83e582124e.pdf
2019-07-01
4077
4084
10.21608/ejhm.2019.42302
Prenatal Diagnostics
Neurosurgical Pathologies
Hamdy Mohamed
Bhiry
1
Department of Neurosurgery, Faculty of Medicine, Al-Azhar University
AUTHOR
Adel Ragab
Al Melesy
2
Department of Neurosurgery, Faculty of Medicine, Al-Azhar University
AUTHOR
Ahmed Mohamed Kamer Eldawla
abdelmotaal
ahmadkamer@yahoo.com
3
Department of Neurosurgery, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
ORIGINAL_ARTICLE
Open Wedge High Tibial Osteotomy versus High Fibular Osteotomy in Management of Osteoarthritis Knee
Background: osteoarthritis is the most common inflammatory joint condition and is expected to have an increasing prevalence in middle-aged and elderly patients. Objectives: to evaluate the functional outcome of open wedge High Tibial Osteotomy (HTO) versus High Fibular Osteotomy (HFO) with segment resection in management of medial compartment osteoarthritis of the knee. Patients and Methods: we compared 10 cases of HTO and 10 cases of HFO complain with uni-compartment knee osteoarthritis. Results: success in HTO depends on good technique. The determination of the exact localization of the osteotomy site, not to fracture lateral cortex, frequent assessment of the correction angle at every step of the operation, avoidance of overcorrection, the selection of an appropriate Puddu plate size fit for the osteotomy gap. During follow up, mean improvements obtained in KSS scores was 26.70. According to this assessment scale, preoperative score was deemed worse, and postoperative scores was good. HFO relieves pain and improves joint function in human knee osteoarthritis. This new surgery is simple, safe and affordable. Pain relief after surgery occurs in almost all patients. HFO may delay or replace TKA in a subpopulation of patients with knee osteoarthritis. Conclusion: HFO is a simple, safe, fast and affordable surgery to relieve pain and improve joint function and the medial joint space in human knee osteoarthritis.
https://ejhm.journals.ekb.eg/article_42303_ea73eb242a69de50e88b9b2b30180c08.pdf
2019-07-01
4085
4091
10.21608/ejhm.2019.42303
High Tibial Osteotomy
High Fibular Osteotomy
Osteoarthritis Knee
Ahmed
Shamma
1
Orthopedic Surgery Department, Faculty of Medicine, Al-Azhar University
AUTHOR
Mohammed
Elnahas
2
Orthopedic Surgery Department, Faculty of Medicine, Al-Azhar University
AUTHOR
Loay Hassanin Mahmoud
Ibrahim
loayyhusssen@gmail.com
3
Orthopedic Surgery Department, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
ORIGINAL_ARTICLE
Assessment of Autologous (Platelet-Rich-Plasma) as A Monotherapy for Treatment of Dry Eye Disease
Background: treatment of dry eye disease (DED) depends on minimizing inflammation and improving various components of the tear film. Artificial tears remain an important part of patient comfort, with many lipid- and gelbased formulations for a healthy ocular surface. Objective: the work aimed to evaluate the role of autologous platelet-rich plasma (PRP) as a monotherapy for treatment of dry eye disease, versus artificial tears use. Patients and Methods: a prospective comparative study. The study included 55 eyes of 30 patients with moderate to severe dry eye disease. The study was performed at Ophthalmology Department in Alazhar University Hospitals. Results: in our study PRP group of patients all are improved in all parameters and all of them were statistically significant. Symptoms OSDI score decreased indicating improvement in 86.6% of patients. TBUT improved in 66.6% of cases. CFS improved up to disappearance of staining in 33% of cases and fair improvement in 53.3%, total improvement was 86.6%. Schirmer test improved in 40% of cases. BCVA improved in 26.6% of patients, improvement was not more than one line. Conclusion: PRP is very effective in treatment of moderate and severe cases of DED at the level of subjective symptoms, TBUT, CFS, BCVA, and Schirmer test.
https://ejhm.journals.ekb.eg/article_42651_bab62739a106d3778e5e080cc7d48899.pdf
2019-07-01
4092
4098
10.21608/ejhm.2019.42651
Platelet-Rich-Plasma
Dry Eye Disease
Mohamed Mahmoud
Wahdan
1
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University
AUTHOR
Mohamed Mohamed-Aly
Ibrahim
2
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University
AUTHOR
Mohammad Farag Abdelsalam
Elaraby
tantawy_wael@yahoo.com
3
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
ORIGINAL_ARTICLE
Immediate Outcomes of Trans Radial Approach versus Anatomical Snuff Box Access for Coronary Procedures
Background: Radial Artery catheterization is a fundamental approach that is used as a procedural access in the different catheterization interventions in more than 90% of procedures due to low prevalence of access-related complications. Aim of the work: The aim of the study was to develop and to implement a new radial artery access (located at hand) for performing endovascular interventions. Also, our object to reduce the rate of access-related complications by comparison between the traditional radial access and new trans distal radial approach by history and Doppler investigation and follow up. Materials and methods: This was a clinical trial study that included 100 patients who presented to the Cardiology Departments in El Sayed Galal Hospital to perform planned trans radial coronary angiography and coronary intervention for diagnosis and treatment of ischemic heart events. The study was carried out on 100 patients that were divided into two groups, one group had 50% of patients underwent the procedure through the traditional Trans radial approach and the other half of the patients underwent the procedure through the new approach (The Anatomical Snuffbox). Results: the results revealed that Complication higher in radial but not significant (12% in Snuff- box group and 24% in Radial group). Conclusion: To be proficient with both approaches, the operator needs to understand the differences between these two routes in terms of patient preparation, procedural technique, catheter selection and laboratory setup.
https://ejhm.journals.ekb.eg/article_42652_f3c0a267d167fdb9346d2fbc18eba12b.pdf
2019-07-01
4099
4105
10.21608/ejhm.2019.42652
radial artery
Snuff Box
Catheterization Clinical Trial
Mamdouh Helmy
El Tahaan
1
The Department of Cardiology, Faculty of Medicine, Al-Azhar University
AUTHOR
Abd EL Hamid Ismael
Abd EL Hamid
2
The Department of Cardiology, Faculty of Medicine, Al-Azhar University
AUTHOR
Ahmed
Abd El Samad
aelgholam@gmail.com
3
The Department of Cardiology, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
ORIGINAL_ARTICLE
Topographic Study of Corneal Periphery in Selected Rheumatic Diseases
Background: many of autoimmune diseases associated with ophthalmological complication, such as Peripheral ulcerative keratitis. Objective: to evaluate the potential changes in the peripheral corneal thickness in selected rheumatic autoimmune diseases. Patients and Methods: a case control study was been held in Al-Azhar University Hospitals on 80 eyes for 40 patients and subjects. The patients and subjects was been examined by Pentacam examination. Results: as regard peripheral corneal thickness, the mean peripheral thickness of RA patients was 668.6 ± 32.1 micron, the mean peripheral thickness of SLE patients was 667.5 ± 34.8 micron, the mean peripheral thickness of SNA patients was 637.8 ± 86.7 micron and the mean peripheral thickness of control patients was 681.2 ± 12.8 micron (p-value = 0.045). Conclusion: the peripheral corneal thickness was thinner in autoimmune patients than in normal subjects.
https://ejhm.journals.ekb.eg/article_42653_82dc69d54b13154d8ba6099009fcc29d.pdf
2019-07-01
4106
4109
10.21608/ejhm.2019.42653
peripheral keratitis
autoimmune diseases
pentacam
Ahmed I.
Kamel
1
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University
AUTHOR
Mahmoud M.
Khalil
2
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University
AUTHOR
Hatem G.
Abdallah
3
Department of Rheumatology and Rehabilitation,Faculty of Medicine, Al-Azhar University
AUTHOR
Mohammed H.
Ragheb
mohammedhamed2018@yahoo.com
4
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
ORIGINAL_ARTICLE
Perioperative Use of Levosimendan in Patients with Left Ventricular Systolic Dysfunction Undergoing Cardiac Surgery on Cardiopulmonary Bypass
Background: Patients undergoing cardiac surgery are becoming older and with greater comorbidities, carrying an increased risk for perioperative complications, which result in higher mortality and higher costs for the health care service. Objective: Our study is randomized, double-blind, placebo-controlled, multicenter clinical study to evaluate the efficacy of levosimendan given preoperatively in high-risk patients with Left ventricular ejection fraction (LVEF) ≤35% undergoing cardiac surgery on cardiopulmonary bypass (CPB). Patients and methods: This study was carried out in Cardiothoracic Department, Natinaol Heart Institute, Al Hussin hospital, Air Forced Specialized Hospital, and Saudi German Hospital. 60 patients treated with study drug were enrolled, the study population was drawn from patients with an LVEF ≤35% scheduled to undergo cardiac surgery with planned CPB. Results: Our results showed that the relative risk for postoperative mortality at 60 days was reduced by 10% in the levosimendan group when compared with the control group [4 of 30 (13%) in the levosimendan group vs 7 of 30 (23%) in the control group] with p value =0.5, however the incidence of 30-day out-of-hospital complications was not statistically different between the two groups. In the levosimendan group, no significant reduction in the rate of renal replacement therapy was observed [7 of 30 (23.3%) in the levosimendan group vs 8 of 30 (26.7%) in the control group]. Conclusion: Levosimendan is safe and well tolerated in patients undergoing cardiac surgery with cardiopulmonary bypass who have low LVEF and are at risk of the development of postoperative low cardiac output syndrome (LCOS).
https://ejhm.journals.ekb.eg/article_42655_2306403c07a1f20af03ad15bdede93c8.pdf
2019-07-01
4110
4118
10.21608/ejhm.2019.42655
Levosimendan
left ventricular systolic dysfunction
cardiac surgery
Cardiopulmonary bypass
Gamal Lotfy
Abd Elrahman
1
Department of Anesthesia and Intensive Care, Faculty of Medicine, Al-Azhar University
AUTHOR
Mostafa Mohammed
Sabra
2
Department of Anesthesia and Intensive Care, Faculty of Medicine, Al-Azhar University
AUTHOR
Amr Soliman
Abd Elmageed
3
Department of Anesthesia and Intensive Care, Faculty of Medicine, Al-Azhar University
AUTHOR
Abd Elkader Abd Elrhman Abd Elkader
Elbakery
dr.sparklight@hotmail.com
4
Department of Anesthesia and Intensive Care, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
ORIGINAL_ARTICLE
Comparative Study between Total Thyroidectomy and Hemithyroidectomy in Treatment of Solitary Thyroid Nodules Diagnosed as Follicular Lesions by Fine-Needle Aspiration Cytology
Background: Thyroid nodular (TN) lesions are a common clinical problem in the world. These are more common in women and in areas of iodine deficiency. Exposure to ionizing radiation in childhood and adolescence increases the risk of solitary thyroid nodule and thyroid carcinoma. Objective: Determination of the optimal surgical approach for individuals undergoing thyroidectomy for solitary thyroid nodule identified as indeterminate follicular lesion on preoperative fine needle aspiration cytology (FNAC) diagnosis and to estimate the long term outcome of patients treated by lobectomy for solitary follicular thyroid nodule. Patients and methods: From June 2017 to June 2019, 50 patients having a solitary thyroid nodule with a cytological diagnosis of “indeterminate follicular lesion” were selected prospectively. Results: There were 26 women and 24 men with a mean age of 56 years (range: 28-83). Hemithyroidectomy (HT) was performed in 25 patients (50%) and a total thyroidectomy (TT) in 25 (50%). Postoperative morbidity was 3.50% in patients who underwent HT and 9.75% in those who underwent TT. At the histological analysis 3 (12%) patients of hemithyroidectomy group had a malignant lesion. Conclusions: Considering the high rate in which HT represents the adequate treatment, and the low rate of reoperation morbidity, HT seems to be the preferable initial surgical approach for indeterminate follicular lesions. Long-term ultrasonographic follow-up seems advisable.
https://ejhm.journals.ekb.eg/article_42947_619cd921c06ebe64e8f6684841be56aa.pdf
2019-07-01
4119
4123
10.21608/ejhm.2019.42947
Fine-needle biopsy
Follicular lesion
Hemithyroidectomy
Total Thyroidectomy
Mohamed Mahdy
Abdelnassef
surgmahdy@gmail.com
1
Departments of General Surgery, Faculty of Medicine - Al-Azhar University
LEAD_AUTHOR
Mohamed Ebrahim
Shalamesh
2
Departments of General Surgery, Faculty of Medicine - Al-Azhar University
AUTHOR
Atef Mohamed
Al-Mahdy
3
Departments of General Surgery, Faculty of Medicine - Al-Azhar University
AUTHOR
Ebrahim Hassan
Mohamed
4
Departments of General Pathology, Faculty of Medicine - Al-Azhar University
AUTHOR
ORIGINAL_ARTICLE
The Predictive Value of Non-Invasive Blood Ammonia Level for the Presence of Oesophageal Varices in Patients with Liver Cirrhosis
Background: portal hypertension leads to the formation of portosystemic collateral veins in liver cirrhosis. Rupture of esophageal varices is common and can be fatal. Gastroesophageal varices are present in 50% of patients with cirrhosis. Their presence correlates with the severity of liver disease. Objective: the aim of this work was to investigate the diagnostic utility of blood ammonia level as a noninvasive predictor for presence of oesophageal varices and correlate it with variceal size in patients with liver cirrhosis. Patients and Methods: this cross-sectional study was carried out in the department of Internal Medicine, Gastroenterology and Hepatology Unit, Al-Hussein University Hospital. A total of 70 consecutive patients and 20 normal healthy volunteer were included in the study. Results: There was a highly significant increase in the mean values of ammonia levels, spleen and portal vein diameters in cirrhotic patients with OV in comparison to patients without OV. There was a highly significant decrease in the mean values of haemoglobin in patients with OV in comparison to other patients without OV For detection of OV. There was a highly significant increase in the mean values of serum ammonia in patients with OV in comparison to other patients without OV. Conclusion: the blood ammonia level may be clinically useful as it correlates with and is an independent predictor for both endoscopic risk signs and risk factors of bleeding, and therefore, it could be used in cirrhotic patients to decrease the number of screening endoscopies they are subjected to.
https://ejhm.journals.ekb.eg/article_43077_6bab8e94601b20f2e57aee1da7fe2efe.pdf
2019-07-01
4124
4132
10.21608/ejhm.2019.43077
Non-Invasive Blood Ammonia Level
Oesophageal varices
Liver cirrhosis
Mohamed Abdelhakeem
Aboushady
1
Departments of Internal Medicine, Faculty of Medicine, Al-Azhar University
AUTHOR
Arafat Abdelazeem
Kassem
2
Departments of Internal Medicine, Faculty of Medicine, Al-Azhar University
AUTHOR
Mohamed Saad Eldeen
Radwan
3
Departments of Clinical Pathology, Faculty of Medicine, Al-Azhar University
AUTHOR
Abdou Ragab Ahmed
Ismail
abdouragab2016417891@gmail.com
4
Departments of Internal Medicine, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
ORIGINAL_ARTICLE
Evaluation of Pre-Peritoneal Mesh Repair in Management of Ventral Hernia
Background: Ventral hernias are defined as a defect of the fascia in the anterior abdominal wall with or without a bulge. Clinical presentation varies from small incidental defects to giant and complicated hernias with fistulas and viscera located outside the abdominal cavity covered only by peritoneum and skin. It includes incisional hernias, paraumbilical hernias, umbilical hernia, epigastric hernias, and spigelian hernias, respectively. Objective: The aim of the present study was to evaluate the functional outcome of pre-peritoneal mesh repair in management of ventral hernia. Patients and methods: This was a case control study of incisional hernia repair by pre-peritoneal mesh implantation that was carried out on 40 subjects collected consecutively at Kafr El-Sheikh General Hospital and Sayed Galal University Hospital. Diagnosis was based on clinical criteria. Results: Regarding to symptoms, 34 cases showed swelling (85%), only 5 cases had swelling and pain (12.5%) and a case showed swelling, pain, and vomiting (2.5%). Chest infection was the most common complication seen with 3 cases (7.5%), wound infection and persistent pyrexia were seen in 2 cases for each (5%) and cellulitis, seroma and post-operative ileus were seen in only one case for each (2.5%). Conclusion: follow up findings showed no complications except recurrence in only one case. Therefore our study affirms that pre-peritoneal mesh repair or sublay mesh is the ideal repair technique and highly recommended for ventral hernia.
https://ejhm.journals.ekb.eg/article_43078_8331c36b4ad01e5090bc17b73de21d5e.pdf
2019-07-01
4133
4137
10.21608/ejhm.2019.43078
Pre-peritoneal mesh repair
Ventral hernia
Sameh Gabr
Attia
1
Department of General Surgery, Faculty of Medicine, Al-Azhar University
AUTHOR
Mohamed Ibrahim
Shalamesh
2
Department of General Surgery, Faculty of Medicine, Al-Azhar University
AUTHOR
Ahmed Shokry
Helal
tantawy_wael@yahoo.com
3
Department of General Surgery, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
ORIGINAL_ARTICLE
Effect of Adding L-Carnitine to Clomiphene Resistant PCOs Women on the Ovulation and the Pregnancy Rate
Background: polycystic ovary (PCO) syndrome is an endocrionologic disorder that affecting about 6-10% of women in their reproductive age. Conception rate with clomiphene citrate treated cycles is about 40% only and the number of ovulated oocyte decrease significantly with repeated cycles of ovulation. Objective: evaluation of the effectiveness of usage of clomiphene citrate with L-carnitine (LC) in induction of ovulation in clomiphene citrate resistant patients. Patients and Methods: Randomized controlled study included a total number of 50 women with clomiphene-resistant PCOs. They were divided into 2 groups, group (A) where patients received 100 to 150 mg clomiphene citrate from day three until day seven of the cycle and L-carnitine (LC) 3g daily till positive pregnancy test and group (B) received 100 to 150 mg clomiphene citrate with placebo. Results: There was statistically significant difference (p-value <0.05) between both groups as regard infertility duration (months), ovulation rate, no. of chemical pregnancies and no. of clinical pregnancies. There was highly statistically significant difference (p-value < 0.001) between both groups as regard days until HCG injection, endometrial thickness (mm), no. of pre-ovulatory follicles >17 mm and E2 on day of HCG injection. Conclusion: Adding L-carnitine to clomiphene from the follicular phase and extending through the luteal phase in patients with clomiphene-resistant PCOS, at the given dose and duration, may be of beneficial to the quality of ovulation and the clinical pregnancy rate.
https://ejhm.journals.ekb.eg/article_43079_b33d99265e44236e33d9eb80c2fe9596.pdf
2019-07-01
4138
4143
10.21608/ejhm.2019.43079
L-carnitine
clomiphene-resistant
PCOs
Pregnancy
Ahmed Taha
Abd-Elfattah
dr.taha17@yahoo.com
1
Departments of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
LEAD_AUTHOR
Fahd Abd El-aal
Elomda
2
Departments of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Mahmoud Abd-Ellatif
Hashish
3
Departments of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Hossam Ibrahim
Megahed
4
Departments of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
ORIGINAL_ARTICLE
The Value of Mastectomy Flap Fixation on Seroma Formation after Mastectomy
Background: seroma occurs in most patients after mastectomy. It is thought to be caused by the fact that mastectomy leaves a lot of an "empty space" under the skin where the breast tissue used to be. Aim of the work: it was to study the effect of closure of dead space by suture fixation of the mastectomy flaps to the underlying chest wall on the amount and duration of postoperative drainage and seroma formation. Patients and Methods: the current study included 40 female patients with breast carcinoma scheduled for modified radical mastectomy and they were randomized into two groups according to suture fixation of the mastectomy flaps to the underlying chest wa1l. Group I, 20 patients undergone suture fixation of the mastectomy flaps to the underlying chest wa1l raw by raw, closing every potentia1 space. Group II, 20 patients where the wound was c1osed in the conventiona1 method. Results: the flap fixation technique is a valuable procedure that significant1y decrease the incidence of seroma formation, the need for frequent visits to the physician for seroma fluid aspiration, the tota1 amount of drained fluid and also allowing for earlier remova1 of the drains as well as avoidance of complications resulting from the occurrence of seroma. Conclusion: This method appears to have much many advantages that over-exceed its disadvantage of time consumption during the operation. It should be tried on a much wider scale to prove its validity in decreasing the incidence of seroma formation and its subsequent complications.
https://ejhm.journals.ekb.eg/article_43080_9249d51c5bc1f4702784cbd106a73984.pdf
2019-07-01
4144
4147
10.21608/ejhm.2019.43080
Breast
Cancer
mastectomy
seroma
flap fixation
Ahmed Abd El Aal
Sultan
dr.ahmedsultan@azhar.edu.eg
1
Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
LEAD_AUTHOR
Ahmed Mohamed
Abd El-Wahab
2
Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Magdy Salah El-Din
Hussain
3
Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
ORIGINAL_ARTICLE
Comparison between a 595-nm Pulsed Dye Laser and a 1064-nm Nd:YAG Laser for Treatment of Chronic Cutaneous Lupus Erythematosus with Clinical & Histopathological Outcome Evaluation
Background: Chronic cutaneous lupus erythematosus (CCLE) is limited to the skin, commonly affecting the face, frequently disfiguring and sometimes therapeutically challenging. Cutaneous lupus erythematosus has been treated with different laser in many studies and reports with promising results, presenting another new line of CCLE treatment. Aim of the work: This work aimed to evaluate and compare between the efficacy and safety of pulsed dye laser (PDL) versus ND: YAG laser for CCLE treatment. Patients and methods: This comparative study included a total of twenty patients with CCLE who had active lesion and with histologically confirmed lupus erythematosus, attending at Dermatology Outpatient Clinic of Al-Azhar University Hospitals. The patients were divided into 2 groups; group (A): 20 patients were treated by PDL and group (B): 20 patients were treated by ND:YAG laser. The degree of CCLE and clinical response evaluation was assessed using CLASI system. Results: In both groups A & B clearance rate was equal (50%) and Improvement rate was 100% with significant decline in ‘‘active’’ CLASI after laser treatment in both groups. P-value was 0.04 in group A and 0.005 in group B, without significant difference between both groups. Conclusion: PDL and ND: YAG laser are safe and effective in CCLE treatment with insignificant difference between them. So, we recommend early laser usage as main treatment of CCLE particularly for refractory cases for other treatment line or as an adjunctive therapy to decrease incidence of atrophy and scarring.
https://ejhm.journals.ekb.eg/article_43081_d0c50337653b9854f5a22f75950562a7.pdf
2019-07-01
4148
4154
10.21608/ejhm.2019.43081
Chronic cutaneous lupus erythematosus
PDL
ND: YAG laser
Abdel Shakour Abdel Hafiz
Al-Mohamady
1
Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Hussein Mohamed Hassab
El Naby
2
Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Shady Mahmoud
Attia
3
Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Sara Abdel Hafez
El-Hussiny
sara.abdel_hafez@yahoo.com
4
Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
LEAD_AUTHOR
ORIGINAL_ARTICLE
Corneal Endothelial Changes Following Refractive Lens Exchange
Background: clear lens extraction (CLE) by phacoemulsification and posterior chamber intraocular lens (PC IOL) implantation in a series of highly myopic and hyperopic eyes was effective and had an acceptable predictability and a low rate of complications especially on corneal endothelium. Aim of the work: to study corneal endothelium changes (number and morphology) following phaco-aspiration in refractive lens exchange procedure (1 month and 6 months postoperatively) Subjects and methods: a non-randomized prospective study was carried out from October 2018 to May 2019 on twenty five eyes of 14 subjects with age (38-48) years old with high myope> 8 D and high hyperopia > 6 D; these patients were not candidate for corneal refractive surgery or phakic IOL procedure. They were selected from outpatient Ophthalmology Clinics of Al-Azhar University Hospitals in Cairo. The patients were examined by specular microscopy before and after refractive lens exchange procedure (1 month and 6 months postoperatively) Results: Log MAR BCVA improved from (0.47) preoperatively to (0.5904) at the end of the 6 th month with P-value 0.35. Changes in endothelial cell count from (2.650) cells/mm2 before surgery to (2.372) cells/mm2 1 month after surgery to (2.358) cells/mm2 6 months after surgery with P-value <0.001. Error of refraction improved from (-14.94) in myope and (7.98) in hyperope preoperatively to (-1.42) in both groups at the end of the 6th month after surgery with p-value <0.001. Conclusion: CLE surgery by phaco-aspiration technique is less harmful to the corneal endothelium because it uses no phaco power.
https://ejhm.journals.ekb.eg/article_43082_60c4b1dd2479685a213ab23ef3f66ad8.pdf
2019-07-01
4155
4161
10.21608/ejhm.2019.43082
Refractive Lens Exchange
Corneal Endothelium
Mohamed Z.
Eid
1
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo – Egypt
AUTHOR
Sayed M.
Elsayed
2
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo – Egypt
AUTHOR
Mohamed A.
Yousef
mohamed.abdelbaset.967@g-mail.com
3
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo – Egypt
LEAD_AUTHOR
ORIGINAL_ARTICLE
Comparison of Outcomes of Early Versus Delayed Laparoscopic Cholecystectomy in Acute Calcular Cholecystitis
Background: acute cholecystitis is the most common cause of hospitalization for gastrointestinal disease. Although cholecystectomy is the definitive management, the timing of surgery in relation to the first episode of acute cholecystitis remains an area of considerable practice variation. Objective: The aim of this study was to evaluate the results of early laparoscopic cholecystectomy versus conservative management and delayed elective cholecystectomy in acute calcular cholecystitis. Patients and Methods: the present study is a prospective randomized study done during the period from November 2018 to June 2019. The study included 40 patients with acute calcular cholecystitis presented to Al-Azhar University Surgical department. They had been classified randomly by taking every two patients; one patient to the group A, the other patient to group B, and each group consisted of 20 patients. Results: the mean operative time in the early group was more than the mean operative time in the delayed group. The conversion rate to open cholecystectomy in the early group was less than the conversion rate in the delayed group. The mean total hospital stay in the early group was less than the mean total hospital stay in the delayed group. Finally the overall complications in the early group were less than complications occurred in the delayed group. Conclusion: early laparoscopic cholecystectomy for patients with acute cholecystitis has both medical and socioeconomic benefits and it is the preferred approach in comparison to delayed approach.
https://ejhm.journals.ekb.eg/article_43083_2ef4bc22695dde3305b626722483a287.pdf
2019-07-01
4162
4168
10.21608/ejhm.2019.43083
Laparoscopic cholecystectomy
Calcular Cholecystitis
Mohammed Mohammed
El-Kordy
1
Department of General Surgery, Faculty of Medicine Al-Azhar University, Cairo, Egypt
AUTHOR
Al Sayed Basiony
Aboulyazid
2
Department of General Surgery, Faculty of Medicine Al-Azhar University, Cairo, Egypt
AUTHOR
Ahmed Fakhry Ahmed
Mahmoud
ahmedfakhry41@gmail.com
3
Department of General Surgery, Faculty of Medicine Al-Azhar University, Cairo, Egypt
LEAD_AUTHOR
ORIGINAL_ARTICLE
Comparison between The Efficacy of Intracoronary Nitroglycerin versus Nitroglycerin Plus Glycoprotein Inhibitors for Treatment of Patients with Thrombolysis in Myocardial Infarction Flow Less Than Three during Primary Percutaneous Coronary Intervention
Background: Primary percutaneous coronary intervention (PPCI) is currently the cornerstone of management in patients with ST-segment elevation myocardial infarction (STEMI). Aim of the work: comparison between the efficacies of intracoronary nitroglycerin (NTG) versus nitroglycerin plus glycoprotein inhibitors (GP) IIb/IIIa for treatment of patients with thrombolysis in myocardial infarction flow less than three during primary percutaneous coronary intervention. Patients and methods: we prospectively enrolled 30 patients with STEMI undergoing PPCI randomized to receive IC NTG only (n = 15) versus NTG plus GP IIb/IIIa inhibitors (n = 15) during PPCI. The primary outcome was the incidence of angiographic MVO as defined by thrombolysis in myocardial infarction flow less than 3 or thrombolysis in myocardial infarction flow 3 with myocardial blush grade less than 2. Results: NTG plus GP IIb/IIIa inhibitors were associated with better primary outcome compared to NTG only TIMI 3 & MBG > = 2 (40%vs 73.3%, respectively; P = 0.036). There was a trend towards improved left ventricular ejection fraction with NTG plus GP IIb/IIIa inhibitors (44.33 ± 9.76 vs 52.87 ± 11.23, respectively; P = 0.035). In addition, NTG plus GP IIb/IIIa inhibitors was associated with lower incidence of 30-day major adverse cardiovascular events (26.7 vs. 66.7% respectively; P = 0.028). Conclusion: In PPCI, NTG plus GP IIb/IIIa inhibitors resulted in significant improvements in no-reflow and MVO with a better safety profile compared to NTG only. Larger trials should be conducted to confirm these results.
https://ejhm.journals.ekb.eg/article_43084_334398711c922e4a89008e3befc5eb10.pdf
2019-07-01
4169
4175
10.21608/ejhm.2019.43084
Acute myocardial infarction
Microvascular obstruction
Primary percutaneous coronary intervention
No reflow
Nitroglycerin
Platelets glycoprotein IIb/IIIa inhibitors
Ahmed Mohamed Kamal
Motaweh
1
Department of Cardiology, Faculty of Medicine, Al-Azher University
AUTHOR
Mohamed Ahmed Mosaad
Zaki
2
Department of Cardiology, Faculty of Medicine, Al-Azher University
AUTHOR
Mahmoud Abd El-Naser Ahmed
Hussieny
mahmoudnaseraswan2108@gmail.com
3
Department of Cardiology, Al- Agoza Hospital
LEAD_AUTHOR
ORIGINAL_ARTICLE
Effect of Blood and Fistula Flow Rates on Dialysis Adequacy, Phosphate Removal and Cardiac Function in Hemodialysis Patients
Background: dialysis adequacy refers to the delivery of a dose of dialysis considered high enough to promote an optimal long term outcome. Quantification of the dialysis dose is an essential element because the adequacy has a profound effect on patient morbidity and mortality. Aim of the study: assessment the effect of blood and fistula flow rates on dialysis adequacy, phosphate removal and cardiac function in hemodialysis patients. Patients and Methods: this study was conducted on eighty patients with regular hemodialysis (HD) selected from Al-Azhar University Hemodialysis Unite in New Damietta. The studied patients were divided into two main groups according to blood flow rate (BFR) as follows: Group A 40 patients on BFR 250 mL/min and Group B 40 patients on BFR 350 mL/min. Results: there was statistically significant decrease of pre dialysis phosphate in group A in comparison to group B. There was statistically significant increase of KT/V, UUR and PRR in group B in comparison to group A. Arteriovenous fistula (AVF) Qa had negative correlation with TAPSE while it had positive correlation to all echocardiography findings except EF and heart rate (HR), kt/V and URR in group A. AVF Qa had positive correlation to all echocardiography findings except (EF, HR and TAPSE), kt/V, URR and PRP in group B Conclusion: increasing of blood and fistula flow rates are effective in increasing dialysis adequacy and phosphate reduction ration and it is more evident where using high-flux hemodialysis.
https://ejhm.journals.ekb.eg/article_43085_fce8a2a9924ff3887832109aa9efae4c.pdf
2019-07-01
4176
4181
10.21608/ejhm.2019.43085
Hemodialysis
Arteriovenous fistula
Ahmed Alaa-Eldin
Ahmed
1
Internal Medicine Department, Faculty of Medicine, Al-Azhar University, Cairo
AUTHOR
Ahmed Salama
Al Adl
salama139@azhar.edu.eg
2
Internal Medicine Department, Faculty of Medicine, Al-Azhar University, Damietta
LEAD_AUTHOR
Tarek Mustafa
Emran
3
Clinical Pathology Department, Faculty of Medicine, Al-Azhar University, Damietta
AUTHOR
Sharif Kamal
Hussein
4
Radiology Department, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
AUTHOR
Ayman Mahmoud
Abdel-Fattah
5
Internal Medicine Department, Faculty of Medicine, Al-Azhar University, Damietta
AUTHOR
ORIGINAL_ARTICLE
Macular Thickness Asymmetry Measurements in Relatives of Primary Open Angle Glaucoma Patients
Background: A family history of glaucoma was found to carry a relative risk of 2.1 times for being associated with at least possible primary open angle glaucoma (POAG) in middle aged and older individuals. Around half of all POAG patients have a positive family history and their first degree relatives have an approximately 9-fold increased risk of developing glaucoma. Objective: the aim of the present study was to demonstrate possible early macular alterations in young relatives of POAG patients using spectral domain optical coherence tomography (SD-OCT) posterior pole asymmetry analysis (PPAA) map. Patients and methods: in a prospective comparative study; 40 subjects were classified into 2 groups: group of young healthy relatives of POAG patients and another group of young healthy subjects as control. All participants had OCT of the PPAA, retinal nerve fiber layer (RNFL), ganglion cell complex (GCC) and hemi-field macular thickness. Results: There was no statistically significant difference between the relative and control group in aspect of RNFL, macular hemi-fields and PPAA measurements (P-value >0.05). Regarding GCC thickness, there were statistically significant differences between both groups in the superior, inferior and nasal thickness measurements. Conclusion: Young healthy relatives of POAG patients didn’t show any early glaucomatous damage when compared with controls except for GCC thickness which showed statistically significant decrease.
https://ejhm.journals.ekb.eg/article_43086_ed1b4e2d0dba64bd5f3faa377a3646ab.pdf
2019-07-01
4182
4188
10.21608/ejhm.2019.43086
Primary Open angle glaucoma
Optical Coherence Tomography
Posterior pole asymmetry analysis
Retinal nerve fiber layer
Ganglion cell complex
Sherien R.
Ramadan
sherien.roshdy1@gmail.com
1
Department of Ophthalmology, Faculty of Medicine (For Girls), Al-Azhar University
LEAD_AUTHOR
Mona M. Aly, Samia H.
El Ashry
2
Department of Ophthalmology, Faculty of Medicine (For Girls), Al-Azhar University
AUTHOR
ORIGINAL_ARTICLE
Serum Fibrinogen as Adetection of Severity of Postpartum Hemorrhage
Background: postpartum bleeding or postpartum hemorrhage (PPH) is often defined as the loss of more than 500 ml or 1,000 ml of blood within the first 24 hours following childbirth. The most common cause is poor contraction of the uterus following childbirth. However, the placenta being delivered, a tear of the uterus or poor blood clotting are other possible causes. Objective: the aim of the present work was to study the role of serum fibrinogen as a predictor for the severity of postpartum hemorrhage. Patients and Methods: this prospective multicenter study was conducted from February 2017 to October 2017 at Department of Obstetrics and Gynecology, Sayd Galal Hospital, Al-Azhar University. Results: PPH was severe for 43 of the 100 (43%) women included, but not for 75 (57%). Among the women with severe haeb hemorrhage, no women required embolization, 12 ligation of the uterine arteries, and 7 hysterectomy; 7 were transferred to intensive care, 37 received transfusions, and 42 had a postpartum hemoglobin level that decreased more than 4 g litre. None of the women died. Conclusion: the fibrinogen level at PPH diagnosis is a marker of the risk of aggravation and should serve as an alert to clinicians.
https://ejhm.journals.ekb.eg/article_43087_af75c187887609da1619eb5f2fe9e105.pdf
2019-07-01
4189
4194
10.21608/ejhm.2019.43087
Fibrinogen
post partum Hemorrhage
Abd El-monam Mohamed
Zakaria
1
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
AUTHOR
Abd El-Monsef Abd El-Hamid
Sedek
2
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
AUTHOR
Mekky Abdel-Monem
Aly
3
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
AUTHOR
Mohamed Ali Mohamed
Mohamed
mohamedgamalomer90@gmail.com
4
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
ORIGINAL_ARTICLE
Clinico-Seroepidemiological Evaluation of Toxocariasis in Asthmatic Egyptian Children
Background: Toxocariasis was recorded as one of the most commonly zoonotic helminthic infections in the world and still a poorly diagnosed disease hence largely unknown either to health professionals and/or the general of Egyptian population. The excretory-secretory antigens of T. canis larvae (TES) are widely used for both the diagnosis and seroepidemiological studies. Aim of the work: The aim of the present study was to assess the relationship between toxocariasis and bronchial asthma in asthmatic children through means of a case-control study in Cairo, Egypt and to determine its relation to epidemiological risk factors, laboratory tests and clinical signs. Patients and Methods: The study included two groups (Group1): asthmatic group included 72 children with confirmed asthmatic bronchitis and (Group 2): non-asthmatic group included 72 children selected randomly as a control group. The sociodemographic data was assessed as risk factors for toxocariasis based on a questionnaire collected from the children’s parents or guardians. The selected cases were subjected to stool analysis to exclude other parasitic infection, CBC for eosinophilia and immunoblot assay for detection of Toxocara canis IgG. Results: Out of 72 asthmatic patients toxocariasis IgG was positive in 16 cases (22.2%), negative in 56 cases (78.6%) compared to 5 positive cases (6.9%), and 67 negative cases (93.1%) in control group. There was a significant relation between positive antiToxocara IgG and asthmatic bronchitis. This study confirmed a significant correlation between the seroprevalence of Toxocara and possible socioepidemiological factors as contact with pets, geophagia and residence. Conclusion: Rising knowledge of toxocariasis will enable pediatricians to consider it as a cause of asthmatic bronchitis in their patients, initiate appropriate treatment, and educate patients and parents on how to avoid becoming infected
https://ejhm.journals.ekb.eg/article_43088_ceefb126bb4c86f8686ea763d261a6af.pdf
2019-07-01
4195
4201
10.21608/ejhm.2019.43088
children
bronchial asthma
Toxocariasis
seroprevalence
immunoblot IgG
Samir A.
Shahat
1
Department of Medical Parasitology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
AUTHOR
Khaled Abd El-Aziz
Mohammad
2
Department of Medical Parasitology, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
AUTHOR
Mohammed Youssef
Saad
3
Department of Medical Parasitology, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
AUTHOR
Tarek M.
Emran
4
Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Damietta, Egypt.
AUTHOR
Soma Abdallah
Mohamed
5
Department of Pediatrics, Faculty of Medicine (girls), Al-Azhar University, Cairo, Egypt
AUTHOR
Mahmoud Elsayed Ali
Elshahat
ma536552@gmail.com
6
Department of Medical Parasitology, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
LEAD_AUTHOR
ORIGINAL_ARTICLE
Evaluation of Chandelier Assisted Pars Plana Vitrectomy for Management of Epiretinal Membranes
Background: ERM is a vision affecting disorder, frequently developed secondary to advanced PDR. DR remains one of the leading causes of legal blindness in the working- age population. Aim of the work: evaluation the safety, efficacy and feasibility of the chandelier assisted PPV for management of fibro-vascular membranes. Patients and methods: 43 eyes in 36 patients presented with ERM of different etiologies. After full ophthalmic examination, all patients underwent chandelier assisted PPV with silicone oil or gas tamponade without or with phacoemulsification and posterior chamber IOL implantation. Results: Combined phacoemulsification and PPV was done in 12 cases (27.9%), 2 cases were Pseudophakic while lens sparing PPV was done in 29 cases (67.4%). Complete ERM removal was achieved in 38 cases (88.4%) and incompletely removed in five cases (11.6%). Residual tractional RD was observed in two cases (4.7%). Iatrogenic breaks were occurred in 7 cases (16.3%). Endo-laser photocoagulation was done in 33 cases (76.7%). Silicone oil tamponade was used in 33 cases (76.7%), gas in 8 cases (18.6%) while air tamponade was used in 2 cases (4.7%). There was improvement of BCVA in 31 cases (72.1 %), while 10 cases (23.3%) remained the same and worsened in 2 eyes (4.7%) due to recurrent proliferation, consecutive optic disc atrophy and development of neo-vascular glaucoma. Conclusion: Chandelier assisted bimanual PPV is an effective, safe and an attainable technique for management of ERM, learning curve with this technique and coast benefit ratio may be considered.
https://ejhm.journals.ekb.eg/article_43089_3eb308a4e20616b312e9aab516098d48.pdf
2019-07-01
4202
4212
10.21608/ejhm.2019.43089
Chandelier
Bimanual vitrectomy
Epiretinal membrane
Abdelhafez
Y.
1
Department of Ophthalmology, Faculty of Medicine Al-Azher University, Damietta
AUTHOR
Mohamed
I. A.
2
Department of Ophthalmology, Faculty of Medicine Al-Azher University Cairo
AUTHOR
Ghali
A.
3
Department of Ophthalmology, Faculty of Medicine Al-Azher University, Damietta
AUTHOR
Omran
M.
my.omran22@gmail.com
4
Department of Ophthalmology, Faculty of Medicine Al-Azher University, Damietta
LEAD_AUTHOR
ORIGINAL_ARTICLE
Evaluation of Both Single Layer Simple Interrupted Extramucosal Sutures and Single Layer Interrupted Connell Sutures for Intestinal Anastomosis in Children in Elective and Emergency Laparotomy
Background: Intestine anastomosis in pediatric surgery is a relevant matter because of the frequency of the procedure, nonetheless, there is no general agreement about the most appropriate surgical technique, nor are there records comparing the different methods in children. To validate the better technique in children, it is necessary to have clinically comparative experimental studies. Objective: the aim of this work is to evaluate both single layer simple interrupted extramucosal and single layer interrupted Connell sutures for intestinal anastomosis in children in elective and emergency laparotomy as regard technical, functional and financial aspects. Patients and Methods: his study was carried out on 40 patients candidate for intestinal anastomosis in elective and emergency laparotomy managed at Pediatric Surgery Department, Al-Azhar University in Cairo throughout the period from January 2017 to May 2019. Results: As regard the most frequent diagnosis or cause for anastomosis in our study, jejunal atresia was the most common cause of anastomosis with 9 cases (45%) in the extramucosal group and one case (5%) in the Connell group, then the intussusception with 2 patients (10%) in the extramucosal group, and 7 patients (35%) in the Connell group, then ileal atresia, 3 patients (15%) in the extramucosal group, and one patient (5%) in the Connell group. Conclusion: We concluded that both techniques for intestinal anastomosis are effective, safe and successful. We prefer single-layer interrupted extramucosal technique in elective and emergency laparotomy due to less operative time, and valuable cost-effectiveness.
https://ejhm.journals.ekb.eg/article_43551_7756212117d8687ac5fed460ce4a94c0.pdf
2019-07-01
4213
4219
10.21608/ejhm.2019.43551
Single Layer Simple Interrupted Extramucosal Sutures
Single Layer Interrupted Connell Sutures
Intestinal Anastomosis
Children in Elective and Emergency Laparotomy
Soliman Mohamed
Soliman
1
Department of Pediatric Surgery, Faculty of Medicine, Al-Azhar University
AUTHOR
Ibrahim Ahmed Ismail
Gamaan
2
Department of Pediatric Surgery, Faculty of Medicine, Al-Azhar University
AUTHOR
Ahmed Abdel-Aal El-Sayed
Sultan
3
Department of General Surgery, Faculty of Medicine, Al-Azhar University
AUTHOR
Mohamad Mobarak
Alsakka
4
Department of Radiology, Faculty of Medicine, Al-Azhar University
AUTHOR
Abdelaleem Abdelaleem Aly
Elgendy
5
Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University
AUTHOR
Mohammed Gomaa Ahmed El-Sayed
Fouda
m.goma1986@gmail.com
6
Department of General Surgery, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
ORIGINAL_ARTICLE
Exercise Electrocardiography Testing in Patients with Calcific Non-obstructive Coronary Lesions at Cardiac Multislice Computed Tomography
Background: Non-obstructive coronary artery disease (NoCAD), cardiac syndrome X (CSX), conduit vessel endothelial dysfunction and microvascular angina are all terms used to describe patients that have chest pain yet no obstructive coronary artery disease on coronary angiography. Objectives: the purpose of this study was to evaluate exercise ECG (Ex-ECG) test in patients with subclinical atherosclerosis who were diagnosed by multi-slice computed tomography (MSCT) coronary angiography to have nonobstructive lesions. Patients and Methods: 100 patients were recruited in the current study (their age ranged from 30 – 66 years), they were classified into three groups: group (A) 30 patients with non-calcific normal coronaries by MSCT, group (B) 35 patients with non-calcific non-obstructive lesions (zero calcium score) by MSCT and group (C) 35 patients with calcific non-obstructive lesions (calcium score < 400 HU) by MSCT. Results: There was statistically highly significant difference between the three groups as regard results of exercise ECG test (P value=0.001). Positive exercise ECG test results occurred with calcific and mixed plaques in group (C) more than soft plaque in group (B), and there is significant difference between two groups with (P-value = 0.001). Positive exercise ECG test results in group (C) occurred more frequently with higher calcium score ranged from (59 – 362) HU. Conclusions: MSCT angiography and calcium scoring system can provide valuable results which is helpful in avoiding an extra unnecessary invasive coronary angiography in patients for whom exercise ECG test results seemed to be positive or for whom high cardiovascular mortality risk from ischemia is not present.
https://ejhm.journals.ekb.eg/article_43799_35e912be79d3c2dbe162aef318e7c7af.pdf
2019-07-01
4220
4227
10.21608/ejhm.2019.43799
electrocardiography
Calcific Non-obstructive Coronary Lesions
Cardiac Multislice Computed Tomography
Eslam Shawky
Abdelaziz
1
Cardiology Department, Faculty of Medicine, Al-Azhar University, Egypt
AUTHOR
Ashraf Al-Amir
Abdelfattah
2
Cardiology Department, Faculty of Medicine, Al-Azhar University, Egypt
AUTHOR
Mahmoud Gabr Ahmed
Abdellateef
mahmoud.gabr.abd@gmail.com
3
Cardiology Department, Faculty of Medicine, Al-Azhar University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Evaluation of Lateral Pelvic Lymph Nodes Involvement in Rectal Carcinoma
Background: worldwide, colorectal cancer is the third most commonly occurring cancer in men and the second most commonly occurring cancer in women. There were over 1.8 million new cases in 2018. Objective: evaluation of lateral pelvic lymph node involvement among patients with middle and low rectal carcinoma. Patients and Methods: a descriptive prospective study was conducted at Surgical Unit of Oncology Bab Elshaarya University Hospital, Al Azhar University, during the period between November 2018 and July 2019 (a total period of 8 months), in which 20 patients of middle and low rectal carcinoma were identified. Results: all patients had rectal adenocarcinoma; 17 patients (85%) with grade 2 and 3 patients (15%) with grade 3. Of the 20 identified patients, 15 patients (75%) had vascular invasion and 5 patients (25%) had no vascular invasion. Only 4 patients (20%) had positive lateral pelvic lymph nodes and 11 patients (55%) had positive mesorectal lymph nodes. All patients with positive lateral pelvic lymph nodes had also positive mesorectal lymph nodes. Conclusion: total Mesorectal Excision (T.M.E.) is a standard operation for rectal carcinoma due to high incidence of mesorectal lymph node metastases. Transanal total mesorectal excision (TaTME) is a promising technique in rectal surgery especially in low rectal cancers. Most of patients had positive mesorectal lymph nodes and all patients with positive lateral pelvic lymph nodes also had positive mesorectal lymph nodes.
https://ejhm.journals.ekb.eg/article_43800_8d06a13c41906431aada77a0e61ce0ef.pdf
2019-07-01
4228
4234
10.21608/ejhm.2019.43800
Lateral lymph node
Rectal carcinoma
Total Mesorectal Excision
Abd Elfattah Tawfek
Elsheekh
1
Department of General Surgery, Faculty of Medicine, Al-Azhar University
AUTHOR
Khaled Omar
Elkhateb
2
Department of General Surgery, Faculty of Medicine, Al-Azhar University
AUTHOR
Ahmed Mohamed Gouda
Embaby
dr.ahmedembaby@hotmail.com
3
Department of General Surgery, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
ORIGINAL_ARTICLE
Efficacy of Pulsed Dye Laser Plus Topical Calcipotriol and Corticosteroid Combination versus Topical Calcipotriol and Corticosteroid Combination Alone in Treatment of Nail Psoriasis
Background: psoriasis is a chronic, inflammatory skin disease that causes significant distress and morbidity. Objective: the aim of this study was to compare the efficacy of PDL plus topical calcipotriol and corticosteroid combination versus topical calcipotriol and corticosteroid combination in the treatment of nail psoriasis. Patients and methods: thirty patients with bilateral fingernail psoriasis were recruited from the Dermatology Outpatient Clinic at Al Hussein Hospital, Al Azhar University and Al-Haud Al-Marsoud Hospital between September 2014 and February 2017. Results: regarding treatment sessions, total treatment sessions, follow up sessions or total follow up sessions, there was no statistically significant difference (p-value > 0.05) between right hand and left hand. There was no statistically significant difference (p-value > 0.05) between the 2 subgroups (< 30 years and > 30 years), (male and female) or (skin type 3 and type 4) as regard 1st, 2nd, and 3rd treatment session. There was highly statistically significant (p-value < 0.001) positive correlation between (1st Rt. Vs 2nd Rt.) and (2nd Rt. Vs 3rd Rt.) treatment sessions. Also, statistically significant (p-value < 0.05) positive correlation between (first Rt. Vs 3rd Rt.) treatment sessions. Conclusion: laser therapy had been shown to be effective and safe for nail psoriasis. It could be used alone or combined with different therapeutic modalities, being especially beneficial with topical treatments.
https://ejhm.journals.ekb.eg/article_43801_d6caa54b76eac39a7593836de097fbee.pdf
2019-07-01
4235
4239
10.21608/ejhm.2019.43801
Pulsed Dye Laser Plus
Topical calcipotriol
Corticosteroid combination
Psoriasis
Azmy Ahmed
Abdel-latif
1
Department of Dermatology and Venereology, Faculty of Medicine, Al-Azhar University
AUTHOR
Ibrahim Mearaj
Ibrahim
2
Department of Dermatology and Venereology, Faculty of Medicine, Al-Azhar University
AUTHOR
Shady
Mahmoud
3
Department of Dermatology and Venereology, Faculty of Medicine, Al-Azhar University
AUTHOR
Walaa Abdel-hady Awwad
Mahgoub
w_prp@yahoo.com
4
Department of Dermatology and Venereology, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
ORIGINAL_ARTICLE
Evaluation of Right Ventricular Systolic Function in Patients with Right Bundle Branch Block Using Two-Dimensional Speckle Tracking Echocardiography
Background: the prevalence of right bundle branch block (RBBB) is estimated to be 0.2-2.3% in healthy individuals in many previous studies. The prevalence of RBBB increases with age, higher in men, diabetics and in patients with hypertension. Objectives: the purpose of this study was to evaluate the right ventricular systolic function in patients with right bundle branch block with structurally normal heart disease using conventional and speckle tracking 2D echocardiography. Subjects and Methods: forty patients with right bundle branch block (RBBB) were classified into 2 groups each of 20 patients; complete right bundle branch block (CRBBB) and incomplete RBBB (IRBBB), beside 20 normal individuals matched in age and sex served as controls. Results: Tricuspid annular plane systolic excursion (TAPSE) and right ventricle free wall longitudinal strain (RV FWLS) were not statistically significant in patients with RBBB, there was decrease in CRBBB than normal individuals. In right ventricle global longitudinal strain (RV GLS), tricuspid lateral annular systolic velocity (S’), Tei index by both tissue and pulsed Doppler assessment, fractional area change (RV FAC%) and RV basal diameter; and in incomplete right bundle branch block in the mean of RV STE GLS%, S’, Tei index by both tissue and pulsed Doppler. Conclusion: Isolated right bundle branch block has an effect on the RV morphologic characteristics, systolic function compared with healthy individuals by 2D, M-mode, Doppler and speckle tracking echocardiographic assessment.
https://ejhm.journals.ekb.eg/article_43802_a950820304ce46b340e15a62dca93e12.pdf
2019-07-01
4240
4245
10.21608/ejhm.2019.43802
Right Ventricular Systolic Function
Right Bundle Branch Block
Two-Dimensional Speckle Tracking Echocardiography
Mohy E. Mansour
Elabbady
1
Cardiology Department, Faculty of Medicine, Al-Azhar University
AUTHOR
Abdelmohsen M.
Aboualia
2
Cardiology Department, Faculty of Medicine, Al-Azhar University
AUTHOR
Ahmed S.
Attia
a7mad.sob7y@gmail.com
3
Cardiology Department, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR