Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
71
5
2018
04
01
The Role of Olive Leaves and Pomegranate Peel Extracts on Diabetes Mellitus Induced in Male Rats
3079
3085
EN
Fahmy G. Elsaid1,2,*, Khalid M. Alsyaad1,
Fatimah A. Alqahtani1
1Biology department, Science College, King Khalid University, KSA 2Zoology department, Faculty of science, Mansoura University, Egypt
<span>Background: </span><span>Metabolic diseases such as diabetes mellitus (DM) were progressively widespread all over the world and the alteration of oxidative stress and antioxidants associated with DM was established.<br /> </span><span>Aim of the work: </span><span>The natural products were used in many ancient cultures to overcome the DM, so pomegranate peel and olive leaves will be investigated in this work.<br /> </span><span>Materials and Methods: </span><span>Adult male albino rats (</span><span>Sprague Dawley</span><span>), weighing 220-250 g, were used in this study. Animals were classified into five groups, five rats in each group. Control group: rats were served as normal healthy control and were received no treatment but only normal chow diet and water </span><span>ad libitum </span><span>for 4 weeks. Diabetic group: rats were intraperitoneal injected with STZ at dose of 40 mg / kg b. wt. for a single dose. Diabetic and olive leaves extract group: diabetic rats were orally administered with watery extract of olive leaves at dose of 250 mg / kg b. wt. for 4 weeks. Diabetic and pomegranate peel extract group: diabetic rats were orally administered with pomegranate peel at 250 mg / kg b. wt. for 4 weeks. Diabetic and mix of olive leaves & pomegranate peel group: diabetic rats were orally administered with pomegranate peel and olive leaves at 250 mg / kg b. wt. for 4 weeks.<br /> </span><span>Results: </span><span>The oxidative stress markers such as lipid peroxidation and hydrogen peroxide were increased but there was a decrease in the antioxidants makers such as glutathione peroxidase, superoxide dismutase, glucose- 6-phosphate dehydrogenase, reduced glutathione and total antioxidants capacity in the liver of diabetic rats. The expression of insulin receptor and glucose transporter 2 genes was inhibited in liver of diabetic rats. Watery extracts of olive leaves and pomegranate improved the biochemical and molecular changes associated with DM. </span><span>Conclusion: </span><span>The results showed a hypoglycaemic, hypocholesterolemic and hypolipidemic action of olive leaves and pomegranate peel.<br /> </span>
Diabetes mellitus,antioxidants,Oxidative Stress,glucose transporters,insulin receptor,pomegranate,Olive leaves
https://ejhm.journals.ekb.eg/article_8579.html
https://ejhm.journals.ekb.eg/article_8579_8c33fdd5735f294d8fb190c01dd00aad.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
71
5
2018
04
01
Adenovirus Association with Graft versus Host Disease in Paediatric Bone Marrow Transplantation Recipients
3086
3092
EN
Arwa Kamhawy 1, Kouka Saad Eldin Abd Elwahab 1,
Jaylan Ayoub 1,
1-Microbiology and Immunology Department, Faculty of Medicine for Girls, Al Azhar University, Cairo
Abd Elrahman Zekri 2,
Alaa Elhaddad 3
2-Molecular Biology and Virology Department, National Cancer Institute, Cairo University, Cairo, 3- Paediatric
Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
<span>Background: </span><span>Adenovirus (Ad) infections have delayed clearance in paediatric patients. The immune suppression that occurs after hematopoietic stem cell transplantation (HSCT) can reactivate adenovirus, resulting in life- </span>
<span>to assess adenovirus infection in recipients of bone marrow transplantation and to find out if there is an association between adenovirus infection and the occurrence of graft versus host disease (GVHD) in these patients. </span><span>Patients and methods: </span><span>The study was conducted on 30 pediatric patients admitted to Nasser institute, for bone marrow transplantation. Serum and stool samples were collected one day prior to bone marrow transplantation, and every one or two weeks afterwards till the patient completed 100 days after </span><span>HSCT</span><span>. The adenoviral DNA was monitored in the </span><span>patient‟s </span><span>serum and stool samples by quantitative real time polymerase chain reaction (qPCR). The stool samples that tested positive for the presence of adenovirus were processed by cell culture technique for isolation of the virus. </span><span>Results: </span><span>Adenoviral DNA was detected in the fecal samples of 11 out of 30 patients (36.6% of cases); the viral load ranged from 1.2 X 103 copies/gram, to 8.4 X 10</span><span>7 </span><span>copies per gram, two patients had 2 positive stool samples with rising titer indicating the reactivation of the adenovirus. The adenoviral DNA was detected in the serum samples of only two patients (6.6% of cases), with a low titer, one of them was only 500 copies/ml and the other one was 1.6 X 10</span><span>4 </span><span>copies /ml. The remaining serum samples of the patients who shed the adenovirus in their stool were all negative for adenoviral DNA. These two patients, who had Ad DNA in their serum, had no adenoviral shedding in their stool. The adenovirus reactivation </span>
<span>was not associated with increased risk of developing GVHD, diarrhea or CMV reactivation.<br /> </span><span>Conclusion: </span><span>although the adenovirus was shed in the stool of 9 patients, the viral shedding was not associated with increased risk of developing GVHD, diarrhea or CMV reactivation.<br /> </span>
Adenovirus,hematopoietic stem cell transplantation (HSCT),graft versus host disease (GVHD),Bone Marrow Transplantation
https://ejhm.journals.ekb.eg/article_8580.html
https://ejhm.journals.ekb.eg/article_8580_0fc642fd48a198d116ac028331f46b02.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
71
5
2018
04
01
Role of Immunohistochemistry in the Differentiation between Low Grade Prostatic Adenocarcinoma (Small Acinar Pattern) and Some Benign Mimickers
3093
3100
EN
Salah El-din Sayed
Omar
Semary
Department of Pathology, Faculty of Medicine Al-Azhar University, Damietta
Al-Sayed A.
Abd-Elrahman
Department of Human Anatomy, Faculty of Medicine Port Said University
Wagih M.
Abdelhay
Department of Histology and Cytology, Faculty of Medicine Al-Azhar University, Cairo
Esam O.
Kamel
Department of Histology and Cell Biology, Faculty of Medicine Al-Azhar University, Assuit Branch
Wail M.
Gad-Elrab
Department of Human Anatomy, Faculty of Medicine Al-Azhar University
<strong>Background</strong>: prostatic adenocarcinoma is characterized by diverse architectural growth patterns and can be confused with some benign prostatic lesions. The most common pseudoneoplastic lesions in the prostate that can mimic low-grade prostatic adenocarcinoma are post-atrophic hyperplasia (PAH), atypical adenomatous hyperplasia (AAH) and sclerosing adenosis of the prostate (SAP). <strong>Objective:</strong> this study aimed to evaluate the histopathological and immunohistochemical features of some pseudoneoplastic lesions of the prostate that could potentially be confused with low-grade prostatic adenocarcinoma (small gland pattern). <strong>Material and Methods</strong>: 100 specimens of prostatic lesions were enrolled in this study and analyzed retrospectively (50 needle biopsy specimens and 50 transurethral resection of prostate (TURP) specimens). All cases had atypical foci that required further workup. Four slides per specimen were cut, one slide for hematoxylin and eosin stain (H&E) and the other 3 slides for immunohistochemical (IHC) staining by antibodies against 34βE12 cytokeratin, p63 and alpha methyl acyl coenzyme A racemase (AMACR). <strong>Results: </strong>histological examination (prior to IHC staining) revealed provisional histological diagnosis of 35 cases of PAH, 12 cases of AAH, 13 cases of SAP and 40 cases of low grade prostatic adenocarcinoma. Immunohistochemical results revealed immunopositivity to 34βE12 in a discontinuous pattern in 13 out of the 35 cases of PAH (13/35), immunopositivity to 34βE12 and p63 in a continuous basal pattern in 17 cases (17/35) and negativity for all markers in 5 cases (5/35). 29 cases out of the 40 prostatic carcinomas showed immunopositivity for AMACR and negativity for 34βE12 and p63 (29/40), 5 cases were negative for all markers (5/40) and 6 cases were positive to p63 and negative for AMACR and 34βE12 (6/40). 8 out of the 12 cases diagnosed as AAH showed immunopositivity to 34βE12 and p63 in a discontinuous pattern and negative to AMACR (8/12), 2 cases were positive to AMACR and negative to basal cell markers (2/12) and 2 cases were negative to all markers. All the 13 cases diagnosed histologically as SAP showed immunopositivity to 34βE12 and p63 and immunonegativity to AMACR. <strong>Conclusion</strong>: immunohistochemistry (IHC) can be contributive in the diagnosis of prostatic adenocarcinoma if used with care and experience. No single marker can establish a diagnosis on its own, but interpretation must always be in conjunction with H&E morphology.
prostatic carcinoma,benign mimickers,Immunohistochemistry
https://ejhm.journals.ekb.eg/article_8581.html
https://ejhm.journals.ekb.eg/article_8581_2173de0e79752494ec87e83adfed5ce6.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
71
5
2018
04
01
Renal Stones among Adult Population in Arar City, Northern Saudi Arabia
3101
3108
EN
Alfuhigi, Zuhur Dhaher M1, Amer Ogla Faleh Alfuhigi2, Ahmed Hamad Ahmed Sulaiman3, Alruwaili, Anwar Eid M1, Alshalan, Maha Hazzaa F1, Alanazi, Alaa Ali S1, Alshammari, Mashail Rasheed M1, Alshammari, Nujud Muteb D1, Alanazi,
Abrar Asaad M1, Alshubayni, Bashaer Mahmoud A1, Maha Thiab Abdalaziz Alshbiny1, Alruwily, Zain Amer l1, Albanaqi, Ihtifal Slamah S1, Alanazi, Waad Kareem A1, Alshareef, Zainab Abdullah N1
1 Northern Border University, Arar, 2 Security Forces Hospital,3 Internal Medicine,
Northern Border University, Arar, KSA
<span>Background: </span><span>Renal stone is a major health problem with adverse medico-economic consequences. It cost the healthcare services a great deal of money without reaching any desired destiny. </span><span>Objective: </span><span>To describe the current prevalence, risk factors, manifestations, methods of diagnosis and treatment of renal stones in Arar city, Northern Saudi Arabia </span><span>Method: </span><span>Cross-sectional community based on survey applied to the adult of the general population of Arar city during the period fromJune to October 2017. The statistical significance level is made at less than 0.05. </span><span>Results: </span><span>Among 470 participants, 57.7% male and 42.3% females, 23% had renal gravel, 13% had renal stones. Only 15% complained from recurrent renal colic and 28% had family history of renal stones or gravels. Among the found cases of renal stones, 39.7% had family history of renal stones (P<0.05), 30% had other chronic diseases, 67% have renal gravels (P<0.05) and more than half (55.2%) of them had recurrent renal colic (P<0.05) and 39.9% were obese (P<0.05). The most common symptom is renal colic as it appear in 55% of cases and 82% of affected people are diagnosed by complete urine analysis and ultrasound examination. The most common type is oxalate stone 55.2%, uric acid stones 27.6% and mixed stones 17.2%. More than half (55.2%) of renal stones are small in size and 46% found in the kidney. Most (84%) of the cases get herbal treatment, 89% medical treatment and only 8.6% got surgical treatment but 46% had recurrent stones. </span><span>Conclusion: </span><span>The prevalence of renal calculi and associated renal colic in Arar city, Northern is considerable. Suggestions for health education about risk factors in addition to future researches are mandatory.<br /> </span>
Renal stones,Oxalate stone,Uric acid stones,Adult Population,Arar city,Northern Saudi Arabia
https://ejhm.journals.ekb.eg/article_8582.html
https://ejhm.journals.ekb.eg/article_8582_de74a925a8f7167f981712c820b2f2cb.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
71
5
2018
04
01
Factors Affecting Difference between EGW and AGW in Liver Transplantation
3109
3115
EN
Mohamed Kamel Sobhi, Ahmed Gamal El-Din Othman, Hany Saeid Abdel-Baset,
Mohamed Mohamed Bahaa El-Din
Department of General Surgery, Faculty of Medicine, Ain Shams University
mohmmdkamel@gmail.com
<strong>Background: </strong>An accurate preoperative estimate of the graft weight and remnant liver volume is vital to avoid small-for-size syndrome(SFSS) in the recipient and ensure donor safety after Living donor liver transplantation (LDLT). CT has been widely used as a method for the preoperative volumetric assessment of the liver transplantation.The graft size as measured from preoperative imaging which is often different from the actual weight of the liver graft as obtained by the donor hepatectomy.
The difference between preoperative volumetry and Actual graft weight (AGW) was graded into minimal difference (≤15%) and big difference (>15%).
<strong>Aim of The Work: </strong>This study was conducted to assess different preoperative factors that might affect the difference between estimated graft weight and actual graft weight in liver transplantation.
<strong>Patients And Methods: </strong>This single center retrospective study was conducted on 86 cases who have been subjected to donation for liver transplantation in Ain Shams Center of organ transplantation.<strong>Donors were divided into two groups: </strong>
<strong><em>Group (A):</em></strong> formed of 33 donors who showed minimal difference (≤15 %) between EGV and AGW.
<strong><em>Group (B): </em></strong>formed of 53 donors who showed big difference (>15 %) between EGV and AGW.
<strong>Each donor data was examined for: Age, Sex:</strong> male or female, Body mass index (BMI), Lipid profile (positive / negative) Type of hepatectomy (Rt lobe / Lt lobe), AGW.Estimated graft weight (EGW), Total liver volume, Liver biopsy: Fibrosis (positive/ negative), Steatosis: Negative: (0%) and Positive: (5% or 10%).
<strong>Results: </strong>EGW of 903 gm was identified as cutoff point of the best specificity with the best sensitivity showing 60.4 % and 60.6% for sensitivity and specificity, respectively. At this cutoff point, 47.7% of cases (n=41) showed EGW < 903 gm, while 52.3% of cases (n=45) showed EGW ≥ 903 gm. Thus, it can be said that cases showed EGW ≥ 903 gm have a probability of 71.1% to have big difference between EGW and AGW (≥15%).
EGW of 1069 gm was identified as another cutoff point of a better specificity on ROC curve showing 32.1% and 93.9% for sensitivity and specificity, respectively, on ROC curve. At this cutoff point, 77.9% of cases (n=67) showed EGW < 1069 gm, while 22.1% of cases (n=19) showed EGW ≥ 1069 gm. Thus, it can be said that cases showed EGW ≥1069 gm have a probability of 89.5% to have big difference between EGW and AGW (≥15%).
TLW of 1587 gm was identified as cutoff point of the best specificity with the best sensitivity and specificity on ROC curve showing 56.6% and 60.6% for sensitivity and specificity, respectively, on ROC curve. At this cutoff point, 50% of cases (n=43) showed TLW < 1587 gm, while 50% of cases (n=43) showed TLW ≥ 1587 gm.
Thus, it can be said that cases showed TLW ≥1587 gm have a probability of 69.8% to have big difference between EGW and AGW (≥15%).
TLW of 1807 gm was identified as another cutoff point of better specificity on ROC curve showing 18.9% and 93.9% for sensitivity and specificity, respectively, on ROC curve. At this cutoff point, 86% of cases (n=74) showed TLW < 1807 gm, while 14% of cases (n=12) showed TLW ≥ 1807 gm. Thus, it can be said that cases showed TLW ≥1807 gm have a probability of 83.3% to have big difference between EGW and AGW (≥15%).
<strong>Conclusion: </strong>TLV and EGV in CT volumetry are most reliable preoperative factors that can predict big difference between EGW and AGW. Re-evaluation of CT volumetry protocol is recommended for better prediction.
AGW: EGW. EGW: EGW. LDLT: Living donor liver transplantation. SLV: standard liver volume. TLV: total liver volume
https://ejhm.journals.ekb.eg/article_8583.html
https://ejhm.journals.ekb.eg/article_8583_671dcb54a380062b2cdccab14e600890.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
71
5
2018
04
01
Conventional Hemorrhoidectomy versus Ligasure Hemorrhoidectomy: A Comparative Study
3116
3120
EN
Al Sayed A Hamdy, Yaser H Hasan,
Muhammad M Allam
Department of General Surgery, Faculty of Medicine – Al-Azhar University
muhammad.allam1@outlook.com
<strong>Background: </strong>Hemorrhoidal disease is one of the most common anorectal diseases and surgical hemorrhoidectomy remains one of the most common operations in general surgery. Milligan-Morgan Described the conventional hemorrhoidectomy since about 70 years ago, then surgical hemorrhoidectomy had changed little over years until the introduction of LigaSure hemorrhoidectomy. <strong>Aim </strong><strong>of the Work: </strong>Is to compare between conventional (Milligan-Morgan) hemorrhoidectomy and LigaSure hemorrhoidectomy in treating patients with 3<sup>rd</sup> and 4<sup>th</sup> degree internal piles.<strong> Patients and Methods: </strong>This randomized control clinical trial was done at Mounira General Hospital over a period from April 2017 to March 2018 on the basis of: It included 40 adult patients with 3<sup>rd</sup> and 4<sup>th</sup> degree hemorrhoids divided randomly into 2 equal groups: Group A (n: 20 patients) underwent LigaSure hemorrhoidectomy. Group B (n: 20 patients) underwent Conventional hemorrhoidectomy. <strong>Results: </strong>There was a highly significant difference between the two study groups as regard the operative time, in the LigaSure hemorrhoidectomy group the mean operative time was 11.15 ± 2.68 minutes, while in the conventional technique group the mean time was 28.75 ± 4.20 minutes. As regards the post-operative pain, in the 1<sup>st</sup> day, there was a highly significant difference between the two study groups; in the LigaSure hemorrhoidectomy group the mean post-operative pain was 3.80 ± 1.54; while in the conventional technique it was 5.95 ± 0.99. Regarding the post-operative pain, in the 1<sup>st</sup> week, the LigaSure hemorrhoidectomy group mean was 2.60 ± 1.27; while in the conventional method was 4.80±0.89. As regard the intra-operative estimated blood loss, a significant difference between the two study groups was present. In ligaSure hemorrhoidectomy group 40% had almost no bleeding, 20% had minimal blood loss, 20% had mild loss and 20% had moderate blood loss in comparison with conventional method group patients; 0% with no blood loss, 15% with minimal loss, 55% with mild loss and 30% with moderate blood loss. As regards duration of wound healing, in the LigaSure group, the mean time was 2.65 ± 0.74 weeks while in the in the conventional technique group, it was 4.60 ± 0.82 weeks which was statistically highly significant. With LigaSure hemorrhoidectomy only 6 patients out of 20 needed anal packing, in contrast with conventional method group that needed an anal pack for the whole 20 patients. <strong>Conclusion: </strong>We conclude that LigaSure hemorrhoidectomy is better than conventional (Milligan-Morgan) hemorrhoidectomy in terms of less operative time, less intra-operative blood loss, less post-operative pain, less post-operative analgesics and earlier wound healing and return to daily work hence higher patient satisfaction. <strong>Recommendations:</strong> Further studies on a larger scale of patients are needed to confirm the results obtained by this work.
LigaSure Hemorrhoidectomy,Conventional Hemorrhoidectomy,Milligan-Morgan
https://ejhm.journals.ekb.eg/article_8584.html
https://ejhm.journals.ekb.eg/article_8584_a7a4aaeaa7f1d5ebd9e7dd6f84cbcc16.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
71
5
2018
04
01
Interbody Fusion. Is It Has a Rule in Broken Screws in Surgical Management of Lumbar Spondylolisthesis?
3121
3124
EN
Micheal
Zohney
Department of Neurosurgery, Nasser Institute for Research and Treatment, Cairo
Ahmed
Sawy
Department of Neurosurgery, Nasser Institute for Research and Treatment, Cairo
Nazek
Ahmed
Department of Neurosurgery, Nasser Institute for Research and Treatment, Cairo
Hamdi Nabawi
Mostafa
Department of Neurosurgery, Faculty of Medicine, Misr University for Science and technology, Giza
hamdi.nabawy@gmail.com
<span>Background: for many years, posterolateral fixation for lumbar spondylolisthesis by using pedicle screw has been the standard procedure for lumbar spondylolisthesis. For increasing fusion and anterior support, the interbody fusion, either with cage or bone, were used by many surgeons, one of the most disappointing complications of pedicle screw fixation is broken screw. Aim: it was to compare the number of cases with a broken screw in case of interbody fusion and control group. Patients and Methods: this is retrospective cohort study in six years comparing between two groups: Group I posterolateral fixation (PLF), Group II posterolateral interbody fusion (PLIF). it analyzed 26 cases of broken screw occurred in six years from 2010 to 2016 which were done in Nasser Institute by the same surgeon and same system. Results: twenty-six cases were reviewed, the mean age was 44.6 years, female : 6/26 (23%), male : 20/26 (77%),mean weight: 74.8 kg, site for broken screw: (L1: 4 patients – L2: 2 patients – L3: 2 patients – L4: 4 patients – L5: 6 patients – S1: 8 patients), 6 patients had broken screws following trauma, while 20 patients were found spontaneous, all patients were found intraoperatively to have posterolateral fixation, they underwent redo screw fixation,18 patients underwent redo screw fixation with posterolateral interbody fusion (PLIF) while the other 8 patients underwent redo screws fixation with posterolateral fixation. All patients with PLIF didn’t come back with broken screws, while 2 patients with posterolateral fixation came back with broken screws again Conclusion: posterolateral interbody fusion (PLIF) may have a rule in preventing broken screw in the management of lumbar spondylolisthesis.<br /> </span>
Spondylolisthesis,Posterolateral fixation (PLF),posterior lumbar interbody fusion (PLIF),broken screw
https://ejhm.journals.ekb.eg/article_8585.html
https://ejhm.journals.ekb.eg/article_8585_041a335f1d948b00c6054ff7f526e796.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
71
5
2018
04
01
Epistaxis: The Commonest Otolaryngological Emergency in Arar, Northern Saudi Arabia
3125
3130
EN
Raed Khalid Raja Alanazi1, Turki Suliman Saleh Alkhuliwi2, Alhanouf Hussein Saad Alahmari3,
Mana Abdullah Saud Al Yami4, Awwatf Sattam Alshammari1, Haifa Lafi Alenzi1,
1 Northern Border University, Arar, 2 Ministry of Health, 3 King Khalid University, Aseer “ Abha “,
4 Najran University, Najran,
Nawaf Fahad Alshuraym5, Munirah Abdullah Almakhayitah6
Narjis Bakkar7
5 Imam Muhammad Ibn Saud Islamic University, Riyadh,
6 King Faisal University, Alhassa, 7Almareefa College, Riyadh, KSA
<strong>Background:</strong> Epistaxis is a common clinical condition that ranges from a minor nuisance to a life threatening emergency. It may be a chronic problem or symptom of generalized disorder . <strong>Objective:</strong> to determine the etiology, risk factors and the outcome of the conservative and surgical management of epistaxis in the studied population. <strong>Methods:</strong> This is a cross-sectional, community-based survey being directed to the Saudi adult population living in Arar city during the period of October and November 2017. The study instrument is a self-administered, pre-designed questionnaire. <strong>Results</strong>: The study included 175 epistaxis cases, 39.4 % females and 60.6 % males, 45.1 % were 20-29 years . Hypertension was found in 4.0%, 20% were smokers and 7.4% were ex-smokers. Epistaxis was idiopathic in 56.6 % of cases, local injury in 16%, nasal allergy in 8.6%, nasal infection in 7.4%, mucosal irritation in 2.9%, high blood pressure in 2.9%, foreign bodies in 2.2%, nasal tumors in 1.7% and blood dyscrasias in 1.1%. Most (85.1%) of the cases were treated at home and 14.9% in the emergency department of hospitals. Cauterization of bleeding point, employed for only 1.7% of the cases and surgical treatment in only 1.1%. <strong>Conclusion:</strong> epistaxis was more common in males than females, most cases are idiopathic, local injury and nasal allergy are also considered causes. The majority of epistaxis were not life threatening and can be treated conservatively. Most of the cases were treated at home mainly by pressure on the nose and considerable percentage treated in the emergency department of the hospitals mainly by nasal backing.
epistaxis,Otolaryngological,Arar,Northern Saudi Arabia
https://ejhm.journals.ekb.eg/article_8586.html
https://ejhm.journals.ekb.eg/article_8586_35a87d38be4311b92d859a3be99ec798.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
71
5
2018
04
01
Variations of Corneal Hysteresis in Myopic Patients with Normal Pentacam Findings
3131
3135
EN
Amr Esam Ali, Ahmed Youssef,
Abdel Megid Tag El Din
Al Hussein University Hospital, Al Azhar University, Cairo governorate, Egypt
<span>Background: </span><span>hysteresis refers to the energy lost during the stress/strain cycle which is the result of viscous damping in the corneal tissue, is an indicator of corneal biomechanical properties. Refractive surgery currently uses corneal thickness as a basic qualification and planning parameter. However, corneal hysteresis may be more useful as a qualification factor for LASIK, a significant decrease in the IOP and biomechanical properties is found in eyes following LASIK surgery<br /> </span><span>Objective: </span><span>this study aimed to reveal the variations of corneal hysteresis in patients with normal pentacam findings and to see if a correlation exists between corneal hysteresis, corneal resistance factor, mean keratometric reading, central corneal thickness and anterior chamber depth during the pre-operative assessment of myopic patients going for LASIK.<br /> </span><span>Patients and methods: </span><span>in this study we did an analysis of corneal hysteresis in a group of myopic patients with normal pentacam findings undergoing evaluation for refractive surgery. In our study we included 50 eyes of 26 patients aged between 18 and 44.</span><span>Results: </span><span>this study included a mean keratometric reading of 44.108 D± 1.3243D, the mean central corneal thickness was 522.1um±38.416um, the mean anterior chamber depth was 3.2098mm±0.249mm the mean corneal hysteresis was 9.582 mmHg±1.4702 and the mean corneal resistance factor was 9.64 mmHg ±1.9838.</span><span>Conclusion: </span><span>our data suggested that patients should get their corneal hysteresis tested as a part of their routine investigation portfolio before undergoing refractive surgery as it may play a role in determining patients that are at higher risk of developing ectasia after surgery.<br /> </span>
Corneal Hysteresis,Myopic Patients,normal pentacam
https://ejhm.journals.ekb.eg/article_8587.html
https://ejhm.journals.ekb.eg/article_8587_cfcde52b759614662c1fe80797731222.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
71
5
2018
04
01
Clinical Features Clusters in Systemic Lupus Erythematosus
3136
3141
EN
Mansour M,
and Helaly M
Rheumatology Department, El-Galaa Military Family Hospital, Cairo, Egypt.
<span>Background: </span><span>Systemic lupus erythematosus (SLE) is a multi-systemic heterogeneous autoimmune disease. Attempts have been made trying to classify lupus into more homogenous subsets with pathogenic, therapeutic, or prognostic significance. </span><span>Objective: </span><span>was to evaluate the possibility of existence of the main clinical features of Systemic Lupus Erythematosus (SLE) in clusters. </span><span>Patients and Methods: </span><span>The demographic data, cumulative clinical and laboratory features of 150 Egyptian SLE patients were studied. Some of the main clinical manifestations were then selected for cluster analysis using the K-means cluster analysis procedure. </span><span>Results: </span><span>Three distinct groups of patients were identified. Cluster 1 (n: 27) showed higher age at diagnosis and was characterized by high prevalence of mucocutaneous manifestations (malar rash, discoid rash, photosensitivity, oral ulcer) and arthritis but having low prevalence of serositis and hematologic manifestations (hemolytic anemia, leukopenia, and thrombocytopenia). Patients in cluster 2 (n: 81) showed mainly renal and hematological manifestations but had the lowest prevalence of mucocutaneous manifestations and arthritis. Cluster 3 patients (n: 42) had the most heterogeneous features; they had a high prevalence of mucocutaneous manifestations, serositis, hematologic manifestations and renal involvement. </span><span>Conclusion: </span><span>patients with systemic lupus erythematosus could be divided into clusters of distinct patterns of clinical manifestations.<br /> </span>
SLE,clusters,CLINICAL FEATURES
https://ejhm.journals.ekb.eg/article_8588.html
https://ejhm.journals.ekb.eg/article_8588_af120adcd1171d6f26920355ff2a3d16.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
71
5
2018
04
01
Dose Response Effect of Nitroglycerin on Cardiac Hemodynamic Functions and Myocardial Infarction in a Rat Model of Ischemia Reperfusion
3142
3147
EN
Nada Kotb Abd Elfatah Kotba, Amany H Hasanina, Nevien Fekry Abdalla Hendawya,
Naglaa Samir Ahmedb and Ahmed Nour Eldin Hassana.
Departments of aClinical Pharmacology, and bPathology, Faculty of Medicine,
Ain Shams University, Cairo, Egypt
<span>Background: </span><span>Millions of people suffer from acute coronary syndrome, angina, acute myocardial infarction (MI), or related illnesses. These patients are prescribed nitroglycerin (NG) for the management of these diseases. Accordingly, any risk associated with the use of nitroglycerin can potentially affect those people despite of the undeniable benefit in relieving acute angina. </span><span>Aim of the present work: </span><span>was to study the potential of treatment with 3 different doses of NG (25, 50, 100 mg/kg) to develop nitrate tolerance.<br /> </span><span>Materials and Methods</span><span>: 50 Male Albino rats were randomly divided into 2 main groups: sham group and ischemia/reperfusion (I/R) groups, which was further subdivided into 4 groups, Untreated group; NG 25, 50 and 100 mg groups; rats received nitroglycerin three times daily for 3 days before induction of ischemia reperfusion. the effect of NG on cardiac functions and infarction size and severity score were assessed. </span><span>Results: </span><span>Rats exposed to I/R exhibited a significant decrease </span><span>in their cardiac hemodynamic functions (↑ </span><span>left ventricular end diastolic pressure; </span><span>LVEDP and ↓dp/dt</span><span>max</span><span>) and development of a measurable cardiac infarction area. Regarding pretreatment with NG; NG 25 mg/kg improved cardiac functions and myocardial infarction size & severity score. NG 50 mg/kg significantly decreased myocardial contractility and increased myocardial infarction size. Meanwhile NG 100 mg/kg produced significant decrease in cardiac functions and significant increase in myocardial infarction size & severity score.<br /> </span><span>Conclusion</span><span>: NG pretreatment dose dependently decreased cardiac hemodynamic functions and increased myocardial infarction size & severity score in a rat model of ischemia reperfusion.<br /> </span>
Nitroglycerin,Cardiovascular System,LVEDP,LV dP/dtmax,Ischemia/reperfusion
https://ejhm.journals.ekb.eg/article_8589.html
https://ejhm.journals.ekb.eg/article_8589_8edc4424b337a71265e92374ac137722.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
71
5
2018
04
01
Confidence Levels of Intern Doctors during Root Canal Treatment Procedures in Saudi Arabia
3148
3152
EN
Ahmad Y AlQisi, Ibrahim Yahya A Alsalhi, Waleed Hussain Ali Alwadei, Zahra A. Alsafi,
Eman A. Alshahrani
College of Dentistry, King Khalid University, Saudi Arabia
<span>Introduction: </span><span>Endodontic is one of the difficult branches in dentistry as it requires special skills to deals with treatment of the root canals. These difficulties comes from anatomical complexities of the roots, working area is very limited, and clear and clean area before final obturation is required which is difficult to achieve. In addition, complications and subsequent retreatment are difficult and are time- and materials-wasting. </span><span>Methods: </span><span>A self-administrated questionnaire was distributed to intern dentists at all dental school all around the Kingdom of Saudia Arabia. It consisted of 10 questions related to all possible procedures in endodontic treatment. The confidence level was scored in 5-</span><span>points Liker scale ranging from 1 “very little confidence” to 5 “very confident”. Data were analyzed using SPSS V22 software program. A p</span><span>-value < 0.05 was considered significant.<br /> </span><span>Results: </span><span>Thirteen different dental schools from 13 different universities including 230 intern dentists were included in the analysis. Number of the included interns varied considerably between universities. The largest number of participants were from King Khalid University with 47 interns (18.7%) and the least number of participants were from Alfarabi College and Majmaah University with 9 interns, equally. Most participants were confident or very confident of most of the endodontic procedures. More than two thirds (71.74%) of participants had no experience in removing broken instruments from root canals. About 19.57% of participants also had no experience in performing retreatment of failed RCT. Twenty eight (12.17%) participants had very little confidence regarding using rotary instruments. Less than one third (29.13%) of participants were confident regarding irrigation of root canals. Only three questions had significant differences in means between universities. With regard to gender, no significant differences were found in relation to all confidence questions.<br /> </span><span>Conclusion: </span><span>Level of confidence regarding endodontic treatment among intern dentists in Saudia Arabia is acceptable. More practical training, however, for the most difficult procedures are highly recommended. </span>
education,endodontics,self-confidence,dental students,Saudi Arabia
https://ejhm.journals.ekb.eg/article_8590.html
https://ejhm.journals.ekb.eg/article_8590_244aa83741fb68699c53a16ab3fcaeca.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
71
5
2018
04
01
Role of Ketamine as an Adjuvant to Bupivacaine in C-Arm Guided Thoracic Paravertebral Block Analgesia for Modified Radical Mastectomy
3153
3157
EN
Sanaa Mohamed Elnoamany 1, Nabil Ali El Sheikh 1, Asmaa Fawzy Amer 1,
Areeg Kotb Ghalwash 2
1 Anethesiology & Surgical I.C.U, Faculty of Medicine, Tanta University, 2 M.B.B.CH
<span>Background: </span><span>Breast cancer is the most common type of cancer found in women and today represents a significant challenge to public health. Postoperative pain is the most distressing symptom experienced by the patient. Pain induces metabolic, hormonal and cardio-respiratory responses that affect the outcome of surgery.<br /> </span><span>Aim of the Work: </span><span>The aim of this study was to evaluate the role of ketamine as an adjuvant to bupivacaine in c- arm guided thoracic paravertebral block analgesia for modified radical mastectomy. </span><span>Patients and Methods: </span><span>This study was carried out in Tanta University Hospitals in Surgery Department from April 2016 to October 2016 on sixty-two patients scheduled for elective modified radical mastectomy divided into two equal groups each contain 31 patients, group 1 received PVB with bupivacaine only under c arm and group 2 received PVB with bupivacaine and ketamine as pre emptive analgesia and watch what is the outcome. Written informed consent was taken from each patient. </span><span>Results: </span><span>This prospective randomized double blind study was carried out on 62 patients divided into two equal groups where group two showed statistically significant decrease in VAS , total amount of analgesic and delay in time of first analgesic requirement in comparison with group one and significant difference as regard hemodynamics and postoperative complication between two groups. </span><span>Conclusion: </span><span>We concluded that addition of ketamine to bupivacaine as an adjuvant in C-arm guided PVB appears to be more beneficial than the use of bupivacaine alone for postoperative analgesia in modified radical mastectomy surgery.<br /> </span>
Ketamine,Bupivacaine,Radical mastectomy,C-Arm Guided Thoracic Paravertebral,Block Analgesia
https://ejhm.journals.ekb.eg/article_8591.html
https://ejhm.journals.ekb.eg/article_8591_2d203ca8a47b208d6494327c1e9323c5.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
71
5
2018
04
01
Levonorgestrel Releasing IUS (Metraplant E) in the Management of Copper IUD Related Heavy Painful Menstrual Loss
3158
3165
EN
Mohamed Ezz El-Din Aly Azzam*, Amal El-Shabrawy EL-Sayed,
Samah Mohamed Ali Abd El- Azym
* Obstetrics and Gynecology Department, Ain Shams University.
<span>Background: </span><span>the LNG-IUD was first introduced in Finland in 1990 and is currently marketed in most European countries and in the US since 2000</span><span>. </span><span>The Levonorgestrel IUD is approved for 5 years, but lasts up to 10 years and reduces the menstrual blood loss and pelvic infection rates.<br /> </span><span>Aim of the Work: </span><span>this study aimed to evaluate safety and efficacy of levonorgestrel releasing IUS (Metraplant-E) in the management of copper IUD related heavy painful menstrual loss. Among women of low socioeconomic status attended to family planning clinic at Abo-Elnomros Hospital (Abo-Elnomros is small village </span><span>–</span><span>Giza Government, Egypt. </span><span>Patients and Methods: </span><span>this was a prospective cohort study and it was performed in Abo- Elnomros hospital. Women who attended to the hospital (Family planning clinic) for IUD follow up and had complications (bleeding and dysmenohrea) for which copper IUD is removed. </span><span>Results: </span><span>all women in the present study reported a marked reduction in MBL, which started from the first menstrual period following insertion of Metraplant </span><span>–</span><span>E. Bleeding was reduced further over the next months until the 6</span><span>th </span><span>month except two cases . Amenorrhea occurred in 38 cases. The difference in menstrual bleeding was highly significant (P <0.0001). Hemoglobin level increased from a mean baseline value of 10.0 ± 1.3 at baseline controls to a mean level of 10.5 ± 1.2 after 6 months of Metraplant-E use. Differences in hemoglobin levels were highly significant P <0.0001. </span><span>Conclusion and Recommendations: </span><span>the copper IUD is the most commonly used method of reversible contraception worldwide and is used by an average of 23 percent of female contraceptive users. The copper IUD is associated with increased menstrual flow both in length of menses and in amount of blood loss. The most common reasons for the discontinuation of this method are menstrual bleeding and dysmenorrhea. Metraplant- E is effective in significantly reducing the amount of menstrual blood loss in women with heavy painful menstrual loss related to copper IUD. Strong endometrial suppression is the principal mechanism, explaining both the effect on menstrual blood loss and the contraceptive performance of the IUS. Proper treatment of the chronic endometritis prior to Metraplant-E insertion is recommended. Actively informing women about benefits, risks and common side effects of IUS appears to improve consideration and acceptance of the method.<br /> </span>
levonorgestrel releasing IUS,metraplant E,IUD,LARC
https://ejhm.journals.ekb.eg/article_8592.html
https://ejhm.journals.ekb.eg/article_8592_6b38a269c6a12e042236ef3a41366f39.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
71
5
2018
07
02
Screening of Oral Cancer Using Plasma Biomarkers
3166
3170
EN
Hamdi Abdulwahab
Alhakimi
Department of Dental Health, Albaha University, Saudi Arabia
<span>Aim of the work</span><span>: there are many types of biomarkers (DNA biomarkers, RNA biomarkers and protein biomarkers). They have a pivotal role in early detecting of oral cancer. In this review, we aimed to summarize the potent plasma biomarkers which have been reported to have pivotal role in the detection and diagnostic different types of oral cancer. </span><span>Methods</span><span>: an electronic search in MEDLINE was conducted through PubMed using this search strategy (Plasma biomarker or plasma indictors) and (Oral cancer or oral tumor or oral squamous cell carcinoma). The search resulted in 158 eligible study and finally 10 potential articles were included in this systematic review. </span><span>Results</span><span>: in general, 9 articles used oral squamous cell carcinoma (OSCC) while, only one study used gingival squamous cell carcinoma as a type of oral cancer in order to evaluate the potential of biomarker to detect oral cancer. In eight articles microRNAs were predominantly used as potent biomarkers, different types of microRNAs were used. Plasma hsa-miR-542-3p recorded potential performance as biomarker in diagnosis of OSCC with AUC 0.82. Down regulation of hsa-miR-542-3p were correlated with increasing of surviving expression in OSCC. </span><span>Conclusion</span><span>: we can conclude that plasma microRNAs biomarkers occupied wide scope of the included studies in this review and could be serve as potent and sensitive biomarkers (especially plasma miR-125b expression and combination of miR-196a and miR-196b) for prognostic and diagnostic different types of oral cancer.<br /> </span>
oral cancer,biomarkers,plasma,Screening,DNA,RNA,protein
https://ejhm.journals.ekb.eg/article_8593.html
https://ejhm.journals.ekb.eg/article_8593_16904197f0bec859a8be4a742db9b63b.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
71
5
2018
04
01
Types of Surgical Repair and Outcome in Patients with Tetralogy of Fallot: Experience from A Single Center in Saudi Arabia
3171
3178
EN
Kafaf S Jalali 1, Mohamed Mofeed F Morsy2,4, Sherif S Salim3,4, Abdulhameed A Alnajjar4 , Saad Q Khosh-Hal4, Aitizaz U Sayed4,
Ali E Jelly4, Ibrahim H Alharbi4, Khalid M Alharbi4, Mustafa A Almuhaya4 , Mansour M Almutairi4
1Taibah University, Medina, Saudi Arabia, 2Sohag University, Egypt, 3Menoufiya University, Egypt, 4Pediatric Cardiology, Medina Cardiac Center, Saudi Arabia
<span>Background: </span><span>Congenital heart disease is the most prevalent form of primary congenital disability in newborns and is the leading cause of death in children with congenital malformations. It occurs in approximately 0.8% of live births. With advances in both palliative and corrective surgery, the number of children with congenital heart disease surviving to adulthood has increased dramatically . Tetralogy of Fallot (TOF) is one of the conotruncal </span>
<span>family of heart lesions in which the primary defect is an anterior deviation of the infundibular septum (the muscular septum that separates the aortic and pulmonary outflows). </span><span>Objective: </span><span>To revise patients with tetralogy of Fallot (TOF) underwent palliative or total corrective surgical repair in Madinah, Saudi Arabia. </span><span>Methods: </span><span>retrospective study was approved from the institutional review board of Madinah cardiac center and abandoned the need for patient consent. Patient Demographic data and procedure details were retrieved from the hospital information system (HIS). From 2014 till end of 2017, 72 patients had the diagnosis of TOF (ICD 10 code, Q21.3). Twelve patients were excluded from them. Thus, 60 patients were left as the study cohort. Fifty four patients had total repair from the start (Group I), 3 patients had initial palliative procedure (group II) and 3 patients had both initial palliative procedure then later total repair. All patients from 1 day to less than 14 years are included. All data were analyzed using GraphPad prism version 5.00 for windows. </span><span>Results: </span><span>61.67% of our patients were males, and 38.33% were females with the ratio of 1.6 (Male: Female). Six (10%) cases were subjected to a palliative correction surgery (group I) and 57 (95%) cases were subjected to total repair surgery (group II). 11 (18.3%) cases had post-operative complications, 2 (18.2%) cases from group I and 9 (81.8%) cases from group II. Regarding to the type of surgery there was no statistically significant difference between gender and pre and post-operation stay. Also no significance with length of stay, re-intervention, mortality and complications. While there was a significant correlation between age, weight, RPA and LPA. </span><span>Conclusion: </span><span>In our cohort of TOF patients the incidence of the disease was higher among males than females. The continuous follow up was highly recommended for TOF patients. The outcomes of surgical treatment including palliative, total and intervention correction surgeries was a complete recovery of 28.33% of studied patients, and the remaining (71.67%) had post-surgical complications. </span>
Tetralogy of Fallot,Palliative,surgical correction,complication,congenital heart defect
https://ejhm.journals.ekb.eg/article_8594.html
https://ejhm.journals.ekb.eg/article_8594_326ea10ab7bd3aa7f1b4939d7f386467.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
71
5
2018
04
01
Value of Midkine as a Diagnostic Serum Marker in Hepatocellular Carcinoma
3179
3183
EN
Desouky E. Abou Ammo 1 , Ashraf F. Barakat 2,
Amira Y. Ahmad 1 , Rehab R. Farag 1
1- Department of Clinical Pathology, 2- Department of oncology, Faculty of Medicine, Tanta University
<span>Background: </span><span>hepatocellular carcinoma (HCC) represents a global health problem. It is the fifth most common cancer but the second leading cause of cancer-related death in men worldwide. In Middle Eastern countries, liver cancer is a major concern among men, especially in Egypt and Saudi Arabia. The incidence of HCC has increased sharply in the last 5</span><span>–</span><span>10 years, with an especially high incidence in Egypt. So, early detection and diagnosis of these cases are required for successful treatments and improved outcomes. </span><span>Aim of the Work: </span><span>this study aimed to detect the efficacy of serum level of Midkine as an early marker for HCC diagnosis compared to AFP serum level. </span><span>Patients and Methods: </span><span>this prospective study was conducted on a total of 50 subjects, 30 of them with HCC and 20 apparently healthy subjects matched for age and sex with patients. It was carried out at the Clinical Pathology Department, Tanta University Hospital. </span><span>Results: </span><span>a significant increase (p < 0.001) in serum midkine level was detected in HCC group compared with control group from a mean of 391.45 ± 96.09, in control group to a mean of 1074.53 ± 106.27, in HCC. </span><span>Conclusion: </span><span>serum midkine may serve as a novel diagnostic tumor marker for the detection of hepatocellular carcinomas. </span><span>Recommendations: </span><span>it was recommended to do further studies on early cases with larger population including AFP-negative patients, to justify its implementation in clinical practice.<br /> </span>
Hepatocellular carcinoma,Midkine,alpha-fetoprotein
https://ejhm.journals.ekb.eg/article_8595.html
https://ejhm.journals.ekb.eg/article_8595_b808f018ed0c749e337de71821f11e31.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
71
5
2018
04
01
Role of Magnetic Resonance Imaging in Diagnosis and Staging of Uterine Cervical Carcinoma
3184
3190
EN
Ahmed F Abdel Ghany, Mona A Abdel Wahed,
Waleed K AL-Habash
Radiodiagnosis, Faculty of Medicine – Ain Shams University
<strong>Background:</strong>MRI examination is a useful modality for staging and evaluation of gynecologic malignancy. The diffusion-weighted MR imaging (DW-MRI or DWI) method has been introduced to cancer diagnostics, and has widened the diagnostic capabilities of MRI. Functional information from DWI and DCE-MRI can supplement morphologic information obtained with conventional cross-sectional imaging methods.
<strong>Aim of the Work:</strong> The aim of the present study is to evaluate the role of MRI in the diagnosis & staging of uterine cervical cancer & to assess the value of apparent diffusion coefficient (ADC) in the studied individuals.
<strong>Patients and Methods: </strong>This prospective study included twenty two patients with clinically suspected cervical cancer and twenty two apparently healthy women with normal MRI appearance of the cervix. It was conducted in El-Demerdash Hospital. The patients were referred from the Gynecology Department to the Radiology Department (Women’s Imaging Unit) for further MRI assessment with DWIs. Ten patients were followed up after receiving chemo-radiotherapy.<strong> Results: </strong>There was a high statistical difference between cervical cancer patients (Before-treatment) and control group according to ADC Value. There was a high statistical difference between cervical cancer patients (post-treatment) and control group according to ADC Value. In addition, there was a high statistical difference between cervical cancer patients (pre-treatment) and (post-treatment) according to ADC Value. The comparative study between ADC values versus tumor size and between ADC values versus histopathological result (types and grading) of the tumor was statistically non-significant.<strong> Conclusion:</strong> DWI serves as a functional technique, which provides information about water mobility, tissue cellularity, and stability of membrane integrity that can discriminate cervical carcinoma from healthy tissue, and increasing the radiologist’s confidence in image interpretation. Therefore, it implies a non-invasive technique, which can be used especially if contrast intake is avoided as in pregnancy. ADC values are reliable for differentiating cervical cancer from normal cervix with higher diagnostic accuracy when added to DWI interpretation.<strong> Recommendations: </strong>Further studies on a larger scale of patients are needed to confirm the results obtained by this work.
MRI,uterine cervical carcinoma
https://ejhm.journals.ekb.eg/article_8596.html
https://ejhm.journals.ekb.eg/article_8596_bf35f5068bfa19697dc3b2b32694c2b1.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
71
5
2018
04
01
Towards Precise Identification of The Medically Important Flesh Fly, Sarcophaga (Liopygia) argyrostoma (Robineau-Desvoidy, 1830) (Diptera: Sarcophagidae)
3191
3199
EN
Ahmad
M. M. Galhoum
Department of Zoology, Faculty of Science, Al-Azhar University, Cairo, Egypt.
ahmadgalhoum@hotmail.com
<span>Although of its medical importance and its role in the forensic investigation field, flesh fly, </span><span>Sarcophaga </span><span>(</span><span>Liopygia</span><span>) </span><span>argyrostoma </span><span>is not well taxonomically studied. This work aimed to use different tools (morphological and biochemical) toward precise identification of this species. By using SEM, different types of antennal sensilla (used for host location among other functions) had been classified to be applied as potential accurate taxonomic character. Trichoid sensilla are the most common and numerous types on </span><span>S. argyrostoma </span><span>antennae, in addition chaetica, basiconica and campaniform types are found to be represented by a few numbers.Gas chromatography-mass spectrometry (GC/MS) analysis characterized thirty-eight cuticular hydrocarbons components (CHCs) found in the flesh fly integument. The hydrocarbons identified were belonged to seven categories (i.e. Alkane, Alkene, Cycloalkane, monocyclic hydrocarbons, Alkyne, Polycyclic and Cycloalkane hydrocarbons), with chain length ranged from C</span><span>5 </span><span>to C</span><span>35</span><span>. Cuticular hydrocarbon profile now used precisely in insect taxonomy. Most studies on </span><span>Sarcophaga </span><span>were carried out on larvae, it's very important to study adult flies to suggest precaution and control measures against adults to reduce their harmful role in diseases transmission. </span>
Sarcophaga Argyrostoma,Taxonomy,Medical importance,Myiasis,SEM,CHCs
https://ejhm.journals.ekb.eg/article_8597.html
https://ejhm.journals.ekb.eg/article_8597_5a9c5b907454c5f9c039bdfb5bb6cd35.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
71
5
2018
04
01
The Prevalence of Stress among Medical Students and Its Effects on Academic Performance in The Kingdom of Saudi Arabia
3200
3205
EN
Bashaer Mahboub Alalwani (1) , Abdulkader Al Juhani(1) , Saja Mohmmmed Fallatah(2) , Sefana Abdulhaleem Abdulmajeid(2),Douaa Alawi Alsaidi(2) ,
Raghad Abdulmueid Mahyuddin(2),Zuhour Mohammed Haneef(2)
Royal Commission Medical Center (1), Batterjee Medical College (2)
<span>Background: </span><span>A definition of stress is anything that can disturbs the normal individual’s mental or physical </span><span>wellbeing. Medical school is known to be stressful branch in higher education and requires a lot of effort. </span>
<span>In fact there is an increase in the incidence of stress between medical students. Young students are more liable to develop stress due to the high competitive field of medicine.<br /> </span><span>Aim of Study: </span><span>the study is to explore the prevalence of stress among medical students and its </span><span>effects on their academic performance in the Kingdom of Saudi Arabia. </span>
<span>Methods: </span><span>A cross sectional study was conducted in under graduate medical students and interns at Faculty of Medicine in the kingdom of Saudi Arabia, a quota sampling was used. The questionnaire was validated, self - administrated with a Kessler Psychological Distress Scale (K10) used to conduct the data . </span><span>Results: </span><span>In total, of 1900 students and interns , 29.5% were males , 70.1% females .The prevalence of stress among undergraduates 82.1% and interns 17.1%, the prevalence of severe stress was in the undergraduate female 84.6%. According to the results the proportion of female who had stress was higher 70.1%than their counterpart males 29.5%. The prevalence of stress was highest among fourth year students 21.1%, and first year 4.8% showed the lowest .There was a high association between a study year and level of stress p </span><span>></span><span>(0.00) There is high association between studying medicine and developing symptoms of stress( p value 0.001). Most of the 60.6% of the participants developed symptoms related to exposure to stress, most common symptoms were gastrointestinal (67.19%).There is significant association between marriage and stress (p vale 0.19).There is no association between work and stress (p <0.132).There is no association between martial statues and stress (p value<0.386). </span><span>Conclusion: </span><span>The main result in this study shows high prevalence of stress among medical students in Kingdom of Saudi Arabia compared to others studies .The Level of stress is more among the female students compared to the male students. The main causes of stress are related to hours of sleep, hours of studying and marriage. </span>
Stress,Medical students,study medicine
https://ejhm.journals.ekb.eg/article_8598.html
https://ejhm.journals.ekb.eg/article_8598_a42bb29736a9ef0153ac385c396a9c2a.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
71
5
2018
04
01
Vaginal Progesterone versus Cervical Cerclage or Both for Prevention of Preterm Delivery
3206
3210
EN
Mohammed Abdel Samie*, Hossam Hassan Elkatatny*,
Rehab Mouhamed Magdy Naim**
*Faculty of Medicine Al-Azhar University, Assuit,** Obstetrics and Gynecology in Akhamim Hospital
magdyrehab86@yahoo.com
<strong>Background:</strong> Preterm labor (PTL) occurs in 5-13% of pregnancies before 37 weeks' gestation. Multiple pregnancy and iatrogenic preterm birth remain important causes of prematurity. Three interventions have been proposed to treat patients with a sonographic short cervix: (1) vaginal progesterone administration, (2) cervical cerclage for patients with a history of preterm birth and (3) vaginal pessary. <strong>Aim of the work: </strong>evaluate the efficacy of vaginal progesterone supplementation, cervical cerclage, or a combination of both in the prevention of PTL and their impact on the perinatal outcome. <strong>Patients and methods:</strong> Randomized controlled trial done on asymptomatic women with a sonographic short cervix (cervical length <25 mm) in the midtrimester, singleton gestation, and previous spontaneous preterm birth at less than 37 weeks of gestation. The study conducted in the Obstetrics and Gynecology Department at Sohag General Hospital.<strong> Results:</strong> this study showed that there was no significant difference between the 4 studied groups regarding each of age, cervical length and gestational age. It also showed that either vaginal progesterone only or cerclage only reduced the risk for preterm labor significantly compared to control. Moreover, combination of cerclage and vaginal progesterone resulted in higher reduction of preterm labor.
Cervical Cerclage,Cervical Incompetence,Preterm Delivery,Vaginal Progesterone
https://ejhm.journals.ekb.eg/article_8599.html
https://ejhm.journals.ekb.eg/article_8599_d8982f69844cbe22e715b08acee3e5fe.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
71
5
2018
04
01
Imaging of Postoperative Cosmetic Breast Surgery
3211
3220
EN
Sherif H. Abogamra, Khaled A. Ali,
Asmaa M. Esmail
Department of Radiodiagnosis, Faculty of Medicine, Ain shams University
drasmaamabrouk@gmail.com
<span>Background: </span><span>cosmetic breast procedures, as well as implants, are increasingly being performed and many women who had undergone cosmetic operation present for mammographic screening. There are three general categories of cosmetic surgery performed on the breast including breast augmentaion,breast reduction and breast reconstruction. A wide variety of breast implants which being used in most of augmentation surgeries are available on the market and are broadly categorized by lumen number, filler type, and surface contour. </span><span>Aim of the work: </span><span>this study aimed to illustrate the role of different imaging modalities in postoperative cosmetic breast surgery. </span><span>Results</span><span>: MRI is the modality of choice for evaluation of silicone breast implant integrity. MRI is not recommended as a screening modality for implant rupture in asymptomatic women with breast implants. </span><span>Conclusion: </span><span>Since the number of cosmetic breast surgeries is increased with increased number of patients present for assessing the operation as example; implant integrity; a radiologist should be familiar with the spectrum of appearances of the complications. The imaging appearances of the cosmetic breast as common breast implants and their complications using different radiological modalities as mammogram, ultrasound and MRI are varied. </span><span>Recommendations: </span><span>In symptomatic patients, after an initial evaluation with mammography and USG, non</span><span>‐</span><span>contrast MRI is recommended to rule out the diagnosis of rupture. Dynamic contrast</span><span>‐</span><span>enhanced MRI could be indicated in patients with breast reconstruction surgeries after mastectomy for breast cancer or in breast implant patients with suspicious masses</span><span>.<br /> </span>
imaging modalities,postoperative cosmetic breast surgery
https://ejhm.journals.ekb.eg/article_8600.html
https://ejhm.journals.ekb.eg/article_8600_991b2e7db652135b26cfde0822436251.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
71
5
2018
04
01
Role of 320 Detector Row CT Perfusion in Assessment of Myocardial Perfusion
3221
3228
EN
Fatma Salah Eldin, Omar Farouk Kamel, Ahmed Hassan Soliman,
Nadin Fawzy Abd Elaziz
Radiodiagnosis Department, Ain Shams University, Cairo ,Egypt
<span>Aim of the work: </span><span>this study aimed to evaluate the coronary artery morphology and myocardial perfusion by single reproducible non-invasive contrast enhanced CT acquisition by using DECT scanners with high sensitivity and specificity as well as high diagnostic accuracy without the need to increase the contrast material or radiation dose. </span><span>Patients and Methods</span><span>: this study was done during the period from October 2016 to December ,2017; age was ranged between 42 to 73 years old, were 35 patients with CAD diagnosed by cCTA underwent DECT for assessment of myocardial perfusion. The study included 35 patients referred for DECT myocardial perfusion examination in the Police Authority Hospitals, Radiodiagnosis Department in Cairo after diagnosing by cCTA. Each patient included in the study was subjected to full history taking, reviewing medical sheet, cCTA and CT myocardial perfusion examination. Technique was performed by using Aquilion one dynamic volume 320 detector rows CT, Toshiba Medical System, Tochigi-ken, Japan. </span><span>Results</span><span>: our study showed a significant correlation and good agreement between the findings of DECT myocardial perfusion defects and the findings of stenosis and its degree on cCTA on a segmental basis with 83% sensitivity, 87% specificity, 86% accuracy, 74% positive predictive value and 92% negative predictive value. </span><span>Conclusion</span><span>: DECT myocardial perfusion has high diagnostic as compared to cCTA as the gold reference standard</span><span>.<br /> </span>
coronary CT angiography,dual energy CT (DECT) myocardial perfusion
https://ejhm.journals.ekb.eg/article_8601.html
https://ejhm.journals.ekb.eg/article_8601_91fa2daa9f78adfb55bbeea0a82ead39.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
71
5
2018
04
01
Role of Diffusion Weighted MR Imaging in Assessment of Hepatocellular Carcinoma after Radiofrequency Ablation
3229
3231
EN
Hossam Fahmy Abdel Hamid, Ahmed Hassan Soliman,
Jalal Khaleel Abduljaleel
Department of Radio-diagnosis, Faculty of Medicine, Ain Shams University
<span>Background: </span><span>hepatocellular carcinoma (HCC) is the most common primary liver malignancy. Surgical resection and local ablative therapies represent the most frequent first lines therapies adopted when liver transplantation cannot be offered. </span><span>Aim of the work: </span><span>this study aimed to evaluate the feasibility of DWI and the corresponding ADC values to detect tumor response after radiofrequency ablation for hepatocellular carcinoma. </span><span>Patients and methods</span><span>: </span><span>MR examinations were done for 20 HCC patients post-RFA. Pre and post gadolinium enhanced images as well as DW sequences were performed. ADC values of ablation zones and liver parenchyma were assessed. ADC values of ablation zones and adjacent signal alterations identified in DWI were analyzed. </span><span>Results: </span><span>residual or recurrent lesions were detected in 4 patients (20%). The mean ADC value of ablated zones differed significantly from that of normal liver parenchyma. The corresponding ADC values were significantly lower in patients with residual lesion than in patients without residual lesion. </span><span>Conclusion: </span><span>it can be concluded that DWI is a feasible follow-up tool for post ablation liver contributing in detection of residual lesion.<br /> </span>
MRI,carcinoma,Radiofrequency ablation,liver tumor
https://ejhm.journals.ekb.eg/article_8602.html
https://ejhm.journals.ekb.eg/article_8602_9d46ea3a33c6461a4f1ff78f133c6a66.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
71
5
2018
04
01
The Prevalence of Hernia Repair and its Associated Risk Factors in Saudi Arabia
3232
3235
EN
Yazid Abraheem Ayed Alzapni 1, Yousef Ateeg Awad Alsadi 1, Manal Abdullah Flaywi Alhamazani 1, Abdulmohsen Saad Mohsen Alghassab 1, Abdullah Ahmed Alkhalaf 1, Yahya Dokhi Rashid Altamimi 1,
Zaid Awad Hamoud Alshammari 1, Anfal Hazza Abdullah Alhobera 1, Yossef Fahad Khaled Alshammari 1, Alzamil Abdullah Fahad A 1, Adnan Meteb Mohamed Almezani 1,
College of Medicine University of Hail 1 ,
Faisal Hameed Al-Anazi 2, Nawaf Faisal Al-Harthi 3,
Nwaf Shabram Alsabi Alenezi 4
College of Medicine Prince Sattam Bin Abdulaziz University 2, College of Medicine Tabuk University 3, College of Medicine Northern Border University 4
<span>Background: </span><span>despite the modern life and people knowledge about certain diseases, the prevalence of hernia repair procedures and its associated conditions have been increased in the recent years in Saudi Arabia.<br /> </span><span>Objectives: </span><span>prevalence of hernia repair procedures is almost known in the modern countries. This study was done to know the prevalence of hernia repair procedures in Saudi Arabia.<br /> </span><span>Methods: </span><span>a cross-sectional study on knowing the prevalence of hernia repair procedures in Saudi Arabia was distributed among men and women from February to January to February 2018 to 523 participants on many different social media platforms.<br /> </span><span>Results: </span><span>3.8% of the participants had done hernia repair procedure. Regarding risk factors that may lead to hernia repair procedure, 29.1% of the participants had a positive family history of hernia repair procedure, 44.5% of the participants were obese, 27.6% were smoker, 25.8% ate high fat diet, 17.5% suffered from chronic constipation, 12.6% suffered from chronic cough, 8.3% had major surgeries, 7.7% were diabetic, 5.2% had been admitted to ICU, 4.6% suffered from urinary retention, 2.1% had major trauma, 1.25% had been diagnosed with atherosclerosis disease and 37.7% were having no risk factors.<br /> </span><span>Conclusion: </span><span>at the end of this study, we found out that hernia repair procedure is increased among people in Saudi Arabia and multiple people are suffering from many risk factors that may lead to hernia and then hernia repair procedure eventually.<br /> </span>
Hernia,Obesity,chronic constipation
https://ejhm.journals.ekb.eg/article_8605.html
https://ejhm.journals.ekb.eg/article_8605_888204672e536a4045c2fb54ac1506aa.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
71
5
2018
04
01
Medication Safety Practice in Pediatric Ward
3236
3240
EN
Alotaibi Rashed H , Alhalabi Mohammed W,Essa Marwan A, Alzahrani Fahad A,
Alqarni Mohammed A,Maimsh Omar M,Aljefri Hasan M
Department of Pediatrics, College of Medicine, King Abdulaziz University Hospital , Jeddah, Saudi Arabia
maimsh24@gmail.com
<span>Background: As the medicine advanced, drug therapy became one of the most important and effective therapies in health care system. Which also raises the possibility of its mortality and morbidity. Drug-drug interaction (DDI) is defined as the occurrence of a harmful combination of prescribed drugs in a given patient. DDIs is a known cause of hospital visits, admissions and increases in health care use that could be prevented. In this study, we aimed to detect the DDIs prevalence in pediatric patients in King Abdulaziz university hospital(KAUH), Saudi Arabia. </span>
<span>Methodology: Retrospective cross-sectional study on a sample taken from all pediatric patients at KAUH in Jeddah, Saudi Arabia between January </span><span>– </span><span>December 2106, with no exclusion criteria. We extracted the data from KAUH medical files. DDIs, severity and documentation of the DDIs were identified using micromedex. Data entry using microsoft office 2016. Data analysis using SPSS 21 and multivariate regression was done to assess the association of DDI with other factors. </span>
<span>Results: Three hundred and fifty-nine patients were selected with the mean age (SD) 7.06 (5.9), 202 (56.2%) were male. A total of 233 DDIs were identified in 64 (17.8%) of the patients with the mean (SD) 3.64 (3.52). Of all identified DDIs, the severity classification was: major [123 (52.79%)], moderate [67 (28.76%)], minor [37 (15.88%)] and contraindicated [6 (2.58%)]. The documentation of DDIs was excellent [9 (3.8%)], good [89 (38.2%)] and fair [135 (58%)]. Significant association with medications number 5 or more had been suggested. Conclusion: The prevalence of DDIs although much less than other studies but the higher proportion of major severity. Patients 1-3 years of age and those on 5 or more medications need more strict monitoring as they have more risk to have DDIs. </span>
medications,drugs,Pediatrics,safety,interactions
https://ejhm.journals.ekb.eg/article_8606.html
https://ejhm.journals.ekb.eg/article_8606_57804d5910b621afd802944d8b71359a.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
71
5
2018
04
01
Fungemia in Immunocompromised Patients (Hematological Malignant and Hematopoietic Stem Cell Transplant Patients during Febrile Neutropenia)
3241
3248
EN
Mohammed Mohammed Sherif1, Mohammed Mostafa Elsaadawy1,
Hatem Mohamed Newishy1
1 Microbiology and immunology Department, Faculty of Medicine, Al- Azhar University, Cairo, Egypt,
Mohamed Hamed Khalaf 2,
Mostafa Mahmoud Elnakib3
2 Oncology and Hematology Hospital, Maadi Armed Forces Medical Compound, Cairo, Egypt,
3 Microbiology and Immunology Department, Military medical academy, Cairo, Egypt
<span>Background: </span><span>Fungal infections are a major cause of morbidity and mortality among febrile neutropenic patients.<br /> The choice of empiric antifungal regimen is based on susceptibility pattern of locally prevalent pathogens.<br /> </span><span>Objectives: </span><span>to determine fungemia, identify fungal spectrum and their antifungal susceptibility pattern.<br /> </span><span>Methods: </span><span>From 150 hematological malignant and hematopoietic stem cell transplant patients during febrile neutropenia, blood cultures (B.C) were processed. </span><span>Results: </span><span>Eight fungal isolates (5.3%) were recovered which found to be represented by </span><span>candida </span><span>spp. Five of them were non albicans </span><span>Candida (</span><span>62.5%) and three of them were </span><span>Candida albicans </span><span>(37.5%). </span><span>C. parapsilosis </span><span>resulted in the most frequent </span><span>Candida non albicans </span><span>(CnA) species (37.5%). All </span><span>C. parapsilosis </span><span>strains were isolated from patients with vascular catheters. </span><span>C. krusei </span><span>fungemia generally occur in patients with previous exposure to fluconazoles. All species of </span><span>Candida </span><span>were sensitive to amphoterecin B, echinocandins and voriconazole. Persistent fever for prolonged duration and prolonged broad spectrum antibiotic use were statistically significant risk factors for developing fungemia. Also extent of neutropenia, duration of chemotherapy, immunosuppressive therapy, altered mucosal barriers and presence of central venous lines were considered major risk factors for development of fungemia. </span><span>Conclusion: </span><span>The current study was limited by method of diagnosis and low sample size in a single center experience. Furthermore review of the epidemiology of fungemia which was represented by candidemia at our institution revealed the percentage of candidemia was 5.3% and </span><span>non albicans Candida </span><span>species were the predominant isolates. </span><span>Recommendations: </span><span>The choice of therapy in neutropenic patients should be formulated based on local antimicrobial susceptibility of these organisms. Close monitoring of fungal infection in patients receiving broad-spectrum antibiotics is mandatory.<br /> </span>
Febrile Neutropenia,Fungemia,Aetiology,risk factors
https://ejhm.journals.ekb.eg/article_8607.html
https://ejhm.journals.ekb.eg/article_8607_23ac794c4c0645e0087720f5a6824907.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
71
5
2018
04
01
The Prevalence of Cholecystectomy and its Associated Risk Factors and Complications in Saudi Arabia
3249
3253
EN
Sultan Mahja
Marzouq Alanazi
College of Medicine University of Hail
sulti7@yahoo.com
Abrar Hamad Saleh Alageel 1, Faisal Fahad Aljuaid 2, Marwan Ahmed Jaafari 2,
Nojoud Mohammed Abdullah Al_Farhan 3, Hussain Saad Bin Hussain Alahmari 3
College of Medicine Prince Sattam Bin Abdulaziz University2,
College of Medicine King Khalid University3
<span>Background: </span><span>despite the modern life and people knowledge about certain diseases, the prevalence of cholecystectomy procedures have been increased in the recent years in Saudi Arabia.<br /> </span><span>Objectives: </span><span>prevalence of cholecystectomy is almost known in the modern countries. This study was done to know the prevalence cholecystectomy procedures in Saudi Arabia.<br /> </span><span>Methods: </span><span>a cross-sectional study on knowing the prevalence of cholecystectomy procedures in Saudi Arabia was distributed among men and women from January to February 2018 on 523 participants on many different social media platforms.<br /> </span><span>Results: </span><span>6.5% of the participants had done cholecystectomy procedure. 32.4% of the participants who had the procedure suffered from post procedure complications. Regarding risk factors that may lead to cholecystectomy procedure, 45.5% of the participants had a positive family history of cholecystectomy, 44.5% of the participants were obese, 27.6% were smoker, 25.8% ate high fat diet, 17.5% suffered from chronic constipation, 12.6% suffered from chronic cough, 8.3% had major surgeries, 7.7% were diabetic, 5.2% had been admitted to ICU, 4.6% suffered from urinary retention, 2.1% had major trauma, 1.25% had been diagnosed with atherosclerosis disease and 37.7% were having no risk factors. 61.4% of the participants thought that cholecystectomy is the definite treatment of cholecystitis.<br /> </span><span>Conclusion: </span><span>at the end of this study, we found out that cholecystectomy procedure is increased among people in Saudi Arabia and multiple people are suffering from many risk factors that may lead to cholecystitis and then cholecystectomy procedure eventually<br /> </span>
Cholecystectomy,Obesity,Smoking
https://ejhm.journals.ekb.eg/article_8608.html
https://ejhm.journals.ekb.eg/article_8608_e20717f6f10ce5261aa942adf7f254cf.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
71
5
2018
04
01
Effect of Aminophylline on Atracurium Induced Neuromuscular Block
3254
3260
EN
Mostafa ME El-Hamamsy, Josef M Botros, Hani M Yassen,
Moaz I Mohammed*
Department of Anesthesiology, Faculty of Medicine, Fayoum University
abumalik5@yahoo.com
<span>Background: </span><span>theophylline is a naturally occurring methylxanthine that plays a role in various body functions through different mechanisms which include: phosphodiesterase enzyme inhibition, adenosine receptor antagonism etc. Its action on skeletal muscles to counteract fatigue and /or paralysis is through increasing acetylcholine release from motor nerve ending and increasing calcium concentrations within the muscle fiber itself. These combined effects therefore can antagonize nondepolarizing neuromuscular blockers through competitive antagonism in generally anesthetized patients. By the use of neuromuscular monitors, this effect could be evaluated and also to assess doses for reversal of residual drug-induced neuromuscular paralysis.<br /> </span><span>Aim of the Study: </span><span>the aim of this study was to evaluate the effect of theophylline on facilitating the recovery from atracurium induced neuromuscular blockade. </span><span>Patients and Methods: </span><span>this study was performed on sixty (60) patients undergone elective surgeries had been expected to be about one-hour duration, with balanced general anesthesia after obtaining approval of the Ethical and Scientific Committee of Al Fayoum University, and written informed consents from patients. In this study, we used theophylline to antagonize atracurium induced muscle paralysis. </span><span>Results: </span><span>the results showed effective antagonism of atracurium paralyzing effect and rapid recovery from this paralysis. </span><span>Conclusion: </span><span>theophylline antagonizes atracurium induced neuromuscular blockade by several mechanisms either at the prejunctional or postjunctional level by AR antagonism or PDI or by RyR channel activation. </span><span>Recommendations</span><span>: we recommend further studies to be done on different categories of patients as diabetics, cardiac patients, elderly and etc. to assess its safety among those patients. We recommend further studies to be done on different categories of patients as diabetics, cardiac patients, elderly and etc. to assess its safety among those patients.<br /> </span>
Phosphodiesterase enzyme inhibition,Theophylline,Neuromuscular blockade,atracurium,Neuromuscular monitoring,Train of four (TOF)
https://ejhm.journals.ekb.eg/article_8609.html
https://ejhm.journals.ekb.eg/article_8609_97e7bc53970fd3c4513e00bb69b1a0b4.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
71
5
2018
04
01
Comparative Study between 2D and 3D Ultrasound Cervicometry and Digital Assessment of the Cervix before Induction of Labour
3261
3272
EN
Yahia A. Wafa1, Nabil F. Mohamed2,
Mohamed S. Abouzeid1*
1Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
2Department of Obstetrics and Gynecology, Al-Agoza Police Hospital
tahasaber49@gmail.com
<strong>Background: </strong>labor is the physiological process by which the fetus is expelled from the uterus to the outside world. It is defined as increase in myometrial activity or more precisely, a switch in the myometrial contractility pattern from contractures (long-lasting, low-frequency activity) to contractions (frequent, high intensity, high frequency activity), resulting in effacement and dilatation of the uterine cervix.
<strong>Aim of the Work:</strong> this study aimed to compare between 2D and 3D ultrasound cervicometry and digital assessment of the cervix before induction of labor.
<strong>Patients and Methods</strong>: this study was carried out at Obstetrics and Gynecology Departments of Al-Hussien University Hospital and Al-Agoza Police Hospital from July 2016 to January 2018 on one hundred (100) women; their ages ranged from 18 to 35 years and the gestational ages ranged from 37-42 weeks. All patients had medical indications for labor induction.
<strong>Results:</strong> there were highly statistically significant relations <strong>(HS)</strong> between mode of delivery and cervical length, bishop score and posterior cervical angle as pvalue <strong>(0.001)</strong>.It was found that the more obtuse the angle, the higher the probability of vaginal delivery and the reverse for the cervical length. This means that Bishop Score and cervical length and posterior cervical angle had the same dependency in predicting successful labor induction.
<strong>Conclusion:</strong> in this study we found that the successful induction correlated significantly with transvaginal ultrasonographic measurments of the posterior cervical angle and cervical length and Bishop Score. But, Bishop Score appeared to be specific and accurate than the ultrasonographic measurements in prediction of successful vaginal delivery.
<strong>Recommendations: </strong>further studies on large number of participant with the same indication of induction and the same gestational age are recommended to assess Bishop Score and transvaginal ultrasonographic measurements and to evaluate each of them as predictors of successful labor induction.
2D and 3D ultrasound,cervicometry,digital assessment,cervix,Induction of Labour
https://ejhm.journals.ekb.eg/article_8610.html
https://ejhm.journals.ekb.eg/article_8610_27e5160fec078109d8b79e89a10fe287.pdf