Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
1
2020
10
01
The Relation between Visual Motor Integration and Cognitive Development in Full Term versus Preterm Infants
1151
1155
EN
Hadeer Ahmed El-Sayed Mohammed
El-Deeb
Department of Physical Therapy for Pediatrics - Faculty of Physical Therapy, Cairo University
Elham Elsayed
Salem
Department of Physical Therapy for Pediatrics - Faculty of Physical Therapy, Cairo University
Kamilia Saad
Abdelhamid
Department of Psychology - Faculty of Arts Cairo University, Cairo University
Mona Nabil
Mohamed
Department of Physical Therapy for Pediatrics - Faculty of Physical Therapy, Cairo University
10.21608/ejhm.2020.110514
Background: Preterm children present more often than children born at term with neurological problems that include severe neurological handicaps, such as cerebral palsy or severe mental retardation, or more subtle cognitive impairments. Purpose of the study: To investigate the relation between visual motor integration and cognitive development in full term versus preterm infants. Subjects: One hundred and twenty infants (full term & preterm infants) from both sexes, their ages ranged from 6 to 24 months. They were selected from Saray El-kobba Medical Center & Sawa Academy Nursery in Cairo (Ain shams area). Methods: Children were divided into 2 groups of equal number, Group A: Included sixty full term infants and Group B: Included sixty preterm infants (low risk preterm). Within the 2 groups children were subdivided into 3 subgroups according to their chronological age for full term and corrected age for preterm. The participants of both groups were assessed by the following tools to assess their visual motor integration and cognition by The Peabody Developmental Motor Scales–Second Edition (PDMS-2) and the Portage Guide to early childhood education: (Arabic version) respectively. Results: The results revealed that there was a strong positive correlation between PDMS-2 and Portage scale in full term sub groups (6-12months), (12-18 months) and (18-24 months) scores [( r= 0.48, p=0.03), (r=0.84, p=0.0001) and (r=0.75, p=0.0001) respectively]. There was strong positive correlation between PDMS-2 and Portage scale in preterm subgroups (6-12 months), (12-18 months) and (18-24 months) scores [(r=0.84, p=0.0001) – (r=0.63, p=0,003) –(r=0.88, p=0.0001) respectively]. Conclusion: Based on this study, it could be concluded that there is a relation between visual motor integration and cognitive development in full term versus preterm infants.
Visual motor integration and Cognitive development,Full term infants,preterm infants
https://ejhm.journals.ekb.eg/article_110514.html
https://ejhm.journals.ekb.eg/article_110514_fe33474091e742b5bccf625338d6aba3.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
1
2020
10
01
Scavenger Receptor Class B Type 1 Gene rs5888 Single Nucleotide Polymorphism: Association with Risk and Severity of Premature Coronary Artery Disease
1156
1164
EN
Wessam El Sayed
Saad
Manal Mohamed
Abd Al Aziz
Marium El Sayed Ahmad
Fathi
cutemar2@hotmail.com
Adham Ahmed
Abdeltawab
Hoda Ahmad
Abdel Sattar
10.21608/ejhm.2020.110515
Background: Many different genetic associations with premature coronary artery disease (PCAD) have been identified. One exonic single nucleotide polymorphism (SNP) rs5888 of Scavenger receptor class B type1 (SCARB 1) gene has been linked to lipid traits as well as subclinical atherosclerosis. Objective: To investigate the association between SNP rs5888 of SCARB 1 gene and PCAD risk and severity. Patients and Methods: This study was conducted on 50 Egyptian patients diagnosed as PCAD by coronary angiograph (PCAD group) and (50) age- and sex-matched non-CAD subjects who showed no luminal stenosis in coronary angiographic served as a control group (non-CAD group). Gensini score was calculated as an indication for atherosclerosis severity for patients only. Detection of rs5888 polymorphism of SCARB 1 gene was done by realtime polymerase chain reaction (PCR) and high resolution melting analysis (HRM). Results: The mutant TT and CT genotypes were more frequently distributed in PCAD group compared to nonPCAD group (34 % and 48 % vs. 26 % and 18 %, respectively). The (CT) genotype conferred a positive risk for PCAD in males (OR: 6.117, 95% CI (1.744-21.452); p < 0.01). T allele conferred a positive risk for PCAD (OR: 2.564, 95% CI (1.440-4.543); p < 0.05). Highest Gensini score was found in PCAD patients with (TT) genotype (p < 0.01). Conclusion: The mutant (CT) genotype and the T allele of SCARB 1 SNP rs5888 were associated with increased risk of PCAD and the mutant (TT) genotype was associated with disease severity calculated by Gensini score.
PCAD,SCARB 1,genotypes,Gensini
https://ejhm.journals.ekb.eg/article_110515.html
https://ejhm.journals.ekb.eg/article_110515_8526e11af6da14f03b6fc36ffa1acc47.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
1
2020
10
01
Hypomagnesemia as a Predictor of Cardiovascular Morbidity in Patients Undergoing Hemodialysis
1164
1172
EN
Haitham
Ezzat
Department of Nephrology, Faculty of Medicine - Ain Shams University, Cairo, Egypt
haitham_ezzat@hotmail.com
Hesham
Abo El Leil
Department of Nephrology, Faculty of Medicine - Ain Shams University, Cairo, Egypt
Doaa
Elwasly
Department of Nephrology, Faculty of Medicine - Ain Shams University, Cairo, Egypt
dr.dodoelwasly@hotmail.com
10.21608/ejhm.2020.110516
Background: Dialysis patients may be particularly vulnerable to the effects of magnesium deficiency, yet scant if any attention is being given to this cation in most dialysis centers, which should be rectified. Objective: To find whether hypomagnesaemia represent an independent risk factor for increased cardiovascular morbidity in hemodialysis patient (HD) either with or without residual renal function (RRF). Patients and methods: 60 prevalent hemodialysis patients were included and subdivided into 15 each; group 1a with normal serum magnesium and residual renal function, group 1b with low serum magnesium and residual renal function, group 2a with normal serum magnesium and no residual renal function and group 2b with low serum magnesium and no residual renal function. Patients were subjected to history taking, clinical examination, lab. tests, echo and ECG. Results: Among 60 hemodialysis patients divided into 30 with RRF and 30 without, hypomagnesemia was found in 30% of whole patients. HD patients with RRF had lower mean serum magnesium level than those without. There was no statistical significant difference between the 2 groups regarding cardiovascular morbidities including diastolic dysfunction, pulmonary hypertension, and others, suggesting that RRF has no effect on cardiovascular morbidities in HD patients. There was no correlation between hypomagnesemia and diastolic dysfunction or pulmonary hypertension or hypertensive heart and left ventricular hypertrophy (LVH) or arrhythmias but we found significant correlation between hypomagnesemia and ischemic heart disease. Conclusion: There is a close relationship between hypomagnesemia and risk factors for cardiovascular disease morbidity in hemodialysis patients.`
hypomagnesemia,residual renal function,Hemodialysis,Cardiovascular Disease Morbidity,ECHO
https://ejhm.journals.ekb.eg/article_110516.html
https://ejhm.journals.ekb.eg/article_110516_84683b34aabcd5f4819ca925f5c77e00.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
1
2020
10
01
Association Between Serum Uric Acid and Metabolic Syndrome Components in Prep Ubertal Obese Children (Tanner Stage I) At Zagazig University Hospital
1173
1177
EN
Laila Raslan
Abd El Aziz
Saed Mohamed
Morsy
Hanan Samir
Ahmed
Mustafa Mohammed Abd El Hameed
Ahmed
10.21608/ejhm.2020.110517
Background: Biomarkers are useful in the early detection and risk stratification of metabolic syndrome (MetS) patients. Serum uric acid (SUA) is the end metabolite product of purine degradation and is the most abundant antioxidant in human plasma, as it protects against free radical oxidative damage. Objective: To investigate the potential association between serum uric acid (sUA) and MetS. Patients and Methods: A prospective case-control study was conducted in Cardiac Unit, Zagazig University Children’s Hospital, during the period from February 2019 until August 2019. Our Study included 26 patients with metabolic syndrome who were randomly selected from 129 random obese pediatric patients according to waist circumference and BMI with percentage of 20.1%. We enrolled matched control with same number. Results: Cases were significantly higher concerning uric acid. We found significantly positive correlation between body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), triglycerides (TG), total cholesterol, low-density lipoproteins (LDL) and serum uric acid (SUA), while significant negative correlation of serum uric acid and high density lipoprotein (HDL-C). According to ROC curve analysis, the AUC of SUA for detection of metabolic patient with best cutoff value > 4.3 with sensitivity 70% and specificity 96.3%, and this was maximizing sensitivity and specificity to predict future metabolic syndrome and their area under the curve was 0.79. Conclusion: Serum uric acid showed a significant correlation with components of metabolic syndrome making it a potent biomarker for diagnosing of metabolic syndrome patients in coming years.
Serum uric acid,Metabolic syndrome,obese Tanner Stage I
https://ejhm.journals.ekb.eg/article_110517.html
https://ejhm.journals.ekb.eg/article_110517_b91ff65a1300247b38723bc901c5fe46.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
1
2020
10
01
Thoracolumbar Fractures in Adolescent Patients: Epidemiological, Clinical, Radiological Characteristics and Recent Methods of Management
1178
1185
EN
Magdy Elsayed Hassan
Rashed
Department of Neurosurgery, Faculty of Medicine, Zagazig University, Sharkia, Egypt
Atif Kelany Abdel
Wanes
Department of Neurosurgery, Faculty of Medicine, Zagazig University, Sharkia, Egypt
Mohammed Mohammed Salem
Selim
Department of Neurosurgery, Faculty of Medicine, Zagazig University, Sharkia, Egypt
mosad8rashed@gmail.com
10.21608/ejhm.2020.110518
Background: Spine fractures account for a large portion of musculoskeletal injuries worldwide; approximately 54.9% of the patients had fractures in the thoracolumbar spine; with most of these occurring at the thoracolumbar junction (T10-L2). Objective: To assess the epidemiologic characteristics of spinal injuries in adolescents, their unique anatomic, and radiographic characteristics. Patients and Methods: 18 selected patients presented with traumatic thoracolumbar fractures admitted to the Neurotrauma Unit of Neurosurgery Department, Zagazig University Hospitals, and Al-Ahrar Teaching Hospital, Sharkia, Egypt with our study prospective study and post-resuscitation they were of both sexes and their age range starts from 12:17 years adolescent group. Results: the number of patients (18 patients) was 20.2% from 189 cases of all spine fractures in adolescent patients. Sex were 11 males (61.1%) falling from height is the most common cause of thoracolumbar fractures (50%), followed by road traffic accidents (33.3%). the most common type of fracture in both groups was a wedge and burst where it constituted more than 80%. Orthopedics fractures were the most common associated injuries which were found in 6 patients (33%). According to motor power, 14 patients had full motor power (77.7%). the most common level of injury was L1 vertebrae 11patients (61.1%). The mean height of the vertebral body in the conservative treated group was 26.11±4.85, but in the surgically treated group is 25.55 ±4.63. Conclusion: The most common cause of trauma was fall from a height (50%). The most affected vertebra was L1 (61.1%). Over 80% of patients were neurologically intact. The angle of kyphosis in the surgically treated group improved and decreased from 23 degrees to18.22 degrees.
Serum Eosinophil Derived Neurotoxin,bronchial asthma,Evaluation,severity
https://ejhm.journals.ekb.eg/article_110518.html
https://ejhm.journals.ekb.eg/article_110518_2242c0861d6352c61bed217465cfef1e.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
1
2020
10
01
Comparative Study between Pressure Controlled Ventilation and Volume Controlled Ventilation and Their Effects on Respiratory Mechanics for Posterior Lumbar Spine Surgery Patients in Prone Position
1186
1192
EN
Ahmed Mohamed Reda
Ragheb
Ahmed ELSaied
Abdul Rahman
Ayman Mohamady
Aldemrdash
Sherif Kamal Hafez
Arafa
10.21608/ejhm.2020.110519
Background: Prone position is one of the challenging and widely used surgical positions with high rates of complications. The applied position and selected ventilation parameters during the operation are known to influence the pulmonary mechanics. Objective: This study was conducted to compare two modes of ventilation; volume controlled and pressurecontrolled ventilation and their effect on improvement of respiratory dynamics. Patients and Methods: This prospective randomized controlled study included a total of 60 patients who had posterior lumbar spine surgery in prone position, attending at Department of Anesthesiology and Surgical ICU, Aswan University Hospital, Egypt. This study was conducted between June 1, 2017 to December 13, 2018. Patients were randomly divided between two groups, 30 patients each; Group (I): were received VCV mode and Group (II): were received PCV mode. Then study parameters were recorded intraoperative and postoperative in the two groups of ventilation modes. The study parameters which were recorded: Peak inspiratory pressure (Ppeak), Plateau pressure (Pplateau), dynamic compliance (Cdyn), ETCO2, Tidal volume (VT), respiratory rate (RR). Results: As regarding Ppeak and Pplat, they were statistically significant lower in PCV group than VCV group at both supine and prone positions. As regarding Cdyn, it was statistically significant higher in PCV group than VCV group at both supine and prone positions. Arterial oxygen tension (PaO2) was significantly higher in PCV group intraoperative in prone position and postoperative. Conclusions: Compared with VCV, PCV is better regarding the respiratory dynamics including lower Ppeak and Pplat. It has also higher Cdyn and oxygenation. PCV it is more suitable for general anesthesia of posterior lumbar spine surgery patients in prone position.
Pressure-Controlled Ventilation,volume controlled ventilation,respiratory mechanics,Lumbar spine surgery
https://ejhm.journals.ekb.eg/article_110519.html
https://ejhm.journals.ekb.eg/article_110519_57766a370c0527c097d6804c0e6fe111.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
1
2020
10
01
Serum Neopterin Level in Early Onset Neonatal Sepsis
1193
1203
EN
Hanan Mohammed Abd El-Moneim
Awad
Departemnt of Pediatrics - Faculty of Medicine, Aswan University
Mohammed Bahaa El-amir
Hawary
Departemnt of Pediatrics - Faculty of Medicine, Aswan University
Emad Farah Mohammed
Kholef
Departemnt of Pediatrics - Faculty of Medicine, Aswan University
Manal Abdel Rahim Ahmed
Ali
Departemnt of Pediatrics - Faculty of Medicine, Aswan University
10.21608/ejhm.2020.110520
Backgound: Neonatal sepsis is defined as a clinical syndrome of bacteremia with signs and symptoms of infection in the first four weeks of life. A better understanding of the neonatal inflammatory response to sepsis and identification of sensitive and specific markers of inflammation or rapid microbe-specific diagnostic tests would assist in the early detection of neonatal sepsis. Objective: Evaluate of serum neopterin level as an early diagnostic marker in neonatal sepsis for early detection of neonatal sepsis and early implementation of the appropriate therapeutic strategies. Patients and Methods: The current study included 90 newborns admitted into NICU with 30 of them septic, 30 suspected neonatal sepsis and 30 control at Aswan University Hospital during the study period after obtaining consent from the parents. Results: Neopterin level was significantly higher in cases than control (p < 0.001). A highly significant positive correlations was found between serum neopterin with TLC, T. neutrophils, immature/total neutrophil (I/T) ratio, serum C-reactive protein (CRP) level, ESR 1st hour, ESR 2nd hour and sepsis score. On the other hands, negative correlation was found between serum neopterin level and gestational age, with poor Moro reflex & apnoea. Moreover, no significant relation was found between serums level of neopterin and socio-demographic data. Conclusion: Combined use of one or more laboratory marker as Haematological scoring system (HSS) and CRP with neopterin will enhance the diagnostic accuracy, early detection and consequently prevention of complications of infected cases.
Neopterin,Neonatal sepsis,HSS,CRP
https://ejhm.journals.ekb.eg/article_110520.html
https://ejhm.journals.ekb.eg/article_110520_4e9ca0767dc7ed6c6b8161725197f657.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
1
2020
10
01
Local Experience on Clinical Characteristics of COVID-19: Single Center Experience
1204
1208
EN
Nezar
Refat
Ahmed H
Kasem
Fatma MM
Kamel
Ahmed F
Mady
10.21608/ejhm.2020.110696
<span>Background: </span><span>Coronavirus disease 2019 (COVID-19) emerged in December 2019 in Wuhan, the capital of Hubei province, China. COVID-19 is an acute respiratory disease caused by a newly emerged zoonotic coronavirus. The virus is now known as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease it causes is called coronavirus disease 2019 (COVID-19). In March 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a pandemic.<br /> </span><span>Aim of the work: </span><span>Clinical description of COVID-19 patients presented to El-Minia University Hospital Screening Triage. Identification of different varieties of COVID-19 clinical manifestations and complications.<br /> </span><span>Patients and Methods: </span><span>A retrospective study on the clinical manifestation and complications of 76 patients of COVID-19.<br /> </span><span>Results: </span><span>Average age 50 years old 43 male and 33 female. 29% with previous history of smoking, 26% with hypertension, 15% diabetic patient and 9% chronic kidney disease. The most common presentation is fever 80%, dry cough 81.6% and shortness of breath 75%, productive cough 9%, anosmia 18.4%, myalgia and bone aches in 60.5%, easy fatigability 61.8% and persistent headache in 34%. GIT manifestations including diarrhea 22% and vomiting 14.5%. Another 3 cases diagnosed as mesenteric vascular occlusion and 2 cases presented with eye involvement. The acute kidney injury (AKI) occurred in 5.3% of the patients.<br /> </span><span>Conclusion: </span><span>SARS COV-2 can present with different clinical manifestation affecting multiple body systems.<br /> </span>
COVID-19,comorbidity,GIT manifestations,Acute kidney injury
https://ejhm.journals.ekb.eg/article_110696.html
https://ejhm.journals.ekb.eg/article_110696_08cd2b3b1391b4901f49ea38e510e413.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
1
2020
10
01
The Diagnostic Value of High-Resolution Ultrasound in Evaluation of Ankle Sports Injuries: A Comparative Study with MRI
1209
1216
EN
Mohamed Abdel-Moneim Ismail
Mokbel
Professor of Radiodiagnosis - Faculty of Medicine, Zagazig University, Sharkia, Egypt
Khaled Mohamed
Shawky
Professor of Radiodiagnosis - Faculty of Medicine, Zagazig University, Sharkia, Egypt
Maged Abd El-Galel
Hamed
Professor of Radiodiagnosis - Faculty of Medicine, Zagazig University, Sharkia, Egypt
Hossam A.
Al-Kenawy
Professor of Radiodiagnosis - Faculty of Medicine, Zagazig University, Sharkia, Egypt
10.21608/ejhm.2020.110697
<span>Background: </span><span>Usually, the ankle joint’s lesions are due to trauma, infl</span><span>ammatory disorders, or overuse syndrome. </span>
<span>Different imaging modalities are used to evaluate the ankle joint including plain radiography, CT, US, and MRI. </span>
<span>Objective: </span><span>The aim of the current study had to assess the value of high-resolution ultrasonography in sports injuries </span>
<span>compared to high field MRI. </span>
<span>Patients and methods: </span><span>High-frequency (7</span><span>–</span><span>15 MHz) ultrasound and MRI were performed in 30 patients with an acute ankle injury (traumatic ankle pain) in the age range between 18 and 55 years, complaining of unilateral ankle sports injuries.<br /> </span><span>Results: </span><span>Sensitivity of US in the detection of sprain comparing to MRI as the gold standard was 75%, specificity was 100% and accuracy was 92.2% and there was statistical significance agreement between two tests. Regarding, the sensitivity of the US in the detection of tears comparing to MRI as gold slandered was 90%, specificity was 100% and accuracy was 96.7% and there was statistical significance agreement between two tests (P-value < 0.001). The sensitivity of the US in the detection of joint effusion comparing to MRI as gold slandered was 75%, specificity was 95.5% and accuracy was 90% and there was statistical significance agreement between the two tests. </span>
<span>Conclusion: </span><span>Ultrasonography and MRI are two complementary tools of investigation with formers being used as a primary tool of investigation and the latter is done to confirm the diagnosis and the extent of the lesion especially when surgical interference is planned.<br /> </span>
Ankle Sports Injuries,CT,US,MRI
https://ejhm.journals.ekb.eg/article_110697.html
https://ejhm.journals.ekb.eg/article_110697_364519c388241db5f4d8cc834b95e5f2.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
1
2020
10
01
Cord Blood Albumin as a Predictor of Neonatal Jaundice
1217
1225
EN
Hanan Mohamed Abd El-Moneim
Awad
Department of Pediatrics, Faculty of Medicine - Aswan University
Mohamed Nashat Moawed
Hasan
Department of Pediatrics, Faculty of Medicine - Aswan University
Ghadeer Sayed Mostafa
Khaleil
Department of Pediatrics, Faculty of Medicine - Aswan University
dr.ghadeersayed@yahoo.com
10.21608/ejhm.2020.110698
<span>Background: </span><span>Neonatal jaundice is a very common condition worldwide occurring in up to 60% of term and 80% of preterm newborns in the first week of life. Even though extreme hyperbilirubinemia is rare in developed countries it is still quite rife in developing countries often resulting in kernicterus with its attendant medical, economic and social burden on the patient, family and society.<br /> </span><span>Objective: </span><span>The present study was conducted to evaluate the predictive value of umbilical cord blood albumin level for subsequent neonatal jaundice in healthy full-term neonates.<br /> </span><span>Patients and Methods: </span><span>The current study was carried out in the Pediatric Department, Faculty of Medicine, Aswan University Hospital. The study was conducted on 100 healthy full-term newborn after obtaining consent from parents. Cord blood was collected at birth and cord blood albumin estimation was done.<br /> </span><span>Results: </span><span>The incidence of neonatal hyperbilirubinemia in our study (64%). In terms of demographic data: males represented (32.5 %) of the jaundiced cases in the study and females represented (62.5 %); the difference was statistically insignificant (P value 0.325). Cord serum albumin level of (> 3.3) g/dl has a sensitivity of (86%) and specificity of (80%), PPV (81%), NPV of (85%) and the accuracy rate was (83 %) in predicting neonatal hyperbilirubinemia.<br /> </span><span>Conclusion: </span><span>There is significant correlation between cord serum albumin level and neonatal hyperbilirubinemia in healthy full-</span><span>term neonates ≥ 2.5 kg birth weight and that serum albumin level taken from the blood of the umbilical </span><span>cord is an effective way to predict neonatal hyperbilirubinemia in term healthy infants.<br /> </span>
Cord Blood Albumin,Predictor of Neonatal Jaundice,Hyperbilirubinemia
https://ejhm.journals.ekb.eg/article_110698.html
https://ejhm.journals.ekb.eg/article_110698_33e0ac4e04b371ad46a48bc88aaaa399.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
1
2020
10
01
Necrotizing Pneumonia Complicated by Pulmonary Artery and Middle Cerebral Artery Pseudoaneurysms in A Healthy Young Child in Saudi Arabia
1226
1230
EN
Ayed
Alenazi
Department of Pediatric, Prince Sultan Medical Military City.
Dana
Albassam
Department of Pediatric, Prince Sultan Medical Military City.
Khaled
Baqais
Department of Pediatric, Prince Sultan Medical Military City.
Abdullah
Al-Shamrani
Department of Pediatric, Prince Sultan Medical Military City.
dr.alshamrani99@gmail.com
10.21608/ejhm.2020.110699
<span>Background: </span><span>Necrotizing pneumonia (NP) is a common complication of community-acquired pneumonia. However, pulmonary artery pseudoaneurysm (PAP) is a rare but serious complication that could follow the infection including NP even in previously healthy children. The usual presentation of PAP are fever, cough with hemoptysis, which is commonly encountered in significant numbers of bronchopneumonia.<br /> </span><span>Objective: </span><span>Prompt diagnosis and early intervention to prevent a fatality, identification of the underlying cause, prognosis and outcome.<br /> </span><span>Material and Methods: </span><span>A case report of PAP and cerebral pseudoaneurysm complicating NP with residual central nervous system sequelae.<br /> </span><span>Results: </span><span>The patient stayed in the hospital for 6 weeks, received vancomycin and meropenem, antifungal therapy, levetiracetam for seizure and prophylactic enoxaparin. His level of consciousness was gradually improving. However, he had left hemiparesis. His speech and swallowing was markedly improved. His follow up chest x-ray 6 months after the vent was normal.<br /> </span><span>Conclusion: </span><span>Many causes for PAP exist including lung infection. PAP need to be considered in patients with pneumonia who develop hemoptysis. Cerebral artery pseudoaneurysm can rarely complicate NP with PAP, especially in patients with neurological manifestations.<br /> </span>
Necrotizing pneumonia (NP),Pulmonary artery pseudoaneurysm (PAP),cerebral artery pseudoaneurysm,endovascular embolization
https://ejhm.journals.ekb.eg/article_110699.html
https://ejhm.journals.ekb.eg/article_110699_1c178388048209dbdb49c244009d4393.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
1
2020
10
01
Steroid-Responsive Encephalopathy Associated with Autoimmune Thyroiditis (SREAT): A Case Report
1231
1233
EN
Hessah Abdulaziz
Al Hussaini
Department of Internal Medicine, College of Medicine, King Faisal University, Al Ahsa, Kingdom of Saudi Arabia
10.21608/ejhm.2020.112309
<span>Background: </span><span>Steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT), also known as </span><span>Hashimoto’s encephalopathy, is a disorder characterized by an encephalopathy associated with anti</span><span>-thyroid antibodies in the absence of alternative causes. It has a wide range of clinical, laboratory and radiological features.<br /> </span><span>Objective: </span><span>Cases of steroid-responsive encephalopathy associated with autoimmune thyroiditis are difficult to diagnose and requires a high index of suspicion, as this will determine the early timing of management and disease outcome.<br /> </span><span>Patient and Methods: </span><span>Here we present a case report of twenty-year-old woman presenting with neurological and psychological symptoms. She was found to have high anti-thyroid peroxidase antibodies (Anti-TPO) with normal thyroid function and negative screening for other etiologies of encephalopathy. Based on her presentation, she was diagnosed with steroid-responsive encephalopathy associated with autoimmune thyroiditis.<br /> </span><span>Results: </span><span>Patient was started on high dose steroids upon which she responded partially. Then she required the addition of immunotherapy in the form of Rituximab to improve her symptoms.<br /> </span><span>Conclusion: </span><span>After exclusion of other causes of encephalopathy, the presence of thyroid antibodies prompts the susp < /span><span>icion of SREAT and therefore the early initiation of steroids to improve patients’ outcome.<br /> </span>
Steroid-Responsive Encephalopathy Associated with Autoimmune Thyroiditis,SREAT,Hashimoto’s encephalopathy,Encephalopathy,Autoimmune thyroiditis
https://ejhm.journals.ekb.eg/article_112309.html
https://ejhm.journals.ekb.eg/article_112309_233944da55e48c22e996e996e9b6eb8f.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
1
2020
10
01
Analysis of the Variables Affecting the Outcome of Management of Distal Radius Fractures with a Variable-Angle Volar Locking Plate
1234
1239
EN
Ahmed Mohamed
Abdel Wahed
Department of Orthopedic Surgery, Faculty of Medicine, Zagazig University, Sharkia, Egypt.
Mohamed Safwat Mostafa
Shalaby
Department of Orthopedic Surgery, Faculty of Medicine, Zagazig University, Sharkia, Egypt.
Mohamed Elsadek
Attia
Department of Orthopedic Surgery, Faculty of Medicine, Zagazig University, Sharkia, Egypt.
Reda Hussien
Elkady
Department of Orthopedic Surgery, Faculty of Medicine, Zagazig University, Sharkia, Egypt.
10.21608/ejhm.2020.112310
<span>Background: </span><span>The new low-profile plates and locking systems have popularized surgical options. Treatment modalities exist for surgical management of distal radius fractures, including open reduction and internal fixation (ORIF) with volar or dorsal plates and screws.<br /> </span><span>Objectives: </span><span>This study aimed to find a possible correlation between various parameters, either patient-related (age, bone quality) or fracture-related (type, reduction), and to analyze the impact of these factors on the radiological and clinical outcome of distal radius fractures treated by a variable-angle volar locking plate.<br /> </span><span>Patients and Methods: </span><span>The study included 18 patients suffering from fractures of the distal radius admitted to the Orthopedic Department in Zagazig University Hospital. All patients were operated from January 2019 to June 2019. A total of 18 patients complete at least 6 months follow up period.<br /> </span><span>Results: </span><span>The results were assessed according to the disabilities of arm, shoulder, and hand scoring system (DASH score), eight patients had excellent results with average 3.54 ±1.23, eight patients had good results with average 9.71 ±1.97.<br /> </span><span>Conclusions: </span><span>There was a negative correlation between patients’ age, sex, type of fracture</span><span>, or presence of an associated ulnar styloid fracture and the final score. This correlation was statistically insignificant. A correlation was found between the affected dominant hand or number of rows of distal screws and the final functional score. this was found to be statistically significant.<br /> </span>
Distal Radius,variable angle,locking plates
https://ejhm.journals.ekb.eg/article_112310.html
https://ejhm.journals.ekb.eg/article_112310_7856eda1c785d3f90c72f0f61fe4cc17.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
1
2020
10
01
The Possible Protective Effect of Platelet Rich Plasma on Aspirin Induced Gastric Ulcer in Adult Male Albino Rat
1240
1250
EN
Fatma Fawzy
Nada
Department of Anatomy, Faculty of Medicine, Menoufia University, Menoufia, Egypt
dr_fatmanada@yahoo.com
Fatma El-Nabawia A.
El-Safty
Department of Anatomy, Faculty of Medicine, Menoufia University, Menoufia, Egypt
Abeer E.
El –mehi
Department of Anatomy, Faculty of Medicine, Menoufia University, Menoufia, Egypt
Noha M.
Issa
Department of Anatomy, Faculty of Medicine, Menoufia University, Menoufia, Egypt
10.21608/ejhm.2020.112312
<span>Background: </span><span>High morbidity and mortality due to gastric ulcer made its management is a medical challenge. Platelet rich plasma (PRP) had been used for treatment of skin ulcers, some hair and bone problems as PRP contains many growth factors which make it suitable for management of gastric ulcer.</span><span>Objectives: </span><span>The current work was aimed to study the protective role of PRP on gastric ulcer induced by aspirin. </span><span>Materials and Methods: </span><span>Forty adult male albino rats were divided into four groups. Group I; sham control, group II received PRP, group III received aspirin for induction of gastric ulcer and group IV was provided with PRP then received aspirin. All rats were sacrificed then the fundic mucosa was processed for light and scanning electron microscopic study. Paraffin sections were stained by hematoxylin and eosin, mallory trichrome and combined periodic acid Schiff (PAS) and alcian blue (AB) stains. Immunohistochemical staining for iNOS and EGFR were also performed. </span><span>Results: </span><span>Aspirin had induced mucosal destruction in the form of ulceration, epithelial surface desquamation, hemorrhage, vacuolation and inflammatory cellular infiltration. Scanning electron microscopic examination of aspirin group showed decreased mucus, widening of gastric pits and cavitation of mucosal folds. PRP produced a great preservation of gastric structure in protected group (IV). </span><span>Conclusion: </span><span>It could be concluded that aspirin caused ulcerating changes in gastric mucosa and PRP had ameliorating effects on these changes. </span>
aspirin,Gastric ulcer,PRP,Scanning Electron Microscopy
https://ejhm.journals.ekb.eg/article_112312.html
https://ejhm.journals.ekb.eg/article_112312_503cdcec428e0c26777fc5edb3ed1aae.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
1
2020
10
01
Assessment of Serum Concentrations of Omentin-1 in Children with Type 1 Diabetes as Indicator of Insulin Resistance
1251
1254
EN
Mahmoud Mohamed
El-Adly
Mohamed Nagiub
Abu-Elfotoh
Hesham Samy
Abd-Elhamed
Ahmed Mohamed
Gaballah
10.21608/ejhm.2020.112313
<span>Background: </span><span>Omentin-1, a protein produced mainly in visceral adipose tissue. Its function is most likely to increase insulin sensitivity and stimulate glucose metabolism. This effect can be both local and systemic.<br /> </span><span>Objective: </span><span>To evaluate the concentrations of selected gastric peptide omentin-1 in serum of children with type 1 diabetes, relevant to the disease duration.<br /> </span><span>Patients and Methods: </span><span>This case control prospective study was conducted during the period from 2018 to 2020. This study was carried out in Endocrinology Unit and Outpatient Clinic at Pediatric Department, Zagazig University Hospital. The sample size was 85 (17 in every group). Serum omentin-1 level was measured.<br /> </span><span>Results: </span><span>Cases were significantly higher than control regarding FBS, PPBS and HA1c. Cases were significantly higher than control as it was distributed as 426.04 ± 137.6 and 103.21 ± 32.5 respectively</span><span>. </span><span>Significant AUC with cutoff > 191.7 and 100.0% sensitivity and specificity</span><span>. </span><span>Regarding FBS & PPBS, control group were significantly lower than other groups but group 4 was significantly higher than other groups regarding PPBS. Regarding HA1c, control group was significantly lower than other groups but groups 1 & 4 were significantly higher than other groups. Concerning omentin, control group was significantly lower than other groups and group 4 was significantly higher than other groups also groups 2 & 3 were significantly higher than group 1.<br /> </span><span>Conclusion: </span><span>T1DM is a common health problem in the pediatric age group. Omentin-1 level was significantly high in T1DM and its level is strongly correlated to duration and insulin resistance.<br /> </span>
Type 1 diabetes,Omentin-1,Insulin Resistance
https://ejhm.journals.ekb.eg/article_112313.html
https://ejhm.journals.ekb.eg/article_112313_40afffe65e0b781d48493e6f2a36046c.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
1
2020
10
01
Insulin-Like Growth Factor Binding Protein-1 versus Cervical Length in Prediction of Successful Induction of Labor after 37 Week. Observational Study
1255
1261
EN
Ibrahim Saif
Elnasr
Dalia Sabry Mohamed
Said
Thoria Ahmed
Omar
Hesham
Ammar
amar_hesham@yahoo.co.uk
10.21608/ejhm.2020.112314
<span>Background: </span><span>Bishop Score is still the usual method to expect the results of labor induction. Transvaginal ultrasonographic measurement of cervical length (TVUS-CL) is more objective and insulin like growth factor binding protein-1(IGFBP-1) has been recently used for this aim.<br /> </span><span>Objective: </span><span>This study was conducted to compare between TVUS-CL and detection of cervical (IGFBP-1) for prediction of results of induction of labor after 37 week of pregnancy. </span>
<span>Patients and Methods: </span><span>A prospective cohort study on 140 pregnant women underwent induction of labor</span><span>. </span><span>All patients were subjected to TVUS-CL and detection of cervical (IGFBP-1) and Bishop Score. The primary outcome measure was induction success. The secondary outcome measure was induction to delivery interval.<br /> </span><span>Results: </span><span>In our study (97) females delivered by simple vaginal delivery (SVD), (79) females delivered within 24 hour of induction, (18) females delivered after 24 hour, and (43) females delivered by caesarian section. The mean cervical length measured by TVUS in females who delivered by SVD was 24.89 ±5.48 mm and was 26.79±3.06 mm in those who delivered by CS. IGFBP-1 was positive in 71 females who delivered by SVD and in 17 females who delivered by CS and it was negative in 26 females who delivered by SVD and 26 females who delivered by CS. </span>
<span>Conclusion: </span><span>Success of labor induction correlated significantly with detection of cervical IGFBP-1 and measurement of cervical length by TVUS.<br /> </span>
induction of labor,Bishop Score,Transvaginal ultrasonographic measurement,Cervical length,IGFBP-1
https://ejhm.journals.ekb.eg/article_112314.html
https://ejhm.journals.ekb.eg/article_112314_cba1d1c28d8c697704e940a5a6dad8b2.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
1
2020
10
01
Pressure Controlled Ventilation versus Volume-Controlled Ventilation Regarding Hemodynamics and Stress Response for Posterior Lumbar Spine Surgeries in The Prone Position
1262
1268
EN
Ahmed Mohamed Reda
Ragheb
Department of Anaesthesiology and Intensive care, Faculty of Medicine – Aswan University, Aswan
Ahmed ELSaied
Abdul Rahman
Department of Anesthesiology and Intensive care, Faculty of Medicine – Sohag University, Sohag, Egypt
Ayman Mohamady
Aldemrdash
Department of Anaesthesiology and Intensive care, Faculty of Medicine – Aswan University, Aswan
Sherif Kamal Hafez
Arafa
Department of Anaesthesiology and Intensive care, Faculty of Medicine – Aswan University, Aswan
10.21608/ejhm.2020.112315
<span>Background: </span><span>Prone positioning may induce alterations of airway pressures and hemodynamic that may affect intraoperative blood loss. Ventilation mode may modify these alterations.<br /> </span><span>Objective: </span><span>Our study aimed to differences between pressure-controlled ventilation (PCV) and volume-controlled ventilation (VCV) in their effects on hemodynamic changes during posterior lumbar surgeries performed in the prone position.<br /> </span><span>Patients and Methods: </span><span>This is a prospective randomized controlled study, which was performed in the Department of Anaesthesiology and Surgical ICU, Aswan university, Egypt at the duration from 1-6-2017 to 13-12-2018 for 60 patients who had posterior lumbar spine surgery in prone position who were eligible to inclusion/exclusion criteria divided into two groups; Group (I) were received VCV mode (n = 30) and Group (II) were received PCV mode (n = 30) then study parameters were recorded intraoperatively and postoperatively in the two groups of ventilation modes. </span><span>Results: </span><span>As regarding heart rate, mean arterial blood pressure, serum glucose level, and serum cortisol level, they were statistically significantly lower in PCV group than VCV group both intraoperative and postoperative which reflects that stress response is lower with PCV more than VCV and that may have also a rule in decreasing intraoperative blood loss and improving the surgical field in these surgeries.<br /> </span><span>Conclusions: </span><span>for lumbar spine surgeries in the prone position, PCV was associated with decreased HR, blood pressure, cortisol, glucose levels compared with VCV. The stress response is lesser with PCV which is better for this type of patients.<br /> </span>
Pressure-Controlled Ventilation,Volume-Controlled Ventilation,Hemodynamic changes,Lumbar spine surgery
https://ejhm.journals.ekb.eg/article_112315.html
https://ejhm.journals.ekb.eg/article_112315_d85c6fd282a275211f0ae0ee13159473.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
1
2020
10
01
Evaluation of Lipoxin A4 as A Marker of Severity of Bronchial Asthma in Pediatrics in Zagazig University Hospital
1269
1274
EN
Kossay Usama
Mohamed
Saad Ahmed
Mansour
Sanaa Mahmoud
Abdelsalam
Seham Mahrous
Zaki
10.21608/ejhm.2020.112317
<span>Background: </span><span>Asthma is a common, chronic respiratory disease affecting 1-18% of the population in different countries. Lipoxins were the first agents to be identified as anti-inflammatory endogenous lipid mediators involved in the resolution of inflammation</span><span>.<br /> Objective: </span><span>The study aimed to test this hypothesis via investigating the serum levels of lipoxin A4 in a group of pediatric patients comparing to controls. Also to examine potential differences in lipox in A4 levels in relation to the severity of asthma.<br /> </span><span>Patients and Methods: </span><span>A case-control study was conducted at Zagazig University. Sample size was 22 children in cases group and 22 children in controls group. Twenty two patients were classified as mild, moderate and severe persistent asthma. All children were subjected to lipoxin levels assay.<br /> </span><span>Results: </span><span>Serum lipoxin A4 levels were significantly higher in all asthmatic patients compared to controls group with P value (<0.05). There was statistically significant difference between degree of severity and lipoxin level. On pairwise comparison, the difference was significant between mild and severe group (P=0.01). Our study shows that there was significant increase of serum LXA4 levels in patients with severe asthma compared to those with moderate and mild asthma.<br /> </span><span>Conclusion: </span><span>Serum lipoxin was significantly elevated in asthma patients when compared to controls (P <0.05). Serum lipoxin levels in severe asthmatics were significantly higher than in moderate and mild asthmatics (P <0.01). </span>
Lipoxin A4,bronchial asthma,Severity of Asthma
https://ejhm.journals.ekb.eg/article_112317.html
https://ejhm.journals.ekb.eg/article_112317_1df9dfa2d623d27089664574984e8787.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
1
2020
10
01
Regulation of Liver Fibrosis during Murine Schistosomiasis Mansoni
1275
1280
EN
Tarek K
Zaalouk
Gamal A
Abo-Sheishaa
Ibrahim R
Shalash
10.21608/ejhm.2020.112318
<span>Background</span><span>: The main pathology of </span><span>Schistosoma mansoni </span><span>(</span><span>S. mansoni</span><span>) infection is induced by a granulomatous tissue reaction against the parasite eggs. Unfortunately, no therapy has been proven to prevent the progression of hepatic fibrosis associated with granulomatous hypersensitivity to parasite eggs. Accumulating evidence has demonstrated a critical pathogenic role for both interleukin 17 (IL-17) and interleukin 13 (IL-13) in organ fibrosis. </span><span>Objective</span><span>: The present study investigated the role of IL-17 and IL-13 in the pathogenesis of liver fibrosis during </span><span>S. mansoni </span><span>infection.<br /> </span><span>Material and Methods</span><span>: Thirty female C57BL/6 mice were divided into three groups, normal, infected, and anti- mouse IL-17 treated groups. The infected and anti-mouse IL-17 groups were infected with 40±5 cercariae of </span><span>S. mansoni </span><span>per mouse. Neutralizing rat anti-mouse IL-17 mAb or an isotype-matched rat IgG mAb was first administered intraperitoneally 3 weeks after </span><span>S. mansoni </span><span>infection (62.5μg per mouse) then at the same dose every third day until 2 days before killing. Serum IL-17, IL-13, and proinflammatory cytokines levels were determined by ELISA. Liver granulomas were measured by an ocular micrometer.<br /> </span><span>Results</span><span>: Serum level of IL-17 was significantly higher in infected mice compared with non-infected animals. Reducing IL-17 activity using anti-IL-17 monoclonal antibodies improves liver functions and reduces the size of the liver granulomas. Meanwhile, Th-2 profibrogenic cytokine IL-13 was also decreased in infected/anti-IL-17 mAB- treated mice. IL-17-induced proinflammatory mediators (IL-1</span><span></span><span>L</span><span></span><span>and TNF-</span><span></span><span>that involved in liver fibrosis were markedly reduced in anti-IL-17 mAB-treated mice.<br /> </span><span>Conclusion</span><span>: IL-17 and IL-13 contribute to granulomatous inflammatory and fibrosing reactions in murine schistosomiasis.<br /> </span>
Schistosoma mansoni,Liver fibrosis,Mice,IL-17,IL-13
https://ejhm.journals.ekb.eg/article_112318.html
https://ejhm.journals.ekb.eg/article_112318_9dfe35a378432dd63512b49606211a9d.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
1
2020
10
01
Clinical Utility of Enzyme-Linked Immunosorbent Assay for Hepatitis C Core Antigen Quantification in Diagnosis and Monitoring Patients Treated with Direct-Acting Antivirals in A Resource Limited Setting
1281
1284
EN
Ahmed ElMetwally
Ahmed
Gastroenterology and Hepatology Unit, Internal Medicine Department, Faculty of Medicine, Ain Shams University
Wael Ahmed
Yousry
Gastroenterology and Hepatology Unit, Internal Medicine Department, Faculty of Medicine, Ain Shams University
Ghada Kamal Mohamed
Abdel-Halim
Gastroenterology and Hepatology Unit, Internal Medicine Department, Faculty of Medicine, Ain Shams University
Walaa Mohammad
Hashem
Gastroenterology and Hepatology Unit, Internal Medicine Department, Faculty of Medicine, Ain Shams University
10.21608/ejhm.2020.112402
<span>Background: </span><span>Hepatitis C virus core antigen (HCV-cAg) assay has been proposed as a more economical alternative to HCV RNA detection. </span><span>Aim of the work: </span><span>To evaluate the clinical utility of ELISA for HCV-cAg quantification in diagnosis and monitoring treatment outcomes in patients treated with direct acting antivirals (DAAs) for chronic hepatitis C. </span><span>Patients and Methods: </span><span>A prospective study on 40 subjects recruited from hepatology department and outpatient clinic in Ain Shams University Hospitals</span><span>. </span><span>Group I included 20 patients with positive anti-HCV antibody. Group II included 20 healthy subjects. The patient group received a combination of sofosbuvir 400 mg and daclatasvir 60 mg once daily for 12 weeks. The levels for both HCV-cAg and HCV RNA were evaluated at baseline and 12 weeks after completion of therapy. </span><span>Results: </span><span>Baseline HCV-cAg levels showed good correlation with HCV viral load (r=0.808, p < 0.001). A sustained virological response 12 weeks off therapy (SVR12) was achieved in all patients with HCV-cAg levels decreasing significantly at the end of treatment (EOT) (21.5±8.5 vs 5.4±3.63 IU/ml respectively, p < 0.001). The sensitivity and specificity of HCV-cAg in predicting HCV RNA was 100% and 90% respectively at cut-off value >8 IU/ml. </span><span>Conclusion: </span><span>ELISA for HCV-cAg can replace the high sensitivity HCV RNA molecular assay to confirm the presence of HCV infection and to monitor treatment outcome.<br /> </span>
Hepatitis C virus,HCV-core antigen,HCV RNA, Direct acting antiviral agents
https://ejhm.journals.ekb.eg/article_112402.html
https://ejhm.journals.ekb.eg/article_112402_42c6ab3c8963dadcf097352c3a432772.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
1
2020
10
01
Effect of High Flux Hemodialysis versus Hemodiafiltration on Metabolic Status in Hemodialysis Patients
1285
1291
EN
Sara Tito
Ibrahem
Adela Mahmoud Gad
Salama
Hanaa Mohammed Eid
Elsayed
Mahmoud Ahmed
Ali
10.21608/ejhm.2020.112403
<span>Background</span><span>: </span><span>Hemodiafiltration </span><span>(HDF) is a newly developed renal replacement therapy blood purification technology with more advantageous effects on hemodynamic stability and better removal of B2 microglobulin </span><span>and phosphorous<br /> </span><span>Objective: </span><span>The aim of this study is to compare effect of high flux (HF), low flux (LF) dialysis membranes and hemodiafiltration (HDF) on the metabolic status in hemodialysis patients </span><span>and quality of life of those patients. </span><span>Patients and Methods: </span><span>This study included 60 patients more than18 years old, clinically stable with end stage renal disease on regular HD for at least three years (3 yrs), selected from HD unit in (Kobry El Kobba Military Nephrology Hospital) in the period from </span><span>March </span><span>2018 to </span><span>September </span><span>2018. The patients were divided into three groups equally. </span><span>Group I: </span><span>20 patients on low flux dialyzer, </span><span>Group II</span><span>: 20 patients on high flux dialyzer, </span><span>Group III: </span><span>20 patients on hemodiafiltration.<br /> </span><span>Results</span><span>: There was a highly significant decrease in iPTH, B2 microglobulin and Phosphorous in patients received HDF (363.80±149.04, 8.79±7.22 and 4.31±0.74 respectively in comparison with patients received HF hemodialysis (540.10±242.55, 20.47±3.97and 4.58±1.07 respectively) and patients received LF hemodialysis (725.95±270.01, 36.60±7.22 and 5.73±1.34 respectively).Also, there were a highly significant increase in urea reduction ratio in HDF group compared to HF and LF groups (80.43±7.46, 76.03±9.55 and 65.81±7.42 respectively.<br /> </span><span>Conclusion: </span><span>Hemodiafiltration is the most effective dialysis technique than high flux and low flux dialysis membrane in removal of medium sized molecule and improvement of quality of life.<br /> </span>
Online Hemodiafiltration,high flux hemodialysis,B2 microglobulin,quality of life
https://ejhm.journals.ekb.eg/article_112403.html
https://ejhm.journals.ekb.eg/article_112403_e947b9f58fd24dd699e0376b8afdedb0.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
1
2020
10
01
Nailfold Capillaroscopic Changes in Dermatomyositis and Polymyositis Egyptian Patients: Relation to Disease Activity
1292
1298
EN
Shafica Ibrahim
Ibrahim
Howaida Elsayed
Mansour
Gamer Abdelrahman
Azrag
Safaa Abd Elsalam
Hussein
10.21608/ejhm.2020.112404
<span>Background: </span><span>Nailfold capillaroscopy (NFC) has been described to be a valuable instrument used in diagnosis of systemic sclerosis (SSc) and juvenile dermatomyositis (JDM) patients. Though, NFC has been infrequently assessed in adult dermatomyositis (DM) patients.<br /> </span><span>Objectives: </span><span>Our aim was to visualize nailfold capillary changes in dermatomyositis (DM) and polymyositis (PM) Egyptian patients and to identify a specific diagnostic capillary pattern and to assess its relevance to disease activity, clinical and laboratory findings.<br /> </span><span>Patients and Methods: </span><span>This study included 20 patients (12 DM, 5 PM, and 3 overlap syndrome). Routine laboratory assessment was done, disease and skin activity scores were evaluated. Assessment of the nailfold capillary circulation using the videocapillaroscope was done and capillary density score was assessed.<br /> </span><span>Results: </span><span>The mean age was 39±12 years and their mean disease duration was 24±19 months. The mean muscle disease activity score was 3.8±3.3, and global disease activity score (DAS) 3.92±3.09. The mean skin activity score was 2±3. The global DAS was significantly higher in patients with branched capillaries (p=0.041). Skin activity score was significantly higher in patients with capillary hemorrhage (p=0.024). More severe capillaroscopic findings were prominent in DM patients rather than PM or overlap patients.<br /> </span><span>Conclusion: </span><span>Capillary branching is more common in patients with higher global DAS and capillary hemorrhage is more frequent in patients with higher skin activity score. Capillaroscopic changes are evident in DM patients rather than PM or overlap patients.<br /> </span>
Nailfold capillaroscopy,Dermatomyositis,Polymyositis,disease activity
https://ejhm.journals.ekb.eg/article_112404.html
https://ejhm.journals.ekb.eg/article_112404_9676dc1f79a7548421d74bb24e4238ad.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
1
2020
10
01
Relation between Substitution of Threonine for Isoleucine at Β2 Adrenergic Receptor on Bronchial Asthma in Children
1299
1302
EN
Samir
Zamzam
Khalid Mohamed
Salah
Rania Mohammed Mohammed
Amer
Rana Ahmed
Waheed
10.21608/ejhm.2020.112405
<span>Introduction: </span><span>Pediatric asthma is a complex disorder involving immunologic, genetic, environmental and other factors. </span><span>Objective: </span><span>To evaluate the role of substitution of threonine for isoleucine at codon 164 on bronchial asthma susceptibility, severity and response to short- and long- term acting </span><span>β</span><span>2</span><span>-adrenergic receptor agonists in children. </span><span>Patients and Methods: </span><span>This study was a prospective case control study, which was done in Pediatric Department of Zagazig University Hospital from Pulmonology Clinic in the period from February 2016 to February 2018. 100 children were included, 50 of them had asthma with bronchodilator and their ages ranged from 5 to 12 years (25 males and 25 females) with the mean age of 6.8 ± 2.5 years. In addition, 50 healthy age and sex matched worked as control children. All studied groups were subjected to full history taking, clinical examination, pulmonary function tests, total serum IgE and identification of adrenergic </span><span>β</span><span>2 </span><span>receptor (ADR</span><span>β</span><span>2</span><span>) substitution of threonine for isoleucine at codon 164 polymorphism. </span><span>Results: </span><span>In this study, there was a significant association between homozygous isoleucine and increase incidence of asthma, this mean that the gene gives harmful effect when it is in a homozygous form. However, there was no statistically significant difference between asthma severity and gene polymorphism (CC, CT and TT). </span><span>Conclusion: </span><span>In the present study ADR</span><span>β </span><span>Thr164Ile polymorphism is reported as an important variant at salbutamol refractoriness in sever asthmatics. In addition, the polymorphism form is susceptible variant to develop asthma risk.<br /> </span>
Threonine for Isoleucine,Adrenergic Receptor and bronchial,Asthma,ADRβ2
https://ejhm.journals.ekb.eg/article_112405.html
https://ejhm.journals.ekb.eg/article_112405_14e4c00cecedcb3ed8c47bf0891eea76.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
1
2020
10
01
Value of Screening for Osteoporosis among Children with Juvenile Idiopathic Arthritis
1303
1306
EN
Alaa-Eldin A.
Hassan
Mohammed M M
Rayan
Tarek M.
Abdel-Aziz
Awad Saad
Abbas
Mohamed Z.
Shoaeir
Mohammed M.S.
Younis
Departments of 1 Pediatric and 2Rheumatology and Rehabilitation,
Faculty of Medicine, Al-Azhar University, Assiut, Egyp
10.21608/ejhm.2020.112406
<span>Background: </span><span>Juvenile idiopathic arthritis (JIA) is one of the most common rheumatic diseases in children. In all subtypes of JIA, a low bone mass has been detected in a high percentage of children due to failure to develop adequate bone mineralization.<br /> </span><span>Objective: </span><span>To determine the extent of osteoporosis among children with JIA.<br /> </span><span>Patients and Methods: </span><span>A cross sectional study on thirty patients diagnosed with JIA. In addition, age and sex matched thirty healthy children worked as control. Bone mineral density (BMD) and Z score of lumbar spine, neck of the femur and distal radius were analysed and adjusted for age and sex among patients and controls. Lunar DPX-NT 2013 made in USA by General Electric did dual energy X-ray absorptiometry (DEXA) scan.<br /> </span><span>Results: </span><span>60% of patients were males with a male to female ratio of 3:2. Our patients' age ranged between 6-15 years. The disease duration ranged between 6 months and 10 years. We found that 24 patients (80%) had osteoporosis (age- matched Z score was below normal), while among the control group only 4 children (13.3%) had osteoporosis. There was a significant difference between patients and controls regarding DEXA scan findings. Patients with longer duration of JIA at diagnosis had more osteopenia and osteoporosis than those with short duration of disease. The mean ± SD of disease duration in patients with JIA who were suffering from osteoporosis was 5.1 ± 2.76 years. In oligoarticular type, majority of the cases had osteoporosis 40% (12 patients). In systemic onset JIA 8 cases (26.7%), six of them were osteoporotic. The psoriatic type was diagnosed in four patients (13.3%), all of them were osteoporotic. The polyarticular RF +ve type was diagnosed in four patients (13.3%), half of them were osteoporotic and the polyarticular RF -ve type was diagnosed only in 2 patients (6.7%), all of them were within normal bone density.<br /> </span><span>Conclusion: </span><span>Results obtained from this study suggest that osteoporosis was a frequent complication of JIA. JIA patients are likely to have low BMD. Children with JIA who have oligoarticular and systemic onset of JIA patients were more susceptible to low BMD.<br /> </span>
JIA,Osteoporosis,DEXA
https://ejhm.journals.ekb.eg/article_112406.html
https://ejhm.journals.ekb.eg/article_112406_2b22e5a78ccdda1cc880bb9eddffad56.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
1
2020
10
01
Prevalence and Risk Factors of Intellectual Disabilities in Children
1307
1313
EN
Hosny Mohamed Ahmed
Elmasry
Department of Pediatrics, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
Mohamed Abo-elwafa
Aladawy
Department of Pediatrics, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
Mamdouh Mahmoud
Abd-elhamid
Department of Pediatrics, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
10.21608/ejhm.2020.112407
<span>Background: </span><span>Intellectual disabilities in childhood constitutes a major health problem throughout the world and a handicapping illness with long term costly treatment and bad impact on the family. It constitutes a major problem in Egypt affecting the quality of life of children and the welfare of their families.<br /> </span><span>Objective: </span><span>To identify the prevalence and risk factors of intellectual disabilities in children aged 2-16 years in the Pediatric Neurology Out-patient Clinic, Al-Azhar University Hospital, Assiut.<br /> </span><span>Patients and Methods: </span><span>The present study included one thousand (1000) children randomly selected and examined for the presence of intellectual disabilities from patient attending the clinic, ninety of them (9%) (63 males - 27 females) had intellectual disabilities. The present study has been conducted at the pediatric neurology out-patient clinic of Al-Azhar University in Assiut from 1/11/2018 to 30/6/2019.<br /> </span><span>Results: </span><span>There was a significant statistical attachment between intellectual disabilities and family’s socioeconomic </span><span>profile in terms of residence, maternal and paternal education, and </span><span>Father’s job and parent</span><span>'s consanguinity. In the present study the total number of cases was 90, 63 males 27 females, 76% of cases were coming from rural areas while 24% of cases were coming from urban areas. As regards the investigation, neuro-imaging (CT-MRI) was not done in (41.1 %) while normal in (38.9 %), (11.1%) with brain atrophy, (6.7%) with focal lesion and congenital brain malformation represent (2.2 %).<br /> </span><span>Conclusion: </span><span>Mentally retarded cases are more common in rural areas and male sex. Socioeconomic factors like education of parents and parental consanguinity play a role in the occurrence of MR.<br /> </span>
intellectual disabilities,risk factors,children
https://ejhm.journals.ekb.eg/article_112407.html
https://ejhm.journals.ekb.eg/article_112407_53a9b88f5493a0e54a5f9b521841ffd0.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
1
2020
10
01
Lower Limb Muscles Activity and Inclined Squat Position in Normal Children (Cross Sectional Study)
1314
1316
EN
Ahmed A.
Allam
Captain Physiotherapist at Al Agouza Police Hospital.
Emam H.
Elnegmy
Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University
Mahmoud S.
El Fakharany
Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University
10.21608/ejhm.2020.113062
Background: Benefits associated with squat performance are not limited to the athletic population. Given that most activities of daily living necessitate the simultaneous coordinated interaction of numerous muscle groups, the squat is considered one of the best exercises for improving quality of life because of its ability to recruit multiple muscle groups in a single maneuver. Objective: To determine the effect of inclined squat position on the vastus medialis oblique (VMO) and gluteus maximus (GM) at the different ankle angles 5°-10° degrees of inclination in normal children. Subjects and methods: thirty non-athletic children of both genders, age ranged from 14 to 18 years, were selected from the Egyptian governmental schools at Sixth of October City and Sixth of October Sporting Club. The maximum voluntary isometric contraction (MVIC) was measured after the electrodes were attached to the GM and the VMO of the subject during squat postures which applied on two inclined borders 5 and 10 degree of inclination; the feet are spread out shoulder width, hip 70° flexion, knee 75° flexion and in the erect posture. Results: There was a significant increase in the VMO activity in 5° ankle angle compared with that of 10° ankle angle (p = 0.0001). There was a significant decrease in the GM activity in 5° ankle angle compared with that of 10° ankle angle (p = 0.0001). Conclusion: modification of ankle dorsiflexion during squat position should be integrated in the rehabilitation programs of the different injuries.
Squat Position,muscles activity,Isometric contraction,electromyography
https://ejhm.journals.ekb.eg/article_113062.html
https://ejhm.journals.ekb.eg/article_113062_d811f266100187dc9f1283e2edf66485.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
1
2020
10
01
The Peripheral Blood Expression of Lipoic Acid Synthetase Gene as an Early Marker for Diabetic Nephropathy
1320
1325
EN
Marwa M.
Esawy
0000-0002-2198-258X
Clinical Pathology Department,
Faculty of Medicine, Zagazig University, Egypt
Mahmoud M.
Magdy
Internal Medicine Department, Faculty of Medicine, Zagazig University, Egypt
10.21608/ejhm.2020.113064
Introduction: Diabetic nephropathy (DN) is one of the diabetic complications, which leads to end-stage renal disease. This study aimed to assess the expression of the lipoic acid synthetase (LIAS) gene in type 2 diabetic patients and DN patients. Subjects and Methods: A case-control study conducted on 60 patients who had type 2 diabetes, 60 patients who had DN, and 60 healthy matched individuals. The peripheral blood expression of the LIAS gene was assessed by real-time qRT-PCR. Results: In diabetic and DN patients, the expressions of LIAS were significantly lower than controls (p < 0.001). The LIAS expression showed a reducing trend with the progress of DN (p < 0.001). The LIAS expression showed a sensitivity of 95 % and specificity of 88.3% in the differentiating between diabetic and DN patients and it can detect early DN with a sensitivity of 93.5 % and specificity of 90%. LIAS expression in DN patients had significant negative correlations with disease duration and albuminuria. LIAS gene expression can protect significantly from the DN. It had an odds ratio of 0.01 [95% confidence interval (CI): 0.001-0.03] (p < 0.001). LIAS gene expression can significantly predict disease severity. Conclusion: Peripheral blood expression of the LIAS gene was significantly lower in diabetic and DN patients in comparison to controls. The LIAS expression negatively correlated with the progress of DN. LIAS gene expression seems to be a promising marker for prediction and early detection of DN in type 2 diabetic patients.
diabetic nephropathy,Gene expression,Lipoic acid synthetase
https://ejhm.journals.ekb.eg/article_113064.html
https://ejhm.journals.ekb.eg/article_113064_1fe2325f93fbc2cb079d77418556f62a.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
1
2020
10
01
The Role of Anti-ovarian Autoantibodies in Polycystic Ovary Syndrome
1326
1329
EN
Mary M.
Shoukry
Department of Clinical Pathology, Faculty of Medicine, Ain Shams University
Hanaa A.
Amer
Department of Clinical Pathology, Faculty of Medicine, Ain Shams University
Rania H.
El-Kabarity
Department of Clinical Pathology, Faculty of Medicine, Ain Shams University
Nancy S.
Wahba
Department of Clinical Pathology, Faculty of Medicine, Ain Shams University
10.21608/ejhm.2020.113081
Background: Autoimmunity has been proposed in the pathogenesis of polycystic ovary syndrome (PCOS) since early 1990s. Studies of anti-ovarian antibodies (AOA) that were performed so far yielded conflicting results. Objective: This study aimed at evaluating the association between PCOS and AOA. Patients and method: The study was conducted on 80 Egyptian women who were divided into two groups: cases group of 40 women with PCOS, and a control group of 40 healthy age-matched normally cycling fertile women. For both cases and control groups, serum level of AOA was measured using ELISA. Results: Serum AOA level was significantly higher among cases than controls (p value < 0.05). No significant difference was found between cases and controls regarding their hormonal profile (estrogen, FSH, LH, and testosterone) except for the level of mid luteal progesterone which was significantly lower among cases (p value <0.05). No significant correlation was found between AOA and age, body mass index (BMI), FSH, LH, E2, mid luteal progesterone and testosterone in control group. However, a significant negative correlation between AOA and serum testosterone level was found in PCOS group. Conclusion: Our results suggest that autoimmune ovaritis may be frequently associated with PCOS. Circulating AOA may represent a practical and suitable marker for diagnosis of PCOS.
Autoimmunity,Anti-ovarian antibody,Polycystic Ovarian Syndrome,Pregnancy
https://ejhm.journals.ekb.eg/article_113081.html
https://ejhm.journals.ekb.eg/article_113081_8a9aed64b57e6be88d9504b7a5ef8ed6.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
1
2020
10
01
Oral Gabapentin versus Pregabalin for Postoperative Pain Relief in Elective Cesarean Section Patients under Spinal Anesthesia
1330
1337
EN
Neveen Mahmoud
Alaasar
Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Zagazig University
Dalal El-sayed Mohammed
soud
Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Zagazig University
Asmaa Mohammed
Galal El-Deen
Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Zagazig University
Ahmad Ibraheem Ahmad
Abd Elfattah
Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Zagazig University
10.21608/ejhm.2020.113393
<span>Background: </span><span>Pain after Cesarean delivery is the main postoperative complain in parturients, pregabalin and gabapentin have been shown to decrease acute postoperative pain in parturient. </span><span>Objective</span><span>: The aim of the study was to compare gabapentin and pregabalin as oral premedication in patients for elective cesarean section under spinal anesthesia for postoperative pain relief and the need to rescue analgesia.<br /> </span><span>Methods: </span><span>This study was carried out at Obstetric Operating Rooms, Zagazig University Surgical Hospitals. The study included 54 consenting women aging 20</span><span>–</span><span>40 yrs old with uncomplicated pregnancies that were scheduled to undergo elective Cesarean section delivery under spinal anesthesia. They were randomly allocated into three equal groups. Group (P) received 300 mg pregabalin, group (G) received 900 mg gabapentin, and control group (C). The study medication given orally one hour before the anticipated time of the surgical incision, and data measured included visual analogue scale (VAS), the total doses of analgesia, the incidence of post-operative nausea and vomiting (PONV) and the level of sedation. </span><span>Results: </span><span>The VAS was comparatively low in patients of group P as compared to G and C groups (P value < 0.05). Total analgesic requirement of pethidine in first 24 h was significantly lower in groups P as compared to groups G & C (P value < 0.001). We found that there was statistically significant increase in the sedation scores of the patients in P group as compared to G & C groups.<br /> </span><span>Conclusion: </span><span>Pregabalin 300 mg was more effective than gabapentin300 mg in reducing post Cesarean section pain, opioid consumption, nausea, and vomiting.<br /> </span>
cesarean section,Postoperative Pain,Pregabalin,Gabapentin
https://ejhm.journals.ekb.eg/article_113393.html
https://ejhm.journals.ekb.eg/article_113393_2bf8376bc40654b751c7f3ed74c3a71a.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
1
2020
10
01
Neurological Manifestations of Renal Diseases in Children at Zagazig University Hospital
1338
1341
EN
Ahmed Galal
Siam
Department of Pediatrics, Faculty of Medicine, Zagazig University, Sharkia, Egypt
Mohammed Mohammed
Abdel Salam
Department of Pediatrics, Faculty of Medicine, Zagazig University, Sharkia, Egypt
Hatim Saed
Haweej
Department of Pediatrics, Faculty of Medicine, Almergib University, Libya
hatemhoeg84@gmail.com
10.21608/ejhm.2020.113394
<span>Background: </span><span>Chronic renal failure (CRF) may have many effects on the nervous system and manifest as headache, seizure, dialysis disequilibrium syndrome, cerebral hemorrhage, hypertensive encephalopathy, uremic neuropathy. </span><span>Objectives</span><span>: This study aimed to identify the neurological manifestations in children with renal diseases at Zagazig University hospital.<br /> </span><span>Subjects and methods</span><span>: This is cross-sectional was carried out in the Pediatrics Department, Zagazig University Hospitals, on 270 Children with renal diseases during the period from January 2019 till June 2019. All patients included in the study were subjected to history taking, detailed data about renal diseases.<br /> </span><span>Results</span><span>: our results revealed that Frequency of neurological manifestations in renal disease patients was (3%), Common presentations of renal diseases was (7.4%) had dysuria, (70.37%) had edema, (3,7 %) had hematuria, (18.51%) had hypertension and 8 cases (3%) had neurological presentations, of whom, 5 had febrile seizures, 2 had cerebral thromboembolism, and 1 encephalopathy.<br /> C</span><span>onclusion: </span><span>Neurological manifestations of pediatric renal diseases still are common and the neurological presentations in 3 % of children with renal diseases, and febrile seizures were the most common presentation. </span>
Renal disease,children,Neurological manifestations
https://ejhm.journals.ekb.eg/article_113394.html
https://ejhm.journals.ekb.eg/article_113394_6b28984db94626188f76f67af03eb45a.pdf