Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
5
2020
10
01
Occupational Pesticides Intoxication among Agricultural Workers
1916
1923
EN
Mahmoud Ali
Saleh
Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Benha University
Hassan El Sayed
El far
Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Benha University
Omyma Mahmoud
Hassan
Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Benha University
Marwa Salah El-Dien
AbdElRaouf
Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Benha University
marwad24@yahoo.com
Shaima Adel Elsayed
Ali
Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Benha University
10.21608/ejhm.2020.122712
Background: Pesticide intoxication is a public health problem in many developing countries. Approximately 18.2 per 100 000 agricultural workers worldwide have occupational-related pesticide acute and chronic toxicity symptoms. Objective: This study aimed to investigate the toxic symptoms in pesticide-exposed agricultural workers. Patients and Method: A cross sectional study was conducted on 390 agricultural workers using an interview questionnaire that consists of socio-demographic and exposure data, safety practices and self-reported toxicity symptoms. Physical examination and investigations were done. Results: Among the self-reported toxicity symptoms, cough was the most common acute symptom (59%) while skin problems were the most reported chronic symptoms (11.5%). There was a statistically significant difference regarding age between those with & without blurring of vision [(median, 50 and 39 years respectively) P < .001], muscle spasm [(median, 49 and 40 years respectively) P < .001] and skin problems [(median, 48 & 41 years respectively) P < 0.007]. Regarding duration of exposure, there was a statistical significant difference between those with & without blurring of vision [(median, 10 and 50 years respectively) P < .001], muscle spasm [(median, 10 and 6 years respectively) P < .001] and skin problems [(median, 12 and 6 years respectively) P < .001]. There was statistical significant negative correlation between serum cholinesterase level and age, duration of pesticides exposure and body mass index. Conclusions: The most self-reported pesticides toxicity symptom was cough (59%) while walking problems were the least reported one (5.9%). Age and duration of pesticides exposure are significant risk factors for pesticides toxicity.
Pesticides,toxicity,Agricultural workers
https://ejhm.journals.ekb.eg/article_122712.html
https://ejhm.journals.ekb.eg/article_122712_875fb4f1171e14f8ddb3dd912e408c64.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
5
2020
10
01
Urinary Netrin-1 as an Early Marker for Diabetic Nephropathy
1924
1930
EN
Ezzat M.
Mohammed
Fawzy A.
El-Messallamy
Ahmed M.
Mazroue
Islam A.
Elsayed
Amal A.
Zidan
10.21608/ejhm.2020.122713
Background: Netrin-1, a laminin-related secreted protein, is a proximal tubular injury urinary marker. It is released in the urine of both humans and mice and highly stimulated after acute and chronic renal diseases. Objective: The current study aimed to assess the value of urinary netrin-1 level as an early marker for diabetic nephropathy. Patients and Methods: A total of 60 diabetic patients and 20 healthy controls were enrolled in this case-control study. Diabetic patients were subdivided into normoalbuminuria, microalbuminuria, and macroalbuminuria. Urinary netrin-1 levels were analyzed by enzyme-linked immunosorbent assay (ELISA). Results: Urinary netrin-1 excretion was significantly higher in the diabetic group (1418.3±733.6 pg/mg creatinine) compared to the control group (477.4±283.6 pg/mg creatinine) with the highest value in the macroalbuminuria group (1919.4±573.4 pg/mg creatinine) and the lowest value in normoalbuminuria group (833.7±595.3 pg/mg creatinine). ROC curve analysis showed that urinary netrin 1/creatinine at a cutoff point of >630.75 pg/mg with AUC of 0.899 had 83.3% sensitivity and 85% specificity for prediction of diabetic nephropathy (P<0.001). Conclusion: Our study is suggesting that urinary netrin-1 may be a useful biomarker for early detection of diabetic nephropathy
diabetic nephropathy,netrin-1,albuminuria
https://ejhm.journals.ekb.eg/article_122713.html
https://ejhm.journals.ekb.eg/article_122713_3f0effff718c1a7d82f6f09680c5319f.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
5
2020
10
01
Role of Hysterolaparoscopy in The Evaluation and Management of Female Infertility
1931
1936
EN
Wael Hussein
Al-Bromboly
Department, Obstetrics and Gynecology, Faculty of Medicine, Zagazig University, Egypt.
Hussein Mohammed
Abdel-Dayem
Department, Obstetrics and Gynecology, Faculty of Medicine, Zagazig University, Egypt.
Amr Ahmed
Abdel-Rahman
Department, Obstetrics and Gynecology, Faculty of Medicine, Zagazig University, Egypt.
Bashaer Rashad Ali
Gamal El-Din
Department, Obstetrics and Gynecology, Faculty of Medicine, Zagazig University, Egypt.
10.21608/ejhm.2020.122714
Background: The definition of infertility is one year of unprotected intercourse with no pregnancy among married couples. Objective: The aim of the study is to assess the efficacy and safeness of combined hysterolaproscopy on evaluation and management of female infertility. Patients and Methods: A prospective clinical triad study was carried on 416 patients infertile women aged between 18 and 42 years with either primary or secondary infertility with normal hormone profile and without male factor infertility at the Cytogenetics and Endoscopy Unit, at Zagazig University. Those females underwent both hysteroscopy and laparoscopy through the period from August 2017 to July 2018. Results: This study showed that 42.7% of primary infertility and 59.5% of secondary infertility cases did not have any abnormality detected on laparoscopy. Endometriosis was the most common abnormality found in primary infertility followed by peritoneal adhesions, which was(12.2%) the most common abnormality found in second infertility followed by endometriosis. Abnormality in cases of primary infertility was intrauterine septum, and in secondary infertility was intrauterine synechia. Conclusions: Diagnostic hysterolaparoscopy is a very safe and effective tool for the evaluation of infertility particularly for detection of conditions like endometriosis, tubal adhesions, and intrauterine septum
female infertility,Infertility,Hysteroscopy,Laparoscopy
https://ejhm.journals.ekb.eg/article_122714.html
https://ejhm.journals.ekb.eg/article_122714_ad5c4a0de5781e958fb503e10a55644e.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
5
2020
10
01
Role of Ultrasonography in Diagnosis of Pleuropulmonary Diseases in Adults
1937
1947
EN
Tarek MA
Elziat
Department of Diagnostic Radiology,
Faculty of Medicine, Aswan University
Salah MA
Maklad
Department of Diagnostic Radiology,
Faculty of Medicine, Aswan University
Shaimaa RM
Ali
Department of Diagnostic Radiology,
Faculty of Medicine, Aswan University
shaimaaragab20@gmail.com
Sayed AE
Mohammed
Department of Chest Diseases
Faculty of Medicine, Aswan University
10.21608/ejhm.2020.122715
Introduction: The advantage of transthoracic ultrasound (TUS) includes the absence of ionizing radiation, easy performance, rapid, accurate, safe, short time of examination, lower cost, bedside availability and high sensitivity in detecting pleural and pulmonary diseases. Aim of this study: Aim of the current study was to assess of the role of transthoracic ultrasound in pleuropulmonary diseases in adults. Patients and methods: The present study included 50 patients who fulfilled the selection criteria and formed the study population. The present study was conducted in Radiology Department, Aswan University Hospital in the period from December 2016 to November 2017. All patients were subjected basically to full history taking, full clinical examination, chest x-ray, chest ultrasonography, CT chest and histopathological correlation for some cases. Results: In this study, patients were classified into 2 groups based on the final diagnosis. The first group included 28 cases with pleural diseases that the US reported sensitivity of 96.43%, specificity of 81.8%. The second group included 22 patients with pulmonary diseases that the US reported sensitivity of 95.45%, specificity of 78.57%. Recommendations: TUS has a valuable role at diagnosis of pleuropulmonary diseases
TUS,pleural diseases,pulmonary diseases,BLUE protocol,Pleural effusion,Pneumothorax,pneumonia,pleural masses,pulmonary masses,TUS guided interventions
https://ejhm.journals.ekb.eg/article_122715.html
https://ejhm.journals.ekb.eg/article_122715_c0af4ed0fa561801efda8c54d664b6d6.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
5
2020
10
01
Frequency of Inborn Errors of Metabolism among Infants with Non-Apparent Causes of Failure to Thrive in Zagazig University Hospitals
1948
1952
EN
Azza Ibrahim
El-Desouky
Department of Pediatrics, Faculty of Medicine – Zagazig University
Sherif Mohamed
El-Gebally
Department of Pediatrics, Faculty of Medicine – Zagazig University
Tarek Mahmoud
Beyoumi
Department of Pediatrics, Faculty of Medicine – Zagazig University
tarekmahmoudbayoumi@gmail.com
10.21608/ejhm.2020.122716
Background: Inborn errors of metabolism (IEM) are disorders in which there is a block at some point in the normal metabolic pathway caused by a genetic defect of a specific enzyme. Diagnosis is important not only for treatment and prognostication but also for genetic counseling and antenatal diagnosis in subsequent pregnancies. Objective: The present study aimed to find out the relative frequency of inborn errors of metabolism among infants with unapparent cause of failure to thrive (FTT). Patients and Methods: This study was cross-sectional prospective study, which was conducted during the period from 2017 to August 2019. It included 58 cases with non-apparent cause of failure to thrive admitted at Pediatric Department, Faculty of Medicine, Zagazig University. All studied cases were subjected to: EMS (extended metabolic screen) using filter paper by Tandem Mass Spectrometry. Urinary organic acids analysis was performed. Results: In this study, frequency of inborn errors of metabolism (IEM) among the studied unapparent causes of FTT cases was 8.6%. Types of IEM diseases among the studied cases were one case for each of biotinidase enzyme deficiency (1.7%), methyl malonic acidemia (1.7%), mitochondrial disease (1.7%), organic acidemia (1.7%) and phenylketonuria (1.7%). There was statistically significant increase in complains of vomiting and diarrhea among cases with inborn errors of metabolism than those without inborn errors of metabolism. Conclusion: There was high frequency of inborn errors of metabolism (IEM) among FTT without apparent cause. Frequency of hypoglycemia, positive ketone in urine, high anion gap and high serum ammonia were significantly more frequent among cases with inborn errors of metabolism than those without inborn errors of metabolism.
Inborn errors of metabolism,Unapparent cause of failure to thrive,frequency
https://ejhm.journals.ekb.eg/article_122716.html
https://ejhm.journals.ekb.eg/article_122716_867f6de27c39a7c4c2a31f92ffc8dcc2.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
5
2020
10
01
Different Treatment Modalities of Colo-Rectal Cancer (Retrospective Study)
1953
1957
EN
Abbas Mahmoud
Sarhan
Department of Clinical Oncology, Faculty of Medicine, Zagazig University, Sharkia, Egypt.
Mohammed Abdelgawad
Soliman
Department of Clinical Oncology, Faculty of Medicine, Zagazig University, Sharkia, Egypt.
Eman Ali
El-Sebai
Department of Clinical Oncology, Faculty of Medicine, Zagazig University, Sharkia, Egypt.
Mahmoud Mohammed Ahmed
El-Demery
Department of Clinical Oncology & Nuclear Medicine, Ahmed Maher Teaching Hospital, Cairo, Egypt
mahmod.eldemery@gmail.com
10.21608/ejhm.2020.123478
Background: Colorectal Cancer (CRC) is the most common type affecting the gastrointestinal tract accounting for about 13% of all malignancy diagnosed each year. Although Surgery stays the most effective treatment in managing colorectal carcinoma, there is a rapid increase in the use of preoperative radiotherapy and chemotherapy. Objective: So, the present study was conducted to identify the different therapeutic modalities used in the treatment. Patients and Methods: This study was a retrospective study that included CRC patients treated at the Clinical Oncology Department, Zagazig University Hospital during the period from 2012 to 2017. Medical records of 385 patients, who were referred to the Clinical Oncology Department after being diagnosed with CRC were obtained and used to collect data about different treatments and then analyzed. Results: Chemotherapy regimen FOLFOX was received in (45.5%) of cases and partial response in 41 % of cases was observed. Patients received at least one line of chemotherapy with either adjuvant or palliative intent. Rectal cancer patients who received neoadjuvant concurrent chemo& radiotherapy showed a partial response in 45.5 % of cases. Xeloda was the most common chemotherapy received in most cases who received either adjuvant or neoadjuvant CCRT. Recurrence occurred in (81%) of cases. Conclusion: Chemotherapy regimen FOLFOX was received in most cases. Patients received at least one line of chemotherapy with either adjuvant or palliative intent, FOLFOX was the most chosen protocol. Xeloda was the most common chemotherapy received in most cases
Treatment modalities,colorectal cancer,Retrospective
https://ejhm.journals.ekb.eg/article_123478.html
https://ejhm.journals.ekb.eg/article_123478_82d137ab12ae3f9bfc740a4cf5147fe1.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
5
2020
10
01
Studies on the Effect of Aqueous Green Tea Extract on Lipid Profile and Vascular Reactivity in Hypercholesterolemic Albino Rats
1958
1966
EN
Mohammed Hassan
El-Bakry
Department of Pharmacology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
Ramadan Hassan
Ibrahim
Department of Pharmacology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
El-Shazly Abdelaal
Mohaseb
Department of Pharmacology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
hazly_1234@yahoo.com
10.21608/ejhm.2020.123477
Background: Hypercholesterolemia is one of the most important risk factors for atherosclerosis and subsequent cardiovascular disease (CVD). CVD is the leading cause of cardiovascular morbidity and mortality worldwide, currently, there is a major trend to use herbal remedies for the treatment and prevention of hypercholesterolemia. Objective: In the present work, we investigated the effect of aqueous green tea extract on lipid profile and vascular reactivity & changes in body weight in hypercholesterolemic albino rats Materials and methods: Adult male albino rats were chosen as an animal model for this study. Rats were brought from animal house, Faculty of Medicine, Assiut University, Assiut, Egypt, and were maintained on a balanced diet with water supply freely in clean containers. They were kept for two weeks to adapt to the laboratory conditions before the start of the experiment. Forty age-matched male albino rats with initial body weights ranging from 200 to 220g were used. Results: In group (III & IV), total cholesterol, LDL, and triglyceride levels were significantly decreased respectively& HDL were significantly increased compared with the group II (p < 0.05). also in group (III & IV) the aortic contractility is decreased and aortic relaxation were significantly increased compared with the group II (p < 0.05) & body weight was decreased significantly (p < 0.05) in group IV compared with the group II. Conclusion: The results obtained by the present study showed that administration of aqueous green tea extract to the hypercholsterolemic rats has a role in improvement of plasma lipids, vascular reactivity& body weight.
Aqueous green tea,Lipid profile,vascular reactivity,Hypercholesterolemic albino rats
https://ejhm.journals.ekb.eg/article_123477.html
https://ejhm.journals.ekb.eg/article_123477_a36dfa1631cc290b2fd6e18ad6935444.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
5
2020
10
01
Purine Nucleoside Phosphorylase (PNP) Deficiency: A Case Report
1967
1969
EN
Rawia
Albar
rawia992002@gmail.com
Alaa
Alesa
alaa.alesa@gmail.com
Dina
Saqa
dr.dina.ts@hotmail.com
Jamanah
Abdulaziz
jumana.abdulaziz@hotmail.com
Mohammad
Batouk
mbatouk92@gmail.com
Abdullah
Alesa
10.21608/ejhm.2020.123480
Background: Purine nucleoside phosphorylase (PNP) deficiency is a rare genetic disease that results in combined immunodeficiency. Its inheritance is autosomal recessive and affects the purine metabolic pathway. There is a profound effect on T-cells and variable B-cell dysfunction. There is a strong association with neurological dysfunction in as many as two thirds of cases and autoimmunity in one third. When PNP activity is absent or greatly diminished, deoxyguanosine triphosphate (dGTP) is believed to accumulate in the mitochondria, which inhibits ribonucleotide reductase and mitochondrial DNA repair. This is very harmful to T lymphocytes and leads to DNA damage and apoptosis during thymus selection. Case: A toddler girl diagnosed with PNP) deficiency that is currently being managed using different type of modalities with good response. Results: The patient was admitted in an outside hospital when she developed fever for 4 days along with a perianal abscess. Septic shock was suspected, and she was initially started on gentamycin and tazocin then switched to vancomycin, mereponem and metrodinazole. After resolution of fever, the patient was transferred to our tertiary care center to undergo immunology work up. Upon finally receiving the patient she was stable and afebrile, however there was severe neutropenia and leukopenia. A multidisciplinary team, which included general pediatrics, hematology, Infectious diseases and immunology, handled her case. Furthermore, the patient was switched back to tazocin and gentamycin and completed 14 days with good response and full resolution of fever. Following the multidisciplinary team plan, an immunology/hematology work up was initiated. Conclusion: After 14 days of treatment, there was a good response and resolution of fever. Then, a multidisciplinary team plan, an immunology/hematology work up was initiated.
PNP,immune deficiency,immunity,Pediatrics
https://ejhm.journals.ekb.eg/article_123480.html
https://ejhm.journals.ekb.eg/article_123480_d567b0dc4dbf01256c082f1c17d36ab2.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
5
2020
10
01
Anandamide Level in Men with Oligoasthenoteratozoospermia
1970
1976
EN
Moustafa A
El Taieb
Abdallah Mahmoud A
Ali
Mona H
Sedeek
Aya AA
Hussein
10.21608/ejhm.2020.123482
Background: Male infertility is a relatively common medical condition. Male partners are found to be solely responsible for 20–30% of infertility cases. Oligoasthenoteratozoospermia (OAT) is the most common laboratory finding in infertile men. Endocannabinoids are endogenously produced substances, that primarily act at cannabinoid receptors (CBRs), thus reproducing some of the biological actions of the natural cannabis sativa components (the “cannabinoids”). The endocannabinoid system is involved in several physiological processes, including fertility and body weight control. Objective: The aim of this study was to detect the level of anandamide (AEA) in patients with OAT and its relation to BMI. Patients and methods: This study was a case control study. It was hold between June 2018 to April 2019 in the Dermatology, Venereology and Andrology Department at Aswan University Hospital. The study included 20 patients with OAT and 9 as controls. Semen analysis using CASA was done. AEA level in seminal plasma was measured using ELISA kits. BMI was calculated. Results: AEA level in seminal plasma significantly decreased in men with ligoasthenoterat- ozoospermia than control (P < 0.009). AEA concentration on seminal fluid was significantly increased with an increase in BMI (P= 0.023). On the other hand, a significant negative relationship was present between BMI and semen volume (P= 0.03). Conclusion: AEA concentration in seminal plasma was significantly decreased in patients with OAT. AEA concentration in seminal fluid was significantly increased with an increase in BMI. On the other hand, a significant negative relationship was present between BMI and semen volume.
Anadamide,Oligoasthenoteratozoospermia,BMI
https://ejhm.journals.ekb.eg/article_123482.html
https://ejhm.journals.ekb.eg/article_123482_692e092d5db692b3e4a93b0ab666d6a7.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
5
2020
10
01
Femoral Cartilage Thickness and Vitamin D Level in Systemic Sclerosis Patients and Relation to Disease Severity
1977
1984
EN
Mohammed Abd El Monem
Teama
Internal Medicine Department, Division of Rheumatology and Immunology, Faculty of Medicine,
Ain Shams University, Cairo, Egypt
mohteama2009@yahoo.com
Hanan Mohamed
Farouk
Internal Medicine Department, Division of Rheumatology and Immunology, Faculty of Medicine,
Ain Shams University, Cairo, Egypt
Safaa A.
Hussein
Internal Medicine Department, Division of Rheumatology and Immunology, Faculty of Medicine,
Ain Shams University, Cairo, Egypt
Fatma Mohammed
Badr
Internal Medicine Department, Division of Rheumatology and Immunology, Faculty of Medicine,
Ain Shams University, Cairo, Egypt
10.21608/ejhm.2020.123483
Background: Systemic sclerosis (SSc) is a heterogeneous autoimmune disorder associated with vascular dysfunction and fibrotic changes. Low vitamin D levels and decreased femoral cartilage thickness (FCT) have been observed in SSc. Objectives: This study aimed to evaluate the relation between serum level of vitamin D and FCT among SSc patients and to correlate both with clinical features and disease severity score. Patients and Methods: This study included 40 SSc patients, divided into 2 groups; group 1: sufficient vitamin D (level > 30 ng/ml), group 2: insufficient vitamin D (level < 30 ng/ml). All patients were subjected to history taking, clinical examination, and assessment of disease severity by Medsger Disease Severity Index (MDSI), laboratory investigations, 25 (OH) vitamin D level and musculoskeletal ultrasound of both knees to assess FCT. Three midpoint measurements of FCT were taken from each knee: lateral femoral condyle (LFC), femoral intercondylar area (ICA) and medial femoral condyle (MFC). Results: Thin FCT was found in 60% of patients. There was insufficient vitamin D level in 65% of patients. Age was negatively correlated with FCT at right MFC area and female parity was also negatively correlated with right ICA and MFC areas. FCT was significantly lower in group 1 at areas of left MFC and LFC areas, but no relation between femoral cartilage thickness and vitamin D level with disease severity. Conclusion: There is significant relation between femoral cartilage thickness and vitamin D level in scleroderma patients, both decline in SSc patients but not related to disease severity score.
Scleroderma,Vitamin D,Femoral cartilage thickness,Disease severity score,Musculoskeletal ultrasound
https://ejhm.journals.ekb.eg/article_123483.html
https://ejhm.journals.ekb.eg/article_123483_5f22a772c2427ff37528e8e25390755b.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
5
2020
10
01
Factors Affecting Employment in Maintenance Hemodialysis Patients in Egypt
1985
1992
EN
Magdy
El-Sharkawy
Department of Internal Medicine and Nephrology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Yahya
Makkeyah
Department of Internal Medicine and Nephrology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Doaa
Elwasly
Department of Internal Medicine and Nephrology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
dr.dodoelwalsy@hotmail.com
10.21608/ejhm.2020.123484
Background: Most of hemodialysis patients are unemployed and the few who are working are at risk of losing their jobs. Therefore, factors affecting employment need to be studied. Objective: Our aim was to access factors affecting employment among working-age patients on hemodialysis all over Egypt as it was not assessed before. Patients and Methods: This study was conducted between October 2012 and April 2015 in multiple hemodialysis centers by direct interview of the patients and collecting the data from the medical record in a special data collection sheet. Results: The study was conducted on 16280 hemodialysis patients in 19 Egyptian governorates. 21.2% of the patients were employed, 81.6% of the employed patients were men, and their mean age was 47.25+11.31. Hypertension was the most common etiology of end-stage renal disease (ESRD) and was the commonest comorbidity in employed patients. Employment was affected by age, gender, ESRD etiology and most comorbid conditions apart from comorbid chronic liver disease and chronic obstructive pulmonary disease. Factors affecting employment was dialysis frequency, duration, complications, dialyzer type, material, and surface area, dialysate type, dialysate Na, K and vascular access, haemoglobin (Hb) level, Ca/PO4 ratio, parathormone (PTH), iron injection, blood transfusion, erythropoietin intake, vitamin B complex intake, L carnitine intake, phosphate binders, cinacalcet and folic acid intake while Kt/v and urea reduction ratio and vitamin D supplements did not affect employment. Conclusion: Similar to the other studies we found that employment was not common among hemodialysis patients, which was affected by age, gender, ESRD etiology and comorbidities apart from chronic obstructive pulmonary disease (COPD) and chronic liver disease (CLD) which differed from other studies.
Employment,ESRD,Hemodialysis,Hypertension
https://ejhm.journals.ekb.eg/article_123484.html
https://ejhm.journals.ekb.eg/article_123484_e945c7cf254b5d05db018fc6b820780e.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
5
2020
10
01
Serum Golgi Protein 73 as a Biomarker for Liver Fibrosis in Chronic Hepatitis C Patients
1993
2000
EN
Hala A
Abdel-Azeez
Department of Clinical Pathology, Faculty of Medicine, Zagazig University
Samar M
Sharaf
Department of Clinical Pathology, Faculty of Medicine, Zagazig University
Eman A
Elshamy
Department of Tropical Medicine, Faculty of Medicine, Zagazig University
Abeer A
Fikry
Department of Clinical Pathology, Faculty of Medicine, Zagazig University
abfikry@gmail.com
10.21608/ejhm.2020.124772
Background: Serum Golgi protein 73 (GP73) is a promising biomarker of liver fibrosis, but most data are from hepatitis B virus-related liver diseases rather than hepatitis C virus (HCV). Objective: To evaluate the use of GP73 as a marker for liver fibrosis in chronic HCV patients and to correlate it with fibrosis staging of liver biopsy and other laboratory findings. Subjects and Methods: The study included 37 chronic HCV patients who were subdivided according to liver biopsy results into chronic HCV patients without fibrosis (10) and chronic HCV patients with fibrosis (27). 37 healthy individuals were taken as control. All participants were subjected to determination of liver function tests with calculation of AST-to-Platelet Ratio Index (APRI) and serum GP73 by ELISA. Results: GP73 was significantly increased in chronic HCV patients with fibrosis when compared to patients without fibrosis and healthy control. A significant positive correlation was observed between GP73 and advanced liver function tests, increased fibrosis stage and APRI in chronic HCV patients with fibrosis. Based on receiver operating characteristic (ROC) curve analysis, GP73 had an area under curve (AUC) of 0.909 with 81.8% sensitivity and 93.3% specificity for prediction of significant fibrosis. On combination with APRI, the sensitivity was increased to 90.9%. Conclusion: GP73 can be used as serum marker for prediction of significant liver fibrosis in chronic HCV patients either alone or in combination with APRI. It can be also useful in monitoring fibrosis progression.
hepatitis C,Golgi protein 73,APRI,Liver fibrosis
https://ejhm.journals.ekb.eg/article_124772.html
https://ejhm.journals.ekb.eg/article_124772_0dd1991dd9158048c227719a9a47c97d.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
5
2020
10
01
Clinical Outcomes of Upper Gastrointestinal Bleeding in Egyptian Patients with Decompensated Liver Cirrhosis, Does the Bleeding Source Matter?
2001
2005
EN
Mohamed S
Mohamed
Internal Medicine Department, Faculty of Medicine, Zagazig University
Mohamed G
Hamed
Internal Medicine Department, Faculty of Medicine, Zagazig University
Amr S
Hanafy
Internal Medicine Department, Faculty of Medicine, Zagazig University
Mohamed AA
Bassiony
Internal Medicine Department, Faculty of Medicine, Zagazig University
dr_mbh13303@yahoo.com
10.21608/ejhm.2020.124774
Background: Upper gastrointestinal bleeding (UGIB) is a prevalent emergency and mortality cause in cirrhotic patients. It prolongs the hospital length of stay (LOS) and increases hospital readmission. Objectives: We investigated the clinical outcomes of acute variceal bleeding (AVB) and non-variceal bleeding (NVB) in patients with decompensated cirrhosis and the possible risk factors for prolonged hospital LOS. Patients and Methods: All patients with decompensated liver cirrhosis and UGIB (AVB & NVB) hospitalized from August 2018 to March 2019 were enrolled in this study. We assessed mortality rate, the hospital LOS and hospital readmission rate along with the probable risk factors associated with prolonged hospital LOS. Results: Our study included 582 patients with decompensated liver cirrhosis, 367 patients had AVB and 215 patients had NVB. There was no significant difference in mortality rate between both groups (11.4% vs. 9.3%, P= 0.43). The hospital LOS in AVB patients was longer than that in NVB group (5.8 ± 2.2 vs. 4.3 ± 1.8, p=0.001). Rate of hospital re-admission within 30 days was significantly higher in the AVB group (27%) compared to NVB group (18%). Inhospital re-bleeding and the need for repeated endoscopy were also higher in AVB patients (20%) than in NVB patients (12%). Risk factors for prolonged hospital LOS were development of hepatic encephalopathy, spontaneous bacterial peritonitis (SBP), in-hospital re-bleeding, Child C score and higher Model for end-stage liver disease (MELD) score. Conclusion: Patients with decompensated cirrhosis and AVB have longer hospital LOS and re-hospitalization rate than those with NVB with no significant difference in mortality rate between both groups.
Decompensated cirrhosis,variceal bleeding,Non-variceal bleeding,Peptic ulcer,length of hospital stay,In-hospital re-bleeding
https://ejhm.journals.ekb.eg/article_124774.html
https://ejhm.journals.ekb.eg/article_124774_b2f96cc10885e2206ef1139567906aec.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
5
2020
10
01
Immunohistochemical Nucleocytoplasmic Localization of Light Chain3 in the Keratinocytes of Psoriatic Skin
2006
2011
EN
Rehab Monir
Samaka
Department of Pathology, Faculty of Medicine, Menoufia University, Menoufia, Egypt
Alaa Hasan
Marae
Department of Dermatology, Andrology & STDs, Faculty of Medicine,
Menoufia University, Menoufia, Egypt
Manar Ali
Faried
Dermatologists, Menoufia Governorate, Egypt
manarfaried@yahoo.com
10.21608/ejhm.2020.124780
Background: Light chain3 is a sensitive autophagy-related protein distributed within the mammalian tissues. The role of LC3 localization in psoriasis pathogenesis is still poorly understood. Objective: This study aimed to investigate, for the first time up to our knowledge, the localization of Light chain3 (LC3) in the keratinocytes of psoriatic skin by immunohistochemical study. Materials and methods: This prospective case case-control study was carried out on 30 patients presented with chronic plaque psoriasis versus 30 age and gender-matched apparently healthy volunteers. Clinical data were collected and Psoriasis Area and Severity Index (PASI) was assessed. From all controls and cases (lesional and perilesional), skin biopsies were taken and the epidermis was assessed for histopathological changes and LC3 immunoreaction. Results: There was a highly significant difference (P<0.001) between the control skin and psoriatic skin (lesional and perilesional) regarding the epidermal LC3 localization. Nucleocytoplasmic LC3 localization was dominant in lesional skin specimens. Conclusion: Nucleocytoplasmic localization of LC3 in the keratinocytes of the psoriatic skin might play a pivotal role in psoriasis pathogenesis. This can open a new gate for target therapy in psoriasis.
Psoriasis,autophagy,LC3,Immunohistochemistry
https://ejhm.journals.ekb.eg/article_124780.html
https://ejhm.journals.ekb.eg/article_124780_203525c16f18dc33d0bcf00ae2384f16.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
5
2020
10
01
Outcome of Direct Acting Antiviral Drugs (DAADs) for Hepatitis C Virus (HCV) in the Setting of Chronic Kidney Disease (CKD) in Upper Egypt
2012
2015
EN
Iman Ibrahim
Sarhan
Department of Nephrology, Faculty of Medicine-Ain Shams University
Mohamed Mostafa
Ali
Department of Nephrology, Faculty of Medicine-Ain Shams University
Ahmed Abd Elmonem
Hassan
Department of Nephrology, Faculty of Medicine-Ain Shams University
Mostafa Abd Elnasier
Abd Elgawad
Department of Nephrology, Faculty of Medicine-Ain Shams University
mostafaabdelnasier@gmail.com
10.21608/ejhm.2020.124783
Background: The frequency of hepatitis C virus (HCV) infection remains high in patients with CKD and plays a detrimental role in mortality in this population, and patients undergoing maintenance dialysis are still at risk of developing HCV infection and HCV disease prevalence of anti-hepatitis C virus (HCV) patients who undergo longterm dialysis are significantly greater than those with normal kidney function. Objectives: The aim of the study was to assess outcomes (efficacy, side effects, and possible complications) of DAADs for HCV in presence of CKD. Subjects and methods: this was retrospective cohort study that was conducted at Aswan Fever Hospital and Luxor Fever Hospital for anti HCV therapy between Jan 2018 and July 2018 including 60 patients recruited from both hospitals with all stages of CKD and were receiving DAADs. Results: the results revealed that PC (%) in patients from Aswan ranged between 61-100 with mean ±S.D. 83.09±9.258 while in patients from Luxor it ranged between 66-100 with mean ±S.D. 84.95±6.764. There was no statistically significant difference between groups (P=0.458). HCV PCR in all patients from Aswan at baseline were positive while after 3 months 27 (90%) were negative and 3 (10%) were positive and after 6 months all patients were negative while in patients from Luxor they all were positive while after 3 months 28 (93.3%) were negative and 2 (6.7%) were positive and after 6 months all patients were negative. There was no statistically significant difference between groups. Conclusion: Treatment with newer DAAs is effective and safe for the treatment of HCV-infected chronic kidney disease patients.
DAAs,kidney,Treatment,CKD,HCV
https://ejhm.journals.ekb.eg/article_124783.html
https://ejhm.journals.ekb.eg/article_124783_51ca657614003cee72de8ef54dcae348.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
5
2020
10
01
Assessment of Right Liver Lobe Size / Serum Albumin Ratio as a New Non-Invasive Predictor for the Presence of Oesophageal Varices in Egyptian Patients with HCV Related Liver Cirrhosis
2016
2025
EN
Emad Ahmad
Awad
Department of Internal Medicine, Gastroenterology and Hepatology, Faculty of Medicine,
Ain Shams University, Cairo, Egypt
Wael Ahmed
Yousry
Department of Internal Medicine, Gastroenterology and Hepatology, Faculty of Medicine,
Ain Shams University, Cairo, Egypt
Hasan Mokhtar
Hasan
Department of Internal Medicine, Gastroenterology and Hepatology, Faculty of Medicine,
Ain Shams University, Cairo, Egypt
Ahmed Mohamed
ElGhandour
Department of Internal Medicine, Gastroenterology and Hepatology, Faculty of Medicine,
Ain Shams University, Cairo, Egypt
ghandour80@hotmail.com
10.21608/ejhm.2020.124793
<span>Background: </span><span>Oesophageal varices are the most critical porto-systemic shunts that develop secondary to portal hypertension, which is considered the main complication of liver cirrhosis. Many studies recommend the screening of all cirrhotic patients by endoscopy, but repeated endoscopic examinations are unpleasant for patients and have a high- cost impact and burden on endoscopic units. </span><span>Objective: </span><span>This study aimed to evaluate the accuracy of using the right liver lobe size/serum albumin ratio as a non-invasive predictor of esophageal varices in patients with HCV-related liver cirrhosis. </span><span>Patients Methods: </span><span>This prospective study included 30 patients with liver cirrhosis and 30 patients who underwent upper gastrointestinal endoscopy for any causes other than liver cirrhosis. All studied subjects underwent a detailed history and clinical examination, biochemical workup, upper gastrointestinal endoscopy, and abdominal ultrasound. The right liver lobe/serum albumin ratio was calculated for all patients.<br /> </span><span>Results: </span><span>There was a statistically significant difference between the control and the study subgroups as regards the Right lobe of the Liver/Albumin ratio (p-value 0.007). The diagnostic accuracy of the Right lobe of the Liver/Albumin ratio was assessed using the ROC curve which revealed a sensitivity of 86.67% and specificity of 73.33% at cut-off value >3.88, with an acceptable discriminative accuracy of 79.9%.<br /> </span><span>Conclusion: </span><span>The use of Right liver lobe/serum albumin ratio can help physicians by restricting the use of endoscopic screening only to patients presenting a high probability of esophageal varices. This is especially useful in clinical settings where resources are limited, and endoscopic facilities are not present in all areas.<br /> </span>
Non-invasive diagnosis of oesophageal varices,Right liver lobe size/serum albumin ratio,Oesophageal varices,HCV
https://ejhm.journals.ekb.eg/article_124793.html
https://ejhm.journals.ekb.eg/article_124793_66d2d64dfb3af307ea4fbf67cf254fad.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
5
2020
10
01
The Stress Hormone Copeptin as a Prognostic Biomarker in Acute Illness
2026
2029
EN
Raef Malak
Botros
Department of Internal Medicine & Endocrinology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Maram Mohamed
Maher
Department of Internal Medicine & Endocrinology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Rahma Khaled
El Shaer
Department of Internal Medicine & Endocrinology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Hanan Mahmoud
Ali
Department of Internal Medicine & Endocrinology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
hanan.mahmoud29@yahoo.com
10.21608/ejhm.2020.124798
<span>Background: </span>
<span>Copeptin has been evaluated as biomarker for several illnesses such as cerebrovascular stroke, heart </span>failure, showing a promising role mainly as a prognostic biomarker. Copeptin levels seem to be strongly related to short, mid, and long-term mortality in patients admitted to hospital showing that copeptin could be a valuable prognostic tool in the most frequent disease entities.
<span>Objective: </span><span>The aim of the current study was </span><span>t</span><span>o study the level of copeptin as a prognostic biomarker in acute illness. </span>
<span>Patients and Methods: </span>This study included a total of 64 patients with acute deterioration of their chronic illness as chronic liver diseases (most of them were child C on Child-Pugh score), COPD (admitted with infective exacerbation), cerebrovascular stroke and Decompensate heart failure and 20 controls, attending at emergency room, Ain Shames University Hospital.
<span>Results: </span><span>Serum copeptin levels have positive correlation with longer duration of hospitalization, the higher the copeptin level the more length of hospital stay (r= 0.264</span><span>* </span><span>p= 0.035). There was highly statistically significant difference between copeptin level and survival rate, </span><span>copeptin concentrations were significantly higher in non- survivors than in survivors </span><span>(p=0.000).The mean of copeptin level among patient who died was 500 ) pmol/L with range of 70 to 750 pmol/L, while the mean of copeptin level among survivors was 60 pmol/L with range of 20-600 pmol/L.<br /> </span><span>Conclusion: </span><span>It could be concluded that copeptin has a role in prognosis of mortality and morbidity of hospitalized patients and high copeptin level significantly associated with a longer hospital stay and a poor outcome of hospital admission.<br /> </span>
Copeptin,Acute illness,Prognostic biomarker
https://ejhm.journals.ekb.eg/article_124798.html
https://ejhm.journals.ekb.eg/article_124798_de65e10fad5a3806a74cb8e8dad9161a.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
5
2020
10
01
Vitamin D Levels in Full-Term Neonates with Indirect Hyperbilirubinemia
2030
2035
EN
Neveen T.
Abed
Department of Pediatrics, Faculty of Medicine, Benha University, Egypt
Farida F.
Negm
Department of Pediatrics, Faculty of Medicine, Benha University, Egypt
Enas S.
Ahmad
Department of Clinical and Chemical Pathology, Faculty of Medicine, Benha University, Egypt
Heba A.
Mohammed
Department of Pediatrics, Faculty of Medicine, Benha University, Egypt
heba.anwar.soliman@gmail.com
10.21608/ejhm.2020.124800
<span>Background: </span><span>Jaundice is a common clinical sign in neonatal medicine. Considering the different roles of vitamin D, its lower level may be correlated with neonatal jaundice. </span><span>Objectives: </span><span>This study aimed to demonstrate the relationship between serum vitamin D level and neonatal hyperbilirubinemia and to measure its level in their mothers. </span><span>Subjects and methods: </span><span>This case-control study was conducted on 90 neonates and their mothers, 60 neonates with hyperbilirubinemia in patients group and 30 healthy neonates age and sex matched in control group < /span><span>. </span><span>Blood samples from neonates and their mothers were obtained and sent for laboratory estimation of 25-hydroxy vitamin D, calcium, magnesium, phosphorus, alkaline phosphatase and parathyroid hormone. </span><span>Results: </span><span>There is highly significant decrease of vitamin D levels among patients than controls, significant negative correlation between vitamin D levels and serum bilirubin in neonates and no significant difference regarding different laboratory parameters among their mothers. </span><span>Conclusion: </span><span>Decreased levels of vitamin D were significantly correlated with neonatal indirect hyperbilirubinemia so, low vitamin D can be included among risk factors for neonatal jaundice.<br /> </span>
Jaundice,Mothers,Neonatal,Vitamin D
https://ejhm.journals.ekb.eg/article_124800.html
https://ejhm.journals.ekb.eg/article_124800_8df31c618ea46ac1573410228c4a5172.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
5
2020
10
01
Short-Term Results of Patient Specific Instruments (PSI) – Total Knee Replacement (TKR)
2036
2045
EN
Mohamed Mosa Mohamed
Mahmoud
Department of Orthopaedic and Trauma Surgery, Faculty of Medicine, Al Azhar University, Assiut Branch
drmohamedmosa@yahoo.com
Amr Abdelhalem
Amr
Department of Orthopaedic and Trauma Surgery, Faculty of Medicine, Al Azhar University, Assiut Branch
MA
Hafez
Department of Orthopaedic and Trauma Surgery, Faculty of Medicine, 6 October University
10.21608/ejhm.2020.124803
<span>Background: </span><span>TKR is an effective treatment for severely arthritic knees. PSI TKR is a recent technique, which relies on preoperative formulation of specific instruments for every patient preoperatively, aiming at decreasing surgical time and instruments and increasing accuracy and functional outcome. </span><span>Objective: </span><span>Assessment of functional and radiological outcome of PSI TKR after a period of 3 years duration. </span><span>Patients and Methods: </span><span>40 TKRs in 24 patients were done using CT-based PSI technique. Pre-and postoperative knee society score (KSS) were measured and digital long-leg X-rays were obtained for all patients. Hip-knee-ankle, proximal tibia land lateral distal femoral angles together with mechanical axis deviation were measured for all patients to assess the mechanical axis alignment after TKR. </span><span>Results: </span><span>HKA (hip knee ankle) has decreased from 4.70 varus preoperatively to 1.27 varus. The mean knee society score had markedly increased from 31.2 preoperatively to 85.3 with fair to excellent KSS was 95% after 3 years duration. </span><span>Conclusion: </span><span>PSI TKR is an effective technique in knee replacement as conventional method. With the advantages of reduction of the operative steps and concurrent potential complications.<br /> </span>
PSI,TKR
https://ejhm.journals.ekb.eg/article_124803.html
https://ejhm.journals.ekb.eg/article_124803_65e7faeb5b01b37a268309ce16a216c7.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
5
2020
10
01
Changes in Fetal and Uteroplacental Doppler Waveforms After Antenatal Dexamethasone Administration in Women at Risk of Spontaneous Preterm Birth
2046
2053
EN
Mohamed Elsibai
Anter
Obstetrics and Gynecology Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
mohamedsibai681@yahoo.com
Ayman Abd Elkader
Shabana
Obstetrics and Gynecology Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
Sally Mohamed Ali
Badr
Obstetrics and gynecology department, El-Bagour general Hospital, Menoufia, Egypt
Nehad Mahmoud
Hoseny
Obstetrics and Gynecology Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
10.21608/ejhm.2020.124872
<span>Background: </span><span>Early detection of fetal risk is one of the main issues in today's obstetrics. Ultrasound diagnosis plays a significant role, as the introduction of the Doppler imaging method in the evaluation of blood flow has enabled non- invasive assessment of uteroplacental circulation.<br /> </span><span>Objective: </span><span>To assess the impact of maternal dexamethasone on doppler waveforms velocity flow of the fetal umbilical and middle cerebral arteries and maternal uterine arteries in pregnant women at risk of preterm labor with normal fetal vascular resistance. </span>
<span>Patients and methods: </span><span>This cross-sectional study was conducted at the Department of Obstetrics and Gynecology at Menoufia University hospital on 36 patients who were diagnosed as having threatened preterm birth. All the patients were enrolled in the study with routine follow up according to local protocols in the period between January 2019 and November 2019. Full history taking, full general, obstetric examination, and Ultrasound examination was performed. </span>
<span>Results: </span><span>After dexamethasone administration, Umbilical A resistive and Pulsatility indexes were significantly decreased to (1.084 ± 0.118 and 0.66 ± 0.054) in comparison to before dexamethasone (1.121±0.124 and 0.70±0.058). Regarding the Uterine Doppler values, mean Pulsatility index before dexamethasone was 0.79±0.049 (right) and 0.78 ±0.038 (left) decreased significantly to 0.78±0.044 (right) and 0.77±0.036 (left) after dexamethasone. Similarly, the mean Resistive index before dexamethasone was 0.55±0.027 (right) and 0.54±0.026 (left) decreased significantly to 0.53±0.023 (for right and left) after dexamethasone. </span>
<span>Conclusions: </span><span>dexamethasone administration for the pregnant mothers at risk of preterm labor enhance the flow of blood to the fetal umbilical, middle cerebral arteries and maternal uterine arteries 24 hrs. after its administration.<br /> </span>
antenatal,dexamethasone,Doppler waveforms,Fetal Health,preterm birth,Uteroplacental
https://ejhm.journals.ekb.eg/article_124872.html
https://ejhm.journals.ekb.eg/article_124872_09efc6423df77135943829bc41b19892.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
5
2020
10
01
Physiotherapy is A New Line in Management of Chronic Pelvic Inflammatory Diseases
2054
2056
EN
Dalia Ibrahim
Morsi
Department of Obstetrics and Gynecology, Faculty of Medicine, Menoufia University, Egypt
Ahmed Mohammed
Nofal
Department of Obstetrics and Gynecology, Faculty of Medicine, Menoufia University, Egypt
nofal3030@gmail.com
10.21608/ejhm.2020.124873
<span>Background: </span><span>Pelvic inflammatory disease (PID) is an inflammatory condition of the upper female genital tract. Chronic PID include both residue of acute and subacute attack of infection. Generally shortwave diathermy (SWD) is used to decrease pain and edema, thus improves the inflammatory reaction and accelerates the healing of the chronically inflamed tissues. </span><span>Objective: </span><span>To evaluate the therapeutic efficacy of shortwave diathermy in the management of chronic PID. </span><span>Materials and methods: </span><span>80 patients with chronic PID for more than 6 months diagnosed by thorough history, clinical examination and cervical swabs. Patients were divided into two groups: First group (group 1): patients received both medical treatment and shortwave diathermy. Second group (group 2): patients received only medical treatment. </span><span>Results </span><span>There was a statistically highly significant improvement of clinical and laboratory manifestations in the first group of patients compared to the baseline and compared to the second group.<br /> </span><span>Conclusion </span><span>shortwave diathermy has a fair therapeutic efficacy in the treatment of chronic PID.<br /> </span>
Pain,Pelvic Inflammatory Disease,Shortwave Diathermy
https://ejhm.journals.ekb.eg/article_124873.html
https://ejhm.journals.ekb.eg/article_124873_a547e22e2e9bcc59fcc4b7cc8575eff7.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
5
2020
10
01
Incidence of Atrial Fibrillation in Hemodialysis Patients
2057
2062
EN
Mohamed El-Tayeb
Nasser
Department of Nephrology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Adham Ahmed
Abdel Tawab
Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Raafat Boshra
Mehany
Department of Nephrology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
raffatboshra2010@yahoo.com
Mostafa Abd El-Nassier
Abd El-Gawad
Department of Nephrology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
10.21608/ejhm.2020.126399
Background: Chronic kidney disease patients usually experience several comorbid conditions including cardiovascular disorders and at final end-stage renal disease (ESRD) stage, cardiovascular mortality accounts for about 50% of total mortality. End-stage renal disease (ESRD) patients commonly have a higher risk of developing cardiovascular diseases than general population. Objective: The aim of the work was to detect the incidence of atrial fibrillation (AF) in hemodialysis patients for six months. Patients and Methods: The study was a prospective cohort study for six months included 250 adult patients with end stage renal diseases on regular hemodialysis sessions in National Institute of Urology and Nephrology in Cairo, Egypt for at least six months with no past history suggestive of any arrhythmias and normal holter ECG at the start of the study. Results: The study included 250 patients, of them 37 patients refuse follow up after 6 months and 18 patients were died before our follow up holter ECG so mortality rate 14.4%. For the current study population, there were 102 male patients (52.3%) and 93 female patients (47.7%) with mean age 54.39 ± 9.98 (19:73) and BMI 29.01±1.28 (24.5:34). In study population 96 patients were diabetic (49.2%), 84 patients were hypertensive (43.1%), 100 patients were with ischemic heart diseases (51.3%) with median renal replacement duration 4 (3 – 6) with range (1 – 13). The main etiological causes of dialysis were diabetes mellitus, hypertension and analgesic nephropathy and other different causes of dialysis 35 patients (45%).The study showed association between incidence of AF in hemodialysis patients and different factors as increased BMI (0.006), prolonged duration of renal replacement therapy (0.017), diabetes mellitus (0.005), hypertension (0.000), ischemic heart diseases (0.02) and left atrium dilation (0.000). Conclusion: It could be concluded that the incidence of AF in patients with ESRD is 16.4% .The risk factors for increased incidence of AF in hemodialysis are; increased BMI, increased duration of renal replacement therapy, hypertension, diabetes mellitus, ischemic heart diseases and left atrium dilation by echocardiography.
Chronic Kidney Disease,End-stage renal disease,Arrhythmias,Atrial Fibrillation
https://ejhm.journals.ekb.eg/article_126399.html
https://ejhm.journals.ekb.eg/article_126399_f8825f38b5bb5e5b1d8dfee0087c65e1.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
5
2020
10
01
The Effect of Adding Kinesio Tape to Mulligan's Mobilization in Patients with A Cervicogenic Headache
2063
2068
EN
Lamyaa Ahmed
Neyazi
Department of Physical Therapy, International Institute of Cancer, Cairo University
dr.lamya3@gmail.com
Nadia Abdelzim
Fayaz
Department of
Physical Therapy for Musculoskeletal Disorders and its Surgeries, Faculty of Physical Therapy, Cairo
University
Samah Saad Almoogy
Zahran
Department of
Physical Therapy for Musculoskeletal Disorders and its Surgeries, Faculty of Physical Therapy, Cairo
University
Ahmed Hamdi
Azzam
Department of Orthopedic Surgeries, Faculty of Medicine, Cairo University, Egypt
10.21608/ejhm.2020.126400
Background: Cervicogenic headache is a major problem in many people suffering from upper cervical dysfunction with a great conflict in its physical therapy management. Objective: The aim of the work was to determine the effect of Adding Kinesio Tape To Mulligan's Mobilization in patients with a cervicogenic headache. Patients and methods: Fifty four patients with cervicogenic headache included in the study; from outpatient clinic, Faculty of physical therapy, Cairo University Hospital (Kasr El Ainy), were randomly assigned into two equal groups ; group A (Kinesiotaping and mulligan techniques), Group B (mulligan techniques). Their mean ± SD age, weight, height and BMI were 37.74±5.55 years, 80.62±6.27 kg, 170.11±5.5 cm and 27.48±2.73 kg/m² respectively. The visual analogue scale (VAS) is used for measuring intensity of cervicogenic headache. Frequency and duration of cervicogenic headache are collected from subjective data of patients. Correlations between the examined parameters were also measured. Kinesiotaping application with mulligan SNAGs were companied in group A and mulligan SNAGs done only in group B. Results: There was significant improvement of VAS outcome scores and frequency and duration of cervicogenic headache in Group (A) more than Group (B). Conclusion: It could be concluded that adding kinesio tape to mulligan's mobilization in patients with a cervicogenic headache is found to be an effective in treatment of cervicogenic headache.
Cervicogenic headache,Kinesiotaping,SNAGs
https://ejhm.journals.ekb.eg/article_126400.html
https://ejhm.journals.ekb.eg/article_126400_321571e2ba4d3c7eea0496a627310d4e.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
5
2020
10
01
A Case Report of Cesarean Scar Site Endometriosis: Diagnosis and Management
2069
2070
EN
Medhat Monir K
Fadel
Department of Reproductive Health and Family Planning, National Research Institute
medhat.fadel@nhs.net
Mariam Sherif S
Zaki
Department of
Occupational and Environmental health, Benha University, Qalyubia, Egypt
10.21608/ejhm.2020.126403
Endometriosis is a frequent clinical problem in women of reproductive age, which means the presence and proliferation of endometrial glands and stroma outside the uterus, the most common site of endometriosis is in the pelvic cavity, extra pelvic endometriosis as on the surgical scar (as caesarean section, laparoscopic incision, episiotomy, and hysterectomy scars) which is relatively rare, it is clinically presented by chronic pelvic pain, dysmenorrhea, dyspareunia, subfertility, infertility, and poor both maternal & fetal outcomes and even stillbirth. Caesarean section endometriosis is presented with cyclic pain and bleeding from the scar site. Our 33- year case presented with a scar site endometriosis after the third Cesarean section. MRI was done to exclude uterine fistula and a definite diagnosis has been made by histopathology. Management involved different modalities of treatment including medical management, Mirena coil insertion. However, the definite treatment was surgical excision of the endometriotic lesion and reclosure of the skin incision.
Endometriosis,Caesarean section,scar,Management
https://ejhm.journals.ekb.eg/article_126403.html
https://ejhm.journals.ekb.eg/article_126403_20ab222c3fd5654219f8e7403e2d520c.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
5
2020
10
01
Assessment of Serum (YKL-40) As an Early Diagnostic Marker of Diabetic Nephropathy in Patients with Type 2 Diabetes Mellitus
2071
2077
EN
Mohamad Ahmed
Shaaban
Mohamad Abd El-raoof
Korany
Rania Mohamad Azmy
El-Shazly
Mohammad Ali Nasr
Ibrahem
Kfr Elshiekh Liver Centre, Kfr Elshiekh-Egypt.
drmohamed183@gmail.com
10.21608/ejhm.2020.126404
Background: YKL-40 is an inflammatory marker, a positive association between elevated circulating YKL-40 levels and increasing levels of albuminuria, which have been described in patients with type 1 and type 2 diabetes indicating a role of YKL-40 in the progressing vascular damage resulting in microvascular disease. Objectives: To assess serum YKL-40 as an early diagnostic marker of diabetic nephropathy in type 2 diabetes mellitus. Patients and Methods: 70 patients with type 2 diabetes mellitus (46 males and 24 females) were included in this study, another 19 healthy volunteers (12 males and 7 females) were chosen as a control group (group I). Patients were further classified according to their Albumin/creatinine ratio into three groups: group II; Diabetic normoalbuminuric, group III; Diabetic microalbuminuric and group IV; Diabetic macroalbuminuric. All subjects (patients and controls) participating in the study were subjected to full history and clinical examination and routine laboratory investigations and also specific laboratory investigations include glycated hemoglobin (HbA1c), urine creatinine, microalbumin, albumin creatinine ratio, and serum YKL 40. Results: The present study showed that serum YKL-40 significantly increased in diabetic patients than in the control group. In addition, there was a significant increase of YKL-40 in the macroalbuminuric group compared to the normoalbuminuric group and microalbuminuric group and a significant increase of YKL-40 in a microalbuminuric group compared to the normoalbuminuric group. Conclusion: The serum levels of YKL-40 in type 2 DM were significantly higher than in normal patients, and its level increased with increasing urinary albumin excretion rate.
Albumin/Creatinine Ratio,albuminuria,Diabetes mellitus,diabetic nephropathy,YKL-40
https://ejhm.journals.ekb.eg/article_126404.html
https://ejhm.journals.ekb.eg/article_126404_5c4d07fc068c28e80e24c2dc1b988bf7.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
5
2020
10
01
Mirabegrone versus Solifenacine in Treatment of Overactive Bladder in Female Patients in Zagazig University Hospitals
2078
2083
EN
Abd Allah Mohammed
Salem
Department of Urology, Faculty of Medicine - Sert University, Libya
Osama Mostafa
Kamhawy
Department of Urology, Faculty of Medicine – Zagazig University, Egypt
Emad Abd Elhamid
Salem
Department of Urology, Faculty of Medicine – Zagazig University, Egypt
Ibrahim Ismail
Elsayed
Department of Urology, Faculty of Medicine – Zagazig University, Egypt
10.21608/ejhm.2020.126406
Background: Overactive bladder (OAB) syndrome, consisting of urgency, with or without urgency incontinence, often with frequency (voiding more than eight times in a 24- h period) and nocturia (need to wake up one or more times per night for urination), is a highly prevalent disorder with a significant impact on quality of life (QoL). Objective: To evaluate the safety and efficacy of mirabegron 50 mg in comparison to solifenacin 5 mg in the treatment of female patients suffering from overactive bladder symptoms. Patients and Methods: This prospective randomized study was conducted in Zagazig University Hospitals during the period From November 2018 to April 2019. Thirty consecutive female patients aged from 18 to 65 years old were included in this study. Results: Mirabegrone significantly was associated with hypertension only in one case, and Solifenacine significantly was associated with blurred vision, constipation and dry mouth. Comparison between mirabegron and solifenacin group according to day and night frequency, urge and urge incontinence pretreatment showed that there was no significant difference between both groups. Comparison between mirabegron and solifenacin groups according to day and night frequency, urge and urge incontinence after taking mirabegrone or solifenacin showed that mirabegron group was significantly lower as regards day and night frequency also in urgency and urgency incontinence post treatment. Conclusions: Solifenacin and mirabegron were effective in improving over active bladder symptoms. Mirabegron showed greater tolerability with fewer patients discontinuing therapy because of side effects. mirabegron can be considered as the drug with the better balance between efficacy and tolerability in the treatment of OAB.
Mirabegrone versus Solifenacine,Overactive bladder (OAB),Urgency incontinence
https://ejhm.journals.ekb.eg/article_126406.html
https://ejhm.journals.ekb.eg/article_126406_d65aa2d5cb747ace88e9e65049f1d914.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
5
2020
10
01
Study of The Effect of Nutrition and Glycemic Control and on IGF-1 and Growth in Pre-pubertal Egyptian Children with T1DM
2084
2087
EN
Raef Malak
Botros
Aliaa Ahmed Abdo
El-Sherbeeny
Nancy Samir
El Barbary
Ala Muhammed
Muhammed
Hanan Mahmoud
Ali
hanan.mahmoud29@yahoo.com
10.21608/ejhm.2020.126407
Background: Pre-Pubertal children who have T1DM are shorter than their non-diabetic peers. Objective: In the current study we aimed to evaluate the role of HbA1c and IGF-1 in these cases. Patients and Methods: The present study was a cross-sectional study conducted on 80 pre-pubertal Egyptian children: 30 males, 30 females with T1DM and 20 age-matched controls (10 males and 10 females), the participants were recruited from the Outpatient Clinic of the Pediatric Department of Ain Shams University Hospitals and the National Institute of Diabetes and Endocrinology in Cairo, Egypt during the period from July 2018 to January 2019. Results: The height and weight percentiles were found to be lower in type 1 diabetic children when compared to the controls with median values of 14.50 (IQR 27.98) in male patients, 17.95 (IQR 29.18) in female patients, and 87 (IQR 20.58) in the controls. A negative correlation between serum IGF-1 and HbA1c as well as the height and weight percentiles were found with (P = 0.014, 0.009, and 0.05 respectively). Serum IGF-1 levels were also found to be significantly lower in patients (P <0.001) with a mean value of (77.60 ± 69.377) in male patients and (64.0 ± 29.402) in female patients and (201.0 ± 102.798) in the controls. HbA1c was also found to be negatively correlated with height percentile (P = 0.012). Conclusion: The glycemic control tested by HbA1c is an important indicator of linear growth in pre-pubertal children, Height, and weight percentiles were found to be lower in type 1 diabetic patients when compared to the healthy controls (P < 0.001) in both cases.
T1DM,IGF-1,Growth
https://ejhm.journals.ekb.eg/article_126407.html
https://ejhm.journals.ekb.eg/article_126407_f882889981e64205e692a1dea7b1225c.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
5
2020
10
01
Optical Biometry Versus Ultrasound Biometry
2088
2092
EN
Abd Elkhalek I.
Elsaadani
Department of Ophthalmology, Faculty of Medicine Menoufia University, Menoufia, Egypt
Nermeen M.
Badawi
Department of Ophthalmology, Faculty of Medicine Menoufia University, Menoufia, Egypt
Asmaa Z.A.
Elterawy
Department of Ophthalmology, Faculty of Medicine Menoufia University, Menoufia, Egypt
asmaazakaria987@gmail.com
10.21608/ejhm.2020.126408
Background: Implantation of an intraocular lens (IOL) is the gold standard in modern-day cataract surgery. Over the last decade, IOL power calculations have become a focal point of cataract surgery. Objective: To compare the sensitivity and specification of optical biometry and applanation ultrasound biometry in the measurement of intraocular lens. Patient and methods: This prospective cohort study was done on 100 eyes from one hundred patients undergoing phacoemulsification with primary intraocular lens implantation. and scheduled for cataract surgery in the Ophthalmology Department of Menoufia University Hospitals and El-Mahalla Ophthalmology Hospital. Fifty eyes of patients were measured by ultrasound measurement (by A-Scan, Group 1) and the other 50 eyes by optical biometry (by IOL Master, Group 2). Result: in Group 1There were 22 eyes of 22males (44%), and 28 eyes of 28 females (56%) with a mean age was 58.4 ±10.13years. While, in Group 2, there were 16 eyes of 16 males (32%), and 34 eyes of thirty-fourth females (68%) and the mean age of the patients in this group was 61.2±9.25 years. The mean IOL of the patient in Group I was (18.86±2.57) with minimum IOL power (16.29) and maximum IOL power (21.43). Whereas, the mean IOL potent ion of the patient in group II was (20.5±1.98) with minimum IOL power (18.52) and maximum IOL power (+22.48). Conclusion: We can conclude that IOL measurements performed by using the Zeiss IOL Master, using partial coherence interferometry, resulted that a significantly better IOL power forecast and therefore the refractive result in cataract surgery than Applanation US biometry.
Optical biometry,Ultrasound biometry,Intraocular lens
https://ejhm.journals.ekb.eg/article_126408.html
https://ejhm.journals.ekb.eg/article_126408_6e4b29fcb7133aa6e4ccd946f7e2826c.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
5
2020
10
01
Relationship between Hepatic Artery Resistive Index and Liver Fibrosis Score in Non-Alcoholic Fatty Liver Disease Patient
2093
2098
EN
Ashraf Mohammed Mohammed
Alkabeer
Tarek Mohamed Mohamed
Mansour
Mohammed Atef Mohammed
Abd El Kader
Mohammed Mahmoud
Abd El Naser
10.21608/ejhm.2020.126410
Background: Nonalcoholic fatty liver disease (NAFLD) is one of the most important precursors of chronic liver disease all over the world. Doppler ultrasonography is an essential part of evaluating the vascular haemodynamic variation seen within NAFLD. Objective: Assessment of the role of Hepatic Artery Resistive Index (HARI) in NAFLD patient and the relation between HARI and grading of fatty liver by ultrasound. Patients and methods: One hundred Egyptian patients diagnosed to have NAFLD based on ultrasound abdomen 35, 35, and 30 patients in grade1, grade 2, and grade3 NAFLD, respectively and 20 healthy subjects as control group were subjected to hepatic artery Doppler study. The study was carried out in the Outpatient Clinic of Internal Medicine Department, Faculty of Medicine, Al-Azhar University, Assiut, Egypt. Results: Our study results showed high statistical significant difference (p-value < 0.001) between studied groups as regards hepatic artery resistance index. There was an inverse relationship between HARI and different grades of fatty liver in patients (p < 0.001). Hepatic artery resistance index (RI) decreased as the severity of diffuse fatty infiltration increases. Conclusion: Hepatic artery resistance index (RI) decreases as the severity of diffuse fatty infiltration increases.
Hepatic artery resistive index,Non-alcoholic fatty liver disease,NAFLD fibrosis score
https://ejhm.journals.ekb.eg/article_126410.html
https://ejhm.journals.ekb.eg/article_126410_59db9cc8a2a8ca88fc94e8cb9dc3d7bb.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
81
5
2020
10
01
Study of The Podocalyxin as An Early Marker for Diabetic Nephropathy and Its Correlation with Stages of Diabetic Nephropathy in A Sample of Egyptian Patients with T2DM
2099
2102
EN
Salah El-Din Ahmed
Shelbaya
Department of Internal Medicine and Endocrinology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Rana Hashem
Ibrahim
Department of Internal Medicine and Endocrinology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Nourhan Safwat
Sawirs
Department of Internal Medicine and Endocrinology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Hanan Mahmoud
Ali
Department of Internal Medicine and Endocrinology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
hanan.mahmoud29@yahoo.com
10.21608/ejhm.2020.127000
<span>Background: </span><span>Nephropathy is a major complication of diabetes, and is the main cause of end-stage kidney disease. Early recognition of nephropathy in diabetic patients is critical because it creates an opportunity to prevent the occurrence of diabetic nephropathy and/or even slow down the process of end-stage kidney disease attributable to diabetes. Human cells; podocytes (pods) have been shown to be functionally and structurally affected in the natural history of diabetic nephropathy.<br /> </span><span>Objective: </span><span>Study of the podocalyxin as an early marker for diabetic nephropathy and its correlation with stages of diabetic nephropathy in a sample of Egyptian patients with type 2 diabetes mellitus (T2DM).<br /> </span><span>Patients and Methods</span><span>:This study was a cross sectional study conducted on 80 subjects divided into four groups: Group 1: 20 diabetic patients with normalbuminuria. Group 2: 20 diabetic patients with nephropathy and microalbuminuria stages. Group 3: 20 diabetic patients with nephropathy and macroalbuminuria stages, Group 4:20 apparently healthy volunteers were included as a control group.<br /> </span><span>Results: </span><span>Urinary podocalyxin (PCX) was significantly higher in patients group compared to control group. Urinary PCX was significantly higher in macroalbuminuric group followed by microalbuminuric group then normoalbuminuric group. There was a positive significant correlation between urinary PCX and glycemic profile [Fasting blood sugar (FBS), 2hrPP, Glycosylated Hemoglobin (HbA1C)], serum creatinine and albumin creatinine ratio (ACR).<br /> </span><span>Conclusion: </span><span>Urinary podocalyxin is a beneficial as an early marker for early stages of diabetic nephropathy in type 2 DM patients.<br /> </span>
diabetic nephropathy,Podocalyxin,T2DM
https://ejhm.journals.ekb.eg/article_127000.html
https://ejhm.journals.ekb.eg/article_127000_50026e2bfca655f553d5eead73890ee0.pdf