Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
73
4
2018
10
01
Pattern and frequencies of patients with abdominal trauma admitted to ICU of tertiary care center (southern region, Saudi Arabia)
6382
6384
EN
Ali
Albshabshe
Department of Internal Medicine, College of Medicine, King Khalid University (KKU)
albshabshe@yahoo.com
Fahad Abdullah Saeed
Al Jarad
Department of Internal Medicine, College of Medicine, King Khalid University (KKU)
Jubran Safar Mater
Al Shahrani
Department of Internal Medicine, College of Medicine, King Khalid University (KKU)
Salah Saeed al Jathnan
Al Qahtani
Department of Internal Medicine, College of Medicine, King Khalid University (KKU)
Saeed Mohammed Saeed
Alghamdi
Department of Internal Medicine, College of Medicine, King Khalid University (KKU)
Ali Ahmad Saeed
Alsaleem
Department of Internal Medicine, College of Medicine, King Khalid University (KKU)
Mohammed Saeed Abdullah
Alqahtani
Department of Internal Medicine, College of Medicine, King Khalid University (KKU)
10.21608/ejhm.2018.14403
<strong>Background: </strong>Traumatic injuries are a significant threat to public health worldwide, nowadays trauma has become the greatest reason of death particularly in the under developing countries. As per the Korean emergency medicine report, the ratio of trauma patients increased from 1.87% in 2007 to 2.71% in 2011. It remains a major public health problem in every country.
<strong>Methods</strong>: In a cross sectional retrospective study design, we reviewed randomly selected 200 poly trauma patient’s files during the period from June 2016 till May 2017.
<strong>Results: </strong>A total of 200 patient’s data were randomly retrieved, 162 (81%) were between age of 18-45 years of, 126 (63%) less than 30 years.184 (92 %) were males. 168 (84%) were motor vehicle accidents and the rest between gunshot, stab wounds and falls.
<strong>Conclusion:</strong>Abdominal trauma is common among young poly trauma patients and the commonest cause is the motor vehicle accidents. We need an urgent and effective intervention at regional and national level to drop and stop car accidents.
Trauma,accident,mortality
https://ejhm.journals.ekb.eg/article_14403.html
https://ejhm.journals.ekb.eg/article_14403_fc667283dcb4bc1f21e9e8f5676977f0.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
73
4
2018
10
01
Improvement of safe injection practices among nurses in Zagazig University Hospitals
6385
6391
EN
Ghada M.
Khalil
Public Health and Preventive Medicine, Faculty of Medicine, Zagazig University, Egypt
ghadamahmoud1@hotmail.com
10.21608/ejhm.2018.15088
<strong>Aim of the work: </strong>this study aimed to detect assessment of injection practice using WHO safe injection tool then implantation of education program and post intervention evaluation. <strong>Methods</strong>: this study was anon randomized intervention study performed in Zagazig University Hospitals and targeting nurses , 700 observation before and 700 observation after intervention starting by evaluation of injection practice using WHO safe injection tool then training on safe injection practice applied for nurse staff then post training evaluation of practice. <strong>Results: </strong>hand hygiene soap and alcohol rub was available in hospitals sitting in 80%,85% of observation and after intervention increased up to 95% and98% with a significant difference. Safety boxes were available for sharp disposal before intervention and become 100% available after intervention. Hospital supply 100% percent single use syringes for each patient, but the problem was for drug administration process due to deficient in cleaning of drug preparation area 88% of pre intervention observation, but practice improved to 98% after intervention with a significant difference; sharp disposal practice was improved after intervention up to 98% with significant difference. 67% of observation used non touch technique and changed to 95% after intervention with high significant difference .Vaccination coverage reached 100% after intervention and percent of nurses who received training on safe injection was 45% increased to 100% after intervention, also post needle stick injury counseling was 57% reached 100%after intervention. <strong>Conclusions: </strong>training and education of nursing staff on safe injection practice was crucial for improvement of safe injection practice and improved both staff and patient safety.
safe injection,needle stick,Hand hygiene,sharp disposal
https://ejhm.journals.ekb.eg/article_15088.html
https://ejhm.journals.ekb.eg/article_15088_a3552e8f153bfcaf187c2a1866e45c44.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
73
4
2018
10
01
Correlation Between Anti Mullerian Hormone Level and Antral Follicle Count Using Three-Dimensional Ultrasound in Cases of Recurrent Spontaneous Abortion
6392
6400
EN
Khaled Zakaria
El-Sheikha
Obstetrics & Gynecology Department, Faculty of Medicine,
Al-Azhar University, Cairo, Egypt
Abd El Monsef Abd Elhamid
Sedek
Obstetrics & Gynecology Department, Faculty of Medicine,
Al-Azhar University, Cairo, Egypt
Ibrahim Hassan
Mohammed
Biochemistry Department, Faculty of Medicine,
Al-Azhar University, Cairo, Egypt
Ahmed Mohamed Hussein
Hafez
Obstetrics & Gynecology Department, Faculty of Medicine,
Al-Azhar University, Cairo, Egypt
drahmedhussin8@gmail.com
10.21608/ejhm.2018.15089
<strong>Background: </strong>abortion is one of the most common complications of pregnancy, occurring in 10–15% of pregnant women, whiles recurrent spontaneous abortion, rate of 2–5%, is defined as ≥ 3 spontaneous abortions.<br /> <strong>Aim of the Work: </strong>was totry to find relationship between serum AMH concentration which represent ovarian reserve, Antral Follicular count and any pelvic Structural abnormality using 3D ultrasound in assessment cases with spontaneous recurrent abortion.<br /> <strong>Patients and Methods: </strong>A multicenter, randomized trial included 100 women who were divided into 2 groups; <em>Group 1</em>, included 50 patients with ≥ 3 recurrent abortions and <em>Group 2</em>, included 50 parous women with regular menstrual cycles and having one or more living child without any history of pregnancy loss or pelvic structural abnormality. Every subject was subjected to assessing hormonal profile including anti-müllerian hormone (AMH) and Transvaginal ultrasonography.<br /> <strong>Results: </strong>AMH was found to have negative correlation with age, number of abortions, FSH and LH.<br /> <strong>Conclusion: </strong>It could be concluded that Anti-Müllerian hormone is the best indicator of ovarian reserve with a high sensitivity and specificity<strong>, </strong>so ovarian reserve of women with recurrent spontaneous abortions is not defective.
Anti Mullerian Hormone Level,Antral Follicle Count,three-dimensional ultrasound,Recurrent spontaneous abortion
https://ejhm.journals.ekb.eg/article_15089.html
https://ejhm.journals.ekb.eg/article_15089_0dc0302beba9ddfd991deac1be834fa5.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
73
4
2018
10
01
Comparing non-operative management and surgical fixation in treatment of clavicle fractures
6401
6405
EN
Mohammad Abdallah Yahya
Alhakamy
Faculty of Medicine, Jazan University, Saudi Arabia
dr.research222@gmail.com
Ahmad Sameer Ahmad
Alrefaie
Faculty of Medicine, Jazan University, Saudi Arabia
Mahdi Ali Kariri
Alhassan
Faculty of Medicine, Jazan University, Saudi Arabia
Ali Mahdi Ali
Kariri
Faculty of Medicine, Jazan University, Saudi Arabia
Nedaa Sameer Abdo
Jelan
Faculty of Medicine, Jazan University, Saudi Arabia
Mohammed Bahkali Ali
Altherwi
Faculty of Medicine, Jazan University, Saudi Arabia
Alaa Ahmad Hassan
Allayl
Faculty of Medicine, Jazan University, Saudi Arabia
Asim Bishi Mohammed
Hakami
Faculty of Medicine, Jazan University, Saudi Arabia
Hiba Salah
Abdelgadir
Family Medicine, Public and Tropical Health Program, University of Medical Sciences and Technology, Khartoum, Sudan
10.21608/ejhm.2018.15091
<strong>Background: </strong>Clavicle fractures are common among males from sport injuries and the non-operative treatment has been indicated as treatment of choice. Recently, delayed healing, pain and shoulder weakness have reported as frequent complications of non-operative treatment and many studies found better outcomes with surgical treatment. This review aimed at evaluating evidence that compared non-operative treatment and surgical intervention in management of clavicle fractures to provide evidence-based data about the best modality of treatment aiming to improve patients’ outcome.<strong> Methods:</strong> A web-based search was achieved in MEDLINE resulted in 40 eligible studies. The reference lists of the articles and reviews were screened for relevant articles. After exclusion of irrelevant, duplicated and review studies, 7 studies were included in this review.<strong> Results:</strong> The outcome and success after surgical intervention compared to non-operative treatments was reported in all of the included studies. Most of the interventional studies found significant improvement in the surgical in treatment, while the majority of the non-operative group showed no improvement.<strong> Conclusions:</strong> The review of the evidence suggested that use of surgical fixation in treatment of clavicular fracture is superior to the non-operative treatment if there are no contraindications to the surgery.
clavicle,fracture,Management,surgical,Healing
https://ejhm.journals.ekb.eg/article_15091.html
https://ejhm.journals.ekb.eg/article_15091_7f19af6c64f0276f289d0da19b231f12.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
73
4
2018
10
01
Maternal behavior as a risk factor for growth and development retardation in infant and toddlers up to 18 months
6406
6411
EN
Ghada M.
Khalil
Public Health and Preventive Medicine, Faculty of Medicine, Zagazig University, Egypt
ghadamahmoud1@hotmail.com
Eman M.
Salama
Family Medicine, Ministry of Health
10.21608/ejhm.2018.15093
<strong>Background: </strong>early 18 months of life characterized by the most rapid growth and development and mainly affected by mother behavior and traits <strong>Objectives</strong>: to promote child development to improve the quality of life for our children in the future through assessment of child development in the first eighteen months of life, to identify factors affecting early childhood development. <strong>Subjects and </strong>M<strong>ethods</strong>: cross section study takes infant from birth to 18 month, attending Family Unit at Kafr Mohamed Ismail, Fakous, Sharkia governorate. Sample size 140 infant, using structured growth and development sheet and structured mother’s interview. <strong>Result: </strong>The study found that male children retardation were 13.2%and female children retardation were 15.3%, artificially feed children were 100% retarded , low social class children were 100% retarded, children of illiterate mother 100% were retarded , Breast feeding, rapid response to child needs when crying, stimulating activities during feeding the child and giving different types of toys are factors having good impact on child development with significant difference. <strong>Conclusion</strong>: Program for early detection of developmental delay through screening of children attending PHC and family medicine units are important to assess development risk factor and Maternal stimulation for promoting early child development through better attachment and communication with infants.
maternal behavior,growth retardation,infant,toddler,Development
https://ejhm.journals.ekb.eg/article_15093.html
https://ejhm.journals.ekb.eg/article_15093_1252757d0e343a276dd8e6cb489e6606.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
73
4
2018
10
01
Intravenous Thrombolysis with rt-PA in Patients with Acute Ischemic Stroke: Experience of Al-Azhar University Hospitals and Almaadi Military Hospital Stroke Units
6412
6416
EN
Nabil H
Mohamed
Departments of Neurology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Ahmed A
Nemr
Departments of Neurology, Military Medical Academy, Cairo, Egypt
Hussein A
Elghareeb
Departments of Neurology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Elsayed E
Abed
Departments of Neurology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
sayed_neuro@outlook.com
10.21608/ejhm.2018.15102
<strong>Background</strong>: Ischemic stroke <strong>(IS)</strong> is defined as a focal neurologic deficit of sudden onset and of presumed ischemic origin that lasts at least 24 hours and is not associated with hemorrhage on computed tomography <strong>(CT)</strong> or magnetic resonance imaging <strong>(MRI)</strong> of the brain. About 87% of strokes are <strong>ischemic</strong>, the rest being <strong>hemorrhagic</strong>. Bleeding can develop inside areas of ischemia, a condition known as "hemorrhagic transformation" <strong>(HT). </strong>Definitive therapy within the first few hours is aimed to removing the blockage by breaking the clot down (thrombolysis), or by removing it mechanically (thrombectomy). <strong>Aim of the Work</strong>: was to correlate the safety of recombinant tissue plasminogen activator <strong>(rt-PA)</strong> in acute ischemic stroke <strong>(AIS) </strong>patients in Egypt. <strong>Subjects and Methods</strong>: A number of case series of patients with <strong>AIS</strong> who were treated at Stroke Units of Al-Azhar University Hospitals and Almaadi Military Hospital over a period of <strong>1</strong>years within a time window were reported.<strong> Results</strong>: we observed a statistically significant correlation between <strong>AIS </strong>patients who were treated by thrombolysis in time window and vascular risk factors and many important infrastructure-logistic factors. <strong>Conclusions: </strong>It could be concluded that thrombolytic therapy is a good standard treatment in time window but many barriers in developing countries were found.
Ischemic stroke,Time Window,rt-PA
https://ejhm.journals.ekb.eg/article_15102.html
https://ejhm.journals.ekb.eg/article_15102_628a8678f8db188a78c86da8a44f7869.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
73
4
2018
10
01
Comparative Study between Drained and Drainless Sub-rectal Mesh Hernioplasty in Paraumbilical Hernia
6417
6422
EN
Raouf Mahmoud
Sallam
Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Ahmed Mohamed
El-sayed
Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Abdou Mahmoud
Abdou
Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
abdoumahmoud1986@gmail.com
10.21608/ejhm.2018.15103
<strong>Background: </strong>The evolution of para-umbilical hernia repair has a very long history, from the Recognition of para-umbilical hernias to its current management, with significant contributions from different authors. Advances in surgery have led to more cases of para-umbilical hernia formation, and this has required the development of new techniques and new materials for para-umbilical hernia management.<br /> <strong>Objectives:</strong> To compare between the results of drained and drainless sub-rectal mesh hernioplasty in paraumbilical hernia (PUH), to achieve the most accepted post-operative condition.<br /> <strong>Patient and methods: </strong>This comparative prospective study included a total of 50 patients with a follow up of 6-month time interval who were all complaining of an uncomplicated para-umbilical hernia and all are treated with the sub-lay repair technique with 25 patients with suction drain placement and 25 patients with no suction drain placement, attending at Al-Azhar University Hospitals.<br /> <strong>Results: </strong>Sub lay (sub-rectal) mesh repair is a good alternative to other traditional repairs, this study advocates this method of Para-umbilical hernia repair as it is applicable type of repair, the complication rate is low and there is a no recurrence rate or seroma formation and suction drain usage on hazardous patients are beneficial to avoid fluid accumulation or further complication to occur.<br /> <strong>Conclusion: </strong>Placing mesh in the sub-muscular or sublay position is claimed to be more challenging but not beyond the competence of a trained general surgeon. Placing mesh in this plane has mechanical and physiologic advantages. The sub-lay technique proves itself as one of the best surgical technique in management of para-umbilical hernia.
Sublay,retromuscular,submascular and mesh
https://ejhm.journals.ekb.eg/article_15103.html
https://ejhm.journals.ekb.eg/article_15103_2d7dfb0ec35f315f2e8103c93dc36c88.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
73
4
2018
10
01
Comparative Study between "Onlay" Versus "Retrorectus" Hernioplasty in Management of Uncomplicated Venteral Hernias
6423
6430
EN
Seif El-Deen Mahmoud
Alsoudany
Department of General Surgery, Faculty of Medicine, Al-Azhar University
Osama Osman Ali
Khalil
Department of General Surgery, Faculty of Medicine, Al-Azhar University
Ahmed Mohamad Abdel-Ghany
Shebl
Department of General Surgery, Faculty of Medicine, Al-Azhar University
sheblphone@gmail.com
10.21608/ejhm.2018.15105
<strong>Background: </strong>Hernias of the anterior abdominal wall, or ventral hernias have a various types that can be categorized into either congenital or acquired, also can be categorized according to various locations into primary ventral hernias (true ventral- non incisional hernias) which include two subtypes lateral ventral hernia, and midline ventral hernias. <strong>Objective: </strong>The aim of the study was to compare between two techniques of mesh placement in uncomplicated ventral hernias, onlay (mesh on external oblique) versus sublay (mesh in the retromuscular space), regarding the operative technique and the postoperative complications.<strong> Patients and Methods: </strong>In this study, a comparative study between two methods of surgical treatment for ventral hernia was made. The study included 40 adult patients with uncomplicated ventral hernia divided randomly into two groups according to the surgical technique used for the repair, without any specific criteria used in selection for any technique as follows<strong>:</strong> Group A (Onlay mesh repair): Twenty patients were operated by placing the mesh above the anterior rectus sheath and the external oblique muscle. Group B (Sublay “Reteromuscular” mesh repair): Twenty patients were operated by placing the mesh in the retro- muscular space. <strong>Results: </strong>In this study no significant difference found between both methods as regarding: Age and gender, type of ventral hernia. Duration of the operative procedure. Amount of intra-operative blood loss. Postoperative hospital stay. Hernia recurrence.<strong> Conclusion: </strong>Sublay (Retromuscular) mesh repair is a good alternative to onlay mesh repairs, this study advocates this method of ventral hernia repair as it is applicable to all sites of ventral hernia, the mesh is mostly hidden and anchored behind the rectus sheath, the complication rate is low and there is a low recurrence rate and finally We suggest carrying out more trials on the retromuscular mesh repair technique to include a bigger number of cases and a longer period of follow up.
Onlay,retrorectus,Laparoscopic ventral hernia repair
https://ejhm.journals.ekb.eg/article_15105.html
https://ejhm.journals.ekb.eg/article_15105_0238550e899681b3b7b349302d0b66dc.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
73
4
2018
10
01
The Influence of Fetal Head Circumference and Fetal Weight Measurement Assessed By Intrapartum Ultrasound on Labor Outcome
6431
6438
EN
Mohamed Taher
Ismail
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
Yousef
Abo-Shady
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
Hamdy Aly
Abd-El Fattah
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
hamdyaly.alex@yahoo.com
10.21608/ejhm.2018.15107
<strong>Background:</strong> labor is a clinical diagnosis characterized by regular, painful uterine contractions that increase in frequency and intensity is associated with progressive cervical effacement or dilatation. More specifically, it is associated with a change in the myometrial contractility pattern from irregular "contractures" (long-lasting, low-frequency activity) to regular "contractions" (high-intensity, high frequency activity).
<strong>Aim of the work:</strong> it was to determine if fetal head circumference and fetal weight could predict the rate of caesarian section and operative vaginal deliveries in nulliparous women in labor.
<strong>Patients and Methods:</strong> this study was carried out at Al Alamein Hospital from January 2017 to January 2018 on two hundred (200) primigravida women; their ages ranged from 20 to 30 years and the gestational ages ranged from 38-40 weeks with normal singleton pregnancy with cephalic presentation in labor.
<strong>Results: </strong>there were highly statistically significant relations between mode of delivery and fetal head circumference and estimated fetal weight as p value (0.001).it was found that large fetal head circumference relative to maternal pelvic diameter is the main cause of prolonged labor and therefor increased risk of primary caesarian section.
<strong>Conclusion:</strong> the numerical data have a significant relation between intra partum head circumference and fetal weight and the incidence of primary caesarian section, maternal and fetal complications.
<strong>Recommendations:</strong> according to numerical results obtained from this study. The study recommends strict labor monitoring by partogram in cases where fetal head circumference is more than 35cm or fetal weight is more than 3950gms.
Fetal Head Circumference,Fetal Weight,Intrapartum Ultrasound,labor outcome
https://ejhm.journals.ekb.eg/article_15107.html
https://ejhm.journals.ekb.eg/article_15107_d921a977cc6dee7e625e04a55e31d3b8.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
73
4
2018
10
01
Assessment and Management of Pain in the Intensive Care Unit
6439
6445
EN
Mohammad Ibrahim
Aljumah
Western Sydney University
Enass Farouk
Aboshoushah
King Abdulaziz University Hospital
Daniel
Coric
Nepean Hospital, NSW, Australia
Alaa Matuq
Alaithan
King Fahad Hospital Hofuf
Abdullah Abdulmohsen Abdullah
Almulhim
ER resident in King Fahad Hospital Hofuf
Naif Matar
AlOtaibi
Prince Sultan Military Medical City
Mazen Hassan Sadoun
Alaslani
GP of Comprehensive Clinics of Ministry of Interior-Riyadh
Fahad hussain
kammas
King Fahad General Hospital Jeddah
Ayat Salman
al saeed
Alfaisal University
Ali breek
alharthi
King Abdullah Hospital . Bisha city-ICU resident
10.21608/ejhm.2018.15108
<strong>Background: </strong>Management and assessment of pain in patients in critical care unit is a daily challenge for the health care professionals, particularly in the intubated patients, patients on mechanical ventilation, or patients who are on analgesia as such patients are unable to self-assess existence and intensity of pain. It is crucial for physicians to follow guidelines that help in pain assessment and management effectively.
<strong>Aim of the work: </strong>Our aim in this study was to study how to evaluate and manage pain in an intensive care unit patient, predominantly those patients who are unable to self- report or assess.
<strong>Materials and methods:</strong> We conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE, January 1994, through March 2017. The following search terms were used: pain in ICU, pain management in ICU, pain assessment methods, pain assessment in intubated patients.
<strong>Conclusion: </strong>Physical clues, which are given by comatose and intubated patients in critical care unit, should be taken in consideration, as they can be used as a method to identify existence of pain, and must be followed by effective management to decrease discomfort and prevent acute and chronic adverse effects.
Pain in ICU,Intensive care unit assessment of pain,ICU pain management,guidelines to pain management
https://ejhm.journals.ekb.eg/article_15108.html
https://ejhm.journals.ekb.eg/article_15108_8be3a78452cb653edaf9bdb35dadfaf6.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
73
4
2018
10
01
Outcome of delayed surgery in developmental hip dysplasia in a tertiary care setting
6446
6451
EN
Mohammad Khabti
Alnamshan
King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City
Ayman H.
Jawadi
King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City
Yazeed Adeeb
Alshoaibi
King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City
Afaf
Moukaddem
King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City
afaf_9@hotmail.com
10.21608/ejhm.2018.15109
<strong>Background</strong>: The delay in the detection of developmental dysplasia of the hip (DDH) can lead to incomplete hip stabilization and poor outcomes. This might also infer that the delay in DDH surgery can also be associated with unfavorable consequences. The purpose of this study was to compare the outcome of delayed versus early surgery on DDH patients with respect to clinical and radiological factors. <strong>Methods</strong>: This is a retrospective cohort study in which the charts of patients who underwent DDH surgery and whose age was less than 5 years at the date of referral to the orthopedic clinic, between 2008 and 2011 were reviewed. <strong>Results</strong>: This study included 62 patients, 34 of which presented with unilateral joint involvement and 28 affected bilaterally. Half of the patients underwent early surgeries ( Post-operatively the range of motion was significantly limited in the late surgery group (P=0.001). Limping gait was also significantly associated with late surgery (P=0.005).<br /> Radiological abnormalities of all the X-Ray findings didn’t reveal any statistically significant difference between early and delayed surgery except for the reduction in acetabular angle in the right hip post-op (P=0.04). <strong>Conclusion</strong>: Delayed DDH surgery can lead to a worse clinical outcome, physical disability and possible radiological effects on the patients. Poor outcome was significantly associated with the timing of the surgery. It is therefore recommended to perform DDH surgeries as early as possible to decrease the morbidity and prevent adverse clinical and radiological outcomes.
Developmental Dysplasia of the Hip,Surgery,Pediatrics
https://ejhm.journals.ekb.eg/article_15109.html
https://ejhm.journals.ekb.eg/article_15109_a55952f912c54e0c26a9de907c7577d0.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
73
4
2018
10
01
Imaging in blunt abdominal trauma; a review in current literature
6457
6462
EN
Mojahed Hadi Ali
Rudainee
Aseer Central Hospital
Tahani Saleh A.
Alsaery
Resident at KFAFH
Ghaida Wael
Khayat
Ibn Sina National College for Medical Studies
Majed mohammed fahed
Alharbi
Taibah University
Mazen Hassan Sadoun
Alaslani
Gp of Comprehensive clinics of minstory of interior-Riyadh
Sarah Mohammed
Mahrous
Taibah University
Muhammad
Al Ahmad
Oyun City Hospital
Yara Mofarih
Assiri
King khalid university
Arwa Musaad
Alsubhi
Taibah University
Nader Awad
Alanazi
Imam Muhammad Ibn Saud Islamic University
10.21608/ejhm.2018.15111
<strong>Introduction:</strong> The common imaging modalities used for the diagnosis of pelvic and abdominal trauma range from ultrasonography, X-ray, computed tomography, and others. In each different kind of abdominal condition, a different modality is preferred depending on the nature of condition, the patient, and the hospital facility where the management is provided. Some conditions require more than one source of imaging. <strong>Aim of the work: </strong>In this study, our aim was to discuss various abdominal and pelvic pathologies separately to explore the preferred type of imaging modality. <strong>Methodology: </strong>we conducted this review using a comprehensive search of MEDLINE, PubMed and EMBASE from January 1994 to March 2017. The following search terms were used: ultrasound versus CT, abdominal radiology, acute abdomen imaging, pelvic pain diagnosis. <strong>Conclusion:</strong> Blunt abdominal traumas are very common with many causes including motor vehicle accidents, bicycle accidents, and falls. Appropriate and early management of blunt abdominal trauma is essential to prevent the occurrence of significant long-term morbidities and high mortality rates. Due to non-specific clinical manifestation, establishing a proper diagnosis mainly depends on radiologic modalities.
abdominal trauma,Ultrasound,Computed tomography,Acute abdomen,gynecologic emergency,abdominal imaging
https://ejhm.journals.ekb.eg/article_15111.html
https://ejhm.journals.ekb.eg/article_15111_1cc981fbdbd3a4bbfed9accc1e7ba0a5.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
73
4
2018
10
01
Comparison between Trans-cerebellar Diameter, Bi-parietal Diameter and Femur Length for Gestational Age Measurement Accuracy in Third Trimester of Pregnancy
6463
6469
EN
Ahmed Taha
Abd El Fattah
Obstetrics and Gynecology Department, Faculty of Medicine, Al-Azhar University
Hazem Sayed
Shaban
Police Authority Hospital
Eman Ahmed Abdelsalam
Younis
Obstetrics and Gynecology Department, Faculty of Medicine, Al-Azhar University
10.21608/ejhm.2018.15112
<strong>Background: </strong>the provision of obstetric and neonatal care, as well as the public health monitoring of pregnancy outcomes, relies upon the accurate determination of gestational age. Uncertain gestational age has been associated with adverse pregnancy outcomes including low birth weight, preterm delivery and perinatal mortality, independent of maternal characteristics.
<strong>Aim of the Work: </strong>was fine out an accurate method for assessment of gestational age in third trimester of pregnancy comparing the Transcerebellar diameter, Biparietal diameter and femur length.
<strong>Patients and Methods: </strong>a total of 200 pregnant women in third trimester pregnancy were assessed in this prospective observational study held at Al-Hussein University Hospital and New Cairo Police Hospital using two-dimensional ultrasound technique during the period from January to June 2018 in order to assess an accurate method for assessment of gestational age in third trimester of pregnancy. Examinations were performed after a written consent received from the patients lying in the dorsal supine position. Two-dimensional ultrasound examination was carried out. Fetal biometry and amniotic fluid volume were assessed. These ultrasound parameters were done under the supervision of a certified gynecologist to exclude bias.
<strong>Results: </strong>the majority of the patients in our study belong to the age group 20 to 30 years (65%) with minimum of 15 years and maximum of 35 years. In our study, also 55 patients out of 200 were primigravida and 145 patients were multigravida. Our patients showed that the percentages of accurate assessment of gestational age within 3 days were as follow: Out of 200 patients, TCD gave accurate assessment within 3 days in 118 patients (59%), FL gave accurate assessment within 3 days in 92 patients (46%), while the BPD gave accurate assessment within 3 days in 59 patients (29.5%).
<strong>Conclusion: </strong>we concluded that TCD is the most accurate method for the assessment of gestational age in third trimester followed by FL, and the least accurate is the BPD. Also by combining accuracy of TCD (90%) and that of FL (80%).
Trans-cerebellar Diameter,Bi-parietal Diameter,femur length,Gestational age,Third Trimester
https://ejhm.journals.ekb.eg/article_15112.html
https://ejhm.journals.ekb.eg/article_15112_98c61c96f8024f2e568890013aeacb82.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
73
4
2018
10
01
Role of Serum Cystatin–C in Prediction of Acute Kidney Injury in Critical ILL Patients
6470
6480
EN
Mahmoud Maged
Hlemy
Anesthesia and Intensive Care,
Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Gamal Lotfy
Abd-Elrahman
Anesthesia and Intensive Care,
Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Salama Saad
Abd El-lateef
Clinical Pathology Departments,
Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Saeed Mostafa
Abd El-hameed
Anesthesia and Intensive Care,
Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Ahmed Shafek
Nabil
Anesthesia and Intensive Care,
Faculty of Medicine, Al-Azhar University, Cairo, Egypt
ahmedshafek123@gmail.com
10.21608/ejhm.2018.15113
<strong>Background: </strong>acute kidney injury (AKI) is a syndrome characterized by a rapid (hours to days) deterioration of kidney functions. It is often diagnosed in the context of other acute illnesses and is particularly common in critically ill patients. The clinical consequences of AKI include the accumulation of waste products, electrolytes, and fluid, but also less obvious effects, including reduced immunity and dysfunction of non-renal organs (organ cross-talk). <strong>Aim of the Work: was </strong>to assess the role of serum Cystatin C in early prediction of Acute Kidney Injury in critically ill patients. <strong>Patients and Methods: </strong>This a prospective cohort study included a total of 30 critically ill patients who suffered of Acute Kidney Injury and 30 subjects confined to the same age as control, attending at ICU, Al-Azhar University Hospitals. Blood samples were taken for estimation of serum cystatin C and serum creatinine at (2, 24, 48 and 72 hours). <strong>Results: </strong>showed that at day zero at 2 hours all patient showed normal kidney functions, and no one has acute kidney injury after 24 hours about 10 patient developed acute kidney injury according to KDIGO classification with a percentage of 33.3%. after 48 hours all 30 patients developed acute kidney injury according to KDIGO classification with a percentage of 100% and after 72 hours the patients state began to improve and only 28 patients have acute kidney injury with a percentage of 93.3% and level of serum creatinine started to decrease to all patients. This was due to treatment and interference to the patients. <strong>Conclusion: </strong>Cystatin C level is a valuable biomarker in prediction and early detection of acute kidney injury. Moreover, cystatin C level may be also used for prognosis of cases of acute kidney injury. Further a large-scale study may be needed to validate its predictive value.
Serum Cystatin–C,Acute kidney injury,Critical Ill Patients
https://ejhm.journals.ekb.eg/article_15113.html
https://ejhm.journals.ekb.eg/article_15113_ac99629b3bd4fc6bdfb19915cb8b47f2.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
73
4
2018
10
01
Comparative Study between Naloxone as an Additive to Lidocaine and Naloxone Infusion in Intravenous Regional Anaesthesia for Short Procedures of Upper Limb Surgeries
6481
6488
EN
Ali Abdalla Ali
Eissa
Department of Anesthesiology and Intensive Care,
Faculty of Medicine, Al-Azhar University
Alaa El-Din Mahmoud
Sayed
Department of Anesthesiology and Intensive Care,
Faculty of Medicine, Al-Azhar University
Mohammed Mohammed El-sayed Ameen
Hegab
Department of Anesthesiology and Intensive Care,
Faculty of Medicine, Al-Azhar University
dr.hegab1985@gmail.com
10.21608/ejhm.2018.15114
<strong>Background: </strong>intravenous regional anesthesia (IVRA) was first described by August Bier in 1908. IVRA is an anesthetic technique for surgical procedures on the body's extremities where a local anesthetic is injected intravenously. The local anesthetic diffuses from the peripheral vascular bed to nonvascular tissue such as axons and nerve endings.
<strong>Objective: </strong>The aim of the present study was to compare the effect of adding ultra-low dose of naloxone to lidocaine for IVRA and the effect of using intravenous naloxone infusion with IVRA for elective short procedures in the upper limb.
<strong>Patients and Methods:</strong> This is Prospective; randomized, controlled, multicenter, double blind study that done in Alazhar University hospitals. <strong> </strong>Each group contains 30 patients. The lidocaine in the study is 2% 3mg/kg in all groups. In all groups 0.9% NaCl is added to make up a total volume of 30 ml.
<strong>Results:</strong> The result of our study showed that local intravenous adjuvant naloxone (100 or 50ng) with lidocaine 1 % shortens the onset of blocks and prolongs the recovery from anesthesia. Moreover, it reduces the amount of opioids consumption and intraoperative pain score in patient undergoing short upper limb surgeries.
<strong>Conclusion: </strong>Naloxone IV infusion not improves the analgesic effect of intravenous anesthesia or prolongs the recovery from anesthesia. Regarding safety, adjuvant naloxone appears to be safe with no recorded side effects.
Lidocaine,naloxone,Intravenous regional anesthesia
https://ejhm.journals.ekb.eg/article_15114.html
https://ejhm.journals.ekb.eg/article_15114_e33efa6c84d3a6107f34ecab8390b7c3.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
73
4
2018
10
01
Knowledge, Attitude and Practice of Family Planning Methods among Husbands in a Village of Assiut Governorate
6489
6493
EN
Zeinab F.
Hamed
Department of Public Health and Community Medicine Faculty of Medicine, Assiut University, Assiut, Egypt
zainabfarag2016@gmail.com
Amira F.
EL-Gazzar
Department of Public Health and Community Medicine Faculty of Medicine, Assiut University, Assiut, Egypt
Farag M.
Moftah
Department of Public Health and Community Medicine Faculty of Medicine, Assiut University, Assiut, Egypt
10.21608/ejhm.2018.15115
<strong>Background:</strong> husbands usually are the decision makers about sexual activity, and the desired number of children. They often know very little about the health benefits of planning and spacing pregnancies. Without accurate information on the benefits and various methods of family planning (FP), they resist supporting FP use because of misinformation. <strong>Aim: </strong>it was to assess the knowledge, attitude and practice of family planning among husbands in El-Mansheah El-Kobra village, El-Qusiya District, Assiut Governorate. <strong>Subjects and Methods:</strong> a cross-sectional study was conducted in El-Mansheah El-Kobra village, from January to March 2017. A semi-structured questionnaire was used to collect data from husbands with wives in reproductive age group (15-49 years). <strong>Results: </strong>more than fourth (28.5%) of studied husbands have a good knowledge about FP and 54.9% of them have positive attitude towards FP. The contraceptive prevalence among studied husbands was disappointly low (16.2%), of that low percentage of the husbands 11.9% were currently users of male method. The level of husband involvement in FP in the current study was high (71.5%). <strong>Conclusion: </strong>some (28.5%) husbands have good knowledge about FP and 60% have positive attitude towards FP. The health team is the main source of information. The current use of FP methods is low. <strong>Recommendation: </strong>the study recommended that FP physicians should provide proper counseling and support to their male clients not only females; this will increases husband involvement in FP.
Family Planning,Husbands involvement,Egypt
https://ejhm.journals.ekb.eg/article_15115.html
https://ejhm.journals.ekb.eg/article_15115_80944613b446ceebca3d0a3afb48616d.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
73
4
2018
10
01
Peptic Ulcer Disease in Elderly Population of Arar City, Northern Saudi Arabia
6494
6501
EN
Mashael Jaza H
Alshammari
Faculty of Medicine, Northern Border University, KSA
Omar Mohamed Bakr
Ali
Faculty of Medicine, Sohag University, Egypt
Samar khaled
al-shamlani
Faculty of Medicine, Northern Border University, KSA
Shada Khaled
Bashantoof
Faculty of Medicine, Hail University
Zahra Ali
Qalib
Faculty of Medicine, Uclan University
Bashayr Zayed
Al-Amri
Faculty of Medicine, Al Jouf University
Nora Henaf Hia
Alrwely
Faculty of Medicine, Al Jouf University
Sulaiman Zayed S
Alamri
Faculty of Medicine, Al Jouf University
Abduljawad Salem S
Alharbi
Faculty of Medicine, King Abdulaziz University
Elham Hamid O
Alfallaj
Faculty of Medicine, Almaarefa University
10.21608/ejhm.2018.15116
<strong>Background: </strong>peptic ulcer disease (PUD) is a common disease of the digestive system. Peptic ulcer disease is a problem of the gastrointestinal tract characterized by mucosal damage secondary to pepsin and gastric acid secretion. It usually occurs in the stomach and proximal duodenum; less commonly, it occurs in the lower esophagus, the distal duodenum, or the jejunum. IT is a multifactorial health problem affecting almost all populations worldwide. The number of people who are ≥ 60 years old increased worldwide. The elderly population is susceptible to various benign and malignant diseases. Peptic ulcer is among the common health problems that affect the elderly. <strong>Aim of the study</strong>: this study aimed to determine the prevalence and risk factors of PUD in elderly population of Arar city, Northern Saudi Arabia. <strong>Subjects and methods:</strong> this was a cross sectional study and conducted in five randomly selected primary healthcare centers in Arar city (KSA), from September 2017 to March 2018. It included 217 elderly patients. A questionnaire was designed for data collection about socio-demographic variables, smoking, BMI, chronic diseases and physician diagnosed peptic ulcer among participants. <strong>Results:</strong> our findings showed that out of 217 of the studied elders, 55.3% were females and 21.2% were suffered from peptic ulcer. There were significant relations between peptic ulcer with gender, marital status, educational level and smoking status, while there was an insignificant relation between peptic ulcer with age group and BMI group. On the other hand, there were significant relations between peptic ulcer and musculoskeletal disorders, kidney diseases and insomnia. While, there was insignificant relations between peptic ulcer and cardiovascular diseases, ischemic heart diseases, hypertension, neurological disorders, diabetes mellitus and psychological disorders. <strong>Conclusion:</strong> among the elderly participants 21.2% were suffered from peptic ulcer. There was a significant relation between peptic ulcer with gender, smoking status, musculoskeletal disorders, kidney diseases and insomnia. While, there was insignificant relations between peptic ulcer with age group and BMI group.
Peptic ulcer,Smoking,Obesity,pattern,Elderly,Arar,Northern Saudi Arabia
https://ejhm.journals.ekb.eg/article_15116.html
https://ejhm.journals.ekb.eg/article_15116_0ae172c61f3b8efe84d446eb9891b238.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
73
4
2018
10
01
Laparoscopic versus Open Appendectomy in Adults
6502
6506
EN
Rohiya E.
Hejazi
Faculty of Medicine, Ibn Sina College
rohiya.hejazi@gmail.com
Rakan M.
Aljedaani
Faculty of Medicine, King Saud bin Abdulaziz University for Health Sciences
Mohammed A.
Alshehri
Faculty of Medicine, King Saud bin Abdulaziz University for Health Sciences
10.21608/ejhm.2018.15117
<strong>Background: </strong>Appendicitis is the most frequent surgical emergency. It affects people of all ages and gender. Methods to manage appendicitis are either medically by antibiotics and watchful waiting or surgery. The surgical approach includes laparoscopic and open appendectomy; neither surgical technique was proved to be the most efficient method to do an appendectomy. <strong>Objectives:</strong> comparison between laparoscopic appendectomy versus open appendectomy in regards to the complications, applicability, cost and hospital stay. <strong>Material and Methods:</strong> In this review, we used a comprehensive search of EMBASE, Pubmed, MEDLINE, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews from January 1, 1995, to July 17, 2018.
<strong>Conclusion: </strong>Open appendectomy is the preferred choice in case of a perforated appendix or severe inflammation. Laparoscopic appendectomy offers fewer complications, hospital stay and lesser time in the operation room.
Appendectomy,Laparoscopic,Technique,Appendicitis
https://ejhm.journals.ekb.eg/article_15117.html
https://ejhm.journals.ekb.eg/article_15117_bf20fcd02c1296ab28e3c608c1196c62.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
73
4
2018
10
01
Clinical Comparative study of the effect of preoperative pregabalin on reduction of the incidence of headache after spinal anesthesia in cesarean section
6507
6514
EN
Mohsen Mohamed
El –guoshy
Department of Anesthesiology and Intensive care, Faculty of Medicine Al- Azhar University
El-sayed Mostafa Mohamed Ali
Stohy
Department of Anesthesiology and Intensive care, Faculty of Medicine Al- Azhar University
Hossam-aldin Hussein Kamel
Sale
Department of Obstetrics and Gynaecology, Faculty of Medicine Al- Azhar University
Abdalwahab Abdelsatar
Saleh
Department of Anesthesiology and Intensive care, Faculty of Medicine Al- Azhar University
Mahmoud Mohamed Mohamed Abdallah
Seliem
Department of Anesthesiology and Intensive care, Faculty of Medicine Al- Azhar University
seliemmahmoud@gmail.com
10.21608/ejhm.2018.15392
<strong>Background:</strong> Post dural puncture headache (PDPH) is unpleasant complication following dural puncture. Incidence of PDPH following dural puncture range from 0.3% to 20% in spinal anesthesia. The incidence rate of PDPH is related to age, gender, needle size, pregnancy and previous history of PDPH.PDPH is characterized by severe, dull non throbbing pain aggravated by sitting or erect position, coughing, sneezing or straining and diminished in supine position. <strong>Objective:</strong> To evaluate the effect of preoperative administration of oral pregabalin (150 mg) before cesarean section on the incidence of post dural puncture headache, postoperative nausea and vomiting and postoperative shivering, motor block, time to rescue analgesia, time of two segment regression and Apgar score of baby at 1 and 5 minute.
<strong>Patients and Methods: </strong>A prospective randomized study that was done in Alazhar University Hospitals after approval of ethical committee, An informed consent was obtained from the patients.
<strong>Results:</strong> The incidence of post dural puncture headache, postoperative nausea and vomiting and postoperative shivering were significantly lower at pregabalin groups. Time to rescue analgesia and time of two segment regression were significantly longer at pregabalin groups. Patients at pregabalin groups reach modified Bromage motor scale grade <strong>3</strong> earlier than patients at groups without pregabalin.
<strong>Conclusion: </strong>Preoperative oral pregabalin 150 mg before cesarean section reduced the incidence of PDPH, postoperative nausea and vomiting and postoperative shivering, beside the earlier onset of motor block with increase duration of analgesia and time of two segment regression with no effect on baby.
Spinal anesthesia,preoperative pregabalin,headache
https://ejhm.journals.ekb.eg/article_15392.html
https://ejhm.journals.ekb.eg/article_15392_06502babe851ac37604930c4dcb80d82.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
73
4
2018
10
01
A Comparison between Oral Hypoglycemic Agents and Insulin in treating Gestational Diabetes Mellitus regarding their Safety and Efficacy
6515
6521
EN
Nadin Anam A
Mahabbat
King Saud Bin Abdulaziz University For Health Sciences
Jannah Abdulrahman
Alkinani
Ibn Sina National College
Hadeel Taha Yahya
Alsaadi
Ibn Sina National College
Ahdab Faisal
Nono
Ibn Sina National College
Sara Mutni
Almutairi
Al-Qassim University
Narjes Hassan
Alawami
Jordan University of Science and Technology
Shahad Abdullah
Almagboul
Umm Al-Qura University
Ammar Osama
Alaaddin
Umm Al-Qura University
Talha Kamal
Shagdar
King Abdulaziz University
Ziyad Abdullah
Mandura
King Abdulaziz University
10.21608/ejhm.2018.15396
<strong>Background: </strong>Gestational Diabetes Mellitus (GDM) is one of the most common comorbidities of pregnancy. It can cause a various complications for both mother, and fetus. Therefore, many studies have been done to evaluate different management measures.<strong> Objective</strong>: In this study, our objective was to assess the recent literatures regarding the comparison between oral hypoglycemic and insulin in treating GDM regarding the safety and the efficacy.<strong> Methods: </strong>PubMed database was used for articles selection, and the following keys used in the mesh ("Gestational Diabetes Mellitus/management"[Mesh] OR “Gestational Diabetes Mellitus /metformin"[Mesh] OR “Gestational Diabetes Mellitus /insulin"[Mesh]). A total of 99 articles were found, with further restriction by PubMed filters, and reviewing the articles titles and abstracts the final results were 7 articles.<strong> Conclusion</strong>: Oral hypoglycemic can be an effective and safe alternative treatment to insulin for women with GDM. There was no significant risk of maternal or neonatal adverse outcome with the use of metformin or glyburide. Treatment with metformin or glyburide was found to be equivalent for both women and newborns. However, metformin was found to be associated with a higher failure rate than glyburide in treating GDM.
Gestational diabetes mellitus,Oral hypoglycemic,Insulin,Safety and the efficacy
https://ejhm.journals.ekb.eg/article_15396.html
https://ejhm.journals.ekb.eg/article_15396_eaf75c59546428e3bcdc23555b524fdb.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
73
4
2018
10
01
Prevalence and some of determinant factors of chronic kidney diseases among Saudi elderly in Arar, KSA
6522
6530
EN
Ajaweed Saud Muharrab
Alruwaili
Faculty of Medicine, Northern Border University, KSA
Amjad Saud Mhrb
Alrowili
PhD clinical pharmacy, Northern Border University, KSA
Manal Nashi O
Alshammari
Faculty of Medicine, Northern Border University, KSA
Fahad Saad Salem
Alanazi
Faculty of Medicine, Northern Border University, KSA
Nouf Saad
Alanazi
Faculty of Medicine, Northern Border University, KSA
Mona Theyab
Alanazi
Faculty of Medicine, Northern Border University, KSA
Reem Abdullaha
Alanazi
Faculty of Applied Medical Scinse, Northern Border University, KSA
Mubark Saleh Mubark
Almarjan
Faculty of Medicine, Northern Border University, KSA
Mohammad Humood Meshref
Alenezi
Faculty of Medicine, Northern Border University, KSA
Mohammed Sulaiman
Aljamal
BPharm, MSc., PhD Clinical Pharmacy, University of Manchester
10.21608/ejhm.2018.15398
<strong>Background</strong>: Chronic kidney disease (CKD) is a global public health problem, affecting more than 10% of the world’s population and more than half of adults older than 70years. It is one of several conditions that are common in older people, such as hypertension, diabetes, and hyperlipidemia, and are associated with an increased risk of cardiovascular disease. The <strong>aim of this study</strong> was to determine the prevalence and some of determinant factors of chronic kidney diseases among Saudi elderly in Arar, KSA.<strong> Methods: </strong>The present cross sectional community based study was conducted in Arar city, the capital of Northern Borders Governorate on 276 participants, of age 60 years and more. Systematic random sampling technique was followed. Data was collected through personal interviews with the sampled population and filling the questionnaire which guided us to the data of socio-demographic characteristics such as age, sex, educational status and marital status, it also included smoking status and certain types of diseases that may be prevalent among elderly suggested affecting renal diseases such as hypertension, diabetes millets and obesity.<strong> Results: </strong>The majority of the participants was females (55.2%), had mean age (±SD) of 60 (±9.25) years, 6.5% had renal insufficiency, 5.8% diabetic nephropathy, 1.4% chronic kidney failures. Only 3.2% had both hypertension and kidney resection, 3.2% hypertension with diabetic nephropathy and 6.3% had hypertension and renal insufficiency, 13.7% had diabetes with diabetic nephropathy, 3.9% had diabetes with chronic kidney failure and 7.8% had both diabetes and renal insufficiency. 3.2% were obese and had kidney resection, 6.3% obese with diabetic nephropathy, and 3.2% obese with chronic kidney failure and 4.8% obese with renal insufficiency. <strong>Conclusion:</strong> Chronic kidney diseases are common in older people in Arar city, Northern Saudi Arabia. 6.5% had renal insufficiency, 5.8% had diabetic nephropathy, 1.4% had chronic kidney failures and 1.4% had Kidney resection. Large scale community based studies with detailed investigations are needed. Health education directed to elderly population and their care givers about renal diseases and its risk factors are mandatory.
prevalence,determinants,factors,chronic kidney diseases,Saudi elderly,Arar,KSA
https://ejhm.journals.ekb.eg/article_15398.html
https://ejhm.journals.ekb.eg/article_15398_66324708362dcb2cb5d466a2c3924cdf.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
73
4
2018
10
01
Assessment of knowledge and attitude and practice towards migraine prevention and treatment among general population in Saudi Arabia
6531
6534
EN
Osama Sulaiman
Alkhudhairi
Imam Muhammad Ibn Saud Islamic University
Ala Musa
Alghthy
Tabuk University
Wejdan Saddiq Mohammed
Hindi
Jazan University
Shatha Ibrahim Qassim
Alqassemi
Jazan University
10.21608/ejhm.2018.15401
<strong>Background<em>: </em></strong>migraine is considered as one of the most common chronic neurological disorder with a high prevalence among adults worldwide. <strong>Objective <em>:</em></strong> this study aimed to detect the knowledge and attitude and practice towards migraine prevention and treatment among general population in Kingdom of Saudi Arabia (KSA). <strong>Methods<em>:</em></strong> this was a descriptive cross sectional questionnaire study that was conducted at Saudi Arabia, from April to July 2018 among a random sample consisted of 600 adults in distributed in different parts of KSA. <strong>Results: </strong>the awareness level among the respondents was inadequate among most of the subjects regarding, the gender effect, the triggering factors of migraine and the prophylactic treatment.The attitude and the level of practice were also improper among most of the subjects as most of them don’t consider migraine as a disorder that needs consultant and the majority would take medication without consultation.
<strong>Conclusion: </strong>the KAP level regarding migraine prevention and treatment was in adequate among most of the included subjects however the majority of included subjects were highly educated.
Knowledge,Attitude,Practice,Migraine,prevention,Treatment,KSA
https://ejhm.journals.ekb.eg/article_15401.html
https://ejhm.journals.ekb.eg/article_15401_3baa77fe6f97e4a56f057099375c1e36.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
73
4
2018
10
01
Association of Diabetes Mellitus with ABO Blood Groups & Rh with
6535
6540
EN
Mohammed Abdullah A
Alanazi
Northern Border University
Mohammed Abdullah S
Alkhidhr
Northern Border University
Anwar Mohammed O
Alhadhari
Northern Border University
Amjad Waleed
Al-Hathloul
King Faisal University
Elaf Jameel
Alsharif
Ibn Sina National College
Sarah Fahad AlOwaywid
Albahli
Princess Nora University
Saud Abdullah Saud
Alshagraawi
Prince Sattam Bin Abdulaziz University
Fatimah Mohammed
AlJerani
Imam Abdulrahman Bin Faisal University
Ibrahim Saleh
Almesned
King Saud bin Abdulaziz University for Health Sciences
10.21608/ejhm.2018.15408
Studies have observed an association between ABO blood group and risk for obesity. <strong>Objective:</strong> to evaluate the prevalence of DM in various ABO and Rh blood group subjects, and to explore any association between ABO and Rh blood groups with DM. <strong>Methods:</strong> A cross-sectional study, conducted in Arar city, Northern Saudi Arabia. It included 312 participants from the general population of Northern Saudi Arabia. Data were collected by a pre-designed online questionnaire which was distributed among the population. It was self-administered, after a brief explanation of the idea of the research. The questionnaire included the clear questions to collect the relevant data. <strong>Results:</strong> the study included 532 participants, 318 (59.8%) were males and 119(22.4%) were suffering from diabetes mellitus. Surprisingly, more than half the cases were Type 1 diabetics (53.8%). The majority (38.7%) of the studied population had O blood group, 26.1% had B, and 23.5% had A, while AB were only observed in 11.8%. Around three-quarters (74.8%) were Rh positive and 23.5% were hypertensive. The results showed insignificant relations between ABO blood group with gender, DM and type of DM. There was a highly significant relation between DM and (Rh) blood group, while it showed insignificant relations between gender and type of DM with (Rh) blood group. <strong>Conclusion:</strong> The finding of the present study indicated that, in Arar city population, no evidence was found that particular ABO blood group was more susceptible to develop diabetes mellitus. While the study showed a highly significant relation between DM and (Rh) blood groups.
ABO blood group,Diabetes mellitus,Arar city,Rhesus factor (Rh),risk factor,association
https://ejhm.journals.ekb.eg/article_15408.html
https://ejhm.journals.ekb.eg/article_15408_4447646aa20edbbde217c840183e1b11.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
73
4
2018
10
01
Diagnosis of Minimal Hepatic Encephalopathy of Cirrhotic Patients Using a Combination of Neuropsychiatric and Neurophysiological Tests
6541
6554
EN
Assem Mahmoud
El-Sherif
Department of Internal Medicine, Faculty of Medicine, Al-Azhar University
assem@gmail.com
Fathy Ghamry
Abdelrazik
Department of Internal Medicine, Faculty of Medicine, Al-Azhar University
Ahmed Elwassief
Helal
Department of Internal Medicine, Faculty of Medicine, Al-Azhar University
Ahmed Essmet
Ali
Department of Neurology,Faculty of Medicine, Al-Azhar University
Mohamed Mahmoud
Abdelsayed
Department of Internal Medicine, Faculty of Medicine, Al-Azhar University
10.21608/ejhm.2018.15411
<strong>Background:</strong> Minimal Hepatic Encephalopathy (MHE) is characterized by mild cognitive impairment, attention deficits, psychomotor slowing and impaired vasomotor and bimanual coordination. These non-evident symptoms can be revealed with neuro psycho metric and neuro physiological testing.<strong> Aim: </strong>to validate a comprehensive set of neuropsychiatric test battery in addition to the neuro physiological tests in detecting MHE. <strong>Patients and Methods:</strong> Thirty patients with liver cirrhosis and no clinical evidence of HE were selected for this study. Patients underwent laboratory screening, Neuropsychiatric and Neuro physiological tests. <strong>Results: </strong>Impairment of at least one psychometric test was documented in 50% of patients, with 50% abnormal NCTA, 46.7% abnormal DST and 40% abnormal LTT. VEP records showed prolonged P100 in 46.7% of patients with 40% prolongation of P100 in the right eye and 46.7% in the left eye. EEG recording was abnormal in 43.3% patients and the recorded abnormalities included; slow theta waves in 33% of patients, slow delta waves 10%, and 56% had normal EEG.<strong> Conclusion:</strong> The incidence of MHE can vary according to the strategy of diagnosis and while strict dependence on neuropsychiatric tests can diagnose MHE in 50% of patients, adopting a more strict policy that incorporate neuro physiological tests can limit the diagnosis 40% of patients. There is moderate concordance between neuropsychiatric and neurophysiologic tests.
Cirrhosis of liver,psychometric tests,Electroencephalogram,visual evoked potential,Minimal hepatic encephalopathy
https://ejhm.journals.ekb.eg/article_15411.html
https://ejhm.journals.ekb.eg/article_15411_a177a00e52eca61e43a6bc9f8e69db30.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
73
4
2018
10
01
Total intravenous anaesthesia versus volatile induction and maintenance anaesthesia for controlled hypotension in lumbar spine fixation surgery: Comparative clinical study
6555
6561
EN
Mohammed
Mohammed Salah Eldin
Shamloul
Department of Anesthesiology and Intensive Care, Faculty of Medicine, Al-Azhar University
Ahmed Mohamed
Abd-Elgaleel
Department of Anesthesiology and Intensive Care, Faculty of Medicine, Al-Azhar University
Islam Essam
Hosseiny Ibrahim
Askar
Department of Anesthesiology and Intensive Care, Faculty of Medicine, Al-Azhar University
islamaskar94@gmail.com
10.21608/ejhm.2018.15416
<strong>Background: </strong>Controlled hypotension during general anesthesia aims to lower the mean arterial blood pressure (MAP)to values between 55 and 65 mmHg in patients with normal blood pressure, with the goal of significantly reducing blood loss by maintaining it at this level throughout the operation process. Controlled hypotension is frequently used for obtaining better exposure during spine surgery as small bleeding areas can produce better surgical field visibility and result in decreased time of surgery.<strong>Objective: </strong>This study was done to compare the efficacy and safety of TIVA and VIMA to induce hypotensive technique during spine surgery, with attention on the amount of blood loss, blood transfusion, hemodynamics, time of recovery and postoperative nausea and vomiting.<strong> Patients and Methods: </strong>This study included 40 patients of both sex, admitted for lumbar spine fixation surgery carried out at Al- Azhar University Hospitals (El-Hussein and Bab El-Sharia)<em>.</em> They were randomly allocated into two equal groups, 20 patients each (n= 20): Group I (TIVA); Total intravenous anaesthesia using (fentanyl and propofol). Group II (VIMA); Volatile induction and maintenance anesthesia (Inhalational anaesthesia) using (fentanyl and sevoflurane). <strong>Results: </strong>The following parameters were assessed between the 2 groups: Hemodynamics (HR, SBP, DBP and MAP), SPO<sub>2</sub> and ET CO<sub>2</sub> were continuously monitored and recorded at 15 min interval. Intraoperative blood loss, blood transfusion, duration of surgery, time of recovery and postoperative nausea and vomiting were monitored in all patients.<strong> Conclusion: </strong>this study showed that both TIVA and VIMA were effective in producing controlled hypotension for lumbar spinal fixation surgery. However, only TIVA was beneficial, allowing properly controlled hypotension, minimized intraoperative bleeding, and improved surgical field visibility compared to VIMA.
Controlled hypotension,propofol,Fentanyl,Sevoflurane
https://ejhm.journals.ekb.eg/article_15416.html
https://ejhm.journals.ekb.eg/article_15416_9c6a350c8e183f87ec41e7ef61d439d2.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
73
4
2018
10
01
Assessment of Left Atrial Function in Patients with Non-ST-Segment Elevation Myocardial Infarction Using Two-Dimensional Speckle Tracking Echocardiography
6562
6570
EN
Mansour M.
Mostafa
Cardiology Department, Faculty of Medicine, Al-Azhar University
Wael M.
Attia
Cardiology Department, Faculty of Medicine, Al-Azhar University
Mohamed O.
Taha
National Heart Institute (NHI), Cairo, Egypt
Mohamed N.
Mahmoud
Cardiology Department, Faculty of Medicine, Al-Azhar University
dr.mohamednassim@gmail.com
10.21608/ejhm.2018.15418
<strong>Background</strong>: the left atrium (LA) plays a major role in Left ventricular (LV) performance. LA function is a surrogate marker of LV diastolic dysfunction. LA mechanical dysfunction occurs in LV systolic and diastolic dysfunction, coronary artery disease, myocardial infarction (MI), hypertension, aortic stenosis and cardiomyopathies. In the MI process, the contribution of the LA to LV function may increase if the cardiac myocytes are not affected by direct ischemia. However, myocyte necrosis or ischemia of the LA or significant LV systolic/diastolic dysfunction affects this booster effect. Assessment of LA size and function provides prognostic data for the outcome of patients with MI or ischemia. <strong>Aim of the Study</strong>: was to evaluate LA function in patients with non-ST-segment elevation myocardial infarction (NSTEMI) by two-dimensional speckle tracking echocardiography (2D STE). <strong>Patient and Methods: </strong>60 patients with NSTEMI and 20 age-matched normal control individuals were enrolled in this study. Conventional echocardiographic parameters and global longitudinal strain rate (GLSR) were measured at left ventricular (LV) and LA segments. <strong>Results: </strong>Compared with healthy subjects, patients with NSTEMI had significantly increased LA volumes but significantly decreased LA emptying fraction and GLSR. LA-GLSR had significant correlations with the 2D Doppler echocardiographic parameters of LA function. In particular, global LA peak negative strain rate during early ventricular diastole (LA-GLSRe) was significantly correlated with both LA 2D Doppler echocardiographic parameters and LV contractile function. This could be suggested as a better indicator to evaluate LA function as a preferred parameter of STE. <strong>Conclusion: </strong>It could be concluded that two-dimensional speckle tracking echocardiography represented a non-invasive, relatively simple and reproducible technique to assess left atrial myocardial function in patients with NSTEMI.
Two-Dimensional Speckle Tracking Echocardiography,Strain rate,Non-St-Segment Elevation Myocardial Infarction,Left atrial function
https://ejhm.journals.ekb.eg/article_15418.html
https://ejhm.journals.ekb.eg/article_15418_75a0fa866e579f21d1503ebc10a2b4b3.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
73
4
2018
10
01
Assessment of High-Sensitive Cardiac Troponin I in Coronary Artery Disease Patients Undergoing Regular Hemodialysis
6571
6576
EN
Mostafa A.
ElBallat
The Department of Internal Medicine, Faculty of Medicine, Al-Azhar University
Alsayed M.
Rashed
The Department of Internal Medicine, Faculty of Medicine, Al-Azhar University
AbdElraouf A.
Abonar
The Department of Internal Medicine, Faculty of Medicine, Al-Azhar University
Ahmad M.
Hegazy
The Department of Internal Medicine, Faculty of Medicine, Al-Azhar University
10.21608/ejhm.2018.15420
<strong>Objective</strong>: to examine the prevalence of elevated cardiac troponin I level in asymptomatic and symptomatic end-stage renal disease (ESRD) patients on regular hemodialysis (HD) as a strong predictor of worse cardiovascular outcomes. <strong>Background:</strong> ESRD on regular hemodialysis patients with elevated cardiac troponin I have a higher cardiac mortality rate, it is important to detect elevated cardiac troponin I patients as predictor of worse cardiovascular outcomes. <strong>Methods: </strong>The patients were divided into three groups: Group (A): ischemic heart disease patients (IHD) with normal kidney function,Group (B): ischemic heart disease patients on regular hemodialysis,Group (C): non ischemic heart disease patients on regular hemodialysis. <strong>Results:</strong> Our study revealed elevated serum cardiac troponin I (CTnI) in group B, with normal level CTnI in other two groups (A and C). There was significant positive correlation between elevated CTnI, ejection fraction, E/A ratio and regional wall motion abnormalities. There was inverse correlation between CTnI elevation and EF%, also there was direct correlation between CTn I elevation and E/A ratio in group B. <strong>Conclusion: </strong>Troponin I was elevated in symptomatic IHD patients on regular HD and normal in IHD patients with normal kidney function and in non IHD on regular HD patients. The elevated CTnI may play in past a role in cardiomyopathies in IHD on regular HD and this could be related to some acute coronary syndromes in these patients which carries worse cardiovascular outcomes.
Cardiac troponin I (CTnI) – hemodialysis – ischemic heart disease
https://ejhm.journals.ekb.eg/article_15420.html
https://ejhm.journals.ekb.eg/article_15420_3d9b0d2cc3e3f9fdbb607b8cf76379f6.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
73
4
2018
10
01
Iron deficiency anemia with pica syndrome in 5 years old child
6577
6580
EN
Nafea Hamoud
Alanazi
Pediatric Department, College of Medicine, Al-Jouf University
dr.nafea1@gmail.com
Eyad Ahmed A
Bohassan
Pediatric Department, College of Medicine, Al-Jouf University
Ahmed Fakhri
Alsabi
Pediatric Department, College of Medicine, Al-Jouf University
Ridha Hussein A
Bohassan
Pediatric Department, College of Medicine, Al-Jouf University
Ali Hamoud N
Alenazi
Pediatric Department, College of Medicine, Al-Jouf University
10.21608/ejhm.2018.15423
Pica is an irregular want for and ingestion of either palatable or unpalatable substances. The condition has been distributed in medicinal diaries for quite a long time. The present case report is about a 5 years old female child reported to Department of General Pediatric with a chief complaint of high fever and constipation. The fever was progressive course for 2 days and constipation for 5 days. Furthermore, there was a history of abnormal behavior of ingestion of inedible substances like stones and sand. We seek through our report to shed the lights on the importance of reminding the physicians of diagnostic utility of pica side effects related with iron deficiency. As here in our case, if we ignored these diagnoses that caused pica, the child may suffer from serious complications such as very low hemoglobin, GIT abstraction, severe anemia and serious infection. Consequently, we concluded, that detailed medical and individual history of kids, helps in a superior determination and a proper treatment design.
Pica,Anemia,syndrome
https://ejhm.journals.ekb.eg/article_15423.html
https://ejhm.journals.ekb.eg/article_15423_e8ae1115e74d62dc500fb1a7f2265de2.pdf
Pan Arab League of Continuous Medical Education
The Egyptian Journal of Hospital Medicine
1687-2002
2090-7125
73
4
2018
10
01
Effects of Irritable Bowel Syndrome (IBS) on the health-related quality of Life among Saudi Males at Al-Jouf, Kingdom of Saudi Arabia
6581
6585
EN
Ahmed Mari M
Alruwaili
Family Medicine Department, College of Medicine, Al-jouf University
ahmeed.gh71@gmail.com
Khalid Salem A
Albalawi
Family Medicine Department, College of Medicine, Al-jouf University
Fawaz Rawi D
Alfuhigi
Family Medicine Department, College of Medicine, Al-jouf University
Atallah Fadel
Alruwaili
Family Medicine Department, College of Medicine, Al-jouf University
Bandar Abdulmohsen Ali
Altaleb
Family Medicine Department, College of Medicine, Al-jouf University
Jarid Saleh
Aljarid
Family Medicine Department, College of Medicine, Al-jouf University
10.21608/ejhm.2018.15587
<strong>Background: </strong>Irritable bowel syndrome (IBS) is a functional disorder of the gastrointestinal tract. Moreover, it is characterized by recurrent episodes of abdominal discomfort which may improve with defecation.
<strong>Objective: </strong>The objective of this study was to assess and evaluate the effect of IBS on the HR-QoL among Saudi population at Al Jouf region (Northern Saudi Arabia) by using generic Arabic translated questionnaires.
<strong>Materials and methods: </strong>This was a descriptive and cross-sectional survey study in which 70 patients were enrolled in the investigation (all men, aged 20±4 years .All participants met the Rome criteria-II for IBS. Furthermore, data were collected via structured questionnaires (25-IBSQoL).
<strong>Results: </strong>The results showed that 63% of the study population consent that IBS is a health concern; whilst 55% agreed that IBS restricted their activities and social life. Furthermore, 40% agreed that IBS affecting their emotional mode. Equally important, 69.1% agreed that IBS restrict their food and diet interest and 34.6% of the study population agreed that their sexual life is affected by IBS.
<strong>Conclusion: </strong>IBS is negatively affecting the quality of life of the study population. It constitutes to remain a health concern for them restricting their diet interests and badly affecting their social life. Hence, participants seem to be lacking knowledge and are unaware of their condition. Therefore, we recommend the health authorities to launch an awareness-raising campaign and an initiative program towards community awareness of this disease.
IBS,syndrome,HR-QoL
https://ejhm.journals.ekb.eg/article_15587.html
https://ejhm.journals.ekb.eg/article_15587_c06f81a105141513387063b05b2e4df9.pdf