2024-03-29T16:31:59Z
https://ejhm.journals.ekb.eg/?_action=export&rf=summon&issue=1774
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2018
72
2
Sonomammography versus MRI in Evaluation of BI-RADS III Breast Lesion
Hanan Mohammed Eisa, Eman Ahmed Shawki Genedi, Ayman Mohamed Ibrahim,
Fatma Mohammed Helmy*
Background: Breast cancer is sometimes found after symptoms appear, but many women with breast cancer have no symptoms. This is why regular breast cancer screening is so important, early detection and treatment are the most important strategies to prevent deaths from breast cancer. Breast cancer that’s found early, when it’s small and has not spread, is easier to treat successfully, regular screening tests are the most reliable way for early detection. Objective: to high light the role of sonomammography versus Magnetic Resonance Imaging (MRI) in evaluation of BI-RADS III (Breast Imaging Reporting and Data System) breast lesion. Patients and Methods: in this retrospective study, 28 patients with BI-RADS III breast lesion were assessed by Digital mammography (DM), Ultrasound (US) and MRI. The resultant images were correlated with reports of the pathology specimens. Results: histopathological analysis was done for each lesion with 13 lesions (46.43%) proved to be benign, 15 lesions (53.57%) proved to be malignant. The sensitivity, specificity, Positive predictive value (PPV) and Negative predictive value (NPV) of mammography (MG), ultrasonography and MRI in BI-RADS III breast lesions were calculated. Conclusion: BI-RADS III lesions group is a very critical group to deal with as it exhibits characters of both malignant and benign lesions. According to our study Dynamic contrast enhanced - Magnetic Resonance Imaging. (DCE-MRI) should go hand by hand with sonomammogaphy especially in BI-RADS III patients group, patients with benign looking lesion six months follow up is recommended and those with malignant looking lesion biopsy should be done.
Breast lesion
BI-RADS
Mammography
Ultrasound
Magnetic Resonance Imaging
2018
07
01
3861
3866
https://ejhm.journals.ekb.eg/article_9061_9b92c839fd260b9d6c35de987d7849f0.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2018
72
2
Incidence of Malignancy in Egyptian Patients with Cold Thyroid Nodule(S): Retrospective Study
Mohamed Atta Hassanain Swelam, Seleim Saeed Abd Elrahman Elnemr,
Ahmed Mohamed EL-Sayed
Background: this study was to evaluate the incidence of malignancy in Egyptian patients with cold thyroid nodule(s) after total thyroidectomy and histopathlogical analysis and the final result in our study was the incidence of malignancy in Egyptian patients with cold thyroid nodule(s) was (20%). Aim: the aim of the work was to evaluate the incidence of malignancy in Egyptian patients with cold thyroid nodule either solitary thyroid nodule or dominant cold nodule in multi-nodular goiter through retrospective study. Materials and Methods: the study was carried out on 30 Egyptian patients suffering from cold nodule(s) in the thyroid gland. Patients were managed at Al- Azhar University hospital; Cairo; Egypt. The study was controlled retrospectively. Ethical approval from the local Ethics Committee of Surgery Department was obtained. Results: according to the descriptive statistics of our study, the total number of cases was thirty patients, twenty-six of them were females and four were males, also the mean age of studied group was (37.87). The final results of post-operative histopathological examination were twenty-four cases diagnosed as benign and six malignant cases. Conclusion: in this retrospective study the final results of histopathological examination were 24 benign cases (80%) and 6 cases were malignant (20%). So in our study the incidence of malignancy in Egyptian patients with cold thyroid nodule(s) was (20%).
Incidence of malignancy
Cold
THYROID
nodule(s)
Retrospective study
2018
07
01
3867
3872
https://ejhm.journals.ekb.eg/article_9062_99caff7cd5bca55b9c27ed174dc6373c.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2018
72
2
Diaphragmatic Excursion Assessment by Ultrasound versus Volume Associated Weaning Parameters as A Prediction in Extubation in Critically Ill Patients
Mohamed Ahmed Abdel Hamid Shaalan, Gamal Ali Badr ,Atef Abou Elfotouh Ibrahim,
Amr Ahmed Mostafa
Background: Liberating a patient from ventilator is a continuous process as with any disease condition which starts with recognition of patient being ready to be weaned from ventilator by letting the patient breathe on T-piece and, if successful proceeding to SBT followed by extubation, if it is tolerated well (simple weaning). Otherwise letting patient on ventilator till next such trial being successful. Difficulty in weaning from mechanical ventilation is one of the most frequently encountered problems in MICU. An estimated 20% of mechanically ventilated patients face failed extuabtion (requiring reintubation within 48 h of extuabtion). Aim of the study: This study was designed to assess the value of the excursion of diaphragm tested by ultrasonography to predict weaning from mechanical ventilation versus volume associated weaning parameters in medical intensive unit’s patients. Patients and Methods: A prospective study was carried out on 30 patients ready for weaning. All patients were divided into two equal groups.Group A (successful weaning group) and Group B (failed weaning group). Results: Of the entire group of 30 patients, 21 patients (70%) had succeeded extubation and 9 patients (30%) failed. By applying cut-off level 1cm determined in our study the sensitivity and specificity of mean liver and spleen displacement were 95.2% and 88.9% respectively, which is higher than Pi max (85.7% and 77.8%) by cut-off level ≤ 20 cm H2o, ƒ/VT (85.7% and 66.7%) by cut-off level ≤ 105 breath/min/l. Conclusions: The present study concluded that ultrasonographic measurement of liver and spleen displacement during SBT before extubation is a good method for predicting extubation outcome.Ke
Bedside ultrasonography
Critically Ill
Diaphragmatic dysfunction
2018
07
01
3873
3878
https://ejhm.journals.ekb.eg/article_9063_cdd1f8112ae93487a0cf66a1cb8b3085.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2018
72
2
Role of MRCP in The Assessment of Patients Undergoing Cholecystectomy
Marmar Essam Mahmoud Salama, Hossam Abd Elkader,
Ahmed Mohamed Hussein
Aim of the work: this study aimed to assess if the Magnetic Resonance Cholangiopancreatography (MRCP) in patients undergoing cholecystectomy, changed the treatment plan or changed the operation method. Patients and method: this study was carried out in the Radiology Departments of Ain Shams University Hospitals. A total of 30 patients undergoing cholecystectomy were referred for preoperative MRCP. They were 20 (66.7%) females and 10 (33.3%) males. Their age was ranged from 20-60 years old. Results: Among the 30 cases, 21 cases had dilated common bile duct (CBD), 11 patients had CBD stones, 2 of which were silent, one case had silent CHD stone, one case had Mirizzi type I syndrome, 3 cases had trifurcation of the CHD, 4 cases had cystic duct anatomic variants and one case had duplicated GB. Conclusion: In candidate patients for cholecystectomy, routine preoperative MRCP is mandatory for confirmation of the already known pathologies, detection of other missed pathologies by US as well as detection of anatomical variants of biliary tract, these will help the surgeon for replanning and adjusting the surgical approach to preventing or at least decreasing the probability of post operative complications.
MRCP
GB
stones
Cholecystectomy
2018
07
01
3879
3885
https://ejhm.journals.ekb.eg/article_9064_32be7ac80cde5eb931c34b9cbbd44b27.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2018
72
2
Effect of Buspirone on Fetuses of the Pregnant Rats
Nadia G.
Zaki
Magdy H.
Abouel-Magd
Aim of the work: the purpose of this study was to detect effect of buspirone hydrochloride (Buspar) on the structure of cerebellum cortex of the fetuses of the pregnant rats. Material and methods: buspirone hydrochloride tablets are an antianxiety. Buspirone hydrochloride (buspar) tablets were obtained from SmithKline Beecham-Haram-Giza- Egypt. Thirty pregnant female rats were randomly categorized into three groups (Ten pregnant female rats in each group). Group I (control group) pregnant rats were administered oral doses of distilled water, group II: in this group pregnant rats were treated with buspirone hydrochloride, they were administered oral doses of drug in the distilled water equivalent to 0.27 mg/100g. body weight/day respectively for 15 days from the 6th day to the 20th day of gestation. , group III: pregnant rats were treated with to oral doses of buspirone hydrochloride in the distilled water equivalent to 0.41 mg/100g. body weight/day respectively for 15 days from the 6th day to the 20th day of gestation. Pregnat rats of all groups were sacrificed on the 20th day of gestation and their fetuses were obtained for the histopathological and histochemical studies. Results: treatment of pregnant rats with buspirone hydrochloride (buspar) showed many dystrophic changes in brain of their fetuses; these changes were more obvious in case of the toxic dose of buspirone which resulted in some sorts of neurotoxic structural changes in the cerebellum of fetuses of pregnant rats as evident by deformity in the cerebellar layers and degeneration of Purkinje cells. Conclusions: buspirone hydrochloride (buspar) has many adverse effects on the fetal cerebellum tissue.
fetal rats
buspirone drug
cerebellum cortex
histopathology and histochemistry
2018
07
01
3886
3899
https://ejhm.journals.ekb.eg/article_9065_2f72b0188213509c9d90f6af80859b8b.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2018
72
2
Evaluation of Rhomboidal Flap in Recurrent Pilonidal Sinus
Magdy Mahmoud Mostafa, Mohamed Hassan Al-Kaseer,
Ahmed Mohamed Said Hassan
Background: A pilonidal sinus (PNS) is a small cyst or abscess that occurs in the cleft at the top of the buttocks. A PNS usually contains hair, dirt, and debris. It can cause severe pain and can often become infected. If it becomes infected, it may ooze pus and blood and have a foul odor. The exact cause of pilonidal sinuses is unclear. It is generally thought they are caused by loose hairs pushing into the skin. They could also be caused by deep layers of skin being stretched and moved, leading to a hair follicle rupturing. Aim of the Work: The prospective study aimed at evaluating the outcomes of management of recurrent pilonidal sinuses by rhomboid flap. Patients and Methods: A prospective study of cases with recurrent pilonidal sinus, was done at the department of general surgery at In Al-Azhar University hospitals over the period from July 2017 with medium follow up period of three months. Results: Age: ranged between 17 to 36 years with mean = 24.7±5.57. Sex: included 12 male and 8 female. Conclusion: Based on this study, it seems to us that the rhomboid flap is a good alternative for recurrent sacrococcygeal pilonidal sinus, especially for complex sinuses, and it could be appropriate for cases where simpler techniques have failed. It permits early return to complete activity, does not require prolonged postoperative attention, and has very low recurrence rate and postoperative morbidity which may compensate the inconveniences related to an unfavorable cosmetic look.
Rhomboidal Flap
Recurrent Pilonidal Sinus
Sacrococcygeal Pilonidal Sinus
2018
07
01
3900
3903
https://ejhm.journals.ekb.eg/article_9066_67f9b5adf6f589b747b549dac668c65e.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2018
72
2
Comparative Study between Alvarado Score and Appendicitis Inflammatory Response Score in Diagnosis of Acute Appendicitis
Hesham Wefky Anwar, Ahmed Mohammed Elsayed,
Hesham Sayed Ahmed Ahmed
Background: The appendix is a worm like extension of caecum and for this reason has been called "vermiform appendix". Appendicitis may occur due to several reasons, such as an infection of the appendix, but the most important is the obstruction of appendiceal lumen. Acute appendicitis has remained the most common acute surgical condition of the abdomen in all ages and of course, a common disease in surgical practice. The usual picture of appendicitis is often not classical, leaving in many cases a diagnostic problem. In patients with questionable findings, the aggressive surgical approach has been "when in doubt, take it out, "and the price paid is the frequent removal of normal appendix. Aim of the Work: The aim of the work is to evaluate the appendicitis inflammatory response (AIR) score and compare its performance in predicting the risk of appendicitis to the Alvarado score. Patients and Methods: In this randomized prospective study, 100 patients with acute pain in right lower quadrant of abdomen were admitted to the surgical department of Al-Hussain University Hospital in the period from June 2017 to October 2017. All the patients had indications for appendectomy. The present study was carried out among patients suffering from acute pain in right lower quadrant of abdomen. Results: This randomized prospective study comprised 100 patients, of whom 52 were females (52%) and 48 were males (48%). Their ages ranged from 16 to 42 years old with a mean age of 21 years. These 100 patients were presented with acute pain in right lower quadrant of abdomen. All female cases proved to be pregnant were excluded from the study. Recurrent sub-acute appendicitis were also excluded from the study. Patients with known abdominal malignancies or previous abdominal surgery were also excluded from the study. Conclusion: This prospective study comprised 100 patients with acute right iliac fossa pain for evaluation and comparing between Alvarado score and AIR score in diagnosis of acute appendicitis. The present study showed that the AIR score has a good statistical discrimination for patients with acute appendicitis and outperforms the Alvarado score.
Alvarado Score
Appendicitis Inflammatory Response Score
acute appendicitis
2018
07
01
3904
3908
https://ejhm.journals.ekb.eg/article_9067_4f9f329014ac99e00ec6cf1ac5960b9a.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2018
72
2
Overview of Allopurinol Decisions in Primary Care: A Narrative Review
1Multag Jaual Alqahtani,
2Abdullah Mohammad Alshamrani
Background: Allopurinol is a type of drug called a xanthine oxidase inhibitor. It functions by lowering the production of uric acid in the body. It can be found in the kind of an oral tablet. Generalist physicians, specifically general internists and primary care physicians, are usually the first to see individuals with gout and for that reason play an essential role in the diagnosis and management of these patients. Gout is mostly managed in primary care and lasting treatment aims to reduce serum uric acid degrees with using allopurinol. Urate lowering therapy is indicated in patients who have had an acute gout attack and whose uric acid level remains high, increasing the risk of a subsequent attack. The effect of allopurinol on uric acid level is dose dependent and variable. Aim of the Study: In the present review, we aimed at discussing the indications of Allopurinol in primary care along with its benefits and side effects which should be considered by patients and physicians before prescribing it. Methods: Narrative review was conducted using electronic database such as; PubMed/Medline, Embase, Google scholar, for relevant articles related to our concerned topic which is about the usage of allopurinol in primary care and methods that family doctors use to make a decision about the usage, published up to 2018. Conclusion: The benefit-risk balance of allopurinol should
be carefully assessed with respect to the patients’ condition and medical profile before prescription in the PCU.
Allopurinol
Primary Healthcare
xanthine oxidase inhibitors
2018
07
01
3909
3913
https://ejhm.journals.ekb.eg/article_9068_56791b75fccdec3288acf416edb91724.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2018
72
2
Ultrasound Guided Therapeutic Excisional Vacuum Assisted Biopsy in Fibroadenoma (BIRAD3 Lesions)
Ahmed Mohamed Monib, Ahmed Hassan Soliman,
Haneen Ahmed Najeeb
Background: Our study showed that ultrasound-guided, vacuum-assisted excision can play an efficient role in the diagnosis of benign breast lesions and is a safe and successful alternative treatment of fibroadenomas. Although the breast fibroadenoma is a common benign breast tumor, the treatment and follow-up of these lesions is still debatable. We suggest that UGVAB, which has a well-documented role in the diagnosis of breast lesions, may provide an option for the definitive treatment of breast fibroadenomas. Objective: The objective of our work was to evaluate ultrasound-guided, vacuum-assisted excision (UGVAE) as an alternative approach in the diagnosis of radiologically benign breast lesions. Patients and Methods: We prospectively evaluated breast lesions excised using VAB between April -October 2017 at Ain-Shams University /interventionl radiology unit at radiology department, which had a proven diagnosis of fibroadenoma. An informed consent form was obtained from each patient of a total of 25 cases ultrasound-guided VABB using biopsy system. All patients have been subjected to breast ultrasound examination. Results: Thirteen patients developed hematomas during UGVAE but none needed surgical intervention, while twelve patients pass with no significant hematomas, with 100% cure rate. None of the patients experienced significant enough pain to require the cessation of the procedure, although 22 (88%) patients reported mild pain and moderate pain (12%) during procedure. At the two week control, 3(12%) patients reported taking paracetamol for mild pain. In ten of them (40%) the pain was strong enough to interfere with sleep. Conclusion: Vacuum assisted Ultrasound-guided biopsy allows real-time imaging, could be performed without breast compression, and is the preferred method if the lesion is detectable with ultrasound.
Breast fibroadenomas - Vacuum assisted excisional biopsy - ultrasound-guided
vacuum-assisted excision
2018
07
01
3914
3917
https://ejhm.journals.ekb.eg/article_9069_1e09930036abebb01845e6771fe082c2.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2018
72
2
Risk Factors for Post-Operative Thyroid Related Complications in Patient Undergoing Thyroidectomy: A Single Center Study
Fatemah Saleh AlTheyab1, Renad Nasser AlOnazi1, Ibtehaj Mohammed AlHarbi1,
Hessa Mohammed AlHarbi1, Sultan AlSaigh2
Background: Thyroid diseases are one of the most prevalent endocrinopathies globally (1). Most of the thyroid diseases treated surgically. The operation duration is under multiple factors can be predicted preoperatively (2). Hypocalcaemia and nerve injury are serious complication after thyroid surgery and we hypothesized it could be prevented by simple measures to avoid such complications. Objective: Was to assess the correlation between thyroidectomy operating time, histo-pathological diagnosis of thyroid disease and pre-operative vitamin D supplementation with post thyroidectomy complications mainly hypocalcaemia and nerve injury. Method: An observational retrospective cohort study with a total of 187 patients who underwent thyroidectomy from October 7th 2013 to January 4th 2018 were included in this study. Data were analyzed for demographic information including age, sex, nationality, height and weight. Information about the use of vitamin D supplementation before or after the operation, the clinical and the histological diagnosis of thyroid diseases, the name of the procedure (partial or total thyroidectomy), and the presence of any complications. Result: The mean age of the patients was 39.7±12.71 years. 81.8%(153) were females and 18.2%(34) were males. 53.5%(100) were given Vitamin-D supplements before or after the surgery. Histopathology showed that the most prevalent type was papillary Carcinoma accounting for 68 (36.4%). No significant association between histological diagnosis and complication of hypocalcaemia and nerve injury. Mean duration of surgery performed was 135.61±47.668. 83 of our patients suffered from hypocalcaemia and 6 suffered from nerve injury. When correlating between duration of surgery with hypocalcaemia and nerve injury, The independent t-test was associated with statistically insignificant effect t(182)= -1.85 , p= 0.066 (>0.05) for hypocalcaemia and t(185)= -0.075 , p= 0.940 (>0.05) for nerve injury. Conclusion: Our study suggested that there was no significant correlation between the duration of surgery as well as histo-pathological diagnosis and the development of post-operative hypocalcaemia and nerve injury.
Thyroidectomy
Post-operative hypocalcaemia
Post-operative nerve injury
Complications
Vitamin D
2018
07
01
3918
3923
https://ejhm.journals.ekb.eg/article_9070_05cefc57a74053edf29b4d8a165687df.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2018
72
2
Prevalence and Risk Factors of Dyspnea among General Population of Arar City, Kingdom Saudi Arabia
Abdulelah Aziz Eissa Alenzi1, Osama Alsallum Alanazi1, Tariq Hulayyil Alanazi1, Abdulwahab
Mabkhoot Ali Meqbel2, Nasser Theeb Alqahtani3,
Munirah Abdullah Almakhayitah4, Wejdan jumyaan alharbi5,
Israa Abed Alfadhli5, Wijdan Salem Almatrafi5, Asma Salem Almatrafi5
Background: Dyspnea is defined as the subjective experience of breathing discomfort. It is increasing by age and it is a common problem affecting up to half of patients admitted to acute, tertiary care hospitals and also affecting one quarter of ambulatory patients.Study objective: to determine the prevalence and risk factors of dyspnea among general population of Arar city, Northern Border Province, Saudi Arabia. Methods: This was a cross-sectional, community-based study. It was conducted on the general population of Arar city during the period from 1st October, 2015 to 30th June 2016.Data were collected using a predesigned online self- administered questionnaire covering all the needed items. Results: Dyspnea was reported in 35.2% of the study population. Causes of dyspnea reported in our study were mainly of unknown causes (38.6%), bronchial asthma (23.9%), allergy (22.7%), psychological causes (12.5%), cardiac causes (1.1%), and COPD (1.1%).It was more common among females as 44.8% of females reported dyspnea while it was reported in only 31.7% of males. Our study has also shown that dyspnea was most prevalent among the < 20 age group by ratio as 52.6% of them reported dyspnea. However, 36.1% of subjects aged between 20 and 40 have reported dyspnea. Precipitating causes of dyspnea were found to be mostly due to dust (30.7%), smoking (22.7%), climate changes (14.7%), nervousness (13.6%), specific food/ingested material (11.4%), and excess physical activities (6.8%). It was also founded in our study that 56.5% of participants with family history of dyspnea suffered from dyspnea. While 72.9% of those who did not have a family history of dyspnea did not suffer any dyspnea. Conclusion: Dyspnea was reported in 35.2% of Arar population. Our study showed that dyspnea was more common among females than males. large scale study with detailed investigations about causes and precipitating factors are required.
Dyspnea
hard breathing
prevalence
chronic disease
2018
07
01
3930
3934
https://ejhm.journals.ekb.eg/article_9072_511b844f8d8b14399971373db5c23841.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2018
72
2
Hyper- and Hypoglycemic Coma among Diabetic Patients in Arar, Northern Saudi Arabia
Nada Kareem S Alruwaili1, Yasamiyan Mohammed A Alanazi1, Seham Mohammed Alanazi2, Wafaa Kareem S Alruwaili1, Almaha Ahmad Abdulaziz Alali1, Zaynab Hussain M Almukalaf1,
Noof Saud J Alenezi1, Shouq Saud J Alanazi1, Razan Mohammed G Aldahmashi1
Background: Diabetic coma is a reversible form of coma found in people with diabetes mellitus. It is a medical emergency. Three different types of diabetic coma are identified; Severe low blood sugar in a diabetic person, diabetic ketoacidosis (usually type 1) advanced enough to result in unconsciousness from a combination of a severely increased blood sugar level, dehydration and shock and exhaustion, hyperosmolar non ketotic coma (usually type 2) in which an extremely high blood sugar level and dehydration alone are sufficient to cause unconsciousness. The aim of this study was to determine the prevalence of diabetic coma among the studied diabetic patients and to illustrate the relationship between type of diabetic coma and type of DM, period
of diabetes and place of management of coma. Methods: A cross-sectional study was carried out on 113 diabetic patients (both type I and II DM) in Arar city, Northern Saudi Arabia, KSA, during the period from 1 December to 30 June 2017. Data collected by a pre-designed online self-administered questionnaire. Results: The mean age of participants was 35.62 (±21.62) years and 67.3% were females. The prevalence of diabetic coma among the studied diabetic patients was 57.5% and the type of coma was hypoglycemic in 70.7% and hyperglycemic in 29.3%. 42.1% of hyperglycemic coma patients had type I diabetes and 57.9% had type II. While, 50% of hypoglycemic coma patients had type I diabetes. On the hand, 21.1% of hyperglycemic coma patients treated in the emergency department, 10.5% admitted to the hospital and 68.4% treated at home. While 34.8% of hypoglycemic coma patients treated in the emergency department, 6.5% admitted to the hospital and 58.7% treated at home. There was no significant relation between type of DM and type of diabetic coma (P= 0.562) or between period of diabetes and type of diabetic coma (P= 0.060). Conclusion: The prevalence of diabetic coma among the studied diabetic patients was 57.5% and the type of coma was hypoglycemic in 70.7% and hyperglycemic in 29.3%. We recommend to spread awareness of the diabetic patients about causes and manifestations of diabetic coma to guard against it. Also we recommend a large scale and more detailed researches.
Hyper and Hypoglycemic Coma
Type I and Type II diabetes
Diabetes emergency
Arar, Northern Saudi Arabia
2018
07
01
3935
3940
https://ejhm.journals.ekb.eg/article_9073_7d578de087564c54b58ae420511b2902.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2018
72
2
Evaluation of the Association of Bariatric Surgery with Development of Cholelithiasis
Sultan Abdullah Bin Jerais1, Rana Mohammed Ahmad 1, Mohammad Ibrhim Taleb2, Raad Jamaan Al-Ghamdi3,
Fahad Obaid Al-Namshah4, Sarah Mohamed Sayed5, Wejdan Abdulmoniem Alsumaien6,
Marram Jaber Al Haider6, Ahmed Tabaan Alenezi7,
Ashwaq Musaed AL-Mutairi8
Background: Significant research papers have been published to assess the relation between rapid weight loss and the development of cholelithiasis, and the risk factors behind it. Assessment of cholelithiasis development after rapid weight loss as a result in most of bariatric surgery will help in reducing the admission rate to hospitals because of colic pain, and the complication related to stones formation. Objective: This study aimed at measuring the association of rapid weight loss with the development of gallbladder stones and identifying the role of prophylactic cholecystectomy. Methods: PubMed database was used for articles selection. All relevant articles to our review with the following topics: Bariatric Surgery, Gallbladder stones, bariatric surgery complication were included. We excluded other articles which are not related to this field. The data were extracted according to specific form in which it is going to be reviewed by group members to assess the relation between bariatric surgery and the development of stones, and weight loss as well as the benefits of prophylactic cholecystectomy against gallbladder stones. Conclusion: Bariatric surgery can lead to gallstone formation because of the rapid excess weight loss. Small percentage may become symptomatic and rarely cholecystectomy becomes needed during the first year of the bariatric surgery. So, it is not evidently recommended to be done as prophylaxis. However, Prophylactic medicinal therapy (Ursodeoxycholic acid) in the first 6 months can be used instead.
Bariatric surgery
Cholelithiasis
Gallstone
rapid weight loss
medicinal therapy
prophylactic cholecystectomy
2018
07
01
3941
3945
https://ejhm.journals.ekb.eg/article_9074_244606a46d6294f0dd10aa28827fd14e.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2018
72
2
Evaluation of the Risk Factors and Emergency Management Plan of Status Asthmatics in Children: A Simple Literature Review
Khaled Abdullaziz Alasous 1, Khalil Ibrahim Kariri 2, Sultan Mousa Bakri 3, Sultan Masoud Almasoud 4,
Nawaf Fahad Alshuraym 4, Abdulrahman Nabih Aljaber 5,
Wed Mohammed Alluhaibi 6, Samia Zaben Almurshadi 7,
Zainab Ibrahim Albahouth 7, Haidar Taher Aldulaim
Background: Significant research papers were published to assess different risk factors associated with development of status asthmaticus (SA) in children and prevention. Understanding the different risk factors associated with SA development in children will help in the early prediction of the cases that might develop SA in future which may cause death in few cases. Objectives: In this study, we aimed at evaluating the various risk factors, etiologies that stand behind of status asthmaticus development and Assessment of SA management in emergency department. Methods: PubMed database were used for articles selection. All relevant articles related to our review were chosen to cover the following topics: Asthma, SA management, SA in children risk factors. We excluded other articles, which are not related tour objectives . The data have been extracted according to specific form to be reviewed by the group members to assess the different risk factors, and management modalities of SA. Conclusion: Delay in seeking medical help, poor compliance to the treatment, multiple previous admissions, frequent chest infections, and obesity are major risk factors of complicating asthma in children leading to life threatening attacks (SA). Preventing the risk factors is major task of the management and it is as important as the treatment of asthmatic attacks.
risk factors
Emergency
management plan
Status Asthmatics
children
2018
07
01
3946
3950
https://ejhm.journals.ekb.eg/article_9075_31d181f28da2834bc4dfa0effe51a375.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2018
72
2
Evaluation of the Most Common Complications of Sickle Cell Anemia and Management in Children: Simple Literature Review
Ghadeer Awad Alenazy1, Asma Mutni Almutairi2, Lamia Aiad Al-Onazi2, Ghaid Mohammed H Alkharaz3,
Shuruq Hassan Alsulami4, Manal Nasser Alotaibi4, Eyman Abdulmajeed Alfaraj5,
Afnan Hussain Alshaikhali5, Mahabbat Nadin Anam A6,
Ammar Mohammad M Bahati7
Background: Sickle cell anemia is an autosomal structural defect that affect the hemoglobin. It is associated with reduction in the RBC life span especially under stress. As a result of this structural defect the RBCs takes a sickle shape which is associated with a lot of complications that significantly have an effect on the patient’s life. Objective: In this study, we aim at evaluating the most common complication of sickle cell anemia. Also, the assessment of the various management plans to prevent it if occurred. Methods: PubMed database were used for articles selection as well as all relevant articles to our research interest with the following topics: Sickle cell anemia, Complications, Mortality, Prevention and Management. We excluded other articles, which are not related to this field. The data were extracted according to specific form in which it is going to be reviewed by the group members. Conclusion: Sickle cell anemia have various complications that have impact on quality of life and arise from effect of three main pathophysiological mechanisms i.e. Vasooclussive, hyper-haemolytic and infective complications. Hydroxyurea, chronic blood transfusion, and routine Transcranial Doppler Ultrasound are still the most useful preventive measures of SCA complications.
Sickle cell anemia
Complications
quality of life
children
2018
07
01
3951
3960
https://ejhm.journals.ekb.eg/article_9076_c7174e403322e9a23ca23f51c0bcb636.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2018
72
2
Audiological Profile in Children with Autism Spectrum Disorders
1Ali Abdel Dayem Ali, 2Shoura Youssef Darwish, 1Ahmed Mohammed Ahmed Mahmoud,
1Mohammed Moneer Mohammed Hassanain
Background: Autism spectrum disorder is defined by the Diagnostic Statistical Manual of Mental Disorders V (DSM V) as a neurobehavioral disorder manifested by persistent deficits in social and communication interaction, deficits in developing, understanding and maintaining relationships, as well as abnormal and fixed interests and repetitive behavior. Symptoms must be present at early childhood and interfere with daily function. The majority of individuals with ASD demonstrate some degree of auditory dysfunction. The level and expression of this dysfunction ranges from deafness and increased thresholds to hyperacusis and difficulty listening with background noise. Objective: The purpose of this study was to characterize the findings of audiological and electrophysiological hearing assessment in individuals with autism and to compare these findings to those obtained in typically developing individuals. Subjects, Materials & Method: Forty one Autistic children are divided into two groups:- group (1) Mild to moderate autism were seventeen children & group (2) Severe autism were twenty four children) were enrolled in this study (Whose ages were 2-6.5 years old) compared with ten typically developing matching peers. All Autistic children in the study had a definite medical diagnosis of Autism according to DSM-5 and based on the severity of symptomatology, ASD children were assessed and divided using CARS score (Childhood autism rating scale). Audiologic evaluation consisted of a case history, otoscopic examinatioin, behavioral free field evaluation, acoustic immittance measures (Tympanogram and Acoustic reflexes), speech audiometry, measurement of distortion product otoacoustic emissions and auditory brain stem response. Results: Our results support an association between ASD and higher DPOAEs S/N ratios at only 500 & 750 Hz. Moreover, ABR in ASD children showed a significant increase in waves III & V absolute latencies and I- III & I-V inert peak latencies (In both groups of ASD), with inter aural asymmetry as shortened right ear III-V & I-V inter peak latencies reflecting a more right ear advantage (mild to moderate group), in addition to a significant decrease in waves V/I amplitude ratio (Both ASD groups). Conclusion: The OAE responses of children with ASD were highly significantly only at 500 Hz (Both groups) 750 Hz (Mild to moderate group). ASD children (either mild to moderate or severe) had a significant increase in ABR waves III & V peak absolute latencies and I-III & I-V inter peak latencies. Asymmetrical ABR findings also noted in children with ASD (mild to moderate group) as shortened right ear III-V & I-V inter peak latencies (more prominent right ear advantage). In ABR also the amplitude of peak I in response to 90 dB nHL click stimulation was greater than the amplitude of peak V significantly in both groups of ASD children than controls.
Auditory Brainstem Response - Autism Spectrum Disorders - Acoustic Stapaedial Reflex – Otoacoustic emissions - Cytosine
Guanine
2018
07
01
3961
3967
https://ejhm.journals.ekb.eg/article_9078_17419337f7aed6207f28ec30ae3b2ee5.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2018
72
2
Risk Factors of Delayed Milestones Among Children Attending Sohag General Hospital
1Ekram M. Abdel khalek, 1Sabra M. Ahmed,
2Ramadan A. Ahmed,
3Gamal
E. Soliman
Background: developmental delay occurs when a child exhibits a significant delay in the acquisition of milestones or skills, in one or more domains of development (i.e., gross motor, fine motor, speech/language, cognitive, personal/social, or activities of daily living). Aim of the work: the present study aimed to investigate the most common risk factors of delayed development in children under four years attending Sohag General Hospital. Subjects and Methods: a case control study was conducted in Sohag General Hospital during the period from January 2015 to June 2016 on children attending Pediatric, Physiotherapy and Phoniatric clinics in Sohag General Hospital, Sohag Governorate. The sample size was 150 cases and 150 controls. One hundred and fifty children (aged 1.5 month to 48 months) diagnosed with developmental delay by a specialist or/and a developmental pediatrician were recruited as cases. Results: in the logistic regression model, the odds of developing delayed milestones is significantly higher among children with cyanosis (OR=16.391), low birth weight (OR=6.147), parental consanguinity (OR=5.489), 1st birth order (OR=4.048), urban residence (OR=3.702) and history of neonatal jaundice (OR=2.518). Conclusion: the urban children, first children and from few number of family members were more frequently at risk for developmental delay.
developmental delay
risk factors
children
Sohag General Hospital
2018
07
01
3968
3978
https://ejhm.journals.ekb.eg/article_9079_13b554176cbc91a98d1b81a6e12edb3c.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2018
72
2
The Use of Levonorgestrel-Releasing System (Metraplant-E) in the Treatment of Abnormal Uterine Bleeding
Mohamed Ezz-Eldin A. Azzam*, Magd Eldin M. Mohamed, Laila A. Farid, Alshaimaa AA Mahmoud,
Reem Abdelazeem Hussein, Alaa Rashid
Background: Dysfunctional uterine bleeding (DUB) is one of the commonest condition for which patient seeks out medical consultation. The prevalence increases with the increase of age peaking before menopause. Objective: The aim of this work is to evaluate the effect of this new form of levonorgestrel-releasing IUD on the treatment of patients with abnormal uterine bleeding. Subjects and methods: A prospective age-specific comparative analysis of 61 peri-menopausal women presented with dysfunctional uterine bleeding who constituted the study group. They underwent hysteroscopy and endometrial sampling during an 18 months period from June 2014 to January 2016 at Ain Shams University Materity Hospital. Prior to metraplant-E application, all the patients in this study were in the age of 25-58 years old. Results: The role of Metraplant-E in the treatment of abnormal uterine bleeding (AUB) was evaluated. Sixty-one women with failed attempt(s) of medical treatment unwilling or unfit for hysterectomy were treated with Metaplant- E. Menstrual blood loss was assessed by pictoral bleeding assessment chart (PBAC), bleeding index (B.I) and total bleeding score (T.B.S/month). The bleeding patterns in the form of the mean menstrual blood loss estimated by bleeding index and the mean menstrual loss estimated by the total bleeding score/month and PBAC decreased significantly (p = 0.001). The quality of life scale (Likert scale) improved significantly (p = 0.001). All 15 cases who had endometrial sampling demonstrated progestational effect on histo-pathological examination. Conclusion: Metraplant-E was found to be effective in managing dysfunctional menorrhagia on both clinical and histopathological levels.
Metraplant-E
LNG-IUS
menorrhagia
contraceptives
2018
07
01
3979
3985
https://ejhm.journals.ekb.eg/article_9082_fae49ce9f4fd8dd688f7f3c915bfdb87.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2018
72
2
Evaluation of Graded Transcutaneous Levator Muscle Recession with Mullerectomy for Treatment of Upper Eyelid Retraction in Dysthyroid Patients
Ahmad H. and
Abd Elmagid M. Tag Eldin
Purpose: To evaluate the efficacy, advantages and disadvantages of graded transcutaneous levator muscle recession with mullerectomy for treatment of dysthyroid upper eyelid retraction. Design: Randomized, prospective and interventional case series. Methods: This prospective interventional case series comprised 20 eyes of ten patients. Inclusion criteria included patients with bilateral upper eyelid retraction, with or without other manifestations of thyroid orbitopathy, without diplopia and with stable thyroid state for at least 6 months. All patients were subjected to graded transcutaneous levator muscle recession with mullerectomy after full ophthalmological assessment. All patients included in the study have signed a written consent and the study has been approved by the ethical committee of AL-AZHAR faculty of medicine. Results: Postoperatively the mean decrease of MRD1 was 2.87 mm. Mean improvement of lagophthalmos was 0.78 mm. Mean increase of upper lid crease height was 0.65mm. Good lid contour achieved in 85.9%. Temporal flare persisted in one lid (5%) and nasal ptosis was reported in two eye lids (10%). Conclusion: According to this study graded transcutaneous mullerectomy with levator muscle recession is a good and a reliable surgical technique for correction of dysthyroid upper lid retraction and is successful as a lengthening procedure for retracted upper eyelid regardless the severity of retraction with significant symptomatic and cosmetic improvement.
Mullerectomy
Upper eyelid retraction
Dysthyroid
Graded transcutaneous levator muscle recession
Levator lengthening
2018
07
01
3986
3989
https://ejhm.journals.ekb.eg/article_9084_de491bacd47b674c53e1b8ea67c4e3c9.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2018
72
2
The Effect of Aflibercept and Ranibizumab in Patients with Diabetic Macular Edema: A comparative Study
Abdallah H. Hamed, Ahmad E. Hudieb,
Mohamed A. Eid*
Background: Diabetic macular edema is one of the most significant causes of blindness and severe visual impairment in patients with diabetes, which can result in reduced quality of life. Three commonly used intravitreous VEGF inhibitors aflibercept, bevacizumab and ranibizumab have been shown to be beneficial and relatively safe for the treatment of diabetic macular edema, but only aflibercept and ranibizumab are approved by the Food and Drug Administration (FDA) for this indication. Aim of the Work: To compare between the effect of ranibizumab and aflibercept in patients with diabetic macular edema as a diabetic retinopathy complication that leads to visual impairment. Patients and Methods: A prospective study of 20 patients (20 eyes) was conducted in Al-Mouneer diabetic eye center with three times injection one month apart. The patients were divided into two groups, Group A was consisted of 10 patients who received ranibizumab as 0.5 mg (0.05ml of 10mg/ml solution) an intra vitreal injection. Group B was consisted of 10 patients who received aflibercept 2 mg (0.05mL of 40mg/ml solution) as an intra vitreal injection with follow up for three months. Results: A statistically significant difference over the time through BCVA and central macular thickness with ranibizumab. There was also a statistically significant difference over the time through BCVA, central macular thickness and IOP with aflibercept. Conclusion: There was more improvement in BCVA which was significant and more reduction in central macular thickness with ranibizumab than with aflibercept. Recommendations: Larger group studies to confirm our results; longer term study for the effect of ranibizumab and aflibercept injection on the central macular thickness and IOP and comparing the effect of single injection versus multiple injections. Searching for the causes of resistance or delayed response to the intravitreal injections in some patients.
Diabetic Macular Edema
Aflibercept
ranibizumab
2018
07
01
3990
3995
https://ejhm.journals.ekb.eg/article_9085_4c0eb40382dff4805300752528f3876a.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2018
72
2
Evaluation of Capillary Network Abnormalities in Branch Retinal Vein Occlusion by Optical Coherence Tomography Angiography
Khaled Mohamed Selim, Ahmed El-Sayed Hudieb,
Mahmoud Salah Aldin Aldemardach
Objectives: Is to detect the vascular morphological changes in the two intra retinal; layers superficial network layer and deep network layer by optical coherence tomography angiography (OCT-A) in cases with acute onset branch retinal vein occlusion (BRVO). Study Design: An observational cross-sectional study in new Kafer El-Sheikh Ophthalmology Hospital. Population: This study included ten patients with (BRVO) of recent onset within the last three months. Methods: Demographic data such as age, gender, sex and hypertensive history were obtained. A detailed evaluation of cases including complete anterior segment evaluation and posterior segment evaluation was done. OCT-A and fluorescein angiography (FA) were used to study the vascular morphological changes in the (BRVO) area. Results: As regarding 5 disc area of retinal ischemia FA detected ischemia in 2 cases (20%), detected no ischemia in one case (10%) and was not able to evaluate ischemia in 7 cases (70%) compared to OCT-A, that detected the ischemia in the superficial capillary plexus (SCP)in 4 cases (40%), and detected no ischemia in 6 cases (60%), but it detected the ischemia in the deep capillary plexus (DCP) in 6 cases (60%) and detected no ischemia in 4 cases (40%). Conclusion: Our study demonstrated that OCT-A was superior to FA in detection of macular ischemia in cases with acute onset branch retinal vein occlusion (BRVO), macular ischemia detected in the DCP by OCT- A had stronger negative relation with V.A. than that of SCP. By OCT-A macular edema (ME) was present mainly in the DCP compared to SCP.
Branch retinal vein occlusion (BRVO)
fluorescein angiography (FA) capillary non-perfusion
foveal avascular zone(FAZ)
macular ischemia
macular edema(ME)
optical coherence tomography angiography(OCT-A)
superficial capillary plexus (SCP)
deep capillary plexus (DCP)
2018
07
01
3996
3999
https://ejhm.journals.ekb.eg/article_9086_3ab8d987b8cc3a0bc8166a023952db48.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2018
72
2
Evaluation of Polymorphnuclear Leucocyte Elastase as Diagnostic Tool in Neonatal Sepsis
1Bothina Mohamed Abdel-Aziz El-Nagar, 1Soheir Ibrahim Mohamed,
2Sabah Ibrahim Abdelrahim, 1Mohamed Abdel-Gawad Morsy
Objectives: Neonatal sepsis is clinical syndrome of bacteremia with systemic signs and symptoms. Neonatal sepsis is still a leading cause of mortality in neonatal intensive care units all over the world. Early diagnosis and treatment of the newborn infant with suspected sepsis are essential to prevent severe and life threatening complications. Objective: The aim of this study was to evaluate polymorph nuclear (PMN) leucocyte elastase as a diagnostic tool in neonatal sepsis. Subjects and Methods: This study was conducted on 45 full term and preterm neonates suspected as neonatal sepsis compared to 45 apparently healthy neonate with matched age and sex, as a control group. Results: 55.6% of our patients group were full-term patients and 44.4% were preterm. All the patients were subjected to full history taking, full clinical examination, lab investigation including CBC, CRP, blood culture and sensitivity, and measurement of serum polymorph nuclear leucocyte elastase enzyme. Conclusion: Significant elevation of serum polymorph nuclear leucocyte elastase level in neonatal sepsis with high specificity.
Polymorphonuclear leucocyte
Escherichia coli
Early onset sepsis
Late onset sepsis
2018
07
01
4000
4004
https://ejhm.journals.ekb.eg/article_9087_44e23f1d75507e76ef8628595e3ab38a.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2018
72
2
Role Of Insulin Like Growth Factor in Polycystic Ovary Syndrome
Magdi A. Laban1, Tarek A. Shemais2, Ehab Mohamed Elhelw3 and
Ahmed R. El-Hassanin2
Objectives: The polycystic ovary syndrome (PCOS) is conventionally defined as a combination of hyperandrogenism and anovulation with polycystic ovaries. Insulin-like growth factor I (IGF-I) is a 70 aa polypeptide hormone with endocrine, paracrine, and autocrine effects. it is now established that the ovary is a site of IGF-I gene expression and reception. However, this huge amount of data could be somehow distractive since different species may produce distinct IGFs (or their relative binding proteins and receptors) at different stages of follicular development. Objective: The aim of this work was to determine the serum level of IGF-I to evaluate its role in PCOS. Subjects and Methods: Twenty-five infertile women with PCOS diagnosed by ultrasound examination and a history of oligomenorrhea, hirsutism and obesity were studied. Serum levels of insulin-like growth factor-1 (IGF-1) and hormonal profile were measured. Fifteen healthy and fertile women with regular menstrual cycles served as a comparison group. Results: The serum levels of IGF-I were significantly elevated in women with PCOS compared with control and there was positive correlation between IGF-I from one side and each of BMI, W/H ratio, LH, LH/FSH ratio, TSN, T/SHBG ratio, right and left ovarian volumes. On the other side, IGF-I was inversely correlated with SHBG, right and left uterine artery PI and RI. Conclusion: The significant finding of this study is that PCOS patients have increased circulating IGF-I levels than healthy controls and it can be used as a biochemical marker for PCOS.
Insulin-like growth factor
Polycystic ovary syndrome, Hormonal profile
2018
07
01
4005
4011
https://ejhm.journals.ekb.eg/article_9088_172da990eae9202be9d6c22ed5145443.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2018
72
2
Awareness of Risk Factors of Hernia among Adults in Al-jouf region, Saudi Arabia
Yazeed A. Al judaya, Abdullah L. Al Hassan, Ahmed F.H Al Sabi, Ahmed M. Alruwaili, Sultan M. Alshalan,
Hassan A. Al Judia
Background: A hernia is characterized as the distension of an organ or tissue through an abdominal muscle ordinary opening, it happens when an organ or greasy tissue presses through a feeble spot in an encompassing muscle or connective tissue called fascia (1). Objective: This study aimed at assessing the awareness of the risk factors of abdominal hernias among adults in Al-jouf, Saudi Arabia. Material and Methods: This is a cross-sectional community-based study of a qualitative approach. The present study enrolled 105 candidates (aged 18 to 45), males 63, 42 Female. Moreover, candidates were subjected to structured self- administered close-ended study questionnaire during the period between January and February 2018 and one month for data analysis Results: The present study enrolled 105 candidates, from both gender male (63, %60) and female (42, %40). Age groups were (18-25) %62, (26-35) %35, (36-45) %3 Ages were varied according to the level of education (high school, college, graduated). Evaluation of the knowledge about Hernia: the highest proportion goes to %38 for Very Good then, %36 for Good, and the less %26 for Excellent. Recommendation and Conclusion: The present study revealed that the study group of Saudis, both gender have knowledge on the risk factors for hernia regardless to the age, gender and level of education. In the face of, 59% related Hernia with asthma, 81% constipation, 40% smoking, 41% enlarged prostate, 88.5% pregnancy, 89.5% heavy lifting, and 86% surgery. Unlike, participants have no knowledge about relating DM to hernia with proportion of 44%, This indicates that further studies are needed to clarify these conclusions. We recommend establishment of an awareness campaign for hernia risk factors among Saudi adults such as social media.
adults
Hernia
Inguinal
risk factors
KSA
2018
07
01
4012
4016
https://ejhm.journals.ekb.eg/article_9089_e07e1b37ad668f0d6e603cd674347b1f.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2018
72
2
Knowledge, attitude and practice of dental students, practitioners and specialist on composite shade matching in Al-jouf, KSA
Mazen N.
Alruwaili
Abdulkarim O.
Alanazi
Rakan M.
Albilasi
Yunus K.
Alruwaili
Adel H.
Alanazi
Faisal F.
Almusieb
Background: Shade selection is an essential system to give patients an aesthetics renovation that correspondently merges to the patient's current dentition. Moreover, natural teeth are acknowledged to have various shades in their surfaces. Objective: The aim of the study was to evaluate the awareness of knowledge, attitude and practice about the complications in shade selection and to utilize for improving the quality of training being imparted in the dental school and general practitioners. Methods and Material: Participants were divided into six Groups: operative dentist and endodontist, 3rd Year students, 4th Year students, 5th Year students, Intern and VI-General practitioners; 20 Questionnaire survey forms were distributed to fill among all the groups. Results: The results that the highest proportion was 41% for skill factor, knowledge was the second with 26%. Whilst, individual observer was 13.5% and 12.6% for the factor talent. 4.5% for (All) the factors. The lowest proportion was for more than two answers. Conclusion and Recommendation: The need of flourishing of cosmetic dentistry required to keep with up-to- date information considering all conceivable factors which influence shade selection.
Shade selection
factors
Knowledge
2018
07
01
4017
4020
https://ejhm.journals.ekb.eg/article_9091_467d84a675ba47a776b0dc5417b137d2.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2018
72
2
Harmful effects of water pollution on some physiological responses of the Nile tilapia (Oreochromis niloticus) in both Qarun and Burullus Lakes
1Eman, G.E. Helal; 2Abd El-Atti, M. S. and
3Yasmina, M.Ekraim
Background: Qarun and Burullus Lakes suffer from serious pollution problems owing to the enormous input of untreated agricultural, domestic and industrial effluents. This study was conducted to explain the effect of water pollution of these lakes on some physiological parameters of O. niloticus. Results: Showed clearly that water collected from both Qarun and Burullus Lakes were contaminated with high levels of lead and cadmium. The concentration of Pb and Cd in Lake Qarun (0.074 and 0.006 ppm respectively) were much lower than that of Burullus Lake (0.112 and 0.011ppm respectively). The study showed that the rates of Pb bioaccumulations were increased significantly in the muscles of O. niloticus collected from Brurllues Lake than that of Qarun Lake. It can be seen also that there are insignificant differences of Cd concentrations in muscles of tilapians collected from both Lakes. Analysis of liver functions shwoed a highly significant increase in the level of ALT in O. niloticus liver collected from Brurllues Lake than tilapia'sb liver from Qarun Lake. Both AST and GGT levels were insignificantly changed in fishes collected from both Lakes (no change in the table). Investigation of kidney functions of tilapias collected from Qarun and Burullus Lakes showed that urea concentration was significantly increased in kidney of Tilapia gathered from Burullus Lake (32.40 ± 0.93 mg/dl) than those collected from Qarun Lake (28.80 ± 0.73 mg/dl). Creatinine concentrations were significantly increased in kidney of tilapias gathered from Burullus Lake than Qarun Lake. Cholesterol, Triglycerides, high density lipoproteins (HDL), low density lipoproteins (LDL), and very low density lipoproteins (VLDL) in the muscles of tilapians collected from Burllues Lake were highly significant increase while total proteins were significantly decreased in comparison with tilapians of Qaron Lake.
Oreochromis niloticus
Physiology- Qarun and Burullus Lakes
Water Pollution
2018
07
01
4021
4025
https://ejhm.journals.ekb.eg/article_9092_48b02fa4f4fb72dc94bb1b37db1d189f.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2018
72
2
Expression of micro RNA-9 in Patients with Acute Myeloid Leukemia and its Impact on Treatment Strategy
1Mona A. Ismail, 2Hanaa R.M. Attia, 1Mona H.I. Farag, 1Dalia A.D. El Dine Salem,
1Mysra S. Youssef
Background: Acute myeloid leukemia (AML) is a malignant disorder of hematopoietic tissue. It is one of the most common malignancies in adults. It is characterized by its heterogeneous and complex nature that includes chromosomal, genetic and epigenetic abnormalities. MicroRNAs have been described to be one of the epigenetic regulators in AML. Objective: The present study focused on measuring expression levels of miR-9 in de novo AML patients. 30 bone marrow samples were collected from patients attending at Hematology and Oncology Unit of Aldemerdash Hospitals.MiR-9 expression levels were measured using real time PCR. These expression levels were compared to 30 adult healthy volunteers. Patients and Methods: The present study was carried out in medical oncology and Clinical Pathology Departments of Ain Shams University and National Research Centre, Egypt during the period between September 2017 and April 2018. Results: Statistical analysis of the results showed that miR-9 was significantly down regulated in AML patients in comparison to controls. It is also significantly correlated to platelet count. Regarding diagnostic performance, this study showed that miR-9 has weak diagnostic performance but regarding screening function, it has perfect sensitivity but weak specificity so it can be used as an excluding test. Conclusion: This study showed reduction of miR-9 in bone marrow of AML patients and opened the horizon for future studies on diagnostic and screening performance of miR-9 to be performed on larger scale and different ethnic groups.
Leukemia
myeloid
Acute
miR-9
treatment outcome
2018
07
01
4026
4033
https://ejhm.journals.ekb.eg/article_9093_b26be01c8e5e537bf3315987d3cdfbec.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2018
72
2
Role of Anti-Hepatitis C Virus (HCV) Signal to Cut-off Ratio (S/CO) in Following- up Patients Received Anti-HCV Therapy in Egypt
Ahmed M. Saba; Sayed A.M. Mahmoud;
Shaheen A.M.
Background: Hepatitis C Virus (HCV) infection is diagnosed by antibody and RNA based methods. Anti HCV-RNA testing based methods are introduced to confirm viremia in seropositive samples. This study aimed to evaluate the relationship between quantitative anti-HCV (S/CO ratio) and HCV-RNA by PCR as a diagnostic test to identify viremic from non-viremic HCV patients received anti-HCV therapy in Egypt. Subjects and Methods: Patients serum samples used in this study were collected from Al Hussein University hospitals after they had completed their anti-HCV therapy. A total of 172 patients were included in this study 82 were positive RNA, 90 of them were negative RNA their serum samples were assessed for the presence of antibodies to HCV using ELISA method. Results: The results were expressed as the ratio between the signal detected on the sample and the cutoff value of the run (S/CO). Patients with HCV-positive RNA were considered viremic. Receiver operator characteristic (ROC) curve was constructed by plotting sensitivity versus 1 − specificity, using HCV RNA and the S/CO ratio results respectively. Of the 172 patients with HCV infection the mean age was 51.9 ± 7.2 years ranging 35-67 years, 111 (64.5%) were males while 61(35.5%) were females. In the present study there was significant difference in S/CO ratio between viremic and non- viremic subjects. The sensitivity, specificity, negative predictive value, and positive predictive value were 98.78%, 71.11%, 98.46%, and 75.70%, respectively in the S/CO ratio of 8. Area under ROC curve was estimated to be 0.982 (95% confidence interval 0.967 – 0.997). Conclusion: by establishing 8 as cutoff value of the S/CO, it is possible to distinguish between viremic and non-viremic patients without need to use Anti HCV-RNA testing as a confirmatory test.
hepatitis C
Hepatitis C antibody. Enzyme Linked Immunosorbent Assay. Signal-to-cut-off ratio
2018
07
01
4034
4038
https://ejhm.journals.ekb.eg/article_9094_cb4e572197ffa5ff3f2cb334735ec03a.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2018
72
2
Survey of Awareness of Thyroid Disorders among the Riyadh Population, Central Region of Saudi Arabia
Atheer Mohammed D Alotaibi1,
Abdulrahman Ibrahim S Almousa2
Background: Thyroid diseases are among the commonest endocrine disorders worldwide and attention to physical examination findings, combined with selected laboratory and radiologic tools and aids in the early diagnosis and treatment of thyroid endocrine disorders is fundamental. Health education is considered an essential component to improve knowledge and change behavior. People affected by thyroid diseases often have inadequate knowledge about the nature of thyroid diseases, its risk factors and associated complication. Objectives: The aim of this study was to assess the awareness of the Riyadh population with various aspects of thyroid diseases. Methods: A cross-sectional study was carried out during the period from 1 December 2017 to 28 February 2018 in Riyadh city. A random, representative sample from Saudi nationals were included. Those who are under 18 years old were excluded. Systematic random sampling technique was followed. An online well constructed questionnaire translated into Arabic was disseminated and self administered by each participant. Data were analyzed by SPSS version 16, using descriptive statistics. Results: The total number of participants was 870 among which 297 (34.1%) were males and 573 (65.9%) were females. The participants were classified into 4 age groups, most of them were in the 31-50 years old group, counting 492 (56.5%). Only 6.6% among the participants did not know what the thyroid gland is, while 93.4% have chosen specific answers that are facts regarding the thyroid on different levels of knowledge. Among participants, 17% related thyroid disorders to disturbances in the menstrual cycle, recurrent miscarriage, and birth of dead fetuses, while 30.3% related that to psychological factors as depression, confusion, lack of concentration, mood swings, and anxiety, 27.4% to neck and joint pain with fatigue and weight loss, and 25.3% constipation and/or diarrhea, voice changes and swelling of the neck. Among our participants, 16.8% reported suffering from hypothyroidism. Regarding hypothyroidism, 30.9% answered yes to the question regarding whether or not ionized salt has a role in the treatment of hypothyroidism, when 22.2% responded with ‘No’ and the majority (46.9%) responded ‘I do not know’. The majority (39.0%) answered ‘Yes’ to whether the treatment can be stopped when investigations become normal in hypothyroidism, and (43.6%) answered ‘I do not know,’ in hyperthyroidism. Moreover, 26.6% thought that herbal remedy can cure hypothyroidism as well as (26.0%) in hyperthyroidism. Conclusion: This study recommended that health policy makers must conduct more effective health education sessions to increase knowledge of the population and their caregivers about various aspects of thyroid diseases and the importance of compliance with its treatment.
Awareness
Thyroid diseases
Knowledge
Riyadh City
Saudi Arabia
2018
07
01
4039
4044
https://ejhm.journals.ekb.eg/article_9095_c88620fc9667d01028cd513e831992b0.pdf