2024-03-29T15:44:25Z
https://ejhm.journals.ekb.eg/?_action=export&rf=summon&issue=7138
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2019
77
1
Loop versus Divided Colostomy in Patients with High and Intermediate Anorectal Malformations: Randomized Controlled Study
Ibrahim Mohamed
Hagras
Mohammed Awad
Mansour
Mohamed Mahmoud
Shalaby
Ashraf Ahmed
El-Attar
Ahmed Eissa
Abdalla
Background: Colostomy is performed as a step of staged management of high-type anorectal malformations in pediatrics. Creating a colostomy, by itself, is a minor surgical procedure, but it has many complications. Aim: The aim of the study was to compare the outcome results of loop versus divided colostomies in patients with high and intermediate anorectal malformations. Methods and Material: This randomized prospective study was performed on 34 patients with imperforate anus. Patients were divided into 2 groups (17 patients each); group A were subjected to loop colostomy and group B were subjected to divided colostomy. Results: There was no significant difference between both groups as regards to demographic data (gestational age, sex and birth weight), age of first presentation, associated congenital anomalies and types of fistula. The mean operative time was 42.05 ±6.19 min in group A and 51.76 ±8.21 min in group B. The difference between both groups in this point was statistically significant (P value =0.04). The hospital stay and postoperative complications showed insignificant difference between both groups. Patients with loop stomas were significantly more likely to develop prolapse (P=0.033). Conclusions: Both techniques of colostomy are easy to perform and safe in the anorectal malformation (ARM) patients. Loop colostomy had a shorter operative time, but the complications rates, especially prolapse and urinary tract infection (in cloaca patients), are significantly higher in the loop colostomy when compared to the divided colostomy.
Anorectal malformations
loop colostomy
divided colostomy
2019
10
01
4675
4680
https://ejhm.journals.ekb.eg/article_45933_16099a53be2577f93c53fef56047ee35.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2019
77
1
Role of Plasma Amino Acids Profiles in Pathogenesis and Prediction of Severity in Patients with Drug Resistant Epilepsy
Tahia H.
Saleem
Ahmed Y.
Nassar
Hamdy N
El-Tallawy
Sara A
Atta
Marwa A.
Dahpy
Background: Abnormal plasma levels of free amino acids may predict the severity in patients with drug resistant epilepsy (PRE), having probability to affect their therapeutic approach. Objectives:We aimed to illuminate the effect of plasma free amino acids (PFAAs) profiles on the etiology of patients with PRE and their contribution on the frequencies of epileptic fits. Patients and Methods:We collected clinical and metabolomic data of 90 subjects; 45 of them were PRE patients, and other 45 age and sex matched healthy controls. Quantitative measurements of PFAAs profiles using SykamAutomatic Amino Acid Analyzer S433, in addition to fasting blood sugar, liver function tests, kidney function tests and lipid profile also, were determined. Results: The plasma levels of glutamate, glycine and Gamma amino butyric acid(GABA) plasma levels were significantly increased in PRE group compared to controls (p˂0.0001),their plasma levels also showed significant increase with increased frequency of epileptic fits. Plasma leucine, phenylalanine, aspartate ,ornithine, citrulline, serine and alanine levels (p˂0.0001) were significantly increased in PRE group in relation to healthy controls. Interestingly, on the other hand, histidine, isoleucine, lysine, threonine and the amino acid derivative taurine levels were significantly decreased in PRE patients compared to healthy controls. Conclusion:Few biomarkers of PRE are available to find the severity and rate of progressionof PRE. The present study showed that altered plasma amino acids and their derivatives may be candidate markers for PRE, help explaining its pathogenesis, and for further researches concerning normalization of the disturbed amino acid/s or its derivative/s (GABA and taurine) in managing PRE patients.
Aminogram
Plasma free amino acid profile
Pharmacoresistant epilepsy
2019
10
01
4681
4687
https://ejhm.journals.ekb.eg/article_45934_34aed0b2edac70ad3a770bff1766d096.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2019
77
1
Preoperative Assessment of Crystalline Lens by A-Scan Quantitative Echography and Its Correlation with Phacoemulsification Parameters
Doaa A.
Mahmoud
Hanan S.
Hegazy
Purpose: To evaluate the correlations between the total ultrasound energy consumed during phacoemulsification with various preoperative parameters, including the best- corrected distant visual acuity (BCDVA) and quantified metrics taken from A-scan ultrasound biometry. Patients and methods: A prospective observational interventional study included 40 eyes of 40 consecutive patients scheduled for cataract surgery. We assessed the lens internal reflectivity in the A-scan echograms within a range of 0% to 100%, and calculated the mean of all spikes. All eyes with cataract underwent clear corneal phacoemulsification. At the end of the operation we recorded the phacoemulsification time and mean percent power. The correlations of echographic and phacoemulsification data were assessed. Results: Quantitative echography in the 40 studied eyes with different types of cataract revealed acoustic reflections having various configurations according to the biomicroscopic type of cataract, i.e. cortical, nuclear and posterior subcapsular cataract. The mean spikes were 31.027% ± 25.5908, the mean lens thickness was 4.291 ± 0.6166, the mean best corrected distant visual acuity in decimal was 0.205±0.1435, the mean phaco power% was 6.400 ± 3.0701 and the mean phaco time is 84.225. There was statistically insignificant correlation between spikes% and phaco power% in the study group (p>0.05). There was statistically insignificant correlation between mean spikes% and lens thickness in the study group (p>0.05).There was statistically insignificant correlation between spikes% and phaco time (in seconds) in the study group (p>0.05). Conclusion: With regards to the predictive value of lens hardness changes in the acoustic properties identified by our method, it is not correlated with the ultrasound energy required intraoperatively. The A-scan is helpful for the clinical prediction of lens opacity location, but not predictive of lens hardness quantification.
crystalline lens
A-scan quantitative echography
Phacoemulsification
2019
10
01
4688
4691
https://ejhm.journals.ekb.eg/article_45935_856e0acbf6f250305cabdd2692e28dbe.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2019
77
1
Serum Anti-Mullerian Hormone, Follicle Stimulating Hormone and Antral Follicle Count Measurement as a Prediction for Pregnancy Rates in IVF/ICSI cycle
Abd El Monem Mohamed
Zakaria
Ebrahim Hasan Mohamed
Yosef
Osama Mohamed
Deif
Mohammed Mahmoud Ahmed
Khalil
Background: A successful in vitro fertilization treatment depends on the ability of the ovary to respond to gonadotrophin stimulation. This response reflects the ovarian function or ‘ovarian reserve’. Poor ovarian response may be associated with reduced number of oocytes and embryos and may lead to cycle cancellation in severe cases. On the other hand, exaggerated response leads to increased risk of ovarian hyper-stimulation syndrome. Objective: The aim of this study is to assess role of serum AMH, FSH and AFC measurement as a prediction of pregnancy rates in IVF/intracytoplasmic sperm injection (ICSI) cycle. Patients and Methods: A prospective cross sectional study was conducted at Specialized Air Forced Hospital in the period between January 2018 and December 2018. The study included 100 unexplained infertility patients undergoing IVF/ICSI treatment cycles. They were 82 patients primary infertility and 18 patients secondary infertility. Results: Type of infertility showed insignificant difference between the 2 groups while menstrual history and gonadotrophins type showed significant difference. Age and duration of infertility were significantly higher in nonpregnant group than pregnant. The mean value of FSH, day 3 E2 levels did not have any significant difference between the 2 group while the mean value of serum E2 the day of HCG injection, serum AMH day 3, AFC were significantly higher in pregnant group than non-pregnant. Conclusion: No test can predict pregnancy in high accuracy as it is multifactorial however, mean levels of FSH, E2, a day HCG injection and AFC showed significant difference between pregnant and non-pregnant.
Anti-Mullerian hormone
Follicle Stimulating Hormone
Antral Follicle
Pregnancy Rates
IVF/ICSI cycle
2019
10
01
4692
4699
https://ejhm.journals.ekb.eg/article_45936_ac011fe98b87cb9539776902d8598605.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2019
77
1
Early Versus Delayed Umbilical Cord Clamping in Preterm Births
Tarek Ramadan
Abbas
Adel Aly
Elboghdady
Mohammed Elnady Abdel Samea
Mohammed
Background: Preterm infants are at a great risk for both cognitive and motor delay. Hypovolemia secondary to immediate cord clamping, may be disruptive to the developing brain resulting in subsequent motor delay. Objective: The aim of this work is to compare early versus delayed cord clamping in cases of preterm birth. Patients and Methods: This is a prospective randomized controlled study which was performed at Al-Azhar University Maternity Hospital from July 2018 to February 2019. It included 100 pregnant patients. They were divided into two equal groups: Group I with early cord clamping (ECC). Group II with delayed cord clamping (DCC). Results: In our study the hematocrit on day 1 was also significantly higher in the DCC group (5.2%+50.8 ±vs. 58.5 ±5.1 %, p value 0.00). The DCC group required significantly longer duration of phototherapy (55.3±40.0 h vs. 36.7±32.6 h, p value 0.016) and had a trend towards higher risk of polycythemia probably due to the higher hemoglobin and bilirubin pool in those babies, however the incidence of significant jaundice was not different. In this study, there was no statistically significant difference in blood pressure between neonates of both groups of ECC and DCC. Our study found that 24% of the group underwent delayed cord clamping needed blood transfusion versus 70% of infants of the group of the immediate cord clamping. Conclusion: Delayed cord clamping (DCC) (more than 30 seconds) in preterm births is associated with higher Hb, hematocrit and less need for blood transfusion compared to immediate cord clamping.
Umbilical cord
DCC
ECC
Preterm Births
2019
10
01
4700
4704
https://ejhm.journals.ekb.eg/article_45937_882736578e114acd0d29f10145c23e3c.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2019
77
1
Assessment of Curve Correction in Cases of Adolescent Idiopathic Scoliosis Operated Through Posterior Approach by Ordinary Pedicle Screws
Ibrahim Ahmed
Mustafa
Mohammad Abdelmenem
Negm
Mohammad Nagah Elnoemany
Ashour
Background: Curve correction is the main aim in treatment of adolescent idiopathic scoliosis (AIS). Many methods were published for correction and the most common method now is curve correction through posterior approach. Objective: This study was conducted to assess curve correction in cases of adolescent idiopathic scoliosis that were operated through posterior approach by ordinary pedicle screws. Patients and methods: This was a retrospective study carried out at Al-Azhar University Hospitals between November 2018 and August 2019. Twenty (20) patients with AIS were treated through posterior approach by ordinary pedicle screw. The patients were cooperative and reliable. The sample was comprised of 17 female and 3 male patients with a mean age of 15.3 ± 2.9 years (range 10 - 20 years). Results: The results were analyzed and compared with the results published by other authors which revealed that SRS 24 questionnaire with an average of 100.2 (of total score 120 representing good outcome). All patients gained height ranged from 3 cm to 8 cm with an average of 4.6 cm. Correction of rib hump ranged from 2.2 cm to 7.4 cm with an average of 4.5 cm (about 77%). Conclusion: Finally, we concluded that all pedicle screw constructs are reliable in the treatment of AIS, while longer follow up period is needed.
Adolescent idiopathic scoliosis
scoliosis research society
2019
10
01
4705
4713
https://ejhm.journals.ekb.eg/article_46099_15e638fe53043b6e41c5e5ca22b9f942.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2019
77
1
Accuracy of Fetal Transcerebellar Diameter in the Prediction of Gestational Age in Singleton Pregnancy at the Second and the Third Trimesters
Hanna Abd-Elhammed
El-Ebeisy
Hanan Abd-Elmonem
Mohammed
Basma Osman
Mohammed
Background: Gestational age (GA) is an important parameter in obstetrics for management of pregnancy and evaluating fetal development. High incidence of perinatal mortality has been noted in patients whose accurate gestational age is not known. Objective: The aim of this study was to evaluate whether trans-cerebellar diameter (TCD) in singleton gestations can serve as a reliable predictor of gestational age (GA) in fetuses in the second and third trimester between 14-40 weeks of pregnancy in women attending the clinic for routine ultrasound examination. Patients and methods: This prospective study was carried out at the antenatal outpatient clinic at Al-Zahraa university Hospital and El-Sahel Teaching Hospital. This study was hold one thousand of pregnant women attending the outpatient clinic for routine ultrasound examination during second and third trimester between 14-40 weeks of pregnancy in a period from 1 December 2016 to March 2019. Patients and methods: This prospective study included a total of one thousand of pregnant women, attending at Antenatal Outpatient Clinic, Al-Zahraa University Hospital and El-Sahel Teaching Hospital. The accuracy of the transverse Cerebellar Diameter (TCD) in the prediction of gestational age (GA) in fetuses in the second and third trimester between 14-40 weeks of pregnancy was assessed. This study was conducted between December 2016 to March 2019 Results: According to accuracy of measured gestational age according to measured parameters in relation to actual gestational age (accuracy within 2 weeks), TCD had the highest accuracy (98.7%) than other parameters in early second trimester. Accuracy of TCD in late second trimester was 91.6% and 82% in early third trimester while in late third trimester TCD had the lowest accuracy (68.1%). Conclusion: TCD is an accurate parameter in estimation of gestational age as its values are in close relation with that of GA by LMP. TCD is a better predictor of the gestational age when compared to other parameters especially between (14-22) weeks.
Transcerebellar Diameter
Prediction of Gestational Age
Singleton Pregnancy at the Second and the Third Trimesters
2019
10
01
4714
4719
https://ejhm.journals.ekb.eg/article_46100_2db74fca311960527e613c776d1f050c.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2019
77
1
Assessment of Left Ventricular Function and Contractile Reserve in Patients with Hypertension
Kamal Ahmed
Marghany
Abd-Elhamid Ismail
Abu Rahhal
Abd-Elrahman Atef
Shawkat
Background: Hypertension is a prevalent and well-recognized cardiovascular risk factor, which may lead to left ventricular (LV) systolic impairment through chronic pressure overload. Aim of the work: An impaired contractile reserve (CR) may be an early manifestation of left ventricular (LV) systolic dysfunction in hypertensive patients. Using normotensive patients as controls, we examined LV CR and its correlates in hypertensive patients. Material and methods: The study was conducted prospectively on fifty cases. 30 cases (24 males and 6 females aged 55.57 ± 10.07) had hypertension. All patients were subjected to complete history taking including comorbidities, risk factors and full clinical examination. Patients with significant coronary or valvular disease, previous myocardial infarction or revascularization and diabetes were excluded. LV ejection fraction (LVEF) & global longitudinal strain (GLS) were measured at rest and at low-dose dobutamine. Results: Hypertensive patients, compared to control had significantly impaired GLS at rest (-19.00 ± 2.34% vs. -20.50 ± 1.52%, P <0.015) and at low dobutamine dose (-19.90 ± 2.33% vs. -22.60 ± 1.88 %, P <0.001). Absolute and relative GLS CR were significantly lower in hypertensive patients (-0.88 ± 0.45% vs.-2.12 ± 0.77% and 4.70 ± 2.76% vs. 10.33 ± 3.78 %, respectively, both P < 0.001). Absolute and relative LVEF CR were significantly lower in hypertensive patients (3.31 ± 0.97 % vs. 7.09 ± 1.67% and 5.37 ± 1.64% vs. 11.61 ± 3.19%, respectively, both P < 0.001). Conclusion: Compared to control, hypertensive patients with no other co-morbidities had impaired LV GLS at rest and impaired CR despite normal LVEF.
Hypertension
Ventricular function
contractile reserve
Echocardiography
Speckle tracking strain
2019
10
01
4720
4726
https://ejhm.journals.ekb.eg/article_46750_eb28bfdb99386dad2bcf49437988193f.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2019
77
1
Prediction of The Functional Outcome in A Group of Egyptian Patients with Posterior Circulation Stroke
Fathi M. Afifi
Nasra
Ahmad H.
Ali
Abdelmonem M.
Hassan
Yasser A.
Alzainy
Background: Stroke is the third most common cause of disability and second most common cause of death worldwide. Brainstem is involved in almost all the important functions of the central nervous system, and brainstem infarction is relatively dangerous with high mortality. Early prediction of the severity and degree of disability and identification of high-risk patients are critical for the treatment of patients with brain stem infarction and might contribute to reduce death rates and comorbidities after stroke. Objective: To assess the usefulness of Posterior circulation Alberta Stroke Program Early CT Score (pc-ASPECTS) for predicting functional outcome in posterior circulation stroke patients. Subjects and Methods: A cohort study on 61 patients with first-ever acute ischemic stroke who were admitted within 24 h from onset. Results: We observed a statistically significant correlation between poor outcome and high NIHSS score on initial assessment, as well as low pc-ASPECTS score, in contrast to other factors involved in the study such as, age, sex, hypertension, atrial fibrillation, diabetes mellitus, high lipid profile, smoking, time from onset to presentation, ESR, initial blood glucose measurement, HbA1C, leukoaraiosis, silent infarction or type of stroke. Conclusion: both the pc-ASPECTS and NIHSS help clinicians predict functional outcomes. The pc-ASPECTS is more reliable than the NIHSS in minor stroke prediction. Moreover, the combination of the pc-ASPECTS and NIHSS has an additive effect in predicting the functional outcomes of patients with posterior circulation stroke.
Posterior Circulation
stroke
pc-ASPECTS
Outcome
2019
10
01
4727
4732
https://ejhm.journals.ekb.eg/article_46752_02f34a5908e9be4aeb165d6e9170ec6a.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2019
77
1
Effect of Adding Dexmedetomidine as Adjuvant to Different Regional Anesthetic Techniques after Inguinal Herniorrhaphy
Ezzat Mahmoud Ali
El-Saudi
Waheed Mohamed
Ali
Esraa Mohamed Mohamed
Abd-elsalam
Background: Inguinal herniorrhaphy is one of the most commonly performed surgeries, often performed on a fast-track basis. However, inguinal herniorrhaphy is frequently associated with persistent postoperative discomfort and pain, which can lead to patient distress, delayed discharge, and subsequent complication. Objective: Aim of this work is to compare TAP block technique versus local infiltration with or without dexmedetomidine regarding analgesic effect and endogenous stress response. Patients and Methods: This randomized prospective study included 120 patients of both genders scheduled for non-complicated inguinal hernioplasty. Their age ranged between 18 and 60 years, with ASA physical status I and II, and body mass index ≤ 35 kg /m². The study was approved by the medical ethics committee of Al-Azhar University Hospital in Assiut and a written informed consent is obtained from all patients. Results: The major finding in this study was that the pain scores were statistically significantly lower when we added dexmedetomidine than when we did not add it and in the surgical site infiltration groups than TAP block groups at postoperative 2nd, 6th, and12th hours. 1st request for analgesia in this study among all groups was similar. Frequency of analgesic doses was statistically significant among all groups, and group T used the most frequent doses. In this study, local wound infiltration and TAP block with dexmedetomidine showed decrease number of analgesic doses and attenuated the stress response indicators (norepinephrine and glucose levels) without side effects. Conclusion: Dexmedetomidine added to bupivacaine in both local infiltration and TAP block had better visual analogue scale, decreased number of analgesic doses and attenuated postoperative stress response indicators. Norepinephrine is the most accurate stress response indicator while blood glucose is accurate and the cheapest one.
Dexmedetomidine
Regional anesthetic techniques
Inguinal herniorrhaphy
2019
10
01
4733
4741
https://ejhm.journals.ekb.eg/article_46754_bf24100468f2945b61d16013fa74d0ef.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2019
77
1
Interleukin 28B Polymorphism as a Predictor of Response to Treatment of Egyptian HCV Patients Working in Nuclear Material Authority
Hisham E
Zidan
Randa M
Talaat
Amal A A
Ammar
Moustafa A
Sakr
Background: A Single nucleotide polymorphism upstream of the interferon-λ3 gene (IFNL3; formerly referred to IL28B), strongly linked to unprompted and treatment-induced HCV infection clearance. Interleukin 28B genotype predictive value over the outcome interferon-α/ribavirin treatment was assessed carefully and contrasted with virological predictors Objective: The study aimed to evaluate IL-28B rs12979860 polymorphism in the reaction of HCV patients with directacting antiviral (DAA) regimens (sovosbuvir) and ribavirin therapy and the allele frequencies of this gene in Egyptian HCV patients working in the Egyptian Nuclear Materials Authority contrasted to healthy control. Subjects and Methods: The study was conducted on randomly chosen fifty Egyptian patients infected with genotype 4 HCV aged 30 or more and received antiviral therapy (sovosbuvir and ribavirin) before six months or more. Another Fifty age and gender matched apparantely healthy individuals were also selected as a control group. The study was carried out in accordance with the ethical principles and guidelines of the Declaration of Helsinki and a written informed consent was obtained from all subjects. Results:IL-28B genotype CC was found in 34.6% of patients, while CT and TT genotypes were identified in 42.3 and 23.1% of patients, respectively. Forty (40%) patients achieved an SVR, whereas ten (20%) did not. Of the 40 patients with an SVR, 12 had genotype CC, 25 had genotype CT, and 3 had genotype TT. CT genotype patients has achieved considerably higher SVR rates (62.5%) compared with CC (30%) and TT patients (7.5%). Conclusion: Polymorphism Il-28B is an autonomous predictor of SVR to Peg IFN / RBV in patients with genotype 4 in Egyptian HCV favorable.
Interleukin 28B
hepatitis C
Sofosbuvir
2019
10
01
4742
4747
https://ejhm.journals.ekb.eg/article_46755_a30f9cb6683b6eec64820ba6ba969318.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2019
77
1
Interferon-Lambda 4 Gene Polymorphisms Predict Treatment Response in Egyptian HCV Genotype 4 Patients Exposed to Radiation
Hesham E
Zedan
Randa M
Talaat
Amal A A
Ammar
Moustafa A
Sakr
Background: Direct-acting antivirals (DAAs) has seen a significant increase of the count of patients with hepatitis C virus (HCV) clearing their infection. Interferon Lambda Four (IFNL4) polymorphism plays a distinguished role in spontaneous and treatment-output clearance of HCV infection. Aim of this Work: This study aimed to assess IFNL4 polymorphism among hepatitis C Egyptian patients who were exposed to radiation, compared to normal by a polymerase chain reaction with restriction of fragment length polymorphism (PCR-RFLP) technique. Materials and Method: This study included 50 HCV-positive Egyptian patients working in Egyptian Nuclear materials Authority treated with DAAs therapy. According to treatment, they were split into two groups. Group I included 40 patients with sustained viral response (SVR). Group II included 10 patients with no response (nSVR). Fifty healthy people served as controls. Liver function tests, complete blood count, evaluation of viral markers, HCVRNA by PCR, and evaluation for IFNL4 single nucleotide polymorphisms for rs368234815 were performed by PCRRFLP in all patients. Results: Of the 50 patients, 40 (80%) achieved sustained virological response (SVR). Of the 23 patients with rs368234815 TT/TT genotype, 21 (91.3%) achieved SVR, while in 27 patients with non‑ TT/TT genotypes, 19 (70.4%) achieved SVR. The rs368234815 was a powerful predictor of SVR. However, in the present research individuals, the predictive power of this SNP was the same as that of rs12979860 SNP. Conclusion: In Egyptian HCV-positive patients with genotype 4, IFNL4 rs368234815 SNP is an autonomous predictor of SVR to DAAs treatment.
Interferon Lambda Four
hepatitis C
polymerase chain reaction
2019
10
01
4748
4753
https://ejhm.journals.ekb.eg/article_46756_5ea73d076ddc694a92f2604afebce1e5.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2019
77
1
Pattern of Eye Diseases in Ophthalmic Outpatient Clinic of Al-Zahraa University Hospital: An Observational Descriptive Study
Afaf Hassan
Rashwan
Omaima I.
Abo-Elkheir
Aya Alsayed I.
Metwally
Background: A study of the pattern of the eye diseases is very essential because while some eye conditions are only causing of ocular morbidity, others invariably lead to blindness. However, some conditions are curable, others are largely preventable. Objective: The aim of this study was to determine the pattern of different eye diseases among patients attending the Ophthalmic Outpatient Clinic of Al-Zahraa University Hospital. Subjects and methods: This study was carried out on 500 patients recruited from the Outpatient Clinic of the Ophthalmology Department, AL-Zahraa University Hospital. The study was performed from December 2018 to August 2019. All participants were subjected to fulfilling a pre designed questionnaire including questions about demographic data, a detailed ophthalmological history and a complete Ophthalmological Examination. Results: Retinal diseases (20.2%) were the most common eye diseases among the studied group followed by errors of refraction (19.6%), cataract (19.4%), dry eye (12.8%) and intravitreal injection (6.4%). There was a significant difference between male and female population regarding ocular trauma and different eye diseases. Also, there was a significant difference between occupation groups regarding diagnosis of different eye diseases and between age groups regarding diagnosis of different eye diseases. Conclusion: It could be concluded that due to the presence of a variety of ocular disorders that affect different anatomical parts of the eye, routine clinical examination and screening programs to decrease the incidence and prevalence of ocular morbidity are required.
Pattern of eye diseases
ophthalmology clinic
Cairo
Al-Azhar University
Egypt
2019
10
01
4754
4759
https://ejhm.journals.ekb.eg/article_46757_d3865648c832268026b49f57764b61e4.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2019
77
1
Diagnostic Value of Combined Diffusion Weighted MRI and Conventional MRI in The Diagnosis of Non-Palpable Undescended Testes
Elsayed Ahmed Ibrahim
Awad
Abd Ellah Nazeer
Yassin
Maged Mohamad
AbdlAziz
Background: Additional MRI assessments, as DWI are useful methods to improve the accuracy and sensitivity of diagnosis of non-palpable testes. Objective: The aim of this work was to assess diagnostic value of combined diffusion weighted MRI and conventional MRI in the diagnosis of non-palpable undescended testes before laparoscopy. Patients and Methods: This was a prospective study during a period of 12 months duration from January 2018 to December 2018 including 30 male patients with 33 non-palpable undescended testes (unilateral in 27 cases and bilateral in three cases). They were prospectively enrolled in this study. Their ages ranged from 6 months to 21 years old (mean age = 4.04 ± 4.004 years, mood=1 years). The research was carried on the Radiology Department, Al Azhar University Hospital and AlAhrar Teaching Hospital. All patients underwent ultrasound then underwent magnetic resonance imaging included different pulse sequences and scanning planes. Results: Conventional MRI showed sensitivity of 79.31%, specificity of 100% and overall accuracy of 81.82%; DWI had higher sensitivity (82.76%) but lower specificity (75%) and similar overall accuracy (81.82%) compared to conventional MRI; combined assessment had the highest sensitivity (86.21%), specificity (100%) and accuracy (87.88%). Conclusion: DWI findings complement the information on the location and viability of undescended testes obtained with conventional MRI before laparoscopy.
Conventional MRI
DWI
UDT
2019
10
01
4760
4767
https://ejhm.journals.ekb.eg/article_46758_3311322555f6451eae60903f501c7969.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2019
77
1
Assessment of Degree of Fibrosis in Chronic Hepatitis C Virus Patients Treated with Direct Acting Antiviral Agents
Fathy Ghamry
Abd-Elrazik
Magdy Abd-Elkarim
Aldahshan
Arafat Abd-Elazim
Kasim
Haitham Ahmed Ali
Gabr
Mohamed Nasr
Mohamed
Background: Weighing in at around 3 pounds, the liver is the body’s second largest organ; only the skin is larger and heavier. The liver performs many essential functions related to digestion, metabolism, immunity, and the storage of nutrients within the body. These functions make the liver a vital organ without which the tissues of the body would quickly die from lack of energy and nutrients. Fortunately, the liver has an incredible capacity for regeneration of dead or damaged tissues; it can grow as quickly as a cancerous tumor to restore its normal size and function. Objective: to evaluate the levels of fibrosis regression by ARFI in the patients with successful eradication of chronic hepatitis C virus after 12 weeks and 24 weeks after completion of treatment with direct acting antiviral drugs (sustained virological response, SVR 12 and SVR 24). Patients and Methods: This prospective and observational cohort study was conducted during the period between June 2016 and February 2019 in total of 60 individuals at Al-Azhar (Al-Hussein) Hospital and National Search Institute in Cairo divided into three groups. Results: Results show that the median fibrosis degree measured by ARFI in all patients was significantly decreased after HCV eradication with 100 % success in cure rate and 16.5% of patients failed to regress fibrosis. Conclusion: A disappointing percentage (16.5%) failure in fibrosis regression although reaching a sustained virological response.
Hepatitis C virus
sustained virological response
Liver cirrhosis
2019
10
01
4768
4776
https://ejhm.journals.ekb.eg/article_46759_3815a1d26d7f2d09d858d4fe70f28c98.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2019
77
1
Detection of Some Genetic Polymorphism and Serological Factors Associated with Rheumatoid Arthritis in Egyptian Patients
Kareman M.
Bakr
Maha M.
Abd Al-Rahman
Aml E.
Abdou
Hegazy M.
Al-Tamimy
Background: Rheumatoid arthritis is a chronic inflammatory autoimmune disease thatis characterized by destruction of cartilage and bone. PADI4 gene encoding the peptidyl arginine deiminase 4 citrullinating enzyme that has been found to be over expressed in rheumatoid arthritis patients. Objective: To investigate relation between PADI4 gene polymorphisms and anti–cyclic citrullinated peptide (Anti-CCP) autoantibody levels in sera of Egyptian rheumatoid arthritis patients, and to find its relevance to the disease activity(DAS28 score) and other inflammatory markers as Rheumatoid factor (RF). Methods: PADI4-89 andPADI4 -92 single nucleotide polymorphisms (SNPs) were analyzed in thirty RA patients and twenty healthy controls by polymerase chain reaction- restriction fragment length polymorphism (PCR-RFLP) method. Serum anti-CCP levels were measured by enzyme-linked immunosorbent assay (ELISA). Results: PADI4-89 genotype A/G was present in RA patients at higher frequency compared to controls (P = 0.024). (G) allele frequency was significantly higher in RA patients than in controls (P= 0.047). Level of Anti – CCP was significantly higher in RA patients serum than in controls (P= 0.000).PADI4-89 A/G + G/G genotype and PADI4-92 C/G+GG genotype were associated with higher DAS28 score, Rheumatoid factor (RF), and anti-cyclic citrullinated protein (Anti – CCP). Significant positive correlation was found between serum level of Anti– CCP and DAS28 score (P= 0.023). Conclusion: The SNPs A/G and G/G of PADI4-89 were associated with RA susceptibility. Relation was found between both PADI4 polymorphism and anti-CCP levels.
Rheumatoid Arthritis
PADI4
Single nucleotide polymorphism
Anti– CCP
2019
10
01
4777
4784
https://ejhm.journals.ekb.eg/article_46760_bdb2af2788ca6e92d6446a9d427d8ac8.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2019
77
1
Evaluation of Right Ventricle Diastolic and Systolic Function in Patients with Intracardiac Shunts by Strain Echocardiography and Tissue Doppler
Raghda Ghonimy
El Sheikh
Suzan Bayoumy
Elhefnawy
Ayman Ahmed
Gaafar
Tarek Hanafy Mahmoud
Mahdy
Background: The right ventricle performance is very important in the prognosis of the patients with intracardiac shunts. Development of RV failure is associated with higher mortality. It can be directly related to the shunt itself or indirectly associated with elevated pulmonary artery pressure. Objective: The aim of this work wasto assess the diastolic and the systolic performance of the right ventricle in patients with different types of intracardiac shunts by the Echocardiography in comparison with the normal population. Patients and methods: Our study included 132 patients undergoing echocardiography in the Outpatient Clinic of Tanta University Hospital. The study was conducted starting from 1st of February 2018 to 28th of February 2019. The study included 63 female and 69 male patients. Their age ranged from 1 month to 49 years old. RV diastolic and systolic function were assessed in the four groups using MPI, Stroke work, longitudinal RV strain rate. Results: Our results showed higher values of the parameters measured in the atrial septal defects (ASD) patients' group compared to the normal subjects and the other intracardiac shunt's patients. Also, ASD's patients were associated with higher pulmonary artery pressure values and worse RV function parameters in general. Conclusion: We concluded that the new echocardiographic measures are good and reliable tool to assess the right ventricle function in the patients with intracardiac shunts. Additionally, ASD’ patients are associated with worse outcome especially if they develop elevated pulmonary artery pressure.
Right Ventricle Diastolic and Systolic
Echocardiography
Tissue Doppler
2019
10
01
4785
4796
https://ejhm.journals.ekb.eg/article_46761_b1980e9bdc5be3702542d3603131ba06.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2019
77
1
Outcome of Patient with Moderate Functional Tricuspid Regurgitation Underwent Mitral Valve Replacement without Tricuspid Valve Repair
Abd-Allah Abd-Alhamid
Sallam
Mohammed Eldesoky
Sharaa
Bahaa Abd-El Gawad Hassan
El Khonezy
Mahmoud Hamed Al-Emam
Zidan
Mohammed Abd Elhameed
Mohammed
Background: The tricuspid valve is often called the "forgotten valve" or "lost valve," because it is relatively understudied relative to the other cardiac valves. Left-sided valvular heart diseases represent the most common cause of functional tricuspid regurgitation (FTR) and the reported prevalence reached 25% to 30%. Objective: The aim of the work is to give an attention to the problem of moderate functional tricuspid valve regurgitation with mitral valve replacement and includes revision of anatomy of tricuspid valve, pathophysiology, diagnosis and management of functional tricuspid valve regurgitation. Patients and Methods: In the present retrospective study, 30 randomly selected patients with moderate functional tricuspid valve regurgitation (grade 2) underwent mitral valve replacement for the first time at Al-Hussein University Hospital without repair of their moderate functional tricuspid regurgitation. The study was approved by the medical ethics committee of Al-Azhar University Hospitals and a written informed consent is obtained from all patients. Results: In the present study and according to the sex, the females (9) represent (30%) while males (21) were (70%). Their age ranged between 40-60 years with mean 48.40 ± 6.92. The Degree of TR was mild 15 (50.0%), moderate 6 (20.0%), severe 3 (10.0%) and Trivial 6 (20.0%) of Echo data after 6 months. Conclusion: Functional tricuspid regurgitation (TR) is commonly associated with mitral valve (MV) diseases and the presence of significant TR is reported to be an indicator of poor prognosis after the surgical correction of MV diseases.
Moderate functional tricuspid regurgitation
Mitral valve replacement
Tricuspid valve repair
2019
10
01
4797
4801
https://ejhm.journals.ekb.eg/article_46762_c850c757de83a75b7e23b5c654baa895.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2019
77
1
Risk Factors of Anemia in Pre-end-Stage Renal Disease
Mohammed M.
Nussier
Mohammed S.
Allam
Background: Anemia is a common complication of chronic kidney disease (CKD). Observational studies indicate that low Hb levels in such patients may increase risk for progression of kidney disease and cardiovascular morbidity and mortality. Objective: The aim of the work is to study the different risk factors contributing to anemia in preend stage renal disease patients (stage 3 and 4 CKD). Subjects and methods: The study involved 50 patients with history of CKD, not receiving any treatment or dialysis, 29 men and 21 women, 22-72 years old. In addition to 20 healthy persons as a control group. They were randomly selected from the outpatient clinics and inpatient department of Internal Medicine Departments, Al-Azhar Assiut University Hospitals over a period of two years. Results: There were different risk factors causing anemia among patients group; 1-Anorexia was present in (44%) of patients, 2-Fecal occult blood test was positive in (6%) of patients, 3-The indicators of inflammation including high levels of CRP, ESR (were high in 100%) and serum ferritin was high in (80%) of patients, 4-The indicators of “uremic milieu” including increased level of blood urea and S. creatinine and moderate to severe albuminuria in addition to decreased level of GFR, all were present in (100%) of patients, and 5-erythropoietin deficiency also was present in (54%) of patients. Conclusion: Our study concluded that anemia in pre end stage renal disease (ESRD) is multifactorial and the prevalence of different risk factors is inversely correlated with hemoglobin level.
risk factors
Anemia
Pre-end Stage Renal Disease
2019
10
01
4802
4809
https://ejhm.journals.ekb.eg/article_47001_1a8af7b9c04813d01c5893846ef289ca.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2019
77
1
Prevalence of Hepatitis C virus (HCV) and Hepatitis B Virus (HBV) Co-infection among Human Immunodeficiency Virus (HIV/AIDS)
Mohamed Abdel-Basset
gumie
Saeed Abdel-Baki
Gad
Ahmed Alaa-Eldin Abdelrahman Ahmed
Elgayar
Background: HIV, HBV and HCV are still major public health concerns. Infections with these viruses rank among ten leading causes of death attributable to infectious diseases. The variability in the prevalence of HIV/hepatitis coinfection worldwide is multifactorial, and depends on geographic regions, infections’ risk factors and type of exposure. Objective: To investigate HBV and HCV prevalence in HIV patients. Patients and Methods: This study was conducted on HIV infected, and AIDS patients attending Alexandria Fever Hospital during the period from August 2018 to July 2019, assuming prevalence of HCV in HIV patients is 15% sample was calculated to be 141 patients using epi info version 7 program with test power 80%, CI 95%. Results: The incidence of infection with hepatitis C virus was 45 patients (31.9%), all the 45 tested positive for PCR for HCV RNA as HIV accelerated progression of the disease making it almost impossible for HCV spontaneous clearance. This percentage is much higher than that of ordinary people, and the incidence of hepatitis B infection is 9 patients (6.4%). The Prevalence of co-infection between hepatitis C virus and HBV among immunodeficiency patients was 2.8%, with the combined infection among the three viruses in only 4 patients out of 141 patients. Conclusion: the results of the present work underline the importance of continued screening of HIV positive for HBV as well as HCV markers before initiation of highly active antiretroviral therapy (HAART) as this practice would guide correct choice of drug combination.
HCV
HBV
HIV
AIDS
2019
10
01
4810
4814
https://ejhm.journals.ekb.eg/article_47002_46fe812aec6b30de73c9e061f94b9abd.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2019
77
1
Evaluation of The Effect of Combined Intra-Vitreal Ranibizumab Injection and Sub-Tenon Tri-Amcinolone Acetonide Injection in The Management of Diabetic Macular Edema
AbdelKader Sayed
Abdelkader
Nour eldin
abdelhamid
Mohamed Mustafa
Bahnassy
Background: to monitor and compare the effect of intravitreal ranibizumab injection alone or with sub-tenon triamcinolone acetonide injection on patients with diabetic macular edema. Aim of the Work: To assess the effect of combined intravitreal ranibizumab injection, and sub-tenon triamcinolone acetonide injection in the management of diabetic macular edema. Patients and Methods: Patients with non-proliferative diabetic retinopathy associated with DME (Central macular thickness over 300 um) which are aimlessly divided into two groups. In group 1, three monthly doses (0.5 mg) of intravitreal ranibizumab are received. In group 2, the anti-VEGF injection was performed 10 days after the sub-tenon steroid injection [triamcinolone acetonide]. All patients’ visual acuity, IOP and CMT were followed up for 3 months. Results: The combined treatment showed improved best corrected visual acuity from baseline 0.24 ± 0.32 log MAR to 0.56 ± 0.18 log MAR (p = 0.023) which was statistically significant. In addition, there was decreased CMT from baseline 420.1 ± 112.84 to 275.73 ± 90.81 which was highly statistically significant (p > 0.001). When comparing the combination treatment with the anti-VEGF treatment alone, recovery of BCVA and CMT was statistically significant (p = 0.041 and p = 0.001, respectively). Conclusion: Steroid addition to the routine anti-VEGF therapy is an effective method of treatment of diabetic macular edema
macular edema · Steroid · Ranibizumab · Diabetic · Combined treatment
2019
10
01
4815
4819
https://ejhm.journals.ekb.eg/article_47003_72c391c43a2f77c8a204c37d11d979bd.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2019
77
1
Incidence of Solid Organ Injury after Isolated Blunt Abdominal Trauma in Pediatric Patients in Tanta University Hospital
Nahla El-Sebaie
Mostafa
Khalid Ahmed
Ismail
Akram Mohammed
Elbatarny
Khalid Mohammed
ElShimy
Background: Trauma is considered the leading cause of children death worldwide. The most common cause of death in pediatric trauma is abdominal trauma. Aim of the study: This study aimed to evaluate incidence of solid organ injury after blunt abdominal trauma (BAT) in pediatric patients. Patients and Methods: The study was conducted on pediatric patients admitted to Emergency Department, Tanta University Hospital with suspected solid organ injury after isolated blunt abdominal trauma. Results: In this study, we had 119 patients with blunt abdominal trauma presented to emergency department. FAST (Focused Assessment with Sonography for Trauma) showed that intra-peritoneal free fluid (IPFF) only with no solid organ injury was found in 39.5%. Splenic injury was found in about 38.7% of patients while hepatic injury was present in about 18.5%. Renal injury was found in about 1.7%. Both renal and splenic injury were present in about 0.8%. Conclusion: Splenic injury was the most common solid organ to be injured in blunt abdominal trauma in pediatrics.
Pediatric
blunt trauma
abdominal
intra-abdominal injury
2019
10
01
4821
4823
https://ejhm.journals.ekb.eg/article_47004_571bac3bcf000dd3a61e2836db03bf2a.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2019
77
1
Citric Acid Inhibits Clonogenic Power and Anchorage-Independent Growth of Glioma Cells
Mongi
Ayat
Background: Glioblastoma multiforme (GBM) is the most fatal glioma with poor prognosis. C6 glioma is an experimental model to simulate GBM growth and biology. GBM benefits from Warburg effect (aerobic glycolysis ending in lactate formation even in the presence of oxygen) in tumor growth, invasion and metastasis. Citric acid is an antioxidant and inhibitor of glycolysis pathway (phosphofructokinase inhibitor) that constitutes the major source of energy supply to aggressive cancer cells. Citrate is a promising inhibitor of Warburg effect through blocking glycolysis upstreatm of lactate formation step. Methods: Ability of citric acid to inhibit experimental GBM colony formation and anchorage-independent growth were investigated. Results: Citrate induced a dose-dependent inhibition of growth and proliferation of glioma colonies (attached to substratum). High citrate dose (9 mM) inhibited initial formation of glioma colonies. A similar picture was observed where citrate induced a dose-dependent inhibition of growth of glioma colonies in soft agar (i.e. not attached to a substratum). High citrate dose (9 mM) inhibited initial formation of glioma colonies. In conclusion, citrate inhibited 3D tumor models of GBM. Citric acid inhibited clonogenic power of glioma cells. Conclusion: Citric acid may be a promising therapeutic modality for glioma and glioblastoma. That is quite promising in treating GBM tumors and can be generalized for research in different tumors.
2019
10
01
4824
4831
https://ejhm.journals.ekb.eg/article_47005_62b1cc97663ef642416f64d4dd9c8e9a.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2019
77
1
Clinical Outcomes in Diabetic Patients with Stable Coronary Artery Disease Treated with Second- Generation Drug Eluting Stents (Short and Mid-Term Follow Up)
Ehab Abdelwahab
Hamdy
Mohamed Naseem
Hussien
Ayman Ahmed
El Sheikh
Mohamed Abdel Moatty
Emam
Buckhound: The increased prevalence of type 2 diabetes mellitus (DM) is an important public health problem. The number of patients with DM worldwide is estimated to rise to 366 million by the year 2030. In general, individuals with DM have more severe and diffuse atherosclerotic disease, which accounts for the significantly higher incidence of cardiovascular events in their native coronary, cerebrovascular, and peripheral arteries. Objective: The aim of this study was to assess the short and mid-term clinical outcomes in type 2 diabetic patients with stable coronary artery disease treated with 2nd generation drug eluting stents. Patients and Methods: This prospective observational study included a total of 100 type 2 DM-CAD patients, attending at Department of Cardiology, Tanta University Hospitals. This study was conducted between January 2018 till January 2019. Assessment of the mid and short-term clinical outcomes in patients was done. Results: Non-significant difference as regards age, sex and family history (p > 0.05) was found. Non-significant difference as regards height, weight, BMI, HTN and smoking (p > 0.05) was found. Significant increase in inverted T wave in Major Adverse Cardiovascular Events (MACE) group; compared to normal group; with significant statistical difference (p = 0.015). Non-significant difference as regards creatinine, ST elevation, ST depression, pathological Q, LBBB and RBBB (p > 0.05) were found. Highly significant decrease in EF in MACE group; compared to normal group; with highly significant statistical difference (p < 0.01) were found. Conclusion: Diabetes mellitus is a condition in which the use of 2nd generation zotarolimus-eluting stents is preferable, in order to reduce the incidence of MACE adverse events.
diabetic
Coronary artery disease treated
Second- Generation drug eluting stents
2019
10
01
4832
4839
https://ejhm.journals.ekb.eg/article_47405_6c58b5363ee9e7220b16c5f8c36f8469.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2019
77
1
Prediction of Admission to Delivery Time by Transvaginal Ultrasonographic Assessment of the Cervix in Cases of Preterm Prelabour Rupture of Membranes
Omar S.
Ayad
Mohammad R.
Abd El Zaher
Mohammad T.
Ismaeil
Background: Preterm Premature Rupture of Membranes (PPROM) heralds about 30% of cases with spontaneous preterm births. Latency in PPROM is delineated as the time interval between PROM and delivery. It might be beneficial to predict this latency period as it may help to make a decision concerning in-utero transfer of fetus to better neonatal centers with advanced facilities and to administer corticosteroids in favor of fetal lung maturity. Objective: The aim of the current study was to assess the usefulness of measuring the cervical parameters by transvaginal sonography mainly cervical length and posterior cervical angle, in predicting the interval from admission to delivery in women with (PPROM). Subjects and methods: This study was conducted at Kafr El- Shiekh General Hospital and Al-Azhar University Hospitals and included 100 pregnant women with a singleton pregnancy of gestational age between 28-34 weeks and PPROM presenting within 24 hours and not in labour. Results: showed non-significant differences between the mean of PCA among different groups (P>0.05). Nevertheless, the results indicated that amniotic fluid index (AFI) increased significantly in patients with latency period >7days group (P<0.001). Furthermore, the mean Cervical length (CL) was observed to increase in PPROM patients’ group with high latency period. The latency period had significant positive correlation with AFI and cervical length (p<0.05). Also, it had significant negative correlation with birth weight, gestational age at hospitalization, CRP, and TLC, and neonatal sepsis (p<0.05). Conclusion: It could be concluded that assessment of Cervical length via transvaginal sonography is a valuable tool in the evaluating the interval between rupture of membranes and delivery in women with PPROM.
PPROM
TVS
Cervical length
posterior cervical angle
latency period
2019
10
01
4840
4846
https://ejhm.journals.ekb.eg/article_47406_6997a1a6e5d7f4521d419e7120b2d49b.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2019
77
1
Serum Calcium, Magnesium, Uric Acid and C-Reactive Protein in Preeclampsia and Normal Pregnant Women
Mostafa A.
Abdel-Hamid
Abd El Moneim m.
Zakaria
Fahd A.
Alomda
Mekky
Abd El Moneim
Objective: To assess and to look at serum levels of calcium, magnesium, uric acid and C-reactive protein in mild, extreme preeclamptic ladies and ordinary pregnant ladies and to connect these levels with seriousness of the ailment. Methods: This investigation was a planned observational case-control study that was led at the division of Obstetrics and Gynecology, Al-Azhar University, Maternity Hospital on 90 pregnant ladies in the third trimester of pregnancy (gestational age from 28 to 40 weeks of pregnancy) chosen from the individuals who had gone to the antenatal facility and the banquet hall in the period from January 2018 to June 2019. They were divided into 3 groups: 30 patients with serious preeclampsia, 30 patients with gentle preeclampsia and 30 normotensive ladies free of any medicinal issue (control group). The study was approved by the medical ethics committee of Al-Azhar University Hospitals and a written informed consent is obtained from all participants. Results: The mean estimations of CRP and serum uric acid were fundamentally higher in the pregnant ladies with preeclampsia than in the sound control ladies (p<0.05), while the mean estimations of serum calcium were altogether lower in the pregnant ladies with preeclampsia than in the solid control ladies (p<0.05). The mean serum magnesium didn't demonstrate critical contrasts among preeclampsia and solid ladies (p>0.05). Conclusion: These discoveries bolster the speculation that hypocalcaemia, hyperuricemia and expanded C-reactive protein could be potential etiologies of preeclampsia and that they relate to the seriousness of the illness.
Serum calcium
Serum magnesium
Serum uric acid
C-reactive protein
preeclampsia
Normal pregnancy
2019
10
01
4847
4854
https://ejhm.journals.ekb.eg/article_47417_adbe15f9294ec387a79c52212cbbd745.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2019
77
1
A Study of Helicobacter Pylori Infection in Patients with Non-Alcoholic Fatty Liver Disease
Abd El-Hamid E.
Khalil
Hesham E.
lashin
Mahmoud M.
Metwally
Mohamed
Rady
Background: Helicobacter pylori (H. Pylori) infection has been notified to enhance the progression of distinct extra-digestive manifestations, embraced type 2 diabetes, liver, and cardiovascular diseases. Currently, the association between H. pylori infection and nonalcoholic fatty liver disease (NAFLD) was suggested. Conversely, evidence from various studies was doubtful. Aim of the study: This study was performed to assess the prevalence of H. Pylori infection and the possible predictors of H. Pylori infection among NAFLD patients. Patients and Methods: This prospective observational case-control study included a total of 60 patients with NAFLD and 20 apparently healthy subjects served as control, attending at the Outpatient Clinic and Internal Medicine Department, Sayed Galal; Al-Azhar University Hospitals. This study was conducted between February 2018 to March 2019. All participants were submitted to full history taking, complete physical examination, and routine laboratory investigations. H. pylori Ag in stool test was tested to reveal the existence of infection along with abdominal ultrasonography using Hamaguchi scoring system for assessment of NAFLD. Results: An overall 80 participants were included in the current investigation. Based on the presence of NAFLD, participants were assorted into healthy control group (20 candidates) and NAFLD group (60 patients) with a mean age of 35.65±10.73 and 39.72±11.14, respectively. An overall 48 patients were infected with H. Pylori. Of them, 6 (30%) were among the healthy control group, whereby 42 (70%) were among NAFLD group (P<0.001). Based on the multivariate logistic regression model, the male gender and the levels of high density lipo-proteins (HDL-C) were statistically significant predictors of H. Pylori infection among NAFLD patients. Conclusions: The burden of H. Pylori infection among NAFLD patients was noticeably high. Additionally, obese males with decreased levels of HDL-C were more expected to be H. Pylori positive infection.
H. pylori
Nonalcoholic fatty-liver disease
High density lipoprotein cholesterol
2019
10
01
4855
4860
https://ejhm.journals.ekb.eg/article_47421_946ac034bcfa9cb41a0788d639eb9c70.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2019
77
1
Botulinum Toxin-A, Fexofenadine Hydrochloride, and Nasal Corticosteroid (Triamcinolone) Spray in Treatment of Allergic Rhinitis
Ahmed
Abdelfattah
Essam A.
El-Moselhy
Background: allergic rhinitis (AR) is a common health challenge and its prevalence is rising. Many medications were used for treatment. Aim of the work: to compare the effects of monotherapy with topical steroid, Botulinum Toxin-A (BTX-A) or Fexofenadine hydrochloride in treatment of AR. Patients and Methods: one hundred and fifty patients with AR were included. They were divided into three equal groups; the first treated with a single dose intranasal injection of BTX-A, the second treated with Fexofenadine (once/day), and the third treated with intranasal steroid spray (Triamcinolone, once/day). All patients were evaluated before treatment for nasal symptoms and each symptom was scored by severity. In addition, patients were administered the rhinoconjunctivitis quality of life (RQoL) questionnaire. All patients were followed-up each two weeks till the end of the third month and data was evaluated in each visit. Results: at baseline, groups were comparable regarding symptom severity and quality of life (QoL). At 2 weeks, all groups showed improvement in symptom severity and QoL. Regarding symptom severity, the lower was Triamcinolone followed by Fexofenadine and then BTX-A group, but QoL was significantly improvement in BTX-A, Fexofenadine and Triamcinolone respectively. At the end, there was significant reduction of symptom severity scores for obstruction, rhinorrhea, sneezing, itching, eye irritation, total nasal symptoms’ score (TNSS) and QoL scores. Conclusion: BTX-A may be a suitable alternative therapy for AR treatment. Otherwise, the treatment with second generation antihistamine or corticosteroids is effective.
Allergic Rhinitis
Botulinum toxin-A
Fexofenadine
Triamcinolone
severity
quality of life
2019
10
01
4861
4865
https://ejhm.journals.ekb.eg/article_47424_74beab1c37acbc7dbeda87b85bf27935.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2019
77
1
Intranasal Oxidized Cellulose (Surgicel®) Sheet Application after Partial Inferior Turbinectomy, Can It Make A Difference?
Ahmed
Abdelfattah
Background: hemostasis, throughout and after endonasal surgery, still raise loads of debates as regarding the foremost optimal technique as regard the efficacy, patient comfort, risks and costs. Objective: assessment of the worth of applying the intranasal surgicel® sheet after partial inferior turbinectomy (PIT) surgery Patients and Methods: a prospective, randomized comparative study was conducted from July 2015 to July 2018 at Al-Azhar University hospitals. A total of hundred and twenty patients underwent bilateral PIT. They were randomly divided into a pair of groups; group A enclosed sixty patients had PIT with intranasal surgicel® sheet application and group B enclosed sixty patients had PIT without surgicel® sheet. A comparison was made between the two groups at three time points; forty eight hours, one week, and four weeks postoperatively. Results: at forty eight hours after surgery, number of patients reported milder pain before and after pack removal in group A were significantly higher than patients within the group B. Patients in Group A bled less with shorter hemostasis time than those in group B. At one week postoperatively; visual analogue score (VAS) for pain was significantly less in group A with a better healing. At four weeks postoperatively; healing was significantly better in group A. Conclusion: the utilization of intranasal surgicel® sheet after PIT can decrease pain and bleeding and lessen hemostasis duration during pack removal and decreased postoperative pain with decreasing rates of intranasal adhesions.
Partial inferior turbinectomy
Intranasal pack
Nasal obstruction
Surgicel®
2019
10
01
4866
4873
https://ejhm.journals.ekb.eg/article_47426_dc28e9453185375a279d4ea641d7916e.pdf
The Egyptian Journal of Hospital Medicine
1687-2002
1687-2002
2019
77
1
Comparison between Intravenous Magnesium and Lidocaine Administration on Postoperative Pain during Spinal Anesthesia for Anal Surgery
Ezzat Mahmoud Ali
El-Soudy
Waheed Mohamed
Ali
Hoda Moneer Hassan
Ahmed
Background: Perioperative analgesia has been administered traditionally as opioid analgesics, but routine use of opioids for postoperative analgesia has recently been critically challenged. Excessive use of potent opioids may actually increase postoperative pain as a result of rapid elimination and development of acute tolerance and decrease patient satisfaction. Objective: The aim of this study was to assess and compare the effect of IV infusion of lidocaine and magnesium sulphate (Mg) as adjuvant for postoperative pain in anal surgery after spinal anesthesia regarding duration, potency of analgesia, analgesic consumption and hemodynamics. Patients and methods: In this prospective, observational, randomized, double blinded (nurse and junior doctor) placebo study, 150 patients of ASA (American Society of Anesthesiologists) physical status I and II with the age between 18-40 year, undergoing anal surgery under spinal anesthesia were included. The study was conducted in Al-Azhar University Hospital, Assiut during the period from June 2018 to Oct 2018. Results: The results showed that there were significant differences between the three groups according to BP and HR. The patients in Mg group showed more hypotension and bradycardia than the patients in lidocaine and placebo groups. Patients in Mg group showed lower VAS score than lidocaine and placebo groups. The amount of analgesic consumption was lower in Mg group than lidocaine and placebo groups. Conclusion: Usage of IV MgSO4 at 50 mg/kg followed by continuous infusion of 10 mg/kg/h leading to decrease in postoperative pain and analgesic consumption in patients undergoing anal surgery under spinal anesthesia.
Intravenous magnesium
Lidocaine
Postoperative Pain
Spinal anesthesia
Anal surgery
2019
10
01
4874
4880
https://ejhm.journals.ekb.eg/article_47429_a9a8152f06b9c3cbfa4cf60595b63d36.pdf