Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200253120131001Low Dose Nicotinamide as an Adjunctive Therapy to Calcium Carbonate for Control of Hyperphosphatemia in Hemodialysis Patients7527621582710.12816/0001636ENMagdy El-SharkawyAin Shams University, Nephrology Department, Faculty of medicine, Cairo EgyptMostafa KamelAin Shams University, Nephrology Department, Faculty of medicine, Cairo EgyptAhmed RamadanAin Shams University, Nephrology Department, Faculty of medicine, Cairo EgyptManal El-HamamsyClinical Pharmacy department, Faculty of Pharmacy, Cairo, EgyptShaimaa AllamClinical Pharmacy department, Faculty of Pharmacy, Cairo, EgyptJournal Article20181003<strong>Abstract</strong><br /> <strong>Background: </strong>Hyperphosphatemia remains a common problem in patients on maintenance dialysis and contributes to the development of secondary hyperparathyroidism. Current therapies for the treatment of hyperphosphatemia are frequently insufficient to achieve the recommended K/DOQI goal of maintaining serum phosphorus level between 3.5 and 5.5 mg/dl. Niacinamide inhibits intestinal sodium/ phosphorus co transporters and reduces serum phosphorus level in some clinical studies. So, we aimed to evaluate the safety and the efficacy of nicotinamide as adjunctive therapy to calcium carbonate (as calcium based phosphate binder) in hemodialysis patients.<br /> <strong>Methods: </strong>Sixty hemodialysis patients with serum phosphorus level ≥ 5.0 mg/dl were randomly assigned to 8 weeks of the study. Patients were divided into two groups:<strong>(</strong><strong>group I) </strong><strong>(control group): </strong>30 cases calcium carbonate only and <strong>(group II)</strong><strong> (study group): </strong>30 cases received a combination of calcium carbonate and nicotinamide. Nicotinamide dose was started as 500mg/day and increased on 8<sup>th</sup> day to 1000 mg/day. <strong>Results:</strong><em>In the <strong>study group</strong> (nicotinamide group):</em> serum phosphorus level fell significantly <em>(p<0.001),</em> calcium × phosphorus product dropped significantly <em>(p<0.001),</em> with a significant elevation of serum calcium <em>(p<0.05).</em> <em>In the <strong>control group</strong>:</em> there was insignificant change in former parameters <em>(p values>0.05</em>). Intact parathyroid hormone, uric acid, platelet count, total cholesterol, hemoglobin, ASAT, and ALAT and lipid profile remained insignificantly changed <strong><em>in both groups</em></strong>. Diarrhea, flushing and skin rash were the major adverse effects seen with nicotinamide therapy resulting in early withdrawal of 4 patients from the study. <strong>Conclusion: </strong>In hemodialysis patients, nicotinamide in single dose of 1000 mg daily can effectively reduce serum phosphorus level when administered with calcium carbonate (as phosphate binder) with less potential side effects reported.<br /> <strong> </strong><br /> <strong> </strong>https://ejhm.journals.ekb.eg/article_15827_575a7efc809639640750c648ee19a004.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200253120131001The Effect of Lupinus albus and Hyphaene thebaica on Chromosomal Aberrations and Histopathological Changes of Liver and Pancreas in Streptozotocin-induced Diabetic Rats7637691582810.12816/0001637ENAmany A TohamyDepartment of Zoology and Entomology, Faculty of Science, Helwan UniversityRasha S MohammedDepartment of Zoology and Entomology, Faculty of Science, Helwan UniversityMohga S AbdallaDepartment of Chemistry, Faculty of Science, Helwan UniversityAdel K IbrahimDepartment of Clinical Pathology, Veterinary Medicine, Cairo UniversityKhaled F MahranDepartment of Clinical Pathology, Veterinary Medicine, Cairo UniversityKawkab A AhmedDepartment of Pathology, Veterinary Medicine, Cairo University.Journal Article20181003<strong>Background: </strong>The folk medicine in Egypt has described several kinds of Egyptian herbs and plant prescriptions, belonging to various families to be concerned with the treatment of diabetes mellitus<strong>.</strong>The present study focuses on evaluating the chromosomal aberration in somatic cells of STZ-diabetic rats treated with <em>Lupinus albus </em>(termis) and <em>Hyphaene thebaica </em>(doum) as well as their effect on liver and pancreas histopathology.<br /> <strong>Material and methods:</strong> STZ was injected intraperitoneally at a single dose of 50 mg/kg to induce diabetes. Termis seeds suspension (75 mg/100 g b.wt.) was daily orally administered, doum fruit suspension was daily orally administered (1g/kg b.wt.) and also gliclazide, reference drug, was administered at a dose equivalent to the therapeutic dose of rat. After four weeks of administration, bone-marrow metaphases were prepared for examining chromosomal aberration. These were followed by statistical analysis. Liver and pancreas were dissected, processed and stained with H&E for investigating histopathological changes. <br /> <strong>Results: </strong>The results of chromosomal analysis showed that, diabetic rats had a highly significant increase of chromosomal aberrations compared to that of normal healthy control. Animals which were treated with <em>Lupinus albus</em> and <em>Hyphaene thebaica</em> showed significant improvements in the frequencies of chromosomal aberrations. Also, treatment of diabetic rats with termis and doum revealed marked improvement in liver and pancreas histopathology. <br /> <br /> <strong>Conclusion: </strong> It is concluded that diabetes is much harmful on the histological picture of liver and pancreas and on chromosomal aberration frequencies in the animal body, whilst the administration of termis or doum reduced these harmful effects of diabetes.<br /> <strong> </strong>https://ejhm.journals.ekb.eg/article_15828_594290d39464add08c02ea9131451b3e.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200253120131001Effect of Curcumin on Some Heavy Metals Induced Renal and Testicular Injuries in Male Rats7707811582910.12816/0001638ENTamer, M. M. SaadMedical and Radiation Research Dept., Nuclear Materials Authority, Cairo, EgyptJournal Article20181003<strong>Back ground </strong>Toxic heavy metals in water, air and soil are global problems that are a growing threat to humanity. Heavy metals are widely distributed in the environment and some of them occur in food, water, air and tissues even in the absence of occupational exposure. The antioxidant and protective influences of curcumin on a mixture of some heavy metals (Pb, Hg and Cd) induced renal and testicular injuries in male rats were detected.<br /> <em> </em>Curcumin, a yellow pigment from <em>Curcuma longa</em>, is a major component of turmeric and is commonly used as a spice and food-coloring material. It exhibits anti-inflammatory, anti-tumor, and antioxidant properties.<br /> <strong>Aim</strong> The present study aims to evaluate the antioxidative activities and protective role of curcumin against some heavy metals induced renal and testicular injuries in male rats.<br /> <strong>Material and Method </strong><br /> Male Swiss albino rats were orally administrated by curcumin (150 mg/kg B.W.) using suitable stomach tube (eight weeks) before receiving mixture of heavy metals (Pd, Hg and Cd) in drinking water for two weeks. Levels of plasma creatinine, urea, uric acid and serum testosterone concentration were measured, glutathione content and superoxide dismutase activities in kidney and testis tissues were estimated and also histological examinations for kidney and testis tissue were detected. <br /> <strong>Results</strong><br /> The results revealed that mixture of heavy metals lead to significant increase in the level of plasma creatinine, urea and uric acid, Meanwhile, significant decrease in serum testosterone concentration. Glutathione content and superoxide dismutase activities in kidney and testis tissues were significantly decrease by using a mixture of heavy metals. But groups administrated with curcumin before administrated with mixture of heavy metals, exerted noticeable amelioration against their damage in most of the biochemical and histological tested parameters.<br /> <strong> </strong>https://ejhm.journals.ekb.eg/article_15829_7f49bdd5869c780db8ab0e70a7117084.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200253120131001Self Perception of Community Dwelling Elderly toward Aging in Shubra El Khima City7827881583010.12816/0001639ENAhmed K MortagyGeriatrics and Gerontology department, Faculty of Medicine, Ain shams university, Cairo, EgyptTamer M FaridGeriatrics and Gerontology department, Faculty of Medicine, Ain shams university, Cairo, EgyptEkramy E Abdul RahmanGeriatrics and Gerontology department, Faculty of Medicine, Ain shams university, Cairo, EgyptAsmaa F AbdellahGeriatrics and Gerontology department, Faculty of Medicine, Ain shams university, Cairo, EgyptHoda I FahimCommunity department; Faculty of Medicine, Ain shams university, Cairo, EgyptJournal Article20181003<strong>Background:</strong> Elderly with positive self-perception of aging tend to engage in additional health behaviors related to prevention and report better functional health and live longer.
<strong>Objectives</strong>: The aim of the study is to assess the self-image of community dwelling elderly toward aging in shubra el khima city.
<strong>Design:</strong> A cross sectional study.
<strong>Participants</strong>: Four Hundred of community dwelling elderly<strong><span style="text-decoration: underline;">.</span> Settings: </strong>shubra el khima city.
<strong>Measurements</strong>: Minimental status examination (MMSE-30)<strong>, </strong>Geriatric Depression scale (GDS-15), Direct interview by researcher to fulfill a structured battery of questionnaire formed of several subscales from seven different questionnaires investigating self perception of aging by participating individual:Age Stereotypes Scale, Quality of Life Scale, Satisfaction with Life Scale (SWLS), Positive and Negative Affect Schedule (PANAS), Lawton’s Philadelphia Geriatric Center (PGC) Morale Scale, Subjective Age Scale, Ryff'sPsychological Well Being Scales.
<strong>Results:</strong> Older people feel younger than they actually are generally are satisfied with their aging, have high levels of positive affect and low level of negative affect and have higher morale, have positive age stereotype, have positive self-acceptance (good psychological well-being) and positive purpose in life. The three most important things for a good quality of life among studied participants were in order: good health followed by having good pension and good relationship with family members or friends. <strong>Conclusion: </strong>elderly in shubra el khima city have positive self-perception of aging.
<strong> </strong>https://ejhm.journals.ekb.eg/article_15830_e49e0979633595079552f948b7195dae.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200253120131001The Effect of Lupinus Albus (Termis) and Hyphaene Thebaica (Doum) on Some Biochemical Parameters in Streptozotocin-Induced Diabetic Rats7897941583110.12816/0001640ENAmany A TohamyDepartment of zoology and entomology, Faculty of science, Helwan UniversityRasha S MohammedDepartment of zoology and entomology, Faculty of science, Helwan UniversityMohga S AbdallaDepartment of chemistry, Faculty of science, Helwan UniversityAdel K IbrahimDepartment of clinical pathology, Veterinary Medicine, Cairo University.Khaled F MahranDepartment of clinical pathology, Veterinary Medicine, Cairo University.Journal Article20181003<strong>Background:</strong> Several plants have been used as dietary adjuvant and in treating the number of diseases because of their perceived effectiveness, minimal side effects in clinical experience and relatively low costs.The present study focuses on evaluating the effect of <em>Lupinus albus</em> (termis) and <em>Hyphaene thebaica</em> (doum) on STZ-diabetic rats at the level of some biochemical parameters <strong>Material and methods:</strong> STZ was injected intraperitoneally at a single dose of 50 mg/kg to induce diabetes. Termis seeds suspension (75 mg/100 g b.wt.) was daily orally administered. Doum palm fruit suspension was daily orally administered (1g/kg b.wt.) and also gliclazide (reference drug) was administered of a dose equivalent to the therapeutic dose of rat. After four weeks of administration, blood samples were collected for biochemical measurement. <strong>Results: </strong>Blood glucose level was significantly increased. Diabetes increased serum total lipids, cholesterol, triglycerides and LDL but serum HDL wasdecreased. Also activities of serum enzymes ASAT, ALAT, ALP, GGT and LDH were elevated. However, <em>L. albus </em>and<em> H. thebaica </em>improved the level of mostly all biochemical parameters.
<strong>Conclusion: </strong> It is concluded that termis and doum may be dietary adjuvant in reducing the harmful of diabetes.
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<strong> </strong>https://ejhm.journals.ekb.eg/article_15831_59229b441cc66e82e6e915fdd445857d.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200253120131001Depression as a Predictor of Length of Hospital Stay in Elderly Patients Admitted to Ain Shams University Hospitals7957981583210.12816/0001641ENSherine M. ElbanoubyGeriatrics and Gerontology department, Faculty of Medicine, Ain shams university, Cairo, EgyptSarah A. HamzaGeriatrics and Gerontology department, Faculty of Medicine, Ain shams university, Cairo, EgyptSamia A. Abdel RahmanGeriatrics and Gerontology department, Faculty of Medicine, Ain shams university, Cairo, EgyptAhmed Kamel MortagyGeriatrics and Gerontology department, Faculty of Medicine, Ain shams university, Cairo, EgyptJournal Article20181003<strong>Background:</strong> Depression among the physically ill is common and frequently under-diagnosed. Elderly patients with depressive symptoms are at higher risk of hospital admission for non psychiatric conditions and are more likely to have longer hospital stays and worse hospital outcomes, compared with non depressed patients.
<strong>Objectives:</strong> The aim of this study was to find out if depression can be considered a predictor of prolonged hospital stay in elderly patients.
<strong>Design:</strong> A prospective cohort study. Participants: 205 consecutive patients 60 years and over both males and females. <strong>Settings:</strong> Ain shams university hospitals. <strong>Measurements:</strong> All participants were assessed using comprehensive geriatric assessment including Geriatric depression scale (GDS) and the length of stay was registered. <strong>Results:</strong> Depressed patients had longer length of hospital stay compared to non depressed patients and the least length of hospital stay was for cases with no risk on GDS scale compared to other groups and the difference is highly significant statistically (p=<strong><</strong>0.001).
<strong>Conclusion:</strong> length of hospital stay is significantly longer among depressed elderly.
<strong> </strong>https://ejhm.journals.ekb.eg/article_15832_90c06927936e39b28b368e4001b5b788.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200253120131001Effect of Vitamin C and/or Vitamin E on Kidney, Liver and brain Functions of Streptozotocin-Induced Diabetic Rats7998081583310.12816/0001642ENGhada Z A SolimanNational Nutrition Institute, Cairo, EgyptJournal Article20181003<strong>Introduction:</strong> Diabetes Mellitus is one of the main threats to human health in the 21<sup>st</sup> century. <strong>Purpose:</strong> To evaluate the effect of vitamin C and/or vitamin E on liver, kidney and brain function of streptozoticin induced-diabetic rats.<strong> Study Design:</strong> One hundred and twenty male adult Sprague Dawley rats were divided into 6 groups (20 rats each), normal control, STZ-induced diabetic rat, STZ-induced diabetic rats treated with: antidiabetic drugs; vitamin C; vitamin E; vitamin C+E. <strong>Material and Methods:</strong> Blood samples were collected from all groups, Urea, creatinine, uric acid, total protein, Alanine/ aspartate transaminase and vitamin E were measured in plasma. <strong>Results: </strong>Urea, creatinine, uric acid, ALT, AST, vitamin E, LDH (in brain and liver) and MDA (brain) were significantly increased in STZ-induced diabetic rats. Treatment with vitamin C and/or E decrease significantly the increased level of the tested parameters and this may be due to the scavenging free radicals properties of vitamin C and/or E which prevents damage induced by hyperglycaemia; Also may be because vitamin C and/or vitamin E decreased lipid peroxidation and augmented the activities of antioxidant enzymes. <strong>Conclusion:</strong> Vitamin C and/or E may thus be a useful adjuvant therapy in the management of diabetes mellitus but it is better to use combination of the two vitamins rather than in single supplements to prevent the perturb antioxidant–proxidant balance.
<strong> </strong>https://ejhm.journals.ekb.eg/article_15833_f9cde2b7c0a39c6f2a2b9665b9d3f502.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200253120131001Effect of Rosmarinus Officinalis on Lipid Profile of Streptozotocin-induced Diabetic Rats8098151583410.12816/0001643ENGhada Z A SolimanAssociate Professor of Biochemistry,
National Nutrition Institute, Cairo, EgyptJournal Article20181003<strong>Introduction:</strong> Diabetes mellitus (DM) is considered as one of the main threats to human health in the 21<span style="text-decoration: underline;"><sup>st</sup></span> century. The use of herbs as medicines has increased all over the world, gaining popularity and played an important role in disease treatment especially in diabetes mellitus. <strong>Aim:</strong> The present research was designed to evaluate the effects of dried rosemary leaves powder on blood sugar and lipid profile of streptozotocin-induced diabetic rats.
<strong>Material and methods: </strong>One hundred (100) male Sprague Dawly rats aged 3 months, weighing 184±11 g, divided into 5 groups (20 rats/group) as follow:G 1: Normal Control; G 2: STZ-induced Diabetics; G 3: STZ-induced Diabetic+ Glibenclamide; G 4: STZ-induced Diabetic+ Dried rosemary leaves powder; G: Normal Control+ Dried rosemary leaves powder. At the end of the experiments (6 weeks, 45 days), rats were fasted overnight, and then sacrificed under ethyl ether and blood was taken for further biochemical analysis.
<strong>Results:</strong> The body weight and High density lipoprotein were decreased significantly in STZ-induced diabetic group of rats when compared to normal control rats. Diabetes induced by STZ resulted in a significant elevation in the levels of fasting blood glucose (FBG), glycosylated haemoglobin (HbA1c), lipid profile (Cholesterol, low, very low density lipoprotein cholesterol) and triacylglycerol. Treatment of STZ-induced diabetic rats with dried rosemary leaves powder reduced the elevated blood glucose, HbA1c, triacylglycerol, cholesterol and LDL-C by 53.97, 24.56, 45.43, 39.31 and 33.89 % respectively in respect to untreated STZ-induced diabetic group. Dried rosemary powder leaves have no significant influence on body weight, plasma glucose level and lipid profile of normal rats.
<strong>Conclusion:</strong> The results of this experiment may indicate that the dried rosemary leaves powder has a beneficial effect as an anti-diabetic agent and its complications as well as improving lipid metabolism in diabetics with no effect on normal rats.
<strong> </strong>https://ejhm.journals.ekb.eg/article_15834_7a00695e16fc772b332952d0f5ebf6aa.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200253120131001Role of PET/CT in Management of Chest Tumors8168261583510.12816/0001644ENHeba NabilNasser Institute Hospital for Research and Treatment, Cairo, EgyptKarima M MaherRadiodiagnosis Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.Sameh AR MahdyRadiodiagnosis Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.Hossam M SakrRadiodiagnosis Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.Khalid Abdel KarimClinical Oncology Depatment, Faculty of Medicine, Ain Shams University, Cairo, EgyptJournal Article20181003<strong>ABSTRACT</strong><br /> <strong>OBJECTIVE</strong>: to identify the role of PET-CT in management of chest tumors.<br /> <strong>PATIENTS AND METHODS</strong>: Whole body PET/CT study was performed on 32 patients of variable primary & secondary chest tumors who were under evaluation for primary or secondary chest tumors by recent CT, referred for staging before treatment and / or follow up after treatment.<br /> <strong>RESULTS:</strong> Our findings indicate that FDG PET/CT has an important impact on diagnosis & management of chest tumors , as it delineated the metabolic activity of the disease in 19 patients (59.4 %), outlined the metabolic activity of the tumoral residue in 6 patients (18.75%) , differentiated between tumoral residue & post irradiation pneumonitis in 1 patient (3.1%), followed up the therapeutic response in 4 patients (12.5 %), differentiated between residual mass & post therapeutic fibrosis in 1 patient (3.1%) and delineated the metabolic activity of the disease for preparing for BMT in 1 patient (3.1%) and so had an impact on the management of chest tumor patients.<br /> <strong>CONCLUSION:</strong> By recognizing the relevant radiologic and metabolic behavior of chest tumors, understanding the appropriateness of staging disease with the TNM classification system, and being familiar with potential imaging pitfalls, PET/CT can make an important contribution to diagnosis, treatment and outcome in chest tumor patients.<br /> <strong> </strong>https://ejhm.journals.ekb.eg/article_15835_13cf43d4eace7aa7859443545d337753.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200253120131001Risk Factors for Coronary Artery Disease in Egyptian Women8278361583610.12816/0001645ENBahnasawy MHZoology department, Faculty of science, Damietta University, EgyptHabbak LZZoology department, Faculty of science, Damietta University, EgyptAl-Maie MMZoology department, Faculty of science, Damietta University, EgyptAl-Ashry MAIntensive care unit, Damietta chest hospital, Damietta, EgyptJournal Article20181003<strong>Introduction:</strong> Coronary artery disease (CAD) is a major public health problem both in developed and in developing countries. The disease is multifactorial and many predisposing risk factors are responsible for this disease. The present study was performed to determine the prevalence of CAD risk factors among Egyptian women at Damietta governorate.
<strong>Patients and methods</strong>: The study was based on investigation of 113 randomly chosen women who had CAD. Demographic data, risk factors were determined by taking history, physical examination and laboratory tests.
<strong>Results: </strong>The results indicated that the age of the patients ranged from 24 to 82 years with a mean of 55.95±11.04 years. The mean total cholesterol, LDL-C and HDL-C were 233.17, 150.77 and 44.80 respectively. The blood sugar ranged from 75 to 488. Risk factors analysis revealed a significant higher prevalence of obesity and overweight (96.46%), hypertension (83.19%), total cholesterol (78.76%), physical inactivity (70.8%), stress (69.03%), diabetes mellitus (57.52%) and family history of CAD (46.9%).
<strong>Conclusion: </strong>This study provides useful information about the health characteristics of the Egyptian women at Damietta governorate and indicates that the development of health education programs and early chick-up is necessary to prevent the risk factors of this disease.
<strong> </strong>https://ejhm.journals.ekb.eg/article_15836_7076362b04222699739d4dc535cb9134.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200253120131001Adverse Effects of Digoxin, as Xenoestrogen, on Some Hormonal and Biochemical Patterns of Male Albino Rats8378451583710.12816/0001646ENEman G.E. HelalDepartment of Zoology, Faculty of Science, Al-Azhar University (Girls)Maha G. SolimanDepartment of Zoology, Faculty of Science, Al-Azhar University (Girls)Nadia A. Abdel-KawiDepartment of Zoology, Faculty of Science, Al-Azhar University (Girls)Mohamed M.M. BadawiDepartment of Biochemistry, National organization for Drug Control and ResearchNashwa M. G. AbozaidDepartment of Biochemistry, National organization for Drug Control and ResearchHany Nady YousefDepartment of Biological and Geological Sciences, Faculty of Education, Ain Shams UniversityJournal Article20181003<strong>Background: </strong>Xenoestrogens are widely used environmental chemicals that have recently been under scrutiny because of their possible role as endocrine disrupters. Among them is digoxin that is commonly used in the treatment of heart failure and atrial dysrhythmias. Digoxin is a cardiac glycoside derived from the foxglove plant,<em> Digitalis lanata</em> and suspected to act as estrogen in living organisms.
<strong>Aim of the work</strong>: The purpose of the current study was to elucidate the sexual hormonal and biochemical patterns of male albino rats under the effect of digoxin treatment.
<strong>Material and Methods: </strong>Forty six male albino rats (100-120g) were divided into three groups (16 rats for each). Half of the groups were treated daily for 15 days and the other half for 30 days. Control group: Animals without any treatment. Digoxin L group: orally received digoxin at low dose equivalent of 0.0045mg/200g.b.wt. Digoxin H group: administered digoxin orally at high dose equivalent of 0.0135mg/200g.b.wt. At the end of the experimental periods, blood was collected and serum was separated for estimation the levels of prolactin (PRL), FSH, LH, total testosterone (total T), aspartate amino transferase (AST), alanine amino transferase (ALT), alkaline phosphatase (ALP), urea, creatinine, total proteins, albumin, total lipids, total cholesterol (total-chol), Triglycerides (TG), low density lipoprotein cholesterol (LDL-chol) and high density lipoprotein cholesterol (HDL-chol).
<strong>Results: </strong>Results showed marked elevation in PRL and FSH levels and significant reduction in LH and total T levels in all treated groups compared to the corresponding controls. Serum enzyme activities (ALT, AST and ALP) and levels of urea, creatinine, total lipids, total-chol, TG and LDL-chol were obviously elevated in all the treated groups as compared to control groups. Marked decline was recorded in the values of total proteins, albumin, A/G ratio and HDL-chol in all the treated groups at the end of the two time intervals of treatment compared to controls. Regarding serum globulin level, treatment of rats with the low dose of digoxin for 15 days induced significant reduction in this parameter, while globulin returned back to its normal level after 30 days of treatment. On the other hand, the high dose of digoxin caused significant decline in serum globulin concentrations at the two time intervals of treatment. Most of the recorded changes in hormonal and biochemical parameters exhibited dose and time-dependent manner.
<strong>Conclusion: </strong>The results of the current research confirmed that digoxin disrupts the sexual hormonal pattern and biochemical parameters. So, we recommend replacing of this drug by others without estrogenic activity, particularly if it is indicated at a high dose or for a long period of time.
<strong> </strong>https://ejhm.journals.ekb.eg/article_15837_1f683aadf130faf064fd2796a4ccd884.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200253120131001Role of Tumor Necrosis Factor Alpha, Ghrelin, Evoked Potentials in Hepatic Encephalopathy8468541583810.12816/0001647ENWafaa M. ElzefzafyDepartments of Tropical Medicine, Neurology Faculty of Medicine for Girls, Al-AzharUniversityAbeer AboulElaDepartments of Tropical Medicine, Neurology Faculty of Medicine for Girls, Al-AzharUniversityManal H. MaabadyDepartments of Tropical Medicine, Neurology Faculty of Medicine for Girls, Al-AzharUniversityRadwa S. ShahinClinical Pathology Faculty of Medicine for Girls, Al-AzharUniversityJournal Article20181003<strong>Background</strong>: Hepatic encephalopathy has a negative effect on patient health-related quality of life. Apart from increased blood ammonia, alterations in various other substances (Tumor necrosis Factor- Alpha (TNF-α), Ghrelin)have been implicated in the pathogenesis of hepatic encephalopathy (HE). Ghrelin and TNF-alpha have numerous metabolic actions.
<strong>Aim of the work:</strong> was to estimate the role of TNF -α, Ghrelin and Evoked Potentials changes in patients with hepatic encephalopathy, and their relation to grades of hepatic encephalopathy <strong>Methods:</strong> We measured serum levels of TNF -α, Ghrelin in 40 patients with liver cirrhosis (20 with hepatic encephalopathy & 20 without encephalopathy) and 10 healthy controls. All subjects underwent to neurophysiological test: p300,visual and auditory evoked potentials.
<strong>Results</strong>: The results of this study showed highly significant increase in TNF -α, Ghrelin & levels in both groups when compared to the control group with a significant increase in the cirrhotic encephalopathic group. Also significant correlation between TNF-α, Ghrelin & grading of encephalopathy was found. Delay in latency and decrease amplitude of VEP, p 300 and ABR were significant in cirrhotic patients with hepatic encephalopathy.
<strong>Conclusion</strong>: TNF -α, Ghrelin levels are sensitive indicators of the severity of liver disease. Patients with liver cirrhosis can be followed up by measurement of these serum markers which might predict the development of encephalopathy. The increasing levels of Ghrelin & TNF-α is more prominent in cirrhosis with encephalopathy. The presence of nutritional and metabolic abnormalities, including malnutrition in cirrhosis, at least partly, elucidates high Ghrelin level. The applied neurophysiological tests are a simple, suitable and objective method for differentiating the degrees of encephalopathy and for identifying the preclinical stage of encephalopathy because abnormalities in these tests may prompt the clinician to initiate treatment.
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https://ejhm.journals.ekb.eg/article_15838_a4f6171377322efa8482fc94edec0eab.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200253120131001Treatment of Cisplatin Induced Kidney Injury in Rats by Bone Marrow- derived Mesenchymal Stem Cells8558681583910.12816/0001648ENHabbak L.ZZoology Department, Faculty of Science, Damietta University, Egypt.Bahnasawy M.HZoology Department, Faculty of Science, Damietta University, Egypt.Zatar S.MZoology Department, Faculty of Science, Damietta University, Egypt.Sobh M.AUrology and Nephrology Center, Mansoura University, EgyptAmin M.MPathology Department, Faculty of Medicine, Mansoura University, EgyptJournal Article20181003<strong>Background</strong>: Cisplatin is one of the most important antineoplastic drugs used in the treatment of many cancers; however the main dose-limiting side effect of cisplatin is nephrotoxicity. It has multiple cellular targets and modes of action that lead to nephrotoxicity. The present study aims to test whether bone marrow-derived mesenchymal stem cells (BM-MSCs) may play a therapeutic role in the treatment of nephrotoxicity. <br /> <strong>Material and methods</strong>: Adult male Sprague Dawley rats (SD), were divided into four groups. The first group was injected (i.p) with <strong>1ml</strong> normal saline alone and kept as control, the second group was injected (i.p) with <strong>1ml</strong> normal saline containing <strong>5mg/kg</strong> cisplatin, the third group was injected (i.p) with <strong>1ml</strong> normal saline containing <strong>5mg/kg</strong> cisplatin and <strong>0.5</strong> <strong>ml </strong>of culture media containing <strong>5 x10<sup>6</sup></strong> BM-MSCs into the tail vein in the first day post cisplatin injection and the fourth group was injected with <strong>1ml</strong> normal saline containing <strong>5mg/kg</strong> cisplatin and <strong>0.5</strong> <strong>ml</strong> of culture media into the tail vein in the first day post cisplatin injection.<br /> <strong>Results:</strong>Serum creatinine, blood urea nitrogen, creatinine clearance and malonadialdehyde were decreased in the kidney that received BM-MSCs while; superoxide dismutase and glutathione were increased to reach the normal values. Infusion of BM-MSCs ameliorated the renal dysfunction and enhanced tissue injury caused by cisplatin.<br /> <strong>Conclusion: </strong>The present study shows BM-MSCs can exert a protective effect on cisplatin nephrotoxicity and suggests that BM-MSCs might be a new therapeutic approach for patients with kidney injury.<br /> <strong> </strong>https://ejhm.journals.ekb.eg/article_15839_d72af35f71d691c92af507eda1a46137.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200253120131001Prescrotal Orchiopexy for the Palpable Undescended Testicle (UDT): Initial Experience and Comparison with The Standard Inguinal Approach8698731584010.12816/0001649ENSuoub M.Section of Urology medical school, Mu’tah University, Karak Teaching Hospital, JordanFadi SawaqedSection of Urology medical school, Mu’tah University, Karak Teaching Hospital, JordanSayel Al-KhitanSection of Urology medical school, Mu’tah University, Karak Teaching Hospital, JordanYaser El-HoutSection of Urology medical school, Mu’tah University, Karak Teaching Hospital, JordanJournal Article20181003<strong>Objective</strong>: To review our initial experience with prescrotal orchipexy, to illustrate this surgical approach, and to compare it with the standard two incision inguinal approach.
<strong>Material and Methods</strong>: This is a single institution retrospective comparative review of 135 patients (pts) who underwent orchiopexy for UDT over 4 years. Pts undergoing the standard inguinal orchiopexy were compared to those undergoing the emerging single-incision prescrotal approach in regards to operative time, complications and cosmesis.
<strong>Results:</strong> The study was completed on 96 pts who met the inclusion criteria. Group A (72 pts, 75%) underwent the standard two-incision inguinal orchiopexy while Group B (24 pts, 25%) underwent the single-incision prescrotal orchiopexy. Average age at surgery was 3.2 years, with a mean follow up of 13 months. Average operative time was 56 minutes for Group A and 32 minutes for Group B, by using SPSS significant P value difference (p < 0.05) was calculated . All patients from the two groups had uneventful postoperative period with one pt in Group A who had a scrotal wound infection. None of the pts in Group B need conversion to the inguinal approach. At last follow-up, all patients in both groups had testicles in the scrotum with no atrophy. While the cosmetic appearance in Group A was acceptable, cosmesis in Group B was superior.
<strong>Conclusion</strong>: Prescrotal orchipexy is a safe alternative to the standard inguinal orchiopexy for the palpable UDT. Our study demonstrates similar outcome, shorter operative time and superior cosmesis.
<strong> </strong>https://ejhm.journals.ekb.eg/article_15840_e34ab10b3ff99cef6a9eac5ac45e3272.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200253120131001The Relation of Retinol-Binding Protein 4 (RBP4) With Insulin Resistance in Hemodialysis Patients8748821584110.12816/0001650ENEman I. SarhanAin Shams University,faculty of medicine,Internal Medicine&NephrologyAhmed A. AbdelnabyAin Shams University,faculty of medicine,Internal Medicine&NephrologyHyam M. ArefAin Shams University,faculty of medicine,Internal Medicine&NephrologyYasser M. El ShahawyAin Shams University,faculty of medicine,Internal Medicine&NephrologyMohammed R. HalawaAin Shams University,faculty of medicine Internal Medicine&EndocrinologyNahla M. TeamaAin Shams University,faculty of medicine Internal MedicineJournal Article20181003<strong>Background:</strong> Insulin resistance (IR) is one of the important causes of abnormal glucose homeostasis in CKD even in the absence of overt diabetes mellitus. Retinol-binding protein 4 (RBP4) is a lipocalin superfamily molecule that is synthesized primarily by hepatocytes and adipocytes. CKD may contribute to the increased survival and retention of RBP4 in the circulation. RBP has recently been proposed as a novel adipokine involved in the metabolism of glucose.
<strong>Objective: </strong>
To evaluate Retinol Binding Protein 4 in stage 5 Chronic kidney disease patients on regular hemodialysis and its contribution to insulin resistance in those patients.
<strong>Patients &Methods:</strong>
The patients divided into 2 groups:
<strong>Group I: </strong>Patients group consist of 50 ESRD patients on regular hemodialysis; they were 20 females (40.0%) and 30 males (60.0%) with age ranged from 19 years to 52 years and with mean±SD (38.08±7.1 years).
<strong>Group II: </strong>Control group consists of 50 normal subjects; 26 females (52%) and 24 males (48%) with age ranged from 21 years to 51 years and with mean±SD (35.38±8.77 years).
<strong>Results: </strong>comparison between group I and group II show that there was highly significant increase in RBP4 (p 0.000) while no statistically significant difference found between the two studied groups regarding HOMA (p 0.260).
<strong>Conclusion:</strong>no correlation betweenRBP4 and HOMA in hemodialysis patients.
<strong> </strong>https://ejhm.journals.ekb.eg/article_15841_fa9df7faa21e66eb46562ebcd5af8b11.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200253120131001Histological Studies on Skeletal Muscles of Albino Rats under the Effect of Atorvastatin8839031584210.12816/0001651ENHassan S. A. El DawiHistology Departments, Faculty of Medicine (Cairo and Damietta),
Al-Azhar UniversityGamal S. ElgharabawyHistology Departments, Faculty of Medicine (Cairo and Damietta),
Al-Azhar UniversityEzz El-Dein El SharkawyHistology Departments, Faculty of Medicine (Cairo and Damietta),
Al-Azhar UniversityAbd El Ghany A. MoustafaHistology Departments, Faculty of Medicine (Cairo and Damietta),
Al-Azhar UniversityIbraheim M. AmrHistology Departments, Faculty of Medicine (Cairo and Damietta),
Al-Azhar UniversityOsama I. R. BayomyHistology Departments, Faculty of Medicine (Cairo and Damietta),
Al-Azhar UniversityJournal Article20181004<strong>Introduction</strong>:The purpose of this study was to evaluate the effect of atorvastatin on the structure of skeletal muscles in male albino rats and the possibility of recovery of any changes in the muscles.
<strong>Drug used:</strong> Atorvastatin (Lipitor 20mg) tablets<strong>.</strong>The daily single oral dose was 1.6 mg /kg body weight.
<strong>Experimental animals: </strong>Twenty five adult local strain male albino rats with average weight of 160 gm were chosen, divided into five equal groups and fed on ordinary rat diet<strong>:</strong> Group <strong>I</strong> (control group), Group <strong>II</strong> treated with atorvastatin (1.6 mg/kg/b.wt/day) for two weeks, Group <strong>III</strong> treated with atorvastatin for two weeks then stopped receiving treatment for two weeks (recovery group <strong>1</strong>), Group <strong>IV</strong> treated with atorvastatin for four weeks and Group <strong>V</strong> treated with atorvastatin for four weeks then stopped receiving treatment for four weeks (recovery group <strong>II</strong>).
<strong>Results:</strong> Administration of atorvastatin for long duration resulted in some sort of myotoxic structural changes and apoptosis as evident by deformity in the mitochondria , lack of striation , degeneration of nuclei and splitting of muscle fibres in the adult male albino rat skeletal muscle.
<strong>Conclusions:</strong>Atorvastatin (statin) has many adverse effects on the skeletal muscle tissues with treatmant for long duration (Group IV). So, patients should avoid the possible side effects.
<strong> </strong>https://ejhm.journals.ekb.eg/article_15842_19f90c658d2f9fc037ea3d503ab532f5.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200253120131001The Relationship between Serum Leptin Level and Bone Mineral Denisty in Postmenopausal Osteoporotic Women9049081584310.12816/0001652ENFahmy EmamPhysical Medicine, Rheumatology and RehabilitationSobhia Ali MahmoudPhysical Medicine, Rheumatology and RehabilitationAmany Mohammed El-SaidClinical Pathology ,Faculty of medicine for girls, Al-Azhar UniversityMona Mokhatr El-MetwallyClinical Pathology ,Faculty of medicine for girls, Al-Azhar UniversityJournal Article20181004Postmenopausal osteoporosis is a heterogeneous disorder characterized by a progressive loss of bone tissue that begins after menopause and leads to fracture within 15-20 years from the cessation of the ovarian function.Human leptin is a protein of 167 amino acids. It is manufactured primarily in the adipocytes of white adipose tissue, and the level of circulating leptin is proportional to the total amount of fat in the body.Leptin’s effects on bone are mediated via a central neuroendocrine signaling pathway, as well as directly on bone marrow stem cells to enhance their differentiation to osteoblasts and inhibit their differentiation to adipocytes.
<strong>Aim of the Study: </strong>to detect the relation between serum leptin level, total lipid profile and bone mineral denisty in postmenopausal osteoporotic women.
<strong>Subjects and Methods: </strong>The study was carried on 40 postmenopausalfemales. According to Dual Emergy X-ray absorptiometry (DEXA), the subjects were divided into group A, Tt-score <span style="text-decoration: underline;"><</span>-2.5, group B, t-score <-1, leptin and lipid profile were measured for all subjects.
<strong>Conclusion:</strong>The current study has provided evidence that bone mineral density is influced by serum leptin level in postmenopausal osteoporotic women and positive correlation between serum leptin level and bone mineral density was found.
<strong>Recommendation: </strong>Serum leptin level measurement could be used as a simple and non invasive method for screening programs for osteoporosis in postmenopausal women but the accuracy of this test still needs furtherer studies.
<strong>Abbreviation:</strong> Ob gene : Obese gene; BMD : Bone Mineral Density;
NOF: National Osteoporosis Foundation; M-CSF : Monocyte colony stimulating factor;
BMI: Body mass index; DEXA: Dual-energy X-ray absorptiometry
https://ejhm.journals.ekb.eg/article_15843_f0b5ae47f3b995e4954ec6ba2b9b5afd.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200253120131001Bioleaching of Rare Earth Elements and Uranium From Sinai Soil, Egypt Using Actinomycetes9099171584410.12816/0001653ENMaha Amin HewedyCollege of Women for Arts, Science and Education, Ain Shams University Cairo, EgyptAbeer Ahmed RushdyCollege of Women for Arts, Science and Education, Ain Shams University Cairo, EgyptNoha Mohammed KamalCollege of Women for Arts, Science and Education, Ain Shams University Cairo, EgyptJournal Article20181004The use of microorganisms in the recovery of Rare Earth Elements (REEs) and Uranium (U) from low grade ores provides an appropriate eco-friendly alternative to chemical methods used in extraction and/or removal of metals from soils, with a higher efficiency, less destruction to the environment, and lower cost from a commercial view especially given that high-grade mineral resources that can be used in the chemical extraction of metals are being depleted. The feasibility of using actinomycetes to recover REEsand Ufrom a low-grade ore occurring in an Egyptian soil in Wadi Abu Thor, Sinai, Egypt, was investigated. The most effective isolate in REEs-bioleaching was <em>Streptomyces fungicidicus</em> YH04, while the most effective isolate in U-bioleaching was <em>Streptomyces aureofaciens</em> 3001(1).<em> Streptomyces fungicidicus</em> YH04 bioleached 37.13% of the REEs present in the sample, while <em>S. aureofaciens </em>3001(1) bioleached of 12.56% of the U present in the sample. The isolated strains of actinomycetes can be used to extract REEs and U by better, more economic and less polluting bioleaching processes instead of the chemical processes which are in common use today.
https://ejhm.journals.ekb.eg/article_15844_0c545b96acbc735d5f8eb56ee1755b64.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200253120131001A Study of the Effect of Angiotensin Converting Enzyme Inhibitors and Thiazides on Bone Mineral Density in Hypertensive Elderly9189221584510.12816/001654ENAhmed K MortagyGeriatrics and Gerontology department, Faculty of Medicine, Ain shams university, Cairo, EgyptSara A HamzaGeriatrics and Gerontology department, Faculty of Medicine, Ain shams university, Cairo, EgyptHoda MF WahbaGeriatrics and Gerontology department, Faculty of Medicine, Ain shams university, Cairo, EgyptNermien N AdlyGeriatrics and Gerontology department, Faculty of Medicine, Ain shams university, Cairo, EgyptAsmaa M NabielGeriatrics and Gerontology department, Faculty of Medicine, Ain shams university, Cairo, EgyptJournal Article20181004<strong>Background:</strong> Hypertension and osteoporosis are two major age-related disorders. Several studies have shown greater Bone Mineral Density (BMD) in people receiving thiazides diuretics compared with controls. The benefit of Angiotensin Converting Enzyme Inhibitors (ACEIs) to improve bone metabolism has been supported by some clinical studies. Therefore, these drugs might be a part of the therapeutic regime for osteoporotic hypertensive elderly. <strong>Objective:</strong> to compare between the effect of ACEIs and thiazides on BMD when used separated or combined in hypertensive elderly.
<strong>Patients&method:</strong> A retrospective comparative study recruiting 171 participants who were aged 60 years and above from the outpatient clinics of Ain shams University Hospitals. The participants were divided into three groups: Group I: 57 participants receiving thiazides, Group II: 57 participants receiving combined ACEIs and thiazides, Group III: 57 participants receiving ACEIs. Each group was subdivided into two subgroups; older and younger than the median age (65years) of participants. Patients with systemic diseases or on drugs that affect BMD were excluded from the study. All participants were subjected to: BMD measurement at lumbar spine (L2-L4) and left femur neck using Dual-energy x-ray absorptiometry (DEXA) [lunar DPX DEXA system].
<strong>Results</strong>: As regard lumbar (L2-L4) BMD T-score ,there was no significant difference found between the groups as a whole sample (P-value 0.383), nor the age subgroups ,when subdivided into two subgroups older than the median age (65 years old)(P-value 0.832) and from 65 years old and younger (P- value0.259) (the same was found as regard z-score). As regard BMD of the Left Femur Neck T-score there was no significant difference found neither between the groups as a whole sample (P-value 0.921), nor among the age subgroups when subdivided into two subgroups older and younger (p-value 0.889), (the same was found as regard z-score). <strong>conclusion:</strong> the current study found no evidence that there is a difference between thiazides therapy and ACEIs therapy as regard their effect on BMD in elderly hypertensive patients when used separated or combined.
<strong> </strong>https://ejhm.journals.ekb.eg/article_15845_fe7b03394023a80aeb619aae258207e6.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200253120131001Role of MR Spectroscopy in Characterization of Breast Masses9239341584610.12816/0001655ENSherif T Gamal El DinDepartment of Radiodiagnosis, Ain Shams University.Mohammed A DarwishDepartment of Radiodiagnosis, Ain Shams University.Ahmed M MonibDepartment of Radiodiagnosis, Ain Shams University.Togan T Abd El AzizDepartment of Radiodiagnosis, Ain Shams University.Journal Article20181004<strong>Introduction: </strong>Dynamic contrast enhanced magnetic resonance imaging “MRI” is not 100 percent accurate in distinguishing benign from malignant lesions, resulting in a large number of breast biopsy procedures recommended on the basis of imaging findings. Proton magnetic resonance spectroscopy “¹H MRS” can provide chemical information about a lesion by measuring the levels of choline compounds, which are markers of an active tumor. In most cases, the results indicate whether the lesion is cancerous without need for biopsy. In addition to being used in breast cancer diagnosis, in vivo ¹H MRS has also been used to monitor breast cancer response to chemotherapy as well as in differentiating between scar tissue and recurrent cancer after breast-conserving therapy.
<strong>Aim of the work:</strong> To evaluate the diagnostic performance of magnetic resonance spectroscopy “MRS” in characterization of breast masses with histopathologic findings or follow up used as the reference standard.
<strong>Methods:</strong> The studied group included 50 female patients referred for MRI breast for workup of a suspicious clinical, mammographic, or sonographic abnormality. ¹H MRS was added to the routine study. Results of the contrast enhanced bilateral breast MRI and ¹H MRS of the 50 patients were all reported and compared with the histo-pathological results of surgery or biopsy and with the results of follow up of lesions that were not surgically removed or biopsied.
<strong> Results: </strong>there was a highly significant relation between ¹H MRS and histopathological. Follow Up results with p value = 0.005. The sensitivity, specificity, positive and negative predictive values of ¹H MRS for characterization of suspicious breast lesions in patients included in the study, were 90%, 93.3%, 90%, and 93.3% respectively.
<strong>Conclusion: </strong>¹H MRS is a short non-invasive scan that can be inserted easily into standard clinical breast MRI protocols as a potential adjunct that can be added routinely to conventional breast MRI. Detection of choline peak with estimation of the choline signal to noise ratio “SNR” can accurately differentiate benign from malignant breast lesions with high sensitivity and specificity especially when its results are combined with the results of the standard dynamic MRI scan.
<strong> </strong>
https://ejhm.journals.ekb.eg/article_15846_59f1e2862326ce4275f0461c69f269a9.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200253120131001Role of Diffusion MRI & Dynamic Contrast-enhanced MRI in Assessment of Hepatocellular Carcinoma after Trans-arterial Chemoembolization9359461584710.12816/0001656ENFatma S.El-dien MohammedRadiodiagnosis Department, Faculty of Medicine, Ain Shams University, Cairo, EgyptHanaa Abd Elkader Abd ElhamedRadiodiagnosis Department, Faculty of Medicine, Ain Shams University, Cairo, EgyptYosra Abdelzaher IbrahimRadiodiagnosis Department, Faculty of Medicine, Ain Shams University, Cairo, EgyptAli Haggag Ali NoreldienRadiodiagnosis Department, Faculty of Medicine, Ain Shams University, Cairo, EgyptJournal Article20181004<strong>Abstract</strong>:<strong>Purpose</strong>: to assess the effectiveness of diffusion & Dynamic contrast enhanced MRI in imaging of hepatocellular carcinoma after chemoembolization.<br /> <strong>Patients and Methods</strong>: between November 2011 & September 2013, 30 patients were treated with chemoembolization in our interventional radiology unit. All patients underwent pretreatment MRI within 10 days before chemoembolization & post-treatment MRI after one month from treatment. The arterial enhancement as well as the mean Apparent Diffusion Coefficient (ADC) of the focal lesion was prospectively assessed & the percent change in both was assessed. The significance of differences between ADC values of complete & partially responding lesions was calculated.<br /> <strong>Results</strong>: Thirty male patients, ranging in age between 51 & 73 years who met the inclusion criteria were prospectively studied. According to the results of this study, there was a statistically significant difference between patients with partial response & those with complete response as regard the percent change in the mean ADC value of the focal lesion after treatment with P-value less than 0.001. There was significant positive correlation between the percent change in the mean ADC value & the percent change in the diameter of the enhancing tumor tissue after treatment. The percent change in the mean ADC value among patients with complete response was higher than that among patients with partial response with P-value less than 0.001. The best predictive cut off value for differentiation between complete & partial response was 24 % increase in the mean ADC value, with 99 % sensitivity, 84 % specificity, 90 % positive predictive value, 99 % negative predictive value & 86 % accuracy. The % change of the mean ADC value is considered better positive than negative predictor for response to treatment. On the otherhand, there was no statistically significant difference between patients with complete & partial response as regard the mean ADC of the focal lesion before chemoembolization.<br /> <strong>Conclusion</strong>: After chemoembolization, completely responding HCC lesions exhibited more increases in the mean ADC than partially responding lesions. Pretreatment mean ADC values were not predictive of response to chemoembolization<br /> <strong> </strong>https://ejhm.journals.ekb.eg/article_15847_5077844e98819153ecedaed4eb91dabb.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200253120131001Effect of Insulin-sensitizer Drug (Metformin) on Some Physiological Parameters in Some Infertile Obese Egyptian Women Undergoing ICSI9479591584810.12816/0001657ENEman G.E. HelalZoology Department, Faculty of Science, Al-Azhar University (Girls)Samia M. Abd El-WahabZoology Department, Faculty of Science, Al-Azhar University (Girls)Aziza M. Aly MansourInternational Islamic Center for Population Studies and Research, Al-Azhar UniversityMervat M. MahmoodInternational Islamic Center for Population Studies and Research, Al-Azhar UniversityAmira B. MehaneyInternational Islamic Center for Population Studies and Research, Al-Azhar UniversityJournal Article20181004<strong>Background: </strong>Egyptian infertileobese women with polycystic ovary syndrome (PCOS) were markedly increased in ART Unit for infertility treatment undergoing ICSI. In a trial to enhance the ovulation, fertilization response and pregnancy outcome treated patients with Metformin as insulinsensitizing drug, 3 months before ICSI processing.<br /> The aim of this study was to evaluate the effect of Metformin on the hormonal profile, lipid and lipoprotein profile and insulin resistance in obese PCOS patients undergoing ICSI.<br /> <strong>Setting: </strong>This study was conducted at International Islamic Center for Population Studies and Research, Assisted Reproduction Unit, Al-Azhar University during the period between 2009 and 2011.<br /> <strong>Design: </strong>A prospective randomized study.<br /> <strong>Patient and Methods:</strong> A total of 75 patients with obese PCOS were randomized to receive oral Metformin for three months. For each patient, FBS and Hb, hormonal profile included FSH, LH, FSH/LH ratio, E<sub>2</sub> and PRL, lipid and lipoprotein profile included total cholesterol, LDL, HDL and triglycerides evaluation were performed at baseline and after 3 months of treatment.<br /> <strong>Results:</strong> There was a significant decrease in the FBS in cases treated with Metformin when compared with control or obese PCOS, no significant differences were noticed in the level of Hb% in both groups. Total lipids, triglycerides and total cholesterol were decreased significantly compared with obese PCOS group. Significant decrease was also observed in respect to LDL in cases of Metformin than cases of obese PCOS. Significant increase in the level of HDL was recorded. Significant decrease was detected in FSH, LH and FSH/LH ratio in Metformin treated group while no difference was observed in prolactin or estradiol hormonal profiles. Observed improvement was detected in the number of received HMG ampoules, mature oocytes, number of grade A embryos and in pregnancy outcome.<br /> <strong>Conclusion:</strong> Metformin as lowering insulin resistance, improving the response in obese PCOS women undergoing ICSI, by enhance their resistance sensitivity in transadipose tissue leads to improvement the function of gonads and hormonal and lipids profile .This improvement was detected by decreased total cost for ICSI, lowering the number of both given stimulation ampoules and mature collected oocytes and finally the percent of successful pregnancy rate.<br /> <strong><span style="text-decoration: underline;"> </span></strong>https://ejhm.journals.ekb.eg/article_15848_a4b696cb28b7aa24f2a1a40ed9c7069c.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200253120131001Biochemical Diagnosis of Peroxisomal Disorders by GC/MS: Egyptian Patients with X-linked Adrenoleukodystrophy9609661584910.12816/0001658ENEkram FateenBiochemical Genetics Department, Human Genetics and Genome Research Division, National Research Centre.Amr GoudaBiochemical Genetics Department, Human Genetics and Genome Research Division, National Research Centre.Mona IbrahimBiochemical Genetics Department, Human Genetics and Genome Research Division, National Research Centre.Journal Article20181004<strong>Background: </strong>Peroxisomes are organelles responsible mainly for metabolism of lipids and peroxides. Lack of peroxisomes or dysfunction in any of their normal functions is the cellular basis for human peroxisomal disorders (PDs).<strong> </strong>
<strong>Aim of the Work: </strong>diagnosis of peroxisomal disorders among a high risk group of Egyptian patients using gas chromatography mass spectrometry<strong>.</strong>
<strong>Subjects and Methods:</strong> Forty six patients suspected to have peroxisomal disorders were included in this study. Their ages ranged from 2 to 20 years. They were referred to The Biochemical Genetics Department, National Research Centre from all over Egypt. Forty one (89%) were males while five were females (11%). Parental consanguinity was positive in 28 cases (61% out of 46). Very long chain fatty acids were quantified after extraction from plasma of all cases using gas chromatography/mass spectrometry (GC/MS) technique.
<strong>Results: </strong>The present study included 46 cases suspected clinically to have one of the peroxisomal disorders; four of them (8.7%) proved to have X-linked adrenoleukodystrophy by quantitative determination of the very long chain fatty acids after extraction from their plasma. The other 42 cases showed normal profile for very long chain fatty acids.
<strong>Conclusion: </strong>
This study showed that GC/MS analysis for VLCFA discriminates patients from controls, representing a non-invasive, reliable, specific and sensitive method for the diagnosis of peroxisomal disorders.https://ejhm.journals.ekb.eg/article_15849_b76048dd90e38c2d0554573268c55d99.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200253120131001Unexplained Somatic Symptoms due toDepression and/or Subclinical Hypothyroidism9679751585010.12816/0001659ENHala El Said SayyahAssistant professor of psychiatry, BeniSuef University, EgyptMaha Mahmoud El ShafeiLecturer of internal Medicine, Mansoura University, EgyptRania Hussein MohamedLecturer of psychiatry, Al-Azhar University ( For Girls ),Egypt.Journal Article20181004<strong>Background:</strong> Unexplained somatic symptoms are common presentation of many diseases including subclinical hypothyroidism and depression. Subclinical hypothyroidism (mild thyroid failure) represents an early stage of thyroid disease that will commonly progress to overt hypothyroidism.
<strong>Objectives: </strong>To assess the presence of depression and subclinical hypothyroidism (mild thyroid failure) in patients presenting with unexplained somatic symptoms aiming for better care provided to those patients. Special care should be provided to females as they are more likely to be affected by both conditions.
<strong>Method: </strong>Patients were collected conveniently from those attended internal medicine clinic during the period from January to August 2013 complaining from multiple unexplained somatic symptoms. Patients with clinical hypothyroidism or anemia or other cause of their presenting somatic complaints were excluded from the study. Remaining 48 patients were having only unexplained somatic symptoms which proved after investigation to have subclinical hypothyroidism with high TSH while their T4 were normal. Then they were screened for depression byPatient Health Questionnaire 9 (PHQ-9), fatigue severity scale (FSS), Somatic Symptom Inventory (SSI), and Sheehan Disability Scale (SDS) for measurement of functional impairment.
<strong>Results:</strong> Females (n=36) represent 75% of cases while males (n=12) represent only 25% of cases. FSS was significantly higher in females than males (t=2.373, p=0.023). Fatigue is the most common presenting symptom among all patients (n=21, 43.7%) followed by weight gain (n=16, 33.3%)
and lastly generalized aches (n=11, 22.9%). More females presented with fatigue (n=15, 72.7%) than males (n=6, 28.6%). Females are earlier than males to seek medical advice. Only 19 patients (39.6%) were presented early and females were majority of them (n=17, 89.5%). There were positive correlations between severity of depression and (physical symptoms severity, fatigue, and degree of functional disability). There were significant negative correlations between T4 serum level and (depression severity and degree of functional disability).
<strong>Conclusion: </strong>Mild thyroid failure frequently progresses to overt hypothyroidism. It may clearly be associated with somatic symptoms, depression, memory and cognitive impairment. It is common more in females than males regardless their age. Early detection & treatment of mild thyroid failure and depression has been reported to be cost-effective and can prevent further functional impairment.
<strong> </strong>https://ejhm.journals.ekb.eg/article_15850_6382c22d69f7b7535ee281dfa553aa2b.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200253120131001Wheezy Chest in Children: Findings and Outcome9769871585110.12816/0001660ENAbdelaziz, A. El-SadekPublic Health and Community Medicine . Faculty of Medicine - Al Azher UniversityKhaled ZaedPediatrics Departments. Faculty of Medicine - Al Azher UniversityJournal Article20181004<strong>Background</strong>: wheezy chest is a serious public health problem throughout the world, affecting people of all ages and were recognized as leading cause of morbidity and mortality in the under-five children in developing countries. The disease places a burden on the health services in term of admission to hospitals and health centers.
<strong>Objectives</strong>: to identify some epidemiological aspects and fate of hospitalized cases of wheezy chest.
<strong>Material and Methods</strong>: A descriptive study was used to the study 385 children with wheezy chest among those admitted to el-Husen university hospital, Cairo, from January to December 2012 using a pre-designed questionnaire to collect data from mothers of the admitted children. The children recruited were those < 12 years coming with respiratory distress for one year. The variables included are age, sex, education, income, crowding index, symptoms presented. Laboratory findings and x ray were done to some cases when needed in the clinical pathology and x ray departments at hospital in the routine investigation of such cases. Administrative and ethical issues as patient consent and confidentiality were followed in all steps of the study. The data were analyzed by SPSS program version 18. Descriptive and analytic statistics were done. The lowest accepted level of significance was 0.05 or less.
<strong>Results</strong>: The highest affected age was infants (54%), males (53.7%), and of low income families (69.6%). Cough, dyspnea and tachypnea are the most frequent clinical findings (82.3%). Most investigations were normal, and more than half of cases have positive CRP. High percent had bronchovascular marking plus pneumonic patches and hyper-inflated chest in about 34.1% and 36.5% respectively. Most of admitted cases stayed at hospital for 10 days on average. High percent of the studied cases have respiratory distress (41.2%), wheezes (30.6%) and also recurrent wheezy chest (20.0%). The studied cases diagnosed as acute bronchiolitis (27.1%), bronchial asthma (18.8%) and bronchopneumonia (34.1%). The fates of cases were: improved with no complications (72.9%), improved with nebulizer (23.5%) and no case fatality recorded. Bronchopneumonia recorded highest CRP readings than the other acute respiratory infections.
<strong>Conclusions and recommendations</strong>: wheezy chest is a major cause of hospitalization of male infant of poor families. Cough, dyspnoea and tachypnea were major findings. Wheezy chest were recognized as pneumonia, acute bronchiolitis, and bronchial asthma with better outcome. We recommend admission of severe cases of wheezy chest, and the wheezy chest with other health problems (liable for complications) to minimize over use of beds.
<strong> </strong>https://ejhm.journals.ekb.eg/article_15851_7a5cc600d38c33de5ddbd695803e9b93.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200253120131001Chest Pain in Pediatric Patients Referred to Pediatric Cardiology Clinic9889901585210.12816/0001661ENMajdi JaafrehPediatric cardiologist, Queen Alia Heart Institute, Amman, JordanJournal Article20181004<strong>Objectives: </strong>To evaluate causes of chest pain in children referred to pediatric cardiology clinic and the need for echocardiography in these patient.<br /> <strong>METHODS: </strong>A prospective study conducted in Prince Ali Hospital, in the southern of Jordan, between Nov. 2010 till Nov. 2012. Clinical history and physical examination done. Electrocardiogram, chest X-ray, and echocardiogram for all patients, and a 24-hour Holter monitoring, if needed.<strong><br /> RESULTS: </strong>A total of 145 children were referred to pediatric cardiology clinic.
Musculoskeletal causes were the most common accounting for (36.6%), idiopathic chest pain (31%), respiratory causes (15%), gastrointestinal causes (4.1%) and miscellaneous disorders (6.9%), while cardiac causes found in 9 patients (6.2%), echocardiography was positive in 4 patients (2.8%).<strong> <br /> CONCLUSIONS: </strong>The study reveals that cardiac etiologies for childhood chest pain account for a small percentage, and these can be excluded by a complete history and physical examination. Therefore, echocardiogram may not be necessary, and shouldn't be part of routine evaluation of children with chest pain<strong>.</strong>
<strong> </strong>https://ejhm.journals.ekb.eg/article_15852_e5ec0095f6ac99ab865fe644415056d4.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200253120131001Effect of Lifestyle Modification in Hypertensive Patients in Greater Cairo99110061585310.12816/0001662ENFargally MPublic Health and Community Medicine Department, Faculty of Medicine, Al-Azhar University CairoElsadek APublic Health and Community Medicine Department, Faculty of Medicine, Al-Azhar University CairoAbdelhady ASPublic Health and Community Medicine Department, Faculty of Medicine, Al-Azhar University AssiutGhandor APublic Health and Community Medicine Department, Faculty of Medicine, Al-Azhar University Damietta branchJournal Article20181004<strong>Introduction: </strong>The World Health Organization has estimated that hypertension causes one in every eight deaths, making it as the third leading killer in the world. In Egypt, 2004, hypertension reached about 26.3% of whole population. Lifestyle modifications have an important role in the management of patients with hypertension; when used effectively.
<strong>Objective:</strong> to assess efficacy of lifestyle modifications on hypertensive patients, and also assessing their compliance towards lifestyle modifications advice<strong>.</strong>
<strong>Subjects and Methods: </strong>An intervention study was carried out on 448 hypertensive patients recruited among those attending 5 accredited health centers in greater Cairo from May 2007 to March 2008. Patients were divided into 2 groups: case group (240 patient) & control one (248 patient). Both groups were examined for baseline data: blood pressure, obesity parameters & lipid profile & fulfilled a pre-coded questionnaire containing the relevant variables. Then only intervention group was submitted for 3 months to an educational program about lifestyle modifications, while control group received routine outpatient services & asked to maintain their usual lifestyle including dietary & exercise habits. After 3 months both groups were re-examined for the same baseline data done before 3 months. Administrative and ethical issues were followed in all stages of the study, and appropriate statistical design and tests of significance were performed.
<strong>Results: </strong>The results of this study showed the following findings: Applying of a Comprehensive lifestyle modifications program including regular physical activity, reducing salt intake, weight reduction …etc. had a direct beneficial effect on lowering both systolic and diastolic blood pressure, weight & lipid profile of the studied cases. Low rate of regular physical exercises practicing by the studied cases was detected before the intervention .There was a good compliance of the studied cases towards practicing regular physical activities, consuming little salty & starchy foods, excess vegetables, fruits, fish & using plant oil in cooking, while they were un-compliant as regards drinking coffee or tea, consuming eggs ,sweets & quitting smoking.
<strong>Conclusion & Recommendations: </strong>the study concluded that modifying life style lowers level of blood pressure, lipid profile and minimizes the use of Anti-hypertensive, and recommended: increasing the awareness of hypertensive patients about lifestyle modifications program and its importance to control their high blood pressure through health providers or health educators. Ensure more focusing on lifestyle modifications as preventive and curative measures for hypertension in medical curricula. Further research based on evidence based guidelines to improve health related quality of life of hypertensive patients should be encouraged.https://ejhm.journals.ekb.eg/article_15853_efe88ce162399287d6df6988b9dbf818.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200253120131001The Trans-radial Approach for Diagnostic Coronary Angiography and Interventions. Our Experience at Queen Alia Heart Institute / Amman – Jordan.100710131585410.12816/0001663ENWalid SawalhaQueen Alia Heart Institute – King Hussein Medical Centre Amman – JordanAshraf Ahmad Abu AlsamenQueen Alia Heart Institute – King Hussein Medical Centre Amman – JordanLaith Saad ObaidatQueen Alia Heart Institute – King Hussein Medical Centre Amman – JordanRamzi Abdelmajeed AlhyariQueen Alia Heart Institute – King Hussein Medical Centre Amman – JordanJournal Article20181004The aim of our study was to assess our experience of coronary angiography and intervention via the radial artery in comparison to the standard approach from the femoral artery at Queen Alia Heart Institute.
<strong>Method;</strong>
This was a prospective study conducted from September 2010 till August 2013. This was a single operator experience. All adult patients undergoing coronary angiography or intervention were enrolled into this study. It was left to the operator’s discretion to decide which patient is for trans-radial access. Demographic data, risk factors for coronary artery disease (CAD), the amount of contrast used, fluoroscopy time, and the diagnosis were collected. We also looked at the time taken for mobilization of patients following procedure, the incidence of pain from the site, any local complications and hospital stay. The data was compared to a similar number of patients who had coronary angiography via the femoral artery.
<strong>Results</strong>;
We looked at 456 patients. There were 346 males (76%) and 110 females (24%). Their age ranged from 29 – 76 years with a mean of 53.5 (± 10.5) years. The right radial artery was used in almost all cases (454 patients, and the left radial in 2 patients). The prevalence of diabetes was 48.5%, hypertension 59.2%, family history of premature CAD 28%, hyperlipidaemia in 30% and 44% were smokers. These figures were the same for patients who had the procedure via the trans-femoral artery done during the study period.
Successful angiography was feasible in 449 patients (98.46%). Diagnostic angiography was done in 319 patients (71%), while coronary intervention was done in 130 patients (29%). Total procedural time averaged 41 (± SD = 22) minutes for trans-radial compared to 40 (± 23) for trans-femoral approach (P non significant). Fluoroscopy time was 15 (± 10) minutes for the former compared to 18 (± 13) minutes for the later approach (P non significant). The amount of contrast used was 180 (± 64) ml for trans-radial compared to 192 (± 73 ml) for the trans-femoral approach (P non-significant). On average patients in the trans-radial group had less access site complications with early mobility and earlier discharge.
<strong>Conclusion;</strong>
Coronary angiography and intervention via the radial artery has a high success rate with no difference in terms of procedure time, amount of contrast or fluoroscopy time. It has demonstrable advantages in terms of local site complications, early mobility and discharge leading to better patient’s satisfaction.
<strong> </strong>https://ejhm.journals.ekb.eg/article_15854_a3759471a1437f7d72eb2d1b3bf461f0.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200253120131001Effect of Noise and Crowding Related Stress on Serum Level of TSH and Thyroid Hormones in Female Albino Rats.101410181585510.12816/0001664ENEman G. E. HelalZoology Department, Faculty of Science, Al-Azhar University (girls)Samia M. Abd El-WahabZoology Department, Faculty of Science, Al-Azhar University (girls)Neama M. TahaZoology Department, Faculty of Science, Al-Azhar University (girls)Journal Article20181004<strong>Background: </strong>Noise and crowdingare the most stressful factors for human beings.
This study is aimed to clarify their effect on some thyroid hormones and the amelioration effect of sulprid .
<strong>Material and Methods: </strong>Thirty six female rats were divided into four groups (6/each):
1-control, 2-treated with sulpiride drug, 3- rat exposed to noise (90db/3hper day for 45 days) 4-Noise plus drug, 5 – rat exposed to crowded exposure and 6- crowded plus drug.
<strong>Results:</strong> Noise and crowding stresses caused a significant increase only of T3 and T4 while there was a significant decrease in TSH. Sulpiride drug was ameliorated these parameters.
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<strong> </strong>https://ejhm.journals.ekb.eg/article_15855_6a3263653d8202e189cad5ad9cbf2de5.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200253120131001Risk Assessment of Physical Health Hazards in Al-Azhar University Hospital in New Damietta, Egypt101910351585810.12816/0001665ENAlaa Abdel-WahedIndusrial Medicine,
Faculty of Medicine, Al-Azhar UniversityRaed Mohammed AlazabIndusrial Medicine,
Faculty of Medicine, Al-Azhar UniversityWaheed Hussien ElsaidyIndusrial Medicine,
Faculty of Medicine, Al-Azhar UniversityMohammed El-Hady ImamDepartments of Community ,Faculty of Medicine, Al-Azhar UniversityAhmed Ali GhandourDepartments of Community ,Faculty of Medicine, Al-Azhar UniversityJournal Article20181004<strong>Introduction</strong>: Personnel working in hospitals are exposed to many occupational hazards that may threaten their health and safety. Physical hazards that are encountered in hospital working environment include temperature, illumination, noise, electrical injuries, and radiation.
<strong>Objectives</strong>: The objectives of this study were to identify physical health hazards in all departments of Al-Azhar University Hospital in new Damietta,to measure risk level of these hazards, and to recognize safety measures in these departments.
<strong>Study Site</strong>: The study was conducted in Al-Azhar University Hospital in Damietta Governorate.<strong> Study Subjects</strong>: All personnel (328) working in the hospital were recruited.
<strong>Study Methods</strong>: Interview forms; a workplace inspection checklist, assess physical health hazards in the hospital and a modified checklist (workplace safety and health risk management, assess leadership commitment towards workplace safety and health). Risk assessment matrix was used to describe the risk level. Also, environmental measurements of noise, temperature, relative humidity, and lighting were taken in all departments including auxiliary service offices.
<strong>Results</strong>: Majority of the staffs reported stairways were free of obstacles, emergency lighting worked properly, and temperature was suitable. Minority of the staffs reported stairways were slippery, they were informed on hazards of noise and non-ionizing radiation, and they were given radiation safety training. Measurements of physical agents revealed noise levels were above standard of the WHO in all wards and above slandered of OSHA as in laundry, kitchen, etc. Range of noise level was from 58 dB in renal dialysis unit to 88 dB in kitchen. Lighting level was from 290 to 1150 Lux, temperature level was from 25 to 31°C, relative humidity level was from 45 to 59%, and heat index was low in all departments except kitchen and boiler room, it was moderate. Risk level of electrical and fire hazards was medium 22 (B), while other hazards were of low risk level; 01, 11, and 12 (A). Leadership commitment towards safety and health in the hospital was only 14.3%.
<strong>Recommendations</strong>: Workplace environment should be monitored and evaluated. Environmental and behavioral interventions are indicated for all personnel to prevent undue exposures. Noise monitoring and noise engineering and administrative control should be established. Increase leadership commitment towards workplace safety and health. Training programs on health and safety issues should be conducted to all healthcare workers. Lastly, further studies in different hospitals in Egypt are needed to investigate this health problem.
<strong> </strong>https://ejhm.journals.ekb.eg/article_15858_eea8cc72694def1363aa290907ab8628.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200253120131001The Potency of Some Natural Products on Dimethyl Benz(A)antheracene(DMBA) Induced Hepatotoxicity in Rats103610481586010.12816/0001666ENWafaa El KholyZoology department ,Faculty of Science,Mansoura University, EgyptHanaa SeragZoology department ,Faculty of Science,Mansoura University, EgyptAsharf ZakariaZoology department ,Faculty of Science,Mansoura University, EgyptAziza El MetwalyZoology department ,Faculty of Science,Mansoura University, EgyptJournal Article20181004<strong>Aim of the work:</strong>the present study was carried out to investigate the possible ameliorating effects of three herbs: hops(H) 1.5g/kg diet , rosemary(R) 5g/kg diet and cat's claw (C C) 1.7g/kg diet on hepatic toxicity induced by 7,12-Dimethyl benz(A)antheracene , a hydrocarbon involves various negative consequence for human health and ecosystems conversation .<strong>Results</strong>:in this work,48 female rats at 50 day of age were divided into 8 groups; control ,hops(H), rosemary(R), cat<sup>'</sup>s claw(CC),DMBA, DMBA+H,DMBA+R and DMBA+CC groups.Results:the results indicated that a single intraperitonial (i.p) dose of DMBA (30mg/Kg b.W) caused significant decrease in the percentage of body weight gain, but an increase in the hepatosomatic index. In addition , the results illustrated an increase in the liver malondialdehyde (MDA) contents and hydrogen peroxide levels (H<sub>2</sub>O<sub>2</sub>) accompanied by significant decrease in reduced glutathione (GSH) content and superoxide dismutase (SOD) and glutathione-S-transferase (GST) activities.The results, also reported significant decrease in serum total proteins, total albumin , globulin and liver total protein but serum total bilirubin was significantly elevated in the DMBA intoxicated group. Furthermore, aspartate aminotransaminase (ASAT), alanine aminotransaminase (ALAT) , γ-glutamyltransferase (GGT) and alkaline phosphatase (ALP) activities were significantly increased in serum but significantly decreased in the liver.
On the other hand, intake of hops, rosemary and cat<sup>'</sup>s claw minimize the disturbances observed in most of the tested parameter's resulted from DMBA administration and improve the liver functions mostly in the following order, rosemary ˃ hops ˃ cat's claw. <strong>Conclusion</strong>: it can be concluded that intake of such herbs (hops , rosemary, cat<sup>'</sup>s claw)may be effective in reducing DMBA toxicity.
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https://ejhm.journals.ekb.eg/article_15860_4d16dc335cf13e23b6d1b3385503805d.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200253120131001Hematological and Immunological Studies on the Effect of Hepatitis B Virus Vaccination in Hepatitis and Non-Hepatitis, Iron Chelating Dependent or Independent Egyptian Thalassemia Patients104910631586210.21608/ejhm.2013.15862ENEman G. HelalAl-Azhar University, Faculty of Science (Girls)Noran Abu- OufAl-Azhar University, Faculty of Science (Girls)Ali F.M. El-SayedVirology Sector Research Unit, VACSERA. Egypt.Nahla G. MohamedVirology Sector Research Unit, VACSERA. Egypt.Mona A.M. AhmedVirology Sector Research Unit, VACSERA. Egypt.Journal Article20181004<strong>Background: </strong>Regular transfusion in thalassemia major patients increases life expectancy and improves quality of life. Blood transfusion is the main sources for viral transmission to Thalassemia patients. So, detection of viral antigens using more than one technique must be adopted. Iron and its binding proteins have immune regulatory properties and shifting of immune regulatory balance by iron excess or deficiency may produce severe deleterious physiological effects. Thus, the aim of this study was to assess the efficacy of immunization and determine the immune response of beta-thalassemia patients. Also, to evaluate the effects of iron overload chelating therapy and hepatitis B virus (HBV) vaccination on some immunological and hematological parameters in hepatitis and non hepatitis Egyptian thalassemia patients.
<strong>Methods:</strong> Forty homozygote Thalassemia patients attending blood bank, therapeutic unite, Holding company for Biological production and Vaccine, VACSERA were chosen for this study (age range 4-30years, mean 14 years, 18 females 46% and 22 males 54%).
<strong>Results: </strong> There was no significant correlation between HBs Ab level in control and non vaccinated groups that include Thalassemia, hepatitis, non hepatitis, either iron chelating therapy dependent or independent patients. In the same time, there was no significant correlation between Ab level in vaccinated control and Thalassemia groups. HbF and HbA2 % showed significant and highly significant increases respectively, in most of groups especially, Thalassemia, hepatitis and iron chelating independent, vaccinated or non vaccinated groups. While HbA may be present in small amount or completely absent. RBCs count, Hb%, Hematocrit and MCV values were decreased significantly in all patient's groups vaccinated or non vaccinated compared to control group, while MCH and MCHC were not changed in patient' groups compared to control group. Platelets count was increased significantly in most patient' groups (except non vaccinated, Thalassemia, hepatitis, iron chelating dependent) compared to control group. Also, WBCs count was increased significantly in most groups (except non vaccinated, Thalassemia, hepatitis or non hepatitis, iron chelating dependent or independent) in comparison with the control group. All patients (hepatitis, vaccinated or non vaccinated) had high significant increase in gamma globulins compared to control group.
<strong>Conclusion: </strong>Hematological and immunological measurements for hepatitis Thalassemia patients are important to monitor and treat the disease.
<strong> </strong>https://ejhm.journals.ekb.eg/article_15862_cca49480ff8f4f3a741757e8a3615f6a.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200253120131001Therapeutic Efficacy of Conventional Treatment Combined with Manuka Honey in the Treatment of Patients with Diabetic Foot Ulcers: A Randomized Controlled Study106410711586410.12816/0001668ENMohamed Al SaeedDepartment of Surgery, Taif University and Head of Surgical Department of king Abdul Aziz Specialist Hospital, Taif, Saudi ArabiaJournal Article20181004<strong>Background and aim of the work: </strong>Foot ulcers are a major problem of diabetes for which conventional treatment modalities alone have had limited success in promoting complete wound closure; however, there are large amounts of evidences that exist for the effectiveness of manuka honey as a wound dressing especially in diabetic foot. The aim of this study was to compare the efficacy of Manuka honey combined with conventional modalities to that of conventional treatment alone in the treatment of diabetic foot ulcers.
<strong>Patients and Methods:</strong> This was a prospective double-blind, randomized clinical trial conducted at the King Abdul Aziz Specialist Hospital in Taif, Saudi Arabia. Fifty-nine patients, enrolled from January 2011 to January 2013, were randomized to receive conventional treatment plus manukahoney impregnated dressings (honey treatment group) or conventional treatment alone (control group). Outcomes were; time to eradicate infection, length of hospital stay, percentage of completely healed ulcers after six weeks and six months.
<strong>Results: </strong>The mean time to eradicate infection and the hospital stay were significantly reduced in the honey treatment group compared to control group (51.1% and 53.8% respectively, P<0.05). Percentages of ulcers that were completely healed were significantly greater in the honey group than the control group, at six weeks (61.3% vs. 11.5%; P <0.05) and at six months (87.1% vs. 42.3%; P<0.05). There were less toe amputations in the honey-treated group (9.7% vs. 34.6%; P<0.05)<strong>.</strong>
<strong>Conclusion: </strong>Combination of conventional treatment with manuka honey impregnated dressings is superior to conventional treatment alone in controlling wound infection, promoting the complete healing of diabetic foot ulcers, and decreasing the rate of minor amputations.
<strong> </strong>https://ejhm.journals.ekb.eg/article_15864_392c08d14d2e0a02088903652fddc1ad.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200253120131001Protective Effect of Nigella Sativa Against Diabetic Complications on The Liver in White Male Rats107210821586510.12816/0001669ENNassar Ayoub AbdellatifDepartment of Anatomy, Faculty of Clinical Pharmacy, Taif University, Saudi Arabia andFaculty of medicine, Sohag University, Egypt.Journal Article20181004Aim of the work: The effect of diabetes on the liver is associated with histological changes. The aim of the present study was to evaluate the histological changes following administration of nigella sativa (NS) in the streptozotocin (STZ) induced diabetes mellitus in rats.<br /> Materials and Methods: Thirty six male white rats (n=36), weighing (180–230 g) were taken for this study. The animals were divided into 3 groups: 1- Normal control group. 2- Diabetic group. 3- Diabetic group treated by Nigella Sativa (N.S) oil. Diabetes was induced in the experimental rats via intraperitoneal injection of streptozotocin (45 mg/kg body weight) in a single dose. The fasting blood glucose was estimated, 5ml\kg of body weight of N. sativa oil was given orally for three weeks. After an overnight fast, the animals were sacrificed. The livers were identified, weighed and observed for any gross appearance and color changes and tissues were preserved for histopathological studies using hematoxylin & eosin (H&E) and periodic acid Schiff (PAS) stains.<br /> Results: In streptozotocin treated animals, the body weight was significantly decreased compared to normal rats, while treating diabetic rats with <em>N. sativa </em>oil showed significant increases in the body weight. Administration of nigella sativa oil to diabetic rats resulted in a<br /> significant decrease in blood glucose after three weeks compared to untreated diabetic rats. In untreated diabetic group, there was a significant decrease in the liver glycogen. Light microscopic examination of the liver of diabetic rats revealed profound histological changes. Nigella sativa consumption could reverse most of these histological and biochemical changes in the liver of the diabetic group owing to its hypoglycemic and antioxidant effect.<br /> Conclusion: The Nigella Sativa due to its antioxidant role may be helpful in reversing the changes in the liver in diabetes mellitus.<br /> https://ejhm.journals.ekb.eg/article_15865_a75cc1f0f2043f7bd948ff1d3d9d9338.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200253120131001Effect of Noise Stress on Lung and Heart of the Adult Albino Rats and the Possible Protective Role of Sulpiride.108311051586610.12816/0001670ENTamer M. M. Abu-AmaraHistology&Cytology Department,College of Medicine, Al-Azhar University, EgyptGamal S. ElgharabawiHistology&Cytology Department,College of Medicine, Al-Azhar University, EgyptMoustafa E. E. MotaweeHistology&Cytology Department,College of Medicine, Al-Azhar University, EgyptSalah E. MouradAnatomy Department, College of Medicine, Al-Azhar University, EgyptNeama M. TahaPhysiology Department, College of Medicine, Umm Al-Qura University, KSA.Journal Article20181004Exposure to noise stress is associated with increased respiratory system morbidity; however the underlying mechanisms are unclear. Thus there is a need for more study about this harmful effect. Sulpiride had been shown to have a protective role against noise stress on other systems but this role did not studied well on respiratory system.<br /> <strong>Aim of the work: </strong>To investigate using histological, histochemical and morphometric methods the possible harmful effects of noise on adult female albino rats' lung, heart and the possible protective role of combined sulpiride treatment.<br /> <strong>Material and Methods: </strong>The present study was carried out on 24 adult female albino rats which were randomly divided into <strong>Group 1(C, untreated negative control), Group 2 (N, noise exposed or positive control) </strong>where rats were exposed to noise “>90 decibel/3h/day” for 1 month<strong>, Group 3(D, sulpiride treated) </strong>where rats were exposed to sulpiride “0.028 mg/B.W./day” and <strong>Group 4 (N+D, noise+ sulpiride exposed). </strong>Paraffin sections were prepared for histological, histochemical and morphometric study. Also statistical analysis was done.<br /> <strong>Results</strong>: Rats exposed to noise only or sulpiride only showed highly significant damaging changes on lung such as thickening in the interalveolar septa and obliteration of the alveoli, inflammatory cells infiltration within the pulmonary interstitium, peribronchiolar infiltration and fibrosis, thickening of the pulmonary blood vessels walls, interstitial collagen fibres deposition and apoptotic cellular changes. On the level of heart, highly significant decrease in the diameters of the myocardial muscle fibres with focal areas of necrosis and apoptotic changes was detected. Also, increased collagen fibres deposition was marked in sulpiride group. When noise and sulpiride treatment was combined, the damaging effects were maximized on the lung and to a lesser extent on the heart.<br /> <strong>Conclusion</strong>: These results provide evidence that noise stress cause obvious lung and heart tissue damages. No protective role for sulpiride was proofed. This is as using sulpiride alone or in combination with noise showed marked damaging effects on the lung and heart tissues.<br /> <strong> </strong>https://ejhm.journals.ekb.eg/article_15866_0a5dbdb2b44c73aef19a7d0c5c7e8417.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200253120131001Achieving Targets in Secondary Prevention of Hyperlipidaemia in Patients with Coronary Artery Disease.110611091586710.12816/0001671ENDr Walid SawalhaQueen Alia Heart Institute – King Hussein Medical Centre Amman – JordanDr Ashraf Ahmad Abu AlsamenQueen Alia Heart Institute – King Hussein Medical Centre Amman – JordanDr Laith Saad ObaidatQueen Alia Heart Institute – King Hussein Medical Centre Amman – JordanDr Ramzi Abdelmajeed AlhyariQueen Alia Heart Institute – King Hussein Medical Centre Amman – JordanJournal Article20181004<strong>Abstract</strong>
<strong>Aim:</strong>
We set our study to assess how good are we at achieving targets of lipid profile in patients with coronary artery disease at Queen Alia Heart Institute – King Hussein Medical Centre Amman – Jordan.
Method:
This was a retrospective analysis of the lipid profile of patients who are being followed up for coronary artery disease at Queen Alia Heart Institute. Lipid profile (total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides) of patients who are legible for secondary prevention was collected and compared to the targets set by the Adult Treatment Panel (ATP) III guidelines. Demographic data and risk factors for coronary artery disease (CAD) were collected. The type and dose of lipid lowering drug was recorded.
Results;
Lipid profiles of 1250 patients were looked at. Their age ranged from 29 – 76 years with a mean age of 59.6 years (±12.8). 27% of our study were females. The mean age for females was 64.2 years (±11.4) and for males was 57.4 years (±13.1). The prevalence of diabetes was 48.5%, hypertension 59.2%, hyperlipidaemia in 30%, family history of premature CAD 28% and 44% were smokers. Target total cholesterol was achieved in 67% of patients, and target LDL in 54% and HDL in 49% of patients. Almost all patients were on statins or fibrates (94%). 52% were on Simvastatin (84% of them on 20mg) and 38% on Atorvastatin (88% of them on 20mg).
<strong>Conclusion</strong><span style="text-decoration: underline;">;</span>
Target lipid profile in our patients has only been moderately achieved in patients with coronary artery disease. Only modest doses of statins are used. More efforts with better follow up is needed.
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https://ejhm.journals.ekb.eg/article_15867_35c90e28b098b3b494788ed9081b7dc7.pdf