Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200267220170401A Study of Effect of Experimental Pre-Eclampsia on Plasma Lipocalin-2 Level in Rats5185271420210.12816/0037801ENMohamed S. A. ZamzamDepartment of Physiology, Faculty of Medicine, Zagazig UniversityAhmed B. E. Abd AllahDepartment of Physiology, Faculty of Medicine, Zagazig UniversityAzza A. Y. MegahedDepartment of Physiology, Faculty of Medicine, Zagazig UniversityEman Mahmoud Farg AllahDepartment of Physiology, Faculty of Medicine, Zagazig UniversityJournal Article20180920<strong>Background:</strong> preeclampsia (PE) is a pregnancy related complication defined as a disease that begins in the placenta and ends at the maternal endothelium. It is a multi-stage disease that starts by utero-placental insufficiency and leads to generalized maternal endothelial dysfunction.Lipocalin2 (LCN2) is a 25kDasecretory glycoprotein implicated in many functions such as apoptosis and innate immunity. Also, it has been recognized to have potential effects in obesity, inflammation and insulin resistance in mice and humans<strong><em>. </em></strong>Many controversial studies about the changes in the plasma LCN2 levels in PE are reported.<br /> <strong>Aim:</strong> The current study was designed to perform an animal model of experimental PE in a trial to demonstrate the possible relationship between PE and the circulating LCN2 levels.<br /> <strong>Design:</strong> forty eight healthy adult female albino rats and eight adult male albino rats were used. The male rats were used for induction of pregnancy. The adult female rats (n=48) were divided into four equal groups: group I (control non-pregnant group), group II (non-pregnant treated with L-NAME), group III (normal pregnant group) and group IV (pregnant treated with L-NAME to induce a model of experimental PE). In all groups, body weight, body mass index (BMI), blood pressure, circulating levels of urea, creatinine, triglycerides (TGs), IL-6, endothelin-1(ET-1), vitamin D (VD), LCN2 and D-dimers in addition to total urinary proteins are measured. Histopathological examination of placental sections was done in group III and group IV.<br /> <strong>Results:</strong> The results of the present study revealed a significant increase in the body weight, BMI, MAP, total urinary proteins, circulating levels of urea, creatinine, TGs, IL-6, ET-1, LCN2 and D-dimers in both group II and IV. In addition to a significant decrease in VD in the same two groups. In group III, there was a significant increase in body weight, BMI, total urinary proteins and circulating levels of TGS, D-dimers and LCN2. There was a significant decrease in VD and MAP. Moreover, there was a positive significant correlation between LCN2 and all measured parameters except VD in group IV together with a positive significant correlation between LCN2 and MAP, IL-6, ET-1and D-dimers in group II.The results in group IV are supported by the histopathological examination results.<br /> <strong>Conclusion:</strong> L-NAME can be used for induction of experimental PE and plasma levels of LCN2 can be used as an indicator for the renal complications and coagulopathies in PE. Further studies are needed to ascertain this association.<br /> <strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200267220170401Anti-Diabetic Effect of Balanites Aegyptiacea Leaves Extract (Heglig) by Regulation of Erythrocyte Glucose Uptake in Diabetic Patients Type 2 in Vitro5285351420310.12816/0037802ENEl-Sayed M. El-Sayed MahdyBiochemistry Unit, Chemistry Department Faculty of Science, Helwan University,Hatem A. El-MezayenBiochemistry Unit, Chemistry Department Faculty of Science, Helwan University,El-Mowafi Abdo ElmowafiMedicinal and Aromatic Plants Unit, Horticulture Research
Institute and National Gene Bank, Agricultural Research Center andShaimaa Sabry MohamedMedicinal Plant Department, Horticulture Institute Agricultural Research CenterJournal Article20180920<strong>Background:</strong> in Diabetes, the increase in the oxidative stress and decrease in the antioxidant defense may elevate he susceptibility of diabetic patients to many pathological complications, oxidative induced cell damage has been proposed to play an important role in the etiology of numerous pathological conditions. So, the aim of the present study was to investigate the antioxidant potential of Alcoholic Leaves extract of Balanites aegyptiacea (Heglig) due to the presence of phenolic and flavonoids compounds on uptake of glucose in vitro by erythrocytes of diabetic patients.<br /> <strong>Results:</strong> in hyperglycemic patients, erythrocytes malondialdehyde level was highly significantly increased (P<0.0001) than that of control. However, the erythrocytes glutathione content was highly significantly decreased (P< 0.0001) when compared to that of corresponding control values. The glucose uptake by erythrocytes of diabetic patients was highly significantly decreased (P < 0.0001) with increasing hyperglycemia (Fasting Blood glucose), while it was highly significantly elevated (P< 0.0001) after addition of Balanites aegyptiacae leaves extract to the incubation medium. On the other hand, the malondialdehyde concentration was highly significantly reduced (P < 0.0001) on adding the extract. So, it could be concluded that , an appreciate support for enhancing Antioxidant supply from natural sources such Balanites aegyptiace leaves extract may help control blood glucose levels and prevent pathological complications of diabetes <br /> <strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200267220170401Surgical Correction of Alar Collapse with Alar Batten Graft:Technique and Results5365431420410.12816/0037803ENAbdel Aziz Kamal SaadDepartments of Otolaryngology Faculty of Medicine, Al-Azhar University, Cairo, EgyptAhmed TahaPlastic & Reconstructive Surgery,Faculty of Medicine, Al-Azhar University, Cairo, EgyptJournal Article20180920<strong>Background</strong>: nasal valve collapse has great perception of nasal obstruction. The alar batten graft technique has proven to be a valid method for treatment of external and internal valve collapse.<strong> Aim:</strong> the aim of the present study was to evaluate a two year experience and follow up for external nasal valve collapse treatment using alar batten graft technique regarding results and complications.<strong> Patients and Methods: </strong>this prospective study was carried out on 18 patients attended the ENT and Plastic Surgery outpatient clinics of Al-Azhar University hospitals from January, 2014 to January 2016. Written consent was taken from every patient. All patients were complaining of nasal obstruction of gradual onset and progressive course with 7 years average. All patients were subjected to detailed history taking and questionnaire including the NOSE scale. Surgical correction was performed to all patients using the alar batten graft harvested from the septa cartilage or conchal cartilage. Postoperative results recorded in relation to subjective sensation of nasal obstruction and aesthetic appearance of the nose. <strong>Results</strong>: eleven patients (61.1%) were males and seven (38.9%) were females. Their age ranged from 18 to 45 years with a mean of 32±2. Bilateral obstruction was found in 33.3% of cases and unilateral obstruction in 66.7% of cases. There were 22.2%, 27.8%, and 50.0% of the cases had moderate, fair, and severe obstruction, respectively. Postoperatively, these figures were changed to no obstruction77.8% (P=0.0), mild 0.0%, moderate 11.1%, fair 11.1%, and sever 0.0%(P=0.0005). The technique significantly abolishes the severe nasal obstruction. Postoperative complications include 1 case with graft resorption (4.2%) and 1 case of graft displacement (4.2%). Both were improved on subsequent surgery. Regarding postoperative findings there was tenderness and hypertrophic postauricular scar in 5.5% of patient and nasal tip edema in 22.2%, all resolved. In the early postoperative period, 33.3% of patients complained of fullness in the supraalar region. <strong>Conclusion: </strong>Successful surgical correction of nasal obstruction requires the precise diagnosis of the anatomic point of collapse. Alar batten graft improves the rigidity of lower lateral cartilage preventing collapse of the lateral nasal wall preventing collapse during moderate and deep inspiration. The graft varies according to the severity of the obstruction and size of the collapsible area of the lateral nasal wall. The septal cartilage is usually sufficient. The technique significantly improves nasal breathing.<br /> <strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200267220170401Impact of Kangaroo Position on Serum Nitric Oxide in Preterm Infants5445461420510.12816/0037804ENLayla A El ShallClinical Pathology, Al-Azhar UniversityAfaf A KorraaPediatrics Department,Al-Azhar UniversityRagaa A MohamedPediatrics,Al-Azhar UniversityReham B Abo El-HagagJournal Article20180920<strong>Background: </strong>Kangaroo mother care is a standardized protocol-based care for preterm and low birth weight infants. The core feature is early positioning of the infant, prone and upright on the mother or father’s chest to maximize skin to skin proximity. Kangaroo mother care (KMC) is a safe and effective method of caring for low birth weight infants and is promoted for its potential to improve newborn survival.<br /> The aim of this study was to investigate serum nitric oxide (NO) in stable preterm infants before and after 60 min kangaroo position & to find out a relation between serum NO and neonatal temperature during that position. <strong>Results: </strong>showed a statistically significant increase in body temperature, peripheral oxygen saturation and mean arterial blood pressure immediately after 60 min of KMC compared to the results before this maneuver. There was significant increase in NO immediately after 60 minutes KMC. <strong>Conclusion</strong>: Kangaroo position could increase body temperature through NO dependent mechanisms. KMC is effective in improving all vital signs especially Temperature in preterm infants avoiding the harmful consequences of hypothermia in those infants.<br /> <strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200267220170401Hepatitis C Virus in Peripheral Mononuclear Cells in Patients on Regular Hemodialysis5475521420610.12816/0037805ENEmad Allam MohamedInternal Medicine Department, Faculty of Medicine ,Al-Azhar UniversityMostafa Abd Elfattah ElballatInternal Medicine Department, Faculty of Medicine ,Al-Azhar UniversityMostafa Mostafa Kamel El-AwdyInternal Medicine Department, Faculty of Medicine ,Al-Azhar UniversityAhmed Abo-Elyazid AliInternal Medicine Department, Faculty of Medicine ,Al-Azhar UniversityJournal Article20180920<strong>Background:</strong> Occult hepatitis C virus infection (OCI) was identified as Hepatitis C virus (HCV), characterized by undetectable HCV antibodies and HCV RNA in serum, while HCV RNA is detectable in liver and peripheral blood mononuclear cells (PBMCs) only. Nosocomial transmission in dialysis units maintains a higher prevalence of hepatitis C virus (HCV) infection in patients on maintenance dialysis than in the general population. HCV infection has a detrimental effect on survival in patients on maintenance dialysis and after renal transplantation. The excess risk for death in HCV-positive patients was partially attributed to chronic liver disease with its attendant complications, particularly hepatocellular carcinoma and liver cirrhosis<strong><em><sup>(1)</sup>.</em></strong><br /> <strong>The aim of this study</strong>: was to evaluate the hidden infection of hepatitis C virus among regular hemodialysis patients in Bab Al Sharia University Hospital with negative ELISA and PCR by using PCR in mononuclear cells as a marker in the serum of these patients<br /> <strong> Patients and methods:</strong>in this prospective study, 60 patients with end-stage renal disease on regular hemodialysis(for at least 6 months duration)were included. For all patients thorough medical history, clinical examination, kidney function tests, liver function tests, complete blood count, pelvi-abdominal ultrasound, HCVantibodies, hepatitis C viral RNA, quantitative, HbsAg,. HCV PCR done for all patients in serum and mononuclear cells.. Patients with acute or chronic HCV infection as marked by positive hepatitis C antibody,acute or chronic HBV infections marked by hepatitis B surface antigen,other causes of liver dysfunction ( e.g., primary biliary cirrhosis, autoimmune hepatitis, HIV infection) and patient on anti HCV treatment.were excluded.<br /> <strong>Results: </strong>showed detection of HCV-PCR in PBMCs in the absence of HCV-PCR in plasma; was found in three of the 60 patients (3.3%). All patients had negative HIV, HBsAg, HCV Ab and serum HCV PCR.<br /> <strong>Conclusion:</strong> it could be concluded that testing for HCV-RNA in PBMCs is more reliable than hepatitis serological markers in identifying patients with an OCI when a liver biopsy is not available.<br /> <strong> </strong><br /> Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200267220170401Subclinical Peripheral Nerve Affection in Hypothyroidism5535631420710.12816/0037806ENMai AbdelazeemPhysical Medicine, Rheumatology and Rehabilitation Department
Faculty of Medicine, Ain Shams University,Cairo, EgyptAbeer ElZohieryPhysical Medicine, Rheumatology and Rehabilitation Department
Faculty of Medicine, Ain Shams University,Cairo, EgyptMona ElhussienyPhysical Medicine, Rheumatology and Rehabilitation Department
Faculty of Medicine, Ain Shams University,Cairo, EgyptMohamed RagaaiPhysical Medicine, Rheumatology and Rehabilitation Department
Faculty of Medicine, Ain Shams University,Cairo, EgyptJournal Article20180920<strong>Background: </strong>Hypothyroidism is most common endocrinal disorder. The existence of hypothyroid neuropathy is a point of debate and its pathogenesis is incompletely understood.<br /> <strong>Objective:</strong> To detect subclinical motor or sensory peripheral nerve affection among hypothyroid patients.<br /> <strong>Methods:</strong> The study was conducted on 30 hypothyroid patients without any neurological symptoms and signs. 10 healthy subjects were included as a control group. All participants were subjected to full medical history taking thorough clinical examination; full general and neurological examination, laboratory & radiological investigations and neurophysiologic nerve conduction study.<br /> <strong>Results:</strong> The study revealed polyneuropathy, mainly sensorimotor, in 86.6% of the patients either axonal demyelination or axonal affection. Median and peroneal nerves were the dominantly affected nerves. High incidence of entrapment neuropathy was encountered among the patients especially carpal tunnel CTS (66.67%).<strong>Conclusion:</strong> Hypothyroidism is associated with polyneuropathy,mainly of a mixed type (axonal -demyelinating type).Nerve conduction tests should be performed routinely in hypothyroid patients early in the course of the disease, even among asymptomatic patients, to minimize structural damage and disability<strong>.</strong><br /> <strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200267220170401The Role of Tonsillectomy in the Treatment of Obstructive Sleep Apnea5645701420810.12816/0037807ENAbdullah GhafouriKing Fahad Armed Forces Hospital, JeddahSuzan Sulaiman AlzaidiKing Fahad Armed Forces Hospital, JeddahReem Raddah AL-ZayediKing Fahd Hospital, Jeddah2Nihal Khalid N AlsoluArabian Gulf University, BahrainMaria Khalifah AlhamedKing Faisal University4Fetoon Nasser AlsharifIbn Sina National College5Journal Article20180920<strong>Background:</strong> Obstructive Sleep Apnea (OSA) is caused by a partial or complete obstruction of the upper airway. OSA is a very inconvenient and relatively common disorder with daytime and nocturnal symptoms. The intervention and management of OSR is dependent on the patients’ case severity. The aim of this study was to evaluate the role and the optimal choice of Tonsillectomy for treatment of OSR.<br /> <strong>Methods:</strong> a systematic search in the scientific database (Medline, EMBASE, Google Scholer and Ovid) from 1980 to 2016 was conducted for all relevant retrospective studies including; randomized controlled trials, cohort studies and case–control studies were analyzed and included based on the preset inclusion and exclusion criteria. <strong>Results: </strong>the search has yieldedtwelve studies to be included in the present SR (n = 206 patients, 34.4 ± 10.0 years and body mass index: 29.3 ± 9.6 kg/m2) met criteria. Tonsils sizes were hypertrophied, large, enlarged, extremely enlarged, or grades 2 to 4. Apnea-Hypopnea Index decreased by 65.2% (from 43.7± 21.7 /hour to 13.7 ± 12.7 /hour) (n = 198). The AHI mean difference (MD) was −30.2 per hour (95% confidence interval [CI] −39.3, −21.1) (P value < 0.00001). The AHI SMD was −1.37 (−1.65, −1.09) (large effect). Lowest oxygen saturation improved from 77.7 ± 11.9% to 85.5 ± 8.2% (n = 186). Lowest oxygen saturation MD was 8.5% (95% CI 5.2, 11.8) (P value < 0.00001). The Epworth Sleepiness Scale decreased from 11.6 ± 3.7 to 6.1 ± 3.9 (n = 125). Individual patient outcomes (n = 52) demonstrated an 85.2% success rate (AHI < 20/hour and ≥ 50% reduction) and a 57.4% cure rate.<br /> <strong>Conclusion:</strong> tonsillectomy is an effective and safe surgical intervention for treatment of OSA in adults, particularly among carefully selected patients with large tonsils and mild to moderate OSA severity. <br /> <strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200267220170401First Line Management of Adult Diabetic Ketoacidosis Patients5715771420910.12816/0037808ENAmirah Ali AlshammariHail UniversityLouai M AlahdalSFHJenanTajuddin JawiIbn Sina CollgeHanouf Abdullah AlnofaieTaif UniversityNourah Ali AldossariKing Faisal UniversityHala Mohammad Abdulaziz AlassafHail UniversityJournal Article20180920<strong>Background:</strong>Diabetic Ketoacidosis (DKA) is a hyperglycemic crisis that can occur in patients with both type 1 and 2 diabetes mellitus. It is a medical emergency with a significant morbidity and mortality. It is however a potentially reversible condition in case an emergency and immediate medical attention, prompt recognition, diagnosis and treatment were provided.<br /> <strong>Aim of the Study:</strong>was to leverage the current research data in order to construct a treatment guideline for diabetic ketoacidosis in the emergency department.<br /> <strong>Methods:</strong>A literature search was carried out on MEDLINE (including MEDLINE in-process), CINAHL,Embase and the Cochrane Library. Databases using “diabetic ketoacidosis” as a MeSH heading and as textword. High yield journals were also hand searched.<br /> <strong>Findings:</strong>The initial treatment phase aims to restore circulating volume, reduce blood glucose levels, to correct any electrolyte imbalances and to reduce ketone levels which in turn corrects the acidosis. Evidence also showed that there is no need for insulin bolus prior to starting an insulin drip in the treatment of diabetic ketoacidosis. Also, using beta-hydroxybutyrate at presentation can expedite diagnosis and therefore treatment. Implementing treatment guidelines into the emergency department may help expedite diagnosis and treatment.<br /> Conclusion:Prompt first line management of DKA is the most critical stage to profoundly reduce morbidity and mortality rates of this potentially fatal crisis. It’s therefore crucial to follow the evidence-based guidelines and DKA protocol in the emergency department to expedite diagnosis, guide treatment, and improve continuity of care between the emergency department and the ICU as well as improving the clinical outcomes of patients with DKA. Initially, this will improve outcomes by decreasing the delay until treatment is initiated andprovide a continuum of treatment between the emergency department and the intensive care unit.<br /> Furthermore, the healthcare providersmust ensure that they have the ability to provide support and education to people at risk of developing DKA and those that have had an episode of DKA by spreading awareness and education to help reduce both the initial occurrence and recurrence of this often preventable life-threatening condition.<br /> <strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200267220170401Role of Positron Emission Tomography/Computed Tomography (PET/CT) in Detection of Bone Metastases5785901421010.12816/0037809ENAhmed FaradDepartment of Radiology, Faculty of Medicine, Benha University,EgyptIslam El-ShazleyDepartment of Radiology, Faculty of Medicine, Benha University,EgyptAhmed SherifDepartment of Radiology, Faculty of Medicine, Benha University,EgyptJournal Article20180920<strong>Background and Aim of the Work:</strong> Early detection of skeletal metastasis is critical for accurate staging and optimal treatment. Among the various imaging modalities currently available for imaging skeletal metastasis, hybrid techniques which fuse morphological and functional data are the most sensitive and specific, and positron emission tomography (PET)/computed tomography imaging will almost become increasingly important in this regard<strong>.</strong> We tried to assess the efficacy of <em>fluorine-18 fluoro-deoxy-glucose Positron Emission Tomography/Computed Tomography (PET/CT) ((18) F-FDG-PET/CT) scan</em> in detecting bone metastases among various primary malignancies. In order to detect accuracy of fused PET/CT in the initial detection & characterization of osseous metastases compared to isolated PET and CT with contrast.<br /> <strong>Patients and methods</strong>: The study included thirty patients (with a mean age = 27) with various primary malignancies (pathologically proven) to whom PET/CT was done. In this study population, a detailed retrograde lesion based analysis was performed for a total of 80 detected bone lesions on PET, CT and fused PET/CT images. Sensitivity, specificity, PPV and NPV of each modality were calculated. Stastical analysis of the lesions were performed to study the relationship between the lesion’s SUV and its corresponding morphologic pattern on CT and to set a reliable SUVmax cut-off value that can predict the presence of malignant lesion.<br /> <strong>Results:</strong> The calculated fused PET/CT sensitivities and specificities in various malignancies ranged from 95.2% to 99.6% and 75% to 100%, respectively. The combined PET/CT has significantly improved the low CT sensitivity (especially in lymphoma) as well as both separate CT and PET specificities (using SUVmax of 3 as a cut off value for malignant osseous lesions).<br /> <strong>Conclusion</strong>: Detection of early bone marrow infiltration not apparent on CT, resolution of metabolic activity before definite signs of complete healing on CT, detection of missed sclerotic metastases on PET due to their relatively low metabolic activity, detection of intra and extra osseous recurrence and differentiation of benign from malignant bone lesions.Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200267220170401The Therapeutic Effects of Stem Cell Enhancer on Changes of Some Physiological Parameters in Male Albino Rats Treated With Mixture of Food Additives )Food Preservative, Food Coloring Agent, and Flavor Enhancer)5915981421110.12816/0037810ENEman G.E. HelalDepartment of Zoology, Faculty of Science (Girls), Al-AzharUniversity,Cairo, Egypt,Rasha A.A. El-SayedDepartment of Zoology, Faculty of Science (Girls), Al-AzharUniversity,Cairo, EgyptGomaaMostafa- HedeabPharmacology Department, Faculty of Medicine, Beni Suef University, Egypt,Mariam S. El-GamalDepartment of Zoology, Faculty of Science (Girls), Al-AzharUniversity,Cairo, EgyptJournal Article20180920<strong>Background: </strong>food additives are substances intentionally added to food to change its characteristics, to maintain and improve safety, to improve or maintain the nutrient value and to improve taste, texture, and appearance. Sodium nitrite is an inorganic salt with widespread applications in the food industry as a food preservative in meat and fish. However, Annatto is used as a dyeing agent in the food industry in coloring butter, cheese, and ice-cream whereas Monosodium Glutamate (MSG) is one of the most used flavorenhancers which is ingested as part of commercially processed foods. Stem cell enhancer is a natural stem cell mobilizer that can trigger the release of millions of adult stem cells from bone marrow into the circulation, and its considerable safety allows for a sustained oral daily intake over long periods of time.<br /> <strong>Aim</strong><strong> of the work:</strong> this study was aimed to determine the therapeutic effects of Stem Cell Enhancer (SCE) against the hazardous effects of sodium nitrite, annatto and monosodium glutamate on some physiological parameters in male albino rats. <strong>Materials and methods: </strong>this study had been done on thirty male albino rats with an average body weight 120-140 g. The animals were divided into three groups; <strong>Group 1: </strong>control (untreated group),<strong> Group 2:</strong>rats treated with food additives mixture (sodium nitrite, annatto, and monosodium glutamate);<strong> Group 3: </strong>rats treated with food additives mixture, in addition to Stem Cell Enhancer. Blood samples were collected, and the separated sera were used for estimation of some biochemical parameters (liver enzymes, kidney functions, glucose, protein profile and lipid profile) and hormonal levels [testosterone,triiodothyronine (T3) and thyroxine(T4<strong>)</strong>].<br /> <strong>Results:</strong> the biochemical results showed an increase in the activities of liver enzymes [aspartate aminotransferase (AST) and alanine aminotransferase (ALT)], and the levels of glucose, kidney functions (urea, and creatinine), lipid profile [total cholesterol, triglycerides, low-density lipoprotein(LDL-c), high-density lipoprotein(HDL-c)and risk factors 1& 2] and thyroid hormones [T3 and T4]in the mixture accompanied by a significant decrease in protein profile (total protein, albumin and globulin), HDL-and testosterone hormone levels as compared to the control rats. On the other hand, these results turned back to nearly to the normal values after receiving the Stem cell Enhancer.<br /> <strong>Conclusion:</strong> the present study clearly revealed thetherapeutic capability of SCE to fight the grievous effects of food additives mixture on major physiological parameters.<br /> <strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200267220170401The Effect of Mehotrexate in the Treatment of Alopecia Areata5996041421210.12816/0037811ENHaneen Saud AlsufyaniUmm Al Qura University, Makkah, KSAWahhaj Abdullah RawasUmm Al Qura University, Makkah, KSASufyan Saud AlsufyaniUmm Al Qura University, Makkah, KSANebras Faisal AlsaadiUmm Al Qura University, Makkah, KSAMohannad Sami FelembanUmm Al Qura University, Makkah, KSAMouad Mohammed AlqadiUmm Al Qura University, Makkah, KSAJameel Abdullah AwadainUmm Al Qura University, Makkah, KSAMeshal Mohammed Abdullah AlbaqamiUmm Al Qura University, Makkah, KSAAli Mohammed AlasmariUmm Al Qura University, Makkah, KSAMohammed Aiman A HalawaniUmm Al Qura University, Makkah, KSAWael Hamed AlsaediUmm Al Qura University, Makkah, KSAJournal Article20180920<strong>Background:</strong> Alopecia areata (AA) is one of the most common autoimmune disorders and its severe types are resistant to almost all conventional therapies. Methotrexate (MTX) has been used as an adjunctive therapy in some autoimmune disorders and has been proposed to be effective in the treatment of severe alopecia areata both as a monotherapy and in combination with corticosteroids.<br /> <strong>Aim of the study: </strong>was toevaluate the outcome and safety of MTX therapy in patients with severe forms of AA, whether as monotherapy or in combination with systemic or intralesional corticosteroids; and to assess therapeutic response according to sex, age, pattern of AA, disease duration and cumulative MTX dose.<br /> <strong>Methods:</strong> 28 patients were evaluated in a retrospective, non-controlled study, with alopecia areata in current or prior treatment with methotrexate to assess the therapeutic response according to sex, age, pattern of alopecia areata, disease duration, and cumulative dose of methotrexate as well as the use of systemic corticosteroids or other treatments, and drug safety.<br /> <strong>Results:</strong> 77.8% % of patients experienced a more than 50% regrowth rate, with the best responses observed in those with <strong>Conclusion:</strong> methotrexate is a convenient and relatively inexpensive drug that could be used as a safe and well tolerated adjunctive therapy for severe alopecia areata although careful monitoring of adverse effect is necessary.<br /> <strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200267220170401Effects of Some Food Additives on Some Biochemical Parameters in Young Male Albino Rats and the Ameliorative Role of Royal Jelly6056131421310.12816/0037812ENEman G.E. HelalDepartment of Zoology, Faculty of Science (Girls), Al-AzharUniversity,Cairo, Egypthttps://orcid.org/0Rasha A.A. El-SayedDepartment of Zoology, Faculty of Science (Girls), Al-AzharUniversity,Cairo, Egypt, GomaaMostafa HedeabPharmacology Department, Faculty of Medicine, Beni Suef University, EgyptMariam S. El-GamalDepartment of Zoology, Faculty of Science (Girls), Al-AzharUniversity,Cairo, EgyptJournal Article20180920<strong>Background</strong><strong>: </strong>the use of food additives is one of the most important problems in the human health nutrition field. Food additives are widely used for various purposes; including preservation, coloring, and sweetening, however, the physiological and biochemical changes may be produced.<br /> <strong>Aim</strong><strong> of the work:</strong> was to investigate the protective role of royal jelly (RJ) against abnormalities in metabolic biochemical parameters that induced by these food additives in male albino rats.<br /> <strong>Materials and Methods: </strong>thirty young male albino rats with an average body weight 120-140 g were divided into three groups (10/cage);<strong> Group I</strong>: served as normal control group, <strong>Group II</strong>: rats orally administrated with the mixture which consists of sodium nitrite (NaNO2 0.1 mg/kg b.wt./ day), annatto (0.065 mg/kg b.wt./day) and monosodium glutamate (MSG 15 mg/kg b.wt./day) and <strong>Group III</strong>: rats orally administrated with the previous mixture and then orally administrated with royal jelly (14.28 mg/kg b.wt./day soluble in maize oil). At the end of the experiment, blood samples were collected for biochemical estimations which including levels of serum glucose, creatinine, urea, testosterone, thyroid hormones (T3 and T4), activities of AST and ALT, total protein (TP), albumin, total cholesterol, triglycerides, high-density lipoprotein (HDL-c) and low-density lipoprotein (LDL-c). <strong>Results:</strong> the present study showed marked elevation in levels of fasting blood glucose, activities of AST, ALT, levels of serum urea, creatinine, TC, TG, LDL-c, VLDLand ratios of TC/HDL-c and LDL-c/HDL-c (risk factors) as well as albumin /globulin ratio and serum thyroid hormones (T3&T4) accompanied with significant reduction in the body weight, serum total proteins, albumin, globulin, albumin/creatinine, testosterone and HDL-C concentrations in the group that administrated with the mixture which consists of (NaNO2, MSG and annatto) as compared to control rats. While administration with royal jelly significantly ameliorated the disturbed biochemical parameters and showed significant improvement in most of these parameters.<strong> Conclusion:</strong> it could be concluded that royal jelly offers a therapeutic advantage that minimizes the metabolic abnormalities and biochemical changes which induced by these food additives.<br /> <strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200267220170401Vaginal Misoprostol versus Bilateral Uterine Artery Ligation in Decreasing Blood Loss in Trans-Abdominal Myomectomy: A Randomized Controlled Trial6146271421410.12816/0037813ENIhab Hassan Abdel-FattahFaculty of Medicine – Ain Shams UniversityAhmed Adel TharwatFaculty of Medicine – Ain Shams UniversityWalid,El Basuony MohammadFaculty of Medicine – Ain Shams UniversityMortada El-Sayed AhmedFaculty of Medicine – Ain Shams UniversityAliaa Mohammad Ali MaatyFaculty of Medicine – Ain Shams UniversityJournal Article20180920<strong>Background: </strong>Uterine leimyomas are tumors of the smooth muscles and the connective tissues of the uterus. They are considered to be the most common benign pelvic tumor affecting about 20% of women above the age of 35. The diverse symptomatology of fibroids can be attributed to size, number and location of the tumors. The common symptoms include menorrhagia, infertility, abdominal mass and pressure effects. <strong>Aim of the Work:</strong> The aim of this study is to compare between the effect of medical (preoperative vaginal misoprostol) and non-medical (bilateral uterine artery ligation) regarding their efficacy to decrease blood loss in trans- abdominal myomectomy. <strong>Patients and Methods:</strong> Prospective randomized controlled interventional clinical trial. The study was conducted in Ain Shams University Maternity Hospital, Cairo, Egypt in the period between August 2015 till December 2016. It was approved by the Ethical Research Committee, Obstetrics and Gynecology Department, Ain Shams University, Cairo, Egypt. It included 60 women recruited from those attending the outpatient gynecology clinic, seeking treatment for symptomatic uterine myomas. <strong>Results:</strong> The current study revealed that there was no statistically significant difference between both groups regarding operative time, blood loss and postoperative hospital stay.<br /> <strong>Conclusion:</strong> A single pre-operative dose of 400 micrograms of vaginal misoprostol is as effective as uterine artery ligation in decreasing blood loss in transabdominal myomectomy. Misoprostol is a simple, cheap, fast, available and applicable tool that can be administered even an hour preoperatively. <strong>Recommendation</strong><strong>s: </strong>Preoperative vaginal misoprostol is an effective practical tool in decreasing blood loss in transabdominal myomectomy. Investigation of misoprostol use in larger population groups and with different dosages and administration routes, together with comparison of other methods used to reduce bleeding during myomectomy, is recommended.<br /> <strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200267220170401Relationship between Diabetic Retinopathy and Methylenetetrahydrofolate Reductase Gene Polymorphism6286341421510.12816/0037814ENJihan Abdallah M,Ophthalmology Department ,Faculty of Medicine (for Girls), Al-Azhar University, Cairo, EgyptSeham Mohamedclinical pathology Department,
Faculty of Medicine (for Girls), Al-Azhar University, Cairo, Egypt.Hamdia Ezzat Aclinical pathology Department,
Faculty of Medicine (for Girls), Al-Azhar University, Cairo, Egypt.Eman Salah Mclinical pathology Department,
Faculty of Medicine (for Girls), Al-Azhar University, Cairo, Egypt.Journal Article20180920<strong>Purpose: </strong>To assess MTHFR rs1801133 (C677T) gene polymorphism in diabetic patients as a risk factor for diabetic retinopathy and to establish the changes in Platelet indices & count in diabetic patient as compared to the healthy control group.<br /> <strong>Patients and Methods:</strong> The study included 40 patients with Type 2 Diabetes Mellitus. They were divided into 2 equal groups, 20 patients with Diabetic Retinopathy, 20 patients without Diabetic Retinopathy. Patients were selected from those attending the outpatient Ophthalmology Unit and Diabetes Clinic of Al-Zahraa University Hospital in the period from June 2014 to June 2015. Their ages ranged between 34 to 66 years old. They were 14 males and 26 females. Twenty cases apparently healthy individuals were selected as a control group. All cases were subjected to full history taking and complete ophthalmological examination. Also laboratory investigations were done including complete blood picture, kidney and liver function tests, coagulation profile, urine analysis, lipid profile, fasting and postprandial blood sugar and Genetic study for detection of MTHFR gene C677T mutation (rs 1801133)by real time PCR.<br /> <strong>Results</strong>: In all diabetic patients the mutant homozygous TT showed a highly statistically significant increase in FBS (p=0.000), PPBS (p=0.000), HbA1C (p=0.000) and cholesterol (p=0.001) as compared to wild type. Also in all diabetic patients the mutant homozygous TT showed a highly statistically significant increase in FBS (p=0.002), PPBS (p=0.001), HbA1C (p=0.019) and cholesterol (p=0.012) as compared to heterozygous mutant type.<br /> <strong>Conclusion: </strong>The homozygous mutant type (TT) of rs1801133 was detected in 10% of DR patients group while absent in DWR group and the control group. The heterozygous mutant type (CT) was increased in DR group (50%) as compared to DWR group (35%) and the control group (25%).<br /> Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200267220170401Interferon Lambda 4 Gene (IFNL4) Linked to Hepatitis C virus clearance, treatment6356441421610.12816/0037815ENSaadia FaridDepartment of Tropical Medicine,National Hepatology and Tropical Medicine Research Institute and
Faculty of Medicine, Cairo UniversityLaila RashedDepartment of Biochemistry,National Hepatology and Tropical Medicine Research Institute and
Faculty of Medicine, Cairo UniversitySamya SweilamDepartment of Medical Biochemistry
National Hepatology and Tropical Medicine Research Institute and
Faculty of Medicine, Cairo UniversityJournal Article20180920<strong>Background: </strong>AdesignatedIFNL4 gene, encoding the interferon-λ4 protein (IFNL4), which is moderately similar to IFNL3, is more strongly associated with HCV clearance in individuals of African ancestry, whereas it provides comparable information in Europeans and Asians. <br /> <strong>Aim of the work: </strong>The study was attempted for the identification of interferon Lambda 4 (IFNL4) gene expression in the liver biopsy and the recombinant IFNL4 protein in the serum of CHCV patients.<br /> <strong>Patients and methods: </strong>Eighty five patients with chronic hepatitis C virus infection (CHCV), whose age ranged between 19 and 57 years, were selected from the National Hepatology and Tropical Medicine Research Institute were included in this study, before chronic HCV therapy, during the preparation of patients, and ten healthy individuals were included to serve as controls. All the patients and controls were subjected to the following: history, clinical examination, abdominal ultrasonography and collection of blood samples for routine laboratory investigations, CBCs. Liver biopsy was done to all patients and controls. Patients revealed mild fibrosis (Metavir fibrosis from F1 to F3). Using freshly frozen liver biopsies to identify gene (IFNL4) by real time-PCR and the detection of its serum protein levels by ELISA.<br /> <strong>Results: </strong>Patientswith CHCVhave higher hepatic expression of IFNL4 before treatment and also recombinant IFNL4 protein expression was detectable in serum with high levels.<br /> <strong>Conclusion: </strong>An inducible human protein-coding gene IFNL4, which is related to, known IFNs have been identified in genotype 4 CHCV patients.<br /> <strong>Recommendations: </strong>Thetherapeutic inhibition of IFNL4 might represent a novel biological target for the treatment of HCV and HBV infection and possibly other diseases.<br /> <strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200267220170401Effects of High Flux versus Low Flux on Serum C-Reactive Protein A as an Inflammatory Biomarker in Hemodialysis Patients6456551421710.12816/0037816ENEmad Allam MohamedNephrology Unit, Faculty of Medicine, Al-Alzhar Universit.Magdy Elsayed MohamedNephrology Unit, Faculty of Medicine, Al-Alzhar Universit.Haytham Sabry AbdelhamidNephrology Unit, Faculty of Medicine, Al-Alzhar Universit.Mohammed Al-Arabi MohammedNephrology Unit, Faculty of Medicine, Al-Alzhar Universit.Journal Article20180920<strong>Background</strong>: Traditional low-flux dialysis cannot improve micro-inflammatory status, while new high-flux dialysis can improve the micro-inflammation and lipid metabolism, it helps to improve the quality of life and survival rate of patients, so how to improve the micro-inflammatory status are a focus for researchers.<br /> <strong>Objective</strong>: was to observe the effect of high flux hemodialysis (HFHD) with Gambro polyflux 170H dialyser and low flux hemodialysis (LFPD) with polyflux 17L dialyser on high-sensitivity C-reactive protein in patients with maintenance hemodialysis.<br /> <strong>Methods</strong>: 60 patients with maintenance hemodialysis were randomly divided into HFHD group and LFHD group. Another 20 cases for physical examinations served as normal control group. The maintenance hemodialysis patients were treated with HFHD using 170H dialyser dliahyser and LFHD using 17L dialyser, three times per week, 4 hours once. After 6 months of the treatment, high-sensitive C-reactive protein was determined in patients as well as normal controls before and after treatment.<br /> <strong> Results and Conclusion</strong>: in two groups, the levels of high-sensitive C-reactive protein before the treatment were higher than normal control (P <0.001). In HFHD group, serum high-sensitive C-reactive protein markedly decreased (P <0.01). In LFHD group, these indices remained unchanged after the dialysis for 6 months. HFHD with 170H polysulfone dialyser is effective in improving micro-inflammation in maintained hemodialysis patients.<br /> <strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200267220170401Operational Difficulties in Obese Patients6566591421810.12816/0037817ENNawaf AL-HazmiCollege of Medicine, Taif University, Saudi ArabiaAhmad Al-ZahraniCollege of Medicine, Taif University, Saudi ArabiaAbdallah AliCollege of Medicine, Taif University, Saudi ArabiaHisham AdulbasetCollege of Medicine, Taif University, Saudi ArabiaJournal Article20180920<strong>Background and aim of the work:</strong> to give optimal care for obese surgical patients, surgeons and healthcare personnel should be aware about the surgical problems which may be met in obese patient and how to overcome a variety of challenges. In this study the awareness of the surgeons about the obesity as surgical problem would be evaluated from the surgical staff point of view.<br /> <strong>Patient and methods:</strong> a cross-sectional study was done by interviewing the surgeons to fill the questionnaire focusing on their awareness about the prevalence of operational difficulties in obese patients.<br /> <strong>Results:</strong> the study included 82 surgeons most of them practice general surgery. The majority of surgeons found that the main cause of obesity amongst their patients is dietary factors (91.5%). The same percent of surgeons (higher percentage in residents) agreed that obesity might modify the surgical decision. According to the survey, they patients of age between 30-45years represented the majority and most of them were females. Over 89% of surgeons found that the complications are more in obese patients than in average weight patients. All specialties (especially general surgeons) agreed that obesity increases the operative time. Infection was the major problem mentioned by surgeons followed by anesthetic problems and the size of the instrument used. Over 64.6% of surgeons agreed that some operations need to reduce patient weight to be performed. Most of surgeons (42.7%) agreed that surgical error is higher in obese patients; however, 37.8% agreed that surgical errors in obese and average weight patients are equal. The majority of surgeons (68.3%) agreed that experience of the surgeon will differ in theatre. 81.7% of surgeons agreed that obese patient needs more evaluation prior to surgery than average weight patient. 72% agreed that obese patients have prolonged hospital stay.<br /> <strong>Conclusion:</strong> The study revealed a good to excellent awareness of KSA surgeons about surgical problems which may be met in obese patient and how to overcome a variety of challenges reflecting the values of continuous medical education programs applied in their hospitals.<br /> <strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200267220170401Laparoscopic Appendectomy between the Advantages and Complications:A Cross Section Study –Jeddah – Saudi Arabia – 20166606651421910.12816/0037818ENAsmaa Yaseen NassirIbn Sina National CollegeAhmad Mohammad KashhaBattarjee Medical CollegeAli Hassan AltrabolsiIbn Sina National CollegeAbdullah N GhannamIbn Sina National CollegeOmar Abdulelah SindiIbn Sina National CollegeAhmed Mohammed AlzimaityKing Abdulaziz Hospital & oncology centerJournal Article20180920<strong>Background: </strong>Appendectomy is the most common surgical procedure performed in emergency surgery. Laparoscopic appendectomy (LA) for acute appendicitis has several advantages over open appendectomy (OA). In cases of complicated appendicitis, LA is converted to OA at a constant rate, though converting appendectomy (CA). In this study, we aimed to assess the LA complication and the prevalence of CA.<br /> <strong>Methods: </strong>A cross Sectional survey conducted among 243 patients with acute appendicitis who were suitable for the study between April and July 2016. Operative time, length of hospital stay, post-operative complication return to normal activity has been assessed among the all patients.<br /> <strong>Results and Conclusion: </strong>Our results showed the advantages of the laparoscopic appendectomy approach including shorter hospital stay, decreased need for postoperative analgesia, early food tolerance, earlier return to work, lower rate of wound infection. Furthermore we found a considerable preference (during the collection of consent) of patients and a high satisfaction after the surgery.<br /> <strong> </strong><br /> <strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200267220170401The Prophylactic Role of Probiotics for Preterm Infants/Neonates6666711422010.12816/0037819ENAbdulrahman Mohammedsaeed BaqasiUmm Alqura UniversityAli Hussain ALAbdullahMedical University Of WarsawFares Ahmed BadghishIbn Sina National CollageJasseer Ahmed AlghamdiIbn Sina National CollageMaram Mohammed AssiryIbn Sina National CollageAteeq Alharbi KoloudIbn Sina National CollageJournal Article20180920 Necrotizing enterocolitis (NEC) is a major morbidity and cause of mortality in preterm neonates. Probiotics seem to have a beneficial role in preventing NEC, which is confirmed in meta-analyses of randomized controlled trials (RCTs). We therefore aimed to review and confirm the efficacy of probiotics in preterm neonates obtained in observational studies. To assess the effects of prophylactic probiotics in preterm infants.<br /> <strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200267220170401Diagnosis and Management of Systematic Lupus Erythematosus (SLE)6726781442610.12816/0037820ENYousef Taleb Gaafar AL-katheriIbn Sina CollegeFoad Assad M BukhariKing Abdulaziz UniversityMurad Muneer MawlawiKing Fahd General HospitalAL NIHAB ALI NAJI AAnak General HospitalReem Ahmed B AlanaziAlmaarefa collageBayan Saeed A AlghamdiIbn Sina CollegeAhdab Abdulmuti Alkubaydiibn Sina CollegeNada Talal Ibrahem Bimaibn Sina CollegeRayan Marzooq F AlmutairiUmm Alqura UniversityAbdullah Salem Z AlghamdiUmm Alqura UniversityJournal Article20180923<strong>Background:</strong> Systemic lupus erythematosus (SLE) is the prototypic multisystem autoimmune disorder with a wide range of clinical presentations impacting almost all organs and tissues, such extreme heterogeneity suggests that SLE represents a syndrome rather than a single disease. Although the precise etiologic mechanism is unknown, genetic, hormonal, and environmental factors, as well as immune abnormalities, have been detected. Associations between lupus onset and age, sex, geography, and race have also been established.
<strong>Aim of the work:</strong> This review will focus on advances in the diagnosis and management of SLE.
<strong>Conclusion:</strong> The diagnosis of SLE must be based on the proper constellation of clinical findings and laboratory evidence. Management of this disease should be individualized and should include both pharmacological and non-pharmacological modalities for symptom relief and resolution as well as improved quality of life.Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200267220170401Cesarean Section among Primigravidae: Cross Section Study – Abha Saudi Arabia6796821442710.12816/0037821ENRoaa Fahad AlshabanahKing Khalid UniversityTahani Saeed AlmohayyaKing Khalid UniversityEbtesam Mohammed AlahmariKing Khalid UniversitySarah Saeed AlshahraniKing Khalid UniversityNorah Ibraheem AlmanieKing Khalid UniversityReem Ali AlmanieKing Khalid UniversityAmal Nasser AlqahtaniKing Khalid UniversityJournal Article20180923<strong>Background:</strong>The Primary caesarean section (CS) delivery worldwide rate is increasing due to public interest to avoid fetal complications and acceptance by most of the couple to complete their family with one or two children. This study was undertook to study selected cases of primary CSs in primigravid women, keeping the objectives to study the complications lead to cesarean section, maternal morbidity and mortality.
<strong>Methods:</strong>Cross sectional survey conducted among Primigravidae in maternity & Pediatrics hospital – Abha – obstetrics & gynecology department between January 2016 and December 2016. Overall 170 cesarean section has been done out of 1167 births.
<strong>Conclusion: </strong>Preeclampsia, eclampsia, placenta previa, intrauterine growth restriction, macrosomic fetus, malpresentation of the fetus, loss of fetal moment, fetal distress and labor dystocia are all indication of cesarean section. Our study revealed that cesarean section among Primigravidae still low in our area of the study.
<strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200267220170401Depression and Anxiety in Early Pregnancy and Its Risk for Preeclampsia6836911443010.12816/0037822ENAbdullah Mohammedalsasi A AlawamirIbn Sina College – JeddahNadia Issa ZakariaIbn Sina College – JeddahWafaa Mohammed AlsbhaniIbn Sina College – JeddahArij Mohammed Khalifah6th October University – EgyptAsma Abdulkarim AlmohamadIbn Sina College – JeddahAdhwaa Ahmed M Al ShamraniIbn Sina College – JeddahAfrah Muhaisen Al LehabiTaif Collage – TaifRuya Abdulaziz AlthomaliTaif Collage – TaifAlaa Abdullah AlghamdiIbn Sina College – JeddahMada Salim Al MatrafiIbn Sina College – JeddahTithkar Abdu OthmanResident-Coordinator of Breastfeeding Support Program in Jazan HealthSafa Abdulkhaleq AlmomenKing Faisal UniversityNorah Abdullah AlhabshanAlmareefa CollegeNameer Mohammed A AlshinqeetiIbn Sina CollegeGhadir Alwan Abdullah AlnahariIbn Sina CollegeJournal Article20180923 Handling depression is one of the greatest challenges facing pregnant women across the globe. The level of antenatal depression and anxiety has a prevalence rate of above five percent but less than twelve. Escalated depression has been associated with increasing maternal and infant mortality because of the development of secondary disorders such as preeclampsia and other obstetric-related conditions. The objective of this review was to determine the relationship that exists between depression and anxiety and preeclampsia in early pregnancy.
The present paper draws conclusions on the etiology and potential predisposing factors of preeclampsia based on the studies consulted which ascertained the existence of a correlation between antenatal anxiety and depression and preeclampsia which should serve as the baseline for the assessment of the pathogenesis and future direction, the existing literature has
<strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200267220170401Incidence and Risk Factors for Neonatal Jaundice among Neonates with Urinary Tract Infection in Abha - Saudi Arabia6926961443110.12816/0037823ENTahani Saeed AlmohayyaKing Khalid Univerity, Abha, Saudi ArabiaRoaa Fahad AlshabanahKing Khalid Univerity, Abha, Saudi ArabiaEbtesam Mohammed AlahmariKing Khalid Univerity, Abha, Saudi ArabiaNorah Ibraheem AlmanieKing Khalid Univerity, Abha, Saudi ArabiaReem Ali AlmanieKing Khalid Univerity, Abha, Saudi ArabiaAmjaad Saleh Saad AlJelbanKing Khalid Univerity, Abha, Saudi ArabiaSalha Ali Ahmad AseryKing Khalid Univerity, Abha, Saudi ArabiaJournal Article20180923<strong>Background: </strong>Hyperbilirubinemia is one of the presenting signs of bacterial infection in newborns, and the association of neonatal jaundice with urinary tract infection (UTI) has been particularly emphasized. The aim of this study was to determine the prevalence of UTI in asymptomatic jaundiced neonates younger than 4 weeks old. <strong>Method:</strong> A cross sectional survey has been conducted at Newborn Unit of Maternity & Pediatrics Hospital – Abha from January 2016 to August 2016. A total of 15 patients have been included in the study, who were diagnosed with hyperbilirubinemia due to urinary tract infection (UTI) after exclusion of unrelated criteria. <strong>Conclusion: </strong>It could be concluded that UTI should be routinely investigated in early (⩽10 days) idiopathic neonatal jaundice in which all other etiologic factors of neonatal hyperbilirubinemia are ruled out, and the presence of UTI should be considered in case of a poor phototherapy response in cases receiving phototherapy.
<strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200267220170401The Prophylactic Role of probiotics for Preterm Neonates6977041443310.12816/0037824ENWaad Abdullah Saad AljubairahMaternity & Children Hospital – AlhassaEman Ahmad AlmubarakImam Abdulrahman Bin Fisal UniversityFatimah Sharif ModawiKing Khalid UniversityFatimah Mohammed AlhabibImam Abdulrahman Bin Fisal UniversitySara Abdullah BinsalmanIbn Sina National CollegeNahla Shaker SaatiFamily Medicin/KAAUWasan Usamah ShehatahIbn Sina National CollegeAbdullah Yahya Al DhbanKing Khalid UniversityAreej Ahmad AbulelaIbn Sina National CollegeAmmar Yasser AlansariIbn Sina National CollegeJournal Article20180923<strong>Background:</strong> Probiotics are live microorganisms which when administered in adequate amounts confer a health benefit on the host. Probiotics have been used for prevention and treatment of various medical conditions in children and adults. Studies on probiotics in premature infants have focused on normalizing intestinal flora, improvement in feeding intolerance, prevention of necrotizing enterocolitis which is the leading causes of death in the neonatal intensive care unit.
<strong>Objective of the Study:</strong> was to provide an overview of the controversies regarding probiotic use in preterm infants and to shed light on the practical considerations for implementation of probiotic supplementation.
<strong>Methods:</strong> A Systematic search in the scientific database (Medline, Scopus, EMBASE , and Google Scholer) from 1990 to 2016 was conducted for all relevant retrospective studies including; retrospective , prospective and randomized controlled trials and cohort studies were analyzed and included based on the preset inclusion and exclusion criteria.
<strong>Results:</strong> The search results yielded 16 studies, 12 of which were RCTs with 2340 premature neonates and 4 meta-analyses with 10227 neonates which showed a significantly decreased incidence of Necrotizing Enterocolitis (NEC) (risk ratio, RR = 0.35, 95% confidence interval, 95% CI, 0.23-0.54; p = 0.0006) and mortality (RR = 0.46, 95% CI, 0.32-0.67; p < 0.0001). Sepsis did not differ significantly between the two groups (RR = 0.93, 95% CI, 0.76-1.15; p = 0.05).
<strong>Conclusion:</strong> there is a strong body of evidence supporting that Probiotic supplementation reduces the risk of NEC and mortality in preterm infants yet there is no sufficient evidence to support the optimal strain, dose and timing need further investigation.
<strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200267220170401Open Surgery versus Endoscopic Intervention in the Management of Bile Duct Stones7057121443510.12816/0037825ENBayan Saeed A AlghamdiIbn Sina national CollegeOmar Abdulelah SindIbn Sina national CollegeWahhaj Hani RajabUmm alqura universitySaeed Hamed AlzahraniNajran UniversityHezab Abdulrahman T AlrayesAljouf universityLeena Hatem MoshrefKing Abdulaziz universityNibras Khaled Al JabriUmm alqura universityMana Abdullah Saud Al YamiNajran UniversityWafaa Mohammed AlsbhaniIbn Sina national CollegeShaima Mohammed Al-GhuraybiBattarjee medical collegesMohammed Hundur AlasmariNajran UniversityJournal Article20180923<strong>Background:</strong> Choledocholithiasis or the presence of common bile duct stones (CBDS) is one of the medical conditions that requires surgical intervention. The management of choledocholithiasis has evolved from open common bile duct exploration (OCBDE) to therapeutic endoscopic retrograde cholangiopancreatography (ERCP) to laparoscopic common bile duct exploration (LCBDE). Each entails a degree of difficulty. In this review we aim toassess and compare the benefits and pitfalls of open surgery (OCBDE) versus endoscopic retrograde cholangiopancreatography (ERCP) in management of common bile duct stones.
<strong>Methods:</strong> A systematic review of the electronically searched publications of the scientific literature. We searched the Cochrane HepatoBiliary Group Controlled Trials Register, Cochrane Central Register of Controlled Trials in The Cochrane Library, MEDLINE (1946 to 2016), EMBASE (1974 to 2016), and Science Citation Index Expanded (1900 to 2016). Initially all randomized clinical trials which compared the results from open surgery versus endoscopic clearance for common bile duct stones were included, articles were selectively screened according to the eligibility criteria.
<strong>Results:</strong> eight publications were selectively included with 761 participants compared to open surgical clearance with ERCP. All trials had a high risk of bias. There was no significant difference in the mortality between open surgery versus ERCP clearance (eight trials; 733 participants; 5/371 (1%) versus 10/358 (3%) OR 0.51;95% CI 0.18 to 1.44). Neither was there a significant difference in the morbidity between open surgery versus ERCP clearance (eight trials; 733 participants; 76/371 (20%) versus 67/358 (19%) OR 1.12; 95% CI 0.77 to 1.62). Participants in the open surgery group had significantly fewer retained stones compared with the ERCP group (seven trials; 609 participants; 20/313 (6%) versus 47/296 (16%) OR 0.36; 95% CI 0.21 to 0.62), P = 0.0002. Meta-analysis of the outcomes duration of hospital stay, quality of life, and cost of the procedures could not be performed due to lack of data.
<strong>Conclusion: </strong>open surgery intervention in order to remove the gallbladder and trapped gallstones appears to be as safe as endoscopy and further suggested to be more successful than the endoscopic technique in clearing the duct stones.
<strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200267220170401Carotid Endarterectomy versus Medical Therapy in Stroke Prevention7137201443610.12816/0037826ENYazeed Musaad AlkhuzimPostgraduate KSU, MOHHanouf Abdullah AlnofaieTaif universityAbaad Ayed AL MutairiKing Abdulaziz UniversityMuna Darwish FadhelIbn Sina National CollegeIsraa Hassan AlamoudiIbn Sina National CollegeAhmed Abdullah JalalUmm Al-Qura UniversityAbdulrahman Waleed BagarIbn Sina National CollegeIbrahim Abdulmajeed AffanIbn Sina National CollegeSalah Ghazi AlmatrafiIbn Sina National CollegeAnas Awad AlsolamiKing Abdulaziz UniversityJournal Article20180923 Stroke is one of the leading causes of deaths in different parts of the world affecting individuals of different ages. it is mostly dominant among people having risk factors such drug abuse, having a background of a mild stroke, and overweight. Various approaches including carotid endarterectomy (CEA) and medical therapy have been used as mechanisms for preventing stroke particularly ipsilateral ischemia. However, there are several studies suggesting that even though CEA has the potential of reducing the risks of stroke, incidences of a high residual risk of stroke after carotid endarterectomy since Various cases of increased short-term myocardial infarction after CEA are recorded. Based on the results drawn from randomized trials comparing the effectiveness of CEA and medical therapy ,CEA provides better protection from ipsilateral strokes than the latter. The efficacy of CEA is more pronounced in patients presenting symptomatic and asymptomatic carotid artery disease. The aim of this study was to explore the comparative merits and demerits of using carotid endarterectomy and medical therapy to determine the most appropriate of the two approaches to be used in specific cases<strong>. </strong>
This research concludes that even through both therapeutic methods and carotid endarterectomy have the ability to reduce the predisposition of patients to different events of stroke, each of them have inherent limitations that must be addressed effectively to contribute to overall positive medical outcomes.
<strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200267220170401Evaluation of the Relationship between Air Bubbles Depth and Pregnancy Rate in ICSI Cycles7217251443710.12816/0037827ENElBishrey GDepartment of Obstetrics and Gynecology- Ain Shams UniversityMakled A KDepartment of Obstetrics and Gynecology- Ain Shams UniversityGomaa I ADepartment of Obstetrics and Gynecology- Ain Shams UniversityElnashar HDepartment of Obstetrics and Gynecology- Ain Shams UniversityJournal Article20180923<strong>Objective</strong>: to determine the relationship between embryo transfer outcome and the distance between fundal endometrial surface and air bubbles assessed by trans-abdominal ultrasound
<strong>Design</strong>: Prospective (cohort) study
<strong>Setting</strong>: This study was conducted in assisted reproductive technology (ART) unit of Ain Shams University Hospital from April 2015 to October 2016.
<strong>Patient(s): </strong>Eighty two women undergoing ICSI were enrolled in and a written informed consent was obtained from each participant.
<strong>Intervention</strong>(s): no patient received any additional procedure or intervention.
<strong>Outcome</strong> <strong>measuers</strong>: The primary outcome was biochemical pregnancy rate based on serum beta-hCG level at 14 days after ET. Secondary outcome was clinical pregnancy rate using trans-vaginal US examination at 6 – 8 weeks of amenorrhea to detect the presence of fetal sac & pulsation.
<strong>Results</strong>: Implantation, biochemical and clinical pregnancy rates were significantly higher in distance < 10 mm group than ≥ 10 mm group.
<strong>Conclusion</strong>: air bubble used as an identifier of the position of the embryo at ET can be determinative for pregnancy rates. Clinical PRs were higher in cases with air bubbles < 10 mm from fundal endometrial surface.
<strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200267220170401Prediction of Preterm Birth in Women with Short Cervix7267301443910.12816/0037828ENAbdullah Mousa M AlmadaniKing Abdulaziz UniversityRasha Ali Ahmed AbuandoosKing Khalid UniversityRuya Abdulaziz AlthomaliTaif UniversityDina Nasser AldhabanAlfaisal UniversityAlanoud Abdulrahman Ali AlshamraniAlfaisal UniversityAhmed Saeed H. AlqahtaniKing Khalid UniversityBshaer Haji A AlrizqIbn Sina National CollegeEman Najib M AlsafwaniIAU ( Imam Abdulrahman Bin Faisal University )Khlood Ibraheem HIbn Sina National CollegeAyah Ali Mohammed MohammedTaif UniversityJournal Article20180923<strong>Background:</strong> Second trimester short cervical length identifies women at increased risk for an early spontaneous Preterm birth (sPTB), hence raising a compelling needed for Cervical Assessment for prediction and possible Preventing Preterm Delivery.
<strong>Objective of the study:</strong> to assess the implications associated with a short cervical length as well as the use of ultrasonographic-derived cervical length measurement in predicting preterm birth.
<strong>Methods:</strong> the present review includes relevant randomized controlled trials (RCTs) that investigated the in Medline (via PubMed), Cochrane Library and Embase. Retrospective and Prospective Cohort studies, Case-control and Randomised controlled trials. There were no restrictions by outcomes examined, language or publication status.
<strong>Results:</strong> The critical search results yielded 6 articles (randomized trials=2, cohort studies=3, case-control study=1) representing 653 patients . Five of the 6 presented similar pregnancy outcomes (spontaneous preterm birth or pregnancy loss < 24 weeks’ gestation) between the ultrasound-indicated and the history-indicated cerclage groups. 45–69% of the patients followed with cervical ultrasound were able to avoid cerclage.
<strong>Conclusion:</strong> Evidence from randomized trials supports that transvaginal ultrasound is predictive of preterm birth in women with prior preterm birth and a short cervix. The thresholds proposed vary from 15 mm to 28 mm and cerclage is thus recommended.
<strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200267220170401Evaluation of Antidiabetic and Antioxidant Activity of Aegle marmelos L. Correa Fruit Extract in Diabetic Rats7317411444110.12816/0037829ENInas Z.A. AbdallahNutrition and Food Science Department, Faculty of Home Economics, Helwan UniversityIbrahim, S. SalemNutrition and Food Science Department, Faculty of Home Economics, Helwan UniversityNayrouz A.S. Abd El-SalamNutrition and Food Science Department, Faculty of Home Economics, Helwan UniversityJournal Article20180923<strong>Background</strong>: Diabetes mellitus is regarded as a serious chronic disease that carries a high risk for considerable complications. The use of natural plant products for management of diabetes is increasing due to their minimal side-effects and economical aspects<em>. Aegle marmelos </em>L. Correa (<em>A. marmelos</em>), family Rutaceae is highly reputed medicinal plant commonly known as bael. <em>A. marmelos </em>fruit is widely used in folk medicine for the treatment of diabetes mellitus.
<strong>Aim of the work:</strong> This study was aimed to evaluate the antidiabetic and antioxidant activity of <em>A. marmelos</em> fruit ethanolic extract against alloxan-induced diabetes in male rats.
<strong>Material and Methods</strong>: Twenty five male albino rats with an average body weight 180-195g were divided into two main groups; first group: control (n=5) and second group: diabetic rats (n=20), which were divided equally to four subgroups as follows: diabetic untreated rats , diabetic rats treated with 125 mg/kg/day <em>A. marmelos</em> fruit extract; diabetic rats treated with 250 mg/kg/day <em>A. marmelos</em> fruit extract and diabetic rats treated with 500 mg/kg/day <em>A. marmelos</em> fruit extract. Diabetes was induced by a single intraperitonial injection of alloxan (120 mg/kg).
<strong>Results:</strong> Phytochemical screening of <em>A. marmelos</em> fruit extract revealed the presence of alkaloids, carbohydrates, glycosides, flavonoids, tannins, coumarins, sterols and triterpenoids. Results of the biological study reported that alloxan-induced diabetic group exhibited hyperglycemia, hyperlipidemia, elevation in malondialdehyde (MDA) level accompanied with weight loss and reduction in high density lipoprotein cholesterol (HDL-C) level, reduced glutathione (GSH) level and superoxide dismutase (SOD) enzyme activity when compared to control group. Treatment with <em>A. marmelos</em> fruit extract at the three dose levels reported improvement in the biological evaluation, lipid profile, glucose, insulin, MDA and GSH levels and SOD enzyme activity when compared to the diabetic group. The improvement was most pronounced in 500 mg/kg <em>A.marmelos</em> treated group.
<strong>Conclusion</strong>: It could be concluded that <em>A. marmelos</em> fruit extract had hypoglycemic activity; this effect may be attributed to its antioxidant activity and its high content of active constituents which was proved in this study. Therefore, it could be recommended that <em>A.marmelos</em> fruit may be useful as a healthy food and in the development of antidiabetic drugs.
Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200267220170401Comparison of Endoscopic Papillary Large Balloon Dilation and Endoscopic Sphincterotomy for Retrieval of Choledocholithiasis7427481444310.12816/0037830ENMohamad Amer AfifiDepartment of Tropical Medicine, Faculty of Medicine, Al-Azhar UniversityShaaban Salah Abd ElmoniemDepartment of Tropical Medicine, Faculty of Medicine, Al-Azhar UniversityGamal Mohamad Mohamad SolimanDepartment of Tropical Medicine, Faculty of Medicine, Al-Azhar UniversityHany Kamal Abd ElhameedDepartment of Tropical Medicine, Ahmad Maher Teaching HospitalAhmad Abd Elkader ElgendyDepartment of Tropical Medicine, Ahmad Maher Teaching HospitalJournal Article20180923<strong><em>Background: </em></strong>Endoscopic sphincterotomy (EST) combined with balloon catheters and/or baskets are the routine endoscopic techniques for stone extraction in the great majority of patients. Whereas large common bile duct (CBD) stones are treated conventionally with mechanical lithotripsy<strong>, </strong>large balloon papillary dilation after endoscopic sphincterotomy (ELPBD) represents the onset of an era in large CBD stone extraction and the management of “impaction”. That is because it seems effective, inexpensive, less traumatic, safe and easy method that does not require sophisticated apparatus and can be performed widely by skillful endoscopists<strong>. </strong>Studies comparing the efficacy and safety of EPLBD with EST have reported mixed outcomes<strong>. </strong>The aim of the study to compare the success and complications rates between endoscopic papillary balloon dilation and endoscopic sphincterotomy for enlargement of papillary opening during endoscopic removal of common bile duct stones<strong>. </strong>
<strong>Methods:</strong> Randomized prospective comparative study was conducted on seventy four patients with CBD stone(s), subjective to therapeutic ERCP procedures for endoscopic extraction of common CBD(s). The enrolled patients were randomly divided into two groups according to the maneuver for dilate the papillary orifice into: Group I: Thirty one patients underwent EPLBD technique combined with balloon catheters and/or baskets for stone extraction. Group II: Forty three patients underwent EST combined with balloon catheters and/or baskets, which is considered as conventional endoscopic technique for stone extraction in the great majority of patients. <strong>Results:</strong> Complete extraction CBD stones among the patients of group1; EPLBD was effective for clearance of (92.5%) of CBD stones in patients with the stone sized < 1cm and in (83%) of patients with stone size <span style="text-decoration: underline;">></span> 1cm, (overall clearance rate=87%). Overall adverse effects of patients of group1 was (29%) as mild self-limiting post ERCP pain occurred in (9.6%) and mild intra- procedure bleeding occurred in (9.6%), whereas more serious complication as melena which occurred in (3.2%), and mild pancreatitis occurred in (6.4%). Whereas complete CBD stones clearance among the patients of group 2; EST was effective in (96%) of patients with the stone sized < 1 cm, while stone clearance occurred in (56%) in patient with stone size<span style="text-decoration: underline;">></span> 1cm, (overall clearance rate=79%). Overall adverse effects of patients of group 2 was (18.5%) as mild self-limiting post ERCP pain occurred in (7%) and mild intra-procedure bleeding occurred in (4.6%), whereas more serious complications as mild pancreatitis developed in (4.6%), and post ERCP cholangitis in (2.3%). The comparison between the two groups regarding the extraction of CBD stones revealed combination of papillary large balloon dilation after EST is not required in patients whose the CBD stone size < 1 cm. Whereas the clearance rate of CBD stones in the patients with stone size <span style="text-decoration: underline;">></span> 1cm among the group 1 was (83%) which better than among the group 2 which was (56%) with nearly statistical difference (P value=0.07). <strong>Conclusion:</strong> Conventional EST is an effective method for removal of common bile duct stones < 1cm in diameter whereas the use of large papillary balloon dilation after endoscopic sphincterotomy improve the clearance rate of bile duct stones<span style="text-decoration: underline;">></span> 1cm which is difficult to be extracted by conventional sphincterotomy and extraction devices. Endoscopic papillary large balloon dilation is an adjunctive tool to endoscopic sphincterotomy for removing large or difficult CBD stones.
<strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200267220170401Treatment of Iron Deficiency Anaemia in Patients with Inflammatory Bowel Disease7497571444610.12816/0037832ENAbdulilah Ateeq M AlsolamiKing Abdulaziz UniversityHosam Wahid WaliUmm Alqura UniversityHoussam Nasser S BajoudahMedical University of WarsawMohammed Saleh DumyatiUmm Alqura UniversityBasam Zuhaer SindiUmm Alqura UniversityAbdulaziz Saad M AlshamraniAlbaha UniversityMaha Abdullah AlzubaidiIbn Sina National CollegeFaisal Adnan AlshabrawiBattarjee Medical CollegeOthman Rushdy FilfilanUmm Alqura UniversityJournal Article20180923In spite of the fact that anemia is the most widely recognized systemic sign of inflammatory bowel disease (IBD), among the expansive range of extraintestinal malady complexities experienced in IBD, including joint inflammation and osteopathy, it has for the most part gotten little thought. In any case, as far as recurrence, as well as to its potential impact on hospitalization rates and on the personal satisfaction and work, sickliness is, in fact, a huge and expensive intricacy of IBD.
Frailty is multifactorial in nature, the most predominant etiological structures being iron deficiency anemia (IDA) and anemia of a chronic disease. In a condition related to irritation, for example, IBD, the assurance of iron status utilizing normal biochemical parameters alone is insufficient. A more exact evaluation might be achieved utilizing new iron lists including reticulocyte hemoglobin content, the rate of hypochromic red cells or zinc protoporphyrin. While oral iron supplementation has generally been a backbone of IDA treatment, it has likewise been connected to a broad gastrointestinal reactions and conceivable infection compounding. Be that as it may, numerous doctors are as yet hesitant to administer iron intravenously, in spite of the wide accessibility of an assortment of new IV arrangements with enhanced safety profiles, and in spite of the proposals of worldwide master rules. We present a review of the pathophysiologic mechanisms of IDA in IBD, improved diagnostic and therapeutic strategies, efficacy, and safety of iron replacement in IBD.
<strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200267220170401Flexible Ureteroscopy and Laser Lithotripsy Intervention for the Management of Stone Disease7587641444710.12816/0037833ENDaham Abdulmohsen AlbdaiwiMasstricht UniversityMohammed Ali AlmuanniKing Faisal UniversityMohammad Sameer ShobianKing Abdullaziz UniversitySarah Maher MoshrefKing Abdulaziz Hospital & Oncology CenterMuhannad Basheer QarahKing Faisal Specilaliset Hospital& ResearhSahar Sameer Al-JubaliIbn Sina CollegeJournal Article20180923<strong>Background:</strong> The role of ureteroscopy has dramatically evolved over the past twenty years driven by profound enhancement in various factors and assisting techniques such as the ureteroscope size, deflection capabilities, video-imaging, and in lithotripsy (stone breakage) with the advent of holmium laser, however, the stone size plays a critical role in determining outcomes and operative approach. <strong>Aim of the work:</strong> we conducted a systematic review of the literature to look at the safety and efficacy of flexible utereroscopy and laser lithotripsy intervention in patients with stone disease; particularly those with stones larger than 2 cm.
<strong>Methods:</strong> A systematic search was performed in the scientific database particularlyMEDLINE (2000–2017), EMBASE (2000– 2017), Cochrane Central Register of Controlled Trials, CINAHL (2000–2017), Google Scholar, and individual urologic journals.<br /> <strong> Results:</strong> The search yielded eight studies involving 392 patients, (390 renal units) were reportedly treated with FURSL. The mean operative time was 80.7 minutes (26-215 min). The mean stone-free rate was 91.2% (77%-96.7%), with an average of 1.6 procedures per patient. The mean stone size was 2.5 cm except for one most recent study which reported stones size less than 0.5 cm. An overall complication rate was 8.1%. Major complications developed in 21 (4.2%) patients and minor complications developed in 19 (3.9%) patients. <br /> <strong>Conclusion:</strong> Flexible Ureteroscopy and Laser Lithotripsy intervention has proven to be not only a less invasive treatment but also a successful with a low complication and stone free rate (SFR) for renal calci larger than 2 cm. FURSL may represent an alternative therapy to standard percutaneous nephrolithotomy (PCNL) with satisfactory efficacy and low morbidity.
<strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200267220170401Evaluation of Knowledge in Hypertensive Saudi Population in Makkah, KSA7657701444910.12816/0037834ENSamah Ali AlharbiUndergraduate students, Ibn Sina College of Medicine, KSAMohammad Abdulrahman WedhayaUndergraduate students, Ibn Sina College of Medicine, KSAMaha Fahad AlluqmaniUndergraduate students, Ibn Sina College of Medicine, KSASami Samran AlrehailiUndergraduate students, Ibn Sina College of Medicine, KSAJournal Article20180923<strong>Background:</strong> Hypertension remains a major health problem, causing high mortality and morbidity all over the world. It is considered a major risk factor for both cerebrovascular accidents (CVAs) and coronary artery disease (CAD).
<strong>Objectives:</strong> To assess the level of knowledge of hypertensive patients in Makkah City.
<strong>Methods: </strong>A cross-sectional analytical questionnaire based study among hypertensive patients of Makkah City.
<strong>Results: </strong>The mean age was 45 years, ranged from 35 to 70 and 63.33% were females and 36.67% were male respondents. The majority of them had college degree and were employed. Most of the respondents had good knowledge about hypertension, risks and treatments. Neither age nor gender showed association with the levels of knowledge in included subjects but education was significantly associated with high levels of knowledge.
<strong>Conclusion: </strong>The general knowledge score was good with high knowledge about risks and treatments. Doctors were not informative to patients about hypertension. Also, education significantly impacts the knowledge of population about hypertension.
<strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200267220170401Role of Bone Marrow Transplantation in Reducing the Dangerous Effect of Multi-Walled Carbon Nanotubes or/and Gamma Rays on Male Rats7717831447210.12816/0037835ENMona M. El TonsyZoology Department, Faculty of Science, Al-Azhar UnivNeamat H. AhmedRadiation Biology Department, National Center for Radiation Research and Technology, Egyptian Atomic Authority.Ahkam M. ElgendyZoology Department, Faculty of Science, Al-Azhar Univ.Amal G. Abo-El FetouhThe Ministry of ManpowerJournal Article20180924<strong> Aim of the work: </strong>this study evaluated the efficacy of bone marrow (BM) transplantation to protect male rats from dangerous effect of multi-walled carbon nanotubes (MWCNTs) or/and γ-irradiation on the hematopoietic and lung tissues.<strong> Materials and methods:</strong> experimental animals were divided into 8 groups each consist of 6 male albino rats. Control group, BM-injected group, MWCNTs-injected group, 5Gy γ-irradiated group, 5Gy γ-irradiated+ MWCNTs-injected group, MWCNTs-injected+ BM-injected group, 5Gy γ-irradiated+ BM-injected group and 5Gy of γ-irradiated+ MWCNTs-injected + BM-injected group. All the treated animal groups were sacrificed after 28 days of the treatments. Blood components, MDA and GSH levels in the lung tissue were analyzed. The histopathological study in the lung tissue was also recorded. <strong>Results: </strong>exposure to MWCNTs or/and γ-radiation induced a significant decrease in certain blood components (WBCs, RBCs, Hb content, HCT value and PLT count). Furthermore, a significant elevation in MDA level and a significant decrease in GSH content were detected in the lung tissue. The histopathological changes after exposure of rats to MWCNTs recorded perivasculitis, atelectasis and interstitial pneumonia. Also, γ-radiation represented more collapsed and thickened walls in the alveoli, thickened bronchiolar walls with partial epithelial lining and foci of pulmonary hemorrhage in the lung tissue. The effect of BM transplantation after MWCNTs or/and γ-radiation ameliorated the values of blood components, MDA and GSH levels in the lung tissue. The improvement occurred by BM transplantation in rats treated with MWCNTs or/and exposed to γ-radiation were also recorded. The lung tissue showed numerous alveoli with thin interalveolar septa, alveolar sacs and terminal bronchioles with highly folded mucosa. <strong>Conclusion: </strong>treatment with BM transplantation improved the most deleterious parameters obtained in the blood and lung tissue of MWCNTs exposed or/and γ-irradiated rats.Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200267220170401Vitamin D Deficiency in Orthopedic Patients, Riyadh, Saudi Arabia7847881447310.12816/0037836ENFaqih Eman Abdulaziz H, Abdulrahman Ahmed AlrehailiMedical Students, Almaarefa colleges, Riyadh, Saudi ArabiaAhmed Mohammed AlzahraniMedical Students, Almaarefa colleges, Riyadh, Saudi ArabiaNawaf Wael AlolayanMedical Students, Almaarefa colleges, Riyadh, Saudi ArabiaNessreen Muhammad AlgushiryMedical Students, Almaarefa colleges, Riyadh, Saudi ArabiaHind Mesfer AlghamdiMedical Students, Almaarefa colleges, Riyadh, Saudi ArabiaThekra Ali MurehMedical Students, Almaarefa colleges, Riyadh, Saudi ArabiaBashayer Ali MurehMedical Students, Almaarefa colleges, Riyadh, Saudi ArabiaSummer Saeed AlmutawaMedical Students, Almaarefa colleges, Riyadh, Saudi ArabiaJournal Article20180924<strong>Background: </strong>Low levels of blood serum vitamin D have been connected to various musculoskeletal and non musculoskeletal conditions. Vitamin D lack shows up moderately high among different patient subpopulations, including patients with break non-union. We directed a review study to decide the pervasiveness of vitamin D lack what's more, inadequacy in an expansive populace of patients with orthopedic trauma. <strong>Methods: </strong>The review incorporated all patients who were over age 18 years, had no hazard components for vitamin D inadequacy and was dealt with for an intense break at a Level 1 injury focus. <strong>Results: </strong>Between April 2016 and October 2016, 100 injury patients had recorded serum 25-hydroxyvitamin D levels. The general commonness of joined vitamin D inadequacy/deficiency was 77%; commonness of vitamin D inadequacy alone was 39%. There were no actually critical (P < .05) age or sex contrasts among the populace. There did not seem, by all accounts, to be a regular distinction. Vitamin D inadequacy and deficiency in intense orthopedic injury, patients showed up extremely normal. Assist examination is expected to completely comprehend the clinical noteworthiness. <strong>Conclusion:</strong> The Pervasiveness of low serum levels of vitamin D among patients experiencing orthopedic trauma is extremely normal. Given the significance of vitamin D in musculoskeletal wellbeing, such low levels may adversely affect tolerant results.
<strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200267220170401Role of Rebamipide and \ or Pantoprazole in Preventing Dexamethasone Induced Gastritis in Senile Male Albino Rats7898051447610.12816/0037837ENAmgad Ali El ZahabyTropical Medicine Departmen Faculty of Medicine, AlAzhar UniversityAhmed Abdel AlimTropical Medicine Departmen Faculty of Medicine, AlAzhar UniversityAyman F. El SharawyHistology and Cell Biology Department, Faculty of Medicine, AlAzhar UniversityJournal Article20180924<strong>Aim of the work:</strong> gastritis is the inflammation of the lining of the stomach<strong> .</strong>It is caused by many factors like infection by <em>Helicobacter pylori,</em> drug induced such as aspirin, Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), corticosteroids and alcohol consumption<strong>. </strong>Pantoprazole prevents HCL formation by blocking proton pumps in parietal cells of the stomach leading to stoppage of pepsinogen enzyme activation. Rebamipidestimulates prostaglandins synthesis so the mucous barrier can be build up to protect the gastric mucosa, so this study aimed to evaluate the efficacy of Pantoprazole and Rebamipide on stomach mucosa protection from the gastritis that was induced by Dexamethasone in rats.
<strong>Material and methods: </strong>twenty-five male senile albino rats were included in this study and divided into five groups: <strong>G1 </strong>(Control group), <strong>G2</strong> (Dexamethasone administrated group), <strong>G3</strong> (Pantoprazole administrated group), <strong>G4</strong> (Rebamipide administrated group) and <strong>G5</strong> (Pantoprazole and Rebamipide administrated group). The collected stomach specimens were subjected to hematoxylin and eosin, PAS and alcian blue stains.
<strong>Results</strong>: the most weight loss was detected in Dexamethasone administrated group, while the least weight loss was realized in dexamethasone and Rebamipide administrated group. Gastric samples showed improvement in gastric mucosa in <strong>G3</strong> and <strong>G4</strong>, but the best improvement was demonstrated in <strong>G3.</strong>
<strong>Conclusion: </strong>Rebamipide has a better protective effect than the Pantoprazole in prevention of gastric mucosal injuries.
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