/ 0
- Details
- Category: Vol. 80, December 2012
- Hits: 1084
Evaluation of Myocardial Cell Membrane Integrity by Using 201Thallium - Gik Infusion: Is it the Effect of Insulin; High Dose 201Thallium Chlorideor Rate of Radiopharmaceutical Infusion?, FOUAD KHALIL and AKRAM ALDESOKY
Abstract
Introduction: There are many trials that used 201thallium-glucose insulin potassium (201Tl-GIK) as a radiopharmaceu-tical material to detect the myocardial cells viability which is an important step before taking the decision of revascular-ization procedure. These trials showed an improvement in the detection of the myocardial cells viability by more than 30%, in comparison to the traditional techniques used before for the same purpose, but the question that shines in minds is whether this improvement could be attributed to the higher dose of 201Tl-chloride used in this technique or due to the rate of injection (infusion) of the radiopharmaceutical, or lastly the effect of insulin that used in the GIK combination. In this study, we tried to get answers for these questions.
Methods: Sixty male non diabetic patients with previous history of myocardial infarction (MI) were included in this study. All of them were subjected to thorough history taking, clinical examination, ECG evaluation and echocardiography imaging to detect the extent of dysfunctional left myocardial ventricle segments. Our patients were then subjected to two SPECT studies: The first study was a 201Tl-SPECT stress myocardial perfusion study, followed by a second study, a 201Tl-SPECT reinjection (rest) myocardial perfusion study, which evaluates the extent of underlying ischemia as well as the infarcted segments to be evaluated afterwards. These patients were then divided into two groups: The first group was subjected to a third SPECT study by using 201Tl-GIK infusion (111MBq) over 30 minutes on a separate day. The second group was subjected to a third SPECT study by using 201Tl-G infusion (111MBq) over 30 minutes on a separate day.
Results: Our work showed that the first group of patients showed 42% improvement in detection of viable segments {110 segments of 378 initially diagnosed as scar segments (29%) showed complete improvement (normalized), and 49 segments (13%) of these 378 showed partial improvement} whereas; the second group showed only 12% improvement in detection of viable segments {28 segments of 328 initially diagnosed scar segments (9%) showed complete improvement (normalized), and 12 segments of these 328 segments (3%), showed partial improvement}. This means that the insulin component of the radiopharmaceutical (201Tl-GIK) can en-hance the detection of viable myocardial cells (cells with intact cell membranes). This could be attributed to the effect of insulin which enforces the 201Tl to enter inside the cells through the intact cell membrane via the Na-K channels. This occurs due to the similarity in kinetics between potassium and thallium inside the body.
Conclusion: Our results recommend that using TL-201 (GI K) infusion is considered as a safe, simple, tolerable and reliable study that can significantly improve detection of viable myocardial segments by three folds in comparison to other used techniques.
Aim of the study: Creating a new imaging protocols with improved sensitivity and specificity in detection of viable myocardial segments, with figures near to the other highly sensitive but more expensive and less widely distributed imaging modalities like PET studies.
/ 0
- Details
- Category: Vol. 84, September 2016
- Hits: 1083
A Systematic Review: Effect of Low Level Laser on Hypertrophic Scar Post Burn, AFKAR Z. ELBANOBY, MOHAMED M. KHALLAF, HEBA M. MOHAMADY and SAYED M. EL-SAYED
Abstract
Background: Burn scars are known to be difficult to treat because of their tendency to worsen with hypertrophy and contracture. Various experimental and clinical efforts have been made to alleviate their effects but the problem has not been solved. Since patients keep asking for Low Level Laser Therapy (LLLT) and believe in its effectiveness on burn scars, and since former studies show contradictory results of the influence of LLLT on hypertrophic scars, this study was designed to objectify the effects of LLLT on burn scars.
Aim of the Study: The purpose of this study is to system-atically review the effects of low level laser therapy) He-Ne, Ga-AS) on hypertrophic scar post burn.
Material and Methods: Systematic review of all published studies with all research designs except expert opinions. A search was made in PubMed, Cochrane library, Pedro and Google scholar.
Results: Seven studies met the inclusion criteria in this SR, two studies included in meta-analysis but the remaining studies is included in descriptive analysis in order not to exclude their results.
Conclusion: The current level of evidence to support the effectiveness of effect of low level laser therapy on hyper-trophic scar post burn shows that LLLT has insignificant effect on hypertrophic scars post burn. The main limitations are the heterogeneity between included studies in meta-analysis and small number of the studies involved.
/ 0
- Details
- Category: Vol. 82, December 2014
- Hits: 1082
Vitamin D Deficiency During Pregnancy: Risk for Preeclampsia and Adverse Neonatal Outcome, HANAN F. MOHAMED, SHERIF MAGDY and MOHAMED ELMOHANDES
Abstract
Preeclampsia is a pregnancy specific syndrome charac-terized by high blood pressure and proteinuria after 20 weeks gestation that may occur in up to 8% of pregnant women. Women who develop preeclampsia are at increased risk for development of pulmonary oedema, coagulation defects, hepatic or renal failure, seizeurs and even death. Infants born to preeclamptic mothers are at increased risk of prematurity and more likely to be small for gestational age.
An emerging area of study that has garnered significant attention, is the role of vitamin D in preeclampsia. Vitamin D has direct influence on the molecular pathways proposed to be important in the pathogenesis of preeclampsia.
Our objective was to assess the effect of maternal 25- hydroxy vitamin D deficiency on the risk of preeclampsia and to assess the vitamin D status of newborns of preeclamptic mothers.
Records were obtained for 160 pregnant women with singleton pregnancy followed from less than 16 weeks gestation till delivery. 30 subjects met the criteria for diagnosis of preeclampsia as described below and served as (cases group), 90 cases remained normotensive without any complications till delivery and served as (control group). The rest who developed gestational diabetes, autoimmune disorders or other medical diseases were excluded.
Serum 25 hydroxy vitamin D concentrations were mea-sured by vidas kit on Mini VIDAS immunoassay analyzer supplied by Bio Merieux using the ELFA technique (Enzyme Linked Fluorescent Assay).
Our results revealed that Serum 25 hydroxy vitamin D was significantly decreased among patients with preeclampsia compared to healthy control subjects 18.1±5.4ng/ml vs 32.1±9.8ng/ml (p-value 0.0003).
Cord serum 25(OH)D concentration were significantly lower among neonates of preeclamptic mothers than among neonates of non preeclamptic control mothers (17.7±2.9ng/ml vs 21.6±2.3ng/ml, p=0.02).
Logistic regression analysis when performed, demonstrated that 25(OH)D at levels <20ng/ml was statistically significantly
associated with a tendency towards increased risk of preec-lampsia [Odds Ratio 3.8,95% CI (1.6-9.1), p 0.002]. A strong inverse relation between serum 25(OH)D and the probability risk of preeclampsia was derived from linear regression correlation curve (slope = –0.102, r2=0.877, p=0.0009).
In conclusion, our study reinforces the potential link between vitamin D deficiency and preeclampsia risk. Thus preeclampsia may be added to the growing list of adverse health consequences of maternal vitamin D deficiency. Sup-plementing vitamin D among deficient women either in the preconception period or in early pregnancy should be explored as a safe and effective means of preventing preeclampsia and promoting neonatal well-being.
Thus, we recommend early screening of all pregnant women for vitamin D deficiency for earlier supplementation to mitigate its adverse outcomes.
/ 0
- Details
- Category: Vol. 77, June 2009
- Hits: 1052
Arthroscopic Decompression in the Management of Subacromial Impingement Syndrome,NASEF M. NASEF, AHMAD M. KHOLEIF and SHERIF ABD EL LATIF
Abstract
Background: Open acromioplasty has classically been described as a method of treatment for subacromial shoulder impingement syndrome. However, the arthroscopic method of management has also recently gained wide popularity.
Objective: The aim of this work was to present clinical outcome of arthroscopic decompression in the management of subacromial shoulder impingement syndrome.
Study Design: A case series.
Patients and Methods: The study involved 30 patients with stage II-III impingement; 18 females (60%) and 12 males (40%). Arthroscopic decompression was done from the bursal side (subacromial decompression). Among other exclusion criteria in this series; there were no cases with concomitant rotator cuff ruptures requiring repair.
Outcome Measures: The primary outcome measure was success of the procedure as judged by postoperative University of California at Los Angeles (ULCA) score on the last follow-up visit and Neer Criteria for "satisfaction". The secondary outcome was complications of the procedure.
Results: Average age at time of operation was 43.3 years. The mean follow-up was 25 months (range, 9-45). Outcome was satisfactory in 90%; 53.3% excellent and 36.7% good. Three patients had unsatisfactory results; 2 fair and one poor. No postoperative complications were found.
Conclusion: Results of arthroscopic subacromial decom-pression-though somewhat technically demanding-are grati-fying when performed properly in selected patients. Hospital-ization is brief with rapid return to daily activities and little risk of deltoid muscle complications.
/ 0
- Details
- Category: Vol. 81, June 2013
- Hits: 1043
Assessment of Removable Short Total Contact Cast in Comparison to Irremovable Total Contact Cast in the Management of Diabetic Neuropathic Ulcers,WALEED A. SOROUR, AYMAN M. SAMIR, ABDELRAHMAN M. GAMEEL and MOHAMMED E. ELSHERBENI
Abstract
Purpose: To Compare between removable short total contact cast (rsTCC) and irremovable total contact cast (iTCC) in management of diabetic neuropathic ulcers.
Methods: From July 2010 to June 2011, 50 patients suffering from diabetic neuropathic ulcers presented to Zagazig University hospitals were randomly divided into 2 groups, one group (26 patients) was treated with rsTCC and the other group (24 patients) was treated with iTCC. Follow-up for four months to all patients was done in the outpatients clinics, where the neuropathic ulcers were evaluated and managed. The outcome of both groups was compared as regard healing of the ulcers and duration of healing.
Results: 14 patients (53.8%) were males and 12 patients (46.2%) were females in the first group while in the second group 12 patients (57.1%) were males and 9 patients (42.9%) were females after exclusion of 3 cases. There were no significant differences between the 2 groups in any of the demographic or clinical variables. The mean duration of healing was (54.6±16.2 days) in the first group and (51.6±16.1 days) in the second group, with no statistically significant difference between the two groups (p=0.701) as regard healing rates in both groups.
Conclusion: rsTCC is as effective as iTCC in the treatment of diabetic neuropathic plantar ulcers concerning proportion of patients that achieved healing and its duration.
/ 0
- Details
- Category: Vol. 77, March 2009
- Hits: 1042
Effect of Low Calorie Diet and Exercise on Thyroid Hormones and Leptin Levels,SOAD SULTAN and LAILA RASHED
Abstract
Aim of the Work: To investigate the effect of low calorie diet alone and the effect of low calorie diet and exercise on the levels of thyroid hormones, leptin, and BMI. Also we tried to investigate if there is a relation between thyroid hormones and leptin levels.
Subjects and Methods: Two groups of normal male sub-jects, each group consists of 25 person matched for age and BMI. Group I had low calorie diet program for one month (1200-1500 Kcal). Group II had the same low calorie diet in addition to program of therapeutic exercise on treadmill with moderate intensity every other day for one month. Evaluation of free T3, freeT4, TSH, leptin levels, and BMI were done before and after the study. Correlation between thyroid hor-mones and leptin levels were done.
Results: This study showed significant increase in Free T3, T4, and significant decrease in TSH, leptin and BMI after one month of low calorie diet program (group I) compared to their levels before the study.
After one month of low calorie diet and the exercise program (group II), a highly significant increase in free T3, T4 and highly significant decrease in TSH, leptin and BMI compared to their levels before the study.
Comparing the studied parameters of both groups after the study showed that there is a more significant increase in T3 & T4 and a more significant decrease in TSH & BMI in group II compared to group I. Leptin level showed no statis-tically significant difference. A positive correlation between BMI and leptin was found in both groups. We found no relation between thyroid hormones and leptin levels.
Conclusion: Low calorie diet caused increase in the level of circulating thyroid hormones, and a decrease in TSH, leptin levels and BMI. Low calorie diet and moderate intensity therapeutic exercise caused more significant increase in the level of circulating thyroid hormones, more significant decrease in TSH level and BMI. No statistically significant difference in leptin level of both groups after the study. We found no relation between leptin level and thyroid hormone levels.
/ 0
- Details
- Category: Vol. 78, June 2010
- Hits: 1037
Drugs of Abuse and Immuno-Modulation,NASHWA MAHMOUD RADWAN
Abstract
Introduction: Drugs of abuse are in fact associated with increased susceptibility to infectious diseases, especially opportunistic intracellular microbial infection and HIV infec-tion. The effects of morphine on immune system are mediated through central as well as peripheral mechanisms.
The immune system of drug dependent individuals is known to be suppressed, dysfunctional and hyper stimulated.
Objective: To determine the level of proinflammatory cytokines in opiate, cannabinoid and tramadol addicts.
Subjects and Methods: The studied population comprised 80 individuals divided into 4 groups:
1-20 individuals are opiate addicts.
2-20 individuals are cannabbinoid addicts.
3-20 individuals are tramadol addicts.
4-20 individuals as control group.
They are all males and matched with the control group as regards socioeconomic status and smoking habits. All subjects were interviewed with a detailed questionnaire about presence of respiratory and skin symptoms. Detailed personal, medical examination was done. Determination of the level of interleukin 1, tumor necrosis factor alfa and inter leukin 6 (IL1, TNFa, IL6) in the serum was performed. Toxicologic screen was done and total leucocytic count was done as well.
Results: Respiratory and skin manifestations showed a statistically significant difference between addicts and control group.
Level of cytokines (IL6, TNFa, IL1) showed a statistically significant difference between addicts and control group. In correlation with the duration of addiction and age, a statistically significant negative correlation was found between opiate and cannabinoid addicts and control group as regards the level of cytokines. Total leucocytic count of the studied groups showed that addicts had higher values.
Conclusion: The results strengthen the relationship be-tween addictive drugs especially opiates and cannabinoids and immune-modulation documented by low levels of proin-flammatory cytokines (IL6, TNFa, IL1). Tramadol addiction had unique effect on cytokines level.
/ 1
- Details
- Category: Vol. 81, September 2013
- Hits: 1035
Sound Eye Versus Amblyopic Eye Surgery for Correction of Unilateral Sensory Strabismus, MOHAMED M.K. DIAB and KAMAL A.M. SOLAIMAN
Abstract
Purpose: Based on Herring's law of equal innervations to the yoke muscles, this study aims at comparing the anatom-ical outcome following sound eye surgery versus amblyopic eye surgery for correction of unilateral sensory strabismus in adult patients.
Patients and Methods: A prospective study that included 148 adult patients with unilateral sensory strabismus (50 prism Diopters) and amblyopia. Patients were randomly allocated between two groups: Group A included patients subjected to surgery in the sound eye only, and group B included patients subjected to surgery in amblyopic eye only. Patients were followed-up for at least 6 months to detect the anatomical success rate as well as any residual, consecutive or recurrent strabismus.
Results: After a mean follow up period of 7.68±1.93 months in group A, 61 patients (82.4%) had orthotropia, two patients (2.7%) had residual strabismus, 8 patients (10.8%) showed consecutive overcorrection, and three patients (4.1%) had recurrent strabismus. In group B and after a mean follow-up period of 7.24±1.72 months, 49 patients (66.2%) had orthotropia, 3 patients (4.1%) had residual strabismus, 9 patients (12.2%) had consecutive overcorrection, and lastly thirteen patients (17.6%) had recurrent strabismus. The dif-ferences between the results of both groups were statistically significant (p<0.05) only in the patients who achieved orthotro-pia and those with recurrent strabismus.
Conclusion: For unilateral sensory strabismus and ambly-opia in adults, sound eye surgery could give a higher success rate with a lower chance for recurrence at six months, as compared to amblyopic eye surgery.
/ 0
- Details
- Category: Vol. 84, September 2016
- Hits: 1026
Effect of Muscle Energy Technique on Lumbar Hyperlordosis in Asymptomatic Adults, SARAH A. MONIR, WADIDA H. EL-SAYED and HANAA K. ATA
Abstract
Background: Excessive lordosis is one of the most com-mon postural abnormalities of the lumbar region.
Purpose: This study was conducted to investigate the effect of muscle energy technique on lumbar hyperlordosis in asymptomatic adults.
Subjects: Forty-six subjects aged from 18-30 years from both sexes randomly divided into two groups with equal numbers.
Material: Study group received postural correction exer-cise and post isometric relaxation for hip flexors and back extensors, while control group received postural correction only. Absolute Rotatory Angle (ARA), pelvic inclination angle and lumbar flexion and extension Range of Movement (ROM) were taken at two intervals pre-treatment and post-treatment.
Results: Statistical analysis indicated that there were significant effects of the tested group (the first independent variable) on the all tested dependent variables; absolute rotatory angle, pelvic tilting angle, ROM of lumbar flexion, and extension (F=8.152, p=0.0001 *) and this significant difference in favor of Group (A) than Group (B).
Conclusion: Muscle Energy Technique (MET) is consid-ered as an effective factor in improving excessive lumbar lordosis.
/ 0
- Details
- Category: Vol. 77, June 2009
- Hits: 1026
Accelerated Rehabilitation after Anterior Cruciate Ligament Reconstruction: Comparison of Closed Kinetic Chain (CKC) Versus Open Kinetic Chain (OKC) Exercises,SAMIA M.H. FADDA, NOHA A. AZAB, HALA A. RAAFAT and AHMAD M. KHOLEIF
Abstract
Background: Anterior cruciate ligament (ACL) is one of the most commonly injured ligaments of the knee. ACL reconstruction (ACL-R) is the treatment of choice in cases of severe knee instability to avoid recurrent knee injuries and subsequent degenerative changes. Accelerated rehabilitation after ACL-R greatly affects the healing response and signifi-cantly helps patients to gain dynamic stability in the knee joint. Much debate surrounds the difference between open kinetic chain (OKC) and closed kinetic chain (CKC) exercises during ACL-R rehabilitation.
Objective: It was the aim of this study to compare the effects of a comprehensive rehabilitation program with quad-riceps strengthening in closed kinetic chain (CKC) exercises with the same rehabilitation program with quadriceps strength-ening in open kinetic chain (OKC) exercises in patients with ACL reconstruction and to evaluate the effects on knee func-tions.
Subjects and Methods: Forty consecutive patients with ACL reconstruction for isolated ACL injury were included in this study. They were subjected to a rehabilitation program for 4 months supplemented with OKC exercises in one group and CKC exercises in the second group.
Results: Patients in CKC exercise group showed at the end of the four months’ rehabilitation programs, a statistically significant increase in passive range of motion (PROM) (p<0.001), in Lysholm score (p=0.002) and a significant decrease in number of patients with extension deficit ³5º (p= 0.008), all indicating improvement in knee functions, while OKC group only showed improvement in PROM as regards knee functions (p=0.049). Comparing both groups - as regards the outcome of rehabilitation program on knee functions-showed that there was a non significant difference between the two groups concerning PROM, Lysholm score or improve-ment of extension deficit and thigh atrophy (p=0.463, p= 0.757, p=0.085, p=0.430 respectively). At the end of the 4 months, there was statistically significant more improvement of knee pain in CKC group than OKC groups (p=0.018) and more number of patients who gave a response of "satisfied" in CKC group than OKC groups (p=0.027).
Conclusion: We conclude that both CKC and OKC exer-cises appear to be suitable for rehabilitation after ACL recon-
struction; however, CKC exercises showed better outcome after rehabilitation than OKC exercises as regards knee function, knee pain and patient satisfaction.
/ 0
- Details
- Category: Vol. 77, June 2009
- Hits: 1024
Unconsummated Marriage: Relationship between Honeymoon Impotence and Vaginismus, SHERIF GHAZI and AMANY SHALTOUT
Abstract
Unconsummated marriage is a common problem in the andrology clinics in eastern communities. The aetiology of this problem is attributed to factors like erectile dysfunction, premature ejaculation and vaginismus. The aim of this study is to examine the role of vaginismus in erectile dysfunction of newly married men refractory to conventional treatment. 40 men were include in this study. All had erectile dysfunction dating since marriage with history of normal erectile function before marriage and failure of PDE5 inhibitors treatment as well as intracorporal injection home therapy. Twenty-five female partners were diagnosed for vaginismus. Following treatment all but two women (drop outs) were improved. However when women were ready for intercourse 12 men were still having erectile dysfunction and needed to use Tadalafil for a short term before having normal erectile function. We concluded that vaginismus is important etiological factor in unconsummated marriage and it should be considered when treating men presenting with honeymoon erectile dys-function.
/ 0
- Details
- Category: Vol. 77, March 2009
- Hits: 1019
Effect of Conflict on Nurses’ Perceptions of their Professionalism in Various Healthcare Sectors in Saudi Arabia
OLFAT A.M. SALEM, NAZIK M. ZAKARI and NADA I. AL-KHAMIS
Abstract
The organizational structure of many hospitals conflicts with the practice of professional nursing, adversely affecting patient outcomes. The ability of nurses to practice in a profes-sional manner may be influenced by the organizational culture of their work environment and conflict level. This study was designed to explore the nature of the relation between conflict and nurses’ perceptions of their professionalism. This aim was to be achieved through answering the following research questions: 1) What is the conflict level among nurses working in different healthcare sectors? 2) What is the level of perception of professionalism among nurses working in different healthcare sectors? (3) What is the relationship between conflict level and perception of professionalism among these nurses? The study was carried out using an analytic cross-sectional design and was conducted in three different healthcare sectors in Saudi Arabia. These were namely a university hospital, a governmental hospital, and a military hospital. A non-probability convenience sampling was recruited for the study. It consisted of nurse managers in first-line and mid-level positions, as well as bedside nurses. The sample size was calculated to determine any expected level of conflict or professionalism of 35.0% or more, with a 15% standard error and a 95% level of confidence. Out of 420 questionnaire forms distributed, 346 were returned validly completed, with a response rate of 82.4%. Two Instruments were used to collect the data which are 1) perceived conflict scale (Huber, 1996) will be used to assess the conflict level and 2) Valiga concept of nursing scale (Valiga, 1996) will be used to assess the ideas, which the nurse currently holds about nursing as a profession. The study findings point to low perception among studied nurses of their professionalism. Only about one-third of the sample had a high perception of nursing. A number of factors might explain this low level of perception of professionalism. These relate to the workplace itself, as well as the personal background of the nurses, which includes the personal interest in the nursing profession, as well as the family, society and the consumers’ look to the profession.
/ 0
- Details
- Category: Vol. 83, September 2015
- Hits: 1017
New Technique for the Single Stage Management of Congenital Vertical Talus by Percutaneous Tenotomies, Open Talonavicular Reduction and Percutaneous K-Wire Fixation, MOHAMED M. HEGAZY, SHERIF M. ISMAIL, AHMAD S. HASSAN and IBRAHEM S. HANTERA
Abstract
Background: Management of Congenital Vertical Talus (CVT) may depend upon the age of initial presentation. Early management may involve a trial of single stage correction, a two-stage correction, or the addition of subtalar arthrodesis. These procedures are associated with a high complication rates.
Methods: A prospective cohort of 20 feet (11 patient) with CVT all under 30 months of age of both idiopathic and teratologic variety is presented. The condition was treated by a novel technique utilizing percutaneous tenotomies of the tibialis anterior, extensor digitorum, extensor hallucis longus, peroneal longus and brevis tendons, along with the Achillis tendon. This was combined with a minimal midfoot incision to allow for reduction and K-wire fixation of the talonavicular and calcaneocuboid joints, followed by plication of the spring ligament. Patients then were casted in an above knee cast for 8 weeks. Following which, a below knee orthotic with medial arch support was applied for one year.
Results: Minimum follow-up period was for twenty months. Results were evaluated using the 10-point system developed by Adelaar et al., initial correction was achieved in all cases with significant improvement of radiological parameters (p<0.05). There were two cases of relapse (in a bilateral case diagnosed as Escobar syndrome).
Conclusion: The described technique appears to give initial promising results. The recurrence rate is statistically related to later age of management and to teratologic varieties. However, this rate still appears to be lower than reported complication rate associated with the more extensive open surgical techniques.
Level of Evidence: Level IV case series study.
/ 0
- Details
- Category: Vol. 77, March 2009
- Hits: 1012
Obesity and its Relationship with Glycemic Control in Type-2 Diabetes,HASSAN A.E. ABDELWAHID and NADIA M. MANSOUR
Abstract
Background: Obesity is central to the development of insulin resistance, leading to type 2 diabetes and cardiovascular disease, among other serious medical conditions. In patients with type 2 diabetes, the benefits of weight loss include both improved overall glycemic control and cardiovascular disease risk profile.
Aim: The aim of the present work was to study the pattern of overweight and obesity in type-2 diabetes. The Specific objectives included determination of the prevalence of the overweight and obesity among type-2 diabetes and assessment of their effects on the glycemic control.
Methods: A cross sectional design was used. The target population was type-2 diabetic patients in Ismailia City, Egypt. The study population was type-2 diabetics attending the family medicine clinic in Ismailia University hospital. The study included 220 type-2 diabetics who were screened for over-weight and obesity.
Results: The present study illustrates that, only 14.5% of type-2 diabetics had BMI within the normal range, (35% of male patients and 8% of female patients), while 45.9% were overweight; the percentage of overweight male patients was higher (50%) than female patients (45%). Obesity was found in 39.5% of the patients (15% of the male and 47% of the female patients). Extreme obesity was detected only in females (18%). The glycosylated hemoglobin (g %) of overweight (11.5±2.7) was significantly different from that of the obese patients (13.2±3.6). The study demonstrates, also, that fasting blood sugar (mg/dL) of diabetic patients with normal BMI (155.9±70.5) was significantly different from each of the overweight (227.5±87.7) and obese diabetics (210.9± 79.9).
Conclusion: Overweight and obesity are highly prevalent in type-2 diabetics. Also increase in the BMI is associated with poor glycemic control. These findings signify life style modifications that are immensely needed to decrease the bodyweight and improve the glycemic control.
/ 0
- Details
- Category: Vol. 77, June 2009
- Hits: 1010
Dysregulation of Immune System in Diabetic Child,EHAB A. ALBANNA, HALA EL-GENDY and NEHAD ABD EL-MONEM
Abstract
Introduction: Diabetes is a chronic disease associated with selective destruction of the pancreatic B-cells. The exact etiology of the disease is unclear; however, insulin deficiency results from autoimmune destruction of B-cells. The appear-ance of auto antibodies to beta cell antigen, such as those against the 65-KDA isoform of glutamic acid decarboxylase GAD65 and the protein tyrosine phosphates in the peripheral circulation is a predictive sign of clinical disease in non diabetic individuals. Although GAD65 and IA-2 (insulin auto antibodies) may not be directly involved in the pathogenic processes in beta-cell destruction. They are good markers in assessing the risk of disease manifestation.
Aim of the Work: This study aimed to evaluate GAD65 (glutamic acid decarboxylase) and ICA (islet cell auto anti-bodies) and IA-2 (insulin auto antibodies) auto antibodies as a disease markers and their relationship to certain residual beta-cell function and glycemic control in type I diabetes and risk group, and assess the relation between CD4+ CD25+ (T-regulatory cells) and immune mediated diabetes.
Patients and Methods: This study was conducted on 50 subjects randomly selected from those attending pediatrics outpatients clinics in the period of 2008. The subjects were classified into 3 groups: 1- Group A (patient group): This group included 20 patients diagnosed as type I DM according to WHO classifications. Their ages ranging from 3-16 years with a mean age of 10.6±4.0. They were 11 males and 9 females. 2- Group B: (Risk group): included 20 sibling of diabetic (type I DM) father, mother or both. They were 9 females and 11 males their ages ranging from 18 years to 25 years with a mean of age 21±2.5. 3- Group C: Control group, included 10 healthy children; they were 5 females and 5 males, their ages ranging from 5-16 years with a mean age of 10.8±2.8, with no family history of diabetes mellitus. All subjects are subjected to: Complete history taking, Full clinical examina-tion, Complete blood picture, Glycosylated Hb using ion-exchange chromatography, C-peptide of insulin by- ELISA, Determination of GAD 65, ICA and IA-2 auto antibodies by ELISA technique, Flowcytometric measurement of the expres-sion of the CD4+/CD25+ of T- regulatory cell.
Results: The most frequently encountered antibody in children group was GAD65 in 60% of cases, followed by
ICA, 40%. When taken together, both GAD65 and ICA were detected in 30%. IA-2 was detectable only in 30% of cases. When both GAD65 and IA-2 were taken together, they were detected in 25% of cases also ICA and IA-2 were detected in 15% of cases. When GAD, ICA and IA-2 were taken together, they were detectable in 5% of cases. The most frequently encountered antibody in risk group was ICA in 15% of cases, followed by GAD, in 10%. When taken together, both GAD65 and ICA were detected in 10%. IA-2 was detectable only in 10% of cases. When both GAD65 and IA-2 were taken to-gether, they were detected in 5% of cases also ICA and IA-2 were detected in 5% of cases. When GAD, ICA and IA-2 were taken together, they were detectable in 5% of cases. There was highly significant difference between 3 groups for prevalence of GAD65 autoantibody (p<0.001) and significant difference between 3 groups for prevalence of ICA autoanti-body (p<0.005) and significant difference between 3 groups for prevalence of IA-2 autoantibody (p<0.003). There were highly significant differences in the level of fasting C-peptide of insulin between patient and control groups. (p value <0.001). There were significant difference between level of fasting C-peptide and single and multiple autoantibody positivity (p<0.05). In the children group the mean and SD of the percentage of CD4+ CD25+ from CD4 cells were 0.96, 0.46 respectively. In the control group the mean and SD of the percentage of CD4+ CD25+ from CD4 cells were 2.85, 0.92 respectively. The difference between control and study group according to the mean and SD of the percentage of CD4+ CD25+ from CD4 cells was statistically highly significant (p<0.001). In the Risk group the mean and SD of the percentage of CD4+ CD25+ from CD4 cells were 0.99, 0.7 respectively.
In the control group the mean and SD of the percentage of CD4+ CD25+ from CD4 cells were 2.96, 0.62 respectively. The difference between control and risk group according to the mean and SD of the percentage of CD4+ CD25+ from CD4 cells was statistically non significant. There was highly sig relation (p<0.001) between percent of CD4+ CD25+ out of CD4 cells and the presence and absence of auto antibodies in the children group. There was no sig relation between percent of CD4+ CD25+ out of CD4 cells and the presence and absence of auto antibodies in the in risk group.
Conclusions: At the time of diagnosis almost all patients with type I diabetes have auto antibodies that are reactive to islet antigens and auto antibodies GAD, ICA, IA-2 are of value for predicting IDDM in sibling of diabetic parents type I also CD4+ CD25+ T-regulatory cells actively suppress activation of the immune system and prevent pathological self-reactivity.
/ 0
- Details
- Category: Vol. 80, March 2012
- Hits: 1006
Association between Non Alcoholic Fatty Liver Disease and Early Carotid Atherosclerosis, BAHAA EL-DIN ZAYED, SHERIF SARIE EL-DIN and EMAD EL-MOOATISM
Abstract
Background and Aim of the Work: The increasing rate of morbidity and mortality from cardiovascular disease are probably among the most important clinical features associated with NAFLD. Recent cross-sectional studies have shown that NAFLD is associated with increased carotid artery intima-media thickness (IMT), a marker of early generalized athero-sclerosis. We have, therefore, assessed whether patients with NAFLD with normal LDL have a greater carotid IMT than control subjects.
Material and Methods: 70 patients and 30 controls in-cluded in the study with history intake and clinical examination for: BP, BMI, waist circumference, Abdominal U/S, liver function tests, serology for Hepatitis B and C, lipid profile, FBG and carotid duplex.
Results: The study group included seventy (70) patients; their mean age was 41.0±5.5 years. Thirty three males (47.1 %) and thirty seven females (52.9%). The mean BMI was 22.5± 0.3Kg/m2, the mean waist circumference was 74.9±4.1cm, mean FBG was 85.3±7.4mg/dl, mean PT was 12.5±0.7sec, the mean of the serum albumin was 3.4±0.3 (g/dl). They had fatty liver by U/S which was categorized into mild, moderate, and severe. There was statistically significant difference in liver enzymes, synthetic liver function tests between the study and the control groups mean. Carotid IMT in control subjects was 0.6±0.03mm, in the study group was 0.8±0.1mm. with statistically significant difference, also comparing the carotid intima-medial thickness in the three subgroups of the study group according to the degree of fatty infiltration (mild, moderate, and severe) it was found that the mean carotid IMT thickness in mild group was 0.8±0.2mm, moderate group was 0.9± 0.01mm and severe group was 0.9±0.01mm (p=0.0001).
Conclusion: NAFLD is strongly associated with early carotid atherosclerosis, the degree of fatty infiltration add another risk factor for incidence of early carotid atherosclerosis as a marker for early generalized atherosclerosis.
/ 5
- Details
- Category: Vol. 85, March 2017
- Hits: 1005
Nephrotic Syndrome Knowledge and Health Care Related Practices among School Age Children and their Mothers, SUZAN I. KHIDER, AFKAR R. MOHAMED, NAGLAA F. MAHMOUD and RASHA ESSAME
Abstract
Background: Nephrotic syndrome is documented as a common chronic disease in childhood. The knowledge of parent from different angles of the disease is vital to increase the parental awareness about therapeutic facilities to treat children and to enhance the quality of life and the health of the community.
Aim of the Study: The current study was designed to assess nephrotic syndrome knowledge and health care related prac-tices among school age children and their mothers.
Subjects and Methods: A descriptive exploratory research design was utilized in this study. A convenient sample includes 50 school age children aged 8-12 years old with nephrotic syndrome and their mothers. The settings were the Pediatric Medicine Inpatient Departments and Outpatient Clinic at two Pediatric Hospitals affiliated to Cairo University. The required data was collected through structured interview questionnaire which developed by the research investigator. Nephrotic syndrome knowledge sheet and health related practices ques-tionnaire were developed to assess knowledge and health care related practices among school age children with nephrotic syndrome and their mothers.
Results: The current study revealed that the highest percentages of the children who suffer from nephrotic syn-drome and their mothers had unsatisfactory level of total knowledge and health related practices.
Conclusion: Mother education, occupation, place of residence and family income had a high statistical significant relation with mothers' total knowledge and health related practice, however there were no statistical significant relation between mothers' age and their knowledge. In addition, children age, education and place of residence and family income had statistical significance relation with children total knowledge.
Recommendations: Pediatric nurses should provide edu-cational sessions for school age children and their mothers about nephrotic syndrome to raise their level of health aware-ness about care of the disease.
/ 0
- Details
- Category: Vol. 77, March 2009
- Hits: 1005
Changes in Molecular Size and Shape of Hemoglobin of Systemic Lupus Erythermatosus,SAMIR W. AZIZ, BASSEM M. RAFAAT, NAHED S. HASAN and AHMED HANAFY
Abstract
Different hemoglobin derivatives concentration and elec-trical conductivity were measured for patients suffered from, in addition the dielectric relaxation in the frequency range 100KHz up to 10MHz of Hb molecule of systemic lupus patients compared to normal control. Abnormal dynamic motion of Hb was found, a lack of changes in the size and/or shape of Hb. Also, the dielectric results indicating that the molecular shape tends to deviate from the spherical form as the activity (severity) of the disease increases.
/ 0
- Details
- Category: Vol. 82, March 2014
- Hits: 1004
Prevalence of Metabolic Syndrome among Obese Egyptian College Students, MAGDY M. AHMED, MARZOUK A. ELLITHY, ABLA M. HAMED and SAMAR H KASEM
Abstract
Background: The frequency of the metabolic syndrome is increasing throughout the world. The etiology of the meta-bolic syndrome is dependent on different factors.
Aim: This survey study aimed to evaluate the metabolic syndrome among obese Egyptian college students.
Methods: The study conducted on eight hundred female students, and their age (18-24 years). The obese students were collected from Cairo, October 6th and Misr university for sci-ence and technology (MUST) universities. Metabolic syndrome was diagnosed using Adult Treatment Panel-III (ATP-III) guidelines. The anthropometric measurements (body weight, height, body mass index, waist circumference, and waist-hip ratio) were measured. Also, blood pressure was measured and laboratory investigations (FBS, TG, HDL-c and LDL-c) were analyzed.
Results: The mean body weight, mean body mass index, waist circumference, systolic blood pressure, diastolic blood pressure, fasting blood glucose and TG levels were significantly higher in the students with metabolic syndrome. The frequency of metabolic syndrome was 24.37% among obese students. The prevalence of high blood glucose level, low HDL-c level; high TG level and high blood pressure were 18.5%, 33.5%, 28.4% and 26.25% respectively. Low HDL-c level (33.5%) and high triglyceride level (28.4%) are the most frequent characteristics in comparison to other metabolic components.
Conclusion: These findings indicate the need for study of the components of metabolic syndrome and detailed analysis of the risk factors for metabolic syndrome among college students in Egypt (especially central obesity). National health policies designed to prevent the Metabolic Syndrome, its individual abnormalities and its complications using population-based characteristics of our nation will generate improved outcomes.
/ 0
- Details
- Category: Vol. 78, September 2010
- Hits: 1003
Does Hydration Shorten the Duration of Labour?,AHMAD REZK, MOHAMED ABDEL RAZEK, MOHAMED ABDEL KAREM, and NADIA EID
Abstract
Objectives: To assess the effect of intravenous infused fluid on progress of labour.
Patients and Methods: This is a randomized controlled trial conducted at the Department of Obstetrics and Gynae-cology at Benha University and Al-Mahla General Hospital, in which 150 pregnant women in active phase of labour were randomaly allocated into three groups. Group A received 250ml/hour Ringer’s Solution, Group B received 125ml/hour Ringer’s Solution and Group C control group. Patients were followed-up until delivery and all their data were recorded on the partogram.
Results: Group A has more uterine contractions than group
B & group C and this difference was statistically significant. In addition to that, group A showed faster descent of the fetal head than group B & group C and this difference was signif-icant statistically. Women in group A showed a longer mean ± SD duration of contraction than that of group B and group
C [(38.44±1.7 min.), (36.22±1.1 min.), (35.15±0.07 min.)] respectively. Besides that women in group A had faster rate of cervical dilatation than that of group B and group C [(5.90±0.45 min.), (5.50±0.24 min.) and (4.92±0.46 min.)] respectively. In addition to this, women in group A had a shorter first stage of labour than group B and group C and this difference was statistically significant [(292.50±50.47 min.), (310.33±33.52 min.) and (329.56±43.28 min.)] respec-tively.
Conclusion: Administration of 250ml/hour Ringer’s So-lution enhances labour and makes the first stage of labour shorter, consequently, the duration of labour.
/ 0
- Details
- Category: Vol. 77, March 2009
- Hits: 1002
Bone Mineralization and Body Composition in Turner Syndrome,HANAN H. AFIFI, AHMAD I.S. EL-KOTOURY, MOUSHIRA E. ZAKI and MARWA I. SHEHAB
Abstract
Females with Turner syndrome are at risk for decreased bone density from ovarian failure and possibly from haploin-sufficiency for bone-related X-chromosome genes. We studied the relation between bone density, anthropometry, body com-position and chromosomal abnormalities in Turner syndrome.
The study included 18 females with Turner syndrome. They were divided in two groups. Group A consisted of 12 cases with 45, X karyotype (classic Turner syndrome) and their mean age of 13.5±5.5 years. Group B included 6 cases with mosaic karyotype and their mean age of 16.3±4.2 years. Bone mineral density (BMD) was determined using dual energy X-ray absorptiometry scans (DEXA). BMD was mea-sured in the femoral neck (FN), lumber spine (LS), and forearm (FA). Body composition was assessed using RJL body fat analyzer. Anthropometry was carried out for each case.
Seventy-two percent of females investigated had osteope-nia. When BMD was expressed as z-scores (individual values compared to normal reference data matched for age and weight) for all cases at it was 0.587±0.10 at FN and was 0.630±0.17 at LS.
In group A bone mineral density was decreased (osteope-nia) by 66.7% in FN, and 25% in LS. In group B bone mineral density was decreased by 66.7% in FN, and 50% in LS. When comparing females in group A with those of group B, there was no statistical difference in BMD at femur and spine. The ostopenia found in patients of group A and B was not related to type of X-chromosomal aberrations.
Group A showed significant increase in TBW and Cormic index SDS as compared to group B. Body fat and lean per-centages are similar in the two studied groups. Also, no correlation was found between BMD and body weight, body height, body fat or percentage body fat.
Conclusion and Recommendation: Body composition changes seem to be more impressive in classic Turner patients, while BMD changes are similar in the two groups. Achieving optimal bone density is of critical importance for fracture prevention in TS.
/ 0
- Details
- Category: Vol. 77, September 2009
- Hits: 1001
Evaluation and Clinical Correlation of Bone Marrow Angiogenesis and Levels of Serum Angiogenic Factors in Acute Leukemia,AMIRA M. KHORSHID, KHALED M. ABOUL ENEIN, SONYA F. ARSANYOS, IMAN A. ABDEL GAWAD, OLA M. EL DESSOUKY, HALA M.R. HASSANEIN and GEHAN M. MAHMOUD
Abstract
In this study serum angiogenic factors [vascular endothelial growth factor (VEGF), hepatocyte growth factor (HGF) and tumour necrosis factor a (TNF a)] and cellular angiogenic factors (VEGF and VEGF-R2) were studied in 50 newly diagnosed acute leukemia patients, they were 24 ALL and 26 AML patients. The correlations of the studied angiogenic factors to each other and to the patients’ survival and disease outcome were studied. During the follow-up period of 6 months, 22 patients died and 28 patients remained alive from whom 11 patients were refractory and 17 patients achieved complete remission.
On comparison between pretreatment concentration levels of measured serum angiogenic factors (VEGF, TNF-a and HGF) in ALL, AML and the control group, all the comparisons were statistically significant (p<0.0001, <0.0001 and 0.021 respectively). All serum markers were higher in AML group than control group, but only VEGF showed statistically significant elevation (p<0.0001), while in ALL patients, all markers were significantly higher than control group (p=0.01).
When comparing ALL and AML cases according to cellular angiogenic factors detected by immunocytochemistry, cellular VEGF-R2 was slightly higher in ALL group, while cellular VEGF was slightly higher in AML group. The comparisons were statistically non-significant for both angiogenic factors.
As regards response to therapy, in ALL, cases with high sVEGF showed a statistically significant lower rate of complete remission than cases with low sVEGF (p=0.041). The same results were obtained for AML but the comparison did not reach a significant level (p=0.082).
Serum VEGF was the only reliable marker to predict relapse in ALL (p=0.009) and AML (p=0.049).
On comparing serum VEGF to the outcome in ALL, high sVEGF cases showed a statistically significant higher rate of death than low sVEGF cases (p=0.05), while in AML, the same results were obtained but the comparison did not reach a significant level.
As regards the survival time, cases with low sVEGF level showed higher mean survival and 6-month survival than cases with high sVEGF level (p=0.03).
A significant negative correlation was detected between serum VEGF and serum TNF-a (correlation coefficient (r) =–0.642, p<0.0001).
Conclusion: Serum angiogenic factors (VEGF, TNF-a and HGF) are markedly increased in cases of acute leukemia compared to normal controls. Cases with high sVEGF showed higher rate of death than cases with low sVEGF, so its targeting may provide a potent novel therapeutic approach in acute leukemias. VEGF may also be useful as a new prognostic factor and a predictor of relapse in different types of acute leukemia. Further studies with larger number of patients and longer duration of follow-up are recommended to throw more light on the significance of other angiogenic factors in relation to acute leukemia.
/ 0
- Details
- Category: Vol. 78, June 2010
- Hits: 994
Association of Pentraxin3 with Severity of Heart Failure Due to Different Etiologies,BAHAA D.M. GRACE, YASSER M. ABDELHAMID, MANAL A. AZIZ and REEM J. FAREED
Abstract
Background: Pentraxin3 (PTX3) is an acute phase protein that is expressed locally in response to a variety of infectious and inflammatory responses. Although both short and long pentraxins are acute phase proteins involved in the innate immunity and inflammation, yet a long pentraxin, (PTX3), is produced by vascular cells or inflammatory cells and released into the circulation, possibly reflecting local inflammation in the cardiovascular system. Plasma PTX3 levels might be a potentially useful biomarker to predict prognosis as well as to detect inflammatory status in patients with congestive heart failure (CHF).
Objective: The aim of this work is to evaluate the useful-ness of Pentraxin3 in the stratification of morbidity in heart failure patients including etiology, severity and risk factors of heart failure.
Methodology: This study included 50 subjects divided into: 30 patients (Group A) were diagnosed as having features of heart failure based on:
1-Echo cardiographic finding (ejection fraction less than 50%).
2-NYHA classification.
In addition to 20 normal controls (group B). All patients were subjected to clinical evaluation, laboratory investigations, echocardiography and measurment of plasma pentraxin3 level.
Results: Pentraxin3 levels were positively correlated with patients classification by NYHA and negatively correlated with the percentage of ejection fraction. Moreover, Pentraxin3 level was significantly higher in patients with moderate and severe degree of heart failure (NYHA III and IV) than those with mild disease (NYHA I and II).
Conclusion: Plasma Pentraxin3 is a useful marker for detection of severity of heart failure independent of age, sex and C-reactive protein (CRP).
Plasma Pentraxin3 level in heart failure does not differ between patients with or without hypertension, diabetes mellitus, hyperlipidemia, ischemic heart disease, rheumatic heart disease or cardiomyopathy as risk factors or etiological factors for heart failure.
/ 0
- Details
- Category: Vol. 77, June 2009
- Hits: 992
Arthroscopic Anterior Cruciate Ligament Reconstruction Using Quadrupled Semi-Semitendinosus and Gracilis Tendon without Side Screw Fixation,EMAD G.K. MOHAMAD and AMR M.S. ABD EL-MEGUID
Abstract
Background: Erectile dysfunction (ED) is a growing common health problem that affects men of different age groups. Despite it is thought to be a para-aging disease, it affects young and middle aged men as well. Color duplex Doppler is a non-invasive tool of evaluation of the vascular mechanism of erection in patients suspected to have an organic cause of ED.
Objective: To demonstrate the color duplex Doppler measurements of cavernosal arterial hemodynamic parameters in non-diabetic patients with erectile dysfunction.
Patients and Methods: 100 consecutive non-diabetic men with erectile dysfunction were evaluated clinically and with color duplex Doppler ultrasonography after intracavernosal injection of papaverine to induce erection. Peak systolic and end diastolic velocities as well as the resistive index were measured in the right and left cavernosal arteries.
Results: Patients were classified into 4 groups according to the peak systolic and end diastolic velocities, that help to categorize patients as regard treatment options into patients recommended for medical treatment (having good veno-occlusive mechanism) and others recommended for surgical management (patients with veno-occlusive malfunction).
Conclusion: We conclude that peak systolic & end diastolic velocities of the cavernosal arteries as measured on duplex sonography gives an accurate evaluation of the vascular status in patients with vasculogenic erectile dysfunction, that help in choosing of management options.
/ 0
- Details
- Category: Vol. 77, June 2009
- Hits: 986
Arthroscopic Management of Osteochondral Lesions of the Talus,AHMAD KHOLEIF, KAMAL S. ABDEL MEGUID and NASEF M. NASEF
Abstract
Objective: Arthroscopic management of osteochondral defects (OCDs) of the talus reduces morbidity associated with open surgical correction. This study presents a case series of arthroscopic management of OCDs of the talus for assessment of the outcome and factors affecting it.
Subjects and Methods: A series of 21 patients with subacute or chronic OCDs of the talus who received arthroscopic are presented; 2 patients were lost to follow up, leaving 19 patients with 19 ankles for evaluation. Duration of follow-up ranged between 12 and 28 months with a median of 18 months. Lesions were classified according to the radiographic staging of Brendt and Hartey. The primary outcome measure was success of surgery as assessed by Ogilvie-Harris score system. The secondary outcome measure was the presence of post-operative complications.
Results: According to Ogilvie-Harris score, excellent or good outcome was achieved in 14 ankles (73.7%). Outcome was unsatisfactory (fair or poor) in 5 ankles (26.3%). Outcome was not related to age at operation or duration of the lesion. According to Brendt and Hartey stages, cases of stage III or IV 41.7% resulted in unsatisfactory outcome, while all stage II cases resulted in excellent or good outcome (p=0.106).
Conclusion: Arthroscopic treatment of osteochondral defects of the talus is a safe and effective procedure with reasonable degree of success.
/ 0
- Details
- Category: Vol. 80, June 2012
- Hits: 982
Cardiac Troponin I as a Marker of Sepsis Severity and Mortality Prediction,SALLY SALAH ELDEEN, MERVAT M. KHALAF and KHALED E. EL HADIDY
Abstract
Background: Cardiac troponins I (cTnI) are biomarkers that are currently used for diagnosis and risk stratification in patients with myocardial infarction and congestive heart failure, however, their prognostic and diagnostic impact in patients with sepsis syndrome need more clarification.
Aim: To study the prognostic value of cTnI on mortality and adverse complications in patients with sepsis and septic shock, and to study the relation of cTnI with ICU scoring systems.
Methods: A prospective comparative study was conducted on forty five patients admitted to the ICU with sepsis or septic shock. Then patients were divided into 2 groups; group 1: included 20 patients with positive cTnI (mean age 58±18.9yrs, 40% males) and group 2: included 25 patients with negative cTnI (mean age 52±19.3yrs, 64% males), comparisons between 2 groups were done according to all demographic, scoring systems, medications used and adverse outcome.
Results: Seventeen patients 85% of cTnI positive group vs. 36% of patients in cTnI negative group had severe sepsis or septic shock (p-value=0.001). There were statistically significant relations between the 2 groups as regards APACHE II (34.6±10.9 vs. 17.8±5.4, p-value=0.001), SOFA on admission (14.9±4.2 vs. 6.9±4.5, p-value=0.000 1) and SOFA at 2nd day (15.8±5.4 vs. 5.5±4.4, p-value=0.0001). The need for vaso-pressors was significantly higher in cTnI positive group than cTnI negative group (85% vs. 24%, p-value=0.0001). Mortality was significantly higher in group 1 than group 2 (90% vs. 60%, p-value=0.024). Cardiac troponins I was highly correlated with APACHE score on admission (r=0.71, p-value=0.0001), and with SOFA score both on admission and 2nd day (r=0.69, r=0.64 respectively p-value=0.0001). Only APACHE II and SOFA scores were found to be predictors of mortality in the study groups (p-value=0.0001), while Cardiac troponins I was not found to be predictor of mortality (p-value=0.29) by logestic regression analysis.
Conclusions: Sepsis patients with high cTnI levels are usually more critically ill and more prone to adverse outcome and mortality but cTnI level is not a predicator of mortality.
/ 0
- Details
- Category: Vol. 77, December 2009
- Hits: 977
Comparative Study of Cool Tip RFA and Expandable RFA in Ablation of HCC, SHERIF HAMDY, MOHAMAD MAHMOUD, AHMAD SAMY and MOHAMAD HAMED
Abstract
Background and Study Aims: Liver cancer is the fifth most common cancer in the world (564 000 cases per year) and the third most frequent cause of cancer-related death, Several reports have indicated that RF ablation is effective for the local control of small HCC nodules, in this study we aimed to prospectively compare the effectiveness of RF ablation performed by using the internally cooled electrode and the expandable electrode for the treatment of small HCC nodules.
Patients and Methods: It included 40 patients suffering from HCC (44 focal hepatic lesions) proved by either Coin-cident finding by US and typical enhancement in triphasic CT or FNAC in non-revealing cases, they were randomly allocated to undergo RF ablation with an internally cooled electrode (Radionics) group I or with an expandable electrode (Radiotherapeutics 3000) group II, 20 patients in each group.
Results: Complete ablation was detected in 86% and 82% of group I & II respectively, the difference was not statistically significant. There was no procedure related mortalities. There was no significant difference between both groups as regards follow up and survival (p value = 0.94).
In conclusion: Both RFA devices are safe and effective methods in ablation of HCC in minimally invasive way.
/ 0
- Details
- Category: Vol. 77, June 2009
- Hits: 972
Distribution of Cyclooxygenase-3 (Cox-3) in Rat Nervous System,SEHAM A. ABD EL-ALEEM, MOSTAFA ABDEL-HAMID, DANIEL L. SIMMONS and LUCY F. DONALDSON
Abstract
Background: Cyclooxygenase-3 (Cox-3) is a recently identified cyclooxygenase which is inhibited by paracetamol-related drugs rather than traditional non-steroidal anti-inflammatory.
Aim of the Work: In this study the distribution of Cox-3 has been studied in the rat nervous system both in the central and peripheral nervous system.
Materials and Methods: Ten adult male Wistar rats weigh-ing 300-400g were killed by decapitation under brief anesthe-sia. Nervous system; brains, spinal cords, spinal ganglia and spinal nerves were removed and processed for immunohis-tochemistry using an antibody raised against Cox-3.
Results: Cox-3 was widely distributed in the rat nervous system. The expression appeared mainly neuronal. In the central nervous system, Cox-3 was localized in neurons in the brain and spinal cord. In the brain Cox-3 was highly expressed in cerebral cortex, hippocampus and cerebellum. In the peripheral nervous system Cox-3 was localized in neurons in the spinal ganglia and in the spinal nerves.
Conclusion: Cox-3 was widely distributed in the nervous system. Thus, this isoform could be contributing to the gen-eration of the physiological levels of prostaglandins normally needed for homeostatic regulation in the nervous system. Localisation of Cox-3 in areas associated with nociception and pain such as brain, spinal cord and spinal ganglia support the hypothesis that Cox-3 may be the central target of parac-etamol and other related centrally acting analgesics / anti-pyretics.
/ 0
- Details
- Category: Vol. 79, September 2011
- Hits: 972
Cell Mediated Immune Affection Among Dental Staff Exposed to Mettalic Mercury SAWSAN F. HELAL, M.D. and NEVEEN A. MANSOUR, M.D.
Abstract
For more than a century and half, silver/mercury amalgam fillings have been used in dental practice as the preferred tooth filling material. Currently, occupational exposure of dental staff to mercury vapor released from the amalgam, has been an issue of concern because of its possible adverse outcomes.
Aim: The aim of this work was to determine the mercury body burden in dental staff exposed to elemental mercury during their work course and the relation of this burden with exposure conditions. Besides, the study aimed at investigating the potential impact of metallic mercury vapor on the cellular immune system and cytokine (IL6) as a possible mechanism of its immunotoxicity.
Study Population: The study population consisted of group of dental staff (n=39) and a matched control group (n=42). Dental staff group was further subdivided into a group of dentists (n=21), and a group of nurses (n=18).
Methods: Each individual was subjected to detailed oc-cupational and medical history taking and estimation of urinary mercury (U-Hg) and blood mercury (B-Hg) as indicators of mercury of body burden and exposure, respectively. Measure-ment of IL-6, CD3, CD4 and CD8 as immunological param-eters.
Results: The study revealed statistically significant higher U-Hg and B-Hg levels in the dental staff compared to their controls. This elevation of mercury body burden was associated with marked significant reduction in CD3, CD4, and CD8 and increase in Il-6 among exposed group compared to the control group.
Recommendations: Exposure to mercury vapour produced in operating rooms is the main concern for dentists. Every effort should be made to avoid contact with mercury vapour if possible by using barrier techniques, reducing the temper-ature of the operating room and of the amalgam restoration. Air conditioning and proper ventilation of the operating room, the use of coolant sprays, good suction and proper handling of amalgam waste is recommended.
/ 0
- Details
- Category: Vol. 83, March 2015
- Hits: 971
Interval or Late Debulking Surgery in Advanced Ovarian Cancer: Progression Free and Overall Survival Advantages, LOAIE EL-HELW and HANAA EL-KHENINI
Abstract
Purpose: Interval (IDS) or late debulking surgery (LDS) following neoadjuvant chemotherapy (NAC) may have a role in treating advanced epithelial ovarian cancer (AEOC) where primary debulking surgery is not possible. We aimed to study the outcome of such patients who were treated in our centre during the last 3 years.
Methods: This was retrospective study of AEOC patients who had NAC with or without IDS/LDS in the City General Hospital, Stoke-On-Trent between May 2011 and July 2014.
Results: Forty six patients with AEOC were treated under our oncology team during that period. Thirty one patients (67.4%) were in stages III and 15 were in stage IV (32.6%). All patients were recommended NAC; 30 patients (65.2%) had paclitaxel and carboplatin regimen and 16 (34.8%) single agent carboplatin. Response to chemotherapy was assessed after 2 cycles. Twenty seven patients (58.7%) had partial response, 16 (34.8%) stable disease and 3 (6.5%) progressive disease. Seventeen patients (37%) proceeded to IDS after cycle 3 and 4 patients (8.7%) to LDS after cycle 6.
After a median follow-up period of 12 months, 39 patients (84.8%) had relapsing/progressive disease. The median pro-gression free survival duration (PFS) for all patients was 9 months and 2 years PFS probability was 4.5%. The median PFS was 10 months for patients who had either IDS or LDS compared to 8 months for no debulking.
The median overall survival (OS) duration was not reached yet but the 2 years OS probability was 76% for all patients; 94% for patients who had IDS and 58% for no debulking. One year OS probability for patients who had late debulking was 100%.
Conclusion: In our study, we documented PFS and OS advantages for patients who IDS or LDS and therefore should be considered whenever possible as part of the primary treatment of AEOC patients.
/ 0
- Details
- Category: Vol. 80, September 2012
- Hits: 970
Conservative Management of Acute Hydronephrosis of Pregnancy: Two Centers Experience,TAREK R. ABBAS and MAHMOUD M. OSMAN
Abstract
Objectives: This study is aiming to detect the value of conservative management of acute hydronephrosis of preg-nancy by facilitating postural drainage of the affected kidney.
Patients and Methods: This prospective study was carried out from March 2011-March 2012, in two centers: [Bab Alshaaria University Hospital (Cairo), and Assiut University Hospital (Assiut)]. One thousand two hundred pregnant women managed till full term, 86 of them (7.1%) presented with unilateral loin pain and were in the third trimester of pregnancy at presentation (13 patients at 28 weeks, 39 patients at 30 weeks, and 34 patients at 32 weeks). Age range was 18-39 years.
Seventy six patients (88.3%) presented with right-sided loin pain and 10 (11.7%) had pain in the left loin. There was no evidence of incipient urinary tract infection (UTI). Ultra-sound scan (USS) confirmed presence of ipsilateral mild to moderate hydronephrosis with no evidence of renal/ureteric calculus.
All were refractory to routine enteral or parenteral anal-gesia over 72 hours.
They were managed in a semiprone position while in bed, with the affected side up and non-dependant. Head end of their bed was kept raised by 10º throughout this period of conservative management; initiated in the hospital and con-tinued at home until term.
Results: Eighty of the 86 women (93%) had symptomatic improvement. None required regular analgesia and went to term without further intervention (e.g. nephrostomy, stenting .... ). Follow-up by Ultrasound scan (USS) at three months post-partum revealed complete resolution of hydro-nephrosis.
Conclusions: Postural drainage of the kidney is highly effective in the management of acute symptomatic hydroneph-rosis of pregnancy in the majority of cases (93%), and if used diligently, it will help to prevent the need for invasive uro-radiological intervention.
/ 0
- Details
- Category: Vol. 82, June 2014
- Hits: 968
Effects of Percutaneous Coronary Intervention on Ischemic Mitral Regurgitation, AHMED H. GABER, KHALED EL TOHAMY, TAREK ANBER, MOHMED ABAS and EMANWEL A. AZIZ
Abstract
The management of ischemic mitral regurgitation repre-sents a therapeutic challenge and is still controversial. The restoration of coronary blood flow reduces left ventricular remodeling and improves regional and global left ventricular function. This strategy is expected to attenuate ischemic mitral regurgitation. Our aim in this study is to evaluate the effect of successful total revascularization by PCI on the degree of ischemic mitral regurgitation.
50 patients with mild, moderate or severe ischemic MR were included in this study. All patients were subjected to proper clinical assessment, 12-lead ECG, transthoracic echocar-diography before and 4 weeks after PCI. All of them underwent successful total PCI.
There was a significant improvement in ischemic mitral regure IMR) degree after total revascularization using PCI for either single or multivessel disease in 58% of patients (p<0.05). The most important predictor of ischemic mitral regurgitation improvement post total PCI was revascularization of totally occluded coronary artery (p=0.030, Odds ratio= 11.8) and absence of DM (p=0.040, Odds ratio=5.5). In the present study, patients with multivessel disease had 83% of severe IMR and all of them improved after PCI.
We conclude that successful total revascularization using PCI may improve ischemic mitral regurgitation whatever its degree.
/ 0
- Details
- Category: Vol. 82, March 2014
- Hits: 968
Role of Ultrasound Biomicroscopy in the Management of Retinoblastoma, SAFWAT K. ELKADY
Abstract
Purpose: To determine the role of Ultrasound Biomicro-scopy (UBM) in the management of Retinoblastoma cases.
Method: The medical records of 10 eyes of eight patients diagnosed with retinoblastoma from February 2011 to July 2013 were reviewed and data were analysed. Ultrasound biomicrospic examination was performed for all cases under general anesthesia using Ultrasound biomicroscope (Model DICON P45 UBM Plus Paradigm instruments) with 50 MHz transducer. UBM was used to determine the features of the intraocular tumor and possible extension into anterior retina, ciliary region, and anterior segment.
All cases were enucleated for different reasons, such as poor visual prognosis (six cases) and unilaterality (two cases). Histopathological examinations were performed for all enu-cleated eyes. UBM findings were compared and correlated with the histopathological features of the enucleated eyes.
Results: UBM documentation was available in 10 eyes of the eight patients which were included in the study. Only 7 eyes were diagnosed on UBM to have extension of the tumor anterior to the ora serrata, and were enucleated. Exten-sion was absent in the other 3 eyes. Histopathological exam-ination confirmed the anterior extension in all the 7 eyes and confirmed the absence of extension in the other 3 eyes. UBM did not yield any false negative or any false positive results.
Conclusion: UBM is an indispensable tool for visualization of the anterior retina, ciliary region, and anterior segment allowing a better staging of the advanced disease process. Primary assessment of the true extent of retinoblastoma is critical for the selection of an optimal management approach. UBM may provide useful diagnostic data governing the indications for enucleation in advanced cases of retinoblastoma.
/ 0
- Details
- Category: Vol. 80, June 2012
- Hits: 968
Assessment of Routine Management of Third Stage of Labor for Normal Delivery in Women's Health Center (University Hospital) and El-Eman Hospital (Ministry of Health Hospital) for Obstetrics and Gynecology,MONA IBRAHIM, AHMED M. MAKHLOUF, MERVAT A. KHAMIS and EMAN R. AHMAD
Abstract
In the Arab world, most research efforts and programmatic interventions have understandably focused on complicated deliveries. However, globally normal deliveries represent 85% of births. Few studies have documented routine facility practices for normal labor in developing countries, little is known regarding facility-based normal labor in the Arab world. This study was unable to find data regarding actual (vs. reported) third-stage management in Egyptian facilities. This study was carried out to assess the routine management of third stage of labor and to identify gaps that required improving clinical care at Women's Health Center (University Hospital) and El-Eman Hospital (Ministry of Health Hospital) for Obstetrics and Gynecology. With respect to: Assess ma-ternal outcome as regards to sequence of third stage of normal labor, these hospitals were selected for data collection. The sample comprised of 1000 women (500 women in each hospital as A & B respectively) who were delivered normal vaginal delivery in Emergency wards. The study applied a descriptive cross sectional design in which two tools were used for data collection. A special structured questionnaire was designed to entail data related to sociodemographic, previous and current obstetric history and the second tool included obser-vation of health care providers' practices related to third stage management among two hospitals. The results demonstrated that about three-quarters (72.8%) of women in group (A) received active management of third stage of labor compared with (43.2%) of women's in in group (B). Almost all women managed by active method received uterotonic drugs (Oxyto-cin) during the third stage of labor. The minority among both groups had postpartum haemorrhage, only tears were apparent significantly increase among women received expectant management of third stage than active management group. Obstetricians encourage the women to pass urine for the majority of sample among group (A) (97.8%) compared with less than half (48%) among group (B).
Conclusion: 'Active management' is superior in use to 'expectant management' at University Hospital compared with Ministry Hospital. It is miserable that the majority of women attended the ministry hospital had certain aspects of managing third stage of labor by auxiliary workers.
/ 0
- Details
- Category: Vol. 79, March 2011
- Hits: 967
Carnitine Serum Levels in Children with Iron Deficiency Anemia,SULIMAN H. AL-FIFI
Abstract
Objective: To evaluate carnitine serum levels as a co-morbidity in children with iron deficiency anemia.
Patients and Methods: Fifty-four well nourished children (29 boys and 25 girls) with iron deficiency anemia were enrolled. Twenty-five healthy non-anemic age- and sex-matched children were included as a control group. For all anemic children and controls, we performed complete blood cell count, serum ferritin, serum iron, and total iron binding capacity. Carnitine levels were measured by spectrophotometric method.
Results: Serum carnitine levels were significantly lower in children with iron deficiency anemia than in the controls (p<0.001). There were strongly significant positive correlations between serum carnitine and hemoglobin, serum iron, and serum ferritin (p<0.001 for all).
Conclusions: Low serum levels of carnitine in those children may be due to iron deficiency. Therefore, iron forti-fication of diet of children seems to be essential not only to prevent anemia but also to avoid possible effects of iron deficiency in growing children such as secondary carnitine deficiency.
/ 0
- Details
- Category: Vol. 79, March 2011
- Hits: 967
Role of Cytokines in Diabetic Retinopathy,TAMER F. EL-MEKAWY, SAFAA S. MAHMOUD, AMR I. ELAWMERY and AHMED T. ISMAIL
Abstract
Background: Diabetic retinopathy is a progressive vision threatening complication of diabetes. Raised plasma level of tumor necrosis factor and other cytokines are accepted as the key in early events in the development of vascular disease.
Objective: The aim of this study was to assess the level of some cytokines in diabetic retinopathy and its effect on the severity of diabetic retinopathy.
Patients and Methods: This study was conducted on 60 diabetic patients and 15 healthy subjects as a control group. Diabetic patients were subdivided into 4 groups, group 1 included 15 cases without retinopathy, group 2 included 15 cases with non proliferative DR, group 3 included 15 cases with preproliferative DR, group 4 included 15 cases with proliferative DR. Full ophthalmological examination was done and any posterior segment pathologies was excluded. Blood samples were taken and quantitative determination of glycohemoglobin (HbA1C), ELIZA assay was used to deter-mine the levels of different cytokines. Urine samples were collected to determine the level of ketone bodies and to test for microalbuminuria.
Results: There was a significant correlation between the level of tumor necrosis factor (TNF) and the degree of retin-opathy, the mean level in group 1 (40.7±5.3) in group 2 (98.5± 6.8), in group 3 (116.1±6.2), in group 4 was (313.7±71). Its level was also elevated in vitreous samples in group 3 and 4, group 3 (216±17), group 4 (260.13.±7). Interlukin 6 showed marked elevation in blood and vitreous in diabetic patients with advanced retinopathy, group 3 and 4, group 3 (107±120) blood, vitreous (120±31), group 4 (253.7±130) blood, vitreous (200±1.1). There was a strong correlation between ketosis and elevated TNF and interlukin 6.
Conclusion: In diabetic retinopathy the increased level of some cytokines as tissue necrosis factor and interlukin 6 may stimulate endothelial cells for neovascularization process, there was a significant correlation between clinical grades of diabetic retinopathy and the expression levels of cytokines.
/ 0
- Details
- Category: Vol. 77, March 2009
- Hits: 966
Are Arrhythmias in Rheumatic Mitral Regurgitation Common as in Mitral Valve Prolapse in Children ?,WAEL LOTFY, OSAMA TAYEH, GEHAN HUSSEIN, SHERIF TAWFIK and FADIA MAHMOUD
Abstract
Rheumatic fever is a common cause of acquired heart disease in children and young adult throughout the developing world and the pancarditis caused by rheumatic fever may manifest by palpitations. Ventricular arrhythmias are a common feature in patients with mitral valve prolapse (MVP) and several factors have been identified in those patients who progress to sudden death, including severe mitral regurgitation. So could arrhythmias in children with rheumatic mitral regur-gitation (MR) be as common as in patients with mitral valve prolapse?
Patients and Methods: This study included 30 patients (pts) with isolated rheumatic mitral regurgitation with different grades (mild, moderate and severe mitral regurgitation) diag-nosed by echocardiography (group I) compared to group II (control group), which included 30 healthy children with a normal heart confirmed by echocardiography. All the study population was subjected to the following: Full medical history and physical examination, laboratory investigations, twelve leads ECG, chest X-ray, echocardiography and Ambulatory twenty four hours ECG monitoring (Holter).
Results: The total prevalence of arrhythmias detected by Holter monitoring in the studied patients and control group were 40% (12 pts) and 16.6% (5 pts) respectively, p value=0.04. As regard the type of arrhythmias; sinus tachycardia occurred in 10 pts (33.3%) and 4 pts (13.3%) in group I and II respec-tively (p value >0.05). Infrequent premature atrial contractions (PACs) occurred in 2 pts (6.7%) in group I and one patient (3.3%) in group II (p value >0.05). The incidence of arrhyth-mias detected by Holter recording was insignificant with mild MR compared to the control group (p value=0.4). Thereafter, the prevalence of arrhythmias increased proportionally to the degree of MR. The occurrence of arrhythmias in pts with moderate and severe rheumatic MR was significantly higher as compared to the control group (p value=0.02 & 0.009 respectively). The incidence of arrhythmias was not signifi-cantly higher in cases of rheumatic MR with active rheumatic fever (4 pts had arrhythmias out of 5 pts with rheumatic activity) than those with rheumatic MR without rheumatic activity (p value=0.07). The prevalence of arrhythmias in the patients studied in relation to the echocardiographic findings revealed a significantly higher incidence of arrhythmias in rheumatic MR with left atrial enlargement; eleven out of thirteen pts had sinus tachycardia and PACs (p value=0.0001).
Conclusions: We conclude from this study that rheumatic mitral regurgitation in the pediatric age group is associated with sinus tachycardia and uncommonly with premature atrial contractions; no other arrhythmias were detected even in association with cardiac enlargement or active carditis. The incidence of arrhythmias in MVP is much more common than in rheumatic MR. Ventricular arrhythmias occurs in MVP, while it did not occur with rheumatic MR in our study. The incidence of arrhythmias in rheumatic MR is significantly related to the severity of mitral regurgitation.
/ 0
- Details
- Category: Vol. 82, June 2014
- Hits: 965
Case Report: Effect of Bee Stings on the Viral Clearance in Chronic Hepatitis-C Virus, MOHAMED N. EL-BASSIONY and RASHA E. BADR
Abstract
A 47 year old male patient suffered from chronic hepatitis C virus (CHC) infection since 1999 came to Bee Venom Research Center (BVR) at El-Arish City in June 2006 asking to be one of volunteers in Bee Venom Therapy (BVT) courses. He was treated with traditional interferon (IFN) and ribavirin (RBV) for 12 months since May 2000 to May 2001. After completion of his treatment course, quantitative Polymerase chain reaction (PCR) for Hepatitis C virus Ribonucleic acid (HCV-RNA) was done and the result was negative. In June, quantitative PCR for HCV-RNA was repeated and the result was positive. He was involved in BVT course for three months starting from July 2006 to the end of September 2006. At the end of BVT course quantitative PCR for HCV-RNA was done and the result was negative. Since September 2006 until now repeated quantitative PCR for HCV-RNA were negative.
/ 0
- Details
- Category: Vol. 79, December 2011
- Hits: 965
Clinical Analysis and Surgical Outcomes of 15 Cases of Cauda Equina Tumors,TARIQ E. ELSHAFEY and SALEM S. FAISAL
Abstract
Objective: To evaluate the clinical results of gross total resection of cauda equina tumors.
Patients and Methods: Between June 2007 and October 2011, 9 males and 6 females (mean age 37) diagnosed with intradural tumor in the region of the cauda equina were surgically treated at Suez Canal University Hospital. The neurological and functional states of each patient were eval-uated according to the modified McCormick scale. Magnetic resonance imaging was used in diagnosis and follow-up.
Results: The most common symptoms presented were pain (in 93.3%); weakness presented by 2 patients (13.3%), and incontinence by 1 patient (6.6%). Gross total resection (achieved in 13 patients = 86%) through a posterior approach. Surgical resection of these tumors led to significant alleviation of pre-operative symptoms.
Conclusions: Cauda equina tumors generally carry a favorable prognosis: Most of these tumors are benign, and the aim of treatment is to restore function and prevent recur-rences. The determining factors for optimal clinical results after surgery are a gross total resection of the tumor and good neurological condition before the operation.
/ 0
- Details
- Category: Vol. 81, June 2013
- Hits: 962
Effect of Nutritional Health Education Program on Elderly Nutritional Knowledge, Attitude and Practice in Abu Khalifa Primary Health Care Center, Ismailia Governorate,REHAB A. MOHAMED, MOHAMMED M. AWAD, SAID I. SHALABY and HEBATOLLAH N.E. ABDELSATAR
Abstract
Introduction: Old age is the greatest challenge that an individual faces. It is a continuous process that begins with conception and ends with death. Malnutrition among the aged is caused by a number of factors such as condition of the family, illiteracy, poverty, ignorance, superstition, lack of food, frequent infections etc. In the era of population aging, understanding the dynamic needs along with social psycho-logical dynamics of help-seeking behavior among elderly persons is fundamental to assessing the impact of food pro-grams.
Aim of the Study: The aim of this study was to improve elderly nutritional knowledge, attitude, and practice.
Subjects and Methods: An interventional study design with pre-post assessment was used. It involved (115) elderly who were selected through a consecutive sample. An interview questionnaire form was designed by the researcher to collect the data pertaining to the study objectives.
Results: The pre-post changes in the intake of the main food groups according to recommended daily requirements showed significant decrease of cereals (p0.001), and increase of dairy products (p=0.03). The total knowledge increased from a pre-intervention level of 26.1% to a post-level of 82.6% (p<0.001). The percentage of elderly with total positive attitude increased from a pre-intervention level of 28.7% to a post-level of 60.0% (p<0.001). The percentage of elderly taking balanced diet increased from 7.8% at the pre-intervention phase to 11.3% at the post-phase. The statistically significant independent predictors of the knowledge scores were the intervention and the level of education, income, and health perception, all being positive.
Conclusion: The counseling intervention was effective in improving their knowledge and changing their attitudes to more positive, which led to improvements in their dietary practices.
/ 0
- Details
- Category: Vol. 78, March 2010
- Hits: 961
Biophysical Approach of Anemia in Cadmium Induced Toxicity of Rats, SHERIF A. MOUSSA, SAMIR A. BASHANDY and BASSEM M. RAFAAT
Abstract
The effect of exposure to cadmium (Cd) on blood, lipid peroxidation, antioxidant enzymes, and oxidative stress of hemoglobin (Hb) were studied. Male Wister rats (6 months old) were treated with cadmium (2.5mg/kg BW) three times weekly for eight weeks. Cd exposure reduced significantly (p<0.05) erythrocyte count (RBCs), hemoglobin content (Hb), hematocrit value (Hct), mean cell hemoglobin (MCH) and mean cell hemoglobin concentration as compared to control. Intoxication with cadmium significantly increased the lipid peroxidation marker malonaldialdehyde (MDA), while the antioxidant enzyme glutathione reductase (GSH) significantly decreased as compared to conmared to control. Intrinsic viscosity of Hb significantly increased, while the electrical conductivity of Hb significantly decreased. The results showed that hemoglobin suffers from a significant increase in the autooxidation rate in case of anemia in Cd-treared rats followed by an enhancement in both methemoglobin and hemichrome levels and a significant decrease in oxyhemoglobin concen-tration.
/ 0
- Details
- Category: Vol. 77, June 2009
- Hits: 960
Scarf Osteotomy for Correction of Hallux Valgus Deformity,AHMAD M. KHOLEIF
Abstract
Objective: Presentation of clinical and radiological out-come of a case series of scarf osteotomy.
Patients and Methods: The study involved 20 patients with 24 feet affected with symptomatic moderate to severe hallux valgus. Clinical assessment was done using American Orthopedic Foot and Ankle Society (AOFAS) score. Radio-logical assessment utilized measurement of hallux valgus angle (HVA), intermetatarsal angle (IMA) and the distal metatarsal articulation angle (DMAA). Akin closing-wedge osteotomy was added for 6 feet (25%).
Results: Mean age of patients was 35.6±3.5 years; with 16 females and 4 males. All the clinical and radiological scores improved significantly after surgery compared to the baseline scores (p<0.001, for all comparisons). There was no correlation between the clinical score and radiological angles pre- and postoperatively.
Conclusion: Scarf osteotomy of the first metatarsal can be considered to be a safe and reliable solution for the treatment of hallux valgus deformity.
/ 0
- Details
- Category: Vol. 83, June 2015
- Hits: 955
Sleep Disorders among Female Students in Assiut University, Upper Egypt, DALIA G. MAHRAN, and SABRA M. AHMED
/ 0
- Details
- Category: Vol. 81, December 2013
- Hits: 955
Effects of Melatonin Premedication on the Hemodynamic Responses and Perfusion Index During Laryngoscopy and Endotracheal Intubation, AHMED A. MOHAMED, HOSAM M. ATEF, ALAA EL-DIN M. EL KASSABY, SALAH A.M. ISMAIL and AMR M. HELMY
Abstract
Context Rational: Several techniques have been proposed to prevent or attenuate the hemodynamic responses following laryngoscopy and intubation, preoperative melatonin has a significant analgesic and anxiolytic effect for patients under-going surgery. Melatonin may play an important role in controlling hypertension also in humans. The current study aimed at assessing the usefulness of melatonin in attenuating the pressor response to direct laryngoscopy and tracheal intubation.
Methods: After approval of the ethics committee and informed written patients consent the study was carried out at rotine surgical theatre of the Suez Canal University Hospital, during the peroid from 2011 – 2012 on 90 patients with ASA physical status I, II scheduled for any elective surgery under general anesthesia with endotracheal intubation. Patients were randomly allocated according to computer-generated random-ization into three groups: Group I (control group); Group II (melatonin 6mg tablet group) and Group III (melatonin 9mg tablet group). Primary outcome measures include; Heart rate (HR, Systolic blood pressure (SBP), diastolic blood: pressure (DBP), mean arterial pressure (MBP) and perfusion index were recorded before drug premedication, pre-induction, pre-intubation, 1, 2, 3, 5 and 10 minutes after laryngoscopy and intubation. Moreover perioperative anxiety was evaluated by recording the preoperative and postoperative verbal anxiety score (VAS) of the sample patients.
Results: Significant decrease in blood pressure in group II and group III receiving 6mg and 9mg of oral Melatonin 1 hour preoperative at 1, 2, 3, 5 and 10 minutes after intubation as regard SBP, DBP and MBP compared to group I. As regards to heart rate, no significant difference was found between the three groups throughout different time of measurement except for a significant difference at 1 minute after intubation measures for group II and group III compared to the control group. Moreover postoperative verbal anxiety score (VAS) was decreased significantly group II and group III compared to the control group.
Conclusion: Preoperative administration of melatonin one hour before surgery provided a significant decrease hemodynamic response of direct laryngoscopy and tracheal intubation as regard hemodynamic parameters and perfusion index.
/ 0
- Details
- Category: Vol. 77, June 2009
- Hits: 953
Echography-Verified Retrobulbar Triamcinolone Injection in the Treatment of Uveitis,MAHMOUD M. GAMAL, YASMINE M. EL-SAYED and KHALID ABU EL EINEIN
Abstract
The Purpose: The aim of the present study is to assess the efficacy of sonography-verified retrobulbar injecition (RBI) of Triamcinolone acetonide (TAA) in the treatment of uveitis and the management of persistent and refractory uveitic macular edema (ME).
Subjects and Methods: In this prospective study 26 eyes of 20 patients were included. Patients underwent RBI of TAA for intraocular inflammation and/or cystoid macular edema (CME) caused by chronic non-infective anterior, intermediate, posterior or pan uveitis. Patients with ocular hypertension or glaucoma were excluded from the study. The etiology of uveitis, Snellen visual acuity (VA) in decimal fraction, appla-nation intraocular pressure (IOP) were recorded, anterior segment findings were evaluated by slit lamp and posterior segment findings by ophthalmoscopy, slit lamp biomicroscopy or ultrasonography. Fundus fluorescein angiography (FFA) was performed whenever the ocular media allowed. The primary outcome measures were: Improvement of uveitis (inflammatory activity), angiographic appearance of CME at 6 months of follow-up and change in VA.
Results: There were 9 cases of Behcet's disease (45%), 4 cases of VKH (20%), 2 cases of intermediate uveitis (10%) and 5 cases of idiopathic uveitis (25%) There was a statistically significant improvement of visual acuity (VA) after injection in all patients with a p-value of 0.045. Complete resolution of anterior uveitis occurred in 6 eyes in the 1st week, 4 eyes in the 2nd week and 2 eyes in the 1st month. One case (2 eyes) failed to achieve complete resolution at the end of follow-up (7%). Regarding vitreous inflammatory activity, complete resolution occurred in 6 eyes in the 1st week, 4 eyes in the 2nd week, 3 eyes in the 1st month, 4 eyes in the 2nd month and 5 eyes in the 3rd month. 4 eyes failed to achieve complete resolution at the end of follow-up (14%). Although the IOP tended to be temporarily higher after injection, the increase in IOP was not statistically significant.
Conclusion: Sonographic confirmation of the paramacular location of depot steroids after RBI can potentially raise the therapeutic success in refractory uveitis and CME; although the effect may be transient. The procedure is relatively safe. Week 2 is the most probable time for the development of a high IOP. The most significant therapeutic effect of retrobul-barly-injected TAA on inflammatory activity appears at 4weeks; however, its effect in terms of patient satisfaction and reduction in CME is maintained for as long as 4 months.
/ 0
- Details
- Category: Vol. 77, September 2009
- Hits: 951
Double Chromosomal Abnormalities in Live Birth Infants,NAGWA A. MEGUID, SAHAR EL BAYOUMI, HODA BASHEER, NAGHAM ELAMEER, SAIDA A. HAMMAD, HASSAN A. HOUSIEN, LAILA A. HOSNY and AMAL M. MOHAMAD
Abstract
Objectives: The aim of this study was to present rare cases with coexistence of double chromosomal abnormality involving chromosome 21 and to discuss different mechanisms of double anomaly in live births for better counseling.
Introduction: The coexistence of two chromosomal ab-normalities in the same individual is relatively a rare phenom-enon. Most of the previously reported cases of double abnor-mality were found in spontaneous abortions. Multiple chromosomal abnormality occurs as a consequence of a minimum of two errors during meiosis. The zygote carrying a double anomaly usually results from a double error in a single germ cell. However the coincidence of a single anomaly occurring in both gametes was also observed.
Material and Methods: In this study, we described nine live births with double chromosomal abnormality involving chromosome 21. Cytogenetic studies and fluorescence in situ hybridization (FISH) analysis were carried out for all infants and their parents. The first new born had double trisomy involving chromosomes 21 and X in a female infant (karyotype 48,XXX,+21). Second and third cases had both trisomy 21 and trisomy 18 (karyotype 48,XX,+21,+18) the fourth case had apparent monosomy 21 and trisomy 18 (karyotype 46XX,- 21,+18). Cases 5-9 had trisomy 21 associated with deletion or translocation. In all cases the double chromosomal abnor-mality is de novo except in cases 1 and 6.
Conclusion: We concluded that genetic counseling in such cases is difficult. Neither satisfactory data concerning the clinical outcome of the double chromosomal anomaly in live infants nor any information concerning the recurrence risk for their parents. However, we recommend the study of different tissues to parents of children with de novo double chromosomal anomaly.
/ 0
- Details
- Category: Vol. 82, September 2014
- Hits: 949
Case Report: Cutaneous Mucormycosis after Trauma, AZIZ A.A. AL-SOHAIMI, HASAN S. AL-GHAMDI and SADIQ A. ARIF
Abstract
Background: Cutaneous mucormycosis is a rare, but frequently fatal fungal infection.
Case Report: We report a case of cutaneous mucormycosis following a road traffic accident.
Conclusions: A high level of clinical suspicion with appropriate tissue biopsy, prompt managementand close follow-up are essential to reachrecovery for mucormycosis.
Recommendations: To raise the awareness of Physicians toward this frequently fatal fungal infection in order to manage it properly and reach a good outcome.
/ 0
- Details
- Category: Vol. 77, March 2009
- Hits: 948
Obstructive Sleep Apnea: Relationship of Some Clinical Parameters to Severity of the Disease,TAREK F. YOUSSEF, ASHRAF S. ABOU-HALAWA, MOHAMAD N. EL-ATRIBY, NAGY M. ISKANDER and QASEM M. BUHAIBEH
Abstract
Background: Although essential before surgery, in-lab polysomnography and in-hospital sleep studies cannot be done indiscriminately for all patients with potential diagnosis of obstructive sleep apnea (OSA). Some clinical parameters may be used to select patients for these studies, thus increasing their cost-effectiveness.
Objective: Studying the relationship of body mass index (BMI), modified Mallampati index (MMI), tonsil size and thyroid-mental distance (TMD) to the grade of OSA.
Study Setting: Tertiary referral hospital.
Patients and Methods: Thirty consecutive patients (20 men and 10 women) in the age range of 30 to 60 years with snoring for at least 3 months and observed cessation of respiration during sleep were included. SAMTM monitor (Intercare Technologies, Inc, Milwaukee, WI) was used for an eight-hour in-hospital sleep study.
Results: There was a statistically significant relationship between BMI, MMI and tonsil grade and the grade of OSA (p=0.01, p=0.036, p=0.05 respectively). No statistically sig-nificant relationship was found between TMD and grade of OSA (p=0.456).
Conclusion: In patients with potential diagnosis of OSA, BMI, MMI and tonsil size grade are helpful in selecting patients for in-hospital sleep studies.
/ 0
- Details
- Category: Vol. 77, June 2009
- Hits: 948
Endocrine Disorders in Patients with Sickle Cell Anemia,NASHWA A. EL-SARRAF and AHMAD M. SULAIMAN
Abstract
Red blood cell transfusions are a therapeutic mainstay in Sickle Cell Disease (SCD) and repeated transfusions can result in iron overload. Endocrine dysfunction is the most common and earliest organ toxicity seen in subjects with chronic iron-induced cellular oxidative damage. The aim of the present work is to investigate some of the endocrine functional disorders in patients with SCD.
Methods: The present study consisted of 30 patients with SCD (proved by hemoglobin electrophoresis from the start of the condition) recruited from the Medical Department of King Fahd Hospital- Hofuf, Eastern Province-Saudi Arabia. Most of the patients had a history of repeated blood transfusions (5 times/year). Patients were classified into two groups. Group 1 (15 males) and Group 2 (15 females) with mean age for both sex (28.6±5.4 years). Thirty age and sex matched normal subjects were, also, included in the study as a control group. Plasma level of testosterone for group 1 and male control group, FSH and LH for group 2 and female control group. Complete blood count, biochemistry, iron profile, as well as thyroid function tests were assessed for both group 1 and 2 and control group.
Results: A total of 30 patients with SCD were recruited in the study (15 males and 15 females) with mean age 28.6± 5.4 years. They were compared to a control group of 30 healthy subjects and showed no significant difference between group 1 and the control group regarding the level of testoster-one (5.03±3.37 Vs 6.95±1.69; respectively, p=0.05). Also the plasma level of testosterone showed insignificant correlation with the serum iron level among group1 (r=-0.18, p=0.5). A significant lower level in T4 was detected in group1 compared to the control group (5.17±3.41 Vs. 11.01±1.44; respectively, p=0.001). There was insignificant correlation between test-osterone level in group 1 and the T4 level in the same group (r=-0.01, p=0.89). On the other hand, no significant correlation was detected between group 1 and control group as regard TSH level (p=0.3).
Female patients with SCD (group 2) have a significant lower level of LH than the control group (72±5.44 Vs. 16.2± 2.74; respectively, p=0.001). The present study revealed that there was no significant difference between the level of FSH among group 2 and the control group (6.19±3.60 Vs. 6.4±1.3; respectively, p=0.05), as regard the correlation between the LH level and the serum iron among group 2, there was no significant correlation (r=-0.35, p=0.18 ). Also group 2 showed significant lower level of the T4 than the control group (6.58±
6.3 Vs 11.64±1.05; respectively, p= 0.001). On the other hand no significant correlation was found between patients in group 2 and control group as regard TSH level (p=0.3).
There was no significant correlation between the level of T4 and the serum iron level in both group 1 and group 2 (p= 0.5).
Conclusion: The present study had demonstrated that SCD had a depressant effect on the hormone LH in female patients with SCD, and T4 in both males and females with SCD irrespective of the serum iron level.
/ 0
- Details
- Category: Vol. 78, March 2010
- Hits: 947
Effect of Nutritional Interventions on Anemic Pregnant Women’s Health Using Health Promotion Model,MARIAM AMER AL-TELL, FATEN KHAYRAT EL-GUINDI, NAWAL MAHMOUD SOLIMAN and HISHAM EL-NANA
Abstract
Iron deficiency anemia is one of the main health problems in Palestine, it affects about a quarter of pregnant women who attended the Ministry of Health facilities in the West Bank. It is preventable while its consequences can’t be prevented or treated easily. Health Believe Model (HBM) is widely used in intervention programs that aiming to changing behaviors.
Aim of the Study: Was to evaluate the effect of nutritional interventions using health promotion model through changing in their perception regard the risk of anima.
Subjects and Methods: Quasi-experimental design, using control group.
Sample: It was a convenient sample included 102 pregnant from antenatal care (ANC) of MOH in Nablus city/Palestine.
Research Tool: Two tools were used for data collection; the interviewing questionnaire that consist of 3 parts; the socio-demographic and maternal profile of pregnant women, their perception about risk and susceptibility to iron anemia and their dietary habits/practice. The second tool was the investigation /laboratory tool that assessed the hemoglobin level of pregnant women. All pregnant women interviewed, and results of blood samples for hemoglobin level obtained from the MOH laboratories. Data were analyzed using SPSS soft ware.
Results: The study result showed overall significant relationship between perceiving risk of anemia and eating practices, and between changing eating practices and improve-ment in hemoglobin level of pregnant women. Actions at mother child health centers regarding management of anemia among pregnant women using principles of Health Promotion Model/Health Belief Model in different intervention programs should be request for.
/ 0
- Details
- Category: Vol. 80, September 2012
- Hits: 946
Conservative Versus Delayed Laparoscopic Exploration for Blunt Abdominal Trauma,TAMER M. NABIL, SALAH S. SOLIMAN, WAEL N. THABET and RAMI M. MAKKAR
Abstract
Introduction: The key issue in the choice of investigation is the cardiovascular stability of the patient. Diagnostic peritoneal lavage (DPL) is no longer the gold standard for determination of the need for laparotomy in blunt abdominal trauma not only because more specific and sensitive diagnostic procedures are available like delayed laparoscopic exploration (DLE), but also to avoid the unnecessary laparotomies even in cases of true positive DPL. The aim of this study is to compare conservative versus DLE for blunt abdominal trauma management as regards accuracy of diagnosis, decreasing incidence of complication, decreasing the need for unnecessary laparotomies and to shorten the hospital stay.
Material and Methods: 28 hemodynamically stable patients with blunt abdominal trauma (BAT) were selected randomly and divided into two groups, there was no statistically signif-icant difference in the mode of trauma between the two groups using the rank student t-test, also, no statistically significant difference in the age and the sex distribution between the two groups, as they passed the normality test.
Group (A): Included 15 patients, managed by the classic conservative management with close monitoring by vital signs, urine output, laboratory tests and repeated imaging by abdominal US.
Group (B): Included 13 patients managed by (DLE) at the third day of the trauma, patients had US, CT abdomen on admission and remain under observation till the third day. Follow-up for the patients from both groups after discharge to detect late complications after 3 months.
Results: In 9 patients included in the study representing approximately 32% of all patients, there were injuries missed by U/S and detected by CT. And in 17 patients representing approximately 64%, U/S and CT detected the same injuries. Among the 13 patients that underwent delayed laparoscopic exploration (DLE) representing approximately 46% of all patients there were 5 missed injuries by CT that was discovered during (DLE) representing 38% of the 13 patients. Therapeutic laparoscopic intervention occurred in 3 patients representing approximately 23% of the 13 patients. Hospital stay for the patients managed with (DLE) ranged between 4 to 10 days with an average of 5.69 days (±1.887). Hospital stay for the patients managed with conservative management ranged between 5 to 14 days with average of 8.93 days (±2.89). Follow-up information was available for all the patients over a period of 3 months after discharge, neither infective nor late hemorrhagic complications were observed.
Conclusion: In the light of this study, (DLE) was found most significant for blunt abdominal trauma patients with CT scan showing haemoperitonium with no organ injuries, and to less extent in cases with splenic injuries, while in patients with hepatic injuries there was no significant data favoring (DLE) on conservative treatment.
/ 0
- Details
- Category: Vol. 77, June 2009
- Hits: 946
Emergency Obstetric Hysterectomy in Abha, Saudi Arabia: A 15-Year Review of 72 Cases, ADEKUNLE A. SOBANDE and MONA A. ALMUSHAIT
Abstract
Objectives: To determine the incidence of, indications, associated risk factors, maternal and fetal morbidities and mortalities resulting from emergency obstetrics hysterectomy.
Materials and Methods: This was a retrospective study of 72 patients who had emergency hysterectomy performed at Abha General Hospital, Abha, Saudi Arabia over a 15-year period. According to parity, they were divided into 3 groups, as follows; group 1 (para 0, n=2), group 2 (para 1-4, n=26) and group 3 (para 5 or more, n=44). A comparison was also made according to the type of hysterectomy and history of previous Caesarean section.
Results: The incidence of emergency obstetric hysterec-tomy was 1.2 per thousand deliveries; 6 (8.3%) followed vaginal deliveries and 66 (91.7%) after Caesarean section (CS). Major indications were abnormal placentation 40 (55.5%), uterine atony, 14 (19.4%), others (rupture of uterus, DIC, profuse uncontrollable bleeding) were 18 (25%). Iden-tifiable risk factors included previous Caesarean, 55 (76.4%), maternal age between 30-39 years, 51 cases (70.8%), and grand multiparity, 44 (61.1%). Histopathologically-proven placenta accreta was found in 8 (30.7%) and 13 (31.8%) in groups 2 and 3, respectively. There were three maternal deaths in the study and overall perinatal mortality was 8.5%.
Conclusion: The incidence of obstetric emergency hys-terectomy in this study is 0.12% with an associated maternal mortality of 3 (4.1%), one of which was attributable to placenta accreta. Although the major indication was placenta accreta in 40 (55.5%) of the cases, this was proven histologically in 21 cases (42.5%). The identifiable risk factors are grand multiparity, maternal age range of 30-39 years and a previous Caesarean section. Proper counseling in these high risk patients should be mandatory, efforts should be made to reduce the incidence primary CS, therefore CS hysterectomy by involving experienced obstetricians in decision making regarding the CS.
/ 0
- Details
- Category: Vol. 83, September 2015
- Hits: 945
Optimization of Different Reconstructive Approaches for Reconstruction of Intraoral Defects after Tumor Extirpation, NAZEM M. SHAMS, MOHAMED A. HEGAZY, ASHRAF A. KHATER, SAMEH R. ABD EL-AZIZ and ISLAM A.A. EL-ZAHABY
Abstract
Oral cancer is one of the most common and lethal malig-nancies in the head and neck. Surgery remains the mainstay treatment in resectable oral cancer. Curative resection with negative margins remains the corner-stone in achieving the proper oncologic outcome. The larger the size of the tumor, the wider the resection and the larger the defect which usually results in the sacrifice of important aesthetic and functional subunits in the oral cavity. Reconstruction of such intra-oral defects is technically challenging. Despite the great advances achieved in reconstructive surgery and the introduction of free tissue transfer which became the state of the art recon-structive method in head and neck cancer patients, many oral cancer patients and many institutions are not candidate for this complex, sophisticated, and costy procedure. So that selection of the appropriate reconstructive approach in oral cancer patients is a great dilemma that should be individualized and couldn't be dogmatic for all cases; and it is affected by several patient, tumor and health care factors, moreover it differs according to the oral cavity subunit.
In this study, we underwent surgical excision and imme-diate reconstruction in ninety eight patient with oral tumors and then underwent a critical appraisal and analysis of the used reconstructive methods in terms of safety, reliability of reconstruction, morbidity, mortality, oncologic and functional outcome in order to create a stylistic approach and an efficient algorithm for the reconstruction of different defects in the variable oral cavity subsites.
/ 0
- Details
- Category: Vol. 83, September 2015
- Hits: 942
Effects of Maternal Corticosteroids Administration for Enhancement of Fetal Lung Maturity on Non Stress Test and Fetal Biophysical Activities, SHAMEL M. HEFNY, AHMED M.T. HASHEM and AMIRA E. YEHIA
Abstract
Objective: To evaluate the effects of maternal corticoster-oids administration on Non stress test and fetal biophysical activities in pregnancies with normal fetoplacental vascular resistance.
Study Design: Prospective study.
Patients and Methods: Included singleton pregnancies at risk of preterm labour between 28 weeks and 34 weeks gestation, preterm birth was anticipated on the basis of: History of previous preterm birth, preterm contractions of the uterus, placenta previa and third trimester bleeding, preterm premature rupture of the membranes, polyhydramnios, history of recurrent spontaneous abortion.
Intramuscular dexamethasone was given as 4 doses dex-amethasone (6mg/12 hours for 48hrs), a non stress test and ultrasound study for biophysical activity (FHR, breathing and limb movement, AFI) were done for all women immediately and at 2 and 4 days later.
Results: There was a statistically significant (p<0.001) difference in the frequency of non-reassuring fetal heart rate tracings and fetal breathing episode, limb movement 48 hours after dexamethasone.
Conclusion: Corticosteriods administration can cause a remarkable, but impermanent reduction in fetal biophysical profile scores.
/ 0
- Details
- Category: Vol. 84, June 2016
- Hits: 941
The Role of Intensive Phototherapy Device in Treatment of Neonatal Jaundice, OSAMA A. ELFEKY, AMR M. EL-KHASHAB, AHMAD A. SOBEIH and MOHAMMED G. ABD EL-HAMEED
Abstract
Objectives: To assess the effectiveness of intensive pho-totherapy in treatment of neonatal jaundice and elimination of exchange transfusion.
Methods: The case control study was conducted at El-Galaa Teaching Hospital, from October 2014 to April 2015, and comprised 200 newborns with indirect hyperbilirubi-naemia. The 100 subjects were treated with Bilisphere 360 (Bilisphere group) compared with 100 who had been treated with conventional phototherapy (control group). Both groups were subjected to complete clinical evaluation and laboratory investigations.
Results: Bilisphere 360 decreased the need for exchange transfusion to 16 (16.0%) neonates of the Bilisphere group versus 66 (66.0%) of the control group (p<0.001); decreased the level of serum bilirubin as exchange transfusion [5.7mg/dl (22.5%) in the subjects vs. 6.0mg/dl (22.8%) in the controls]; shortened the duration of phototherapy (1.7 days in the subjects, vs. 4.1 days in the controls; p<0.001).
Conclusion: The use of intensive phototherapy (Bilisphere 360) in the treatment of indirect pathological hyperbilirubi-naemia is very effective in lowering total serum Bilirubin when its level is within 2-3mg/dl (34-5umol/l) of the exchange transfusion level. Bilisphere 360 has succeeded in reducing exchange transfusion and duration of phototherapy.
/ 0
- Details
- Category: Vol. 80, December 2012
- Hits: 938
Angiopoietin 2 Level in Type 2 Diabetic Patients with Cardiovascular Complications,SAMIHA ABO EL-YAZEED, KARIMA Y. AHMED, LAMYAA I. AHMED, OMIMA M. ALI and NAGWA A. MOHAMED
Abstract
Introduction: Diabetic patients have an increased risk of developing cardiovascular complication and this is due in part to genetic variation that influence both glucose homeostasis and atherosclerotic lesion growth. Angiopoie2 is a secreated glycoprotein that plays acomplex role in angiogenesis and inflammation.
Objective: The aim of this study to asses and compare angiopoietin2 level in healthy and type 2 diabetic patients with and without cardiovascular complication.
Methods: The present study included 75 subjects, age rang (42-62 years), 50 of them type 2 diabetic patients and 25 healthy, age and sex matched subjects who served as control group. Diabetic patients were recruited from Internal Medicine Department in Al-Zahraa University Hospital during the period from February 2011 through November 2011. Diabetic patients were classified according to cardiovascular complications into 2 groups:
Group I: Included 25 diabetic patients with cardiovascular complications.
Group II: Included 25 diabetic patients without cardiovascular complications.
Patients with history of liver diseases, renal impairment and malignancy that interfere with angiopoiten-2 level and action were excluded from this study. All individuals were submitted to the following: Full medical history and clinical examination, Anthropometric measurement: Height and weight were measured by standard procedures to calculate body mass index (BMI), ECG and Echocardiography, Fasting blood glucose, Post prandial blood glucose, Hb A1c, liver function tests (ALT, AST, Albumin), kidney function tests (urea & creatinine), cardiac enzymes (CPK & CK-MB), lipid profile (cholesterol & triglycerides), insulin level and serum angiopoi-ten-2 level.
Results: In the present study, there is highly significant increase in serum Ang-2 level among all diabetic patients when compared to all healthy control groups. Also by com-parison between diabetic patients group I and diabetic patients group II regarding serum ang-2 level we demonstrated that more significant increase in ang-2 level in patients group I than patients group II.
Conclusion: The study concluded that angiopioten-2 serum level is higher in type 2 diabetic patients compared to control group and it increased in diabetic patients with car-diovascular complications more than diabetic patients without cardiovascular complications. Circulating Ang-2 could serve as a new marker of oxidative stress and vasculopathy.
/ 0
- Details
- Category: Vol. 80, June 2012
- Hits: 936
Cardiac Misconceptions and Patients' Point of View about Explanation of Medical Diagnosis and the Therapeutic Regimen,NAGWA R.A. GAD
Abstract
Aim of the Study: 1- To determine cardiac patients' mis-conceptions and the levels of cardiac patients' misconceptions in general and specific misconceptions related to certain cardiac diseases such as MI, Angina and heart failure. 2- To identify the cardiac patients' point of views about explanation of medical diagnosis, therapeutic regimen and their adherence to therapeutic regimen.
Subjects and Methods: Study design: The study design was descriptive study (qualitative). Setting: The study was conducted at Cardiology department including CCU, interme-diate unit and word rooms in Tanta Main University Hospital. Sample: A convenient sample of ninety (90) patients were collected and divided according to diagnosis as the following, thirty cardiac patients of any cardiac diseases and thirty angina patients, fifteen heart failure and fifteen MI patients. Tools: Four tools were used to collect data: Patient's views & generic misconception tool, York Angina beliefs questionnaires, Maeland and Havik scale to measure cardiac misconceptions among MI & Heart failure patient's misconceptions tool.
Results: In general, 60% of total the cardiac patients sample were female and 62.5% of them were with high level of misconceptions while male Patients' represents 40% of the total patients sample with 37.5% with high level of miscon-ceptions and 83.3%, 90% of patients were afraid to ask their doctors and nurses about specific symptoms respectively. Statistical significant difference was found between age, duration of illness, education level, time lapsed since care seeking, person encourage to care seeking and self perception of health status and misconceptions level respectively. High level of misconceptions was found in male patients suffered from myocardial infarction, angina and heart failure 76.9%, 70% and 46% respectively. While heart failure female patients were the highest level of misconceptions 53.5% the angina female patients were have the lowest levels of misconceptions. Conclusion and recommendations: The patients views that the information delivered was insufficient to help them to adhere to therapeutic regimen and they prefer to be offered by the physician this is reflect that the nursing education still in need to be enhanced to ameliorate this views of patients and to promote patients adherence/compliant to therapeutic regimen This study recommended that assessment of cardiac misconceptions must be done by nurses and doctors upon patient admission as a six vital signs, to prevent complications and readmission and decrease cost of care. Also the study recommended that tailoring the education to patients' level of understanding, specific learning needs & learning styles as well as taking into consideration patients' point of view when designing patients care plan.
/ 0
- Details
- Category: Vol. 79, June 2011
- Hits: 935
Design and Work Plan for Establishing a Standardized Patient (SP) Program at King Abdul- Aziz University: A "How to" Guide,LANA A. AL-SHAWWA and SARA K. HAGI
Abstract
One of the main objectives for establishing a Clinical Skills Center in King Abdul Aziz University Hospital (KAUH) is to teatch and train students and faculty members in the field of medicine to contribute to high quality health care service. The basis for establishing the Standardized Patient (SP) Based Instruction and Assessment Programs arises from:
1-Strategic Goals number (2), (7), (8), (10) and (11) set by the university.
2-Educational reform with reversion to the SPICES Model Curriculum.
3-The growing demand of innovative instruction and evalu-ation methods appropriate for delivering the new curriculum.
4-The mandate to develop competencies in terms of knowl-edge, skills and attitude, to smoothly and appropriately deliver the new curriculum.
Situation: The current status reveals that the Clinical Skill Center does not possess the facilities and manpower to initiate and implement the Standardized Patients Program (SP) in both teaching and testing strategies, and yet there is a great need to initiate and develop a Standardized Patient Based Instruction and Assessment Programs to be used in enhancing students, and faculty members, communication skills and examination skills.
Vision: Establishing a program for faculty members in KAUH and other health professions institutions all over the Kingdom of Saudi Arabia; who can participate in the devel-opment of Standardized Patients (SP) Based Instruction and Assessment Programs.
Mission: The Clinical Skills Center is committed to design a program that fosters interactive encounters between students, faculty members and standardized patients that promote the development and assessment of examination, interpersonal and communication skills thet are keys to successful practice.
Methodology: Stadardized Patient (SP) Based Instruction and Assessment Program is planned to be established by October 2010. Upon the agreement between King Abdul Aziz University and Illinois University in Chicago Illinois, USA, the Medical Education Department organized a fellowship program to take place during the month October 2009 in the United States of America. A group of faculty members was trained in the Graham CPC in Illinois University. Five faculty members: Two from Obstetrics and Gynecology Department, one from Pediatric Department, one from the Radiology Department and one from the Medical education Department joined the fellowship program as the first task force group. One Clinical Skills Center Technician was among the task force group. The SPs Fellowship Program at the GCPC pro-vided the theoretical knowledge and practical skills faculty members needed in order to design and implement the Stan-dardized Patient (SP) Based Instruction and Assessment programs in health professions education settings. This group is responsible to initiate, design and establish the SPs program. This group will also be responsible to recruit and train faculty members in the use and management of the SPs program in KAUH. This paper describes the steps necessary to implement an SP program at KAU integrated within the undergraduate curriculum. The suggested facility, manpower, and operational phases were designed specifically for this purpose.
/ 0
- Details
- Category: Vol. 77, June 2009
- Hits: 934
Ophthalmogenetic and Epidemiological Studies of Egyptian Children with Mental Retardation,AMIRA A. ABDEL AZEEM, MANAL H. ABU EL ELA, FATMA A. SOLIMAN and ADEL A. EL-DIN
Abstract
Background: Mental retardation (MR) is a congenital or early onset lifelong impairment of cognitive adaptive func-tioning or daily living skills. It is a serious and lifelong disability that places heavy demands on society and the health system. The prevalence of visual and ocular disorders in children with MR is high and can influence sensory-motor development and learning ability.
Purpose: Assessment of the genetic and epidemiologic aspects of mental retardation and clarifying the ocular and visual problems among mentally disabled children.
Subjects and Methods: A cross-sectional hospital based study was conducted, through a period of two years, included 190 children under 18 years of age with mild to profound intellectual disabilities who were diagnosed among 480 cases referred to the Genetic clinic, Research Institute of Ophthal-mology for genetic diagnosis and counseling. The definition of MR and the criteria for diagnosis were adopted from the World Health Organization (WHO) classification. The etiology of MR was specified by obtaining information about the personal and family history that included a three generation pedigree analysis, with special attention to the presence of similar cases, thorough clinical examination including complete neurological evaluation, chromosomal and other investigative studies. Ophthalmologic examination included visual acuity testing, ocular motility and examination of the external eye and anterior segment; cycloplegic refraction and fundus examination.
Results: One hundred and ninety patients representing 39.6% of the total examined cases in two years were classified etiologically into 6 groups. Specific causes were found in 161 cases (84.7%) and the etiology was unknown in 15.3% of children. Metabolic and chromosomal disorders comprised the most common etiological problems of the examined mentally retarded children in this study. The percentage of mild, moderate, severe and profound MR was 67.5%, 26%, 5.8% and 0.7%, respectively. Family history was positive in 34.7% of patients and autosomal recessive inheritance was the commonest mode of transmission (48.4%) that reflects the high percentage of consanguineous marriages among Egyptians. Microscopically visible chromosomal anomalies of intellectually disabled patients included 25 numerical and 11 structural aberrations. Errors of refraction and strabismus were the most common in children with chromosomal disorders
(24.7%) and (28.1%) respectively. While the highest percentage of optic atrophy, retinal dystrophy, microphthalmia, cataract and corneal opacities were diagnosed in children with meta-bolic disorders representing 76.2%, 93.3%, 38.5%, 50% and 80% of cases diagnosed in all categories respectively.
Conclusion: In this study, metabolic and chromosomal disorders represented the most common etiological problems among the examined mentally retarded children with the highest proportion of specific ocular and visual problems represented among them to the extent that the eye could be considered as a window for their diagnosis. In most cases, diagnosis will assist families in understanding the condition, its prognosis and recurrence risks; more epidemiological studies have to be undertaken to determine the magnitude of the problem and its pattern of distribution in our country. The results also emphasize the need for establishing an efficient system to provide regular ophthalmic care for children with mental retardation.
/ 0
- Details
- Category: Vol. 77, June 2009
- Hits: 931
Oral Thioctic Acid (a-Lipoic Acid) and Gabapentin as Co-adjuvants in Paraneoplastic Neuropathic Pain,ABEER H. EL-KHOULY
Abstract
Thioctic acid is a powerful antioxidant. Several studies indicate that oxidative stress play important role in nerve damage and neuropathy. Thioctic acid also controls NMDA receptors activity which are involved in hyperalgesia and allodynia in neuropathic pain. Gabapentin is a potent anticon-vulsant, which was considered as a first choice drug in man-agement of secondary neuropathic pain. This study was designed aiming to evaluate the role of oral thioctic acid or gabapentin or their combination as co-adjuvant to oral mor-phine in neuropathic cancer pain therapy. Forty five patients were randomized to one of three groups (n=15). The gabapentin group received oral gabapentin 1200 mg/day; the thioctic acid group received oral thioctic acid 600 mg 3 times daily and the combined group received both thioctic acid and gabapentin in the same prescribed doses in the previous two groups but together. Pain intensity was measured by Visual Analog Scale of pain (VAS) 10-cm line, allodynia area (in cm2) and severity of allodynia by VAS. Total oral morphine rescue analgesic per day and side effects were recorded. The decrease in VAS pain scores and severity of allodynia were more significant in the combined group than the other two groups at any measurement time (p<0.05). The reduction in allodynia area was up to 40% in the gabapentin group, 25% in thioctic acid group and 45% in the combined group. Patients of the com-bined group showed less daily consumption of morphine on days 14 and 28 (p=0.012, p=0.005) respectively. The incidence of headache and sedation was higher in the thioctic acid group, while the incidence of somnolence was higher in the gabapentin group. Side effects were tolerable in the combined group. We can conclude that thioctic acid and gabapentine as co-adjuvant to oral morphine significantly improved pain scores and allodynia in neuropathic pain.
/ 0
- Details
- Category: Vol. 79, September 2011
- Hits: 931
Hemodynamic Effects of Propofol Versus Midazolam in Mechanically Ventilated ICU Patients MAGED ABULMAGD, M.D.; TAMER FAHMY, M.D.; TAREK EL GOHARY, M.D. and MOAEMEN YEHIA, M.Sc.
Abstract
Objective: To compare the efficacy, hemodynamic effects, days on mechanical ventilation, ICU length of stay, ICU mortality, and the ICU cost of two commonly sedatives, propofol and midazolam in mechanically ventilated ICU patients.
Design: Randomized prospective study.
Setting: Department of Critical Care Medicine, Cairo University.
Patients: A total of 20 critically- ill patients with respira-tory failure and expected to require mechanical ventilation for more than 48 hours. Patients were randomly assigned to one of two groups, ten patients will receive intravenous infusion of propofol (group P), and the other group will receive intravenous infusion of midazolam (group M).
Interventions: None.
Measurements and Results: A total of 20 critically-ill patients with respiratory failure, expected to require mechanical ventilation for more than 48 hours were enrolled in our study. Base-line demographic data, Acute Physiology and Chronic Health Evaluation (APACHE IV) score, and the reason for admission to the intensive care unit were recorded for all patients. An intravenous infusion of either propofol or mida-zolam was administered by a physician-implemented protocol to achieve a target Riker’s Sedation-Agitation Scale [SAS], with a brief daily “wake-up”.
For hemodynamic assessment, a pulmonary artery catheter (PAC) was inserted in all patients. Compared to midazolam, propofol caused a significant reduction in both MAP (89.1±5,32 to 54,6±2,72, p<0.0001 vs 69,90±8,44 to 69,10±8,06, p: NS), and SVR (1889.76±990.2 to 1109.46±630.09, p<0.05 Vs 1579.58±598.84 to 1522.96±567.55, p: NS). There was no
Abbreviations:
APACHE IV: Acute Physiology and Chronic Health Evaluation IV.
MAP: Mean Arterial Pressure.
SVR : Systemic Vascular Resistance.
Correspondence to: Dr. Tarek El Gohary, The Department of Critical Care Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
significant difference between both groups in duration of mechanical ventilation (7.2±5.25 days in Group P versus 6.3±6.11 days in Group M, p: NS). Compared to midazolam, patients on propofol have significantly longer hospital stay. The overall ICU mortality was comparable in both groups (6 in group P Vs 5 in Group M, p: NS).
Conclusions: To achieve a target level of sedation in critically ill ventilated patients, MAP and SVR were signifi-cantly depressed with propofol infusion, but not with mida-zolam. In both groups, there was insignificant difference in days of mechanical ventilation or ICU mortality. Despite the less time for wake up in propofol group, the ICU cost for propofol sedation is significantly higher than midazolam.
/ 0
- Details
- Category: Vol. 77, December 2009
- Hits: 930
Assessment of Fetal Renal Volume Using Three-Dimensional Ultrasound and its Relation to Fetal Growth and Placental Blood Flow,OMNEYA HELAL, EMAN ZAIN, DALIA ABDALLA and HODA ABD EL-AAL
Abstract
Objective: Intrauterine growth restriction may lead to renal disease and hypertension in adult life. This study was performed to determine whether renal volume differs between fetuses that are intrauterine growth restricted and fetuses that are not. We also aimed to examine the association of fetal blood flow parameters, the amniotic fluid index with the fetal renal volume.
Patients and Methods: Fetal biometry was examined in 200 pregnant women between 27 and 36 weeks of gestation. Women were divided into two groups: mothers with intra-uterine growth restricted fetus (group A, n=17) and mothers within normal range fetal biometry i.e. control group (group B, n=183). In all participants, total renal volume was measured using 3D ultrasound and umbilical as well as the middle cerebral artery resistance index which was calculated using color Doppler technique. All measured parameters were compared to fetal growth state and correlated to the total renal volume.
Results: The mean total fetal renal volume was 10.26±2.62 in group A and 16.85±5.35 in group B. (p value <0.0001). Head circumference, abdominal circumference and estimated fetal weight were positively correlated with the total renal volume "TRV" in both groups "r=0.7, 0.72, 0.8 respectively in Gp A, and 0.7, 0.6, 0.7 respectively for Gp B, with a statistically significant p value for both groups". Umbilical artery resistance index was inversely correlated with the total renal volume in group A (r=-0.70, p<0.002). The middle cerebral artery resistance index did not show a significant correlation with the TRV in group A "r=0.37, p=0.2" in contrast to the control group where a significant negative correlation existed between the 2 parameters "r=-0.4, p=0.0001". The amniotic fluid index showed a positive correlation with the TRV in both groups "r=0.5, p=0.04 in Gp A, and r=0.2, p= 0.02 for Gp B".
Conclusion: Intrauterine growth restriction appears to be associated with a decrease in fetal renal volume. This study supports the hypothesis that intrauterine growth restriction may be linked to renal disease and hypertension in late life.
/ 0
- Details
- Category: Vol. 80, June 2012
- Hits: 929
The Diagnostic Value of Pleural Fluid Cytology in Benign and Malignant Pleural Effusions,SAMAR A. EL-SHEIKH
Abstract
In developing countries, where investigations and health facilities are inadequate and cost of treatment is unaffordable, cytological examination of body fluids is considered a cheap, rapid, and highly effective tool in identification of the etiology of effusion with prediction of the underlying disease. Cyto-logical examination can detect malignant cells in effusions and sometimes it's superior to biopsy in detecting serosal malignancy. Good clinical history, history of asbestos exposure, absence of other malignancy elsewhere in the body and radiologic findings are very important aids in confirmation of cytological diagnosis of malignancy. Sometimes, the definite diagnosis is not reached by cytology alone and the need for tissue biopsy or even other ancillary methods becomes man-datory. This work aimed at studying the different cytomor-phological features of pleural effusion samples in relation to other clinicopathological variables with special highlights on malignant cases in order to identify the role of cytology as an important diagnostic tool in cancer detection even before the clinical diagnosis. To perform this study, the slides of 606 cases of pleural effusion stained with H & E, Giemsa, and papanicolaou stains were collected from the archives of the Cytology Unit, Pathology Department, Faculty of Medicine, Cairo University, Kasr Al-Aini Hospitals, during the period from January 1, 2006 till December 31, 2010. The slides were revised and the results were statistically analysed. This study has found a statistical correlation between the clinical presen-tation and the cytological diagnosis. Also the relation between the gross appearance of effusion and the cytological diagnosis was statistically significant. In conclusion, these findings suggest that cytologic examination of pleural fluid is of great diagnostic value in both non-neoplastic and neoplastic effu-sions. Cytology also plays a central role in the etiological clarification of pleural effusion specially if good clinical data are available and sometimes it has an instructive significance in diagnosis of malignancy even before the clinical diagnosis.
/ 0
- Details
- Category: Vol. 78, March 2010
- Hits: 929
Descriptive Study of Intoxicated Cases Received at Emergency Department at Suez Canal University Hospital in Ismailia City,ALAA M. AL-KASSABI, NAHED M. MOSTFA, ABEER M. HAGRAS and AHMAD A. E. ABD EL GAWAD
Abstract
Objectives: The study aimed at investigating the epide-miology, clinical course, diagnosis, management and outcome of acute poisoning cases received to Emergency Department at Suez Canal University hospitals in Ismailia city.
Subject and Methods : This is descriptive study conducted at the Emergency Department at Suez Canal University Hos-pital in Ismailia city, Egypt in the period between July and December, 2007.
Results: The total number of cases was 70 in 6 months. The large number of cases was in age between 21-35 years. The mean age of the patients was 26.3 years. Accidental poisoning was the commonest mode of intoxication (accidental 81.4% intentional 17.6%). Ingestion was the most common route of exposure. Males were more common than females (62.9% males and females 37.1%).
Conclusion: Intoxication is a health problem in Ismailia governorate. There is a defect in registration of poisoning cases. Intoxication was common in adults. Food poisoning affected a large number of cases followed by medical poison-ing.
/ 0
- Details
- Category: Vol. 83, June 2015
- Hits: 928
The Use of Triangular Spreader Graft for Correction of Deviated Nasal Dorsum, USAMA ABD EL-NASEER, AHMED NASSAR, HASSAN EL-HOSHY and AHMED F. EL-DEHN
/ 0
- Details
- Category: Vol. 81, December 2013
- Hits: 928
Fatty Liver Disease among Adults in Southwestern Saudi Arabia, GHAZI A. ALSHUMRANI, KHALID A. SHAWKY, YAHIA I. ASSIRI, MOHAMMED A. ALGATHRADI, AHMED A. MAHFOUZ and OSSAMA A. MOSTAFA
Abstract
Background: Fatty liver may progress to steatohepatitis, which can lead to liver cirrhosis and hepatocellular carcinoma.
Objective: To assess the distribution of hepatic steatosis among adults in the Southwestern Saudi Arabia using unen-hanced CT scan.
Methods: This study was conducted at a tertiary care hospital in the Southwestern Saudi Arabia during the period from May to September 2012. Unenhanced CT scans of one hundred consecutive adult patients (76 men and 24 women) with no previously known liver disease were evaluated. Their age ranged from 19 to 77 years. They presented for the first time with suspected renal colic symptoms to the Outpatient Clinic or to the Emergency Department and, therefore, unen-hanced CT scans were performed to detect urinary stones. Several CT attenuation criteria to diagnose fatty liver disease were applied.
Results: The study included 100 adults with mean liver attenuation of 51.6±14.5 Hounsfield units. The proportion of patients with fatty liver ranged from 18% to 54%, based on different cut-off definitions of fatty liver disease. There were no statistically significant differences in the proportion of hepatic steatosis regarding gender and nationality. Comparison of proportions using the readings of overall liver, right lobe and left lobe densities showed no statistically significant differences.
Age range:
Conclusions: Fatty liver disease is high among adults in the Southwestern region of Saudi Arabia.
Recommendations: Raising awareness among health care professionals about fatty liver disease is necessary.
/ 0
- Details
- Category: Vol. 84, June 2016
- Hits: 926
Clinical Presentation and Risk Factors of Bronchial Asthma in Yemeni Children, ALI AL-ERYANI, AHMED AL-KHORASANI, NAJLA AL-SONBOLI and NASHER AL-AGHBARI
Abstract
Background: Asthma is a disorder defined by its clinical, physiological, and pathological characteristics. The predom-inant feature of the clinical history is episodic shortness of breath, particularly at night, often accompanied by cough. Wheezing appreciated on auscultation of the chest is the most common physical finding. The main physiological feature of asthma is episodic airway obstruction characterized by expir-atory airflow limitation. Factors influencing the development and expression of asthma includes host factors such as atopy, male gender and environmental factors such as tobacco smoke, airborne allergens, viral respiratory infections and the diet.
Objective: To explore the clinical profile and identify the risk factors for developing bronchial asthma among asthmatic children in comparison with age-matched healthy control group in Sana'a City.
Methods: It was a hospital based prospective case control study. The target population was children of an age group 5- 15 years in Sana'a, Yemen attending two referral pediatrics hospitals: Al-Sabeen for Maternity & Childhood and Al-Thawra General Modern Hospital. Data collection was for a period of 12 month. The cases were children with confirmed asthma of an age group of 5-15 years old, and the age matched controls were children without respiratory signs or symptoms and attending for day care surgery. The data was collected according to a structured questionnaire and the pulmonary function tests was conducted by using the Vitalgraph Spirotrac version 4.36 (UK). Analysis was conducted using Epi-info 2000-Version 1.02 programs.
Results: Fifty asthmatic children and 50 age matched (5- 15y) healthy controls were enrolled.
The mean (SD) age of asthmatic children was (8.54± 3.04) years and of the control group was (8.05±2.6). Recurrent wheeze, shortness of breath and nocturnal cough were the most frequent symptoms they were found in 50 (100%), 46 (92%) and 46 (92%) of the cases respectively. Wheeze and tachypnea were the most common physical signs 47 (94.0%) and 31 (62.0%). Univariate analysis showed that family history of asthma, family history of atopic disease, male gender, personal history of atopic disease, prematurity, early weaning, severe LRTI in early life, birth at winter season, low birth weight, and exclusive breast-feeding duration <4 months were all significant risk factors of childhood asthma. However the multivariate analysis showed that the independent risk factors for childhood asthma in a descending order of significance were: Positive family history of asthma, exclusive breast-feeding duration <4 months, history of atopic disease, low birth weight and prematurity.
Conclusion: Asthma can't always be prevented, but it is thought that early identification of children at high risk for asthma may improve their management. Some of the risk factors of childhood asthma are preventable such as respiratory infections in early life, lack of exclusive breast feeding and early weaning, thus permitting a possible reduction of the prevalence of asthma in children.
/ 0
- Details
- Category: Vol. 82, June 2014
- Hits: 926
Can Metformin Reduce Recurrence of Gestational Diabetes in Obese Women?, ASHRAF HAMDY, MOFEED FAWZY and MOHAMED A. MOHAMED
Abstract
Objective: To evaluate the efficacy of using metformin in pregnancy on prevention of recurrence of gestational diabetes in obese women.
Methods: This is a multicentric randomized non placebo clinical trial including 91 obese women with past history of GDM women in 2 groups. 44 women in intervention group used metformin therapy during the second trimester of preg-nancy compared to 47 women in control group. Screening test for GDM were performed to all women at 12-14 week and at 24-28 week gestation to detect cases with recurrent GDM.
Results: Women in the intervention group showed a signifi-cant lower rate of recurrence of GDM in the second pregnancy compared to women in the control group (18.1% vs 53.1%, OR=0.19, 95% CI=0.07–0.5, p<0.001).
Conclusion: Using metformin in the second trimester of pregnancy can effectively reduce the recurrence of GDM in obese women.
/ 0
- Details
- Category: Vol. 83, March 2015
- Hits: 923
The Effect of Intraoperative Fluid Mangement on Haemodynamics during Laparoscopic Radical Cystectomy, INAS F. ABDUL AAL, MAI W. ABDALLAH, ENAS M. SAMIR and NORHAN A. ALY
Abstract
Background: Prolonged pneumoperitoneum in laparoscop-ic radical cystectomy (LRC) leads to impairement in haemo-dynamics. This is manifested by increase in systemic vascular resistance, decrease in cardiac output and arrhythmias.
Aim of the Study: To determine whether intraoperative fluid management could prevent cardiovasvular changes from hazards of pneumoperitonuem in patients undergoing laparo-scopic radical cystectomy operations.
Study Design: Randomized controlled trial.
Methodology: Eighty patients with cancer bladder sched-uled for laparoscopic radical cystectomy, classified by the American Society of Anesthesiologist (ASA) to class (ASAII or ASAIII) were divided into 2 equal groups group I received 2ml/kg/hr LR (Lactated ringer), group II received 8ml/kg/hr LR. Both groups received 8ml/kg LR as a preload.
Results: No statistical significant difference was found in HR and MAP while there was statistical significant differ-ence in CVP after 180 minutes T6 (5.6±2.42 versus 7.1±2.73).
Conclusion: In patients undergoing laparoscopic radical cystectomy, intraoperative infusion of 8ml/kg/hr Lactated Ringer could maintain haemodynamic stability without causing pulmonary edema or volume overload compared to low volume infusion of 2ml/kg/hr Lactated Ringer.
/ 0
- Details
- Category: Vol. 83, June 2015
- Hits: 921
Effect of Focused Ultrasound Cavitation on Cholesterol in Prehypertensive Centrally Obese Men, MOSAAB R. AL-SAID, KARIM A. FATHY and EMAN K. FAHMY
/ 0
- Details
- Category: Vol. 80, March 2012
- Hits: 918
Contrast Enhanced Digital Mammography: Does it Add to Conventional Mammography?,NOHA ABDELSHAFY ELSAID and AMIRA RAAFAT
Abstract
Background: Contrast Enhanced Digital Mammography (CEDM) is a recent development of digital mammography using the intra-venous injection of an iodinated contrast agent in conjunction with a mammography examination. CEDM should result in a simple way to enhance the detection and the characterization of breast lesions especially in dense breasts.
Aim of Work: To investigate the potential of using intra-venous contrast material with full-field digital mammography to facilitate the detection and characterization of lesions in the breast.
Subjects and Methods: The study included 26 Egyptian patients (Age ranged from 37 to 62 years, mean = 49.5 years) who came to the National Cancer Institute presenting by breast lump or coming for follow-up after treatment or for screening (high risk patient). They underwent both conventional mam-mography and high energy post contrast digital mammography.
Results: The cases presented were 13 malignant and 4 benign, the malignant lesions were 10 intra ductal carcinoma (IDC) and 3 lobular carcinoma (from them five post chemo-therapy cases) and the benign lesions were 3 fibroadenomas and one papilloma). One IDC case showed also fibroadenoma. Three cases showed just areas of architectural distortion, two cases presented by breast lumps in a dense breast and proved to be simple cysts, and five cases with post operative paren-chymal distortion showed no recurrent masses.
Conclusion: Dual-energy contrast-enhanced digital mam-mography is a useful technique in identification of lesions in mammographically dense breasts and capable of demonstrating lesions that are not visible at standard mammography.
CEDM is useful in follow-up of cases after surgery and monitoring lesion size after chemotherapy.
/ 0
- Details
- Category: Vol. 77, June 2009
- Hits: 918
Variable Depth Arcuate Astigmatic Keratotomy in Kerato – Lenticulo – Plasty, MAHMOUD M. GAMAL
Abstract
The purpose of this study was to introduce and evaluate the a new concept in surgical correction of preexisting corneal astigmatism (PEA) by using the variable depth dependent arcuate astigmatic keratotomy (AK) combined with 3.2mm clear corneal cataract incision (CCI) for cataract surgery.
Subjects and Methods: Arcuate AK was performed on 17 eyes of 15 patients for correction of low and moderate levels of regular corneal PEA. All procedures were performed by the same surgeon. The preoperative astigmatism ranged from one to 4.5 diopters (D) (means 2.12±1.31). They were divided into three sub groups; Group 1 (included 6 patients with PEA of <1.25 D), Group 2 (included 5 patients with PEA between 2.00 and 1.25D) and group 3 (included 6 patients with PEA >2.25D). The size of the optical zone (7mm) and the number, and lengths of the transverse incisions (one pair of 90º arc) were constant. The intended depth of the arcuate AK was varied according to the level of attempted preoperative astig-matism correction. The primary outcome measures included preoperative and postoperative manifest refraction. The sec-ondary outcome measures were: Visual outcome [unaided and best-corrected visual acuity (UAVA, BCVA)] and any compli-cations.
Results: The results were evaluated using both simple analysis and vector analysis methods. Patients were seen on the first postoperative day and thereafter at 1st month and 3rd month. One pair of AK cuts, at the 7.0mm optical zone, with a depth of 60% of the local corneal thickness produced an astigmatic correction of 0.46 D. The pair at 70% depth pro-duced astigmatic correction of 0.75D and the AK cuts at 80% produced correction of 1.83D. The elimination of spherical error was recorded in 92.8% of cases. After surgery, astigma-tism was reduced to a mean of 1.15D (range 0 to 2.25D). The mean decrease in astigmatism was 1.03D. The mean of axis shift was 6.58±18.18D. The difference between the achieved axis and the desired axis was less than 10º in 70% of the cases and less than 20º in 90% of the cases. None of the cases showed any reduction in the BCVA.
Conclusion: Results indicated that PEA in cataract cases can be corrected, or at least, effectively reduced by variable depth transverse arcuate AK simultaneously with CCI. Pre-dictable results can be achieved with this technique. A sim-plified nomogram is included.
/ 0
- Details
- Category: Vol. 77, March 2009
- Hits: 918
Comparison of the Effect of Caudal Ropivacaine, Ropivacaine-Clonidine and Ropivacaine- Magnesium on Postoperative Analgesia and Stress Response in Children,SAHAR ELSHAL, KARIM KAMAL, SAHAR BADAWI and MOHAMAD ABDELHAMID
Abstract
Background: Caudal analgesia is widely used for various surgical procedures in children. In order to decrease intra and postoperative analgesic requirements after caudal blockade, various additives can be added with local anesthetics.
Objective: The aim of this study was to compare the efficacy of pre-emptive caudal blockade using ropivacaine 0.25% alone or combined with clonidine, or magnesium sulfate-on stress response and postoperative pain relief in children.
Methods: We performed a prospective, randomized study on 60 children, aged 4-10 years, undergoing hypospadius surgery. Patients were randomly assigned into three groups to receive either caudal ropivacaine alone (group R), caudal ropivacaine + clonidine (group RC) or caudal ropivacaine + magnesium sulfate (group RM) prior to a standardized sevof-lurane anesthetic. Postoperative pain and analgesic require-ments, postoperative sedation, catecholamines plasma levels, as well as hemodynamic parameters were compared among the three groups.
Results: Group RC had significantly lower objective pain scale (OPS) scores than group R & group RM in the first six postoperative hours. Fewer patients in group RC required postoperative analgesics than in groups R & RM. The time to 1st analgesic dose & number of analgesic doses in each group were significantly less in group RC than in groups R & RM. The sedation score was significantly higher only during the first 2 postoperative hours in group RC than groups R & RM. There was a significant decrease in the mean values of plasma epinephrine (E) and norepinephrine (NE) at the end of surgery and 1 hour after recovery compared to pre-block values in all groups.
Conclusion: The addition of clonidine to ropivacaine 0.25% significantly increases the duration of caudal analgesia and decreases postoperative analgesic requirements in children. The addition of magnesium to ropivacaine is comparable to the effect of ropivacaine alone. Caudal analgesia resulted in a significant reduction in catecholamine levels.
/ 0
- Details
- Category: Vol. 78, June 2010
- Hits: 916
The Partograph: Knowledge, Attitude, and Utilization by Professional Birth Attendances in Port-Said and Ismailia Cities,NAGAT S. SALAMA, INAS M. ABD ALLAH and MANAR F. HEEBA
Abstract
The partograph has been proven to be the single most important tool that when effectively used, any deviations from normal can be quickly detected and actions taken in good time. The aims of this study were to assess the existing knowledge, attitude and practice of professional birth attendants (PBAs) (Nurses/Physicians) regarding the use of partograph as well as to explore the factors limiting its use in the Health Centers and District Hospitals in Port-Said and Ismailia cities. A cross sectional descriptive study was conducted on 103 professional birth attendances (Nurses and Physicians). Two tools were used to collect the data named self administered questionnaire, was used to collect the necessary data in relation to the PBAs' knowledge and attitude toward partograph and revision audit to evaluate the accuracy of recording data on partograph. Results of the study revealed that the majority of nurses (91.3%) had an unsatisfactory score of knowledge regarding using of partograph, while more than half of phy-sicians (55.9%) had a satisfactory score. The great majority of PBAs either physicians or nurses (97.1%, 91.3% respec-tively) had positive attitude toward partograph. Regarding the actual use of partograph, about two third of physicians and one fifth of the nurses, reported that they may use the partograph to manage a selected cases. The absence of obli-gation from health settings policy to perform the partograph was the most reason that limits its utilization as described by PBAs. In relation to the PBAs' accuracy in recording and plotted the data on partographs, there were incomplete and poor monitoring of parameters on the partograph against the recommended standards; that reflects poor skills of birth attendances on the use of a partograph. It recommended supporting usage of partograph in all institutions where women go for delivery services, and training all birth attendances on the use of the partograph and enforcing its use.
/ 0
- Details
- Category: Vol. 79, December 2011
- Hits: 914
A Levonorgestrel-Releasing Intrauterine System for the Treatment of Idiopathic Menorrhagia,MOHAMED ABD ELZAHER, ASHRAF MOAWAD and HANAA ABU-RIA
Abstract
Objective: To determine whether the levonorgestrel-releasing intrauterine system can safely reduce menstrual blood loss and improve quality of life in patients with idiopathic menorrhagia.
Study Design: Prospective Multicentre study.
Setting: Obstetrics and Gynecology Departments (King Khalid University Hospital-KSA, Enjab Hospital for infertility-UAE and Gulf Medical College and Research Centre-UAE).
Patient (s): Forty patients with MBL over 80ml.
Intervention (s): Insertion of the LNG-IUS on cycle days 5-7 and follow-up at 6-month intervals for 3 years.
Main Outcome Measure (s): Measurement of MBL, serum ferritin, and hemoglobin for evaluation of efficacy of treatment.
Result (s): A significant reduction of MBL to 36.3mL (77.9% decrease), 30.5mL (81.7% decrease), 7.9mL (95.3% decrease), and 23.5mL (85.7% decrease) at 6,12,24, and 36 months, respectively. After 6 months, one-fourth of the patients experienced amenorrhea, and one-third, spotting. Hemoglobin increased significantly from 12.2g/dl pre insertion to 13.4g/dl after 36 months, while serum ferritin levels increased signif-icantly from 21.9ng/mL before insertion to 92.8ng/mL after 36 months.
Conclusion (s): The LNG IUS was associated with a profound reduction in menstrual blood loss and the increase in hemoglobin and serum ferritin levels in the treatment of idiopathic menorrhagia.
/ 0
- Details
- Category: Vol. 78, December 2010
- Hits: 914
Vestibular Evoked Myogenic Potentials (VEMP) in Conductive Hearing Loss,MOUSTAFA M. EL-KHOUSHT, NOHA A. HOSSNI, SHERENE M. EL-ABD and AMIRA M. EL-SHENAWY
Abstract
Background: Conductive hearing loss is one of the com-monest diseases that result from a multitude of causes. VEMP is one of the tools used to test the vestibular system. Sound elicited VEMP require an intact conductive system. To over-come the conductive element, stimulation could be performed by bone conduction.
Aim: This study tries to clarify the effect of bone conduc-tion stimulation on VEMP response.
Method: Twenty patients with chronic suppurative otitis media and conductive hearing loss were examined as well as 10 healthy individuals as a control group. All of them had pure tone audiometry for air conduction and bone conduction as well as VEMP by air conduction and bone conduction.
Results: It was found that 75% had VEMP to bone con-duction stimulation while 25% had VEMP to air conduction stimulation.
Conclusion: VEMP can be used to test the presence of a conductive hearing loss as bone conduction VEMP can be elicited with higher degree of accuracy.
/ 1
- Details
- Category: Vol. 80, June 2012
- Hits: 910
Case Report: Optic Neuritis in Childhood May Be an Early Presentation of Alarming Disease Acute Disseminated Encephalomyelitis,MANSOUR Y. OTAIF, AHMED AL-JARIE, ALI M. ALSUHEEL, AYED A. SHATI, MUHAMMAD RAFIQUE and SAMY A. DAWOOD
Abstract
We are reporting a 5-year old girl with isolated acute visual loss related to a bilateral edematous optic neuropathy after an episode of viral illness. MRI brain showed bilateral, multiple sub-cortical hyper-intense lesions indicating white matter disease, acute disseminated encephalomyelitis (ADEM) with bilateral optic neuritis. Treatment with pulse steroids resulted in favorable visual recovery. After 4 weeks follow -up, MRI images showed complete resolution of sub-cortical pathology. Bilateral isolated optic neuritis in childhood may be the only presenting symptom in ADEM which requires proper evaluation and early therapeutic management. Up to our knowledge, this case is the first reported case in Saudi Arabia having this presentation.
/ 0
- Details
- Category: Vol. 83, December 2015
- Hits: 909
Corneal Thickness Changes after Collagen Cross Linking in Keratoconus, RASHA A. ABD ELGHAFAR, AMR S. ABD EL-HAKIM, TAREK A. KATAMESH and HEBA M. AHMED
/ 0
- Details
- Category: Vol. 77, December 2009
- Hits: 904
B Lymphocyte Stimulator (BLyS) Overexpression in Patients with Systemic Lupus Erythematosus, DINA R. BAHGAT, RASHA E. GHEITH and OLFAT SHAKER
Abstract
Members of the tumour necrosis factor (TNF) family induce pleiotropic biological responses, including cell growth, differentiation and even death. B lymphocyte stimulator (BLyS), a member of the tumour necrosis factor (TNF) super-family, is a cytokine that induces B-cell survival, expansion, and differentiation both in vitro and in vivo. Considerable evidence points to a role for (BLyS) overproduction in murine and human Systemic Lupus Erythematosus (SLE). Increased levels of BLyS mRNA correlates well with biologic and clinical sequelae of BLyS overexpression.
Aim of Work: To assess the level of mRNA BLyS in systemic lupus erythematosus patients and correlate it to clinical and laboratory features of the disease.
Material and Methods: Thirty SLE patients and ten age-and sex-matched healthy individuals were enrolled in the study. Blood samples from patients and controls were subjected to the following: Detection of BLyS mRNA expression by reverse transcriptase-polymerase chain reaction (RT-PCR) method, followed by semiquantitation of their levels by comparing levels of BLyS mRNA to ß-actin mRNA levels using densitometric analysis.
Results: The mean intensity of full-length BLyS mRNA expression was significantly higher in SLE patients when compared to the control group (p<0.001). Elevated BLyS mRNA in SLE patients are significantly associated with disease activity as they are statistically correlated with SLE disease activity index (SLEDAI) score. BLys mRNA levels were closely associated with serum anti-dsDNA levels and are not correlated to percentage of leucocyte lineages in the patients’ peripheral blood samples, denoting that among SLE patients, the elevated levels of BLyS mRNA are not related to percentage of myeloid lineage, they are expressed from.
Conclusion: BLyS mRNA levels may be a helpful biom-arker in the clinical monitoring of SLE patients. These findings also reinforces the rationale underlying clinical trials with BLyS antagonists in SLE.
/ 0
- Details
- Category: Vol. 82, December 2014
- Hits: 903
The Impact of Non-Clinical Factors on the Rate of Caesarean Section in Egypt, MOHAMED M. FARGHALI, AHMED R. RASHED, HESHAM FATHI, AMGAD M. MOUSTAFA and WALAA S. ABDEL RAHMAN
Abstract
Objective: Caesarean section (CS) rates have been in-creasing worldwide. The objective of our study was to inves-tigate the factors indicating CS in two major hospitals in Cairo, Egypt, and to assess the impact of non-clinical factors such as physician convenience and the patient’s socioeconomic status on the rate of CS deliveries.
Study Design: Prospective cross-sectional study.
Methods: Demographic, socioeconomic and medical information of all C.S deliveries, between 01/01/09 and 31/05/09, were prospectively analyzed (n=2544).
Results: The overall rate of CS was worryingly high at 36.7%. The CS rate in the teaching hospital was 35.2% (n=2274), while the CS rate in the military (non-teaching) hospital was 57.6% (n=270). The indications for the caesarean sections were classified as reasonable (1381 women, 54.2%) and unreasonable (1163 women, 45.7%). The commonest indications in the reasonable C.S group were previous >!2 C.S (18%), malpresentations (8%), failed labor progress (7.43%), antepartum hemorrhage (4.5%). The commonest indications in the unreasonable C.S group were previous C.S with no trial of scar (20%), severe preeclampsia (4.5%) and poorly defined fetal distress (3%).
Conclusions: Factors as young age, low parity, low edu-cational level, high monthly income, induced labor, delivery in private sectors and time of delivery (midnight to 8am) played significant roles in increasing the rate of unreasonable (poorly justified) C. S. The results of this study lend support to the hypothesis that physicians are motivated to perform CS for social, financial and convenience incentives.
/ 0
- Details
- Category: Vol. 79, June 2011
- Hits: 899
Comparison of Stromal CD10 Expression in Benign, Borderline and Malignant Phyllodes Tumors,WAEL S. IBRAHIM
Abstract
Phyllodes tumors are group of biphasic fibroepithelial tumors of the breast of varying malignant potential, ranging from benign tumors to fully malignant sarcomas. According to the Egyptian National Cancer Institute, female malignant cases showed appreciable increase in the recent time period for breast cancer with the malignant phyllodes tumors repre-senting 0.41% of cases in the year 2003-2004. This is an immunohistochemical study to compare CD10 expression in benign, borderline and malignant phyllodes tumors, in order to highlight its diagnostic and prognostic values. This study conducted 34 Egyptian female cases of phyllodes tumors of different grades to be studied histologically and immunohis-tochemically using antibodies against CD10. The Chi square test was used to determine differences in CD10 expression between benign, borderline and malignant tumors. One way ANOVA test was used to determine whether the difference was significant. Significance was established at p<0.05. In the 24 cases of benign phyllodes tumors, only 4 cases (16.7%) showed positive CD10 reactivity. Three cases (60%) out of 5 borderline phyllodes tumors showed positive CD 10 reactivity, while 4 (80%) out of 5 cases of malignant phyllodes tumors showed positive CD10 staining. In conclusion, from these highly significant results this study suggests that there is a strong correlation between CD 10 expression and tumor grade, which could be an important observation that may have both diagnostic and prognostic implications as well as promising potential target for development of novel therapies.
/ 0
- Details
- Category: Vol. 77, March 2009
- Hits: 899
The Changes Induced in the Electrical and Magnetic Properties of Hemoglobin in Patients Suffered from Iron Deficiency Anemia,SAMIR W. AZIZ, BASSEM M. RAFAAT, ATEF M. MAHMOUD and AHMAD EL-HEFNAWY
Abstract
The present study was conducted to sixty children (38 male and 22 female) with an average age eight years. Hemo-globin (Hb) was used to assess anemia. Iron deficiency anemic children were determined in a convenience sample of children aged 12-36 month from low-income families who were at-tending the out-patient clinic of Kasr Al-Aini hospital with iron deficiency anemia (IDA). Twenty normal children were chosen as a control group. This study aimed to evaluate the changes induced in the electrical and magnetic properties of Hb in IDA. Oscillator strength, magnetic susceptibility, electrical conductivity, concentrations of some trace elements (Zn, Cu, Fe, Pb and Ph), serum ferritin, transferrin and adenosine triphosphate (ATP) as well as superoxide dismutase (SOD) activity were measured. Results showed increase in hemoglobin electrical conductivity, serum ferritin either in male or female and concentrations of cupper and phosphorus. An increase in the molar magnetic susceptibility of Hb of the IDA patients was observed, when compared to control subjects. ATP, serum transferrin and iron concentrations were decreased in IDA patients. It was concluded that iron deficiency anemia affect the spin state of heme iron and the tertiary structure of hemoglobin and altering the hydrophobic/hydrophilic ratio on the hemoglobin molecule surface.
/ 0
- Details
- Category: Vol. 83, March 2015
- Hits: 898
Intralenticular Ceramic Foreign Body: A Case Report, SAMIR H. KHAIRALLAH
Abstract
We are reporting a 25-year-old male, Egyptian ceramic worker, who presented to the Emergency Department of King Fahad University Hospital in Khobar, Saudi Arabia with a history of a ceramic piece which struck his right eye while working two days earlier. To our knowledge, this is the first case in literature, reporting an intralenticular ceramic foreign body.
/ 0
- Details
- Category: Vol. 77, June 2009
- Hits: 898
Benefit of the Left Ventricular Repair During Coronary Revascularization in Dilated Ischemic Cardiomyopathy,WALID SHAKER, MOSAAD A. ABOUALNASR and HAZEM M. ZAKI
Abstract
Objectives: Studying the outcome of the addition of the left surgical ventricular restoration (SVR) to CABG compared to isolated CABG after a time interval from 6 to 24 months from the initial operation. We adopted in this research, the DOR repair using the Endoventricular circular patch to restore the ventricular shape after excision of the scar tissues.
Methods: We collected from our database 32 coronary patients operated between 2005 and 2008. These patients were presented with poor LV function, EF <30%, dilated LV di-mension with a LV end diastolic diameter (LVedD) >6 cm. All the 32 patients had left heart catheterization, left ventri-clography, nuclear scanning for viability and function. TEE was done to evaluate the wall motion, function, degree of mitral regurgitation, and LV dimensions including LVesD and LVedD. 14 of these patients (group A) had DOR repair during the coronary revascularization. 18 patients (group B) had only coronary revascularization without DOR repair and represent the control group. The patients in the 2 groups were assessed in a time interval ranging between 6 and 24 months [average 15 months] from the initial operation. Mortality, morbidity and symptoms of heart failure were compared in both groups. LV function, LV geometry were assessed by TEE and Cine MRI. Results related to the findings were compared statistically with a p value <0.05 considered to be significant. All values were calculated as mean ± SD.
Results: The operative data showed no difference between the 2 groups. The average number of grafts was 3±1 and 3± 0.8 respectively in group A and B. Mitral repair was done in 6 cases in group A and 4 cases in group B. No operative mortality in both groups. The post operative IABP was used in 2 patients in group A and were started before surgery to stabilize the patient hemodynamic. In group B, 4 patients needed IABP for post operative cardiac support. The post operative data collection was done over a time interval from 6 to 24 months after the initial operation [average 15 months]. these data showed significant improvement of the LV function and reduction of the LVedV in group A with the DOR repair. Only 1/14, (7%) patient had signs of congestive heart failure compared to 6/18, (33.3%) patients in group B who received only coronary revascularization. Rehospitalisation was needed for 2/18, (11.1%) patients in group B for signs of heart failure. Persistent moderate mitral regurgitation occurred in 2/18, (11%) cases in group B. One case of late mortality, 18 months after the initial surgery occurred in group B. The Cause was not identified.
Conclusion: DOR ventricular repair associated with coronary revascularisation in patient with dilated ischemic cardiomyopathy could improve the ventricular function and decrease morbidity, mortality, incidence of heart failure and rehospitalisation in this high risk group of patient.
/ 0
- Details
- Category: Vol. 78, March 2010
- Hits: 895
Relationships of Ghrelin and Adiponectin Levels to Menstrual Disorders in Female Athletes, ELHAM S. MAREI, AZZA A. MOHAMMAD, MOHAMAD A. DIAB and ALIA A. GAD
Abstract
Both ghrelin and adiponectin are related to energy balance that regulates food intake.
Objective: The aim of the present study was to explore whether ghrelin and adiponectin would be linked to menstrual disorders in athletic females.
Subjects and Methods: A total of 40 athletic girls, ages 13-21 yr, including 15 with amenorrhea (AA), fifteen eumen-orrheic athletes (Eu A) with regular menstruation and 10 non athletic served as controls. Fasting blood was drawn for assay of peripheral hormones including active ghrelin, adiponectin, sex hormone binding globulin (SHBG), estradiol (E2) and testosterone using ELISA.
Results: Amenorrheic girls had significantly lower body mass index than controls (p<0.05), and were strongly positively correlated to gonadal steroid levels (p<0.001). Both ghrelin and adiponectin levels were significantly higher in AA than Eu A and control groups (p<0.05).
Conclusions: Body mass index is a positive predictor to gonadal steroids. Higher ghrelin and adiponectin levels in AA compared with normal menstruating athletic females, and their associations with low gonadal steroids might explain menstrual disorders among athletics.
/ 0
- Details
- Category: Vol. 78, March 2010
- Hits: 893
Effect of Statin Therapy in Early Sepsis: Effect on Endothelial Function and Prognostic Implication, HAZEM EL-AKABAWY, HANAN ZAGHLA, NAEL SAMER and ABD EL-RAOF
Abstract
Background: Sepsis, defined as the systemic inflammatory response syndrome that occurs during infection, is generally viewed as a disease aggravated by the inappropriate immune response encountered in the affected individual. HMG-CoA reductase inhibitors are potentially powerful inhibitors of the inflammatory process by a lipid independent mechanism as they are not related to lowering LDL cholesterol.
Purpose: To determine efficacy and safety of the new regimen of Atorvastatin as an adjunctive line of treatment in early sepsis as well as its effect on endothelial function and in modifying the inflammatory markers.
Methods: A total of 50 patients with early sepsis were alternatively randomized to statin group (25 patients) and received (Atorvastatin 80mg/day for 4 consecutive days, plus conventional sepsis treatment) or control group (25 patients) and received only conventional sepsis treatment and followed by: Inflammatory markers (CRP and PCT), Nitric oxide metabolites, Severity of illness as indicated by SOFA score monitoring and need for organ supportive measures, Length of ICU stay, 28 day mortality and final outcome and ALT, AST and CPK to assure the safety of statins in early sepsis.
Results:
•The mean level of CRP and PCT at day 4 significantly reduced in statin group than in control group (p value = 0.007, 0.001 respectively).
•The mean level of Nox metabolites at day 4 nonsignificantly reduced in statin group compared to control group (p value = 0.1).
•The short term high intensity Atorvastatin therapy reduce nonsignificantly the total cholesterol level at day 4 (p value = 0.1).
•The short term high intensity Atorvastatin therapy signifi-cantly reduce the development of severe sepsis as indicated by reduction of Mean SOFA score and Highest SOFA score; (p value = 0.038 and 0.043 respectively).
•The short term high intensity Atorvastatin therapy signifi-cantly reduce the need for vasopressor use in the course of sepsis (p value = 0.001) and also reduce the need for me-chanical ventilation (p value = 0.044).
•The short term high intensity Atorvastatin therapy nonsig-nificantly reduce the length of ICU stay (p value = 0.25) and 28 day mortality (p value = 0.26).
•The short term high intensity Atorvastatin therapy are safe to be used in early sepsis regarding their effect on liver and muscle enzymes.
Conclusion: The use of a short term high intensity Ator-vastatin therapy in patient with early sepsis seems to be safe and associated with promising effects on inflammatory cascade and endothelial function reflected clinically by its effect on clinical course and mortality from sepsis.
/ 0
- Details
- Category: Vol. 79, December 2011
- Hits: 892
A Study on the Effect of Sildenafil Citrate on Acute Renal Ischemic-Reperfusion Injury in Male Rats,HASSAN M. EISSA, NAHED S. MOHAMED, MONA M. MOUSA and SUZAN ALBERT
Abstract
Several studies suggest that acute ischemia reperfusion (IR) of the kidney results in deterioration of its performance resulting in bad outcome of kidney transplantation operations and major operations in which the kidneys are exposed to acute ischemia reperfusion.
The present study was designed to investigate if sildenafil citrate (SC) has a protective role in renal I/R injury and to study its possible mechanisms of action in rats by inducing bilateral renal ischemia followed by one hour reperfusion and measurement of serum creatinine, blood urea nitrogen and nitric oxide (NO) level in renal tissues. 60 rats were used & were subjected to sham operated (control group-1), 50min renal ischemia (group-2), ischemia for 50 minutes then rep-erfusion for 2 hours (group-3), SC (1mg/kg orally) + sham operated group (group-4). Ischemia of the kidneys for 50 minutes, one hour after SC oral treatment (Group 5), I/R of the kidneys, one hour after SC oral treatment (Group 6).
Results: The study documented that I/R resulted in a significant increase (p<0.05) in the serum creatinine, blood urea nitrogen levels, rat tail systolic blood pressure and a significant decrease (p<0.05) in NO level in renal tissues.
SC prophylactic treatment resulted in partial reversal of measured parameters compared to the groups untreated with the same drug. There was a significant decrease (p<0.05) in serum creatinine, blood urea nitrogen and a significant increase (p<0.05) in NO level in renal tissues in I/R after SC prophy-lactic treatment compared to the groups untreated with the same drug.
It can be concluded from this study that renal I/R resulted in deterioration of renal function, elevation of systolic blood pressure and decreased NO level in renal tissues. SC provided a partially protective role against renal I/R injury as after prophylactic treatment with SC kidney functions were ame-liorated and the level of NO in kidney tissue increased sug-gesting that this protective effect of SC may be mediated through NO. However, there was no significant difference in rat tail systolic blood pressure after SC prophylactic treatment suggesting that this drug has no significant secondary systemic effects.
/ 0
- Details
- Category: Vol. 83, June 2015
- Hits: 891
Predictive Value of Phosphorylated Neurofilament H as A Marker of Brain Injury after Cardiac Arrest, MOHAMMED S. MOHAMMED, SAMEH K. EL-MARAGHI, NAEL SAMIR, and HAMDY M. SABER
/ 0
- Details
- Category: Vol. 83, June 2015
- Hits: 888
Assessment of Carcinoembryonic Antigen-Related Cell Adhesion Molecules (CEACAM6) in Pancreatic Ductal Adenocarcinoma, A Combined Serum and Immunohistochemical Study, MOSTAFA M. AMER, GHADA A. ABD EL-FATTAH, MOHEBAT H. GOUDA, RASHA M. EL-SAWI, EBADA M. SAEED and AHMED ZEEDAN
/ 0
- Details
- Category: Vol. 83, March 2015
- Hits: 888
Preserved Prostaglandin Analog and Ocular Surface Disorders in Open-Angle Glaucoma, AYMAN M. SHEHATA
Abstract
Purpose: Long-term use of topical ocular medications may affect ocular surface health. Purpose of this study was to evaluate the influence of BAK-preserved prostaglandin analog (bimatoprost 0.03%) treatment on the ocular surface health in patients with newly diagnosed POAG.
Methods: 40 newly diagnosed POAG patients were in-cluded in this prospective study. Intraocular pressure (IOP), tear break-up time (TBUT), and ocular surface disease index (OSDI) were assessed at baseline and 3-month after starting treatment with BAK-preserved bimatoprost 0.03% ophthalmic solution.
Results: IOP decreased in all patients from baseline to 3- month final visit (24.70±1.65mmHg versus 15.68±1.68mmHg). Mean TBUT decreased from 10.71±1.85 seconds at baseline to 7.25±1.21 seconds at 3-month final visit (p<0.001). Mean OSDI score increased from 31.63±18.48 to 44.41±16.48 (p<0.001).
Conclusions: BAK-preserved bimatoprost 0.03% is an effective medication in newly diagnosed POAG patients, but its long-term use may negatively influence ocular surface health by disrupting the tear film stability.
/ 0
- Details
- Category: Vol. 80, June 2012
- Hits: 886
Age at Onset and the Risk of Proliferative Retinopathy in Type 1 Egyptian Diabetic Patients,MOHSEN KHALID, ALI H. SAAD and MOHAMED H. MAHFOUZ
Abstract
Background: Growing evidence suggests that the age at onset of diabetes may influence the development of prolifer-ative retinopathy in type 1 diabetic patients.
Aim of Work: This study was designed to evaluate how the age at onset of type 1 diabetes influences the long-term risk of proliferative retinopathy in Egyptian patients with type 1 diabetes.
Subjects and Methods: This study included 115 type 1 Egyptian diabetic patients (64 females, 51 males) attending the outpatient clinics of NIDE and 50 normal controls. Blood pressure, waist circumference, BMI, FBS, HBA1c, lipid profile, urea, creatinine, uric acid and microalbuminurea were measured. Fundus examination, chest X-ray and ECG were performed for all subjects and echocardiography was done when indicated.
Results: 46.1 % of of patients with type 1 diabetes included in the study had no diabetic retinopathy. Non proliferative diabetic retinopathy was found in 32.2% of patients, while proliferative retinopathy was found in 21.7% of patients. There was a highly significant statistical difference among the studied patients regarding systolic and diastolic blood pressure, fasting plasma glucose, HBA1c, microalbuminurea and duration of diabetes being higher in patients having proliferative retinopathy, than patients having non proliferative retinopathy, being lower in patients with no diabetic retinop-athy. when we compared patients included in the study ac-cording to the age at onset of type 1 diabetes; there was a high statistical difference among the studied patients being higher in patients with age at onset between 5 and 14 years of age (27.5%) than patients with age at onset >!14 years (15.1%), being lower in patients with age at onset between 0 and 4 years (7.7%).
Conclusion: The highest risk was in age at onset 5-14 years, whereas the lowest risk was in age at onset 0-4 years.
/ 0
- Details
- Category: Vol. 78, September 2010
- Hits: 885
Circumareolar Inferior Pedicle Mammaplasty for Treatment of Gynecomastia with Breast Ptosis,ABD EL-NASER EL-NAGAR
Abstract
Gynecomastia is a benign enlargement of the male breast due to physiological or pathological factor that interferes with the balance between estrogens and androgens in the serum. Gynecomastia itself requires no treatment unless the persistant enlargement of the male breast is a source of embarrassment and/or distress for the adolescent or adult man. Indications for surgical treatment of gynecomastia are founded on two main objectives: (1) Restoration of male chest shape and (2) diagnostic evaluation of suspected breast lesions. The diagnosis begins with an adequate history and a thorough breast exam-ination helped by laboratory tests and instrumental research. Several approaches for surgical treatment have been described in the literature. Some problems arise in patients who have significant enlargement and ptosis of the breast that will require skin reduction and in some patient requiring nipple-areola complex reduction. The complete circumareolar tech-nique creates the best aesthetic results, with fewer complica-tions in patients with moderate and severe ptotic glandular breast enlargement that have skin redundancy combined with areolar enlargement. From 2007 through 2009, a total of 28 patients with moderate to severe gynecomastia were treated surgically using a complete circumareolar approach. All patients achieved a good aesthetic contour of the chest. Only one-patient had slightly skin retraction that resolved sponta-neously and another patient developed a seroma that resolved after a single aspiration.
/ 0
- Details
- Category: Vol. 83, September 2015
- Hits: 882
Determining the Correlation between Axial Length and Macular Thickness in Myopia, LAMEECE M. HASSAN, AYMAN F. EL-SHIATY, MARWA M. SALAMA and MOHAMED EL-SAYED
Abstract
Purpose: To correlate macular thickness in the different degrees of myopia caused by increased axial length using Optical Coherence Tomography (OCT).
Patients and Methods: In this cross-sectional study. 40 myopic eyes of 20 cases, all above age eighteen, were selected from the outpatient clinic of Kasr El-Aini, Cairo University Hospital between September and December 2011. They were subdivided according to axial length into low (24-26.5mm) and high myopes (above 26.5mm). Axial lengths were deter-mined by A-scan ultrasound (Sonomed® A-2500 A-Scan). Macular mapping was obtained by spectral domain OCT (RTVue-100) to determine thickness overall and in nine quadrants subdividing the macula. Exclusion criteria included prior ocular surgery, best corrected vision less than 6/36 (Snellen), any other ocular pathology or macular abnormality detected by OCT.
Results: On assessment of the cases as one group there was a negative correlation between increasing axial length and overall average macular thickness (highly significant, p <0.01) and in all quadrants (significant), except in the fovea (no correlation found, p=0.4). The macular thickness was significantly less in high than low myopes except in the fovea (no correlation found, p=0.284). In the low myope group the thicknesses could not be correlated except in the parafoveal superior (p=0.026) and inferior quadrants (p=0.04). In the high myope groups, there were no correlations of statistical significance found in any quadrants.
Conclusion: The average overall thickness of the macula showed significant negative correlation with the degree of myopia; even though it is less in high myopes than in low myopes except in the fovea.
/ 1
- Details
- Category: Vol. 82, June 2014
- Hits: 882
Awareness and Knowledge of Non-Communicable Diseases Patients Regarding Patients’ Rights before and after Applying an Interventional Educational Session, KHALID M. AL-MOSA and MOHAMMED S. AL-GHAMDI
Abstract
Objective: To assess to assess the awareness of non-communicable diseases (NCDs) patients toward the Saudi Patients' Bill of Rights and their knowledge toward their rights.
Patients and Methods: This study was conducted at the chronic disease clinics of primary health care centers in Jeddah City. A simple random sample was adapted to select eight primary health care centers within Jeddah City. Within each primary health care center, the researcher followed a consec-utive sampling technique to interview 341 patients attending the chronic diseases clinic. The researcher constructed a study questionnaire that comprised socio-demographic variables and variables related to the awareness of non-communicable diseases patients regarding the Saudi Patients' Bill of Rights (PBR) and their knowledge toward patients' rights.
Results: The age of patients ranged between 18 and 82 years with a mean of 49.2±13.0 years. More than half of them (53.8%) were females. 7.7% of NCDs patients heard of patients' rights bill while 1.6% of NCDs patients read about it. The Younger, single, university educated, those recruited from Al-Salama sector, those who never complained about appointments and those who heard of patients' rights showed higher level of patients' rights awareness about patient rights. Patients' knowledge about patients' rights significantly improved after an educational intervention among all groups.
Conclusions: The great majority of non-communicable diseases patients have low level of awareness about the PBR. The level of knowledge about patients' rights is associated with some characteristics (i.e., age, qualification, gender, diagnosis, geographical sector and occupation). Patients' knowledge regarding patients' rights improves significantly after conducting educational intervention session.
Recommendations: To raise the knowledge and awareness of the public toward patients' rights through the media and the internet. Further research is required to measure the long-term effectiveness of interventional health education on raising the awareness and knowledge of patients. Distributing clear and simplified brochures and leaflets about PBR in all health facilities as a part of health education program aiming to raise the awareness of patients about the PBR.
/ 0
- Details
- Category: Vol. 83, September 2015
- Hits: 880
The Impact of Pyloric Pouch Size (3 cm and 6 cm) in Sleeve Gastrectomy on Postoperative Reflux and Vomiting, MOHAMED A. EL-MASRY, MUHAMMAD EL-MARZOUKY and YEHIA FAYEZ
Abstract
Some evidence has shown that sleeve gastrectomy and similar procedures can be complicated by significant post-operative reflux symptoms. With an intact pylorus, severely restricted stomach capacity, and physiologically disrupted motility possibly creating stasis, one would expect that LSG would not be likely to relieve heartburn reflux symptoms, as does LRYGB.
Aim of Work: The aim of this study is to find out the impact of resecting the stomach 3cm from the pylorus versus 6cm regarding vomiting and reflux symptoms by randomly selecting the patients presenting to our department with morbid obesity and BMI >40 in Kasr Al-Ainy between January 2013 and March 2014.
Methods: This was a randomly selected prospective study carried out on morbidly obese patients presented to Kasr El-Aini Teaching Hospital during the period from January 2013 to March 2014, where sixty patients underwent sleeve gas-trectomy. These patients grouped into two groups according to the starting point of resection of the stomach; Group (A) started 3cm from the pylorus towards the gastro-esophageal junction and Group (B) 6cm from the pylorus. The decision to do 3cm resection or 6cm resection randomly selected. These patients followed over a period of 6 months for post-operative nausea; vomiting and reflux symptoms where the assessment of the reflux was based mainly on the symptoms given by the patient.
Results: There was no statistical difference between both groups (6cm and 3cm) regarding post-operative reflux, where most of patients (61.7%) didn’t suffer reflux symptom versus (38.3%) who suffered from reflux where most of them had already pre-operative reflux symptoms. In addition, (43.8%) of patients in 3 cm group suffered from reflux versus (32.1 %) in 6cm group who suffered from reflux taking in consideration that the sample size is sixty patients so higher sample size may confirm this correlation.
Conclusion: The 3cm group (Group A) were >14 times at a higher risk to have minor complications in the form of nausea, vomiting and reflux compared to 6cm group (Group B).
/ 0
- Details
- Category: Vol. 83, September 2015
- Hits: 876
Case Report: Spontaneous Intraperitoneal Rupture of an Infected Kidney in A Young Patient, ADEL A. ASSIRI
Abstract
Background: Non-traumatic or spontaneous rupture of the kidney is rare. There is usually an underlying pathology, e.g., hydronephrosis, calculi, pyonephrosis, or tumors.
Objective: To present an unusual presentation of a young man presenting with an acute abdomen and having a final diagnosis of ruptured renal pelvis.
Case Report: A 21 years old male presented with severe pain at the right iliac fossa for 2 days associated with loss of appetite, vomiting and fever. On physical examination, the patient looked sick, with tachycardia (120 beats/min), blood pressure 125/83mmHg, febrile (38ºC) with generalized ab-dominal tenderness and guarding. Urine dipstick revealed blood (++) but no protein, high leukocytic count, and C-reactive protein. Abdominal X-ray showed no abnormal findings. The provisional diagnosis was "perforated appendix", however, the abdominal CT scan revealed normal appendix and a distal right ureteric stone with significant perinephric pus collection extending to the pelvis. Third generation cephalosporin was started and he was taken to the operative theater. Endoscopically, a ureteral stent was fixed. Postoper-atively, the patient dramatically improved, and was discharged 3 days after surgery. Six weeks later, the ureteral stent was removed. Retrograde pyelogram was done and there was no extrvasation with complete healing of the renal pelvis. The stone was fragmented using Holmium: YAG laser.
Conclusions: Early diagnosis of underlying renal or ureteral stones in patients presenting with peritonitis is im-portant. Full urological investigations in such cases are important to avoid severe complications.
/ 0
- Details
- Category: Vol. 80, December 2012
- Hits: 876
Impact of Non-Computerized Home Blood Glucose Monitoring Program on Glycemic Control of Saudi Patients with Type 2 Diabetes Mellitus,ABDULLAH A. KHAWAJI
Abstract
Objective: To assess the impact of home blood glucose monitoring program (HBGMP) on glycemic control of type 2 diabetic patients.
Research Design and Methods: This study included 222 diabetic patients. Data were collected at baseline, 3, 6 and 12 months.
Results: There was a progressive improvement in HbA1c levels from start of the HBGMP till one year later (p<0.001). About half of participants practiced self blood glucose mon-itoring (SMBG) as once/day at 3, 6 and 12 months. There were increasing numbers of patients practicing SBGM only once/day on alternate weeks across the steps of HBGMP and a decreasing numbers of patients practicing SMBG 3 times/day across the steps of HBGMP (20.27%, 13.96% and 11.26%, respectively). Frequency of management by oral hypoglyc-emics and insulin gradually and decreased across the study period. Combined oral hypoglycemic and insulin treatment gradually increased (p<0.001). A progressive and significant improvement in the levels of HbA1c from start of the HBGMP till the end of one year later in all patients treated with different treatment modalities (p<0.001). There were significant differ-ences among patients according to their treatment modality. Patients with worst HbA1c were kept on combined oral hypoglycemic and insulin treatment.
Conclusions: HBGMP is effective in improving diabetes control among adult type 2 diabetics. HBGMP helps the treating physician to closely and interactively adjust the prescribed treatment modalities in order to effectively control blood glucose levels and it is more effective among older diabetic patients and those with more duration of disease.
/ 1
- Details
- Category: Vol. 84, December 2016
- Hits: 874
Prevalence and Risk Factors for Irritable Bowel Syndrome among Saudi Teachers, SAAD A. ALZULFAH, MOHAMMED AL-MASTOOR, ISMAIL MOHAMMED and OSSAMA A. MOSTAFA
Abstract
Aim of Study: To assess the prevalence, types and risk factors of Irritable Bowel Syndrome (IBS) among Saudi teachers in Khamis Mushayt City, Saudi Arabia.
Subjects and Methods: A total of 402 teachers could be included in the present study. The data collection sheet com-prised two parts, i.e., personal characteristics and the IBS questionnaire.
Results: Almost three-fifths of teachers (73.9%) had symptoms of IBS. Most teachers had IBS with alternating diarrhea and constipation (IBS-M), (55.7%). Prevalence of IBS was significantly higher among teachers at primary and intermediate schools than those in secondary schools (78.4%, 77.9% and 65.4%, respectively, p=0.025). Females had higher prevalence of IBS than males (79.6% and 68.2%, respectively, p=0.009). Smokers had significantly higher prevalence than non-smokers (92.6% and 64.3%, respectively, p<0.00 1). Types of IBS were significantly different according to participant teachers' gender (p=0.043), smoking status (p=0.004), and years of experience in teaching (p=0.005).
Conclusions: Most teachers in Khamis Mushayt City have symptoms suggestive of IBS, with IBS-M is the most common type. Some personal characters are associated with significantly higher prevalence of IBS, (e.g., females and smokers; with higher prevalence of IBS-C and IBS-M among females and higher prevalence of IBS-D among males and all types of IBS are significantly higher among smokers than nonsmokers).
Recommendations: To provide health education programs for teachers on how to avoid IBS. To provide health care services for teachers to mitigate symptoms of IBS, especially among high risk groups, e.g., females and smokers. To advise smokers, especially those who suffer from symptoms of IBS to quit smoking.
/ 0
- Details
- Category: Vol. 81, June 2013
- Hits: 874
Calprotectin Measurement in Ascitic Fluid: A New Test for the Rapid Diagnosis of Spontaneous Bacterial Peritonitis,ALI A. GHWEIL, AHMED N. SALEM and HASAN S. MAHMOUD
Abstract
Introduction: Spontaneous bacterial peritonitis (SBP) is diagnosed by the presence of q250 polymorph nuclear cells (PMN) per milliliter (ml) in ascitic fluid. However, the pro-cedure is time-consuming, operator-dependent, and not always readily available. Calprotectin is a cytosolic protein in neu-trophilic leukocytes that is released in response to inflammatory processes. In the GI tract calprotectin in feces is considered a valid marker of intestinal inflammation.
Aims and Methods: The study aimed to assess the role of calprotectin concentrations in ascites for the diagnosis of SBP. Forty patients [mean age 50±2 years, 10 (25%) females] with HCV liver cirrhosis. Who were referred for paracentesis were included in this study; the following investigations were performed: Serum-ascites albumin gradient, ascitic PMN cell count (microscopic hand-count), bacterial cultures and cyto-logical analysis. In addition, ascitic calprotectin was measured using an enzyme-linked immunosorbent assay (ELISA).
Results: Ascitic calprotectin values measured by ELISA correlated well with PMN cell count (p-value=0.001, rho—F0.729). Calprotectin levels of patients with PMN q250/m1 (N=8, 20%) were higher than in patients with PMN <250/ml (N=32, 80%). Ascitic calprotectin values correlated well with albumin level (p-value=0.001, rho=-0.716).
Conclusion: Measurement of calprotectin in ascites might be a valuable surrogate marker for PMN cell count. It might be valuable for the rapid diagnosis of SBP.
/ 0
- Details
- Category: Vol. 84, September 2016
- Hits: 871
Significance of C-KIT and SOX10 in the Diagnosis of Salivary Gland Neoplasms: An Immunohistochemical Study, AHLAM A. ABD EL-MAKSOUD and MARWA S. ABDALLAH
Abstract
The histopathological features of salivary gland tumors on routine H & E are the gold standard for diagnosis. Tumors with somewhat equivocal histological features may need additional immunohistochemical markers for establishing final diagnosis.
Objective: To study the immunohistochemical pattern of SOX10 and CD 117 (c-KIT) in human samples of normal and neoplastic salivary gland tissues, trying to characterize and distinguish the various types of salivary gland tumors and to determine their origin from epithelial (luminal) and myoepi-thelial/basal (abluminal) cells of salivary glands.
Material and Methods: Forty malignant salivary gland tumors [ten cases of Mucoepidermoid Carcinoma (MEC), 10 cases of Adenoid Cystic Carcinoma (AdCC), 8 cases of Acinic Carcinoma (AcC), 6 cases of Polymorphous Low Grade Adenocarcinoma (PLGA), 3 cases of Carcinoma Ex-pleo-morphic Adenoma (CXPA) and 3 cases of Epithelial Myoep-ithelial Carcinoma (EMC)] and 22 benign tumors [12 cases of Pleomorphic Adenoma (PA) and 10 cases of Warthin Tumor (WT)], in addition to 10 control cases of chronic sialadenitis were included in this study. Histopathological diagnosis was made on freshly prepared H & E sections followed by immu-nohistochemical application and analysis of c-KIT (CD117) and SOX10 markers.
Results: The mean age of the patients with salivary gland tumors was 48±12 (mean SD) (range, 18-84) years. There were 33 male and 29 female patients. Eight cases of PA, 9 cases of AdCC, 6 cases of AcC and 4 cases of PLGA were positive for c-KIT. No significant difference was found between the positivity of c-KIT expression in these four types of salivary gland tumors. Although the percent of positive tumor cells was different between them, however this difference was still insignificant. Other salivary gland tumors examined showed weak and focal c-KIT expression.
In normal human salivary gland tissue, SOX10 expression was specific to the nuclei of acini and both luminal and abluminal cells of intercalated ducts but not in other sites. SOX10 expression can differentiate salivary tumors into two subgroups in which acinic cell carcinomas, adenoid cystic carcinomas, epithelial-myoepithelial carcinomas, and pleomorphic adenomas, including the pleomorphic adenoma component of carcinoma (CXPA), were strong SOX10 positive, while mucoepidermoid carcinomas, PLGA and Warthin tumors were weak or negative for SOX10.
Conclusion: These results suggested that c-kit of no use in differential diagnosis between AdCC, AcC, PLGA and PA. Using of SOX10 may be helpful in diagnosis of some neo-plastic lesions of salivary gland and may help in understanding the histogenesis of salivary gland tumors. SOX10 expression pattern of salivary gland tumors mirrors those of normal tissues, showing acinus and intercalated duct differentiation in a biphasic manner.
/ 0
- Details
- Category: Vol. 82, December 2014
- Hits: 871
Impact of a Structured Teaching Program for Prevention of Ventilator Associated Pneumonia on Knowledge and Practices of Intensive Care Nurses at Central Quwesna Hospital, Egypt, AMINA I. BADAWY
Abstract
Background: Ventilator-associated pneumonia (VAP) is considered a serious health hazard among ventilated patients. The frequency of VAP in the ICUs is high and its negative impact on patient outcomes and resource utilization is huge.
Aim of the Study: This study was carried out in order to examine the effect of a structured teaching program for prevention of ventilator-associated pneumonia on knowledge and practices of intensive care nurses at Central Quwesna Hospital, in Egypt.
Design: A quasi-experimental research design was utilized.
Setting: This study was conducted at the Central Quwesna Hospital in the intensive care unit.
Subjects: Purposive sample consisted of all nurses, (30 nurses) who provide care for patients admitted to the intensive care unit in the previously mentioned hospital.
Tools: Pre/posttest interview questionnaire sheet: It was designed to test nurse's knowledge about prevention of ven-tilator associated pneumonia, an observational checklist (pre/posttest), and teaching program for prevention of VAP.
Results: The study findings revealed that, 30% of respon-dents were in the age group of 21-25 years followed by 36.7% in the age group of 26-30 years and 33.3% in the age group of above 30 years with a mean age of 32.32 years. Also, in relation to gender, 76.7% of nurses were found to be females. Concerning total clinical experience 43.3% of the nurses had 1-5 years of clinical experience, 30% had 6-10 years of clinical experience and 26.7% had above 10 years of clinical experi-ence. With respect to professional educational qualification, it was observed that 23.3% of the respondents were having bachelor degree in nursing and 76.7% of respondents had technical institute degree in Nursing. As well, it was cleared that none of the nurses in the study sample had satisfactory total knowledge score at the pre-program implementation, however, the score of total knowledge increased immediately after the program, and continued to be higher at the first follow-up phase. Also, none of the nurses in the studied sample adequate practice at the pre-program phase, however, the score of total practice increased immediately after the program, and continued to be higher at the first follow-up phase. Moreover, a strong positive correlation was found between age, experience, knowledge, and practices of study subjects. As well, knowledge and practices were positively correlated. In addition, sex, education, and years of experience as socio-demographic variables were having an impact on knowledge, and practices regarding prevention of VAP among study subjects.
Conclusion: The current study shows that nurses were having unsatisfactory total knowledge and practice at the pre-program implementation, however, the score of total knowledge increased immediately after the program, and continued to be higher at the first follow-up phase, indicating that the nurses gained knowledge after implementation of teaching program. On the other hand it was observed that there were association between age, years of experience, knowledge, and practice of intensive care nurses on prevention of VAP. As well, sex, level of education, and years of experience were found to have an impact on knowledge and practice scores.
Recommendations: The current study recommended de-veloping manuals, information booklets and self-instruction module in areas of prevention of VAP.
/ 0
- Details
- Category: Vol. 84, September 2016
- Hits: 870
Effect of Different Thawing Temperatures on the Motility Recovery of Cryopreserved Human Sperm, ASHRAF FAYEZ, SARWAT AL-AHWANI, AHMED EL-GUINDI, AMR ALAHWANI, SHADY ZAKI and ISLAM FATHY SOLIMAN ABD EL-RAHMAN
Abstract
Introduction: standard protocol designed to optimize sperm motility recovery after thawing has not yet been established.
Purpose: We aimed to study the effect of different thawing temperatures on the motility recovery of cryopreserved human sperm.
Patients and Methods: Fifty semen samples of males complaining of primary infertility and oligoasthenoteratozoospeтrniа. A semen sample was obtained and evaluated. Every sample was divided into three straws that underwent cryopreservation, then thawing at three different temperatures; 25°C, 37°C and 40°. Pre-cryopreservation sperm motility was compared to the post-thawing motility at each of the three thawing temperatures.
Results: Total motility percentage was better at thawing temperatures of 37°C and 40°C compared to 25°C. Rapidly progressive motility was the highest at thawing temperature 40°C compared to the other thawing temperatures; 25°C and 37°C as p-value was 0.08, <0.001 and <0.001 respectively denoting no significant difference in change of the rapidly progressive motility before cryopreservation and at thawing temperature 40°C.
Conclusion: Thawing cryo-preserved semen samples with severe oligoasthenoteratozoospermia at 40°C provides highest potential for restoring sperm motility.
/ 0
- Details
- Category: Vol. 83, March 2015
- Hits: 870
A Comparison between Volume-Controlled Ventilation and Pressure Controlled Ventilation Volume Guaranteed in Providing Better Oxygenation in Obese Patients Undergoing Upper Abdominal Laparotomies, MAI M. EL-RAWAS, IKRAMY M. ABD EL-GHAFFAR, SAHAR A. TAWFIC, MAIE K. HELALY and TAREK A. RAAFAT
Abstract
Background: The maintenance of adequate oxygenation is an important issue during anesthesia of obese patients. There is no specific guideline on the ventilation modes for this group of patients. Although several studies have been performed to determine the optimal ventilatory settings in these patients, the answer is yet to be found. The ideal venti-lation strategy is expected to optimize gas exchange and pulmonary mechanics and to reduce the risk of respiratory complications. This work was planned to test the hypothesis that a new mode of ventilation Pressure-Controlled Ventilation-volume Guaraaranteed (PCV-VG) is associated with improve-ments in gas exchange and outcome when compared with the conventional Volume-Controlled Ventilation (VCV) in obese patients undergoing upper abdominal laparotomies.
Subjects and Methods: Sixty obese patients with normal preoperative pulmonary functions scheduled for upper abdom-inal laparotomies were randomized into two groups. Those in group A received VCV and those in group B received PCV-VG. Arterial blood gases (ABG) were obtained pre-, intra-and postoperatively. Peak expiratory flow rate (PEFR) and CT chest were done pre and postoperatively.
Results: PEFR values were significantly lower postoper-atively when compared to the preoperative values in each group. However, there was no difference when comparing the values of the two groups postoperatively. There was no difference between the two groups as regards to occurrence of postoperative atelectasis. There was no statistical difference in arterial partial pressure of oxygen (PaO2) and arterial oxygen saturation (SaO2) between the two groups intra-and postoperatively. However, arterial carbon dioxide tension (PaCO2) was lower in the PCV-VG group intraoperatively.
Conclusion: PCV-VG group showed no advantage over VCV as regards to the occurrence of atelectasis or as regards to oxygenation. However, PCV-VG offered better CO2 clear-ance.
/ 0
- Details
- Category: Vol. 84, September 2016
- Hits: 867
Effect of Acupressure on Glycated Hemoglobin and Lipids Profile in Type 2 Diabetic Women, SANDRA A. GUIRGUIS, HANY F.E.M. EL-SISI, FARAG A. ALY and YOUSSEF S.S. ALY
Abstract
Background: The use of acupressure for Type 2 Diabetes Mellitus (T2DM) can offer patients a complementary form of treatment that is non-invasive and does not require the use of drugs or other medical procedures. It is considered safe and should not cause negative side effects.
Aim of this Study: To determine the effect of application of acupressure on glycated hemoglobin (HbA1c) and lipids profile levels in type 2 diabetic women.
Patients and Methods: Forty women with type 2 diabetes mellitus were randomly assigned into two equal groups, their age ranged from 35 to 50 years. This study was conducted from July 2015 till the end of April 2016. The patients were selected from out patient clinic, in Internal Medicine Depart-ment, El-Sahel Teaching Hospital-Shoubra-Cairo-Egypt. The study group (20 patients): Received Acupressure Therapy (AT) on specific acupuncture diabetic point (Sp-6), 3 minutes and repeated 3 times per session on both legs for three times per week, for 12 weeks, in addition to their regular hypogly-cemic drugs. The control group (20 patients): The patients of who group did not received acupressure, but followed the prescribed hypoglycemic drugs only for 12 weeks. HbA1C and lipids profile levels were measured before and after 3 months of completion of the study. While measurement of random blood glucose was done before and after each session and for 12 weeks for all patients.
Results: Patients in Study group showed significant de-creased percentage of HbA1 C, Total Cholesterol (TC), Trig-lyceride (TG), low density lipoprotein, and Random Blood Glucose (RBG) and increased high density lipoprotein HDL. While in control group, results showed non significant de-creases in HbA1C and (TG) and increased in (TC), and LDL, with non significant increases in HDL, combined with signif-icant decreases in RBG.
Conclusion: Application of acupressure therapy is effective in decreasing HbA1C, TC, TG, LDL, RBG, and improved HDL level in type 2 diabetic women.
/ 0
- Details
- Category: Vol. 83, September 2015
- Hits: 862
Prevalence and Risk Factors of Noise Induced Hearing Loss and other Work-Related Health Problems among Stone Saw Workers in West Bank-Palestine, HATIM M. JABER, MONA S. MOHAMED, AMAL M. EL-SAFTY, OMAIMA K. EL-SALAMONI and HANAN M. IBRAHIM
Abstract
Introduction: Stone quarrying have been known as highly hazardous work, whereby workers are affected by many debilitating occupational health hazards and diseases.
Objectives: To determine the prevalence of work related health problems and to the risk factors of Noise Induced Hearing Loss (NIHL) among Palestinian stone cutting workers.
Methods: This is an analytical cross-sectional study including 259 male workers, who were available at all stone-saw workshops (n=42 workshop) in northern part of West Bank, Palestine, (April-June 2012). They were interviewed using structured questionnaire including socio-demographic data and work conditions. Examination of the workers by occupational audiometry and clinically for musculoskeletal and skin diseases was performed. An environmental measure-ment such as noise level meter was done.
Results: All participants were males, the mean age was 36.85±11.41 years and mean duration of service is 13±9.1 years, 45.2% of the workers had NIHL, 35.9% had history of work injuries, 26.6% had musculoskeletal problems and 11.6% had skin lesions. Significant associations (p<0.05) were identified by multivariate analysis between NIHL and the work type, noise, dust, duration of work, educational level, periodic health appraisal, using personal protective equipment, smoking and residence. Noise level was found to be between 93-123 dB.
Conclusion: Stone-saw workers are at risk of NIHL, dermatoses and musculoskeletal disorders as well as injuries. Certain factors like non usage of personal protective equipment increase the risk for developing these health effects. It is recommended to screen for hearing loss for people working in stone cutting workshops. Prevention programs and legisla-tion which already exist should be implemented and enforced.
/ 0
- Details
- Category: Vol. 83, December 2015
- Hits: 861
Use of Differentiated Mesenchymal Stem Cells in Experimental Diabetes Type 1 in Rats, MOHAMED A. WASSEF, HANAN FOUAD, DINA SABRY, NOHA AFIFI and ABBAS M. ABBAS
/ 0
- Details
- Category: Vol. 82, September 2014
- Hits: 861
Upper Extremity Functional Outcomes With and Without Trunk Restraint in Stroke Patients, SALAH A. SAWAN, HUSSEIN A. SHAKER, EBTESAM M. FAHMY and NAGWA I. REHAB
Abstract
Background and Purpose: Task-specific training improves functional outcomes after stroke. However, gains may be accompanied by increases in movements compensating for motor impairments. This study hypothesized that restriction of compensatory trunk movements may encourage recovery of premorbid movement patterns leading to better functional outcomes. The goal of this study was to determine whether task-specific training with trunk restraint produces greater improvements in upper extremity function than training without trunk restraint in post-stroke patients.
Patients and Methods: Thirty male chronic stroke patients with age ranged between 40-55 years were included in this study. Patients were divided into two equal groups (Group I and Group II). The first group (Group I) received reach to grasp and transfer blocks and pins using Box and Block Test (BBT) and Purdue Pegboard training during which compen-satory movement of the trunk was prevented by trunk restraint. The second group (Group II) practiced the same task without trunk restraint. Motor function of the upper limb and gross manual dexterity were recorded using Upper Extremity Per-formance Test (TEMPA) and BBT respectively.
Results: There was a statistically very highly significant increase and highly significant increase of the mean value of the TEMPA score of the affected upper limb post treatment in both groups (p=0.0001 in GI and p=0.001 in GII). Also, there was a statistically very highly significant increase in BBT score post treatment in both groups (p=0.0001). Trunk-restraint group had statistically non significant greater im-provement in motor function as compared to group without trunk restraint (p=0.057) but trunk-restraint group had a statistically very highly significant improvement of gross manual dexterity as compared to group without trunk restraint (p=0.0001).
Conclusion: Task-specific training with trunk restraint can be suggested as an effective method in improving upper extremity function in patients with impaired arm and hand function post stroke.
/ 0
- Details
- Category: Vol. 80, December 2012
- Hits: 860
Liver Transplantation and Outcome Predictors in Critical Care Unit,MOSTAFA ELSHAZLY, MOHAMED EL-SHAFAY, SALLY SALAH ELDINE and MOHSEN AYOB
Abstract
Background and Study Aims: In the absence of cadaveric donor liver transplantation, living-donor liver transplantation (LDLT) is an alternative option for patients with end-stage liver disease. This may help to decrease waiting time. A shorter waiting time may reduce the risk of dying or of further deterioration that could render the patient too sick to undergo successful transplantation. This study aims at determination of early predictors for morbidity and mortality in these patients.
Patients and Methods: A Retrospective study enrolled 30 recipients, 24 males (80%) and 6 females (20%) who underwent Living Donor Liver Transplantation (from October 2004 to December 2008) at Cairo University Hospital. For all patients complete laboratory profile is done daily,as well as CRP and serum level of FK. Other laboratory work includes billirubin level, hemoglobin and hematocrite levels in the surgical drains. Continuous assessment of haemodynamics was done.
Results: From the 30 recipients, 24 males (80%) and 6 females (20%) Their mean age was 35±20 years old, ranging from 1 to 63 years old. The mortality rate was 26.7% (8 patients), causes of death were sepsis (62.5%), rejection (25%), and portal vein thrombosis (12.5%). There was positive impact of serum CRP levels during the early post-operative days, as an indicator of infection and inflammation, on the outcome and survival after LDLT (p=0.0001). CRP levels within normal range (5.16±3.6), had good outcome than patients with elevated CRP levels (22.09±7.9). Recipients of younger aged donors (29.2±5.3 years), had better outcome than those with more elderly donors (40.0±2.6 years). Tachy-cardic patients upon ICU admission always have a poor prognosis in comparison with patients that are not (p=0.008). platelet count was significantly higher in survivor with mean 108 vs 58.33 in non survivor p=0.02. Another predictor for outcome was the length of ICU stay post-operatively and outcome after LDLT (p=0.003).
Conclusion: A smooth ICU course after liver transplant is dependent on satisfactory graft function, which can be assessed by clinical parameters, some can be predictor for outcome as heart rate, laboratory test as CRP, stable platelet counts, declining transaminases.
/ 0
- Details
- Category: Vol. 82, June 2014
- Hits: 850
Augmentation of Atrophic Deprssed Scars Utilizing the Deepithelialized Scar Tissue Itself, WAEL SAADELDEEN and AHMED KAMAL
Abstract
Background: Various surgical techniques and modalities have been used to treat scars, but non showed definite efficacy controlling that abnormally-placed fibrous tissue. Contractile forces of healing in addition to the nature of primary injury greatly influence the final scar appearance. Atrophic depressed scars are a major challenge that a Plastic Surgeon may ever face. Lack of dermal skin layer should be replaced for a perfect reconstructive surgery result.
Objective: To augment the atrophic depressed scars with autologous tissue that is already present in-place reaching aesthetically pleasant reconstructive results; the de-epithelized scar tissue itself.
Methods: Thirty-seven (37) patients with atrophic and depressed scars (caused by trauma) were surgically treated with scar revision surgery where the authors employed the scar tissue itself after being de-epithelized for augmentation of the absent or abundant atrophic scars' dermal layer. The assessment of the results was conducted by comparison of the before and after surgery photographic documentation 6 months following segmentation surgery as well as patients' satisfaction.
Results: Dramatic improvement of the scar morphology with good patients’ satisfaction has been obtained.
/ 0
- Details
- Category: Vol. 83, March 2015
- Hits: 847
Pediatric Craniofacial Injuries: Concept of Treatment, FAWZY T. AL-SAYED and MOHAMAD A. SHOEIB
Abstract
Pediatric craniofacial trauma is one of the leading factors of morbidity and mortality. Significant advances in manage-ment have been made through the last three decades. The objective of this study was directed to study the pattern of pediatric craniofacial fracture according to child age. Retro-spective study was done on 18 pediatric cases treated at the last two years at the Department of Neurosurgery and Maxil-lofacial Surgery Shebin Al-Kom Teaching Hospital. The age of the cases ranged from six months to 14 years with mean age 7-6 years. Road traffic accident was the cause in 13 cases while fall from height was the cause in five cases. After complete evaluation clinically and radiographically with necessary consultation, the cases were treated under general anesthesia by both maxillofacial and neurosurgeon in almost all of the cases. The post-operative course was uneventful except in one case, a second surgery was needed for removal of the micro plates which was missed for two years and local arrest of growth happened. The pediatric craniofacial skeleton is unique from that of the adult in different aspects. The pattern of fractures changes according the stage of the child growth and it has a good reflection on method of treatment.
/ 0
- Details
- Category: Vol. 84, December 2016
- Hits: 845
Effect of Reflexology on Pain and Pulmonary Function in Patients with Cervical Spondylosis, ZAHRA M.H. SERRY, AMIRA M. AFIFY and AMANI Z. AL-JAMMALI
Abstract
Background: Reflexology is a form of complementary medicine techniques that is known to be used in pain manage-ment, relief of tension and fatigue, and improving psycholog-ical status of patients suffering various conditions. The effect of reflexology on cervical spondylosis chronic pain and related respiratory dysfunction is not yet addressed.
Objective: To study the effects of reflexology on pain and ventilatory parameters in patients with cervical spondylosis.
Methods: Thirty patients with cervical spondylosis were assigned to Reflexology (RL) group (11 men and 4 women), and control group (11 men and 4 women). Mean age in RL group was 59.93±4.36, and in control group was 57.66±3.37. Patients in both groups were assessed pre-treatment and post-treatment at the end of 4 weeks for pain using Visual Analogue Scale (VAS) and ventilatory function tests that included VC, FVC, FEV1, and FEV1/FVC. The reflexology group received 3 sessions/week (45 minutes each) for 3 weeks.
Results: Pain significantly improved at post-treatment than pre-treatment in RL group. Likewise pain was significantly less than the control group at post-treatment assessment. Ventilatory function tests did not show any significant differ-ence neither within groups comparing pre and post-treatment assessment nor between groups comparing pre and post-treatment assessments in both groups.
Conclusion: Pain intensity but not ventilatory parameters is improved by application of reflexology in patients with cervical spondylosis.
/ 0
- Details
- Category: Vol. 83, March 2015
- Hits: 845
Imaging of Neonatal Upper Gastro-Intestinal Atresia Beyond the Esophagus in Correlation with Surgical Findings, MOHAMMED ZAKI and AHMED M.A. GAFAR
Abstract
Background: Neonatal intestinal atresia is commonly encountered congenital anomaly in the early days of life. Imaging is important for early diagnosis.
Objective: This study was conducted for detecting radio-logical findings of different types of upper gastro-intestinal atresia (other than esophageal atresia) in correlation with surgical data.
Patients and Methods: From April 2009 to April 2014, 38 neonates (21 boys and 17 girls) were diagnosed as upper gastro-intestinal atresia (excluding esophageal atresia) were referred for abdominal ultrasound, abdominal X-Ray and contrast imaging were done to identify the level of obstruction. All cases were managed surgically by one pediatric surgeon in the Pediatric Surgery Unit at Sohag University Hospitals. The radiological data were correlated with surgical diagnosis. Other causes of small intestinal obstruction were excluded from the study.
Results: Our study included 38 neonates. Twenty five of them were diagnosed to have jejuno-ileal atresia (JIA) (13 jejunal and 12 ileal), 10 cases with duodenal atresia (DA) and 3 cases with pyloric atresia. Radiological examinations were diagnostic in all cases and consistent with surgical findings.
Conclusion: Intestinal atresia is an important entity to be diagnosed by radiological imaging and managed early by suitable surgical repair.
/ 1
- Details
- Category: Vol. 83, September 2015
- Hits: 844
Value of TRUS in the Diagnosis of Chronic Prostatovesiculitis in Infertile Men, AMR M. ABD EL-RAHEEM, HATEM M. EL-AZIZY and AHMED M. HASSANIN
Abstract
Introduction: Chronic Prostatovesiculitis (CPV) is con-sidered a potential cause of infertility that gained a lot of consideration in the last decade. CPV can cause infertility through secretory dysfunction of the accessory glands, in-creased ROS and obstruction of the seminal ducts. CPV can be symptomatic or asymptomatic, bacterial and none bacterial and it can be present with absence of pus cells in Expressed Prostatic Secretion (EPS). Rrecently TRUS is considered an important tool for diagnosis of CPV.
Objective: This work aimed to detect the value of TRUS in the diagnosis of CPV in infertile men.
Patients and Methods: This study included 201 infertile men. They were grouped into 4 groups according to semen parameters. Group 1 (37 participants): Low semen volume Azoospermic (AZ), Group 2 (22 participants): Low semen volume olig and/or asthenospermic (OAZ), Group 3 (62 participants): Normal semen volume AZ and group 4 (80 participants): Normal semen volume OAZ.
Expressed prostatic secretion analysis, seminal fructose and serum total testosterone estimation were done for all participants. All were screened by TRUS for evidence of CPV.
Results: TRUS evidence of CPV was detected in 29 (14.2%) participants. Of them: 9 (3 1%) had low semen volume, 20 (69%) had normal semen volume, 14 (48.3%) were AZ and 15 (51.7%) were OAZ. The percentage of TRUS evidence of CPV among the 4 groups was comparable. All participants with clinical and/or laboratory evidence of CPV had TRUS evidence of CPV. Of the TRUS evident CPV, 13 (44.8%) had normal pus cell count in EPS, 17 (58.6%) had normal pus cell count in semen and 21 (72.4%) had normal seminal fructose. Comparative study among groups for the incidence of increased pus cells in EPS and semen showed insignificant difference.
Conclusion: TRUS may have a role in the diagnosis of CPV in infertile men. TRUS evidence of CPV had comparable incidence in low and normal semen volume infertile men.
/ 0
- Details
- Category: Vol. 80, June 2012
- Hits: 844
Negative Pressure Wound Therapy for Treatment of Extensive Degloving Injury of the Left Lower Limb Associated with Open Fracture of the Femur (Case Report),MAGED S.S. SALEH and ABDUL-MALIK A. AL-AMIN
Abstract
Background: Degloving is a potentially serious injury in which an extensive area of skin is torn from its underlying attachments and thereby deprived of its blood supply.
Case Report: Negative pressure wound therapy (NPWT) was used for the treatment of extensive degloving of left lower limb in an obese patient with co-existing fractured femur.
Conclusion: NPWT can provide an excellent alternative to traditional wound care for large surface area wounds and circumferential wounds before skin grafting. It can convert a non-operable wound to an operable wound with a healthy granulated wound bed ready for grafting.
/ 0
- Details
- Category: Vol. 83, September 2015
- Hits: 842
The Effect of Peroperative Steroid Therapy on the Surgical Field during Endoscopic Sinus Surgery, NADER EL-FEKY
Abstract
Background: Bloodless surgical field during functional endoscopic sinus surgery is very important not only to make the surgery more easy but also to decrease the incidence of complication.
The aim of the present study was to determine is the short term preoperative corticosteroid oral therapy have effect on the operative field in functional endoscopic sinus surgery or not.
Methods: Functional endoscopic sinus surgery was per-formed in 24 patients with extensive polypoid rhinosinusitis. Patients were divided into two groups steroid group "Group 1" (received 45mg of prednisone daily for 6 consecutive days before operation) and control group "Group 2". Total blood loss and visualization of the surgical procedure were compared in the 2 groups.
Results: The visual conditions of the surgical field im-proved significantly, however the total blood loss was only slightly less in the steroid group.
Conclusions: Short term preoperative steroid therapy before functional endoscopic sinus surgery in patients with severe polyposis significantly improved the operative field and shortened the time of surgery.
/ 0
- Details
- Category: Vol. 84, March 2016
- Hits: 838
Neuroprotective Effects of Pramipexole in Parkinson's Disease Induced by Rotenone in Mice, NAJLA'A K.M. AL-SHAIBANI, ABD EL-AZIM ASSI, RASHA B. ABD EL-LATIEF and DALIA A.H. ELSERS
Abstract
Background: Pramipexole (PPX), an agonist for Dopamine (DA), has been used to treat both early and advanced Parkin-son's Disease (PD).
Objectives: This study was done to evaluate the neuro-protective effect of PPX in a DA neuron degeneration model of PD induced by rotenone.
Methods: Thirty six male mice were used and divided into three equal groups. The first group, the control group, received only the vehicle (sunflower oil) for a period of 7 weeks (49 days). The second group received rotenone (2mg/kg; IP) dissolved in sunflower oil daily for 49 days. The third group received a combined treatment of rotenone (2mg/kg, IP) and PPX (1mg/kg, IP) daily for 49 days. Behavioral tests were performed a day prior to drug administration and then once weekly along the duration of drugs or vehicle adminis-tration. At the end of the 49 days all animals were sacrificed and their midbrains were subjected to immunohistochemical analysis for dopaminergic neurons staining for Anti-Tyrosine Hydroxylase (TH) antibodies. Midbrain tissues were also isolated for biochemical measurements.
Results: Behavioral tests revealed that PPX counteracted the rotenone effect in mice locomotor activity and catalepsy. Immunohistochemistry results showed that PPX inhibited the rotenone-induced loss of TH-immunopositive neurons in the substantia nigra pars compacta. Biochemical measurements demonstrated that PPX treatment significantly reversed the rotenone-induced decrease in midbrain DA level. Interestingly, PPX ameliorate the rotenone-induced increase in the malon-dialdehyde and nitric oxide levels as well as the decrease in total antioxidant capacity.
Conclusion: The results indicate the beneficial effect of PPX against the dopaminergic neurodegeneration induced by chronic IP administration of rotenone. This neuroprotective effect seems to be mediated by inhibition of rotenone induced oxidative stress and nitric oxide overproduction and through maintenance of the cellular antioxidant status.
/ 0
- Details
- Category: Vol. 80, December 2012
- Hits: 838
Neoadjuvant Hormonal Therapy Versus Radiotherapy Alone in Treatment of Locally Advanced Prostate Cancer,MAHER EDAROS, NASHWA NAWAR, MOHAMMED A. BADAWY, AHMED M. ELIWA, HAZEM ELGALALY and SALEM KHALIL
Abstract
Introduction: Despite adequate local therapy for carcinoma of the prostate, significant proportion of patients developed a progressive or metastatic disease. Neoadjuvant hormonal therapy not only provides possible early systemic treatment for a subclinical disease, but may also help in improving local disease control by increasing the number of patients eligible for definitive local therapy (via down staging).
Objective: To compare neoadjuvant hormonal therapy before definitive radiotherapy and radiotherapy alone in treatment of locally advanced prostate cancer.
Patients and Methods: We retrospectively compared the oncologic outcome of neoadjuvant hormonal therapy before radical radiotherapy versus radical radiotherapy alone in patients with locally advanced prostatic cancer (T3-T4, Nx, M0) treated between June 2004 and September 2007. Thirty seven patients were included in the study as two groups; group I included 19 patients treated with neoadjuvant hormonal therapy before and during radical radiotherapy (LHRH ana-logue for four months with added flutamide in the 1st month), and group II included 18 patients treated by radical radiotherapy alone. The dose of radiation therapy was 70G (44G to the whole pelvis and 26 G to the prostate and seminal vesicle). Patients were followed for a minimum of 5 years. Follow-up included serum PSA, and TRUS performed three months after therapy. Five-year survival and biochemical-disease-free survival were calculated foe both treatment groups.
Results: The mean patient age was (71.3 y) and (69.7 y) for group I and II respectively. Mean pretreatment PSA was 37.1 ng/ml in group, I and 39.5 ng/ml in group II. Twenty six patients (70.2%) were T3 [group, I (12 patients) and group II (14 patients)] while 11 patients (29.8%) were T4 [group, I (6 patients) and group II (5 patients)]. The Mean follow-up was 61.5 months in group, I and 68 months in group II. There was significant reduction in prostate volume in group, I with a reduction ratio of 25.5% while in group II volume reduction was insignificant. Eleven patients (29.73%) died due to tumor progression, four (10.81%) in group I and seven (18.91%) in group II. Five-year survival rate was 80% in group, I compared to 52.5% in group II. Additionally 5-years biochemical diseasefree survival was 79% in group, I compared to 57% in group II. The time to PSA nadir was earlier in group, I compared to group II (11.2Vs 19.2 months).
Conclusion: Neoadjuvant hormonal therapy combined with radiotherapy showed benefits in terms of 5-year overall survival, biochemical disease-free survival and time to PSA nadir compared to radiotherapy alone. Prospective randomized trial is needed to recommend optimal course, dose and patient selection criteria.
/ 0
- Details
- Category: Vol. 83, December 2015
- Hits: 837
A Study of Serum Nicotine Levels and Pulmonary Function Tests in Passive Cigarette Smokers, IMAM A. AL-SHARIEF, AYMAN A. MOHAMED, MAHMOUD M. ELAASSER and MUSTAFA M. RIDA
/ 0
- Details
- Category: Vol. 83, September 2015
- Hits: 834
Role of Ultrasonography in Evaluation of Knee Joint Synovial Lesions, MAGED A. HAWANA, HATEM M. EL-AZIZY and NAGUI M. ABD EL-WAHAB
Abstract
Background: Synovial lesions involving knee joint are considered common causes of intra articular masses and can be classified as noninfectious synovial proliferative processes (synovial osteochondromatosis, Pigmented Villonodular Syn-ovitis [PVNS], hemophilic hemoarthrosis, rheumatoid arthritis), infectious diseases (septic arthritis) and malignancies (synovial sarcoma, synovial metastases). The use of Ultrasonography (US) in patients with suspected synovial proliferation in inflammatory arthritides has increased dramatically over the last decade and most rheumatologists have adopted this technique as an integral part of routine diagnosis and man-agement of musculoskeletal diseases. An increasing number of publications support the use of US in early detection ,quantification and follow-up of several synovial pathologic changes affecting knee joint.
Aim of the Work: The purpose of this study is to emphasis the role of ultrasonograghy in the assessment of synovial lesions involving knee joint.
Patients and Methods: Thirty nine cases; 25 females and 14 males with 69 symptomatic knee joints were included in this study at the period from November 2011, till January 2014, age range 22 to 62 years old (average 42 years). Patients were referred to the Radiology Department at Kasr Al-Aini Hospital after full clinical examination and laboratory inves-tigations to evaluate their knee joints synovial affection using US and MRI.
Results: The high correlation rate between the results of US and MRI have shown that in patients with knee joint synovial lesions involvement, US is an effective alternative/ complimentary method of examination in detection of knee joint early signs of synovitis, effusion and mass lesions.
/ 0
- Details
- Category: Vol. 81, March 2013
- Hits: 834
64-Slice Computed Tomography Versus Coronary Angiography in Assessment of Stent Pattency, SHERIF S. EL-ZAHWY, RAMY R. ELIAS, HAMDY S. MAHMOUD and MOATASEM M. SAMIR
Abstract
Background: A non-invasive detection of in-stent restenosis (ISR) would result in an easier and safer way to conduct patient follow-up.
Objectives: This study sought to evaluate the diagnostic accuracy of 64-slice multislice computed tomography coronary angiography (MSCT) versus invasive coronary angiography (ICA) in follow-up of patients with previous coronary stent implantation.
Methods: The study population consists of 50 patients (with 118 stented lesions) presenting for follow-up after previous coronary stent (2.5mm diameter) implantation within at least a period of 6 months up to 1 year regardless the presence or absence of symptoms suggestive of instent restenosis. The diagnostic accuracy of MSCT compared with ICA was evaluated.
Results: By ICA, 21 (17%) ISR were diagnosed with a sensitivity, specificity, PPV and NPV of 85.714%, 94.845%, 78.261% and 96.842%. We found that 95 stents (80.5%) screened by MSCT were patent, 92 stents (77.9%) of this total number were seen patent by ICA. While 3 stents (2.5%) of those were seen non patent. Also, 97 stents (82%) of total number of patients taken in this study assessed by ICA were patent, 92 stents (77.9%) of this total number were seen patent by MSCT while 5 stents only (4.2%) were seen non patent by MSCT.
Conclusion: 64-MSCT coronary angiography is a very helpful test in excluding patients with coronary instent rest-enosis.
/ 0
- Details
- Category: Vol. 83, March 2015
- Hits: 832
Hemodynamics and Respiratory Stability during Awake Craniotomy: Dexmedetomidine-Based Sedation Versus Propofol-Based Sedation, MOSTAFA M. ELADANY, FATMA M. KHAMIS, MAGDY A. OMERA, AMGAD A. MATAR and HOSSAM M. MOSTAFA
Abstract
Background: Awake craniotomy aims to remove most of the brain tumour while preserving the eloquent area of the brain, many factors affecting hemodynamics and respiration during awake craniotomy especially sedative drugs: Type and doses.
Aim: To detect hemodynamics and respiratory effects of dexmedetomidine-based sedation and propofol-based sedation in patients undergoing awake craniotomy for resection of brain tumours, which has encroachment on eloquent area of the brain.
Patients and Methods: Randomized, prospective, com-parative clinical trial study was carried out on 28 patients of both sexes undergoing elective surgery for brain tumor resec-tion in the routine surgical lists in Suez Canal University Hospital, from January 2012 to April 2014, patients are divided into two equal groups (14 patients): Propofol group and dexmedetomidine group.
Results: There were more hemodynamically stability and respiratory stability among dexmedetomidine group, there were statistically significant difference between the two groups in some time intervals.
Conclusions: Dexmedetomidine provide more hemody-namically stability and less effects on respiration during awake craniotomy.
/ 0
- Details
- Category: Vol. 84, June 2016
- Hits: 813
The Effect of Vitamin D Replacement Therapy on Serum Leptin and Follicular Growth Pattern in Women with Clomiphene Citrate Resistant Polycystic Ovary, ABD EL-SAMIE ABD ELMONAEM, WAEL SAMIR, FADWA ABD EL-REHEEM and AHMED TANTAWY
Abstract
Objective: To detect the effect of vitamin D on serum leptin and follicular growth pattern in women with clomiphene citrate resistant polycystic ovary.
Methods: 40 female candidates with Polycystic Ovary Syndrome (PCOS) who attended Fayoum University Hospital gynecology outpatient clinic. They are divided into two groups study group twenty patients received vit. D, clomiphene and HMG. Control group twenty patients received only clomiphene and HMG. All women are subjected to measurement of leptin and follicular growth before and after treatment. 25 Hydrox-yvitamin D3 (OHVD3) was done in the study group before and after treatment and in control group only before treatment.
Results: 26 of the patients have deficiency of 25 OHVD3 that represent 65% with the mean in the study group (12.74± 13.29) and the control group (13.77±24.12) with no statistical difference (p=0.868). There was no significant improvement in the follicular growth in the group treated with vit. D in comparison to the other group (65% vs 55%) respectively with p-value=0.519. There is also no statistically significant difference in leptin level after treatment in both groups (p= 0.823).
Conclusion: Vitamin D deficiency is present in about 65% of the PCOS patient. The vitamin D level is not related to BMI, leptin level or FSH level. There is negative correlation between vitamin D level and LH level and FSH/LH ratio. If vitamin D is given with clomiphene citrate and HMG, there was no statistically significant improvement in the follicular growth pattern or leptin level. For that reason, it is recom-mended to do another study on large number of PCOS patients.
/ 0
- Details
- Category: Vol. 83, March 2015
- Hits: 797
Hepatoprotective Potentials of Ghrelin and/or N-Acetyl Cysteine in Thioacetamide Induced Chronic Liver Injury in Rats, NOHA I. HUSSIEN
Abstract
Background: Ghrelin is a gut hormone that has protective effects on many tissues' injury while its role in chronic liver injury (CLI) remains unclear as well as N-acetyl cysteine (NAC) has powerful health benefits derive from its ability to restore intracellular levels of glutathione (GSH), which is the body's most powerful antioxidant.
Objective: This study was designed to detect the hepato-protective potentials of ghrelin or NAC and their combination in thioacetamide (TAA) induced CLI in rats and the possible mechanisms involved.
Material and Methods: Forty male rats were divided into five groups: Group I: Control; Group II: Chronic liver injury (CLI); Group III (CLI+Ghrelin); Group IV: (CLI+NAC); Group V: (CLI+Ghrelin+NAC). Liver enzymes, albumin, bilirubin and tumor necrosis factor alpha (TNF-a) were measured in serum. Nitric oxide (NO), Malondialdehyde (MDA), glutathione peroxidase enzyme (GSH-Px) and hy-droxyproline were assessed in the liver tissue. Histopatholog-ical examinations were also performed for detection of in-flammation and fibrosis.
Results: Results showed that Ghrelin and NAC signifi-cantly decreased liver enzymes, MDA, NO metabolites, bilirubin, hydroxyproline and TNF-a levels with increased GSH-Px and albumin levels. Combination of Ghrelin and NAC leads to more improvement in all parameters reaching the control level. Furthermore histopathological examination showed that Ghrelin has more protective effect on CLI than NAC, while their combination showed the most protective effect.
Conclusion: These findings suggested that Ghrelin and NAC have promising hepatoprotective potential against TTA induced chronic liver injury by their anti-oxidant, anti-inflammatory and anti-fibrotic effects. As well as Ghrelin has more protective effect than NAC in histopathological exam-ination.