Medical Dental Practitioners Assessments of Electronic Dental Record in Primary Health Care in Kuwait
BASHAIR A. ALMUTAIRI, Ph.D.;
HENRY W.W. POTTS, Ph.D.
author
NOURA H.
ALAJMI, Ph.D.
The Departments of Medical Record*, Oral & Dental Health***, College of Health Sciences, Public Authority for Applied Education and Training, Kuwait and UCL Institute of Health Informatics, University College of London, London, United Kingdom**
author
text
article
2018
eng
AbstractBackground: The adopting of electronic patient records can improve healthcare quality and efficiency, including in dentistry. Doctors understanding are important for the suc-cessful implementation of such systems into routine use.Aim of the Study: The study objective was to assess the dentists prospective about electronic dental records.Material and Methods: For this cross-sectional national survey, 300 self-administered questionnaires were distributed to dentists working at randomly selected primary-health centers in the five healthcare regions of Kuwait during November (2016) and March (2017). We received 247 completed ques-tionnaires (82% response rate). This study collected socio-demographic data and responses on Likert scales to 44 state-ments on the benefits, features and functionality of electronic records, accessing and sharing, as well as obstacles preventing their use and practitioners' resistance.Results: Participants responded very positively, particularly on issues such as the storage of radiographic images (85% agreed) and records (89%), sharing patient records with other dentists (96%), and the potential for improving medical histories (98%). The main obstacles to uptake identified were software/hardware issues (57%) and the need for technical training (55%) and maintenance (65%). There was some regional variation in positive responses.Conclusions: Kuwaiti medical dental practitioners recog-nize the need for electronic patient records to optimize the quality of patient care. They generally have positive attitudes towards electronic records, and most agree that accessing and sharing them with other healthcare providers is useful. They identified several obstacles to uptake, such as the need for technical support and training. Our findings indicate a context supportive of the widespread adoption of electronic dental records in Kuwait.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1083
1091
https://mjcu.journals.ekb.eg/article_56121_56c0c4b312992a7e02bfee084e6489ef.pdf
dx.doi.org/10.21608/mjcu.2018.56121
Effect of Electrical Stimulation of Abdominal and Back Muscles on Balance in Children with Spastic Diplegia
NOUR EL-HODA M. AHMED, B.Sc.;
EMAM H. EL-NEGAMY, Ph.D.
author
AMINA H. SALEM, M.D.;
RAMI M. GHARIB, Ph.D.
The Department of Physical Therapy for Growth & Development Disorders in Children & its Surgery,
Faculty of Physical Therapy* and The Department of Pediatric Neurology, Faculty of Medicine**, Cairo University
author
text
article
2018
eng
AbstractBackground: Spastic diplegia is one of the most common clinical subtypes of cerebral palsy regardless of birth weight and gestation. It is used when there is motor impairment in the upper extremities as well as the lower extremities, although it is milder in the upper extremities than the lower one. Children with spastic diplegia may exhibit clumsiness and frequent falls during regular motor activities or may not be able to maintain standing position independently.Aim of the Study: The purpose of this study was to inves-tigate the effect of neuromuscular electrical stimulation of abdominal and back muscles on balance in spastic diplegic children.Material and Methods: Thirty children with spastic diple-gic CP of both sexes were selected, ranging in age from 4 to 8 years. They were classified randomly into two groups of equal number (A & B). Evaluation of children balance was performed before and after 6 weeks of treatment using Biodex stability system. Group (A) received traditional physical therapy program based on neurodevelopmental approach used for rehabilitation of such patients and Group (B) received the same traditional physical therapy program applied on Group (A) in addition to 30min neuromuscular electrical stimulation of abdominal and back muscles.Results: No significant difference in Overall Dynamic Stability Index, Antero/Posterior Stability Index and, Medio/ Lateral Stability Index (ODSI, APSI, and MLSI) was recorded between the two groups before treatment, significant improve-ment was recorded in ODSI, APSI, and MLSI in each group after treatment. Significant differences in ODSI, APSI, and MLSI were recorded between the two groups after treatment in favor of Group (B).Conclusion: From the obtained results of this study, supported by the relevant literature it can be concluded that neuromuscular electrical stimulation of abdominal and back muscles can be added to the physical therapy program to improve the balance in spastic diplegic children.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1093
1098
https://mjcu.journals.ekb.eg/article_56122_edf897b15cd451b29b93961cd9b5ad3f.pdf
dx.doi.org/10.21608/mjcu.2018.56122
Relationship between Mechanical Neck Pain and Dorsal Hyperkyphosis
EMAN M.A. TANTAWY, M.Sc.;
NADIA A. FAYAZ, Ph.D.
author
KARIMA A. HASSAN, Ph.D.;
AHMED H.E. AZZAM, Ph.D.
The Department of Physical Therapy, National Medical Institute, Damanhour*, The Department of Physical Therapy for Musculoskeletal Disorders, Faculty of Physical Therapy** and Orthopedic Surgery, Faculty of Medicine***, Cairo University, Egypt
author
text
article
2018
eng
AbstractBackground: Dorsal hyperkyphosis is a condition indicated by the abnormal increase in the curvature convexity of the thoracic vertebral column. The neck pain is a common clinical complaint that commonly seen at physiotherapy clinics all over the world. In order to properly prevent or treat a clinical problem, potential risk factors need to be identified.Aim of the Study: The purpose of this study was to inves-tigate the correlation between thoracic hyperkyphosis and cervical ROM, neck pain and functional abilities of the neck.Subjects and Methods: Sixty subjects diagnosed as me-chanical neck pain with dorsal hyperkyphosis of both sexes participated in this study. Their ages ranged from 20 to 40 years. Agreement of the Ethical Committee of Faculty of Physical Therapy was obtained before beginning of the study, degree of hyerkyphosis was measured by gravity dependent inclinometer, assessment of cervical range of motion was performed by the researcher via using OB Myrien inclinometer, VAS scale was used for assessment of neck pain, and NDI was used for assessment of neck disabilities.Results: There was a statistical significant positive corre-lation between degree of hyperkyphosis and neck pain, there was a statistical significant negative correlation between degree of hyperkyphosis and neck extension, there was no correlation between degree of hyperkyphosis and neck disa-bilities and there was no correlation between degree of hyper-kyphosis and neck flexion, side bending and neck rotation.Conclusion: Degree of dorsal hyperkyphosis could affect the severity of neck pain and could decrease the mobility of the neck in the extention range of motion. On the other side degree of dorsal hyperkyphosis couldn't affect neck abilities and the mobility of the neck in the other directions.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1099
1099
https://mjcu.journals.ekb.eg/article_56123_6ad06f58f12e534e0a88ade665681080.pdf
dx.doi.org/10.21608/mjcu.2018.56123
Effect of Pronated Foot Posture on the Arabic Version of WOMAC Index in Women with Medial Compartment Knee Osteoarthritis
AALAA M. SWEELAM, M.Sc.;
SALWA F. ABD EL-MAGEED, Ph.D.
author
EBTESSAM F. GOMAA, Ph.D.;
AHMAD H. AZZAM, M.D.
author
text
article
2018
eng
AbstractBackground: Knee Osteoarthritis (KOA) is one of the most common musculoskeletal conditions affecting old pop-ulation and is rated as the 4th suspected cause of disability by year 2020. Recent studies have reported difference in foot characteristics between people with medial compartment KOA and asymptomatic controls, indicating a more pronated foot posture in those with OA. Abnormal feet position is associated with altered lower extremity functional and muscle activation patterns.Aim of the Study: To investigate the effect of pronated foot posture on the Arabic Version of WOMAC index in women with knee osteoarthritis.Patients and Methods: Sixty six female patients with mean ages (61.66±5.77) years and body mass index (28.71± 1.16) Kg/m2 with primary knee osteoarthritis grade II, III only with a radiographic and diagnostic criterion knee pain participated in this study. Foot posture assessment was done first to categorize them into 3 groups (normal, pronated and supinated) feet using foot posture index. Group (A) normal foot consisted of 24 participants. Group (B) pronated foot consisted of 24 participants. Group (C) supinated foot consisted of 18 participants; knee function assessment was done by using the Arabic version of WOMAC index.Results: The results demonstrated that that there was significant difference between (Group B (pronated) Vs. Group C (supinated)) with significant increase in ArWOMAC subscale for physical function in favor to Group B (pronated) while no significant difference was found in the other two subscales (pain and stiffness)of the ArWOMAC index (F=1.368, p= 0.203).Conclusion: It can be concluded that there was a significant effect of pronated foot posture on physical function subscale of ArWOMAC index in KOA, while all other foot postures don't affect pain, stiffness or physical function subscales of ArWOMAC index in patients with KOA.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1111
1117
https://mjcu.journals.ekb.eg/article_56125_dd75f8cc6e140769226144e55e6621a9.pdf
dx.doi.org/10.21608/mjcu.2018.56125
Early Intervention of Ultrasound and Active Mobilization Post Surgical Repair of Hand Flexor Tendon Laceration
AHMED M. ZARRAA, M.Sc.;
MOHAMED M. KHALLAF, Ph.D.
author
ASHRAF A. KHALIL, M.D.;
WALID A. ABOU EL-NAGA, Ph.D.
The Departments of Physical Therapy for Surgery, Faculty of Physical Therapy* and The Department of Plastic Surgery, Faculty of Medicine**, Cairo University
author
text
article
2018
eng
AbstractBackground: Hand flexor tendon lacerations are very common and their surgical repair and postoperative rehabili-tation, particularly in zone II, present a formidable challenge to hand surgeons and therapists.Purpose: The current study was conducted to investigate the effect of an early intervention of ultrasound and active mobilization on Interphalangeal (IP) joints active Range of Motion (ROM) affected by peritendinous adhesions post surgical repair of hand flexor tendon laceration.Subjects and Methods: 30 male patients who underwent zone II flexor tendon primary direct four-strand repair tech-nique participated in this study. Their ages ranged from 20 to 35 years. They were selected from Cairo University Hospitals and divided randomly into three groups: Group (A) composed of 10 patients (15 operated digits) who received early Ultra-sound (US) therapy, and at the 4th and 6th post-operative weeks, the 2nd and 3rd phases of Early Active Mobilization (EAM) program were added respectively to the US therapy, Group (B) composed of 10 patients (16 operated digits) who received EAM, and Group (C) composed of 10 patients (16 operated digits) who received early intervention of US therapy and active mobilization. Patients in each group received the treatment (3 sessions/week) from the 3rd day post-operative till the end of the 6th week post-operative. Post surgical medical care (medications including analgesics and antibiotics, and wound dressings) was provided for all patients in each group. Finger goniometer was used to measure the IP joints active ROM of the operated digits at end of 3rd and 6th post-operative weeks.Results: Group A, B, and C showed significant improve-ment in the active ROM at end of 6th week post-operative compared with that at end of 3rd week post-operative. There was a significant improvement in the active ROM at end of 3rd and 6th week post-operative of Group B compared with Group A. Group C showed significant improvement in the active ROM at end of 3rd and 6th week post-operative when compared to Group A but no significant improvement when compared to Group B.Conclusion: Early intervention of US and active mobili-zation can improve the IP joints active ROM post flexor tendon repair significantly more than early US therapy alone but not significantly more than EAM alone.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1119
1128
https://mjcu.journals.ekb.eg/article_56126_0349dc9dbbf9ef765504af7b52cdfc3f.pdf
dx.doi.org/10.21608/mjcu.2018.56126
Occupational Health Hazards as Perceived by Poultry Processing Slaughterhouse Workers
HANAA H. MOHAMMED, M.Sc.;
SANEYA M. RIZK, D.N.Sc.
author
EBTESAM M.
EBIED, D.N.Sc.
The Departments of Community Health Nursing* and Gerontological Health Nursing**, Faculty of Nursing, Cairo University
author
text
article
2018
eng
AbstractBackground: Poultry workers are exposed to a variety of occupational health hazards on a daily basis.Aim of the Study: The study aimed to assess occupational health hazards as perceived by poultry processing slaughter-house workers. A descriptive exploratory research design was utilized.Material and Methods: Setting; the study was conducted in large poultry slaughterhouse at El-Menofia Governorate. A systematic random sample of 278 poultry workers was selected. one tool was used to collect data which includes 4 parts demographic data, occupational and medical history of worker, health habits and life style and workers' perception of occupational health hazards which consists of knowledge of workers about physical, chemical, mechanical, psychological and biological hazards and self reported practices.Results: Reveals that 46.8% of workers aged more than 30 years old. Furthermore 71.9% of workers had unsatisfactory level of knowledge. While 80.6% of workers had unsatisfactory level of self reported practices. There was a highly statistical significant correlation between the workers' total knowledge and their self reported practices (p=0.0001). There was also a highly statistical significant correlation between workers' educational level, knowledge and self reported practices (p=0.0001).Conclusion: Study concluded that workers had unsatis-factory level of perception (knowledge and self reported practices) regarding occupational health hazards they are exposed to.Recommendations: It is recommended to raise workers' awareness about occupational hazards they are exposed to through occupational health programs to promote workers' health, ensure safety and enhance productivity.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1129
1138
https://mjcu.journals.ekb.eg/article_56127_6bd53b093452f6659278b2af59e5ee02.pdf
dx.doi.org/10.21608/mjcu.2018.56127
Relationship between Static Lower Limb Alignment and Patellofemoral Pain Syndrome
GAMILA S.T. ABBAS, M.Sc.;
NADIA A. FAYAZ, Ph.D.
author
KARIMA A. HASSAN, Ph.D.;
AHMED H. ABD EL-AZEEM, M.D.
author
text
article
2018
eng
AbstractBackground: Patellofemoral Pain Syndrome (PFPS) is one of the most common orthopedic knee conditions encoun-tered in athletes and general population and is more prevalent in females than in males. Lower limb malalignment is an important etiological factor for PFPS.Aim of the Study: The purpose of this study was to deter-mine if there was any relationship between static lower extremity alignment and PFPS.Patients and Methods: Forty nine patients (38 females and 11 males) diagnosed as PFPS had participated in this study with age ranged from eighteen to thirty five years. Each patient was assessed for static lower limb alignment measures (pelvic tilting angle, tibial torsion using PALM (PALpation meter); femoral neck anteversion using inclinometer; Q-angle, tibiofemoral angle using plastic standard goniometer and navicular drop using ruler) and patellofemoral pain by kujala scale.Results: The results showed no relationship between lower limb alignment measures and PFPS Pelvic angle (r=0.03, p=0.839), Tibial torsion (r=0.145, p=0.319), Q-angle (r= 0.074, p=0.612), Tibiofemoral angle (r=0.051, p=0.729), FNA (r=–0.144, p=0.436), Navicular drop (r=0.03, p=0.836).Conclusion: Lower extremity malalignment does not affect pain and function in patients with PFPS.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1139
1148
https://mjcu.journals.ekb.eg/article_56129_db78a9313e870435526aac3b609081b1.pdf
dx.doi.org/10.21608/mjcu.2018.56129
Frontoorbital Advancement and Forehead Remodeling for Correction of Anterior Calvarial Craniosynostosis, Surgical Technique and Results in Low Economic Facilities: Benha Experience
MOHAMMED H. EL-TANTAWY, M.D.;
AHMED A. ARAB, M.D.
author
MOHAMMED
EL-SAYED, M.D.
The Departments of Neurosurgery* and ENT**, Faculty of Medicine, Benha University, Benha, Egypt
author
text
article
2018
eng
AbstractBackground: Craniosynostosis is a congenital problem that affects brain development and causes disfigurement of the head and face. Anterior calvarial craniosynostosis involves the metopic and/or coronal sutures. The most accepted surgical correction involves frontoorbital advancement and forehead remodeling. Lack of knowledge about craniosynostosis, the need for equipped facilities in addition to the fear of compli-cations from surgery led to delay in doing surgery at the optimum age, and with this delay more complex surgical techniques are needed, with a less favorable outcome.Aim of the Study: In this study, we described our experience and technique in surgical correction of anterior calvarial craniosynostosis at Benha University Hospital using the frontoorbital advancement technique without the use of any expensive miniplates or helmets compensating the low soci-oeconomic standard of the community.Study Design: This is a retrospective study case series of 15 patients, their ages ranged from 4 to 30 months. All patients have anterior calvarial craniosynostosis and were treated surgically using the frontoorbital advancement technique. Patients had been followed after surgery for a period of time ranged from 8 to 20 months during the years from March 2013 to December 2016.Patients and Methods: Fifteen patients were included; four with pure metopic craniosynostosis, five with combined metopic and coronal, four patients with bilateral coronal and two with unilateral coronal. Patients were clinically and radiologically evaluated using CT scan skull with 3D recon-struction. Pre and post-operative scans as well as patient photographs have been compared and evaluated for the degree of correction of the relationship between the supra orbital bar and the cornea as well as the degree of correction of the deformity in the face and forehead.Results: Out of 15 patients with craniosynostosis involved in this study, 11 (73.3%) patients had achieved very good cosmetic and functional outcome, two patients (13.3%) had an unsatisfactory cosmetic outcome in the form of irregularities in the shape of the skull that necessitated to do another surgery, one patient (6.67%) had a bad cosmetic outcome, and one patient died in the early post-operative period.Conclusion: Frontoorbital advancement with forehead remodeling is the best option for treating anterior calvarial craniosynostosis. For achieving better results surgery should be done at the optimum age and in well equipped medical center. Although using miniplates and helmets may help with the outcome, surgery can be performed with minimal resources in accordance with the economic state of the community with good results.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1149
1158
https://mjcu.journals.ekb.eg/article_56130_ecd68de7470e838315fc5c5b3f66bc4b.pdf
dx.doi.org/10.21608/mjcu.2018.56130
Value of Thoracoscopic Lung Biopsy in Diagnosis of Diffuse Interstitial Lung Diseases
ISMAEIL A. ATTIA, M.D.;
MOHAMED S. AL-HAKIM, M.D.
author
KHALED M.I. HALIMA, M.D.;
MOAZ A.E. ABD EL-ATI, M.Sc.
The Departments of Chest Diseases* and Histopathology**, Faculty of Medicine, Al-Azhar University, Egypt
author
text
article
2018
eng
AbstractBackground: Diffuse interstitial lung disease represent a diagnostic difficulty because the etiology is frequently uni-dentified. Lung biopsy may be necessary for the diagnosis, particularly in patients who do not suffer a well established underlying disease that comprises the lungs or have a well defined environmental exposure. Medical thoracoscopy for lung biopsy provides better inspection of the lung and allows more areas to be biopsied in contrast to the surgical biopsy that limit the choice of biopsy to the most accessible area.Aim of the Study: To determine the diagnostic value of lung biopsy taken by thoracoscopy in diagnosis of different interstitial lung diseases.Subjects and Methods: This study was conducted at Endoscopy Unit in Chest Department, Bab El-Sha'aria and Al-Hussin Hospitals, Al-Azhar University in the period be-tween July 2015 to September 2017. Medical thoracoscopic lung biopsy using coagulation cup forceps was performed in forty patients with diffuse lung disease that is not specified after full clinical and investigational assessment.Results: The diagnosis was obtained in all patients 100% of cases and the distribution of pathological diagnosis among patients was as the following idiopathic pulmonary fibrosis was diagnosed in 18 patients (45%), chronic hypersensitivity pneumonitis in 6 patients (15%), sarcoidosis in 5 patients (12.5%), non-specific interstitial pneumonia in 4 patients (10%), desquamative interstitial pneumonia in three patients (5%), silicosis in tow patients (5%), and finally adenocarci-noma in tow patients (5%). The mean duration for chest tube placement after thoracoscopy was 3.7 days. There was no complications in 37 (92.5%) of patients, three patients (5%) develop surgical emphysema and only one patient (2.5%) develop empyema.Conclusion: Medical thoracoscopy using coagulation cup forceps biopsy technique is a simple procedure that can be performed safely under local anaethesia with spontaneous ventilation for diagnosis of diffuse interstitial lung diseases that remain undiagnosed after extensive investigations.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1159
1163
https://mjcu.journals.ekb.eg/article_56131_7ab98c73c16815e20a11df1cec7e6e64.pdf
dx.doi.org/10.21608/mjcu.2018.56131
Accuracy of Ultrasound in Estimating Fetal Weight at Term
SAAD MOKHTAR, M.Sc.;
MOHAMED S.M. FOUAD, M.D.
author
MAHMOUD S.
ISMAIL, M.D.
The Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
text
article
2018
eng
AbstractBackground: To compare the accuracy of different sono-graphic formulae for fetal weight estimation at term.Material and Methods: Comparative cross-sectional study to evaluate 8 different formulae using 300 sonographic weight estimations performed within 24 hours before delivery. Using correlation coefficient, regression analysis and Bland and Altman method, to compare between the studied formulae with each other and knowing the effect the different fetal biometric indices on accuracy of estimates by ultrasound.Results: A considerable variation in the accuracy of the different formulae was found. For Birth Weights (BWs) in the range of 2500 to 3500g, formulae based on 3 or 4 fetal biometric indices were significantly more accurate than formulae that incorporated only 1 or 2 indices. The accuracy of formulae decreased at the extreme of birth weight >_4000gs, leading to underestimation of ABW (actual birth weight).Conclusion: We conclude that to improve the accuracy of fetal weight estimation, sonographic formulae that are based on 3 or 4 fetal biometric indices should be preferred.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1165
1170
https://mjcu.journals.ekb.eg/article_56133_a0ffca1582f1fffa87a3664ebc8de989.pdf
dx.doi.org/10.21608/mjcu.2018.56133
Clinical Values of Orally Administrated Gastrografin in Management of Adhesive Small Bowel Obstruction
SAMY OSMAN, M.D.;
HANY ABD EL-KAREEM, M.D.
author
MOHAMED YAHYA, M.D.;
AHMED SALAH, M.Sc.
The Department of General Surgery, Faculty of Medicine, Assiut University Hospital, Assiut, Egypt
author
text
article
2018
eng
AbstractBackground: Adhesive Small Bowel Obstruction (ASBO) is the most common cause of small bowel obstruction. Patients with ASBO are difficult to evaluate and to manage and their treatment is still controversial. Diagnostic and therapeutic benefits of oral gastrografin in management of patients with ASBO are investigated by several studies, but there is no consensus.Aim of the Study: The aim of the study was to assess the diagnostic and therapeutic roles in the management of ASBO of gastrografin in cases of ASBO.Material and Methods: A total of 80 patients diagnosed as ASBO were included in this study. Patients were randomized into control and gastrografin groups. In the gastrografin group 100mL of gastrografin was administered through a nasogastric tube followed by serial abdominal radiographs. Patients in whom the contrast failed to reach large bowel within 24h were considered to have complete obstruction and laparotomy was performed. Patients in whom gastrografin reach in the colon within 24h after dye administration were considered as partially obstructed, and conservative treatment was continued. The patients were operated on if signs of strangulation were developed or they failed to improve within 48h.Results: Out of forty patients with ASBO received oral gastrografin, six patients required surgical intervention with operative rate of 15% in control group. Four-teen out of forty patients treated with the traditional conservative treatment required surgical intervention with operative rate of 35% in control group. Hospital stay was shorter in gastrografin group (3.2 days), than in control group (5.3 days).Conclusion: The use of gastrografin in ASBO reduces the surgical rate, resolution time and the hospital stay.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1171
1177
https://mjcu.journals.ekb.eg/article_56134_918a18400e7d52adf1732df077c53141.pdf
dx.doi.org/10.21608/mjcu.2018.56134
Role of Fibrin Glue in Management of Perianal Fistula in Assiut University Hospital
TAREK A. MOSTAFA, M.D.;
MOSTAFA A. ABD AZIZ, M.D.
author
AHMED M. ALI, M.D.;
MOHAMED B. NOAMAN, M.Sc.
The Department of General Surgery, Faculty of Medicine, Assiut University, Assiut, Egypt
author
text
article
2018
eng
AbstractBackground: A fistula-in-ano is an abnormal hollow tract or cavity that is lined with granulation tissue and that connects a primary opening inside the anal canal to a secondary opening in the perianal skin; secondary tracts may be multiple and can extend from the same primary opening.Patients and Methods: In our study we had 40 patients who were complainingof fistula in ano (high and low perianal fistula). They were evaluated in the post-operative period for the complications as recurence, sphincteric disturbance, post-operative abscess and post-operative pain from June 2016 till May 2017 in the General Surgery Department in Assiut University Hospital.Results: After injection of 40 cases of perianal fistula it was found that 5 cases out of 16 cases of high perianal fistula (31.2%) developed recurrence of their fistulas tract, while 11cases did not develop recurrence (69.8%) after 6 moths follow-up. On the other hand 5 cases of low perianal fistula out of 24 cases (20.8%) developed recurrence of their fistulas with 19 cases (79.2%) that did not develop recurrence their fistulous tract after 6 months follow-up. Other complication noticed in this study was post-operative abscess and reported in 3 cases only (7.5%). There was no post-operative inconti-nence or post-operative pain or bleeding reported in this study.Conclusion: Injection of fibrin glue in aperianal fistula is simple, easy and safe technique with lower rate of compli-cation as loss of sphincteric function, post-operative pain, intra operative bleeding and post-operative wound infection. This technique can be repeated even at the out patient clinic.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1179
1183
https://mjcu.journals.ekb.eg/article_56265_39cd5d3f47a70afc4be88fc9b28467a7.pdf
dx.doi.org/10.21608/mjcu.2018.56265
Inguinal Hernial Repair, Laparoscopic versus Open Approach
AHMED R. MAHMOUD, M.Sc.;
MOHAMED A. OSMAN, M.D.
author
MOHAMMED Y.
FARRAG, M.D.
The Department of General Surgery, Faculty of Medicine, Assiut University
author
text
article
2018
eng
AbstractBackground: Hernia occurs when soft tissue (usually omentum) or part of the intestine protrudes through a weak point in the abdominal muscles. In our study, comparison is between laparoscopic and open approaches in inguinal hernia repair.Patients and Methods: Our study include a 30 patients with inguinal hernia subjected to hernioplasty in the Depart-ment of Surgery, Assiut University. Group A: 15 patients subjected to open surgery and Group B: 15 subjected to laparosopic surgery.Results: In comparison between Group A and B the operative time is more in laparoscopic group, with more postoperative pain in open group, and more post-operative pain in laparoscopic group.Conclusion: Assessment of laparoscopic inguinal hernia repair found that it has some advantages that make them more preferable than open repair: Less post-operative pain, less recovery time the patient returns quickly to their full activities, diagnostic laparoscopy was performed together with hernia repair, hernia sac repair at the highest possible site, more cosmotic incision with decrease in incidence of recurrent hernia. Some disadvantages may appear with laparoscopic hernia repair as: Bladder, bowel, vascular injuries, the need of general anesthesia, with increase cost of the operation. Laparoscopic hernia repair has a role in management of patients with recurrent hernia or bilateral inguinal hernia.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1185
1185
https://mjcu.journals.ekb.eg/article_56268_3b16d44585add8380e4b350764baa097.pdf
dx.doi.org/10.21608/mjcu.2018.56268
Salmonella Typhimurium Treated by Gamma Radiation as an Approach for Cancer Management
IBRAHIM H. BORAI, Ph.D.;
ZAHIRA S. TAWFIK, Ph.D.
author
EMAN N. ALY, Ph.D.;
EMAN N. ALY, Ph.D.
author
SAWSAN MOHAMMED EL-SONBATY, Ph.D.;
NEVEEN A. MOHAMED, M.Sc.
The Department of Biochemistry, Faculty of Science, Ain-Shams University* and The Departments of Radiation Microbiology** and Radiation Biology***, National Center for Radiation Research and Technology, Atomic Energy Authority, Cairo, Egypt
author
text
article
2018
eng
AbstractBackground: Salmonellae are gram-negative, facultative anaerobes, it can survive and colonize in hypoxic environment of the tumor, leading to a substantial reduction in the tumor size. Bacteria can be attenuated by radiation which resulted in complete loss of replicative ability but remained metabol-ically active.Aim of the Work: This study was conducted to evaluate the efficiency of y-radiation as a tool to decrease the virulence of Salmonella typhimurium wild type strain ATCC 14028 (S. typhimurium.WT.) capable of tumor regression.Methods: Exposure of Salmonella typhimurium wild type strain (S.typhimurium.WT.) to different doses of y-radiation, testing S.typhimurium.WT. that exposed to different doses of y radiation for cytotoxic activity in vitro, and its pathogenicity in mice as well as the wild type strain was assessed. The antitumor activity of the y-irradiated Salmonella in vivo was tested as well. Sixty adult male weighty 20-25g were used for this purpose and the mice divided into 6 experimental group, three of these groups were mice bearing EACs solid tumor, after the tumor volume reached approximately 1cm3, the mice were treated with S.typhimurium.WT. parent strain and S.typhimurium.WT. exposed to 1and 4kGy y-irradiation dose histopathological analysis, as well as, proliferation and immunological biomarker, was assessed. The study has been carried out for last three years in the National Center for Radiation Research and technology, Atomic Energy Authority, Egypt.Results: Results showed a reduction in S.typhimurium.WT. viable count with the increase of y-radiation exposure dose, also a highly significant inhabitation in EAC cells count % was occurred when S.typhimurium.WT. exposed to y radiation at dose of 1 and 4kGy, it was found S.typhimurium y-1kGy give a high inhabitation percentage in cell line and became less virulent to mice than S.typhimurium wild type strain, results revealed that, treatment with S. typhimurium y1kGy caused retardation in tumor growth in mice bearing tumor groups more than the wild type strain do. This was leading to a reduction in tumor volume accompanied with a significant increase in caspase-3 activity. In addition, histopathological analysis revealed that irradiated Salmonella achieve improve-ment of the muscular thigh tissue compared to EAC tumor bearing mice.Conclusion: The exposure of S.typhimurium.WT. to y-radiation decreases its virulence in mice and increase its antitumor activity in vivo and in vitro.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1193
1202
https://mjcu.journals.ekb.eg/article_56270_08f45f31b97b1f799cce66ec413b6e9e.pdf
dx.doi.org/10.21608/mjcu.2018.56270
Comparative Study between Hydrostatic Reduction of Infantile Intussusception by Saline and Air Under Sonographic Guidance in Assiut University Hospital
AHMED R. ABD EL-MEGEED, M.Sc.;
AHMED T. ZAYAN, M.D.
author
ABDALLAH B. ABDALLAH, M.D.;
ALMOATAZ A. EL-TAYEB, M.D.
The Department of General Surgery, Faculty of Medicine, Assiut University, Assiut, Egypt
author
text
article
2018
eng
AbstractBackground: Intussusception is the invagination of one bowel segment into another, Once the diagnosis is settled, reduction of intussusception is an emergency procedure to be carried out immediately, reduction is done either by saline or air enema [1].Patients and Methods: Our study included 40 cases with infantile intussusception to evaluate the safety and efficacy of reduction of intussusception by using either air (group A) or saline enema reduction (group B) from November 2016 till April 2017 in General Surgery Department, Assiut Univer-sity Hospital.Results: Successful reduction was achieved in 90% of group A (pneumatic reduction) and 85% of group B (hydrostatic reduction ), group A show less complication rate than group B as there is only one perforated cases in group A while 2 perfoation in group B.Conclusion: Pneumatic reduction under US guidance avoid the exposure to radiation as with fluoroscopy and also can identify if there is any recurrence or resuidal intussuception. Pneumatic reduction is safe in 95% of cases and effective method of reduction of intussusception with less complication rate than that with hydrostatic reduction.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1203
1208
https://mjcu.journals.ekb.eg/article_56272_2544a34d3e8a928b8f61030abd39bc94.pdf
dx.doi.org/10.21608/mjcu.2018.56272
Clinical Audit on Sedation in Mechanically Ventilated Child
ASMAA H. SHOREIT, M.D.;
MOHAMED A. FATHY, M.D.
author
MAHMOUD K.
AHMED, M.Sc.
The Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt
author
text
article
2018
eng
AbstractBackground: Sedation is a necessary component in the care of all critically ill patients, especially those requiring mechanical ventilation to prevent asynchronous ventilation, improve oxygenation, and prevent inadvertent extubation.Patients and Methods: Data of 100 children (1m-18y) age receiving mechanical ventilation in pediatric intensive care unit of Assiut University Children Hospital during period of six months from April 2016 to October 2016 is collected and analyzed and is compared with the standard guidelines according to American Association of Critical Care (2012) as a reference standard in sedation in mechanically ventilated child.Results: Midazolam is the most common drug used by (70%) of cases. Monitoring of sedation by sedation assessment scale (simplified COMFORT scale) done only for (30%) of cases.Conclusion: We need to stick with the international guidelines as a reference standard to facilitate the correct selection of drugs, their appropriate administration and careful monitoring, improve the quality of sedation and avoid their adverse effects.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1209
1212
https://mjcu.journals.ekb.eg/article_56274_82956270fb1c81d2be06227191cdf329.pdf
dx.doi.org/10.21608/mjcu.2018.56274
The Correlation between Macular Ischemia by Fundus Fluorescein Angiography and Spectral Domain Optical Coherence Tomography Findings in Diabetic Macular Edema
DINA T. ABDEL-SALAM, M.Sc.;
AHMED DAHAB, M.D.
author
ADEL FATHY, M.D.;
KARIM RAAFAT, M.D.
The Department of Ophthalmology, Faculty of Medicine, Cairo University
author
text
article
2018
eng
AbstractBackground: To study the association between the OCT structural changes, and vascular changes around the fovea in FFA in the detection of ischemic diabetic maculopathy.Material and Methods: A 35 eyes of 25 patients with ischemic and mixed diabetic maculopathy were included as determined by irregular margins of the FAZ in fluorescein angiography. We measured the best-corrected visual acuity (BCVA), central macular thickness, inner retinal layer thickness and the lateral extent of inner segment-outer segment (IS-OS) disruption on SD-OCT images, as well as the FAZ to optic nerve head (FAZ/ONH) area ratio using the Image J program.Results: The central macular thickness and the inner retinal layer thickness showed no significant correlation with FAZ/ONH area ratio (p=0.161, 0.480 respectively). The mean horizontal and vertical extents of IS-OS disruption were not significantly correlated with FAZ/ONH area ratio (p=0.630 and p=0.732 respectively. The horizontal and vertical extents of IS-OS disruption showed a significant correlation with Log MAR BCVA (r=0.798 and 0.795 respectively, p<0.001 in both). The FAZ/ONH area ratio was positively correlated with LogMAR BCVA but was not statistically significant (p=0.815, r=–0.041).Conclusion: In patients with diabetic retinopathy, it is not possible to predict FAZ area based solely on the measure-ments assessing volume and thickness or retinal structure evaluation on OCT. Consequently, at present OCT cannot replace FA in the detection of ischemic or mixed diabetic maculopathy.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1213
1219
https://mjcu.journals.ekb.eg/article_56275_736f918fd7205ddbe0d2f7f076f7eac6.pdf
dx.doi.org/10.21608/mjcu.2018.56275
Evaluation of the Functional and Clinical Outcome of Intramedullary Osteosynthesis with Gamma Nail in Treatment of Unstable Peritrochanteric Fractures
AHMED M. MOHAMMED, M.D.;
YASSER A. RADWAN, M.D.
author
MOHAMMED ABO ELSOUD, M.D.;
EHAB A. HUSSEIN, M.D.
author
HOSSAM ELDIN E.
MOHAMMED, M.D.
The Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University and Al-Helal Hospital
author
text
article
2018
eng
AbstractBackground: Peritrochanteric fractures of the femur rank among the most common fractures in elderly people. The Gamma Nail is one of the latest advances in the treatment of trochanteric fractures based on intramedullary nailing principles during closed procedures.Purpose: This paper is made to assess the Functional & clinical Outcome of closed intramedullary osteosynthesis with a gamma nail in the treatment of unstable peritrochanteric fractures.Material and Methods: The study was based on a total of 30 patients surgically treated for unstable peritrochanteric femoral fracture by gamma nail fixation in the period between June/2012 till February/2014, including 10 males and 20 females with the mean age is 67.63 (range 50 to 81). The right side was affected in 16 patients and left side was affected in 14.Results: There were 28 patients (93.33%) with good reductions while there was 2 cases with mild displacement (<8mm) in both AP & lateral views but considered accepted. The fracture had healed in all the patients with no significant varus displacement except in 2 patients where their fracture had healed with mild (<20) degrees varus angulations. No intraoperative complication were reported. Post operative fracture of femur midshaft had occurred in 1 patient after 10 weeks. Screw cutout had occurred also in 1 case while 3 cases sustained suerficial infection. Recovery situations of all patients were evaluated based on Harris scoring with an average of 87 points. There are indications and improved functional outcome in the treatment of unstable intertrochanter-ic fracture with Gamma 3 intramedullary nail.Conclusion: Various studies found favorable results with gamma nail in managing a greater variety of unstable hip fractures with a less invasive technique and with better results. Other studies have reported favorable results with GN in terms of shorter operation time, less blood loss, shorter hospital stay, decreased wound infection and reduced complication rate.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1221
1225
https://mjcu.journals.ekb.eg/article_56277_587e07f40c5a007ad040342bb4d30cce.pdf
dx.doi.org/10.21608/mjcu.2018.56277
Case Report: An Unusual Clinical Presentation of Acute Lymphoblastic Leukemia in a Child
ZEINH H. FARDAN, M.D.;
HESSA M. GILBAN, M.D.
author
ALI H. ASIRI, M.D.;
ASHWAG A. ASIRI, M.B.B.S.
author
ABDULLAH A.
ALAMOUDI, M.B.B.S.
The Department of Child Health, King Khalid University*, Pediatrics Department, Maternity & Children's Hospital** and Resident of Pediatrics, Department of Child Health, King Khalid University***, Abha, Saudi Arabia
author
text
article
2018
eng
AbstractBackground: Acute lymphoblastic leukemia (ALL) is an aggressive disease, which cause accumulation of immature early bone marrow hematopoietic cells known as blast cells.Objective: To report an unusual presentation of a case of acute lymphoblastic leukemia in a Saudi female child.Case Report: A four-Year old Saudi girl presented to Abha Maternal and Children's Hospital, Saudi Arabia, with repeated hematemesis. She had a history of fever reaching 39°C, which started 5 days earlier and responded to antipyretics, with no chills or rigor. On physical examination, the patient was conscious, alert, pale, lethargic, with mild dehydration. Res-piratory rate was 30 breaths/minutes, and the heart rate was 135 beats/minutes. Her growth parameters were normal. Bone marrow aspirations revealed being markedly infiltrated by blast cells, with marked reductions of all normal cells. There-fore, the case was diagnosed as acute leukemia, most probably acute lymphoblastic leukemia. She was referred to the Com-prehensive Cancer Center at King Fahad Medical City in Riyadh, to start her chemotherapy course for management of her condition.Conclusions: Uncommon clinical presentations include hematemesis and diarrhea may lead to delay in diagnosis. Awareness of the uncommon signs and symptoms of childhood acute lymphatic leukemia helps in early diagnosis and proper management of patients.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1227
1230
https://mjcu.journals.ekb.eg/article_56278_90c010fb4ab75d0e98a14ef568f2e8a7.pdf
dx.doi.org/10.21608/mjcu.2018.56278
Comparative Study between the Effect of Ondansetron, Mesalazine, and their Combination on Oxazolone-Induced Colitis In Albino Rats
ALAA H. ABD EL-AZEEM, M.Sc.;
FLEUR F. ABD EL-MONEIM, M.D.
author
AHMAD I. YASSIN, M.D.;
AMANY A. ABDIN, M.D.
The Department of Medical Pharmacology, Faculty of Medicine, Tanta University
author
text
article
2018
eng
AbstractBackground: Ulcerative Colitis (UC) is an inflammatory bowel disorder that represents a common health problem. 5 Hydroxy Tryptamine 3 (5-HT3) receptors are widely distributed in the gut and 5-HT3 receptor antagonists have been reported to have anti-inflammatory effects.Objectives: Evaluates the possible effects of ondansetron, mesalazine and their combination in oxazolone induced-colitis in albino rats.Methods: This experiment was performed on 50 male Wister albino rats divided into 5 equal groups; (Group I) control group received intrarectal vehicle of ethanol then oral 0.5% carboxymethyl cellulose daily for 21 days, (Group II) untreated induced-colitis group received intrarectal oxazolone then oral 0.5% carboxymethyl cellulose daily, (Group III) oxazolone induced-colitis rats were treated by mesalazine (100mg/kg/day by oral gavage) for 21 days, (Group IV) oxazolone induced-colitis rats were treated by ondansetron (2mg/kg/day) by intraperitoneal injection for 21 days, (Group V) oxazolone induced-colitis rats were treated by mesalazine and ondansetron in the same dosage regimen. Animal body weights, occurrence of diarrhea, and rectal bleeding were recorded daily over the experiment to calculate Disease Activity Index (DAI), at the end of the study all rats were sacrificed, portions of distal colons were dissected and proc-essed for assessment of myeloperoxidase activity, tumor necrosis factor-a levels, caspase-3 activity, histopathological examination and immunohistochemistry of Toll Like Receptor 2 (TLR2).Results: The present study showed that treatment with ondansetron produce significant decrease in the whole studied parameters, also its combination with mesalazine produce significant decrease in all studied parameters when compared to untreated induced-colitis group as well as produce better response than each drug alone.Conclusion: These findings suggest that ondansetron produce promising effects in oxazolone induced-colitis which mimics UC in human. Its combination with mesalazine exhib-ited synergistic effects superior to each monotherapy. It could be recommended to verify these results in further clinical studies.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1231
1241
https://mjcu.journals.ekb.eg/article_56279_5982198ef369b28784b79f38b1dcde67.pdf
dx.doi.org/10.21608/mjcu.2018.56279
Foetal Kidney Development and Amniotic Fluid Formation in Upper Egyptian Pregnancies
MANAL M.S. EL-MELIGY, M.D.;
RENEAH R. BUSHRA, M.D.
author
HAYAM Z. THABET, M.D.;
NAGWA M. GHANDOUR, M.D.
author
MAHMMOUD A.
ABD EL-ALEEM, M.D.
The Departments of Human Anatomy & Embryology*, Forensic Medicine & Clinical Toxicology** and Obstetrics & Gynecology***, Faculty of Medicine, Assiut University, Egypt
author
text
article
2018
eng
AbstractBackground: The foetal kidney development is important for its normal function. The Amniotic Fluid Index (AFI) is used to assess the amniotic fluid volume. The main source of the amniotic fluid is the foetal urine.Aim of the Work: To establish reference values for the foetal kidney length and the AFI throughout the second and third trimesters of the normal Upper Egyptian pregnancies and to clarify the correlations between these measurements.Subject and Methods: An ultrasonographic examination was performed to measure the foetal kidney length and the AFI on 232 normal pregnant women from the 14th week to the 42nd week of gestation. The correlations between the measurements were analysed statistically.Results: The foetal kidney length increased gradually with gestation. There was a significantly positive correlation between the foetal kidney length and the gestational age. The linear regression showed that the gestational age could be assessed by using the foetal kidney length with an accuracy of ±1.078 week. From the 14th week, the AFI increased progressively until the 24th week. There was a positive correlation between the AFI and the gestational age and between the AFI and the foetal kidney length. From the 25th week to the 32nd week, the AFI demonstrated little variations. From the 33rd week, the AFI declined gradually. There was a negative correlation between the AFI and the gestational age and between the AFI and the foetal kidney length.Conclusion: The present study introduces reference values for both the foetal kidney length and the AFI in the normal Upper Egyptian pregnancies. It also discusses the correlation between the foetal kidney length and the AFI as early as the second trimester of pregnancy. At first, it is a direct correlation. Then, it shows minimal variations. Finally, it becomes an inverse one. The obtained information could be usefully applied clinically.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1243
1252
https://mjcu.journals.ekb.eg/article_56281_4477f3b83a8c6d1bd9f39523b302f01f.pdf
dx.doi.org/10.21608/mjcu.2018.56281
Nitroglycerin Patch in Traumatic Hemorrhagic Shock to Improve Signs of Poor Peripheral Perfusion
MEDHAT S. ALI, M.Sc.;
HASSAN I.M. KOTB, M.D.
author
ALAA M. AHMED ATIA, M.D.;
ABUALAUON M. ABD EL-MOHSEN, M.D.
The Department of Anesthesiology and Intensive Care, Assiut University Hospital, Assiut, Egypt
author
text
article
2018
eng
AbstractBackground: Microcirculatory function is the main pre-requisite for adequate tissue oxygenation and organ function. It transports oxygen and nutrients to tissue cells, ensure adequate immunological function and, in disease, delivers therapeutic drugs to target cells. Recruiting microcirculation, i.e., non-perfused or intermittently perfused capillaries might improve tissue perfusion, mitigating the progression to organ failure and death. Nitroglycerin has been used in different shock states particularly in sepsis. The effect is variable and debatable suggesting an improvement of microcirculation.Patients and Methods: 60 adult patients with hemorrhagic shock admitted to the Emergency Department within 6 hours of trauma event, resuscitation immediately started according to advanced trauma life support ATLS® protocol 2016 with control of the bleeding source. Nitroglycerine patch 5mg applied to patients after the first hour of resuscitation. The study period corresponded to the outcome of the first 48 hours of trauma unit or ICU resuscitation. Patients considered successfully resuscitated if they had normal lactate levels (£2mmol/L).Results: 60 patients enrolled in this study, 10 patients were excluded; 3 of them due to uncontrolled bleeding and 7 due to marked hypotension. 50 patients continued in the study (38 men, 12 women) with mean age was (29.1±10.8ys); of them 45 survived (90%) and 5 did not survive (10%). Patients received mean crystalloid volume (6100±1410.67ml), mean colloid volume (490±457.25ml), mean packed RBCs (4.34±1.33 units), mean fresh frozen plasma (3.08±1.65 units) and mean nor-adrenaline dose (7.94±10.55mg/kg/minute). Baseline perfusion index was (0.37±0.21), mean heart rate (128.46±18.18 beat/minute), systolic blood pressure (78.08± 7.47mmHg), diastolic blood pressure (40.20±7.39mmHg), mean arterial pressure (53.44±6.43mmHg), central venous pressure (–1 .46±2.77cmH2O) and baseline modified shock index was (2.45±0.56). Baseline serum lactate was (8.61±1.86 mmol/L), base deficit was (–12.59±5.57). Perfusion index showed statistically significant increase in survivors than non survivors at 12, 18, 24, 30, 36, 42, 48 hours (p<0.001). Serum lactate level was significantly higher in non survivors group than survivor group (p<0.001). Base deficit was significantly higher in non survivors than survivors (p<0.001). Conclusion: Use of nitroglycerin patch 5mg improved PI at 6 to 48 hours post resuscitation and reduce mortality rate (in this study was 10%) while in other previous studies with the same sample size of hemorrhagic shock patients without use of nitroglycerin it was higher (about 30%).This study is registered at www.clinicaltrials.gov under number NCT03235921.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1253
1261
https://mjcu.journals.ekb.eg/article_56283_5bb8dcff44e2f3bb93723fc9fd562c5c.pdf
dx.doi.org/10.21608/mjcu.2018.56283
Assesment of Human Mammaglobin (hMAG) as a New Marker for Early Diagnosis of Breast Cancer
ZEINAB A. ABD EL-HAFEZ, M.D.;
MOHAMMED I. SEDDIK, M.D.
author
KHALED M. RIZK, M.D.;
YASMIN T. EL-GAMMAL, M.Sc.
The Departments of Clinical Pathology, Faculty of Medicine* and Clinical Oncology, South Egypt Cancer Institute**, Assiut University, Assiut, Egypt
author
text
article
2018
eng
AbstractBackground: Breast cancer may originate either from the ducts, known as ductal carcinomas or from the lobules, known as lobular carcinomas. There are many different types of breast cancer, with different stages (spread), aggressiveness, and genetic makeup. Breast cancer is the most frequent cancer in women affecting approximately 6% of the females. It constitutes almost 20% of all malignancies in women. In Egypt, breast cancer affects 37.7% of all women and accounts for 29.1% of their cancer-related mortality with a total of 6546 deaths.Aim: The aim of this study is to study correlations between hMAG level and different stages of breast cancer (TNM staging) and to study correlations between hMAG as a new marker and routine markers used in breast cancer (CA 15-3 & CEA).Patients and Methods: This study was carried out on 80 Breast Cancer female patients their age ranged aged 25 to 65 years. Ten age matched healthy females served as controls. Patients were referred from Assiut University Hospital, General Surgery Department, and South Egypt Cancer Institute. Formal consent was obtained from patients and controls. The study was approved by Ethical Committee of Faculty of Medicine Assiut University.Results: None of the healthy females in control group (group1) had elevated mammaglobin level above the cut-off value which was 41.49ng/ml. Elevated levels of mammaglobin was detected in 65%, 75%, 90% and 100% of patients in groups II, III, IV, and V respectively. There was a significant positive correlation between Mammaglobin positivity with CEA and CA 15-3 concentrations. The combination CA15- 3, CEA and mammaglobin resulted in the highest sensitivity (97%), highest specificity (95%) and highest diagnostic accuracy (96%).Conclusion: Mammaglobin levels in peripheral blood samples obtained from Egyptian female individuals with breast cancer, are good markers for detection of breast cancer. This marker can be used to aid in detection of metastasis as it is correlated with the clinical staging of the disease. A combination of CA15-3, CEA and mammaglobin may be used as a panel for diagnosis of metastasis among breast cancer patients.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1263
1270
https://mjcu.journals.ekb.eg/article_56287_05006f27c5dcea44e5eac78e57a3bf96.pdf
dx.doi.org/10.21608/mjcu.2018.56287
Bronchoscopic Closure of Bronchopleural Fistula Using Gelfoam Versus Autologous Blood
FARES M. OUF, M.D.;
NABIL F. AWAD, M.D.
author
KHALED M.I. HALIMA, M.D.;
EMAD H.G.A. TAYEL, M.Sc.
The Department of Chest Diseases, Faculty of Medicine, Al-Azhar University, Egypt
author
text
article
2018
eng
AbstractBackground: Diagnosis and management of bronchopleu-ral fistula remains a major therapeutic challenge for physicians, since it is medical diagnosis and localization may be trouble-some and needs various imaging techniques, likewise it is associated with a significant morbidity and fatality so fruitful bronchoscopic management is considered a perfect choice as it is less invasive procedure especially in patients who are unsuitable for surgery and standard anesthesia or associated with comorbidities, additionally it would lessen cost and lifelong hospital stay.Aim of the Study: To compare efficacy of gelfoam and autologous blood injection in bronchoscopic closure of bron-chopleural fistula.Subjects and Methods: This study carried out at Fibrooptic Bronchoscopy Unit in Chest Department, Al-Hussein Hospital, Al-Azhar University in the period between October 2015 to October 2017. One setting of fibrooptic bronchoscopic closure trial was performed in forty patients with bronchopleural fistula using gelfoam injection in twenty patients (Group A) and autologous blood in another twenty patients (Group B) after full clinical and investigational assessment.Results: Successful closure occurred in 19 patients (95%) in (group A) using gelfoam and in 18 patients (90%) in (group B) using autologous blood, the mean hospitalization time was 7.05 days in (group A) and 9.35 days in (group B) the mean time from procedure to chest tube removal was 3.2 days in (group A) and 5.75 days in (group B) also the mean time from procedure to discharge was 3.8 days in (group A) and 6.5 days in (group B) pneumothorax and death did not occur in both groups but hemoptysis occurred in 5 patients (25%) in (group A), and 7 patients (35%) in (group B) also cough occurred in 16 patients (80%) in (group A), and 18 patients (90%) in (group B) and low grade fever occurred in 12 patients (60%) in (group A) and 15 patients (75%) in (group B).Conclusion: Bronchoscopic closure of bronchopleural fistula utilizing gelfoam or autologous blood is a straightforward procedure which can be performed safely and securely under local anesthesia with promising outcomes, it is ought to be viewed an as an ideal choice particularly in small sized fistulae in patients who are unfit for surgery and general anesthesia.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1271
1279
https://mjcu.journals.ekb.eg/article_56291_7cf8556349172b985706b29f5bf6336c.pdf
dx.doi.org/10.21608/mjcu.2018.56291
Association of Helicobacter Pylori Infection with Portal Hypertensive Gastropathy in Liver Cirrhosis
AFAF T. EL-NASHAR, M.D.;
HASSAN A. HASSANIEN, M.D.
author
ASHRAF A. ASKER, M.D.;
HANAA M. ABD EL-AZEEM, M.Sc.
The Departments of Pathology* and General Medicine**, Faculty of Medicine, Sohag University
author
text
article
2018
eng
AbstractBackground: Portal hypertensive gastropathy (PHG) is an important cause of morbidity in patients with Liver cirrhosis (LC). Helicobacter pylori (HP) infection is a common cause of gastritis and is an endemic disease in Egypt.Aim of the Work: To study the presence of H. pylori infection in cases of LC with and without PHG.Material and Methods: Fifty patients with LC including 25 cases with PHG and 25 cases without PHG who attended Sohag Faculty Hospital during the period 9/2016-3/2017 were examined for the presence of H pylori infection histologically using Hematoxyline and Eosin and Geimsa stains. The corre-lation between H pylori infection and the severity of PHG was studied statistically.Results: H. pylori were detected in 76% of cases of LC (72% in LC with PHG and 80% of cases LC without PHG). Although there was an association between H pylori infection and the severity of PHG (5/7 cases), there was no statistically significant difference between H pylori infection and PHG.Conclusion: H. pylori infection can be seen in cases of LC irrespective of the presence or absence of PHG more than in general population.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1281
1286
https://mjcu.journals.ekb.eg/article_56293_fbe51f856810e608ce88a20177f0a21f.pdf
dx.doi.org/10.21608/mjcu.2018.56293
Hysteroscopic Detection of Intrauterine Pathology in Women with Unexplained Infertility
ESSAM KHALIFA, M.D.;
AHMED FAYK, M.D.
author
ESSAM RASHAD, M.D.;
AHMED ALY, M.Sc.
The Department of Obstetrics & Gynaecology Women's Health Hospital, Faculty of Medicine, Assiut University
author
text
article
2018
eng
AbstractBackground: Abnormalities of the uterus are relatively uncommon cause of infertility but should be considered, if no other reason, they can adversely affect the outcome of pregnancies achieved by successful treatment. The anatomic uterine abnormalities that may adversely affect fertility include congenital malformations, leiomyoma's, intrauterine adhesions, and endometrial polyps, but their reproductive implications are most unclear. One of the basic steps of an infertility workup is to evaluate the shape and regularity of the uterine cavity. Acquired uterine lesions, such as uterine fibroids, endometrial polyps, intrauterine adhesions, or all of these, may cause infertility by interfering with proper embryo implantation and growth. Congenital uterine malformations are also thought to play a role in delaying natural conceptionAim of Study: This study was designed to evaluate the role of hysteroscopy in women with unexplained infertility.Patients and Methods: Women with unexplained infertility were included in this cross sectional study, evaluated with transvaginal sonography and diagnostic hysteroscopy. Diag-nostic hysteroscopy was performed between the 7th and 11th day of the cycle. The criteria for hysteroscopic findings were based on the cervical canal, uterine cavity, endometrium, visualization of the tubal ostium and lesions of the utero-tubal junction. Patients were classified according to the hysteroscopy results into two groups: Patients with no abnormality detected (n=49), patients with uterine abnormalities (n=71).Results: One hundred twenty women with unexplained infertility were included, all patients underwent diagnostic hysteroscopy. Based on hysteroscopic findings, 22 of them (18.3%) were finally diagnosed to have polyps, 6 patients had cervical stenosis (5%), 1 patients have myomas (.8%), 8 patients had intrauterine synechia (7%) and 19 patients had congenital uterine anomalies (16%). Cervicitis was found in 12 cases (10%), while 3 cases had endocervical cysts (2.5%), cornu not accessible in 4 cases (3.3%), while ostia not seen in 8 cases (6.6%), 3 cases had tight isthmus (2.5%) and 3 cases had polypidal thickness at isthmus (2.5%) while hyster-oscopy results were found to have no abnormality in 49 patients (40.8%).Conclusions: Routine hysteroscopy should be used as a basic part of the work-up for women with unexplained infer-tility.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1287
1294
https://mjcu.journals.ekb.eg/article_56294_bb89b9ab1800adc7bda78c0253e2e8d4.pdf
dx.doi.org/10.21608/mjcu.2018.56294
Smoking Habits Among Assiut University Students: Prevalence and Associated Risk Factors
HALA H. ABOU-FADDAN, M.D.;
SABRA M. AHMED, M.D.
The Department of Public Health, Faculty of Medicine, Assiut University, Assiut, Egypt
author
text
article
2018
eng
AbstractAim of Study: To study the prevalence and socio–demo-graphic associated factors of smoking among Assiut university students.Patients and Methods: A cross-sectional study design was carried out. Data were collected by using anonymous self-administered questionnaire. The questionnaire covered the socio-demographic characteristics of the students in addition to questions about smoking history of students and their family members and friends. Bivariate and multivariate logistic regression analyses were performed to assess correlates of tobacco use.Results: Among 1095 students participated in the study 18.9% have ever used cigarette in their life time and 17.1% are using tobacco currently. Smoking was significantly related to male gender (OR=13.2), students with drug abuse (OR =12.1), smoker friend (OR=11.5), smoker father and/or brother (OR=10.8), pocket money >150 pounds per month (OR=4.5) and students who liver away from their families (OR=3.7).Conclusion and Recommendations: Smoking is prevalent among Assiut University Students. An integrated smoking prevention program in the university students was recom-mended.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1295
1301
https://mjcu.journals.ekb.eg/article_56296_55a9e9712bec92726433f9cc2a231b45.pdf
dx.doi.org/10.21608/mjcu.2018.56296
The Effect of Vitamin-D Supplementation in Severe Pneumonia Among Infants
MADONNA M. GABER, M.Sc.;
FATMA A. ALI, M.D.
author
KHALED S.
ZAGHLOL, M.D.
The Department of Pediatrics, Faculty of Medicine, Assiut University, Egypt
author
text
article
2018
eng
AbstractBackground: Worldwide, acute lower respiratory tract infection (ALRTI) is a leading cause of mortality in children less than 5 years old, more than 90% are in developing countries. Pneumonia is the leading infectious cause of death in children, accounting for 18.3% of all deaths in children less than 5 years of age. Vitamin D is thought to have roles in the improvement of immune function and the reduction of inflammation and may reduce respiratory tract infection susceptibility in children. Vitamin D has an important influence on the host's immune system, modulating both innate and adaptive immunity and regulating the inflammatory cascade.Aim of Study: We aimed to compare the duration and outcome of severe pneumonia of children in the two study groups receiving the standard therapy (appropriate antibiotic and other supportive therapy) with those receiving vitamin D3 supplementation in addition to the standard therapy. Our hypothesis is that vitamin D supplementation decreases the duration of resolution of severe pneumonia in children less than two years of age.Patients and Methods: This was a double-blinded, rand-omized, placebo-controlled trial undertaken in the Children University Hospital, Assiut University during winter. Infants with severe pneumonia between the ages of 3 and 23 months are studied. Patients were randomized to receive vitamin D3 treatment (intervention group) or placebo (control group) to assess the clinical benefit of oral supplementation of vitamin D3, in addition to standard antibiotic and other supportive therapy, to hospitalized infants less than two years of either sex with severe pneumonia.Results: The results of this small randomized controlled clinical trial indicate that short-term supplementation with vitamin D along with antibiotic treatment, significantly reduces the mean time taken for resolution of severe pneumonia (p<0.001) and the mean time taken for the improvement of oral feeding (p<0.05), in the intervention group receiving vitamin D 100IU/kg for at least 5 days from the first day of admission. Vitamin D supplementation was well tolerated in all patients without showing any side effects.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1303
1309
https://mjcu.journals.ekb.eg/article_56297_853db4b7d43bea77408cedc60baccca2.pdf
dx.doi.org/10.21608/mjcu.2018.56297
Effects of Monosodium Glutamate on the Kidney of Male Adult Albino Rat and the Possible Protective Role of Vitamin C
HALA H. ABOU-FADDAN, M.D.;
SABRA M. AHMED, M.D.
The Department of Public Health, Faculty of Medicine, Assiut University, Assiut, Egypt
author
MOHAMED A. DOSUKY, M.D.;
DORREIA A. ZAGHLOL, M.D.
author
SALWA M. OUIES, M.D.;
HANAA A. ABD EL-NAEIM, M.Sc.
The Department of Human Anatomy & Embryology, Faculty of Medicine, Sohag University***
author
text
article
2018
eng
AbstractBackground: Monosodium glutamate is used commercially as a food additive and is commonly marketed as a flavour enhancer. It is now used by most fast-food chains and in many food-stuffs, in particular, processed foods. Vitamin C (ascorbic acid) is a very important and powerful antioxidant that works in aqueous environment of the body Vitamin C protects against common cold. Beneficial effects in conditions such as cancer, vascular disease, cataracts, diabetes, asthma, arthritis, Parkin-son's disease, autism and depression have also been suggested.Aim of the Work: The aim of this study was to study the potential protective effect of Vitamin C on kidney damage caused by monosodium glutamate in adult male rats.Material and Methods: Sixty adult albino rats were used. The animals were equally divided into three groups each of them consists of 20 rats: Group I: "Control" were given 1ml of saline daily by oral route "for one month. Group II: Were given monosodium glutamate (4gm/kg of body weight/day, dissolved in saline orally) for one month. Group III: Were given Vitamin C (500mg/kg of body weight /day, orally) then after 2 hours were given monosodium glutamate (4gm/kg of body weight/day, dissolved in saline orally) for one month.At the end of the experiment, the rats were anaesthetized by ether then perfused with saline then with the appropriate fixator (formalin 10%). The abdomens were opened and the kidneys of the control and treated animals were extracted, cut, and processed for light and transmission electron micro-scopic studies.Results: Monosodium Glutamate (MSG) markedly de-structed glomeruli and tubules of the kidney at light and electron microscopic examination and morphmetric studies. Administration of Vitamin C could attenuate these changes.Conclusion: MSG caused degenerative changes in the cortical glomeruli and tubules. On the addition of Vitamin C can decrease that toxic effects of MSG.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1311
1321
https://mjcu.journals.ekb.eg/article_56299_6bfbc2c42cb7adb29d3b4ce5f9059feb.pdf
dx.doi.org/10.21608/mjcu.2018.56299
Quality of Life among Patients with Hepatorenal Syndrome
ENTESAR S.M. AHMAD, M.Sc.;
KHAIRIA A. EL-SAWI, D.N.Sc.
author
NAGAT E.
IBRAHIM, D.N.Sc.
The Department of Medical Surgical Nursing, Faculty of Nursing, Cairo University
author
text
article
2018
eng
AbstractBackground: Hepatorenal syndrome is a unique form of functional renal failure due to diminished renal blood flow. It is a severe complication that affects patients with liver cirrhosis and ascites, the deterioration in kidney function is quantified by an elevation in creatinine level in the blood and decrease GFR. Assessing QOL of individuals with diseases has become common clinical practice. The aim of this study was to assess QOL among liver cirrhosis patients with HRS.Patients and Methods: A convenient sample of 100 adult patients diagnosed with liver cirrhosis admitted in medical wards at one of Cairo University affiliated hospitals was recruited as study sample. A descriptive research design was utilized. Data was collected using 2 tools including tool 1 demographic and medical related data, tool 11, Quality of Life (QOL) for patients with chronic liver disease CLD.Results: The study revealed that (52%) of patients, their age above 50 years with mean of (51.91±5.36), about (78%) of patients were employmed have income more than 1000 L.E . As regard to medical data, about (55%) have hepatitis C, about (77%) of patients were frequently readmitted com-plaining of hematemsis, there was decrease in GFR with increase in creatinine level, about (46%-39%-43% and 32%) of patients were feeling abdominal discomfort, feeling tired, muscles cramp, unable to hold or carry heavy objects respec-tively, while (51% and 47%) of patients were feeling unhappy and worried about the effect of disease on their family respec-tively. Finally the total mean score of QOL for patients with CLD of the studied sample equal (96%) which indicating moderate QOL.Conclusion: There was a moderate QOL among patients with HRS and there was relation between total scores of each domain and total QOL scores in CLD and between abdominal factors and other domains of QOL namely (fatigue, systemic symptom, activity and emotion) except worry. There was no relation between worry domain and other domains of QOL except emotion and there was a relation between worry domain and emotion domain.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1323
1329
https://mjcu.journals.ekb.eg/article_56300_b1b868d5367f01e5179172838d49fa2e.pdf
dx.doi.org/10.21608/mjcu.2018.56300
Prevalence of Lumbosacral Radiculopathy among Dentists
SHIMAA A. ABD EL-BASET, M.Sc.;
EMAN S. FAYEZ, Ph.D.
author
NEVEN
ABD EL-LATIF, Ph.D.
The Departments of Neurology & Neurosurgery* and Basic Science**, Faculty of Physical Therapy, Cairo University
author
text
article
2018
eng
AbstractBackground: The dentists are at high risk of lower back-ache problems.Aim of the Study: Was to detect point prevalence of work related the lumbosacral radiculopathy (low back pain and sciatica) among dentists who are currently working in ministry of health in Cairo, Egypt.Material and Methods: Specific questionnaire based on Roland Morris questionnaire and Modified Roland Morris questionnaire (RMQ, RMQ-L) were given to dentists who are currently working in Ministry of Health in Cairo, Egypt. Five hundred volunteer dentists participated in this study. The results of this study showed that the point prevalence of Work Related Low Back Pain (WRLBP) was 60.8%, point prevalence work related leg pain was 35.2%. There was no statistical significant difference between female and male subjects in the median values of Visual Analogue Scale (VAS), Roland Morris questionnaire (RMQ) back pain. On the other hand, the median value of Modified Roland Morris questionnaire (RMQ-L) was significantly higher in female group than in male. The median value of VAS was significantly higher in full time than in part time. On the other hand, there was no statistical significant difference between full time and part time in the median values of Roland Morris questionnaire (RMQ) back pain and Modified Roland Morris questionnaire (RMQ-L). The median value of VAS was significantly higher in training group than in non-training group. On the other hand, there was no statistical significant difference between training and non-training in the median values of Roland Morris Questionnaire (RMQ) back pain and Modified Roland Morris questionnaire (RMQ-L). The median value of VAS was significantly higher in Pediatric Dentists (PEDO) than both General Practitioner dentists (GP) and other specialties dentists. There was a positive correlation between Roland Morris Questionnaire (RMQ) back pain and years of experi-ence, VAS and RMQ leg. On the other hand, there was no statistical significant correlation between Roland Morris Questionnaire (RMQ) back pain and age and Body Mass Index (BMI). There was a positive correlation between Modified Roland Morris questionnaire RMQ leg and VAS.Conclusion: Work-related low back pain is common among Egyptian DENTISTS at the POINT prevalence, Making Cairo's dentists at a high-risk group, which necessitate appro-priate intervention to manage such squeal.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1331
1337
https://mjcu.journals.ekb.eg/article_56333_e39d84673d99f5c5db4f620d4284e7a1.pdf
dx.doi.org/10.21608/mjcu.2018.56333
Management of Cardiomyopathy in Pediatric Cardiology Unit at Assiut University Children Hospital (Clinical Audit)
SAFIEA A. EL-DEEB, M.D.;
DUAA M. RAAFAT, M.D.
author
AML
H.H. AHMED, M.Sc.
The Department of Cardiology, Pediatric Cardiology Unit, Assiut University Children Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt
author
text
article
2018
eng
AbstractBackground: This study aims to assess how much the staff in the Pediatric Cardiology Unit are sticking to the agreed upon unit's protocol in the management of children admitted with Dilated Cardiomyopathy (DCM). It is aiming also to compare the Cardiology Unit's agreed upon protocol to one of the international guidelines.Methods: This audit was conducted on 25 children with Dilated Cardiomyopathy (DCM) admitted to Pediatric Cardi-ology Unit at Assiut University Children Hospital in the period between May 2015 and May 2016. The study included 20 males & 5 females. Their ages ranged from 3 months to 16 years.Results: The prevalence of male sex was 80% and 20% of cases were females. Cases <3 years constituted 40% of cases. In 60% of cases the age was older than 3y up to 16 years of age; the number of cases presenting as first admission was 68% and in 32% of cases the admission was recurrent; carvidelol was used in 32% of children with DCM and in the rest of cases (68%) carvidelol was not used; amiodarone was used in 2 cases (8% of the cases): In one case it was used alone, and in the second case it was used in combination with propranolol.The unit's protocol was followed in 100% of cases by staff members of the Cardiology Unit at Assiut University Children Hospital.Regarding the difference between unit's protocol and Canadian guidelines: There were three main differences. The 1st one was the absence in the unit's protocol of taking family history of cases with DCM. This was emphasized in the Canadian guidelines. The 2nd difference was that in the unit's protocol amiodarone was the 1st drug of choice in cases of DCM with arrhythmia. The 3rd difference was the use of L-carnitine and aspirin regularly initially and for follow-up in all cases with DCM in the unit's protocol. This point was not mentioned in the Canadian guidelines.Conclusion: Due to lack of genetic studies performed by Assiut University Children Hospital in cases with DCM, taking family history of cardiac diseases has been omitted by the staff of the unit. Taking family history of cardiac diseases will be emphasized in future researches.This is because idiopathic DCM is now thought to have genetic basis in many cases. Furthermore, besides emphasizing taking a family history this study will recommend family cardiac screening by echocardiography to be done for all family members or at least for both parents and young sibling.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1339
1344
https://mjcu.journals.ekb.eg/article_56334_01002b045efe710c100385f4dac5aac4.pdf
dx.doi.org/10.21608/mjcu.2018.56334
Causes and Consequences of Street Life on Homeless Children: Choice or Compulsion?
MAGDA A. MOHAMED, D.N.Sc.;
MANAL F. MOHAMED, D.N.Sc.
author
MONA A. HASSAN, D.N.Sc.;
SOHIER G.E. ABD EL-RAHMAN, D.N.Sc.
author
text
article
2018
eng
AbstractBackground: Homelessness influences every facet of a child's life. The experience of homelessness inhibits the physical, emotional, cognitive, social, and behavioral devel-opment of children.Aim: This study aimed to assess the causes and conse-quences of street life on homeless children. Overall situation of street children living in Port Said City.Material and Methods: Descriptive design was used. A sample of 200 homeless children was collected from Port Said City during the period from January to December 2015; non-random sampling technique which includes both snowball and purposive sampling was used.Tool: An interview questionnaire was the main instrument of data collection developed and it completed by researchers.Results: The study has revealed that the great majority of street children (94.5%) were males, never been attended school and different causal factors have contributed for their street life but, poverty was found to be one of major causes followed by child abuse to push children to move to the street. They were exposed to different types of exploitation and health problems.Conclusion/Recommendation: The majority of street children faced physical abuse followed by sexual abuses. Drug and substance abuse is very common among street children like cigarette, sniffing glue. So, the study recom-mended that; awareness raising program should be given for the general public to bring about effective and sustainable change in the lives of these innocent children because street life is viewed as a negative phenomenon by the majority of the societies. Child welfare centers should be supplemented with good infrastructures to accommodate street children.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1345
1355
https://mjcu.journals.ekb.eg/article_56335_1142e3f9bdaa06651a92ea6ca82d8bac.pdf
dx.doi.org/10.21608/mjcu.2018.56335
Effect of Neuromuscular Exercises on Osteoarthritic Knee Functional Mobility after Hyaluronic Acid Injection
AHMED M.M. ABD EL-AZIZ, M.Sc.;
ALAA EL-DIN A. BALBA, Ph.D.
author
MAHA M. MOHAMMED, Ph.D.;
MOHIE EL-DIN M. FADEL, M.D.
The Department of Musculoskeletal Disorders & their Surgery, Faculty of Physical Therapy, Pharos* and Cairo** Universities and the Department of Orthopedic Surgery, Faculty of Medicine, Alexandria University***, Egypt
author
text
article
2018
eng
AbstractBackground: Knee Osteoarthritis (OA) is most common disabling disease with middle and old ages widely distributed need future researches to detect the effect of therapy. Recently Hyaluronic Acid (HA) and therapeutic exercises like neu-romuscular exercises used as treatment option with recent good evidence.Purpose: To detect the effect of neuromuscular exercises on knee OA after Intra-Articular Hyaluronic Acid (IA-HA) injections in the functional mobility.Patients and Methods: This study was conducted on thirty patients both gender with mild to moderate knee OA. Their age ranged from 40-60 years old. All patients were referred by orthopedic surgeons who are responsible for diagnosis and injecting HA based on clinical and radiological examination. All patients were randomly assigned into 2 groups: Group (A) this group included 15 patients received IA-HA injections, Group (B) This group included 15 patients received IA-HA injections and neuromuscular exercises, three sessions per week for one month. The study was conducted at private physical therapy orthopedics rehabilitation center from October 2016 to July 2017.Evaluation: Timed Up and Go (TUG) test was used to assess the functional performance. Results showed that both groups were effective in improving of the functional mobility, but HA alone (Group A) were less effective than HA added to neuromuscular exercises.Conclusion: It can be concluded that both HA injection and HA added to neuromuscular exercises are effective treat-ment for knee OA functional mobility, and adding neuromus-cular exercises gained better results than isolated.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1357
1366
https://mjcu.journals.ekb.eg/article_56336_7dc6b336da766e6ae201b899fbf4a6c3.pdf
dx.doi.org/10.21608/mjcu.2018.56336
Effect of Low Level Laser in Combination with Pneumatic Compression in Modulation of Swelling in Patients with Knee Hemoarthrosis
ALAA R.
MORGAN, Ph.D.
The Department of Physical Therapy for Disturbance of Growth & Development in Pediatrics & its Surgeries, Faculty of Physical Therapy, Cairo University
author
text
article
2018
eng
AbstractBackground: Low level laser in combination with inter-mittent Pneumatic compression have effect in modulation of swelling in cases with knee hemoarthrosis in hemophilic children.Aim of this Study: To investigate the effect of low level laser in combination with intermittent pneumatic compression in modulation of swelling in cases with knee hemoarthrosis in hemophilic children (after successive three months of treatment).Patients and Methods: Forty hemophilic children their age ranging from seven to fourteen years, divided randomly into two groups (Group A and Group B). Group A received selected physical therapy program only (stretching, and strengthening exercises), while the Group B received low level laser therapy and intermittent pneumatic compression in addition to the same program given to the Group A. The swelling parameter (tape measurement and range of motion), was measured before and after successive three months of treatment.Statistical Analysis: The collected data of the current study was statistically treated by the student's t-test for comparison of means of two independent groups. The alpha point of 0.05 was used as a level of statistical significance (when p<0.05, the difference is significant and when p<0.01, difference is highly significant); Minitab version 13 was the used statistical program.Results: The study revealed significant improvement in most of the measured variables of the two groups, but in Group B the improvement was significantly increased more than Group A.Conclusion: It may conclude that low level laser therapy in combination with intermittent pneumatic compression is an effective additional tools to physical therapy program in treating swelling in cases with knee hemoarthrosis of hemophilic children as it plays an important role in decreasing swelling of the knee joint.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1367
1376
https://mjcu.journals.ekb.eg/article_56337_ff9defc8d09c2c78550a027b47021400.pdf
dx.doi.org/10.21608/mjcu.2018.56337
The Influence of Application of Kinesio Taping on Pregnancy-Related Low Back Pain
IKRAM I. ALYAN, M.D.;
MOHAMED M. YOUSEF, M.D.
The Departments of Rheumatology & Rehabilitation* and Obstetrics & Gynecology**, El-Galaa Teaching Hospital, Cairo
author
text
article
2018
eng
AbstractBackground: Back pain in pregnant women can reduce daily activity and cause functional disability. The purpose of this study was to compare the effectiveness of Kinesio Taping (KT) and Transcutaneous Nerve Stimulation (TENS) added to paracetamol on pain intensity and disability in pregnant women suffering from back pain.Patients and Methods: A total of 130 pregnant women treated with paracetamol because of their back pain were divided randomly into two groups, the 1st group received KT (n=65), two bands of KT were applied vertically on each side of the lumbar spine and 2 applied horizontally. The 2nd group (n=65) were treated by TENS. Visual Analog Scale (VAS) and the Roland-Morris Disability Questioner (RMDQ) were employed in the evaluation of pregnant patients with Low Back Pain (LBP) and disability before and after 3 weeks of treatment.Results: Both groups showed significant improvement in pain intensity and disability after 3 weeks compared with baseline (for all p<0.001). Nevertheless, considering the change data from baseline to 3rd week, the KT group was significantly superior to the TENS group in all the outcome measures (for all p<0.001).Conclusion: KT and TENS added to paracetamol can decrease back pain related to pregnancy and improve disability. KT was found to be superior to TENS.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1377
1382
https://mjcu.journals.ekb.eg/article_56338_95be817b40c0b052b6e13d17ac852c0d.pdf
dx.doi.org/10.21608/mjcu.2018.56338
Effect of Using Dexmedetomidine with Ultrasound Guided Transversus Abdominis Plane Block on Postoperative Stress Response in Abdominal and Pelvic Surgeries: Comparative Study
NAHLA N. SHEHAB, M.Sc.;
MAIE K. EL-HELALY, M.D.
author
AYMAN A. GHONEIM, M.D.;
GHADA M. NABIH, M.D.
The Department of Anesthesia, Pain & Intensive Care, National Cancer Institute, Cairo University
author
text
article
2018
eng
AbstractBackground: Perioperative pain and stress of surgery induces changes in hormonal secretion. Tissue trauma that occurs as a result of surgical interventions is associated with both metabolic and endocrine responses. The present study was performed in abdominal and pelvic cancer surgeries, to compare the effect of bupivacaine versus bupivacaine with dexmedetomidine in ultrasound guided Transversus Abdominis Plane (TAP) block on post-operative heamodynamics and attenuation of endocrine response during surgery.Patients and Methods: The study included seventy five patients who were randomly allocated into three groups: Bilateral ultrasound guided TAP block was done to all patients before recovery where group TAP (n=25) received bupivacaine (0.25%), group TAP + Dex (n=25) received dexmedetomidine with the bupivacaine and group TAP + IV-Dex (n=25) received bupivacaine in addition to intravenous dexmedetomidine. Blood samples were withdrawn before the block and at 8 hours and 24 hours post-operative.Results: Heamodynamics did not show clinically signif-icant difference in the three groups where only 3 patients had bradycardia that was treated with atropine. Serum cortisol and glucose levels were comparable in all study groups. Cortisol level was within normal range and showed decline at 8 and 24 hours postoperative which indicates attenuation of the surgical stress response.Conclusion: The use of dexmedetomidine with TAP block blunted the stress response to surgery without affecting heamodynamics.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1383
1389
https://mjcu.journals.ekb.eg/article_56339_7a0621c6a0850f996f1a3298970679e1.pdf
dx.doi.org/10.21608/mjcu.2018.56339
Predictors of Left Ventricular Dysfunction in Patients with First Acute Anterior Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention
MOHAMED H. SENARA, M.Sc.;
SEHAM F. BADR, M.D.
author
EHAB A. AL-GENDY, M.D.;
MOHAMED N. HUSSIEN, M.D.
The Department of Cardiovascular Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt
author
text
article
2018
eng
AbstractBackground: LV dysfunction after acute MI is the most important factor affecting morbidity and mortality. Any effort should be made to minimize it.Aim of the Study: To evaluate the effect of clinical and angiographic variables on LV systolic function in patients with first acute anterior MI undergoing primary PCI.Patients and Methods: A prospective observational study conducted from October 2016 to June 2017, at the Cardiovas-cular Medicine Department, Tanta University Hospitals in Gharbia Governorate, Egypt. The study enrolled 100 consec-utive adult patients of both genders who were diagnosed with definite first acute anterior MI within 12 hours from the time of symptoms onset and were treated by primary PCI. Clinical and angiographic data were collected prospectively. Clinical outcome (death, major cardiovascular event) were evaluated during hospitalization. Patients were divided into three groups by degree of LV dysfunction, normal-mild (EF >50%), mod-erate (EF=40-50%) and severe (EF <40%) and compared for clinical, angiographic and procedural variables.Results: On statistical analysis between studied groups, the principal finding of this study was that depressed LV function in patients with first acute anterior MI was associated with longer time to door (r=0.560, p=<0.001) and door to balloon (r=0.378, p=<0.001) times, higher CKMB level (r=0.565, p=<0.001), renal impairment defined as creatinine clearance <60mL/min (p=0.013), peripheral vascular disease (p=0.013), low TIMI flow grade before and after angioplasty (r=0.347, p=<0.001), low myocardial blush grade (r=0.347, p=<0.001). Regarding in-hospital mortality and major cardi-ovascular events defined as recurrent myocardial infarction, repeat coronary revascularization of the target lesion, and heart failure, was higher in Group III.Conclusion: Degree of LV dysfunction following first acute anterior MI can be identified by clinical and angiographic variables that are readily available at the time of initial assessment. The principal finding of this study is that abnormal LV systolic function after first acute anterior MI can be predicted by longer door to balloon time and larger infarction size as assessed by CKMB levels. Renal impairment, peripheral vascular disease, multi-vessel disease and low TIMI flow grade before and after angioplasty are associated with depressed LV function in patients with first acute anterior MI.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1391
1398
https://mjcu.journals.ekb.eg/article_56340_f8ae533b56dc4db38b12c83f76789162.pdf
dx.doi.org/10.21608/mjcu.2018.56340
Prospective Randomized Controlled Study Comparing Caudal Block versus Dorsal Penile Nerve Block as Postoperative Analgesia in Children Presented for Penile Surgery
SALMA E. KANDIL, M.Sc.;
YASSER A. RAGHEB, M.D.
author
SAMEH A.
ISMAIEL, M.D.
The Department of Anesthesiology and Intensive Care, Faculty of Medicine, Tanta University, Tanta, Egypt
author
text
article
2018
eng
AbstractBackground: Caudal block is recommended for analgesia during and after surface operation on the penis, for example circumcision and hypospadias repair. The aim of this study was to compare caudal block versus dorsal penile block in children undergoing penile surgery, regarding duration and quality of post-operative analgesia.Aim of the Study: To compare caudal block versus dorsal penile block in children undergoing penile surgery, our primary outcome was the duration of postoperative analgesia while our secondary outcome was the quality of post-operative analgesia.Patients and Methods: 60 children, ASA I-II, 1-4 year's old undergoing penile surgery under general anesthesia were enrolled in the study. Children were randomly classified into two groups: (Group I) (penile group=30 patients) received a penile block using a mixture of lidocaine 3mg/kg (2%) and plain bupivacaine 1mg/kg (0.25%) on each side, Group II (caudal block group=30 patients) patients of this group received a caudal block using a mixture of lidocaine 3mg/kg (2%) and plain bupivacaine 1mg/kg (0.25%). Assessment of post-operative pain will be done by the Faces Pain Scale which is a self-report measure of pain intensity developed for children. It was adapted from the Faces Pain Scale to make it possible to score the sensation of pain on the widely accepted 0-to-10 metric, "0" equals "no pain" and "10" equals "very much pain". This done immediately postoperative and every 2H until 6H post-operative.Results: Faces pain score was significantly lower in group II at 2H, 4H and 6H post-operative with increase on the duration of block in Group II, also there was significant decrease in heart rate in Group II at 30min, 45min, 75min, 90min, 105min, 120min and 135min respectively from the start of surgery so there was significant increase of bradycardia and need of atropine in group.Conclusions: Caudal block seemed to be more effective in reducing post-operative pain score and decreasing the need of rescue analgesia with prolongation of the duration of the block.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1399
1406
https://mjcu.journals.ekb.eg/article_56341_6f1ae5afbd9fa141a8fa708cec417297.pdf
dx.doi.org/10.21608/mjcu.2018.56341
Comparative Study between Adductor Canal Block and Femoral Nerve Block for Postoperative Analgesia in Knee Arthroscopy
MAI K. ABD-ALLAH, M.Sc.;
MOHAMAD G. EL-MAWY, M.D.
author
AHMED A. ABD EL-HAFEZ, M.D.;
SOHAIR M. SOLIMAN, M.D.
The Department of Anesthesiology & Surgical Intensive Care, Faculty of Medicine, Tanta University, Tanta, Egypt
author
text
article
2018
eng
AbstractBackground: Femoral Nerve Block (FNB) is one of the easiest peripheral nerve blocks. However, prolonged motor blockade is associated with a clinically important risk of fall. With the advent of ultrasonography, the adductor canal can be easily visualized at the mid-thigh level, allowing perform-ance of Adductor Canal Block (ACB) with a high success rate.Aim of the Study: To compare the safety and efficacy of ultrasound guided adductor canal block versus ultrasound guided femoral nerve block as postoperative analgesic in patients undergoing knee arthroscopy.Patients and Methods: This study was carried out in Tanta University Hospitals from September 2015 till March 2016 on 105 adult patients of both sexes with ASA physical status I/II scheduled for knee arthroscopy. Patients divided into three equal groups (Group I) received basic analgesia in the form of paracetamol and diclofenac, (Group II) received ultrasound guided FNB and (Group III) received ultrasound guided ACB.Results: There were no significant differences among the three studied groups according to demographic data. Compar-ison of the mean value of NPS score showed no significant difference between FNB and ACB, but there were significant increase in control group in comparison to both FNB and ACB. The first time to introduce morphine and total morphine consumption showed no significant difference between FNB and ACB. There was significant decrease of BBS score in FNB till 6-8h post-operative in comparison with control group and ACB.Conclusion: Ultrasound guided adductor canal block is efficient as ultrasound guided femoral nerve block in control post-operative pain in patients undergoing knee arthroscopy. Also ACB result in early mobilization with no risk of fall that renders ACB preferred.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1407
1413
https://mjcu.journals.ekb.eg/article_56342_868d44378384974c8108ee95e5d6693c.pdf
dx.doi.org/10.21608/mjcu.2018.56342
Tendon Transfers Around Wrist in Cases of Obstetric Brachial Plexus Injury
MOHAMMED A. MOHAMMED, M.Sc.;
TAREK A. EL-GAMMAL, M.D.
author
AMR EL-SAYED, M.D.;
MOHAMED M. KOTB, M.D.
The Department of Orthopedic & Trauma Surgery, Faculty of Medicine, Assiut University
author
text
article
2018
eng
AbstractBackground: Wrist extension is essential in the develop-ment of motor skills in young children. Adequate wrist extension is important for good grip function of the hand, as a slightly extended wrist results in a better and stronger grip.Material and Methods: This prospective series reports on 32 patients with sequlae obstetric brachial plexus injury who underwent tendon transfer around wrist. The mean age at time of transfer was 9.9 years. FCU tendon was utilized in 25 cases, PT in 3 cases, BR in 2 cases, PL in 1 case and FDS in 1 case. The recipient tendon was ECRB in 14 cases, EDC in 12 cases, ECRL in 2 cases EPL in 2 cases, and FPL in 2 cases. Raimondi score, Toronto scale, Medical research council muscle grading system, Range of motion and hand grip strength were used to evaluate results. Good results (MRC grading of 4) were obtained in 24 cases (75%).Conclusion: Tendon transfers around wrist are considered good operative option in cases of sequlae of obstetric brachial plexus injury for restoration of hand function with or without other procedures tailored to the need of every case.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1415
1419
https://mjcu.journals.ekb.eg/article_56343_8499b25a4aa843150ae636ff418a9bf7.pdf
dx.doi.org/10.21608/mjcu.2018.56343
Effect of Irisin on Experimentally-Induced Preeclampsia in Female Albino Rats
REHAM H. IBRAHIM, M.D.;
MARWA A. HABIB, M.D.
The Department of Physiology, Faculty of Medicine, Zagazig University, Egypt
author
text
article
2018
eng
AbstractBackground: Preeclampsia is a syndrome associated with pregnancy and characterized by new onset hypertension and proteinuria that might result from hypoxic placenta which secretes pathogenic factors that enter the maternal blood stream and result in endothelial dysfunction. Irisin is a myokine that improves endothelial dysfunction and has anti-oxidant and anti-inflammatory effects. Therefore, the current study aims to explore the possible effects of irisin on a model of preeclampsia induced experimentally in adult female albino rats and to explain the possible underlying mechanisms.Material and Methods: 24 adult female albino rats were divided into three groups: Group I (control pregnant rats): That were injected daily with saline solution from 7th day to 14th day of gestation, Group II (preeclamptic rats): In which pregnant rats were injected daily with L-NAME starting from the 7th day to 14th day of gestation, and Group III (irisin-treated preeclamptic rats): In which L-NAME-induced preec-lamptic rats were treated daily with intravenous irisin; 2μg/kg; from 10th day to 19th day of gestation. In all groups, systolic and diastolic Blood Pressure (BP), Total Urinary Proteins/24 hour (TUP), number of living pups and serum Endothelin-1 (ET-1), Interleukin-6 (IL-6), Nitric Oxide (NO), Placental Growth Factor (PGF), insulin, glucose, Super Oxide Dismutase (SOD), Malondialdehyde (MDA) were measured and HOMA-IR was calculated.Results: Irisin-treated preeclamptic rats showed significant decrease in systoilic BP, diastolic BP, TUP, ET-1, IL-6, HOMA-IR, MDA and significant increase in the number of living pups, NO, PGF, SOD in comparison to preeclamptic rats.Conclusion: Irisin may be a promising molecule for treatment of vascular complications of preeclampsia, as manifested by the improvement of hypertension and proteinuria in preeclamptic rats, through several mechanisms that may involve decreasing the oxidative stress, IL-6, ET-1 and insulin resistance or increasing the levels of PGF and NO.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1421
1429
https://mjcu.journals.ekb.eg/article_56344_5e648b44f6b64529952ee653ad32e8ce.pdf
dx.doi.org/10.21608/mjcu.2018.56344
Effect of Glucagon Like Peptide-1 on Serum Kisspeptin Level in Adult Male Albino Rats Treated by Anabolic Androgenic Steroid
DOAA A. ABD EL-MOETY, M.D.;
HANY A. EL-KATTAWY, M.D.
author
MOHAMMED A.
ATTIA, M.D.
The Department of of Physiology, Faculty of Medicine, Zagazig University* and The Department of Pharmacology, Faculty of Medicine, Mansoura University**, Mansoura, Egypt
author
text
article
2018
eng
AbstractBackground: Anabolic Androgenic Steroids (AAS) are widely used among youth and athletes for improving their physical appearance and performance. However, its use has adverse effects on sexual health and metabolism. Glucagon Like Peptide-1 (GLP-1) is a gut hormone that participates in the neuroendocrine control of hypothalamic-pituitary axis (HPG), and may play an important role in the reproductive functions as a component of GIT-brain axis. Also, the hypoth-alamic neuropeptide kisspeptin stimulates the Hypothalamic Pituitary Gonadal (HPG) axis and controls gonadotropin secretion. Few researches were performed to study the rela-tionship between each of GLP-1 and kisspeptin with HPG axis.Aim: To evaluate the potential protective role of (GLP-1) against some altered sexual, metabolic, and histopathologic changes induced by the use of AAS in adult male albino rats.Material and Methods: 40 adult male albino rats were divided into 4 groups; Group I (control or vehicle treated), Group II (GLP-1 + vehicle treated), Group III (AAS-treated) and Group IV (GLP-1 + AAS). In all groups, Body Weight (BW) was measured and Body Mass Index (BMI) was calcu-lated. Serum testosterone, Luteinizing Hormone (LH), Follicle-Stimulating Hormone (FSH), kisspeptin, glucose and insulin levels were measured, homeostasis Model Assessment of Insulin Resistance (HOMA-IR) was calculated, and lipid profile was estimated. The changes in the histopathological aspects of testis were examined. The testicular weight, testicular coefficient, epidydimal sperm count and motility were inves-tigated.Results: The study revealed that peripheral injection of GLP-1 for 5 weeks to androgen treated-rats in Group IV (GLP-1 + AAS) significantly increased levels of serum kisspep-tin, LH, FSH, testosterone and consequently epidydimal sperm count and motility compared with rats in Group III (AAS-treated). In addition, GLP-1 treatment induced significant reductions in the values of fasting serum glucose and HOMA-IR, serum total cholesterol and LDL levels with no significant changes in serum insulin, HDL and TG levels in Group IV compared with Group III.Conclusion: The administered GLP-1 may attenuate some altered sexual, metabolic and histopathological adverse effects induced by AAS use in adult male rats. Therefore, it may be a novel approach for managing AAS abuse.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1431
1445
https://mjcu.journals.ekb.eg/article_56345_d1a01ba3eb6ec75d4c0b5b8aee715544.pdf
dx.doi.org/10.21608/mjcu.2018.56345
Interleukin 17 Expression in Psoriatic Skin Lesions before and after Treatment with Platelet Rich Plasma (PrP)
ENAS S. MOHAMMED, M.Sc.;
MONA A. ATWA, M.D.
author
SAHAR F. MANSOUR, M.D.;
NADER A. ISMAIL, M.D.
The Department of Dermatology & Venerology, Port-Fouad General Hospital* and The Departments of Dermatology, Venerology & Andrology** and Pathology***, Faculty of Medicine, Suez Canal University
author
text
article
2018
eng
AbstractBackground: Psoriasis is a chronic immune-mediated inflammatory disorder with epidermal hyperplasia. There is some evidence that the Interleukin (IL) 17 has a role in the pathogenesis of psoriasis. Platelet Rich Plasma (PrP) is autologous concentration of platelets may improve the condi-tion because of its anti-inflammatory nature.Aim of Work: This study has been conducted in an attempt to assess the effect of PrP as a new modality for treatment of chronic localized plaque psoriasis on IL17 expression in psoriatic skin lesions.Patients and Methods: This study is a randomized con-trolled clinical trial study in which 24 psoriasis patients attending Dermatology and Andrology Outpatient Clinics in Suez Canal University Hospitals between January 2016 to January 2017 were enrolled. Two symmetrical plaques were injected weekly intradermally with PrP and saline as placebo and skin biopsy was taken from each plaque before and after treatment. Skin biopsies were assessed for IL17 expression.Results: All the clinical parameters used for assessment of clinical response (size, erythema, thickness and scaling) significantly decreased after PrP injection by (27.39±29.33, 28.47±51.89, 25.35±66.23, and 24.31±44.36%) respectively, while plaques injected with saline showed significant decrease of scaling only. Moreover 6 plaques out of the 9 plaques that were positive for IL17 converted to negative after treatment with PrP, while all them remained positive for IL17 expression after injection with saline as placebo.Conclusions: Although psoriatic plaques treated with PrP showed variable clinical and immunological improvement compared to lesions injected with saline as placebo, PrP treatment alone can't be considered as a therapeutic modality for treatment of localized plaque psoriasis.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1447
1456
https://mjcu.journals.ekb.eg/article_56346_fc1c84616ca5f21852041aad8d66042a.pdf
dx.doi.org/10.21608/mjcu.2018.56346
Laparoscopic Para-Umbilical Hernial Repair versus Conventional Surgical Management
MOHSEN H. ABD EL-KADER, M.Sc.;
MAHMOUD Th. AYOUP, M.D.
author
MOHAMED B.M. KOTB, M.D.;
ABD EL-RADI A. FARGALY, M.D.
author
MOSTAFA Th.
AHMED, M.D.
The Department of General Surgery, Faculty of Medicine, Assiut University
author
text
article
2018
eng
AbstractBackground: Para-umbilical hernia repair has shown a progressive development. It was initially performed by the open technique. With the introduction of new mesh types, laparoscopic para-umbilical hernia repair is gaining increasing acceptance.Patients and Methods: The study included 45 patients with para-umbilical hernia with defect size 3cm or less. 15 of these patients were operated upon laparoscopically (group 1) using composite mesh, and the other group (group 2) with open surgery using polypropylene mesh.Results: Group 1 showed less post-operative complications and short hospital stay in comparison to the open (group 2). It also showed no recurrences in comparison to 6.7% for the group 2 but group 1 is accompanied with long operative time and high cost.Conclusion: Our results suggest that laparoscopic para-umbilical hernia repair is safe, effective and technically feasible operation with reduced morbidity, earlier recovery and shorter hospital stay and less recurrence rate than the open group.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1457
1463
https://mjcu.journals.ekb.eg/article_56347_c6571341db63369eb4ff4e80710b81e9.pdf
dx.doi.org/10.21608/mjcu.2018.56347
Effect of Acupressure on Frequency and Severity of Nausea and Vomiting among Leukemic Children Undergoing Chemotherapy
HANAA G. MOHAMMED, M.Sc.;
AZZA A. ATTIA, D.N.Sc.
author
HEWIDA A. HUSSEIN, D.N.Sc.;
WAEL Z. KHALED, M.D.
The Department of Pediatric Nursing, Faculty of Nursing, Modern University for Technology & Information* and Cairo** Universities and The Department of Pediatric Oncology, National Cancer Institute, Cairo University***, Egypt
author
text
article
2018
eng
AbstractBackground: Acupressure is one of non-pharmacological techniques that can control chemotherapy induced nausea and vomiting among children with leukemia.Aim of the Study: The current study aimed to evaluate the effect of acupressure on frequency and severity of nausea and vomiting among leukemic children undergoing chemotherapy.Subjects and Methods: Quasi-experimental research design was utilized for the current study.Setting: The current study was conducted at national Cancer Institute and sixth floor of Dar Essalam Hospital which affiliated to Cairo-University Hospitals.Sample: A convenience sample was consisted of sixty school age children with leukemia divided into two equal half to acupressure and control group. The required data was collected by using four tools including personal data ques-tionnaire sheet, nausea assessment sheet, vomiting assessment sheet and acupressure observational checklist.Results: The current study revealed that frequency and severity of acute and delayed chemotherapy induced nausea and vomiting significantly decreased after application of acupressure technique. More than half of school age children having leukemia were less than nine years and male gender. There were statistically significant relationships between level of caregivers' education and with severity of acute and delayed nausea and vomiting. There were positive correlations between improvement of nausea and vomiting as well as improvement of delayed symptoms of nausea and vomiting.Conclusion: The current study concluded that there was a positive effect of acupressure on decreasing frequency and severity of acute and delayed chemotherapy induced nausea and vomiting among school age children with leukemia.Recommendations: The current study recommended that acupressure technique should be included in the chemotherapy protocol; children and their caregivers should teach the tech-nique of acupressure before beginning of chemotherapy sessions.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1465
1473
https://mjcu.journals.ekb.eg/article_56348_16f4ef79b7b1358bd887b865d7493762.pdf
dx.doi.org/10.21608/mjcu.2018.56348
Case Report: Obstructive Sleep Apnea and Lhermitte’s Sign Following Chemoradiation in Head and Neck Cancer
ALI M. ALI, M.D.;
PIERRE Y. MARCY, Ph.D.
author
JULIETTE
THARIAT, Ph.D.
The Department of Clinical Oncology, Faculty of Medicine, Sohag University, Sohag, Egypt* and The Departments of Radiodiagnostics** and Radiation Oncology***, Centre Antoine Lacassagne, University Nice Sophia Antipolis, Nice, France
author
text
article
2018
eng
AbstractBackground: Obstructive Sleep Apnea (OSA) and L' hermite Sign (LS) are known but uncommon manifestations of various general and local illnesses both non malignant and malignant ones. Screening the PubMed for studies linking either one or both of these manifestations with Head and Neck Cancers (HNCs) treated by concomitant radio chemotherapy found that few studies reporting on LS in association with chemo rather than radiotherapy. Even fewer those studies that reported on OSA and, perhaps only one case report that described simultaneous incidence of both of these morbidities in one patient, that was the present case report.Case Report: The authors describe a case of locally advanced head and neck squamous cell carcinoma treated with chemo followed by concomitant chemoradiotherapy and developed an early post treatment simultaneous occurrence of OSA and LS both of them got improved after vitamin supplement, steroid and, Continuous Positive Airway Pressure (CPAP) therapy.Conclusion: This case highlights the importance of keeping the doses of neurotoxic chemotherapeutic drugs mainly cispl-atin as low as possible when given concomitantly with radio-therapy in head and neck cancers also, the maximum dose to the spinal cord below 46 gray.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1475
1477
https://mjcu.journals.ekb.eg/article_56349_dd41e4d5ce75c7b8f55a982aca2132c3.pdf
dx.doi.org/10.21608/mjcu.2018.56349
Comparison of Two Percutaneous Approaches in Varicocele Embolization: Study of Complications, Radiations and Recurrence Rate
MOHAMED
MAGDY EL-RAKHAWY, M.D.
The Department of Radiodiagnosis, Faculty of Medicine, Mansoura University, Egypt
author
text
article
2018
eng
AbstractBackground: In this retrospective study, we will compare two approaches in percutaneous embolization of varicocele, right common femoral vein access and right internal jugular vein access, we will compare technical success, complications and recurrence rate.Aim of the Study: This study constructed, to compare two percutaneous access routes in varicocele embolization, the transfemoral and the jugular routes. It was a comparison of complications, radiations and recurrence rates.Patients and Methods: This study was retrospective study of the records of 34 male patients with clinically and radio-logically proved varicocle who were treated by percutaneous embolization, in the period from 2014 to 2016. They included two groups, Group I (17 patients) treated using the transfemoral route and Group II (17 patients) treated using jugular route. The embolic materials used included, coils (14 patients), N-butyl-2-cyanoacrylate (12 patients) and sclerosing agents or polidocanol in 8 patients. The catheters used were cobra head-5-Fr, Bern 4Fr and microcatheter (progreat 2,7F). The com-plications, time of radiation, technical success and recurrence were compared in both groups.Results: In Group I (percutaneous transfemoral route), there was failure of catheterization of right internal spermatic vein in one patient due to acute angle, while in Group II there was successful catheterization of left and right internal sper-matic vein in all (17 patients). Also, post-procedural pain was seen in 3 patients in Group I and in 2 patients in Group II. Contrast extravasation was seen in one patient in Group I, groin hematoma in 2 patients, glue migration in one patient and recurrence in 2 patients, while in Group II no vein injury, no hematoma or glue migration and recurrence was seen in one patient only. The mean procedure time and the fluoroscope time were longer in Group I as compared to Group II. In Group I the mean procedure time was 52 minutes and fluor-oscopy time was 23 minutes while in Group II. They were 40 minutes and 15 minutes respectively.Conclusion: Percutaneous embolization of varicocele is relatively safe technique and has high success rate. The percutaneous transjugular route is easy for catheterization of both right and left internal spermatic vein, while for left sided varicocele, the right common femoral vein access is easy and safe. The transjugular route has less complications, less radiation time and low recurrence rate.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1479
1484
https://mjcu.journals.ekb.eg/article_56350_2cfe3495c8832e3cfa01a3d29d983ff7.pdf
dx.doi.org/10.21608/mjcu.2018.56350
A Dosimetric Comparison between RapidArc and Conventional 3D Conformal Radiotherapy in Post-Operative Irradiation of Low Grade Gliomas: Any Added Benefit?
RADWA H. AZAB, M.Sc.;
KARIM MASHHOUR, M.D.
author
MOHAMED ABDALLA, M.D.;
HANAN DARWISH, M.D.
author
HODA ABD EL-GHANY, M.Sc.;
SHAWKY EL-HADDAD, F.R.C.R., M.D.
The Department of Clinical Oncology, Faculty of Medicine* and The Department of Medical Physics, Kasr Al-Ainy Hospital**, Cairo University, Egypt
author
text
article
2018
eng
AbstractBackground: Low-Grade Gliomas (LGG) comprise a rare group of central nervous system tumors and clinically chal-lenging cases to manage. They account for approximately 15% of all primary brain neoplasms. Radiotherapy (RT) remains an important component in the treatment of low grade gliomas and Three-Dimensional Conformal RT (3DCRT) is the current state of art for RT delivery. The main gain of modern RT technology is more likely reducing treatment related toxicity rather than an improvement in overall survival. RapidArc (RA) technology (Varian Medical Systems, Palo Alto, CA) is a novel radiation therapy technique integrating 3 important factors for treatment delivery.Aim of the Study: The aim of the study is to investigate the potential dosimetric benefit of RapidArc (RA) in compar-ison to conventional 3D-CRT for low grade gliomas of the brain regarding target coverage and doses received by organs at risk (OAR).Material and Methods: Twenty patients diagnosed with low grade glioma (WHO grade I-II) were referred to our center for postoperative irradiation using 3D-CRT. The pre-scribed dose was 54 Gy/30F/6weeks. CT scans of the 20 patients was done and delineation of the target volumes and organs at risk was performed. Two set of plans were done for each patient, one using conventional 3D-CRT and other using a RA plan. Dosimetric parameters regarding target coverage and dose received by OAR were evaluated and compared. Monitor units was also calculated.Results: Target coverage in terms of V95% was signifi-cantly better in the RA plans with a value of 98.0±1.9 versus 96.0±2.6 for the 3D-CRT plans (p-value of 0.006). The RA plans gave a better conformity with a CI95% of 1.01±0.012 compared to1.07±0.024 achieved with the 3D-CRT plans (p-value of 0.678). The Homogeneity Index (HI) was higher for the 3D-CRT plans with a value of 0.131±0.112 compared to 0.097±0.033 for the RA plans (p-value of 0.114). The OAR received less dose in RA than 3D-CRT except for both lenses which received higher doses in the RA plans with a significant p-value of 0.002 and 0.001 for the right and left lens, respec-tively. The maximum dose and D1% for the healthy brain tissue was significantly lower in the RA plans when compared to 3D-CRT (p-value of 0.001). With respect to the average MUs ±SD needed per fraction, it was found to be 257.6±16.1 for the 3D-CRT plans as opposed to 355.6±44.4 RA plans (p-value of 0.001).Conclusion: RA plans dosimetrically achieved a better PTV coverage, dose conformity, more homogenous dose distribution and better OAR sparing when compared to con-ventional 3D-CRT plans except for both lenses. The 3D-CRT plans utilized a lower number of MUs than RA.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1505
1511
https://mjcu.journals.ekb.eg/article_56351_779b74d9767af960202c736bdb96de12.pdf
dx.doi.org/10.21608/mjcu.2018.56351
Pitfalls of Dynamic Contrast Enhanced MR Mammography (DCE-MRM) in Evaluation of Post-Biopsy Suspicious Breast Lesions
ENASS M. KHATTAB, M.D.;
TAREK M. SOBHY, M.D.
author
ABD EL-HAFEZ M.
EL-SHEWAIL, M.D.
The Departments of Diagnostic Radiology* and General Surgery**, Faculty of Medicine, Zagazig University, Egypt
author
text
article
2018
eng
AbstractBackground: Breast MRI examination after diagnosis of breast cancer has been established to assess true extension of the disease. Therefore, it is important to evaluate any potential effect of biopsy on imaging characteristics.Aim of the Study: This study aimed to evaluate efficacy of contrast enhanced magnetic resonance mammography (DCE-MRM) in evaluation of post-biopsy breast lesions.Patients and Methods: Sixty-five female patients with suspicious breast lesions were included in this study. Dynamic contrast enhanced MR mammography (DCE-MRM) were performed to all patients pre and post biopsy, histopathological correlation was done as a golden slandered.Results: There was over-estimation in 3 patients that were categorized as BIRADS3 based on pre-biopsy DCE-MRM and upgraded to BIRADS4 in post-biopsy examination, how-ever their pathology were negative for malignant cells. There was under-estimation in 2 patients that were categorized as BIRADS5 based on pre-biopsy DCE-MRM and downgraded to BIRADS4 in post biopsy examination, their pathology were positive for malignant cells. Number of BIRAD4 cases in-creased in post-biopsy DCE-MRM by 5 lesions. The pre-biopsy DCE-MRM accuracy was 91.8% and the post-biopsy was 85.7%. p-value <0.00001 which was statistically highly significant.Conclusion: Breast biopsy can cause uneven changes with possibility of alter the appearance on DCE-MRM. Chang-es in imaging characteristics can lead to inaccuracy of nature and extension of the tumor, which could have significant impact on treatment planning.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1513
1522
https://mjcu.journals.ekb.eg/article_56352_2254efa0fdc34edefaca4f1da259b6dc.pdf
dx.doi.org/10.21608/mjcu.2018.56352
Nesfatin-1 Ameliorates Testicular Function Changes in Type 2 Diabetic Rats
KHALED A.A. ABULFADLE, M.D.;
SAMA S. KHALIL, M.D.
The Department of Physiology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
author
text
article
2018
eng
AbstractBackground: Type 2 Diabetes Mellitus (T2DM) is a common problem that is accompanied by disturbed metabolic homeostasis, oxidative stress and increase in proinflammatory cytokines. On the other hand, normal body metabolism is essential for the testicular function. Also, nesfatin-1 is a peptide hormone produced by numerous tissues, including the testes and shared in regulation of metabolic homeostasis and had antioxidant and anti-inflammatory properties.Aim: To investigate the effects of T2DM on testicular functions and the effects of exogenous treatment with nesfatin-1 on modulation of those effects, and, to declare the possible involved mechanisms.Material and Methods: 24-healthy adult male albino rats with a weight of 180-200gm, were divided into three groups of 8 rats each; control, type 2 diabetic (T2DM) and nesfatin-1 treated type 2 diabetic (T2DM + Nesfatin) groups. The control group received a standard diet, while, the diabetic groups (T2DM and T2DM + Nesfatin) received a High Fat Diet (HFD). Five weeks after beginning HFD, rats were fasted for 12h and received streptozotocin, in a dose of 35mg/kg, dissolved in 0. 1M sodium citrate buffer (pH 4.5) intraperito-neally (i.p.). Then, rats of the control and T2DM groups received normal saline i.p. in a dose of 1ml/kg/day for more 4 weeks and they continued to be fed with their corresponding diet, while, those of T2DM + Nesfatin group were treated with nesfatin-1 in a dose of 2mg/kg/day i.p. for more 4 weeks and they continued to be fed with HFD. The serum levels of testosterone, Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), tumor necrosis factor alpha (TNFa) and interleukin-1 beta (IL-1b) were measured in the studied groups. Also, epididymal sperm motility and count, testicular histopa-thology and antioxidant enzymes Superoxide Dismutase (SOD) and catalase (CAT) activities were examined.Results: A significant (p<0.001) increase in the final Body Mass Index (BMI), Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) index, serum levels of glucose, insulin, Total Cholesterol (TC), Triglycerides (TG), Low Density Lipoprotein (LDL), TNFa and IL-1b was found in the T2DM group in comparison to the control group. On the other hand, a significant (p<0.001) decrease in serum levels of High Density Lipoprotein (HDL), FSH, LH, and testosterone was AbstractBackground: Type 2 Diabetes Mellitus (T2DM) is a common problem that is accompanied by disturbed metabolic homeostasis, oxidative stress and increase in proinflammatory cytokines. On the other hand, normal body metabolism is essential for the testicular function. Also, nesfatin-1 is a peptide hormone produced by numerous tissues, including the testes and shared in regulation of metabolic homeostasis and had antioxidant and anti-inflammatory properties.Aim: To investigate the effects of T2DM on testicular functions and the effects of exogenous treatment with nesfatin-1 on modulation of those effects, and, to declare the possible involved mechanisms.Material and Methods: 24-healthy adult male albino rats with a weight of 180-200gm, were divided into three groups of 8 rats each; control, type 2 diabetic (T2DM) and nesfatin-1 treated type 2 diabetic (T2DM + Nesfatin) groups. The control group received a standard diet, while, the diabetic groups (T2DM and T2DM + Nesfatin) received a High Fat Diet (HFD). Five weeks after beginning HFD, rats were fasted for 12h and received streptozotocin, in a dose of 35mg/kg, dissolved in 0. 1M sodium citrate buffer (pH 4.5) intraperito-neally (i.p.). Then, rats of the control and T2DM groups received normal saline i.p. in a dose of 1ml/kg/day for more 4 weeks and they continued to be fed with their corresponding diet, while, those of T2DM + Nesfatin group were treated with nesfatin-1 in a dose of 2mg/kg/day i.p. for more 4 weeks and they continued to be fed with HFD. The serum levels of testosterone, Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), tumor necrosis factor alpha (TNFa) and interleukin-1 beta (IL-1b) were measured in the studied groups. Also, epididymal sperm motility and count, testicular histopa-thology and antioxidant enzymes Superoxide Dismutase (SOD) and catalase (CAT) activities were examined.Results: A significant (p<0.001) increase in the final Body Mass Index (BMI), Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) index, serum levels of glucose, insulin, Total Cholesterol (TC), Triglycerides (TG), Low Density Lipoprotein (LDL), TNFa and IL-1b was found in the T2DM group in comparison to the control group. On the other hand, a significant (p<0.001) decrease in serum levels of High Density Lipoprotein (HDL), FSH, LH, and testosterone was reported in T2DM group in comparison to the control group. Also, a significant (p<0.001) decline in right testis weight, testicular SOD and CAT activity, and, epididymal sperm motility and count was found in T2DM group in comparison to the control group. Also, in T2DM group, a significant negative correlation between testicular functions (serum testosterone, epididymal sperm count and epididymal sperm motility) and each of final BMI, HOMA-IR, serum levels of IL-1b and TNFa, and, testicular SOD and CAT activity, was reported. After exogenous nesfatin-1 treatment, the changes noticed in T2DM group were reversed as a significant (p<0.001) decrease in final BMI, HOMA-IR index, serum levels of glucose, insulin, TC, TG, TNFa and IL-1b was found in the T2DM+Nesfatin group in comparison to the T2DM group. On the other hand, a significant (p<0.001) increase in serum levels of HDL, FSH, LH, and testosterone in the T2DM + Nesfatin group was recorded in comparison to the T2DM group. Also, a significant (p<0.001) rise in right testis weight, testicular SOD and CAT activity, and, epididymal sperm motility and count was found in the T2DM + Nesfatin group when compared with T2DM group.Conclusion: T2DM decreased testicular functions, sper-matogenesis and steroidogenesis, through disturbing metabolic homeostasis, decreasing the gonadotropins secretion, reducing testicular antioxidant activity and increasing proinflammatory cytokines. On the other hand, exogenous nesfatin-1 treatment ameliorated testicular function changes in T2DM through controlling body weight, improving metabolic disturbances, increasing FSH and LH secretion, its antioxidant and its anti-inflammatory properties.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1485
1495
https://mjcu.journals.ekb.eg/article_56353_efb8de9386988793b3448a35bfec4cd2.pdf
dx.doi.org/10.21608/mjcu.2018.56353
Lung Ultrasound: Role and Efficacy in Diagnosing and Follow-up of Patients with Neonatal Respiratory Distress Syndrome
ASMAA M. ABD EL-MAGIED, M.D.;
YASMEEN A. MANSI, M.D.
The Departments of Radiodiagnosis* and Pediatrics**, Faculty of Medicine, Cairo University
author
text
article
2018
eng
AbstractBackground: Neonatal Respiratory Distress Syndrome (NRDS) or hyaline membrane disease result from surfactant deficiency with subsequent alveolar instability and collapse impeding the normal gas exchange. NRDS diagnosis is based primary on clinical findings, laboratory tests and chest radi-ography. Early diagnosis is crucial to start respiratory support and surfactant replacement.Aim of Work: Evaluate the efficacy of Lung Ultrasound (LUS) in the diagnosis and follow-up of Neonatal Respiratory Distress Syndrome (NRDS) in the premature neonates.Patients and Methods: Evaluation of 68 preterm neonates presented with respiratory distress and admitted in Neonatal Intensive Care Unit (NICU) was done. The gestational age ranged from 26 to 35 weeks (mean=30.24). The birth weight ranged from 800gm to 2.950kg (mean=1.429kg). Forty-one patients (60.3%) were males and 27 (39.7%) were females. All patients were subjected portable Chest X-Ray (CXR) within few hours of admission followed by bedside lung B-mode ultrasound within 24 hours. Follow-up CXR and ultra-sound were done on the 5th day to monitor response to treat-ment.Results: Lung ultrasound was able to diagnose RDS in 68/68 patients on the first day. In comparison with the CXR, LUS had sensitivity, specificity, PPV and NPV of 100% in diagnosing RDS. On 5th day follow-up, LUS in comparison to CXR as regard detection of persistence or clearance of RDS had both specificity and PPV of 100% while sensitivity and NPV were 90% and 90.2% respectively.Conclusion: LUS is safe and non-invasive technique and can be used as diagnostic tool in the diagnosis of RDS and following-up the effect of treatment thus reducing number of carried out X-ray.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1497
1503
https://mjcu.journals.ekb.eg/article_56354_f6d0ecfe6f0c0a5fd1a30f277dbeddb1.pdf
dx.doi.org/10.21608/mjcu.2018.56354
Experienced Burden by Caregivers of Autistic Children
FAISAL SAEED
AL-QAHTANI, S.B.F.M., A.B.F.M.
The Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia
author
text
article
2018
eng
AbstractBackground: Autism is one of the developmental disorders, characterized by qualitative impairments in communication and social interaction and by restricted, repetitive, and stere-otyped patterns of behaviors and interests.Aim of Study: To assess burden experienced by family members of autistic children in Aseer Region, Saudi Arabia.Subjects and Methods: Following a cross sectional research design a total of 157 caregivers of autistic children registered at three rehabilitative centers in Aseer Region were included. The Arabic version, of the validated Zarit Burden Questionnaire was used for data collection.Results: Age of participants ranged from 23 to 61 years with a mean ± SD of 36.5±6.7 years, and 58% were females. Most care-givers (86.6%) experienced burden, while 49% had mild grade of burden, 35% had moderate grade while 2.5% had severe grade. Experienced burden did not differ signifi-cantly according to participants' gender or educational levels. However, those who experienced burden were significantly older than those who did not (p=0.03). The social component of burden was the most common among participants (89.2%), followed by physical (61.8%), financial (60.5%) and lastly the psychological (56.1%). Experienced financial burden did not differ significantly according to participants' gender or educational levels. However, those who experienced financial or psychological burden were significantly older than those who did not (p=0.02 and p=0.04, respectively). Experienced physical burden did not differ significantly according to participants' gender or age. However, those who experienced physical burden had lower levels of education than those who did not (p=0.05). Experienced social burdens did not differ significantly according to participants' personal characteristics.Conclusions: Most caregivers, especially older ones, experience burden due to their autistic relative. The burden is mainly social, followed by physical, financial and psycho-logical burdens. Financial burden is more among older car-egivers, while the physical burden is more among less educated caregivers.Recommendations: Support for caregivers of autistic children is highly needed to minimize their experienced burden. Provided support for caregivers should include social, physical, financial and psychological dimensions.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1523
1528
https://mjcu.journals.ekb.eg/article_56355_660a7bd764f5f1d08c6a27f684a0d208.pdf
dx.doi.org/10.21608/mjcu.2018.56355
Case Report: Cantharidin Poisoning after Insect Ingestion
YOUSSEF ALI AL-QAHTANI, M.D.;
RISHI K. BHARTI, M.D.
author
BOTHAINA GHAZALI, M.D.;
ASMAHAN FAIA MOHAMMAD, M.B.B.S.
author
BAYAN FUAD I. ABBAG, M.B.B.S.;
SHWETA CHAUDHARY, M.D.
author
ASHWAQ Y. ASIRI, M.B.B.S.;
WAFA DAIFALLAH ALSHEHRI, M.B.B.S.
author
text
article
2018
eng
AbstractBackground: Cantharidin is a toxic compound present in the "Spanish Fly", commonly known as "Blister Beetles", which is vesicant and toxic in nature. Clinical features of cantharidin poisoning include hematemesis, gross hematuria, and dysuria.Aim of the Study: To report a case of cantharidin poisoning in a child, after accidental ingestion of a blister beetle.Case Report: We report a case of accidental ingestion of blister beetle in an 18-month old girl, a resident of Aseer Region, Saudi Arabia, who was brought by her father with classical signs and symptoms of cantharidin poisoning, in-cluding hematemesis, abdominal pain, hematuria and suspected poisoning. Her condition was confirmed by her father who brought a similar insect to which was ingested by the patient. The patient recovered after being managed conservatively, serum electrolytes and blood gases were closely monitored. She was discharged after 7 days.Conclusion: Cantharidin poisoning cannot be diagnosed with particular clinical features, but a detailed and in-depth history combined with the presenting clinical symptoms should alert for this rare event. Health education for both the general population and the medical community about cantharidin poisoning may have some value in the prevention of such events.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1529
1531
https://mjcu.journals.ekb.eg/article_56356_bab33e9b540cfaffe0d0eaf43b48c8d9.pdf
dx.doi.org/10.21608/mjcu.2018.56356
The Correlation between Bispectral Index Value and Glasgow Coma Scale in Isolated Head Trauma Patients
AHMED S. SAAD, M.Sc.;
OMAR WAGIH, M.D.
author
INAS EL-SHAZLY, M.D.;
HISHAM ABU EL-DAHAB, M.D.
author
SAFINAZ
OSMAN, M.D.
The Department of Anaesthesiology, Faculty of Medicine, Cairo University
author
text
article
2018
eng
AbstractBackground: We performed the current study to find out if there is a correlation between the Bispectral index value and glasgow coma scale in isolated head trauma patients undergoing surgical intervention.Aim of the Study: Find out if bispectral index value correlate with Glasgow coma scale.Patients and Methods: A total of 40 patients who were admitted in emergency room with isolated head trauma glasgow coma scale and bispectral index readings were recorded at time of arrival, immediately post-operative, after 3 days and 2 weeks post admission.Results: We found that there was a strong correlation between glasgow coma scale and bispectral index readings.Correlation coefficient was 0.956 and p-value <-0.001.Conclusion: We conclude from this study that there is a strong correlation between glasgow coma scale and bispectral index readings.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1533
1536
https://mjcu.journals.ekb.eg/article_56357_a3c47d18f79e729882743d4cf29dde21.pdf
dx.doi.org/10.21608/mjcu.2018.56357
Evaluation of the Satisfaction of Undergraduate Radiological Sciences Students Toward their Clinical Training Experience
TAMADER
AL-RAMMAH, Ph.D.
The Department of Radiological Science, King Saud University, Riyadh, Saudi Arabia
author
text
article
2018
eng
AbstractBackground: Radiology plays a very important role in health care system. Nowadays, most of the diagnoses are based on it.Aim of Study: To evaluate radiological sciences students' satisfaction toward their clinical training experience and to compare their levels of satisfaction experienced at a university hospital and a Ministry of Health (MOH) Hospital.Material and Methods: A total of 92 radiology students from four levels in addition to internship were included in this study. A data collection sheet was constructed by the researcher to assess students' satisfaction toward their clinical training experience. The survey was designed to evaluate students' satisfaction during clinical experience in general and to compare the level of satisfaction of students in two hospitals, one was university affiliated and the other was MOH affiliated.Results: Students' mean satisfaction scores were within the "satisfied" range. However, participant students were mainly dissatisfied with their training at the MOH hospital. The item with least satisfaction was related to the hospital staff being friendly and approachable (40.2%), while the item with highest satisfaction was related to adequacy and acces-sibility of learning resources at hospital (64.1%). Students enjoyed their training significantly more at university hospital (p=0.008); the staff were significantly less friendly at the MOH hospital (p=0.018); internship was significantly more preferred at the university hospital (p<0.001); and students felt as part of the team during their placement significantly less at the MOH hospital (p<0.001).Conclusions: Radiological sciences students are mainly satisfied with their clinical training. They enjoyed training at the university hospital more than at a MOH hospital. Students' feedback should be regularly taken to ensure that they receive the best placement and training environment. Educational and training institutions, supervisors and clinical trainers must collaborate to develop and implement strategies in order to improve practice.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1537
1540
https://mjcu.journals.ekb.eg/article_56358_c46d97d8722d48f7797117bc643c30d4.pdf
dx.doi.org/10.21608/mjcu.2018.56358
Conservative Treatment of Large Lateral Cervical Discs Without Myelopathy; A One Year Follow-Up
MOHAMED MOHAMED, M.D.;
AHMED S.K. ABDELWAHED, M.D.
The Department of Neurosurgery, Faculty of Medicine, Beni Sueif * and Cairo** Universities
author
text
article
2018
eng
AbstractBackground: The natural history of cervical disc prolapse is not fully known and clear indications for operative inter-vention, apart from evident weakness or radiological evidence of cord injury, cannot be established from the literature.Several studies have shown that the largest lumbar disc appear to have the greatest tendency to resolve but there are not enough studies about prolapsed cervical discs.Aim of the Study: The aim of this study was to investigate whether large lateral cervical prolapsed discs without mye-lopathy can be safely managed conservatively leading to clinical & radiological improvement.Patients and Methods: Twenty-four patients were studied by clinical assessments and magnetic resonance imaging (MRI) over the period of one year through which they received intermittent medical treatment (tizanidine, celecoxib, prega-balin).All patients had severe brachialgia at first presentation, but began to show clinical improvement despite the large lateral disc herniations evident on initial imaging. Clinical assessment was done by neurological appraisal. The karnofsky performance Scale was used to measure function and changes in function. Repeat MRI studies every six months allowed measurement of volume changes of the herniated disc material.Results: Initial follow up at three and six months showed positive response in twenty two patients (91.6%). Follow-up at an average of 12 months revealed that twenty-one patient (87.5%) had a complete and sustained recovery. Only threep-atients had unsatisfactory progress and required discectomy. The average karnofsky performance score improved from 60% to 90%.Volumetric analysis of serial MRI scansfound an average reduction of 50% in disc size. There was poor correlation between clinical improvement and the extent of disc resolution.Conclusion: A large lateral cervical disc herniation treat-edconservatively can pursue a favorable clinical course. If early progress is shown, the long-term prognosis is very good and even large disc herniations can be treated conservatively.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1541
1544
https://mjcu.journals.ekb.eg/article_56359_2dd27e8cc17394430a854cecf8556482.pdf
dx.doi.org/10.21608/mjcu.2018.56359
Effect of Restrictive Intraoperative Intravenous Fluids Combined with Prophylactic Noradrenaline on Postoperative Morbidity in Open Abdominal Procedures
ADHAM F. TAWFIK, M.Sc.;
AMINA A. MOUSA, M.D.
author
AHMED K.
ABDEL-HADY, M.D.
The Department of Anesthesiology, Faculty of Medicine, Cairo University
author
text
article
2018
eng
AbstractBackground: Fluid regimens are variable and the choice of restrictive or liberal can have an impact on postoperative outcome especially during major procedures such as those of abdominal surgeries. The use of intraoperative noradrenaline infusion has been attributed to maintain perfusion alongside the restrictive regimen. The outcome is assessed both intra-and postoperatively using biomarkers and morbidity survey (Clavien Dindo classification).Aim of the Study: Our goal was to evaluate the effect of restrictive hydration while infusing noradrenaline followed by postoperative assessment of complications and hospital stay as opposed to liberal hydration in open abdominal pro-cedures.Patients and Methods: In this randomized double blinded study, 70 patients were split into two sections (restrictive and conventional hydration) scheduled for open abdominal pro-cedures namely radical cystectomy & hemi colectomy. They were then evaluated in the postoperative period for any morbidity or mortality.- Restrictive group (n=35): A primary infusion of Ringer's solution (1ml/kg/h) till the accomplishment of tumor resec-tion, followed by a different dose of 4ml/kg/h before post-operative transfer. The dose of the prophylactic noradren-aline infusion perioperatively was 0.08ug/kg/min.- Conventional group (n=35): An initial bolus of 5 ml/kg of Ringer's solution was infused intraoperatively in the early moments of surgery during anesthesia induction. It was then followed by the usual fluid administration in the form of maintenance, deficit and any other losses.The primary outcome we targeted was postoperative morbidity by the Clavien-Dindo classification and length of hospital stay. Secondary outcome included intra and postop-erative biomarkers and hemodynamics.Results: The restricted fluid regimen with prophylactic noradrenaline resulted in lower incidence of complications (whether medical or surgical) in contrast to liberal hydration.Conclusion: Restricting intravenous fluid therapy plus prophylactic noradrenaline infusion is a safe and effective method of intraoperative hydration with better postoperative outcome.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1545
1554
https://mjcu.journals.ekb.eg/article_56360_c83a4a2090f186db6496a3ef0d3c4630.pdf
dx.doi.org/10.21608/mjcu.2018.56360
Anticardiolipin and Anti-(32 Glycoprotein I Antibodies in Pregnant Women with Severe Pre-Eclampsia
NABILA M. THABET, M.D.;
OSAMA BAKR, M.D.
author
DIAA AL-DIN M. AL-NASHAR, M.D.;
HEBA A. ABD EL-HAFEEZ, M.D.
author
MAHA G.
ABD EL-KADR, M.Sc.
The Departments of Clinical Pathology* and Obstetrics & Gynecology**, Faculty of Medicine, Assiut University
author
text
article
2018
eng
AbstractBackground: APA have been associated with a number of obstetric complications however their role in the pathogen-esis of preeclampsia has remained an issue of controversy.Aim of the Study: 1- Detection of Anticardiolipin antibodies and Anti-(32 glycoprotein I antibodies in pregnant women with severe pre-eclampsia. 2- Estimation of the prevalence of APA in pregnant women with severe pre-eclampsia.Patients and Methods: This is a case control study. Eighty pregnant women diagnosed of severe pre-eclampsia and twenty age-parity matched normal on-going pregnant women were recruited as participants for the study. Antiphospholipid antibodies were assayed using Dilute Russel Viper's Venom (DRVV) Lupus Anticoagulant (LA screen and confirm kits), Anticardiolipin Antibody (ACA) Enzyme Linked Immuno-sorbent Assay (ELISA) kits and Anti-(32 glycoprotein I anti-bodies ELISA-based test system were used.Results: The prevalence of APLA in severe pre-eclampsia was 6.25%, while none (0%) of the controls was positive.Conclusion: This study using DRVVT lupus anticoagulant, Anticardiolipin and Anti-(32 glycoprotein I assays has found the prevalence of APA in severe pre-eclampsia women seen at Women’s Health Hospital, Assiut University to be 6.25%, while none (0%) of the controls was positive. These findings suggested that there is a relation between presence of APA and development of severe pre-eclampsia.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1555
1563
https://mjcu.journals.ekb.eg/article_56361_7802ad539761c382dfada2bb79031e3c.pdf
dx.doi.org/10.21608/mjcu.2018.56361
Assessment of the Serum Level of Interleukin-6 and Interleukin-10 in Newly Diagnosed Acute Myeloid Leukemia Patients and the Response to Induction Chemotherapy
ZAINAB A. ABD EL-HAFEZ, M.D.;
MADLEEN A. ABDOU, M.D.
author
TAREQ S. AHMED, M.D.;
MAI M. SALAH EL-DIN, M.Sc.
The Departments of Clinical Pathology* and Clinical Oncology & Nuclear Medicine**, Faculty of Medicine, Assiut University, Egypt
author
text
article
2018
eng
AbstractBackground: Acute leukemia is the most common hema-tological malignancy in adults, characterized by distorted proliferation of immature bone marrow-derived cells (BM blasts) that may also involve peripheral blood or solid organs. Blood cells and their marrow based progenitors are exquisitely responsive to their environment, and cytokines are an essential part of it. The overexpression of cytokines in leukemia patients declines in complete remission suggesting that these events are dependent on AML activity, possibly due to autonomous blast cytokine secretion.Methods: Using ELISA kit, serum levels of IL-6, IL-10 were estimated before and after induction chemotherapy in 30 patients with AML from February 2015 to May 2016 from Clinical Oncology Department, Hematological Diseases Unit in Internal Medicine Department, Assiut University Hospital and Medical Oncology Department, South Egypt Cancer Institute and 20 age and sex matched healthy controls were also enrolled.Results: IL-6 and IL-10 levels were significantly higher in newly diagnosed AML patients than in control group and their levels decreased when patients responded to induction chemotherapy (the blast cell count in their BM fall to >5%).Conclusion: Our study demonstrated the decrease in the serum level of two markers (IL-6 and IL-10) in AML patients after induction chemotherapy, suggesting that assessment of their levels may be used as a prognostic markers and beneficial in the evaluation of the therapy making them highly applicable to routine clinical laboratories.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1565
1572
https://mjcu.journals.ekb.eg/article_56362_9ff1edddcee26389bb8ec78f5695aab8.pdf
dx.doi.org/10.21608/mjcu.2018.56362
Mammographic and Ultrasound Features of Mondor's Disease of the Breast (Original Article)
YASMIN M. TOHAMEY, M.D.;
AMR FAROUK, M.D.
The Department of Radiology, Faculty of Medicine* and National Cancer Institute**, Cairo University
author
text
article
2018
eng
AbstractBackground: Mondor's disease of the breast or superficial thrombophlebitis of the breast is a rare benign breast entity, may be due to lack of awareness of the entity.Aim of Work: The purpose of this study was to demonstrate the mammographic and sonographic findings in patients with Mondor's disease of the breast.Material and Methods: 10 patients (9 females and 1 male) presented with a painful palpable cordlike structure. The youngest patient was 29 years old and the oldest patient is 64 years old. All patients were evaluated by Ultrasound. Mam-mography only was performed on 6 patients. Mammographic and sonographic findings were evaluated retrospectively.Results: The sonographic finding of a superficial vessel without flow on Doppler imaging in addition to a mammo-graphic finding of a tubular density are diagnostic of Mondor's disease of the breast. Being familiar with the imaging findings of Mondor's disease will help its diagnosis & avoiding the pitfall of mistaking it for a dilated duct.Conclusion: The clinical presentation together with sono-mammographic findings are useful in diagnosing Mondor's disease. Being familiar with these radiologic features prevent misdiagnosis and unnecessary treatment.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1573
1576
https://mjcu.journals.ekb.eg/article_56363_07eabf6eae3ebe38cac6065680248b7c.pdf
dx.doi.org/10.21608/mjcu.2018.56363
Immunohisto chemical Study of Colonic Stem Cells Using Lgr5 and CD133 Proteins in Malignant and Pre Malignant Colonic Lesions
SAED ROSIQ, M.D.;
OLFAT HAMMAM, M.D.
author
AHMED ABD EL-ALIM, M.D.;
SAED EL-SHORBAGY, M.D.
author
MOSBAH
AMER, M.Sc.
author
text
article
2018
eng
AbstractBackground: Colorectal cancer is the fourth common tumor in Egypt after lymphoid, breast and urinary tumors. The aim of the study to assess the expression of Lgr5 and CD133 in pre-malignant (adenomatous polyps and IBD), malignant colorectal lesions and normal colonic mucosa by immunohistochemicalstaining.0Material and Methods: This prospective study was done on 100 patients presenting with colonic symptoms, patients were divided into four groups; Group I including 20 patients in the control group, Group II including 20 Ulcerative Colitis (U.C) patients, Group III including 20 patients with adenom-atous polyps and Group IV including 40 patients with Color-ectal Cancer (CRC).Results: Lgr5 and CD133 expression was significantly higher in carcinoma than in adenomas, IBD and normal mucosa (p<0.001). Lrg5 and CD133 was positivelycorrelated with histological grade (p=0.001), depth of invasion (p=0.001), lymph node metastasis (p<0.001), distant metastasis (p<0.004) and TNM stage (p<0.001).Conclusion: Role of Lgr5 and CD133 as stem cell marker was expressed and presented with different expression in normal colonic mucosa, adenoma and CRC and showed increased expression in advanced stage of CRC. This may suggest its possible involvement in colorectal tumorigenesis and invasion.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1577
1587
https://mjcu.journals.ekb.eg/article_56364_4cbe2ddcc7d7f9856fbe264b5da579ba.pdf
dx.doi.org/10.21608/mjcu.2018.56364
Evaluation of the Hazards of Flexible Ureteroscope for the Treatment of Renal and Ureteral Calculi during the Learning Curve
AHMED S. ISMAIL, M.Sc.;
MOHAMED A. EL-BAKARY, M.D.
author
MAGED M. RAGAB, M.D.;
AYMAN A. HASSAN, M.D.
The Department of Urology, Faculty of Medicine, Tanta University, Tanta, Egypt
author
text
article
2018
eng
AbstractBackground: Management of urolithiasis varies from simple clinical observation and medical expulsive therapy to the use of refined endourologic techniques to extract the stone. The therapeutic technique currently available comprises ureteroscopy with or without the need for intracorporeal lithotripsy, percutaneous therapy, (PCNL) Extracorporeal Shock Wave Lithotripsy (ESWL), and surgical modalities (4,5).Objective: Urolithiasis (UL) is one of the most common diseases, with worldwide increasing incidence and prevalence.Aim of the Work: Was to report the hazards of Flexible Ureteroscopy (FURS), the re-treatment rate and its complica-tion outcomes for the treatment of renal and ureteral calculi during the learning curve.Patients and Methods: This study was conducted prospec-tively on forty patients divided into two groups; Group I (ureteric stone group) and Group II (renal stone group)to compare the complications after the introduction of FURS. They underwent FURS and Holmium: YAG laser lithotripsy. The complications were classified using modified stave and the Clavien system (I-IV).Results: The mean patient age in the total procedures was 45.63±10.98 years (range 27.0-62.0 years), and the mean stone size was 1.36±0.37cm (range 0.6-2cm). Group I: Mean stone size 1.36±0.37cm, the stone free rate for all cases was 77.3% (100% for stones <1.5cm and 50% for stones ³1.5cm). The overall intra-operative complications rate in all cases was 27.2% (8.3% for stones <1.5 and 50% for stone size ³1.5cm). The overall post-operative complications rate was 27.4% (9% for stones <1.5cm and 60% for stones ³1.5cm.Group II: The mean stone size 1.46±0.31, the stone free for all cases was 44.4% (70.0% for stones <1.5cm and 12.5%. for stones ³1.5cm. The overall intra-operative complications rate in all cases was 72.2% (52% for stones <1.5cm and 100% for stones size ³1.5cm. The overall post-operative complications rate was 77.7% (60% for stones <1.5cm and 100% for stones ³1.5cm was.Conclusions: The results of the current study indicated that stone size, stone site and surgeon experience were factors affecting complication rates after FURS.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1599
1606
https://mjcu.journals.ekb.eg/article_56365_12b6ab8284115d23ec67e9efa2000200.pdf
dx.doi.org/10.21608/mjcu.2018.56365
Effect of Foot Reflexology on Stress and Anxiety during Pregnancy
EMAN S.A. EL-FEKEY, M.Sc.;
HALA M.H. OMARA, Ph.D.
author
GHADA E. EL-REFAYE, Ph.D.;
MOHAMED F.M. ABOU EL-ENIN, M.D.
The Department of Women's Health, Medical National Institute, Damanhour*, the Department of Women's Health,
Faculty of Physical Therapy, Cairo University** and the Department of Obstetrics & Gynecology, Om El-Masryeen Hospital***, Giza
author
text
article
2018
eng
AbstractBackground: Pregnancy is a period of great stress to a woman both physically and mentally. There is a varied prev-alence of pregnancy anxiety at different trimesters of pregnancy with high levels in first and third trimesters.Aim of the Study: This study was conducted to determine effect of foot reflexology on stress and anxiety during preg-nancy.Patients and Methods: Fifty pregnant women diagnosed clinically by gynecologist/physician as primigravida at their third trimester, they were selected from Outpatient Clinic of Obstetrics and Gynecology in Damanhour Medical National Institute suffering from anxiety based on psychiatric assess-ment. Their age ranged from 20 to 30 years. Their Body Mass Index (BMI) <-30kg/m2. They were assigned randomly into two Groups (A,B) equal in numbers. Group (A) received diaphragmatic breathing exercise, 5-10 minutes, 3-4 times per day for 6 weeks. While, Group (B) received diaphragmatic breathing exercise plus reflexology on pressure points in feet for 30 minutes per session, 3 times/week for 6 weeks. Stress and anxiety were evaluated by blood pressure, pulse rate and Hamilton anxiety rating scale before and after the intervention.Results: There was a highly statistical significant decrease in median value of Hamilton anxiety scale of study Group (B) when compared with its corresponding value in control Group (A) with p-value=0.001.Conclusion: These results suggested that the foot reflex-ology was very effective method in improving stress and anxiety during pregnancy.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1607
1611
https://mjcu.journals.ekb.eg/article_56366_b92dd313ef990cec6ac93fe942d2dc84.pdf
dx.doi.org/10.21608/mjcu.2018.56366
Effect of Cryolipolysis and Electrolipolysis on Postmenopausal Abdominal Adiposity
MIRAL S. MOHAMED, M.Sc.;
KHADIJA S. ABDUL AZIZ, Ph.D.
author
MARWA A. MOHAMED, Ph.D.;
AMIR A. GABR, M.D.
The Department of Physical Therapy for Women Health, Faculty of Physical Therapy* and the Department of Obstetrics & Gynecology, Faculty of Medicine**, Cairo University
author
text
article
2018
eng
AbstractBackground: Menopause is a normal condition that all women experience as they age. Women generally accumulate more intra-abdominal adipose tissue as they go through menopause. Although diet and exercise may be effective in controlling obesity, cosmetic procedures may still be necessary to remove localized adiposity.Aim of the Study: This study was conducted to determine the effect of cryolipolysis and electrolipolysis on post-menopausal abdominal adiposity.Methodology: Fourty five post menopausal women par-ticipated in this study. Their age ranged from 45 to 55 years, patients were distributed randomly into three equal groups (A,B&C). Patients of group (A) received cryolipolysis, patients of group (B) received electrolipolysis and patients of group (C) received cryolipolysis and electrolipolysis. Evaluation was done by measuring waist circumference (by tape measurments), supriliac skin fold (by body fat caliper) and body weight, waist hip ratio, body mass index, abdominal fat percentage (by bioelectrical impedance analysis).Results: There was a significant decrease in waist circum-ference, supriliac skin fold, body weight, waist hip ratio, body mass index and abdominal fat in the three groups A, B and C. when comparing between pre and post study results.On comparing results of the three groups post treatment; there were significant differences in WC, WHR and trunk fat % in group (A) than group (B) and non significant differences between SISF, BW and BMI in group (A) than group (B), also there were significant differences in BW, BMI, and SISF in group (A) than group (C), while non significant differences between WC, WHR and trunk fat % in group (A) than group (C) and finally there were significant differences in BW, BMI, WC, SISF, WHR and trunk fat % in group (B) than group (C).Conclusion: From the results of the present study it can be concluded that Cryolipolysis and Electrolipolysis are effective in reducing abdominal adiposity in post-menopausal women.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1613
1620
https://mjcu.journals.ekb.eg/article_56547_1fd3bec91bdf0973653fd056861af0d8.pdf
dx.doi.org/10.21608/mjcu.2018.56547
Comparative Study between Pressure Controlled Ventilation and Volume Controlled Ventilation on Hemodynamics in Prone Patients Undergoing Elective Spine Surgeries
AHMED E. YOUSSEF, M.Sc.;
HASSAN MOHAMED, M.D.
author
IMAN FOUAD, M.D.;
NADER NOSHEY, M.D.
author
AHMED
RAGAB, M.D.
The Department of Anaesthesiology, Faculty of Medicine, Cairo University
author
text
article
2018
eng
AbstractBackground: As patients turned into prone position expe-rienced change in heamodynamics (heart rate and mean arterial blood pressure) than those on supine position, this prospective, randomized study was designed to compare the effect of PCV and Volume-Controlled Ventilation (VCV) on heamodynamics in the prone position using the Wilson frame during elective lumbar spine surgery.Patients and Methods: Sixty patients scheduled for elective lumbar spine surgery were randomly allocated to receive mechanical ventilation using either the VCV (n=30) or PCV (n=30) mode.Hemodynamic variables (heart rate, mean arterial blood pressure).Results: Heart rate as beat/min. (p-value 1): In volume controlled group during supine position mean ± SD value was (76±12) and during prone position was (69±12) and in pressure controlled group it was (82±17) in supine position and (72±13) in prone position and mean arterial blood pressure as mmHg (p-value 0.6): In volume controlled group mean ± SD in supine position was (80±9) and in prone position it was (77±11), and in pressure controlled group it was (84±14) in supine position and (77±9) in prone position.Conclusions: PCV provides lower Ppeak compared with VCV when the ventilator is set to deliver the same tidal volume and variable respiratory rate to maintain a constant end-tidal carbon dioxide tension in patients undergoing pos-terior lumbar spine surgery in the prone position using the Wilson frame.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1621
1625
https://mjcu.journals.ekb.eg/article_56548_3e8243feef59312d6a1f07f7d6875837.pdf
dx.doi.org/10.21608/mjcu.2018.56548
The Added Value of Multislice CT Venography in Pre-Operative Assessment of the Deep Venous System of Both Lower Limbs; Correlation with the Doppler/US Findings
AMR A.H. GADALLA, M.D.;
HUSSEIN O. ELWAN, M.D.
author
MOHAMED F.
OSMAN, M.D.
The Departments of Diagnostic & Interventional Radiology* and Vascular Surgery**, Faculty of Medicine, Cairo University
author
text
article
2018
eng
AbstractBackground: Deep venous thrombosis is very common disease affecting the public health, so proper assessment and treatment improve the quality of patient's life. In addition DVT may cause pulmonary arterial thrombo-embolism.Aims of the Study: To assess the value of CT venography in detailed assessment of the lower extremities deep venous system in comparison with the Doppler US findings for patients with swollen limbs referred from vascular clinics.Patients and Methods: The study was carried over sixty patients (19 males and 41 females, age range 21-56 year old) from November 2016 to December 2017. Detailed evaluation of all examined patients was done using Doppler/US by experienced sonologist and multislice CT venography with calculation of the body mass index for each patient.Results: Sixty patients (19 males and 41 females, age range 21-56 year old), body mass index range (20-34), Doppler findings showed that 54 patients were free of deep venous thrombosis and 6 patients with chronic deep venous thrombosis. However, multislice CT venography showed that 48 patients were free of deep venous thrombosis and 12 patients with chronic deep venous thrombosis. Also according to these results patients are classified as primary and secondary varicose veins.Conclusion: Based on our results, multislice CT venog-raphy is a non operator dependant technique adding great clinical value in assessment of the patency and detailed delineation of the deep venous system, especially the abdominal and pelvic veins.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1627
1633
https://mjcu.journals.ekb.eg/article_56549_14ac8de39bea949194e08360763ee489.pdf
dx.doi.org/10.21608/mjcu.2018.56549
Assessment of Nutritional Services Provided for Hepatitis C Patients Attending the National Nutrition Institute in Cairo
YOSRA A. EL-SHAIKH, M.Sc.;
HANAN A. EL-RAGHY, M.D.
author
HANAA A. ABOU-ZEINA, M.D.;
DINA I. SHEHAB, M.D.
author
HANADY G.
SHEHA, M.D.
author
text
article
2018
eng
AbstractBackground: Malnutrition is common among chronic liver diseases patients. Thorough nutritional counseling should insure adequate dietary intake of different nutrients to prevent malnutrition and improves the prognosis. Maintenance of weight loss and exercise in overweight patients with liver disease results in a sustained improvement in liver enzymes, serum insulin levels, and quality of life. Adequate nutritional service is mandatory to overcome the challenge for obese Hepatitis C patients on a dietary regimen to supply adequate nutrients.Aim of the Study: To assess the effect of nutritional counseling provided for obese Hepatitis C on their dietary pattern.Subjects and Methods: This is an operational study that was conducted on NNI outpatient hepatic clinic. Two groups of those receiving and providing the nutritional services were interviewed; a sample of 120 obese Hepatitis C patients attending the NNI for at least the second time to follow-up their nutritional status (only 100 of patients agreed to complete the questionnaire and the 24 hour food intake recall with a response rate of 83.3%), all the health care providers in the outpatient hepatic clinic were interviewed. Multiple data collecting tools were used; direct informal observation of activities for hepatic patients attending the NIOHC. Review of existing documents: Policies, protocols, standard operating procedures. Review of the health record system.Results: The results of the analysis of the exit questionnaire showed insufficient provided services and insufficient satis-faction of studied patients.Conclusion: This study concluded that there was lack of standard nutritional services provided for HCPs. Many factors have contributed to the ineffectiveness of this service. There are opportunities for improvement of the nutritional services provided to HCPs.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1635
1648
https://mjcu.journals.ekb.eg/article_56550_0e9bf27cd43fac47bc8c696cd60fcce0.pdf
dx.doi.org/10.21608/mjcu.2018.56550
Assessment of Infection Control Knowledge and Practices among Hemodialysis Nursing Staff in Kasr Al-Ainy Hospitals
MONA SOLIMAN, M.D.;
YASSIN S. IBRAHIM, M.D.
author
NOHA A. OSMAN, M.D.;
HODA I. RIZK, M.D.
author
SALMA A.
SEDDIK, M.Sc.
The Departments of Public Health & Community Medicine* and Internal Medicine**, Faculty of Medicine, Cairo University
author
text
article
2018
eng
AbstractBackground: Hemodialysis (HD) units are considered high risk areas where Blood Stream Infections (BSIs) are common. Infection Control (IC) programs aim to reduce the risk of Healthcare Associated Infections (HAIs) and cross-contamination of the environment. Nursing staff in HD units should be trained and educated about IC measures regularly.Aim of the Study: This study was conducted to assess the baseline knowledge and practices in IC among the nursing staff and to assess IC policies, strategy and implementation in HD units.Subjects and Methods: A cross sectional study design was conducted in the HD units at Kasr Al-Ainy Hospitals, all nurses providing care for chronic HD patients participated in the study (two HD units are present in Kasr Al-Ainy Hospitals, 11 nurses are available in each unit).Results: Regarding the IC knowledge of the nursing staff, the median total score was 49/70 (42-52) in unit (1) and 44/70 (40-56) in unit (2). Regarding the IC practices of the nursing staff, the median total score was 3/17 (1-8) in unit (1) and 6/17 (1-9) in unit (2) for invasive procedures and 0/9 (0-5) in unit (1) and 0/9 (0-4) in unit (2) for non-invasive procedures. Regarding the environmental assessment of HD units, it was found that no documented IC policies and procedures were present, both units didn't follow any immunization policy for HB V and isolation precautions weren't implemented properly. Regarding Focus Group Discussion (FGD) conducted with the nursing staff in HD units, it was found that the main obstacle in compliance with IC practices was absence of well-defined IC team.Conclusion: IC knowledge of the nursing staff was gen-erally low in both dialysis units due to the absence of written IC policies and procedures. IC practices' level of the nursing staff was also low due to the absence of regular IC staff round in both dialysis units.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1649
1656
https://mjcu.journals.ekb.eg/article_56551_ec4d807908d33bf9768cdaf04a25ec65.pdf
dx.doi.org/10.21608/mjcu.2018.56551
Evaluating Stapler Based Ileal Neobladders in Terms of Function and Patient Satisfaction, An NCI Experience
SHARIF A. ABDEL-KARIM, M.Sc.;
ABDALLA M. ELAZAB, M.Sc.
author
EMAN EL-DESOUKY, Ph.D.;
EHAB S. HUSSIEN, M.D.
author
ABDEL-MAKSOUD MOHAMMAD, M.D.;
ISMAIL A. MOURAD, M.D.
The Departments of Surgery* and Biostatistics**, the National Cancer Institute, Cairo University
author
text
article
2018
eng
AbstractAim of the Study: Description of the results of using the stapler based ileal neobladders for reconstruction after radical cystectomy in a subset of patients in the National Cancer Institute of Cairo University in Egypt in terms of functional outcome and patient satisfaction.Patients and Methods: In 2014, A prospective interven-tional study was carried out in the National Cancer Institute involving 29 patients with bladder cancer who met the criteria for neobladder reconstruction after radical cystectomy for whom a modified Y shaped ileal neobladder was created after tumor exanteration aiming at exploring functional outcomes and patient satisfaction rates for a period of one year in such a group of patients compared to other published reconstructive options.Results: The mean value of maximum neobladder capacity was 445ml, the mean pressure at maximum neobladder capacity was 22cm H2O and the mean post-voiding urine residual was about 20ml. By 6 months' post operatively, about 85% of the cases expressed having a good quality of life evidenced by satisfaction about their body image, daily maintenance and general satisfaction.Conclusion: Orthotopic neobladder reconstruction using the Y (Fontana) ileal neobladder can be considered as a simple and practical solution for neobladder reconstruction after radical cystectomy in Egyptian bladder cancer patients.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1657
1661
https://mjcu.journals.ekb.eg/article_56553_c4b83f85cc75c5e33ca0392ef6490858.pdf
dx.doi.org/10.21608/mjcu.2018.56553
Sunitinib in Metastatic Renal Cell Carcinoma: Response Rate and Survival Outcome
ASMAA I. EL-SHARKAWY, M.Sc.;
ASHRAF F. BARAKAT, M.D.
author
HESHAM A. TAWFIK, M.D.;
AMR A. GHANAM, M.D.
The Departments of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Tanta University
author
text
article
2018
eng
AbstractBackground: Sunitinib demonstrated robust antitumor activity in preclinical studies resulting not only in tumor growth inhibition, but tumor regression in models of colon cancer, non-small-cell lung cancer, melanoma, renal carcinoma, and squamous cell carcinoma, which were associated with inhibition of VEGFR and PDGFR phosphorylation.Aim: The aim of this work is to evaluate the role of Sunitinib as a first line treatment in metastatic Renal Cell Carcinoma (RCC) as regard the response rate, survival outcome and toxicity.Patients and Methods: This study was conducted at Clinical Oncology and Nuclear Medicine Departments, Tanta University Hospitals and Tanta Cancer Center. All patients with metastatic renal cell carcinoma who treated throughout the period from January 2012 to December 2015 were included. Patient data were retrospectively and personally collected.Result: All patients were evaluated for tumor response, one (3.3%) of 30 patient had a complete response, 11 (36.7%) patients had a partial response, 6 (20%) patients had a stationary disease and only 12 (40%) had a progressive disease. Median time for treatment failure was 22 months (range 2-34 months). The progression free survival in all patient: the median time was: 22 months 95% CI: 17.5, 27.5 the correlation between PFS and histological types of kidney cancer in which the p-value is <0.001 which is statistically significant in favor of clear renal cell carcinoma. The correlation between OS and MSKCC score in which the p-value is <0.001 which is statis-tically significant. The correlation between OS and histological types in which the p-value is <0.001 which is statistically significant in favor of clear cell carcinoma.Conclusion: The present study has suggested that Sunitinib was both effective as a first-line treatment and well tolerated in patients with metastatic renal cell carcinoma.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1663
1670
https://mjcu.journals.ekb.eg/article_56555_9f25e8f58225f9f8727ee10c2a6ec4b7.pdf
dx.doi.org/10.21608/mjcu.2018.56555
Anti-Nucleosome Antibody as a Marker of Systemic Lupus Erythematosus Activity
NADIA M. ABD EL-WAHAAB, M.D.;
SOHAIR K. SAYED, M.D.
author
OMER HERDAN, M.D.;
MONA A. EL-ZOHRI, M.D.
author
AYMAN M. MAHRAN, M.D.;
HADIER M. HASSOUNA, M.Sc.
The Departments of Clinical Pathology*, Internal Medicine & Rheumatology** and Dermatology***, Faculty of Medicine, Assiut University
author
text
article
2018
eng
AbstractBackground: Systemic Lupus Erythematosus (SLE) is a chronic multisystem autoimmune disease that is highly heter-ogeneous in its presentation. Effective SLE patient care relies on serological biomarkers. There is high interest in the iden-tification of autoantibodies other than Antinuclear Antibodies (ANA) and anti-double stranded DNA (Anti-dsDNA).Aim: To evaluate the use of antinucleosome (Anti-NCS) antibody as a single marker to detect disease activity and renal involvement in SLE patients.Methods and Material: This case-control study was carried out in Clinical Pathology Department at Assiut University Hospital in the period from 2014 to 2017. It included 92 patients. Sixty-two patients were diagnosed as SLE. Thirty patients had connective tissue diseases other than SLE (non-SLE). Twenty apparently healthy subjects were taken as controls. All subjects were tested for ANA, anti-dsDNA antibody and Serum anti-NCS antibody on Alegria ® (OR-GENTEC Diagnostic GmbH-Germany). Statistical analysis: Date entry and data analysis were done using SPSS Version 19, Chicago, USA (Statistical Package for Social Science).Results: There was higher significant elevation in the level of anti-NCS antibodies than anti-dsDNA in SLE patients in comparison to those with non-SLE and control groups.In LN patients anti-NCS antibodies were highly elevated than anti-dsDNA comparing to non LN patients. Anti-NCS anti-bodies had a stronger correlation than anti-dsDNA antibodies with SLEDAI score. In 22 negative anti-dsDNA SLE patients, 13 (59.1%) were positive for anti-NCS. Anti-NCS antibodies showed higher sensitivity and specificity than anti-dsDNA in SLE and LN patients.Conclusion: Anti-nucleosome antibodies is highly sensitive and specific in diagnosis of SLE, especially if anti-dsDNA antibodies are absent. Anti-NCS antibodies are good disease activity markers for the assessment of SLE and LN disease activity.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1671
1678
https://mjcu.journals.ekb.eg/article_56556_f76dea5a8e4cf2dd04de5796d196289b.pdf
dx.doi.org/10.21608/mjcu.2018.56556
Subfoveal Choroidal Thickness in Relation to Age and Refractive Error
SAFAA GALAL, M.Sc.;
MOHAMMAD M. KHAFAGY, M.D.
author
HEBA M. AHMED, M.D.;
SOHEIR M. ESMAT, M.D.
The Department of Ophthalmology, Faculty of Medicine, Cairo University
author
text
article
2018
eng
AbstractBackground: The choroid is a highly vascular structure and it undergoes structural and functional alterations with increasing age which may affect the visual function. In addition, choroidal thickness differs according to the state of refraction and axial length.Aim of the Study: To correlate between the subfoveal choroidal thickness and various clinical data including age, error of refraction, and best corrected visual acuity.Patients and Methods: This cross sectional, non-randomized, non-controlled study was conducted on 124 eyes. Measurement of the subfoveal choroidal thickness was done using spectral domain optical coherence tomography in the Investigative and Laser Unit of the Ophthalmology Department of Kasr Al-Ainy Hospital.Results: Results showed that thinner choroid was associ-ated with older age (r=–0.264, p-value=0.003) and myopic refraction (r=0.243, p-value=0.007), while thicker choroid was related to a better visual acuity (r=0.199, p-value=0.026). Also, there was no significant difference in choroidal thickness measurements by the two obsevers (p-value=0.161).Conclusion: Older persons and eyes with myopic refraction have a thinner choroid. A thicker choroid is related to a better visual acuity. No inter-observer variation was found regarding choroidal thickness measurements.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1679
1681
https://mjcu.journals.ekb.eg/article_56557_78084b51606872397c6e6022a5776a99.pdf
dx.doi.org/10.21608/mjcu.2018.56557
Role of Magnetic Resonant Imaging in Laryngeal Cancer
NAGHAM N. OMAR, M.D.;
ALAA K. ABD EL-HALEEM, M.D.
author
SHERIF M. ABD EL-AL, M.D.;
DINA G.E. MOHAMED, M.Sc.
The Departments of Radiodiagnosis* and Otolaryngology**, Faculty of Medicine, Assiut University
author
text
article
2018
eng
AbstractBackground: MRI plays a significant complementary role to clinical endoscopy in pre therapeutic staging of laryngeal squamous cell carcinoma.Aim of Study: To evaluate role of MRI in laryngeal cancer, detect its accuracy, specificity in staging, differentiates post irradiation from recurrence.Patients and Methods: The study was conducted at the Department of Radio Diagnosis, University of Assiut, Egypt. From September 2015 to April 2016, 40 male patients, aged 50-85 years (median 67.5 years), the study comprised patients with suspected or known laryngeal cancer, the symptomatology was predominantly characterized by hoarseness and cough. The study was performed with the approval of all patients give their informed consent to the study.Results: MRI shows a sensitivity of 100% and a specificity of 97% in assessing areas such as paraglottic space, anterior commissure, thyroid, and arytenoid cartilages with various indications for conservative surgery. The accuracy of MRI In T1 stage was 85% and for laryngoscopy was 85.7%, the accuracy of MRI in T2 stage was 85% and for laryngoscopy was 80%, the accuracy of MRI in T3 stage was 95% and for laryngoscopy was 75%, the accuracy of MRI in T4 stage was 100% and for laryngoscopy was 80%, while for the determi-nation of cartilaginous invasion MR showed a sensitivity 38.9% specificity 100%, accuracy 45%.Conclusion: Despite some limitations, including the small number of laryngeal carcinomas included, DWI may detect changes in tumor size and shape before they are visible by laryngoscopy. The ADC values were lower for patients with laryngeal carcinoma than for those with laryngeal precancerous lesions. The proposed cutoff for the ADC may help to distin-guish laryngeal carcinomas from laryngeal precancerous lesions.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1683
1692
https://mjcu.journals.ekb.eg/article_56559_cd3e9e884f070f15355a1d87a22d67af.pdf
dx.doi.org/10.21608/mjcu.2018.56559
Effectiveness of Different Treatment Regimens on Eradication of Helicobacter Pylori Infection (A Single Center Experience in Kuwait)
HASSAN B. ABD EL-NABY, M.D.;
AHMED M. ABD EL-ALEEM, M.D.
author
WAFAA A. AL-HASHASH, M.D.;
SHERIF S. MEHREM, M.D.
author
text
article
2018
eng
AbstractBackground: Helicobacter pylori treatment still remains a challenge for physicians, and no current first-line therapies are able to cure the infection in all treated patients, recent studies reported declining in eradication rate with commonly usedclarithromycin based triple therapy and high cure rate was observed in patients treated by other regimens such as bismuth based therapy.Aim of the Study: To evaluate the effectiveness of the different regimens (Clarithromycin based triple therapy, bismuth based therapy and levofloxacin based therapy) on eradication of H.pylori infection.Methods: The data of 510H. pylori-infected treatment-naïve subjects (215 males, 295 female) were collected retro-spectively through period between January 2014 and Decem-ber 2016. Patients treated at Gastroenterology Clinic Al-Sabah Hospital Kuwait. Four hundred and twenty nine patients treated by clarithromycin based triple therapy, 75 patients treated by bismuth containing quadruple therapy. C13 urea breath test was used for confirm eradication.Results: Eradication rate was significantly higher in 10 days bismuth based quadruple regimen than 14 days clarithro-mycin based triple regimen (96%, 77% respectively) (p<0.001). Levofloxacin based triple therapy and bismuth based quadruple therapy were effective 2nd line therapy (³90% cure rate).Conclusion: Bismuth based quadruple regimen more effective therapy for H.pylori infection than clarithromycin based triple regimen. Levofloxacin based triple and bismuth based quadruple regimens are effective 2nd line therapy with high cure rate.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1693
1697
https://mjcu.journals.ekb.eg/article_56560_702b72f3d549ff5e4792bcf2008d5c00.pdf
dx.doi.org/10.21608/mjcu.2018.56560
The Impact of Bispectral Index on Isoflurane Consumption and Recovery Profile in Patients Undergoing Upper Abdominal Surgery
NADA A. SADAKAH, M.Sc.;
ABD AL-RAHEEM M. DOWIDAR, M.D.
author
HODA A. EZZ, M.D.;
REHAB S. EL-KALLA, M.D.
The Department of Anesthesiology and Surgical Intensive Care, Faculty of Medicine, Tanta University
author
text
article
2018
eng
AbstractBackground: Isoflurane requires careful administration and monitoring. Its excessive usage in patients may cause significant morbidity because of hypotension, tachycardia and delay in recovery. The Bispectral index (BIS) monitoring may be useful for titration of volatile anesthetic agents more precisely than what is possible by usual clinical parameters.Aim: Our aim is to evaluate the effect of BIS monitoring on isoflurane consumption and recovery profile with monitor-ing of heamodynamic changes in adult patients undergoing upper abdominal surgery.Patients and Methods: This study was carried out on 90 patients, 18-60 years, ASA I-II, scheduled for upper abdominal surgery under general anesthesia. Patients were randomized into two equal groups (45 patients in each group): Group I: SP group: Patients in the SP group had continuous assessment by standard clinical practice. Group II: BIS group: Patients in the BIS group had continuous assessment of BIS monitoring. The following parameters were compared between the two groups: Intraoperative hemodynamics, intraoperative isoflurane consumption, the time taken to extubate the patients, recovery duration using modified aldrete score.Results: There was statistically significant decrease in isoflurane consumption in BIS group as compared to SP group, while there was significant negative correlation between BIS and both time to extubate the patients and recovery time in BIS group. the heamodynamic changes showed insignificant difference between both groups.Conclusions: The use of BIS index, in adult patients undergoing upper abdominal surgery under general anaesthesia, significantly decreases isoflurane consumption and improves recovery profile.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1699
1706
https://mjcu.journals.ekb.eg/article_56563_1dd42f30da5222d6d1cec405f74a5679.pdf
dx.doi.org/10.21608/mjcu.2018.56563
Cardiac Iron Overload: Correlation between MRI T2* & Two Dimensional Strain Echocardiography in Children with b-Thalassemia Major
DINA Sh.M. MANAA, M.Sc.;
MOHAMMED R. EL-SHANSHORY, M.D.
author
OSAMA ABD RAB EL-RASSOL, M.D.;
RASHA A. EL-SHAFEY, M.D.
The Departments of Pediatrics* and Diagnostic Radiology**, Faculty of Medicine, Tanta University
author
text
article
2018
eng
AbstractBackground: b-thalassemia is a group of inherited blood disorders that causes iron overload in the heart. Development of overt heart failure is delayed till the second decade of life. Early detection of cardiac iron overload is necessary before development of heart failure.Aim of the Study: Was to evaluate cardiac function in children with b-thalassemia major having iron overload and to Compare MRI T2* and doppler echocardiography in dem-onstration of iron deposition in cardiac muscles in those patients.Patients and Methods: Fifty children with thalassemia major were subjected to history taking, clinical assessment, laboratory assessment, Doppler echocardiography and MRI for cardiac iron load assessment.Results: There is a negative correlation between cardiac MRI T2* with age, ferritin and serum iron level. As regard correltion between MRI and doppler echocardiography there is a positive correlation between MRI T2* and diastolic echocardiographic parameters Tei index in patients with thalassemia Major.Conclusion: There is a significant correlation between MRI T2* and Doppler echocardiography in patients with b thalassemia major.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1707
1712
https://mjcu.journals.ekb.eg/article_56565_7eaba15a30c9d0cc6370d8fcbde7e636.pdf
dx.doi.org/10.21608/mjcu.2018.56565
The Role of Amplitude Integrated Electroencephalography (a-EEG) in Neonates
SARA A.S. ELTELB, M.B.B.Ch.;
MOSTAFA M.A. EL-HUSSENY, M.D.
author
TAREK M. EL-GOHARY, M.D.;
AMIRA H. DARWISH, M.D.
The Department of Pediatrics, Faculty of Medicine, Tanta University
author
text
article
2018
eng
AbstractBackground: Amplitude-integrated electroencephalogra-phy (aEEG) is a method for continuous monitoring of brain activity that is increasingly used in the neonatal intensive care unit. In its simplest form, aEEG is a processed single-channel electroencephalogram that is filtered and time-compressed. It is useful to monitor cerebral background activity, diagnose and treat seizures and predict neurodevel-opmental outcome.Aim of the Work: Is to identify the role of a-EEG in neonates with different gestational ages, diseases, circum-stances.Patients and Methods: The study was carried out on 40 neonates) 20 patients & 20 controls) admitted in International Tanta University Hospital NICU. Amplitude integrated EEG was done by Nicolet EEG v32. aEEG was recorded from 2 channels: F3-F4 & P3-P4.Results: All controls had normal aEEG while 14 of 20 patients had normal aEEG and 6 had abnormal aEEG. The sensitivity of aEEG for detection of neurological abnormalities was 71.4% and specificity was 92.3%. There was significant difference between aEEG in preterm and full term as regards background activity and sleep wake cycling. Normal aEEG corresponded with normal EEG in 92.85% of the patients, and abnormal aEEG corresponded with abnormal EEG in 83.34% of the patients. 66.67% of patients with abnormal aEEG died and 33.33% had been discharged while 92.85% of patients with normal aEEG had been discharged and 7.15% died.Conclusion: aEEG is a simple, inexpensive bedside mo-dality that has a great role in monitoring brain function in neonates, predicting neurological outcome and demonstrating brain maturation.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1713
1718
https://mjcu.journals.ekb.eg/article_56566_24c92643fadc516d28ec9da024c9121e.pdf
dx.doi.org/10.21608/mjcu.2018.56566
Prevalence of ADHD Symptoms among a Sample of Egyptian School Age Children
REDA EL-SAYED, M.Sc.;
MAHMOUD EL-MOGY, M.D.
author
HASSAN ALI, M.D.;
MOHAMED M.A. GHOWINAM, M.D.
The Departments of Pediatrics* and Psychiatry Medicine**, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
text
article
2018
eng
AbstractBackground: Attention Deficit Hyperactivity Disorder (ADHD) is highly prevalent in school age children worldwide.Objective: This study was undertaken to assess the prev-alence and association of ADHD with child demographics among a sample of Egyptian school age children.Patients and Methods: 111 children admitted to the out-patient pediatric clinic in Al-Azhar University hospitals were evaluated using Psychiatric interview-IQ and Conner's Abbre-viated Rating Scale that consists of several behavioral param-eters for the diagnosis of ADHD.Results: The most prevalent disorder in this study was learning disorder (23.1%) followed by ADHD (20.9%) and impulsive-hyperactive disorder (14.1%). The ADHD showed a positive correlation with conduct disorder, learning problem, psychosomatic disorder, impulsive-hyperactive disorder, and anxiety disorder. Male gender and consanguinity were signif-icantly correlated with higher incidence of ADHD.Conclusion: The most prevalent disorder in this study was learning disorder (23.1 %) followed by ADHD (20.9%). ADHD was significantly correlated with other types of emo-tional and behavioral disorders. Also, male gender and con-sanguinity were a significant predictors for ADHD.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1719
1725
https://mjcu.journals.ekb.eg/article_56567_fbb865fc25408af44edac3f7caab4aec.pdf
dx.doi.org/10.21608/mjcu.2018.56567
Three and Four Levels Anterior Cervical Discectomy and PEEKCage Fusion Alone in Treatment of Cervical Degenerative Radiculomyelopathy
AHMED A. ARAB, M.D.;
MOHAMMED H. EL-TANTAWY, M.D.
author
MOHAMED M.
EL-MAGHRABI, M.D.
The Department of Neurosurgery, Faculty of Medicine, Benha University, Benha, Egypt
author
text
article
2018
eng
AbstractBackground: Anterior Cervical Discectomy and Fusion (ACDF) is the commonest procedure used in treatment of degenerative cervical radiculomyelopathy, and the use of spinal cages with auto graft helps in increasing foraminal height, and regaining the lordotic cervical curvature, besides it gives high rate of fusion with less complications.Aim of the Study: To evaluate the safety and efficacy of three and four levels ACDF with PEEK cages only without plating, and to assess the clinical and radiologic outcome.Study Design: This non randomized non controlled clinical trial case series of seventeen patients, their aged 42 to 73 years of age with cervical degenerative radiculomyelopathy who were treated with three or four ACDF with PEEK cage fusion which were done at Neurosurgery Department of Benha University Hospitals during the period from 2011 to 2016, With mean follow-up 18.6 months.Patients and Methods: Ten males and seven females, of them four cases with cervical spondylotic myelopathy, and thirteen cases with radiculopathy were included. Patients were clinically evaluated using Visual Analogue Score (VAS) for pain and Neck Disability Index (NDI), and radiologically evaluated for neck curvature, fusion rate in lateral radiographs.Results: Five cases underwent four levels ACDF, and twelve cases underwent 3 levels ACDF with a total of 56 levels operated upon. As regard clinical state there was a statistically significant improvement in VAS in neck and arm pain (p<0.001), and also in NDI (p<0.001). All cases with myelopathy had significant satisfactory improvement in spasticity with improved ability. As regard radiology 82.4% of patients had good fusion, significant improvement in lordotic curve (from mean of 7.6º to 16.2º) and increased disc height.Conclusion: Three and four levels ACDF with PEEK cage alone without plating in treatment of degenerative cervical radiculomyelopathy is safe and effective and had good clinical outcome with low complication, and good radiologic outcome with excellent fusion rate, restoring the lordotic curve and increasing and maintaining disc height.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1727
1735
https://mjcu.journals.ekb.eg/article_56568_72299d1ec003d64a4ff5b1000d916211.pdf
dx.doi.org/10.21608/mjcu.2018.56568
The Effect of Tocolysis by Oral Nefidipine on Doppler Velocimetry of Umbilical, Middle Cerebral Arteries and Ductus Venosus
ALAA EL-DIN A. EL-GUINDY, M.D.;
MOHAMMED A. EL-KADY, M.D.
author
AMR M.A. EL-HELALY, M.D.;
AHMED M. SALAH, M.Sc.
The Department of Obstetrics & Gynecology, Faculty of Medicine, Ain Shams University*, Cairo and El-Minia General Hospital**, El-Minia, Egypt
author
text
article
2018
eng
AbstractAim of Work: To assess effect of nifedipine administration as a tocolytic agent on placental and fetal cerebral blood flow as well as on fetal cardiac function by measuring Pulsatility Index (PI) of the umbilical artery, Middle Cerebral Arteries (MCA) and Ductus Venosus (DV) twice, immediately before initial nifedipine dose and 24 hours after the therapy.Methods: Prospective, observational, analytic cohort, clinical trial involved 70 women with single viable fetus between 24-35 weeks undergoing tocolysis by nifedipine. Pulsatility Index (PI) of the umbilical artery, Middle Cerebral Arteries (MCA) and Ductus Venosus (DV) was assessed twice, immediately before initial nifedipine dose and 24 hours after the therapy.Results: The mean age of pregnant participants was (28.6± 3.1), mean Body Mass Index (BMI) was (22.2±1.3). There was no significant effect of nifedipine on Hemodynamic parameters (maternal heart rate, systolic blood pressure and diastolic blood pressure). There was no statistically significant difference of Pulsatility Index (PI) of the umbilical artery, Middle Cerebral Arteries (MCA) and Ductus Venosus (DV) before and after treatment.Conclusion: Oral nifedipine is a safe tocolytic agent on placental and fetal cerebral blood flow as well as on fetal cardiac function when used in pregnant women at risk of preterm delivery during the first 24 hours.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1737
1742
https://mjcu.journals.ekb.eg/article_56569_a202120feaf453f3c968b5735ebb7fa1.pdf
dx.doi.org/10.21608/mjcu.2018.56569
Knowledge and Practices Regarding Menstrual Hygiene among Mentally Retarded Females at Schools
MONA S. ATRESS, M.Sc.;
NAWAL A. FOUAD, D.N.Sc.
author
HEBA M.
HAMAD, D.N.Sc.
The Department of Community Health Nursing, Faculty of Nursing, Cairo University
author
text
article
2018
eng
AbstractBackground: Unhygienic practices during menstruation among mentally retarded female students' endanger their reproductive health and expose them to reproductive diseases such as reproductive tract infections and pelvic inflammatory diseases.Aim: This study aimed to assess knowledge and reported practices regarding menstrual hygiene among mentally retarded female students' at Cairo Governorate preparatory mainstream schools.Design: A descriptive exploratory research design was utilized in this study.Setting: Three educational departments were selected randomly from all educational departments at Cairo Gover-norate. All schools that are affiliated to these three educational departments were included in the study. Total number was 14 preparatory mainstream schools.The study Sample: Convenient sample of 100 mentally retarded female students' from the fourteen selected schools were included in the study.Tool for Data Collection: One tool consisted of three parts was used to collect data pertinent to the study. First part: Student questionnaire about demographic characteristics of the mentally retarded female students' and their parents. Second part: Data about level of knowledge regarding men-struation and menstrual hygiene. Third part: Data about reported practices regarding menstrual hygiene.Results: Study result revealed that 86% of the mentally retarded female students' had poor knowledge regarding menstrual hygiene, while 14% of them had good knowledge. Regarding reported practices 80% of them had poor practice, while 20% had good practice. There were statistically signif-icant relationship between practice scores and the Intelligence Quotient (IQ) with p-value=0.006. There were statistically significant relationship between practice scores and family history of mental retardation with p-value=0.001, between knowledge scores and students' IQ with p-value=0.001 and between total knowledge scores and total practice scores with p-value=0.042.Conclusion: The study concluded that, the majority of mentally retarded females have poor knowledge and practice regarding menstrual hygiene.Recommendations: The study recommended that imple-mentation of educational program to parents and mentally retarded female students' about the menstruation and good menstrual hygiene is very important.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1743
1750
https://mjcu.journals.ekb.eg/article_56570_b28610939da8bac5abd45bab66d2b579.pdf
dx.doi.org/10.21608/mjcu.2018.56570
Neonatal Outcomes in High Risk Pregnancies in an Egyptian Tertiary Health Care Center
AMIRA S. DIEB, M.D.;
AMANY IBRAHIM, M.D.
author
HALA
NABIL, M.D.
The Departments of Obstetrics & Gynecology* and Pediatrics, The Diabetes, Endocrine & Metabolism Pediatric Unit (DEMPU), Children Hospital**, Faculty of Medicine, Cairo University
author
text
article
2018
eng
AbstractBackground: Early neonatal morbidity and mortality represents a major problem caused by maternal medical and obstetric risk factors complicated by lack of primary antenatal care. High risk pregnancy is known to negatively affect the neonatal outcomes.Aim of the Work: This study aimed to compare low and high risk pregnancy neonatal outcomes and to test individual maternal risk factors for poor neonatal outcomes.Patients and Methods: A retrospective study was conducted at a tertiary referral hospital over 6 months. After applying eligibility criteria, 157 high and 125 low risk patients were identified. The neonatal outcome measures were weight, sex, Apgar score at 1 and 5 minutes, respiratory distress, neonatal intensive care unit admission, endotracheal intubation, me-chanical ventilation, meconium aspiration and neonatal death.Results: Neonatal morbidity was higher in high risk group (p<0.05). The Relative Risk of low birth weight, poor Apgar score at 1 minute, respiratory distress, neonatal intensive care unit admission, endotracheal intubation and mechanical ven-tilation was 8.2, 1.85, 5.13, 6.83, 15.37 and 26.42 respectively emphasizing that prematurity affected early neonatal outcomes.Conclusion: The main determinants of poor neonatal outcomes were preterm delivery, previous section and hyper-tensive disorders.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1751
1758
https://mjcu.journals.ekb.eg/article_56571_9d6bcacafc1e6c53ed1d941471b2d1c6.pdf
dx.doi.org/10.21608/mjcu.2018.56571
Comparison of Posterior and Subcostal Ultrasound-Guided Transversus Abdominis Plane Block Approaches for Postoperative Analgesia in Laparoscopic Cholecystectomy
AHMED A. ABO ZAID, M.Sc.;
MOHAMMAD A. EL-HARTY, M.D.
author
ASHRAF E. AL-ZEFTAWY, M.D.;
WAIL E. MESSBAH, M.D.
The Department of Anesthesiology and Surgical Intensive Care, Faculty of Medicine, Tanta University, Tanta, Egypt
author
text
article
2018
eng
AbstractBackground: Pain after LC is complex and characterized by various components with different intensities and time courses. The establishment of LC as an outpatient procedure has accentuated the clinical importance of proper post-operative pain control.Aim: Our aim is to compare between US posterior and subcostal approaches TAP block for post-operative analgesia in LC.Material and Methods: This study was carried out on 60 patients, ASA I-II, scheduled for elective laproscopic chole-cystectomy under general anesthesia. Patients were randomized into three equal groups (20 patients in each group): Group I (control group): Received standard general anesthesia. GroupII (posterior TAP group): Received standard general anesthesia and bilateral US guided posterior TAP block with 15ml bupivacaine 0.25% on each side just before extubation. GroupIII (subcostal TAP group): Received standard general anesthesia and bilateral US guided subcostal TAP block with 15ml bupivacaine 0.25% on each side just before extubation. All groups received post-operative analgesia in the form of IV paracetamol 1gm every 6 hours and rescue analgesic in form of morphine 2mg IV. The following parameters were compared: Post-operative vital signs (HR & MAP), post-operative pain (using 10 point Visual Analogue Scale (VAS) where (0) no pain and (10) most intense pain), time for first post-operative required analgesia and 24-hour morphine consumption were measured in the 3 groups immediately after full recovery of anesthesia, 1h, 2h, 4h, 6h, 8h, 12hr & 24hr.Results: In our study the mean values of HR and MAP were lower in Group II and Group III than Group I & that of Group III were lower than that of Group II at all times after recovery. The mean values of pain assessment by VAS in Group II and Group III were lower than that of Group I at all times after recovery. The VAS in Group III were lower than that of Group II insignificantly immediately after recovery, 1h, 2h, 12h and 24 hours and significantly at 4h, 6h and 8 hours. Also the mean time to the first request of morphine, was longer in Groups II and III than in Group I. Group III was significantly longer than Group II. The total dose of post-operative morphine consumption in Group II and Group III were lower than that in Group I. There was significantly lower total dose of post-operative morphine consumption in Group III than Group II.Conclusion: Both the posterior and subcostal US TAP block provides superior analgesia than the standard IV regimen. However, beyond the initial 4 hours after recovery, patients in the subcostal TAP group had significantly lower pain scores than did patients from the other groups.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1759
1766
https://mjcu.journals.ekb.eg/article_56572_e2e74e29c598d0205cb96a37be9aa55c.pdf
dx.doi.org/10.21608/mjcu.2018.56572
Laparoscopic versus Open Repair of Perforated Peptic Ulcer: Comparative Study
EL-SAYED ABDULLAH, M.D.;
AHMED NEGM, M.D.
author
MOHAMED SAMIR, M.D.;
MAGDY BASHEER, M.D.
author
HOSAM EL-GHADBAN, M.D.;
ABD EL-RAHMAN EL-BAHY, M.D.
author
AHMED ABD EL-MODABER, M.D.;
ASHRAF ABBAS, M.D.
author
MAHMOUD AMIN, M.D.;
IBRAHIM DAWOUD, M.D.
The Department of General Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt
author
text
article
2018
eng
AbstractBackground: Despite the well known benefits of minimal invasive surgery, up till now, there is a marked controversy regarding the real benefits of laparoscopic repair of Perforated Peptic Ulcer (PPU).Aim of the Study: The early outcome results of laparoscopic and open repair of PPU were compared to assess the feasibility and safety of laparoscope.Patients and Methods: Patients with clinical diagnosis of PPU, admitted at Mansoura University Hospital over the period between December 2013 and December 2017, were included in the study after a written consent. They were prospectively randomized for laparoscopic or open repair using pedicled omental patch technique. The pre-operative, operative, and post-operative data were collected for statistical analysis.Results: This study comprised 80 patients, out of them ten excluded due to detection of other pathologies, 33 remained in the laparoscopic group and 37 patients in the open group. The conversion rate from laparoscopic into open technique was (45.5%). The laparoscopic technique in comparison with the open technique showed a significantly longer operative time (61min vs. 46.54min; respectively), shorter hospital stay (5.72 vs. 8.77 days; respectively), lower post-operative anal-gesia requirements (111.11 vs. 268.27mg pethidine/day; respectively), and a lower rate of wound infection (5.6% vs. 34.6%; respectively). The laparoscopic and open groups had a comparable incidence of pulmonary complications, wound dehiscence, leakage, ileus, and intra-abdominal collection. There were no mortalities in the laparoscopic group while there were 6 mortalities in the open group (11.5%). Conversion did not affect the outcome of open repair except for prolon-gation of operative time.Conclusion: Laparoscopic repair of PPU is equally feasible and safe in comparison to the open repair in patients with low surgical risk.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1767
1775
https://mjcu.journals.ekb.eg/article_56573_f580a03209cc3cc22a39535f1f987285.pdf
dx.doi.org/10.21608/mjcu.2018.56573
Clinical and Trichoscopic Study of Tinea Capitis versus Alopecia Areata in Pediatric Patients
LAILA M. MOHAMMED, M.D.;
ABEER A. HODEIB, M.D.
author
WESAM S. IBRAHIM, M.D.;
AYA M. HAGGAG, M.Sc.
The Department of Dermatology and Venereology, Faculty of Medicine, Tanta University, Tanta, Egypt
author
text
article
2018
eng
AbstractBackground: Trichoscopy (hair and scalp dermatoscopy) facilitates the diagnosis of hair and scalp disorders. The aim of this study was to identify the trichoscopic features in diagnosis of Tinea Capitis (TC) and to compare these findings with those of Alopecia Areata (AA).Material and Methods: The current study included 30 patients with TC and 30 patients with AA. They were recruited from Outpatient Clinics of Dermatology and Venereology Department, Tanta University Hospitals. Clinical examination, laboratory investigations (direct microscopic examination with 10% potassium hydroxide and fungal culture) were done to confirm clinical diagnosis and dermoscopically aiming at finding the different dermoscopic features of TC and AA.Results: Short broken hairs, black dots, comma shaped hairs, corkscrew hairs and zigzag shaped hairs were observed in patients with TC. Short vellus hairs, black dots, exclamation marks, white hairs and pig tail re-growing hairs were observed in patients with AA.Conclusion: Comma shaped hairs, zigzag shaped hairs and cork screw were observed only in patients with TC. Yellow dots, exclamation mark hairs and short vellus hairs were observed only in patients with AA. Dermoscopy is rapid and reliable confirmatory test used to differentiate between TC and AA by detecting their characteristic dermoscopic features.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1777
1791
https://mjcu.journals.ekb.eg/article_56574_a24c535d62cbc185f2ba60c52282a311.pdf
dx.doi.org/10.21608/mjcu.2018.56574
Different Methods in Diagnosis of Pulmonary and Extrapulmonary Tuberculosis
HEBAT-ALLAH G. RASHED, M.D.;
MOHAMMED Z. ABD EL-RAHMAN, M.D.
author
ASMAA O. AHMED, M.D.;
ALAA R. MAHMOUD, M.D.
author
AMAL M.H.
ALAM EL-DIN, M.Sc.
The Department of Clinical Pathology, Faculty of Medicine, Assiut University*, Assiut, Egypt and The Department of Chest, Kena Faculty of Medicine, South Valley University**, Kena, Egypt
author
text
article
2018
eng
AbstractBackground: Tuberculosis (TB) has been a major health problem in developing countries.Rapid diagnosis of Mycobacterium tuberculosis infection plays a critical role in controlling the spread of tuberculosis. Conventional methods may take up to several weeks or longer to produce results. This study aimed to compare different methods like culture on Bio F-M media, automated BacT/ ALERT MP bottles, and urine lipoarabinomnnan by ELISA.Subjects and Methods: This study was done on 100 patients suspected to have tuberculosis, cases divided into two groups: (Group A): 68 clinically suspected pulmonary TB cases. (Group B): 32 clinically suspected extrapulmonary TB cases. All samples from Group A and B were subjected to direct staining by Zeihl-Neelsen stain, culture of the samples on Lowenstein Jensen media, Bio FM media and automated BacT/ALERT MP bottles and detection of urine lipoarabi-nomannan by ELISA.Results: In suspected pulmonary tuberculosis cases the sensitivity and specificity of Bio FM were 87.2%, 100% respectively, sensitivity and specificity of BacT/ALERT MP were 74.4%, 100% respectively, sensitivity and specificity of urine lipoarabinomannan were 20.5%, 96.9% respectively and in suspected extrapulmonary tuberculosis cases were the sensitivity and specificity of Bio FM were 87.5%, 100% respectively, sensitivity and specificity of BacT/ALERT MP were 50%, 100% respectively, sensitivity and specificity of urine lipoarabinomannan were 12.5%, 100% respectively.Conclusion: The sensitivity of both solid (Lowenstein Jensen) and liquid (Bio FM) media were the same and better than BacT/ALERT MP. Bio FM media and BacT/ALERT MP show shorter time than Lowenstein Jensen for detection of mycobacterial growth. Detection of urine lipoarabinomannan by ELISA is insensitive for the diagnosis of TB.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1793
1799
https://mjcu.journals.ekb.eg/article_56575_fd53b3d4cdc0f3c97c82080841974b5c.pdf
dx.doi.org/10.21608/mjcu.2018.56575
Study on Primary Closure versus Intraoperative CBD Stenting after Choledocholithotomy
HESHAM A. REYAD, M.D.;
MOHAMMED K. EWAIS, M.D.
author
MAGDY A.
OMRAN, M.Sc.
The Department of General Surgery, Faculty of Medicine, Assiut University, Assiut, Egypt
author
text
article
2018
eng
AbstractBackground: This study aimed to compare intraoperative Common Bile Duct (CBD) stenting with Primary Closure (PC) after choledocholithotomy as regard safety, feasibility, post-operative outcome and complications.Patients and Methods: This study has been done at Assiut University Hospital in General Surgery Department in the period between 1st January 2016 to 30 June 2017 including patients with CBDS and failed extraction of stones by Endo-scopic Retrograde Cholangiopancreatography (ERCP) and candidates for CBD exploration.Results: The study included 30 patients assigned to 2 groups, Group (A) primary closure and Group (B) intraoper-ative CBD stenting after choledocholithotomy, each group formed of 15 patients. There were no significant differences between two groups as regard the demographic characteristics. In Group (A) abdominal pain was reported in 3 cases vs. 7 cases in Group (B) and acute pancreatitis in no case vs. 2 cases in Group (B) and cholangitis in no case vs. 1 case in Group (B). As regard pre-operative biological character Group (A) was reported leukocytosis in 3 cases vs. 7 cases in Group (B), p=0.021. In Group (A) CBD diameter was 16±3mm vs. 13±2 in Group (B). The operation time was 120±28 in Group (A) vs. 125±20 in Group (B).About 53% of cases in Group (A) has been done laparo-scopicaly vs. 13% in Group (B). The hospital stay in Group (A) was 4±1.5 vs. 2±0.5 days in Group (B) Six cases of Group (A) experienced bile leakage vs. 2 cases in Group (B). Four cases of Group (A) were reported to have wound infection vs. 2 cases in Group (B).Conclusion: Intraoperative CBD stenting is a safe and feasible method after choledocholithotomy in cases of CBDS after failure of their extraction by ERCP.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1801
1806
https://mjcu.journals.ekb.eg/article_56576_3b7294a722e3bd38a26b0ffaeb90a65f.pdf
dx.doi.org/10.21608/mjcu.2018.56576
Clinical Audit for Use of Corticosteroids in Treatment of Nervous System Infections
AL-SAYED K.A. KARIM, M.D.;
MOSTAFA S. KHALAF, M.D.
author
DINA K.
EZZAT, M.Sc.
The Department of Pediatrics, Assiut University Hospital, Assiut, Egypt
author
text
article
2018
eng
AbstractBackground: Anti-inflammatory therapy is indicated for CNS infection. Corticosteroids are the most valuable anti-inflammatory drugs for CNS disease. They reduce CNS edema via their action on blood vessels, and they produce anti-inflammatory effects via their action on neutrophils and inhibition of cytokine synthesis.Patients and Methods: Retrospective study was conducted on patients admitted to Emergency Unit, intermediate care unit, Pediatric Intensive Care Unit and Department Neurology at Assiut University Children Hospital during the period from January 2016 to December 2016. Data is collected and com-pared to guidelines.Results: Corticosteroids was used in 100% of cases. Most of cases with CNS infection who received steroid treatment guided by treatment protocol showed marked improvement in GCS score, tendon reflexes, muscle tone and convulsions.Conclusion: Corticosteroids are usually the primary drugs used to treat immune-mediated disorders of the CNS, including corticosteroid-responsive meningitis and corticosteroid-responsive meningomyelitis.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1807
1810
https://mjcu.journals.ekb.eg/article_56577_1b1b2ef49c12b76afe9017a623080af2.pdf
dx.doi.org/10.21608/mjcu.2018.56577
Nutritional Assessment and Intervention in Children with Cerebral Palsy (Clinical Audit)
GAMAL A.A. ASKAR, M.D.;
OSAMA M. EL-ASHEER, M.D.
author
MARCO H.
MASOUD, M. Sc.
The Department of Pediatrics, Faculty of Medicine, Assiut University, Egypt
author
text
article
2018
eng
AbstractBackground: Neurologically Impaired (NI) children are at increased risk of malnutrition due to several nutritional and non-nutritional factors. Among nutritional factors, insufficient dietary intake as a consequence of feeding difficulties is one of the main issues. Feeding problems are frequently secondary to oropharyngeal dysphasia, which usually correlates with the severity of motor impairment and presents in around 90% of preschool children with Cerebral Palsy (CP) during the first year of life. Other nutritional factors are represented by excessive nutrient losses, often subsequent to gastro esophageal reflux and altered energy metabolism. Among the non-nutritional factors, the type and severity of neurological impairment, ambulatory status, the degree of cognitive im-pairment, and use of antiepileptic medication altogether concur to determination of nutritional status.Aim: To assess the degree of adherence of medical staff at neurology unit to new guidelines for nutritional assessment and intervention of children with cerebral palsy.Patients and Methods: The study included all cerebral palsy children admitted at Neurology Unit Assiut University Children Hospital from 1st of January to 30th of June 2017. An observational checklist based on new guidelines developed by the investigators in order to assess the degree of adherence of medical staff at Neurology Unit at Assiut University Children Hospital to protocol for nutritional assessment and intervention in children with cerebral palsy according to this new guidelines.Results: The study included 101 cerebral palsy children, their age ranged from 1 month to 15 years, 65 cases were males and 36 were females.•Children who need no intervention were 7.9% of cases.•Children who need to increase caloric intake were 19.8% of cases.•Children who need to micronutrient supplementation were 19.8% of cases.•Children who need to increase caloric intake and micronu-trient supplementation were 14.9% of case.•Children who need to insert gastrostomy tube were 37.6% of cases.Conclusion: Malnutrition is a frequent complication in CP children impacting on overall health and quality of life. Severity of feeding issues generally increases with reduction of general motor function and cognitive ability. Nutritional assessment and support should be an integral part of the care of CP children aiming at early identification of children at risk of nutrition-related co morbidities. To ensure success of interventions, close monitoring of nutritional status should be performed by a multidisciplinary team.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1811
1816
https://mjcu.journals.ekb.eg/article_56746_60831709c1398f275dd5b567ca4f3ce1.pdf
dx.doi.org/10.21608/mjcu.2018.56746
Clinical Audit on the Use of Vasopressors and Inotropes in Pediatric Intensive Care Unit in Assiut University Children Hospital
ZEINAB M. MOHI-ELDEEN, M.D.;
ZEINAB M. EL-KADY, M.D.
author
BESHOY L.
SHAMSON, M.Sc.
The Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt
author
text
article
2018
eng
AbstractBackground: Shock is a state of circulatory dysfunction where the metabolic demands of the tissue cannot be met by the circulation. The early recognition of signs of shock and aggressive therapy to restore the intravascular volume and reverse the biochemical cascade is believed to improve out-come.Patients and Methods: The study was done on children with shock admitted to intermediate care unit and PICU in assiut university children hospital in one year duration. An observational checklist based on guidelines of management of shock according to Early Goal Directed Therapy (EGDT) developed by the investigators in order to assess the manage-ment plane and the use of vassopressors and inotropes in pediatric shock.Results: In management at 0min.; Items of recognition of mental status, skin colour and determination of high flow O2 each were recorded in 99.05%. Establishing IV/IO access was done in 100%. In management at 5min.; fluid therapy was given to 97.14% of patients, in 77.5% of them it was recorded. RBG was done for 96.19% of patients, recorded in 100% of them. Calcium level was assessed in 98.1% of patients, in 96.1% of them it was recorded. The percentage frequency of using inotropes in management of the studied patients at 15min as follow: Dopamine alone was used in 55.3% of cases, dobutamine alone was used in 44.7% of cases, adrenaline was used in 31.4% of cases in combination with other inotrope and noradrenaline was used in 14.2% of cases in combination with other inotrope. In management of shock at 60min. 35.24% of patients were given hydrocortisone.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1817
1823
https://mjcu.journals.ekb.eg/article_56747_d474ded237b4e875c20c997fbc7551a6.pdf
dx.doi.org/10.21608/mjcu.2018.56747
Assessment of Nutritional Status of Primary School Children in Kallin District, Kafr El-Sheikh Governorate, Egypt
SHIMAA M. KOABAR, M.Sc.;
SALWA A. ATLAM, M.D.
author
SALAH AL-DEEN SHEHAB, M.D.;
SAFYNAZ A. SHALABY, M.D.
The Department of Public Health & Community Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt
author
text
article
2018
eng
AbstractBackground: School health has been acknowledged as important since the beginning of 20th century. Assessment of nutritional status is a major component of school health services.Aim of the Study: This study was undertaken to assess the nutritional status of primary school children of Kallin city-Kafr Al-Sheikh governorate, Egypt.Subjects and Methods: A cross-sectional study design was adopted. 2 in the rural section and 3 in the urban one with a total number of 3773 students. One urban and one rural school were chosen randomly from the governmental schools. A total of 433 pupils were included in the study. For each of the included children, socio-demographic data, dietary habits, food intake, physical examination for signs of nutritional deficiency were obtained and anthropometric measures such as (weight, height, mid upper-arm circumference and triceps skin fold thickness) were measured besides the Hb level which was taken from the health record of the child.Results: The study results revealed that 29 (6.7%) were wasted, 36 (8.3%) were stunted, 6 (1.3%) suffering from severe thinning, 4 (.9%) were underweight, 137 (31.6%) were overweight, and 56 (13.1%) were obese. There were significant statistical relation between the BMI, residence of children and their socio-economic status, dietary habits, and food intake of the child.Conclusion: From the results of the study we can conclude that over-nutrition and obesity were the prominent malnutrition problem among studied group while wasting and underweight was affecting a minimum percentage of their number.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1825
1825
https://mjcu.journals.ekb.eg/article_56748_9b6f0dd60f5071a2fb5f7d5ecb21503a.pdf
dx.doi.org/10.21608/mjcu.2018.56748
Comparative Study of the Effects of Topically Used Insulin and Simvastatin on Thermal Induced Burn in Diabetic Albino Rats
BASMA NABIL, M.Sc.;
AHMED YASSIN, M.D.
author
AMANY ABDIN, M.D.;
FLEUR FATHY, M.D.
The Department of Pharmacology, Faculty of Medicine, Tanta University, Tanta, Egypt
author
text
article
2018
eng
AbstractBackground: Diabetic wound healing is a major compli-cation that may be delayed or impaired. This is resulting from abnormalities in inflammatory and oxidative stress responses, impaired growth factors production, angiogenic responses and collagen deposition.Aim of the Work: The aim of this work was to investigate and compare possible effects of topical insulin and simvastatin on the tissue repair capacity, their anti-inflammatory and anti-oxidant effects.Material and Methods: Sixty male Wister Albino rats were divided into 5 equal groups, group1 normal burned received vehicle, group 2 diabetic burned received vehicle, group 3 diabetic burned received insulin in vehicle, group 4 diabetic burned received simvastatin in vehicle and group 5 diabetic burned received insulin in saline all applied topically. At certain end recording points (3rd, 7th, 14th and 21st days post burning) wound contraction percentage % was calculated and serum tumor necrosis factor-a (TNF-a), blood reduced glutathione and serum malonaldialdehyde (MDA) levels were estimated and dissected burn specimens were prepared for histopathological and immunohistochemical staining for VEGF and a-SMA.Results: Insulin and simvastatin produced more than satisfactory results evidenced by significant improvement in the whole studied parameters.Conclusion: Insulin and simvastatin have anti–inflamma-tory, antioxidant and angiogenic effects improving the healing properties. Although they both in vehicle exhibited similar effectiveness in regard the investigated parameters, they exhibited superiority over insulin in saline.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1837
1845
https://mjcu.journals.ekb.eg/article_56749_66628f06fae6d8b2388e5875400e2667.pdf
dx.doi.org/10.21608/mjcu.2018.56749
The Effect of Adding Ketamine to Bupivacaine in Ultrasound Guided Ilioinguinal and Iliohypogastric Nerve Block for Inguinal Hernia Operations
NOHA O. AL-MOBAYAD, M.Sc.;
HALA M. EL-GENDY, M.D.
author
HODA A. EZZ, M.D.;
MOHAMMED G. AYAD, M.D.
The Department of Anesthesiology and Surgical Intensive Care, Faculty of Medicine, Tanta University, Tanta, Egypt
author
text
article
2018
eng
AbstractBackground: Chronic pain occurs in 5-10% after the inguinal hernia repair that creates an important problem. Peripheral nerve blocks with local anesthetics are a method that may be used in inguinal hernia surgeries. Iliohypogastric (IH) and Ilioinguinal (II) nerve blocks are used for this purpose.Aim: Our aim is to evaluate the effect of adding ketamine to bupivacainein ultrasound guided ilioinguinal and iliohy-pogastric nerve block in patients scheduled for inguinal hernia repair.Patients and Methods: This study was carried out on 90 patient, 18-60 years, ASA I-II, scheduled for elective inguinal hernia repair under general anesthesia with ilioinguinal and iliohypogastric nerve block. Patients were randomized into two equal groups (45 patients in each group): Group 1: Received given 2mg/kg of 0.5% bupivacaine in the block) and Group II (given 2mg/kg of 0.5% bupivacaine with ketamine 2mg/kg in the block) 45 patients the following parameters were compared between the 2 groups: Vital signs (heart rate, mean arterial pressure), Visual Analogue Scale (VAS), the first time for resuce analgesia, dose of rescue analgesia (morphine), incidence of Post-Operative Nausea and Vomiting (PONV) using neumeric rank score and undesirable side effect.Results: There were no significant difference between the two studied groups regarding demographic data, vital signs, Post-Operative Nausea and Vomiting (PONV) and undesirable side effects. The visual analogue scale showed that pain began earlier and more sever in group 1than in Group II. Total dose of rescue analgesia (morphine) was significantly higher in Group I than Group II. The first time for resuce analgesia was earlier in Group I than Group II.Conclusion: Patients undergoing inguinal hernia repair surgery, addition of ketamine 2mg/kg to bupivacaine in ultrasound guided ilioinguinal and iliohypogastric nerve block produce more effective postoperative analgesia as indicated by lower VAS scale and the prolonged duration of sensory block compared to bupivacaine alone.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1847
1853
https://mjcu.journals.ekb.eg/article_56750_7ed7efa30ae4b0d61149933fa0f4a6b5.pdf
dx.doi.org/10.21608/mjcu.2018.56750
Potential Hepatic Protection by Erythropoietin and Ischemic Conditioning in a Rat Model of Renal Ischemia-Reperfusion Injury
MAHER N. IBRAHIM, M.D.;
AZZA A. MEGAHED, M.D.
author
MAHA A. FATHY, M.D.;
HUDA G. MOHAMED, M.Sc.
The Department of Medical Physiology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
author
text
article
2018
eng
AbstractBackground: Renal ischemia reperfusion injury is a com-mon consequence of many clinical conditions including renal transplantation, sepsis, trauma, and shock and usually leads to acute kidney injury. Its adverse effects extend to other organs including the liver leading to remote organ injury. Erythropoietin and ischemic conditioning have an anti-inflammatory, anti-oxidant and anti-apoptotic effects and were reported to have a protective effect against ischemia reperfusion injury in different organs.Aim of the Study: To evaluate the possible protective effect of erythropoietin and ischemic conditioning on the liver following renal ischemia reperfusion injury and to declare some of the possible mechanisms involved.Material and Methods: This study was conducted on 66 adult male albino rats divided into 6 equal groups: Group I: Sham group; Group II: Renal ischemia reperfusion group (I/R); Group III: Erythropoietin pre-treatment renal ischemia reperfusion group (EPO pre-I/R); Group IV: Erythropoietin post-treatment renal ischemia reperfusion group (EPO post-I/R); Group V: Ischemic pre-conditioning-renal ischemia reperfusion group (IPC) and Group VI: Ischemic post-conditioning-renal ischemia reperfusion group (IPOC).Results: Group II showed significant increase in serum creatinine, blood urea, blood urea nitrogen, AST and ALT levels with significant increase in renal and hepatic injury score indicating renal and hepatic injury following renal ischemia reperfusion. In the same group, a significant increase in serum IL6, TNFa, MDA and a significant decrease in serum SOD were found. Both group III and IV revealed a significant decrease in serum creatinine, blood urea, blood urea nitrogen, AST, ALT, renal and hepatic injury score. Levels of IL6, TNFa, and MDA significantly decrease and SOD significantly increased in both groups relative to group II and these changes were significantly higher in group III relative to group IV. In group V and VI, a significant decrease in serum creatinine, blood urea, blood urea nitrogen and renal injury score was found in both groups, while serum AST, ALT and hepatic injury score were significantly decreased in group VI but remained insignificantly changed in group V versus group II. Serum IL6 and TNFa significantly decreased in both groups, while MDA significantly decreased and SOD significantly increased in group VI only and no significant change was noticed in group V versus group II.Conclusion: Erythropoietin pre and post treatment signif-icantly improved renal and hepatic function and morphology following renal ischemia reperfusion injury with better results for erythropoietin pre-treatment. Ischemic post-conditioning induced significant decrease in renal and hepatic injury, while ischemic pre-conditioning provided renal protective effect which didn't extend to involve the liver.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1855
1866
https://mjcu.journals.ekb.eg/article_56751_d25734ca7706af5f0e6521da1de15564.pdf
dx.doi.org/10.21608/mjcu.2018.56751
Comparative Study between the Efficacy of Amantadine Sulphate versus Erythropoietin on Traumatic Brain Injury
MAHMOUD E. EL-TOOKHY, M.Sc.;
MOHAMMAD E. OKAB, M.D.
author
SABRY M. AMEEN, M.D.;
ASMAA F. AMER, M.D.
The Department of Anesthesiology and Surgical Intensive Care, Faculty of Medicine, Tanta University, Tanta, Egypt
author
text
article
2018
eng
AbstractBackground: Traumatic Brain Injury (TBI) is the most common cause of death and disability. Improvement of recov-ery is a challenging process in cases with varying degrees of severe brain injury requiring intensive care. Fortunately, a number of pharmacological interventions show promise in helping patients cope with these losses and deficits. Medica-tions may be used to support recovery, Examples are Eryth-ropoietin (EPO) and Antiparkinsonian drugs (Amantadine Sulphate).Aim: To compare the efficacy of Amantadine Sulphate versus Erythropoietin on improvement of traumatic brain injury outcome.Material and Methods: This study was carried out on three equal groups each group consist of 20 patients according to sample size calculation based on the fact, whether they received or didn't receive Amantadine Sulphate or Erythro-poietin in addition to standard therapy.Group I (Amantadine Group): Patients were received Amantadine Sulphate in dose of 200mg twice daily intravenous (IV) at 9:00am and 3:00pm for 1 week, from 3rd day of hospitalization then oral Amantadine Sulphate 200mg twice daily for 3 weeks in addition to standard therapy.Group II (Erythropoietin Group): Patients received Eryth-ropoietin subcutaneously (SC) from 3rd day of injury 40,000 International Units (IU) once per week for maximum 3 doses at day 3, 10 and 17 including standard therapy.Group III (Control Group): Patients received placebo (0.9% saline) for 4 weeks (standard therapy only). The fol-lowing measurements were recorded: Glasgow Coma Scale (GSC), Disability Rating Scale (DRS), Sedation scale, length of mechanical ventilation, length of surgical ICU stay, hospital stay and complications.Results: In the group of patients with severe brain injuries treated with standard therapy plus Amantadine Sulphate, consciousness was better, the case fatality rate was lower and length of mechanical ventilation, SICU stay and hospital stay were shorter than in the group treated with standard therapy plus Erythropoietin and the group treated with standard therapy only.Conclusions: Using of Amantadine Sulphate is better than using of Erythropoietin for improving neurorecovery on Traumatic Brain Injury (TBI), also we concluded that Eryth-ropoietin is a potentially useful treatment option for TBI but confirmatory evidence is required for that and for the ability of EPO to increase the risk of Venous Thromboembolism (VTE).
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1867
1874
https://mjcu.journals.ekb.eg/article_56752_9206750d0b71a63f00ff06de4db39acc.pdf
dx.doi.org/10.21608/mjcu.2018.56752
Comparative Study between Clinical and Ultrasound Diagnosis of Emergency of Gynecology
HEND E. HASBY, M.Sc.;
ASHRAF E. GHARIEB, M.D.
author
AHMED M.
HAGRAS, M.D.
The Departments of Emergency Medicine & Traumatology* and Gynecology & Obstetrics**, Faculty of Medicine, Tanta University, Tanta, Egypt
author
text
article
2018
eng
AbstractBackground: Acute pelvic pain accounts for up to 40% of the visits to gynecological emergency departments and may indicate a serious condition. Potentially life-threatening gynecological emergencies are acute pelvic conditions that may spontaneously evolve into a life threatening situation. They may also carry a risk of sequelae (organ failure or organ removal) or death in the absence of prompt diagnosis and treatment.The most common gynecological emergencies are ruptured ectopic pregnancy, adnexal torsion, and complicated pelvic inflammatory disease (tubo-ovarian abscess (TOA) and pyos-alpinx). Missing these high-risk conditions may delay treatment that could lead to potentially negative patient outcomes.Methods: This study was carried out over 1 year from September 2016 to September 2017 on 30 female patients. The records of all patients were review and data were collected prospectively. Our study included patients presented to the Emergency Department with gynecological emergencies.These gynecological emergencies included patients pre-sented with acute pelvic pain (e.g. ectopic pregnancy, torsion ovarian cyst, rupture ovarian cyst, pelvic inflammatory disease, tubo-ovarian abscess (TOA), and acute salpingitis) and/or vaginal bleeding (e.g. rupture uterus, and uterine tumors).Results: Ectopic pregnancy was the most common gyne-cological emergency seen in our study (about 46.67% of patients). Other diagnosis found in this study were adnexal torsion (about 16.67%), ovarian cyst rupture (about 13.33%), PID (about 13.33%), and uterine mass (about 10%).In this study, only about 53.33% of patients were diagnosed clinically before ultrasound was done. About 93.33% of patients were diagnosed after assessment by ultrasonography. There was statistically significant difference between clinical diagnosis and diagnosis after ultrasonography. (p<0.05).According to this study, there was a significant difference between clinical and radiological diagnosis using ultrasonog-raphy in diagnosis of ectopic pregnancy, adnexal torsion, and ovarian cyst rupture. (p<0.05).According to our data, physical examination cannot be used alone to safely rule out a surgical emergency in a woman presenting with acute pelvic pain. This suggests the benefit of adding bedside ultrasonography in the first-line diagnostic management of suspected gynecological emergencies.Conclusion: Adding Ultrasonography as a bedside test was found to be superior to physical examination in diagnosis of acute pelvic pain. If a gynecologic disorder couldn't be confirmed, or the sonographic finding are equivocal, Multi-Detector Computed Tomography (MDCT) is another imaging choice.Ultrasound is generally accepted as the first imaging modality used in patients with acute pelvic pain. The true value of ultrasound in acute pelvic pain lies in its ability to detect gynecologic disorders.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1875
1881
https://mjcu.journals.ekb.eg/article_56753_ddb402633a7a02a4c944f1f8a769ef3b.pdf
dx.doi.org/10.21608/mjcu.2018.56753
The Role of Fetal Hemoglobin in Maternal Blood in Determining the Severity of Pre-Eclampsia
FATMA A. ABDALLA ALI, M.Sc.;
ASHRAF E. GHARIEB, M.D.
author
NAREMAN M.
EL-HAMAMY, M.D.
The Departments of Emergency Medicine & Traumatology* and Gynecology & Obstetrics**, Faculty of Medicine, Tanta University, Tanta, Egypt
author
text
article
2018
eng
AbstractBackground: Preeclampsia is a disorder of widespread vascular endothelial malfunction and vasospasm that occurs after 20 weeks of gestation. At this time, preeclampsia still lacks early means of diagnosis and markers that determine the severity of the condition. Extracellular fetal hemoglobin is involved in the pathogenesis of preeclampsia and its con-centration in the maternal blood can be used to determine the severity of preeclampsia.Patients and Methods: The current work is a retrospective randomized study that was conducted on 60 pregnant women. Patients were classified into two groups. Group I (study group) included 40 patients diagnosed as preeclampsia and subdivided into group IA (included 20 patients diagnosed as mild preec-lampsia) and group IB (included 20 patients diagnosed as severe preeclampsia). Group II (control group) included 20 healthy pregnant women with uncomplicated pregnancy.Results: The study revealed as regard socio demographic data that there was no statistically significant difference of age, parity, gestational age between the study and the control group but there was statistically significant difference of gravidity between the two groups.As regard the vital data; there was statistically significant difference of blood pressure between mild and severe preec-lampsia groups.As regard the investigations; there was statistically sig-nificant difference of proteinuria, fatal hemoglobin and uterine Doppler ultrasound between mild and severe preeclampsia groups.Conclusion: Fetal hemoglobin level in maternal blood is an important, simple, cheap and available biomarker for pre-eclampsia. it can be used late in pregnancy for diagnosis of preeclampsia and for determining the severity of pre-eclampsia.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1883
1889
https://mjcu.journals.ekb.eg/article_56754_c5ef02162e9380177270730a0c2cac5f.pdf
dx.doi.org/10.21608/mjcu.2018.56754
Risk Factors and Predictors of Refractory Childhood Epilepsy: Case Control Study
TAGHREED A.M. ISMAIL, M.D.;
MOHAMMED SALAH EL-DEEN, M.Sc.
author
EMAD EL-DEEN M. HAMMAD, M.D.;
KOTB A. METWALLY, M.D.
The Departments of Public Health & Community Medicine* and Pediatrics**, Faculty of Medicine, Assiut University
author
text
article
2018
eng
AbstractBackground: Each year, 3.5 million new cases of epilepsy are reported. Unfortunately, 6-14% of these children will develop refractory epilepsy.Aim: Is to determine the risk factors and predictors of refractory epilepsy.Patients and Methods: Case control study was conducted at Assiut university children hospital. Cases were children aged 2-18 years who were diagnosed as refractory epilepsy whereas controls were matched to cases regarding age, sex, and they were diagnosed as responsive epilepsy.Results: History of birth hypoxia, neonatal cyanosis, neonatal convulsions and NICU admission were significantly higher among patients with refractory epilepsy than those with responsive epilepsy. Past history of CNS infections, intracranial hemorrhage and febrile convulsions were signif-icantly higher among patients with refractory epilepsy than those with responsive epilepsy. Physical and mental develop-mental delay occurred among (80.6% & 78.5%) of children with refractory epilepsy versus (19.4% & 18.3%) of children with responsive epilepsy with statistical significant difference. Age of seizure onset less than one year was reported among 75.3% of refractory epilepsy group versus 43% of those with responsive epilepsy. Multiple seizures type was reported among 36.5% of children with refractory epilepsy versus 6.5% of the responsive group. Moreover, about 90% of children with refractory epilepsy reported daily seizures at the disease onset. History of status epilepticus and presence of epileptic syndromes reported among 43% & 26.9% respectively of children with refractory epilepsy, with statistical significant difference. Microcephaly, motor deficit were statistically higher among patients with refractory epilepsy than those with responsive epilepsy.Conclusion: The most important independent predictors of refractoriness were: High initial seizures frequency, motor deficit, birth hypoxia, delayed mental development and febrile convulsions.Recommendations: Good training of health care providers for the proper management of labor to avoid perinatal hypoxia, professional follow-up of children for early signs of developmental delay and health education and training to the caregiver and health care provider about proper management of fever to avoid febrile convulsions.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1891
1899
https://mjcu.journals.ekb.eg/article_56755_34e8fdf0cc32ab4b12e928f27884a6b1.pdf
dx.doi.org/10.21608/mjcu.2018.56755
The Effect of Pressure Controlled Ventilation on Pulmonary Mechanics in Prone Patients Undergoing Elective Spine Surgeries: Comparative Study with Volume Controlled Ventilation
AHMED E. YOUSSEF, M.Sc.;
HASSAN MOHAMED, M.D.
author
IMAN FOUAD, M.D.;
NADER NOSHEY, M.D.
author
AHMED
RAGAB, M.D.
The Department ofAnaesthesiology, Faculty of Medicine, Cairo University
author
text
article
2018
eng
Abstract Background: As patients turned into prone position expe-rienced more decrease in lung compliance than those on supine position, this prospective, randomized study was designed to compare the effect of PCV and volume-controlled ventilation (VCV) on lung mechanics and heamodynamics in the prone position using the Wilson frame during elective lumbar spine surgery.Patients and Methods: Sixty patients scheduled for elective lumbar spine surgery were randomly allocated to receive mechanical ventilation using either the VCV (n=30) or PCV (n=30) mode. Respiratory variables (peak airway pressure, mean airway pressure, shunt fraction, alveolar-arterial oxygen gradient). Dynamic compliance (Cdyn) of the respiratory system was calculated as VT/ (Ppeak-PEEP). The alveolar dead space-to-tidal volume ratio (VD/VT) will be estimated using the Hardman and Aitkenhead equation: VD/VT=1. 135– (PaCO2-ETCO2)/(PaCO2-0. 005). Results: The Ppeak in the PCV group was lower than that in the VCV group throughout the study period (p-value=0.961 and 0. 0.109 at supine position and prone position, respectively) and was increased at prone position compared with supine position in both groups. Cdyn was decreased from supine to prone position in both groups. However, the Cdyn in the PCV group was higher than that in the VCV group during the study period however it is only statistically significant after 1.5 and 2hrs. The arterial oxygen tension was comparable between the 2 groups during the study period.Conclusions: PCV provides lower Ppeak compared with VCV when the ventilator is set to deliver the same tidal volume and variable respiratory rate to maintain a constant end-tidal carbon dioxide tension in patients undergoing pos-terior lumbar spine surgery in the prone position using the Wilson frame.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1901
1907
https://mjcu.journals.ekb.eg/article_56756_739c56c8f3c330151b577643d4976e2e.pdf
dx.doi.org/10.21608/mjcu.2018.56756
Evaluation of the Capability of the Modified Transtibial Technique in Restoring a Near Anatomic Anterior Cruciate Ligament Reconstruction
AHMED N. MORRA, M.D.;
HESHAM MESBAH, M.D.
author
HAZEM FAROUK, M.D.;
EHAB A. HUSSEIN, M.D.
author
HOSSAM
EL-DIN E. MOHAMMED, M.D.
The Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University
author
text
article
2018
eng
Abstract Background: ACL reconstruction becomes a very common procedure today. There are many techniques to put the femoral and tibial tunnels in a near anatomic position that allow regaining knee function and prevent malpositioning of the tunnels which may results in graft failure. Our hypothesis suggests that modified transtibial technique (MTT) will give comparable measures to native ACL.Purpose: The aim of this paper is to study the effect of modifications on the transtibial technique regarding the graft positions & angles and their impact on clinical outcome.Patients and Methods: The study based on 30 patients, started from February 2013 to December 2014. All patients are males aged between 19-39 years (mean is 28.4 years with 5.0±SD) having torn ACL underwent arthroscopically-assisted ACL reconstruction using hamstring tendons and a modified transtibial technique. Results: Our “MTT” for single bundle ACL reconstruction showed comparable results to traditional TT. Ideally, our MTT graft was coronally inclined similar to that of the native ACL. It was also found to be more coronally oblique than the graft in traditional TT. These radiological results should be correlated with the clinical outcomes in order to note whether or not these improved radiological measurements would result in improved functional and clinical outcomes of the surgery.Conclusion: This technique succeeded to put the graft in a more oblique position that presumably leads to improved clinical and functional outcome.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1909
1915
https://mjcu.journals.ekb.eg/article_56757_dd277a936913dcd9ee8057f8e50655a0.pdf
dx.doi.org/10.21608/mjcu.2018.56757
The Value of Using Amantadine Upon Improving Conscious Level in Isolated Head Trauma Patients Guided by Glasgow Coma Scale and Bispectral Index
AHMED S. SAAD, M.Sc.;
OMAR WAGIH, M.D.
author
INAS ELSHAZLY, M.D.;
HISHAM ABU ELDAHAB, M.D.
author
SAFINAZ
OSMAN, M.D.
The Department ofAnaesthesiology, Faculty of Medicine, Cairo University
author
text
article
2018
eng
Abstract Background: We performed the current study to find out the effect of Amantadine upon rate of improvement of con-scious level in patients with isolated head injuries undergoing surgical intervention.Aim of the Study: Finding out the value of using Amanta-dine upon improving of consciousness in head trauma patients.Patients and Methods: Patients in group 1 (n=20) were given amantadine intraoperative at a dose of 100mg IV infusion over 3 hours, then amantadine were given at a dose of 100mg IV infusion over 3 hours every 12 hours for 7 days then was switched to tablet form at a dose of 300mg per day divided into 3 equal doses, the 1st was given in the morning and the last before 5 o'clock PM.Patients in group 2 (n=20) were given placebo instead at the same form and intervals.Glasgow coma scale and bispectral index readings were recorded at time of arrival, immediate post operative, 3 days and 2 weeks post operative. Results: We found that Glasgow coma scale rate of im-provement in group 1 was 4.53±2.61 and in group 2 was 2.11 ±2.81 which is statistically significant p-value 0.014.Conclusion: We conclude from this study that the rate of improvement of patients given amantadine was significantly higher than those given placebo.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1917
1925
https://mjcu.journals.ekb.eg/article_56758_102c4ac521560520a34e7885a3c7d399.pdf
dx.doi.org/10.21608/mjcu.2018.56758
Comparative Study for Cervical Spinal Fusion Using Cervical Cages with and Without Bone Granules
MOHAMED MOHAMED, M.D.;
AHMED S.K. ABDELWAHED, M.D.
The Department Neurosurgery, Faculty of Medicine, Beni Sueif * and Cairo** Universities
author
text
article
2018
eng
Abstract Background: Cervical spinal fusion is a surgical procedure that joins selected bones in the cervical spine.The anterior approach to the cervical spine was developed for treatment of cervical disc, it involves removing the symp-tomatic disc from an anterior approach without placement of a bone graft. Early studies demonstrated fusion rates with Anterior Cervical Discectomy (ACD) were similar to those of procedures of anterior cervical discectomy and fusion (ACDF) using bone graft. The anterior cervical discectomy and fusion with instru-mentation (ACDFI) technique involves the additional stabili-zation of the cervical spine & graft with instrumentation.Cages were introduced to be used with either autologous or synthetic bone grafts, promoting stability and encouraging fusion. Comparing to graft alternatives, cage interbody implants have better biomechanical properties, designed to maximise biocompatibility and reduced graft dislodgements, increased fusion rates, and decreased foraminal stenosis. However, placement of implants introduces hardware-related complica-tions.Aim of the Study: This prospective study aims to compare the results of ACDFI using cages with & without synthetic bone granules evaluating the outcomes, fusion and associated morbidities.Patients and Methods: Prospective study of 42 patients operated upon between 2012 and 2014 in Cairo University Hospitals & Beni Sueif University Hospital with ACDFI using cervical cages. Patients were divided into two groups: - Group (A) 22 patients operated by ACDFI with placement of cages only - Group (B) 20 patients operated by ACDFI with placement of cages and synthetic bone granules. Both groups underwent postoperative clinical follow-up for an average of 12 months, and results were evaluated according to radiographic evidence of fusion and Fisher exact probability test was used to compare fusion of both groups. We made considerations for patient's age, sex, osteoporosis, and smoking habits. We recorded fusion rates, cervical alignment, postoperative complications & patient satisfaction using Visual Analogue Score (VAS). Results: 42 patients were included in the study. The mean age was 46, 18 of them were females and 24 were males. 29 patients had single level discs and 13 patients had two levels.One year follow-up fusion rates that were achieved in group (A) were 81.8% while group (B) reached 95%. One year follow up on achievement of alignment of cervical spine was 90.9% of patient's in group (A) and in group (B) was 95% of cases.There were no problems regarding surgical technique or dislodgment in both techniques. Only in one patient in group(A)CSF leak developed and resolved. One patient in group(B)developed a keloid at incision site.Conclusion: Fusion rate is one of several factors that guide surgical decision making for cases requiring ACDFI. Fusion rate is significantly higher in group (B) using cages filled with synthetic bone granules than in group (A) with cages only. Age, sex, osteoporosis and smoking status have not given significantly different results between both groups studied.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1927
1932
https://mjcu.journals.ekb.eg/article_56759_83947c236502f5929e0bc197345f51e7.pdf
dx.doi.org/10.21608/mjcu.2018.56759
Aneurysm Sac Size as a Predictor for Endoleak after Endovascular Aortic Aneurysm Repair of Stanford B Dissecting Thoracic Aortic Aneurysm: Role of MDCT Angiography
AMR A.H. GADALLA, M.D.;
HUSSEIN O. ELWAN, M.D.
author
MOHAMED F.
OSMAN, M.D.
The Departments of Diagnostic & Interventional Radiology* and Vascular Surgery**, Faculty of Medicine, Cairo University
author
text
article
2018
eng
Abstract Background: The endovascular techniques for repair of thoracic aortic aneurysms are significantly increased nowadays, so the possibility of endoleak is also raised.Aim of Work: Pre-operative evaluation of the aortic aneu-rysm using the sac size as a predictor for endoleak after endovascular repair of the thoracic Stanford B dissecting aortic aneurysms.Methods: The study was carried over one hundred and seven patients (88 males and 19 females, range 50-75 year old) from October 2016 to November 2017. Pre and post operative evaluation of all examined patients was done using Multislice CT angiography. Types of endoleak were docu-mented as well as the detailed assessment of the rest of the vascular tree was also done. Results: Receiver Operating Characteristics (ROC) curve analysis was performed for aneurysm sac size, area under the curve (AUC) was nearly optimal 0.938 (95% CI 0.891-0.984). The most suitable cut off point for aneurysm sac size was more than or equal to 6.2cm with sensitivity 83.9% and specificity 85.5%.Conclusion: Based on our results, aneurysmal sac size combined with patient's age can be used as predictors for post interventional endoleak.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1933
1938
https://mjcu.journals.ekb.eg/article_56760_1056a2bc70c60e585d172c86368a732c.pdf
dx.doi.org/10.21608/mjcu.2018.56760
Interval Aerobic Exercise versus Cupping Therapy on Essential Hypertension in Women
AZZA A. ABD EL-HADY, Ph.D.;
SHEREEN H. EL-SAYED, Ph.D.
author
WAEL ABO SHOKKA, M.D.;
LAMIA M. FAHMY, M.Sc.
The Department of Cardiovascular, Respiratory Disorders & Geriatrics, Faculty of Physical Therapy, Cairo University* and the Department of Cardiology, Faculty of Medicine, Heart Institute**, Giza, Egypt
author
text
article
2018
eng
Abstract Background: Exercise and cupping therapy has been suggested to be available treatment for hypertension. This study compares the effect of interval aerobic exercise versus cupping on essential hypertensive women.Aim of the Study: To determine the effect of interval aerobic exercise versus cupping therapy on Essential Hyper-tensive women.Subject and Methods: Thirty women had essential hyper-tension stage: 1 (140: 160mmHg systole-90-100mmHg dias-tole) were randomly assigned into two groups equal in number. Group (A) fifteen women received moderate intensity (aerobic interval) exercise (4 to 7) of modified 0-10 Borg scale, exercise session 15:20min, three times per week for a month. Group (B) fifteen women received cupping therapy session on six points in the neck and back 20min, one session at the beginning of a study month. Results: Significant reduction of systolic blood pressure at post-treatment in comparison to pre-treatment (p-value= 0.0001*). There was improvement of systolic blood pressure in group: A percent of change (improvement) was 13.79%. There was improvement of systolic blood pressure in Group B percent of change (improvement) was 11.5%, multiple pair wise comparison tests (post hoc tests) revealed that there was no significant difference of the mean values of the "post" test between both groups with (p=0.096). In spite of that there was no statistical significant difference between Group A and Group B, was clinical difference and high percent of improve-ment in favor to Group A. There was improvement of diastolic blood pressure in Group A and percent of change (improve-ment) was 11.96%. Multiple pair wise comparison tests (post hoc tests) revealed that there was significant reduction of diastolic blood pressure at post-treatment in compare to pre-treatment (p-value= 0.0001*) this mean there was improvement of diastolic blood pressure in Group B and percent of change (improvement) was 13.19%. In spite of there was no statistical significant difference between Group A and Group B, there was clinical difference and high percent of improvement in favor to Group B.Conclusion: It was concluded that participation in aerobic interval exercise or cupping therapy have positive effect on blood pressure in stage one essential hypertensive women and can be used as alternative treatment modalities.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1939
1946
https://mjcu.journals.ekb.eg/article_56923_bac27050295b9b5be8ddcb1322a7b71a.pdf
dx.doi.org/10.21608/mjcu.2018.56923
Dexamethasone versus Ketorolac as Adjuvants to Interscalene Brachial Plexus Block in Shoulder Arthroscopy Under General Anesthesia
MAHMOUD A. ALY, M.D.;
SHERIF SAYED, M.D.
author
ABD EL-RAHMAN H.
MOHAMMED, M.Sc.
The Department of Anesthesia, ICU and Pain Management, Faculty of Medicine, Assiut University, Assiut, Egypt
author
text
article
2018
eng
Abstract Background: The ultrasound guided Interscalene Brachial Plexus Block (IBPB) when used combined with general anesthesia has several advantages for patients scheduled for shoulder surgery. These advantages include, good control of intraoperative hemodynamics, and adequate management of postoperative pain.Aim and Objective: This study compares the effect of adding dexamethasone versus ketorolac to bupivacaine and lidocaine mixture in US guided IBPB regarding postoperative analgesia and intraoperative hemodynamics in patients under-going shoulder arthroscopy.Patients and Methods: This prospective randomized, controlled study was done in Assiut University Hospitals from February 2016 to January 2017. It was approved by Asyut University Ethics Committee, and a written informed consent was obtained from all patients. Sixty patients were enrolled in the study with the following inclusion criteria, ASA I-II, age 18-60 years, scheduled for elective shoulder arthroscopy in Asyut University Hospital. Patients were indiscriminately distributed to three groups: - Group [C] (control group) received 25ml solution: 10ml lidocaine 1%, 10ml bupivacaine 0.25% and 5mL of normal saline 0.9%. - Group [D] (dexamethasone group) received 25ml solution: 10ml lidocaine 1%, 10ml bupivacaine 0.25% and 5mL of dexamethasone (5mg). - Group [K] (Ketorolac group) received 25ml solution: 10ml lidocaine 1%, 10ml bupivacaine 0.25% and 5mL of ketorolac (10mg/ml) (50mg).Sensory and motor block onset in minutes, intensity of post-operative pain assessed by Visual Analogue Score (VAS), duration of post-operative analgesia, and intraoperative he-modynamics were documented and compared between the groups. Results: We founded that the duration of post-operative analgesia including the time for the first analgesic requirement was significantly longer in dexamethasone group with average 13.7±2 hours while it was 10.95±1.05 in ketorolac group and 11.7±3.53 in control group with. Total Rescue analgesia administration was much less in dexamethasone group in comparison with other groups but all groups did not need any additional opioid in the first day postoperative.Conclusion: Dexamethasone provides better post-operative pain relief than ketorolac when added to mixture of lidocaine and bupivacaine in ultrasound guided interscalene block for shoulder arthroscopy under general anesthesia.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1947
1953
https://mjcu.journals.ekb.eg/article_56925_48509abe4c096dd02cc2fc5e1c833eae.pdf
dx.doi.org/10.21608/mjcu.2018.56925
Comparative Study between Bupivacaine versus Bupivacaine with Dexmeditomidine in Ultrasound Guided Transversus Abdominis Plane Block for Postoperative Analgesia in Cancer Patients Undergoing Major Pelviabdominal Surgeries
NAHLA N. SHEHAB, M.Sc.;
MAIE K. EL-HELALY, M.D.
author
AYMAN A. GHONEIM, M.D.;
GHADA M. NABIH, M.D.
The Department of Anesthesia, Pain and Intensive Care, National Cancer Institute, Cairo University
author
text
article
2018
eng
Abstract Background: The main contributor to the pain experienced after abdominal surgery is pain from the incision made in the abdominal wall. The Transversus Abdominis Plane (TAP) block is a peripheral nerve block to the nerves supplying the anterior abdominal wall (T6 to L1). The aim of this study was to evaluate the effect of dexmedetomidine as an adjuvant in ultrasound guided TAP block on post-operative analgesia and morphine consumption in patients undergoing major abdominal or pelvic surgeries.Methods: Seventy five patients were randomly enrolled in the study; patients were divided into 3 groups: Bupivacaine group (group TAP, n=25) received TAP block with bupivacaine done after skin closure, bupivacaine with dexmedetomidine group (group TAP + Dex, n=25) received TAP block with dexmedetomidine added to the bupivacaine and intravenous dexmedetomidine group (group TAP + IV-Dex) received TAP block with bupivacaine in addition to intravenous dexmedeto-midine. Results: The mean time to the first rescue analgesic requirement was significantly longer in both group TAP + Dex (9.8±2.9) hours and group TAP + IV-Dex (10.0±2.3) hours than in group TAP (5.7±1.6) hours (p<0.001). Total morphine consumption in the first 24 hours post-operatively was significantly higher in group TAP (24.3±3.6) mg than in both group TAP + Dex (11 .8±3.7) mg and group TAP + IV-Dex (11.8±3.6) mg (p<0.001). Post-operative VAS pain score was higher in group TAP than in group TAP + IV-Dex at 6 and 12 hours but all three groups were comparable at 2, 4 and 24 hours. Patient satisfaction score was significantly lower for group TAP in comparison to the other two groups (p< 0.001).Conclusion: Dexmedetomidine whether added to bupi-vacaine in the TAP block or administered intravenously improved postoperative analgesia with lower total morphine consumption in the first 24 hours post-operative as a part of multimodal analgesia in abdominal and pelvic surgeries.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1955
1962
https://mjcu.journals.ekb.eg/article_56927_bcd1f22930ef140bc1caad9b50d53a68.pdf
dx.doi.org/10.21608/mjcu.2018.56927
Clinical Audit Study for Use of Corticosteroids in Treatment of Nervous System Infections
AL-SAYED K.A. KARIM, M.D.;
MOSTAFA. S.H. KHALAF, M.D.
author
DINA K.
EZZAT, M.Sc.
The Department of Pediatrics, Faculty of Medicine, Assiut University Hospital, Assiut, Egypt
author
text
article
2018
eng
Abstract Background: Anti-inflammatory therapy is indicated for CNS infection. Corticosteroids are the most valuable anti-inflammatory drugs for CNS disease. They reduce CNS edema via their action on blood vessels, and they produce anti-inflammatory effects via their action on neutrophils and inhibition of cytokine synthesis.Aim of the Study: To assess how much the adopted protocol of using corticosteroids in management of CNS infections is implemented in Assiut University Children Hospital (A.U.C.H).Patients and Methods: Retrospective study was conducted on patients admitted to Emergency unit, intermediate care unit, pediatric intensive care unit and department of neurology at Assiut University Children Hospital during the period from January 2016 to December 2016. Data were collected and compared to guidelines. Results: Corticosteroids was used in 100% of cases. Most of cases with CNS infection who received steroid treatment guided by treatment protocol showed marked improvement in GCS score, tendon reflexes, muscle tone and convulsions.Conclusion: Corticosteroids are usually the primary drugs used to treat immune-mediated disorders of the CNS, including corticosteroid-responsive meningitis and corticosteroid-responsive meningomyelitis.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1971
1974
https://mjcu.journals.ekb.eg/article_56928_4b9fffe43b7ac5ed65105f92a9a42b5e.pdf
dx.doi.org/10.21608/mjcu.2018.56928
Serum Kisspeptin-10 Levels in Pregnant Women Complicated with Intrauterine Growth Restriction With or Without Preeclampsia
SAMA S. KHALIL, M.D.;
KHALED A. ABULFADLE, M.D.
author
WALID M.
ELNAGAR, M.D.
The Departments of Physiology* and Obstetrics & Gynecology**, Faculty of Medicine, Zagazig University, Zagazig, Egypt
author
text
article
2018
eng
Abstract Background: Placental dysfunction is usually associated with a wide range of obstetric complications. Among the most important of these complications are preeclampsia (PE) and intrauterine growth restriction (IUGR), they are associated with a higher rate of perinatal mortality and morbidity. Kisspeptins are peptide products of the KISS-1 gene, which act through binding with the G-protein coupled receptor 54, Kisspeptin-10 (KP-10) produced by trophoblast cells, has an important role in controlling of migratory features and tro-phoblastic invasion. Studies that evaluate the role of KP-10 in pregnancy complications are sparse.Aim of the Work: To investigate serum KP-10 levels in correlation with some parameters in pregnancy complicated with IUGR with or without PE.Subjects and Methods: This study was performed on thirty pregnant woman equally divided into three groups, group I, ten uncomplicated pregnant women with normal blood pressure consider as control, group II, ten preeclamptic women com-plicated by IUGR and group III, ten normotensive pregnant women complicated by IUGR. The maternal serum was ana-lyzed for KP-10 levels and TNFa, while, the maternal urine was analyzed for protein detection. Also, gestational age, fetal birth weight, placental weight, BMI, and MAB were measured. Results: The present findings revealed significant decrease in maternal serum KP-10 levels in both of group II (p<0.05) and group III (p<0.01) rather than group I. Moreover, KP-10 was positively correlated with fetal birth weight and placental weight in group II and group III, while, negatively correlated with protienuria in group II and TNFa in group II and group III. However, no correlations were found with gestational age, BMI, and mean arterial blood pressure in all groups.Conclusion: These results propose that the decrease in KP-10 may be responsible for the pathogenesis that underlying the development of IUGR with preeclampsia and normotensive IUGR. So, its measurement might be helpful as a new biomar-ker in predicting poor placental dysfunction and adverse pregnancy outcome.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1975
1982
https://mjcu.journals.ekb.eg/article_56929_09048f226ea0a64a296e4d8c34949fc6.pdf
dx.doi.org/10.21608/mjcu.2018.56929
Effect of Exercise Training on Metabolic Homeostasis and Some Hepatic and Cardiovascular Functions in a Rat Model of High Fat Diet Induced Obesity
NABIL A. SOLIMAN, Ph.D.;
ALI KH. ASALAH, M.D.
author
SUZAN M.M. MOURSI, M.D.;
SAMAR M. GAMAL, Ph.D.
The Department of Zoology, Faculty of Science* and the Department of Physiology, Faculty of Medicine**, Zagazig University, Zagazig, Egypt
author
text
article
2018
eng
Abstract Background: Obesity is associated with many chronic disorders such as type-2 diabetes mellitus, essential hyperten-sion and Non-Alcoholic Fatty Liver Disease (NAFLD). Phys-ical exercise has been shown to have positive effects in the prevention and attenuation of many of the obesity-related disorders, however; the mechanisms have not been fully elucidated.Objective: The present study was designed to examine the effect of moderate intensity exercise training on existing cardio metabolic and hepatic complications linked to obesity including dyslipidemia, insulin resistance, hypertension and NAFLD.Material and Methods: This study was conducted on 3 groups of adult male albino rats: Group-1: Normal diet fed group Group-II: High Fat Diet (HFD) induced obesity group in which obesity was induced by HFD for 12 weeks and Group-III: HFD induced obesity group fed on HFD for 12 weeks followed by moderate intensity swimming exercise training for 8 weeks. In all groups, BMI, Abdominal Circum-ference (AC), systolic, diastolic and mean arterial blood pressures, heart rate, serum glucose, insulin and HOMA-IR, serum Total Cholesterol (TC), Triglyceride (TG), Very Low-density Lipoprotein Cholesterol (VLDL-c), Low-Density Lipoprotein Cholesterol (LDL-c), High-Density Lipoprotein Cholesterol (HDL-c) and Atherogenic Index (AI), serum adiponectin, leptin, irisin, Tumor Necrosis Factor alpha (TNF-a), Interleukin-6 (IL-6), Malondialdehyde (MDA), Superoxide dismutase (SOD), Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST), Alkaline Phosphatase (ALP), Lactate Dehydrogenase (LDH) and albumin were measured and his-topathological examinations for hepatic tissues were also done. Results: The present study revealed that HFD significantly increased BMI, AC, systolic, diastolic and mean arterial blood pressures, heart rate, serum glucose, insulin, HOMA-IR, TC, TG, LDL-c, VLDL-c, AI, ALT, AST, ALP, LDH, TNF-a, IL-6, MDA and leptin levels, however, there were significant decreases in serum HDL-c, SOD, albumin, adiponectin and irisin levels. NASH and cirrhosis were also observed in HFD-induced obesity group. Conversely, chronic moderate intensity swimming exercise training significantly reversed these manifestations even in absence of caloric restriction.Conclusion: Moderate exercise training seems to be an effective strategy to reverse almost all risk factors of cardio-vascular diseases and NAFLD associated with metabolic syndrome.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1983
1994
https://mjcu.journals.ekb.eg/article_56930_98d71b6fe86527bda8beb0e7b43fb580.pdf
dx.doi.org/10.21608/mjcu.2018.56930
Urinary Albumin Excretion and Severity of Coronary Artery Disease by Coronary Angiography in Patients with Type 2 Diabetes
ELHAM O. HAMED, M.D.;
AHMED M. BOGHDADY, M.D.
author
HASSAN A.H. SHEHATA, M.D.;
ALAA A. GHALEB, M.Sc.
The Departments of Clinical Pathology* and Internal Medicine**, Faculty of Medicine, Sohag University, Sohag, Egypt
author
text
article
2018
eng
Abstract Background: Coronary Artery Disease (CAD) is a major cause of death in developed and developing countries. Many of CAD patients don't have any other classic risk factor except diabetes. The aim of this study was to investigate the relation-ship between urinary albumin excretion and severity of coro-nary artery lesion by coronary angiography in type 2 diabetic patients.Patients and Methods: This study, conducted with 200 type 2 diabetic patients with documented CAD by coronary angiography. The ratio of urinary albumin to creatinine was calculated. The study populations were classified according to albumin to creatinine ratio, Group I: Normoalbuminuric group (120 diabetic patients), Group II (80 patients) and subdivided into Group II a (56 microalbuminuria patients), Group II b (24 macroalbuminuria patients). The severity of CAD was estimated using multi-vessel affection and SYNTAX score. Results: The prevalence of triple vessel CAD was signif-icantly higher in Group II (microalbuminuic and macroalbu-minuric patients). Triple vessel CAD was present in 13.3% of patients in Group I (normoalbuminuric), whereas it was present in 62.5% of patients in Group II (p<0.001). Left main artery stenosis was present in 8.3% in Group I and 20% in Group II (p=0.03). Of patients, 16.6% and 70% in Group I and II had Ostial and Para ostial stenosis respectively (p<0.001). Major side branch stenosis was present in 20% of patients in Group I and in 90% of patients Group II (p<0.001). The severity of CAD by SYNTAX score revealed that, patients of Group II had higher SYNTAX scores compared to Group I (29±8 vs. 16-}6, p<0.001). Patients with macroalbuminuria had higher SYNTAX scores compared to those with micro-albuminuria (30±3 vs. 26-}6, p=0.001). Multivariate logistic regression analysis found smoking, dyslipidemia and albu-minuria were risk factors for coronary artery lesion (p=0.004, p<0.001 and p<0.01 respectively).Conclusion: Patients with microalbuminuria and mac-roalbuminuria have more extensive and severe angiographic CAD compared to those with normoalbuminuria.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
1995
2000
https://mjcu.journals.ekb.eg/article_56932_eb635a36824ecabb9df26f6c3f008115.pdf
dx.doi.org/10.21608/mjcu.2018.56932
Quality of Nursing Care Provided to Patients in the Operating Room, Based on Ministry of Health Standard of Care
OLA Y. HASSAN, M.Sc.;
MAGDA A. EL-MOLLA, D.N.Sc.
author
NAGAT
EL-MORSY, D.N.Sc.
The Department of Nursing Administration, Faculty of Nursing, Cairo University
author
text
article
2018
eng
Abstract Background: Nurses play an important role in preserving the health of the patients, and one of a very critical area of nursing that can be exciting and provide a lot of direct patient care is working as an operating room nurse. So the operation nurse must be highly qualified to provide the patient with high quality nursing care.Aim: This study assessed the quality of nursing care provided to patients in the operating room at Al-Ahrar Zagazig General Hospital.Design: A descriptive cross-sectional design was utilized. Sample: A sample of 40 nurses working in the operating room in two shifts, for observation of their performance as (scrub and circulating).Setting: The study was conducted from eleven operating rooms Al-Ahrar Zagazig General in the Hospital.Methods: Used two checklists: Inventory checklist for infrastructure, environmental safety and presence of policies and records; and an observation checklist for scrub and circulating nurse performance. Results: The results demonstrated major deficiencies in OR general policies, although the infrastructure was generally adequate. Scrub nurses' performance is mostly inadequate, but is better compared with circulating nurses. It is influenced nurses' personal and job characteristics.Conclusion: There was low on the performance of nurses due the absence of clear regulations or guidelines and common procedures as well as the absence of continuous training and education programs for the nurses.Recommendation: Create a clear written job description, and provide continuous training to improve communication and additional skills.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
2001
2010
https://mjcu.journals.ekb.eg/article_56934_0fe1a96b796d7dc1a5c52023228c1827.pdf
dx.doi.org/10.21608/mjcu.2018.56934
Diagnostic Accuracy of Contrast Enhanced Spectral Mammography in Assessment of Indeterminate Breast Lesions in Patients after Breast Conservation Surgery
ASMAA M. ABD EL-MAGIED, M.D.;
EMAD S. KHALIFA, M.D.
The Departments of Radiodiagnosis* and General Surgery**, Faculty of Medicine, Cairo University
author
text
article
2018
eng
Abstract Background: Breast cancer in women represents a major public health problem being the most common cancer among women in both developed and developing countries, it accounts for 22.9% of all new female cancers. In Egypt breast cancer accounts for 37.7% of the total new cancer cases. Contrast Enhanced Spectral Mammography (CESM) is an emerging advanced technique that depict breast tumor angiogenesis. CESM as an adjunct to Mammography (MG) with or without Ultrasound (US) has higher diagnostic accuracy compared to MG with or without US.Aim of Work: To evaluate the diagnostic accuracy of contrast enhanced spectral digital mammography versus the digital mammography in assessment of indeterminate breast lesions in patients after breast conservation surgery.Patients and Methods: 20 female patients under follow-up after breast conservative surgery presenting with indeter-minate/suspicious breast lesion on mammography had been evaluated by dual-energy contrast enhanced spectral mam-mography. The age ranged from 40 to 65 years (mean=50.3). Results of histo-pathological examinations of surgical or biopsy specimens were obtained and served as the gold standard. Results: The surgical and pathological results of our patients revealed 6/20 (30.0%) benign lesions and 14/20 (70.0%) malignant lesions. CESM had a sensitivity of 85.7%, a specificity of 71.4%, a positive predictive value of 92.3%, a negative predictive value of 71.4% compared to digital mammography results which were 71.4%, 71.4%, 90.9% and 55.6% respectively.Conclusion: CESM is a promising tool for increasing the sensitivity and the diagnostic accuracy of conventional mam-mography in follow-up of patients with breast conservative surgery.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
2011
2017
https://mjcu.journals.ekb.eg/article_56935_9dbe6136a64fe6692868f9fc0ec22500.pdf
dx.doi.org/10.21608/mjcu.2018.56935
Clinicopathological Significances of EZH2 & Twist-1 Combined Expressions in Renal Cell Carcinoma (RCC)
ABLA S. MAHMOUD, M.D.;
DINA A. KHAIRY, M.D.
The Department of Pathology, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
author
text
article
2018
eng
Abstract Background: Renal cell carcinoma (RCC) is considered the commonest and most fatal malignant neoplasm of the kidney. Distant metastases are found in 30% of RCC patients at diagnosis, which is considered an important sign of predic-tion of patients' prognosis. So trying to clarify molecular mechanisms of metastases in RCC could help to discover a recent therapeutic target to decrease and control distant metastases and subsequently might improve patients prognosis.Aim of the Study: Was to assess the EZH2 & Twist-1 combined expressions in RCC tissues with different histopatho-logical subtypes and to correlate their expression with clin-icopathological parameters.Material and Methods: We have assessed expression of EZH2 & Twist-1 in tissue by using immunohistochemistry in 50 paraffin blocks of RCC different histopathological subtypes, analyzed correlations between the levels of combined expres-sions and clinicopthological data. Results: Increased EZH2 expression was positively asso-ciated with advanced AJCC stage, Lymph Node (L.N) metas-tases (p=0.006), higher grade (p<0.001), and presence of distant metastases (p=0.045). Increased Twist-1 expression was positively associated with higher grade, L.N (p<0.001) & distant metastases (p=0.04) and AJCC stage (p=0.01). Both EZH& Twist-1 expressions were positively correlated to each other (p<0.001).Conclusion: EZH2 & Twist-1 are considered markers of poor prognosis in RCC and so they could be used as novel therapeutic targets in RCC patients.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
2019
2028
https://mjcu.journals.ekb.eg/article_56936_97a55a4c04ccef7d18640e76a7948e96.pdf
dx.doi.org/10.21608/mjcu.2018.56936
Assessment of Infection Control Knowledge Among Hemodialysis Patients in Kasr Al-Ainy Hospitals
MONA SOLIMAN, M.D.;
YASSIN S. IBRAHIM, M.D.
author
NOHA A. OSMAN, M.D.;
HODA I. RIZK, M.D.
author
SALMA A.
SEDDIK, M.Sc.
The Departments of Public Health & Community Medicine* and Internal Medicine**, Faculty of Medicine, Cairo University
author
text
article
2018
eng
Abstract Background: Chronic Kidney Disease (CKD) is considered a public health issue. End-Stage Renal Disease (ESRD) is the form of CKD in which life can be sustained by dialysis or transplantation. In Egypt ESRD is one of the main health problems. Patients receiving Hemodialysis (HD) are at risk of acquiring infections as Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV). As Devices used in dialysis units create an access site, Patients should be educated on how to keep the access site clean and dry and to recognize and report any signs and symptoms of infection immediately.Aim of the Study: This study was conducted to assess the baseline knowledge in Infection Control (IC) among chronic HD patients and to detect rate of seroconversion from hepatitis B & hepatitis C negative to positive among them.Subjects and Methods: A cross sectional study design was conducted in the HD units at Kasr AlAiny hospitals. Patients with CKD stage 5D on regular HD participated in the study [two HD units are present in Kasr Al-Ainy Hospitals; 60 patients in unit (1) and 50 patients in unit (2)]. Results: Regarding the IC knowledge of the HD patients, the median total score was 6/10 (4-10) in unit (1) and 6/10 (2-10) in unit (2). Regarding rate of seroconversion from HCV negative to HCV positive; in unit (1) one patient out of 65 was seroconverted in 2015. In unit (2); one patient out of 22 was seroconverted in 2014, one patient out of 28 was seroconverted in 2015, and one patient out of 30 was serocon-verted in 2016.Conclusion: IC knowledge of chronic HD patients was generally low regarding the BSIs that they are at risk for, how to protect themselves and the IC practices that nurses should follow with them.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
2029
2034
https://mjcu.journals.ekb.eg/article_56938_253b07df7988e8cffe000c3354edaf3e.pdf
dx.doi.org/10.21608/mjcu.2018.56938
Predictors of Infection and Mortality in Living Donor Liver Transplantation
WESAM S. MORAD, M.D.;
AMR M. AZIZ, M.D.
author
AMAL
EL-SHARNOBY, M.D.
The Departments of Epidemiology & Preventive Medicine*, Hepatopancreato-Biliary Surgery** and Clinical Pathology***, National Liver Institute, Menoufiya University, Menoufiya, Egypt
author
text
article
2018
eng
Abstract Background: Infection is the most frequent cause of morbidity and mortality following liver transplantation in Egypt.Aim of the Study: This study was directed at assessing the frequency of infection occurring in the early postoperative period and the possible associated preoperative, operative, and postoperative predictors of infection and mortality in patients underwent living related liver transplantation at National Liver Institute.Patients and Methods: This was prospective cohort hos-pital based study described rate of infections occurring in the early postoperative period and their predictors as well as predictors of mortality. It was carried out on 40 living donor liver transplantation patients' who provided informed consent to participate. Participants were interviewed to gather predictor factors data using multiple question model previously prepared questionnaire, biophysiologic measures and observation checklist. Results: Living donor liver transplantation complicated Infection was 68.8% in which 59.1% of infection episodes occurred in the first month post transplantation and the incidence declined thereafter. High infection rate was associ-ated with prolonged operative time (14.8±3.07). Infection induced mortality was 77.8%.Conclusion: Most of infection episodes induced mortality occurred in the first month post liver transplantation due to bad selection of donors which were associated with risk factors of infection and predictors of mortality. Recommendations: Careful evaluation of donor and re-cipient prior to liver transplantation prevents serious post transplantation infection, either by excluding risky donors or by defining the need for specific antimicrobial therapy post liver transplantation.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
2035
2043
https://mjcu.journals.ekb.eg/article_56939_213d4c1699a0b13ac5b2ffcb886f075f.pdf
dx.doi.org/10.21608/mjcu.2018.56939
Insulin Glargine 100 Units/mL Alone or in Combination with Short-Acting Insulin in the Management of Uncontrolled Type 2 Diabetes Mellitus: A Prospective Real-Life Study from Egypt (DIAMOND)
MOHAMED KHATAB, M.D.;
MOHAMED REDA, M.D.
author
MOHAMED
ZEITON, M.D.
The Department of Internal Medicine, Diabetes & Endocrine Unit, Faculty of Medicine, Cairo*, Ain Shams** and
Alexandria*** Universities, Egypt
author
text
article
2018
eng
Abstract Background: Recent reports reveal growing evidence of the effectiveness of insulin glargine (Lantus®), a long-acting human insulin analogue, in the management of poorly con-trolled type 2 diabetes mellitus (T2DM). In the present real-life study.Aim of the Study: To investigate the safety and efficacy of insulin glargine in treating patients with T2DM that are poorly controlled on oral anti-diabetic drugs (OADs).Subjects and Methods: In this prospective observational study conducted in Egypt from 2014 to 2016, a total of 1008 people with poorly controlled T2DM were enrolled, and for whom the investigator decided to prescribe insulin glargine with or without short-acting insulin. The decision of adding-on OADs or short-acting insulin was left to the investigators to reflect the "in-practice" approach. Patients were followed up for six months and efficacy and safety outcomes were measured throughout the study period. The primary efficacy endpoint was the change in HbA1c levels from the baseline to the final visit. Results: At the end of follow-up, the mean HbA1c levels decreased significantly from 9.6±1.3% at the baseline to 7.3±0.9% (p<0.00 1). After three months of treatment, 10.2% of the patients achieved the targeted HbA1c £7%, and 1.6% of the patients achieved HbA1c £6.5%. At sixth months, 34.8% of the patients achieved the targeted HbA1c £7%, and 10.7% of the patients achieved HbA1c £6.5%. The differences between patients receiving insulin glargine, with or without OADs, and patients receiving insulin glargine plus short-acting insulin were not statistically significant (p>0.05). A total of 17 hypoglycemia events (11 categorized as serious) and one hyperglycemic event were recorded.Conclusion: Under real-world clinical practice insulin glargine 100U/ml as add-on to OADs, or in combination with prandial insulin, demonstrated a good efficacy and safety profile in people with T2DM uncontrolled previous on OAD therapy.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
2045
2050
https://mjcu.journals.ekb.eg/article_56942_68cbb0b8a24363f2cbf864686e8b6a61.pdf
dx.doi.org/10.21608/mjcu.2018.56942
Comparative Study between Subfoveal Choroidal Thickness in Glaucomatous Eyes Versus Normal Eyes Using Spectral Domain Optical Coherence Tomography
SAFAA GALAL, M.Sc.;
MOHAMMAD M. KHAFAGY, M.D.
author
HEBA M. AHMED, M.D.;
SOHEIR M. ESMAT, M.D.
The Department of Ophthalmology, Faculty of Medicine, Cairo University
author
text
article
2018
eng
Abstract Background: There has been increasing interest in inves-tigating the role of the choroid in the pathogenesis of glauco-matous optic neuropathy. While measurement of choroidal thickness by spectral domain optical coherence tomography (SD-OCT) would be an attractive addition to the armamentar-ium of diagnostic and monitoring tools in glaucoma, the potential role of choroidal thickness as a risk factor requires further investigation.Aim of the Study: To compare subfoveal choroidal thick-ness measurements in primary angle closure glaucoma (PACG), primary open angle glaucoma (POAG) patients, and normal control group, and to correlate between the subfoveal choroidal thickness with each of the average peripapillary retinal nerve fiber layer (RNFL) thickness, the average ganglion cell complex (GCC) thickness, as well as Humphrey field Analyzer parameters in these patients mainly the mean deviation (MD) and pattern standard deviation (PSD).Patients and Methods: Cross sectional observational case-control study. The study included 124 eyes; 40 eyes of PACG patients, 42 eyes of POAG patients and 42 eyes of normal controls. Measurement of the subfoveal choroidal thickness was done using SD-OCT in The Investigative and Laser Unit of The Ophthalmology Department of Kasr Al-Ainy Hospital. Results: There was no significant difference in subfoveal choroidal thickness among normal eyes, eyes with POAG and eyes with PACG (All p-values >0.05). There was a significant positive correlation between choroidal thickness and average RNFL thickness (r=0.804, p-value <0.001).Conclusion: Lack of a significant difference in subfoveal choroidal thickness among normal eyes, eyes with POAG and eyes with PACG. A significant positive correlation existed between choroidal thickness and average RNFL thickness.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
2051
2058
https://mjcu.journals.ekb.eg/article_56945_804e7fd6cb260a4c8a9bffb884d4d72c.pdf
dx.doi.org/10.21608/mjcu.2018.56945
Efficacy of Including Interferential Current Therapy in the Rehabilitation Program of Children with Functional Constipation
IKRAM I. ALYAN, M.D.;
MONA S.H. MAKHLOUF, M.D.
The Departments of Rheumatology & Rehabilitation* and Pediatrics**, El-Galaa Teaching Hospital, Cairo
author
text
article
2018
eng
AbstractAim: To determine the effectiveness of addition of inter-ferential current (IF) stimulatory current to the other conven-tional therapeutic tools related to childhood functional con-stipation (FC).Methods: Children suffering from FC were recognized according to Rome-III criteria of constipation. Two treatment groups, the case group (n=40) underwent IF electrical stimu-lation added to pelvic floor muscle (PFM) exercises and the control group (n=40) received PFM exercises without IF stimulation. A full bowel history with regarding data on defecation frequency/week, form of stool, and the number of fecal soiling episodes/day), a constipation score questionnaire, a visual pain score, a constipation related quality of life questionnaire (QOL) were noted before, after the treatment sessions and 6 months later for all participants.Results: The median of constipation score was decreased in both groups with the cases having lower scores after the treatment (p<0.089 and p<0.0001 respectively). Significantly a better outcome for pain score (p<0.0001) was also observed among the cases after the 6 months follow-up. Fecal soiling episodes/day were reduced after treatment in both groups; this finding was significant in the case group in relation to controls. The constipation-related QOL score has significantly improved all participants.Conclusion: IF stimulatory current was associated with better results in the efficacy of treatment of chronic cases suffering from FC and it should be added to conventional therapy as a part of the rehabilitation program.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
2059
2064
https://mjcu.journals.ekb.eg/article_56947_03f5bd60e7a2772c68b4eba272187b7f.pdf
dx.doi.org/10.21608/mjcu.2018.56947
Model of End Stage Liver Disease Score and Hepatocellular Carcinoma
HANY SHABANA, M.D.;
MOHAMED ASKAR, M.D.
author
MOHAMED ELRAKHAWY, M.D.;
MOHAMED HARAS, M.D.
author
text
article
2018
eng
Abstract Background: Hepatocellular carcinoma (HCC0 is the most common primary hepatic malignancy worldwide [1]. It is the first cause of cancer mortality in Egypt [2] due tothe heavy burden of chronic HCV (14.7%). Among cirrhotic patients, 1-4% per year will develop HCC [3]. HCC patients evaluated for liver transplantation are often given exceptional MELD score, giving them a priority for liver transplantation. We aimed at determining the MELD score in HCC patients, its correlation with TNM tumour stage and tumour size. Also, we aimed at determining a cut off value of MELD score above which chronic HCV (CHC) cirrhotic patients have high chance to develop HCC.Aim of Work: To determine the actual MELD score in HCC patients, its correlation with TNM stage and tumour size. Also, we aimed at termining a cut off value of MELD score above which chronic HCV (CHC) cirrhotic patients have a high chance to develop HCC.Material and Methods: The study included 98 patients with CHC and HCC (group I) and 219 patients with CHC without HCC (group II). CHC was diagnosed by ELISA for HCV Antibody and serum HCV RNA. HCC diagnosis was based on EASL criteria i.e. focal hepatic lesion with arterial phase enhancement and washout in portal and delayed phases, obtained by contrast enhanced abdominal CT and/or MRI. HCC was staged according to the seventh edition TNM tumour staging system. MELD score was calculated using the follow-ing formula: MELD score=10 *[(0.957*In (Creatinine)] + [0.378*In (Bilirubin)] + [1.12*In (INR)] + 6.43. We used the MELD score calculator of the liver application of the EASL. We computed ROC curve for MELD score concerning the prediction of HCC. Stratum specific likelihood ratio (SSLR) was calculated as the pro-portion of diseased subjects (HCC) with a test result in a given range divided by the proportion of non-diseased subjects (non HCC) with a test result in the same range [4].Results: MELD score was significantly higher in group I than group II. The score was 9.71±4.08 in group I versus 5.61±3.25 in group II (p£.000). In group I the MELD score ranged from 0.7 to 20.33. There was significant positive correlation between MELD score and TNM tumour stage (r=0.3 12, p=0.002) but the correlation was insignificant as regards the tumour size (r=0.041, p=0.687). The distribution of TNM tumour stage in group I was as follows: Stage I represented 19.3%, stage II represented 25.5%, stage IIIa represented 19.3%, stage IIIb represented 18.3%, stage IIIc represented 1%, stage IVa represented 8% and stage IVb represented 7%. The cut off value of MELD score above which there was a high risk of HCC development was ³5.74. The area under the curve (AUC) was 78.3%, sensitivity was 87.8%, specificity was 56%, positive predictive value (PPV) of 46.7%, negative predictive value (NPV) of 91%, accuracy of 65.3% and positive likelihood ratio (LR) of 1.96. The SSLR for HCC presence by MELD score was 0.21 in score <5, 0.97 in score from 5 to 10 and 4.57 in score >10.Conclusion: MELD score has significant positive corre-lation with TNM tumour stage in HCC cases. CHC patients with MELD score >10 have SSLR for HCC presence of 4.57 and are in need for closer follow-up.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
2073
2078
https://mjcu.journals.ekb.eg/article_56950_a8250515ef62db41f5453700b8fbcbd3.pdf
dx.doi.org/10.21608/mjcu.2018.56950
Effect of Preoperative Instructions for Mothers on Selected Postoperative Outcomes Among their Children with Hypospadias
WALAA M. KAMEL, M.Sc.;
SOHEIR A. MOHAMED, D.N.Sc.
author
MARWA A. IBRAHEIM, D.N.Sc.;
MOHAMED H. AHMED, M.D.
The Departments of Pediatric Nursing, Faculty of Nursing* and Pediatric Surgery**, Faculty of Medicine, Cairo University, Egypt
author
text
article
2018
eng
Abstract Background: Hypospadias is the most common birth defect among children affecting the penis characterized by ventral position of urethral meatus in which caused by arrest of normal development of the urethra.Aim of Study: To evaluate the effect of preoperative instructions for mothers on selected postoperative outcomes among their children with hypospadias.Subjects and Methods: A quasi-experimental research design (Pre-Posttest) was used to achieve the aim of the current study. A convenient sample of 60 mothers having male children undergoing surgical repair of hypospadias participated in the current study, divided into two equal groups: 30 as a control group and 30 as a study group who were subject to the preoperative instructions. The setting was in-patient pediatric surgical department at Cairo University Specialized Pediatric Hospital (CUSPH). The required data was collected through: 1- Structured interview (questionnaire); 2- Mothers' knowledge and reported practice assessment sheet (pre-posttest) and 3- Postoperative outcomes assessment record. Results: The study's results revealed that, children in the study group exposed to less early postoperative complications such as (bleeding, wound dehiscence, urinary obstruction and urinary catheter fall) than children in the control group. Late postoperative complications (fistula, meatal stenosis, urethral obstruction and infection) occurred in children in the study group less than those in the control group. Children in the study group had appropriate cosmetic appearance of the penis and functional outcome than children in the control group.Conclusion: The current study concluded that children whom mothers received the preoperative instructions about hypospadias had improved outcomes in relation to less com-plications, higher cosmetic and functional outcomes than children in the control group. Recommendation: It was rec-ommended that provision of pre and post-operative care of children undergoing hypospadias repair is mandatory to achieve satisfactory postoperative outcomes.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
2079
2090
https://mjcu.journals.ekb.eg/article_56952_ae2c15cdf6df6da5608190c310e62db7.pdf
dx.doi.org/10.21608/mjcu.2018.56952
Audit on the Application of Surfactant in Premature Babies in Assiut University Children Hospital
RAFIK M.B. HANNA, M.Sc.;
GIHAN M. KAMAL EL-DEIN, M.D.
author
ZEINAB
M.M. EL-KADY, M.D.
The Department Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt
author
text
article
2018
eng
Abstract Background: To evaluate the use of exogenous natural surfactant for Respiratory Distress Syndrome (RDS) in pre-mature babies, identify areas where European Consensus Guidelines on the Management 2013 Update, modified by The Egyptian Consensus on the Management of Neonatal Respiratory Distress Syndrome in Preterm Infants 2014 are applied to as a reference standard in Assiut University Children Hospital and identify those points to be targeted for improve-ment.Patients and Methods: A retrospective audit was under-taken over a 12-month period between 1st of January, 2016 to the 31st of December 2016. It included all babies less than 37 weeks gestation with respiratory distress syndrome who received surfactant as a rescue treatment, guided by European Consensus Guidelines on the Management 2013 Update, modified by The Egyptian Consensus on the Management of Neonatal Respiratory Distress Syndrome in Preterm Infants 2014 and admitted to Neonatal Intensive Care Unit of Assiut University Children Hospital during this period. Results: All cases with severe respiratory distress that needed surfactant injection and admitted in Assiut university children hospital from 1st of January to 3 1th of December 2016 were included in the study. The study included 50 patients with severe respiratory distress syndrome.Conclusion: Surfactant replacement therapy has been available for about 37 years, revolutionizing neonatal respi-ratory care after its introduction in the 1980s. Along with antenatal steroids, surfactants improve survival for preterm babies and they are now recommended routinely as early in the course of Respiratory Distress Syndrome (RDS) as possible. The present study aimed to evaluate the use of surfactant for Respiratory Distress Syndrome (RDS) in premature babies admitted at NICU of Assiut university children hospital during the period from 1st of January to 31st of December 2016 using European Consensus Guidelines on the Management 2013 Update, modified by The Egyptian Consensus on the Manage-ment of Neonatal Respiratory Distress Syndrome in Preterm Infants 2014.The study included 50 cases with respiratory distress syndrome who received surfactant therapy.Data of the study showed that treatment regimens for cases of RDS in Assiut University Children Hospital partially followed the reference standard of the study concerning application of surfactant in premature babies.•Data of the gestational age and weight and sex were recorded in 100% of cases.•Data concerning clinical evaluation of the studied group were recorded in 100% cases.•Data concerning obstetric history and prenatal care were fulfilled well but there were no records concerning receiving a course of antibiotics if there is preterm, pre-labor rupture of membranes nor short term tocolytic drugs. Also, the data showed that only 28% of mothers received a course of prenatal steroids if preterm labor was expected.•Data concerning delivery room stabilization were fulfilled well but there were no records concerning delayed cord clamping and there was no available CPAP at the delivery room nor plastic bag for stabilization of preterm baby with respiratory distress syndrome.•Data concerning surfactant therapy were fulfilled well but there was no data that any case received prophylactic surfactant therapy neither with nor without INSURE tech-nique.•Data concerning respiratory support were fulfilled well but no cases received CPAP as a 1st line respiratory support for any spontaneously breathing preterm with RDS at delivery room and no cases received CPAP with early rescue surfactant which is now considered the optimal management for babies with RDS.•Data concerning supportive care were fulfilled in 100% of cases but no cases received enteral feeding from the 1st day which is strongly recommended with careful fluid balance for early aggressive nutritional support.•Data concerning prognosis showed that the vast majority of dead cases were below 32 weeks and below 1KG.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
2091
2099
https://mjcu.journals.ekb.eg/article_56954_2698e5dd615403ee5cde1bbedadfa8a1.pdf
dx.doi.org/10.21608/mjcu.2018.56954
Bladder Sparing Protocol with Tri Modality Therapy (TMT) “A Prospective Study”
SAMI A. ABBAS, M.D.*;
ALAA A. EL-SHENNAWY, M.D.
author
AYMAN M. EDREES, M.D.;
MOHAMMAD K. SAIFELNASR, M.D.
author
MOHAMED FAWZY, M.D.;
MARWA N. ABDEL-HAFEZ, M.D.
author
text
article
2018
eng
Abstract Background: To evaluate the response of the modern bladder-preservation treatment modality; trimodal therapy (TMT) in muscle-invasive bladder cancer (MIBC). Aiming at bladder preservation in MIBC, TMT was to offer a quality-of-life advantage and avoid potential morbidity and mortality of radical cystectomy (RC) without compromising oncologic outcomes.Aim of Study: To investigate the TMT as a treatment option for muscle-invasive bladder cancer confirmed by cancer specific and overall survival rates in two different institutes.Material and Methods: The study included 64 consecutive patients between 2008 and 2013, and was conducted in National Institute of Urology and Nephrology, Cairo, Egypt, Al-Azhar University, Girls Div., Urology Dept., Cairo, Egypt and National Cancer Institute, Cairo University, Cairo, Egypt. Forty nine patients were males and 15 were females. Mean age was 61±9 years (range, 34-82 years). Sixty nine percent of patients (44) were below 65 years old while 31% (20) were above 65. Sixty six percent (42 patients) were fit for surgery but refused RC as first line of treatment and 34% (22 patients) were unfit for surgery. Results: One third of patients (20) failed TMT and under went RC. Five years overall survival (OS) was 57% and disease specific survival (DSS) was 61%. There was no significant difference observed in OS or DSS between different age, sex or surgical fitness patients groups. Tumor stage showed significant statistical difference between T2 and T3 (p<0.05). Lymph nodes disease progression and distant me-tastases were recorded in 13 and 10% with TMT respectively.Conclusion: This study suggests that bladder preservation with TMT leads to acceptable outcomes comparable with RC and therefore may be considered a reasonable treatment option in well-selected patients.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
2101
2108
https://mjcu.journals.ekb.eg/article_56957_0e89e2131272874c6e7d63afd557dec9.pdf
dx.doi.org/10.21608/mjcu.2018.56957
Effectivness of Micropore Tape in Treatment of Hypertrophic Scar after Wrist Burn
WAFAA BORHAN, Ph.D.;
NESSRIEN A. ABDEL RASHID, Ph.D.
author
WAEL N. THABET, M.D.;
AHMED R.A. Ali, M.Sc.
The Department of Physical Therapy for Surgery & Burn, Faculty of Physical Therapy* and The Department of General Surgery, Faculty of Medicine**, Cairo University, Egypt
author
text
article
2018
eng
Abstract Background: Burns are caused by exposure to excessive heat as flame, hot surfaces, scalding liquids, friction, electricity and chemical burns. Hypertrophic scarring is a frequent and undesirable complication of burn injuries.Aim of Study: This study was conducted to investigate the effectiveness of micropore tape in treatment of hypertrophic scar after wrist burn.Subjects and Methods: Thirty patients complaining of hypertrophic scar after wrist burn selected from learning hospitals (Al-Kaser Al-Ayni Hospital and Om El-Masryeen Hospital) in Cairo shared in this study. Their ages were ranged from 20 to 45 years. Patients who are suffering from malignant tumors, patients with 3rd degree burns of wrist and patients with major burns covering more than 20% of TBS were excluded from this study. They were divided into two equal groups: Group (A) who received micropore tape treatment in addition to normal physical therapy program (stretching exercises and strengthening exercises), routine medical treat-ment and traditional care (dressing) 30 minutes 3 sessions/ week for 12 weeks. Group B who received normal physical therapy program (stretching exercises and strengthening exercises), routine medical treatment and traditional care (dressing) 30 minutes 3 sessions/ week for 12 weeks. Pigmen-tation, vascularity, pliability and height were measured by Vancouver scar scale. Results: The results showed that there is significant difference in Vancouver scar scale in group A pre and post treatment and there is significant difference in Vancouver scar scale in group B pre and post treatment and there is a significant difference in Vancouver scar scale between group A and B pre and post treatment as group A improved more than group B.Conclusion: It can be concluded that micropore tape with physical therapy treatment has an effect on hypertrophic scar after wrist burn more than physical therapy only.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
2109
2113
https://mjcu.journals.ekb.eg/article_57135_9726c8efdd1af17b3a32aedc1f3a0f68.pdf
dx.doi.org/10.21608/mjcu.2018.57135
Effect of Conductive Education on Motor Functions for Children with Cerebral Palsy: Systematic Review
FATEN HASSAN ABD EL-AZIM, Ph.D.;
SHIMAA MOAHMED REFAAT, Ph.D.
author
RAFIK
FAYEZ ATTIA, M.Sc.
The Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University* and Physical Therapy Department, Health Insurance of Egypt
author
text
article
2018
eng
Abstract Background: The purpose of this systematic review is to investigate the effect of conductive education on motor func-tionsin children with cerebral palsy.Aim of Study: The aim of this systematic review was to examine the literature on the effectiveness of conductive education onmotor functions in children with cerebral palsy.Subjects and Methods: Search was made on children with cerebral palsy aged from1 to 16 years. Search was made in Pubmed, Pedro, Cochrane and goggle scholar web site up todate. Systematic review of randomized controlled trials, the intervention used was Conductive Education as a group programs four studies were selected according to inclusive and exclusive criteria and descriptive analysis was conducted due to heterogenity. Outcomes effect of Conductive Education on the primary outcomes were motor functions and secondary outcomes were the activities of daily living. Results: Conductive Educationhad a significant effect on Motor Functions (gross and fine) and significant effect on the activities of daily living in children with cerebral palsy with maintenance of this effect fora long period of time but, no superiority comes from using it when compared with intensive therapy programs.Conclusion: The current level of evidence supports the effectiveness of conductive educationfor improving motor functions in children with cerebral palsy.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
2115
2121
https://mjcu.journals.ekb.eg/article_57136_1a2c57d41deb4bb7e651271fab9f750a.pdf
dx.doi.org/10.21608/mjcu.2018.57136
Metabolic Acidosis after Orthotopic Detubularized Ileocaecal Pouch versus Ileal Neobladder (Y Pouch)
ABDALLA M. EL-AZAB, M.Sc.;
SHARIF ABD AL-KARIM, M.Sc.
author
MOHAMMED S. MOHAMMED, M.D.;
AMRO A. ATTIA, M.D.
The Department of Surgical Oncology, National Cancer Institute, Cairo University, Egypt
author
text
article
2018
eng
Abstract Background: To compare metabolic acidosis early and late following orthotopic detubularized ileocaecal pouch versus ileal neobladder (Y pouch) after radical cystectomy for invasive urinary bladder cancer.Aim of Study: To compare metabolic acidosis early and late following orthotopic detubularized ileocaecal pouch versus ileal neobladder (Y pouch) after radical cystectomy for invasive urinary bladder cancer.Patients and Methods: Patients presenting to the National Cancer Institute, Cairo University from March 2014 to April 2015; Acid base disturbance and metabolic acidosis were measured in 31 patients with orthotopic detubularized ileo-caecal pouch versus 31 patients with ileal neobladder (Y pouch) with mean follow-up every 2 months for 1 year post-operative. Results: In ileal neobladder (Y pouch), Mild Metabolic acidosis was noticed in seven patients (25.9%) in comparison to nine patients (32.1%) in orthotopic detubularized ileocaecal pouch with no significant changes between both groups.Conclusion: There is no significant difference in relation to metabolic acidosis between orthotopic detubularized ileo-caecal pouch versus ileal neobladder after radical cystectomy.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
2123
2126
https://mjcu.journals.ekb.eg/article_57137_14177ef87001b7e1ca21b5d3ef612b1c.pdf
dx.doi.org/10.21608/mjcu.2018.57137
Effect of Nursing Guidelines for Nurses on Occurrence of Selected Post Therapeutic Cardiac Catheterization Complications Among Children
SALMA G. MOHAMED, M.Sc.;
AFKAR R. MOHAMED, D.N.Sc.
author
MARWA A. IBRAHEIM, D.N.Sc.;
AMAL M. ELSISI, M.D.
The Department of Pediatric Nursing, Faculty of Nursing* and Department of Pediatric Cardiology**, Faculty of Medicine, Cairo University, Egypt
author
text
article
2018
eng
Abstract Background: Pediatric cardiac catheterization has shifted from a diagnostic tool to a therapeutic one and now more applicable for therapeutic reasons.Aim of Study: The aim of the current study was to evaluate the effect of guidelines for nurses on occurrence of selected post therapeutic cardiac catheterization complications among children.Subjects and Methods: Quasi-experimental design (Pre-Posttest) was used to achieve the aim of the current study. A convenient sample of 30 nurses and 60 children having cardiac defects undergoing cardiac catheterization were participated in the current study; children were divided into two equal groups: 30 as a control group and 30 as a study group and nurses were the same for the study and control group of children. The current study was conducted at post cardiac catheterization Intensive Care Unit at Cairo University Spe-cialized Pediatric Hospital (CUSPH). The required data was collected through: 1- Structured interview (questionnaire); 2- Nurses's knowledge and observed practice assessment sheet (pre-posttest) and 3- Post cardiac catheterization assessment sheet. Results: The study's results revealed that, children in the study group exposed to less post cardiac catheterization complications such as weak or absent pulse, hypotension and hypothermia; than children in the control group. There was statistically significance difference between the total mean score of nurses' knowledge before and after implementation of the nursing guidelines.Conclusion: The study concluded that nurses who received nursing guidelines sessions had improved outcomes in relation to less complications on children they were caring. Recom-mendation: It was recommended that provision of nursing guidelines of children undergoing cardiac catheterization is mandatory for fewer occurrences of complications. Simple Arabic illustrated booklet about cardiac catheterization care for children undergoing CC should be available in every post CC unit.
The Medical Journal of Cairo University
The Clinical Society of Cairo University
0045-3803
86
v.
June
no.
2018
2127
2139
https://mjcu.journals.ekb.eg/article_57138_4c483ffa5f5331df5f25e65f507dcaf9.pdf
dx.doi.org/10.21608/mjcu.2018.57138