ORIGINAL_ARTICLE
Asymmetric Diabetic Retinopathy and Carotid Insufficiency: A Correlative Study
AbstractBackground: Diabetic retinopathy occurs in both type 1 and type 2 diabetes mellitus and has been shown that nearly all type 1 and 75% of type 2 will develop diabetic retinopathy after 15 years duration of diabetes as shown in epidemiological studies. In western population, diabetic retinopathy has been shown to be the cause of visual impairment in 86% of type 1 diabetic patients and in 33% of type 2 diabetic patients [1].Aim of Study: To detect a relationship between carotid system insufficiency and the presence of asymmetric diabetic retinopathy in diabetic patients.Patients and Methods: A descriptive cross sectional non-controlled non-randomized study was carried between August 2011 and March 2012 on 20 patients with asymmetric diabetic retinopathy graded and documented with fundus fluorescein angiography (FFA). Assessing the carotid system patency and flow parameters using duplex Ultrasound was then done. Primary outcome was to find a correlation between the diabetic retinopathy asymmetry and carotid system insufficiency in terms of presence of atheromtous plaque, increased intima media thickness (IMT) or decreased flow parameters.Results: 50% of cases had a degree of carotid insufficiency. The degree of carotid insufficiency in either common carotid artery and/or internal carotid artery ranged from 15% to 50% stenosis. And 10% had increased IMT and 15% had increased RI all on the ipsilateral side of the eye with more advanced diabetic retinopathy. And an overall 45% increase in IMT.Conclusion: Asymmetric diabetic retinopathy is considered to be the exception rather than the rule as DR is usually symmetric. We found that Carotid stenosis is a contributing factor in causing such asymmetry. So presence of asymmetric DR urges early investigation for detecting carotid system insufficiency and carotid plaques to avoid future strokes.
https://mjcu.journals.ekb.eg/article_53376_e0bda43f6a45b8f5f34ccc7af322d204.pdf
2019-06-10
1331
1335
10.21608/mjcu.2019.53376
Asymmetric diabetic retinopathy
Carotid stenosis
Carotid plaque
MAY I. EL-RASHEDY, M.Sc.;
MALAK I. EL-SHAZLY, M.D.
1
AUTHOR
FOAD A. ABD ALLAH, M.D.;
ABD EL-AZIZ A. SAAD, M.D.
2
The Departments of Ophthalmology* and Neurology**, Faculty of Medicine, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Improving Nutritional Status of Egyptian School Children by A Food-Based Natural Enhancer (Orange and Fish) to Iron Absorption and Omega 3 Supplement
AbstractBackground: Iron Deficiency is a major health problem in Egypt, especially among children. Several approaches have been used to alleviate such a problem, one of which is dietbased programs. Ascorbic acid has been shown to be an enhancer of iron bioavailability and is readily available in Egypt. Omega-3 is polyunsaturated essential fatty acid which can't be constructed by the body and must be obtained throughdiet and is important for human health. Omega-3 fatty acids sources include salmon, sardine, tuna, mullet and olive and canola oils. Omega-3 fatty acids have anti-inflammatory properties and are helpful in treatment of many diseases. Aim of Study: The present study was designed to determine if nutritional status could be improved by using a simple school food-based approach of an enhancer (orange and fish) to iron absorption and omega 3 fatty acid supplements.Subjects and Methods: The first phase of the study started in January 2016, and the second phase in November 2016, and the oranges and fish (tuna sandwich) were served within the school lunch program to a group of school children. The period of intervention was 2 months in the 1 st phase, and 4months in the 2nd phase, to assess the effect of longer periods of intervention. The oranges and fish (tuna sandwich) were provided 6 days a week for both phases duration. A school meal (biscuits fortified with iron) was also provided to those receiving the oranges and tuna sandwich and to the control group who did not receive either orange or fish (tuna sandwich).The children were tested for their hemoglobin, serum ferritin and omega 3 index levels at the beginning and at end of the designated intervention period. Stool analysis for presence of parasites was also performed.Results: During the first phase, there was slight improvement of the mean levels of hemoglobin, ferritin and omega 3 index due to the short duration of orange and tuna sandwich intake. The mean hemoglobin increased from 12.1g/dL to 12.33g/dL, the mean ferritin increased from 26.2ng/ml to 27.6ng/ml while the omega 3 index increased from 1.8% to 2.2%. One hundred and fifty of the intervention children were below 12g/dL (25%). At the post-test, mean hemoglobin for intervention children was 12.43 ± 1.04g/dL. Control group had a mean hemoglobin level of 11.67g/dL at the end. The same rising trend was also seen in the levels of the serum ferritin and the omega 3 index. About forty percent of the intervention group was found to be infected with at least one parasite. Hemoglobin levels, ferritin and omega 3 index were higher in children with no parasites. Conclusion: The results of this study showed significant improvement in the nutritional status among the intervention group, but not in the control group after providing the oranges and fish (tuna sandwich) for 4 months.
https://mjcu.journals.ekb.eg/article_53422_109ead30e0d99038a11da5d45538c978.pdf
2019-06-10
1337
1348
10.21608/mjcu.2019.53422
Nutritional Status
Iron Deficiency
Orange
Tuna sandwich
Omega 3 fatty acid
Dietary supplement
school children
WESAM MORAD, M.D.;
ALIF ALLAM, M.D.
1
AUTHOR
MOHAMED A. EZZAT, M.D.;
MOHAMED EL-GUINDI, M.D.
2
The Departments of Epidemiology & Preventive Medicine* and Pediatric Hepatology**, National Liver Institute, Menoufia University and The Department of Pediatrics***, Faculty of Medicine, Al-Azhar University
AUTHOR
ORIGINAL_ARTICLE
Evaluation of Surgical-Navigation System in Management of Orbital Disorders
AbstractBackground: Surgical navigation guidance is primarily designed to assist with surgery on bony tissues and closed spaces, it is widely used in neurosurgery and sinus surgery. And since the limited mobility of the soft tissues of the orbit, as they are tightly contained within its bony walls, stereotactic navigation may be a useful tool in orbial surgeries such as tumor excisions, biopsies, orbital wall fractures, and orbital decopmression.Aim of Study: To evaluate whether the use of Frameless surgical navigation is useful and time efficient in removing orbital masses and repairing orbital wall fracture as known to be a helpful tool in Neurosurgery and sinus surgery.Patients and Methods: Prospective interventional non-controlled non-randomized case series study was coducted in Cairo Univeristy Hospitals from June 2013 to December 2014 on 15 patients with primary or recurrent post-septal orbital pathology using the Electromagnetic “FusionTM ENT Naviga-tion System” during the surgery. Primary outcomes were assessing time efficiency through operative times (Total Time, Operating Time and Maintenance Time), extent of mass excision and fracture repair. Secondary outcomes were im-provement in Hertel's readings and detecting complication related to the navigation system.Results: The mean of maintenance time percentage com-pared to the total operating time was 46.7% with SD ±6.1 that lead to relatively longer total operating time, but as more cases were performed, it decreased gradually. Complete excision was achieved in 70% of cases. The p-value for improved Hertel's reading was 0.016 and only one case had significant complications.Conclusion: Although promising results were seen in orbital wall fracture and well circumscribed orbital masses. The Surgical Navigation System cannot yet be considered the standard of care for patients with different orbital pathologies as it prolongs the total operating time. However, it is helpful and promising in complicated cases of recurrent and infiltrative masses and massive trauma, where the normal anatomical landmarks are compromised specially with the evolving updates in improving this technology.
https://mjcu.journals.ekb.eg/article_53425_21ffb829c83359c4540e46715a7a8844.pdf
2019-06-10
1349
1355
10.21608/mjcu.2019.53425
Surgical navigation – Orbital fracture – Orbital mass – Brainlab – Electromagnetic “FusionTM
MAY I. EL-RASHEDY, M.Sc.;
RANIA A. ABDEL SALAM, M.D.
1
AUTHOR
IHAB S.
OTHMAN, M.D.
2
The Department of Ophthalmology, Faculty of Medicine, Cairo University
AUTHOR
ORIGINAL_ARTICLE
First Attack of Status Epilepticus in Adults: Etiology and Risk Factors
AbstractBackground: Status Epilepticus (SE) is a common life-threatening neurological emergency the etiology of SE varies according to age and prior history of seizures. In people known to be epileptic poor compliance and drug withdrawal are the commonest causes of SE. On the other hand in patients with no prior seizure history strokes, head traumas, CNS infections, cardiac arrests and metabolic disturbances are the most com-mon causes.Aim of Study: Is to study the possible etiologies and outcome of first attack of SE in adults.Patients and Methods: This was a 6-month duration cross sectional study done at Neuropsychiatry Department, Tanta University Hospital, started from July 2016. All patients presented by first attack of SE over the age of 18 years and didn't have previous history of SE, were considered.Results: Of 42 patients included in the study 35 (83.3%) had non refractory SE while 7 (16.7%) had RSE. 37 patients survived (88.1%) and 5 patients died (11.9%). Analysis of statistically significant and most clinically important variables showed that these factors were significantly higher in RSE, cryptogenic etiology (p=0.024), EEG changes (p=0.015). number of AEDs (p=0.001), duration of hospitalization (p= 0.037), complications due to hospitalization (p=0.015), EMSE scores (p=0.001).Conclusion: Most patients presented by SE over the age of 18 has no prior history of epilepsy. CVAs are the leading cause of de novo SE in adults followed by metabolic derange-ments. Refractory Status Epilepticus (RSE) is associated with prolonged duration of hospitalization and higher rates of complications compared to non-refractory SE. Complications due to seizures were the most common followed by side effects of AEDs while complications of prolonged hospitali-zation were the least common. EEG monitoring is an important tool both in managing and predicting the outcome of status epilepticus. STESS and EMSE scoring systems are easy to use bed side tools to help in predicting the outcome of SE.
https://mjcu.journals.ekb.eg/article_53426_2192ed5718838789085e86aea6fc883d.pdf
2019-06-10
1357
1361
10.21608/mjcu.2019.53426
status
Epilepticus
risk factors
Etiology
AHMED I. EL-SHEIKH, M.Sc.;
AZZA A. GHALI, M.D.
1
AUTHOR
HASSAN G. NASSAR, M.D.;
WAEL A. FADEL, M.D.
2
The Department of Neuropsychiatry, Faculty of Medicine, Tanta University, Tanta, Egypt
AUTHOR
ORIGINAL_ARTICLE
Serum Epidermal Growth Factor Receptor and p53 in Patients with Acute Myeloid Leukemia
AbstractBackground: Acute myeloid leukemia is a clonal hemat-opoietic disorder that may be derived from either a hemat-opoietic stem cell or a lineage-specific progenitor cell. AML is characterized both by a predominance of immature forms and loss of normal hematopoiesis. p53 is a cell cycle check point control protein that detects DNA damage, controls cell growth, DNA repair and apoptosis. EGFR belongs to a family of receptor tyrosine kinases, it plays an important role in many cancers. Since both markers have a role in cell cycle control, we hypothesized that both p53 and EGFR may have a role in AML.Aim of Study: It was to estimate the levels of p53 and EGFR in the serum of patients with AML.Patients and Methods: The study was carried out on forty newly diagnosed AML patients who were selected from Hemato-Oncology Unit, Internal Medicine Department, Tanta University Hospitals. Also on twenty apparently healthy subjects with matched age and sex served as a control group. All studied subjects were subjected to full history, complete physical examination, estimation of p53 and EGFR levels by ELISA. Data was analyzed by using SPSS.Results: The results demonstrated a significant increase of serum p53 and EGFR levels in AML patients group com-pared to control group. A positive significant correlation was noted between p53 and EGFR. Follow-up of patients' group for 18 months revealed that all patients with low p53 and EGFR levels showed good response to therapy and achieved complete remission while patients with high p53 and EGFR levels showed poor outcome.Conclusion: Estimation of both p53 and EGFR levels could be useful as diagnostic and prognostic biomarkers in AML patients either alone or in combination with other biomarkers.
https://mjcu.journals.ekb.eg/article_53428_b5d4f07c9a7b489d36a768ea9d99a5c9.pdf
2019-06-10
1363
1369
10.21608/mjcu.2019.53428
Acute Myeloid Leukemia
p53
EGFR serum levels by ELISA
MADONNA M. EL-TOUKHY, M.B.B.Ch.;
HEBA A.M. MORAD, M.D.
1
AUTHOR
HOSSAM A. HODIB, M.D.;
WAEL F. MOHAMED FARRAG, M.D.
2
The Departments of Clinical Pathology* and Internal Medicine**, Faculty of Medicine, Tanta University
AUTHOR
ORIGINAL_ARTICLE
Assessment of Efficacy of Platelet-Rich Plasma Injection for Facial Rejuvenation
AbstractBackground: Facial rejuvenation includes different ther-apeutic modalities of returning facial youthfulness. PRP injection delivers very high concentrations of growth factors that lead to accelerated tissue regeneration and remodeling.Aim of Study: The aim of this work was to evaluate the efficacy of single session of intradermal injection of autologous Platelet Rich Plasma (PRP) in facial rejuvenation.Patients and Methods: 20 subjects with different types of facial wrinkles were included in this study. They were selected from Dermatology and Venereology Department, Tanta University Hospitals. All of them received single session of intradermal injection of autologous PRP and were clinically assessed before and 2 months after PRP injection using Wrinkle Severity Rating Scale (WSRS), Skin Texture Scale, and Subject Satisfaction Scale.Results: All subjects showed significant clinical improve-ment of all types of facial wrinkles after PRP injection. At the end of follow-up period, there was statistically significant decrease in Wrinkle Severity Rating Scale (WSRS) comparable to that before PRP injection. Additionally, there was a statis-tically significant improvement of skin texture and subject satisfaction after PRP injection.Conclusion: Intradermal injection of autologous PRP is well tolerated and capable of rejuvenating the face and pro-ducing a significant correction of different types of facial wrinkles.
https://mjcu.journals.ekb.eg/article_53430_7d602a37f0aa44f874ec0f779bb1e52a.pdf
2019-06-10
1371
1376
10.21608/mjcu.2019.53430
PRP
Cutaneous aging
Facial rejuvenation
NOHA N. DOGHIM, M.D.;
RANIA A. EL-TATAWY, M.D.
1
AUTHOR
YOMNA M. NEINAA, M.D.;
ZAMZAM M. IBRAHIM, M.Sc.
2
The Department of Dermatology & Venereology, Faculty of Medicine, Tanta University* and Benha Teaching Hospital, Ministry of Health, Benha**, Egypt
AUTHOR
ORIGINAL_ARTICLE
Role of Multislice Computed Tomography in Acute Right Lower Quadrant Abdominal Pain
AbstractBackground: Acute appendicitis is the most widely rec-ognized reason for right lower quadrant pain. However, various different conditions may cause signs and symptoms that mimic acute appendicitis. Multislice Computed Tomography (MSCT) is currently viewed as the imaging modality of choice in patients presenting with right lower quadrant abdominal pain as it helps to make a definitive diagnosis in most of the cases.Aim of Study: To evaluate the role of MSCT in the iden-tification of numerous etiologies in patients with acute right lower quadrant abdominal pain.Patients and Methods: This work was conducted on thirty patients (20 females and 10 males) who presented with acute right lower quadrant abdominal pain. All patients underwent to detailed history taking, clinical examination, laboratory studies, ultrasound examination and MSCT scanning of the abdomen and pelvis. The correlation was done between the MSCT findings and the final diagnosis. The final diagnosis was made by operative procedures, laparoscopy, histopatho-logical results and conservative management.Results: There were 17 patients (56.6%) with acute ap-pendicitis and appendiceal complications, 6 females (20%) with acute gynecological diseases, 4 patients (13.3%) with other acute gastrointestinal (GIT) diseases and 3 patients (10%) with acute urological diseases. There were 24 patients went through surgery or laparoscopy, 6 patients were managed conservatively with close follow-up. The sensitivity of MSCT in our study was highest in acute GIT diseases and acute urological diseases, then appendicular diseases and the last in acute gynecological diseases.Conclusion: Multislice CT is a significantly valuable noninvasive imaging method for identification and assessment of the most recognized reasons such as appendicitis in addition to the less known conditions.
https://mjcu.journals.ekb.eg/article_53432_2a986e3f352a48b93cd3281af412c0d6.pdf
2019-06-10
1377
1387
10.21608/mjcu.2019.53432
Emergency
Right lower quadrant abdominal pain
Multislice CT
Appendicitis
Differential diagnosis
ASMAA Y. AL-KASABI, M.Sc.;
KHALED I. EL-SHAFEY, M.D.
1
AUTHOR
HALA M. EL-GENDY, M.D.;
AL-SHAYMAA Z. EL-SHAHAWY, M.D.
2
The Departments of Radio-Diagnosis & Medical Imaging* and Anesthesiology & Surgical Intensive Care**, Faculty of Medicine, Tanta University
AUTHOR
ORIGINAL_ARTICLE
Evaluation of Cytoskeleton-Linking Membrane Protein 63 as a Serum Marker for the Early Detection of Hepatocellular Carcinoma
AbstractBackground: Hepatocellular Carcinoma (HCC) is the third most common cause of cancer death worldwide. The burden of HCC has been increasing in Egypt with a doubling in the incidence rate in the past ten years. Subsequently, novel serum markers are needed to improve the diagnostic accuracy of HCC especially with the low sensitivity of a-Fetoprotein (AFP).Aim of Study: Evaluation of serum Cytoskeleton Linking Membrane Protein-63 (CLIMP-63) as a marker for diagnosis of HCC.Patients and Methods: Eighty individuals were included and they were divided into three groups (30 HCC patients, 30 cirrhotic patients and 20 healthy individuals). Samples were collected and serum CLIMP-63 was determined with Enzyme-Linked Immunosorbent Assays (ELISA). The area under the Receiver Operating Characteristic curve (AuROC), sensitivity and specificity of AFP and CLIMP-63 levels were evaluated for diagnostic performance.Results: Serum CLIMP-63 levels in HCC patients were much higher than healthy individuals and cirrhotic patients (p-value=0.001). The AuROC, sensitivity and specificity of serum CLIMP-63 for the diagnosis of HCC were 0.782, 80% and 68%, respectively. The AuROC, sensitivity and specificity of AFP for the diagnosis of HCC were 0.712, 75% and 70%, respectively.Conclusions: Serum CLIMP-63 may be a novel serum biomarker for diagnosis of HCC in the early stage and testing serum CLIMP-63 and AFP may improve the detection rate of HCC.
https://mjcu.journals.ekb.eg/article_53433_ec505e6771179ed807828a3483fb662d.pdf
2019-06-10
1389
1394
10.21608/mjcu.2019.53433
HCC
tumor markers
Cytoskeleton linking membrane protein
ALI A. YOUSEF, M.Sc.;
MEDHAT A. GHAZY, M.D.
1
AUTHOR
FAYZA I. LASHEN, M.D.;
MAALY M. MABROUK, M.D.
2
The Departments of Internal Medicine* and Clinical Pathology**, Faculty of Medicine, Tanta University
AUTHOR
ORIGINAL_ARTICLE
Role of Endoglin Expression in Acute Myeloblastic Leukemia
AbstractBackground: Endoglin (CD105), a cell membrane glyco-protein of approximately 180kDa, has been described as a proliferation-associated antigen of leukemia and endothelial cells, and it represents a powerful marker to quantify tumor angiogenesis. CD105 expression is higher on leukemic cells with immature morphological and phenotypic characteristics compared to normal hematopoietic progenitors. Higher amounts of sCD105 were measured in AML and Chronic Myeloproliferative Disorders (CMD) patients than in healthy subjects. CD105 is involved in the control of vascular en-dothelial cell proliferation, adhesion and migration. CD105 might have a direct involvement in cancer by increase of tumor mass. CD105 levels may be useful as an indicator for disease progression and to identify patients at risk of recurrence and metastasis.Aim of Study: Our aim is to evaluate the role of endoglin (CD 105) expression in patients with AML to clarify its role as a prognostic marker.Material and Methods: This study was carried out on 50 patients with newly diagnosed acute myeloid leukemia who attended the Hematology/Oncology Unit of Tanta University Hospitals. The patients were selected for the study on the basis of standard clinical, hematological and immune pheno-typic criteria for diagnosis of AML. CD105 expression was measured in bone marrow aspirate of AML patients using RD SYSTEMS kits and BD FACS calibur.Subjects included in this study were divided into two groups according to CD 105 exppression; positive and negative groups and classified according to FAB subtypes and immu-nophenotypic features.Results: There was a significant difference in distribution of CD105 expression in different FAB subtypes. There was a significant positive correlation between CD 105 expression and Hb concentration, WBCs count and blast count in periph-eral blood and BM. There was no significant correlation between CD105 expression and platelets count and serum LDH level. Kaplan-Meier survival curve show significant higher overall survival and disease free survival in negative CD105 expression group than in positive CD105 expression group.Conclusions: Positive CD105 expression levels are asso-ciated with a bad outcome in AML patients and its expression can be easy determined in routine flow cytometric analysis. Therefore, it should be regularly investigated as a bad prog-nostic factor for assessment of AML patients.
https://mjcu.journals.ekb.eg/article_53434_228f22ae9bf4be0e9737d45156ca786a.pdf
2019-06-10
1395
1402
10.21608/mjcu.2019.53434
Acute myeloid leukemia (AML)
Flow cytometry
Endoglin (CD105)
SARAH S. ABD EL-GHANY, M.Sc.;
AMIRA Y. AHMED, M.D.
1
AUTHOR
AMR M. GAWALY, M.D.;
SAHAR M. HAZZAA, M.D.
2
The Departments of Clinical Pathology* and Internal Medicine**, Faculty of Medicine, Tanta University
AUTHOR
ORIGINAL_ARTICLE
Soluble Alpha Klotho Serum Level in Chronic Kidney Disease
AbstractBackground: Chronic Kidney Disease (CKD) is a world-wide public health problem which has bad side effects. Soluble alpha klotho is a phosphate and calcium regulatory hormone which can be used as a biomarker in diagnosis of chronic kidney disease.Aim of Study: Evaluation of the level of soluble alpha klotho and its role in diagnosis of chronic kidney disease.Patients and Method: The study was done on eighty cases that were divided into two categories according to their health status and estimated Glomerular Filtration Rate (eGFR), diseased group including sixty patients with chronic kidney disease (eGFR <120ml/min/1.73m2) and control group includ-ing twenty individuals (eGFR >120ml/min/1.73m2). Patients group were subdivided into five subgroups according to variation in their eGFR. All subjects were subjected to full history taking, thorough clinical examination and assessment of age, sex and risk factors for CKD as hypertension, diabetes mellitus and urinary tract infection. Routine laboratory tests included urea, creatinine, Ca, Po4 level and protein in urine. Serum soluble alpha klotho was estimated by Enzyme Linked Immunosorbent Assay (ELISA).Results: Our study found that there was significant de-crease in soluble alpha klotho serum level with progression of chronic kidney disease which started to be more obvious in stage IIIB.Conclusion: Soluble alpha klotho is a novel biomarker of chronic kidney disease that shows a significant decrease with disease progression and correlates with other mineral disorders of the disease, so it can be used in diagnosis of chronic kidney disease.
https://mjcu.journals.ekb.eg/article_53506_47fa4f2e6d19dadb51ce624da0d030cd.pdf
2019-06-10
1403
1406
10.21608/mjcu.2019.53506
Chronic Kidney Disease
Soluble alpha klotho
RANIA M. EL-MAGHRABY, M.Sc.;
AMAL S. EL-BENDARY, M.D.
1
AUTHOR
OLA A. AL-SHORA, M.D.;
ABEER A. SHAHBA, M.D.
2
The Departments of Clinical Pathology* and Internal Medicine**, Faculty of Medicine, Tanta University
AUTHOR
ORIGINAL_ARTICLE
Relationship between Cardiac Catheterization Patients' Expectations and their Satisfaction with Health Service Quality in Selected Hospitals
AbstractBackground: Health service quality has become important for customers when deciding on services; which are intangible and depends on their perceptions and expectations.Aim of Study: Was to identify the relationship between cardiac catheterization patient's expectations and their satis-faction with health service quality in selected hospitals.Subjects and Methods: A descriptive, correlational design was conducted to achieve the aim of the study. The study was conducted in the Cardiac Catheterization Units at El-Manial University Hospital (ISO non-certified hospital) and the New El-Kasr Al-Ainy Teaching Hospital (ISO certified hospital), Egypt. A convenient sample of 147 patients from both units participated in the current study. A modified service quality (SERVQUAL) tool was adopted to collect the data.Results: There was a highly significant relation between levels of expectations and satisfaction of patients with health service quality.Conclusion: Most of the patients with high expectation had also high satisfaction while most of the patients with moderate expectation had moderate satisfaction. The most important factors contributing to expect quality was reliability and responsiveness while the most important factors contrib-uting to satisfaction with quality was empathy.Recommendations: Hospital managers and health care providers should identify patient's expectations before health services delivery to enhance their satisfaction and health service quality.
https://mjcu.journals.ekb.eg/article_53508_f360da1121aa58a9cbdea6e61fda90b9.pdf
2019-06-10
1407
1414
10.21608/mjcu.2019.53508
Cardiac Catheterization
Health service quality
Patient's expectation
Patient's satisfaction
WAFAA M. MOSTAFA, M.Sc.;
MAGDAA A. ABD EL-FATAH, D.Sc.N.
1
AUTHOR
AHMED A.
MOHAMED, D.Sc.M.
2
The Departments of Nursing Administration, Faculty of Nursing* and Critical Care Medicine, Faculty of Medicine**, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Apolipoprotein-1 (Apol-1) Gene Polymorphism in Hypertensive Nephroscelerosis Egyptian Patients
AbstractBackground: Arterial Hypertension (AHTN) represents a major public health problem for its high frequency among the unselected population and, particularly, for its strong association with cardiovascular morbidity and mortality. Progressive renal disease has always been comprised among the possible end-organ damage-related to hypertension. The APOL1 G1 and G2 risk variants are highly associated with non-diabetic non-HIV associated forms of kidney disease, and in particular FSGS and hypertensive nephropathy.Aim of Study: To study influence of the APOL1 gene variants (G1 and G2) on the hypertensive induced kidney disease among Egyptian Patients.Subjects and Methods: In the current study, we examined 88 adult patients (>!18 years old) of both sexes with essential hypertension for >!5 years and classified into two groups: Group I: Included fifty-three patients with essential hyperten-sion (Bl.Pr. >!140/90) who have normal kidney function. Group II: Included thirty-five patients with essential hypertension (Bl.Pr. >!140/90) who have impaired kidney function mostly attributed to HTN. Essential hypertension was diagnosed if the patient gave history of hypertension, with antihypertensive medications or if Bl.Pr. >!140/90 at the time of examination without definite cause. All patients were subjected to thorough medical history taking, physical examination, and many investigations were done as well as APOL1 gene study using Polymerase Chain Reaction (PCR).Results: There is significant statistical difference between both groups as regard APOL1 G1 rs73885319, G1 rs60910195 and G2 rs71785313 genotypes and alleles (the abnormal genotypes AG, GG, TG, DI, DD are more frequent in patients with hypertensive nephroscelerosis; Group II). Most patients with hypertensive nephroscelerosis (Group II) carry two risk alleles and showed more decline estimated Glomerular Filter-ation Rate (eGFR) than Group I despite matching in the hypertension duration and severity.Conclusion: APOL1 G1 rs73885319, G1 rs60910195 and G2 rs71785313 gene polymorphism is associated with in-creased risk of hypertensive induced kidney disease among Egyptian patients. Most patients with hypertensive nephros-celerosis (Group II) showed more decline in e-GFR than group I despite matching in the hypertension duration and severity.
https://mjcu.journals.ekb.eg/article_53509_e92d73da9a5c25321b8f80db2d9c2c5c.pdf
2019-06-10
1415
1428
10.21608/mjcu.2019.53509
Hypertensive nephrosclerosis
Apolipoprotein 1 gene
HASSAN A. AHMED, M.D.;
YASSEIN S. YASSEIN, M.D.
1
AUTHOR
AHMED M. ZAHRAN, M.D.;
MAHMOUD A. EMARA, M.D.
2
AUTHOR
RANIA M. AZMY, M.D.;
AZZA A. GOMAH, M.D.
3
The Departments of Internal Medicine* and Medical Biochemistry**, Faculty of Medicine, Menofia University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Ameliorative Effect of Exercise Training on Age-Related Vascular and Biochemical Changes in Rats
AbstractBackground: Physical exercise is suggested as a life style modification to improve the age related patho-physiologic heamodynamic alterations.Aim of Study: The present study was designed to evaluate the possible ameliorating role of aerobic exercise training in improving age associated vascular dysfunction and hemody-namic disturbance.Material and Methods: Thirty male albino rats of local strain were used for this study. Rats were divided into three main groups: The young control (aged 3-4 months, weighing 150-200gm) (n=10), aged sedentary (aged 22-24 months, weighing 300-400gm) (n=10) and aged exercised group (aged 22-24 months, weighing 300-400gm) (n=10). Rats in the aged exercised group practiced moderate intensity treadmill exercise for 5 days/week for 6 weeks. After 6 weeks rats were subjected for rat tail-measurement of SBP. Then, fasting retro-orbital blood samples were collected for measuring serum lipid profile (TC, HDL-C, LDL-C, VLDL-C and TGs) and inflammatory cytokine (TNF-a). Lastly, rats were sacrificed and abdominal aorta was exposed for assessing MNV and RP using Doppler ultrasound.Results: In aged sedentary group, there were significant increase in SBP, RP, serum (TC, LDL-C, HDL-C) and serum TNF-a associated with significant decrement in MNV when compared to the corresponding values in the young control ones. Exercise training for six weeks significantly restored age-related vascular and biochemical changes except for HDL-C and TC there was insignificant diffrence when compared to the corresponding values in aged sedentary group.Conclusion: Regular exercise training in aging has a beneficial effect on the cardiovascular functions by accelerating blood flow and decreasing resistance to blood flow, also it has an additive beneficial effect on the associated dyslipidemia and chronic inflammatory state in aging.
https://mjcu.journals.ekb.eg/article_53511_44277fd7dc0fc4b29b63591b5fa07d85.pdf
2019-06-10
1429
1438
10.21608/mjcu.2019.53511
exercise
aging
Doppler U/S
Rats
MOHAMED H. HASSAN, M.D.;
OMNIA AMEEN, M.D.
1
AUTHOR
EMAN I. EL-GIZAWY, M.D.;
SAMAR RASHAD, M.Sc.
2
The Department of Medical Physiology, Faculty of Medicine, Menoufia University, Menoufia, Egypt
AUTHOR
ORIGINAL_ARTICLE
Comparative Clinical and Histological Study of Narrow Band UVB Phototherapy Versus Combined Narrow Band UVB Phototherapy and Microneedling in Treatment of Vitiligo
AbstractBackground: Vitiligo is an acquired pigmentary disorder of unknown etiology that affects up to 1% of the general population of all skin types.It is a multifactorial disorder. There are numerous medical and surgical treatments aimed at repigmentation.Microneedling is a minimally invasive procedure that uses fine needles to puncture the epidermis. The indications for microneedling therapy have grown significantly and it is becoming a widely used treatment in Dermatology.Aim of Study: To study the clinical and histological efficacy of combined NB-UVB phototherapy and microneedling versus NB-UVB phototherapy in the treatment of vitiligo.Patients and Methods: Twenty patients were divided into two Groups (A & B), each of 10 patients. Both groups were matched regarding age, sex, skin type and have a depigmented patch at the same corresponding site. Group A was subjected to microneedling with dermapen at one depigmented patch followed by NB-UVB phototherapy sessions twice weekly for three months. Group B was subjected to NB-UVB photo-therapy sessions twice weekly for three months. Two Skin biopsies one before and one after the therapy were taken for immunohistochemical examination by HMB 45.Results: The mean percentage of improvement was sig-nificantly high in Group A (48.50%±26.46) than Group B (20.0%±19.58). In Group A 20% showed mild improvement (G1), 20% showed moderate improvement (G2), (40%) showed good improvement (G3) and 20% showed excellent improve-ment (G4). In Group B 30% showed no improvement, 50% showed mild improvement (G1), 10% showed moderate improvement (G2) and 10% showed good improvement (G3). There was statistically significant difference between both groups (p=0.027*).Immunohistochemical changes revealed marked expression of HMB45 in Group A more than Group B, the mean of color intensity in Group A was 0.05±0.04 and a median of 0.03 while in Group B was 0.01±0.01. There was statistically significant difference between both groups (p=0.002*).Conclusion: Microneedling prior to NB-UVB photother-apy sessions was clearly superior to NB-UVB phototherapy alone with accelerating response. Microneedling is a tolerable procedure, safe with minimal side effects.
https://mjcu.journals.ekb.eg/article_53513_a214b979410def73a8ab1565bb5520dd.pdf
2019-06-10
1439
1448
10.21608/mjcu.2019.53513
Microneedling
NB- UVB phototherapy
HMB45
Vitiligo
AMIRA A.A. EL-ZEFTAWY, M.Sc.;
WAFAA M. RAMADAN, M.D.
1
AUTHOR
KARIMA I. EL-DESOUKY, M.D.;
NAEIM M. ABD EL-NABY, M.D.
2
Dermatology & Leprosy Hospital, Ministry of Health* and The Department of Dermatology & Venereology** and Pathology***, Faculty of Medicine, Tanta University, Tanta, Egypt
AUTHOR
ORIGINAL_ARTICLE
Effect of Upper Thoracic Mobilization on Chronic Mechanical Neck Pain
AbstractBackground: Recently, attention has been given to use the manual therapy for thoracic spine to treat Mechanical Neck Pain (MNP).The Aim of Study: To investigate the effect of upper thoracic mobilization on Cervical Range of Motion (CROM), resting pain level and functional abilities of the neck in patients with chronic mechanical neck pain.Subjects and Method: Thirty patients with chronic me-chanical neck pain participated in this study. Subjects were divided into two groups, fifteen in each group. The first group was the treatment group (Group A) who received upper thoracic mobilization and traditional physical therapy program; and the second group was the control group (Group B) who received the traditional physical therapy program only. Before and after the treatment, the CROM was measured by baseline cervical inclinometer, the rest pain level was measured by a Visual Analog Scale (VAS) and neck disability was measured by Neck Disability Index (NDI). Patients in treatment group were treated with upper thoracic mobilization, infra-red, transcutaneous electrical nerve stimulation and cervical muscle stretching exercises. On the other hand, patients in control group were treated the same like treatment group without upper thoracic mobilization.Results: There is a statistical significant difference between both groups. There is a positive effect of upper thoracic mobilization on CROM and neck function when comparing with routine physical therapy, there was no a statistical significant effect of upper thoracic mobilization on resting pain level when compared with routine physical therapy.Conclusion: There is a positive effect of upper thoracic mobilization on all CROM and neck function, although there was no a significant effect on resting pain level.
https://mjcu.journals.ekb.eg/article_53515_9b9a794baafa4704914ec9ae1754341a.pdf
2019-06-10
1449
1457
10.21608/mjcu.2019.53515
Mechanical neck pain
Upper thoracic spine
Mobilization
HOSSAM ALDEN AL-BASSIOUNY, M.Sc.;
SALWA SHENDY, Ph.D.
1
AUTHOR
HAMED
EL-KHOZAMY, Ph.D.
2
The Department of Physical Therapy for Musculoskeletal Disorder, Al-Rahmania Hospital* and Faculty of Physical Therapy, Cairo University**, Egypt
AUTHOR
ORIGINAL_ARTICLE
Establish Registry of Cerebral Palsy in Qalubia Goveronrate
AbstractBackground: Patient registry is“an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves a predetermined scientific, clinical, or policy purpose(s).Aim of Study: To establish registry of Cerebral Palsy (CP) in Qalubia governorate.Subjects and Methods: Children with CP who are receiving physical therapy services of both genders, ranged in age from 2 months to 18 years in govermental hospitals, Health insurance hospitals and private physical therapy centers which deal with children in Qalubia governorate. The number of cases which included in this study was 181 cases. The outcomes measures were Viking speech Scale, Manual Ability Classification System (MACS), Gross Motor Function Classification System (GMFCS) and Gross Motor Function Measure (GMFM).Results: One hundred and eighty one cases were enrolled with a prevalence of 6 per 100.000 live births. The participants in the study, spastic CP was the most common type represent-ing, 84.60% of the total sample, while Hypotonic was 13.20%, Ataxic was 1.7% and Dyskinetik was 0.60%. Percentage of CP based on GMFCS were 1.20% for level I, 21.50% for level II, 12.70% for level III, 9.90% for level IV, and 54.70% for level V. GMFM was used to determine the score of performance for each participant. According to MACS and Viking speech scale high incidences of children with CP were classified at level IV.Conclusion: The current study revealed that prevalence of CP in Qalubia governorate was 181 children representing 6 per 100.000 live births. The spastic type 84.60% was the most common while the ataxic type 1.7% is the least preva-lence. Demography revealed 51.9% of children wereboys and 48.1% were girls, high incidence of children with CP level V using GMFCS, and level IV using MACS and Viking speech scale.
https://mjcu.journals.ekb.eg/article_53562_f89dc03682e787bc68945eab381dc381.pdf
2019-06-10
1459
1467
10.21608/mjcu.2019.53562
Qalubia
Cerebral palsy
Registry
Physical therapy
GEHAN EL-MENIAWY, Ph.D;
RANIA GALAL AL-DEEN, Ph.D.
1
AUTHOR
YASMEIN N.
MOHAMMED, M.Sc.
2
The Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University* and Shibin El-Kanater General Hospital**, Egypt
AUTHOR
ORIGINAL_ARTICLE
Age and Gender-Related Changes in Renal Haemodynamics of Albino Rats: The Possible Role of Cytokines and Prostaglandins
AbstractBackground: The normal aging process leads to changes in kidney morphology, hemodynamics and function, which are influenced by several factors, including gender. Females develop less age-dependent loss of renal function due to cardiorenal protective effects of estrogens.Aim of Study: The aim of this study was to elucidate the age and gender-related changes in some renal haemodynamics in albino rats with special focusing on the role of cytokines and prostaglandins in establishment of such changes.Material and Methods: Sixty albino rats (30 males & 30 females) of local strain were divided into 2 major groups (Group I of male rats and Group II of female rats) was further subdivided into 3 subgroups: Young (4wk), young adult (3mo) and old (25mo). Body Weight (BW) and absolute Kidney Weight (KW) were measured. The Systolic Blood Pressure (SBP) of the rats was measured by the rat-tail plethysmography technique using a tail-cuff sphygmomanometer. The Renal Blood Flow Velocity (RBFV) and Renal Vascular Resistance (RVR) were measured using bi-directional blood flow meter with FFT-analysis. The blood samples were collected after a period of overnight fasting, left to be clotted, centrifuged and serum was separated for measurement of serum testosterone in male rats, serum estrogen in female rats, creatinine clearance, serum IL1beta, IL6 and serum PGE.Results: The aging of male rat group is accompanied by change in the renal hemodynamic and some blood measure-ments. This is represented by significant increase in systolic blood pressure, renal vascular resistance, serum PGE, serum interleukin1-b & 6, impaired renal function and significant decrease of renal blood flow. It was observed that the old female group had decreased in estrogen hormone level, which led to increase in systolic blood pressure, renal vascular resistance, serum PGE, serum interleukin1-b & 6 and signif-icant decrease renal blood flow.Conclusion: Aging has a significant influence in renal hemodynamic (decrease of renal blood flow and increase of renal vascular resistance) and also, serum interleukin1-b & 6 have a role in this change accompanied with pathophysiology of aging. Female is more protected from complications of the kidney aging than male due to the previous effect of estrogen hormone.
https://mjcu.journals.ekb.eg/article_53563_f77953ce2a42113353714f512ab0b3ab.pdf
2019-06-10
1469
1479
10.21608/mjcu.2019.53563
aging
Renal Haemodynamics
Cytokines
Prostaglandins
Rats
MOHAMED A. BENDARY, M.D.;
SAFAA M. SALEH, M.D.
1
AUTHOR
GHADA S. AMER, M.D.,
ESSAM O. HENDIA, M.D.
2
AUTHOR
RANA A.
TAWFIK, M.Sc.
3
The Department of Medical Physiology, Faculty of Medicine, Menoufia University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Lipolytic Effects of Testosterone Hormone Replacement Therapy in A Rat Model of Andropause Versus Normal Controls
AbstractBackground: Testosterone (T) actions extend beyond the reproductive functions to include diverse metabolic pathways. Lipolytic effect of T is still underinvestigated, especially regarding the involved enzymes.Aim of Study: This work measures two key lipolysis-enzymes in both normal and orchiectomized rats with/without T administration.Material and Methods: Forty rats (200-300g) were sub-divided into 4 equal groups (n=10/group); (A) Group I: Sham-operated control group. (B) Group II: Sham-operated rats were injected with IM testosterone undecanoate (100mg/kg, for two weeks). (C) Group III: Andropause model was done by orchiectomy, (D) Group IV: Testosterone-replacement therapy in orchiectomized rats. T, Hormone-Sensitive Lipase (HSL), Adipocyte Triglyceride Lipase (ATGL), Free Fatty Acids (FFA), and lipid profile were measured using the commercially available ELISA kits. Food intake was measured manually in addition to body weight changes before during and after treatment. ANOVA with LSD post hoc test and Pearson correlation were used for analysis.Results: The castrated rats showed lower food intake, lower body weight, and lower weight gain. Regarding adipose tissue lipolytic enzymes, ATGL was significantly decreased while both HSL and FFA were insignificantly changed. T replacement therapy in castrated rats increased blood products of lipolysis due to an increased level of ATGL, HSL, and FFA, in addition to the significant increase in food intake without significant wt changes. Similar effects were demon-strated in normal rats treated with T.Conclusion: T hormone therapy increased food intake, without significant changes in weight due to stimulation of lipolysis process mainly via stimulation of ATGL and HSL.
https://mjcu.journals.ekb.eg/article_53565_19542b22d27e7939f36dc83b61f5b842.pdf
2019-06-10
1481
1488
10.21608/mjcu.2019.53565
testosterone
Orchiectomy
food intake
Hormone-sensitive lipase
ATGL
ALAA I. ALI, M.D.;
MAHMOUD M.A. ABULMEATY, M.D.
1
AUTHOR
EBTESAM M.
IBRAHIM, M.D.**
2
The Departments of Clinical Pharmacology* and Medical Physiology**, Faculty of Medicine, Zagazig University
AUTHOR
ORIGINAL_ARTICLE
Evaluation of Results of Combined Blocking Screw and Interlocking Intramedullary Nail in the Treatment of Diaphyseo-Metaphyseal Tibial Fractures
AbstractBackground: Diaphyseo-metaphyseal tibial fractures tend to malalign while treatment by interlocking intramedullary nail. Multiple techniques are used to avoid malalignment as provisional unicortical plate, percutaneous clamping, universal distractor, fibular plating in distal tibia and blocking screw.Aim of Study: Was to evaluate the results of combined blocking screw and interlocking intramedullary nail in the treatment of diaphyseo-metaphyseal tibial fractures.Patients and Methods: This study was done on 21 patients with closed proximal or distal diaphyseo-metaphyseal tibial fractures, admitted at Tanta University Hospital. The distri-bution of patients was according to age, sex, and side, mode of trauma, and AO type of fracture, medical history, smoking, fracture level, time lag, fibular fixation and design of inter-locking nail. Fixation was done by interlocking intramedullary nail and the reduction was assisted by blocking screw in the coronal plane for varus or valgus malalignment and in the sagittal plane for recurvatum or procurvatum malalignment. Clinical evaluation was according to Hospital of Special Surgery Knee Rating Scale.Results: There were significant statistical correlation between the final clinical result and interlocking nail design either conventional or expert tibial nail or the time for union. There were significant statistical correlation between the time of union and sex of patients, mode of trauma, type of fracture, fibular fracture fixation and smoking.Conclusion: Blocking screw is a simple technique that assist in the reduction of diaphyseo-metaphyseal tibial fractures while fixation by interlocking nail, maintenance of the reduc-tion and stability of the fracture.
https://mjcu.journals.ekb.eg/article_53566_da6879266aaefa00354088cfddd80f18.pdf
2019-06-10
1489
1495
10.21608/mjcu.2019.53566
Blocking screw
Diaphyseo-metaphyseal tibial fracture
Malalignment
MOHAMED M. NAGLA, M.Sc.;
ALI M. EMRAN, M.D.
1
AUTHOR
ABD EL-HAFEZ A. MEGAHED, M.D.;
MAMDOUH F. LASHIN, M.D.
2
The Department of Orthopedic Surgery, Faculty of Medicine, Tanta University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Evaluation of Serum Level of Glutathione Peroxidase Activity in Vitiligo Patients
AbstractBackground: Vitiligo is an acquired disorder with loss of epidermal melanocytes. Oxidative stress is thought to play a significant role in the pathogenesis of vitiligo. Glutathione Peroxidase (GPx) is one of the most important antioxidant enzymes.Aim of Study: To estimate serum levels of Glutathione Peroxidase activity in patients with vitiligo to assess its role in the disease activity.Patients and Methods: This study included (60) patients with vitiligo and (20) healthy individuals served as a control group. They were collected from the Outpatient Clinic of Dermatology and Venereology Department Tanta University Hospital. Serum levels of glutathione peroxidase activity were estimated in the patients and control group.Results: Serum GPx activity level showed a statistically significant increase in vitiligo patients compared to control group.Conclusion: Oxidative stress is thought to play a significant role in the pathogenesis of vitiligo represented by significantly increased GPx activity level in vitiligo patients.
https://mjcu.journals.ekb.eg/article_53567_1502c6331ac220ead8a6305b13fc604b.pdf
2019-06-10
1497
1502
10.21608/mjcu.2019.53567
Vitiligo
glutathione peroxidase
AYA E. ARAFAT, M.Sc.;
ENGI S.E. SHAKER, M.D.
1
AUTHOR
MAALY M. MABROUK, M.D.;
MOHAMMAD M. GAMEE, M.D.
2
The Departments of Dermatology & Venereology* and Clinical Pathology**, Faculty of Medicine, Tanta University, Tanta, Egypt
AUTHOR
ORIGINAL_ARTICLE
Dobutamine Stress Echocardiography for Predicting the Postoperative Recovery of Left Ventricular Function in Patients with Chronic Severe Aortic Regurgitation: A Comparative Prospective Study
AbstractBackground: Patients with chronic severe aortic regurgi-tation often present to our practice at a late stage. Patients with poor left ventricular function may or may not improve functionally or by left ventricular dimensions after surgery.Aim of Study: We aim to answer this question; can dob-utamine stress echocardiography predict the postoperative recovery of left ventricular function in patients with chronic severe aortic regurgitation?Patients and Methods: This is a comparative prospective study from December 2014 to December 2015 in which we studied 49 patients undergoing aortic valve replacement for chronic severe aortic regurgitation. Patients were divided into 2 groups according to their resting ejection fraction, Group I with ejection fraction <50% and Group II with ejection fraction >50%. Group I was further divided into Ia and Ib. Group IA included 16 patients who respond to dobutamine infusion by increase in ejection fraction >30%. Group IB included 16 patients who respond to dobutamine by increase in ejection fraction <30%. All the relevant clinical data was collected from all patients pre-operatively and 3 month follow-up visit. All patients in were stressed by infusion of dobutamine 20ugm/kg/min and the change in their End Systolic Volume (ESV) and End Diastolic Volume (EDV) and Ejection Fraction (EF) were evaluated.Results: There was no hospital or 3 months mortality for the whole group. For Group II, the comparison between the response to aortic valve replacement and peak dobutamine reveals: The mean 3 months post-operative EF 56.87±6.03%. The peak dobutamine EF was 68.3±7.5%. There was statisti-cally significant difference between the 2 values (p-value <0.001) i.e there relation was not obvious in this group.For Group IA; the mean 3 months post-operative EF was 44.27±8.78%. The peak dobutamine EF was 47.2±10.69%. There was no statistically significant difference between the 2 values (p-value=0.177). For Group IB; the mean 3 months post-operative EF was 37.75±13.7%. The peak dobutamine EF was 41.33±7.44 %. There was no statistically significant difference between the 2 values (p-value=0.175). Conclusion: Dobutamine stress echocardiography was found to be predictor for post-operative left ventricular function in patients with chronic severe aortic regurgitation and impaired function.
https://mjcu.journals.ekb.eg/article_53568_358127b036c87aa7781d34ef4afa5723.pdf
2019-06-10
1503
1514
10.21608/mjcu.2019.53568
Dobutamine
Stress Echocardiography
Lt Ventricular Function
Aortic Regurgitation
AMR ABO EL-FOTOH, M.D.;
MOHAMED EL-FIKY, M.D.
1
AUTHOR
MOHEY
AL-ABBADY, M.D.
2
The Department of Cardiology, Nasser Health Institute, Egypt
AUTHOR
ORIGINAL_ARTICLE
Association of Serum Vitamin D Level and Vitamin D Receptor Polymorphism (Apa 1) and Breast Cancer
AbstractBackground: The active form of Vitamin D is thought to be protective against breast cancer. The activity of this steroid hormone is mediated mainly through the Vitamin D Receptor (VDR).Aim of Study: The aim of the current study was to assess the possible association between serum Vitamin D level together with Apa1 receptor polymorphism and breast cancer.Patients and Methods: This study was conducted at Clinical Oncology and Clinical Pathology Departments, Menoufia University. A total of 114 participants were included. Vitamin D levels and Apa1 polymorphism were assessed in both patients and healthy controls.Results: Mean serum Vitamin D levels were significantly higher among normal controls compared to cancer patients (31.54±4.57 versus 14.12±1.43) respectively (p-value <0.001). In relation to Apa1 gene polymorphism the serum Vitamin D levels were significantly associated with AA and AC genotypes (p-value <0.001) and both of these genotypes were prevalent in breast cancer compared to CC genotype. Low Vitamin D levels and AC genotypes were significantly related to Her 2 positive disease.Conclusion: Testing the effect of varying genotypes and Vitamin D levels on the function of the VDR could help to improve future testing and treatment of woman at risk for breast cancer.
https://mjcu.journals.ekb.eg/article_53570_fbf3d1593e19e0a90d899b49caa7b547.pdf
2019-06-10
1515
1523
10.21608/mjcu.2019.53570
Vitamin D
breast cancer
Risk
Vitamin D receptor
Apa 1
Polymorphism
BELAL A.E. MONTASER, M.D.;
SUZY F. GOHAR, M.D.
1
AUTHOR
SUZAN A. AL-HASSANIN, M.D.;
SHAIMAA S. SOLIMAN, M.D.
2
The Departments of Clinical Pathology*, Clinical Oncology & Nuclear Medicine** and Public Health & Community Medicine***, Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt
AUTHOR
ORIGINAL_ARTICLE
Effect of Aerobic Exercise Training on Body Mass Index and Functional Performance in Diabesity Women under Intermittent Fasting 16/8 Protocol
AbstractBackground: The increased number of patients suffer from diabesity provoke the scientific researchers to deal with its complications either acute or chronic as well as increasing the debate about the effect of aerobic exercises with intermittent fasting 16/8 protocol in modulating this issue.Aim of Study: The current study aimed to determine the effect of aerobic exercise on metabolic profile in diabesity patients under intermittent fasting16/8 protocol.Material and Methods: Forty women diabesity patients with mean age 40.2±2.98 years old. They are diabetic since 5-7 years with class II obesity according to their Body Mass Index (BMI) classification and were assigned randomly using the sealed envelope method of randomization into two groups equal in number. Both groups were under controlled diet regimen with the protocol of intermittent fasting 16/8. GroupA performed treadmill aerobic exercise for 3 times/week during the fasting period (window) with intensity of 40-60% of the Maximum Heart Rate (MHR) for 12 weeks & GroupB performed treadmill aerobic exercise for 3 times/week during the eating period (window). According to training intensity with 40-60% of maximum heart rate for 12 weeks participated in the study BMI, Glycosylated hemoglobin (HbA1c) and 6 minute walk test were used for assessment at baseline and after 12 weeks of training.Results: The results revealed that there was significant reduction of BMI in Group A (9.19%) and Group B (7.12%), and in HbA1c Group A (20.7%) and Group B (13.91%) and significant increase of 6 MWT in Group A (23.8%) and Group B (18.36%) in compare to pre-treatment in both groups. Unpaired t-test revealed that there was significant difference of the mean values of the "post" test between both groups in HbA1c and 6 MWT. This significant difference in favor to Group A than Group B. There was no statistical difference between both groups of the mean values of the "post" test in BMI.Conclusion: Intermittent fasting 16/8 protocol with con-trolled diet regimen and treadmill aerobic exercise for 3 times/ week during the fasting period is the best way to decrease body weight, controlling blood glucose and enhance functional performance in diabesity women.
https://mjcu.journals.ekb.eg/article_53571_df822501d89e443ef22a9004186084a7.pdf
2019-06-10
1525
1530
10.21608/mjcu.2019.53571
Aerobic exercise
Diabesity
Intermittent fasting
Functional Performance
EMAN R.A. EL-SAYED, M.Sc.;
NESREEN G. EL-NAHAS, Ph.D.
1
AUTHOR
SALLY A. HAKIM, M.D.;
AZZA A. ABD EL-HADY, Ph.D.
2
AUTHOR
ORIGINAL_ARTICLE
Effect of Acupressure on Nausea and Vomiting during Pregnancy
AbstractBackground: Acupressure is a part of traditional Chinese medicine to stimulate energy channels below the skin surface, it reduces stress and restores health.Aim of Study: To assess the effect of acupressure on nausea and vomiting during pregnancy.Material and Methods: 100 pregnant women with gesta-tional age less than 15 weeks were included in a 7 consecutive day's study. They were randomly divided into two groups: A study and control group. The study group received Acupressure on the pericardium 6 points (P6) bilaterally for about 60 minutes per day for 7 consecutive days. While the control group received only P6 touch with the same steps and period. Gathering data and Rhodes index scale were completed for both groups.Results: In the study group, the severity and frequency of nausea and vomiting reduced significantly after starting the treatment compared to the control group.Conclusions: P6 acupressure is effective in reducing the severity and frequency of nausea and vomiting during preg-nancy.
https://mjcu.journals.ekb.eg/article_53572_135207e8164a5eb38ff052182213e746.pdf
2019-06-10
1531
1537
10.21608/mjcu.2019.53572
Acupressure
Nausea
Vomiting
Pregnancy
P6
MAHA M. MADY, Ph.D.;
SAFAA G. ALY, D.N.Sc.
1
AUTHOR
INASS K. ALY, D.N.Sc.;
AYAT M.A. EL-ABD, M.Sc.
2
AUTHOR
ORIGINAL_ARTICLE
Volumetric Brain MRI Changes in Schizophrenic Patients
AbstractBackground: The core symptoms of schizophrenia is associated with changes in volumes of specific regions of the brain.Aim of Study: Is to correlate between Prefrontal Cortex (PFC), Hippocampus, (HC) and Cerebellum (CRM) volumes and schizophrenic core symptoms (cognitive, negative and positive).Methods: The study included twenty schizophrenic patients and 20 matched healthy individuals as control group. DSM-IV-TR was used for diagnosis of Schizophrenia while Positive and Negative Syndrome Scale (PANSS) for symptoms assess-ment. 3D Slicer version 4.2.2 software was used for regional volumetric measurements. Both patients and control were assessed by [Wechsler Memory Scale (WMS), Trail Making test (TM) and Folstein Mini Mental State Examination (MMSE] cognitive tests.Results: Significant decrease of volumes of HC [right, p=0.042,], vermis [p=0.02], right, p=0.25], PFC [left p=0.009, right p=0.006], and CRM [left p=0.041. The scores of WMS sub tests (p<0.005), MMSE (p=0.001) and two stages TM delay time (p<0.01) revealed significant reduction in patients than control. PANSS negative symptoms score revealed negative correlation with vermis (p<0.001) and right CRM lobe volume (p<0.001), while positive correlation between PANSS positive symptoms score and cerebellar vermis (p=0.007) and negative with both HC volumes (p=0.01).Conclusion: Hippocampus, prefrontal cortex, and cere-bellum volumes reduction and correlation with core symptoms help in assessment of the pathophysiology of schizophrenia.
https://mjcu.journals.ekb.eg/article_53573_5fb28c39792ce4b159a293174d5a2fb0.pdf
2019-06-10
1539
1545
10.21608/mjcu.2019.53573
Volumetric
MRI
Schizophrenia
RASHA EL-SHAFEY, M.D.;
AHMED MUBARAK, M.D.
1
AUTHOR
ADEL BADAWY, M.D.;
RANIA MESHREF, M.Sc.
2
The Departments of Radiodiagnosis* and Neuropsychiatry**, Tanta University Hospital, Tanta, Egypt
AUTHOR
ORIGINAL_ARTICLE
Changes in Outer Membrane Proteins of Benzalkonium Chloride Adapted Pseudomonas Aeruginosa and Mutations in GyrA and ParC Genes
AbstractBackground: Benzalkonium Chloride (BC) is widely used in hospitals, industry and cosmetics. Adaptation of Pseu-domonas aeruginosa to BC was increased. This adaptation may lead to the emergence of cross-resistance to other disin-fectants and antibiotics. Little attention has been focused on the resistant mechanisms.Aim of Study: Examination of mutations in the Quinolone-resistance-Determining Region (QRDR) of GyrA and ParC genes and alterations of Outer-Membrane Proteins (OMPs) in Benzalkonium Chloride (BC)-adapted Pseudomonas aeru-ginosa isolates.Material and Methods: GyrA and ParC genes of the BC-adapted P. aeruginosa isolate and the wild-type strain ATCC 15442 were amplified by Polymerase-Chain-Reaction (PCR) and sequenced. OMPs of these isolates were also analyzed by Sodium Dodecyl Sulfate-Polyacrylamide Gel Electrophore-sis (SDS-PAGE) in the presence and absence of permeabilizer disodium Ethylenediamine-Tetraacetate (EDTA) to investigate the variations.Results: The results manifested a single mutation in both GyrA (Thr-83-Ile) and ParC (Ser-87-Leu). In SDS-PAGE, one band with molecular weight of 52.23kDa was detected in all samples. Seven bands with molecular weights of 71.44, 38.48, 36.01, 33.03, 26.17, 21.14 and 6.35kDa were stable in both ATCC 15442 and treated isolate. Also, seven bands with molecular weights of 120.83, 90.89, 79.72, 44.58, 28.91, 16.12 and 12.49kDa were newly induced in the treated isolate.Conclusions: These results revealed that mutations in GyrA and ParC genes, and alteration of OMPs contributed to the adaptation of P. aeruginosa to BC, co-operating with efflux pump over-expression.
https://mjcu.journals.ekb.eg/article_53574_9c390102d0eae01089bca4ae2db00456.pdf
2019-06-10
1547
1555
10.21608/mjcu.2019.53574
Benzalkonium chloride
Pseudomonas aeruginosa
GyrA, ParC
mutations
Outer membrane proteins
SDS
PAGE
MOHAMED E. OSMAN, Ph.D.;
HODA H. EL-HENDAWY, Ph.D.
1
AUTHOR
AHMED M. HASSAN, Ph.D.;
AHMED M. HASSAN, Ph.D.
2
AUTHOR
DINA E.
MAHMOUD, M.Sc.
3
The Department of Botany & Microbiology, Faculty of Science, Helwan University* and National Organization for Drug Control & Research**, Egypt
AUTHOR
ORIGINAL_ARTICLE
Sleep Quality and Fatigue in Egyptian Rheumatoid Arthritis Patients
AbstractBackground: Pain, fatigue & sleep disturbance have been linked to lower quality of life & reduced survival among patients with Rheumatoid Arthritis (RA).Aim of study: Assessment of sleep abnormality, pain and fatigue symptoms among RA patients and their relations with disease activity and other patient characteristic data.Subjects and Methods: Eighty-four patients with RA fulfilling the 2010 American College of Rheumatology (ACR)/ European League Against Rheumatism classification criteria were enrolled in the study. Disease activity as evaluated by Disease Activity Score 28 (DAS28). Sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI), pain intensity was measured by Visual Analog Scale (VAS), while fatigue was assessed by Fatigue Severity Scale (FSS).Results: The mean age of the participants was 45±8 years, the mean Disease Activity score (DAS28) was 4.2±1.3, the patients had poor sleep quality with the mean PSQI was 0.9± 1.2, the mean VAS score was 7±2.39 and the mean FSS was 5.13±1.75. Strong correlations were found between the DAS28 score and each of PSQI, FSS, and VAS (r-value 0.75, 0.85 & 0.74 respectively) with p-value (0.02, 0.001 and 0.03 respec-tively).Conclusion: Sleep disturbances and fatigue were com-monly noticed in RA patients due to interaction of pain and disease activity.
https://mjcu.journals.ekb.eg/article_53575_2b2e94ac95d06155928fead7f1b66928.pdf
2019-06-10
1557
1562
10.21608/mjcu.2019.53575
Rheumatoid Arthritis
Pain
Fatigue
Sleep quality
MERVAT
ESSAM BEHIRY, M.D.
1
The Department of Internal Medicine, Faculty of Medicine, Cairo University
AUTHOR
ORIGINAL_ARTICLE
The Prospective Protective Effect of Selenium Against Chronic Restraint Stress-Induced Memory Impairment in Male Albino Rats
AbstractBackground: Selenium (Se) had underscored many bene-ficial neuroprotective potentials, particularly with respect to learning and memory. However, the protective effect of Se in memory impairment associated with Chronic Restraint Stress (CRS) is not yet elucidated.Aim of Study: The present study was carried out to examine the effect of Se treatment against CRS induced behavioral and biochemical abnormalities.Material and Methods: The stress was induced by restrain-ing the animals in well ventilated tubes (6h/d) for consecutive 21 days. Animals were randomly divided into 4 groups (8 rats each): Normal control, drug control, CRS and Se treated CRS groups. After 21 days of the experiment, memory function was evaluated by Passive Avoidance (PA), T-maze and object recognition tasks. Hippocampal oxidative stress markers, Brain Derived Neurotrophic Factor (BDNF), amyloid P (AR) protein, phosphorylated TAU (p-TAU) protein as well as glutamate and acetylcholinestrase activity (AchE) levels were assessed.Results: This study revealed that the memory performance was markedly deteriorated in CRS group, accompanied by noticeable alterations in hippocampal oxidative stress markers, depleted levels of BDNF together with overproduction of AP, p-TAU and glutamate as well as, excessive activity of AchE enzyme. Meanwhile, these behavioral and biochemical devi-ations were alleviated under 21 days of Se co-treatment in CRS exposed rats.Conclusion: This study proved the beneficial protective effects of Se in CRS-induced memory deficits and its associated pathological changes in rats, which may draw the attention to Se as a new therapeutic candidate for memory dysfunction associated with stress and its related disorders.
https://mjcu.journals.ekb.eg/article_53576_065bf68bdd4c4f7f954c028ce10661d7.pdf
2019-06-10
1563
1572
10.21608/mjcu.2019.53576
selenium
Chronic restraint stress
Memory impairment
Passive avoidance
T maze
ISLAM I. HEGAB, M.D.;
RAMEZ A.E. BARHOMA, M.D.
1
AUTHOR
RANIA N. ABD EL-LATIF, M.D.;
RASHA EL-ESAWY, M.D.
2
The Departments of Physiology*, Biochemistry** and Pharmacology***, Faculty of Medicine, Tanta University, Egypt
AUTHOR
ORIGINAL_ARTICLE
A Study on the Impact of Irisin "A Novel Myokine" in Ameliorating Polyneuropathy of Experimentally-Induced Diabetic Rats
AbstractBackground: Irisin is a new myokine, has been known to its effect on diabetes.Objectives: This work is designated to evaluate the possible neuroprotective role of irisin in ameliorating DPN in an experimental model of type 2 diabetes mellitus (T2DM) in adult male albino rats.Patients and Methods: 40 male albino rats of local strain were used, the rats will be randomly divided into 4 equal groups, 10 rats each, control group, irisin group, diabetic group and diabetic-irisin group. Diabetes was induced by feeding rats a high-fat diet (60% kcal fat) for 4 weeks, then they will subjected to a single IP injection of Streptozotocin (STZ) of 40mg/kg in 10ml sodium citrate buffer PH 7.4. rats in irisin group will be injected S.C subcutaneously with irisin 150ul per rat for 4 weeks during which the rats will supple-mented with a normal chow diet. Rats in diabetic-irisin group will be treated with SC injection of irisin 150ul per rat for 4 weeks during which the rats will be supplemented with a normal chow diet. At the end of the experiments (after 4 weeks), rats will be subjected to the following measurements: Food intake, body weight, height and Body Mass Index (BMI), waist circumference, hot plate analgesia meter test, perirenal fat pads/body weight ratio, Nerve Conduction Velocity (NCV) of the sciatic nerves. Blood samples were collected for meas-uring serum glucose and serum insulin and Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), HbA1C, serum Tumor Necrosis Factor alpha (TNF-a), sciatic nerve tissue level of irisin receptors gene expression, Glutathione Peroxidase1 enzyme (GPX1) and Thio Barbituric Acid Reac-tive Substances (TBARS).Results: T2DM resulted in substantial alterations in biochemical variables and the markers of inflammation (in-crease TNF-a) and oxidative stress (rise of TBARS and decrease of GPX-1) in the sciatic nerve tissue. Irisin supple-mentation effectively restored the abnormalities, suggesting that this compound would be beneficial in mitigating the nereve conduction deterioration associated with T2DM.Conclusion: Irisin improve nerve conduction velocity in diabetic neuropathy associated with T2DM.
https://mjcu.journals.ekb.eg/article_53577_595249b0de049123a6553117171ae043.pdf
2019-06-10
1573
1583
10.21608/mjcu.2019.53577
Irisin
Diabetic neuropathy
Nerve conduction velocity
Rats
MOHAMED H. HASSAN, M.D.;
MOHAMED A. BENDARY, M.D.
1
AUTHOR
SAFAA M. SALEH, M.D.;
SALLY S. DONIA, M.D.
2
AUTHOR
EMAN I. EL-GIZAWY, M.D.;
EMAN M.K. ABDUL-RAHMAN, M.Sc.
3
The Department of Medical Physiology, Faculty of Medicine, Menoufia University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Studies MicroRNA 208 as a Novel Cardiac Marker in Acute Coronary Syndrome in Egyptian Patients
AbstractBackground: Acute coronary syndrome ACS patients presented to Emergency Department ED require rapid differ-ential diagnosis. Although troponin is the gold marker for ACS, there still undiagnosed patients. MicroRNAs circulate in human plasma and affected by varying cardiac pathologies. miRNA-208 was found to be elevated with ACS specially AMI.Aim of Study: The aim of this study was to investigate cTnI levels, correlated to miRNA-208 levels in ACS patients to evaluate rapid, accurate and final diagnosis in ED.Subjects and Methods: One hundred consecutive patients with ACS presenting to the Emergency Department of the National Heart Institute, Giza (Egypt) between March and June 2018, were recruited for the study, stratified into four groups according to the final diagnosis as AMI (including twenty five patients) and unstable angina UA (including twenty three patients), other cardiac patients (eighteen patients) and non cardiac (fourteen patients) twenty control subjects. Were included their cardiac markers and miRNA-208 levels were assayed and compared to the control healthy group on admis-sion.Results: Results revealed significant difference between cardiac levels on admission compared to that obtained for miRNA-208. Only miRNA-208 levels were diagnosed on admission compared to that of cTnI. MiRNA-208 was found to be increased up to 38.6 folds without differential cut off.Conclusion: Early measurement of both troponin I and miRNA-208 may revolutionize the diagnostic accuracy and therapeutic decision-making in patients with symptoms sug-gestive of ACS; differentiate between UA or AMI patients on admission. Cardiac troponin 1 cTnI alone require more time to be controlled as diagnostic while high sensitive cTn may lead to false positive results. MiRNA-208 can be used as a novel marker for early diagnosis of ACS although RT-PCR still time consuming, requires time improved techniques.
https://mjcu.journals.ekb.eg/article_53578_d9de7878ca8d683a9f73f36671b35b63.pdf
2019-06-10
1585
1591
10.21608/mjcu.2019.53578
Acute Coronary Syndrome
Novel cardiac marker
MicroRNA 208
MOHAMED Y. NASR, Ph.D.;
SALWA E. MOHAMED, Ph.D.
1
AUTHOR
ABLA A. MOHAMED, B.Sc.;
SABAH F. EL-ABED, Ph.D.
2
AUTHOR
ORIGINAL_ARTICLE
Variations in Renal Artery in Egyptian Population: Cadaveric and Angiographic Study
AbstractBackground: Variations of Renal Artery (RA) are impor-tant in uroradiological procedures. Pre-operative visualization of the renal vascular anatomy is crucial for selecting the proper kidney during renal transplantation and avoiding vascular injuries.Aim of Study: The present study aimed to describe RA variations and different branching patterns in a section of Egyptians using dissected cadavers and Multi Detector Com-puted Tomography Angiography (MDCTA).Subjects and Methods: The study included 207 renal pedicles (7 kidneys and 100 CT images). The specimens were examined for morphological patterns of RA. MDCTA images were evaluated for the level of origin, length, caliber and presence of additional renal arteries.Results: The renal arteries in the dissected specimens showed fork (duplicate and triplicate) and ladder patterns. The level of origin of RA in MDCTA images was at L1 (52%), L2 (32%), L1-L2 intervertebral disc (11%), T12-L1 interver-tebral disc (3%), T12 (1.5%) and L2-L3 intervertebral disc (0.5%). The mean caliber of the left RA was greater than the right RA (left 6.99±1.47mm, right 6.55±1.51mm, p=0.003). Out of 200 renal pedicles, 21 (10.5%) additional arteries were observed in the form of 13 (6.5%) accessory renal arteries, 2 (1%) aberrant superior polar arteries, 2 (1%) superior polar arteries, 3 (1.5%) aberrant inferior polar arteries and 2 (1%) dual renal arteries. The most commonly seen branching pattern was the hilar (82%), followed by prehilar (11.5%) then inta-parynchymal branching pattern (6.5%).Conclusion: Variations of RA are common in Egyptian population. The most important are the presence of additional arteries and different branching patterns. Variations in renal vasculature in relation to population should be taken in consideration during urological interventions.
https://mjcu.journals.ekb.eg/article_53579_0abcb8430cd82aa4eed7d0064b95182b.pdf
2019-06-10
1593
1603
10.21608/mjcu.2019.53579
Renal artery
Variation
MDCTA
Branching pattern
AL-MOATASEM-BELLAH M. AL-SHERIF, M.D.;
AHMED S. AWAD, M.D.
1
AUTHOR
DOAA M. SHUAIB, M.D.;
EMAN F. FARID, M.Sc.
2
The Departments of Anatomy & Embryology* and Diagnostic & Interventional Radiology**, Faculty of Medicine, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Assessment of Mothers' Knowledge Regarding Care of Children Connected with Permanent Pacemaker
AbstractBackground: Permanent pacemaker is a small batterypoweredmedical device designed to electrically stimulate theheart muscle in an effort to restore the heart rhythm towardsnormal. Pediatric pacemaker implantation is performed totreat abnormalities of Sinoatrial (SA) node.Aim of Study: To assess mothers' knowledge regardingcare of children connected with permanent pacemaker.Subjects and Methods: A descriptive research design wasutilized. A convenient sample of 50 mothers of children underfive years have implanted permanent pacemaker were participatedin the study. The study was conducted in the arrhythmiaout-patient clinic at the Preventive Medicine and Social Center,affiliated to Cairo University Hospitals. The required datawas collected through structured interview questionnairewhich developed by the research investigator to assess mothers'knowledge regarding care of children connected with permanentpacemaker.Results: The results of the current study revealed thatmore than three quarters of the mothers had unsatisfactorylevel of knowledge regarding care of their children withpermanent pacemaker, although, the majority of them obtainedsatisfactory level of reported care. There were statisticallysignificant positive correlations between the total mean scoreof mothers' knowledge and reported care and their age, occupation,place of residence and level of education.Conclusion: The results concluded that the highest percentageof the mothers had unsatisfactory level of knowledgeregarding care of children connected with permanent pacemaker.It was recommended that raising the awareness ofmothers about care of children connected with permanentpacemaker is mandatory through health education sessionsabout the pacemaker, child's activities and home pre cautions.
https://mjcu.journals.ekb.eg/article_53880_9ee772647794d3ac2353a3560591418b.pdf
2019-06-10
1605
1613
10.21608/mjcu.2019.53880
Permanent pacemaker
Children under five years
Mothers' knowledge
SEHAM Y. ZEDAN, M.Sc.;
SOHEIR A. MOHAMED, D.N.Sc.
1
AUTHOR
MARWA A.
IBRAHIM, D.N.Sc.
2
The Department of Pediatric Nursing, Faculty of Nursing, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Effect of Alpha Lipoic Acid on Apoptotic Mechanisms and Oxidative Stress in Pancreatic Cells of High Fat Diet Induced Type II Diabetes Mellitus in Rats
AbstractBackground: Type 2 Diabetes Mellitus (T2DM) is a worldwide health problem with significant morbidity and mortality. b-cell failure is a main contributor to the develop-ment of T2DM. Oxidative stress and enhanced apoptosis play a critical role in pathogenesis of b-cell failure. Recently, Alpha Lipoic Acid (ALA), a universal antioxidant, has been shown to exert anti-apoptotic actions.Aim of Study: The present study was aimed to evaluate the possible ameliorative effect of ALA against pancreatic tissue oxidative stress and apoptotic mechanisms in a rat model of High Fat Diet (HFD)-induced T2DM.Material and Methods: Eighty albino rats were included, 20 rats received a standard diet and served as normal control group (Group I) and 60 rats were fed a homemade HFD for 6 months for induction of T2DM, only diabetics (40 rats) were included and divided into 2 groups; 20 continued to receive HFD for further 21 days, served as diabetic untreated group (Group II); 20 received ALA (50mg/kg i.p) for 21 days and served as ALA-treated group (Group III). Thioredoxin Interacting Protein (TXNIP) and cyclic Adenosine Monophos-phate (cAMP) were immunoassayed in addition to determina-tion of levels of plasma fructosamine, fasting blood glucose (FBG) and pancreatic tissue Malondialdehyde (MDA) along with pancreatic catalase and Superoxide Dismutase (SOD) activities.Results: ALA treatment showed significant improvement in fructosamine and FBG levels, decreased MDA level and increased catalase and SOD activities, in addition to increased cAMP level and decreased TXNIP level.Conclusion: We concluded that ALA has the ability to interfere with b-cell dysfunction associated with HFD-induced T2DM possibly by improving redox status, rescuing cAMP signaling and decreasing the level of TXNIP.
https://mjcu.journals.ekb.eg/article_53884_4ba9283077a7449c798b0e541c72368d.pdf
2019-06-10
1615
1623
10.21608/mjcu.2019.53884
Alpha Lipoic Acid (ALA)
High Fat Diet (HFD)
Malondialdehyde (MDA)
Thioredoxin Inter-acting Protein (TXNIP)
Cyclic Adenosine Mono-phosphate (cAMP)
DOAA T. EL-SABBAGH, M.Sc.;
LAMEES M. DAWOOD, M.D.
1
AUTHOR
AHMED A. ABDALLAH, M.D.;
SOBHY A. HASSAN, M.D.
2
The Department of Medical Biochemistry, Faculty of Medicine, Kafr El-Sheikh* and Tanta** Universities, Egypt
AUTHOR
ORIGINAL_ARTICLE
Case Load of Placenta Previa and Accreta at Assuit Women's Health Hospital: Maternal and Neonatal Outcomes
AbstractBackground: Placenta previa and accreta is considered a severe pregnancy complication that may be associated with massive and potentially life-threatening intrapartum and postpartum hemorrhage, so it has become one of the most important leading cause of emergency hysterectomy which represents 40-60% of cases. Maternal morbidity had been reported to occur in up to 60% and mortality in up to 7% of women with placenta accreta. Also the additional potential intra operative and post-operative morbidity were associated with massive blood transfusion, hypovolymea, surgical injury to the ureters, bladder, bowel, or neurovascular structures; adult respiratory distress syndrome, need for blood transfusion, electrolyte imbalance, renal failure and infection.Aim of Study: The aim of the current study was to define the prevalence of placenta previa and accreta in the period from January 2016 to December 2016 and to evaluate the maternal and neonatal outcomes.Patients and Methods: The study design was a retrospec-tive descriptive study from recorded data in the period from January 2016 to December 2016 on all patients delivered at Women's Health Hospital, Assuit University including all cases of placenta previa with or without placenta accretta, maternal and neonatal data was evaluated. Finally, the obtained data was analyzed by means of SPSS software (Version 16.0) and pResults: Total number of deliveries 13486 cases the incidence of placenta previa was 267 cases (1.98%), also the incidence of placenta accreta was 55 cases (0.4%), uterine artery ligation in 166 cases (62.1%), placenta left in situ in one case (0.37%), intra uterine balloon insertion in 6 cases (2.25%), transverse B Lynch in 10 cases (3.75%), internal iliac artery ligation in 4 cases (1.5%), cesarean hysterectomy was performed in 37 cases (13.8%), bladder injury occurred in 33 cases (12.4%), ureteric injury in 3 cases (1.1%), colon injury in one case (0.37%), vascular injury occurred in one case (0.37%), post partum internal hemorrhage occurred in 3 cases (1.1%), post partum pelvic hematoma occurred in one case (0.37%), ICU admission was needed in 20 cases (7.5%), post-operative blood transfusion was needed in 62 cases (23.2%), re intervention needed in 8 cases (2.9%), maternal mortality was 4 cases (1.5%), the mean gestational age was 34.73±2.8 weeks. Also there were 66 neonatal cases (22.1%) needed assisted ventilation in the form of ambu bag or en-dotrachial intubation gestation. NICU admission needed in 41 neonatal cases (15.4%), and neonatal mortality reported in 7 neonatal cases (2.6%). Congenital anomalies were reported in 2 neonatal cases (0.7%).Conclusion: The incidences of placenta previa and placenta accreta were higher than which reported internationally due to increase CS rate. Also there is no definite planned manage-ment method widely accepted except for hysterectomy.
https://mjcu.journals.ekb.eg/article_53888_242e41ad39132b0fa63d9f6b4dfe1546.pdf
2019-06-10
1625
1630
10.21608/mjcu.2019.53888
Placenta Previa
Accrete
Neonatal outcomes
MAHMOUD S. ZAKHERAH, M.D.;
ESSAM R. ABD EL-HAFIZE, M.D.
1
AUTHOR
MERVT A.
MOHAMED, M.Sc.
2
The Department of Obstetrics and Gynecology, Faculty of Medicine, Assuit University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Role of Diffusion-Weighted MRI in Colorectal Cancer
AbstractBackground: To reveal the adding value of diffusion-weighted Magnetic Resonance Imaging (MRI) in the detection and differential diagnosis of the colorectal cancer, comparing the results of Apparent Diffusion Coefficient (ADC) value with histopathological studies.Aim of Study: The aim of the study was to determine the effectiveness of MRI in the diagnosis of colorectal cancers and to reveal the adding value of DWI in the detection and differential diagnosis of the colorectal cancer, comparing the results of ADC value with histopathological studies.Material and Methods: Fifteen patients with suspected colorectal cancers clinically, endoscopically or by CT and US images were included in this study. All cases have been evaluated with 1.5 MR scanner. In addition to the conventional sequences (T2-axial, sagittal and coronal weighted images (WI), axial T2 STIR, T1 WI and a Diffusion-Weighted Images (DWI) with 4 different b-values (0, 400, 600 and 1000s/mm2 and ADC maps were obtained then the results have been compared to histopathological diagnosis.Results: All cases of malignant colorectal cancer showed high signal (restricted diffusion) on DWI. Receiver Operating Curve (ROC) analysis of ADC values yielded an Area Under Curve (AUC) of 0.912, setting a threshold ADC value of Conclusion: DWI with high b-values and ADC value is a feasible method and has the potential to be effective in detection of colorectal cancer.
https://mjcu.journals.ekb.eg/article_53892_18465b15501e7f67832fb05d34cfe8c2.pdf
2019-06-10
1631
1637
10.21608/mjcu.2019.53892
Colonic cancer
MRI
DWI
Apparent diffusion coefficient (ADC)
NEHAL K. MOHAMED, M.Sc.;
EMAN A. AHMAD, M.D.
1
AUTHOR
MOHAMED Z. MOHAMED, M.D.;
ABO EL-HASSAN H. MOHAMED, M.D.
2
The Department of Diagnostic Radiology, Faculty of Medicine, Assiut University
AUTHOR
ORIGINAL_ARTICLE
Breast-Conserving Therapy Versus Modified Radical Mastectomy in the Early Breast Cancer Management: Oncological Outcome and Quality of Life
AbstractBackground: Breast cancer is the most common malig-nancy among women. Mastectomy is the current standard surgical procedure for ipsilateral tumor of the breast. However, there is little evidence about the prognostic effect of the surgical procedure (mastectomy versus lumpectomy) for early management of breast cancer. We investigated the breast-conserving therapy versus radical mastectomy in the early breast cancer management, and investigated the effect of treatment modalities on quality of life after breast cancer surgery.Aim of Study: To investigate the oncological outcomes of Breast-Conserving Therapy (BCT) versus Radical Mastec-tomy (MRM) in the early breast cancer management and to investigate the effect of treatment modalities on Quality of Life (QOL) more than 1 year after breast cancer surgery by comparing the QOL of the two groups of patients who under-went Breast Conserving Surgery (BCS) or Modified Radical Mastectomy (MRM).Patients and Methods: A retrospective-prospective cohort study between June 2010 and June 2017, at Zagazig University Hospitals in the General Surgery and Oncology Departments, a group of 456 patients (295 patients in the BCT group, 161 patients in the MRM group) was selected. Of the 456 patients enrolled, 383 patients gave their consent and completed the study questionnaire (177 patients in the BCT group, and 206 patients in the MRM group.Results: After 2-6years of follow-up, the overall survival was lower for BCT group 93.9%. While in MRM group was 94.4% with no statistical difference between both groups regarding this parameter. Quality of life after BCT was found better than MRM in the social and the emotional functions.Conclusions: The breast-conserving-therapy has been shown to be as effective as mastectomy in the treatment of early breast cancer in the local recurrence and overall survival rate of those patients. BCT improves the patients' QOL more than MRM does.
https://mjcu.journals.ekb.eg/article_53898_43aadd387bf2fc0d8dd3a6a7e52d2108.pdf
2019-06-10
1639
1647
10.21608/mjcu.2019.53898
breast cancer
Conservative therapy
Radical mastectomy
quality of life
HALA A. EL-MAGHAWRY, M.D.;
MOHAMED F. AMIN, M.D.
1
AUTHOR
MOSTAFA M. KHAIRY, M.D.;
AHMED S. ARAFA, M.D.
2
AUTHOR
HANAA A. NOFAL, M.D.;
ABD EL-MOTALEB MOHAMED, M.D.
3
AUTHOR
AHMED
EL-AZONY, M.D.
4
The Departments of Community, Environmental & Occupational Medicine*, General Surgery** and Clinical Oncology***, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Association of Ki-67 Expression and the Aggressiveness of Hepatocellular Carcinoma
AbstractBackground: Ki-67 is a nuclear proliferative marker. It is therefore widely used as a cell proliferation marker to grade tumors.Aim of Study: The aim of the current study was to assess the possible association between Ki-67 and the aggressiveness of hepatocellular carcinoma.Material and Methods: This study was conducted at Pathology Department in National Liver Institute, Menoufia University. A total of 114 cases were included. TMA was performed for tumor blocks and stained with antibody against Ki-67.Results: The percentage of Ki-67 expression ranged between 1 and 95% with a mean ± SD of 56.72±40.53 and a median of 80. As regard Ki-67 expression, large tumor size group were significantly associated with increased expression of Ki-67 (p=0.049). On the other hand, older age group (>60 years) and large tumor size group (>5cm) were significantly associated with increased percentage of Ki-67 expression (p=0.035 and 0.015) respectively.Conclusion: Ki-67 expression is associated with aggressive hepatocellular carcinoma, so it could change the type of therapy for these tumors.
https://mjcu.journals.ekb.eg/article_53903_c9e9c76760b568ce78af17acd4f78c40.pdf
2019-06-10
1649
1655
10.21608/mjcu.2019.53903
Ki-67
Hepatocellular carcinoma
Aggressive-ness
TMA
expression
WALAA G. EL-GENDY, M.Sc.;
NANIS S. HOLAH, M.D.
1
AUTHOR
DALIA R. EL-SHARAKY, M.D.;
DINA S. EL-AZAB, M.D.
2
AUTHOR
ASMAA G. ABDOU, M.D.;
MOHAMMED T. BADR, M.D.
3
The Department of Pathology, National Liver Institute* and Faculty of Medicine**, Menoufia University, Shebin El-Kom, Egypt
AUTHOR
ORIGINAL_ARTICLE
Overweight Problem among Early Adolescents in Preparatory Schools in Tanta City
AbstractBackground: Overweight is a major public health problem affecting adolescents. Prevalence of overweight and obesity is rapidly increasing. Good nutritional knowledge and behavior may help in prevention of overweight and obesity.Aim of Study: 1- Assess the prevalence of overweight and obesity among preparatory school children in Tanta City. 2- Assess students' nutritional knowledge and eating habits.Subjects and Methods: Cross sectional study carried-out at the preparatory schools in Tanta City, Egypt. The study subjects included; 250 boy and 250 girl were chosen by stratified random sample technique. The first stratum was boys and girls schools and the second stratum was school grades. Each school was divided into three grades and one class was chosen randomly from each grade.Tools of the Study:1-Predesigned questionnaire asked about (sociodemographic data, nutritional knowledge and eating behavior).2-Weight and height measurements to calculate BMI.Results: The prevalence of overweight and obesity among studied group was (22.8% and 11.8%) respectively. Prevalence of overweight among girls and boys (13.4% and 9.4%) re-spectively, while obesity (5.2% and 6.6%) respectively. (76.4%) of the students had fair nutritional knowledge level while only (19.4%) of them had good nutritional knowledge. (88.4%) of the students had fairly sound nutritional behavior while only (5.4%) of them had sound nutritional behavior.Conclusion and Recommendations: More than one fifth of the students in the study were overweight with smaller percent of obesity. Overweight was more common among females while obesity was more among males. Fair nutritional knowledge and behavior were found in most of the students. So we should encourage healthy eating among adolescents and provide healthy snacks at school canteen with a suitable price. Guide students and their families to the best YouTube channels that can help them to prepare healthy food in a rapid and delicious way.
https://mjcu.journals.ekb.eg/article_53908_6591b23d93ac2935a3d6a13e97176d51.pdf
2019-06-10
1657
1664
10.21608/mjcu.2019.53908
overweight
Obesity
Adolescents
Nutritional knowledge
Nutritional behavior
AYA M. RABIE, M.Sc.;
WALAA M. SHEHATA, M.D.
1
AUTHOR
NADIRA MANSOUR HASAN, M.D.;
NIHAL SALAH EL-DEEN SHIHAB, M.D.
2
The Department of Public Health and Community Medicine, Faculty of Medicine, Tanta University
AUTHOR
ORIGINAL_ARTICLE
Management of Cervical Disc Disease Using Intervertebral Cage and Dynamic Cervical Implant (DCI): Short Term Radilological Comparison Study between Fixed and Dynamic Groups
AbstractBackground: This study details analysis of the indications,safety, efficacy and complications of dynamic cervical replacementfor replacement of cervical disc in cases cervicaldisc diseases compared to PEEK cage insertion.Aim of Work: The study aims to compare the outcome oftwo modalities for the treatment of the cervical disc diseases,the first group is the fixed group (treated by insertion of intervertebral cages), and the second group is the dynamic one,(treated by insertion of the dynamic cervical implants or DCI).Patient and Methods: A prospective study conducted on50 patients with single or double level cervical disc diseaseslike herniated or degenerative lesions treated with fixed anddynamic prosthesis, confirmed by clinical data.Results: Average age of presentation was 44.1 years forboth groups, female ratio for the fixed group was 1.5:1, and1:1.08 for the dynamic group, with age ranged between 35and 53 years for both studies with an average of 44.1 ±6.345years. The average duration of symptoms was 51.4 weeks.The average follow-up period in our study was 22.5 months,21 cases had left sided radiculopathy, 10 cases had right sidedaffection. The most common presenting symptom after brachialgia(100%) was neck pain, most common sign was sensorychanges. Most common operated level was C5-6 for bothgroups. The average follow-up period in our study was 22.5months.Conclusion: The DCI implant is the alternative to cagefusion and total disc prosthesis with a wider range of indications.The DCI implant offers stable, controlled (adequate)motion to already significantly degenerated motion segments.
https://mjcu.journals.ekb.eg/article_53919_64b9586d38d0e21edfeb9d713c85f605.pdf
2019-06-10
1665
1674
10.21608/mjcu.2019.53919
cervical spine
Disc herniation radiculopathy
Neural foramen
ESAM R. AL-GEHAWY, M.D.;
MOHAMED B. ABD EL-SALAM, M.D.
1
AUTHOR
MOHAMED M. MOHIELDIN, M.D.;
EHAB M. ABD EL-GHAFAREISSA, M.D.
2
AUTHOR
HAMDI N. MOSTAFA, M.D.;
SALAMA G. KORAITIM, M.Sc.
3
The Department of Neurosurgery, Faculty of Medicine, Cairo University* and Misr University for Science & Technology**
AUTHOR
ORIGINAL_ARTICLE
Expression of Hypoxia Inducible Factor-1a Correlates with Microvessel Density in Glioblastoma Multiforme
AbstractBackground: Glioblastoma multiforme (GBM) is the most aggressive brain tumour characterized by marked angiogenesis, invasiveness and poor outcome. Intratumoral hypoxia possibly plays a key role in GBM growth and angiogenesis. A key regulator of adaptive response to hypoxia is the hypoxia inducible factor 1-alpha (HIF-1a) protein.Aim of Study: The present study aimed to evaluate the expression of HIF-1a in tumour cells of GBM and analyze its relation to tumour microvessel density.Material and Methods: Fifty formalin fixed paraffin embedded tissue blocks of GBM were studied immunohisto-chemically for HIF-1a expression using anti-HIF-1a mono-clonal antibody and for microvessel density using anti-CD34 monoclonal antibody.Results: HIF-1a expression was observed in 86% of the studied cases. The immuostaining scores were negative in 14%, weak positive in 20%, moderate positive in 28% and strong positive in 38% of cases The mean microvessel counts were 14.3±11.5 in the negative cases, 21.6±15.8 in the weak positive cases, 27.2±21.7 in the moderate positive cases and 32.8±16.3 in the strong positive cases. A statistically significant relation was found between the expression of HIF-1a protein and microvessel density in the studied GBM cases (p=0.01).Conclusion: Our findings have shown that expression of HIF-1a protein is correlated to the microvessel density in GBM, supporting evidence that different types of tumours can induce aberrant angiogenesis through HIF-1a. Thus, an understanding of the relationship between HIF-1a and tumour angiogenesis in GBM may provide further therapeutic oppor-tunities for patients with this tumour.
https://mjcu.journals.ekb.eg/article_53924_b1204357894459fb3ab4ebc19293dfb5.pdf
2019-06-10
1675
1679
10.21608/mjcu.2019.53924
Glioblastoma Multiforme
Hypoxia Inducible Factor-1a
Microvessel Density
MOHAMED
WAGIH, M.D.
1
The Department of Pathology, Faculty of Medicine, Beni-Suef University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Benefits of MR Diffusion Tensor Imaging and Fiber Tractography Over Conventional MRI in Preoperative Evaluation of Pediatric Brain Tumors
AbstractBackground: Diffusion tensor imaging (DTI) is a nonin-vasive magnetic resonance imaging (MRI) modality which accurately shows the location and orientation of subcortical white matter (WM) tracts. The surgeon benefits from DTI as it depicts the relationship of the intra-axial tumor to local WM tracts in multiple planes.Aim of Study: The purpose of this study is to evaluate the role of MR diffusion tensor imaging and fiber tractography and its benefits over conventional MRI in accurate preoperative localization of important eloquent areas in pediatric brain tissue and their relation to the brain tumor. The aim of the study is to help the surgeon in planning his surgical corridor which causes the least damage and minimizes the postoperative neurological deficits.Patients and Methods: A total of fifty patients with brain tumors were included in this study using pre-operative contrast-enhanced magnetic resonance imaging and DTI fiber tractog-raphy for preoperative localization of important white matter tracts. Diffusion tensor imaging, by improving the recognition and characterization of white matter tracts, offers a glimpse into the brain microstructure at a scale that is not easily accessible with other modalities.Results: The extent of white matter pathway involvement was clearly identified in all patients by using color-coded DT imaging maps and MR Tractography.The study revealed that the most common tract involve-ment pattern detected was pattern (displacement). It was seen in 36 cases representing 72% of all cases. Pattern I (not affected) was detected in 6 cases representing 12%. Pattern III (edematous) was detected in 11 cases representing 22%. Pattern IV (partially disrupted) was detected in 13 cases representing 26%. Pattern V (destroyed) was detected in 3 cases representing 6%. Combined pattern of affection has been detected in most of the cases.Conclusion: The effect of cerebral neoplasms on white matter pathways is not precisely understood with the aid of standard diagnostic modalities. Diffusion-tensor imaging allowed for the preoperative identification of white matter pathways involved by tumor but the preoperative planning should be optimally complemented by various intraoperative procedures in order to insure a good neurological outcome of the surgery and valid functional prognosis.
https://mjcu.journals.ekb.eg/article_53925_f8394d5abd9ae074a472fa939c1daf26.pdf
2019-06-10
1681
1689
10.21608/mjcu.2019.53925
Diffusion tensor imaging( DTI)
Brain tumor
Magnetic resonance image
Tractography
White matter tracts
SAMIA Y. HEIKAL, M.Sc.;
IMAN M. ZAKY, M.D.
1
AUTHOR
MOHAMED A. EL-BELTAGY, M.D.;
AYMAN ABD EL-HAMID EL-BASMY, M.D.
2
The Departments of Radio-diagnosis*, National Cancer Institute, Radiology** and Neurosurgery***, Faculty of Medicine, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Assessment of Efficiency of Using Clinical Pulmonary Infection Score (CPIS) on the Outcome and Cost of Mechanically Ventilated Cases
AbstractBackground: Ventilator-Associated Pneumonia (VAP) is a common Healthcare Associated Infection (HAI) in critical care department; VAP occurs frequently and is associated with significant morbidity and mortality in critically ill patients.Aim of Study: To improve health outcome of patients on Mechanical Ventilation (MV) through early diagnosis of (VAP), early management with appropriate antibiotics pre-scription using Clinical Pulmonary Infection Score (CPIS) and measurement the cost of hospital stay and cost of the antimicrobial therapy.Methods: Operational research, quasi-experimental inter-ventional study design. The study was conducted in the in Critical Care Department in the Faculty of Medicine Cairo-University. The study has 2 phases Phase 1: Recruiting the Control group (40 cases) on MV not using CPIS. Phase 2: recruiting the Interventional group (40 cases) on MV using CPIS.Results: The CPIS was lower in intervention group at the day 3 with significant difference p=0.01. Deaths in intervention group (who were followed by CPIS) were insignificantly lower. The median of total cost and medication cost were lower in intervention group and the median of antibiotic cost was significantly lower in patients (who were followed by CPIS) in intervention group than control group p=0.01.Conclusion: CPIS considered tool to monitor patient's condition on MV and monitor their response to antibiotic treatment for early modification which in turn reflected on hospital stay and cost.
https://mjcu.journals.ekb.eg/article_53942_ecc126a4d9ed109a0ec0c14fc4c902ca.pdf
2019-06-10
1691
1696
10.21608/mjcu.2019.53942
Mechanical ventilation MV
Ventilator associated pneumonia VAP
Intensive Care Unit ICU
Clinical pulmonary infection score CPIS
Acute physiology and chronic health evaluation APACHE
cost
SARA A.A.M. HEIKAL, M.Sc.;
SALWA ABD EL-AZEEM, M.D.
1
AUTHOR
SAHAR YASSIN, M.D.;
DOA&#;A A.E. SALEH, M.D.
2
AUTHOR
LAMIA'A H.
MOHAMMED, M.D.
3
The Departments of Public Health & Community Medicine* and Critical Care**, Faculty of Medicine, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Comparative Study between Single, Double and Intra-Cluster Injection in Ultrasound-Guided Supraclavicular Brachial Plexus Block: A Randomized Trial
AbstractBackground: There are many different approaches for ultrasound-guided supraclavicular brachial plexus block. Each approach has a different success rate and complications.Aim of Study: The aim of this study is to compare intra-cluster injection technique compared with the most common supraclavicular approach single and double injection tech-niques.Material and Methods: Thirty-six patients received supr-aclavicular block were divided in to three groups. The total volume of local Anesthetic was 30ml 0.5% bupivacaine, In Gs (n=12) the whole volume was injected at corner pocket, while in Gd (n=12), half the volume of local anesthetic was injected at corner pocket and the other half was injected supero-lateral to subclavian artery. In Gic (n=12) the whole volume was injected inside main and satellite neural cluster. the onset time was recorded as the primary outcome.Results: Gic showed rapid onset compared to Gs and Gd (8.17±1.64 minutes, 18±2.45 minutes, 12.58±1.83 minutes, p<0.001) respectively. While Gd showed the longest duration than Gic and Gs (444.17±64.73 minutes, 310±50.09 minutes, 125.83±43.32 minutes, p<0.001) respectively. Time of first rescue analgesia was longer in Gd relative to Gic and G s (455±65.68 minute, 337.50±49.38 minutes, 136.67±49.10 minutes, p<0.001). Complication was noticed in only one patient in Gd.Conclusion: Intra-cluster technique for Supra-Clavicular Brachial Plexus Block showed rapid onset with adequate post-operative analgesia and minimal complications.
https://mjcu.journals.ekb.eg/article_53948_99cacc39f2b672d7460767927c0d7bf4.pdf
2019-06-10
1697
1702
10.21608/mjcu.2019.53948
Single injection
Double injection
Intra- cluster injection
Ultrasound guided brachial plexus block
SHERIN REFAAT, M.D.;
ASHRAF RADY, M.D.
1
AUTHOR
AHMED EL-SONBATY, M.D.;
AHMED MAHMOUD, M.Sc.
2
The Department Anesthesiology and Critical Care Medicine, Faculty of Medicine, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Ferulic Acid Promotes Growth of Both Fast Glycolytic and Slow Oxidative Skeletal Muscles in Corticosteroid-Induced Rat Myopathy
AbstractBackground: Glucocorticoids (GCs) are wide spread anti-inflammatory supplementation associated with various side effects especially in long term administration. Currently, there is no universally accepted prophylactic treatment for patients commencing long-term steroids.Aim of Study: This research aims to study the possible beneficial role of Ferulic Acid (FA), as a naturally existing antioxidant and anti-inflammatory, in preventing muscle atrophy and promoting growth of fast glycolytic and slow oxidative skeletal muscle fibers in rat model of glucocorticoid induced myopathy.Material and Methods: 48 rats were divided into 4 groups: Control, Ferulic acid supplemented group, Dexamethasone (Dex) supplemented group, rats supplemented with FA and Dex. After 2 weeks, all rats were sacrificed after taking blood samples. Left legs were preserved for histopathological and RT- PCR examinations. While, the right legs were kept for recording of isometric muscle contractility.Results: Dex group showed marked decrease in muscle mass, isometric contraction forces, antioxidant enzymes and Mechano-Growth Factor (MGF) expression together with increase in myostatin expression and malondehyde. FA ad-ministration improved all these deleterious effects of Dex on both skeletal muscle fibers. This beneficial effect of FA was proved by histopathological improvement of sarcoplasmic degeneration, inflammatory cells infiltration and Zenker's necrosis of muscle bundle which featured rats' muscles of Dex group.Conclusion: Ferulic acid, as an antioxidant and anti-inflammatory, can be used as an adjuvant therapy with anti-inflammatory corticosteroids to augment its therapeutic effect and reduce its myotrophic changes.
https://mjcu.journals.ekb.eg/article_53950_3e9bcfdff5961ceef22e9168706f6989.pdf
2019-06-10
1703
1715
10.21608/mjcu.2019.53950
Dexamethazone (Dex)
Ferulic Acid (FA)
Myostatin
Mechano- growth factor (MGF)
Fast glycolytic
Slow oxidative
SHEREEN M. SAMIR, M.D.;
ABEER F. MOSTAFA, M.D.
1
The Department of Medical Physiology, Faculty of Medicine, Mansoura University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Ultra Sonographic Evaluation of the Pancreatic Size in Type II Egyptian Diabetic Patients
AbstractBackground: The pancreas is an insulin-secreting gland and is prone to varying degrees of destruction and change in patients with Diabetes Mellitus (DM). Various morphological changes including reduction in the pancreas size have been described in DM. Real time sonography can assess the gland in most of cases and it is accurate in diagnosis of pancreatic disorders.Aim of Study: To evaluate the pancreatic size in type II Egyptian diabetic patients.Patients and Methods: Comparative cross-sectional study was carried out on 120 subjects over a 6 month period in Tanta University Hospitals to evaluate the ultra sonographic size of the pancreas and both the duration of the disease and type of treatment in type II Egyptian diabetic patients. Group (A): 100 patients with type II diabetes mellitus. Group (B): 20 non-diabetic patients (healthy controls). We excluded patients of type I diabetes mellitus and patients with known or possible history of pancreatic diseases such as pancreatitis, cystic fibrosis, autoimmune disorders, pancreatic tumors, and chronic alcohol consumption. Complete clinical examination, routine laboratory investigations and specific investigation including. HbA1 c and Pelvi-abdominal ultrasonography were done. Sonographic measurements of the size of the pancreatic head, body, and tail of both study groups were performed.Results: There is a significant difference between diabetic group and control group as regard to head (cm), body (cm) and tail (cm), p-value (0.001, 0.001 and 0.001). There are pancreatic head, body and tail size decrease more significantly in the group on oral hypoglycemic drugs than the group receiving oral hypoglycemic drugs plus insulin p-value (0.001, 0.001, 0.037). There is a negative significant correlation between duration and pancreatic head, body and tail size in diabetic group, p-value (0.001, 0.001, 0.001).Conclusion: From the results of the present study, we can conclude that the pancreas size of diabetic patients is signif-icantly smaller than those of normal control group. We also concluded that in type II diabetes longer duration of illness was associated with smaller pancreas head, body and tail size. The pancreatic head, body and tail size decrease more significantly in the group on oral hypoglycemic drugs than the group receiving oral hypoglycemic drugs plus insulin.
https://mjcu.journals.ekb.eg/article_53952_ac399444b1105d84211331089c1430ad.pdf
2019-06-10
1717
1721
10.21608/mjcu.2019.53952
pancreas
Diabetes mellitus
Ultrasonography
AZZA S. KHALAF, M.Sc.;
MOHAMMED H. ABO FREIKHA, M.D.
1
AUTHOR
SHERIF E. EZZAT, M.D.;
ABDALLAH A. AL-SAWY, M.D.
2
The Department of Internal Medicine, Faculty of Medicine, Tanta University
AUTHOR
ORIGINAL_ARTICLE
Relationship between Plasma Adiponectin Level and Peptic Ulcer Disease
AbstractBackground: Adipose tissue is an endocrine organ that secretes various bioactive adipocytokines, such as adiponectin. Adiponectin has anti-inflammatory, anti-diabetic and anti-atherosclerotic properties. Therefore, it may act as a protector against multiple metabolic disorders, including diabetes mellitus, dyslipidemia, and hypertension. In addition, it may have a relationship with some gastrointestinal disorders, such as gastro-esophageal reflux disease, gastritis and peptic ulcer disease.Aim of Study: Aim of the work: The main contribution of this work is to determine the relation between plasma adi-ponectin level and peptic ulcer disease which was diagnosed previously by endoscopy.Subjects and Methods: This study was carried out on 60 patients and 20 healthy control individuals, who were subjected to full history taking, thorough clinical examination and Body Mass Index (BMI) measurement. Laboratory investigations were carried out including Fasting Blood Glucose (FBG), Complete Blood Count (CBC), liver function tests, renal function tests, helicobacter pylori antigen in stool, serum triglyceride, serum cholesterol and serum adiponectin level. Upper GIT endoscopy was used for screening the individuals to diagnose gastritis or ulcer.Results: A negative correlation was established between endoscopically diagnosed patients with Peptic Ulcer Disease (PUD) and gastritis and plasma adiponectin level.Conclusion: Patients with peptic ulcer disease and gastritis had low plasma adiponectin level.
https://mjcu.journals.ekb.eg/article_53956_33f4548323178ec152ad081315fa5986.pdf
2019-06-10
1723
1730
10.21608/mjcu.2019.53956
adiponectin
Endoscopy
Gastritis
Peptic ulcer
SALLY A. EL-SHANWANY, M.Sc.,
M.B.B.Ch.*; HEBA A. MOURAD, M.D.
1
AUTHOR
MOHAMED A. EL-SEBAEY, M.D.;
WALEED S. MOHAMED, M.D.
2
The Departments of Internal Medicine* and Clinical Pathology**, Faculty of Medicine, Tanta University
AUTHOR
ORIGINAL_ARTICLE
Effect of Vitamin D on Serum Fibroblast Growth Factor-23 and Cardiac Tissue Hydroxyproline Levels in Experimentally Induced Insulin Resistance Associated with Left Ventricular Hypertrophy in Rats
AbstractBackground: Insulin resistance cardiomyopathy refers to functional and structural changes at the level of myocar-dium; independent of hypertension, coronary artery disease, or any other known cardiac diseases, leading to HF, with LVH as the main structural hall mark for it. Several factors have been documented in its pathogenesis; in obese insulin resistant FGF-23 a bone derived hormone can be involved .The role of vitamin D, has gained much attention over the last years as a potential therapeutic agent for prevention of insulin resistance and its protective role against ventricular hypertrophy.Aim of Study: Was to evaluate the potential effect of vitamin D as a protective factor against the development of LVH in experimentally induced insulin resistance in rats using the level of FGF-23 as a predictor and cardiac tissue hydrox-yproline as a biomarker for cardiac affection.Material and Methods: This study was conducted on 60 male albino rats divided randomly into four equal groups as follow group I (normal control group), group II (vitamin D treated control group), group III (high sucrose subjected group) and group IV (vitamin D co-treated high sucrose subjected group). In order to induce insulin resistance and cardiomyopathy both third and fourth groups were allowed to get free access to 35% sucrose as their drinking water for 16 weeks, during induction of insulin resistance cardiomyop-athy by sucrose in the fourth group rats were co-treated by giving vitamin D orally in a dose (1000IU/kg) dissolved in 1ml olive oil, given every other day by gavage for 12 weeks. At the end of the experiment blood samples were collected by cardiac puncture after ether anesthesia, chest and abdomen were opened and the heart was extracted. All groups were subjected to estimation of: Serum measurement of fasting glucose level using colorimetric assay and fasting insulin level by rat insulin ELISA kit to asses insulin resistance using (HOMA-IR index). Also, serum FGF-23 by rat FGF-23 ELISA kit as well as left ventricular tissue hydroxyproline content using colorimetric assay. Histopathological examination of the left ventricle specimens was done.Results: There were statistically significant differences between group III compared to other groups (I, II, IV), regarding fasting serum glucose, serum insulin, HOMA-IR, serum FGF-23 hydroxyproline content of the left ventricle. These parameters were significantly increased in high sucrose subjected group compared to other groups. Also, histopatho-logical study confirmed the biochemical findings.Conclusion: Vitamin D helped to ameliorate metabolic derangement in IR and the associated left ventricular hyper-trophy directly and through modifying FGF-23 levels.
https://mjcu.journals.ekb.eg/article_53958_561173ec094c365da4b6ef6f3e7be34d.pdf
2019-06-10
1731
1740
10.21608/mjcu.2019.53958
Insulin Resistance
cardiomyopathy
FGF-23
hydroxyproline
EMAN S. ABD EL-LATIF, M.Sc.;
ROWIDA R. IBRAHIM, M.D.
1
AUTHOR
AMAL A. BAALASH, M.D.;
SALWA M. ALMELIGY, M.D.
2
The Department of Medical Biochemistry, Faculty of Medicine, Tanta University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Nonoperative Treatment Compared with Plate Fixation of Displaced Midshaft Clavicular Fractures in Adults
AbstractBackground: Fracture clavicle is one of the most common fractures, it constitutes about 4% of all fractures. 76% of clavicular fractures are fracture of the mid shaft. Clavicular fractures have classically been treated conservatively with favourable results. However, unsatisfactory results were found in recent clinical series as nonunion and malunion. The debate is still present between conservative and operative treatment of displaced fracture clavicle. This study is meant to compare the outcomes of nonoperative conservative treatment and operative treatment with plate fixation of the completely displaced midshaft clavicular fractures to clarify the merits and possible disadvantages of each method.Aim of Study: Comparison between the outcomes of the non-operative and operative treatment of displaced mid-shaft clavicular fracture to reveal the advantages and disadvantages of each method to refine the indications of each method.Patients and Methods: This study was performed on fourty adult patients with mid-shaft clavicular fracture, sub grouped randomly in two matched groups regarding age, sex and type of fracture. 20 patients (Group A) were treated non-operatively by immobilization with broad arm sling and 20 patients (Group B) were treated operatively by open reduction and internal fixation (ORIF) with plate and screws. Patients were collected from orthopedic surgery department, Tanta University Hospitals, followed up at a period of 18 months and assessed using the constant shoulder score (CSS).Results: Results were functionally satisfactory in 90% of group A patients and in 70% of group B patients according to CSS. ORIF was attended with higher complication rate, inferior overall outcome and more unsatisfied patients.Conclusions: According to the study results, non-operative treatment by broad arm sling is the preferred line of treatment in solitary closed uncomplicated mid-shaft clavicular fractures. ORIF is recommended in cases of associated scapular neck fracture “floating shoulder”.
https://mjcu.journals.ekb.eg/article_53960_88955ed330189a581d6f78e8956e1a19.pdf
2019-06-10
1741
1751
10.21608/mjcu.2019.53960
Fracture mid-shaft clavicle
Nonoperative VS operative treatment
Plate fixation
Displaced fracture
Comparative study
AHMED HEGAZY, M.Sc.;
AHMED AL-OLEMY, M.D.
1
AUTHOR
MOHAMMED QUOLQELA, M.D.;
MOHAMMED ROMEIH, M.D.
2
The Department of Orthopedic Surgery, Faculty of Medicine, Tanta University
AUTHOR
ORIGINAL_ARTICLE
Reversal of Haemostatic Changes in Letrozole-Induced PCOS Rat Model with Vitamin D Supplementation
AbstractBackground: Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine condition that appears to be associated with a prothrombotic tendency. Hypovitaminosis D is very common in PCOS patients and may exacerbate the metabolic abnormalities. Vitamin D supplementation might produce beneficial effects in these associated metabolic and haemostatic abnormalities.Aim of Study : The present study was designed to examine the effects of vitamin D supplementation on some metabolic, oxidative stress, inflammatory and haemostatic parameters in letrozole-induced PCOS rat models.Material and Methods: This study was conducted on 3 groups of adult female albino rats: Group-1: (Control) in which 1ml water was given orally by gavage daily for 21 days, and, group-II: (PCOS induced) in which letrozole was given orally by gavage at a dose of 1mg/kg dissolved in water daily for 21 days, and group-III: (PCOS induced treated with vitamin D) in which letrozole was given orally by gavage with cholecalciferol (200 IU/day) for 21 days. In all groups, serum levels of 25(OH) vitamin D, glucose, insulin, HOMAIR,lipid profile parameters, Luteinizing hormone (LH), Follicle-stimulating hormone (FSH), testosterone, estradiol,progesterone, interleukin-6 (IL-6), tumor necrosis factoralpha (TNF-a), plasma fibrinogen, factor VIII (FVIII), Von Willebrand factor (vWF), tissue plasminogen activator (tPA), plasminogen activator inhibitor 1 (PAI-1) activity and Ddimers levels were measured. Bleeding time (BT), whole blood clotting time (WBCT), prothrombin time (PT), activated partial thromboplastin time (aPTT) were also evaluated and ovaries were dissected and used for histopathological examination and evaluating malondialdehyde (MDA), superoxidedismutase (SOD) and glutathione peroxidase (GPx) levels.Results: The present study showed that letrozole-induced PCOS rat group (II) showed a statistically significant increase in the serum levels of insulin, glucose and calculated HOMAIR, Cholesterol, Triglyceride, LDL-c, VLDL-c, testosterone, FSH, LH, TNF-a, IL-6, ovarian MDA, plasma FVIII, Vwf, D-dimers, PAI-1 activity and fibrinogen levels (with statistically significant negative correlations with serum vitamin D level) while there were a statistically significant decrease in the serum levels of 25(OH) vitamin D and HDL-c, estradiol,progesterone, ovarian SOD and GPx, bleeding and clotting times, PT and aPTT when compared to controls (with statistically significant positive correlations with serum vitamin D level). Interestingly, all of the above measures were improved with vitamin D3 supplementation in the treated group (III).Also, vitamin D3 supplementation reduced the size and number of the cystically dilated ovarian follicles observed in the histopathological examination of letrozole-induced PCOS group. Conclusion: PCOS are associated with hypovitaminosis D and characterized by metabolic disturbances and a prothrombotic state that can be explained by increased both insulin resistance and inflammatory mediators together with the development of oxidative stress. These changes were improved by vitamin D supplementation.
https://mjcu.journals.ekb.eg/article_53961_fab3442146ac6b191b3f05ce387a9546.pdf
2019-06-10
1753
1767
10.21608/mjcu.2019.53961
PCOs
Haemostasis
Vitamin D
SUZAN M.M. MOURSI, M.D.;
EMAN EL-BAHAIE, Ph.D.
1
AUTHOR
SHEREIN F.
EL-SAYED, M.D.
2
The Departments of Physiology, Faculty of Medicine* and Zoology, Faculty of Science**, Zagazig University
AUTHOR
ORIGINAL_ARTICLE
Immunohistochemical Expression of Yes-Associated Protein-1 (YAP-1) in Cutaneous Lichen Planus
AbstractBackground: Lichen planus is a chronic muco-cutaneous inflammatory disease that affects skin, mucous membranes, scalp, and nails. The exact pathogenesis of the disease remains unclear but cell-mediated cytotoxicity is regarded as a major mechanism of pathogenesis of lichen planus. Yes-Associated Protein (YAP-1) was originally identified in Drosophila as a key component of the Hippo pathway, which regulates cell proliferation, apoptosis and migration.Aim of Study: The aim of this work was to study YAP-1 expression in cutaneous lichen planus.Patients and Methods: This study was carried out on 20 patients with cutaneous LP and 10 normal skin specimens served as controls. All specimens were examined by H&E, and by immunohistochemistry for YAP-1 expression.Results: There was statistically significant increase of YAP-1 expression in lesional skin of lichen planus patients in comparison to normal skin of healthy controls.Conclusion: Increased expression of YAP-1 was found in cutaneous lichen planus in comparison to normal skin suggesting a possible role of YAP-1 in lichen planus patho-genesis.
https://mjcu.journals.ekb.eg/article_53963_56471b9b613314f85197175db0ac2c91.pdf
2019-06-10
1769
1773
10.21608/mjcu.2019.53963
YAP-1
Immunohistochemistry
lichen planus
RANIA A.R. EL-TATAWY, M.D.;
DAREEN A. MOHAMED, M.D.
1
AUTHOR
YOMNA MAZID EL-HAMD A. NEINAA, M.D;
HEBA A.A. EL-BANBI, M.Sc.
2
The Departments of Dermatology & Veneral Diseases* and Pathology**, Faculty of Medicine, Tanta University
AUTHOR
ORIGINAL_ARTICLE
Endothelial-Platelet Dysfunction as an Indicator of Pre-Eclampsia and its Severity
AbstractBackground: Pre-Eclampsia (PE) is a common, pregnancy-specific syndrome defined by clinical findings of elevated blood pressure combined with proteinuria and edema. It affects 2-8% of pregnancies worldwide. Hypertensive disorders (including pre-eclampsia) are one of the most common causes of death during pregnancy. It also increases the risk of poor outcomes for both the mother and the baby. It is characterized by a generalized dysfunction of the maternal endothelium, as demonstrated by the increased levels of factor VIII, total and cellular Fibronectin (FN), thrombomodulin, endothelin. En-dothelial-platelet dysfunction new concept shows a vital role of endothelial cell and platelet: Endothelial dysfunction, increased vascular reactivity and platelet activation.Aim of Study: The present study was designed to evaluate the value of serum fibronectin and Von Willebrand Factor (VWF) as indicators of endothelial and platelet dysfunction in pre-eclampsia and its severity.Patients and Methods: The study was done on 50 pregnant women divided into 2 groups with 25 patients in each group. The levels of FN, VWF were measured by ELISA and Platelet Count (PLT) was measured by an automated cell counter.Results: The level of both FN and VWF were significantly higher while PLT count was significantly lower in cases group compared to the control group. Also, the level of FN was significantly higher in cases of severe pre-eclampsia compared to cases of mild pre-eclampsia.Conclusion: Endothelial-platelet dysfunction may explain the pathogenesis of pre-eclampsia. FN, VWF level and PLT count may be used as a marker of endothelial and platelet dysfunction in pre-eclampsia and may play a role in confirming the diagnosis. FN level may be also used to differentiate between mild and severe pre-eclampsia.
https://mjcu.journals.ekb.eg/article_53964_aa640b8b760436f09a451fca6c9a3ff7.pdf
2019-06-10
1775
1782
10.21608/mjcu.2019.53964
Pre-eclampsia
Endothelial -platelet dysfunction
Fibronectin
Von Willebrand Factor
HADER I. SAKR, M.D.;
AKEF A. KHOWAILED, M.D.
1
AUTHOR
MOATAZ M. KAMEL, M.D.;
MAHA E. FARGHALY, M.Sc.
2
AUTHOR
EMAN Z.
FARID, M.D.
3
AUTHOR
ORIGINAL_ARTICLE
The Association of Serum Omentin-1 Levels with Severity of Nonalcoholic Fatty Liver Disease in Correlation with Cardiovascular Risk Factors among Egyptian Women
AbstractBackground: Non-Alcoholic Fatty Liver Disease (NAFLD) is a pathologic condition with insidious course that varies from simple steatosis to steatohepatitis (NASH) with potential progression to cirrhosis. NAFLD is associated with metabolic syndrome, obesity, diabetes mellitus and insulin resistance. Omentin-1 is an adipokine which possesses anti-inflammatory effects; the role of omentin-1 in NAFLD is scarcely investi-gated.Aim of Study: Our study aimed to evaluate serum omentin-1 levels in women with NAFLD and to assess its relation to the severity of NAFLD and risk factors for cardiovascular morbidities among Egyptian women.Subjects and Methods: Case control study enrolled 55 women biopsy-proven NAFLD and forty healthy volunteers as a control group. NAFLD patients were divided into three groups; simple steatosis (n=30), NASH (n=15), and cirrhosis (n=10). Serum omentin-1 levels were measured using an Enzyme-Linked Immunosorbent Assay (ELISA).Results: Our results revealed that, NAFLD patients had lower values of serum omentin-1 when compared to controls. Among NAFLD patients, patients with cirrhosis had the lowest values of serum omentin-1. We detected significant negative correlations between serum omentin-1 levels and cardiomet-abolic parameters, obesity indices and liver function among patients with NAFLD.Conclusion: Women with NAFLD had lower values of serum omentin-1 than control group; moreover, among NAFLD groups, the lowest values were observed in patients with cirrhosis. The diagnostic power of serum levels of omentin-1 was highly significant thus; it could represent a promising noninvasive diagnostic biomarker of NAFLD.
https://mjcu.journals.ekb.eg/article_53966_2240db681ef33a190995c84a09af0c28.pdf
2019-06-10
1783
1791
10.21608/mjcu.2019.53966
NAFLD
Omentin-1
Cardiovascular
NASH
Cirrhosis
NEARMEEN M. RASHAD, M.D.;
AHMED F. GOMAA, M.D.
1
AUTHOR
HALA G. ABOMANDOUR, M.D.;
EBTESAM M. IBRAHIM, M.D.
2
AUTHOR
MAI M.
HASAN, M.D.
3
The Departments of Internal Medicine*, Cardiology** and Medical Physiology***, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Therapeutic Effect of L-Carnitine on Acute Pancreatitis Induced by L-Arginine in Rats: Possible Role of Beclin Gene and Inducible Nitric Oxide Synthase
AbstractBackground: Acute Pancreatitis (AP) is characterized by a severe inflammation, associated with premature activation of pancreatic digestive enzymes, cytoplasmic vacuolization, and infiltration of inflammatory cells into the pancreas. Medical therapy remains the principal option for treating AP. However, there is no specific effective drug to treat it.Aim of Study: This study is an experimental study that evaluates the therapeutic effect of L-carnitine at different doses on l-arginine induced pancreatitis in rats.Material and Methods: Thirty healthy adult male albino rats were involved in this study. AP was induced by L-arginine at a dose of (200mg/100g intraperitoneal twice at an interval of 1h). L carnitine (100, 300, 500mg/kg) was injected daily intraperitoneally for one week in treatment of acute pancreatitis in rats. The pancreatic injury was assessed using pharmaco-logical, biochemical and histological approaches. We evaluate the systolic blood pressure before and after treatment and pancreas to body weight ratio. Biochemical measurement of serum amylase, pancreatic tissue glutathione and malondal-dehyde, gene expression of Beclin by real time PCR. Also, all groups were examined histopathologically.Results: Our work revealed that L-arginine injected group showed significant acute pancreatitis biochemically and histopathologically in addition to increased percentage change of systolic blood pressure. While those treated by L-carnitine especially (500mg/kg) showed significant improvement bio-chemically as shown by increased pancreatic tissue glutathione level and decreased pancreatic tissue malondialdehyde level, also decreased gene expression of Beclin that approaches to normal, and histopathologically mainly in area of iNOS which is decreased towards normal.Conclusion: It is concluded that dose related L-carnitine can have a role of acute pancreatitis treatment not only by its antioxidant effect but also by being inhibitor of nitric oxide synthase and by affection of autophagy which is represented by Beclin gene expression.
https://mjcu.journals.ekb.eg/article_54021_717e558e5d770c39b80bedbacf050307.pdf
2019-06-10
1793
1803
10.21608/mjcu.2019.54021
Acute pancreatitis
L-carnitine
L-arginine
Beclin
iNOS
GHADA F. SOLIMAN, M.D.;
WALAA IBRAHIM, M.D.
1
AUTHOR
HANAN
ABDALLAH, M.D.
2
The Departments of Medical Pharmacology*, Medical Biochemistry & Molecular Biology** and Medical Histology**, Faculty of Medicine, Cairo University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Factors Causing Sleep Disturbances among School Age Children with Sickle Cell Disease
AbstractBackground: Sickle Cell Disease (SCD) is a group of inherited autosomal recessive hemolytic disorders. Sickle cell disease causes poor sleep quality that affect disease course. So it was important to assess causes of sleep disturbance among these children which in turn will improve children with SCD health outcomes and quality of life.Aim of the Study: To assess factors causing sleep distur-bances among school age children with SCD.Patients and Methods: A purposive sample of 50 children who had SCD and attend the outpatient clinic of hematology for follow-up and eligible for inclusion criteria.Tool of Data Collection: These were 4 tools which utilized which were personal characteristics and medical history sheet, knowledge assessment questionnaire, sleeping disturbance scale for children and structured questionnaire to assess factors causing sleep disturbance.Results: The study results revealed that more than two thirds of children were between 6Duration of the Study: The study took about 7 months and half as it started from the beginning of October 2016 till half of May 2017.Conclusion: The current study concluded that environ-mental, psychological, medical and treatment factors were factors causing sleep disturbances among school age children with SCD.Recommendations: Assessment of sleep disturbances among children with SCD is important to determine its pattern, factors affect sleep disturbances and health education program should be designed and provided for children with SCD, their caregivers about SCD factors causing sleep disturbances and how to deal with them.
https://mjcu.journals.ekb.eg/article_54023_2715d9452a016f65e83cff0580edb21f.pdf
2019-06-10
1805
1815
10.21608/mjcu.2019.54023
Sickle cell disease
school age children
Sleep disturbances
factors
MOUSA A.M. HASSAN, M.Sc.;
MIRRET M. DARWISH, D.N.Sc.
1
AUTHOR
HEWIDA A. HUSSIEN, D.N.Sc.;
MARWA A. ABD EL-SAMED, M.D.
2
The Departments of Pediatric Nursing, Faculty of Nursing* and Pediatric Medicine, Faculty of Medicine**, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Impact of Initial Platelet Count on Baseline Angiographic Finding in Patients with Acute ST- Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention
AbstractBackground: Platelets play an important role in cardio-vascular disease both in the pathogenesis of atherosclerosis and in the development of acute thrombotic events. Rupture of atheromatous plaque and subsequent occlusive thrombus formation are believed to be responsible for most acute myocardial ischemic events.Aim of Study: The aim of this study is to assess the relation and effect of initial platelet count on baseline angiographic findings in patients presented with acute ST Segment Elevation Myocardial Infraction (STEMI) undergoing Primary Percuta-neous Coronary Intervention (pPCI).Patients and Methods: This study was conducted at the Department of Cardiovascular Medicine, Tanta University Hospital at the period between June 2017 to December 2017, It was carried out on 150 patients diagnosed definitively with acute STEMI and treated with pPCI. Blood samples were collected from the patient on admission to show initial platelet count before coronary intervention followed by assessment of the angiographic findings before wiring of the infract related artery by TIMI flow grade system and scoring of the coronary anatomy with SYNTAX score.The patients were divided into two groups, group (1): Included patients who had TIMI flow grade 0 (82 patients) representing 54.7% and group (2): Patients who had TIMI flow grade 1-3 (68 patients) 45.3%.Results: Group (1) who showed total occlusion of infract related artery (TIMI 0) patients had higher initial platelet count with a mean of (255.74±72.01) X 103/mm3 compared to group (2) (TIMI 1-3) in which patients had lower initial platelet count with a mean of (194.94±47.54) X 103/mm3. There was no significant difference between the two groups as regarding of complexity of coronary arteries anatomy calculated by SYNTAX score.Conclusion: Initial platelet count in patients presented with acute STEMI had a role in predicting pre-interventional angiographic findings, higher initial platelet count is associated with higher incidence of total occlusion of infract related artery in STEMI patients treated with primary PCI, there was no significant relation between initial platelet count and SYNTAX score grade, initial platelet count alone has no effect on SYNTAX flow grade of coronary arteries. It seems that it is affected by multiple risk factors.
https://mjcu.journals.ekb.eg/article_54024_cbde0d10a29f3a8c0c35307036bd99f5.pdf
2019-06-10
1817
1827
10.21608/mjcu.2019.54024
STEMI
Platelets
TIMI
SYNTAX
PPCI
AMIR R. TALHA, M.Sc.;
MEDHAT M. ASHMAWY, M.D.
1
AUTHOR
EHAB A. HAMDY, M.D.;
ENAS E. DERAZ, M.D.
2
The Department of Cardiology, Faculty of Medicine, Tanta University
AUTHOR
ORIGINAL_ARTICLE
Diagnostic Accuracy of Multidetector Computed Tomography in Evaluation of Retroperitoneal Traumatic Injuries and Retroperitoneal Hemorrhage
AbstractBackground: Abdominal trauma represents a main daycare activity in radiology.non surgical treatment has become the standard of care in hemodynamically stable abdominal trauma patients as a result of comprehensive assessment of injury by imaging.MDCT is very sensitive method to detect traumatic injuries and determine the grading of this injuries on which the management will be performed.Aim of Study: To assess diagnostic accuracy of multi-detector CT in evaluation of retroperitoneal traumatic injuries and retroperitoneal hemorrhage.Patients and Methods: Prospective study included 60 patients with abdominal trauma (40 male, 20 females), their age ranged from 7 years to 70 years (mean age 34.8 year). Ultrasonography and MDCT were performed for all patients.Results: 30 patients (50% of the total studied patients) had retroperitoneal injuries, 27 patients of them (90%) were secondary to blunt abdominal trauma and 3 patients (10%) suffered from stab trauma. Fifteen patients had renal injuries; 3 of them associated with adrenal injuries, 2 patients had bowel injuries, 5 patients had pancreatic injuries, 3 patients had vascular injuries and 5 patients had retroperitoneal hematoma related to other injuries; 3 of them had psoas muscle injury and the other 2 patients had urinary bladder rupture.Conclusion: MDCT proved to be accurate and sensitive to evaluate retroperitoneal traumatic injuries and determine the grading and severity of these injuries on which the man-agement will be performed. In addition MDCT proved to be highly sensitive in detection of active hemorrhage which is a life threatening condition.
https://mjcu.journals.ekb.eg/article_54026_29fc1f4ef6e08a1b03551fa32486c809.pdf
2019-06-10
1829
1839
10.21608/mjcu.2019.54026
Retroperitineal
Multidetector CT
Trauma
HAYTHAM H. EL-SAID, M.D.;
MOHAMMED M. DAWOUD, M.D.
1
AUTHOR
MAGED M. RAGAB, M.D.;
MUSTAFA E.E. EL-HAGER, M.Sc.
2
The Departments of Radiodiagnosis* and Urology**, Faculty of Medicine, Tanta University
AUTHOR
ORIGINAL_ARTICLE
Role of Multi Detector Computed Tomography in Preoperative Evaluation of Middle Ear Cholesteatoma
AbstractBackground: Middle ear cholesteatoma is an ectopic squamous stratified epithelium in the middle ear. It is a actually risky disease as it leads to destruction of ossicles and/or walls of middle ear that causes severe complications as hearing loss and brain abscess. Pre-operative assessment of cholesteatoma by Multi-Detectors Computed Tomography (MDCT) is essen-tial for accurate diagnosis and appropriate management to prevent recurrence after surgery.Aim of Study: To assess the diagnostic accuracy of pre-operative MDCT of middle ear cholesteatoma with surgical correlation.Patients and Methods: A prospective study was conducted in Tanta University Hospitals from July 2015 to December 2016 on 30 patients with middle ear cholesteatoma. All patients had a pre-operative MDCT scans. The pre-operative MDCT findings were recorded and correlated with surgical and histopathological results. Sensitivity and specificity of pre-operative MDCT findings were calculated considering oper-ative findings as gold standard.Results: The study included 30 patients, 17 were females and 13 were males with a mean age of 35 years. The diagnostic accuracy of the pre-operative MDCT findings when correlated to intraoperative ones was 100% in detecting soft tissue mass inside the middle ear, 100% in detecting the location of cholesteatoma, 100% in detecting ossicular erosion, 93.3% in detecting scutum erosion and 100% in confirming the diagnosis of cholesteatoma proved by post-operative his-topathological examination. The mean sensitivity of MDCT in preoperative diagnosis and evaluation of middle ear chole-steatoma was 97.4% while the mean specificity was 95.8%.Conclusion: Middle ear cholesteatoma is a distinctive clinical entity with characteristic findings on MDCT scan, that guides in the surgical approach and management plan.
https://mjcu.journals.ekb.eg/article_54027_fb1e9f09537d1782ee71815af6ec09ed.pdf
2019-06-10
1841
1847
10.21608/mjcu.2019.54027
Middle ear cholesteatoma
MDCT
SARA E. ABD EL-DAYEM, M.Sc.;
EMAD M. MASHALI, M.D.
1
AUTHOR
MEDHAT M. MANSOUR, M.D.;
ALSIAGY A. SALAMA, M.D.
2
The Department of Radiodiagnosis, Tanta Cancer Institute*, Faculty of Medicine, Tanta University** and The Department of Otorhinolaryngology, Faculty of Medicine, Tanta University***
AUTHOR
ORIGINAL_ARTICLE
Clinical Outcome Assessment in Patients Treated by Dynamic Cervical Implants (DCI) Versus Fixed Method Using Inter Vertebral Cage in the Treatment of Cervical Disc Diseases
AbstractBackground: This study details analysis of the indications, safety, efficacy and complications of dynamic cervical re-placement for replacement of cervical disc in cases cervical disc diseases compared to PEEK cage insertion.Aim of the Work: The study aims to compare the outcome of two modalities for the treatment of the cervical disc diseases, the first group is the fixed group (treated by insertion of inter vertebral cages), and the second group is the dynamic one, (treated by insertion of the dynamic cervical implants or DCI).Patient and Methods: A prospective study conducted on 50 patients with single or double level cervical disc diseases like herniated or degenerative lesions treated with fixed and dynamic prosthesis, confirmed by clinical data.Results: Average age of presentation was 44.1 years for both groups, female ratio for the fixed group was 1.5:1, and 1:1.08 for the dynamic group, with age ranged between 35 and 53 years for both studies with an average of 44.1±6.345 years. The average duration of symptoms was 51.4 weeks. The average follow-up period in our study was 22.5 months, 21 cases had left sided radiculopathy, 10 cases had right sided affection. The most common presenting symptom after bra-chialgia (100%) was neck pain, most common sign was sensory changes. Most common operated level was C5-6 for both groups. The average follow-up period in our study was 22.5 months.Conclusion: The DCI implant is the alternative to cage fusion and total disc prosthesis with a wider range of indica-tions. The DCI implant offers stable, controlled (adequate) motion to already significantly degenerated motion segments.
https://mjcu.journals.ekb.eg/article_54028_7d8957ebf59f9bf4c09f1cca4f74b97c.pdf
2019-06-10
1849
1856
10.21608/mjcu.2019.54028
cervical spine
Disc herniation radiculopathy
Neural foramen
ESAM R. AL-GEHAWY, M.D.;
MOHAMED B. ABD EL-SALAM, M.D.
1
AUTHOR
MOHAMED M. MOHIELDIN, M.D.;
EHAB M. ABD EL-GHAFAREISSA, M.D.
2
AUTHOR
HAMDI N. MOSTAFA, M.D.;
SALAMA G. KORAITIM, M.Sc.
3
The Department of Neurosurgery, Faculty of Medicine, Cairo University* and Misr University for Science & Technology**
AUTHOR
ORIGINAL_ARTICLE
The Role of Soluble Subtype of the Receptor for Advanced Glycation End Product (sRAGE) in Rheumatoid Arthrirtis Disease Activity and Treatment Follow-up
AbstractBackground: Advanced Glycation End products (AGEs) are products of a non-enzymatic reaction between sugars and free amino groups of protein. They are one of several molecules that play a role in the pathogenesis of Rheumatoid Arthritis (RA). A soluble subtype of the receptor for advanced glycation end products (sRAGE) which can be measured in serum has been gaining interest for its contribution in RA.Aim of Study: The aim of this work is to assess the role of sRAGE in monitoring disease activity, disease treatment and follow-up.Subjects and Methods: This retrospective case-control study was conducted on (50) patients with rheumatoid arthritis (group 1) and their age and sex matching (30) healthy controls (group 2). All subjects recruited in our study were subjected to measurement of serum soluble subtype of the receptor for advanced glycation end products (sRAGE) by ELISA tech-nique.Results: Results of our study shows significant statistical decrease in serum sRAGE levels among different studied disease activity score 28 (DAS28) 28 grades (H:6.02, p<0.05). The inverse association between serum sRAGE and DAS28 is confirmed by the highly significant negative correlation between them (r:–0.397, p<0.01). No significant statistical difference is seen in serum sRAGE between patients on treatment with methotrexate and those not treated with it (Z: 0.39, p>0.05).Conclusion: Serum sRAGE level is strongly related to the disease activity in rheumatoid arthritis with its serum levels being lower in active disease. Our study could not prove its role in disease treatment follow-up.
https://mjcu.journals.ekb.eg/article_54030_46c8dd5e1f3b0a9d327a91fe92fd5fb2.pdf
2019-06-10
1857
1862
10.21608/mjcu.2019.54030
Rheumatoid Arthritis
sRAGE
disease activity
ELISA
DOAA M.A. EL-ZOGHBY, M.D.;
NEHAL EL-FAWY MAHMOUD, M.D.
1
AUTHOR
NERMIN H. EL-GHARBAWY, M.D.;
SAFAA M. ABD EL-RAHMAN, M.D.
2
The Departments of Clinical Pathology, Internal Medicine, Allergy & Immunology , Physical Medicine, Rheumatology & Rehabilitation and Medical Microbiology & Immunology4, Faculty of Medicine, Ain Shams University
AUTHOR
ORIGINAL_ARTICLE
Comparative Study: Role of Handheld Doppler with Complementary Duplex Ultrasonography in Planning of Perforator Flaps for Reduction Mammoplasty
AbstractBackground: The aim of reduction mammoplasty is to reposition the NAC with adequate projection by basing the NAC on a reliable pedicle that provides good vascularity, preserves sensory innervation and enables post-operative breastfeeding.Aim of Study: The purpose of this study is to introduce a breast reduction technique designed to reduce the incidence of post-operative nipple-areola complex ischemia and necrosis following reduction mammoplasty by using handheld doppler in detection of perforators and compare it's finding with complementary color duplex ultrasonography.Subjects and Methods: The study included 10 patients that underwent reduction mammoplasty. The average body mass index of our patients was 33.4. The average suprasternal notch to nipple distance was 41.3cm. The average resection weight per side was 1324.6g.Results: None of the cases experienced NAC necrosis.Conclusion: The pedicle constructed with the aid of preoperative perforator identification with a Doppler and compare it's finding with complimentary color duplex ultra-sonography is an effective technique for breast reduction that results in a very low rate of post-operative ischemia and necrosis of the nipple-areola complex.
https://mjcu.journals.ekb.eg/article_54031_70c43876bf0ca2dae4b5d9953e644759.pdf
2019-06-10
1863
1875
10.21608/mjcu.2019.54031
Handheld Doppler
Perforator flaps
Reduction mammoplasty
MAMDOUH O. KHALIFA, M.Sc.;
NADER G. EL-MELEGY, M.D.
1
AUTHOR
GAMAL I. MOSSA, M.D.;
TAREK G. SHOUKR, M.D.
2
The Departments of Plastic Surgery* and General Surgery**, Faculty of Medicine, Tanta University
AUTHOR
ORIGINAL_ARTICLE
Diagnostic Accuracy of Diffusion Weighted Imaging in Evaluation of High and Low Grade Pediatric Brain Tumors
AbstractBackground: Diagnosis and classification of brain tumors at pediatric age group is a challenging issue. MRI with different sequences including conventional MRI, post contrast study and diffusion weighted imaging (DWI) and well as ADC value measurement are considered accurate imaging modality to properly diagnose, classify brain lesions according to their site, extent and biological behaviour.Aim of Study: To evaluate the diagnostic accuracy of DWI in differentiation of high and low grade pediatric brain tumors.Patients and Method: Pre-operative MRI examination including; conventional MRI, post contrast study and DWI were done for 30 pediatric patients with suspected brain tumors by CT examination. Lesions evaluation regarding their size, site, signal intensity, pattern of enhancement, appearance at DWI and ADC values were done for all cases.Results: The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of diffusion weighted imaging were 89%, 100%, 100%, 86% and 93% respectively. All high grade tumors showed restricted diffusion. Post contrast MRI examination revealed no significant differ-ence between low and high grade tumors.Conclusion: Addition of DWI and ADC values measure-ment to the routine MRI examination of the brain improved the diagnostic accuracy of prediction of pediatric brain tumor histopathological grade.
https://mjcu.journals.ekb.eg/article_54033_96eb3bf51670abc85b9e3ee57a35f1ba.pdf
2019-06-10
1877
1883
10.21608/mjcu.2019.54033
Pediatric brain tumor
DWI
ADC values
Tumor grade
SAHAR M. ABD EL-SALAM, M.D.;
OMNIA MOKHTAR, M.D.
1
The Department of Radiology, Faculty of Medicine, Beni-Suef University* and National Cancer Institute, Cairo University**
AUTHOR
ORIGINAL_ARTICLE
Relationship between Type of White Matter Tract Affection and Pathological Grade of Pediatric Brain Tumour Assessed by MR Diffusion Tensor Imaging and Fiber Tractography
AbstractBackground: Incorporation of WM fibers within a tumor mass, seen especially in low-grade tumors, and destruction of WM fibers by high-grade tumors can be depicted by MR diffusion tensor imaging and fiber tractography. These features have profound implications for the extent of resection amenable for the individual tumor.Aim of Study: The purpose of this study is to evaluate the role of MR diffusion tensor imaging and fiber tractography in accurately depicting the relation between the grade and aggressivity of the paediatric brain tumour and the pattern of affection of white matter tracts in their direct vicinity. These information help the neurosurgeons to take a decision about the extent of excision and safety margin around the tumour.Material and Methods: A total of fifty patients with brain tumors were included in this study using pre-operative contrast-enhanced magnetic resonance imaging and DTI fiber tractog-raphy for preoperative depiction of the relation between white matter tract affection and aggressivity of the tumour.Diffusion tensor imaging, by improving the recognition and characterization of white matter tracts, offers a glimpse into the brain microstructure at a scale that is not easily accessible with other modalities.Result: The extent of white matter pathway involvement was clearly identified in all patients by using color-coded DT imaging maps and MR Tractography and was correlated with the pathological grade of the tumour.Pattern I (not affected) is a rare pattern exclusively found in benign acting tumours. It was seen within 4 cases (17.4%) of the benign acting group only.Pattern II (displacement) is the most common pattern being detected in 19 cases (82.6%) of the benign acting group and in 15 cases (68.2%) of the malignant acting group.Pattern III (oedematous) is the second most common type of tract involvement seen within 2 cases (8.7%) of the benign acting group and within 9 cases (40.9%) of the malignant acting group.Pattern IV (infiltrated and partially disrupted) was seen within 2 cases (8.7%) of the benign acting group and within 7 cases (31.2%) of the malignant acting group.Pattern V (destroyed) was detected in 3 cases (13.6%) of the malignant group and no cases in the benign acting group.Conclusion: Diffusion-tensor imaging allowed for the detailed visualization of WM tract affection by the tumour. The most common pattern of affection detected in our study is the displacement pattern with prevalence in the benign acting group of tumours. Destruction pattern was totally confined to the malignant acting lesions. Edema pattern and partial disruption pattern are more prevalent in the malignant acting lesions. Despite some limitations and pitfalls, DTI is currently the only clinically feasible method of demonstrating the white matter tracts in vivo.
https://mjcu.journals.ekb.eg/article_54034_54c30e4283fc7cfb273e195cd6fbbd54.pdf
2019-06-10
1885
1893
10.21608/mjcu.2019.54034
Diffusion tensor imaging (DTI)
Brain tumor
Magnetic resonance image
Tractography
White matter tracts
SAMIA Y. HEIKAL, M.Sc.;
IMAN M. ZAKY, M.D.
1
AUTHOR
MOHAMED A. EL-BELTAGY, M.D.;
AYMAN ABD EL-HAMID EL-BASMY, M.D.
2
The Department of Radio-Diagnosis, National Cancer Institute*, The Departments of Radiology** and Neurosurgery***, Faculty of Medicine, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Gender Impact on Rheumatoid Arthritis Disease Characteristics in A Cohort of Egyptian Patients
AbstractBackground: Rheumatoid Arthritis (RA) is a chronic inflammatory disease characterized by various extra-articular manifestations and progressive articular damage. It has been a common perception that RA is more severe in females, but the literature is not clear about gender difference regarding RA disease course and prognosis.Aim of Study: To compare between male and female patients with rheumatoid arthritis regarding demographic, clinical characteristics, laboratory features, treatment received as well as the functional disabilities.Patients and Methods: Two hundred and ten RA patients consecutively recruited from the Rheumatology Department outpatient Clinic, Cairo University Hospitals from December 2017 to May 2018. Patients were divided based on sex and were compared regarding clinical characteristics, laboratory features, medications received, disease activity score 28 (DAS28) and The Stanford Health Assessment Questionnaire (HAQ).Results: Out of our studied patients 176 (83.8%) were females and 34 (16.2%) males with male to female ratio 5:1. Female RA patients were statistically significant younger age (p=0.04) and statistically significant had lower hemoglobin level (p=0.00), also had higher number of Tender Joint Count (TJC) (p=0.4), higher DAS28 score (p=0.3), higher health assessment questionnaire score (p=0.5), and more frequently receiving methotrexate (p=0.3) than male RA patients although the differences did not reach statistical significance. On the other hand male RA patients were statistically significant more smoker (p=0.00), and statistically significant more frequently having subcutaneous nodule (p=0.004).Conclusion: Female RA patients demonstrated slightly worse levels of disease activity and functional disability, although the difference did not reach statistical significance.
https://mjcu.journals.ekb.eg/article_54045_c09d308a0dd216eb858da842c16daff4.pdf
2019-06-10
1895
1899
10.21608/mjcu.2019.54045
Male – Female
Rheumatoid Arthritis
Egyptian
NESREEN S. ABD EL-GHANY, M.D.;
IBRAHEM M. SIAM, M.D.
1
AUTHOR
AMIRA M.
MONIR, Ph.D.
2
The Department of Rheumatology and Rehabilitation, Faculty of Medicine, Cairo University*, The Departments of Internal Medicine**, Complementary Medicine***, National Research Center, Cairo
AUTHOR
ORIGINAL_ARTICLE
Assessment of Cervical Cancer Awarness among Women Attending Gynecological Clinic at Beni-Suif University
AbstractBackground: Cervical cancer ranks as the 13th most frequent cancer among women in Egypt and the10th most frequent cancer among women between 15 and 44 years of age.Aim of Study: The aim is to assess cervical cancer aware-ness among women attending gynecological clinic at Beni-Suif University Hospital.Method: A descriptive, exploratory study design was utilized to achieve the aim of the present study. The study sample: A total of 300 women were recruited in the study.Setting: The study was conducted in Gynecological-Obstetrics Outpatient Clinic of Beni-Suif University Hospital.Material: Data were collected using: (1) Interviewing structured tool. (2) Cervical Cancer Awareness Measure (Cervical CAM) Toolkit.Result: Study results revealed that 94.7% of women were unaware related to warning signs of cervical cancer; 94% of women were unaware regarded to risk factors of cervical cancer, 92% of women responded incorrectly regarded to the age most likely women developed cervical cancer, 98% of them were unaware about the availability of screening program while, 98.3% of them unaware about the vaccination program for cervical cancer in Egypt.Conclusion: The study concluded that women attending gynecological clinic at Beni-Suif University Hospital had lack of awareness regarding to cervical cancer.Recommendations: The study recommended developing and implementing educational program to increase awareness about cervical cancer among women.
https://mjcu.journals.ekb.eg/article_54046_a71b496cb68052deb153f289e76beab9.pdf
2019-06-10
1901
1909
10.21608/mjcu.2019.54046
Cervical Cancer
Awareness
Women
HANAN G. MASRY, M.Sc.;
ABEER S. ESWI, D.N.Sc.
1
AUTHOR
HANAN F. AZZAM, D.Sc.;
MAGDY EBRAHIM, M.D.
2
The Department of Maternal & Newborn Health, Faculties of Nursing, Beni-Suif* and Cairo** Universities and The Department of Obstetrics & Gynecology, Faculty of Medicine, Cairo University***
AUTHOR
ORIGINAL_ARTICLE
Gender Differences in Egyptian Systemic Sclerosis Patients: A Pilot Study
AbstractBackground: Some studies have highlighted the role of gender difference in systemic sclerosis (SSc) disease presentation and outcome. Male gender was suggested among poor prognostic factors of the disease.Aim of Study: To outline gender differences in a retrospective pilot study on 62 SSc patients as regards clinicalmanifestations, laboratory data and the medications received.Patients and Methods: This study included 62 SSc patients. Their files were retrospectively revised. Demographic data, clinical manifestations, laboratory investigations and medications received during the last visit were recorded. Modified Rodnan skin score (mRss) was used to asses skin tightness. Results: The patients were 45/62 (72.6%) females and 17/62 (27.4%) males. Their mean age was 40.5 ± 12.2 yearsand mean age of onset was 32.98 ± 11.4. The limited subtype represented 67.7% of SSc patients. Males had higher mRss, but it didn't reach statistical significance (p=0.11). They had statistically significant more frequent arrythmias (p=0.043), and they received statistically significant higher prednisolone doses (p=0.002). Although statistically insignificant, females tended to have a higher frequency of limited cutaneous subtype,pulmonary hypertension, pericardial effusion and calcinosis. Conclusion: Male SSc patients tended to have more diffuse cutaneous subtype and higher Rodnan score. They had more frequent arrhythmias (p=0.043) and received higher doses of prednisolone (p=0.002). Further longitudinal studies are needed to assess the role of gender difference in presentation, course of disease, response to treatment and outcome in SSc.
https://mjcu.journals.ekb.eg/article_54047_f8c27843226e156961bec70be9e77d2d.pdf
2019-06-10
1911
1916
10.21608/mjcu.2019.54047
Male gender
Systemic sclerosis
Arrhythmias
Prednisolone
MARWA H. NIAZY, M.D.;
HEND H. AL-SHERBENI, M.D.
1
The Department of Rheumatology and Rhabilitation, Faculty of Medicine, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Surgical Elevation for Symptomatic Depressed Skull Fractures Over Dural Venous Sinus
AbstractBackground: Symptomatic depressed skull fractures over dural venous sinus occasionally lead to stenosis, obstruction, or thrombosis and resulting in intracranial hypertension and significant neurological deficit. Some neurosurgeons are treating these cases conservatively for fear of venous hemor-rhage. The surgical elevation of the depressed segment in these cases is a matter of controversy and these patients should be treated carefully.Aim of Study: The aim of this retrospective study was to evaluate outcome after surgical elevation of symptomatic depressed skull bone fracture over dural venous sinus.Patients and Methods: A retrospective study of sympto-matic depressed calvarial fractures presented at Mansoura University Hospital from 2015 to 2018 revealed 11 patients with depressed skull fractures over superior sagittal sinus (n=6) and transverse sinus (n=5). The age ranged from 11-31 years. The causes of these fractures were vehicle accidents and falling from height. Significant neurological deterioration ranged from blurring of vision and motor weakness. MR venography was done in stable and late symptomatic cases to assess sinus patency.Results: Surgical elevation was performed in 10 patients suffered from depressed skull fracture over large venous sinus and conservative treatment for one patient at the transverse sinus and the patient shows patent sinus on MRV and clinically well. Rapid resolution of symptoms and signs as well as sinus patency after elevation.Conclusion: Although the risk of sinus injury during surgical elevation of the depressed segment but it is recom-mended to perform surgery for these symptomatic patients with all precautions required like blood transfusion and preparing vascular graft form the pericranium for sinus repair and this leads to rapid resolution of symptoms and signs as well as sinus patency improvement after elevation.
https://mjcu.journals.ekb.eg/article_54048_065a4240a9c1508b104ac98e8f1af0d2.pdf
2019-06-10
1917
1925
10.21608/mjcu.2019.54048
Depresses skull fracture
Venous sinus
Surgical elevation
AMR F. KHALIL, M.D., Ph.D.;
HESHAM EL-SOBKEY, M.D., Ph.D.
1
The Department of Neurosurgery, Faculty of Medicine, Mansoura University
AUTHOR
ORIGINAL_ARTICLE
Comparison of the Efficiencies of Ofloxacin Delivered in Different Forms (Conventional, Nanoemulsion and Nanoparticles) in the Treatment of Acute Diffuse Otitis Externa
AbstractBackground: Acute diffuse otitis externa is usually painful and annoying to the patient. It is an acute inflammation of the external auditory canal, auricle or both. Topical antibiotic preparations are the treatment of choice in uncomplicated cases. With the introduction of nanotechnology in the devel-opment of antibiotics, new horizons were opened up for the treatment of acute diffuse otitis externa.Aim of Study: The objective of the present study is to compare the efficiencies of ofloxacin delivered in different forms (conventional, nanoemulsion and nanoparticles) in the treatment of acute diffuse otitis externa.Patients and Methods: In the present study, we compared the efficiencies of ofloxacin delivered in different forms (conventional, nanoemulsion and nanoparticles) in cases with acute diffuse otitis externa. 40 patients with moderate degree of acute diffuse otitis externa were included in this study. The patients were classified into 4 groups, 10 patients in each group. A different form of ofloxacin was used in each group.Results: The present study showed that: (1) There was no difference in cure rate between cases treated by nanoemul-sion form of ofloxacin and cases treated by nanoparticles form of ofloxacin. (2) Both of the nanoemulsion and nanopar-ticles are more effective than the conventional form (when used in the same concentration). (3) On trial of low concen-tration of the nanoemulsion form, no difference in cure rate from the conventional form was noted.Conclusion: Nanopreparations of ofloxacin are more effective than the conventional form in management of cases of acute diffuse otitis externa.
https://mjcu.journals.ekb.eg/article_54049_862142257403f02bafc2793b26a18a7a.pdf
2019-06-10
1927
1932
10.21608/mjcu.2019.54049
Otitis externa
ofloxacin
Nanoparticles
Nanoemulsion
TAREK E.ABOU-SHARAF, M.D.;
WEDAD S. SAKRAN, M.D.
1
AUTHOR
SHEREN M. SAMEH, M.D.;
YOSRA T. EMAM, M.Sc.
2
The Department of ORL-H & N Surgery, Shebin El-Kom Teaching Hospital* and The Department of Pharmaceutics, Faculty of Pharmacy, Helwan** and 6th of October*** Universities
AUTHOR
ORIGINAL_ARTICLE
Effect of Acrylamide on the Tongue Musculature of Adult Male Albino Rat and the Possible Protective Role of Vitamin E: Light and Electron Microscopic Study
Abstract Background: Acrylamide is a potent toxin and carcinogen, its hazards result from its increased accumulation in the process of cooking food materials. Aim of Study: This study aimed to demonstrate the effects of acrylamide on the skeletal muscle fibers of adult male albino rat tongue for two different durations, using light and electron microscopic study and to investigate the possible protective effect of Vitamin E co-administration. Material and Methods: Sixty adult male albino rats were divided into six groups, each group included ten rats. Group I (control). Group II (Sham control). Group III received acrylamide for 20 days. Group VI received acrylamide for 40 days. Group V received acrylamide and Vitamin E, with 30 minutes interval between the two doses, for 20 days. Group VI received acrylamide and Vitamin E with 30 minutes interval between the two doses, for 40 days. All medications were given orally by gastric gavage. At the end of the experiment the tongue was dissected out for light and electron microscopic studies. Results: Light microscopic examination revealed that acrylamide lead to skeletal muscle damage in rat tongue. In the form of, fragmentations, splitting and inflammatory cellular infiltrations. Electron microscopic study of Group III revealed degeneration of mitochondria, these changes became worse with prolonged duration of exposure. This toxic effect of acrylamide could be minimized when Vitamin E is given concomitantly with it. Conclusion: Acrylamide lead to histological changes in rat tongue. Vitamin E minimized this changes due to its antioxidant effect.
https://mjcu.journals.ekb.eg/article_54050_b3d5d543273980d4c0cceb7e15c2339d.pdf
2019-06-10
1933
1944
10.21608/mjcu.2019.54050
acrylamide
Tongue
histology
Electron microscope Vitamin E
NABILA Y. ABD EL-HALIM, M.D.;
MOHAMED M. SOFII, M.D.
1
AUTHOR
EMAN A.M. MOHAMED, M.Sc.;
MOGEDA M. NASRALLA, M.D.
2
The Department of Anatomy & Embryology, Faculty of Medicine, Cairo* and Fayoum** Universities, Egypt
AUTHOR
ORIGINAL_ARTICLE
Factors Affecting Mortality among Patients with Major Burn at Intensive Care Units
AbstractBackground: Critically ill patients with burn are a risk group whose outcomes are negatively affected by many factors. Among these factors are sepsis, total body surface burned area, and depth of the burn.Aim of Study: To assess factors affecting mortality among burned patients at Intensive Care Units.Patient and Methods: The target population in the study were the adult male and female patients admitted to the ICU and have burn more than or equal 20% over a period of six months. This study was conducted from February to August 2017 in the ICU affiliated to 185 Kasr Al-Aini Hospital for Burn and Emergency which consists of 10 rooms each room contains 4 beds. Three tools were developed by the investigator and utilized for data collection, These tools are: Tool 1: Personal background and medical data, Tool 2: Burn assess-ment tool, and Tool 3: Burn management tool.Results: More than half (55.2%) of the studied sample died and approximately half (44.7%) discharged from the ICU. A significant statistical difference was found between died and discharged subjects regarding length of ICU stay (t/p 2.04/0.04), body mass index (c2/p 20.395/0.002), TBSA (t/p 8.20/0.000), depth of burn (c2/p 32.709/0.000), occurance of wound infection (x2/p 20.73/0.000). No significant statistical difference was found between died and discharged patients regarding age (t/p1.7/0.08), heart rate (t/p1.96/0.054), gender (c2/p 0.017/0.897) and mechanism of injury (c2/p 0.508/0.476).
https://mjcu.journals.ekb.eg/article_54051_2aa5371722a765d91fc668b87b7e21db.pdf
2019-06-10
1945
1950
10.21608/mjcu.2019.54051
Burn
Critically Ill Patients
Total body surface area
Depth of burn
mortality
Infection
MANAL S. ISMAIL, D.N.Sc.;
YOUSRIA A. SELOMA, D.N.Sc.
1
AUTHOR
TAREK A.
SHAHEEN, M.Sc.
2
The Department of Emergency and Critical Care, Faculty of Nursing, Cairo University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Role of Stem Cells in Healing of Tympanic Membrane Perforations
AbstractBackground: Stem cells are biological cells found in all multicellular organisms, that can divide (through mitosis) and differentiate into diverse specialized cell types and can self-renew to produce more stem cells. Currently, surgery is the treatment of choice for repairing the perforation. However, surgery is time-consuming and expensive, and there is a risk of complications. Repairing a perforation by office techniques has been successful for a few cases for small traumatic perforations.Aim of Study: In this study we aimed to study the role of stem cell therapy in management of tympanic membrane perforations by otoscopic examination, microscopic, endo-scopic examination and audiological assessment.Patients and Methods: Thirty patients included in our prospective study in Al-Zahra University Hospital and Shebin El-Kom Teaching Hospital from April 2014 up to December 2018. These patients were operated for simple myringoplasty with stem cell technique. These patients followed-up with otomicroscopic examination of the perforation, tympanometry and pure tone audiometry.Results: There were female patients much more than male patients. The mean age of the patients was 31.9±8.2 years. There is highly significant improvement in the air bone gap and ear canal volume differences before and 3 months after the operation. Doctor satisfaction was 96.7% while patient satisfaction was 94.1%. 96.7% of cases had successful results of perforation closure. Of 30 patients operated by stem cells therapy under complete aseptic techniques 29 patients TM perforations had completely healed after first trial (success rate 96.7%) and one case failed (failure rate 3.3%).Conclusion: Stem cells therapy is a new effective technique more safer successful, economic, easier to operate and time consuming than the traditional tympanoplasty. When the perforation is small to medium size maximum 4 X 4mm and dry since more than one month. This technique is better and to avoid complications and side effects of general anaethesia.
https://mjcu.journals.ekb.eg/article_54052_d140ae0ddfe3cd967b8b5bdf81ce2206.pdf
2019-06-10
1951
1955
10.21608/mjcu.2019.54052
Audiometry
Tympanic membration perforations
Tympanometry
Tymapan-oplasty
Stem cells therapy
MAGDA A. MOHAMED, M.D.;
RASHEDA A. ALY, M.D.
1
AUTHOR
SAYED M. MAKHEMAR, M.D.;
SOAD Y. MOSTAFA, M.D.
2
AUTHOR
SALAMA M. ELSHENAWY, M.D.;
TAREK E. ABO SHARAF, M.D.
3
AUTHOR
ALY HUSEIN ALY, M.D.;
MOHAMED S. EL-KHAFEEF, M.D.
4
AUTHOR
EZZAT R. ABO EL-SAAD, M.D.;
AHMED M. EL-BARKEY, M. Sc.
5
The Department of ENT, Faculty of Medicine, Al-Azhar University (Girls)* and Microbiology & Immunology** and ENT ***, Shebin El-Kom Teaching Hospital, Menoufua University
AUTHOR
ORIGINAL_ARTICLE
Split Calvarial Graft Reconstruction for Growing Skull Fracture in Pediatrics
AbstractBackground: Growing skull fracture is a rare but well-known complication of skull fracture in infancy and early childhood. The definitive treatment is Duro-cranioplasty. The use of alloplastic material in cranial reconstruction has been well described in adult but in children it is hesitation about the safety of nonexpansible alloplastic material.Aim of Study: This is a retrospective study to evaluate autologous split thickness skull grafts and cranioplasty for treatment of growing skull fractures in pediatrics.Patients and Methods: This is a retrospective study of complicated calvarial fractures presented at Mansoura Uni-versity Hospital from 2015 to 2018 and included 10 patients with growing skull fractures. All patients underwent autologous cranioplasty of the skull defect secondary to growing skull fracture after duroplasty.Results: The age at injury ranged from 5M-6 years. The cause of these fractures included falls and vehicle accident. On average, progressive swelling was diagnosed 7 months after the initial injury. The size of the cranial defects was average 3 X 3cm after restoration of dural contour (duroplasty). Six patients (60%) needed blood transfusion. Follow-up for patients was an average of 6 months. All patients showed post-operative bone fusion without evidence of complications.Conclusion: The concern for growth restriction or implant instability in a growing pediatric skull also the cost, limit the use of alloplastic materials. Our data show that autologous bone grafting is the standard in pediatric population regarding the safety and cost with limited post-operative complications. Moreover, early recognition is crucial in the management of GSFs to avoid the progression of neurological consequences and skull deformities.
https://mjcu.journals.ekb.eg/article_54053_f6f015bbb08e0003be0913493d9cc836.pdf
2019-06-10
1957
1966
10.21608/mjcu.2019.54053
Growing skull fractures
Leptomeningeal cyst-Graft
AMR F. KHALIL, M.D., Ph.D.;
HESHAM EL-SOBKEY, M.D., Ph.D.
1
The Department of Neurosurgery, Faculty of Medicine, Mansoura University
AUTHOR
ORIGINAL_ARTICLE
Comparative Study of Novel Biomarkers of Kidney Injury; Kidney Injury Molecule and Liver Type Fatty Acid Binding Protein in Experimentally Induced Diabetic Nephropathy in Rats, and their Correlation with Renal Histopathological Changes
AbstractBackground: Diabetic nephropathy is a serious microvas-cular complication of type 2 diabetes mellitus that can progress slowly to end-stage renal disease that can be fatal. It is characterized by highly specific, slowly progressing histopatho-logical changes. As the standard biomarkers lack the adequate sensitivity, novel biomarkers are needed for the early detection and risk stratification of diabetic nephropathy.Aim of Study: To investigate the histopathological changes occurring in diabetic nephropathy, to study the associated changes of two novel biomarkers; Liver Fatty Acid Binding Protein (L-FABP) and Kidney Injury Molecule (KIM), to correlate their gene expression with the degree of histopatho-logical changes and to compare their sensitivity and degree of correlation against the standard biomarkers, notably blood urea and serum creatinine.Material and Methods: 24 experimental male rats were divided into two groups, a control group, and a diabetic nephropathy group. Type 2 diabetes mellitus was induced by High Fat Diet (HFD) followed by Streptozotocin (STZ) intraperitoneal injection. The presence of diabetes was con-firmed by fasting plasma glucose & insulin levels, and the induction of diabetic nephropathy was confirmed by the presence of albuminuria.Histological examination was performed for all experi-mental rats using hematoxylin and eosin stain (H & E) staining as well as Periodic Acid Schiff (PAS) stain. These results were expressed as the mean optical density of the PAS-positive reaction.The gene expression for L-FABP and KIM were measured by Polymerase Chain Reaction (PCR) reverse transcriptase method and the levels of blood urea and serum creatinine, as standard biomarkers were measured. Statistical correlation analysis was performed by Pearson's correlation method to investigate the correlation of their gene expression and the histopathological changes.Results: Significant histopathological changes occurred in diabetic nephropathy manifested by several changes in the H & E staining as well as PAS-positive reactions. All biomar-kers are elevated in the diabetic nephropathy group compared to the control group. However, no statistically significant correlation was found between the standard renal biomarkers (blood urea and serum creatinine) and gene expression of KIM. Only statistically significant correlation was found between the gene expression of L-FABP and the degree of histopathological changes.Conclusion: The standard biomarkers (blood urea & serum creatinine) are lacking the adequate sensitivity for correlation with the histopathological changes in diabetic nephropathy. L-FABP is a promising future biomarker that can potentially be used for early detection as well as the follow-up of cases of diabetic nephropathy.
https://mjcu.journals.ekb.eg/article_54054_80d483914213aeba2573009f751e4c7b.pdf
2019-06-10
1967
1980
10.21608/mjcu.2019.54054
MOHAMED M. KHALIFA, M.D.;
AHMED ABD EL-TAWAB, M.D.
1
AUTHOR
HANAN A. HASSAN, M.D.;
GEORGE N.B. MORCOS, M.D.
2
AUTHOR
HEBA S.
OMAR, M.D.
3
AUTHOR
ORIGINAL_ARTICLE
Assessment of Efficiency of Using Clinical Pulmonary Infection Score (CPIS) on Length of Stay (LOS) among Mechanically Ventilated Cases
AbstractBackground: VAP is pneumonia that develops in a me-chanically ventilated patient with a first positive bacterial culture beyond 48 hours after hospital admission or tracheal intubation, whichever occurred first. VAP burden relies on the increase of morbidity, cost, prolonged MV, ICU-Length of Stay (LOS) and hospital-length of stay.Aim of Study: Improve health outcome of patients on Mechanical Ventilation (MV) through early diagnosis of (VAP), early management with appropriate antibiotics pre-scription using Clinical Pulmonary Infection Score (CPIS) and to decrease MV days, ICU-Length of Stay (LOS) and hospital-length of stay.Methods: Operational research, quasi-experimental inter-ventional study design. The study was conducted in the in Critical Care Department in the Faculty of Medicine Cairo-University. The study has 2 phases Phase 1: Recruiting the Control group (40 cases) on MV not using CPIS. Phase 2: Recruiting the Interventional group (40 cases) on MV using CPIS.Results: The most common organism in control group was Klebsiella 25% and in intervention group was MRSA 17.5%. The ICU LOS was significantly lower in patients who were followed by CPIS in intervention group.Conclusion: CPIS considered tool to monitor patient's condition on MV for early modification which in turn reflected on ventilator days and ICU length of stay.
https://mjcu.journals.ekb.eg/article_54055_d6623fc31bf471ae784890ce9133cc4d.pdf
2019-06-10
1981
1985
10.21608/mjcu.2019.54055
Mechanical ventilation MV
Ventilator associated pneumonia VAP
Intensive Care Unit ICU
Clinical pulmonary infection score CPIS
Acute physiology and chronic health evaluation APACHE
Length of stay LOS
SARA A.A.M. HEIKAL, M.Sc.;
SALWA ABD ELAZEEM, M.D.
1
AUTHOR
SAHAR YASSIN, M.D.*;
DOA&#;A A.E. SALEH, M.D.
2
AUTHOR
LAMIA'A H.
MOHAMMED, M.D.
3
The Departments of Public Health & Community Medicine* and Critical Care, Kasr El-Aini Hospital**, Faculty of Medicine, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Lung Ultrasound for Early Diagnosis of Ventilator-Associated Pneumonia
AbstractBackground: Lung Ultrasound (LUS) has important role in diagnosis of different lung diseases so it can be used in diagnosis and early detection of Ventilator-Associated Pneu-monia (VAP).Aim of Study: Our aim is to evaluate the sensitivity and the specificity of lung ultrasound for early diagnosis of ventilator-associated pneumonia compared to chest X-ray.Patients and Methods: This study was carried out on 100 patients divided into two Groups (A & B), each one included 50 adult male and female patients with suspected VAP. In Group A (LUS), we searched for lung ultrasound findings as subpleural consolidation, lobar consolidation, and dynamic arborescent/linear air bronchogram while in Group B (CXR), we searched for chest X-ray findings as lung infiltrates and air bronchogram. In both groups, Endotracheal Aspirates (EA) was collected for direct gram stain examination (EAgram) and culture (EAquant). LUS findings were analyzed in scores as the clinical-LUS score (Ventilator-associated Pneumonia Lung Ultrasound Score [VPLUS]) which was calculated as follows: ³2 areas with subpleural consolidations, 1 point; ³1 area with dynamic arborescent/linear air bronchogram, 2 points; and purulent EA, 1 point. Positive direct gram stain examination (EAgram) or positive culture (EAquant) which had 2 points were added to VPLUS to be VPLUS EAgram and VPLUS EAquant.Results: The sensitivity and the specificity of lung ultra-sound findings in Group A (LUS) were higher than chest X-ray findings Group B (CXR) as presence of ultrasound signs in Group A (LUS) (lobar/hemilobar consolidations, dynamic air bronchogram, subpleural consolidations) separate or combined gave us sensitivity 97%, lobar or hemilobar consol-idations had sensitivity 94%, presence of dynamic air bron-chogram or subpleural consolidations gave us sensitivity 94%, VPLUS-EAquant ³3 gave us sensitivity 94%. The best spe-cificity was found also in Group A as (air bronchogram + subpleural consolidations + positive culture or positive gram stain examination) gave us the highest specificity 100%, combination of (dynamic air bronchogram and subpleural consolidations) gave us high specificity 94%, combination of (lobar/hemilobar consolidations, dynamic air bronchogram and subpleural consolidations) gave us also high specificity 94%, (VPLUS-EAquant ³4, VPLUS-EAgram ³4 and VPLUS ³3) had specificity 94%. On the other hand, signs of chest X-ray in Group B had lower sensitivity and specificity com-pared to lung ultrasound in Group A as chest X-ray infiltrates gave us sensitivity 53%, specificity 25%, air bronchogram had sensitivity 33%, specificity 40%, presence of (chest X-ray infiltraes, air bronchogram) separate or combined gave us sensitivity 57%, specificity 25%.Conclusion: The sensitivity and specificity of lung ultra-sound were higher than chest xray, so lung ultrasound is better than chest X-ray for early diagnosis of VAP.
https://mjcu.journals.ekb.eg/article_54304_13ff98d5b0373f5f114b1ed64697adfb.pdf
2019-06-10
1987
1996
10.21608/mjcu.2019.54304
lung ultrasound
Chest X-ray
Ventilator-Associated Pneumonia (VAP)
AHMED A. ABD EL-WAHED, M.Sc.;
THANAA M. AL-NOMANY, M.D.
1
AUTHOR
AHMED A. ABD EL-HAFEZ, M.D.;
AHMED D. ABO HAMAR, M.D.
2
The Department ofAnesthesiology, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Tanta University
AUTHOR
ORIGINAL_ARTICLE
The Early and Mid-Term Follow-up of Drug Eluting Balloon (DEB) For Below the Knee Angioplasty: An Observational Study
AbstractBackground: Re-stenosis following infra-popliteal angi-oplasty could results in many serious consequences like recurrence of ischemic symptoms or break through of wound healing. With the evolving techniques of Paclitaxil release and the rapid advancement in the manufacturing of endovas-cular equipment, drug eluting balloons emerge as a useful option to overcome intimal hyperplasia and subsequent re-stenosis.Aim of Study: To highlight the clinical impact of additional DEB application in patients with CLI attributed to infra-popliteal disease regarding the re-stenosis rate, amputation free survival and limb salvage.Material and Methods: This study is prospective obser-vational study over a period of one year including 33 patients who underwent infra-popliteal angioplasty using DEB.Results: 33 patients (36 limbs) were included in the study, 24 cases (27 limbs) were presented by a re-stenosis or occlusion after previous trial of angioplasty using plain balloon, while 9 patients come with the first presentation (Denovo lesions). Stenotic lesions were found in 21 limbs (58.3%) while occlu-sive lesions were observed in 9 limbs (25%) and combined stenotic and occlusive lesions were found in 6 limbs (16.7%). The mean length of the treated lesions within the tibial arteries using DEB was 7.6±3.4m. Primary patency rate at 3, 6 and 12 months was 91.3%, 82.6% and 70.9%. While limb salvage rate at 3, 6 and 12 months was 91.6%, 81.8% and 72.8% respectively.Conclusion: With the rapid advancement in the endovas-cular tools & equipment, the early results is encouraging and promising with additional application of DEB for patients with infra-popliteal arterial disease in comparison to the traditional use of plain uncoated balloons. However, the mid-term and late results of the IN.PACT DEEP study suggest that an extreme caution is to be considered in this field.
https://mjcu.journals.ekb.eg/article_54314_d3e5ab77ea7b02986507b8fd06e8bb34.pdf
2019-06-10
1997
2004
10.21608/mjcu.2019.54314
Drug eluting balloon – Peripheral vascular disease – Re-stenosis – Below the knee angi-oplasty
MOHAMMED ALI, M.D.;
MAHMOUD NASSER, M.D.
1
The Department of Vascular Surgery, Faculty of Medicine, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Correction of Adolescent Tibia Vara by Ilizarov External Fixator
AbstractBackground: Tibia vara, also termed as blount disease. Blount described a group of children who had an onset of varus deformity of the proximal part of the tibia in later childhood or adolescence, a condition that he described as adolescent tibia vara. It is characterized by proximal varus angulation of the tibia associated with medial metaphyseal depression, internal torsion of the tibia and genu recurvatum, growth retardation, and a propensity toward additional pro-gression.The Ilizarov external fixation and principles provides gradual correction of the angulation, rotation, translation, and length discrepancy, thus minimizing complications.Aim of Study: The purpose of the current study is to evaluate the results of management of adolescent tibia vara using Ilizarov external fixator.The morphological outcome will be evaluated radiologi-cally to determine the amount of correction using different angles, axes and complications.Patients and Methods: Ten were treated lower limbs of 7 patients with tibia vara were treated with application of Ilizarov External Fixator (IEF), between 2014 and 2017 at Ilizarov Unit, Assiut University Hospital. Their mean age was 14 years (range 11-16.8 years). Three patients were males and four patients were females. The right side was affected in one case and the left side in 3 and bilateral in 3. Their main complaint was pain on walking and cosmoses. The patients were subjected to clinical assessment, including local exam-ination as analysis of gait including lateral thrust of the knee and intoeing was done. Followed by AP radiological exami-nation of both lower limbs in standing position for the involved limb. CT scanogram was done for lower limb discrepancy. The residual deformity was reported in 3 extremities. They were above 10 years old, obese, with past history of pervious failed trials for correction. They presented also with decreased knee range of motion. They still satisfied till last follow-up. The varus deformity was associated with shortening in 4 cases with 7 lower limb deformities had shortening ranged from 3- 5cm with mean 4cm, the shortening was corrected with residual limb length difference (±5mm), with procurvatum in 6 cases, with recurvatum in 3 cases and with internal rotation in all patients except one. Ilizarov external fixator was applied and gradual correction was performed. Varus tibiofemoral angle, procurvatum, recurvatum, lower limb discrepancy, internal tibia1 torsion and knee range of motion were measured pre-operatively; post-operatively and at last follow-up.Results: The mean time for deformity correction and Ilizarov stabilization was 14 weeks (range 12-30 weeks), including 2 weeks of dynamization. The mean deformity of 27.6º varus (range, 19.2º-35.9º) was corrected to 2.8º valgus (range 3º-7.51º) and 22.2º internal rotation (range 0º-49º) was corrected 3º extenal rotation (range 0º-8º), the mean 7.2º procurvatum angle (range 0º-25º) was (range 0º-7º) and 12.4º recurvatum angle (range, 0º-28º) was changed to 3.5° (range, 15º recurvatum-6º procurvatum). The mean knee range of motion was 126.55º (range 95º-148º), became 129.2º (range, 85º-145º). The mean shortening of 4.5cm (range 3.5-5.5cm) the shortening had been corrected with residual limb length difference (±5mm) in all patients. Construct modification had to be done in 8 cases without anaesthia, and other additional procedures were done to treat complications of the frame in the same operation time.Wire site inflammation was common and pin tract infection was common and pin tract infection was treated in 8 cases using oral or parentral antibiotics. However there was a case of deep infection that needs debridement. We reported residual deformity in 3 patients, although they were satisfied. There were no neurovascular complications, delayed union or non unions.Conclusion: Gradual correction of severe adolescent tibia vara by Ilizarov external fixator is economic, effective, accurate and safe. Limitation of the study is short term follow-up and relatively small sample size.
https://mjcu.journals.ekb.eg/article_54318_636f5656b91ab981efe626e4d94331a7.pdf
2019-06-10
2005
2011
10.21608/mjcu.2019.54318
Tibia vara – Ilizarov external fixator
KAMAL A.M. EL-GAFARY, M.D.;
MOHAMED M. ABD EL-HAMID MORSY,
1
AUTHOR
WAEL YOUSIF EL-ADLY, M.D.;
SHADY F. MAHMOUD, M.Sc.
2
The Department of Orthopedics & Traumatology, Faculty of Medicine, Assiut University* and The Department of Orthopaedic & Trauma Surgery, El-Eman Hospital**
AUTHOR
ORIGINAL_ARTICLE
Multidetector CT Angiography Role in Evaluation of Vascular Causes of Hemoptysis
AbstractBackground: Hemoptysis has many vascular and paren-chymal causes. Determining the site and the cause of the bleeding is of great value in planning the proper management.Aim of Study: Is to evaluate the role of Multidetector Computerized Tomography (MDCT) in detection and local-izing the site and causes of hemoptysis of vascular origin.Material and Methods: Prospective study included 50 patients suffering from hemoptysis, referred to the Department of Radiology, Amiri Hospital, Kuwait during the period from April 2016 until April 2018. MDCT pulmonary and bronchial angiography was done for all patient as well as bronchoscopy, conventional angiography and biopsy were done for some cases.Results: MDCT angiography was successful in determining the cause of hemoptysis in 88% of cases. Vsacular causes of hemoptysis included bronchial, systemic non bronchial and pulmonary arteries.Conclusion: MDCT pulmonary and bronchial angiography is a very valuable technique in determining and the source and causes of hemoptysis and planning of management.
https://mjcu.journals.ekb.eg/article_54322_164d844e0c74d22f1f0f9feeed8d1730.pdf
2019-06-10
2013
2020
10.21608/mjcu.2019.54322
MDCT angiography – Hemoptysis – Vascular causes
OSAMA R.A. KOMBAR, M.D.;
ALI M. HASSANIN, M.D.
1
AUTHOR
AHMAD
ABBAS, M.D.
2
The Departments of Radiology, Faculties of Medicine, Mansoura* & Zagazig** Universities and The Department of Chest, Faculty of Medicine, Zagazig University***
AUTHOR
ORIGINAL_ARTICLE
Follow-Up of the Mid-Term Results for Mitral Valve Repair for Rheumatic Mitral Regurgitation
AbstractBackground: Rheumatic mitral valve disease is consider-ably less common in North America and European countries than in developing countries, where rheumatic heart disease remains by far the leading cause of valvular diseases. This study was done to evaluate the midterm results over 10y of mitral valve repair for rheumatic mitral regurgitation in term of survival rate and late valve failure and need of redo surgery.Aim of Study: To record mid term results over 10y of our trail to repair the mitral valve with rheumatic pathology that caused uncoaptation and regurge in the mitral valve with special attention to the evaluation of the number of patients survived, delayed failure of the repair done and need of redo surgery.Patients and Methods: This is a retrospective study from January 2004 to January 2014, one hundred and twenty patients with rheumatic mitral valve disease underwent mitral valve repair in our hospital. Age ranged from 15 to 53 years, 80% patients were female. The lesions were pure mitral regurgitation in 95 (79.1%) patients, predominant mitral regurgitation with stenosis in 12 (10%), and predominant mitral stenosis with regurgitation in 13 (10.8%). Ninty patients (75%) patients were in normal sinus rhythm.Results: Follow-up time ranged from 6 to 120 months, mean 55.4±3.2 months. There were 10 late deaths. Survival at 5 and 10 years was 96.5% and 91.2%, respectively. 25 patients (20.8%) patients had mitral regurgitation during follow-up, and 8 underwent reoperation with no hospital mortality. Freedom from reoperation at 5 and 10 years was 93.5% and 82.7%, respectively. Progression of mitral regur-gitation at 5 and 10 years was 71.4% and 59.3%, respectively. Freedom from all late events at 5 and 10 years was 72.6% and 54.2%, respectively.Conclusions: Mitral valve repair for rheumatic mitral regurgitation is associated with a significant rate of valve failure and reoperation. However, it has a satisfactory survival rate and is a good alternative to valve replacement, especially for young female patients in child bearing period to avoid the life-long risks of a prosthetic valve and anticoagulation related problems.
https://mjcu.journals.ekb.eg/article_54328_cca99b3f8d9bb715eb6d27d170596e1e.pdf
2019-06-10
2021
2024
10.21608/mjcu.2019.54328
Rheumatic mitral regurge – Mid-term results – Mitral repair faliure
YASSER MENAISSY, M.D.;
SAMY AMIN, M.D.
1
The Cardiothoracic Department, Faculty of Medicine, Cairo University
AUTHOR
ORIGINAL_ARTICLE
A Comparative Study between Entropy and Clinical Response to Determine the Requirement of Propofol for Induction of General Anesthesia in Geriatric Patients
AbstractBackground: Anesthesia under dosage causes awareness, while over dosage results in drug complications. Endotracheal intubation must be after an adequate level of anesthesia. Propofol is an IV short-acting anesthetic which causes hypo-tension in a dose dependent effect. With entropy, SE level 40- 60 and RE-SE difference Aim of Study: The aim of this study was to compare between the conventional clinical end-point of hypnosis and entropy on the dosage requirement of propofol and hemody-namic during propofol induction of general anesthesia in geriatric patients.Methods and Material: 60 patients, aged 60-80y, from both sexes, ASA I-II scheduled for an elective surgery required general anesthesia and endotracheal intubation were included. Group-I (control group): Propofol 30mg every 1min till loss of response to verbal commands and group-II (entropy group): Propofol 30mg every 1min till response entropy 48±2. Patient's demographic data, the total dose of propofol used for induction, (HR, MAP and entropy parameters) at baseline (T1), after induction of anesthesia (T2), during (T3), 1min and 5min after tracheal intubation (T4, T5).Results: Total dose of propofol, HR & MAP readings revealed no significant difference between two groups. After induction, both RE and SE dropped significantly in both groups when compared to baseline. There was no difference in SE & RE between the two groups.Conclusion: During intubation, usual titration of propofol until loss of verbal response, with the dose given in our study, is as good as entropy monitoring in elderly patients. So, routine use for this may not be necessary and can be used in other age groups, other anesthesia situations, medicolegal purposes and research.
https://mjcu.journals.ekb.eg/article_54329_d4dc530cb76d7d24cf8f25e79bec02d9.pdf
2019-06-10
2025
2031
10.21608/mjcu.2019.54329
Entropy – Clinical response – Requirement of propofol – Geriatric patients
MAI A.K. NIDA, M.Sc.;
WESAM F. MOUSA, M.D.
1
AUTHOR
AHMED S. ELGEBALY, M.D.;
HESHAM E. EL-ASHRY, M.D.
2
The Department Anesthesiology and Surgical Intensive Care, Faculty of Medicine, Tanta University
AUTHOR
ORIGINAL_ARTICLE
The Relation between Platelet to Lymphocyte Ratio with Severity And Complexity of Coronary Heart Disease in Patients with Acute ST- Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention
AbstractBackground: Coronary Artery Disease (CAD) is charac-terized pathologically by atherosclerosis formation which is the predominant cause of death. The chronic inflammatory response is associated with production of platelets and lym-phocytes, elevated platelet counts accelerate atherosclerosis formation, progression, and destabilization of atherosclerotic plaques. The ratio of absolute number of platelets to the number of lymphocyte (PLR) act as an effective biomarker to predict the severity of CAD.Aim of Study: To study the relation between Platelet to Lymphocyte Ratio (PLR) with severity and complexity of coronary heart disease in patients with acute ST-segment Elevation Myocardial Infarction (STEMI) undergoing primary Percutaneous Coronary Intervention (PCI).Methods: This study was conducted on 100 patients diagnosed with STEMI and who underwent primary PCI in Tanta University Hospitals, Cardiovascular Department, from June 2017 to December 2017. To assess the correlation between platelet to lymphocyte parameters and severity of CAD, the sample was divided according to the angiographic severity of CAD by using Gensini score into three groups, Group I Gensini score ranged from zero to 50, Group II Gensini score ranged from 50 to 100 and Group III Gensini score more than 100.Results: Patients with high PLR showed significant tach-ycardia at onset of admission, higher glucose level, higher Killip class II-IV, lower final angiographic TIMI flow, higher Gens iniscore, higher serum LDL level, lower HDL levels and higher triglycerides level, higher all the composite end-points of Major Adverse Cardiovascular Events (MACE) including death, reinfarction and Congestive Heart Failure (CHF).Conclusion: Platelets to lymphocytes ratio is an independ-ent prognostic factor for severity and complexity of CAD in patients with STEMI undergoing primary PCI intervention by using Gensini score.
https://mjcu.journals.ekb.eg/article_54332_b92cc04e196f8970cd354cd2d19e9d07.pdf
2019-06-10
2033
2044
10.21608/mjcu.2019.54332
Coronary artery disease – ST segment elevation acute myocardial infarction – Platelet to lym-phocytes ratio – Congestive heart failure
NEDAA E. EL-DEN, M.Sc.;
AYMAN A. GAFAR, M.D.
1
AUTHOR
MOHAMED A. HENDIA, M.D.;
MAGDY M. EL-MASRY, M.D.
2
The Department of Cardiology, Faculty of Medicine, Tanta University
AUTHOR
ORIGINAL_ARTICLE
Histopathological Changes Produced by Bispenol A in the Renal Cortex of Adult Male Albino Rats
AbstractBackground: Bisphenol A (BPA) is an important endocrine disrupting chemical that is widely used in plastic containers and has tendency to accumulate in many organs and affect their functions.Aim of Study: The aim was to clarify the effect of BPA on the histological structure of the renal cortex in adult male albino rat and to assess the efficacy of its withdrawal in amelioration of this effect.Material and Methods: This study was conducted on forty adult male albino rats which randomly divided into four groups (10 rats each). Group I served as negative control, Group II was vehicle group and received corn oil, Group III which received a daily oral dose of BPA 50mg/kg body of weight for eight weeks and finally Group IV which received the same dose of BPA as Group III then kept for another four weeks without treatment for spontaneous recovery (BPA recovery). Renal cortices were processed for light and electron microscope examinations. Blood samples were collected for biochemical parameters (urea and creatinine). The level of Malondialdehyde (MDA) and catalase activity were estimated in the kidney tissue. In addition, the diameter of renal glomeruli and Bow-man's space surface area were morphometically and statistically analyzed.Results: It was noticed that BPA led to degenerative changes in the renal cortex with partial improvement of such structural findings in the BPA recovery group. Compared with the control groups (negative control, corn oil), the BPA group showed no significant difference in body weights (p=.52) but there was a higher significant increase in kidney weights (p<.001). Comparing between the BPA-treated and BPA recovery groups, no statistically significant differences (p=.34) was reported. Tissue MDA, urea and creatinine levels showed significant increase (p<.001) while catalase activity was dramatically decreased (p<.001) in the in BPA-treated and BPA recovery groups with no statistically significant differ-ences between BPA treated and BPA recovery groups. The glomerular histomorphometry showed a significant decrease in mean glomerular diameter but very statistically significantly higher mean Bowman's space surface area in the BPA-treated and BPA recovery groups than the control groups, with nosignificant difference between the BPA-treated and BPA recovery groups (p=.67, p=.61) respectively.Conclusion: The previous results supported that BPA had toxic effect on the renal cortex structure and the recovery from such effect might need more than four weeks.
https://mjcu.journals.ekb.eg/article_54333_32824a1461bf8eec607c1c8ef82b5238.pdf
2019-06-10
2045
2058
10.21608/mjcu.2019.54333
Bishpenol A – Recovery – Kidney and rats
MARWA M. AHMAD, M.D.;
SHAIMAA H. AMEEN, M.D.
1
The Departments of Human Anatomy & Embryology* and Clinical Toxicology**, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Role of Base Excess as a Predictor for Head Injury Outcome among Patients Admitted to Intensive Care Unit
AbstractBackground: To determine the assocation between Base Excess (BE) and Glasgow Outcome Scale (GOS) and whether BE can be a useful predictor for such outcome.Aim of Study: In this study, most head trauma patients had BE disturbance, mainly in the form of negative BE. This finding may be explained by that the cranial cavity is isolated and limited. Therefore, blood loss and its consequences may not be as in systemic trauma, although, severe head injuries with hypoperfusion may induce coagulation disturbances, and subsequently hemodynamic and acid-base disturbances.Patients and Methods: This study followed a retrospective research design. Data were collected from adult head trauma patients' files and the Registrar's Database of Asir Central Hospital, Saudi Arabia. All patients with head injury who were admitted to Asir Central Hospital Intensive Care Unit (ICU) during the period from January 2015 till December, 2017, were included.Results: The data of 171 adult head trauma patients were included in this study, with their age (mean ± SD) of 25±11 years. A significant association was observed between BE and GOS. There were associations between abnormal BE and both prolonged stay in ICU and low GCS.Conclusions: There is a significant association between BE and GOS. The association between BE with length of stay in ICU can provide moderate accuracy in predicting patients' length of ICU stay. Therefore, BE can help in head trauma patient's management and assessment.
https://mjcu.journals.ekb.eg/article_54335_416b4d3c4ec81015a7847bd2e8a75c15.pdf
2019-06-10
2059
2063
10.21608/mjcu.2019.54335
Head injury – Base excess – Glasgow Coma Score – Glasgow Outcome Scale
IBRAHIM
ALNAAMI, M.D., F.R.C.Sc.
1
Section of Neurosurgery, The Department of Surgery, King Khalid University, The Department of Neurosurgery, Asir Central Hospital and The Department of Pediatric Neurosurgery, Abha Maternity and Children Hospital, Abha, Saudi Arabia
AUTHOR
ORIGINAL_ARTICLE
Preconditioning with Thyroid Hormones Improves Renal Functions Via Poly (ADP-Ribose) Polymerase-1 Reduction in a Rat Model of Renal Ischemia-Reperfusion Injury
AbstractBackground: Ischemia-Reperfusion Injury (IRI) is one of the major triggers of Acute Kidney Injury (AKI). AKI represents an important economic burden that is associated with high mortality and morbidity rates.Aim of Study: This study focused on the role of poly (ADP-ribose) polymerase-1 (PARP-1) in acute renal ischemia-reperfusion injury in case of preconditioning with thyroid hormone.Material and Methods: Forty adult male wistar albino rats were divided equally into; Group I: Sham-operated for renal IRI, Group II: Euthyroid rats subjected to IRI, Group III: PARP-1 inhibitor (3-AB) was administered to the IRI rats aiming to confirm the PARP-1 role in mediating the renal ischemic injury (IRI-3-AB). Group IV preconditioned rats with a single eltroxin dose (100ug/kg/ip) six hours before IRI (precond-IRI).Results: PARP-1 inhibitor was associated with a significant improvement in the all measured renal function parameters, concomitant with reduced renal tissue inflammatory and oxidative stress markers and Apoptosis Inducing Factor (AIF) levels, indicating the intermediary role of PARP-1 in the renal ischemic injury.The preconditioning with thyroid hormones resulted in a significant improvement in the renal functions (without elevation in the thyroid hormone level), via reduction in the inflammatory and oxidative stress markers induced by the IRI, this was confirmed by the histological assessment. The PARP-1, AIF and caspase-3 overexpression were aborted and the ATP level was preserved.The correlations between PARP-1 and renal function parameters and the apoptotic markers may explain its contri-bution in the pathogenesis of renal IRI condition.Conclusion: These results suggest an important role of the preconditioning with thyroid hormone in amelioration of the oxidative stress, inflammation and PARP-1 overactivation in the renal injury induced by IRI.
https://mjcu.journals.ekb.eg/article_54338_ec7f55e1ba6cd41eda4210c4f755dccf.pdf
2019-06-10
2065
2075
10.21608/mjcu.2019.54338
AKI – PARP-1 – Thyroid hormones
HEND ASHOUR, M.D.;
SOMIA A. SOLIMAN, M.D.
1
AUTHOR
HEBA MORSI, M.D.;
MARWA AL-KAFFAS, M.D.
2
The Departments of Physiology, Faculty of Medicine, Cairo University, Egypt1 and King Khalid University, Abha, KSA2, The Departments of Pathology3 and Medical Biochemistry & Molecular Biology4, Faculty of Medicine, Cairo University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Prevalence of Diabetic Nephropathy among Type 2 Diabetes Mellitus, and Glycaemic Control Evaluated by Glycaeted Haemoglobin in Diabetic Patients with and without Diabetic Nephropathy
AbstractBackground: Diabetic Nephropathy (DN) is by far the most common cause of End-Stage Renal Disease (ESRD). Approximately one-third of individuals with diabetes develop DN, with a high likelihood of progression to ESRD. In addition, DN is associated with considerably increased cardiovascular disease risk and mortality.Aim of Study: The purpose of this study is to determine the prevalence of diabetic nephropathy between T2DM, and glycaemic control evaluated by a glycaeted haemoglobin in diabetic patients with and without diabetic nephropathy.Material and Methods: This study was carried out on 100 diabetic patients who attended a private clinic in Aden-Yemen. Over a period from 1st June 2018 to 1st January 2019. All the participants studied were subjected to assessment of sex, age and duration of diabetes with laboratory investigations includ-ing determination of urinary albumin to creatinine ratio, and glycated haemoglobin (HbA1c).Results: The results showed that 14% of all patients have been studied had diabetic nephropathy, there were statistically significant relationships between diabetic nephropathy and duration of diabetes (p=0.040), there were no statistically significant relationships between diabetic nephropathy and age, sex and glycated haemoglobin level (HbA1c) of the patients.Conclusion: Screening for microalbuminuria will enable early identification of patients with DN. Duration of DM and was strong predictor associated with the development of DN in the patients studied.This also raises a red flag against the common medical practice of only using Serum Creatinine as a test to determine renal function.
https://mjcu.journals.ekb.eg/article_54351_1611464798fc314cb829f10a6c7af1bf.pdf
2019-06-10
2077
2081
10.21608/mjcu.2019.54351
Diabetic nephropathy – T2DM – HBA1C
OSAM S. ABDO GABALI, M.D.;
AHMED S.O. AL-GEFRI, M.D.
1
AUTHOR
LINDA M.H.
BAALWI, M.D.
2
The Department of Internal Medicine, Faculty of Medicine and Health Sciences, Aden University, Yemen
AUTHOR
ORIGINAL_ARTICLE
Can Tomosynthesis Solve the Problem of Mammographically Indeterminate Breast Lesions?
AbstractBackground: Breast cancer in women is a major public health problem throughout the world. To reduce the morbidity and mortality associated with breast cancer, early detection becomes a very important job. Addition of breast Tomosyn-thesis to mammography examination reduced and eliminated tissue overlap especially in women with radiographically dense breast.Aim of Study: To evaluate the impact of adding Digital Breast Tomosynthesis (DBT) to Full Field Digital Mammog-raphy (FFDM) in detection, characterization and diagnosis of mammographically indeterminate breast lesions.Subjects and Methods: The study included 80 patients with 86 indeterminate findings on mammography. DBT ex-amination was done and imaging findings were evaluated before and after the use of DBT.Results: Tomosynthesis showed better diagnostic perform-ance compared to mammography. The sensitivity of Tomo-synthesis was 90%, the specificity was 91.1%, the positive predictive value of 88%, the negative predictive value was 92.7% and the diagnostic accuracy was 91%, while the sensi-tivity of mammography was 62.5%, the specificity was 59%, the positive predictive value was 52.1%, the negative predictive value was 68.8%, and the diagnostic accuracy was 60.4%.Conclusion: DBT significantly enhanced the detection and characterization of indeterminate breast lesions on digital mammography especially in the context of dense breast parenchyma.
https://mjcu.journals.ekb.eg/article_54353_5d7b4fc400c1b945cc9fcf6dfd28c89a.pdf
2019-06-10
2083
2098
10.21608/mjcu.2019.54353
Digital mammography – Tomosynthesis – Inde-terminate breast lesions
OMNIA MOKHTAR, M.D.;
SAHAR MAHMOUD, M.D.
1
AUTHOR
AMR
KAMAL, M.D.
2
The Department of Radiology, National Cancer Institute of Cairo*, Faculty of Medicine, Beni-Suef University** and Surgery Department***, National Cancer Institute of Cairo, Egypt
AUTHOR
ORIGINAL_ARTICLE
Role of Dual Energy Contrast Enhanced Spectral Mammography in Differentiation between Benign and Malignant Breast Masses
AbstractBackground: Dual Energy Contrast Enhanced Spectral Mammography (DE-CESM) is a new and advanced clinical application of full field (FFDM) and is easily implemented, fast, and reproducible, and breast doses are comparable to those of standard digital mammography, it might be useful for shifting expensive MRI to digital mammography.Aim of Study: To evaluate the enhancing power of the Contrast-Enhanced Spectral Mammography (CESM) on breast lesions and its ability to differentiate malignant from benign masses.Patients and Methods: A prospective study was carried on 20 patients referred to Radio-Diagnosis Department. At the Air Forces Hospital over 12 months for the evaluation of breast masses, all patients were examined by a dual energy contrast enhanced spectral mammography, a complementary B-mode ultrasound and a histopathological examination of all masses.Results: The study included 8 benign (40%) and 12 malignant (60%) masses, 17/20 (85%) of them were enhanced while 3/20 (15%) were not enhanced. The enhanced masses were further subdivided into faint & avid enhancement as well as homogenous, heterogeneous & ring enhancement. Contrast uptake was significantly more frequent by malignant masses (p-value <_0.301). Irregular mass lesions with intense and heterogeneous enhancement patterns correlated with a malignant pathology (p-value £0.004) DE-CESM was 91.7% sensitive and 87.5% specific. The positive and negative likelihood ratios were 91.7 and 87.5 respectively.Conclusion: Using CESM to assess the morphology and enhancement characteristics of breast lesions improves the ability of digital mammography to differentiate benign from malignant breast lesions.
https://mjcu.journals.ekb.eg/article_54357_7170b120612fb0ca8474ad7ca9bba8b7.pdf
2019-06-10
2113
2120
10.21608/mjcu.2019.54357
Contrast-Enhanced Spectral Mammography (CESM) – Breast lesions – Malignant and benign masses
MOHAMED H. EL-SHAFEY, M.D.;
EL-SHIAMAA Z.M. EL-SHAHAWY, M.D.
1
AUTHOR
AMAL A. HASHISH, M.D.;
GHADA A. KHEDR, M.Sc.
2
The Department of Diagnostic Radiology, Faculty of Medicine* and The Department of General Surgery, Faculty of Medicine**, Tanta University and The Department of Diagnostic Radiology, Benha Educational Hospital***
AUTHOR
ORIGINAL_ARTICLE
Histological Study of the Possible Protective Effect of Lycopene on Glucocorticoid-Induced Osteoporosis in Adult Male Albino Rat
AbstractBackground: Osteoporosis is one of the most commonly occurring bone diseases characterized by decrease in bone mass and increase bone resorption leading to fractures, severe pain and deformities. Glucocorticoid-induced osteoporosis results from long-term and high dose use. Lycopene is an unsaturated carotenoid that gives tomatoes and other fruits their red color. It was reported that it is a natural antioxidant and was associated with the prevention of many chronic diseases and cancers.Aim of Study: This work was performed to study the possible protective effect of lycopene against glucocorticoid-induced osteoporosis in adult male albino rat.Material and Methods: 40 adult male albino rats were used that divided equally into four main groups: Group I (control group) was subdivided equally into two subgroups (I-A & I-B), Group II received lycopene orally 30mg/kg once daily for 8 weeks, Group III received prednisolone orally 20mg/kg once daily for 8 weeks, Group IV concomitantly received lycopene and prednisolone orally once daily at the same previous doses for 8 weeks. At the end of experiment, femur heads of all animals were obtained and processed for histological study and stained with Hematoxylin & eosin, Mallory Trichrome and for scanning electron microscope study.Results: Light microscopic examination revealed structural changes in femur head of Group III in the form of discontinuous thin trabeculae of cancellous bone with apparent faintly stained matrix with multiple pores inside trabeculae associated with minor fractures, wide bone marrow spaces were seen between trabeculae containing abundant clear areas, the endosteal surface showed irregular eroded surface. Regarding Mallory stained sections; they showed decrease collagen fibers contents with their irregular distribution in bone matrix. Scanning electron microscopic specimens showed discontinuous thin and blind ended cancellous bone trabeculae containing some areas of decreased electron density with multiple pores and minor fractures inside them. Wide bone marrow spaces were seen between trabeculae lined with irregular eroded endosteal surface; which revealed the evident of prednisolone induced osteoporosis. Group IV specimens revealed partial preservation of the normal structure of cancellous bone of femur head to some extent.Conclusion: Osteoporosis resulted from glucocorticoids in adult male albino rats can be partially minimized by lycopene co-administration.
https://mjcu.journals.ekb.eg/article_54360_305ebde683374fbe49ac6a3e157788a3.pdf
2019-06-10
2121
2134
10.21608/mjcu.2019.54360
Osteoporosis – Prednisolone – Lycopene – Rat
GEORGE S. MITYAS, M.Sc.;
SADIKA M. TAWFIK, M.D.
1
AUTHOR
EHSAN F.
SALAH, M.D.
2
The Department of Histology, Faculty of Medicine, Tanta University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Role of Multi-Detector Computed Tomography in Differentiation between Benign & Malignant Cavitary Lung Lesions
AbstractBackground: In patients with cavitary lung diseases, it is crucial to detect the lesion for determining adequate treatment. Multislice CT in combination with other radiologic images is currently regarded as the most appropriate diagnostic imaging for differentiation between benign and malignant cavitary lung lesions.Aim of Study: To evaluate the role of multi-detector computed tomography in differentiation between benign & malignant cavitary lung lesions.Material and Methods: The present study included 60 patients with cavitary lung lesions. They were 46 males and 14 females. Their ages ranged l5 years and 83 years with their mean age of 50 years old. All patients were subjected to radiological examination including chest X-ray and 16 slice MDCT scanner.Results: In this study there were 10 patients with airway diseases, 35 patients with infective lesions, and another 15 patients with tumors. The diagnosis was confirmed by (clinical follow-up, needle biopsy or bronchoscopy). In our study, 2 cases had false positive results by CT and one case had false negative results by CT, multislice computed tomography showed sensitivity of 91%, specificity of 88%, and accuracy of 87%.Conclusion: MDCT is superior to plain X-ray in demon-strating the cavitary lung lesions with higher degree of clarity. It can define the exact anatomical site of the cavity, charac-terization of the cavitary wall and abnormalities in the sur-rounding lung parenchyma. It is reliable in detecting lesions in areas difficult to visualize by plain X-ray.
https://mjcu.journals.ekb.eg/article_54362_62ab1455fe52cb17262bce6d43f0b360.pdf
2019-06-10
2135
2143
10.21608/mjcu.2019.54362
Lungs – Abscess – Bronchogenic carcinoma – fungal ball – Plain X-ray – CT
MOHAMED A. SHERIF, M.Sc.;
FATEN M. SALEM, M.D.
1
AUTHOR
ABD EL-HADY M. TAHA, M.D.;
MOHAMED A. YOUSEF, M.D.
2
The Department of Radio-Diagnosis & Cardiothoracic, Faculty of Medicine, Tanta University
AUTHOR
ORIGINAL_ARTICLE
Improving Hepatocellular Carcinoma (HCC) Detectability Using Cone Beam CT (CBCT) During Transarterial Chemo-Embolization (TACE)
AbstractBackground: Trans-catheter arterial chemoembolization is one of the effective therapeutic options for hepatocellular carcinoma (HCC). Ultra-selective chemoembolization is an approach improving the local control, and is associated with a reduced incidence of adverse effects.Aim of Study: It was to evaluate the sensitivity of cone beam computed tomography (CBCT) in detecting HCC tumors and their feeding vessels during trans-arterial chemoemboli-zation (TACE).Patients and Methods: All patients were suspected of having or confirmed to have HCC based on clinical history, underlying liver disease and/or viral infection, the diagnosis of HCC was made by imaging findings. Between January 2018 and January 2019, the prototype chemoembolization guidance software for syngo Dyna CT was retrospectively used in 25 consecutive patients with HCC tumor.Results: The detectability of the tumor with non-selective DSA obtained at the common, proper, right, or left hepatic arteries and compared to cone-beam CT. The tumor stain and feeding branches were evaluated. Detectability of the tumor-feeding branch with non-selective DSA and Dyna CT analyzing the first CT HA images was compared. Tumor detectability on cone-beam CT was significantly greater than on non-selective. Cone beam HA could depict (91.5%) of tumors. Nonselective DSA could depict only (72.1%). Cone-beam CT has satisfactory ability to detect tumors; could identify 81% of tumor-feeding branches at the level of the sub- sub segmental artery of the hepatic artery in HCC lesions.Conclusion: The technical success rates of ultraselective transcatheter arterial chemoembolization may be improved by chemoembolization guidance software that uses cone-beam CT technology.
https://mjcu.journals.ekb.eg/article_54365_0fed8ee95d09e23fc8f3371cc1a6da1d.pdf
2019-06-10
2145
2152
10.21608/mjcu.2019.54365
Cone beam computed tomography – Hepatocel-lular carcinoma – Transarterial chemoemboliza-tion
AHMED H. SOLIMAN, M.D.;
MARWA E. IBRAHIM, M.D.
1
AUTHOR
ALIAA S.
SHEHA, M.D.
2
The Department of Radiodiagnosis, Faculty of Medicine, Ain Shams University
AUTHOR
ORIGINAL_ARTICLE
Percutaneous Vertebroplasty in Metastatic Thoracolumbar Spine Disease Regarding Pain Relief
AbstractBackground: Percutaneous vertebroplasty is a minimally invasive technique used for treatment of painful vertebral compression fracture.Aim of Study: To evaluate the rule of vertebroplasty in treatment of spinal metastasis of thoracolumbar region regard-ing pain relief.Patients and Methods: This is a retrospective study of 14 cases of metastatic spinal disease of thoracolumbar region operated upon by percutaneous vertebroplasty between Feb-ruary 2012 to April 2015. Pain intensity was scored on visual analog scale (VAS) pre-operatively and 6 months following surgery to assess improvement. Pre-operative Plain X-ray and MRI of the spine were obtained in all patients as well as serial post-operative X-ray.Results: 12 patients (85.7%) of our study showed signif-icant pain improvement within 48 hours of the procedure, at 6 months follow-up 10 patients (71.4%) had persistent pain relief. Transient radiculopathy occurred in 1 patient due to cement leakage into the neural foramen.Conclusion: Percutaneous vertebroblasty is a minimally invasive procedure that is effective in reducing pain in patients with metastatic spinal disease of thoracolumbar spine.
https://mjcu.journals.ekb.eg/article_54368_0404701e9792a9a9b82c89f4f43ceba6.pdf
2019-06-10
2153
2158
10.21608/mjcu.2019.54368
Veretebroblasty – Pain – Metastatic
AHMED A. ABDELKHALEK, M.D.;
A. MOHSEN, M.D.
1
The Department Neurosurgery, Faculty of Medicine, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Treatment of Sebaceous Hyperplasia with Pulsed Dye Laser
AbstractBackground: Sebaceous hyperplasias are benign skin lesions mostly seen on the face. These lesions are a common cosmetic concern but are difficult to be treated, as the entire sebaceous gland needs to be destroyed. Multiple treatment modalities have been employed for the management of seba-ceous hyperplasia but some therapies are associated with side effects and recurrence rates. The pulsed dye laser may be an effective and safe alternative treatment option.Aim of Study: To evaluate the efficacy of pulsed dye laser in treating sebaceous hyperplasia.Patients and Methods: Twenty patients with a total of 72 sebaceous hyperplasia lesions were treated by 1-3 sessions of pulsed dye laser, two weeks apart (with parameters of hand piece 7, fluence 9-12J/cm2, pulse width 1.5ms, rate 1HZ and air cooling). The patients were assessed clinically to evaluate the efficacy and safety of PDL.Results: 83.3% of lesions responded to treatment, with complete reduction in 46 lesions (63.9%) and partial reduction in 14 lesions (19.4%). Treatment was well tolerated with no side effects and high patient satisfaction.Conclusion: Pulsed dye laser is effective and safe as a monotherapy for treating sebaceous hyperplasia.
https://mjcu.journals.ekb.eg/article_54369_03038abbbf3fb738cf67dc95d69793ae.pdf
2019-06-10
2159
2164
10.21608/mjcu.2019.54369
Sebaceous hyperplasia – Pulsed dye laser
LAILA M. MOHAMMED, M.D.;
ARWA M. HASSAN, M.D.
1
AUTHOR
EMAN E.
EL-SHOBARY, M.Sc.
2
The Department of Dermatology and Venereology, Faculty of Medicine, Tanta University
AUTHOR
ORIGINAL_ARTICLE
Effect of Peroneal Muscles Fatigue on Repositioning Error in Athletic Females
AbstractBackground: High rate of Lateral Ankle Sprain (LAS) occurs in high rate in athletes near the end of the matches when the fatigue is well established. Understanding the effects of fatigue on Repositioning Error (RE) in athletic persons may partially explain the increased risk of LASs in those populations.Aim of Study: To investigate the effect of peroneal muscles fatigue on RE in volley ball female players.Study Design: One group pretest/posttest cross section design.Material and Methods: 25 female volleyball players with mean age (20±2 years) and mean BMI (22.8±1 .6kg/m2) were recruited from Faculty of Physical Therapy, Cairo University. Proprioception (in the form of RE) was tested before and after induction of fatigue. Fatigue protocol and proprioception assessment were performed using Biodex System III Pro Isokinetic dynamometer. Mean error around 20 degree of inversion was calculated.Results: There was no statistical significant difference in RE before and after peroneal muscles fatigue (p=0.904).Conclusion: RE of ankle joint was not affected by induc-tion of peroneal muscles fatigue.
https://mjcu.journals.ekb.eg/article_54370_5ac100c16014829d87bbcbb77ebce94c.pdf
2019-06-10
2165
2168
10.21608/mjcu.2019.54370
Ankle – Athletes – Peroneal muscles fatigue – Repositioning error
ALAA S. EL-SAID, M.Sc.;
HISHAM M. ABD EL-RAHEEM,Ph.D.
1
AUTHOR
ABEER
ABD EL-RAHMAN, Ph.D.
2
The Department of Basic Science, Faculty of Physical Therapy, Cairo University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Effect of Intermittent Serial Casting on Equinus Ankle Deformity in Children with Hemiplegic Cerebral Palsy
AbstractBackground: Equinus is the most common problem in ambulatory children with spastic hemiplegic cerebral palsy, which results in an unstable and inefficient gait pattern. Without proper management at an early stage, it can lead to permanent foot deformities.Aim of Study: The aim of this study was to evaluate the effect of serial casting on ankle range of motion, tone of the calf muscle and ankle kinematics during gait in children with spastic hemiplegic cerebral palsy.Material and Methods: Twenty-five spastic hemiplegic cerebral palsy children of both sexes (15 boys and 10 girls) participated in this study. Patients were selected at level I according to Gross Motor Function Classification System and the degree of spasticity ranged from 2 to 3 according to Modified Ashworth Scale with true equinus, with their mean age were 4.8±0.8 years. They were randomly assigned to two groups. The first group, 12 children, Group (A) who received a selected physical therapy program once a day/3 times a week for three successive weeks; while the second group, 13 children, Group (B) who received three consecutive casts for five days each and removed in the last two days in each week to conduct the same selected physical therapy program which conducted for the Group (A). Ankle range of motion was assessed by electronic goniometer, calf muscle spasticity was assessed by modified ashworth scale and ankle kinematics during gait was assessed by observational gait scale.Results: The results of the present study revealed that Group (B) showed statistically significant improvement in ankle range of motion, tone of calf muscle and ankle kinematics during gait (p=0.0001 for all) than those of the Group (A).Conclusion: Serial casting of equinus ankle deformity could improve ankle range of motion, tone of calf muscle and ankle kinematics during gait in children with spastic hemiplegic cerebral palsy.
https://mjcu.journals.ekb.eg/article_54373_c093b8c809e00ff64290cf8d99cfa20e.pdf
2019-06-10
2169
2174
10.21608/mjcu.2019.54373
Cerebral palsy – Equinus foot – Hemiplegia – Serial casting – Spasticity
YASSER M. ABD EL-MONEM, M.Sc.;
ELHAM E. SALEM, Ph.D.
1
AUTHOR
MOHAMED I. EL-ASSAL, Ph.D.;
MAHMOUD A. MAHRAN, M.D.
2
The Department of Pediatrics, Faculty of Physical Therapy, Cairo University* and The Department of Orthopedic Surgery, Faculty of Medicine, Ain Shams University**
AUTHOR
ORIGINAL_ARTICLE
Manual Lymphatic Drainage Versus Pneumatic Compression Pump on Cellulite Post Liposuction
AbstractBackground: The presence of cellulite is an aesthetically unacceptable cosmetic problem for most post-adolescent women that can appear post liposuction, it is characterized by dimpled or puckered skin. Manual lymphatic drainage and pneumatic compression pump may be effective in improving cellulite after liposuction.Aim of Study: This study is conducted to compare the effect of manual lymphatic and pneumatic compression pump on cellulite in females post liposuction.Subjects and Methods: Thirty female patients with cellulite grade 3 post liposuction at their thighs participated in this study. Their ages ranged from 25 to 45 years. They were selected from the outpatient clinic of Plastic Surgery Depart-ment at Cairo University Hospitals and were divided into two equal groups, each group consisted of 15 patients. Group (A) received manual lymphatic drainage and walking on treadmill three times per week for 8 weeks. Group (B) received pneu-matic compression pump and walking on treadmill three times per week for 8 weeks. Methods of evaluation are cellulite grading scale and thigh circumference.Results: There was a significant decrease in severity of cellulite in manual lymphatic drainage group when compared with pneumatic compression group.Conclusion: Manual lymphatic drainage is superior to pneumatic compression pump in the treatment of cellulite.
https://mjcu.journals.ekb.eg/article_54375_77c21f3618b03deffd8808d019bf501b.pdf
2019-06-10
2175
2182
10.21608/mjcu.2019.54375
Liposuction – Cellulite – Manual lymphatic drainage – Pneumatic compression pump – Aerobic exercises
AMANY R. SHAFIK, M.Sc.;
HAIDY N. ASHAM, Ph.D.
1
AUTHOR
SAMEH M. EL-TAHER, Ph.D.;
ESRAA H. ROSTOM, Ph.D.
2
The Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University* and The Department of Plastic Surgery, Faculty of Medicine, Ain Shams University**
AUTHOR
ORIGINAL_ARTICLE
The Impact of Serum MicroRNA-21 on Outcome of Diffuse Large B-Cell Lymphoma Patients
AbstractBackground: The emerging role of circulating microRNAs (miRNAs) as diagnostic and predictive tools has become fundamental and promising scope of cancer research. The link between the aberrant expressions of various miRNAs and the pathogenesis of Diffuse Large B-Cell Lymphoma (DLBCL) has been revealed by numerous studies.Aim of Study: This study was planned to analyze the relative expression levels of serum miRNA-21 and to elucidate its potential prognostic significance in DLBCL patients who had received cyclophosphamide, doxorubicin, vincristine, prednisone plus rituximab (R-CHOP) regimen.Patients and Methods: Serum miRNA-21 relative expres-sion levels were analyzed by Polymerase Chain Reaction (PCR) based technique in 65 DLBCL patients prior to immu-nochemotherapy in comparison with 35 healthy individuals. Receiver operating characteristic curve analysis was used to determine the ideal miRNA-21 cutoff and Kaplan-Meier method was used to calculate the overall survival of DLBCL patients.Results: MiRNA-21 expression levels were significantly up-regulated in DLBCL patients compared to healthy controls (p<0.001). MiRNA-21 expression levels were closely associ-ated disease stage, response to therapy, (32 microglobulin, Lactate Dehydrogenase (LDH) and C-Reactive Protein (CRP) (p<0.001; p=0.042; p<0.001; p=0.003; p=0.02 respectively). However, there was no relationship with other characteristics such as age, gender, extranodal site involvement, B symptoms, and International Prognostic Index (IPI) (all ps>0.05). Overall survival was significantly worse in patients with high miRNA-21 expression levels compared to those with low expression levels (p=0.01).Conclusion: Serum miRNA-21 may be employed as valuable non-invasive prognostic marker in DLBCL patients treated with R-CHOP regimen.
https://mjcu.journals.ekb.eg/article_54378_395015e61346d5c715e0209880bb5b04.pdf
2019-06-10
2183
2189
10.21608/mjcu.2019.54378
Circulating microRNA-21 – Diffuse large B-cell lymphoma – Polymerase chain reaction – Prog-nosis
SAMAR M. KAMAL EL-DIN, M.D.;
FATHIA I. EL-BASSAL, M.D.
1
AUTHOR
AMIRA M.F. SHEHATA, M.D.;
AYMAN A. AZZAM, M.D.
2
AUTHOR
SAMAR E. GHANEM, M.D.;
EMAN A. TAWFIK, M.D.
3
AUTHOR
SUZAN A. AL-HASSANIN, M.D.;
SUZY F. GOHAR, M.D.
4
AUTHOR
ORIGINAL_ARTICLE
Assessment of Mean Platelet Volume and Neutrophil/Lymphocyte Ratio in Chronic Kidney Disease Patients with Proteinurea
AbstractBackground: Chronic kidney disease is a chronic inflam-matory process which is the main cause of developing atherosclerosis. The main reason of morbidity and mortality in Chronic Kidney Disease (CKD) is atherosclerosis. Mean Platelet Volume (MPV) and Neutrophil to Lymphocyte Ratio (NLR) have been reported as markers of systemic inflam-mation.Aim of Study: To assess the value of Mean Platelet Volume (MPV) and Neutrophil to Lymphocyte (NLR) in chronic kidney disease patients with proteinurea.Methods: The study was carried out on two groups: Group (I): 50 CKD patients and Group (II): 50 healthy individuals as a control group. The patients were from Outpatient Clinic of Nephrology in Tanta University Hospital. This study was carried out from August 2017 to February 2018. We excluded patients suffer from coronary artery disease, myocardial infarction and heart failure, patients suffer from active infec-tion, patients suffer from diabetes mellitus and patients suffer from malignancy. Complete clinical examination including: Body Mass Index (BMI) and routine laboratory investigations and specific investigations including Neutrophil Lymphocyte Ratio (NLR) and Mean Platelet Volume (MPV) were done.Results: NLR was statistical significance higher in patients group than control healthy groups (Zmw=–7.38, p<.001) and there were statistically significant positive correlation were detected between NLR and proteinuria (p<.001*), CRP (p <.001*), fibrinogen (pConclusion: NLR could be used as a marker of inflam-mation and proteinuria in CKD stages but MPV needs more researches in this field.
https://mjcu.journals.ekb.eg/article_54380_b9c6b2fca968c2d96f2e59660879f780.pdf
2019-06-10
2191
2199
10.21608/mjcu.2019.54380
Neutrophil Lymphocyte Ratio (NLR) – Mean Platelet Volume (MPV) – Chronic Kidney Disease (CKD)
MINA A. FARAG ALLAH, M.Sc.;
MAHMOUD F. SELIEM, M.D.
1
AUTHOR
MAALY M. MABROUK, M.D.;
SHEREEN A. ABD EL-SALAM, M.D.
2
The Departments of Internal Medicine* and Clinical Pathology**, Faculty of Medicine, Tanta University
AUTHOR
ORIGINAL_ARTICLE
Effect of Bilateral Versus Unilateral Use of Smartphone on Cross Sectional Area of Median Nerve
AbstractBackground: The use of smartphones and mobile devices has become widespread, particularly among youth, and the possible impacts on hand function and structures have not been clarified during bilateral and unilateral use of smartphone.Aim of Study: This study was conducted to compare between bilateral and unilateral hand use of smartphone on cross sectional area of median nerve.Subjects and Methods: Fifty-six students aged 18-25 years old were recruited from Faculty of Physical Therapy Kafr El-Sheikh University. By using noninvasive ultrasonography, Cross Sectional Area (CSA) of median nerve was measured while subjects typed specific text on smartphone using bilateral hands then unilateral hand.Results: The results revealed that the paired t-test show significant increase in CSA of median nerve in unilateral than bilateral hands use of smartphone as t-value was 55,000 and p-value was p<.001.Conclusion: Unilateral hand use of smartphone has higher risk on CSA of median nerve so bilateral hands use of smart-phone is recommended than unilateral hand use to reduce risk of Carpal tunnel syndrome.
https://mjcu.journals.ekb.eg/article_54381_5f1f2c73a9796055ee916e07c19dfc3d.pdf
2019-06-10
2201
2205
10.21608/mjcu.2019.54381
Cross sectional area – Median nerve – Smart-phone
MAI E. MOUSA, M.Sc.;
RANIA R. ALI, Ph.D.
1
AUTHOR
MARWA Sh. MOSTAFA SALEH, Ph.D.;
KHALED A. ABO DEWAN, Ph.D.
2
The Department of Basic Science, Faculty of Physical Therapy, Cairo University* and The Department of Neurology, Faculty of Medicine, Tanta University**
AUTHOR
ORIGINAL_ARTICLE
Effect of Platelet Rich Plasma on an Experimental Rat Model of Adriamycin Induced Chronic Kidney Disease
AbstractBackground: Chronic kidney disease (CKD) is a world-wide health problem with increased mortality and morbidity. Currently, there is no effective protective therapy against CKD- induced renal damage with its sequel of end stage renal disease. Platelet-rich plasma (PRP) has a progressively gained consideration in wound healing, repair/regeneration of damaged tissues and conservation of organ function.Aim of Study: This current study was planned to evaluate the possible protective effect of PRP treatment on a rat model of Adriamycin (ADR)-induced CKD.Material and Methods: Sixty male albino rats were in-cluded; 30 were used for PRP preparation and the other 30, were randomly categorized into three equal groups of ten rat each: Normal control group, ADR group and PRP treated ADR group. At the end of experimental regimen (6 weeks), 24h urine samples were collected for measuring 24h urinary protein excretion and creatinine clearance (Cr Cl), then rats were decapitated and blood samples were collected for meas-uring serum albumin, triglycerides and cholesterol along with serum creatinine and blood urea nitrogen (BUN). Renal tissue samples were harvested and used for determination of renal level and mRNA expression of nephrin along with levels of hepatocyte growth factor (HGF), malondialdehyde (MDA), super oxide dismutase (SOD) activity, tumor necrosis factor alpha (TNF-a), interleukin 1-b (IL-1b), and transforming growth factor 1b (TGF 1b) in renal homogenates.Results: Platelet rich plasma treatment improved ADR induced proteinuria, hyperlipidemia and renal dysfunction, which was accompanied by parallel upregulation of renal nephrin and inhanced levels of HGF and SOD activity, whereas the increased levels of TNF-a, IL-1b and TGF 1b were attenuated.Conclusion: Platelet rich plasma could potentially protect against ADR induced CKD by alleviating its associated proteinuria, hyperlipidemia and the altered oxidative stress, inflammatory and fibrogenic responses.
https://mjcu.journals.ekb.eg/article_54382_3d01b349db03ec46b0224f999b6df65b.pdf
2019-06-10
2207
2217
10.21608/mjcu.2019.54382
Platelet rich plasma – Adriamycin – Chronic kidney disease – Proteinuria
ISLAM I. HEGAB, M.D.;
RANIA N. ABD-ELLATIF, M.D.
1
AUTHOR
MARWA M.
ATEF, M.D.
2
The Departments of Physiology* and Biochemistry**, Faculty of Medicine, Tanta University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Left Ventricular Filling Pressure as a Useful Marker of Myocardial Injury Following Elective Percutaneous Coronary Intervention
AbstractBackground: Advances in Percutaneous Coronary Inter-vention (PCI) techniques have improved patient outcome. However, occurrence of myonecrosis after elective PCI has been extensively debated.Aim of Study: We investigated the value of the ratio of early transmittal velocity to tissue Doppler mitral annular early diastolic velocity (E/E') in detecting the occurrence of peri-procedural myocardial injury in patients undergoing elective PCI.Patients and Methods: Sixty two patients undergoing elective PCI were recruited prospectively. All participants had EF% >50% and sinus rhythm. E/E' ratio was measured immediately before, and within 24 hours after PCI. CK-MB and cardiac troponin (cTn) were measured in the same day after successful PCI to diagnose myocardial injury.Results: The cohort age was 56.7±9.7 year, and consisted of forty four (71%) males, 49 (27.4%) had ³ two risk factors for CAD, 60% were symptomatic before PCI. Thirty (48.4%) patients had regional wall motion abnormalities (regional Wall Motion Score Index (WMSI): 0.74±0.29). Myocardial injury was diagnosed by elevated cTn in 39 (62.9%) patients. Patients with predilation showed reduction of LVEDP as estimated by D E/E' (8.9±2.9 Vs. 7.9±3.2, p<0.001). Pearson correlation analysis revealed that the E/E' correlated negatively with LV EF% (r=–26, p<0.03), positively with CK-MB and cTn level after PCI (r=.51, p<0.0001), NYHA functional class (r=.72, p<0.001), the number of risk factors, and number of vessel diseased and the number of vessel treated with PCI (r=36, pConclusion: These data suggest that the tissue Doppler derived-index of LV filling pressure (E/E') may be a useful indicator for predicting early myocardial injury after successful PCI. Patients with an elevated E/E' after PCI may need more careful and closer follow-up.
https://mjcu.journals.ekb.eg/article_54383_150daf837d0f0f511735ddfc54cc0b33.pdf
2019-06-10
2219
2232
10.21608/mjcu.2019.54383
Left ventricular filling pressure – Myocardial injury – PCI
AMR M.N. EL-SHEIKH, M.Sc.;
AYMAN GAFAAR, M.D.
1
AUTHOR
EHAB EL-GUINDY, M.D.;
AYMAN EL-SAID, M.D.
2
The Department of Cardiology, Faculty of Medicine, Tanta University
AUTHOR
ORIGINAL_ARTICLE
Role of Multi Slice - CT Angiography in Evaluation of Lower Limb Ischemic Disease
AbstractBackground: Peripheral Arterial Disease (PAD) is one of the major manifestations of systemic atherosclerosis affecting 12% of the adult population and up to 20% of elderly persons. The most severe form of PAD, Critical or Limb-threatening Ischemia (CLI) occurs when arterial blood flow is restricted so severely that perfusion of capillary beds is inadequate to sustain tissue viability. Many patients do not progress sequen-tially along predefined stages from claudication to CLI. As described in selected longitudinal studies, some patients with symptomatic PAD have been shown to develop CLI, while data from other studies have shown that many patients are asymptomatic prior to the development of CLI.Aim of Study: Evaluate the role of multidetectior CT angiography in evaluation and diagnosis of lower limb ischemia.Patients and Methods: This study includes thirty patients who were referred to the Radiology Department of Tanta University Hospital from the Vascular Surgery Department with suspected aorto-iliac arterial disease. They underwent multi-detector row CT angiography of the aorto-iliac arteries.Results: From the 30 cases in our study, the major symptom present in 30 cases is intermittent claudication but in different stages according to fontain classification, stage I in zero patient, stage II in 15 patient divided into 6 in IIa and 9 in IIb, stage III in 10 patients and stage IV in 5 patients.Conclusion: We predict that MDCT angiography can replace DSA and CCD in the examination of the aortoiliac arteries especially with the development of the new generations of multislice CT e.g. 128 or 160 channel MSCT and become the investigation of choice in this territory.
https://mjcu.journals.ekb.eg/article_54384_d41d8cd98f00b204e9800998ecf8427e.pdf
2019-06-10
2233
2242
10.21608/mjcu.2019.54384
Peripheral Arterial Disease (PAD) – Critical Limb-threatening Ischemia (CLI) – CT Angiogra-phy – Multi Slice
HAYTHAM H. EL-SAEED, M.D.;
ATEF H. TEAMA, M.D.
1
AUTHOR
HASSAN A. HASSAN, M.D.;
AHMED M. EL-MOSELHY, M.Sc.
2
The Departments of Radiodiagnosis* and Vascular Surgery**, Faculty of Medicine, Tanta University, Tanta, Egypt
AUTHOR
ORIGINAL_ARTICLE
Factors Accelerating Recovery of Intestinal Motility after Radical Cystectomy with Urinary Diversion
AbstractBackground: Radical cystectomy (RC) with urinary tract reconstruction currently remains the gold standard treatment for invasive bladder cancer. RC associated with many com-plications, postoperative ileus is the most common one which lead to increasing length of hospital stay. Multiple perioperative care plans was put aimed to decrease POI.Aim of Study: Evaluation of the different factors that can help to accelerate recovery of intestinal motility after radical cystectomy and urinary diversion in order to decrease the length of hospital stay.Patients and Methods: A total of 37 patients who under-went radical cystectomy with urinary diversion using intestinal segments were divided into 2 groups. In group A (n=23), our new protocol of perioperative preparation applied, in group B (n=14) classic way of perioperative preparation applied. The main differences between both ways are one day intestinal preparation with use of fortrans preoperative, anal dilatation intraoperative and chewing gums postoperative.Results: There was statistical significance in first intestinal sound first passage of flatus, beginning of soft diet, time to regular diet and hospital stay in favor of group A as compared to the group B (p-value <0.05).Conclusion: Application of our protocol decrease postop-erative ileus, more rapid time for regular diet and decrease hospital stay after radical cystectomy with urinary diversion.
https://mjcu.journals.ekb.eg/article_54385_75a8aa97121c04010979c0ef195972a4.pdf
2019-06-10
2243
2248
10.21608/mjcu.2019.54385
Radical cystectomy – Postoperative Ileus (POI) – Length of hospital stays (LOS)
MOHAMED A. REFAT, M.Sc.;
TAREK A. GAMEEL, M.D.
1
AUTHOR
MOHAMED A. OMAR, M.D.;
AYMAN A. HASSAN, M.D.
2
AUTHOR
MOHAMED A.
ELBENDARY, M.D.
3
The Department Urology, Tanta University, Tanta, Egypt
AUTHOR
ORIGINAL_ARTICLE
Knowledge, Attitude and Practice of University Hospital Staff Regarding Tobacco Control Measures
AbstractBackground: The best way to protect smoker and non-smokers' health is to provide a smoke-free environment. Hospitals should be 100% smoke-free for the health of all patients, workers and visitors.Aim of Study: To assess the readiness for implementation of smoke free hospital.Material and Methods: A descriptive exploratory health service study conducted at Internal Medicine Hospital (IMH) Cairo University hospital. Smoking behavior, the knowledge, attitude and practice (KAP) of all staff (physicians, nurses and paramedical staff) working in the hospital towards smoke free policy implementation at hospital were assessed.Results: The prevalence of current smoking in male healthcare workers (HCWs) was 18.6%. Majority of HCWS were exposed to second hand smoking (SHS). Knowledge of HCWs was high in most of areas related to tobacco control laws, while physicians have a lower percent of correct knowl-edge in some areas. Positive attitude was high and no tobacco control practices and activities are implemented at the hospital.Conclusion: Some areas of knowledge still need to be addressed for achieving 100% smoke free hospital. A smoke-free policy practices need to be implemented at the hospital like enforcing the protocol of fining for smokers in the hospital and smoking cessation service support at the hospital.
https://mjcu.journals.ekb.eg/article_54388_4e5473c80051bb36cba30ee2b39de2c3.pdf
2019-06-10
2249
2256
10.21608/mjcu.2019.54388
Smoke free hospital – Tobacco control – Health-care workers
ABEER A. ABDEL KHALIK, M.Sc.;
LAILA M. KAMEL, M.D.
1
AUTHOR
ZEINAB E.M. AFIFI, M.D.;
GHADA N. RADWAN, M.D.
2
AUTHOR
SAHIR O.
EL-KHASHAB, M.D.
3
The Departments of Public Health & Community Medicine* and Internal Medicine**, Faculty of Medicine, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Relationship between Upper Limb Co-Ordination and Severity Level in Children with Autism Spectrum Disorder
AbstractBackground: Autism is a multisystem neurodevelopmental disturbance characterized by stereotyped behaviors, restricted interests, as well as impaired communication and social interactions.Aim of Study: The current study examined the relationship between upper limb coordination, as measured by Bruininks-Oseretsky Test of Motor Proficiency 2nd Edition (BOT-2), and autism severity, as measured by the Childhood Autism Rating Scale (CARS).Subjects and Methods: Thirty (30) children with a diag-nosis of Autism Spectrum Disorder (ASD) were evaluated using the CARS and then tested for upper limb coordination using (BOT-2), Statistical analysis was then conducted to examine the relationship between autism severity and upper limb coordination.Results: The results of the present study showed that there was a negative correlation between CARS score and upper limb after adjustment for age, weight, height, gender and year of birth.Conclusion: Evidence suggests that upper limb coordina-tion in children with ASD is related to the severity of the disorder. Further research is needed to determine the extent and consistency of the motor impairments and possible treat-ments.
https://mjcu.journals.ekb.eg/article_54389_eb9560f04217e55243f2ac6931c7e22e.pdf
2019-06-10
2257
2260
10.21608/mjcu.2019.54389
Autism spectrum disorder – Childhood Autism Rating Scale – Bruininks-Oseretsky Test of Motor Proficiency – Motor impairment
SAMAH ATTIA EL-SHEMY, Ph.D.;
MOHAMED SALAH EL-SAYED, M.Sc.
1
The Department of Physical Therapy for Paediatrics, Faculty of Physical Therapy, Cairo* and Horus (HUE)** Universities
AUTHOR
ORIGINAL_ARTICLE
Comparative Study between Laparoscopic Common Bile Duct Exploration and Endoscopic Retrograde Cholangiopancreatography Plus Laparoscopic Cholecystectomy for Choledocholithiasis
AbstractBackground: Overall, 5% to 15% of patients undergoing cholecystectomy for cholelithiasis have concomitant bile duct stones, and the incidence of choledocholithiasis increases with age. Endoscopic Retrograde Cholangiopancreatography (ERCP) with consequent Laparoscopic Cholecystectomy (LC) has been the favored approach for the treatment of choledo-cholithiasis for quite a long time; however in the course of recent years, Laparoscopic Common Bile Duct Exploration (LCBDE) has been offered to patients with suspected choledo-cholithiasis.Aim of Study: The aim of this work is to compare the efficacy, safety, and the surgical outcomes of LCBDE with ERCP followed by laparoscopic cholecystectomy and deter-mine the most appropriate approach for patients with choledo-cholithiasis.Patients and Methods: A prospective randomized clinical study was carried out from March 2017 to September 2018. It included 50 patients with cholecysto-choledocholithiasis who were divided into two groups: Group A (25 patients) included patients who underwent laparoscopic transcystic common bile duct exploration and stone extraction with LC in one stage, and Group B (25 patients) included patients who underwent endoscopic retrograde cholangiopancreatography for CBD stone extraction followed by LC in two stages. The Common Bile Duct (CBD) stone clearance rate, post-operative bile leakage, post-operative morbidity, mortality, overall hospital stay, and patient satisfaction were analyzed.Results: LCBDE and ERCP+LC were similar in terms of clearance rate, operative time postoperative complications, retained CBD stones, and postoperative length of stay, but there was a significant difference in number of procedures and patient satisfaction.Conclusion: Although both approaches have equivalent success rates, LCBDE is better in terms of fewer procedures, and better satisfaction compared with ERCP + LC. Our study suggests that one-stage management is the treatment of choice for patients with cholecystocholedocholithiasis.
https://mjcu.journals.ekb.eg/article_54390_ba1f7a94bc8e5e67ad7594a56089284b.pdf
2019-06-10
2261
2269
10.21608/mjcu.2019.54390
Bile duct stones – Laparoscopic common bile duct exploration – Laparoscopic cholecystectomy – Endoscopic retrograde cholangiopancreatog-raphy
MAHMOUD RADY, M.Sc.;
MOHAMED M. SALEM, M.D.
1
AUTHOR
MOHAMED E. ESMAT, F.R.C.S.;
YASER AMER, M.D.
2
The Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo* and Theodor Bilhariz Research Institute, Giza**, Egypt
AUTHOR
ORIGINAL_ARTICLE
Evaluation of Kisspeptin Level in Non Obstructive Azoospermic Patients
AbstractBackground: Non-obstructive azoospermia is characterized by the complete absence of sperm in the ejaculate due to testicular failure. One of the genetic causes of non-obstructive azoospermia is the mutations in kisspeptin hormone and the kisspeptin hormone receptor (Kiss1r) genes. The level of kisspeptin hormone has been investigated in patients with non-obstructive azoospermia.Aim of Study: The aim of the study was to evaluate the level of kisspeptin hormone (KISS1) in the serum of non-obstructive azoospermic males and its relation to fertility hormones (Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), Testosterone and Prolactin).Patients and Methods: This case control study was done from August 2017 to August 2018 & included 25 non-obstructive azoospermic patients & 25 cases of age matched healthy fertile control subjects. After full history taking and general and local examination, Kisspeptin level was measured using ELISA. Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), Testosterone (T) and Prolactin hormone (PRL) were also measured.Results: The mean value of kisspeptin hormone was significantly lower in cases (6.30±2.07ng/ml) than controls (36.70±9.64ng/ml). The patients had significant high level of FSH (p-value <0.001), high level of LH (p-value=0.001) and low level of Testosterone (p-value=0.022). No correlation was found between plasma kisspeptin levels and (FSH, LH, Testosterone & Prolactin).Conclusion: Kisspeptin level is lower in non-obstructive azoospermic infertile males than the fertile controls, so it might be used as a diagnostic tool for infertility and treatment of infertility disorders in patients proved to have a low level of kisspeptin hormone.
https://mjcu.journals.ekb.eg/article_54391_fa1d35ef53c09f812b488a913bd5711d.pdf
2019-06-10
2271
2275
10.21608/mjcu.2019.54391
Follicle stimulating hormone – Kisspeptins – Luteinizing hormone – Male infertility – Non-obstructive azoospermia – Testosterone
BELAL A.E. MONTASER, M.D.;
ABDALLAH ATTIA, M.D.
1
AUTHOR
HOSAAM EL-DEEN YASSIN, M.D.;
WALIED OSAMA, M.Sc.
2
The Departments of Clinical Pathology* and Dermatology & Andrology**, Faculty of Medicine, Menoufia University
AUTHOR
ORIGINAL_ARTICLE
Safety and Analgesic Efficacy of Spinal Versus Caudal Block in Pediatric Infra-Umbilical Surgery
AbstractBackground: Neuraxial analgesia may improve post-operative outcomes for high-risk children who are susceptible to respiratory complications (e.g. post-operative apnea). The use of spinal anesthesia in infants and children requiring surgeries of sub-umbilical region is gaining considerable popularity worldwide. Caudal analgesia along with general anesthesia is a very popular regional technique for prolonged post-operative analgesia in different pediatric surgical proce-dures where the surgical site is sub-umbilical. Bupivacaine has been thoroughly studied, and a large global experience exists.Aim of Study: Was to investigate the safety and analgesic efficacy of spinal versus caudal bupivacaine combined with sevoflurane anesthesia in children undergoing infra-umbilical surgeries.Material and Methods: One hundred thirty patients of either sex aged between 2-7 years, (ASA I or II) were randomly assigned into two groups of 65 subjects each; Group A (caudal bupivaciane group) and Group B (spinal bupivaciane group). Group A received caudal isobaric bupivacaine, Group B received spinal hyper baric bupivacaine. Both after anesthesia induction and before surgery. Assessment parameters included; time to 1st oral rescue analgesics, post-operative (FLACC scale), post-operative agitation, post-operative motor block component, haemodynamics, perioperative adverse effect.Results: There were no significant differences between the two studied groups in the mean post-operative FLACC scores at any time except in the second post-operative hour in the spinal group (0.84±0.07 Vs. 1.13±0.08, p<0.01). The time to first request for rescue analgesia was significantly lower in the spinal group (6.60±1.82 Vs. 9.23±2.47, p<0.00), compared with the caudal group. There were no differences between the two studied groups in the total IV paracetamol consumption in the 1st 24h post-operatively (p=0.0674). There were no significant differences in the mean post-operative modified bromage scale scores between the two studied groups at any time. The block was associated with few complications in both groups.Conclusion: This study demonstrated that the spinal analgesia is fairly comparable to caudal analgesia in pediatric patients undergoing sub-umbilical surgeries. And we recom-mend the addition of an adjuvant to the intrathecal bupivacaine to prolong its analgesic effect making spinal analgesia a suitable alternative to caudal analgesia.
https://mjcu.journals.ekb.eg/article_54393_e60ebfdfcd98b0a197db904ac7346058.pdf
2019-06-10
2277
2283
10.21608/mjcu.2019.54393
Children – Post-operative pain – Analgesia – Caudal – Spinal
MAHMOUD A. ALI, M.D.;
HALA S. ABD EL-GHAFFAR, M.D.
1
AUTHOR
NAGWA M. IBRAHIM, M.D.;
ALAA M.A. ATTIA, M.D.
2
AUTHOR
PETER S.
ATALLAH, M.Sc.
3
The Department of Anesthesia, Faculty of Medicine, Assiut University, Assiut, Egypt
AUTHOR
ORIGINAL_ARTICLE
Efficacy of Dexamethasone on Prevention of Post-Operative Spinal Shivering in Comparison with Intravenous Ketamine Plus Midazolam during Elective Cesarean Section
AbstractBackground: Post-anesthetic shivering is a common complication of modem anesthesia, affecting 5-65% of patients after general anesthesia and (33%) of patients during epidural anesthesia. Shivering can cause more server complicationin patinets with history of cardio-respiratory diseases.Aim of Study: In this study we compared the anti-shivering effect of dexamethasone with that of ketamine plus midazolam in comparison with placebo after spinal anesthesia, in addition to evaluating any side effect of such medications.Patients and Methods: This study was performed for 90 women ASA I, II at the age of 20-35 years with uncomplicated singleton pregnancies of more than 36 weeks gestation, who was scheduled for elective cesarean delivery under spinal anesthesia. Full medical history and examination was done to each parturient.The patients were allocated randomly to one of three equal groups:•Group D: Received 0. 1mg/kg dexamethasone (n=30).•Group K.M: Received 0.25mg ketamine plus 40mg kg–1 midazolam (n=30).•Group S: Received same volume of saline 0.9% as placebo (n=3 0).Results: Our study results showed a significant decrease in the incidence of shivering among the: Ketamine plus midazolam (10%). Group K.M.Grade I (6.7%), Grade II (3.3%), Grade III (0%), Grade IV (0%) in comparison with the Dexamethasone (33.3%). Group D. Grade I (23.3%), Grade II (6.7%), Grade III (3.3%), Grade IV (0%) and Placebo (40%). Group S. Grade I (26.7%), Grade II (10%), Grade III (3.3%), Grade IV (0%).The incidence of sedation was higher in females who received: Ketamine plus midazolam (26.6%) Group K, M.Grade I (16.6%), Grade II (10%) and Grade III (0%) than Dexamethasone group (0%) Group D and Placebo group (0%). Group S.Conclusion: We conclude that intravenous (0.25mg keta-mine plus 40mg kg–1 midazolam) five min before spinal anesthesia had better anti shivering results than using intra-venous (0.1mg/kg dexamethasone) with minor side effects of such medications in women undergoing elective cesarean section.
https://mjcu.journals.ekb.eg/article_54394_4149866aedad6fbb207e0560e3a72640.pdf
2019-06-10
2285
2294
10.21608/mjcu.2019.54394
Post-operative spinal shivering
ISLAM B. ABD EL-HAFEZ, M.Sc.;
OSAMA ALI, M.D.
1
AUTHOR
GEHAN A.
SAYED, M.D.
2
The Department of Anesthesiology and Critical Care Medicine, Assuit Police Hospital* and Faculty of Medicine, Assuit University**
AUTHOR
ORIGINAL_ARTICLE
Effect of Ferulic Acid on Bladder Over Activity in Diabetic Rat
AbstractBackground: Diabetic bladder dysfunction (DBD) shows a change in the neurotransmission patterns which could be of great importance for drug development.Aim of Study: This study aims to explore whether cholin-ergic or non-adrenergic non-cholinergic (NANC) pathways are altered in their participation in mediating the contraction of diabetic urinary bladder and if ferulic acid could improve DBD.Material and Methods: Rats were divided into three groups (n=12): Streptozotocin induced diabetic group, diabetic with ferulic acid supplemented group, and age matched control group. At the end of 10 weeks, blood samples were collected, and the bladders were removed, weighed, used to measure TBARS reduced glutathione (GSH), and super oxide dismutase (SOD) in bladder homogenate and to record contractility of bladder strips.Results: Diabetic rats received ferulic acid expressed significant reduction in blood glucose, fluid intake, urine output and improvement in bladder wt/body wt. ratio and oxidative stress markers. Ferulic group showed significant improvement in spontaneous contractility and bladder sensi-tivity to different agonist and antagonists when compared to those of diabetic group. The purinergic as well as cholinergic component are significantly decreased in FA treated rats than in diabetic ones which could be explained by its antioxidant activity that ameliorates oxidative stress associated with diabetes. So, in Conclusion: FA could be considered as a beneficial adjuvant in lines of DBD treatment.
https://mjcu.journals.ekb.eg/article_54395_88a5b4e56a7cc82d32dd886a04d17182.pdf
2019-06-10
2295
2304
10.21608/mjcu.2019.54395
Diabetic bladder dysfunction (DBD) – Ferulic acid (FA) – Non-adrenergic non-cholinergic (NANC) pathway – Cholinergic pathway – TBARS
SHEREEN M. SAMIR, M.D.;
ABEER F. MOSTAFA, M.D.
1
The Department of Medical Physiology, Faculty of Medicine, Mansoura University, Egypt
AUTHOR
ORIGINAL_ARTICLE
The Effects of High Definition Transcranial Direct Current Stimulation Targeting the Primary Motor Cortex on Experimental Capsaicin-Induced Pain in Healthy Volunteers
AbstractBackground: Chronic pain is one of the most common health problems in the world and a significant challenge to clinical practice. Which has severe effects on patient's social and daily work that costs a lot of the governmental support. Traditionally, the focus on alleviating chronic pain has relied mainly on pharmacotherapy which has limited efficacy and significant side-effects, especially with of prolonged use. Especially with opioids which is the most widely prescribed drugs for pain.Transcranial Direct Current Stimulation (tDCS) which deliver a weak current up to (2mA) through electrodes on the scalp has attracted much interest as it is safe, inexpensive and easy to implement and can be used as an alternative or adjuvant to pharmacotherapy.Aim of Study: In this study, we aimed to test the effects of the newly developed and more focally targeted anodal High Definition transcranial Direct Current Stimulation (HD-tCDS) targeting the PMC on a capsaicin-induced pain model in healthy subjects. We set out to test the hypothesis that it is possible to use HD-tDCS to stimulate the PMC and to compare this with sham stimulation.Patients and Methods: After obtaining informed consent, 36 healthy volunteers (20 male). All volunteers subjected to the following experimental paradigm: Application of capsaicin cream (0.075%) on a 9cm2 area of skin for 30 minutes on the volar surface of both forearms. The volunteers were blinded and then divided into two groups of 18 with each subjected to 20 minutes of the following: Group 1 received Sham HD tDCS targeting PMC, group 2 anodal HD tDCS (2mA) targets the PMC. Pain severity was collected using Numerical Rating Scale (NRS) score at regular intervals before and after the session. The subjects also asked whether they were able to differentiate between sham and active stimulation and any complications of stimulation recorded. The NRS scores also compared between the two groups. Statistical significance was calculated using suitable tests and pResults: Compared to sham stimulation, the PMC stimu-lation by HD-tDCS associated with a faster reduction in NRS pain scores after application of capsaicin to forearm skin. Also, it was well tolerated without documented adverse effect that necessitates discontinuation of the session.Conclusion: Anodal HD-tDCS of the primary motor cortex was associated with a faster reduction in reported pain score when compared with sham stimulation. Which can be used as a new treatment option for different chronic pain conditions.
https://mjcu.journals.ekb.eg/article_54397_b3fdc4fc062d2c6d6484c328a9f8aefe.pdf
2019-06-10
2305
2315
10.21608/mjcu.2019.54397
Capsaicin-induced pain – Primary motor cortex – High Definition Transcranial Direct Current Stimulatioon (HD tDCS)
SAEID METWALLY, M.Sc.;
HASSAN KOTB, M.D.
1
AUTHOR
ALAA ATTIA, M.D.;
EMAN KHEDR, M.D.
2
AUTHOR
SAM CHONG, Ph.D.;
FREDRIC BOY, Ph.D.
3
AUTHOR
ROMAN
CREGG, Ph.D.
4
AUTHOR
ORIGINAL_ARTICLE
Clinical Audit on Management of Central Nervous System Infections
AbstractBackground: Central Nervous System (CNS) infections cause significant mortality and neurological morbidity through-out the world children.Patients and Methods: All patients aged beyond neonates admitted to Assiut University Children Hospital (during six month duration) from 1/6/2017 to 30/11/2017 with any symp-toms or signs of meningitis, encephalitis or meningeoencepha-litis including fever, convulsions, disturbed conscious level were included in this study to assess how much adopted protocols in management of CNS infections are applied.Results: Shows that 100% of patients had lumber puncture, CSF culture was done to 16.4% of all cases, the first choice of empirical treatment were Ampicillin plus cefotaxime in about 82% of all cases, vancomycin came after in 19.7% of them, then ceftriaxone in 18%, nearly all patients were treated with steroid except for one case, 88.5% were treated with antiviral, mainly all Children 3 month with unconfirmed disease treated with ceftriaxone for 10 days.Conclusion: We need to stick with the international guidelines as a reference standard to avoid miss diagnosis and complications of CNS infections to improve the health services provided in Neurology Unit.
https://mjcu.journals.ekb.eg/article_54398_07ae958952671546ba50f5d1d522d657.pdf
2019-06-10
2317
2322
10.21608/mjcu.2019.54398
Meningitis – Encephalitis – Management guide-lines – Empiric antibiotics – Steroids – Acyclovair
ELSAYED K. ABD EL-KARIM, M.D.;
DUAA M. RAAFAT, M.D.
1
AUTHOR
SAFAA M.
ABD EL-ALEEM, M.Sc.
2
The Department of Pediatrics, Faculty of Medicine, Assiut University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Characterization of Fibrinolytic Enzymes Produced by the Halophilic Streptomyces Flaveolus and Streptomyces Galtieri Isolated from Wady El-Natron Area in North Egypt
AbstractBackground: Intravascular thrombosis is responsible for an increasing number of deaths every year. Lung blood clots in USA alone affect 1,000,000 patients annually. Clots formed from insoluble fibrin restrict the smooth flow of blood in blood vessels, leading to thrombosis and heart attacks. World-wide, over 29% of the total mortalities are due to thrombosis, thus antithrombotic therapy is of great interest. The three fibrinolytic (thrombolytic) agents that are currently being used for this purpose are urokinase, streptokinase and genet-ically engineered tissue-type Plasminogen Activator (t-PA). However, these enzymes are expensive, thermolabile, with low specificity and stability, large therapeutic doses and can produce undesirable side effects such as gastrointestinal bleeding, allergic reactions, and resistance to repercussion. This warrants the search for novel fibrinolytic enzymes from various sources with higher efficacy, safety, specificity and stability and preferably those direct acting activities. Though new fibrinolytic enzymes are being explored from microbes, microorganisms remain the preferred source due to their biochemical versatility, feasibility of mass culture and ease of genetic manipulation. Hence, many fibrinolytic enzymes have been isolated from a variety of microorganisms, including actinomycetes, bacteria, fungi, and algae.Aim of Study: To detect the characterization of fibrinolytic enzymes produced by the halophilic Streptomyces flaveolus and Streptomyces galtieri that were isolated from soil of Wady El-Natron region, in North Egypt, as a potential thrombolytic agent.Material and Methods: Fibrinolytic enzymes, extracted from Streptomyces flaveolus and Streptomyces galtieri, were purified by ammonium sulfate precipitation and gel filtration. By using SDS-Page electrophoresis, determining their molec-ular masses, classified by inhibitory acting materials, charac-terized by determining metal ions influences, anticoagulation clotting time delay with CaCl2, their proteolytic activity in units/mg, the active conc. in μg/ml and the least conc. in μl/ml of thrombolytic activity.Results: The fibrinolytic enzymes extracted from both Streptomyces flaveolus and Streptomyces galtieri are classified as metallo-protease enzymes, their molecular masses were 1 6kDa and 4 1kDa, their proteolytic activity are 1.4 and 2.3 units/mg of proteins, the anticoagulation clotting time assay showed 20 and 15min delay in clotting time with CaCl2, the active conc. of each enzyme was determined from the standard curve using streptokinase as standard fibrinolytic enzyme as 200 and 300μg/ml, and the least conc. of enzyme thrombolytic activity was measured by performing the modified Holmstrom method, as the crude thrombolytic activity were at concentra-tions of 80-100μl, whereas, precipitated enzymes, showed thrombolytic activity at concentrations 20μl and 30μl/ml respectively. Metal ions exhibited different influences on the fibrinolytic enzyme activity produced by Streptomyces flave-olus, such as Ca2+, Cu2+ and Fe2+ promoted the activity of the enzyme, whereas Mg2+ is strongly promoted it. But on the fibrinolytic enzyme activity produced by Streptomyces galtieri, Cu2+ promoted the activity of the enzyme, whereas Ca2+, partially inhibit the enzyme, but the Fe2+ and Mg2+ were strongly and completely inhibit it.Conclusion: These results suggest that the extracted enzymes from both isolated Streptomyces flaveolus and Streptomyces galtieri are with potent and potential applications as thrombolytic agent.
https://mjcu.journals.ekb.eg/article_65659_368514e083388eafb22b62e3bb325e76.pdf
2019-06-10
2323
2332
10.21608/mjcu.2019.65659
Fibrinolytic enzyme – Streptomyces – Milk clotting plate – Thrombolytic activity
MOHAMED E. OSMAN, M.D.;
SAID M. ABD EL-ALL, M.D.
1
AUTHOR
SHAMEL Y.E.
KHALIFA, M.Sc.
2
The Department of Botany and Microbiology, Faculty of Science, Helwan University* and The Microbiology Division, National Organization for Drug Control and Research (NODCAR)**, Cairo, Egypt
AUTHOR
ORIGINAL_ARTICLE
Suitability of EVAR with Hostile Neck
AbstractBackground: Endovascular treatment of abdominal aortic aneurysms (EVAR) is now considered first line of treatment for abdominal aortic aneurysm (AAA) mainly due to the lower morbidity and mortality, hostile neck is a major obstacle in treating such patients, however many endovascular methods are available to overcome such obstacle, EVAR out of IFU is considered one of the lines of management. Further evaluation is needed.Aim of Study: Aim of this study was to evaluate the effectiveness of endovascular treatment of AAA with hostile neck anatomy, with commenting on the perioperative compli-cations, mortality and morbidity.Material and Methods: This study was done retrospectively over a period of 18 months including 10 patients who had endovascular treatment of abdominal aortic aneurysms with hostile neck anatomy.Results: 10 patients were included in this study primary technical success was achieved in 90% of cases while the last case needed aortic cuff as an adjunctive procedure. One case required re-intervention within 30 days post-operative due to limb graft occlusion, managed by femoro-femoral bypass. At one year follow up mortality was 10%.Conclusion: EVAR for AAA patients with HNA is feasible; patients with single feature of HNA showed the best outcome, while patients with more than one feature required the usage of adjunctive techniques for proximal sealing and were more liable to develop post-operative complications.
https://mjcu.journals.ekb.eg/article_54839_d8abdacb4170bc1fd327c65bf81e71c9.pdf
2019-06-10
2333
2338
10.21608/mjcu.2019.54839
AAA – Hostile neck – Endovascular treatment
HOSSAM Z. YOUSIF, M.D.;
AHMED M. EL-MAHROUKY, M.D.
1
AUTHOR
MOHAMMED
ALI HASSAN, M.D.
2
The Department of Vascular Surgery, Faculty of Medicine, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Efficacy of Shockwave Therapy Versus Therapeutic Exercises on Pain and Dynamic Balance in Patients with Plantar Fasciitis
AbstractBackground: Plantar fasciitis (PF) is a painful disorder of the plantar fascia. It is the most common cause of plantar heel pain and accounts for approximately 11-15% of foot symptoms presenting to physicians.Aim of Study: The purpose of this study was to compare the effects of radial shock wave (RSW) alone, therapeutic exercises (stretching and strengthening) alone and RSW combined with therapeutic exercises (stretching and strength-ening) on pain severity and dynamic balance in patients with chronic plantar fasciitis (CPF).Methods: Forty five males and females patients with unilateral CPF participated in this study; their age ranged from 40-50 years. Patients randomly assigned into three groups. Group (A): Received three sessions of RSW therapy. Group (B): Received stretching and strengthening exercises as a home program. Group (C): Received three sessions of RSW therapy (one session every week), stretching and strength-ening exercises as a home program. Patients were evaluated for pain and dynamic balance before 1st session and at the end of treatment program.Results: There was a significant decrease in visual ana-logue scale (VAS) in favor of group C compared with that of group A and that of group B (p<0.01). Also, there was a significant decrease in VAS in favor of group A compared with that of group B (p<0.001). There was a significant increase in anterior, posterolateral and posteromedial excursion of Y balance test in favor of group A compared with that of group B (p<0.05); and a significant increase in anterior, posterolateral and posteromedial excursion in favor of group C compared with that of group B (p<0.001). However; there was no significant difference in anterior, posterolateral and posteromedial excursion between group A and C post treatment (p>0.05).Conclusion: RSW therapy only or combined with thera-peutic exercises are more effective than therapeutic exercises only on pain and dynamic balance in patients with CPF.
https://mjcu.journals.ekb.eg/article_54840_d727bdab57909a9cf1fbdab7f7ec4986.pdf
2019-06-10
2339
2346
10.21608/mjcu.2019.54840
Plantar fasciitis – Radial Shockwave – Therapeutic exercises
AHMED A. MOHAMED, M.Sc.;
ABDEL RAHMAN CHABARA, Ph.D.
1
AUTHOR
HAMED M. EL-KHOZAMY, Ph.D.;
AYMAN A. SHAHEEN, M.D.
2
The Departments of Musculoskeletal Disorders, Faculty of Physical Therapy* and Orthopedic Surgery, Faculty of Medicine**, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Accuracy of Ultrasonography Findings in Cases of Ocular Trauma
AbstractBackground: The superficial location of the eye and its cystic composition make ultrasound ideal for imaging the eye. It is a simple, non ionizing, cost effective, real time imaging modality providing detailed cross sectional anatomy of the entire globe.Aim of Study: To evaluate the accuracy of B-scan ultra-sonography (US) in various types of ocular trauma by com-paring the findings with the clinical examination and surgical findings if possible.Patients and Methods: Descriptive analysis of cases of ocular trauma in patients who presented to Ophthalmology Department, Ain Shams University, in the period from No-vember 2017 to May 2018 to compare clinical and surgical findings in those patients with the ultrasonography findings.Results: Accuracy of US in the present study in prediction of post traumatic cataract was 80%, lens dislocation was 83.64%, vitreous hemorrhage was 100%, PVD was 100%, choroidal detachment was 100%, partial retinal detachment was 96.4% and in detection of metallic IOFB was 100%.Conclusion: Ultrasound B-scan is an excellent, non-invasive, rapid diagnostic tool in assessing intraocular damage caused by blunt or penetrating eye injuries which most of the time renders ophthalmoscopy impossible due to opacification of light transmitting media. The images provide essential and detailed information about soft tissues damage, helping in the decision regarding early surgery, before chronic changes have occurred.
https://mjcu.journals.ekb.eg/article_54841_209de40b2f21e79596e9bd3bd683a445.pdf
2019-06-10
2347
2355
10.21608/mjcu.2019.54841
Ultrasonography – Ocular trauma – Cataract – Retinal detachment – Vitreous hemorrhage
SARAH R.A. MOSTAFA, M.Sc.;
BAHAA ELDEN A. ALI, M.D.
1
AUTHOR
AZZA M. AHMED SAID, M.D.;
KHALID H. MAHMOUD, M.D.
2
The Department of Ophthalmology, Faculty of Medicine, Ain Shams University
AUTHOR
ORIGINAL_ARTICLE
Effects of Hematopoietic Stem Cells on Liver Cirrhosis of Albino Rats
AbstractBackground: Liver cirrhosis is a common serious disease in Egypt due to high incidence rate of infectious liver diseases; hepatitis. Application of Hematopoietic Stem Cells (HSCs) may provide a hope for patients with liver cirrhosis as it is not only safe but also to avoid hazardous complications and immunosuppressive drug following liver transplantation.Aim of Study: Evaluation of the effects of CD34+ hemat-opoietic stem cells in regeneration of hepatic tissue as a new therapy for cirrhotic liver.Material and Methods: Forty five male albino rats were divided into four groups: Control group: Include 18 rats injected with olive oil subcutaneously, (carbon tetrachloride treated group): 9 rats received carbon tetrachloride subcuta-neously, (carbon tetrachloride/hematopiotic stem cells treated group): 9 rats injected with hematopiotic stem cells after induction of liver cirrhosis by carbon tetrachloride and (carbon tetrachloride/fibroblast treated group): 9 rats injected with fibroblast cells after carbon tetrachloride induced liver cirrho-sis. For histological and biochemical study of liver and blood samples were taken from all rats.Results: Rats of carbon tetrachloride treated group & carbon tetrachloride/fibroblast treated group indicated significant changes in liver histological structures accompanied with significant decline of liver function tests. Injection of HSC showed marked improvement in both histological picture and biochemical profile.Conclusion: This study indicates the effectiveness of human CD34+ hematopoietic stem cells in amelioration of CCl4 induced liver cirrhosis in rats. So, treatment with he-matopoietic stem cells therapy can be considered a new hope for cirrhotic patients, especially in Egypt.
https://mjcu.journals.ekb.eg/article_54842_065a45ab4973a95c6ea5b9d6c5a2f28d.pdf
2019-06-10
2357
2368
10.21608/mjcu.2019.54842
Hematopioetic stem cells – Cirrhosis – Albino rats
NEHAL A. BAHAA EL-DIN, M.Sc.;
YOUSSEF HUSSEIN, M.D.
1
AUTHOR
MANAL M. MORSY, M.D.;
NERMIN RAAFAT, M.D.
2
The Departments of Human Anatomy & Embryology* and Medical Biochemistry & Molecular Biology**, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Socio-Demographic and Reproductive Health Profile Among Egyptian Women with Uterine Fibroid
AbstractBackground: Uterine fibroid is the most common benign gynecological tumors affecting as many as 25% of women in the reproductive age.Aim of Study: The aim of the current study is to assess Socio-demographic and reproductive health profile among Egyptian women with uterine fibroid.Subject and Methods: A descriptive research design was adopted in this study.Setting: The study was conducted in Inpatient and out-patient Gynecological Clinic at El-Manial Maternity Hospital.Sample: A non-probability convivence sample of 120 women with uterine fibroid were chosen based on certain inclusion criteria.Tool: Structured interviewing questionnaire sheet was used for data collection.Result: The mean age of the study sample was 41.4±5.3, 46.7% lived in rural areas, 45.8% had completed their sec-ondary education, 82.5% were married, 59.2 were working and 78.3% had low income. 64.2% were obese, 88.3% reported past history of hypertension, 83.3% reported high level of lipid profile and 79.2% had family history of uterine fibroid and their mother was the main first family member suffering from this problems followed by the sister (16.8%) respectively. 65.8% had early menarche at age of <14yrs, Moreover more than half of the study sample 77.8% their gravida more than once, 70.7% their parity ranged between (1-3 times), 57.5% used oral hormonal contraceptive methods.Conclusion: The study conducted that, middle menopausal age, living in rural area, marriage, low socioeconomic sta-tus,obesity, past medical history of hypertension and high lipids, Positive family history of uterine fibroid, Early age of menarch, parity, using oral hormonal contraceptive methods were the most common Socio-demographic and Reproductive health profile among Egyptian women With uterine fibroid.Recommendations: Further studies should be done to predict the association between socio-demographic and reproAbstractBackground: Uterine fibroid is the most common benign gynecological tumors affecting as many as 25% of women in the reproductive age.Aim of Study: The aim of the current study is to assess Socio-demographic and reproductive health profile among Egyptian women with uterine fibroid.Subject and Methods: A descriptive research design was adopted in this study.Setting: The study was conducted in Inpatient and out-patient Gynecological Clinic at El-Manial Maternity Hospital.Sample: A non-probability convivence sample of 120 women with uterine fibroid were chosen based on certain inclusion criteria.Tool: Structured interviewing questionnaire sheet was used for data collection.Result: The mean age of the study sample was 41.4±5.3, 46.7% lived in rural areas, 45.8% had completed their sec-ondary education, 82.5% were married, 59.2 were working and 78.3% had low income. 64.2% were obese, 88.3% reported past history of hypertension, 83.3% reported high level of lipid profile and 79.2% had family history of uterine fibroid and their mother was the main first family member suffering from this problems followed by the sister (16.8%) respectively. 65.8% had early menarche at age of <14yrs, Moreover more than half of the study sample 77.8% their gravida more than once, 70.7% their parity ranged between (1-3 times), 57.5% used oral hormonal contraceptive methods.Conclusion: The study conducted that, middle menopausal age, living in rural area, marriage, low socioeconomic sta-tus,obesity, past medical history of hypertension and high lipids, Positive family history of uterine fibroid, Early age of menarch, parity, using oral hormonal contraceptive methods were the most common Socio-demographic and Reproductive health profile among Egyptian women With uterine fibroid.Recommendations: Further studies should be done to predict the association between socio-demographic and reproductive factors and the risk for uterine fibroid and examine it's impact on the quality of life.
https://mjcu.journals.ekb.eg/article_54843_540ffb9c6bf822f450323e3190fd1c8e.pdf
2019-06-10
2369
2377
10.21608/mjcu.2019.54843
Profile – Uterine fibroid
AFAF A. SHOAIEB, M.Sc.;
MAGDA A. FAWAZ, D.N.Sc.
1
AUTHOR
MOHAMMED
ABDEL FATTAH, M.D.
2
The Departments of Maternal & Newborn Health Nursing, Faculty of Nursing* and Obstetrics & Gynecology, Faculty of Medicine**, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Effects of Autogenic Drainage in Patients with Abdominal Surgery
AbstractBackground: Surgery has become an important part of global health care, estimated to about 234 million patients operated yearly. Surgery and general anesthesia directly affects the respiratory system. Surgeries alter postoperative pulmonary function causes impairment of lungs volume such as total lung capacity, vital capacity and tidal volume and can develop post pulmonary complications.Aim of Study: Is to study the effect of autogenic drainage (AD) breathing technique in abdominal surgery patients to prevent those complications.Patients and Methods: Thirty participants who underwent abdominal surgeries with age 30-60 years were included in the study for one week of intervention. Total seven sessions was given in a week and pre and post readings were taken by using inch tape at Axillary level, inspiratory capacity was taken with help of incentive spirometer (Helios 401) and peak expiratory flow rate with peak flow meter.Results: It showed significant difference when pre values were compared with outcome post measures like inspiratory capacity with incentive spirometer, peak expiratory flow rate with peak flow meter, and chest expansion using inch tape.Conclusion: The present study concluded that Autogenic drainage of breathing control is effective for improving chest expansion, peak expiratory flow rate and inspiratory capacity in abdominal surgery patients.
https://mjcu.journals.ekb.eg/article_54844_7ae51e9026677491d8ddeb335e2eadbf.pdf
2019-06-10
2379
2383
10.21608/mjcu.2019.54844
AD – Abdominal surgeries – Incentive spirometer – Peak flow meter – Inch tape
FATEN A.
HAMZA, Ph.D.
1
The Department Physical Therapy for Cardiovascular-Respiratory Disorders and Geriatrics, Faculty of Physical Therapy, Delta University for Science and Technology, Egypt
AUTHOR
ORIGINAL_ARTICLE
Assessment of Metformin Versus Insulin for the Treatment of Gestational Diabetes
AbstractBackground: Metformin is a logical treatment for women with gestational diabetes, but randomized trials to assess the efficacy and safety of its use for this condition are lacking.Aim of Study: To compare the efficacy of oral metformin therapy versus insulin treatment in patients with gestational diabetes mellitus in term of Maternal glycemic control, Ma-ternal outcome and Fetal outcome.Patients and Method: A total of 156 patients who have the diagnosis of gestationl diabetes were enrolled after fulfilling certain inclusion and exclusion criteria. They were randomly assigned to two groups of treatment with either insulin or metformin. Serial ultra-sound examination and blood glucose level were assessed at enrolment and at follow-up visits. The outcomes were fetal and maternal outcomes.Results: Of the 78 patients at each group 89.7% of patients using metformin were compliant to its use while only 39.7% who received insulin therapy were compliant to it (p-value 0.015), neonatal hypoglycemia was associated more with insulin group than metformin group (7.7% vs. 0.0%, p-value 0.028). The rates of other outcomes did not differ significantly between the groups. There were no serious adverse events associated with the use of metformin.Conclusion: Oral metformin therapy is an effective and safe treatment option for women with gestational diabetes who meet the criteria for starting insulin, and that metformin is more acceptable than insulin. But further follow-up data are needed to establish long-term safety regarding the preg-nancy outcome.
https://mjcu.journals.ekb.eg/article_54845_0af1124c31fc0da77e6e38b4c2f51cff.pdf
2019-06-10
2385
2392
10.21608/mjcu.2019.54845
Metformin – Oral therapy – Gestational diabetes
ABEER B. AHMED, M.D.;
MARIAM L. ABD-ELFATTAH, M.D.
1
AUTHOR
RASHA E.A. KHAMEES, M.D.;
AHMED HASSAN, M.D.
2
AUTHOR
MAHMOUD A.
GREASH, M.Sc.
3
The Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University
AUTHOR
ORIGINAL_ARTICLE
The Association between Highly Sensitive C-Reactive Protein and Interleukin-18 with Nephropathy in a Sample of Type 1 Diabetic Egyptian Patients
AbstractBackground: Diabetic Nephropathy (DN) is a major complication of diabetes and the leading cause of end-stage renal disease that accounts for a large proportion of the excess mortality associated with Type-1 Diabetes (T1D). Inflammation and endothelial dysfunction have been hypothesized to play a role in the pathogenesis of DN. Highly sensitivity C-Reactive Protein (hs-CRP) and Interleukin-18 (IL-18) are associated with systemic inflammation and have been shown to be increased in individuals with Type 1 Diabetic nephropathy.Aim of Study: In our study, we aim to determine the association between hs-CRP and IL-18 with nephropathy in a sample of type 1 diabetic Egyptian patients.Patients and Methods: This study was conducted on 30 type-1 diabetic patients (Group I), who subdivided into three subgroups according to their urine Albumin Excretion Rate (AER); Group IA: 10 patients with AER <20mg/min, Group IB: 10 patients with AER ranges from 20-200mg/min. Group IC: 10 patients with AER is >200mg/min and 10 healthy subjects as a control (Group II). Patients and control were subjected to full history taking, full clinical examination, Fasting Plasma Glucose (FPG), Glycated Hemoglobin (HbA1c%), serum creatinine, Urinary Albumin Excretion (UAE), Highly-sensitive C-Reactive Protein (hs-CRP) by turbidimetry technique and Interleukin-18 (IL-18) by Enzyme-linked Immunosorbent Assay (ELIZA) technique. This work was done during the year 2017.Results: There were statistically significant difference between control group and diabetic group regarding hs-CRP (4.25±6.62, 25.13±23.56), and IL-18 (2.85±0.74, 12.68± 29.12) with (p=0.009, p=0.037) respectively. In diabetic group, we found a positive significant correlation (p<0.001, p=0.012) between UAE and both; levels of hs-CRP (r=0.765), and IL-18 (r=0.453), respectively.Conclusion: Hs-CRP and IL-18 are sensitive markers for diabetic nephropathy in type-1 diabetic patients.
https://mjcu.journals.ekb.eg/article_54846_d494d4d894d80a1caf72b482948a69b3.pdf
2019-06-10
2393
2402
10.21608/mjcu.2019.54846
Type-1 Diabetes (T1D) – Diabetic Nephropathy (DN) – hs-CRP – IL-18
HANAN A. TAHA, M.D.;
HEBA H. MAHMOUD, M.D.
1
AUTHOR
AYMAN S. SOLIMAN, M.D.;
MOHAMMED M. TAHA, M.D.
2
AUTHOR
RABAB A.
MOHAMMED, M.D.
3
The Departments of Internal Medicine*, Physiology** and Clinical & Chemical Pathology***, Faculty of Medicine, Beni-Suef University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Efficacy of Monochromatic Infrared Energy on Pressure Ulcer Healing
AbstractBackground: Monochromatic infrared energy has a lot of uses and in this study I use it to help patients with pressure ulcer in healing of their wounds.Aim of Study: To determine the effect of monochromatic infrared energy therapy on patients with pressure ulcers.Material and Methods: Measuring wound volume with saline and sterilized syringe.Thirty patients (19 males and 11 females) with ages ranging from 30-75 years suffering from pressure ulcer par-ticipated in this study. They were selected randomly from Medical Research Insistute and Sharq El-Madina Hospitals during the year 2018, they were randomly divided into 2 equal groups in number, one study Group (A) and a control one (B). The study Group (A) who received the monochromatic infrared energy for 30 minutes every session, application was done 5 times per week for 6 weeks as a total period of treatment in addition to their medical treatment, the control Group (B) who not received the monochromatic infrared energy but they just received standard medical treatment. Measurements were conducted before starting the treatment as a first record and at the end of the 6 weeks of treatment as a second (final) record.Results: Result showed that the polarized light therapy was effective and fruitful in increasing wound healing in pressure ulcer as evidenced by the highly significant decrease in the wound volume.Conclusion: Monochromatic infrared enenrgy therapy is beneficial in improving wound healing in pressure ulcer.
https://mjcu.journals.ekb.eg/article_54847_1e5184a52127e3e08200f3a36491e243.pdf
2019-06-10
2403
2407
10.21608/mjcu.2019.54847
Monochromatic infrared enenrgy therapy – Pres-sure ulcer – Wound healing
AHMED M. ELANAY, M.Sc.;
ADEL A. NOSEIR, Ph.D.
1
AUTHOR
MAHMOUD A. HEMIDA, M.D.;
ASMAA E. FAWZY, Ph.D.
2
The Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Giza* and The Department of Surgery, Faculty of Medicine, Alexandria University**, Egypt
AUTHOR
ORIGINAL_ARTICLE
Effect of Different Knee Angles on Active Joint Position Sense in Patients with Patellofemoral Pain Syndrome
AbstractBackground: Patellofemoral pain syndrome is a common, painful musculoskeletal condition that affects physically active young adults and adolescents. During assessment of joint position sense, the different positions of the knee may affect the internal structures of the knee differently. Therefore, examining the differences in the two positions between both males and females may shed light on the effect of muscle activation.Aim of Study: To examine the differences between 20 and 60 angles of knee extension on knee joint position sense as well as to examine the differences in knee joint position sense between males and females in patient with patellofemoral pain syndrome.Material and Methods: Thirty nine participants (11 men, 28 women) participated in this study. With a mean age of 18 to 35 years with mean age (24.25±3.40) years, mean weight (68.71±16.01) Kg, and mean height (164.07±10. 14) cm. All subjects were assessed by the same examiner via the Isokinetic Dynamometer Device (IKD) at angles 20º and 60º with angular velocity 2º/sec to determine which angle has more angular error.Results: The results revealed that the 20 angle position had a significantly greater absolute reposition error than the 60 angle position (p=0.039). There was no significant differ-ence in joint position sense between males and females at angle 20 (p=0.829), and angle 60 (p=0.833).Conclusion: The results indicate that there is a significant difference in knee joint position sense between position of 20 degrees of extension and 60 degrees of extension. Specif-ically, as the knee becomes more extended proprioceptive acuity was heightened. Therefore, future research is still needed to discern exactly whether the heightened propriocep-tive acuity comes from the differences in gravitational torque or the differences in the anatomical structures of the knee between the two positions.
https://mjcu.journals.ekb.eg/article_54848_0b9af332e80b8a271ef0c25e14c8f044.pdf
2019-06-10
2409
2415
10.21608/mjcu.2019.54848
Patellofemoralpain – Joint position sense – Isokinetic dynamometer
NADA M. SAAD EL-DEEN, M.Sc.;
SALWA F. ABD EL-MAGEED, Ph.D.
1
AUTHOR
KARIMA A. HASSAN, Ph.D.;
AHMAD H. AZZAM, M.D.
2
The Departments of Orthopedics, Faculty of Physical Therapy* and Faculty of Medicine**, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Diagnostic Role of Serum Neutrophilic/Lymphocytic and Platelet/Lymphocytic Ratio in upper Gastrointestinal Lesions in Correlation with Histopathological Results of Endoscopic Ultrasonography and Upper Gastrointestinal Endoscopic Biopsies
AbstractBackground: Systemic inflammatory markers including neutrophilic lymphocytic ratio and platelet lymphocytic ratio are used as prognostic and diagnostic factors to reflect the inflammatory process and tumor angiogenesis in many tumors including upper gastrointestinal submucosa tumors.Aim of Study: To determine the diagnostic efficacy of the Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) in patients with uppergastrointestinal submucosal tumors.Patients and Methods: The present study included 30 patients with malignant and potentially malignant upper gastrointestinal submucosal tumor, 30 with benign upper gastrointestinal submucosal tumor and 30 healthy volunteers, complete blood counts with automated differential counts were performed. The NLR was calculated by dividing the absolute neutrophilic count by the absolute lymphocytic count while PLR was calculated by dividing the absolute platelet count by the absolute lymphocytic count. The diagnostic performance of NLR, PLR, was estimated by ROC curve.Results: ROC curve analysis showed high diagnostic efficacy of NLR and PLR in malignant and potentially malig-nant submucosal tumors patients with cut-off values of 2.25 (sensitivity=60%, and specificity=86.7, PPV 81.9%, NPV 68.4%) and 169 (sensitivity=93.3%, and specificity=100% PPV 100%, NPV 93.7%) compared to patients with benign lesions and healthy controls, respectively.Conclusion: NRL, PLR, may be useful markers in diag-nostic and early recognition of different upper gastrointestinal submucosal lesions.
https://mjcu.journals.ekb.eg/article_54849_549bfc13d5c8ee6115f8f85df29f9fb6.pdf
2019-06-10
2417
2424
10.21608/mjcu.2019.54849
Submucosal tumors – Neutrophilic lymphocytic ratio – Platelet lymphocytic ratio – Diagnosis
ESSAM M. FARID, M.D.;
WAEL A. YOUSRY, M.D.
1
AUTHOR
SHEREEN A. SALEH, M.D.;
SARAH S. SALEM ASAR, M.Sc.
2
The Department of Gastroenterology & Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
AUTHOR
ORIGINAL_ARTICLE
Complete Atrioventricular Septal Defects "Outcome of Different Techniques"
AbstractBackground: In complete atrioventricular septal defect (CAVSD), a single atrioventricular valve annulus, a common atrioventricular valve, and a defect of the inlet ventricular septum are observed. The deficiency of the atrioventricular septum also results in the presence of a large primum atrial septal defect.Details of the anatomy, particularly the morphology of the atrioventricular valve are crucial in planning surgical repair of this lesion.Total repair of such cardiac lesion is now spreading with intentions to save children at younger age and lower body weight.Improved technical methods and post-operative manage-ment have resulted in declining mortality over time.Aim of Study: The purpose of this study was to compare the outcome of different surgical modalities in total repair of complete atrioventricular canal defects either single patch or double patches techniques.Patients and Methods: This study was conducted at (Al-Hussin University Hospital, Pediatric Unit of National Heart Institute, Cairo University Specialized Pediatric Hospital & Atfal Misr Hospital).Between 2015 and 2017, fifty children with complete atrioventricular canal defects were operated upon. 50 Children with complete atrioventricular canal defects were divided into two groups: Group A included 30 patients who had total repair with single patch technique, and Group B included 20 patients who had total repair with double patches technique.Results: Of 50 patients, 72% of them had Down Syndrome (DS). There were 3 mortalities distributed as 2 patients (6.7%) in Group A & 1 patient (5%) in Group B, while 2 patients were lost during follow-up.Fourty five patients had followed-up by echocardiography to measure the degree of valve regurgitation.At last follow-up, ten patients had moderate or more than moderate left AV valve regurgitation distributed as moderate in 4 patients (14.8%) & severe in 1 patient (3.7%) in Group I & 4 patients (22.2%), 1 patient (5.6%) in Group II respec-tively.Conclusion: Modified single-patch repair in infants with complete AVSD is a safe and reproducible technique. The results are as good as the two-patch technique. Among long-term survivors, most have very good clinical and functional results and minimal or no regurgitation of either AV valves.
https://mjcu.journals.ekb.eg/article_54850_d71281a6b51f2f46058e16c53cb7024e.pdf
2019-06-10
2425
2430
10.21608/mjcu.2019.54850
Complete Atrioventricular Septal Defects (CAVSD) – Atrioventricular – Septal – Defects
MOHAMED E. ABDEL-RAOUF, M.D.;
HOSNY M. EL-SALLAB, M.D.
1
AUTHOR
MUHAMMED SHARAA, M.D.;
LAMIAA K. EL-SHONI, M.Sc.
2
The Department of Cardiothoracic Surgery, Faculty of Medicine, Al-Azhar University, Cairo
AUTHOR
ORIGINAL_ARTICLE
Cervical Spondylotic Myelopathy: Can MR Spectroscopy Be Helpful?
AbstractBackground: Spinal cord myelopathy can happen due to cord compression in variable situations. Understanding bio-chemical and metabolic changes in myelopathy are needed to expect treatment outcomes. The non-invasive technique of 1H-MRS can provide data about chemical microenvironment related to tissue metabolic changes by measuring of N-acetyl-aspartate (NAA), choline (Cho), and creatine (Cr) [1-8].Aim of Study: The aim of current study is to evaluate the diagnostic value of 1H-MRS in the assessment of biochemical changes in cervical spondylotic myelopathy.Subjects and Methods: 26 subjects with cervical myelop-athy and 12 volunteers who were age-matched with no neu-rological problems were considered as control group. MR spectroscopy was done and analysis of MRS to detect NAA (2.0ppm), Cho (3.25ppm), Cr (3.03ppm) and Lactate (Lac) (1.32ppm). Recording of NAA/Cr as well as Cho/Cr were done.Results: Detection of peak of lactate was possible in 10 patients; however no lactate peak was noted in the members of control group.The NAA/Cr ratio was recorded and comparison was done between patient and control group and showed significant difference as the mean NAA/Cr in control subjects equaled 1.87±0.05 versus 1.33±0.057 for patient group (p<0.0001) Figs. (2-6).Furthermore mean NAA/Cr ratio in subjects with lactate peak was lower than that in patients without such peak (1.268±0.028 versus 1.365±0.034) with significant difference (p<0.0001).There was no significant difference between the mean Cho/Cr ratio in patient group and control group (mean= 0.783±0.065 versus 0.764±0.049, p=0.38).Also the mean ratio of Cho/Cr of lactate peak patients was not significantly different from those without lactate (0.79±0.074 versus 0.77±0.061, p=0.44).Conclusion: MRS can provide good data about the meta-bolic changes in patients with Cervical Spondylotic Myelop-athy (CSM).
https://mjcu.journals.ekb.eg/article_54851_9102aa3c134913f62be60d93f88690ff.pdf
2019-06-10
2431
2436
10.21608/mjcu.2019.54851
MRS – Myelopathy – Cervical – MRI – Spondy-losis
MONA A. EL-HARIRI, M.D.;
NESREEN MOHEY, M.D.
1
The Department of Radio-Diagnosis, Faculty of Medicine, Zagazig University, Zagazig, Egypt
AUTHOR
ORIGINAL_ARTICLE
Inflammatory Versus Degenerative (Non Inflammatory) Ultrasound Detected Shoulder Abnormalities in Rheumatoid Arthritis Patients with Shoulder Pain
AbstractBackground: The early and definitive diagnosis of a chronic inflammatory joint disease in Rheumatoid Arthritis (RA) is crucial for initiating optimal treatment. Conventional radiography detects late changes such as joint destruction, but fails to visualize inflammation in synovial membrane.Aim of Study: To compare type and frequency of Ultra-sound (US) abnormal findings (inflammatory versus degen-erative (non inflammatory)) detected in shoulders of RA patients with shoulder pain in relation to disease characteristics.Patients and Methods: Musculoskeletal US (MSUS) shoulder examination and plain radiography were performed bilaterally for 45 RA patients and 45 controls with only painful shoulder and compared.Results: Comparison between RA patients and controls in number (No) and frequency of inflammatory shoulder findings detected by MSUS (active bursitis, synovitis, teno-synovitis, erosions) revealed statistical significant difference (43 (47.8%) versus 18 (20.0%), respectively), p=0.000. There was no statistical significant difference between RA patients and controls in No. and frequency of non-inflammatory findings detected by MSUS (chronic bursitis, tendinopathy, tendon tears, osteophytes), (65 (72.2%) versus 60 (66.7%), respectively), p=0.418. In RA patients, inflammatory MSUS findings were significantly related to shoulder pain, older ages and higher ESR p<0.05. MSUS detected erosions in 42 (180) shoulders versus 6 (180) by X-ray, of the 42 MSUS detected erosions, X-ray detected only 4 (9.5%). Of the 138 MSUS-ve erosions, X-ray agreed in 136 (98.6%), kappa=0.115, p=0.01.Conclusion: MSUS detected shoulder inflammatory ab-normalities are more frequent, symptomatic, usually bilateral in RA patients. They are related to shoulder pain, old age and disease activity. Early diagnosis of joint lesions by MSUS, proved superiority to conventional radiography, is crucial for initiating optimal treatment.
https://mjcu.journals.ekb.eg/article_54852_f18e5b1f51adff83507dd513ceff96c9.pdf
2019-06-10
2437
2446
10.21608/mjcu.2019.54852
Ultrasound shoulder – Rheumatoid arthritis – Inflammatory lesions – Pain
MERVAT ABO GABAL, M.D.;
SHERIN HOSNY, M.D.
1
The Department of Internal Medicine and Rheumatology, Ain Shams University Hospital, Cairo, Egypt
AUTHOR
ORIGINAL_ARTICLE
Effect of Nursing Instructions on Knowledge and Practice of Mothers Having Children with Leukemia Undergoing Chemotherapy
AbstractBackground: Acute Lymphoblastic Leukemia (ALL) is the most common malignancy encountered at the pediatric age group.Aim of Study: Was to evaluate the effect of nursing in-structions on knowledge and practice of mothers having children with leukemia undergoing chemotherapy.Subjects and Methods: One group pre-posttest design quasi-experimental research design was utilized to carry out the current study. The current study was conducted in Pediatric Oncology Outpatient Clinic and Inpatient Department at National Cancer Institute (NCI), Cairo University. A convenient sample of 50 mothers of children with ALL undergoing chemotherapy was participated for the current study. Data were collected using the following tools, structured interview questionnaire; knowledge assessment sheet and reported-practice sheet.Results: The results of the study revealed that there were statistically significant differences between mothers' total mean scores of knowledge and reported practice after than before receiving nursing instructions. All mothers had poor level of knowledge and reported practice regarding care of their children with leukemia undergoing chemotherapy before getting nursing instructions. After receiving nursing instruc-tions, the highest percentage of them had average level of reported practice and good level of knowledge.Conclusion: The study concluded that the designed nursing instructions were effective in improving mothers' knowledge and reported practice regarding care of their children with leukemia undergoing chemotherapy.Recommendation: The study recommended the integration of the designed nursing instructions for mothers in Pediatric Oncology Units; it would provide a framework for mothers' role for their children with leukemia.
https://mjcu.journals.ekb.eg/article_54853_2e7b086a788a001615d07f8325a02056.pdf
2019-06-10
2447
2458
10.21608/mjcu.2019.54853
Nursing instructions – Childhood leukemia – Chemotherapy – Mothers' knowledge and practice
TAHA M. TAHA, M.Sc.;
SOHEIR A. MOHAMED, D.Sc.
1
AUTHOR
NAGLAA F. MAHMOUD, D.Sc.;
WAEL Z. KHALID, M.D.
2
The Department of Pediatric Nursing, Faculty of Nursing* and The Department of Pediatric Oncology, National Cancer Institute**, Cairo University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Moderate Mitral Regurgitation with CABG in EF 40 or Less: To Repair or Not to Repair?
AbstractBackground: The presence of Ischemic Moderate Mitral Regurgitation in patients with ejection fraction 40 or less undergoing CABG surgery is still controversal. Should the mitral valve be repaired or is the CABG surgery sufficient to correct this regurgitation?Aim of Study: This study was conducted to compare the echocardiographic and the clinical outcome of those patients after 2 years post-operatively.Patients and Methods: This study was conducted from 2011 to 2014. Sixty patients with ischemic moderate MR were studied. They were randomly divided into 2 groups: Group A were 30 patients who underwent mitral valve repair together with CABG while Group B were 30 patients who underwent CABG only. Both groups were demographically similar to each other.Results: Group A patients had a significantly improved functional capacity, reversed left ventricular remodeling and reduced degree of mitral regurgitation. The 2 year freedom from cardiac related events leading to death among patients of Group A and B was 92. 1%±1.5% versus 85.3%±2. 1% (p value <0.05). Ischemic mitral regurgitation affects significantly survival in patients with ejection fraction 40% or less. Ischemic mitral regurgitation promotes left ventricular remodeling in all patients. Among the 25 patients with moderate MR in Group B, 18 patients (60%) moved from moderate to severe MR at 2 years follow-up.Conclusions: Ischemic mitral regurgitation significantly increases the incidence of cardiac related deaths among patients with ejection fraction 40% or less. 18 patients (60 who had moderate MR progressed to severe MR.
https://mjcu.journals.ekb.eg/article_54854_2b73669aa47d14a8ad788540b39590af.pdf
2019-06-10
2459
2463
10.21608/mjcu.2019.54854
Coronary heart disease – Coronary artery bypass surgery – Moderate ischemic mitral regurgitation – Impaired left ventricular function
YASSER MENEISSY, M.D.;
SAMY AMIN, M.D.
1
The Department of Cardiothoracic Surgery, Kasr El-Eini, Faculty of Medicine, Cairo, Egypt
AUTHOR
ORIGINAL_ARTICLE
Differential Expression of CD24 and its Significance in Normal Endometrium, Hyperplastic Lesions and Endometrial Carcinoma
AbstractBackground: Endometrial carcinoma is considered the sixth most common cancer in women worldwide comprising 4% of all cancers in women. CD24 protein was originally reported to be expressed by pre-B lymphocytes. This protein had been recognized only as a cell marker for hematopoietic cell lineages. CD24 expression is considered as an important biomarker for diagnosis, disease progression and cancer-related death in many solid tumors, like breast, colonic and ovarian carcinomas.Aim: The present work was conducted to study the immu-nohistochemical expression of CD24 in normal cyclic en-dometrium, hyperplastic endometrium and endometrial carci-noma, in order to demonstrate its expression pattern and to examine its association with various clinicopathological variables in endometrial carcinoma cases.Material and Methods: The present study comprised 110 cases of endometrial tissue: 20 cases (18.2%) of cyclic en-dometrium, 30 cases (27.3%) of endometrial hyperplasia without atypia, 25 cases (22.7%) of atypical endometrial hyperplasia and 35 cases (31.8%) of endometrioid carcinoma. Immunohistochemistry was performed using the avidin biotin-peroxidase complex method.Results: CD24 immunostaining was membranous and cytoplasmic. In the normal cyclic endometrium, membranous CD24 showed down-regulation in the proliferative phase and up-regulation in the secretory phase. Both membranous and cytoplasmic CD24 expression was statistically increase in endometrial carcinoma and reduced in hyperplastic lesion p<0.001 and p=0.004 respectivebly. Among cases of carcinoma, membrnuos CD24 expression was statistically significant with grade, stage and myometrial invasion (p=0.040 & p=0.044 and p=0.036 respectively). Cytoplasmic expression showed significant association with grade only (p=0.037). Membranous CD24 had 71.4% sensitivity and 76% specificity for differen-tiation of endometrioid carcinoma from atypical EH. Cyto-plasmic CD24 had low sensitivity (40%) but high specificity (80%) for distinction of endometrioid carcinoma from atypical endometrial hyperplasia. Total CD24 had 77.2% sensitivity and 76% specificity for distinction of atypical endometrial hyperplasia from endometrioid carcinoma.|Conclusion: Membernous CD24 was expressed in a cyclic pattern in the normal endometrium. CD24 expression was increased in case of endometrial carcinoma than hyperplastic lesion. These results suggest that CD24 can be a useful as diagnostic marker in differentiation between endometrial hyperplasia and carcinoma. Also CD24 implicated in progres-sion of endometrial carcinoma. Total CD24 expression (mem-bernous and cytoplasmic) is more specific and more sensitive in differentiation of atypical endometrial hyperplasia from endometrioid carcinoma.
https://mjcu.journals.ekb.eg/article_54855_0fd9fd039a9b9300f06f33bb8e4ad135.pdf
2019-06-10
2465
2476
10.21608/mjcu.2019.54855
REHAB K. MOHAMMED
YOUSEF, M.D.
1
The Department of Pathology, Faculty of Medicine, Minia University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Role of Diffusion-Weighted Propeller Magnetic Resonance Imaging in Cholesteatoma Diagnosis
AbstractBackground: Cholesteatoma is a pseudotumor with ex-pansive growth that causes destruction of surrounding bone structures and thus damage of surrounding structures like facial nerve or inner ear. Early diagnosis and detection of any recurrence are essential. Radiological detection using Com-puted Tomography (CT) is the technique of choice due to its ability to detect bone destruction epically the destruction of ossicles which is characteristic. However, CT does not have high spatial resolution of tissue which is of particular necessary in congenital, recurrent, abnormal site or post-operative cholesteatoma. MRI overcomes the shortcomings of CT and can be useful in such cases.Aim of Study: The aim of this study was to discuss the role of diffusion-weighted Propeller MRI in the diagnosis of cholesteatoma in non-operated and operated temporal bone.Patients and Methods: A prospective study was performed on 37 patients. All the patients had undergone DW-MRI and CT temporal bone, 29 of them had undergone MRI examination with contrast. Clinical and surgical findings were correlated with diffusion-weighted Propeller MRI results.Results: Sensitivity, specificity, positive and negative predictive values were 100%, 85.7%, 96.8% and 100%, respectively.Conclusion: Diffusion-weighted Propellar MRI imaging is an effective technique in cholesteatoma diagnosis in operated and non operated patients.
https://mjcu.journals.ekb.eg/article_54856_418a6c69175c1ee62d61ab3562e3ecad.pdf
2019-06-10
2477
2484
10.21608/mjcu.2019.54856
DWI diffusion-weighted imaging – DW-EPI diffusion-weighted echo-planar imaging – DWI-Propeller diffusion-weighted imaging with periodically rotated overlap-ping parallel lines with enhanced reconstruction – DW-non-EPI diffusion-weighted non-ech
GEHAN G. ALI, M.D.;
LEILA R. EL-DIEB, M.D.
1
AUTHOR
ENAS A. IBRAHIM, M.D.;
SHERIF KAMAL, M.D.
2
The Department of Radiology, Faculty of Medicine, Ain Shams University*, Ain Shams University Hospital** and The Department of Audiology, Faculty of Medicine, Ain Shams University***, Egypt
AUTHOR
ORIGINAL_ARTICLE
Cervical Disc Arthroplasty Versus Anterior Cervical Discectomy and Fusion
AbstractBackground: The anterior cervical discectomy for cervical disc prolapse has been the work horse for ages and it works fine but the mechanical problems that follows is actually problematic hence the evolution of total disc replacement.Aim of Study: The aim was to compare the efficacy and safety of arthroplasty using the artificial cervical disc with the standard Anterior Cervical Discectomy and Fusion (ACDF) for the management of cervical disc prolapse at single level.Patients and Methods: Sixty patients were included and randomized to one of two groups: Investigational patients (30) underwent arthroplasty using a disc prosthesis, and a control group (30 patients) underwent ACDF with a cervical cage. Patients were assessed pre-operatively, immediate post-operative period and at six weeks, three months, six, twelve, eighteen and-twenty-four months postoperatively. Efficacy and safety outcomes were measured according to the Neck Disability Index (NDI), visual analogue score, gait disturbance, disc height, range of motion (arthroplasty group) or bony fusion (control group), complications, rate of second surgery, and neurological outcome. Overall outcome was considered successful according to four pivot criteria: (1): Improvement of post-operative NDI score more than fifteen points over the preoperative score, (2): Improved neurological presenting symptoms, (3): No serious complications caused by the prosthesis or by the surgical procedure, and (4): No resurgery needed (superimposed fixation, revision, or non-elective implant removal).Results: The one year rate of overall outcome were ninety five percent for the arthroplasty group and eighty six percent for the control group, the arthroplasty group was better than the control group for the NDI score improvement. The per-centage of patients experiencing any adverse effects was six percent in the arthroplasty group and eight percent in the control group, which were not statistically different. Radio-graphic success was achieved in 9 ninety five percent of the arthroplasty group (maintenance of range of motion without bony fusion) and one hundred percent of control patients (fusion).Conclusions: Arthroplasty is as efficient and successful as ACDF for the management of cervical disc pathology.
https://mjcu.journals.ekb.eg/article_54857_5ab6bf956f647fdec3f4616ae9956b38.pdf
2019-06-10
2485
2490
10.21608/mjcu.2019.54857
Cervical disc arthroplasty – Anterior cervical discectomy and fusion – Cervical cage – Artificial cervical disc – Adjacent segment disease
AHMED A. ABDELKHALEK, M.D.;
MOHAMED ALAA ELDIN THABIT, M.D.
1
The Department of Neurosurgery, Faculty of Medicine, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Circulating MicroRNA-21 As A Promising Marker for Early Detection of Breast Cancer and Disease Progression in Egyptian Females
AbstractBackground: The traditional imaging techniques and the currently accepted markers such as serum CA15.3 have limited specificity and sensitivity to identify early stages breast cancer patients. MicroRNAs (miRNAs) regulate gene expression at the post-transcriptional level via mRNA degradation and/or translational repression. They can modulate up to 60% of protein-coding genes in the human genome, one of which is miRNA-21. MiRNA-21 and its alterations play critical roles in breast cancer.Aim of Study: The study aimed at assessing the diagnostic and prognostic role of miRNA-21 in breast cancer females.Subjects and Methods: This case-control study was con-ducted on (150) breast cancer female patients and their age matched (50) healthy controls. All subjects recruited in the present study were subjected to measurement of serum micro-RNA-21 expression using quantitative real time PCR (qRT-PCR) in comparison to serum CA15.3.Results: Serum miRNA-21 expression is upregulated in breast cancer patients compared to controls (Z:4.4, p<0.01), with disease advanced TNMstages (H:24, p<0.001) and neg-ative estrogen receptor status (Z=2.2, p<0.05). At cut off level 1.07 (2–DDCt), miRNA-21 had 100% sensitivity and 90% specificity in discriminating patients with breast cancer from healthy controls. Meanwhile, CA15.3 had 70% sensitivity and 60% specificity in distinguishing between the two groups. At cut off level 3.33 (2–DD Т) miRNA-21 expression had 86.7% sensitivity and 100% specificity in discriminating patients with early breast cancer from patients with advanced disease. While serum CA15.3 had 80% sensitivity and 86.7% specificity in discriminating between the same patients groups.Conclusion: Serum miRNA-21 levels are significantly higher in breast cancer patients compared to healthy subjects. Increased miRNA-21 expression levels correlated with disease stages, estrogen receptor presence reflecting prognosis and influencing constructing treatment modalities.
https://mjcu.journals.ekb.eg/article_54858_aa8bb9ff21e2f155eb895090d0c62dc3.pdf
2019-06-10
2491
2500
10.21608/mjcu.2019.54858
Breast cancer – miRNA-21 – CA15.3 – qRT-PCR
DOAA M.A. ELZOGHBY, M.D.;
NERMINE H. MAHMOUD, M.D.
1
AUTHOR
HEBA H. ALY, M.D.;
MOHAMMED MATAR, M.D.
2
The Departments of Clinical Pathology* and General & Laparoscopic Surgery**, Faculty of Medicine, Ain Shams University, Cairo, Egypt
AUTHOR
ORIGINAL_ARTICLE
Volar Percutaneous Fixation of Recent Fracture Scaphoid
AbstractBackground: Scaphoid fracture is the most commonly fractured carpal bone, frequently results from a fall on an outstretched hand with the wrist in extension. The principal treatment methods are cast immobilization or surgery.Aim of Study: The aim of this study is to evaluate results of volar percutaneous fixation of recent fracture scaphoid.Patients and Methods: In this prospective study, 21 cases with closed scaphoid fractures were treated with volar percu-taneous fixation by Herbert screw. Clinical and radiological data were analyzed.Results: These cases were assessed according to modified mayo scoring system. Clinical results were graded as excellent, good, fair as follows: Excellent in 17 patients (8%), good in 3 patients (14%), fair in one patients (5%) the excellent and good results were considered as satisfactory results while the unsatisfactory included the fair results. Thus, satisfactory results were found in 20 patients (95%), and the unsatisfactory results were found in one patient (5%).Conclusion: This study proves that fixation of recent scaphoid fractures result in predictable satisfactory union rate and functional outcome.
https://mjcu.journals.ekb.eg/article_54860_4fc834dad3be4869e6ff5b4a6272b810.pdf
2019-06-10
2507
2514
10.21608/mjcu.2019.54860
Volar – Scaphoid – Percutaneous fixation
MOHAMED E. ELMOGHANY, M.Sc.;
MOHAMED H. NAGY, M.D.
1
AUTHOR
MOHAMED M. HOSNY, M.D.;
AL-SAYED M. AL-FORSE, M.D.
2
The Department of Orthopaedic Surgery, Faculty of Medicine, Tanta University
AUTHOR
ORIGINAL_ARTICLE
Role of Artificial Ascites Pre-Radiofrequency Ablation of Sub Capsular Liver Tumors
AbstractBackground: Radiofrequency ablation for liver tumours is a common practice because of its many advantages including feasibility, relatively low cost, being a day case procedure, and minimal invasiveness. Sub-capsular hepatomas manage-ment represents a challenge due to liability of thermal injury to major organs and occurrence of serious complications.Aim of Study: To assess the safety and technical efficacy of percutaneous radiofrequency ablation after artificial ascites in sub-capsular hepatoma.Methods: In our study, 18 patients had hydro dissection procedure done to facilitate ultrasound guided Radiofrequency Ablation (RFA) for sub-capsular hepatic lesions. Hydro dissection was performed with 5% dextrose in water to displace adjacent structures away from the liver capsule. RFA system with cluster or single internally cooled electrodes were used for treatment of hepatic malignancies. The feasibility, safety, and efficacy of this technique were assessed on follow-up.Results: Our patients' mean age was 59.6 years old. No major complications related to hydro dissection were recorded. One of our patients had a thermal injury (5.5%). No patients suffered from biliary injury, haemorrhage or tumour seeding. Mean hydro dissection displacement of nearby organs was 1.6cm.Conclusion: Hydro-dissection (artificial ascites) proved to improve technical efficacy and safety for ultrasound guided radiofrequency of sub-capsular hepatomas.
https://mjcu.journals.ekb.eg/article_54861_5f6c862cd90643c89d536316922df270.pdf
2019-06-10
2515
2522
10.21608/mjcu.2019.54861
Sub-capsular hepatoma – Artificial ascites – Radiofrequency
AHMED H.
SOLIMAN, M.D.
1
The Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Ain Shams University
AUTHOR
ORIGINAL_ARTICLE
Preoperative Multidetector Computed Tomography (MDCT) Using Contrast Media for Suspected Acute Appendicitis in Adults: Value and Accuracy
AbstractBackground: Acute Appendicitis (AA) is considered the commonest cause of acute abdomen in adults. Its clinical presentation is not always clear and only 70% of patients have the classic signs and symptoms. Quick and safe diagnosis can be acquired in classic cases clinically assisted by laboratory results. Atypical presentation can be up to one third of patients with AA. Other abdominal conditions may also represent as AA especially in women. Also, the diagnostic value of labo-ratory markers (CRP and WCC) remains a controversial. Missing diagnosis of AA leads to severe complications. Ultrasound (US) examination has many limitations in diagnosis of AA. Multi-Detector Computed Tomography (MDCT) is well established for diagnosis of AA with high sensitivity. So, the radiologist can confidently diagnose or exclude AA, its severity and complications to guide appropriate manage-ment.Aim of Study: The aim of this study is to assess the diagnostic value and accuracy of pre-operative MDCT in suspected AA in adults.Patients and Methods: This prospective study included 200 adult patients presented with clinical picture of AA, either typical or atypical. Post intravenous contrast MDCT was performed for all patients. Axial images were reconstructed with coronal and sagittal reformatted images. Then images were evaluated for the presence or absence of AA, associated complications or other pelviabdominal abnormalities.Results: Two hundred patients (120 females and 80 males with age range between 21-65 years and mean age 35) were having clinical presentation of acute right iliac fossa pain. According to the CT findings 140 patients (70%) diagnosed as AA and 60 patients (30%) were negative for appendicitis. The CT findings were limited to the appendix only in 75 patients (37.5%) and were coping with simple acute appendi-citis. A group of 39 patients (19.5%) diagnosed as AA with peri-appendicular inflammatory changes. CT findings in a small group of patients (12 patients 6%) showed mixed inflammatory reaction with regional lymphadenopathy and minimal free fluid they were diagnosed as AA with phlegmon. CT signs of perforated appendix detected in 10 patients (5%). Only 4 patients (2%) diagnosed as appendicular mucocele. The other 60 patients (30%) were negative for appendicitis. 20 patients (10%) showed right ovarian cysts, 10 patients (5%) had right ureteric stones, 5 patients (2.5%) had epiploic appendagitis and 25 patients (12.5%) negative for any pathol-ogy. All cases with positive CT findings subjected to surgery and the operative findings were matching with the CT findings.Conclusion: MDCT is an accurate, effective technique for diagnosing acute appendicitis. It also affects surgical management plan. In addition, it avoids unnecessary operation.
https://mjcu.journals.ekb.eg/article_54862_700a8ab8f1750de7b3f8ef67db2e1d24.pdf
2019-06-10
2523
2530
10.21608/mjcu.2019.54862
Acute appendicitis – MSCT – Acute abdomen
SAHER E. TAMAN, M.D.;
WAEL H. KAMR, M.D.
1
The Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
AUTHOR
ORIGINAL_ARTICLE
Impact of Head Nurses' Supervision Practices on Quality of Work Life as Perceived by Staff Nurses
AbstractBackground: Head nurses' supervision practices has direct effect on working condition and the relation between supervisor and staff nurses that finally influence the quality of nurses' work life.The Aim of the Study: To assess the impact of supervision practices on quality of work life as perceived by staff nurses.Material and Methods: A descriptive correlational design was used.Setting: The study was conducted at Sohag University Hospital at Units of Medical, Surgical Departments and General Intensive Care. Convenient nurses' sample two hun-dred forty who work at selected hospital. Two tools were used: Supervision practices and quality of work life question-naire. Results: Study revealed that the highest percentage of participants perceived average level of quality of nursing work life, the high mean score quality of work life was related to work context. There was negative significant correlation between supervision practices and quality of work life.Conclusion: Study concluded that head nurses' supervision practices have direct effect on quality of nurses work life. When head nurses improving work context and work life of staff nurses this lead to improving quality of work life.Recommendations: Head nurses should improve the work-ing conditions and making a supportive, friendly, and intimate environment for all the staffs, involving nurses in decision making and respecting their viewpoints. Supervisor should realize and pay attention to the physical and mental conditions of each nurse's staff.
https://mjcu.journals.ekb.eg/article_54863_58d7aec91825a5d58dad66083969b0bf.pdf
2019-06-10
2531
2537
10.21608/mjcu.2019.54863
Nurses – Supervision practices – Quality of Work Life (QWL)
AHMED A. OSMAN, M.Sc.;
MAGDA A. ABD EL-FATTAH, D.N.Sc.
1
AUTHOR
OM HASHEM G.
RAGAB, D.N.Sc.
2
The Department of Nursing Administration, Faculty of Nursing, Sohag* and Cairo** Universities, Egypt
AUTHOR
ORIGINAL_ARTICLE
Bacterial Sanitary Survey of Drinking Water Quality in Some Areas in Giza Governorate
AbstractBackground: Drinking water should be clear and free from unpleasant tastes and odors and from injurious chemicals and microorganisms. Water-borne diseases have been predicted to cause more than two million deaths and four billion cases of diarrhea each year.Aim of Study: This Bacteriological study was conducted on water samples from three areas in Giza Governorate, namely Kerdasa, Kafr El-Gebel and Dahshur, from December 2016 till November 2017, to screen Bacterial Sanitary of Drinking Water Quality in these areas in Giza Governorate.Material and Methods: Water samples (n=846) were collected from tap water, hand pump water, plant water and source water at the four seasons. Fecal and total coliform were detected using the standard membrane filtration technique.Results: The results obtained were compared with WHO guidelines. Among the total coliforms, E.coli, Salmonella spp., Shigella spp. and Klebsiella spp. were reported.Conclusions: Concern should be rasied about the quality of the drinking water in area of study should be taken.
https://mjcu.journals.ekb.eg/article_54864_ba0493208141d55d59e5f5bf3e3d8a7a.pdf
2019-06-10
2539
2546
10.21608/mjcu.2019.54864
Fecal and total coliform – E. coli – Salmonella spp. – Shigella spp. – Klebsiella spp
REHAB H. BAHY, Ph.D.;
NOURAN H. ASSAR, Ph.D.
1
AUTHOR
GHADA S.
MOHAMED, Ph.D.
2
AUTHOR
ORIGINAL_ARTICLE
The Effect of Ethyl Pyruvate on High Mobility Group Box I and Oxidative Stress in Induced Rheumatoid Arthritis in Rats
AbstractBackground: Rheumatoid Arthritis (RA) is autoimmune disease characterized by chronic inflammation and by the destruction of synovial joints, leading to joint deformity and disability. The cause of RA is still unknown, but several factors have been documented. These include environmental factors, genetic factors, microbial pathogens, altered levels of inflammatory mediators, and defects in immune regulation, as autoimmune disease. The response of autoimmunity can be identified by the production of autoantibodies, such as Rheumatoid Factor (RF) or Anti Citrullinated Protein Anti-bodies (ACPAs), in serum. Recently, antioxidant supplemen-tation has been the major focus of attention across the world among the health professionals to explore it as a strategy to protect against the injurious effects of oxidative stress.Aim of Study: This study aimed to investigate the beneficial effects of Ethyl Pyruvate (EP) in a rat model of Complete Freund's Adjuvant (CFA) induced RA.Material and Methods: The current study was carried out in Medical Biochemistry Department, Faculty of Medicine, Tanta University, in accordance to the guidance of Ethical Committee of Medical Research, Faculty of Medicine, Tanta University, Egypt (Approval code 31802/10/17) during 2018.The study was conducted on 60 male albino rats divided into four groups; Group I (control group), Group II (Rheuma-toid arthritis group) and Group III (treated rheumatoid arthritis group) and Group IV (EP-control group) that are received the same dose of EP in treated rheumatoid arthritis group. All groups were subjected to estimation of level of anticyclic citrullinated peptide (AntiCCP) for diagnosis of RA, inflam-matory marker as High Mobility Group Box1 (HMGB1) and Interleukin 1 Beta (IL1B) and also oxidative stress marker as Nitric Oxide (NO) and total antioxidant capacity respectively trying to detect effect of inflammation and oxidative stress in RA.Results: This study showed that EP significantly decrease Anticcp, HMGB 1 and IL1B and NO levels, also significantly in TAC.Conclusion: On basis of these results it could be concluded that EP exhibits anti-inflammatory and antioxidant effects in experimentally induced RA in rats.
https://mjcu.journals.ekb.eg/article_54867_cfb0bf50ae52160f49696c52c1bd91af.pdf
2019-06-10
2547
2554
10.21608/mjcu.2019.54867
Rheumatoid arthritis – Complete Freund's adjuvant – High mobility group box 1
HADEER S. SALAH, M.Sc.;
OMNIA S. EL-DEEB, M.D.
1
AUTHOR
SAAD EL-DEEN A. ABO EL-NOEMAN, M.D.ک
NAGAH K. GAAFAR, M.D.
2
The Department of Medical Biochemistry, Faculty of Medicine, Tanta University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Oxidative Stress Changes Induced by Methotrexate on Parotid Gland Structure of Adult Male Albino Rat: Can Vitamin C Ameliorate These Changes?
AbstractBackground: Methotrexate (MTX) is a cytotoxic chemo-therapeutic agent for several malignancies and various inflam-matory diseases. Salivary dysfunction is one of MTX muco-toxic effects. Vitamin C (vit. C) scavenges the oxidative molecules and free radicals since it is a potent hydrophilic antioxidant.Aim of Study: Is to throw light on the structural alternation in the rat parotid gland after administration of MTX and the probable antioxidant role of vit. C on these structure alterations.Material and Methods: Fifty male albino rats were equally divided into 5 groups; Group I: Rats had received a balanced diet for 9 days; Group II: Rats had received vit. C daily by oral gavage (500mg/kg body weight) dissolved in 5cm distilled water for 9 days; Group III (MTX-treated group): Animals had received MTX intraperitoneally as one single dose (20mg/ kg B.w) on the third day of the experiment; Group IV (MTX-withdrawal group): Rats had received MTX intraperitoneally as one single dose (20mg/kg B.w) on the third day of the experiment then left without treatment for another 15 days; Group V (MTX + vit. C-treated group): Rats had received MTX intraperitoneally as one single dose on the third day of the experiment and vit. C by oral gavage 2 days before and 6 days after MTX administration (at same doses mentioned before). The animals of Group I, II, III and V were anesthetized and scarified after 9 days of experiment, while rats of Group IV were anesthetized and scarified after 18 days of experiment. At the end of experiment, parotid tissues were collected for both light and electron microscopy and biochemical investi-gations.Results: MTX caused parotid histopathological and ultra-structural alterations. The MTX-treated group revealed loss of normal architecture of parotid tissue. Some parotid acini were completely degenerated leaving large spaces. Other acini appeared with numerous intracellular vacuoles. The ducts appeared dilated with stagnation of secretion. Collagen fibers, inflammatory cells infiltration, congested blood vessels and hemorrhage in between the acini were also detected. Biochem-ically, the Malondialdehyde (MDA) level of the MTX- treated group was significantly increased while the Glutathione (GSH) level was significantly reduced in comparison with other groups. The MTX-withdrawal group showed little improvement of biochemical parameters, while structural examination still showed signs of degenerations. However, the MTX + vit. C-treated group demonstrated some improvement of histological features and biochemical parameters as compared to the MTX-treated group.Conclusions: Methotrexate produces marked degenerative changes in the parotid structure while vitamin C has the ability to ameliorate these parotid injuries.
https://mjcu.journals.ekb.eg/article_54869_ae7e8326caa8572756d2eec36e4bcd62.pdf
2019-06-10
2555
2565
10.21608/mjcu.2019.54869
Methotrexate – Vit. C – Parotid salivary gland – Histological changes – Oxidative Stress
SAMAA SALAH ABD EL-FATAH, M.D.;
DOAA MOHAMMED YOUSEF, M.D.
1
AUTHOR
AMIRA E.
AL-SEMEH, M.D.
2
The Department Anatomy and Embryology, Faculty of Medicine, Zagazig University
AUTHOR
ORIGINAL_ARTICLE
Omega-3 Supplementation and its Effect on Lipid Profile in Intrauterine Growth Restriction (IUGR) Neonates
AbstractBackground: IUGR is an important cause of perinatal morbidity and mortality. It is noted to affect approximately 5-15% of pregnant women. Omega-3 fatty acids are considered essential fatty acids. They are necessary for human health, but the body can't make them. They play a crucial role in brain function, as well as normal growth and development.Aim of Study: Was to investigate the serum lipid profile level in full term neonates with IUGR and the effect of Omega-3 supplementation on its level.Subjects and Methods: This prospective clinical trial was carried out at Neonatal Intensive Care Unit (NICU), Tanta University Hospital, over one year between April (2015) to May (2016). It was conducted on 50 full term IUGR neonates. Twenty five of them received Omega 3 supplementation as study group compared to 25 full term IUGR neonates without any supplementation enrolled as a control group. They were subjected to full history taking & thorough clinical examina-tion, and they were investigated for estimation of complete blood picture, C-reactive protein, serum Urea and Creatinine, serum electrolytes (Na+, K+, Ca+2) and Specific Laboratory investigations: (Total Serum Cholesterol, Serum Triglycerides, HDL-Cholesterol, LDL-Cholesterol and VLDL-Cholesterol).Results: There was significant increase in level of LDL in cases and control groups. There was significant decrease of LDL after 1 week in cases group more than control group. As regard rate of decrement of high levels of LDL there was significant decrement rate after 2 weeks of supplementation with Omega 3 by 55.84% in cases group which was more than the decrement in control group which was 31.34%. Also, there was an increase in level of TC initially in IUGR neonates and this level was decreased after supplementation of Omega 3 for 2 weeks. There was a decrease in level of HDL initially in IUGR neonates and this level was significantly increased after supplementation of Omega 3 for 2 weeks. There was an increase in level of TG initially in IUGR neonates and this level was decreased after supplementation of Omega 3 for 2 weeks. There was an increase in level of VLDL initially in IUGR neonates and this level was significantly decreased after supplementation of Omega 3 for 2 weeks.Conclusion: Screening for lipid profile is important to be done in all IUGR neonates at birth and during follow-up. Long term follow-up is recommended for all IUGR neonates for detection of CVD and the effect of Omega 3 on these groups.
https://mjcu.journals.ekb.eg/article_54871_a38c67ab9473bff8c18add9976e6d4ba.pdf
2019-06-10
2567
2579
10.21608/mjcu.2019.54871
Words: Omega 3 – IUGR – Neonatology
ANWAAR R.A. EL-ALKAMY, M.Sc.;
MOHAMED A. ROWISHA, M.D.
1
AUTHOR
HEBA S. EL-MAHDY, M.D.;
HEMMAT E. EL-HORANY, M.D.
2
The Departments of Pediatrics Medicine* and Medical Biochemistry**, Faculty of Medicine, Tanta University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Prevalence and Determinants of “No-Mobile” Phobia (Nomophobia) among University Students
AbstractBackground: A simple random sample was followed to include the total required study sample at study colleges for both boys and girls. In each study college, the lists of students' names with their university IDs were used to select participant students. Selected students were personally contacted by the researcher, with the help of their tutors.Aim of Study: To identify magnitude of “no-mobile phobia” (nomophobia) among Health Sciences students at King Khalid University, Abha, Saudi Arabia.Subject and Methods: Following a cross-sectional study design, 625 health sciences colleges' students were included. A self-administered data collection study questionnaire was designed by the researchers, which included personal charac-teristics; mobile phone use: Duration of use of mobile phone, access to internet, average duration of daily use of the mobile phone, type of used mobile phone and the validated 20-item Nomophobia Questionnaire (NMP-Q).Results: All participants had smartphones. Prevalence of nomophobia among students was 85.3%, with 22.1% having severe nomophobia, and 63.2% having mild nomophobia. Students of applied medical sciences had the highest percentage of severe nomophobia, while students of medicine had the lowest percentage (35. 1% and 15.8%, respectively). Nomo-phobia grades differed significantly according to study colleges (p=0.003). Percentages of students with severe nomophobia were significantly higher among those who had internet access through their personal mobile phones (p=0.017) and also among those who spend more than 2 hours daily with their mobile phones (p<0.001). However, grades of nomophobia did not differ significantly according to students' gender, or Grade Point Average (GPA).Conclusions and Recommendations: Mobile phone addic-tion is common among undergraduate students of Health Sciences Colleges at King Khalid University, Saudi Arabia. Health education of university students is necessary to prevent possible harmful effects of excessive use of mobile phones.
https://mjcu.journals.ekb.eg/article_54873_3f3dfe18a111cc0c99f33cef811d5868.pdf
2019-06-10
2581
2586
10.21608/mjcu.2019.54873
Nomophobia – University students – Health Sciences Colleges – King Khalid University – Saudi Arabia
AYOUB A. AL-SHAIKH, M.B.B.S.;
HASSAN M. ALMUSA, C.A.B.F.M.
1
AUTHOR
SAFAR A. AL-SALEEM, M.D.;
FAISAL SAEED AL-QAHTANI, S.B.F.M.
2
AUTHOR
FATIMA RIAZ, Ph.D.;
RISHI K. BHATI, M.D.
3
AUTHOR
SAAD AL-AMRI, M.B.B.S.;
AHMAD S. ASSIRI, M.B.B. S.
4
AUTHOR
SALEH A. AL-SHAIKHI, M.B.B.S.;
ABDULHAKEEM A. AS SIRI, M.B.B.S.
5
AUTHOR
ABDULLAH A. AL-ARRAFI, M.B.B.S.;
SAMI H.M. ALFAIFI, M.B.B.S.
6
AUTHOR
OSSAMAA.
MOSTAFA, M.D.
7
Family & Community Medicine Department, King Khalid University*, Family Medicine Resident, Ministry of Health** and Family Medicine Specialist, King Khalid University Medical City***, Saudi Arabia
AUTHOR
ORIGINAL_ARTICLE
Compound Depressed Fracture Over Dural Venous Sinuses: Experience of 22 Surgically Treated Cases
AbstractBackground: Due to high risk of massive blood loss of traumatic injury of dural venous sinus at the time of trauma or emergency operation leading to high mortality rate, we considered the appropriate methods that are most essential in treatment of depressed skull fracture over dural venous sinus to decrease mortality rate as much as possible.Aim of Study: For assessment of surgical interference in cases of depressed skull bone fracture with dural venous sinuses injury is it risky with high mortality rate or can be done safely with different methods or it is better to be conserve than surgical interference.Patients and Methods: Twenty two patients with transsinus compound depressed skull fracture were reviewed retrospec-tively who presented to emergency department in Aswan university hospitals between January 2014 and June 2018. All patients submitted to computed tomography scan (CT scan) for assessment of fracture site, size and relation to dural venous sinuses.Results: Twenty two patients with a dural venous sinus injury from severe head injuries who had been treated upon in the two hospitals were reviewed retrospectively. There were 18 males and 4 females patients. All cases underwent surgical interference ,with mortality rate (22.73%) of operated cases, due to massive blood loss intraoperative and uncontrolled sinus repair and hypovolemic shock.Conclusion: When there is depressed skull fracture pen-etrating the sinus, so we will take care for possibility of massive blood loss and uncontrolled repair of injured sinus, and we face a high mortality case. The surgeon should be prepared for the possibility of potentially fatal venous sinus injury, and so, conservative treatment better than surgical intervention of penetrating cases of dural venous sinus injuries as much as possible.
https://mjcu.journals.ekb.eg/article_54874_3d80651480e19598481ee34d2c62a3d5.pdf
2019-06-10
2587
2591
10.21608/mjcu.2019.54874
Cranial sinus injury – Skull fractures
KHALED ISMAIL ABDEL-AZIZ, M.D.ک
MOHAMED ALI RAGAEE, M.D.
1
The Department of Neurosurgery, Faculty of Medicine, Aswan* and Assuit** Universities Hospital
AUTHOR
ORIGINAL_ARTICLE
MicroRNA29-a as Diabetic Nephropathy Biomarker in Diabetic Patients (Type 2)
AbstractBackground: Diabetic nephropathy (DN) is one of the main causes of renal failure. Recent research demonstrated that the serial microbes (miRNA) could be used as a marker to detect pathogenic disease; the DN-related miRNAs could not be studied.Aim of Study: In this study the aim was to investigate the predictive value of miRNA29-a in diabetes mellitus type 2 (T2DM) patients in relation to nephropathy risk onset predic-tion.Subjects and Methods: In the present study a total of (120) persons were divided into three groups as Group (I): (N=20) control group, Group (II): (N=50) T2DM patients without renal symptoms Group (III): (N=50) T2DM patients with renal insufficiency, RT-PCR method was used to determine the relative quantitative of miRNA29-a.Results: Increased levels of HbA1c, FBS, urea, creatinine and Albumin/creatinine ratio (ACR) were observed in subjects under study.An increased levels of miRNA 29-a in group III, DN (51.97-}61.78) and group II, DM (7.06±6.83) when com-pared with group I, control subjects (0.8-}0.2). The result of the present study implied that miRNA 29-a could be served as an early indicator of DM-mediated renal pathogenesis.
https://mjcu.journals.ekb.eg/article_54875_3f5110db71bf302f45589a46cf2b1d2f.pdf
2019-06-10
2593
2597
10.21608/mjcu.2019.54875
Diabetes mellitus type 2 – Diabetic nephropathy – Circulating microRNA – Biomarker
MOHAMED Y. NASR, M.D.;
SALWA E. MOHAMED, M.D.
1
AUTHOR
AHMED M. HASSANAIN, M.D.;
RANDA A. GHANOUM, M.D.
2
AUTHOR
SABAH F.
EL-ABED, M.D.
3
The Department of Molecular Biology, Genetic Engineering & Biotechnology Institut, Sadaat City University* and Laboratory Department, National Heart Institute, General Organization of Hospitals & Teaching Institutes, Ministry of Healthy
AUTHOR
ORIGINAL_ARTICLE
Treating Vestibular Schwannomas with Gamma-Knife Radiosurgery Versus Microsurgery: Long-Term Follow-up of 702 Cases
AbstractBackground: The three treatment options currently con-sidered for vestibular schwannoma are expectant treatment, microsurgery and radiosurgey, and to date no class I evidence favors one treatment over the others.Aim of Study: The objective of this study was to compare long-term functional outcome after gamma knife radiosurgery versus surgical treatment.Methods: A group of 275 patients submitted to microsur-gery and 427 patients treated with radiosurgery in two different centers were followed-up for 15.2±13.6 months and 45.6±26.8 months, respectively. We assessed tumor volumetry based on serial MR images, facial nerve function, hearing function, tinnitus, trigeminal symptoms and vertigo, and compared them between treatment groups.Results: Based on normalized volumetry over time, surgery was more efficient for tumor control than radiosurgery (p<0.001). After radiosurgery, hearing and facial nerve func-tions remained stable regardless of tumor size. On the other hand, after surgery, there was clinical deterioration for both small and large tumors, yet the deterioration for small tumors was very discrete, rendering quite similar functional results across groups in this category. Furthermore, surgery alleviated symptoms like facial hypoesthesia, dizziness, and tinnitus more effectively than radiosurgery.Conclusion: These results represent an important contri-bution to the field and offer evidence-based criteria to support the indication of a particular treatment modality according to the patient's expectations and professional activity.
https://mjcu.journals.ekb.eg/article_54877_2fc80814a55428e1e596fe7db8c4009a.pdf
2019-06-10
2599
2610
10.21608/mjcu.2019.54877
Vestibular schwannoma– Radiosurgery – Micro-surgery – Gamma knife
AHMED R. RIZK, M.D.;
GUIHERME LEPSLI, M.D.
1
AUTHOR
GERHARD A. HORSTMANN, M.D.;
MARCOS TATABIBA, M.D.
2
The Department of Neurosurgery, Eberhard Karls University, Tübingen, Germany*, Gamma Knife Centre Krefeld, Krefeld, Germany** and Department of Neurosurgery, Banha Faculty of Medicine, Benha University, Egypt***
AUTHOR
ORIGINAL_ARTICLE
Study of Serum Cyclophilin A Level in Patients with Acute Coronary Syndrome
AbstractBackground: Acute coronary syndrome (ACS) refers to a group of conditions due to diminished blood flow in the coronary arteries such that part of the heart muscle is incapable to act properly or dies.Aim of Study: Is to evaluate the role of serum cyclophilin A level in acute coronary syndrome, its clinical significance in identifying patients with coronary artery disease and its correlation with the severity of the disease.Methods: This study included 60 ACS cases, were sub-jected to full history taking. Clinical examination, Fasting blood glucose, Lipid profile (Total cholesterol, triglycerides, LDL and HDL), High sensitivity CRP, Troponin I level, CKMB level, Cyclophillin A. 20 apparently healthy age and sex matched subjects serving as a normal control group.Results: Patients were divided into three groups unstable angina, NSTMI and STEMI. according to Cyclophilin A estimation: The mean values of serum Cyclophilin A level were significantly increased in unstable angina group, NSTMI group and STEMI group as compared to those in control group, there was also significant increase in NSTMI and STEMI as compared to those in group unstable angina.Conclusion: From this study, it could be concluded that serum cyclophilin A levels Increased in patients with acute coronary syndrome and its associated with the progression of the disease suggesting its role in accelerating atheroscelerosis and may be a valuable marker for predicting the severity of ACS. So it is reasonable to assume that it could be a target for therapeutic treatment and its down regulation may be a new therapeutic strategy in ACS patients in near future.
https://mjcu.journals.ekb.eg/article_54879_64076b021eb64f3634b6075f04c591d6.pdf
2019-06-10
2611
2619
10.21608/mjcu.2019.54879
Acute coronary syndromes – Cyclophilin A – Atherosclerosis
ESRAA E. EMARA, M.Sc.;
MAALY M. MABROUK, M.D.
1
AUTHOR
TAIMOUR M. ABDALLAH, M.D.;
THORYA E. BADAWY, M.D.
2
The Departments of Clinical Pathology* and Cardiology**, Faculty of Medicine, Tanta University
AUTHOR
ORIGINAL_ARTICLE
Assessment of Efficacy and Safety of Thread Lift in Mid Face
AbstractBackground: Aging is a natural process which occurs with development of human age as the skin becomes thin, dry and loses elasticity mainly in the sun exposed areas. It is caused by intrinsic and extrinsic factors and is affected by genetic, environmental, hormonal and metabolic factors. A lot of methods are used to overcome aging and produce rejuvenation of skin including non invasive, invasive and surgical. Surgical threads are polypropylene sutures which placed under skin and create inflammation and fibrosis around them and restore vitality of skin so they could be a safe and effective method for lifting.Aim of Study: The aim of this study was to assess the safety and efficacy of thread lift in mid face lifting.Patients and Methods: The current study included 12 patients with mild to moderate laxity of skin of mid face. Local anaesthesia was injected and threads were inserted under the skin with suitable number for the degree of skin laxity, differ from patient to another.Results: There was improvement in the mid face of patients immediately after the procedure by the mechanical effect of the threads. Further improvement was observed in follow-up after one month and three months with variable degrees. Mild temporary side effects like pain, oedema and ecchymosis, had been reported.Conclusion: Thread lift is a simple, safe and effective method, which produced a long maintained effect compared with other methods of skin lifting.
https://mjcu.journals.ekb.eg/article_54880_a6c34ea0688707dc2494c8f57f0855bf.pdf
2019-06-10
2621
2629
10.21608/mjcu.2019.54880
Safety of thread lift – Mid face
IMAN H. EL MAADAWY, M.D.;
ABEER A. HODEIB, M.D.
1
AUTHOR
SAMEH A. ALSHAWADFY, M.D.;
DALIA I. ABADA, M.Sc.
2
The Departments of Dermatology & Venereology* and Plastic & Reconstructive Surgery**, Faculty of Medicine, Tanta University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Relationship between Acromiohumeral Distance, and Glenohumeral Internal Rotation Deficit in Patients with Shoulder Impingement Syndrome
AbstractBackground: A loss of glenohumeral internal rotation has been associated with altered kinematics of the glenohumeral and the scapulothoracic joint.Aim of Study: To evaluate the association between Ac-romio-humeral distance (AHD), gleno-humeral internal rotation deficit GIRD).Methods: 40 impingement patients (from 25 to 45 years old), participated in this study,They were evaluated by ultra-sonography for acromio-humeral distance(AHD), digital goniometer for gleno-humeral internal rotation deficit (GIRD).Results: This study showed a positive significant relation between gleno-humeral internal rotation difict (GIRD) and acromio-humeral distance (AHD), GIRD increase, AHD decrease.Conclusion: Glenohumeral internal rotation deficit, de-crease acromiohumeral distance and lead to compression of the rotator cuff and subacromial bursa in this limited space in patients with shoulder impingement syndrome.
https://mjcu.journals.ekb.eg/article_54881_b257a7dc0ad6861d578d935469a2046b.pdf
2019-06-10
2631
2636
10.21608/mjcu.2019.54881
Impingement syndrome – Acromiohumeral distance – Posterior capsule tightness
ALAA A.H. BALBAA, P.h.D.;
HATEM M. EL-AZIZI, M.D.
1
AUTHOR
MOHAMMED A. SARHAN, P.h.D.;
MANAR OBBAHA, M.Sc.
2
AUTHOR
ORIGINAL_ARTICLE
L-Carnitine Supplementation During Hepatitis C Virus Treatment with Sofosbuvir/Daclatasvir Plus Ribavirin: Effect on Anemia: A Pilot Study
AbstractBackground: In the direct acting antiviral era, the role of ribavirin (RBV) in the treatment of hepatitis c virus (HCV) remains crucial, especially in patients with liver cirrhosis and treatment experienced patients. L-carnitine was reported to improve anemia in patients with HCV treated with interferon alone or with ribavirin.Aim of Study: To evaluate the effect of L-carnitine on improving ribavirin induced hemolytic anemia in patients with HCV treated with sofosbuvir/daclatasvir plus ribavirin (SOF/DCV/ RBV).Patients and Methods: Naive patients with HCV related liver cirrhosis and treatment experienced patients who received prior interferon therapy were randomized to receive either SOF/DCV/RBV plus L-carnitine (n=49) or SOF/DCV/RBV (n=49) for 12 weeks as a control group. Changes in hemoglobin concentration, reduction of ribavirin dose and its effect on sustained virological response (SVR) were evaluated.Results: After 4 and 12 weeks of treatment, the hemoglobin concentration was significantly higher in the L-carnitine group than in the control group (p<0.001). RBV dose was reduced in 10.2% of patients in the L-carnitine group versus 22.5% in the control group. The adherence of patients to their ribavirin dose was higher in patients treated with L-carnitine than patients in the control group (89.8% vs. 77.5%). SVR12 rate in the L-carnitine group was higher than that in the control group (93.9%% vs. 87.8%).Conclusion: L-carnitine is effective in improving hemo-lytic anemia induced by ribavirin in patients treated for hepatitis C virus and increase patient's adherence to treatment that guarantees the best opportunity to achieve an SVR.
https://mjcu.journals.ekb.eg/article_54882_34e5ffd443b5d81aacccce5686d22d26.pdf
2019-06-10
2637
2642
10.21608/mjcu.2019.54882
Hepatitis C virus – L-carnitine – Ribavirin
LOBNA ABO ALI, M.D.;
SAMAH ELSHWEIKH, M.D.
1
AUTHOR
SHIMAA
SAIED, M.D.
2
The Departments of Tropical Medicine*, Internal Medicine** and Public Health & Community Medicine***, Faculty of Medicine, Tanta University, Tanta, Egypt
AUTHOR
ORIGINAL_ARTICLE
Prospective Randomized Controlled Study of Efficacy of Self Gripping Mesh in Inguinal Hernia Repair
AbstractBackground: Chronic pain following inguinal hernia repair is a complex problem. Mesh fixation with sutures may be a contributing factor to this pain. A new self gripping mesh (Parietex® Progrip®) was developed to allow sutureless fixation of mesh, avoid chronic pain after hernia surgery and reduce the operative time.Aim of the Work: The aim of this study was to study the efficacy of self gripping mesh in inguinal hernia repair. Methods: Twenty six male patients with uncomplicated inguinal hernia were randomized into 2 groups. Group A: Included 10 patients subjected to repair with polypropylene mesh. Group B: Included 16 patients subjected to repair with parietex® progrip® mesh. They were followed-up for incidence of pain (with VAS) and integrity of the mesh (with U/S).Results: There were no statistically significant differences between both groups regarding age, sex, body mass index or incidence of postoperative pain (p=0.385). The operative time and mesh fixation time were significantly shorter in self gripping mesh group than the sutured mesh group (p<0.001). There were no reported cases of recurrence, haematoma, epididymo-orchitis or testicular atrophy in either group during the follow-up period. Scrotal oedema was detected in 7 cases in group A and 4 cases in group B. Seroma was detected in 3 cases in group A and 2 cases in group B. Wound infection occurred in 2 cases in group A.Conclusion: The higher price of the parietex progrip mesh makes its use questionable. The smaller number of the studied cases with the short follow-up period make us unable to give solid recommendation to use one mesh type than the other.
https://mjcu.journals.ekb.eg/article_54883_0ee6cf5c412d107ad75ea80f3120ae64.pdf
2019-06-10
2643
2650
10.21608/mjcu.2019.54883
Inguinal – Hernia repair – Progrip mesh
MOHAMMED A. ELHARTY, M.Sc.;
MOHAMED A. MOHAMED, M.D.
1
AUTHOR
AYMAN A.ELNEMR, M.D.;
AHMED A. DARWISH, M.D.
2
The Department General Surgery, Faculty of Medicine, Tanta University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Assessment of Occupational Exposure to Organic Solvents, Applied Safety Measures and Their Effect on Liver Function of Exposed Workers in Rubber Industry Tanta City – Gharbia Governorate
AbstractBackground: In rubber manufacturing, health hazards from organic solvents are due to their metabolic conversion to more hazardous substances which may lead to liver injury.Aim of the Work: To measure indoor environmental ex-posure to some organic solvents, to assess applied safety measures in the workplace and to investigate liver function of occupationally exposed workers.Subjects and Methods: This study was a cross sectional study conducted on rubber factoey production departments in the period from July 2017 up to October 2018. The study included 120 workers. Interview questionnaire with exposed workers and filling an audit workplace observational checklist by the researcher were used as tools of the study. Measuring environmental indoor exposure to some volatile organic compounds (benzene, toulene, ethylbenzene and xylene) was done by gas chromatography (GC). Liver function tests for exposed workers were measured.Results: Environmental monitoring revealed higher levels of exposure to benzene, ethylbenzene and toluene (2.13, 560 and 380mg/m3 respectively), while level of xylene was within normal. The mean total score percent for checklist of applied safety measures was 17.94%+7.93%. The study indicated lack of training programs with no periodic medical examination was made for workers. The majority of workers had occupa-tional exposures to chemicals, fumes and dust (70.8%, 73.3% & 60%) respectively. Liver function tests were found to be normal in the majority of workers (93%).Conclusion and Recommendations: There were insufficient applied safety measures in the factory & increased levels of benzene, ethylbenzene and toluene more than the permissible exposure limits. So, regular environmental monitoring, apply-ing the standard safety measures, and periodic medical exam-inations for workers are needed.
https://mjcu.journals.ekb.eg/article_54884_badd3d473e6213f70d9a011b582a7932.pdf
2019-06-10
2651
2656
10.21608/mjcu.2019.54884
Organic solvents – Liver function – Rubber industry workers
ZINAB M. ELGHMRY, M.Sc.;
RANIA M. EL-SALLAMY, M.D.
1
AUTHOR
IBRAHIM A. KABBASH, M.D.;
HAGRAS ELMURSI HAGRAS, M.D.
2
The Department Public Health and Community Medicine, Faculty of Medicine, Tanta University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Omeprazole as an Adjuvant to Praziquantel in Treatment of Experimental Schistosomiasis Mansoni
AbstractBackground: Schistosomiasis is an important parasitic disease. It has a chronic course with noticeable residual effects on health. Praziquantel (PZQ) is recommended by the WHO as the first line in treatment of schistosomiasis. Unfortunately, it has low efficacy against schistosomula and the juveniles stages which can compromise its efficacy. This further needs more research to find new drugs that improve the effectiveness of PZQ. Omeprazole has been found experimentally to have antiparasitic properties against many parasites such as Leish-mania donovani, Plasmodium falciparum, Trichomonas vag-inalis, Entamoeba histolytica and Giardia lamblia.Aim of Study: The aim of this study was to evaluate the efficacy of omeprazole as an adjuvant with PZQ in mice infected with Schistosoma mansoni (S. mansoni).Material and Methods: For this aim, 100 laboratory bred clean male Swiss albino mice were divided into three groups including group I (Normal), group II (Control), group III infected and treated at 4 weeks post infection (P.I.). Group III was divided into 3 subgroups a (treated with PZQ), b (treated with omeprazole) and c (combined treatment). At 6 weeks P.I., all mice were submitted to the following: Count of juveniles worms, liver egg load, histopathological exami-nation of the liver.Results: The results showed significant reduction of counts of juveniles worms, liver egg loads and improvement of the pathological changes in the liver in combined treatment group at 6 weeks P.I. as compared to PZQ treated group.Conclusions: From these results, it was concluded that combination of omeprazole with PZQ shows synergistic effect in the treatment of S. mansoni-infected mice. Therefore, further studies should be done to establish the mechanisms of action of omeprazole and to examine its beneficial effects.
https://mjcu.journals.ekb.eg/article_54886_5ceb16ca5e6e886c1bad688a17f7f918.pdf
2019-06-10
2657
2665
10.21608/mjcu.2019.54886
Schistosoma mansoni – Omeprazole – Praziqu-antel efficacy – Granuloma
ASMAA R. EL LAKANY, M.Sc.;
DINA I. EL GENDY, M.D.
1
AUTHOR
HANAN A. ALSHENAWY, M.D.;
AMIRA E. ABDEL GHAFFAR, M.D.
2
The Departments of Medical Parasitology* and Pathology**, Faculty of Medicine, Tanta University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Hemin Ameliorated Letrozole-Induced Polycystic Ovary Syndrome: A Forward Step for Better Management
AbstractBackground: Previous studies showed that Heme Oxyge-nase-1 (HO-1) level was markedly reduced in Polycystic Ovary Syndrome (PCOS) which might highlight the role of HO-1system in the pathogenesis and treatment of PCOS.Aim of Study: The present study was done to study the effects of the induction of HO-1 system by hemin on Letrozole (LTZ)-induced PCOS in rats.Material and Methods: 40 female rats were divided into 4 equal groups; normal control (I), hemin (II), LTZ (III), hemin + LTZ treated (IV).Results: After three weeks, LTZ administration induced PCOS in female rats as evidenced by histological examination and biochemical analysis. It significantly increased testosterone level, LH and LH/FSH ratio compared with normal control group. LTZ significantly decreased plasma adiponectin level, ovarian Silent Information Regulator 1 level (SIRT1), Glu-tathione-S-Transeferase activity (GST), HO-1 mRNA expres-sion and ovarian B-Cell Lymphoma 2 (BCL2) expression compared with normal control group. While, it increased ovarian hydrogen peroxide (H2O2) level, ovarian BCL2 associated X (Bax) expression and Bax/Bcl2 ratio compared with normal control group. Hemin administration antagonized all these effects.Conclusion: We could conclude that, hemin is a promising drug for treatment of PCOS through its antioxidant, anti-inflammatory and anti-apoptotic effects which can rise up the possibility of involvement of HO system in pathogenesis of PCOS.
https://mjcu.journals.ekb.eg/article_54888_98c71dc618aa361e24ee9bd35b761741.pdf
2019-06-10
2667
2678
10.21608/mjcu.2019.54888
Heme oxygenase-1 – Polycystic ovary syndrome – Letrozole
FATMA H. RIZK, M.D.;
NEMA A. SOLIMAN, M.D.
1
AUTHOR
AMIRA EL-SAADANY, M.D.;
AL-SHIMAA ABO AL-SOUD, M.D.
2
AUTHOR
MARWA A.A. IBRAHIM, M.D.;
SHEREEF EL-SHWAIKH, M.D.
3
The Departments of Physiology1, Medical Biochemistry2, Pharmacology3, Histology4 and Gynecology and Obstetrics5, Faculty of Medicine, Tanta University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Correlation between Carbon Dioxide Production and Mean Arterial Blood Pressure in Fluid Response in Mechanically Ventilated Patients
AbstractBackground: Volume expansion through fluid administra-tion is one of the simplest approaches for initial treatment of hemodynamic instability. In the Intensive Care Unit (ICU) a newly available technique called volumetric capnography (Vcap) allows measurement of carbon dioxide production (VCO2) on a regular basis at the bedside.Aim of Study: The aim of the study was to evaluate VCO2 as an endpoint predictor for fluid resuscitation in mechanically ventilated patients.Methods and Material: This prospective cohort study was carried out on 70 patients in Tanta University Hospitals at surgical ICU from August 2017 till August 2018. All patients included in the study were on controlled mechanical ventilation with tidal volume 6-8ml.kg–1 ideal body weight. Wide bore intravenous lines were inserted and patients were completely sedated and monitored by; pulse oximeter, non-invasive blood pressure monitoring, ECG all connected to monitor (infinium medical-OMNI lll-FL33773-USA). Volumetric capnogram, end tidal capnogram, detected by Y-Piece and sample line connected to (GE Healthcare Finland Oy, E-sCOVX-00- Finland). Bispectral Index (BIS) to assess the depth of sedation (should be between 40-60). Intravenous fluids were given after hypotension till MAP >65mmHg.Results: There was significant increase in MAP and VCO2 and significant decrease in HR after fluid resuscitation and there was no significance difference in BIS, SpO2. There was positive correlation between VCO2 and MAP with sensitivity of VCO2 for fluid responsiveness 92%.Conclusions: VCO2 and EtCO2 are good monitoring toolswhichare well correlated with hemodynamic changes, thus can be used as an indicator for fluid responsiveness and endpoint prediction ofresuscitation.
https://mjcu.journals.ekb.eg/article_54889_2351fd4c84351a9eea2e0b01e9b05281.pdf
2019-06-10
2679
2684
10.21608/mjcu.2019.54889
fluid responsiveness – Volumetric capnography – CO2 production (VCO2) – Hemodynamics
ELHASAB A. EL-GNAIDY, M.Sc.;
LOBNA M. ABO EL-NASR, M.D.
1
AUTHOR
SABRY M. AMEEN, M.D.;
MOHAMMED S. ABD EL-GHAFAR, M.D.
2
The Departments of Anesthesia, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Tanta University
AUTHOR