ORIGINAL_ARTICLE
Spontaneous Spondylodiscitis: Conservative Versus Surgical Management
AbstractBackground: The incidence of spontaneous spondylodis-citis is increasing per year and this attributed to an aging population, increasing prevalence of immunodeficiency and improving radiological technique.Aim of Study: To evaluate the results of conservative versus surgical treatment of spondylodiscitis as regard efficacy, complications and functional outcomes.Patients and Methods: This is a prospective randomized clinical trial study included 16 patients with spontaneous spondylodiscitis presented only with axial spinal pain. They were divided into 2 groups: One managed conservatively and the other surgically.Results: 9 patients were managed conservatively and 7 were managed surgically. After complete course of treatment; only 3 patients of conservative group and 4 patients of surgical group showed fusion assessed by imaging. There was no significant statistically difference between two groups in final clinical outcome using visual analogue scale and MacNab's outcome criteria.Conclusion: Both conservative and surgical methods are sufficient for achieving the goals of treatment of spontaneous spondylodiscitis as both are safe, feasible, and effective procedure in relieving pain.
https://mjcu.journals.ekb.eg/article_60309_7eadce6b711a86d394ff413a4343e7d8.pdf
2018-12-01
3379
3384
10.21608/mjcu.2018.60309
Spontaneous spondylodiscitis – Spondylodiscitis – Discitis – Spontaneous spine infection – Disc infection
ABDALLA R. ABD EL-RAHMAN, M.Sc.;
AHMED A. ISMAIL, M.D.
1
AUTHOR
AHMED F. SHERIF, M.D.;
MOHAMMAD TAGHYAN, M.D.
2
The Department of Neurosurgery, Faculty of Medicine, Assiut University, Assiut, Egypt
AUTHOR
ORIGINAL_ARTICLE
Review Article: Early Onset Scoliosis: Definition, Etiology, Physical Examinations, Classification, and Methods of Treatment
AbstractBackground: Early Onset Scoliosis (EOS) is defined as scoliosis occurring before the age of 5 years. It affects not only the growing spine but also has a direct influence on the cardiopulmonary development and function of the child. Cardiopulmonary function is compromised as a result of decreased size of the thoracic cavity, which has a negative effect on lung alveolar development.The goal in the management of EOS is to control the deformity and allow continued growth of the spine and thoracic cavity.Non-fusion instrumentation facilitates this and allows ongoing respiratory development and optimal cardiopulmonary functions. However some authors describe that early onset scoliosis is that scoliosis starts before the age of 10 years. The debate in these definitions is made because of the differ-ence in spine growth and cardiopulmonary compromise before and after age of five.
https://mjcu.journals.ekb.eg/article_60310_c2b2704164778d1644ae0d343e8c2f58.pdf
2018-12-01
3385
3388
10.21608/mjcu.2018.60310
Early onset scoliosis – Growing rods – VEPTR – Magnetically controlled rods
AMER A.M. EL-SADEK, M.Sc.;
MOHAMMAD GAMAL HASSAN, M.D.
1
AUTHOR
AL-MOATAZ A.Z. EL-SABROUT, M.D.;
MOHAMMAD MOSTAFA AL-SHARKAWI, M.D.
2
The Department of Orthopedic Surgery and Traumatology, Faculty of Medicine, Al-Azhar* and Assiut** Universities, Assiut, Egypt
AUTHOR
ORIGINAL_ARTICLE
Effect of Metformin Pretreatment on Serum Adropin Level in Rats with Adrenalin-Induced Acute Myocardial Infarction
AbstractBackground: Beside adropin's role in energy homeostasis and insulin sensitivity, it is also incriminated in myocardial ischemia. Level of adropin during myocardial infarction (MI) and the effect of metformin pretreatment on serum adropin level in rat models of MI is underinvestigated.Aim of Study: This study investigated the level of adropin in MI and the possible involvement of adropin and endothelial nitric oxide synthase enzyme activity (eNOS) in the cardio-protective effect of metformin during acute myocardial ischemia.Material and Methods: A total of forty adult male albino rats weighing 185-220g were divided equally into four groups Group I: Normal control group. Group II: MI group, which was induced by subcutaneous injection of adrenalin (2mg/kg) in two doses 24 hours apart. Group III: Normal rats which were treated with oral metformin via a feeding tube in a dose of 300mg/kg for 2 weeks. Group IV: Rats with adrenalin-induced MI and pretreated with oral metformin in the same dose and duration before induction of MI on the 13th and 14th days of the study. Serum adropin and eNOS were measured, in addition to cardiac troponin I, Creatine Kinase isoenzyme (CK-MB), and C-reactive protein (CRP). Sections from the heart was stained with Masson's trichrome stain and examined to quantify the degree of ischemic injury at the tissue level.Results: In MI group, both serum adropin level and the eNOS were significantly increased with significant positive correlation between adropin and troponin I, CK-MB, and eNOS in the same group (r= 0.857, 0.97 & 0.845, respectively, p<0.05). However, Metformin pretreatment in group IV, produced significant reduction in the level of adropin accom-panied by significant increase in levels of eNOS enzyme activity in comparison to rats with untreated MI. Additionally histological examination, showed reduction of the inflamma-tory cell infiltration, myocardial fibrosis and necrosis. More-over, there was a positive correlation between adropin and eNOS in the same group (r=0.682, p<0.05).Conclusion: Adropin and eNOS enzyme play a vital role in the pathophysiology of acute myocardial infarction. In addition, the cardioprotective effect of metformin pretreatment in this condition depends on enhancing the activity of eNOS enzyme independent on adropin level.
https://mjcu.journals.ekb.eg/article_60311_f2725d124547e25405fc94887557f704.pdf
2018-12-01
3389
3395
10.21608/mjcu.2018.60311
Adropin – eNOS – Metformin – MI– Rat model
EBTESAM M. IBRAHIM, M.D.;
ALAA I. ALI, M.D.
1
AUTHOR
MAHMOUD M.A.
ABULMEATY, M.D.
2
The Department of Physiology* and Pharmacology**, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Effect of Chronic Regular Swimming Exercise on Thyroid Function in Ovariectomized Rats
AbstractBackground: Thyroid dysfunction may occur in women in menopausal period or after ovariectomy. Effect of exercise on thyroid function remains controversial and need more investigations.Aim of Study: This study was done to investigate the effect of chronic regular swimming exercise on thyroid function in ovariectomized rats.Material and Methods: Rats were divided into 6 groups (7 rats per each); Sham-operated sedentary (sham-S) group, (2) Sham-operated with swimming exercise training (sham + Ex) group, (3) Ovariectomized sedentary (OVX-S) group, (4) OVX-group with swimming exercise training (OVX + Ex), (5) OVX-group injected with 17-b estradiol (OVX + E), (6) OVX-group with swimming exercise training and injected with 17-R estradiol (OVX + Ex + E). 3 months after the surgery, rats were exposed to the exercise protocol for another 3 months. BMI was calculated. At the end experimental period, the serum levels of T3, T4, TSH, estradiol and interleukin-6 (IL-6) were determined. The thyroid glands were weighed. The histopathological examination of thyroid tissue was done for determination of epithelial cell height, follicular and colloidal areas.Results: In OVX-S group, final BMI was significantly increased, serum levels of T3 and T4 were significantly decreased with significant increase of serum TSH level as compared with Sham-S group. While, as compared to OVX-S group, final BMI was significantly decreased, T3 and T4 levels were significantly increased with decrease of TSH level in OVX-treated groups. Estradiol level was significantly decreased in OVX-S group compared to sham-S group. While, in comparison with OVX-S group, its level significantly increased in OVX-treated groups. Serum IL-6 was insignificant changed between Sham-S, OVX-S and OVX + E groups. But, it significantly increased in Sham-Ex, OVX + Ex and OVX + Ex + E groups as compared to Sham-S, OVX-S and OVX + E groups. Histopathological examination showed significant decrease of the thyroid gland weight and height of epithelial cells, with significant increase in the follicular and colloidal areas in the OVX-S group as compared to sham-S group. These histopathological changes were improved in OVX-treated groups.Conclusion: We concluded that regular swimming exercise in OVX-rats ameliorated the thyroid hypofunction which may be related to its ability to increase estradiol level in these rats.
https://mjcu.journals.ekb.eg/article_60312_fa15e706930665ffa6c221378f368bca.pdf
2018-12-01
3397
3406
10.21608/mjcu.2018.60312
Swimming exercise – Thyroid function – Ovariec-tomized rats – 17-b estradiol
MERVAT H. EL-SAKA, M.D.;
NERMIN M. MADI, M.D.
1
AUTHOR
HALA E.
METWALI, M.D.
2
The Departments of Physiology* and Biochemistry**, Faculty of Medicine, Tanta University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Effects of Monosodium Glutamate on the Liver of Male Adult Albino Rat and the Possible Protective Role of Vitamin C (Light and Electron Microscopic Study)
AbstractBackground: Monosodium glutamate (MSG) is the sodium salt of glutamate. When MSG is added to foods, it provides a flavoring function similar to naturally occurring free gluta-mate. It is found in unlimited amounts in a wide variety of packaged foods such as processed meat, semi-preserved fish and food supplements. Vitamin C is a strong reducing agent and as an antioxidant. It is involved in prevention of the damaging effects of free radicals.Aim of Work: The aim of this study was to study the potential protective effect of Vitamin C on liver damage caused by monosodium glutamate in adult male rats using light and Electron microscope.Material and Methods: Sixty adult albino rats were used. The animals were equally divided into three groups each of them consists of 20 rats: Group I: "Control" were given saline daily by oral route "for one month. Group II: Were given monosodium glutamate (4gm/kg of body weight/day, dissolved in saline orally) for one month. Group III: Were given vitamin C (500mg/kg of body weight of /day, orally) then after 2 hours were given monosodium glutamate (4gm/kg of body weight/ day, dissolved in saline orally) for one month. At the end of the experiment, the rats were anaesthetized by ether then perfused with saline then with the appropriate fixator (Formalin 10%). The abdomen was opened and the liver of the control and treated animals was extracted, cut, and processed for light and transmission electron microscopic studies.Results: MSG caused distortion of the arrangement of liver cords around the central veins. There was vacuolation of hepatocytes of the liver at light and electron microscopic examination and morphmetric studies. Administration of Vitamin C could attenuate these changes.Conclusion: MSG caused degenerative changes in the liver. Addition of vitamin C decreased those toxic effects of MSG.
https://mjcu.journals.ekb.eg/article_60313_968f681230b2aee0b04f28d8ea685ec1.pdf
2018-12-01
3407
3418
10.21608/mjcu.2018.60313
Liver – Monosodium glutamate – Vitamin C
MOHAMED A. DOSUKY, M.D.;
DORREIA A. ZAGHLOL, M.D.
1
AUTHOR
SALWA M. OUIES, M.D.;
HANAA A. ABDEL-NAEIM, M.Sc.
2
The Departments of Anatomy & Embryology, Faculty of Medicine, Al-Minia* & Assiut** Universities and Human Anatomy & Embryology, Faculty of Medicine, Sohag University***, Sohag, Egypt
AUTHOR
ORIGINAL_ARTICLE
The Effect of Kinesiotape on Unilateral Sciatica
AbstractBackground: Kinesio Taping is a therapeutic tool used for treatment of musculoskeletal disorders. However, there is little scientific evidence that describes its clinical efficacy.Aim of Study: To investigate the effect of KT on radicular pain, sciatic nerve mobility, and functional disability in patients with unilateral sciatica.Methods: This study was conducted from July 2017 to February 2018 on thirty patients (11 females, 19 males) with unilateral sciatica caused by lumbar disc herniation (LDH). Their age ranged from 30-40 years. All patients were referred by orthopedic surgeons who are responsible for diagnosis based on clinical and radiological examination. All patients were randomly allocated into 2 groups: Group (A) included 15 patients received Kinesio tape (KT) plus neural mobiliza-tion, group (B) included 15 patients received neural mobili-zation only, for 2 sessions per week for 3 weeks.Methods: Visual Analogue Scale (VAS) was used to assess radicular pain. Universal goniometer was used to assess sciatic nerve mobility via range of motion of hip flexion testing. Oswestry disability questionnaire (ODI) was used to assess Functional status.Results: Showed that both groups had improvement of the radicular pain (p=0.001 *), sciatic nerve mobility (p-value =0.0001*), and functional disability (p-value=0.0001 *). To favor of KT group except in sciatic nerve mobility was insignificant between groups.Conclusion: It can be concluded that KT added to neural mobilization are effective treatment for unilateral sciatica caused by lumbar disc herniation.
https://mjcu.journals.ekb.eg/article_60314_065753726e7075e56f8b359e74b109b0.pdf
2018-12-01
3419
3432
10.21608/mjcu.2018.60314
Lumbar disc herniation (LDH) – Kinesio tape (KT) – Neural mobilization – Visual Analogue Scale (VAS) and Oswestry disability questionnaire (ODI)
HEBA ALLAH E. MOHAMED, M.Sc.;
NADIA A. FYAZ, Ph.D.
1
AUTHOR
EBTESSAM F. GOMAA, Ph.D.;
ESLAM A. TABEL, M.D.
2
The Department of Physical Therapy of Benha Fever Hospital, El-Qalubya*, Physical Therapy for Orthopedics, Faculty of Physical Therapy, Cairo University** and Orthopedic Surgery, Faculty of Medicine, Benha University***, Egypt
AUTHOR
ORIGINAL_ARTICLE
Posterior Fossa Intra-Axial Tumors: Surgical Outcomes
AbstractBackground: Central nervous system tumors are the most common solid tumors in children; posterior fossa tumors in children account for about 54%–70% of all brain tumors, while 15% to 20% of adult brain tumors occur in the posterior fossa.Aim of Study: To document the short-term surgical out-comes of posterior fossa intra-axial tumors in patients presented with manifestations of raised intracranial pressure, brain stem and or cerebellar compression.Patients and Methods: Thirty patients diagnosed with posterior fossa intra-axial tumors, presented to Neurosurgery departments, Qena University Hospital, South Valley Univer-sity and Assiut university hospital, from January 2014 to January 2016 were enrolled in this study. Complete clinical and neuroimaging evaluation of the patients was done. All patients underwent microscopic surgical excision. Patients were followed-up clinically and radiologically immediately and within one month postoperatively. The complications noted were documented. The statistical analysis was done using SPSS software (version 16.0).Results: This study included 22 children and eight adults with a mean age 19.367±18.213 (SD). Increased intracranial pressure and/or ataxia were the main manifestations. Twenty-one patients showed significant post-operative symptomatic improvement when compared with pre-operative conditions, while the remaining nine patients showed either no improve-ment or more severely affected afterward two of them have died. Hydrocephalus was the most common post-operative complications and managed by insertion of a ventriculoperi-toneal shunt.Conclusion: The surgical outcome of patients with intra-axial posterior cranial fossa tumors is good due to early correct diagnosis, the advent of microsurgical techniques, proper selection of the appropriate surgical approach and the proper treatment of post-operative complications.
https://mjcu.journals.ekb.eg/article_60315_1dbe3599f29c5d75da279e7f7a83966b.pdf
2018-12-01
3433
3439
10.21608/mjcu.2018.60315
Brain tumors – Posterior cranial fossa – Intra-axial – Surgical treatment
ALI R. HAMDAN, M.D.;
ABD EL-HAKEEM A. ESSA, M.D.
1
The Department of Neurosurgery, Faculty of Medicine, South Valley University, Qena* and Assiut** Universities, Assiut, Egypt
AUTHOR
ORIGINAL_ARTICLE
Endoscopic Interlaminar Discectomy Using Simple Technique Without the use of Complicated Industrial Tubular Systems
AbstractBackground: The fully endoscopic and microscopic dis-cectomy are the most widely used minimally invasive spine decompression techniques nowadays. All Different techniques have been described in the literature for the fully endoscopic lumbar discectomy using tubular systems were used with a limitation of work.Objective: To assess our modified surgical technique of endoscopic interlaminar discectomy using simple port, custom made, and the ordinary sinoscope without the use of compli-cated industrial tubular systems.Study Design: This study is a retrospective clinical study included fifteen patients with unilateral radiculopathy due to L4-5, L5-S 1 disc herniation and unilateral lateral recess stenosis, underwent endoscopic decompression surgery using our technique in the period from May 2013 to September 2015 at Neurosurgery Department, Benha University Hospital. The mean period of follow-up was 25.05±3.79 months.Methods: Analysis was performed with the use of pain intensity and functional outcome assessment scales before and after surgery. Complications and radiographic findings were analyzed.Results: Fifteen patients were studied, nine males (60%) and six females (40%) with mean age 45.5±8.66 (ranging from 21-65 years). Leg pain was reduced from an average NRS of 8.5 preoperatively to 1, 0.5, and 0.3 at 1, 2 and 4 weeks post operatively. Pre operative low back pain improved from an average NRS of 7.6 to 2, 1 and 0.5 at 1, 2 and 4 weeks postoperatively The average QDS reduced from 58 to 35, 20 and 16 at 1, 2 and 4 weeks postoperatively.Conclusion: The endoscopic interlaminar discectomy is an efficient surgical technique for management of unilateral radiculopathy caused by lumber disc herniation and lateral recess stenosis using simple tools without the need for highly expensive endoscopic spine tubular systems offered by the spine companies.
https://mjcu.journals.ekb.eg/article_60316_3b3eb468aad372d8c58a8225b2124c48.pdf
2018-12-01
3441
3449
10.21608/mjcu.2018.60316
Endoscopic– Interlaminar discectomy
MOHAMMED H. EL
TANTAWY, M.D.
1
The Department of Neurosurgery, Faculty of Medicine, Benha University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Doppler Ultrasonography of Foetal Middle Cerebral and Umbilical Arteries in High Risk Pregnancy
AbstractBackground: Foetal hypoxemia is associated with in-creased impedance to flow in the umbilical artery (UA) and decreased impedance in the fetal middle cerebral artery (MCA).Aim of Study: To evaluate Doppler of foetal Middle cerebral (MCA) and Umbilical (UMA) arteries in high risk pregnancies.Patients and Methods: This prospective cross-sectional study was carried on 100 patients at Menoufia university hospital in the period from March 2017 to Febraury 2018 using a 2-5MHz transabdominal probe (GE LOGIC p5 and GE LOGIC p7). The study including two groups, group (A) High risk group: Including 50 patients with pregnancy above 27 weeks presenting with high risk pregnancy, and group (B) control group: Including 50 patients with normal pregnancy above 27 weeks, Doppler examination for both MCA and UMA was done.Results: Out of the fifty pregnant women in Group A, there were 18 cases with abnormal UMA Doppler, 14 cases with abnormal MCA Doppler indices and 10 cases with abnormal cerbroplacental (CPR ). For estimating the associ-ation between high risk pregnancy and resistive index ( RI ) and pulsatility index (PI) of both UMA and MCA for predicting foetal outcome, RI of UMA showed sensitivity and specificity of 70% and 60% and accuracy of 63% and MCA RI showed sensitivity of 74%, specificity of 48% and accuracy of 61%.Conclusion: Doppler ultrasonography of foetal middle cerebral and umbilical arteries plays important role in high risk pregnancies and predicting foetal outcome.
https://mjcu.journals.ekb.eg/article_60317_d1887d1239cb537990bb4d08a20dffc5.pdf
2018-12-01
3451
3458
10.21608/mjcu.2018.60317
Doppler – Foetal outcome – High risk pregnancy – Middle cerebral – Umbilical
EL-SAYED E. EL-SAYED, M.D.;
REHAB M. HABIB, M.D.
1
AUTHOR
MARWA M.
MENISY, M.Sc.
2
The Department of Radiodiagnosis, Faculty of Medicine, Menoufia University* and The Department of Radiology, Egyptian Ministry of Health**, Cairo
AUTHOR
ORIGINAL_ARTICLE
Reconstruction of Comminuted Frontal Bone Fractures by Rib Graft or Titanium Mesh: Assiut University Hospital Experience
AbstractBackground: Frontal bone fractures are one of the common craniofacial fractures [1]. These fractures usually associated with serious complications, such as cerebrospinal rhinorrhea with potential ascending infection, meningeal and intracranial lacerations, obstruction of the lacrimal drainage and nasal airway and oculomotor dysfunction.Aim of Work: To compare the outcome of reconstruction of comminuted frontal bone fractures by rib graft and titanium mesh.Patients and Methods: This study was carried out on 40 patients with comminuted frontal bone fractures and subdivided into 2 groups, group (I) reconstruction of comminuted frontal bone fractures by rib graft and group (II) reconstruction of comminuted frontal bone fractures by titanum mesh.Results: Group I: The patients were hospitalized for an average of 12 days.Patients generally showed remarkable neurologic improve-ment during their hospital stays, considering the tremendous force of impact. No delayed CSF leaks had occurred at the time of the most recent follow-up (range: 6 months). Good cosmetic results (satisfactory to the evaluating physician and the patient or family) with no gross surface deformities were obtained in 16 patients (80%). Group II: The patients were hospitalized for an average of 12 days.Patients generally showed remarkable neurologic improve-ment during their hospital stays, considering the tremendous force of impact. No delayed CSF leaks had occurred at the time of the most recent follow-up (range: 6 months). Good cosmetic results (satisfactory to the evaluating physician and the patient or family) with no gross surface deformities were obtained in 18 patients (90%).Conclusion: Autogenous bone grafts such as iliac or rib require a second surgical site. This may lead to donor site morbidity, inability to obtain adequate bone for large defect. The advantages of employing titanium Mesh consist, not only in the optimal stabilization of the fracture, but also in its excellent biocompatibility and in the minimal inflammatory reactions it provokes, as well as the ease with which it adapts to different shapes; furthermore, titanium produces only minimal artifacts on MRI and CT. Disadvantages include infection, limitation of growth and it may fracture and requires time for shaping and curing. The risk of infection may be reduced by adding antibiotic and using it under sterile condi-tions, beneath well-vascularized skin.
https://mjcu.journals.ekb.eg/article_60318_db427b731b3b7959ed4fdac409935626.pdf
2018-12-01
3459
3466
10.21608/mjcu.2018.60318
Frontal bone fractures – Comminuted rib graft – Titanium mesh – Assiut University
SALAH EL-DIEN G. SHALTOUT, M.D.;
MOHAMMED H. OSMAN, M.D.
1
AUTHOR
WAEL M. ALI, M.D.;
MOHAMMED S. SHAHINE, M.D.
2
The Department of Maxillofacial Surgery, Faculty of Medicine, Assiut University, Assiut, Egypt
AUTHOR
ORIGINAL_ARTICLE
The Use of Serum Survivin and AFP-L3 and their Combination in Improving Hepatocellular Carcinoma Diagnosis Especially in Patients with Low Serum AFP
AbstractBackground: Hepatocellular carcinoma (HCC) is respon-sible for about 4.7% of chronic liver disease in Egypt. Survivin is an essential element in apoptosis inhibition. Survivin is present in fetal and malignant adult tissue and is absent in non malignant tissues. A diagnostic and prognostic HCC marker is the alpha-fetoprotein (AFP) binding to Lens culinaris agglutinin (AFP-L3%) percentage. There is a need for HCC marker that is better than AFP especially in those low AFP.Aim of Study: To detect the role of determination of serum Survivin gene, AFP-L3% and their combination in HCC diagnosis.Subjects and Methods: Fifty HCC patients and 20 healthy control persons were subjected for measurement of serum AFP, survivin gene and AFP-L3%. Reverse transcription-polymerase chain reaction (RT-PCR) was used for detection of serum survivin gene. AFP-L3% was measured by a liquid-phase binding assay on the Wako LiBASys clinical auto analyzer.Results: Serum Survivin gene was positive in 27 (54%) HCC cases and negative in 23 (46%) cases. AFP-L3% was detected in 36 (72%) HCC cases. The combined use of serum servivin gene and AFP-L3% were positive in 43 (86%) of HCC cases. In 22 HCC cases with serum AFP below 200 ng/ml serum servivin gene was detected in 9 (40.9%) cases but AFP-L3% was positive in 13 (59.9%) cases and the combined use of positive serum servivin and AFP-L3 were present in 18 cases (81.18%).Conclusions: The combined use of serum survivin gene and AFP-L3% could have a valuable diagnostic role in HCC especially in those with low AFP.
https://mjcu.journals.ekb.eg/article_60585_7e8d6c374357b80d87b81272db92292a.pdf
2018-12-01
3467
3472
10.21608/mjcu.2018.60585
HCC – Survivin – AFP – AFP-L3 – Tumor markers
MAHMOUD MOAWAD, Ph.D.;
ANWAR MOHAMED, M.D.
1
The Departments of Surgical Pathology, National Cancer Institute, Cairo University* and Hepatology, National Liver Institute, Menoufia University**, Menoufia, Egypt
AUTHOR
ORIGINAL_ARTICLE
Differentiation of Malignant from Benign Portal Vein Thrombi on CT Images Using Thrombus Density
AbstractBackground: Portal vein thrombosis described as the presence of a clot in the portal vein lumen or a permanent obliteration of the portal vein as a result of prior thrombosis with replacement by numerous tortuous venous channels (termed cavernoma). Malignant portal vein thrombus, so named for its neoplastic origin, is a common complication of HCC, and, in some cases, it may be even the initial sign of an undetected HCC. Detection of malignant PVT in a patient with liver cirrhosis heavily affects the therapeutic strategy.Aim of Study: The purpose of this study was to investigate the role of CT thrombus density (measured in Hounsfield Units) in distinguishing between neoplastic and bland portal vein thrombosis on arterial and portal venous phases.Material and Methods: In this study, 30 patients underwent contrast-enhanced CT of abdomen & pelvis were included for characterization of portal vein thrombosis. Assessment of portal vein thrombosis was performed by measuring of CT attenuation values of the thrombi in Hounsfield Units (HU).ROC (Receiver Operating Characteristic) curves were used to identify accuracy and optimal cutoff values.Results: Of the 30 CT studies, 14 neoplastic thrombi and 13 bland thrombi were identified on the images. CT thrombus density (measured in Housinfield Unit) to differentiate neo-plastic from bland thrombus. The AUCs was 0.98 in arterial phase and 0.98 in portovenous phase for thrombus density.The optimal cut off in arterial phase is 47 and in porto-venous phase is 50.Conclusion: CT attenuation values allow reliable differ-entiation between neoplastic and bland thrombi on arterial and portal venous phase CT examination.
https://mjcu.journals.ekb.eg/article_60586_d8ed20dd69fd0970fc67941f1a388337.pdf
2018-12-01
3473
3477
10.21608/mjcu.2018.60586
Triphasic CT – PVT – CT density
MONA F.A. HANNOUT, M.Sc.;
ADEL M. AL-WEKIL, M.D.
1
AUTHOR
REHAB M.
HABIB, M.D.
2
The Department of Radiology, Faculty of Medicine, Menofiya University, Menofiya, Egypt
AUTHOR
ORIGINAL_ARTICLE
The Precise Local Tumor Characteristics of Supraglottic Carcinoma: A Comparison between Clinical, Radiological and Pathological Findings
AbstractBackground: In most cases of supraglottic cancer the tumor has already involved more than one sub site including a broad surface of mucosa with asymmetric extension in both surface and depth. In order to achieve proper loco-regional control of supraglottic cancer while at the same time providing the best possible results regarding organ preservation, knowl-edge of accurate tumor extension is necessary. This is achieved by thorough clinical, radiological and post-operative patho-logical assessment.Aim of the Study: Determine the accurate extension of supraglottic squamous cell carcinoma by whole organ section-ing and comparing it with radiological and endoscopic findings.Material and Methods: This study included 36 patients suffering from Laryngeal carcinoma originating from the supraglottic larynx. Direct laryngoscopy was done for all patients under general anesthesia for detailed primary tumor assessment. Detailed radiological assessmentusing C.T with contrast was done. Detailed histopathological examination by whole organ sectioning was done for the laryngectomy specimen.Results: Radiological assessment was superior to clinical assessment in detection of tumor extension. On comparing radiological and pathological assessment the percentage increase of invasion of the paraglottic space and strap muscles were the only variables that were statistically significant (p-value=0.025, 0.001 respectively). On comparing clinical and pathological assessment base of tongue, vallecula and pyriform sinus were found to increase significantly statistically by pathological assessment (p-values=0.025, 0.046, 0.046 respec-tively).
https://mjcu.journals.ekb.eg/article_60587_9f969bf7d915c83ca926d2374e6ba407.pdf
2018-12-01
3479
3485
10.21608/mjcu.2018.60587
Supraglottic – Squamous cell carcinoma – Clinical – Radiological – Whole organ sectioning
HESHAM NEGM, M.D.;
HESHAM FATHY, M.D.
1
AUTHOR
MOHAMED MOSLEH, M.D.;
AHMED FARAHAT, M.D.
2
AUTHOR
GAMAL KANDIL, M.D.;
AMAL HAREEDY, M.D.
3
The Departments of Otolaryngology Head and Neck Surgery* and Pathology**, Kasr El-Aini University Hospital, Cairo University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Comparison of Measurements from the Heidelberg Edge Perimetry with Standard Automated Perimeter in Glaucoma Patients
AbstractBackground: Testing of the visual field remains the primary basis for evaluating glaucomatous visual function. Recently there have been innovations for perimetry that enhance its clinical utility the visual field was first measured by Thomas Young, in 1825, the outer aspect extends approx-imately 50º superiorly, 60º nasally, 70º inferiorly and 90º temporally.Aim of Study: To compare visual field examination pa-rameters, Mean Deviation (MD), Pattern Standard Deviation (PSD) in glaucoma patients performed on two different devices: Heidelberg Edge Perimeter (HEP) and Humphrey Visual Field analyser (HVF).Patients and Methods: This is a randomized prospective, comparative, study conducted on thirty four eyes diagnosed as primary open angle glaucoma, those patients were recruited from the ophthalmic outpatient clinics at Rod-elfarag ophthal-mic hospital in Cairo & Imbaba Ophthalmic Hospital in Giza at time between May 2016 to June 2017. They had reliable visual field test and controlled by anti-glaucoma treatment without any other cause of secondary increased Intra Ocular Pressure (IOP), any surgical or laser intervention.Results: There were a total of thirty four eyes where visual field examination by Heidelberg Edge Perimeter (HEP) and Humphrey Visual Field analyser (HVF) revealed no statistically significant difference between two perimeters except in severe glaucoma in which HVF showed more increase in PSD than HEP.Conclusion: HVF tend to presents an increase in the level of PSD in severe glaucomatous defect than those measured by HEP.
https://mjcu.journals.ekb.eg/article_60588_bb07a2b6fb20b78f9658a068eaa0fc86.pdf
2018-12-01
3487
3491
10.21608/mjcu.2018.60588
Glaucoma – Heidelberg edge perimeter – Perim-etry – Visual field
HANY A. KHAIRY, M.D.;
MARWA A. ZAKY, M.D.
1
AUTHOR
ABD EL-RAHMAN A.
ISMAEL, M.Sc.
2
The Department of Ophthalmology, Faculty of Medicine, Menofuia University* and The Department of Clinical Ophthalmology, Ministry of Health, Imbaba Ophthalmic Hospital. Giza**, Egypt
AUTHOR
ORIGINAL_ARTICLE
The Role of Erythropoiesis on Hepcidin Level in Polytransfused b-Thalassemia Major Patients
AbstractBackground: Hepcidin peptide hormone is a main con-troller of iron homeostasis, itbecomes elevated in case of iron overload, however despite iron overload in b-Thalassemia major (b-TM) patients a contradictory decrease in Hepcidin occurs. The incompatible Hepcidin level is the main responsible factor causing the iron overload status in iron-loading anemias such as (b-TM) which contributes to organ dysfunctionand to iron toxicity.Aim of Study: To evaluate the conflicting effect of increased erythropoiesis in contrast to the effect of iron overloading on Hepcidin serum level and its correlation with iron status in (b-TM) patients.Subjects and Methods: For all patients and controls Complete Blood Count (CBC), serum assaysof Hepcidin, iron, ferritin, transferrin, HCVAbs, HBs Ag, CRP and serum level were performed.Results: Hepcidin level was significantly lowered in (b-TM) patients compared to controls with high significant difference (p=0.00). There was no correlation between serum Hepcidin and ferritin level, neither was between Hepcidin and serum iron, transferrin, Hb level and reticulocyte count in the study group. Hepcidin/Ferritin ratio showed high significance difference (p<0.000) with mean value in the study group 0.056 vs. 4.75 in controls pointing to an incom-patible levels of Hepcidin to iron overload status. Hepcidin level wasnegative correlatedwith age (p<0.05).Conclusion: Hepcidin was markedly decreased in the study group with no significant correlation between serum Hepcidin and ferritin level as a marker of iron overload in thalassemia major. Hepcidin deficiency is the main contributing factor of iron overload in b thalassemia which results from a strong suppressive effect of the high erythropoietic activity on Hepcidin expression. Hepcidin-ferritin ratio was markedly depressed <1 in all b thalassemia major patients which indicating suppression of Hepcidin out of proportion with the degree of iron loading.
https://mjcu.journals.ekb.eg/article_60589_aa08a0a659b0fd841e65c6af219f3643.pdf
2018-12-01
3493
3497
10.21608/mjcu.2018.60589
Hepcidin – Iron – Thalassemia – Transferrin – Ferritin
EMAN M.N. ABD EL-SALAM, M.D.;
MARWA M.M. TOLBA, M.Sc.
1
AUTHOR
MAHMOUD Y. EL-TAHTAWY, M.D.;
TAGHREED K. EL-DEIN, M.D.
2
AUTHOR
WAFAA S. MOHAMMED, M.D.;
MOSTAFA M. EMBABY, M.D.
3
AUTHOR
KHALED A. NASIF, M.D.;
EBTESAM M. EL-GEZAWY, M.D.
4
AUTHOR
ORIGINAL_ARTICLE
Study and Management of Fracture Mandible among Patients Admitted to Assiut University Hospital
AbstractBackground: Mandible fractures are a frequent injury because of the mandibular prominence and relative lack of support. As with any facial fracture, consideration must be given for the need of emergency treatment.Aim of Study: This study attempts to define current patterns of fracture mandible based on “414” patient demographics and mechanism of injury and variable methods of treatment in Assiut University Hospital in the period from (March 2014 to December 2016).Patients and Methods: This study is a retrospective anal-ysis of medical records available with Trauma Unit Assiut University Hospital. In period from March 2014 to December 2016 “414” patients.Results: There were higher percentage in road accident (69.80%) and (19.80%) fall from height. There were (47.82%) of fracture in body, (3 6.95%) of cases in symphyseal, para-symphyseal. There were (60.86%) of cases had done by open reduction & intend fixation “ORIF” vs. (36.95%) of cases done by closed reduction and (2.2%) of cases treatment conservative. There were (27.77%) of cases have mouth opening normal with (69.0%) have normal occlusion. As regard there were (3.14%) of cases have infection post-operative.Conclusion: As regard there were higher in percentage in function, infection risk of anesthesia and fixation in ORIF group than closed reduction with highly significance difference.
https://mjcu.journals.ekb.eg/article_60590_dbad0c554480578aea8e4edb726a0760.pdf
2018-12-01
3499
3504
10.21608/mjcu.2018.60590
Mandible fractures – open reduction – Intend fixation “ORIF”
SALAH EL-DEIN G. SHALTOUT, M.D.;
MOHAMED H. OSMAN, M.D.
1
AUTHOR
MOHAMMED S. SHAHIN, M.D.;
MOSTAFA G. IBRAHIM, M.Sc.
2
The Departments of Oral & Maxillofacial Surgery* and General Surgery**, Faculty of Medicine, Assiut University, Assiut, Egypt
AUTHOR
ORIGINAL_ARTICLE
Exploring Risk Factors with Ventilator Associated Pneumonia among Infants in Intensive Care Units
AbstractBackground: Ventilator Associated Pneumonia (VAP) is defined as pneumonia occurring more than 48 hours after child is intubated and ventilated mechanically; VAP is the second most common hospital-acquired infection in pediatric Intensive Care Units, which linked to increased morbidity, mortality, lengths of stay in the hospital and intensive care unit with high costs.Aim of Study: The current study aimed to explore the risk factors of VAP among infants in Intensive Care Units.Subjects and Methods: A descriptive exploratory design was used to achieve the current study.Setting: The current study conducted at Pediatric Intensive Care Units at Pediatric University Hospital and Specialized Pediatric Hospital which affiliated to Cairo University Hos-pitals.Sample: A convenience sample of 54 mechanically ven-tilated infants for more than 48 hours enrolled in the study.Tools: The required data was collected by using risk factors assessment sheet and standardized observational checklists which consist of three parts: General infection control measures, nasogastric tube feeding and endotracheal tube suctioning.Results: The current study results revealed that, more than half of infants were less than 6 months of age, nearly two-thirds are males, and near to three quarters of infants developed VAP. Prior antibiotic use, sedatives administration, absence of routine oral care, previous non-invasive ventilation, reintubation, length of stay on mechanical ventilation and PICUs, coma, inadequate general infection control measures, inadequate endotracheal tube suctioning technique, supine position, inadequate nasogastric tube feeding technique, presence of nasogastric tube and oral route of endotracheal tube were statistically significant risk factors associated with VAP. More than half of VAP infants died during period of hospitalization.Conclusion: Prior antibiotic use was the only independent risk factor for incidence of VAP; and sedatives administration, absence of routine oral care, previous non-invasive ventilation, reintubation, length of stay on mechanical ventilation and PICUs were the major risk factors of VAP among infants in pediatric Intensive Care Units.Recommendations: Inservice training program should be conducted for pediatric intensive care nurses about prevention of VAP among infants. Also, similar studies should be con-ducted on large sample and different settings.
https://mjcu.journals.ekb.eg/article_60591_12c37bf698260e8241beff58e95ea269.pdf
2018-12-01
3505
3518
10.21608/mjcu.2018.60591
Pediatric intensive care unit – Mechanical ven-tilation – ventilator-associated pneumonia – Risk factors – Infants
FATMA E. DAGHER, M.Sc.;
AZZA A. ATTIA, M.D.
1
AUTHOR
NAGLAA F. MAHMOUD, M.D.;
AHMED M. BADR, M.D.
2
The Department of Pediatric Nursing, Faculty of Nursing* and The Department of Pediatric Medicine, Faculty of Medicine**, Cairo University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Outcome of Second Line Chemotherapy (Gemcitabine, Dexamethasone, and Cisplatin) in Relapsed and Refractory Non Hodgkin Lymphoma
AbstractBackground: The treatment of patients with relapsed or refractory non-Hodgkin lymphoma remains challenging. The strategy for management of relapsed or refractory disease is to deliver salvage chemotherapy, followed by autologous stem-cell transplantation in responding patient. Such salvage therapies typically consist of cytotoxic agents that have not been used in first line therapy.Aim of Study: In this study we are trying to study one of the salvage chemotherapy lines which is GDP regarding response rate, quality of life and toxicity.Patients and Methods: Seventy patients diagnosed as refractory or relapsed NHL were included in the study; all patients received GDP for 4 to 6 cycles. Primary end point was to evaluate overall response to treatment; secondary end point was to evaluate quality of life and toxicity. An informed written consent was obtained from all the patients and approval of Research Ethics Committee of Assiut, Faculty of Medicine was obtained prior to the study.Results: The overall response was 65% with complete response 25% and partial response 40%. Regarding quality of life it was noticed that 32.9% patients using GDP were improved, 40% were stable patients while significant deteri-oration occurred in 27.1%. Regarding toxicity profile, occur-rence of neutropenia was 50% with grade III-IV 15%, throm-bocytopenia 40% with grade IV-V 5%, anemia 60% with grade II-III 7%. Nausea 50% with grade III-IV 3%, vomiting 40% with grade III-IV 10%, diarrhea 34.3% with grade II-III 5%. Renal toxicity 31.4% with grade I-II 15%, neurological toxicity 40% grade I-II 10%. Hepatic toxicity 25.7% with grade I-II 20%.Conclusion: GDP is effective as second line chemotherapy with good response rate, quality of life and a manageable range of toxicity.
https://mjcu.journals.ekb.eg/article_60592_e2586cc6facc3135bc9a3d0d6cdb1bb2.pdf
2018-12-01
3519
3524
10.21608/mjcu.2018.60592
GDP – NHL – Relapsed – Refractory lymphoma
YOUSRYEIA A. AHMAD, M.D.;
RANIA HAFEZ, M.D.
1
AUTHOR
SABRIN REFAAT, M.Sc.;
MARWA ISMAIL, M.D.
2
The Department of Internal Medicine, Clinical Hematology Unit* and The Department of Clinical Oncology**, Faculty of Medicine, Assiut University, Assiut, Egypt
AUTHOR
ORIGINAL_ARTICLE
Role of Complete Blood Picture in Predicting the Etiology of Extrahepatic Cholestasis
AbstractBackground: Extrahepatic cholestasis is a common prob-lem worldwide and faced in daily practice however it's etiology has a wide range, before starting treatement it is mandatory to reach the cause of the disease. Investigative tools such as computerized tomography, magnetic resonance cholangiopan-creatography etc are expensive, not available in every centers, moreover their accuracy not reaching 100%.Aim of Study: To analyse the role of complete blood count parameters namely RDW, MPV, PDW, PCT, N/L ratio, P/L ratio which are cheap and already available in 1ry care centers in assessment of extrahepatic cholestasis.Patients and Methods: It is a cross-sectional comparative descriptive study conducted during a period of one year starting from 1/3/2016 to 28/2/2017 at Al-Rajhy Liver Hospital, Assiut University Hospitals, on patients presented with defin-itive evidence of extrahepatic cholestasis by clinical exami-nation, laboratory evidence and trans-abdominal ultrasonog-raphy.Results: Thirty eight patients having extrahepatic cholesta-sis were included in the final analysis with a mean age of 47 years of them 14 patients were male. And 10 cases were taken as a control group of them 6 cases were male. Comparing between different etiological types of extrahepatic cholestasis as regards six parameters of the complete blood pictures namely RDW, MPV, PDW, PCT, N/L ratio, P/L ratio shows no significant differences between them. But MPV and PDW were significantly elevated in malignant distal group than control group.Conclusion: Complete blood count parameters namely RDW, MPV, PDW, PCT, N/L ratio, P/L ratio have no significant role in the differentiation between different etiologies of extrahepatic cholestasis. But MPV and PDW were significantly elevated in malignant distal extrahepatic cholestasis than cases without hyperbilirubinemia.
https://mjcu.journals.ekb.eg/article_60593_d59f685aff126ccb854c8c7db1c1e265.pdf
2018-12-01
3525
3532
10.21608/mjcu.2018.60593
Extrahepatic cholestasis – Complete blood count – Malignant – Calcular
WAEL M. MORSY, M.Sc.;
ESAM A. EL-BEIH, M.D.
1
AUTHOR
MUHAMMAD A.
EL-MASRY, M.D.
2
The Department of Internal Medicine, Al-Eman General Hospital* and Faculty of Medicine, Assiut University Hospitals**,*** and Department of Tropical, Al-Rajhy Liver Hospital***
AUTHOR
ORIGINAL_ARTICLE
Prospective Evaluation of Surgical Management Strategy of Thyroid Diseases in Assiut University Hospitals, A Clinical Audit
AbstractBackground: Thyroid surgery is the mainstay of the treatment of surgical goiters. Treatment modalities for the surgical management of goiter include lobectomy, sub-total thyroidectomy, near-total thyroidectomy and total thyroidec-tomy.Aim of Study: To compare current surgical management of thyroid diseases in Assuit University Hospital with man-agement guidelines, planning for improving our management of thyroid diseases and correct obstacles to achieve reduction in the morbidity and mortality result from thyroid diseases.Patients and Methods: Our study included 60 patients who were admitted to General Surgery Department with any thyroid disease during a period of six months and managed surgically. All patients had neck ultrasound and FNAC was done for suspicious cases for malignancy. Benign solitary nodular goiter was managed by unilateral lobectomy and isthmusectomy. MNG was managed by total and sub-total throidectomy. Malignant goiter was managed according to cytology with total thyroidectomy being done for most cases. Controlled toxic goiter was managed by total or sub-total thyroidectomy. All cases were subjected to pre-and post-operative layrngoscopic examination for assessement of vocal cord mobility. Post-operative histopathology is amust in all cases.Results: Mean age of the studied patients was 39.18±11.75 years with range between 15 and 63 years. Out of 60 patients, 49 (81.7%) patients were females and 11 (18.3%) patients were males. 17 (28.3%) of the studied had toxic manifestations and 15 (25%) patients were on anti-thyroid medications. Iodine deficiency was noticed in 9 (15%) patients while 7 (11.7%) patients had endemic goiter. Out of the studied patients, 5 (8.3%) patients had family history of thyroid disease.Unilobar enlargement presented in 12 (20%) patients while 48 (80%) patients had Bilobar thyroid enlargement. Diffuse goiter presented in 4 (6.7%) patients and nodular goiter in 56 (93.3%) patients, 13 (21.7%) solit all patients were subjected to thyroid function tests (TSH, free T3 and T4) before and after thyroidectomy. It was noticed that there were significant improvement in level of TSH, free T3 and free T4 after thyroidectomy (p<0.05).FNAC was done in 41 (68.3%) patients. Total thyroidec-tomy was performed in 43 (71.7%) patients while 10 (16.7%) and 7 (11.7%) patients had subtotal thyroidectomy and uni-lateral lobectomy with isthmusectomy respectively. The most frequent complications post-operatively were hoarseness of the voice and choking occurred in 18 (30%) and 16 (26.7%) patients respectively. Injury of RLN occurred in 5 (8.3%) patients.All of those patients received replacement therapy and none of them received chemotherapy or iodine therapy.Post-operative complications were frequent in those patients had total thyroidectomy where hoarseness of the voice, chocking and injury of recurrent laryngeal nerve oc-curred in 13 (30.2%), 12 (27.9%) and 5 (11.6%) patients respectively.In case of subtotal thyroidectomy 4 (40%) patients had choking and 4 (40%) patients had hoarseness of the voice. Only one patient from those had unilateral thyroidectomy had post-operative complication in form of hoarseness of the voice.Duration of surgeon experience was less than 5 years in majority of cases (56.7%) while in 16 (26.7%) and 10 (16.7%) patients duration of surgeon experience was 5-10 and more than 10 years respectively. With experience less than 5 years, post-operative complications were; 3 patients had R.L.N. injury, 12 patients had hoarseness of voice, and 10 patients had chocking. With surgical experience between 5 to 10 years, complications were; 2 patients had R.L.N. injury, 4 patients had hoarseness of voice, and 5 patients had chocking. While with experience more than 10 years, the complications were so minimal with only 2 patients had transient hoarseness of voice and chocking.In case of controlled toxic goiter; 15 (75%), 3 (15%) and 2 (10%) patients had total, subtotal and unilateral thyroidec-tomy respectively. In case of simple goiter; 7 (58.3%) patients had total thyroidectomy, 4 (8.3%) patients had unilateral thyroidectomy and 1 (8.3%) patient had subtotal thyroidectomy.21 (75%) patients from those with multinodular goiter had total thyroidectomy, 6 (21.4%) had subtotal thyroidectomy and 1 (3.6%) patient had unilateral thyroidectomy.Conclusion: In our study, no major difference was noticed between our surigal management strategy of thyroid diseases and international guidelines. Pre-operative assessement was focused with neck U/S and FNAC being the most important investigations. Choice of the type of operation was based on the type of thyroid disease and the risk of post-operative complications was considered.post-operative complications in the form of RLN injury, hypothyroidism and hypo-parathyroidism were markedly decreased.
https://mjcu.journals.ekb.eg/article_60594_46bf08a52577b39f3ccaaf8c35b247d6.pdf
2018-12-01
3533
3541
10.21608/mjcu.2018.60594
Thyroid surgery – Thyroid guidelines – Goiter
FAROUK A. MOURAD, M.D.;
MOSTAFA A. HAMAD, M.D.
1
AUTHOR
AHMED A.
GAD, M.Sc.
2
The Department of General Surgery, Faculty of Medicine, Assiut University, Assiut, Egypt
AUTHOR
ORIGINAL_ARTICLE
Ascitic Fluid Markers Hepcidin, Calprotectin, and Lactoferrin in Early Diagnosis and Follow-up of Spontaneous Bacterial Peritonitis
AbstractBackground: Spontaneous Bacterial Peritonitis (SBP) is the most serious complication in patients with decompensated liver cirrhosis and ascites. Its diagnosis is based on Polymorph Nuclear Leucocyte (PMNL) count in ascitic fluid >250 cell/mm3, however; SBP occurs at even lower levels, hence the need for early sensitive and specific markers for early detection and prognosis of SBP.Aim of Study: The aim of the study was to assess ascitic fluid Calprotectin, Lactoferrin and Hepcidin as reliable markers for diagnosis and follow-up of SBP.Patients and Methods: Ascitic fluid samples were collected from 88 patients with ascites; 37 with SBP (patients group) and 51 without SBP (control group). Calprotectin, Lactoferrin and Hepcidin levels were measured using Enzyme Linked Immunosorbent assay (ELISA).Results: Calprotectin, Lactoferrin and Hepcidin were significantly higher in patients with SBP than those without SBP (p=0.002, 0.001, 0.029 respectively). The areas under the receiver operator characteristic curve for Calprotectin, Lactoferrin and Hepcidin were (0.695, 0.860 & 0.661 respec-tively) with sensitivity 91.9% for the three markers. Hepcidin showed higher specificity (64.7%) than the other two markers. Calprotectin and Hepcidin decreased significantly after proper antibiotic therapy than before therapy in SBP group (p=0.002 & 0.004 respectively).Conclusion: Ascitic fluid Calprotectin, Lactoferrin and Hepcidin can be used as diagnostic markers of SBP. Calpro-tectin and Hepcidin can be used as markers for follow-up of SBP. Hepcidin was the most specific among them.
https://mjcu.journals.ekb.eg/article_60595_d29bd5fca7d47ddcc66ee5fd11d8c8da.pdf
2018-12-01
3543
3549
10.21608/mjcu.2018.60595
SBP – Calprotectin – Lactoferrin – Hepcidin – Ascites
HANAN MADANI, M.D.;
TAMER EL-BAZ, M.D.
1
AUTHOR
MOHAMMAD EL-SAYED, M.D.;
AHMED CORDIE, M.D.
2
AUTHOR
MAISSA
EL-RAZIKY, M.D.
3
The Departments of Clinical & Chemical Pathology* and Endemic Hepatogastroenterology**, Faculty of Medicine, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Management of Childhood Empyema as a Complication of Community Acquired Pneumonia
AbstractBackground: Pneumonia is one of the most common reasons for hospitalization in childhood. Although most bacterial pneumonia will resolve with treatment of the under-lying infection, some cases will be complicated by the devel-opment of an empyema.Aim of Study: To assess the degree of agreement of the lines of diagnosis and treatment of patients with complicated pneumonia and empyema with the European guidelines for management of childhood empyema.Patients and Methods: This study is a prospective analysis of 60 patients of empyema that were diagnosed and managed at Assuit University Children Hospital over 12 months from 1st March 2016-28th February 2017.Results: History of prolonged pneumonic illness (>15 days) and pleuritic pain were checked in 100% and 86.7% respectively. History of the cardinal signs (cough, fever and respiratory distress) and investigations as CXR, WBC count, blood culture, CRP and ESR of community acquired pneumo-nia was taken in 100%, 100%, 100%, 75%, 41.7% and 41.7% respectively. ELISA test and procalcitonin were not done in any of our patients. History of the lines of management of community acquired pneumonia was taken in 60% of patients. Investigations of empyema as CXR, chest CT scan, analysis of pleural fluid, chest ultrasound, sputum culture were done in 100%, 100%, 75%, 21.7, 8.3% successively. Eighty five % were treated correctly by antibiotics and 65%operated on by chest tube drainage and 1.6% was operated upon by open thoracotomy with decortications. Fibrinolytic therapy was not done in any of our patients.Conclusion: Empyema is still a respiratory problem in pediatrics. Evaluation of the studied patients were done perfectly except for some history points and some laboratory investigations that showed some defects. Management was perfectly done except for fibrinolytic therapy.
https://mjcu.journals.ekb.eg/article_60596_8fff6e612b0ca3861f16d8abf4850de7.pdf
2018-12-01
3551
3557
10.21608/mjcu.2018.60596
Chest tube drainage – Empyema thoracis – Fibrinolytic agents – Open decortications – Thoracocentesis – Video-assisted thoracoscopic surgery
NAGWA A. MOHAMED, M.D.;
KHALED S. ZAGHLOUL, M.D.
1
AUTHOR
GHADA A.
MOHAMED, M.Sc.
2
The Department of Pediatrics, Faculty of Medicine, Assiut University, Egypt
AUTHOR
ORIGINAL_ARTICLE
A Clinical Audit Study on Management of Childhood Epilepsy in Assiut University Hospital
AbstractBackground: Seizures constitute the most common neu-rological problem in children and the majority of epilepsy cases has its onset in childhood.Appropriate diagnosis and management of childhood epilepsy is essential to improve quality of life in these children.Evidence-based clinical practice guidelines can improve the quality of life. There are many recommendations for diagnosis and management of different childhood seizures & epilepsy.Aim of Study: To evaluate management of epilepsy in Assuit University Children Hospital and compare it with the suggested guidelines of epilepsy management.Patient and Methods: The study was conducted on patients attending to out-patient neurological clinic in Assuit University Children Hospital during the period from 1st of January to 30th of June 2017.Results: It was observed that the first line treatment (sodium valproate) was the most common drug used to control generalized epilepsy.It was observed also that the first line treatment (car-bamazepine) was the most commonly described in all cases of focal epilepsy.Conclusion: Sodium valproate and carbamazebine are usually the most common drugs used to treatment of childhood epilepsy, it was observed that the majority of cases of epilepsy were controlled by monotherapy.
https://mjcu.journals.ekb.eg/article_60597_298a2c401cb4bc52a4888e31b88df988.pdf
2018-12-01
3559
3564
10.21608/mjcu.2018.60597
Childhood epilepsy – Convulsions – Brain – Antiepileptic drugs
FAROUK E. HASSANIEN, M.D.;
GAMAL A. ASKAR, M.D.
1
AUTHOR
SAMUEL M.
FATHY, M.Sc.
2
The Department of Pediatrics, Faculty of Medicine, Assiut University Hospital, Assiut, Egypt
AUTHOR
ORIGINAL_ARTICLE
Effect of Grasping Computer Mouse on Median Nerve Conduction Velocity in Computer Users
AbstractBackground: Computer users with a long daily duration of computer use experienced musculoskeletal and neural symptoms.Aim of Study: To examine the possible effect of grasping the computer mouse on median nerve conduction velocity in computer users.Material and Methods: Forty adult computer users of both genders participated in this study. Their age ranged from 20 to 45 years old and they were using computer as a basic agent in their work. The computer users assigned in to two groups: Group A: Twenty participants using computer from 2 to 4 years and Group B: Twenty participants using computer from 5 to 7 year. The Median nerve conduction velocity of both dominant and non-dominant hands of both groups was measured.Results: There is a great effect of using computer mouse on median nerve conduction velocity in computer users.Conclusion: Using the computer mouse for a long time affect the median nerve conduction velocity in computer users.
https://mjcu.journals.ekb.eg/article_60598_253bc234423be8591d0fed8a721ce144.pdf
2018-12-01
3565
3571
10.21608/mjcu.2018.60598
Computer mouse – Median nerve – Conduction velocity – Computer users
RAGHDA A.M. IBRAHIM, M.Sc.;
HAYTHAM M. EL-HAFEZ, Ph.D.
1
AUTHOR
RANIA N. KARKOSHA, Ph.D.;
SAMY HASSANEN, M.D.
2
The Department of Basic Sciences, Faculty of Physical Therapy, Cairo University* and The Department of Neurosurgery, Faculty of Medicine, Zagazig University**
AUTHOR
ORIGINAL_ARTICLE
The Success Rate of Shock Wave in the Treatment of Musculoskeletal Conditions: A Systematic Review
AbstractBackground: Extracorporeal shock wave therapy (ESWT) is an effective and safe non-invasive treatment option for tendon and other pathologies of the musculoskeletal system.Aim of Study: To provide the physical therapist with an objective guideline about the success rate of shock wave in the treatment of musculoskeletal conditions.Methods: Systematic review and meta-analysis. Sources of data: PubMed, PEDro, Cochrane and science direct were searched from January 2007 till September 2017 for studies of any design investigating the effectiveness of ESWT in GTPS, PT, and AT. Citation tracking was performed using PubMed and Google Scholar. Animal and non-English lan-guage studies were excluded. A quality assessment was per-formed by 2 independent reviewers, and effect size calculations were computed when sufficient data were provided.Results: The meta-analysis of the selected studies revealed significant effects of the shockwave on the ligament, tendon, muscle and joint disorders.Conclusion: Shockwave either focused or radial has a significant effect in treatment of musculoskeletal disorders.
https://mjcu.journals.ekb.eg/article_60599_950d3ff868a4e22afffb1ea52eec9cd9.pdf
2018-12-01
3573
3577
10.21608/mjcu.2018.60599
ESWT– RSWT– Musculoskeletal system
HEBA M. ELFEKY, M.Sc.;
DOAA I. AMIN, Ph.D.
1
AUTHOR
HAYTHAM M.
ELHAFEZ, Ph.D.
2
The Department of Basic Sciences, Faculty of Physical Therapy, Cairo University, Egypt
AUTHOR
ORIGINAL_ARTICLE
CD64 and CD11b Versus Conventional Bacteriological Methods in Early Detection of Bacterial Neonatal Sepsis
AbstractBackground: Neonatal sepsis is a life-threatening disease that remains a major cause of morbidity and mortality in the newborn. Early recognition and implementation of appropriate therapy offers the best outcome, and careful assessment of the newborn is essential. Early-onset sepsis (EOS) presents a fulminant multi-system illness during the first days of life. Early detection of neonatal sepsis is difficult as the clinical signs are non-specific and indistinguishable from those caused by a variety of neonatal non-infective disorders such as aspiration syndrome and respiratory distress syndrome. An important early event in sepsis is the generation and release of cytokines by immune cells in response to invasion by bacteria and their toxins. Flow cytometry analysis of cell surface antigens (CD64, CD11b, CD32, CD16, CD69, CD25, and CD45) have been performed to detect neonatal sepsis.Aim of Study: To evaluate the usefulness of estimation of neutrophil expression of CD64 and CD1 1b in bacterial neonatal sepsis and to investigate possible relationship between their levels, other markers of sepsis as total leucocytec count (TLC), platelet count and C Reactive protein (CRP), whether levels of expressed CD64 and CD11b correlated with severity of illness, survival or not and to investigate the possible relation between CD64 and CD11b.Patients and Methods: All Newborns were subjected to complete blood count (CBC), CRP, blood cultures and flow-cytometry analysis that had been done for detection of CD 64, CD11b on neutrophils.Results: All prospective study enrolled newborns docu-mented sepsis group (n=40) and control newborn group (n=40). It was found that the blood cultures in sepsis group demon-strated the presence of E.coli, KlebsiellaPneumoniae, Staphau-reus, Staph Hominis, Staph lentus and Pseudomonas aerog-enosa. Also, the mean levels of CD64 and CD11b in sepsis group were significantly higher than that in healthy group p value is 0.001. ROC analysis showed that both CD64 and CD1 1b could be used for early detection of sepsis with sensitivity and specificity of more than 97%.Conclusion: The expression of the neutrophil activation markers CD11b and CD64 could be a reliable tool for early prediction and diagnostic of early detection of bacterial neonatal sepsis in the suspected presence neonate, irrespective to otherlaboratory results and before the evolution of clinical signs. Thus, they might indicate the necessity of early initiation of antibiotic treatment for sepsis, with corresponding improve-ment of the outcome, and reduce the unnecessary use of antimicrobials in non-infected neonates, without waiting for definitive microbiologic results.
https://mjcu.journals.ekb.eg/article_60600_eb1a240dfefd1e2ed750010585bc0368.pdf
2018-12-01
3579
3587
10.21608/mjcu.2018.60600
Neonatal sepsis – Preterm newborns – CD64 – CD11 b
LAILA M. YOUSIF, M.D.;
ABDEL HAMEAD A. MOHAMED, M.D.
1
AUTHOR
HOSNY M.A.
EL-MASRY, M.D.
2
The Departments of Clinical Pathology*, Faculty of Medicine, Sohag University, Clinical Pathology** and Pediatrics & Neonatology***, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
AUTHOR
ORIGINAL_ARTICLE
Effect of Electroacupuncture on Glucostasis in Diabetic Rats
AbstractBackground: Diabetes mellitus (DM) is a major interna-tional health problem characterized by an absolute or relative deficiency in the production or action of insulin, which results in hyperglycemia. Acupuncture is a part of traditional Chinese medicine (TCM) and is most commonly used form of alter-native medicine, its modulatory effects are mediated by regulation of physiological state of the human body.Aim of Study: The present study was designed to evaluate the possible ameliorating role of Electroacupuncture (EA) on the changes of fasting glucose, insulin, glycosylated hemo-globin HbA1c, C peptide levels, liver glycogen and glucose produced by kidneys in diabetic rats.Material and Methods: Sixty adult male albino rats were used in this investigation, divided into following groups: Non-diabetic (C), diabetic (D), diabetic insulin treated (D+I), diabetic (EA) treated (D+E) and diabetic insulin and EA-treated (D + I + E). Blood samples were collected for estimation of fasting blood glucose (FBG), insulin, (HbA1c) and C peptide levels. Liver and kidneys are removed for estimation of liver glycogen and glucose produced by kidneys.Results: Significant decrease in fasting blood glucose level, (HbA1c,) and glucose produced by kidneys with signif-icant increase in serum insulin, C peptide and liver glycogen in both diabetic insulin treated and diabetic (EA) treated groups compared with the diabetic group, but with significant change between the two groups. There was insignificant change between diabetic insulin and EA-treated (D+I+E) group and non-diabetic (C) group. Conclusion: EA can be used as an adjuvant therapy in diabetic rats.
https://mjcu.journals.ekb.eg/article_60601_27e9616c9a0f1ff5597054150f357f5a.pdf
2018-12-01
3589
3596
10.21608/mjcu.2018.60601
Electroacupuncture – Acupoints – C peptide – Rats
HESHAM A.D. ABDEL-RAZEK, M.D.;
GERGESS S. HANNA, M.D.
1
AUTHOR
SUZAN M. HAZAA, M.D.;
GHADA S. AMER, M.D.
2
AUTHOR
SHAIMAA M. ABDEL GHANY, M.D.;
REDA A.A. ABOEL SOUD, M.Sc.
3
The Department of Medical Physiology, Faculty of Medicine, Menoufia University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Efficacy of Extracorporeal Shock Wave Therapy on Male Coccydenia after Urological Surgery
AbstractBackground: UROLOGIC pelvic surgery is the integration of surgical activities for the pelvis, the colon, urogenital, and gynecological organs primarily for the treatment of obstructions, dysfunction, malignancies, and inflammatory diseases.Aim of Study: To evaluate the efficacy of extracorporeal shock wave therpy on male coccydenia after urological surgery.Subjects: Thirty male patients who complain from coc-cydenia after urological surgery, their age range from 40-60 years old, choosen from El-Sahel Teaching Hospital and Police Hospital in Agoza, Cairo, Egypt during the period of June-2017 to November-2017.Methods: Patients assigned randomly into two groups of equal numbers, Group (A) control group which include 15 patients received routine medication only (anti-inflammatory drugs or NSAID), and Group (B) study group received shock wave therapy one session per week up to four weeks each session took 10 minutes the patients were received 2000 shots of ESWT in the coccyx, the frequency was 5Hz and the pressure was 3-4 bar in addition to traditional medications routine (anti-inflammatory drugs). Both groups were assessed pre and post-treatment for pain level by Visual Analogue Scale (VAS).Results: There was a significant decrease in the median values of visual analogue scale post-treatment of study group compared with control group (p=0.002) in favor of study group.Conclusion: Shock wave therapy is effective as a physical therapy program on improving coccydenia.
https://mjcu.journals.ekb.eg/article_60602_e68cf92e1f3240455e62c2372c8dacfb.pdf
2018-12-01
3597
3600
10.21608/mjcu.2018.60602
Shock wave therapy – Male coccydenia – Uro-logical surgery
ASHRAF H. MOHAMED, Ph.D.;
HEBA M. MOHAMEDY, Ph.D.
1
AUTHOR
MOHAMED R.
MOHAMED, M.Sc.
2
The Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Efficacy of Antimicrobial-Impregnated External Ventricular Drain Catheters: A Prospective, Randomized, Controlled Trial
AbstractBackground: Insertion of External Ventricular Drain (EVD) is associated with considerable risk of Cerebrospinal Fluid (CSF) infection which is a life-threatening complication. Infection occurs when microorganisms colonize along the catheter surface.Aim of Study: The aim of this study is to compare the safety & efficacy of EVD catheters impregnated with Clin-damycin & rifampin with those of standard control catheters for prevention of the catheter-related infections.Subjects and Methods: The prospective study was con-ducted on forty patients between April 2013 – November 2014. All patients were randomly assigned to undergo place-ment of an EVD with a catheter impregnated with Clindamycin & rifampin or a standard non-impregnated catheter (control group). Each group included twenty patients. Standard silicone catheter was the EVD used in both cohorts. Patients diagnosed with a known or suspected CSF infection were excluded from this study. Initial cell counts and cultures were obtained from the CSF, repeated at intervals (72 hours) and at time of Catheter removal. CSF infection rate and its impacton the clinical outcome were evaluated in both groups.Results: Among this series of forty patients with EVDs, three had an EVD-associated CSF infection in the control group giving an infection rate within this group of 15% per patient. Only one case in the Antibiotics-impregnated Catheter (AIC) group had CSF infection. Positive CSF cultures were obtained on day 10, 12 & 14 respectively. Organism isolated from CSF cultures was mainly gram-negative infection. AIC group showed a significant low infection rate compared to the uncoated one (p<0.001).Conclusion: The Catheters impregnated with the antibiotic combination of Clindamycin and rifampin appears to be safe and effective in reducing the risk of infectious complications associated with the placement of an EVD.
https://mjcu.journals.ekb.eg/article_60603_c423762e3707ecd03c830e965af5593f.pdf
2018-12-01
3601
3605
10.21608/mjcu.2018.60603
External ventricular drain – CSF infection – Antibiotics impregnated Catheter
AHMED EL-SAYED, M.D.;
ADHAM EL-SAYED, M.D.
1
The Department of Neurosurgery, Faculty of Medicine, Cairo University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Efficacy Intravenous Tranexamic Acid in Reducing Blood Loss after Elective Cesarean Sections
AbstractBackground: Delivery by CS can cause more complica-tions than normal vaginal delivery and one of the most common complications is primary or secondary postpartum haemor-rhage. The coagulation and fibrinolytic systems are believed to be in a state of dynamic balance that maintains an intact vascular system. Tranexamic acid (TXA) is a potent anti fibrinolytic agent that exerts its effects by blocking lysine binding sites on plasminogen molecules and has the potential to enhance the effectiveness of the patient's own haemostatic mechanisms.Aim of Study: To study the efficacy and safety of tran-examic acid in reducing blood loss during and after the lower segment cesarean section.Methods: This Prospective Comparative study was held on one hundred and fifty patients from Obstetrics and Gynae-cology Department of El-Sayed Galal University Hospital (Al-Azhar University) and El-Sahel Teaching Hospital.•Group A (TA group): 50 patients would had 1g/10mL TA diluted with 20mL of 5% glucose.•Group B (Misoprostol group): 50 patients would had 5 rectal 200 micrograms Misoprostol pills (misotac) were used.•Group C (Oxytocin group): 50 patients would had 20IU oxytocin in 500mL lactated Ringer's solution will be infused at a rate of 125mL/h.Results: No statically differences between groups as regarding demographic characteristics of the patients.No statistically significant difference between groups according to indication of CS. No statistically significant difference between groups according to vital signs before treatment. Statistically significant difference between groups according to vital signs immediately after placental delivery and 1hr after CS for oxytocin group. No statistically significant difference between groups according to vital signs (2hr after CS). No statistically significant difference between groups according to laboratory data before delivery. No statistically significant difference between groups according to Total blood loss. No statistically significant difference between groups according to laboratory data on (2nd day). No statistically significant difference between groups according to neonatal manifestations.Conclusion: The use of tranexamic acid prior to caesarean section may have the effectiveness to reduce and minimize blood loss with no major side effects recorded throughout the study either for the mother nor for the babyagainst postpartum hemorrhage as shown by the results of this study.
https://mjcu.journals.ekb.eg/article_60604_7a4b14304059bfd46a642bbdbba618e8.pdf
2018-12-01
3607
3615
10.21608/mjcu.2018.60604
Postpartum Hemorrhage (PPH) – Tranexamic Acid (TA) – Cesarean Section (CS)
MOHAMED A. MOHAMED, M.D.;
ADEL A. EL-BOGHDADY, M.D.
1
AUTHOR
ESLAM G.F.
HEGAZY, M.Sc.
2
The Department of Obstetrics and Gynecology, Faculty of Medicine Al-Azhar University
AUTHOR
ORIGINAL_ARTICLE
Language Development in Normal Libyan Children
AbstractBackground: Language is central to social life; language development is a cornerstone for successful outcomes later in life. Language refers to the entire system of expressing and receiving information in a way that's meaningful. Language consist of four dimension, the sound system (phonology), the system of meaning (semantics), the rules of sentences formation (syntax) and function or use of language includes (pragmatics) that consists of the goals of language. The Language devel-opment is a complex, dynamic and progressive process. It involves detection of complex patterns and improvement of language competencies. Language development may affected by various factors as neurobiological factors, culture and psychosocial factors. Background history and formal testing are important in assess language development. Early interven-tion for language difficulties are very important also. The earlier language intervention is implemented, the better results will found.Aim of Work: The aim of this study is to evaluate language development in normal Arabic Speaking Libyan Children in order to identify the normal developmental language aptitudes in such population.Study Design: A descriptive research design was used to achieve the aim of this study.Patients and Methods: The subject of this study comprised a convenient sample of 120 normal Arabic Libyan children with age range between 3 months and 7 years. Modified Arabic (PLS-4) Test, Articulation test Standford Binnia test and audiological evaluation were done for all children.Results: The Standred score of Arabic PLS-4 was below normal (77.5) in of cases (56.6%) while it was high in (43.33%). Both receptive and expressive difficulties was found in 30% of children. A highly significant statistical correlation between total language age, receptive language age and expressive language age with chronological age was found. In addition, the study revealed that children more than 6 years and the children from 3-4 years have delayed in receptive language score, expressive language score and total language score regarding their chronological age.Conclusion: The normal Arabic Libyan children was found to be delayed in language development in age groups (more than 6y) and (3-4y) according to standred score in PLS-4. These result will be use to formulate a language aprofile for normal Arabic Libyan children.
https://mjcu.journals.ekb.eg/article_61156_086eb1a62b37723ed1dac8a2b6f01d8f.pdf
2018-12-01
3617
3623
10.21608/mjcu.2018.61156
Language development – Language age difficulties – Receptive language – Expressive language – Chronological age and Arabic PLS-4
ASMAA H. BOSHWISHA, M.Sc.,
AHMED N. KHATAB, M.D.
1
AUTHOR
RASHA M.
SHOEIB, M.D.
2
The Department of E.N.T., Phoniatric Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt
AUTHOR
ORIGINAL_ARTICLE
Lymphocytic Count and Ratio as Predictive Factors for Pathological Response after Neoadjuvant Therapy in Patients with Rectal Cancer
AbstractBackground: To evaluate results of pre-operative Complete Blood Count (CBC), with special emphasis on lymphocytic count and ratio as predictive factors for rectal cancer response to neoadjuvant chemoradiotherapy and prediction of complete pathological response.The Aim of the Study: Is to evaluate results of pre-operative complete blood count, with special emphasis on lymphocytic count and lymphocyte ratio as predictive factors of rectal cancer response to neoadjuvant chemoradiotherapy.Patients and Methods: This research studied the associa-tion between CBC results of patients with stage II or III Locally Advanced Rectal Cancer (LARC) before neoadjuvant therapy and the pathological response found in the specimen after standard surgical management. Patients were divided into two groups; Group I included patients with complete pathological response and Group II included patients with no or partial pathological response to study the predictive factors for complete pathological response.Results: A total of 36 patients (20 females and 16 males) were included. Mean age was 56.40±11.18 years. 19 patients (52.7%) underwent low anterior resections and 17 patients (47.2%) underwent abdomino-perineal resections. Lymphocytic count and ratio were significant predictive factors for the pathological response of the tumor to neoadjuvant therapy (p=0.011 and 0.048, respectively). Comparison between Group I and Group II showed that lymphocytic count and ratio were significant predictive factors for patients in Group I compared to Group II (p=0.001 and p=0.049, respectively).Conclusions: Lymphocytic count and ratio can play an important role as predictive factors for pathological response to neoadjuvant therapy in patients with LARC and also as predictive factors for complete pathological response. Further multicenter studies with larger number of patients are needed.
https://mjcu.journals.ekb.eg/article_61476_29f499ab79b57667a6c8e175d46360b0.pdf
2018-12-01
3625
3632
10.21608/mjcu.2018.61476
Lymphocytic count – Lymphocytic ratio – Cancer rectum – Neoadjuvant chemoradiotherapy
KHALED S. ABBAS, M.D.;
WALID M. ABD EL-MAKSOUD, M.D.
1
AUTHOR
AHMED M.
HUSSEIN, M.Sc.
2
The Department of General Surgery, Colorectal Surgery Unit, Faculty of Medicine, Alexandria University, Alexandria, Egypt
AUTHOR
ORIGINAL_ARTICLE
Awareness and Knowledge of Adult Saudi Patients with Visual Impairment about Cataract
AbstractBackground: Cataract is the leading cause for visual impairment among people of developing and underdeveloped countries.Aim of Study: This study aimed to identify the common patterns of eye diseases among patients with visual impairment and to assess their awareness and knowledge regarding cataract.Patients and Methods: A cross-sectional study was con-ducted in Abha City, Saudi Arabia from October 2017 till December 2017. A total of 300 Saudi adult patients were included. A study questionnaire was used for data collection that evaluates participants' knowledge and awareness about cataract.Results: Among participants, 77% heard about cataract and 66.3% knew that it is "clouding of normally clear lens" while 70% perceived cataract, as an "age-related disease". Hypertension (48%), diabetes (67.3%) and corticosteroids usage (49.7%) were considered as the main precipitating factors for development of cataract. A vast majority (82%) believed that cataract causes decreased visual acuity. Surgery as treatment of cataract was identified by only 61.3% of participants. Only 54% knew that cataract can lead to loss of vision.Conclusions: There is lack of awareness and knowledge among Saudi adult eye patients in Abha City regarding cataract. Hence, health education of the public regarding cataract risk factors, prevention and treatment should be undertaken to encourage efforts for prevention and seeking early detection and to avoidance of complications of cataract.
https://mjcu.journals.ekb.eg/article_61477_ea9948efed30e9aee33bd35932f87c1e.pdf
2018-12-01
3633
3638
10.21608/mjcu.2018.61477
Cataract – Knowledge – Awareness – Risk factors – Prevention – Treatment
ABDULRAHMAN ALAMRI, M.D.;
ABDULHAMID ALGHAMDI, M.D.
1
AUTHOR
RANA S ALOJAIR, M.B.B.S.;
BASHAIR M ESSA, M.B.B.S.
2
AUTHOR
ASHWAQ M ALSHAHRANI, M.B.B.S.;
OSSAMA A. MOSTAFA, D.R.Ph.
3
The Departments of Ophthalmology, College of Medicine, King Khalid, Taif , Abha, Saudi Arabia Universities and Family & Community Medicine, College of Medicine, King Khalid University
AUTHOR
ORIGINAL_ARTICLE
Histopathological Patterns of Nasal Polyps in Aseer Region, Saudi Arabia: A Retrospective Hospital-Based Study
AbstractBackground: Nasal polyps are benign lesions that arise from the mucosa of the nasal cavity or the mucosa of nasal sinuses. Its exact etiology remains obscure. They are often bilateral and multiple, with tendency to recur. They constitute a challenge for physicians regarding its diagnosis and treatment. There are several conditions which are commonly associated with nasal polyposis, e.g., bronchial asthma and bronchiectasis.Aim of Study: To determine the various histopathological types of nasal polyps specimens of Saudi patients who under-went surgery at Khamis Mushayt General Hospital in Aseer Region, Saudi Arabia.Patients and Methods: Following a retrospective, hospital files-based study of 121 patients who underwent surgery to remove nasal polyps at Khamis Mushayt General Hospital during the period from 2012 to 2017, whose diagnosis was confirmed by histopathological examination. A special data collection sheet was designed by the researchers to collect patients' data from their hospital files. It included patients' personal data, i.e., gender and age, and disease-related data, i.e., laterality, recurrence, and histopathology type.Results: More than half of patients (58.7%) were males. Their mean age was 38.2±14.6 years. The majority of patients (81.8%) had bilateral nasal polyps. Nasal polyps were recurrent in 33.1% of patients. The main histopathological features of patients' nasal polyps were edematous including eosinophils (61.2%) or fibro-inflammatory polyps (30.6%). Rare histo-pathological types included angiectatic (3.3%), glandular (2.5%), cystic (1.7%) and atypical stroma (0.8%).Conclusions: Nasal polyps among patients in Aseer Region are more common among middle-aged men. It is mainly bilateral with high recurrence rate. Their most frequent histo-pathological features are the "edematous including eosinophils" or "fibro-inflammatory" types. Histopathological examination of a removed nasal polyp is frequently essential to provide the actual diagnosis.
https://mjcu.journals.ekb.eg/article_61478_703ca49d0b337dcde9749dbc5cc67520.pdf
2018-12-01
3639
3642
10.21608/mjcu.2018.61478
Nasal polyps – Histopathology – Retrospective study design
KHOLOOD S. ASSIRI, M.D., SB-ORL-HNS;
MOHAMMAD S. AL-AHMARI, M.D., SB-ORL-HNS
1
The Department of Otolaryngology, Khamis Mushayt General Hospital, Saudi Arabia
AUTHOR
ORIGINAL_ARTICLE
Effect of Bisphenol (A) on the Cerebellar Cortex of Albino Rats and Possible Protective Effect of Omega 3
AbstractBackground: Bisphenol A is the most commercially used of bisphenol groups in plastic industry. It induces oxidative damage in the brain of rats.Aim of Study: The present work investigates the adverse effects of bisphenol A (5mg/kg/day) on the cerebellar cortex of albino rat's offspring of treated mothers throughout preg-nancy and lactation and the possible protective effect of omega 3.Material and Methods: Fifty pregnant albino rats were used in this work. They were divided into 4 groups: I- Control group (Group C); half of them did not receive any substance with their pallets (Group CN). The other half were given 0.54ml of corn oil/rat (Group CR). II- Omega 3 treated group (Group O); each rat was given 0.54ml of corn oil (contained 54mg of omega 3). III- Bisphenol A treated group (Group B); each rat was given 0.54ml of corn oil (contained 6.3mg of bisphenol A). IV- Bisphenol A and omega 3 treated group (Group BO); each rat was given the same dose of bisphenol A in Group B plus the dose of omega 3 in Group O. The treatments were given as a single daily dose orally by gastric tube throughout pregnancy and for 2 weeks after delivery. The cerebelli of the offspring of all groups were extracted at the ends of the 2nd and 8th weeks and prepared for light and electron microscopic examination and morphometric study.Results: Light and electron microscopic examinations and morphometric study showed that bisphenol A induced various signs of delayed development in the cerebellar cortex. It also induced degeneration and necrosis of the cerebellar cells and nerve fibers in the form of cytoplasmic vacuoles, dilated rough endoplasmic reticulum, swollen and degenerated mitochondria with destructed cristae. Nuclear changes were observed also in form of karyolysis, pyknosis, karyorrhexis and finally nuclear disappearance. Beside that there was decrease in the number of Purkinje cells. The deleterious effects of bisphenol A on the cerebellar cortex were irreversible on stoppage of its administration. However, combined admin-istration of omega 3 with bisphenol A alleviated the majority of its adverse effects.Conclusion: It could be concluded that bisphenol A induced various deleterious changes in the histological structure of the cerebellar cortex of albino rat's offspring of treated mothers throughout pregnancy and lactation. These changes were irreversible on withdrawal of bisphenol A. On the other hand combined administration of omega 3 with bisphenol A alleviated most of these changes.
https://mjcu.journals.ekb.eg/article_61479_0ddd52d2208770e738c2811d29aa4d55.pdf
2018-12-01
3643
3662
10.21608/mjcu.2018.61479
Bisphenol A – Pregnant – Albino rats – Cerebellum – Offspring
SOHAIR A. SADEK, M.D.;
EMAN B. ELSHAL, M.D.
1
AUTHOR
AMANY M. ABO-OUF, M.D.;
MONA T. ABD EL-AAL, M.Sc.
2
The Department of Anatomy and Embryology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Eygpt
AUTHOR
ORIGINAL_ARTICLE
Effect of Intractable Epilepsy on the Physiological Cardiac Performance Parameters and the Serum Levels of Cardiac Fatty Acid Binding Protein in Pediatrics
AbstractBackground: Multiple cardiac changes and various abnor-malities have been linked to epileptic fits. The assessment of cardiac changes and serum biomarkers level are commonly accepted methods to evaluate autonomic disturbances during epileptic fits which is very closely associated with some cardiovascular events especially the sudden unexpected cardiac death.Aim of Study: To evaluate ictal and inter-ictal cardiac changes and plasma levels of heart type fatty acid binding protein (H-FABP) in pediatric patients with treatment resistant epilepsy.Patients and Methods: 32 seizure attacks were recorded in 23 children with intractable seizures. Simultaneous Holter-ECG and video-EEG recordings were done with evaluation of changes in Heart Rate (HR), parameters of Heart Rate Variability (HRV), as well as serum levels of H-FABP as a marker of myocardial ischemia in the ictal and inter-ictal periods and compared with a control group.Results: The recorded HR changes included Ictal Tachy-cardia (IT) (96.87%), Ictal Bradycardia (IB) (3.13%), Prema-ture Atrial Contractions (PAC) (18.75%) and Premature Ventricular Contractions (PVC) (28.13%) in the first post-ictal hour. Significant HR increase was observed in the pre-ictal hour and ictal values compared to basal values and remained high 2 hours post-ictally. Basal HR and serum levels of the H-FABP protein were significantly higher while time domain HRV parameters were significantly lower in the patients compared to controls.Conclusion: Significant cardiac changes may occur even before the seizure onset in cases with intractable epilepsy. The increased levels of H-FABP may indicate the presence of autonomic instability and myocardial ischemia even in asymptomatic patients.
https://mjcu.journals.ekb.eg/article_61480_53cd469583a1922410bb89f961d0f820.pdf
2018-12-01
3663
3672
10.21608/mjcu.2018.61480
Intractable epilepsy – Heart rate – Heart rate variability – EEG – Holter – Heart type fatty acid binding protein
SAAD A. MOHAMED, M.D.;
AHMED ABD EL-TAWAB, M.D.
1
AUTHOR
MOHAMED MANSOUR, M.D.;
ALAA ABD EL-HAMID, M.D.
2
AUTHOR
MOHAMMAD SHAFIQ AWAD, M.D.;
MONA H. TAWFIK, M.D.
3
AUTHOR
ORIGINAL_ARTICLE
Assessment of Laparoscopic Mini-Gastric Bypass (LMGB) as A Treatment for Failed Vertical Band Gastroplasty (VBG); Safety and Outcome
AbstractBackground: Bariatric surgery is one of the most successful methods for sustained weight loss in morbid obese patients. Despite the initial success of Vertical Band Gastroplasty (VBG) 10-25% of patients will require re-operation for un-satisfactory results. Re-operation carries the risk of high morbidity and mortality. The Laparoscopic Mini-Gastric Bypass (LMGB) for revision of failed VBG will be evaluated in this study.Methods: Between January 2015 and March 2017 in Ain Shams University Hospitals 50 patients with failed VBG were enrolled in this prospective study evaluating LMGB as an option for revision.Results: In our study 50 patients underwent LMGB for revision of failed open VBG, the incidence of intra-operative complications was 6% and post operative complications was 22% with significant improvement of BMI after one year of the operation and marked improvement of other symptoms of failure.Conclusion: At our study LMGB appears to be a safe and sound option as a revisional surgery after open VBG with satisfactory weight loss and less incidence of complications.
https://mjcu.journals.ekb.eg/article_61481_0a83cd7ae13cf2df37969e398ef7c83e.pdf
2018-12-01
3673
3676
10.21608/mjcu.2018.61481
Mini-gastric bypass – Vertical band gastroplasty – Revision – Morbid obesity
MOHAMED ABOUL NAGA, M.D.;
MOHAMED MAGDY, M.D.
1
The Department of General Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt
AUTHOR
ORIGINAL_ARTICLE
The Effect of Exercises on Resistin of Post-Menopausal Pre Hypertension Women
AbstractBackground: Emerging evidence suggests a role for resistin in inflammation and vascular dysfunction, which may con-tribute to the pathogenesis of hypertension, but the association between resistin levels and incident hypertension is unknown. The strength exercise can be used to prevent the degenerative processes and inflammation associated with ageing.Aim of Study: To Investigate the effect of strength exercises on serum resistin levels of post-menopausal women.Subjects and Methods: Twenty three sedentary post-menopausal women conduct in this study. The strength exer-cises lasted 12 months and consisted of two week sessions with three sets of 8-12 maximum repetitions and one exercise for each main muscle group. Maximum muscular strength was tested in the following exercises: Bench press, 45º leg press, and standing elbow extension. Serum resistin level was determined using the ELISA method. ANOVA (with repeated measures) was used for the comparisons between periods pre, 6 months and 12 months (p<0.05); Pearson's correlation test was used to evaluate the correlations between resistin X blood pressure, resistin X muscle strength and strength X blood pressure.Results: Women presented the following anthropometric profile: 61.33±3.8 years; height 148.5±32.7cm; body weight 67.56±10.85kg. The Strength exercise decreased resistin levels (30272.4±8100.1 to 16350.6±2404.6pg./mL) and systolic blood pressure (120.5±11.8 to 1 15.8±1 .6mmHg), and increased muscular strength in the leg press 45º (172.3±27.3 to 348.6± 40.8kg), bench press (31.9±4.1 to 41.8±5.6kg) and arm curl (21.0±2.4 to 26.5±2.9kg) after 12 months (p<0.05).Conclusion: Long-term strength exercises increases max-imum muscular strength, decreases systolic blood pressure and serum resistin levels, which are beneficial physiological alterations that reduce the risk for cardiovascular diseases in post-menopausal women.
https://mjcu.journals.ekb.eg/article_61482_3a109e0dfbc7da3c344f7b7bd07a6e97.pdf
2018-12-01
3677
3683
10.21608/mjcu.2018.61482
Post-menopausal women – Blood pressure – Strength exercises – Resistin
FATEN A. HAMZA, Ph.D.;
MOHAMED Y. ABD EL-HAMED, Ph.D.
1
AUTHOR
REHAM
EZZ EL-DEN, Ph.D.
2
AUTHOR
ORIGINAL_ARTICLE
Serum Apelin Level in Normal and Gestational Diabetic Rats: Effect of Treatment with Vitamin D
AbstractBackground: Apelin peptide was identified in a wide variety of tissues including adipose tissue and it was linked to glucose homeostasis in obesity and diabetes. Apelin and its receptors were also identified in the placenta, and play a role in fluid and glucose transport. Vitamin D affects glucose metabolism and its deficiency was linked to gestational diabetes.Aim of the Study: To estimate serum apelin level in normal and gestational diabetic rats and to study the effect of Vitamin D administration on serum apelin level in relation to some metabolic parameters in gestational diabetes.Material and Methods: Healthy adult female albino rats were divided into the following groups, Group I (n=8): Virgin control rats; Group II (n=16): Normal pregnant control group (NP) subdivided into Group IIa (n=8) sacrificed on day 11 and Group IIb (n=8) sacrificed on day 19 of gestation; Group III (n=22): Gestational Diabetic group (GDM), rats were subdivided into Group IIIa (n=11) sacrificed on day 11 and Group IIIb (n=11) sacrificed on day 19; Group IV (n=11): Gestational diabetic Vitamin D3 treated group (GDM + vit D3), gestational diabetic rats received vitamin D3 (50IU/kg/ day) intra-peritoneal from day 10 till sacrificed on day 19. The following parameters were measured in all groups: BMI, blood glucose, serum insulin, lipid profile, C Reactive Protein (CRP), Tumor Necrosis Factor a (TNFa) and HOMA-IR was calculated.Results: A significant increase in serum apelin level was found on day 11, while a significant decrease was found on day 19 of normal gestation relative to non-pregnant level. In GDM groups, apelin level significantly decreased in Group IIIa compared to Group IIa and in Group IIIb compared to Group II b. Vitamin D3 induced a significant increase in apelin level in Group IV compared to Group IIIb. Serum apelin level correlated negatively with blood glucose, HOMA-IR, TC, LDL and TNFa in Group III and IV.Conclusion: Gestational diabetes induced significant decrease in serum apelin level in pregnant rats compared to normal pregnant gestational age matched control. Vitamin D3 supplementation in gestational diabetic rats induced significant increase in apelin level in association with a decrease in insulin resistance.
https://mjcu.journals.ekb.eg/article_61483_92c55ef4894b3322a69b72c480e79279.pdf
2018-12-01
3685
3697
10.21608/mjcu.2018.61483
Gestational diabetes – Insulin – HOMA-IR – Apelin – Vitamin D
MAHA A. FATHY, M.D.;
REHAM H. IBRAHIM, M.D.
1
The Department of Medical Physiology, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Anterior Surgery of Hard and Soft Cervical Disc
AbstractBackground: Anterior access cervical surgery aims to remove the compressing agent which might be soft disc material or bony spur this offender material is the cause of patient complaint which might be electrical like pain or, numbness in one upper limb or both.Anterior cervical surgery of hard & soft disc aims towards the excision of the bony osteophyte or disc material that is compressing the nerve root causing "electrical," "numbness," or "shooting" pain, that often begins in the neck & travels into one or both shoulders and arms.Aim of Study: To compare the results of ACDF using cages for interbody fusion in both soft and hard cervical discs extractions regarding the difference in surgical time, loss of blood, post-operative hospital stay, relief of presenting symp-toms, the incidence of complications & return to regular work.Patients and Methods: This is a, retrospective. Study of 21 patients with the diagnosis of cervical disc prolapse operated upon by ACDF with cages instrumentation in the period from 5/2012-5/2015 in the Department of Neurosurgery, Beni Sueif University.Cases were divided, into 2 groups:•Group A: 14 patients with (single/double) levels soft cervical discs.•Group B: 7 patients with (single/double) levels hard cervical discs.Results: 21 cases were included in this series. The mean age was 35 in group (A) and 49 in group (B), there were six females, and 15 were males. 14 patients had single level discs, and seven patients had two levels.Operative time was to some extent longer in hard disc cases than soft disc cases. Also, blood loss was somewhat more in hard disc than soft disc patient satisfaction is equal in the two groups; but return to regular work was after eight weeks in the hard disc in comparison to 6 weeks in soft disc period of follow-up was six month of both groups showing no difference in the outcome.Conclusion: Although ACDF for hard cervical discs requires longer, operative time and may cause more loss of blood & more delayed return to regular work when compared to the soft discs, the clinical outcome during six months follow-up period showed no difference between the 2 groups.
https://mjcu.journals.ekb.eg/article_61484_bb19f7dd10162fdeddc6bbe36b7fd4a8.pdf
2018-12-01
3699
3704
10.21608/mjcu.2018.61484
Anterior surgery – Hard and soft cervical disc
MOHAMED
SHABAN, M.D.
1
The Department of Neurosurgery, Faculty of Medicine, Beni Sueif University, Beni Sueif, Egypt
AUTHOR
ORIGINAL_ARTICLE
The Predictive Factors of Abnormal Esophageal Motility in Systemic Sclerosis Patients by High Resolution Manometry
AbstractBackground: Esophageal motility changes occur in about 80% of systemic sclerosis (SSc) patients with decreasing the motility of the lower two-thirds of the esophagus and lower esophageal sphincter (LES) pressure.Aim of Study: Using high resolution manometry (HRM) to study the esophageal motility disorder in patients with systemic sclerosis to evaluate the predictive factors associated with esophageal affection.Patients and Methods: A prospective study was done on twenty female patients with SSc. Demographic data and esophageal symptoms including Gastroesophageal Reflux disease (GERD) and dysphagia were evaluated. All patients underwent HRM and High Resolution Computed Tomography (HRCT), Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Hemoglobin level (Hgb), Forced Vital Capacity (FVC).Results: High resolution manometry showed normal upper esophageal contraction in 100% of patients. Middle and lower esophageal contraction were normal in 30%, hypoperestalsis in 5%, and aperestalsis in 65% of patients. Regarding the lower esophageal sphincter pressure, it showed normal pressure in 30%, hypotensive in 65% and hypertensive in 5% of patients. The esophageal involvement was GERD in 70% and dysphagia in 45% of patients. The pulmonary involvement was dyspnea in 70% and cough in 40% of patients. All patients had skin involvement. Abnormal motility was present in 14 out of 20 patients (70%) which was significantly related to Interstitial Lung Disease (SSc-ILD) (p= 0.001), SSc subtypes (p=0.03), dyspnea (p=0.01) and FVC (p=0.046). A significant relation between GERD and ILD (p<0.05) was found.Conclusion: This study confirmed an increased prevalence of esophageal motility disorders in SSc patients with and without esophageal symptoms.
https://mjcu.journals.ekb.eg/article_61485_0dde4f73c766eaf26372ac1e4abf6c60.pdf
2018-12-01
3705
3713
10.21608/mjcu.2018.61485
HRM – Systemic sclerosis – HRCT – Esophageal motility
ESSAM ABD EL-MOHSEN, M.D.;
RANIA M. GAMAL, M.D.
1
The Departments of Internal Medicine* and Rheumatology & Rehabilitation**, Faculty of Medicine, Assiut University, Assiut, Egypt
AUTHOR
ORIGINAL_ARTICLE
Evaluation of Anti-Rheumatoid Arthritis Activity of White, Black Mulberry and Turmeric in Complete Freund's Adjuvant Induced Rheumatoid Arthritis Rats
AbstractBackground: Rheumatoid arthritis (RA) is an autoimmune disorder which affects 0.5-1% of the adult population. RA affects any age group, including children, but is mostly diagnosed between the ages of 40-55 years.Aim of Study: The aim of this investigation is to evaluate of anti-rheumatoid arthritis activity of white mulberry, black mulberry and turmeric in complete freund's adjuvant induced rheumatoid arthritis rats.Materials and Methods: A total of 40 male albino rats weighing (140±10g) were used in this study. Rats were divided into 8 group, first group fed on basal diet as a control negative group, the second group were injected by 0. 1ml of complete fruend's adjuvant and used as a positive control group ,while the other groups were fed on basal diets blended with 5-10% of the white mulberry, black mulberry, turmeric as powder for 28 days.Results: The results showed that turmeric, black mulberry and white mulberry record the better results in Erythrocyte Sedimentation Rate (ESR), and C reactive protein (CRP) at entry, Rheumatoid factor (RF), Anti cyclic citrullinated peptide (Anti-CCP) because of its anti-cancer, anti-inflam-matory, anti-diabetic, and anti-rheumatic properties associated with good tolerability and safety.Conclusion: The study recommends the tested medicinal plants are useful for healing as well as for curing of human diseases because of the presence of phytochemical constituents.
https://mjcu.journals.ekb.eg/article_61486_87e348004c3f5f1d8f58538b0597dbdf.pdf
2018-12-01
3715
3722
10.21608/mjcu.2018.61486
Rheumatoid arthritis – Complete Freund's Adju-vant – Anti-inflammatory – The medicinal plants and Mulberry
SAHAR O. EL-SHAFAI, Ph.D.;
EMAD M.A. EL-KHOLIE, Ph.D.
1
AUTHOR
FATMA M.H.
ABO EL-NOR, M.Sc.
2
The Department of Nutrition & Food Science, Faculty of Home Economics, Menufia University
AUTHOR
ORIGINAL_ARTICLE
Relationship of Adropin Level and Inducible Nitric Oxide Synthase with the Phases of Intestinal Ischemia-Reperfusion in Rats
AbstractBackground: Adropin is a peptide hormone that plays an important role in energy homeostasis and endothelial functions. Nitric oxide is a potent vasodilator synthesized in the vascular endothelium from the Nitric Oxide Synthase enzyme (NOS). There are controversial studies about the role of NOS and its isoforms the endothelial (eNOS) and the inducible (iNOS) forms in Ischemia-Reperfusion (IR) injury. It was found that adropin influences gene expression of eNOS and enhances endothelial cell function. However, few researchers have studied the link between adropin and iNOS activity during different phases of IR-injury.Aim of the Study: To estimate the plasma level of adropin, and iNOS activity and to study the relationship of both of them and their role during different phases of intestinal IR-injury in rats.Material and Methods: A total of 20 rats were used in this study (200-220g). Rats were divided into two groups (10 rats/each); group I (sham-operated group) and group II which exposed to laparotomy and occlusion of the superior mesenteric artery for 30min the reperfusion for 60min. Serial blood samples were taken via an inserted carotid catheter at 0, 30, and 90min. Plasma levels of adropin and iNOS were measured by ELISA kits according to the manufacturer protocols. The contents of the intestinal lumen were centrifuged and examined for detection of hemoglobin and albumin concentrations. ANOVA with a post hoc test, independent sample t-test, and Person correlation were used for statistical analyses.Results: Plasma adropin level and iNOS activity are significantly increased during ischemic and reperfusion phases of intestinal IR-injury when compared to the pre-ischemic phase of group II or when compared to the sham-operated group. Adropin was significantly correlated with iNOS during all phases. Moreover, unlike adropin, the iNOS level was correlated with the severity of the intestinal bleeding.Conclusion: Plasma adropin level is positively correlated with iNOS activity during different phases of intestinal IR-injury in rats, and this may provide new markers for diagnosis of IR-injury during intestinal surgeries.
https://mjcu.journals.ekb.eg/article_61487_72ef781cbabf761ede9e18e50c696027.pdf
2018-12-01
3723
3732
10.21608/mjcu.2018.61487
Adropin – iNOS – Intestinal ischemia-reperfusion
DOAA A. ABD EL-MOETY, M.D.;
MAHMOUD M.A. ABUL-MEATY, M.D.
1
AUTHOR
MAI M.
ABD EL-WAHAB, M.D.
2
The Departments of Physiology* and Pathology**, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Effect of Visfatin on Testosterone Hormone Level in Chronic Restraint Male Albino Rats
AbstractBackground: Stress has been linked in many studies with infertility and hormonal irregularities. Visfatin is a novel adipocytokine which has been proven to decrease in chronic stress in rats.Aim of Study: This study aimed at evaluation of the effect of visfatin in modulation of the complications of chronic restraint on gonadal functions.Material and Methods: 32 male albino rats randomly allocated to four equal groups, group (I): Included rats fed a normal diet (control group) group (II): Included rats fed a normal diet for 2 months then received a single intraperitoneal 500pmol visfatin injection group (III): Included immobilized rats (4hr/day) for 2 months and group (IV): Included immo-bilized rats (4hr/day) for 2 months then received a single intraperitoneal visfatin injection at a dose of 500pmol. After the last visfatin dose blood samples were collected and exam-ined for testosterone, LH and FSH. Then laparotomy was conducted to dissect the right testis for histopathological studies.Results: The restraint stress has inhibitory effects on male testosterone, LH, FSH and testicular tissues in rats, marked deterioration of gonadal functions in immobilization stress group (group III), a significant decrease (p<0.001) in serum testosterone, LH, sperm count and right testicular weights, marked deterioration in the gonadal histoarchitecture, but, there was a non-significant change in serum FSH. Exogenous visfatin administration in (group IV) significantly increased serum testosterone (p<0.01), LH (p<0.001), FSH (p<0.01), and sperm count (p<0.001) than group III, and markedly improved the gonadal histoarchitecture. Group II demonstrated results similar to group III when compared to the control group.Conclusion: Visfatin plays a protective role against chronic stress-induced gonadal dysfunction via maintaining testicular steroidogenesis of Leydig cells.
https://mjcu.journals.ekb.eg/article_61488_10b66e7deeedcfcdf27f1a5d006a2a67.pdf
2018-12-01
3733
3741
10.21608/mjcu.2018.61488
Visfatin – Chronic stress – Testicular function
RADWA M. AL-SAYED, M.D.;
SAFYA E. ESMAEEL, M.D.
1
The Department of Physiology, Faculty of Medicine, Zagazig University
AUTHOR
ORIGINAL_ARTICLE
Phase II Randomized Trial of Biweekly Bevacizumab, Capecitabine, Oxaliplatin and Irinotecan (BEV- CAPEOXIRI) Versus Triweekly Bevacizumab, Capecitabine and Oxaliplatin (BEV- CAPEOX) in Metastatic Colon Carcinoma
AbstractBackground: Bevacizumab, Capecitabine and Oxaliplatin (BEV-CAPEOX) is an effective combination in patients with Metastatic Colon Carcinoma (MCC). Irinotecan is also an active agent in those patients.Aim of the Study: To compare toxicity and efficacy of first-line BEV-CAPEOXIRI (consisting of modified biweekly schedule of BEV-CAPEOX plus irinotecan) with BEV-CAPEOX.Patients and Methods: A total of 65 patients with MCC who are chemo naïve were randomized into 2 groups. Group 1 (n=33) received BEV-CAPEOXIRI and Group 2 (n=32) BEV-CAPEOX.Results: The incidence of grade 3-4 neutropenia, febrile neutropenia and G3-4 diarrhea were higher in BEV-CAPEOXIRI arm (12% versus 0%, 9% vs. 0% and 18% vs. 3%, respectively) while peripheral neuropathy G1-2 & G3 were higher in BEV-CAPEOX arm (41% & 9% vs. 18% & 3%, respectively) and also higher palmar plantar erythrodys-aesthesia G1-2 (38% vs. 21%). On comparing BEV-CAPEOXIRI with BEV-CAPEOX: Partial remission was observed in 82% vs. 69% of patients, progressive disease in 9% vs. 22% of patients, respectively while 9% of patients in each group had stable disease. Median Progression Free Survival (PFS) was 15 months (95% CI; 14-16) vs. 12 months (95% CI; 11-13), respectively, p=0.01. Median Overall Survival (OS) was 26 months (95% CI; 25-27) vs. 24 months (95% CI; 23, 25), respectively, p=0.02.Conclusion: In comparison to BEV-CAPEOX, first-line BEV-CAPEOXIRI is more effective with a higher response rate, median PFS/OS, lower neurotoxicity, lower palmar plantar erythrodysaesthesia but higher manageable diarrhea and neutropenia.
https://mjcu.journals.ekb.eg/article_61489_32d6bbc2ffc5615808cb7f276df188b3.pdf
2018-12-01
3743
3751
10.21608/mjcu.2018.61489
Metastatic colon cancer – Capecitabine – Oxali- platin – Irinotecan – Bevacizumab
ALI ABD EL-ALEEM ALI, M.D.;
MAHMOUD ABUL-MAKAREM, M.D.
1
The Department of Clinical Oncology & Nuclear Medicine, Faculty of Medicine, Ain Shams University* and The Department of General Surgery, Faculty of Medicine, Al-Azhar University**
AUTHOR
ORIGINAL_ARTICLE
Serum Adropin Levels in a Preeclampsia Like L-Name Rat Model Treated with Sildenafil Citrate
AbstractBackground: Preeclampsia, a hypertensive disorder of pregnancy, is detrimental to both mother and fetus. Sildenafil been proposed as a potential therapy to reduce blood pressure and improve uteroplacental perfusion in preeclamptic patients. Adropin is a novel secreted energy homeostasis protein regulating carbohydrate, lipid and protein metabolism, maternal adropin levels in Preeclampsia were still controversy.Aim of the Work: To evaluate serum levels of adropin in preeclampsia-like rat model and in preeclamptic rats treated with Sildenafil and to investigate their associations with some inflammatory, oxidative stress, and metabolic parameters.Material and Methods: 32 pregnant rats were divided randomly into four groups (n=8): Control group, sildenafil treated group, L-NAME group to induce pre-eclampsia and L-NAME with sildenafil treated group. In all groups, maternal Body Mass Index (BMI), placental weights, fetal weights, maternal mean arterial blood pressure (MAP), total urinary proteins, serum glucose, insulin and calculated Homeostatic Model Assessment of Insulin Resistance index (HOMA-IR), serum urea, creatinine, Triglycerides (TGs), Total Cholesterol (TC), Low Density Lipoproteins-cholesterol (LDL-c), High Density Lipoproteins-cholesterol (HDL-c), C Reactive Protein (CRP), Endothelin-1 (ET-1), and adropin were measured, also placental Malondialdehyde (MDA) levels, and activities of the antioxidant enzymes Superoxide Dismutase (SOD) and glutathione peroxidase (GSH) in placental homogenates were determined plus histopathological examination of placental sections were done.Results: L-NAME induced preeclampsia in rats and they showed significant increase in MAP, total urinary proteins, serum levels of glucose, insulin, calculated HOMA-IR, serum urea, creatinine, CRP, ET-1, TGs, TC, LDL-c, adropin and placental tissue MDA with significant reduction in maternal BMI, placental weights, fetal weights, serum HDL-c and placental tissue SOD and GSH activities as compared to other groups, additionally, L-NAME treated and L-NAME + SILD treated groups revealed positive significant correlations between adropin levels and MAP, total urinary proteins, serum levels of urea, creatinine, CRP, ET-1, TGs, TC, LDL-c, and placental tissue MDA, however they showed negative corre-lations between adropin and BMI, placental weights, fetal weights, serum HDL-c and placental tissue SOD and GSH activities.Conclusion: Increased maternal adropin levels in preec-lampsia like model in rats might represent a regulatory feed-back mechanism against endothelial placental dysfunction, insulin resistance, inflammation and oxidative stress which associated with preeclampsia, hence identify it as a potentially protective agent against preeclampsia development. Sildenafil ameliorates preeclampsia symptoms, inflammation and oxi-dative stress in a rat model of preeclampsia.
https://mjcu.journals.ekb.eg/article_61490_f1e09050bb2aa1b4379e6b4f577b942a.pdf
2018-12-01
3753
3765
10.21608/mjcu.2018.61490
Adropin – Sildenafil citrate – LNAME – Preec-lampsia – Rats
NADINE A. RAAFAT, M.D.;
MAHA A. FATHY, M.D.
1
The Department of Physiology, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Effect of Neonatal Phototherapy on Serum Levels of Interleukin 1, 6, 8, TNFa and White Blood Cell Count
AbstractBackground: Recent progress in medical sciences approved Phototherapy (PT) as a standard method of treatment and care for hyperbilirubinemia in the neonatal period. Some investi-gations have expressed concern about potential toxic effects of phototherapy, one possible harmful is affection of cytokines production, which can affect the function of neonatal immune system.Aim of the Study: This work aimed to investigate the effect of PT on serum levels of interleukin 1, 6, 8, TNFa and WBCs count in neonates with hyperbilirubinemia and in normally healthy neonates.Material and Methods: The present study was carried out at Al-Azhar University Hospital (Damietta) during the period from January 2017 to March 2018, the study included 90 Egyptian term neonates with neonatal jaundice who had total bilirubin levels higher than 15mg /dl, and 30 normal healthy neonates were selected as control group. Venous blood samples were obtained from newborn with jaundice before exposure and at 72h after exposure to PT and from controls at the time of examination for estimation of interleukins 1, 6, 8, TNFa and WBCs count.Results: The mean level of IL-1 before PT was (1.84±0.89) and decreased slightly after PT (1.75±0.63) with no statistically significant difference, (p-value=0.43). The mean value of IL-6 before PT was (38.7±19) and decreased slightly after PT (34.6±16.8) with no statistically significant difference (p-value=0.13). The mean level of IL-8 before PT was (376.4± 84.7) and decreased slightly after PT (353.7±94.6) with no statistically significant difference, (p-value=0.09). The mean level of TNFa before PT was (8.63±4.6) and increased after PT (17.6±3.2), with statistically significant difference, p-value (<0.0001). The mean level of WBCs count before PT was (11300±1987) and increased after PT (12500±2281) with statistically significant difference, (p-value=0.0002).Conclusion: Our findings demonstrate that an increased levels of serum TNFa and WBCs count in healthy term neonates after PT could be considered as complications. Therefore, it seems that PT can alter the function of the immune system. Otherwise, the levels of interleukins 1, 6, 8 were very slightly decreased after PT.
https://mjcu.journals.ekb.eg/article_61491_70e3e3f8ce939a6880e88dd72e245d3e.pdf
2018-12-01
3767
3772
10.21608/mjcu.2018.61491
Phototherapy – Interleukins – Tumor necrosis factor a – Jaundice
SAAD A. MOHAMED, M.D.;
AHMAD EL-ASKARY, M.D.
1
AUTHOR
AHMED ABD EL-TAWAB, M.D.;
MOHAMED M. KHALIFA, M.D.
2
AUTHOR
ORIGINAL_ARTICLE
The Prevalence and Correlates of Back Pain in Adults: A Cross Sectional Study from Asir Region
AbstractBackground: Low back pain is a global health problem and it is a common form of muscluskeleton diseases. Low back pain interferes with the quality of life of the individuals, and it is a leading cause of medical consultation. Smoking, life style and physical activity had association with LBP.Aim of the Study: To measure prevalence of back pain among adult population in Asir Region.To assess back pain's correlation with age, gender, smoking and physical activity.To assess influence of times per day and years of smoking on back pain.Methods: The study is descriptive cross sectional study, it was performed during the period from April 2018 to May 2018 on adult educated population in Asir Region. A structured self-administered questionnaire was developed to investigate sociodemographics variables, smoking history, medical history and back pain history.Results: The study included 400 participants, 260 (65%) of them were males and 140 (35%) were females. There were 52.3% of participants reported having back pain, and 97 (24.3%) reported having continuous back pain. Several factors influenced the prevalence of back pain; it was found that being male was associated with suffering back pain (p-value= 0.03). Whereas performing sport activity was associated with having no back pain (p-value=0.02). Age had no significant correlation with back pain. The study included 217 (54.3%) current smoker and 43 (10.7%) ex-smoker. There were 89 (22.3%) smoking 1-3 times per day and 107 (26.8%) smoking since 4-6 years, also in this study we find a strong relation between smoking and back pain (p-value=0.001).Both of times of smoking per day and years of smoking positively associated with back pain (r=+0.3, p-value=0.004; r=+0.4, p-value=0.03 respectively). Persistence of back pain positively associated with years of smoking (r=+0.2, p-value= 0.02).Conclusion: There was moderate prevalence of back pain among our participants. The prevalence of back pain was found to be associated with gender, smoking state and physical activity. It was more prevalent in males and smokers, whereas performing sport activity was associated with having no back pain. The prevalence of back pain was found to be associated with times and years of smoking and the chronic back pain was positively associated with years of smoking.
https://mjcu.journals.ekb.eg/article_61493_1f3b7124d63795f74955eb22442d046f.pdf
2018-12-01
3773
3778
10.21608/mjcu.2018.61493
Lower back pain – Gender – Smoking – Saudi Arabia – Adults
ALI MOHAMMED AL-AHMARI, M.D.;
ABDULLAH ALI AL-QARNI, M.D.
1
AUTHOR
OSSAMA
MUSTAFA, M.D.
2
The Department of Internal Medicine, KKU, Asir Region* and The Department of Family & Community Medicine, King Khalid College of Medicine, Abha**, Saudi Arabia
AUTHOR
ORIGINAL_ARTICLE
Response of Chronic Myeloid Leukemia's Patient to Different Types of Tyrosine Kinase Inhibitors
AbstractBackground: Chronic Myeloid Leukemia (CML) is a proliferative neoplasm with an incidence of one to two cases per 100,000 adults. It accounts for approximately 15% of newly diagnosed cases of leukemia in adults, it is a serious and life-threatening condition, but with the introduction of tyrosine kinase inhibitors, there is much better life expectancy with low incidence of mortality and morbidity.Aim of Study: Retrospective study to determine the re-sponse of CML patients to Imatinib and Nilotinib as a second lines of TKIS.Patients and Methods: Records of CML patients who attended Assiut University Clinical Hematology Unit and Clinical Oncology Unit from 2014 to 2016 were revised and evaluated for complete hematological response, Partial Cy-togenetic Response (PCR), Complete Cytogenetic Response (CCR) and Major Molecular Response (MMR).The study evaluated the response of CML patients to two types of tyrosine kinase inhibitors; imatinib and Nilotinib as a second line therapy either by increasing the dose of imatinib 400mg to 800mg and Nilotinib 600mg to 800mg or shifting to the other line.Results: Administration of Nilotinib 600mg/day or 800 mg/day achieved a higher percentage of MMR than imatinib (p=<0.001).Conclusion: Nilotinib is a selective efficient second line TKI drug after failure or tolerance to Imatinib as it is more effective than imatinib as a second line therapy either by increasing the dose or shifting to it regarding MMR with a p-value 0.04.The development of TKIs has changed the natural history of CML patients with improvement in the overall survival and life style.
https://mjcu.journals.ekb.eg/article_61494_09a343da91f440efd0530ed4a34b7cc3.pdf
2018-12-01
3779
3785
10.21608/mjcu.2018.61494
Chronic myeloid leukemia – Tyrosine kinase inhibitors – Major molecular response – Nilotinib – Imatinib
OSAMA A. IBRAHIM, M.D.;
RANIA M. HAFEZ, M.D.
1
AUTHOR
MARWA I. KHALAF, M.D.;
MARWA A. MAHMOUD, M.Sc.
2
The Departments of Internal Medicine* and Clinical Oncology**, Faculty of Medicine, Assiut University Hospital, Assiut, Egypt
AUTHOR
ORIGINAL_ARTICLE
Circulating CD4+ CD28 Null T Cells and CD4+ CD28+ T Lymphocytes in Systemic Lupus Erythematosis
AbstractBackground: Systemic Lupus Erythematosis (SLE) is a chronic multi factorial systemic autoimmune disease which affects multiple organs such as joints, the skin, kidneys or central nervous system. T cells may be a contributing factor in pathogenesis of SLE.Aim of Study: The objective of this study was to evaluate senescent CD4+ CD28 null T lymphocytes and conventional CD4+ CD28+ T lymphocytes in SLE patients with and without nephritis.Subjects and Methods: The study was conducted on 51 patients with SLE; 21 patients with nephritis and 30 patients without nephritis, in addition to 15 age and sex matched healthy individuals as control. The CD4/CD28 expression on peripheral blood lymphocytes was measured for all study subjects using flowcytometry technique.Results: CD4+/CD28 null T-lymphocytes showed no statistically significant difference among the studied groups. Meanwhile, CD4+/CD28+ T lymphocytes were significantly higher SLE patients with nephritis than controls (p=0.009). There was significant positive correlation between CD4+/ CD28+ T lymphocyte population size and serum creatinine in SLE with nephritis (p=0.004).Conclusion: CD4+/CD28+ T lymphocyte population was higher in SLE patients with nephritis than controls and show statistically significant changes in correlation with serum creatinine level.
https://mjcu.journals.ekb.eg/article_61495_9778da7c3f5838efc87113c39a2cf33d.pdf
2018-12-01
3787
3791
10.21608/mjcu.2018.61495
CD4+/CD28+ – CD4+/CD28null – Lupus – Nephritis – T-lymphocytes
MAHA A. BASSIOUNY, M.D.;
ENAS S. ESSA, M.D.
1
AUTHOR
KHALED M.A. EL-ZORKANY, M.D.;
DOAA M.S. EL-SAYED, M.Sc.
2
The Departments of Clinical Pathology* and Internal Medicine**, Faculty of Medicine, Menoufia University, Menoufia, Egypt
AUTHOR
ORIGINAL_ARTICLE
Value of Renal Diffusion-Weighted MRI as a Non-Invasive Predictor of Renal Dysfunction
AbstractBackground: Chonic kidney disease (CKD) is a widespread health trouble. Laboratory tests and differant radiological procedures are helpful for the assesing tje kidney anatomical cganges and function. Diffusion weighted (DW) MRI with the apparent diffusion coefficent (ADC) are growing fields and numerous studies have tried to estimate their value in the assessment of the renal parenchyma.Aim of Work: To assess relationship between kidney laboratory markers and values of MR apparent diffusion cofficient (ADC) of the renal parenchyma.Patients and Methods: A ratrosective study was made for 100 patients who were examined by DW-MRI (at 0 and 500s/mm2 b-values) for different renal lesions along the year 2017, revealed 44 patients having renal dysfunction and 56 with normal kisney function. Among those 44, 30 patients were known to have CKD. The ADC values were measured for the renal parenchyma of each kidney & compared withe those values of the control normal kidneys. Receicer operating characteristic (ROC) curve was made to specify the ADC cut-off value.Results: Significantly lower average ADC values were noted in patients with renal dysfunction than those in patients having normal kidney function (1.69vs. 2.29 (x10-3mm2/s). An inverse correlation between the ADC value and serum creatinine was statiscally significant (r=0.778, p=0.002). The cut of ADC value for renal dysfunction was 2.0355 (x10- 3mm2/s).Conclusion: Measured MRI ADC values can be a useful marker for prediction od renal parenchymal disease. Beside renal morphological assessment, MRI can give useful idea about the renal function though measuring the ADC values for total comoprehhensive renal assessment.
https://mjcu.journals.ekb.eg/article_61496_45fe1dc65405aee34dd4a81a12c7e992.pdf
2018-12-01
3793
3798
10.21608/mjcu.2018.61496
Chronic kidney disease (CKD) – Apparent diffusion coefficent (ADC) – Diffusion weighted (DW)
SHERIF F. ABD EL-RAHMAN, M.D.;
AHMED M. SHOMAN, M.D.
1
The Departments of Radiology* and Urology**, Faculty of Medicine, Cairo University, Egypt
AUTHOR
ORIGINAL_ARTICLE
The Accuracy of Lung Ultrasonography Versus Chest Radiography for Diagnosis and Follow-up of Pneumonia in Critically Ill Patients
AbstractBackground: Pneumonia is a common and serious infec-tious disease that can cause high mortality. Lung ultrasonog-raphy is being increasingly utilized in emergency and critical settings. The role of Lung Ultrasound (LUS) in the diagnosis and follow-up of pneumonia is becoming more and more important.Aim of the Work: To compare the diagnostic accuracy of LUS against a referent Chest X-Ray (CXR), chest contrast-enhanced Computerized Tomography (CT) scan and/or clinical criteria for diagnosis and follow-up of pneumonia in critically ill adult patients.Patients and Methods: We enrolled 32 (11M, 21F) multi-morbid patients aged 61.31±12.13 years from March 2016 to October 2016. Each participant underwent CXR and bedside LUS within 6 hours from Intensive Care Unit (ICU) admission. LUS was performed by skilled clinicians, blinded to CXR results and clinical history. The final diagnosis (pneumonia vs. no-pneumonia) was established by another clinician re-viewing clinical and laboratory data independent of LUS results and possibly prescribing chest contrast-enhanced CT. Diagnostic parameters of CXR and LUS were compared.Results: 28 patients (87.5%) out of 32 patients with positive LUS had a final diagnosis of pneumonia. LUS was falsely positive in two cases (6.2%) and false negative in two patients (6.2%). The sensitivity and the specificity of LUS were 87.5% (95% CI 78.9-92.7%) and 89.3% (95% CI78.3- 91.9%) respectively.Conclusion: The study supports that LUS when conducted by highly-skilled sonographers, performs well for the diagnosis of pneumonia. Intensivist and Emergency Medicine physicians should be encouraged to learn LUS since it appears to be an established diagnostic tool in the hands of experienced phy-sicians.
https://mjcu.journals.ekb.eg/article_61497_8f1113b52df569c0527e1e21bae7539e.pdf
2018-12-01
3799
3805
10.21608/mjcu.2018.61497
Pneumonia – Lung ultrasound – Chest X-Ray – Chest contrast – Enhanced computerized tomog-raphy
HUDA FAHMY, M.D.;
SAYED KINAWY, M.D.
1
The Departments of Anesthesia & Intensive Care* and Chest Disease**, Aswan University Hospital, Egypt
AUTHOR
ORIGINAL_ARTICLE
Human Platelet Rich Plasma Alleviates Liver Fibrosis in Murine Schistosomiasis Mansoni
AbstractBackground: Schistosoma (S.) mansoni infection leads to hepatic fibrosis that may cause severe complications. Currently, there is no effective medication against schisto-somiasis liver fibrosis.Aim of the Work: The aim of the present study was to evaluate the anti-fibrotic effects of human platelet rich plasma (PRP) against S. mansoni liver fibrosis in experimentally infected mice alone or in combination with praziquantel (PZQ).Materials and Methods: Seventy male BALB/c mice were divided into five mice groups; group I: Uninfected control (UC, n=10); group II: Infected, untreated (IU, n=15); group III: infected, treated 8 weeks post-infection (p.i.) with PZQ (PZQ, n=15); group IV: Infected, received 8 weeks p.i. PRP (PRP, n=15) and group V: Infected, treated 8 weeks p.i. with PZQ then received PRP (PZQ+PRP, n=15). All the mice were euthanized at 12 weeks p.i then parasitological, histopatholog-ical, immunohistochemical studies were done in addition to measuring of serum liver enzymes.Results: PZQ+PRP significantly reduced (p<0.001) the mean liver granuloma diameter by 71%, followed by PRP (51.2%) and then PZQ (33.8%). Also, PZQ+PRP achieved the highest reduction in the liver fibrosis (73.3%), whereas PRP achieved 63.8% reduction in the fibrosis and this was better than that revealed by PZQ (50.8%). On immunohisto-chemical examination of the liver sections, PZQ+PRP caused the least expression of alpha smooth muscle actin (a-SMA), transforming growth factor-b1 (TGF-b1) and inducible nitric oxide synthase (iNOS), while it induced the strongest caspase-3 expression, among the treated mice groups, in comparison to IU mice. PRP alone or in combination with PZQ significantly decreased serum liver enzymes comparing to IU mice.Conclusion: PZQ+PRP significantly reduced S. mansoni induced liver fibrosis in association with improving the liver enzymes. So, it is recommended to treat S. mansoni liver fibrosis by both PZQ and PRP, and this could be applicable in case of human liver fibrosis caused by schistosomiasis mansoni.
https://mjcu.journals.ekb.eg/article_61850_4fb661252d50a32dccb02af171e2af04.pdf
2018-12-01
3807
3823
10.21608/mjcu.2018.61850
S. mansoni – Fibrosis –PRP – Immunohistochem-istry
BAHAA EL-DEEN W. EL-ASWAD, Ph.D.;
SAMAR A. EL-REFAI, M.D.
1
AUTHOR
SHEREEN F. MAHMOUD, M.D.;
MOHAMED A. HELWA, M.D.
2
The Departments of Medical Parasitology*, Pathology** and Clinical Pathology***, Faculty of Medicine, Menoufia University
AUTHOR
ORIGINAL_ARTICLE
Comparative Study between Bone Flap Insertion in Abdominal Wall Versus Flail Replacement in Decompressive Craniectomy of Acute Subdural Hematoma
AbstractBackground: Traumatic acute subdural hematoma remains one of the most lethal of all head injuries patients with Acute Subdural Hematomas (ASDHs) having higher mortality and lower functional recovery rates compared with those of other head-injured patients.Decompressive Craniectomy (DC) for management of ASDH with accompanying brain edema and midline shift has become one of the standard guidelines in many centers. DC remains to be the standard of surgical modality for patients with poor clinical status.Subcutaneous preservation of autologous bone flap is an inexpensive option that preserves the viability of the bone flap, resulting in good cosmetic results and the very low infection rate.Aim of Study: To compare results of (ASDHs) managed with DC with consequent subcutaneous bone flap insertion in the abdominal wall vs subcutaneous hinged flail placement in the craniectomy site.Patients and Methods: A retrospective review of 61 patients with (ASDHs) operated at the Department of Neuro-surgery, Cairo University and Beni Souf University Hospital during the period from Jan. 2012 – Dec. 2015. Patients were divided into:Group (A): 31 patients operated upon with subcutaneous abdominal bone flap insertion, (22 males and 9 females) median age was 42 years. On admission there were 19 patients with Glasgow Coma Score (GCS) below 8, and 12 patients with GCS 8 or above 8.Group (B): 30 patients operated upon with subcutaneous hinged flail bone flap replacement in the craniectomy site, (22 males and 8 females) median age 44 years. On admission there were 18 patients with GCS blew 8, and 12 patients with GCS 8 or above 8.Early surgical evacuation, dural fenestration, intensive care management to monitor intra cranial pressure and follow-up CT brain were done for all patients.Results: Group (A) 14 patients died in the hospital, 4 survived with unfavorable outcome (vegetative state), and 13 survived with favorable outcome.Group (B) 17 patients died in the hospital, 4 survived with unfavorable outcome (vegetative state), and 9 survived with favorable outcome.Conclusion: Analysis of the obtained data reveals that subcutaneous abdominal bone flap insertion shows a statisti-cally significant better prognosis as compared to subcutaneous hinged flail bone flap replacement at the craniectomy site which may be due to better decompression of the brain and allowing for more roomfor expansion.
https://mjcu.journals.ekb.eg/article_61851_761b8f3b958ee44a324b117b36d44843.pdf
2018-12-01
3825
3832
10.21608/mjcu.2018.61851
Bone flap – Abdomen – ASDH – Decompressive craniectomy
AHMED S.K.
ABD EL-WAHED, M.D.
1
The Department of Neurosurgery, Faculty of Medicine, Cairo University, Egypt
AUTHOR
ORIGINAL_ARTICLE
The Role of Magnetic Resonance Imaging in the Evaluation of Children with Cerebral Palsy: A Proton Magnetic Resonance Spectroscopy Study
AbstractBackground: Study of brain metabolites using 1 HMRS in children with cerebral palsy.Aim of Work: To study the metabolite changes in the basal ganglia of children with CP in comparison with a normal control group of the same age by using proton magnetic resonance spectroscopy (1HMRS).Material and Methods: Thirty children with different types of CP with associated developmental delay were exam-ined. Different types of CP were included (spastic, dyskinetic, dystonic or choreo-athetoid and ataxic CP). The control group consisted of twenty normally developing children. The relative concentrations of N-acetylaspartate (NAA), choline (Cho), myo-inositol (mI), creatine (Cr) and their combinations within 1 cm3 brain multi voxels were measured.Results: Children with CP showed reduced ratios of NAA: Cr, NAA: Cho, mI: Cr in the basal ganglia and the increased ratio of NAA: mI and CHO: CR in relation to that of the control group. There was age-dependency increase in NAA: Cr and NAA: Cho in the basal ganglia. Metabolites ratio differs according to the severity of CP.Conclusion: MRS plays a promising role in evaluating children with cerebral palsy and also in determining the degree of learning disability aiming at a better rehabilitation of children with CP.
https://mjcu.journals.ekb.eg/article_61852_64f909b8d55e1053ba68d158f4daf0f1.pdf
2018-12-01
3833
3838
10.21608/mjcu.2018.61852
Cerebral palsy – MRS – Basal ganglia
RANIA S. ABOUKHADRAH, M.D.;
NOHA M. ABD EL-MABOUD, M.D.
1
AUTHOR
AL-SHYMAA
ZAKREYA AL-SHAHAWY, M.D.
2
The Department of Radio-Diagnosis and Medical Imaging, Faculty of Medicine, Tanta University, Tanta, Egypt
AUTHOR
ORIGINAL_ARTICLE
The Role of Lumbar Puncture in Management of Idiopathic Intracranial Hypertension (IIH)
AbstractBackground: Idiopathic Intracranial Hypertension (IIH) is characterized by clinical manifestations of elevated intrac-ranial pressure, normal CSF content, and by neuroimaging studies revealed normal brain with normal or small sized ventricle.Aim of Work: The purpose of this study is to assess clinical, ophthalmological and neuroimaging studies of IIH and the role of lumbar puncture in treatment of IIH.Patients and Methods: This is a prospective study of forty-patients were included in the study. All patients underwent clinical, ophthalmological, imaging, laboratory investigation and CSF manometry evaluations. All patients take chance for Lumbar Puncture (LP). Analysis of data was conducted and evaluation of outcome was assessed.Results: Lumbar Puncture (LP) either once or multiple sessions used for treating intractable headaches and visual impairment associated with IIH with success rate of 90%.Conclusion: Lumbar puncture is considered a high suc-cessful treatment option for IIH.
https://mjcu.journals.ekb.eg/article_61853_d97f8974853cb6f20832a865c4a21b74.pdf
2018-12-01
3839
3843
10.21608/mjcu.2018.61853
Idiopathic intracranial hypertension – Papilledema – Headache – Opening pressure lumbar puncture
KHALED I. ABD EL-AZIZ, M.D.;
AYMAN M. EL-DEMRDASH, M.D.
1
The Departments of Neurosurgery* and Anesthesiology**, Aswan University Hospital, Aswan, Egypt
AUTHOR
ORIGINAL_ARTICLE
Frequency and Presentation of Autoimmune Hepatitis and Type of Autoantibodies among Yemeni Patients Attending Private Medical Clinic in Aden Yemen
AbstractBackground: Autoimmune hepatitis is a complex disease that represents a challenge in diagnosis and management due to the diversity of the clinical presentation, now recognized as a relatively rare disease predominantly affecting females.Aim of Study: This study aimed to describe the frequency and presentation of autoimmune hepatitis and type of autoan-tibodies among patients who attend a private clinic in Aden Yemen.Patient and Methods: A prospective study carried out in a private clinic over a period of two years, from June 2016 to June 2018, all of 60 patients had raised liver enzymes and Antinuclear Antibodies (ANA), Anti-Smooth-Muscle Anti-bodies (ASMA) titers 1:80 or above upper limit, Anti Liver Kidney Microsomal (LKM-1). Titer 1:40 or above upper limit, and IgG more than 10 times of normal have been included in this study, all patients rejected liver biopsy.Results: 60 subjects were recruited into study. The sex distribution showed a prominence of female gender (63%) versus (36%) being male. Residency distribution revealed that, the majority of our patients came from shabwa governorate (53.3%). The frequency of chronic hepatitis is 40% while each of acute hepatitis and liver cirrhosis constituted 30% of patients, antinuclear antibodies was elevated in 73.3% anti-smooth-muscle antibodies in 25% while anti liver kidney microsomal antibody was elevated only in 1.6%.Conclusion: Autoimmune hepatitis frequency, presentation and type of autoantibodies among Yemeni patients do not remarkably differ from studies carried out world wide.
https://mjcu.journals.ekb.eg/article_61854_bc508503b82ab44fe5abcb21bfbf0332.pdf
2018-12-01
3845
3848
10.21608/mjcu.2018.61854
Autoimmune hepatitis – Antinuclear antibodies – Anti-smooth-muscle antibodies
OSAM S.
ABDO GABALI, M.D.
1
The Department of Internal Medicine, Faculty of Medicine and Health Sciences, Aden University, Yemen
AUTHOR
ORIGINAL_ARTICLE
Revisiting of the Epidemiology of Obesity among Primary School Children in Egypt
AbstractBackground: Childhood obesity has more than tripled in the past 30 years. The prevalence of obesity among children aged 6 to 11 years increased from 6.5% in 1980 to 19.6% in 2016 the prevalence of obesity in all age groups has increased dramatically over the past 30 years, such that overweight and obesity are considered to be a major public health concern in many countries.Aim of Study: This study aims to assess the prevalence of obesity among children of primary schools in Menoufia Governorate.Patients and Methods: Across sectional field study was carried out on 7629 Egyptian children to assess prevalence of overweight and obesity among primary school children at age of 6-12 years live in Menoufia Governorate in which 5 schools was randomly selected from rural and 5 schools from urban areas including male and female children. Each child in the study was subjected to medical history, general exam-ination and Anthropometric measurements. Study was done from the first of October 2017 to the end of November 2018 in Menoufia Governorate.Results: This study showed 12.2% of the subjects were overweight and 8.6% were obese. From this study it was concluded that females' subjects were more obese (9.7%) than male subjects (7.5%) Elder children (9-12 years) were more obese than younger children (6-<9 years). Urban residence children with higher socioeconomic standard, studied in private schools, ate fast foods and with sedentary life style showed more obesity than other children.Conclusions: It is evident that there is correlation between gender, residence, higher socioeconomic standard and fast food intake and development of obesity in primary school children.Recommendations: From this study it was recommended that there is an increased need to spread community awareness regarding obesity, its consequences, emphasizing on measures of obesity prevention among children, youth and their families, through promoting healthy diet and promoting physical activ-ities.
https://mjcu.journals.ekb.eg/article_61855_be1889b63b1e7c9a54ef1dadef9398b9.pdf
2018-12-01
3849
3857
10.21608/mjcu.2018.61855
Obesity – Body mass index – Socioeconomic standard – Anthropometric measures – Primary school children
WESAM S. MORAD, M.D.;
ALLIF ALLAM, M.D.
1
The Departments of Epidemiology & Preventive Medicine* and Pediatric Hepatology**, National Liver Institute, Menoufia University, Menoufia, Egypt
AUTHOR
ORIGINAL_ARTICLE
Guidelines for Application of Central Venous Catheters in Pediatric ICU of Assiut University Children Hospital (Clinical Audit)
AbstractBackground: Central venous catheterization can be life-saving but is associated with complication rates of approxi-mately 26.2%. Operator experience, familiarity with the advantages and disadvantages of the various catheterization sites, and strict attention to detail during insertion help in reducing mechanical complications associated with catheter-ization.Aim of Study: Evaluation of health care providers com-pliance to guidelines of application of CVL (central line-associated blood stream infection (CLABSI) guidelines 2013) in PICU (Assuit University Children Hospital).Patients and Methods: The study was conducted on patients 1m to 17 years of age for whom CVCs was applied on attending Assuit University Children Hospital in PICU. The study included 80 cases during aperiod of one year from 1/9/2016 till 1/9/2017. The study data were collected by using checklist and observing health care provider compliance to guidelines of application of CVL.Results: Central venous catheterization can be lifesaving but is associated with complication rates of approximately 26.2% and the main indication for CVC application was shock 56.6%and stick of application of guidlines ranged between 65%-100%.Conclusion: We need to stick with the international guidelines as a reference standard and proper catheter main-tenance care to decrease the frequency of complication mainly displacement and catheter-related infections.
https://mjcu.journals.ekb.eg/article_61856_a219038f96420756284d83a864a83cb6.pdf
2018-12-01
3859
3862
10.21608/mjcu.2018.61856
CVCs – Indications – Complications– Application
MAHER M. AHMED, M.D.;
ISMAIL L. MOHAMAD, M.D.
1
AUTHOR
HEBA M.
AHMED, M.Sc.
2
The Department of Pediatrics, Faculty of Medicine, Assiut University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Vitamin D Status and Spontaneous Intra Cerebral Hemorrhage: Would it be Able to Help?
AbstractBackground: Vitamin D deficiency has in like manner rose as a hazard factor for cerebrovascular stroke. It is ques-tionable if vitamin D status impacts the anticipation of patients who have created intracerebral hemorrhage. In Aswan gov-ernate, most of people had low vitamin D levels in spite of its sunny weather, as well as increased number of hemorrhagic stroke.Aim of Study: Consequently, our study planned to look at the connection between serum 25 (OH) D status and hem-orrhagic stroke, to clear up their relationship with stroke seriousness, and to evaluate its connection with functional outcome and mortality in our considered patients.Patients and Methods: This prospective cross sectional study directed on 125 patients with first time acute stroke with spontaneous intracerebral hemorrhage. All members exposed to full history taking, detailed clinical examination and neurological checking. Brain imaging was performed after hospital admission. Blood tests were drawn for appraisal of serum 25-hydroxyl vitamin D and parathyroid hormone on the first day of admission.Results: 44% and 40% of examined patients with intrac-erebral hemorrhage had lacking and inadequate vitamin D levels respectively. There was a relationship between intrac-erebral hemorrhage with vitamin D levels, and the severity of the stroke and functional outcome. In dead patients with intracerebral hemorrhage, a low vitamin D level was detectable.Conclusion: Vitamin D deficiency may have a relationship with acute intracerebral hemorrhage and its pervasive hazard factors among individuals in Upper Egypt (Aswan). Low levels of vitamin D are freely prescient for deadly strokes with more confirmation of negative result in acute intracerebral hemorrhage. Consequently, It may be a marker of more noteworthy comorbidity and a being causally identified with stroke proposing that vitamin D supplementation is a promising approach in the preventive action of strokes. Further studies are needed to investigate this relationship among different territories of Egypt and for stroke subtypes.
https://mjcu.journals.ekb.eg/article_61857_87703d512bc70e9139e10ded41b60489.pdf
2018-12-01
3863
3872
10.21608/mjcu.2018.61857
Acute stroke – Scandinavian Stroke Scale (SSS) – Modified Rankin Scale (mRS) – Serum 25- hydroxyvitamin D – Parathyroid hormone (PTH)
ABEER A. TONY, M.D.;
EFFAT A. TONY, M.D.
1
AUTHOR
EMAD F. KHOLEF, M.D.;
WAFAA S. MOHAMMED, M.D.
2
The Departments of Neurology*, Internal Medicine** and Clinical Pathology***, Faculty of Medicine, Aswan*,*** and Assiut** Universities, Egypt
AUTHOR
ORIGINAL_ARTICLE
Comparison between Score for Neonatal Acute Physiology-Perinatal Extension II (SNAP-PE II) and Clinical Risk Index for Babies (CRIB) in Prediction of Neonatal Mortality in Neonatal Intensive Care Unit (NICU) of Tanta University Hospital
AbstractBackground: Survival of the newborns who are admitted to the NICUs do not depend exclusively on birth weight and gestational age, but also on other perinatal factors and phys-iological conditions of the individual infants, in particular severity of their disease. More than one decade ago, the score for the neonatal acute physiology (SNAP), later the SNAP-perinatal extension (SNAP-PE) scores and clinical risk index for babies (CRIB) scores were proposed to be used in assessing severity, with sufficient precision to allow their application for quality assessment.Aim of Study: Was to compare between two neonatal mortality risk scores, SNAP-PE II and CRIB, in predicting the neonatal mortality in NICU of Tanta University Hospital (TUH ) over a period of one year and to measure the incidence of neonatal deaths in NICU of TUH over a period of one year.Patients and Methods: This was a prospective cohort study which was carried out on 500 newborns admitted to NICU of TUH over 1 year period. (From February 2016 to February 2017). All neonates were followed-up in NICU till their death or discharge. Neonates who had one of the following criteria were excluded: Newborn who died or was discharged in less than 24 hours after admission to our NICU, Infants whose APGAR score was not known, those who were admitted for observational purposes and those with were inevitably lethal congenital malformations. SNAP-PE II and CRIB scores applied to all the neonates in this study during the first 12 hours after their admission to NICU.Results: Area under the curve of both scores was nearly similar, meaning accuracy of both of them in predicting neonatal mortality.Conclusion: Both SNAP-PE II and CRIB scores have good sensitivity for predicting neonatal mortality which was slightly higher in SNAP-PE II score.
https://mjcu.journals.ekb.eg/article_61858_948e8172ee297ac272b61aeef5c29372.pdf
2018-12-01
3873
3879
10.21608/mjcu.2018.61858
SNAP-PE II score – CRIB score – Neonatal mortality
MARWA K.T. KHALLAF, M.Sc.;
HEBA S. EL-MAHDY, M.D.
1
AUTHOR
NIHAL S. SHIHAB, M.D.;
RASHA M.G. EL-SHAFIEY, M.D.
2
The Departments of Pediatrics* and Public Health & Community**, Faculty of Medicine, Tanta University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Role of Diffusion Weighted Imaging in the Differentiation between Benign and Malignant Breast Masses in Correlation with Sono-Mammography
AbstractBackground: Evaluation of the role of DWI in differe-ntiation between benign and malignant breast lesions with Sono-mammographic and pathologic correlation.Aim of Study: To evaluate the role of diffusion weighted imaging in the differentiation between benign and malignant breast lesions with sono-mammographic and histopathologic correlation.Material and Methods: This study included 30 females (with 31 breast lesions). Their ages ranged from 21 to 65 years. They were subjected to history, Clinical examination, sono-mammography, MRI and histopathology. The Sono-mammographic categories included were 3, 4 and 5. We used 1.5 T MRI system and the sequences performed included T1 W, T2 W and STIR. The DWI was done using b-values 0, 500, 1000s/mm2 then the ADC values were calculated. For statistical analysis we used t-test and ROC curve.Results: The mean age was 42.6 years. The most common clinical presentation was palpable breast lump (16 patients). We had BIRADS 3 (6 lesions), BIRADS 4 (17 lesions), BIRADS 5 (8 lesions). By histopathologic examination we had 9 benign neoplasm, 10 malignant neoplasm, 5 post con-servative changes, 3 fibrocystic changes, 1 granulomatous mastitis, 2 inflammatory hyperplastic changes & 1 localized adenosis. The mean ADC for benign lesions was 1.42 x10-3 mm2 and for malignant lesions was 0.88x10-3 mm2. The cut off value between malignant lesions and benign lesions was £1.175. Finally there was weak negative statistical correlation between sono-mammographic BIRADS results and the ADC values.Conclusion: The DWI and ADC values are useful tools for the differentiation between benign and malignant breast lesions especially in patients with contrast intolerance. These techniques showed considerable specificity and positive predictive values when compared to Sono-mammographic BIRADS and histo-pathologic results.
https://mjcu.journals.ekb.eg/article_61859_d9016c6ef9a73d00342d26de35ade5b0.pdf
2018-12-01
3881
3891
10.21608/mjcu.2018.61859
DWI – Benign – Malignant – Breast masses – Sono-mammography
DALIA M. BAYOUMI, M.D.;
EMAN ABD EL-SALAM, M.D.
1
AUTHOR
MARWA SHABANA, M.Sc.;
OMAR FAROUK, M.D.
2
AUTHOR
NERMIN
SOLIMAN, M.D.*
3
The Departments of Radiology* and Clinical Oncology**, Faculty of Medicine, Mansoura University, Mansoura, Egypt
AUTHOR
ORIGINAL_ARTICLE
Correlation between SOX2 and Mutant IDH1 Protein Expression in Astrocytomas and their Clinicopathologic Significance
AbstractBackground: Recent advances in genomic analyses provide a comprehensive view of the tumour-to-tumour complexity of glioma. Subgroups have been defined based on distinct genetic and epigenetic alterations and gene expression profiles. IDH1gene mutation is among the first genetic alterations observed during the development of the glioma. SOX2 is a transcriptional co-factors that are associated with various developmental milestones and is over-expressed in tumours, It plays a role in maintaining pluripotency in several cancers.Aim of Study: Evaluate the correlation between IHC expression of SOX2 and mutant IDH1 protein in astrocytomas and their clinicopathological significance.Material and Methods: The study was conducted with 50 patients diagnosed as Astrocytomas at the pathology laboratory, Suez Canal University Hospital between 2003 to 2015. The clinicopathological data were obtained from medical records Each case was studied for IHC expression of SOX2 and mutant IDH1(R132H antibody) and correlate expression results with variable clinicopathological features.Results: A statistically significant correlation between the expression of SOX2 and mutant IDH1 protein in astrocytomas and their expressions and grades of astrocytoma as, Glioblas-toma multiform (GBM) showed prominent expression of (SOX2 and mutant IDH1 protein) than other astrocytoma grades. A statistically significant relation between mutant IDH1 protein expression and tumour location with more expression among a tumour at the frontal lobe but no a statistically significant relation between SOX2 expression and tumour location. A higher SOX2 expression was among female patients compared to male patients, with a statistically significant correlation. No a statistically significant correlation between the expression of mutant IDH1 protein and gender. No a statistically significant correlation between the expression of both SOX2 & mutant IDH1 protein and age of the studied patients. A positive relationship between the expression of SOX2 and mutant IDH1 protein in the astrocytomas.Conclusion: Expression of SOX2 and mutant IDH1 protein in astrocytomas mainly GBM suggest a role in tumour invasion and dedifferentiation of tumour cells in astrocytomas.
https://mjcu.journals.ekb.eg/article_61860_0a1d245d1023203a293c99d167176d2d.pdf
2018-12-01
3893
3903
10.21608/mjcu.2018.61860
Astrocytoma – SOX2 – IDH1
SAHAR F. MANSOUR, M.D.;
ASMAA Y. IBRAHIEM, M.Sc.
1
AUTHOR
MUHAMMAD A.A. MUHAMMAD, M.D.;
AMR A. KAMEL, M.D.
2
The Department of Pathology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
AUTHOR
ORIGINAL_ARTICLE
Coronary Artery Atherosclerosis Assessment Using Multi Detector Computed Tomography and its Correlation with Framingham Risk Score Among Symptomatic Patients with Chest Pain
AbstractBackground: A non-invasive assessment of coronary atherosclerosis by means of Framingham risk scoring (FRS) and multi-slice computed tomography coronary angiography (MSCT) could improve patients' risk stratification. However, the data is still limited on the strong association between FRS and imaging modality in the form of MSCT coronary angiog-raphy.Aim of Work: To study the relationship between the extent of atherosclerotic affection among symptomatic patients with chest pain assessed by MDCT & the CAD risk as assessed by FRS.Patients and Methods: This prospective cross sectional study took place between September 2017 and September 2018, at Kobry El-Kobba Military Hospital, and enrolled 150 patients who presented with chest pain. All patients were subjected to clinical assessment with FRS, after which they had undergone MDCT coronary angiography to diagnose the type of vessels affected, number of stenotic segments, as well as the volume of plaques obstructing the vessels.Results: Most of our studied patients were males (70.7%) with mean±SD age 54.9±9.1 years. The mean ± SD FRS score was 15.6±11.3 with median value of 13.2. The majority of the patients were classified as low risk score. The patients with higher FRS showed more than 2 segments of stenosis and correlated strongly with the number of affected segments as well as the volume of detected plaques. Subjects who were in the higher risk group were significantly older, had disturbed lipid profile and showed the highest systolic blood pressure compared to the low and intermediate risk groups.Conclusion: Framingham risk score is a well validated clinical score being moderately correlated with number of affected segments and volume of plagues detected in MDCT coronary angiography. Higher group of FRS was significantly associated with male gender, older subjects and disturbed lipid profile.
https://mjcu.journals.ekb.eg/article_61861_eb9b36bf5b9b3b5cb5c58d7f2f2c80f3.pdf
2018-12-01
3905
3910
10.21608/mjcu.2018.61861
Coronary artery disease – Atherosclerosis – Multi detector computed tomography – MSCT – Fram-ingham risk score – Chest pain – Coronary ang-iography
HUSSAM EZZAT, M.Sc.;
ISLAM SHAWKY, M.D.
1
AUTHOR
AHMED FAHMY, M.D.;
AHMED MAGDY, M.D.
2
The Departments of Cardiology, Suez Canal Authority Hospital, Port Said*, Faculty of Medicine, Al-Azhar University** and Kobry El-Kobba Military Hospital***, Cairo, Egypt
AUTHOR
ORIGINAL_ARTICLE
Determination of Vitamin D3 Content in High, Low and Zero Fat Food Using High Performance Liquid Chromatography
AbstractBackground: Vitamin D, has a significant role in bone metabolism and helps calcium absorption in the body. There are only few vitamin D assay methods available for zero fat food.Aims of Study: (1) To develop an accurate and sensitive LC method for the quantification of vitamin D3 in food by optimization of each step of the analytical method: Extraction, sample preparation, separation and detection. (2) To validate the developed method. (3) To apply the method to quantify the total vitamin D3 in food from several species.Material and Methods: In this study, a rapid, simple, and economical reversed phase liquid chromatographic method was described for the determination of vitamin D3, in some high, low and zero fat samples (milk products, cereal and chewing gum samples). The isolation of fat soluble vitamins includes a saponification step and an extraction step with petroleum ether and diethyl ether. The vitamin D3 content of samples was determined by reversed phase liquid chromatog-raphy. Ultra violet-Visible (UV-VIS) detector and C18 column were used for this purpose.Results: The linearity of standard curves of vitamin D3 were 10-200 mg/ml expressed of the correlation coefficient r2 = 0.9992). The detection (LOD) and quantification (LOQ) limits were 5.09 and 15.42mg/ml, respectively. The accuracy was 101.37±4.37.Conclusion: The described reversed-phase HPLC method is favorable compared with other published HPLC-UV methods (20 and 21) because of its stability-indicating nature, short run time and wide analytical range with outstanding linearity, accuracy and precision. The proposed method allows the determination of vitamin D3 in a single chromatographic run and is suitable for the analysis of the stability of vitamin D3. The obtained results from the assay of vitamin D3 in commer-cial nutrition supplements confirmed that the method is appropriate for the routine analysis of various food samples.
https://mjcu.journals.ekb.eg/article_61862_c28e4a9e566f3be929ac4ab294bf1cca.pdf
2018-12-01
3911
3918
10.21608/mjcu.2018.61862
Analytical measurement – Dietary supplements – Fortified foods – Infant – Vitamin D
AHMAD M. FARAG, Ph.D.;
MAHMOUD S. RIZK, Ph.D.
1
AUTHOR
HAMDY A. EL-BASSEL, Ph.D.;
MONA H. YOUSSIF, M.Sc.
2
AUTHOR
ORIGINAL_ARTICLE
Determination of Serum Endotoxin Level as an Early Cardiovascular Injury Marker in Obese Children and Adolescents
AbstractBackground: Obesity is defined as a BMI at or above the 95th percentile for children and teens of the same age and sex. Childhood obesity is associated with chronic low-grade inflammation and cardiovascular disease.Aim of Work: Was to estimate serum endotoxin level in obese children and adolescents and to evaluate its relation with cardiovascular (CV) injury risk in these children.Subjects and Methods: The current study included 30 patients recruited from the Nutrition Clinic of Pediatric Department at Tanta University Hospital and 15 healthy children and adolescents of matched age and sex enrolled as controls. All studied children were subjected to complete history taking, thorough clinical examination including blood pressure, Anthropometric measures (Weight, height, Body mass index, Triceps skin fold thickness, Waist circumference, Waist/hip ratio, Waist/Height ratio), and laboratory investiga-tions including: CBC, BUN, creatinine, SGOT, SGPT, Fasting glucose, Lipid profile, Serum Endotoxin, abdominal ultrasound.Results: There were significant differences between pa-tients and control group as regard Blood pressure levels and all anthropometric measures except height. Significantly higher levels of total cholesterol, LDH and significantly lower HDL were found in patients compared to control group. Serum Endotoxin was significantly higher in patients than controls. Significant positive correlation between Serum Endotoxin level and both Systolic, diastolic blood pressure, BMI, Waist circumference, Hip circumference, Waist /Height ratio, serum cholesterol, Serum Triglycerides) were found. Significant negative correlation between Serum Endotoxin and serum HDL was found.Conclusion: Serum Endotoxin is higher in obese children and adolescents than none obese. Serum Endotoxin is reliable early marker for obesity related cardiovascular injury in obese children and adolescents.
https://mjcu.journals.ekb.eg/article_65666_b6665b9e3500e2c18377bd77ae2b10f6.pdf
2018-12-01
3919
3926
10.21608/mjcu.2018.65666
Endotoxin – Cardiovascular (CV) injury – Obesity
EMAN M.E. SELF, M.Sc.;
MOHAMMED A. HAMMAM, M.D.
1
AUTHOR
AMANY M. ABO-ELENEIN, M.D.;
RASHA M.G. EL-SHAFIEY, M.D.
2
The Departments of Pediatrics* and Clinical Pathology**, Faculty of Medicine, Tanta University, Tanta, Egypt
AUTHOR
ORIGINAL_ARTICLE
Prevalence of Micro Vascular Obstruction and Major Adverse Cardiac Events by Echocardiography in Patients with STEMI after Reperfusion Therapy Compared with CMR
AbstractBackground: Ischemic heart disease is nowadays the leading cause of morbidity and mortality in the western world. Accurate detection and evaluation of this disease are of major importance. Cardiac magnetic resonance imaging (CMR) has an increasing role in the detection and evaluation of ischemic heart disease, and can be used to measure global and regional myocardial function, the presence of ischemia and myocardial scar tissue.Aim of Study: The primary aim of this study is to compare the CMR with the Echocardiography (Echo) in evaluating occurrence of micro vascular obstruction and major adverse cardiac events within one month of revascularization.Material and Methods: The study was carried out at the National Heart Institutes during the period from 1st of October 2016 till 1st of October 2017. Twenty patients were included in the study with documented ST segment elevation myocardial infarction (STEMI) and underwent reperfusion with primary percutaneous coronary intervention (PCI).All patients are subjected to history, laboratory investiga-tion, Electrocardiogram (ECG), ECHO, revascularization by primary PCI, CMR and another Echo after revascularization.Results: There was highly statistically significant relation between patients with Microvascular obstruction (MVO) and occurrence of major advance cardiac events (MACE) as all patients with MVO had MACE (p-value <0.001), while only 6% of the patients without MVO had MACE. After revascu-larization, 4 patients had MVO (20% of the study population), while MACE occurred in 5 patients (25% of the study popu-lation). There were statistically significant relation between score index (SI) and Ejection Fraction (EF) before and after revascularization (p-value <0.001) with mean score index before 1.27-}0. 15 and after 1. 13-}0.09 while mean EF before 52.80-}5.55 and after 57.80-}4.46.After revascularization there were significant difference between score index by ECHO and that by CMR (p-value= 0.035) while no significant difference measured between EF by ECHO and that by CMR.Before revascularization only EF has significant correlation with MVO, patients without MVO had mean 54.25-}4.68 and patients with MVO had mean 47-}5.41 with p-value=0.029 while no significant relation between score index, left ventricle end systolic diameter ( LVESD), and left ventricle end diastolic diameter (LVEDD) with MVO with p-value >0.05. As regard-ing occurrence of MVO and ECHO there were significant difference in score index between patients with MVO and patients without MVO (p-value<0.05) Also, EF has significant difference between patients with MVO and patients without MVO (p-value <0.05).After revascularization score index by ECHO has signif-icant relation in prediction of MVO (p-value=0.019). Also, score index by CMR has highly significant relation in predic-tion of MVO (p-value <0.001).Conclusion: We conclude that data obtained by CMR are better than ECHO in assessment of MVO and MACE. Delay in revascularization by PCI after STEMI affect cardiac muscle and was associated with post revascularization chest pain, so we should start revascularization by primary PCI as soon as possible to protect cardiac muscle from infarction.
https://mjcu.journals.ekb.eg/article_61863_6d4a04369986203ea52443aed67d9360.pdf
2018-12-01
3927
3935
10.21608/mjcu.2018.61863
ISLAM Sh. ABD EL-AZIZ, M.D.;
ALI A. RAMZY, M.D.
1
AUTHOR
ALI A. EL-SHARKAWY, M.D.;
MOHAMED F. ABD EL-MOATY, M.D.
2
AUTHOR
MOHAMED A.
HASSAN, M.Sc.
3
AUTHOR
ORIGINAL_ARTICLE
Audit of Antibiotic Uses in Pediatric Intensive Care Unit of Assiut University Hospital
AbstractBackground: Antimicrobial therapy is common among patients hospitalized in Intensive Care Units (ICUs) compared with patients in the general hospital population. Overuse and inappropriate use of antibiotics are key factors contributing to emergence of multidrug-resistant pathogens, so surveillance of their use is important.Aim of Study: To assess the appropriateness of antimicro-bial prescription according to clinical and microbiological findings, and formulary guidelines.Patients and Methods: The study included 162 patients who stayed longer than 24 hours in the pediatric ICU.Results: All of the total 162 patients admitted in PICU during the study period received antibiotics: Of them 30.8% (n=50) prophylactically, 70.3% (n=114) empirically, and 11.7% (n=19) therapeutically. 18.5% of patients received one antibiotic, and 81.5% received two or more antimicrobial combination.Conclusion: This study provides valuable insight to antibiotics usage in PICU of developing country, which shows that antibiotics are prescribed universally in our PICU. Strat-egies to assess the need for antibiotic use are needed.
https://mjcu.journals.ekb.eg/article_61864_04cc38e803ea140a4753eea60db3deca.pdf
2018-12-01
3937
3941
10.21608/mjcu.2018.61864
Antibiotic use – infection – Pediatric Intensive Care Unit
AMANY M. SAKHR, M.Sc.;
MOHAMED M.H. GHAZALY, M.D.
1
AUTHOR
ISMAIL L.
MOHAMAD, M.D.
2
The Department of Pediatrics, Faculty of Medicine, Assiut University, Egypt
AUTHOR
ORIGINAL_ARTICLE
The Efficacy of Subcutaneous Swabbing of Cesarean Section Wounds with Povidone Iodine to Prevent Post-Operative Wound Infection: A Randomized Controlled Study
AbstractBackground: Cesarean delivery is one of the most common surgical procedures performed by obstetricians. Infectious morbidity after cesarean delivery can have a tremendous impact on the postpartum woman's return to normal function and her ability to care for her baby. Despite the widespread use of prophylactic antibiotics, post-operative infectious morbidity still complicates cesarean deliveries [1]. Wound irrigation with povidone-iodine, an antiseptic solution, may be useful for reducing infection, but it is of uncertain efficacy and risk. Povidone-iodine irrigation is a simple and inexpensive solution with the potential to prevent surgical site infection [2].Patients and Methods: This study was a randomized controlled prospective study in Assiut University Women's Health Hospital on women undergoing cesarean delivery in the period from November 2015 to September 2016. Study group (Group A) the subcutaneous tissue was swabbed with 10cc of undiluted 10% povidone iodine and was not mobbed. Group B; no swabbing.Aim of Study: To assess the efficacy of subcutaneous swabbing of cesarean section wounds with povidone iodine to prevent post-operative wound infection.Results: In our study, there was no statistically significant difference in personal and clinical history as regarding age, education, residence, urgency of cesarean section, presence of labor, gravidity, number of abortion but there was a statistical difference between the study groups in number of living children and number of previous cesarean section. There was no statistically significant difference in clinical examination as regarding BP, temperature, gestational age, presentation, presence of tender scar and rupture of membranes. There was a statistical difference between the study groups in pulse. There was a statistical difference between the study groups in investigations as regarding WBCs, estimated fetal weight and amniotic fluid index but there was a statistical difference in HB and platlets. There was no statistically significant difference in the operative data as regarding visceral and parietal peritoneal closure and duration of the procedure but there was a statistical difference in the level of the surgeon. There was no statistical difference between the study groups in presence of post-operative infection.Conclusion: There was no benefit of subcutaneous tissue swabbing with povidone iodine in decreasing wound infection following cesarean section.
https://mjcu.journals.ekb.eg/article_61866_d32cbb858b53a1573729621b3d70208f.pdf
2018-12-01
3943
3950
10.21608/mjcu.2018.61866
Cesarean section – Wound infection – Povidone iodine
DIAA EL-DEEN M. ABD EL-AAL, M.D.;
MOHAMMAD M.F. FATHALLA, M.D.
1
AUTHOR
IBRAHEEM I. MOHAMMD, M.D.;
ASMAA M. ABD EL-NABY, M.Sc.
2
The Department of Obstetrics and Gynecology, Faculty of Medicine, Assuit University* and Dairout General Hospital**
AUTHOR
ORIGINAL_ARTICLE
Determination of Activity of Multiple Sclerosis (MS) Lesions in the Brain by Different Magnetic Resonance Imaging (MRI) Pulse Sequences
AbstractBackground: Multiple sclerosis is one of the commonest causes of chronic neurological disability in young and middle aged people. MRI offers a unique in-vivo investigative tool for its evaluation.Aim of Study: To reveal the value of different MRI pulse sequences in evaluation of multiple sclerosis affection of the brain.Patients and Methods: This is a prospective hospital analytic study enrolling 25 patients diagnosed to have definite multiple sclerosis according to the McDonald's Criteria for diagnosing multiple sclerosis during the period from April 2016 to February 2017. The study was conducted in the MRI Unit of the Radiology Department of Assiut University Hos-pital.Results: All the enhancing lesions showed restricted diffusion in DW images at high b values accounting for 100% sensitivity and negative predictive value of DWI pulse se-quence. On the other hand, some of the non-enhancing MS lesions, showed diffusion restriction in DW images, assuming a positive predictive value and specificity of 36.3% and 94% respectively. Post-contrast Magnetization Transfer Contrast (MTC) images could significantly detect higher number of enhancing MS lesions than standard T1W-SE images. All the enhancing lesions depicted on post-contrast T 1 W-SE sequence were also seen enhancing in MTC images, but more conspic-uous.Conclusion: Diffusion weighted imaging and magnetiza-tion transfer imaging provide suitable investigative tools for determination of multiple sclerosis activity.
https://mjcu.journals.ekb.eg/article_61867_10ce93ad06b9b545ea8126ea24aaf082.pdf
2018-12-01
3951
3956
10.21608/mjcu.2018.61867
Multiple sclerosis – Active lesions – Diffusion weighted imaging – Magnetization transfer con-trast
HOSAM A. YOUSEF, M.D.;
ANWER M. ALI, M.D.
1
AUTHOR
NISREEN A. ABBAS, M.D.;
SARA A. ABUEL-WAFA, M.Sc.
2
The Departments of Diagnostic Radiodiagnosis* and Neurology**, Faculty of Medicine, Assiut University, Assiut, Egypt
AUTHOR
ORIGINAL_ARTICLE
Clinical Audit on Service Provider Hand Hygiene at Neonatal ICU of Assiut University Childern Hospital
AbstractBackground: Hand hygiene is considered the simplest and most effective measure to prevent cross-transmission of microorganisms and hospital acquired infection.Aim of Study: To evaluate service providers hand hygiene in Neonatal Intensive Care Unit of Assiut University Childern Hospital within six months.Patients and Methods: The target population in this study were service providers in Neonatal Intensive Care Unit in Assiut University Childern Hospital including physicians and nurses. An observational checklist guidelines was used to assess service provider hand hygiene at NICU within six months between september 2016 and february 2017.Results: The total number of hand hygiene settings eval-uated were 1118 including 891 hand wash (482 nurses, 409 physicians) and 227 hand rub (119 before endo-tracheal intubation and 108 before umbilical catheter insertion).
https://mjcu.journals.ekb.eg/article_61868_dd44ec2e7f078c25238cd608a2389f56.pdf
2018-12-01
3957
3961
10.21608/mjcu.2018.61868
Hand hygiene – Service provider – Hand hygiene preparations – Hand wash – Hand rub – Physi-cians – Nurses
ZEINAB M. MOHEY EL-DIN, M.D.;
NAFISA H. REFAT, M.D.
1
AUTHOR
JOHN N.
AZMY, M.Sc.
2
The Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt
AUTHOR
ORIGINAL_ARTICLE
The Effect of Rebound Therapy on Sitting in Children with Cerebral Palsy
AbstractBackground: Sitting is an essential step to achieve upright position and posture background. Cerebral palsy children have poor trunk control and trunk muscles weakness, that contribute to delayed sitting position.Aim of Study: Examine the effect of rebound therapy on sitting in hemiplegic cerebral palsy children.Material and Methods: Forty children withspastic hemi-plegic cerebral palsy, of both sexes, their ages ranged from 6 months to 1year, were randomly assigned into two equal groups. Control groupreceived traditional physical therapy exercises to facilitate sitting, and study groupreceived rebound therapy exercises to facilitate sitting. The gross motor function measure was used to evaluate the sitting in both groups before and after three months of treatment.Results: The results showed significant difference in some items of GMFMS before and after treatment in both groups (control and study group), while there was nosignificant difference inanother items in both groups.Conclusion: The obtained results suggested that rebound therapy exercises may be beneficial in improving sitting in children with hemiplegic cerebral palsy.
https://mjcu.journals.ekb.eg/article_61869_b723899350a99c8aac3901086f0ec559.pdf
2018-12-01
3963
3969
10.21608/mjcu.2018.61869
Cerebral palsy – Hemiplegia – Rebound therapy – Sitting
KHADIGA A. MOHAMED, M.Sc.;
HEBATALLA M. KAMAL, Ph.D.
1
AUTHOR
WALAA ABD EL-NABI, Ph.D.;
AHMED M. KHOLEIF, M.D.
2
The Department of Physical Therapy for Paediatrics*, Faculty of Physical Therapy, Cairo University and The Department of Orthopedic Surgery**, Faculty of Medicine, Cairo University
AUTHOR
ORIGINAL_ARTICLE
The Relation between Intravenous Fluid Intake and the Course of Labour in Primigravida
AbstractObjectives: To study the impact of maternal intravenous hydration on the following: Labor duration, the need for oxytocin administration, and the occurrence of adverse out-comes due to prolonged labor.Patients and Methods: In a randomized clinical trial 120 nulliparous women with normal singleton pregnancies divided in to three groups. Group A: Included 40 pregnant women received 250ml per hour. Group B: Included 40 pregnant women received 125ml per hour. Group C: Included 40 pregnant women did not receive any IV fluids.Results: The duration of uterine contractions and active labor we found that all these measures were significantly higher in the 250ml group 37.9±3. 1 than in the 125ml group and the control group. There was no significant difference in frequency of oxytocin administration for inadequate labor progress and mode of delivery between the three groups. There was no significant difference between the three groups according to neonatal wellbeing by apgar score at 1,5 and 10 minute after birth.Conclusion: It has been found that adequately hydrated women had a shorter labor duration than poorly hydrated women and that they did not require oxytocin as frequently for labor augmentation.
https://mjcu.journals.ekb.eg/article_62192_c8ad0128d4a516c083ec11e915448462.pdf
2018-12-01
3971
3978
10.21608/mjcu.2018.62192
Labour – Hydration – Partogram – Intravenous fluid – Primigravida
ABD EL-GHAFFAR M. AHMED, M.D.;
SAFWAT A. MOHAMMED, M.D.
1
AUTHOR
AHMED I. HASSANEIN, M.D.;
SHAIMA ALI, M.Sc.
2
The Department of Obstetrics & Gynaecology, Faculty of Medicine, Women Health Hospital, Assiut University
AUTHOR
ORIGINAL_ARTICLE
The Diagnostic Performance of Red Cell Distribution Width and Mentzer Index for Discrimination between Iron Deficiency Anemia and Beta Thalassemia Trait
AbstractBackground: Mild microcytic hypochromic anemias due to Iron Deficiency (IDA) and Beta Thalassemia Trait (b-TT) continue to be a cause of significant burden to the society, particularly in the poorer developing countries, as b-TT is often misdiagnosed as iron deficiency anemia in children because the two produce similar hematologic abnormalities on Complete Blood Count (CBC), and IDA is much more prevalent. So it is important to differentiate between thalassem-ic and non thalassemic microcytosis as both conditions share many characteristics and have important clinical implications. Thus a correct diagnosis in patients with microcytic anemia can provide an indication for supplementing iron to IDA patients, for avoiding unnecessary iron therapy in thalassemia carriers and of course also for preventing severe and lethal forms of thalassemia syndromes in the framework of premarital counseling in high-prevalence areas.Aim of Study: To evaluate the diagnostic performance of simple and costless methods, i.e. red cell distribution width (RDW%), red cell distribution width index (RDWI) and Mentzer index for discrimination between IDA and b-TT.Patients and Methods: The study was conducted on 50 patients with microcytic hypochromic anemia, 26 males and 24 females aged from 2- 4 years recruited from the Hematology Outpatient Clinic. In addition, 15 apparently healthy children with matchable age and sex, selected from relatives of the patients were enrolled in the study as a control group.Results: The highest sensitivity rate (100%) was shown by RDW index but with a low specificity rate, (79.3 1%) followed by Mentzer as well as Green and King indices with a sensitivity=95.24% for each, while the specificity rate of Mentzer index was 93. 1% and that of Green and King index was 79.31%.Conclusion: Among the studied indices, reduced Mentzer index <13 showed the highest diagnostic performance for discrimination between iron deficiency anemia and beta thalassemia trait by detection of increased Hb A2 >3.5% as proved by ROC test.Recommendation: As discrimination between iron defi-ciency anemia and beta thalassemia trait is very essential to reach the suitable therapeutic strategy for such cases, therefore, we recommend the use of Mentzer index as a feasible, costless method with a high diagnostic performance for preliminary discrimination between those two diseases.
https://mjcu.journals.ekb.eg/article_62193_c6041fcec61cc0ab9b2a48092e04bb36.pdf
2018-12-01
3979
3988
10.21608/mjcu.2018.62193
Beta Thalassemia Trait – Iron Deficiency Anemia – Mentzer index – RDW% – RDW index
HANAN S. AHMED, M.Sc.;
EKRAM A. HASHEM, M.D.
1
AUTHOR
OSAMA M. AL-ASHEER, M.D.;
AMAL A. MAHMOUD, M.D.
2
The Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt
AUTHOR
ORIGINAL_ARTICLE
Electrolyte Disturbances in Cerebrovascular Stroke
AbstractBackground: Stroke is a major public health problem. It is one of the leading causes of chronic disability and the second leading cause of death. Electrolyte disturbances have negative influences on the outcome of stroke.Aim of Study: The aim of this study was to find out the relative frequency of electrolyte disturbances among acute stroke patients; and their relationship with severity and outcome of acute stroke. This study was a descriptive proscriptive one.Material and Methods: Samples consisted of 33 1 patients with first ever acute CVS (<48) recruited from emergency department, ICU, stroke unite or inward Neurology Department of Assiut University Hospital. Patients with well-known organ failure were excluded. Patients were evaluated clinically on admission and discharge (within one week) by NIHSS together with estimation of serum electrolyte levels.Results: The result shows that the most common distur-bances was potassium disturbances (25.7%), followed by Sodium disturbances (22.0%), while calcium disturbances and magnesium disturbances recorded in nearly a similar rate (15.1% # 15.4%) from all studied samples. Patients presented with severe CVS (NIHSS >15) had the highest rates of dys-natremia, dyskalemia, dysmagnesemia with significance association between dysnatremia and severity of stroke (p= 0.006). Survivals of acute CVS patients with dysnatremia and dyskalemia showed clinical deterioration. This deterioration was significant among cases with hyponatremia, hypernatremia and hypokalemia who were not amenable for correction of their electrolyte disturbances. Among cases who died of acute CVS dysnatremia was the most commonly encountered elec-trolyte disturbances (40.0%).Conclusion: The incidence of electrolyte disorders in acute stroke patients was high, and severe CVS cases had the highest rates of dysnatremia, dyskalemia, and dysmagnesemia. Dysnatremia had significant association with stroke severity. Dysnatremia and dyskalemia affect prognosis of stroke neg-atively.
https://mjcu.journals.ekb.eg/article_62194_e258fd1de31c4c2a50c5655274cb04ac.pdf
2018-12-01
3989
3996
10.21608/mjcu.2018.62194
Electrolyte disturbances – Sodium – Potassium – Calcium – Magnesium – Severity – Stroke – Outcome – Acute stroke
ASMAA Z.M. KASEM, M.Sc.;
WAFAA M.A. FARGHALY, M.D.
1
AUTHOR
AMAL M.A.
TOHAMY, M.D.
2
The Department of Neuropsychiatry, Faculty of Medicine, Assiut University, Assiut, Egypt
AUTHOR
ORIGINAL_ARTICLE
Efficacy of Incentive Spirometer Training on Diaphragmatic Excursion and Quality of Life in Hemodialysis Patients
AbstractBackground: The generalized muscle weakness found in Chronic Kidney Diseases (CKD) patients on hemodialysis primarily affects the lower limbs and the proximal muscles. Patients also present decreased endurance and decreased respiratory muscle strength.Aim of Work: The purpose of this study was to evaluate the effect of incentive spirometer training on diaphragmatic excursion and Quality of Life (QOL) in Hemodialysis (HD) patients.Subjects and Methods: Sixty HD patients (30 men and 30 women) selected from the National Institute of Urology and Nephrology participated in the study, their ages ranged from 45-55 years from July 2017 to January 2018. They were assigned randomly into two groups equal in number; 30 patients each: Group (A) received incentive spirometer training with hemodialysis for 8 weeks, 3 sessions per week. Group (B) maintained on hemodialysis only for 8 weeks 3 sessions per week with pre and post assessment of diaphragmatic excursion by ultrasonography and QOL questionnaire.Results: Incentive spirometer training induced a significant improvement in diaphragmatic excursion and quality of life questionnaire in study group with percent of change 24.62% and 55.67% respectively while a deterioration was observed in control group with percent of change 26.49%, and 38.68% respectively.Conclusions: Incentive spirometer training for 8 weeks in HD men and women results in an improvement of diaphrag-matic excursion and QOL.
https://mjcu.journals.ekb.eg/article_62195_4cf73e06072c9d3f6a987a4784e5d30e.pdf
2018-12-01
3997
4002
10.21608/mjcu.2018.62195
Hemodialysis – Incentive spirometer – Diaphrag-matic excursion – Quality of life
HADEER S. MANSOUR, M.Sc.;
HALA M. EZZ EL-DEIN, Ph.D.
1
AUTHOR
FATMA A. MOHAMED, Ph.D.;
TAREK F. AHMED, M.D.
2
The Department of Physical Therapy for Internal Medicine, Faculty of Physical Therapy, Cairo University* and The Department of Internal Medicine and Nephrology, National Institute of Urology and Nephrology**
AUTHOR
ORIGINAL_ARTICLE
Comparison of the Changes in Corneal Biomechanical Properties after Photorefractive Keratectomy and Laser in Situ Keratomileusis Using Ocular Response Analyzer
AbstractBackground: Correction of vision using Photorefractive Keratectomy (PRK) or Laser In Situ Keratomileusis (LASIK) flap creation associated with ablation produces profound changes in the corneal structure and biomechanical properties secondary to central thinning and disruption of collagen lamellar continuity.Aim of Work: This study aims to compare the changes in corneal biomechanical properties after PRK and LASIK in the treatment of low and moderate myopia by Ocular Response Analyzer.Subjects and Methods: This study included 42 adult eyes divided into two groups: (1) Contain 21 eyes referred for Lasik surgery. (2) Contain 21 eyes referred for PRK surgery. Ocular Response Analyzer (ORA) was applied to each group to measure Corneal Hysteresis (CH) and Corneal Resistance Factor (CRF).Results: There was no statistically significant difference in CH and CRF, and between CCT and RSB between the two studied groups. There was statistically significant decrease in CH after both LASIK and PRK. There was statistically significant decrease in CRF after both LASIK and PRK. There was statistically significant difference in SE after LASIK and PRK. There was statistically significant difference between LASIK and PRK in CH and CRF change with more decrease after LASIK.Conclusion: PRK and LASIK substantially weaken the biomechanical strength of the cornea, depending on the amount of archived myopic correction, and that the changes in corneal biomechanics were larger after LASIK than after PRK.
https://mjcu.journals.ekb.eg/article_62196_01f425d9a6c3710e52269e4eada47ae3.pdf
2018-12-01
4003
4008
10.21608/mjcu.2018.62196
Corneal biomechanics – PRK – LASIK – Corneal ectasia – Ocular response analyzer
HATEM M. MAREY, M.D.;
OSAMA A. AL-MORSI, M.D.
1
AUTHOR
ISLAM N.
EL-DARAWY, M.Sc.
2
The Department of Ophthalmology, Faculty of Medicine, Menoufia University, Menoufia, Egypt
AUTHOR
ORIGINAL_ARTICLE
Primary Versus Accessory Respiratory Muscles Response to Kinesio Tape in Normal Subjects
AbstractBackground: Kinesio Tape is claimed to have the effect of increasing muscular strength.Aim of Study: Was to find the effect of the Kinesio tape as a muscle technique applied to the primary respiratory muscles and accessory respiratory muscles on Maximum Inspiratory Pressure (MIP) and Maximum Expiratory Pressure (MEP).Material and Methods: Sixty normal individuals their ages ranged from 20 to 30 years old. They were recruited from under & post graduate students at Faculty of Physical Therapy, Cairo University. The subjects were randomly divided into 2 groups equal in number, Group A included 30 subjects, the Kinesio tape was applied to the primary inspiratory muscles (diaphragm and scaleni) of the subjects. Group B included 30 subjects, the Kinesio tape was applied to the sternocleido-mastoid (as accessory inspiratory muscle) and to the external abdominal oblique and internal abdominal oblique (as acces-sory expiratory muscles). The Kinesio tape application session was once every 4 days for a total study program of three weeks.Results: There was a significant increase in the MIP in the group (A) compared with that of group (B) after the study program and there was a significant increase in the MEP in the group (B) compared with that of group (A) after the study program.Conclusion: The results of this study support the impor-tance of applying Kinesio tape over respiratory muscles to improve their functions.
https://mjcu.journals.ekb.eg/article_62197_b6f12217ae6b9351484e32947607ab25.pdf
2018-12-01
4009
4013
10.21608/mjcu.2018.62197
Kinesio tape – Respiratory muscles
AHMED A. ABD AL-RAHEEM, M.Sc.;
HALA E. HAMED, Ph.D.
1
AUTHOR
MARIAM E.
MOHAMMED, Ph.D.
2
The Department of Physical Therapy for Cardiovascular/Respiratory Disorders & Geriatrics, Faculty of Physical, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Role of Multi-Detector Computed Tomography in Diagnosis and Staging of Cholesteatoma
AbstractBackground: Pathology of the middle ear is the third most common reason of visiting a general practitioner or a family doctor. In children and teenagers, inflammatory conditions of the middle ear are the most frequent reasons to prescribe antibiotics and perform surgery.In the majority of these cases, proper diagnosis is made by clinical examination alone and patients will not benefit from additional diagnostic imaging studies. However, the prevalence of ear infections increased significantly and this may suggest that the current approach to preventing and treating middle ear inflammation is not adequate. Therefore, especially in complicated and recurrent conditions, imaging plays an important role; imaging findings may fundamentally influence the treatment. Also, in non-inflammatory conditions of external and middle ear Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) would provide a diagnosis and/or necessary information for surgery in a significant number of cases.Aim of Work: Evaluation the role of Multi-Detector Computed Tomography (MDCT) in diagnosis Chronic Sup-purative Otitis Media (CSOM) with or without cholesteatoma and staging of middle ear Cholesteatoma and assess its impact on the selection of the surgical procedure.Patients and Methods: A prospective study included 30 patients with mean age 30.4 years with CSOM with or without cholesteatoma. They were evaluated regarding to their clinical symptoms, temporal multidetector computed tomography findings, and postoperative results. MDCT staging classified cholesteatoma according to its site in the tympanic cavity (S); erosion of the ossicular chain (O); and associated complications (C).Results: MDCT imaging of these patients showed opaci-fication of middle ear cavity with integrity of the ossicular chain with 100% accuracy. Nondependent soft tissue masses in the middle ear, eroded scutum (n=20), eroded ossicles (n= 20), intact tegmen tympani (n=30), lateral mastoid fistula (n=2) and labyrinthine fistula (n=1) were observed in CSOM with cholesteatoma. All these patients underwent surgical intervention that confirmed the diagnosis of the presence of cholesteatoma in all these patients. But it also added the presence of lateral mastoid fistula and labyrinthine fistula in 1 other patient and discovered the presence of facial nerve injury in 1 patient.Conclusion: MDCT scanning has limitations, but it is a useful in diagnosis, staging and surgic
https://mjcu.journals.ekb.eg/article_62198_6c0a7117620eac5abd094437d156b27d.pdf
2018-12-01
4015
4022
10.21608/mjcu.2018.62198
MDCT – CSOM – Cholesteatoma – Middle ear
MOHAMED S. SADEK, M.Sc.;
GEHAN S. SEIF EL-DEN, M.D.
1
AUTHOR
HAZEM ABUZEID, M.D.;
MOHAMED SALEM, M.D.
2
The Departments of Diagnostic Radiology* and Ear, Nose & Throat (ENT)**, Faculty of Medicine, Assiut University, Assiut, Egypt
AUTHOR
ORIGINAL_ARTICLE
Grade of Dysphonia: Correlation with Patient Self-Assessment Questionnaire and Acoustic Measures
AbstractBackground: The vocal assessment process should con-sider the multidimensionality involved in the demonstration of a voice disorder. Auditory perceptual assessment is the most commonly used clinical voice assessment method (gold standard) for evaluation of voice disorders. However, it has been heavily criticized because it is subjective and classifies severity of vocal disorders but does not address the impact of the vocal disorder has on quality of life which may go beyond the level of perceived voice change. So, it is possible that self-assessment instruments capture a different aspect of the vocal function that cannot be derived from auditory-perceptual or acoustic analysis.Aim of Study: The aim of this work is to investigate the correlation between grade of dysphonia obtained by auditory perceptual assessment, acoustic measures and the degree of handicap a patient experiences (as measured by the Arabic VHI) as a result of their voice disorder.Study Design: This was a descriptive cross-sectional study.Patients and Methods: 70 adult patients with voice com-plaints referred for voice evaluation in the Unite of Phoniatrics, Ain Shams University were included in this study aged 18 years-60 years and 35 normal adult subjects as a control group. Auditory perceptual assessment, acoustic analysis, and appli-cation of Arabic VHI questionnaire were done for all cases.Results: A significant correlation was found between grade of dysphonia and functional subscale of the Arabic VHI. Significant correlation was found between grade of dysphonia and amplitude perturbation quotient (APQ%) and shimmer percent (Shim%).Significant correlation was found between Arabic VHI total score and average fundamental frequency (F0), significant correlation between functional subscale of the Arabic VHI and average fundamental frequency (F0) and jitter percent (Jitt%) and near significant correlation between physical subscale of the Arabic VHI and average fundamental frequency.Conclusion: Auditory perceptual assessment, acoustic analysis and patient's vocal self-assessment measure different aspects of the voice and are not interchangeable. These measures provide complementary rather than redundant infor-mation.
https://mjcu.journals.ekb.eg/article_62199_17f53f20be9ad76e77397eea203ce4b6.pdf
2018-12-01
4023
4031
10.21608/mjcu.2018.62199
Dysphonia – Voice disorder – Patient self-assessment – Arabic VHI
FATMA EL-ZHRAA M. EL-METWALLY, M.Sc.;
YOMNA H. ELFIKY, M.D.
1
AUTHOR
RASHA M.
SHOEIB, M.D.
2
The Department of ENT, Phoniatric Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt
AUTHOR
ORIGINAL_ARTICLE
Comparative Study between Use of Endoscopic Ultrasound before Endoscopic Retrograde Cholangio Pancreatography Versus Endoscopic Retrograde Cholangio Pancreatography Alone
AbstractBackground: Endoscopic Ultrasound (EUS) could be used as non-invasive procedure instead of Endoscopic Retrograde Cholangiopancreatography (ERCP) in pancreatico-biliary disorders diagnosis. The impact of EUS use before ERCP need to be evaluated.Aim of Study: The aim of this study was to determine the impact of EUS use before ERCP in patients of pancreatico-biliary disorders as regard, the procedure accessibility, duration, success rate and rate of complications.Methods: This study was conducted on fifty patients with pancreatico-biliary disorders prepared to ERCP procedure. Randomly, 25 patients were subjected to ERCP directly (group-I) and for the remaining 25 patients EUS was done before ERCP (group-II).Results: There was no significant difference between patients of both groups regarding age and sex, clinical features, laboratory parameters, sonographic and diagnostic findings and post ERCP complications. Use of EUS before ERCP showed significant higher rates of successful stone extraction without lithotriptor and reduced the procedure duration.Conclusion: Our study supports the idea that use of EUS before ERCP showed significant reduction of procedure time and higher rates of successful stone extraction by balloon or basket without use of lithotripter and did not alter the rate of procedure complications.
https://mjcu.journals.ekb.eg/article_62200_14870348d40ee3bee966011699007caa.pdf
2018-12-01
4033
4037
10.21608/mjcu.2018.62200
Endoscopic Ultrasound (EUS) – Endoscopic Retrograde Cholangiopancreatography (ERCP) – Pancreatico-biliary disorders
ALI A. WAHEEB, M.D.;
MOHAMED A. ABD EL-KHALIK, M.D.
1
AUTHOR
ABD EL-HALIM A. EL-SHERIF, M.D.;
AHMED EL-WASSEF, M.D.
2
AUTHOR
AHMED S.
ALI, M.Sc.*
3
The Departments of Tropical Medicine* and Internal Medicine**, Faculty of Medicine, Al-Azhar University, Cairo
AUTHOR
ORIGINAL_ARTICLE
Right Anterolateral Minithoracotomy Versus Median Sternotomy in Mitral Valve Replacement
AbstractBackground: The mitral valve has been traditionally approached through a median sternotomy. However, significant advances in surgical optics, instrumentation, tissue tele ma-nipulation, and perfusion technology have allowed for mitral valve surgery to be performed using progressively smaller incisions including the minithoracotomy.Aim of Study: To compare the surgical outcome of right anterolateral minithoracotomy and median sternotomy in mitral valve replacement.Patients and Methods: This study was done in department of Cardiothoracic surgery at El-Hussen Hospital, Al-Azhar University, after approval of the local ethical committee in the period between December 2016 till December 2017.30 patients with MVD requiring mitral valve surgery were included in the study for operative and short term postoperative results to evaluate the impact of two approaches of replacement on functional status and Quality of Life of those patients who survived the operation will be studied.Results: The thirty patients were divided into two groups where fifteen patients underwent mitral valve surgery via Rt anterolateral minithoracotomy operations rely on direct vision (6-12cm) with femoral artery and vein cannulation, these patients had better cosmoses in the early and the short term postoperative period.Conclusion: It is obvious that not only better cosmoses drive surgeons to perform less invasive cardiac surgical procedures but the less invasive procedures are also intended to minimize harm to patients by reducing blood loss, reducing the amount of blood transfusion, reducing the danger of infection by minimizing wound dimensions, thereby shortening the patient's ICU and hospital stay.
https://mjcu.journals.ekb.eg/article_62779_28e3a9ecd15290512d9611de5c2b0413.pdf
2018-12-01
4039
4045
10.21608/mjcu.2018.62779
Atrial fibrillation – Cardiopulmonary bypass
MOHAMMED ABD EL-HAMEED MOHAMMED, M.Sc.;
AHMED S. ABD EL-AZIZ, M.D.
1
AUTHOR
SALEH R.
HUSSIEN, M.D.
2
The Departments of Cardiothoracic Surgery* and General Surgery**, Faculty of Medicine, Al-Azhar University
AUTHOR
ORIGINAL_ARTICLE
Relationship between Spasticity and Motor Abilities in Children with Hemiplegia
AbstractBackground: Children with spastic hemiplegic cerebral palsy have limited activities of daily living, such as dressing, feeding, and functional mobility, due to problems of the upper limb and hand function. Their gait pattern is characterized by lower speed and lower single stance time in the most compro-mised limb, as well as reduced step length and limb asymmetry.Aim of Study: To determine if there is a correlation between fine and gross motor abilities of hemiplegic children and their spasticity grade.Methods: Eleven hemiplegic cerebral palsy children with mild and moderate spasticity were recruited from physical therapy outpatient clinic Cairo University and Abo-Elreesh Hospital; each child was assessed using Gross Motor Function Measure, Modified Ashwarth Scale and Manual Ability Clas-sification System.Results: There was no significant correlation between the spasticity grade and motor scales.Conclusion: This article shows that the spasticity grade is not the main factor that affects gross and fine motor abilities of hemiplegic children.
https://mjcu.journals.ekb.eg/article_62780_d7298cbbfbc867644a2bd49ca0c72c13.pdf
2018-12-01
4047
4052
10.21608/mjcu.2018.62780
Spasticity – Motor abilities – Hemiplegia
ESRAA ABD EL-AZIZ, M.Sc.;
AMIRA EL- TOHAMY, Ph.D.
1
AUTHOR
ASMAA
OSAMA, Ph.D.
2
The Department of Pediatric Physical Therapy, Faculty of Physical Therapy, Cairo University
AUTHOR
ORIGINAL_ARTICLE
The Effectiveness of Strengthening of Hip Extensors and Ankle Plantar Flexors in Early Post-Anterior Cruciate Ligament Reconstruction
AbstractBackground: Impaired hip strength may underlie abnormal movement patterns, suggesting that diminished hip strength may increase the risk of ACL injury and re injury after anterior cruciate ligament reconstruction.Aim of Study: To investigate the effect of strengthening of hip extensors and ankle plantar flexors in early Anterior Cruciate Ligament reconstruction on knee effusion, knee function, hip, knee and ankle muscles strength.Methods: The study was conducted on 30 male patients referred from the orthopedic surgeon with early post operative Anteior Cruciate Ligament reconstruction by hamstring graft or patellar tendon graft after acute injuries, their age range from 18-40 years and were randomly assigned into two groups. Group A: Consisted of fifteen patients who had received open kinetic chain strengthening exercises for hip extensors and ankle plantar flexors in addition to the traditional accelerated program. Group B: Consisted of fifteen patients who had received the traditional accelerated program for 6 weeks (three sessions per week), effusion grading scale for effusion to assess effusion, handheld dynamometer to assess muscle power, Westen Ontario and MACmaster universities score and Time Up and Go test for functional assessment.Results: There was no significant difference between both groups for, hip extensors force and (TUG at 3 weeks). There was no significant difference between both groups for knee extensors torque between base line and 3 weeks and the same for plantar flexors force and WOMAC at 3 weeks. There was significant difference between both groups for knee extensors torque between 3 and 6 weeks, WOMAC at 6 weeks, TUG at 6 weeks and plantar flexors force between 3 and 6 weeks.Conclusion: Adding strengthening exercises of hip exten-sors and plantar flexors to the traditional accelerated protocol added more beneficial outcomes in relation to function after 6 weeks.
https://mjcu.journals.ekb.eg/article_62782_cf298af7087b8b0188418bdd6179877e.pdf
2018-12-01
4053
4064
10.21608/mjcu.2018.62782
ACLR – Rehabilitation – Accelerated program – Hip extensors and plantar flexors
AHMED M. GAD, M.Sc.;
NADIA A. FAYAZ, Ph.D.
1
AUTHOR
KARIMA A. HASSAN, Ph.D.;
MOHAMMAD H. AHMAD, M.D.
2
AUTHOR
ORIGINAL_ARTICLE
Relationship between Head Nurses Emotional Intelligence and Staff Nurses Job Satisfaction
AbstractBackground: Emotional intelligence has been used by the administrative authorities in many workplaces to explain issues related to the job satisfaction, performance, absenteeism, organizational commitment and leadership. In the context of the emerging 'affective revolution' in social and organizational psychology, emotional intelligence is proposed as an important predictor of key organizational outcomes including job satis-faction. It is a basic requirement in any profession that is based on human relations especially in nursing. Emotions play an important role in the nursing profession which requires both technical expertise and psychologically oriented care. Aim: the current study assesses the relationship between head nurses emotional intelligence and staff nurses' job satisfaction.Subjects and Methods: A descriptive correlational design was utilized for this study to achieve the stated aim. Setting: The study was conducted at New Kaser El-Aini Teaching Hospital.Two groups of sample were invited to participate in the questionnaire as follows. First group all head nurses who were working in inpatient department their number was (30). The second group is all staff nurses in the previous departments; their number was (350). Data was collected by using the following two tools: Emotional intelligence questionnaire and job satisfaction questionnaire.Results: There was a high level of emotional intelligence among head nurses as well as there was a moderate level of job satisfaction.Conclusion: There was a positive relationship between head nurses emotional intelligence and staff nurses' job satisfaction.Recommendation: Measure staff nurses job satisfaction in a regular base in order to find out areas of satisfaction to promote and areas of dissatisfaction to solve and improve. Also the study recommended to give opportunities for further research should be made to investigate factors that affect emotional intelligence and job satisfaction.
https://mjcu.journals.ekb.eg/article_62784_73a189bdeffd3fdfb52e4115cc283ea9.pdf
2018-12-01
4065
4072
10.21608/mjcu.2018.62784
Emotional – Intelligence – Job satisfaction
MAHA M. MOHAMMED, M.Sc.;
NEHAD E. FEKRY, D.N.Sc.
1
The Department of Nursing Administration, Faculty of Nursing, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Surgical Management of Spinal Meningioma
AbstractBackground: Meningioma is a common tumor that ac-counts for 25-46% of spinal neoplasms. It is generally benign, and slow growing. Spinal meningiomas occur after the fourth decade of life Mostly, they are located in the intradural compartment, generally respecting the pial layer of the spinal cord. The most frequent site of spinal meningiomasis in the thoracic region Clinical findings variate from mild to significant neurologic dysfunction; the most frequent clinical findings are back pain,sensori-motor deficit and sphincter dysfunction. The goal of surgical treatment must be total resection, if possible and usually not difficult.Objective: This study was made to present the incidence, clinical presentation, localization, techniques, used in the management of spinal meningioma. And to evaluate the func-tional outcome of surgically treated cases.Patients and Methods: This is a retrospective study of Sixteen patients with spinal meningiomas who had undergone microsurgical resection were treated between 2012 and 2015 in our department. Clinical presentation, diagnosis, histological examination, microsurgical resection, functional outcome were evaluated, defining potential prognosis factors associated with these lesions.Results: Tumors site was intradural,extramedullary the most common site was the thoracic region, posterolateral and antero-lateral. Surgical resection was complete in 14 patients (87.5%) and incomplete in 2 patients (12.5%) At the last follow-up the neurological state was improved or unchanged in 15 patients (93.75%) and worse in one patients (6.25%).Conclusion: Magnetic resonance imaging is the best imaging technique for diagnosis. Total tumor resection im-proved the surgical results of spinal meningiomas.
https://mjcu.journals.ekb.eg/article_62786_43ea001f7f86f19cdde9168afef8efab.pdf
2018-12-01
4073
4080
10.21608/mjcu.2018.62786
Extramedullary – Intradural – Meningioma – Spinal surgery – Spinal tumors
MOHAMED A. HEWEDY, M.D.;
MOHAMED MOHAMED, M.D.
1
The Department of Neurosurgery, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
AUTHOR
ORIGINAL_ARTICLE
Lumbo Peritoneal Shunt in Management of Cases of Depressed Skull Fractures with Superior Sagittal Sinus Occlusion
AbstractBackground: Patients with depressed skull fractures overlying the superior sagittal sinus (SSS) present an ongoing challenge. Many surgeons would opt for a conservative man-agement of these cases if there was no associated deficit to avoid risky sinus surgery. A variable percentage of patients presenting with such fractures suffer from SSS occlusion resulting in Benign Intracranial Hypertension (BIH).Aim of Study: We aim to evaluate SSS patency, evaluate intracranial tension and evaluate options for management in patients with simple depressed skull fractures overlying posterior 2/3 of SSS and not surgically indicated.Patient and Methods: Prospective study of cases which admitted to Cairo University Hospitals, and Bani sueif Uni-versity Hospital, Department of Neurosurgery, Accidents and Emergency between Jan. 2014 and December 2015.Patients with simple and compound depressed skull frac-tures overlying the SSS and not indicated for surgery, with no other intracranial abnormality, with a Glasgow Coma Scores (GCS) of 12 or better were admitted to the study. Patients underwent Magnetic Resonance Venography (MRV) to determine SSS patency on admission, they were clinically followed up using Computerized Tomography (CT) and repeat MRV when needed. Patients underwent serial lumbar manom-etry, and were given medical treatment in the form of aceta-zolamide, furosemide plus low molecular weight heparin and anti platelets. Patients were then assessed and evaluated to be admitted for LP shunt surgery and followed-up.Results: A total of 12 cases were included in the study, 7 patients had complete SSS occlusion and 5 cases has nar-rowing with patent SSS. The 5 cases with incomplete SSS occlusion had a stable course with only one case (20%) developing elevated intracranial pressure (ICP) not responding to medications and requiring LP shunt. Of the 7 patients with complete occlusion, 100% developed elevated ICP not re-sponding to medical treatment, and all required LP Shunt insertion, 5 patients developed multiple contusions due to anticoagulant therapy on top of SSS occlusion, with discon-tinuation of anticoagulants and deterioration of conscious level, 8 patients had LP surgery and showed a stable improving post operative course, 2 patients had restored SSS patency on repeat MRV.Conclusion: Management of depressed skull fractures overlying the SSS remains controversial, patients with partial occlusion have a better prognosis, patients with complete occlusion can improve with best medical treatment. LP shunt is recommended for all cases of SSS occlusion.
https://mjcu.journals.ekb.eg/article_62788_8f54d0b0ef932b9b2f67cb46b5e18f68.pdf
2018-12-01
4081
4087
10.21608/mjcu.2018.62788
Superior – Sagittal – Sinus – Occlusion – Pseudo tumor – BIH – Lumbo peritoneal shunt
AHMED S.K.
ABD EL-WAHED, M.D.
1
The Department of Neurosurgery, Faculty of Medicine, Cairo University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Sodium Fluorescein Guided Excision of High Grade Gliomas: A Tool for Total Excision
AbstractBackground: The best management of high grade gliomas starts with adequate cytoreductive surgery followed by adjuvant therapies. The extent of tumor resection is an important prognostic factor, and it directly affects the tumor progression and the median survival period. Sodium Fluorescein is a fluorescent tracer that crosses the disrupted blood brain barrier, making it suitable for intraoperative visualization of malignant gliomas.Aim: To evaluate the effectiveness of Na Fluorescein to demarcate tumor tissue from brain tissue.Material and Methods: This study was conducted on 30 patients who were indicated for surgical excision of radiolog-ically diagnosed high grade gliomas. All cases had pre and immediate post-operative imaging with contrast to detect the amount of tumor excision. In all our cases at the time of opening the dura, after doing sensitivity testing, 15-20mg/Kg Na Fluorescein was administrated intravenously. The visible yellow stained tumor was then excised using the standard microscopic procedure.Results: All cases had primary brain gliomas (21 were WHO grade IV and 9 cases were grade III). Post-operative imaging showed gross total excision in 23 cases (77%), near total excision (>80% of tumor removed) in 6 cases (20%), and subtotal excision (<80% of tumor removed) in 1 case (3%). None of our cases showed any complications related to reaction from Fluorescein, while 2 cases (6.7%) had transient post-operative motor weakness, and 1 case (3%) had postop-erative dysphasia.Conclusion: The use of Sodium Fluorescein has proven to be an effective tool for demarcation of tumoral tissue from brain tissue; this demarcation was evident using the naked eye, as well as the non-filtered white microscopic light. It is a simple, safe technique, and can be used in economically limited centers; in which Neuronavigation isn't available. The use of Fluorescein increases the chances of safe gross total excision of high grade gliomas, which is reflected on increasing the survival rates as well as decreasing the tumor progression.
https://mjcu.journals.ekb.eg/article_62789_11c0a725176c9f81bdafac2d97c3dbec.pdf
2018-12-01
4089
4094
10.21608/mjcu.2018.62789
Sodium Fluorescein – High grade glioma – Total excision – Median survival
MOHAMED I. REFAAT, M.D.;
EHAB A. ABD EL-SALAM, M.D.
1
The Department of Neurosurgery, Faculty of Medicine, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Effect of Health Teaching Sessions on Women's Knowledge Regarding Selected Danger Signals During Pregnancy
AbstractBackground: Pregnant woman may face the risk of sudden, unpredictable complications called danger signals that could potentially be life threatening to the mother or her fetus. Raising women's awareness about danger signals through antenatal health teaching sessions improved identification and early detection of problems.Aim of Study: The effect of health teaching sessions on women's knowledge regarding selected danger signals during pregnancy. Hypothesis: (H1) women who receive health teaching sessions regarding selected danger signals during pregnancy will show higher knowledge scores in posttests than in their pretest. (H2) Women who receive health teaching sessions regarding selected danger signals will exposed to less danger signal.Subjects and Methods: Design: One group pre-posttest quasi experimental design. Sample: Purposive sample of 150 primigravida pregnant women who free from any medical or obstetrical problem, their gestational age from 20 to 36wks Setting: Data was collected from June, 2016 to Januauary, 2017 at Antenatal outpatient clinic in Obstetrics and Gynecol-ogy, Cairo University Hospitals Tool: Semi-structured interview schedule to collect data related to socio-demographic charac-teristics, Pre-posttest questionnaire for assessment of knowl-edge related to selected dangerous signal and follow-up questionnaire.Results: Women's age ranged from 18 to 35yrs with different level of education. Total knowledge score of all posttests was highly statistically significant difference than pretest (p<0.0001).Conclusion: The current study findings concluded that health teaching sessions had an effect on increasing women's knowledge regarding danger signals during pregnancy which will help in early detection & control the dangerous symptoms and complications that may arise during pregnancy progress.
https://mjcu.journals.ekb.eg/article_62790_ac017ece076c1a7d2b7a2e4292bc8a26.pdf
2018-12-01
4095
4106
10.21608/mjcu.2018.62790
Danger signals– Health teaching
RANIA A. MOHAMMED, M.Sc.;
EMAN M.E. SHAHIN, D.N.Sc.
1
AUTHOR
AHMED
N HOSNI, M.D.
2
The Department of Maternal & Newborn Health Nursing, Faculty of Nursing, Cairo University* and The Department of Obstetrics & Gynecology, Faculty of Medicine, Cairo University**
AUTHOR
ORIGINAL_ARTICLE
The Predictive Effect of Mean Platelet Volume (MPV) and Neutrophil-to-Lymphocyte Ratio (NLR) on the Functional Outcome of Acute Ischemic Stroke
AbstractBackground: Inflammation has been reported to constitute a major component of ischemic stroke pathology. Nevertheless, to the best of our knowledge, no previous studies have inves-tigated the NLR and MPV values in the cases of stroke stratified by subtype.Aim of Study: The aim of our study is to predict the role MPV and NLR in short-term outcome in patients with ischemic stroke and their association to stroke severity, stroke risk factors and functional outcome.Patients and Methods: This prospective cross sectional study directed on 125 patients with first time acute ischemic stroke. All members exposed to full history taking, detailed clinical examination and neurological checking. Brain imaging was performed after hospital admission. Blood tests were drawn for appraisal of the mean platelet volume (MPV) (in FL) and the neutrophil-lymphocyte ratio (NLR).Results: Our results revealed that the mean value for NLR was higher in dead patients with ischemic stroke. By ROC curve, higher NLR at admission predicted the mortality than MPV. We found higher NLR levels in patients with more severe stroke. However, We did not observe a significant correlation between the MPV, the stroke severity, and outcome.Conclusion: NLR was an independent risk factor and serves as a sensitive index for the prognosis of ACI patients. Further well-designed and large-scale prospective studies are necessary to evaluate platelet MPV and NLR for observing patients with cerebral infarction among different territories of Egypt and for stroke subtypes.
https://mjcu.journals.ekb.eg/article_62792_5b764ee7c0b528ac9d64ff2c4b48de50.pdf
2018-12-01
4107
4113
10.21608/mjcu.2018.62792
Acute ischemic stroke – National Institutes of Health Stroke Scale (NIHSS) – Modified Rankin Scale (mRS) – Mean platelet volume (MPV) – Neutrophil/lymphocyte ratio (NLR)
ABEER A. TONY, M.D.;
EFFAT A.E. TONY, M.D.
1
AUTHOR
WAFAA S. MOHAMMED, M.D.;
EMAD F. KHOLEF, M.D.
2
The Departments of Neurology*, Internal Medicine** and Clinical Pathology***, Faculty of Medicine, Aswan*,*** and Assiut** Universities, Egypt
AUTHOR
ORIGINAL_ARTICLE
A Study on the Immunological Changes in Adult Male Obese Rats and the Possible Immune Modulator Effect of Conjugated Linoleic Acid Supplementation
AbstractBackground: Conjugated Linoleic Acid [CLA] is suggested as a novel drug to improve obesity.Objectives: The aim of this study was to elucidate the possible role of CLA in ameliorating the pathophysiology in obese rats and modulate its immune function.Methods: Forty adult male albino rats of local strain, weighing [120-160] grams each, were used. Rats were ran-domly divided into five equal experimental groups, control, CLA-supplemented, obese, CLA-prophylactic obese and CLA-treated obese groups obesity was induced by High Fat Diet [HFD] for 12 weeks. CLA was administered orally in a dose of 1500mg/kg body weight for 12 weeks. Initial and final Body Weight (BW) and Body Mass Index (BMI) and food intake were measured. Total Leucocytic Count (TLC) and its differential count and serum Tumor Necrosis Factor-alpha (TNF-a) were measured. Visceral fat and total white abdominal fat to each 100 [gm]/BW were measured. Caspase 3 expression was evaluated in the abdominal fat biopsies using immuno-histochemistry.Results: High fat diet resulted in deterioration and impair-ment of most measured parameters. CLA supplementation decreased final BW of obese rats, food intake, visceral fat, and total abdominal together with increased CD8+, CD4+ T lymphocytes and eosinophilic %. Moreover, CLA supplemen-tation decreased TNF-a in CLA-supplemented and CLA-prophylactic groups but not in CLA-treated group. High fat diet increased TLC and CD4+ T lymphocytes but decrease eosinophilic % and CD8+ T lymphocytes. In addition, CLA increased the positivity of caspase 3 in CLA-prophylactics and CLA-treated obese groups.Conclusion: CLA supplementation, either as a prophylactic agent or a therapeutic one, to the high fat feed rats could ameliorate most of the detrimental effects of obesity, particu-larly those related to the immune system. This beneficial effect of CLA could be explained by its immune modulator, anti-inflammatory and pro apoptotic effects.
https://mjcu.journals.ekb.eg/article_62793_a37026737bae4d593db9f660fd29d13b.pdf
2018-12-01
4115
4124
10.21608/mjcu.2018.62793
High fat induced obesity – Conjugated linoleic acid – Immunity – Rats
MOHAMED A. BENDARY, M.D.;
ASMAA G. ABDOU, M.D.
1
AUTHOR
GHADA S. AMER, M.D.;
SARA E. ABDOU, M.Sc.
2
The Departments of Medical Physiology* and Pathology**, Faculty of Medicine, Menoufia University, Menoufia, Egypt
AUTHOR
ORIGINAL_ARTICLE
Effect of Ultrasound Versus Low Level Laser Therapy in Treatment of Postnatal Low Back Pain
AbstractBackground: Postnatal low back pain is considered as a serious health problem worldwide because it certainly can limit function and capacity in both work and personal life.Purpose: To compare between the effect of ultrasound and low level laser in treatment of postnatal low back pain.Participants: Thirty women were diagnosed with postnatal low back pain shared in this study. Their ages were ranged from 20 to 35 years old and their Body Mass Indices (BMI) did not exceed 30kg/m2. Patients with spinal fractures, lumbar spinal stenosis from lumbar disc herniation, degenerative joint diseases, or spondylolisthesis, women with BMI exceed 30kg/m2, patients who had polyneuropathy or other neurolog-ical disorders and patients with skin diseases interferes with ultrasound or laser application are excluded from the study. The study was conducted from June to December 2016.Design: They were selected randomly from outpatient clinic of obstetrics department.Location: This study conducted at Al-Zahraa University Hospital in Cairo, Al-Azhar University.Methods: They were divided randomly into two groups equal in number. Group (A) consisted of 15 women and treated by therapeutic ultrasound three times per week for 4 weeks. Group (B) consisted of 15 women and treated by low level laser therapy three times per week for 4 weeks. Evaluations of all patients in both groups (A & B) were done before and after the treatment program.Outcome Measures: Measuring pain intensity with VAS, lumber flexion and extension range of motion with Modified Schober method as well as lateral flexion for right and left sides with tape measurement.Results: There was a statistically significant improvement of pain intensity, significant improvement of lumbar flexion, extension ROM and significant improvement of lateral side bending for right side and left side in both groups (A & B) when comparing post-treatment values to its corresponding pre-treatment values. When comparing both groups together, LLLT group (B) showed significant decrease in pain intensity, significant increase in lumbar flexion and extension and significant improvement of trunk side bending for right side and left side compared with ultrasound group (A).Conclusion: The study revealed that both ultrasound and low level laser therapy are effective modalities for treating post-natal low back pain, as there were significant differences in pain intensity, flexion, extension and lateral side bending ROM after treatment. LLLT is better than ultrasound in decreasing pain intensity and increasing lumbar flexion, extension and lateral side bending ROM.
https://mjcu.journals.ekb.eg/article_62794_a7841593033e6ad3d475cc70234032ca.pdf
2018-12-01
4125
4135
10.21608/mjcu.2018.62794
Ultrasound – Low-level laser therapy – Postnatal – Low back pain
MOHAMED A. AWAD, Ph.D.;
ASMAA M.A. EL-BANDRAWY, Ph.D.
1
AUTHOR
ABD EL-HAMID A. ATTA ALLAH, M.D.;
MINA N. SOLIMAN, M.Sc.
2
The Department of Physical Therapy for Woman's Health, Faculty of Physical Therapy, Cairo University* and The Department of Orthopedic Surgery, Faculty of Medicine (Girls), Al-Azhar University**, Egypt
AUTHOR
ORIGINAL_ARTICLE
Quality of Life among Family Caregivers of Patients Undergoing Hemodialysis
AbstractBackground: Family caregivers of patients undergoing hemodialysis have a lot of great responsibilities toward their patients additional to their daily own obligations which affect their health and quality of life.Aim of Study: To assess the quality of life among family caregivers of patients undergoing hemodialysis.Material and Methods: Design: A descriptive research design was utilized in this study.Setting: Hemodialysis unit which belongs to outpatient clinics of El-Kasr El-Aini University Hospital. Sample: A convenient sample of 130 family caregivers of patients undergoing hemodialysis were included in the study from March to August 2017. Tool for Data Collection: Two tools were used to collect data pertinent to the study. First tool "structured family caregiver questionnaire" which consisted of two parts. First part: Questionnaire about demographic characteristics of the family caregivers. Second part: Questionnaire about demo-graphic characteristics of the patients undergoing hemodialysis. Second tool (WHOQOL Tool): Consisted of 100 questions about quality of life among family caregivers of patients undergoing hemodialysis cover six main domains: Physical, social, psychological, level of dependence, environmental and spiritual domains.Results: Study results revealed that the mean WHOQOL domain scores were 34.83 for the physical domain, 73.57 for the psychological domain, 49.40 for the level of dependence domain, 37.37 for the social relationships domain, 82.55 for the environmental domain and 16.93 for the spiritual domain; There was statistical significant positive correlation found between satisfaction with own health and mean scores of physical, psychological, environmental domains (p=0.007, .003, .005 respectively) and there was statistical significant positive correlation found between own evaluation of QOL and mean scores of physical, psychological, social domains (p=0.010, .009, .005 respectively), also there was a highly statistical significant positive correlation between own eval-uation of QOL and mean scores of spiritual domain (p=.002).Conclusion: The study concluded that, the environmental and psychological domains showed the highest scores (82.55 and 73.57, respectively), while the spiritual domain showed the lowest score 16.93.Recommendations: The study recommended that before the beginning of dialysis therapy, health professionals should identify and explore patient' needs and potential caregiver in the family of patient and established empowerment programs to prepare them for the task to be carried out, mainly in the initial phase of their activities.
https://mjcu.journals.ekb.eg/article_62795_2a86fec6f5791cba2c7917522a9e6805.pdf
2018-12-01
4137
4144
10.21608/mjcu.2018.62795
Family caregiver – Patients undergoing hemodi-alysis – Quality of life
DALIA I. ABD EL-AZEM, M.Sc.;
NAWAL A. FOUAD, D.N.Sc.
1
AUTHOR
EMAN M.
SEIF EL-NASR, D.N.Sc.
2
The Department of Community Health Nursing, Faculty of Nursing, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Natural Orifice Transluminal Endoscopic Surgery for Colorectal Cancer
AbstractLaparoscopic colorectal resection is used increasingly in colon and rectal cancer treatment. In our study, two NOTES techniques were assessed; laparoscopic colorectal resection with Natural Orifice Specimen Extraction (NOSE) in 16 cases and transanal Total Mesorectal Excision (taTME) in 18 cases. Feasibility, short term oncologic outcome, as well as, com-paring both techniques are displayed. Finally, although patients in our study were not randomly assigned to either arm, we could demonstrate better quality of mesorectal excision in the transanal dissection group in comparison to conventional laparoscopy with NOSE technique.
https://mjcu.journals.ekb.eg/article_62796_d02e4694794255109f8ac02683aadca0.pdf
2018-12-01
4145
4151
10.21608/mjcu.2018.62796
NOTES – Transanal – Transvaginal – NOSE – taTME
ISLAM H. METWALLY, M.Sc.;
SHERIF Z. KOTB, M.D.
1
AUTHOR
MOHAMED A. HEGAZY, M.D.;
WALEED EL-NAHAS, M.D.
2
AUTHOR
JOSÉ F.
NOGUERA, M.D.
3
Surgical Oncology Unit, Oncology Center, Mansoura University (OCMU), Mansoura, Dakahlia, Egypt* and General & Digestive Surgery Department, Complejo Hospital Universitario A Coruña (CHUAC), La Coruña, Galicia, Spain**
AUTHOR
ORIGINAL_ARTICLE
The Impact of Myofascial Release on Vital Capacity and Diaphragmatic Excursion in Postsurgical Pleural Effusion
AbstractBackground: Accumulation of fluid in pleural space may affect on function of respiratory muscles primarily because of increase of chest wall volume. Force-length relationship of respiratory muscles indicate that for a given neural acti-vation, the pressure developed by muscles decrease with decreasing length. An increase of chest wall volume decrease length of respiratory muscles mainly diaphragm and increase of expiratory muscles length. It follows that with pleural effusion, all else being the same for a given, neural activation, pressure developed by the inspiratory and expiratory muscles should decrease and increase, respectively. So, the aim of the study to maintain flexibility of the diaphragm and intercostal muscles in order to get the optimum action of theses muscles, increase chest expansion, improve the respiratory function of these patients.Aim of Study: To evaluate the effect of of myofascial release for diaphragm and intercostal muscles on vital capacity and diaphragmatic excursion in post surgical pleural effusion.Subject and Methods: Forty subjects (male only) were randomly assigned into two groups equal in number. (Study group A): Consisted of 20 patients was enrolled in the myo-fascial release protocol in addition to traditional physical therapy program for pleural effusion. (Study group B): Con-sisted of 20 patients was enrolled in the traditional physical therapy program for pleural effusion only. Their vital capacity and diaphragmatic excursion were measured before and after 8 weeks of training program for both groups. The myofascial release protocol performed a 1-hour session 3 times a week for 8 weeks.Results: Group (A) myofascial release group, showed a statistical significant improvement in vital capacity and diaphragmatic excursion, that was 13.49%, more than the improvement in group (B) traditional physical therapy group, that was 8.68%.Conclusions: The myofascial release for diaphragm and intercostal muscles is effective on vital capacity and diaphrag-matic excursion in post surgical pleural effusion.
https://mjcu.journals.ekb.eg/article_62797_a33c54b04c7e347d4317f8e23e8cf878.pdf
2018-12-01
4153
4158
10.21608/mjcu.2018.62797
Pleural effusion – Myofascial release – Diaphragm – Intercostal muscles – Vital capacity – Diaphrag-matic excursion
MOHAMED M. EL-KADY, M.Sc.;
HANY E. OBAYA, Ph.D.
1
AUTHOR
AWNY F. RAHMY, Ph.D.;
MOHAMED MAHMOUD EL-BATANONI, M.D.
2
The Department of Cardiovascular/Respiratory Disorders and Geriatrics, Faculty of Physical Therapy* and The Department of Occupational Medicine, Faculty of Medicine**, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Dysphagia Related Health Consequences among Patients with Acute Stroke in Cairo, Egypt
AbstractBackground: Dysphagia is a common complication of stroke; it places the patient with acute stroke at risk for poor nutrition and dehydration. In addition to other dangerous complications as post stroke pneumonia.Aim of Study: To explore dysphagia related health conse-quences (post stroke pneumonia, length of ICU stay and death) among patients with acute stroke in Cairo, Egypt.Research Design: A descriptive exploratory research design was utilized.Research Question: What are the dysphagia related health consequences as indicated by post stroke pneumonia, length of ICU stay and death) among patients with acute stroke in Cairo, Egypt?Setting: The current study was carried out at a stroke unit affiliated to a selected hospital in Cairo, Egypt.Sample: A purposive sample consisting of 70 adult male and female patients with acute stroke.Tools of Data Collection: Three tools were used by the investigator to collect data pertinent to the study: Tool 1: Personal background and medical data, Tool 2: Gugging Swallowing Screen test (GUSS) Tool 3: Post stroke Pneumonia assessment tool.Results: 30% of the studied sample was in the age group of 61-70 years old, 54% of the study sample was female, and about half (45.7%) of the studied sample had a moderate degree of dyaphagia. 37.1% of the studied sample stayed from 5 to 7 days in the Intensive Care Unit. (7.1%) of the studied sample had died. More than half (57.1%) of the studied sample didn't develop post stroke pneumonia. There was a significant statistical relationship between degree of dysphagia and (post stroke pneumonia, death and length of ICU stay).Conclusion: Dysphagia following the acute stroke is very important issue to be considered during handling, caring and management of patients with it.Recommendation: Replication of this study on a repre-sentative sample for such group of patients all over the Arab Republic of Egypt is highly recommended to set national protocol for prevention and management of dysphagia related health consequences.
https://mjcu.journals.ekb.eg/article_62799_c9bede63e96db7f63307fb366305f377.pdf
2018-12-01
4159
4167
10.21608/mjcu.2018.62799
Dysphagia – Dysphagia related health conse-quences – Acute stroke – Patients with acute stroke
ASMAA EBRAHIM, M.Sc.;
WARDA Y. MOHAMED, D.N.Sc.
1
AUTHOR
FOUAD ABD ALLAH, D.N.Sc.;
YOUSSRIA ABD AL-SALAM, D.N.Sc.
2
The Department of Critical Care and Emergency Nursing, Faculty of Nursing* and The Department of Neurology, Faculty of Medicine**, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Conventional Versus Endoscopic Assisted Septoplasty for Management of Severe Nasal Septal Deviation
AbstractBackground: Endoscopic septoplasty is an attractive alternative to the traditional septoplasty. It ensures the mini-mum dissection of the tissue with less postoperative compli-cations.Aim of Work: The aim of this work was to compare the efficacy of the conventional and the endoscopic assisted septoplasty in the management of cases with severe septal deviation.Patients and Methods: 60 patients with severe symptomatic deviated nasal septum, presented to the Otorhinolaryngology outpatient clinic at Tanta University Hospitals divided into two equal groups: Group A included 30 patients underwent endoscopic septoplasty and group B included 30 patients underwent traditional septoplasty. All participants evaluated regarding the nasal obstruction improvement, and the degree of the improvement, the accompanying symptoms and any complications.Results: There was a significant difference between both groups in duration of surgery, the intraoperative blood loss. In this study, the difference of the endoscopic group as compared to the conventional group was statistically insignif-icant regarding either early post-operative complications or in nasal synechiae development, pain, septal hematoma, septal perforation, or CSF leakage or in the intraoperative flap. The pre-operative nose score comparative evaluation revealed that all patients of both groups reported a severe problem in all parameters (nasal congestion and stuffiness, nasal blockage or obstruction, trouble breath in through the nose, trouble sleeping, and inability to get enough air through the nose during exercise or exertion. No statistically significant differ-ences were detected between both groups.Conclusion: We concluded that, endoscopic septoplasty is superior to traditional septoplasty with better result and less complication.
https://mjcu.journals.ekb.eg/article_62800_6b5cbdc1097071a50cea87d962e4523c.pdf
2018-12-01
4169
4175
10.21608/mjcu.2018.62800
Endoscopic – Septoplasty – Septum – Nasal obstruction
MARAM A. HASABALLAH, M.Sc.;
ABU BAKR S. BEHERY, M.D.
1
AUTHOR
OSAMA A. AL-BIRMAWY, M.D.;
MAGDY E. SAAFAN, M.D.
2
The Department of Otolaryngology, Faculty of Medicine, Tanta University, Tanta, Egypt
AUTHOR
ORIGINAL_ARTICLE
Anterior Segment Biometry Using Spectral Domain Optical Coherence Tomography
AbstractBackground: AS-OCT allows a non-contact examination with high resolution imaging of the anterior segment of the eye of human. It enables assessment and documentation of the condition of the eye's anterior segment.Aim of Study: Evaluation of Anterior Segment Optical Coherence Tomography (AS-OCT) in quantitative analysis of the anterior segment of the eye. Analysis of association between Central Corneal Thickness (CCT), Corneal Epithelial Thickness (CET) and corneal radius of curvature (CC) meas-ured by OCT in relation to other parameters; age, sex, refraction and Intra Ocular Pressure (IOP).Patients and Methods: The present study included 100 normal eye of 100 hundred patients aged from 20:60 years. CCT, CET and radius of CC were measured using anterior segment Spectral Domain Optical Coherence Tomography (SD-OCT) (3D OCT-2000 (Topcon Corp., Tokyo, Japan)). IOP was measured using Goldman applanation tonometer. Measurements of refractive status were detected by autore-fractor and then confirmed by retinoscopy and spherical equivalent was calculated of astigmatic patients.Results: Total number of 100 eye were evaluated for the study. 34 eyes were emmetrope, 34 eyes were myopes and 32 eyes were hypermetropics. The CCT average was 541.62mm (SD ±21. 11). This study showed no statistically significant difference between CCT in myopes, hypermetropes and em-metropes). Mean IOP was 15.65mmHg (SD ±1.56). The correlation between IOP and CCT was highly significant (r= 0.867; p<0.001). The CET average was 54.80 (SD ±2.68). The study has shown the positive relation between CET and CCT. The mean radii of corneal curvature was vertically 7.61 (SD ±0.27) and horizontally was 7.61 (SD ±0.25). We found a statistically relation between error of refraction and corneal radius of curvature. Eyes with more myopic refractive error tend to have steeper corneas with less radii of curvature on controversy with hypermetropic eyes. No correlation between age or sex to all the above.Conclusion: This study has shown that CCT has no cor-relation with degree of refractive error. Whereas there is significant correlation between CCT and IOP and CET as well. The study also has shown that there were no associations between corneal radius of curvature and IOP. However, myopic eyes shows tendency for smaller radii of curvature whereas in hypermetropic ones the radii of curvature tend to be longer. There was no significant relation between age and sex and any parameter of the study. Our findings highlight the value of spectral domain AS-OCT measurements as a standard tool in anterior segment analysis.
https://mjcu.journals.ekb.eg/article_62801_054a2a3bc05d79c933a39854aa87a541.pdf
2018-12-01
4177
4185
10.21608/mjcu.2018.62801
Optical coherence tomography – Central corneal thickness – Corneal epithelial thickness – Corneal radius of curvature – Myopia – Hypermetropia – Emmetropia
AMIRA E.Z. EL-HAYES, M.Sc.;
MOUSTAFA K. NASSAR, M.D.
1
AUTHOR
MOATAZ F.
EL-SAWY, M.D.
2
The Department of Ophthalmology, Faculty of Medicine, Cairo* and Menoufia** Universities
AUTHOR
ORIGINAL_ARTICLE
Clinical Audit on Management of Community-Acquired Pneumonia in Pediatric Intensive Care Unit
AbstractBackground: Paediatric respiratory disease is an important cause of morbidity in both the developing as well as the developed world. Community Acquired Pneumonia (CAP) means an infection of the lung caused by multiple microor-ganisms acquired outside the hospital setting, leading to inflammation of the lung tissue. It is typically associated with fever and respiratory symptoms such as cough and tachypnea, but symptoms may be non-specific in young children. Radio-graphic changes may be useful to confirm the diagnosis. It remains an important cause of death in children throughout the world, especially in developing countries.Aim of Study: To evaluate the following using the 2011 pediatric CAP guidelines in children admitted in the Pediatric Intensive Care Unit (PICU) in the period from 1st of January to 31st of December, 2016 as the reference standard where applicable and try to make Guidline for the management of Community-Acquired Pneumonia in infants and children older than 3 months of age at pediatric Intensive Care Unit (PICU), Assuit University Children Hospital.Patients and Methods: This study is a clinical audit on management of Community Acquired Pneumonia (CAP) among children admitted in the Pediatric Intensive Care Unit (PICU) in the period from 1st of January to 31st of December, 2016. Evaluation was done according to the guidelines of Community Acquired Pneumonia (CAP) in infants and children recommended by the Pediatric Infectious Disease Society and the Infectious Diseases Society of America, August, 2011.Results: Our study was done on children with Community Acquired Pneumonia admitted to the Pediatric Intensive Care Unit (PICU), Assuit University Children Hospital in in the period from 1st of January to 31st of December, 2016. Our study included sixty cases of them there were 36 males (60%) and 24 females (40%). Their ages ranged from 3 months up to 17 years. Fifty five out of sixty cases (91.7%) presented with history of fever while fourty five cases (75%) presented with history of cough. According to WHO guidelines for criteria of respiratory distress in children with pneumonia the most common sign of respiratory distress was pulse oximetry measurement <90% on room air as it was present in fifty two cases (86.7%), followed by tachypnea which was present in fourty four cases (73.3%), altered mental status in thirty five cases (58.3%), chest retraction in twenty five cases (41.7%), grunting was in twenty three cases (38.3%), dyspnea in eighteen cases (30%). Apnea was present in fifteen cases (25%) while there was no case who presented with nasal flaring.Conclusion: An accurate and rapid diagnosis of the path-ogen responsible for CAP provides for informed decision making, resulting in improved care with focused antimicrobial therapy, fewer unnecessary tests and procedures, and, for those who are hospitalized, potentially shorter inpatient stays. Unfortunately, in the diagnosis of CAP, particularly bacterial CAP, there are no single diagnostic tests that can be considered the reference standard.We decided in this clinical audit to evaluate how will the guidelines have been followed in the acute management of children with Community Acquired Pneumonia at Pediatric Intensive Care. After studying patients admitted at PICU for CAP we found that many points in the 2011 pediatric CAP guidelines was neglected and not followed the most common point was Tracheal Aspirates and it was done for only one case (1.7%) while many other points were followed strongly as Pulse Oximetry and Initial Chest Radiographs that were done for (100%) of cases.
https://mjcu.journals.ekb.eg/article_62802_5bfc647f310fea2e11ce7cdeb49793a3.pdf
2018-12-01
4187
4191
10.21608/mjcu.2018.62802
Community acquired pneumonia – Pediatric intensive care unit
MOHAMMED D. MOHAMMED, M.Sc.;
ASMAA H. SHORIET, M.D.
1
AUTHOR
EMAN A.A.
ASKAR, M.D.
2
The Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt
AUTHOR
ORIGINAL_ARTICLE
Recovery of Neurological Injury in Patients with Thoracolumbar Spine Fracture Relevant to the Fracture Pattern
AbstractBackground: Thoracolumbar fracture is the most common skeletal injury of the axial skeleton and accounts for around 90% of all spinal fractures. Spinal cord injury occurs in about 10-30%of traumatic spinal fractures. Many studies included age of the patients and initial canal compromise as variables associated with neurological recovery after neurologic injury with spinal fracture but little documentation in the literature is found on the relationship between fracture patterns assessed by AO classification and neurologic recovery.Aim of Study: To analyze the relationship between fracture patterns according to AO classification and neurological recovery in patients with thoracolumbar spine fracture who underwent transpedicular screw fixation with or without canal decompression.Patients and Methods: The 60 patients (38 men and 22 women) in this series had a follow-up of 12 months, and they were all managed surgically. AO classification had been used prospectively to determine the fracture pattern. Frankel scale was obtained before surgery, after surgery and at the final follow-up.Results: AO-type B fractures were the commonest. The degree of neurologic deficits seen at admission was the greatest in AO-type C and the least in AO-type A while at final follow-up it was greatest in AO-type C and least in AO-type B. The neurologic recovery was the best in AO-type B, assessed by Frankel grading. The neurologic recovery was greater in the lumbar spinal fractures than the thoracic spinal fractures.Conclusions: In conclusion, there is a significant relation between the AO classification fracture pattern and neurological insult and the percentage of neurological recovery. The fracture level is correlated with the percentage of neurological recovery. There is no relation between the degree of canal compromise and the pre-operative neurological deficit in patient. The percentage of neurological recovery is relatively better in patients undergo canal decompression compared with those don't.
https://mjcu.journals.ekb.eg/article_62803_66c5f72b7bd6194ee59c45bd8c95f7ac.pdf
2018-12-01
4193
4197
10.21608/mjcu.2018.62803
AO classification – Thoracolumbar spine fracture – Neurologic deficits – Frankel classification
ESSAM Kh. EL-SHERIEF, M.D.;
HASSAN M. ALI, M.D.
1
AUTHOR
KHALED M. HASAN ALI, M.D.;
ANDREW Th. NASEEF, M.Sc.
2
The Department of Orthopedics and Traumatology, Assiut University Hospital, Assiut, Egypt
AUTHOR
ORIGINAL_ARTICLE
Chronic Subdural Hematoma Prognostic Factors for Recurrence
AbstractBackground: Chronic Subdural Hematoma (CSDH) is a common neurologic disease in elderly. It is not always a benign condition because high recurrence rate had been reported. Independent risk factors for CSDH recurrence, especially the surgical and post-operative factors, had not been sufficiently investigated.Aim of Study: To evaluate the outcome of CSDH after burr hole craniostomy and irrigation with closed system drainage, and to analyze the potential risk factors, emphasizing surgical and post-operative ones, for CSDH recurrence and comparing the results to others mentioned in literature.Methods: We retrospectively analysed data of 82 CSDH patients treated by burr hole(s) craniostomy and irrigation with close system drainage CSDH in Assuit University Hospital from July 2015 to July 2016.Results: Of these CSDH patients, the main age was 58.9 years and 85.4% were males. The CSDH recurrence rate after burr-hole craniostomy was 7.3% in our hospital. CSDH recurrence was significantly associated with diabetes mellitus (p=0.027), hypertension (p=0.021) and prolonged PT (p= 0.025). Moreover an increased CSDH recurrence rate was observed in the patient group that had a mixed type (p=0.047), separated (p=0.044), trabecular (p=0.025) and hematoma thickness more than 20mm (p=0.34) of the CSDH in the preoperative diagnostic imaging .Also there were increased recurrence rate in patients group that had postoperative residual hematoma (p<0.001).Conclusion: We found diabetes mellitus, hypertension, prolonged PT, mixed type hematoma, separated, trabecular internal architecture of hematoma, thickness of hematoma 20mm and post-operative residual hematoma independently predict recurrence of CSDH after burr hole(s) craniostomy. The patients with these risk factors may need closer surveil-lance post-operatively.
https://mjcu.journals.ekb.eg/article_62804_9e4f4c99c7f95c6b21f3fb39ec6962fe.pdf
2018-12-01
4199
4207
10.21608/mjcu.2018.62804
Chronic subdural hematoma – Recurrence – Risk factor – Burrhole – Craniostomy
NAGEEB M. AL-SHAYA, M.Sc.;
AHMAD A. KILANI, M.D.
1
AUTHOR
AHMAD F. SHERIF, M.D.;
MOHAMMAD TAGHYAN, M.D.
2
The Department of Neurosurgy, Faculty of Medicine, Assiut University, Assiut, Egypt
AUTHOR
ORIGINAL_ARTICLE
Fibroscan for Assessment of Non Alcoholic Fatty Liver Disease in Type 2 Diabetic Patients in Tanta University Hospital
AbstractBackground: Fibroscan has recently been investigated as a new technique in the assessment of fibrosis of the liver in many diseases.Aim of Study: Was to evaluate the role of fibroscan in assessment of liver steatosis and fibrosis in patients with type 2 diabetes and NAFLD.Patients and Methods: The study population consisted of 40 patients with type 2 diabetes and 20 patients with obesity as controls. Patients with type 2 diabetes were divided into two groups: Group IA patients with type 2 diabetes and obesity and group IB patients with type 2 diabetes without obesity. Correlation between steatosis and fibrosis and disease was analyzed.Results: Steatosis of patients with type 2 diabetes was significantly higher compared to those of controls (p=0.042) further more patients with type 2 diabetes and obesity had higher level of steatosis than those without obesity. Also, patients with type 2 DM and obesity had higher levels of fibrosis than controls (p=0.023).Conclusion: Diabetic patients with insulin resistance (IR) and obesity have high prevalence of NAFLD and advanced liver fibrosis and we can use fibroscan for assessment of fibrosis and steatosis in those patients.
https://mjcu.journals.ekb.eg/article_62806_6a46c41a433cd81a3aa45b2494f14f2a.pdf
2018-12-01
4209
4217
10.21608/mjcu.2018.62806
Non alcoholic fatty liver disease (NAFLD) – Diabetic – Tanta University
NASRAT M. AYAD, M.D.;
HANAN H. SOLIMAN, M.D.
1
AUTHOR
NOHA E. ESHEBA, M.D.;
MOHAMMED I. GAMAL ELDIN, M.Sc.
2
The Department of Internal Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt
AUTHOR
ORIGINAL_ARTICLE
Role of Anorectal Manometry in Anal Fissure and Outcome of Tailored Lateral Sphincterotomy in Hypertensive Internal Anal Sphincter: A Modified Minimal Invasive Technique
AbstractBackground: CAF is a common benign anorectal problem that substantialy impairs the patient's life. Consequently, a rapid and effective solution is required.1Aim of Study: To do lateral internal sphincterotomy extending up to the upper end of the fissure (but not to the dentate line) in patients have CAF with hypertonic IAS to keep continence. In case of low RAP, V-Y plasty will be done.Patients and Methods: Our study was done on 34 patients with CAF divided into 2 groups, group 1 included 28 patients with hypertonic IAS underwent tailored LIS and group 2 included 6 patients with normotonic/ hypotonic IAS underwent V-Y plasty to keep continence from June 2017 till December 2017 in general surgery department ,Assiut university hospital.Results: In group 1 there is no incontinence or recurrence, complete healing of fissures occurred in 96.4%. Only one patient had unhealing fissures, postoperative complications include bruising occurred in 3.5% and minor sepsis of sphinc-terotomy wound in 3.5%, in group 2 there is minor sepsis of the flap in 16.6%.Conclusion: Our study was done on 34 patients with CAF. These patients were divided according to anomanometric study into 2 groups: - Group 1 included 28 patients with high RAP in whom tailored LIS was done by modified technique which is taiored equal to the length of the fissure which is minimally invasive with good healing rate and no recurrence or incontince postoperative and minor bruising and sepsis of the wound and significant reduction in postoperative RAP. - Group 2 included 6 patients with normotonic /hypotonic IAS in whom excison of fissures were done and the defect is closed by V-Y plasty with good healing rate and low postoperative sepsis.So tailored lateral internal sphincterotomy is the effective treatment of CAF with anal hypertonia, safe and not affect continence.
https://mjcu.journals.ekb.eg/article_62807_ce086264308a8b1f2e122dd30ea81a9e.pdf
2018-12-01
4219
4225
10.21608/mjcu.2018.62807
Anal fissure– Anorectal manometry – Tailored lateral sphincterotomy
BESHOY N. NAEEM, M.Sc.;
ABDALLAH B. ABDALLAH, M.D.
1
AUTHOR
ALMOATAZ A. EL-TAYEB, M.D.;
RAMY A. HASSAN, M.D.
2
The Department of General Surgery, Faculty of Medicine, Assiut University, Assiut, Egypt
AUTHOR
ORIGINAL_ARTICLE
Effect of Socioeconomic Status on Preeclampsia Cross Sectional Study
AbstractBackground: Preeclampsia (PE) is defined as a pregnancy specific syndrome usually occurs after 20 week gestation, it is determined by increased blood pressure (>140mmHg systolic or >90mmHg diastolic) accompanied by proteinuria (>0.3gm protein in a 24h specimen). Preeclampsia is multifactorial disease with environmental, socioeconomic and seasonal influence. It also has genetic predisposition. Preeclampsia affects approximately 5 to 7% of all pregnancies. And it remains the major cause of maternal and fetal morbidity and mortality.Aim of Study: Is detect the possible association between SES of the pregnant woman and PE and to assess whether the rate of PE or its severity is affected by different SES levels.Patients and Methods: Cross sectional study design on pregnant women diagnosed to have preeclampsia at Luxor International Hospital. The purposive sample of 145 case collected through 6 months during the period from 1st October 2016 until the end of April 2017. Sample size calculated using G power Program version 3.1.3 with Confidence Level (CL) 95%. The study consist of 4 parts. 1st part: A structure inter-viewing questionnaire was done for data collection; personal, medical, obestetrical. 2nd part: Clinical examination to diagnose PE. 3rd part: Laboratory investigation to confirm diagnosis. 4th part: The SES data was designed according to modified Fahmy and El-Sherbini scale 2012 to asses the SES of the participating women which consist of 7 domains.Results: The study resulted in no significant statistical difference between severity of preeclampsia and mother age (p=0.800), obstetric history, previous history of PE (p=0.075) and medical diseases such as essential hypertension (p=0.300) and diabetes mellitus (p=0.316); but there was a significant statistical relationship between severity of PE and bronchial asthma (p=0.008). There is also a significant statistical rela-tionship between severity of PE and level of education (p= 0.024), home sanitation (p=0.014), family possessions (p= 0.0.005), and economic status (p=0.030). but there is no significant statistical relationship between severity of PE and occupation (p=0.111), family domain (p=0.161) and health care domain (p=0.217).Conclusion: There is association between level of educa-tion, home sanitation, family possessions, and economic status as an indicators for socioeconomic status and severity of preeclampsia.Recommendation: Health education programs should be organized for pregnant women about the risk factors of preeclampsia; and for staff members about risk factors, early detection and early management of preeclampsia; improving ante-natal care for pregnant mothers in Egypt and improve the health level of poor families to reduce the risks of preec-lampsia and to help early diagnosis; so that can decrease maternal and perinatal mortality.
https://mjcu.journals.ekb.eg/article_62808_0ca51b1c200e95e3560318a745dc3195.pdf
2018-12-01
4227
4234
10.21608/mjcu.2018.62808
Preeclampsia – Socioeconomic status
ALAA EL-DEEN A. YOUSSEF, M.D.;
MOSTAFA H. MOHAMED, M.D.
1
AUTHOR
DINA M. EL-SAYED HABIB, M.D.;
SAMIA S.A. MOUSSA, M.Sc.
2
The Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University* and Luxor General Hospital**, Luxor, Egypt
AUTHOR
ORIGINAL_ARTICLE
Comparative Study between Effect of Sleeve Gastrectomy and Mini-Gastric Bypass on Type 2 Diabetes Mellitus
AbstractBackground: Severe obesity (most often defined as a BMI ³35kg/m2 with comorbid health conditions or a BMI ³40 kg/m2 without such conditions) is a highly prevalent chronic disease, which leads to substantial morbidity, premature mortality, impaired quality of life and excess healthcare expenditures. Bariatric surgery leads to greater weight loss and higher remission rates of type II diabetes and greater reductions in use of anti-diabetic drugs compared with non-surgical treatment for obesity.Aim of Study: The aim of this study is to compare between the effect of sleeve gastrectomy and mini-gastric bypass on patients with type 2 DM and BMI ³35kg/m2.Patients and Methods: A prospective comparative study which included 40 obese patients with type 2 DM (20 patients were operated for Laparoscopic Sleeve Gastrectomy (LSG) and 20 patients for Laparoscopic Mini-Gastric Bypass (LM-GB), with mean age at LSG group 42.95±7.63 with range of 31-59 years, at LMGB group was 42.9±6.17 with range of 34-58 years.Results: In SG cases; complete remission occurred in 11 patients with percentage of 55% and failure of remission occurred in 9 patients with percentage of 45%. No cases developed partial remission in SG cases. In MGB cases; 15 developed diabetic remission with percentage of 75% (11 (55%) patients developed complete remission, 4 (20%) patients developed partial remission). Failure of remission occurs in 5 patients in MGB cases with percentage of 25%.Conclusion: Based on our results, LSG and LMGB are efficient operations for reducing weight in morbidly obese patients and also in diabetic control in T2DM. LMGB might be superior to LSG in %EWL and T2DM remission after 1.5 year follow-up.
https://mjcu.journals.ekb.eg/article_62809_9fdfb95e026ad443f9bc1c02c9ba09b9.pdf
2018-12-01
4235
4241
10.21608/mjcu.2018.62809
Sleeve gastrectomy – Mini-gastric bypass – DM
ABD EL-RAHIM M. MAHMOUD, M.Sc.;
MAGDY M. MOSTAFA, M.D.
1
AUTHOR
MOHAMED A.
ABD EL-MAKSOUD, M.D.
2
The Department of Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
ORIGINAL_ARTICLE
The Impact of A 10-Week Proposed Training Program on Some Physiological Variables and Physical Abilities of Football Referees
AbstractBackground: Football referees' physiological and physical fitnesses have received a growing interest over the last decades.Aim: The purpose of the present study was to evaluate the effect of a 10-week training program on some physiological variables that enable the referees to pass the physical fitness tests endorsed by the international Federation of Football Association (FIFA).Material and Methods: Thirty Egyptian soccer referees from Assiut football branch volunteered to participate in a 10-week training study (pre-to-post measurements) as follows: Second class referees (2nd R, n=11); third class referees (3rd R, n=13) and new referees (NR, n=6). Pre-to-post training measurements of physiological variables (heart rate, blood pressure, Rate-Pressure Product (RPP) and VO2 max) and FIFA-approved physical fitness tests (repeated sprint ability and interval test) were assessed.Results: The decrement of heart rate, blood pressure, RPP and increment of VO2 max were observed following the 10- week training program that enables the referee to pass the fitness test approved by the FIFA.Conclusion: We concluded that the 10-week training program succeeded in improving the physical fitness of football referees in Assiut governorate.
https://mjcu.journals.ekb.eg/article_62810_ebd1baa2383b559ab8abeb162e73313b.pdf
2018-12-01
4243
4247
10.21608/mjcu.2018.62810
Football referees – Repeated sprint abilities – Heart rate – Blood pressure
EMAN S.H. ABD ALLAH, Ph.D.;
IBRAHIM M. RAMADAN, M.Sc.
1
AUTHOR
YASSER H. FARGHALY, Ph.D.;
MOHAMED I.M. SULTAN, Ph.D.
2
AUTHOR
ORIGINAL_ARTICLE
Severe Traumatic Brain Injury: Clinical Outcome of 30 Cases Managed by Decompressive Craniectomy
AbstractBackground: Severe traumatic brain injury is correlated to increased incidence of mortality and severe disability. In the acute phase, medical and surgical management is aimed to prevent intracranial hypertension and to maintain adequate cerebral perfusion pressure. Decompressive craniectomy is a surgical intervention that revealed much interest in the management of refractory intracranial hypertension after severe traumatic brain injury.Aim of Work: To evaluate the clinical outcome of decom-pressive craniectomy in management of severe traumatic brain injury either performed immediately in the acute phase or after failure of the initial medical therapies to control the elevated intracranial pressure.Subjects and Methods: This retrospective study included thirty patients. All patients operated upon by Decompressive craniectomy after severe traumatic brain injury in the period between 2013 and 2017. Patients were divided into 2 groups according to the indications of Decompressive craniectomy. First group included patients whom initially treated by medical treatment and operated upon in a context of refractory intrac-ranial hypertension. The second group patients were operated upon immediately for evacuation of compressive hematoma accompanied with decompressive craniectomy due to severe edema, making it impossible to replace the bone flap. Upon admission, all patients underwent a complete physical and neurological examination. Initial imaging examinations were reviewed with description of the lesions, measurement of midline shift and classification of lesions according to Mar-shall's classification. Intracranial pressure and cerebral per-fusion pressure were monitored and analyzed during manage-ment. Clinical outcome for both groups was graded using the Glasgow Outcome Scale 3 months after operation and at long term follow-up.Results: Twenty patients (67%) in the first group under-went delayed decompressive craniectomy within 7 days after trauma. In the second group, 10 patients (33%) operated upon immediately with decompressive craniectomy within 6 hours after injury. Favourable functional outcome was achieved in 9 patients (45%) among the first group and 3 patients (30%) in the second group at 3 month post-operatively. At 24 month follow-up, 12 patients (60%) and 3 patients (30%) showed favourable outcome in the two groups respectively. Radiologically, midline shift decreased and visibility of the mesen-cephalic cisterns was improved after the Craniectomy. Com-plications occurred in three (14%) of the survived 21 patients included in the study.Conclusion: DC could have beneficial role in improving functional outcome, lowering ICP and mortality in management of severe traumatic brain injury. Additionally, it shows in-creased incidence of complications. Further exploring of long term effects of DC and its influence on prognosis is recom-mended.
https://mjcu.journals.ekb.eg/article_62811_d84e676ec461c55307f66b28de9fb08b.pdf
2018-12-01
4249
4254
10.21608/mjcu.2018.62811
Decompressive craniectomy – Severe traumatic brain injury – Refractory intracranial hyperten-sion
AHMED EL-SAYED, M.D.;
ADHAM EL-SAYED, M.D.
1
The Department of Neurosurgery, Faculty of Medicine, Cairo University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Proprioception Errors in Patients with Cervical Spondylosis at Sagittal Plane
AbstractBackground: Cervical spondylosis is a chronic degenera-tive condition of the cervical spine causing neck pain. Prop-rioception errors may be contributes to the development and maintenance of cervical spondylosis.Aim of Study: The study aimed to determine the proprio-ceptive reposition errors in cervical spondylosis patients.Patients and Methods: Twenty patients with cervical spondylosis (Group A) and twenty matched healthy subjects (Group B). Their age ranged 30-50 years old were represented the sample of the study. Cervical Range of Motion device (CROM) was used for assessment of proprioception error in flexion and extension. Results: There was significant reduction in absolute angular error of neck flexion, extension at neutral and target head reposition tests in Group B compared to Group A (p<0.05).Conclusion: Cervical proprioceptive errors are increased in patients with cervical spondylosis in comparison with matched healthy subjects.
https://mjcu.journals.ekb.eg/article_62812_8561d4035a2a10abf284676c0624b5df.pdf
2018-12-01
4255
4257
10.21608/mjcu.2018.62812
Cervical spondylosis – Proprioception error – CROM
MOSHERA H. DARWISH, Ph.D.;
AMR HASSAN, M.D.
1
AUTHOR
HEBA A. KHALIFA, Ph.D.;
IBRAHIM A. ABU-ELLA, M.Sc.
2
The Departments of Neuromuscular Disorder, Faculty for Physical Therapy* and Neurology, Faculty of Medicine**, Cairo University, Cairo, Egypt
AUTHOR
ORIGINAL_ARTICLE
Maternal and Perinatal Outcome of Major Degree Placenta Previa at Mansoura University Hospital
AbstractBackground: To study risk factors, management, and outcome of major degree placenta previa in our tertiary health care hospital.Patients and Methods: A Prospective observational study was conducted in Obstetrics & Gynecology, Department, Mansoura University Hospital, Egypt during the period from July, 2014 to December, 2015. The patient criteria, method of diagnosis, management, fetal and maternal outcomes of cases with major degree PP were reported and analyzed.Results: This study included 115 cases. Mean age of our cases was 31.1 years (range: 21-40), mean gestational age at delivery was 36.8 weeks (range: 28-39). Previous cesarean deliveries were reported in 93.9% of the cases. Abnormal placental adhesions were found in 30.4%. A stepwise system was used for intraoperative interference. Peripartum hyster-ectomy was performed in 13 cases (11.3%). There were three cases of maternal mortality; one due to anesthetic complication, one due to uncontrolled atonic postpartum hemorrhage and the third was due to postoperative pneumonia.The mean gestational age at delivery was 36.82±1.6 weeks. There were 5 cases (4.3%) of IUFD and 2 cases (1.8%) of early neonatal deaths.Conclusions: Major placenta previa with accrete had significant difference in maternal morbidity and mortality than non-accrete type. Pathological placental adhesions should be excluded by Doppler ultrasound and or MRI. All surgical procedures to control bleeding must be done including hys-terectomy without hesitation to save the patient. Cases must be managed by a collaborative team work in a tertiary center with available ICU.
https://mjcu.journals.ekb.eg/article_62813_f10335eacc18a22e449cdca4074306c2.pdf
2018-12-01
4259
4265
10.21608/mjcu.2018.62813
Maternal – Perinatal – Placenta previa
SAMEH MASHALY, M.Sc.;
EMAD FYALA, M.D.
1
AUTHOR
ASHRAF GHANEM, M.D.;
MOHAMAD NEZAR, M.D.
2
The Department of Obstetrics & Gynecology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
AUTHOR
ORIGINAL_ARTICLE
Diagnostic Value of 64-Slice Multi Detector Computed Tomographic Angiography in Assessment of Complicated Coronary Artery Bypass Graft
AbstractBackground: Coronary Artery Bypass Grafting (CABG) is to replace occluded or stenosed coronary arteries with patent venous or arterial conduits. Long-term sequelae after CABG include native coronary artery disease progression and de novo arthrosclerosis in grafts, resulting in recurrent ischemic symptoms and mortality.Aim of Study: This study was undertaken to form the basis of review on the role of 64 Multi-Detector Computed Tom-ography (MDCT) in detecting possible complications in post coronary artery graft (CABG) patients.Material and Methods: During the period from November 2015 to August 2017, a prospective evaluation of 50 patients with suspected post-CABG complications underwent MDCT coronary angiography in radiology department of International Medical Center in Egypt. Informed consent was obtained from all patients and the study had institutional review board approval. Descriptive statistics were used to analyze the data.Results: There were 40 males and 10 females, their mean age ± (SD) of 59±3.9 years. A total of 129 grafts were available for evaluation. From the total 129 graft 25 grafts were occluded as 24 of them showing the occlusion at the proximal anasto-mosis and the remaining one at the distal anastomosis. 8 grafts showed significant stenosis. Two showing ulceration at anas-tomotic site and 6 showing kinking course while one was showing competitive flow distally and one showing retrograde felling. Four grafts show stent placement. From the total evaluated 50 patients four patients were underwent redu operation. One patient had partial thrombosis in left subclavian artery encroaching upon LIMA origin. Three patients were suffering from fever one had pneumonia and the other two had chest wall infection with retrosternal extension and associated mediastinal involvement. Four patients show sternal dehiscence. One patient showed localized pericardial hemato-ma. Sex patients showed ascending aortic aneurysm and two showed main pulmonary artery aneurysm. All these compli-cations occurred from 6 menthes to 13 years post CABG surgery.Conclusion: MDCT is an easy non-invasive technique which showed to be effective in diagnosis of post-operative CABG related and non-related complications and is very informitive in difficult clinical situations.
https://mjcu.journals.ekb.eg/article_62814_7df26a4dac61c1057b643b8fe1fbedae.pdf
2018-12-01
4267
4277
10.21608/mjcu.2018.62814
MDCT (Multidetector Computed Tomography) – Coronary Artery Bypass Graft (CABG)
EISHA R. MOHAMED, M.D.;
IBRAHIM M. HELMY, M.D.
1
AUTHOR
LOBNA Kh. SAKR, M.D.;
KHALED A. EL-GHAMRAWY, M.Sc.
2
The Department of Radiodiagnosis, Faculty of Medicine for Girls, Al-Azhar University, Cairo*, International Medical Center, National Heart Institute, Cairo and Al-Ahrar Teaching Hospital, Zagazig** and Al-Ahrar Teaching Hospital, Zagazig***, Egypt
AUTHOR
ORIGINAL_ARTICLE
Role of Alpha Hemoglobin Stabilizing Protein Expression in Beta Thalassemia Patients
AbstractBackground: Beta (b)-Thalassemia is an autosomal reces-sive inherited disease causing variable degrees of anemia. The molecular defects are owing to point mutations or small deletions leading to diminution or absence of b-globin chain synthesis. The unmatched a-Hb is destructive to itself and other cellular components, resulting in ineffective erythropoi-esis and hemolysis. Alpha-Hemoglobin Stabilizing Protein (AHSP) is a scavenger protein of erythroid that fastly and reversibly attach the a subunit of hemoglobin molecule preventing its precipitation and subsequent hemolysis.Aim of Work: Is to assess AHSP gene expression in thalassemia major and intermedia and its relation to clinical features, laboratory investigations and to determine its role on the severity of thalassemia.Subjects and Methods: This case-control study is consisted of 120 studied subjects categorized into 40 thalassemia major patients, 40 thalassemia intermedia patients and 40 age healthy individuals as a control group. All subjects underwent the following; history, clinical picture, complete blood picture and Hb electrophoresis, serum ferritin and measurement of AHSP, alpha globin and beta globin genes expression by real time PCR.Results: AHSP gene in thal. intermedia group was higher than both thal. major (p<0.001). Beside thal. intermedia group had higher a globin/AHSP ratio versus thal. major group (p=0.011). b globin/AHSP ratio was not significant between both thal. groups. AHSP in thal.major group correlated with a globin and b globin expression and negatively correlated with organomegally, ferritin and no. of blood transfusion. Whereas in thal. intermedia group, was positively correlated with Hb, HCT, MCV, MCH, a globin gene expression, b globin gene expression and b globin/a globin genes ratio.Conclusion: AHSP expression was higher in thalassemia intermedia group than thalassemia major group. Consequently, AHSP can be considered genetic modifier in b thalassemia.
https://mjcu.journals.ekb.eg/article_62815_c1ac78534b757fefb63727ae5156f60c.pdf
2018-12-01
4279
4288
10.21608/mjcu.2018.62815
AHSP – Thalassemia intermedia – Thalassemia major – Flowcytometry
IMAN A. AHMEDY, M.D.;
SAMIA H. KANDEL, M.D.
1
AUTHOR
SAFAA I. TAYEL, M.D.;
MAHMOUD A. EL-HAWY, M.D.
2
The Departments of Clinical Pathology*, Medical Biochemistry & Molecular Biology** and Pediatrics***, Faculty of Medicine, Menoufia University, Menoufia, Egypt
AUTHOR
ORIGINAL_ARTICLE
Relationship between Absenteeism Rate and Job Satisfaction among ICU Nurses in Selected Hospitals
AbstractBackground: Absenteeism and job satisfaction in nursing are attitudes reflecting on productivity, quality of patient care, and the personal life of nursing staff. Some research has found no correlation between these two variables whereas other studies indicate a weak to moderate relationship between these two variables.Aim of Study: To investigate the relationship between absenteeism rate and job satisfaction among ICU nurses in selected hospitals.Subjects and Methods: A descriptive correlational design was utilized for this study to achieve the stated aim. The study was conducted at New Kaser El-Aini Teaching Hospital and El-Manial University Hospital. A samples of 307 nurses were invited to participate in the questionnaire. For the purpose of this study, questionnaire for nurses was adopted and utilized that consist of three parts: The first part was related to the nurse personal characteristics, the second part assess the nurses perception related to job satisfaction, the third part was related to nurses absenteeism rate from nurses attendance records and results of the current study indicated that the majority of the study sample had low satisfaction level. Moreover the study revealed that nurses' working at ICU at El-Manial University Hospital had low absenteeism rate while absenteeism rate among staff nurses working in ICU at New Kasr El-Ani Teaching Hospital had low absenteeism rate.Conclusion: The study concluded that there was no sta-tistical significant relation was found between total job satis-faction and staff nurses' absenteeism rate. Based on the study results, it was recommended that administrative authority should pay attention to salary of nurses to enhance their satisfaction, managers should develop system for communi-cation with their staff to enhance communication. Similar study should be conducted in all department at New Kasr El-Ani Teaching Hospital and El-Manial University Hospital to identify their absenteeism rate on a large sample to compare and generalize the result.
https://mjcu.journals.ekb.eg/article_62816_2b76bec82b933fbd6d452dcd4ffb9be4.pdf
2018-12-01
4289
4295
10.21608/mjcu.2018.62816
Job satisfaction – Absenteeism rate – ICU nurses
NAHED H. RAMADAN, M.Sc.;
ABEER M. SEADA, D.N.Sc.
1
AUTHOR
AMAL H.
ELIWA, D.N.Sc.
2
The Department of Nursing Administration, Faculty of Nursing, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Effect of Low Load Resistance Blood Flow Restriction Training on Knee Osteoarthritis
AbstractBackground: The initiation, progression, and severity of knee osteoarthritis (OA) have been associated with decreased muscular strength and alterations in joint biomechanics. Resistance exercise has been shown to be an effective inter-vention for decreasing pain, restoring muscle strength and joint mechanics while improving physical function in patients with knee OA. High-resistance exercise has been demonstrated to be more beneficial than low-resistance exercise. However, patients with knee OA may have reduced tolerance of high resistance training programs.Aim of Study: The current study was conducted to assess whether concurrent application of blood flow restriction (BFR) to low load resistance (LLR) training is an efficient and tolerable mean of improving functional mobility in patients with knee OA.Patients and Methods: Forty female patients with mild to moderate unilateral tibiofemoral OA. Their age ranged from 45-60 years old. All patients were referred by orthopedic surgeons who were responsible for diagnosis of OA based on clinical and radiological examination. All patients were randomly assigned into one of two groups: Group (A) This group included 20 patients underwent conventional high load resistance (HLR) training exercises (60% 1RM), group (B) This group included 20 patients received LLR training exer-cises (30% 1RM) combined with BFR, three sessions per week for one month. The study was conducted from September 2017 to February 2018 in a private orthopedic and physical therapy center.Evaluation: Timed up and go (TUG) test was used to assess patient's functional mobility. Results showed that both groups had significant improvement in functional mobility.Conclusion: Both conventional HLR training and LLR-BFR training are effective treatment options for improving functional mobility in patients with knee OA, However, the use of LLR-BFR training resulted in less anterior knee pain during sessions compared to high load training.
https://mjcu.journals.ekb.eg/article_62817_42e90d609b1ee6a6d47081be95a3dbc7.pdf
2018-12-01
4297
4306
10.21608/mjcu.2018.62817
Knee osteoarthritis – Blood flow restriction – Strengthening exercises – TUG test
MAI M.A. ABDALLAH, M.Sc.;
NADIA A. FAYAZ, Ph.D.
1
AUTHOR
MAHA M. MOHAMMED, Ph.D.;
MOHIE ELDIN M. FADEL, M.D.
2
The Department of Physical Therapy for Musculoskeletal Disorders and Their Surgeries *, **, Faculty of Physical Therapy, Pharos* & Cairo** Universities and The Department of Orthopedic Surgery, Faculty of Medicine, Alexandria University***, Egypt
AUTHOR
ORIGINAL_ARTICLE
Identification and in Vitro Susceptibility Pattern of Fungal Pathogens in Immunocomprimised Patients with Pulmonary Fungal Infections
AbstractBackground: The frequency of fungal infections of the lung has increased particularly in immunocompromised pa-tients. Early diagnosis and treatment is important to start antifungal therapy and to avoid unnecessary use of toxic antifungal agents. This study aimed to identify the common fungal species causing pulmonary infection in immunocom-promised patients and their in vitro antifungal sensitivity pattern in Assiut University Hospitals (AUH).Subjects and Methods: This was a hospital based descrip-tive study conducted on 135 patients admitted at different Intensive Care Units (ICUs) and Oncology Department at Assiut University Hospitals (AUH). Collected respiratory specimens were subjected to direct microscopic examination and inoculation on Sabouraud Dextrose Agar (SDA). Identi-fication of isolated yeasts was done using phenotypic methods including chromogenic media (Brilliance Candida agar and CHROMagar Candida differential media), germ tube test, cornmeal agar and API candida while mould isolates identifi-cation was mainly dependent on macroscopic and microscopic features. Some isolates had confirmed using rRNA gene sequencing. In vitro antifungal susceptibility testing was done using disc diffusion method.Results: In this study 80/135 (59.3%) of collected samples were positive for fungal infection. The most common fungal pathogens isolated were Candida and Aspergillus species. In vitro sensitivity test showed that the yeast isolates had the highest sensitivity to Nystatin (90.9%) followed by Ampho-tericin B (80.3%) while for mould isolates, the highest sensi-tivity was to Voriconazole (71.4%) followed by Amphotericin B (57.1%).Conclusion: Pulmonary fungal infection appears to be an important problem in immunocomprimised patients with Candida albicans was the most commonly isolated yeast from various clinical specimens; also the increase in the resistance especially to azoles is a major concern.
https://mjcu.journals.ekb.eg/article_62818_4822f81ac4b6ecca44176d6a1b995621.pdf
2018-12-01
4307
4316
10.21608/mjcu.2018.62818
Pulmonary fungal infection – Candida – Asergillus – Antifungal agents
HANAN H. ABD EL-LATEEF, M.D.;
AHMED M. MOHARRAM, M.D.
1
AUTHOR
MAHA M. EL-KHOLY, M.D.;
SOHAIR K. SAYED, M.D.
2
AUTHOR
MOHAMMED Z. ABD EL-RAHMAN, M.D.;
DOAA M. ABD EL-KAREEM, M.Sc.
3
The Departments of Clinical Pathology, Faculty of Medicine*, Botany & Microbiology, Faculty of Science** and Chest Diseases, Faculty of Medicine***, Assiut University, Assiut, Egypt
AUTHOR
ORIGINAL_ARTICLE
Modulation of Renal Aquaporin-3 by Swimming Exercise in Fructose Induced Metabolic Syndrome
AbstractBackground: Metabolic syndrome is cluster of cardiovas-cular and metabolic pathologies, caused by high fructose in modern times.Aim of Study: We investigated the possible beneficial role of exercise on fructose induced metabolic syndrome in rats with special focus on the role of renal aquaporin-3 (AQP3).Material and Methods: Forty rats were divided into four groups; control, exercised control, MetS (Metabolic Syn-drome), and MetS with exercise. MetS was induced by fructose rich diet and swimming was practiced 3 days per week for 6 weeks, one hour each session.Results: Fructose consumption significantly increased fact accretion, systolic blood pressure, serum lipids, insulin levels and insulin resistance. Also serum MDA, uric acid and renal AQP3 expression increased compared to the control group. Swimming exercise significantly decreased the previ-ously measured parameters compared to fructose group but overexpressed renal AQP3.Conclusion: Increased AQP3 expression may be implicated in fructose induced MetS. Swimming exercise efficiently counteracted metabolic disruption and vascular affection via lowering effect on oxidant and dyslipidemic stresses with renal aquaglyceroporin-3 overexpression.
https://mjcu.journals.ekb.eg/article_62819_623ea89dc461c15842ae3062c6b10070.pdf
2018-12-01
4317
4325
10.21608/mjcu.2018.62819
Swimming exercise – Fructose – Metabolic syndrome – Insulin resistance – Aquaglycerop-orin-3
GHADA S. AMER, M.D.;
DALIA R. AL-SHARAKY, M.D.
1
The Departments of Physiology* and Pathology**, Faculty of Medicine, Menoufiya University, Menoufiya, Egypt
AUTHOR
ORIGINAL_ARTICLE
Study of the Effect of Administration of Citalopram on the Liver of the Pregnant Albino Rats and the Liver of their Offspring
AbstractBackground: Depression and anxiety are common public health problems. Citalopram is the first line of treatment for depression among SSRIs with high potency and selectivity for serotonin uptake. Pregnancy appears to increase the risk of anxiety by 10-30% of pregnant women. Women previously known with depressive disorder have an increased risk of depression in connection with pregnancy. The liver is a primary target of adverse drug reactions because it is the predominant site for the biotransformation and metabolism of the drugs. Aim of the study: The aim of the study was to evaluate the effect of administration of citalopram on the liver of the pregnant albino rats and the liver of their offspring.Material and Methods: Forty pregnant albino rats were chosen for this study. They were divided into two equal groups, each group contained twenty pregnant albino rats. Each group was subdivided into two equal subgroups and each subgroup contained ten pregnant albino rats: Group I (control group): Each pregnant albino rat was already given by a gastric gavage 0.18ml distilled water daily one week before pregnancy. This group was divided equally into 2 sub-groups: Subgroup IA: Each pregnant albino rat was given by a gastric gavage 0.18ml distilled water daily during pregnancy. Subgroup IB: Each pregnant albino rat was given by a gastric gavage 0.18ml distilled water daily during pregnancy and continued daily for 2 weeks after delivery with the same dose. Group II (Citalopram treated group): Each pregnant albino rat was given by a gastric gavage 0.18ml distilled water containing 0.36mg citalopram daily one week before pregnancy. This group was divided equally into 2 sub-groups: Subgroup IIA: Each pregnant albino rat also was given by a gastric gavage 0.18ml distilled water containing 0.3 6mg citalopram daily during pregnancy. Subgroup IIB: Each pregnant albino rat also was given by a gastric gavage 0.18ml distilled water containing 0.36mg citalopram daily during pregnancy and continued 2 weeks after delivery. At the end of the experimental period, the albino rat mothers and their offspring were collected on the 1st day (subgroups IA and IIA) and fifteenth days after delivery (subgroups IB and IIB). Biochemical study was done for all albino rat mothers before liver dissection by taken blood samples to measure the levels of Aspartate Amino Transferase (AST), Alanine Aminotransferase (ALT) and Gamma Glutamyl Transpeptidase (GGT) in the serum followed by statistical analysis of the data using unpaired student’s t-test. Paraffin sections for albino rat mothers and their offspring were prepared to be stained with H & E, Masson's trichrome and Gordon and sweet's stains for light microscopic study. Specimens of the liver were also prepared for electron micro-scopic study. The semithin sections were cut and stained with toluidine blue and examined by light microscope. The ultrathin sections were cut and examined using a transmission electron microscope.Results: Administration of citalopram led to a significant elevation in the liver enzymes of the albino rat mothers. Also, citalopram caused cellular degeneration, necrosis, apoptosis, congestion of the hepatic veins and the portal veins in the hepatic tissue of the albino rat mothers and their offspring.Conclusion: Citalopram caused degenerative changes in the liver of the albino rat mothers and their offspring when it was administered before and during pregnancy and after delivery.
https://mjcu.journals.ekb.eg/article_62821_14760d86304c300a3569a2e2882465be.pdf
2018-12-01
4327
4348
10.21608/mjcu.2018.62821
Citalopram – Pregnant – Albino rats – Liver – Offspring
SHIMAA R. ABD EL-MOHSEN, M.Sc.;
FATMAH H.M.K. ISMAEIL, M.D.
1
AUTHOR
AMANY F.
MOHAMED, M.D.
2
The Department of Anatomy and Embryology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Eygpt
AUTHOR
ORIGINAL_ARTICLE
The Diagnostic Validity of TROP-2 in Recognizing Papillary Thyroid Carcinoma
AbstractBackground: Thyroid cancer is currently the third fastest rising cancer diagnosis in the United States and represents 80.3% of endocrine neoplasms and 2.6% of total malignancies in Egypt with male to female ratio is 1:2. Papillary thyroid carcinoma (PTC) represents the most common histologic type of thyroid carcinoma in Egypt representing 83.3%. Diagnosis of papillary thyroid carcinoma is not always straight forward because some lesions exhibit equivocal nuclear features making the distinction of benign from malignant lesions is difficult. So it is necessary to use ancillary diagnostic tools to reach accurate diagnosis. TROP-2 is a trans-membranous glycoprotein, was originally identified in human trophoblast and choriocarcinoma cell lines and was subsequently reported to be over-expressed in a variety of human carcinomas. Few studies have verified the diagnostic power of TROP2 in PTC suggesting that it could be a potential novel immunohisto-chemical marker for identification of both classic and follicular variants of PTCAim of Study: The aim of this study is to review the diagnostic value of TROP-2 in papillary thyroid carcinoma (PTC) in English literature.Material and Methods: From Medline databases (PubMed, Medscape and Google scholar) and also materials available on the Internet from 2014 to 2017.The initial search presented 5 articles that studied the diagnostic role of TROP-2 in differentiating PTC from non malignant thyroid lesions and were performed on histological specimens only (cytological specimens were excluded).If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures.A structured systematic review was performed with the results tabulated.Results: TROP-2 sensitivity in total papillary thyroid carcinoma cases ranged from 50% to 86.8% passing through 58.3% to 81.5% and 81.6%. Regarding TROP-2 specificity it was 100% in 4 out of 5 articles and 89.3% in the remaining one. Four articles showed 100% of positive predictive value (PPV) and one article demonstrated 84.6%. The negative predicitive value (NPV) ranged from 74.1% to 92.4% and the diagnostic accuracy ranged from 79.4% to 94.3%. As regard non follicular variant PTC (non FVPTC) TROP-2 sensitivities ranged between 81.5% and 98.7%. The NPV ranged between 84% and 99.6%, while diagnostic accuracy ranged between 88.6% and 99.7%. The PPV was 100% in four articles and 82.4% in one article.Conclusion: TROP-2 could be considered as a reliable immunostaining marker in diagnosing papillary thyroid car-cinoma especially non follicular variant owing to its high specificity and sensitivity. TROP-2 is a specific rather than sensitive as its specificities in 4 studies revealed 100%. Ther-efor it is expected to be negative in benign and non-neoplastic thyroid lesions reducing the overdiagnosis of PTC and dis-criminating it from many mimickers.
https://mjcu.journals.ekb.eg/article_62822_33aeb93b6d0d99cdf53628e1910d0e4b.pdf
2018-12-01
4349
4355
10.21608/mjcu.2018.62822
TROP-2 antigen – Immunohistochemistry – Papillary – Thyroid cancer
NEHAL M. NABIL, M.Sc.;
ASMAA G. ABDOU, M.D.
1
AUTHOR
MOHAMMED I. SHABAN, M.D.;
RANIA A. ABDALLAH, M.D.
2
The Department of Pathology, Faculty of Medicine, Menoufia University, Menoufia, Egypt
AUTHOR
ORIGINAL_ARTICLE
Neoadjuvant or Definitive Chemoradiation for Locoregional Esophageal Cancer and its Outcome at South Egypt Cancer Institute (Retrospective Study)
AbstractBackground: It is well known about esophageal carcinoma, the aggressive and invasive nature, in addition to the poor outcome. The experience of south Egypt cancer institute was to review the locally advanced esophageal carcinoma, treated by chemo radiation either followed by surgery or not, and their outcome.Aim of Study: In this study, we evaluate the efficacy of chemoradiation as a definitive or preoperative treatment.Patients and Methods: During the period June 2008, till June 2014, 55 patients with locally advanced esophageal cancer were reviewed for treatment with preoperative or definitive concurrent chemo radiation, at Radiation Oncology Department, South Egypt Cancer Institute, Assiut University. Statistical analysis of data was done by the statistical package for the social science (SPSS) version 20.Results: Out of 55 patients, 26 patients were included for definitive chemo radiation (dCRT). And 29 patients were included for neoadjuvant chemo radiation (nCRT). Squamous cell carcinoma (SqCC) represented in 72.7% of patients. Patients had disease stage II and III (32.7% and 67.3%) respectively. Median total radiation dose was 50.4 Gy over 28 fractions. Cisplatin+Fluorouracil regimen was received by 30 (54.5%) patients, while Paclitaxel+Carboplatin regimen was received by 25 (45.5%) patients. Overall response (CR+PR) was observed in 34 (72.3%) patients, while disease progression occurred in 5 (10.6%) patients and 17% (8 patients) had stable disease. The disease stage at diagnosis was a significant factor affecting clinical response. Out of 29 patients at neoadjuvant group, 18 patients (62%) underwent surgery, without major postoperative complications. Complete patho-logical response (no residual cancer cells) was observed in 6 (33%) patients. Median OS for dCRT and nCRT was 21 and 39 months respectively, it was in favor for nCRT group with no statistical significance (p-value=0.20). Median PFS for dCRT and nCRT was 16 and 18 months respectively, with no statistical significance (p-value=0.363). Disease stage at diagnosis and clinical response after radiotherapy were very highly significant factors affecting patients' overall survival and disease progression survival (p-value=0.014). Overall grade ³3 toxicity 26 events was observed in 16 (29.0%) of the patients.Conclusion: Neoadjuvant chemo radiation followed by surgery is considered as a standard care management for patients with resectable locally advanced esophageal carcinoma and fit for surgery. For patients with inoperable disease or unfit for surgery, definitive chemo radiation is accepted treatment option. The used chemotherapy regimens, Cispla-tin/Fluorouracil and Paclitaxel/Carboplatin, are tolerable in most patients with acceptable toxicity profile; and with no differences between two regimens.
https://mjcu.journals.ekb.eg/article_62823_9f45ff02e465ea1a4f43470e24dc0e4a.pdf
2018-12-01
4357
4366
10.21608/mjcu.2018.62823
Esophageal carcinoma – Definitive concurrent chemo radiation – Neoadjuvant chemotherapy
MOHAMED T. AMIN, M.Sc.;
DALIA MOHAMED, M.D.
1
AUTHOR
ABEER AMIN, M.D.;
SAMIA ABD EL-KAREEM, M.D.
2
AUTHOR
MAHA
EL-NAGGAR, M.D.
3
The Departments of Radiotion Oncology, South Egypt Cancer Institute* and Clinical Oncology, Faculty of Medicine**, Assiut University
AUTHOR
ORIGINAL_ARTICLE
Role of Dipeptidyl Peptidase-4 Inhibitor in the Control of Glycemic State in Type I and Type II Diabetes Mellitus in Rats: A Comparative Study
AbstractBackground: Incretin hormones; glucose-dependent in-sulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) have attracted considerable scientific and clinical interest due largely to their insulin-releasing and glucose-lowering properties. Dipeptidyl peptidase-4 (DPP-4) is the enzyme responsible for cleavage and inactivation of GIP and GLP-1.Aim of Study: The present investigation was assigned to study and compare the effect of DPP-4 inhibitor (vildagliptin) on glycemic state in type I and type II diabetes mellitus in rats.Material and Methods: Fifty male albino rats of local strain were used. Rats were divided into three groups: Non-diabetic (10 rats); type I diabetic (non-treated, 10 rats and Vildagliptin-treated, 10 rats); type II diabetic (non-treated group, 10 rats and Vildagliptin-treated, 10 rats). Type I diabetes was induced by a single intraperitoneal injection (60mg/kg) of STZ dissolved in 0.2ml citrate buffer in adult 6 weeks old rats. 48h later fasting blood samples were taken from rat tail and rats with fasting blood glucose levels greater than 250mg/dl were considered diabetic type I. They were left for 30 days before assessment. Type II diabetes was induced by a single intra-peritoneal injection (90mg/kg) of STZ to a group of 2 days old pups. 6 weeks later, fasting blood samples were taken from rat tail and rats with fasting blood glucose level ³160mg/dl were considered as diabetic type II, they were left for 30 days before assessment. In both treated groups rats were treated daily with Vildagliptin (5mg/kg) by oral gavage for 30 days. At the end of the experiment, retro-orbital fasting blood sample was taken for measurement of serum glucose, serum insulin, glycated hemoglobin (HbA1c), plasma GLP-1 levels, lipid profile, malondialdehyde and total antioxidant capacity. Homeostasis model assessment of insulin resistance (HOMA-IR) index was calculated.Results: Serum glucose, blood HbA1c, serum cholesterol, triglycerides (TG), low density lipoprotein-cholesterol (LDL-cholesterol) and malondialdehyde (MDA) were significantly higher in type I and type II diabetic non-treated groups when compared to corresponding values in non- diabetic group. All the previous parameters were significantly lower in diabetic type I and type II vildagliptin-treated groups when compared to corresponding values in non-treated groups and the same parameters were significantly lower in type II Vildagliptin-treated group when compared to corresponding values in type I vildagliptin-treated group. Serum insulin, high density lipoproteins (HDL-cholesterol) and total antioxidant capacity (TAC) in type I and type II diabetic non-treated groups were significantly lower when compared to corresponding values in non-diabetic group, while all the previous parameters were significantly higher in type I and type II Vildagliptin-treated groups when compared to corresponding values in type I and type II diabetic non-treated groups. The same parameters were significantly higher in type II Vildagliptin-treated group when compared to corresponding values in type I vildagliptin treated group. There was insignificant change in HOMA-IR and plasma GLP-1 level in type I diabetic (both non-treated and Vildagliptin-treated) groups when compared to corresponding values in non-diabetic group; on the other hand HOMA-IR was significantly higher while plasma GLP-1 level was sig-nificantly lower in type II diabetic non- treated group when compared to corresponding values in non-diabetic group. In type II diabetic Vildagliptin-treated group HOMA-IR was significantly lower while plasma GLP-1 level was significantly higher when compared to corresponding values in non-treated group. Upon comparing type I and type II non-treated groups; serum glucose, HbA1c and plasma GLP-1 were significantly higher while serum insulin and HOMA-IR were significantly lower in type I non-treated group when compared to corre-sponding values in type II non-treated group. On the other hand there was insignificant difference in all other parameters between the two groups.Conclusion: Vildagliptin treatment is a good choice for type II diabetes treatment and has beneficial effects in type I diabetes.
https://mjcu.journals.ekb.eg/article_62824_cb3b87291fb299ac37fb79acb63a542d.pdf
2018-12-01
4367
4378
10.21608/mjcu.2018.62824
DPP-4 – Type I diabetes mellitus – Type II diabetes mellitus – Rats
SOHAIR A. SALEH, M.D.;
GERGESS S.Y. HANNA, M.D.
1
AUTHOR
AHMAD M.M. GAAFAR, M.D.;
OMNIA A. ABD EL-MAABOUD, M.D.
2
AUTHOR
EBTEHAL M.M.
METWALLY, M.Sc.
3
The Department of Medical Physiology, Faculty of Medicine, Menoufia University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Evaluating the Outcome of Direct Repair of Bile Duct Injury
AbstractBackground: Bile duct injury (BDI) during laparoscopic cholecystectomy is a surgical catastrophe with an incidence ranging. Between 0.3 to 1,4%. Many surgeons think that direct repair of BDI carries a high risk of stricture that is why the bilioenteric reconstruction is more popular.Aim of Study: Evaluating the results of direct repair in selected cases and compare it to the classic bilioenteric reconstruction.Methods: We had 2 groups, group A had direct bile duct repair and group B had bilioenteric reconstruction. The choice of doing the direct repair was based on the absence of risk factors for biliary complications. Both are compared as regards the presence of postoperative complications either leakage or stricture and hospital stay. All cases were done in Ain Shams university hospitals during the period between January 2013 until December 2017.Results: Bile leakage had happened in one case of group A (11%) and 2 cases of group B (16.7%) with no statistically significant difference, (p-value is 0.72). One case of group A (11.1%) had biliary stricture which was presented at 6 months follow up, managed first by ERCP and stent twice and required reconstruction by Roux en Y after 15 months. For group B, 2 cases had anastomotic strictures presented at 9 and 12 months. They were managed by PTC, dilatation, and stenting and followed by redo reconstruction of the anastomosis at 15 and 17 months after the surgery.Conclusions: Direct repair of the Bile duct can be safely done in properly selected patients with comparable results to bilioenteric reconstruction and no increase in the incidence of postoperative complications.
https://mjcu.journals.ekb.eg/article_62825_a81579cb6f076813dd90bd8379e30ba2.pdf
2018-12-01
4379
4383
10.21608/mjcu.2018.62825
Bile duct injury (BDI) – Direct repair
AHMED KHALIL, M.D.;
KAMAL MAMDOUH, M.D.
1
The Department of Surgery, Faculty of Medicine, Ain Shams University
AUTHOR
ORIGINAL_ARTICLE
Contrast-Enhanced Cerebral MR Venography Overcomes Causes of Drop of Signal in Time of Flight MR Venography
AbstractBackground: Cerebral venous thrombosis is uncommon disease with vague manifestations. Magnetic resonance venog-raphy (MRV) plays an important role in its diagnosis. The cardinal MRV sign of venous sinus thrombosis is sinus drop of signal. Using time of flight MR venography (TOF MRV) -the commonly used technique there are multiple causes of signal drop simulating dural sinus thrombosis.Aim of Study: To diagnose different causes of signal drop on TOF MRV using contrast enhanced MRV to avoid misin-terpretation of dural sinus thrombosis.Patients and Methods: 79 patients with clinical suspicion of cerebral venous sinus thrombosis underwent cerebral 2D-TOF and post-contrast MRV (time-resolved imaging of contrast kinetics (TRICKS) MRV in 40 patients & elliptic centric MRV in 39 patients). Findings in TOF MRV were compared to those in contrast-enhanced MRV.Results: Dural sinus thrombosis was seen in 30 cases. Turbulence of flow in superior sagittal sinus and lateral sinuses was demonstrated in 8 cases, hypoplastic transverse sinus was diagnosed in 23 cases, atretic transverse sinus was shown in 2 cases, stenosis of the transverse sinus was seen in 7 cases. 10 cases demonstrated normal dural sinuses on all used MRV techniques.Conclusion: Drop of signal in dural venous sinuses using TOF MRV has many causes other than thrombosis. To avoid misinterpretation it is important to use contrast enhanced MRV either TRICKS or elliptic centric techniques.
https://mjcu.journals.ekb.eg/article_62826_ad186959891672425511c9373c192e97.pdf
2018-12-01
4385
4390
10.21608/mjcu.2018.62826
Dural sinus thrombosis – TOF MR venography
Time resolved MRV – Elliptic centric MRV – Hypoplastic transverse sinus
FATMA M. SHERIF, M.D.;
TAMER M.E. BELAL, M.D.
1
The Departments Radiology and Neurology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
AUTHOR
ORIGINAL_ARTICLE
Deterioration of School Performance as a Consequence of Parasitic Infestation in Menoufiya Governorate
AbstractBackground: Worm infestation is a major problem in children from developing countries due to bad hygienic conditions. It produces nutritional deficiencies and anemia in children, especially when hookworm infestation is present. Infections impair children's growth and development. Studies have shown associations between helminthes infection and under nutrition, iron deficiency anemia, stunted growth, and poor school attendance.Aim of Study: This study aims to assess the relation between parasitic infestation in primary school children and its effect on school performance.Patients and Methods: The nutritional state of children was assessed by anthropometric measures, clinical examination and laboratory investigation such as hemoglobin (HB) level. The parasitic infestation was assessed by stool and urine analysis, also school performance was assessed by Intelligence quotient (IQ), school achievement and school attendance. Study done from the end of August 2016 to the end of No-vember 2018 in Shebin El-Kom Center and Berkit Sabaa Village, Menoufiya Governorate.Results: This study showed high prevalence of parasitic infestation in rural 67.5% than urban 58.5% with high preva-lence of entameba histolytica , ascaris, giardia, oxyuris, mixed infection while hymenolepis nana, tricuris tricura, anclystoma duodenale. Strongyloides stercoralis and schistsoma mansoni present only in rural with low incidence. There was no statis-tical significant difference between urban and rural school children regarding anthropometric measures including (body weight, height and head circumference) and between infected and non infected except for weight, there was statistical significant difference between non infected children compared to infected. Also there was statistically significant difference in hemoglobin level between urban compared to rural and between infected children compared to non infected as the prevalence of anemia was a higher in rural compared to urban and among infected children compared to non infected. There was statistical significant difference in school performance parameters including (I.Q level and school achievement) between urban compared to rural and infected children com-pared to non infected students.Conclusions: It is evident that there is correlation between parasitic infestation and poor children cognitive function (school performance) and growth.Recommendations: All members dealing with children such as, teachers, pediatric clinics and family physician in family health units and centers for eradication and treatment of all affected children with parasite should be integrated to improve children school performance. Programs for prevention and control of parasitic infection and school performance disorders must be prioritized.
https://mjcu.journals.ekb.eg/article_62827_834035f1e27750a818cbe1273b71f07e.pdf
2018-12-01
4391
4402
10.21608/mjcu.2018.62827
Parasitic infestation – Cognitive function – School performance – Anthropometric measures – School children
WESAM S. MORAD, M.D.;
ALIF A. ALLAM, M.D.
1
The Departments of Epidemiology & Preventive Medicine* and Pediatric Hepatology**, National Liver Institute, Menoufiya University, Menoufiya, Egypt.
AUTHOR
ORIGINAL_ARTICLE
Immediate Postplacental Insertion of Copper Intrauterine Device and Evaluation of Expulsion Rate in Cesarean Section
AbstractBackground: Women who undergo a cesarean section (CS) are in a unique position to receive the intrauterine contraceptive device (IUD). They may also want to use the IUD as a long-acting reversible contraceptive method provided the IUD is safe and effective in the presence of a CS scar.Aim of Study: We aimed to evaluate the efficacy, displace-ment and expulsion rates of immediate post placental insertion of IUD.Patients and Methods: This prospective study was carried out at Obstetrics and Gynecology Department Tanta University Hospital on 60 patients for whom IUD was the chosen con-traceptive method.Results: Mean age among 60 patients included in the present study was 25.10 years, as regard postinsertion com-plications expulsion in 6% of patients, endometritis in 8% and bleeding in 25%, complications occurred after 3 months was in form of expulsion in 2% of patients, bleeding in 4% of patients and PID in 2% and complications occurred after 6 months was in form of expulsion in 4% of patients bleeding in 5% of patients, PID in 4% of patients and pregnancy in 2% of patients.Conclusion: The findings of the present study confirm previous data that immediate postplacental IUD placement is a viable contraceptive option.
https://mjcu.journals.ekb.eg/article_62828_533450c244ceb6ad5d92b13ca209a292.pdf
2018-12-01
4403
4407
10.21608/mjcu.2018.62828
Intrauterine device – Postplacental – Cesarean section
MANAL M. ABDELLAH, M.D.;
SHAHIENAZ H. EL-SHORBAGY, M.D.
1
AUTHOR
AMR M. EL-BADRY, M.D.;
NOHA M. HASSAN, M.Sc.
2
The Departments of Obstetrics & Gynecology* and Radiology**, Faculty of Medicine, Tanta University, Tanta, Egypt
AUTHOR
ORIGINAL_ARTICLE
Mehran and AGEF Risk Scores in Contrast-Induced Nephropathy Among Patients Undergoing Primary Percutaneous Coronary Intervention
AbstractBackground: Primary percutaneous coronary intervention (PCI) is the treatment of choice for ST-segment elevation myocardial infarction (STEMI). Contrast induced nephropathy (CIN) is a serious complication which complicates PCI, resulting in increased morbidity, hospital stay, short and long term adverse outcomes. Prediction of high risk patients for development of CIN is of great importance to conduct pre-ventive measures. Various scoring systems were developed to set up high risk criteria.Aim of Study: To detect the relation between Mehran and AGEF risk scores and CIN. Also, to report other high risk criteria to predict CIN.Patients and Methods: The study included 250 patients with acute STEMI treated by primary PCI. Patients with coronary anatomy not suitable for PCI, with pre-existing renal troubles, on chronic dialysis and who need urgent coronary artery by-pass surgery were excluded.Results: CIN developed among 90 patients (36%). There was no significant association between CIN and patients' age or weight. The independent predictors of the occurrence of CIN were, in order, Mehran score (OR=6.4), Diabetes (OR= 5.8), AGEF score (OR=3.3) creatinine clearance (OR=1.02), non-osmolar contrast volume (OR=0.991). Females, those with low ejection fraction (EF) or previous history of is-chemic heart disease (IHD) were susceptible for CIN.Conclusion: CIN is a challenging health problem among patients undergoing primary PCI. Mehran risk score has a better predictive power that AGEF score in predicting CIN. Several other factors are associated with CIN development like diabetes, female gender, low EF history of IHD and use of non-osmolar contrast.
https://mjcu.journals.ekb.eg/article_63142_5e5e14673c2f17046741b100de4e0c80.pdf
2018-12-01
4409
4415
10.21608/mjcu.2018.63142
Primary PCI – Contrast induced nephropathy – Mehran score – AGEF score
DINA A.A. MOUBASHER, M.Sc.;
AHMED ABD EL-GALEEL, M.D.
1
AUTHOR
HOSAM H. ALI, M.D.;
YEHIA T. KISHK, M.D.
2
The Department of Cardiology, Faculty of Medicine, Assiut University, Assiut, Egypt
AUTHOR
ORIGINAL_ARTICLE
Effect of Oxytocin Treatment on Asprosin Serum Level and Liver Function Changes in Rats with Streptozotocin-Induced Diabetes
AbstractBackground: Asprosin is a newly discovered hormone that was found to be increased in cases of type 2 diabetes mellitus but, few data were available on its serum level changes in cases of streptozotocin (STZ) induced diabetes. Also, studies on the effect of STZ induced diabetes on liver functions were limited. In addition, exogenous oxytocin treatment was re-corded to improve glucose homeostasis in cases of type 2 diabetes mellitus and insulin resistance, but, the information about its effect on STZ induced diabetes was few.Aim of Study: To investigate the effect of exogenous oxytocin treatment on asprosin serum level and liver function changes in rats with STZ-induced diabetes.Material and Methods: 24 Rats were divided equally into 4 groups; control group, streptozotocin treated (STZ) group, streptozotocin treated and pretreated with oxytocin (pre-STZ) group, and, streptozotocin treated and post-treated with oxy-tocin (post-STZ) group. In the control group, 1ml of saline solution was daily injected intraperitoneally (i.p.) for the 1st 6 days and the last 5 days of this 39 days study. In STZ group, a single dose of STZ (60mg/kg, freshly dissolved in 1 ml of saline solution) was injected i.p. on the 6th day after initial 1ml of saline solution was daily injected i.p. for the 1st 5 days. Also, 1ml saline/day was injected i.p. in the last 5 days of the study. In Pre-STZ group, 5mg/kg of oxytocin was daily injected i.p. for 5 days prior to the administration of a single dose of STZ injection and in the last 5 days of the study, 1ml of saline was injected i.p. daily. In post-STZ group, 5m g/kg of oxytocin was daily injected i.p. for 5 days beginning by 28th day following the administration of single dose of STZ injection on the 5th day which was preceded by 5 days i.p. therapy with 1ml of saline/day. At the end of the study, rats were fasted overnight and were killed by decapitation while anaesthetized with ether. Blood from each rat was collected and divided into two parts, a part was kept in heparinized tubes for estimation of glycosylated hemoglobin (HbA 1 c) and the other part was left in non-heparinized tubes to clot and was centrifuged to separate serum which was stored at - 25ºC till used for chemical assays.Results: In STZ group, there was a significant (p<0.001) increase in serum levels of glucose, total cholesterol (TC),triglycerides (TG), low density lipoprotein (LDL), very low density lipoprotein (VLDL), tumor necrosis factor alpha (TNFa), % HbA1c and atherogenic index, but, there was a significant (p<0.001) decrease in final body mass index (BMI) and serum levels of each of insulin, C-peptide and high density lipoprotein (HDL), in comparison to the control group. Also, serum asprosin level was significantly (p<0.001) reduced in STZ group in comparison to the control. Moreover, significant (p<0.001) increases in serum levels of aspartate aminotrans-ferase (AST), alanine aminotransferase (ALT), alkaline phos-phatase (ALP) and total bilirubin, but, significant (p<0.001) decreases in serum direct bilirubin, total protein and albumin levels were found. Furthermore, there were positive associa-tions between serum asprosin and each of final BMI (r=0.948, p<0.01), serum insulin (r=0.946, p<0.01), serum C-peptide (r=0.85, p<0.05), serum HDL (r=0.936, p<0.01), serum direct bilirubin (r=0.902, p<0.05), serum total protein (r=0.867, p<0.05) and serum albumin (r=0.942, p<0.01), but, negative correlations between serum asprosin and each of serum glucose (r=–0.979, p<0.001), serum TC (r=–0.966, p<0.01), serum TG (r=–0.969, p<0.01), serum LDL (r=–0.942, p<0.01), serum VLDL (r=–0.858, p<0.05), % HbA1c (r=–0.918, p<0.01), serum TNF± (r=-0.96, p<0.01), atherogenic index (r=–0.97, p<0.01), serum AST (r=–0.977, p<0.001), serum ALT (r=–0.952, p<0.01), serum ALP (r=-0.958, p<0.01) and serum total bilirubin (r=–0.925, p<0.01). On the other hand, in pre-STZ group a significant (p<0.001) decrease in serum levels of glucose, TC, TG, LDL, VLDL, TNFa, % HbA1c and atherogenic index, but, there was a significant increase in final BMI (p<0.01) and serum levels (p<0.001) of each of insulin, asprosin, C-peptide and HDL, in comparison to the STZ group was found. Also, significant (p<0.001) decreases in serum levels of AST, ALT, ALP and total bilirubin, but, significant (p<0.001) increases in serum direct bilirubin, total protein and albumin levels in comparison to the STZ group were found. In post-STZ group, there was a significant (p<0.001) decrease in serum levels of glucose, TC, TG, LDL, VLDL, TNFa, % HbA1c and atherogenic index, but, a signif-icant increase (p<0.001) in serum levels of insulin, asprosin, C-peptide and HDL, in comparison to the STZ group. Also, significant (p<0.001) decreases in serum levels of AST, ALT, ALP and total bilirubin, but, significant (p<0.001) increases in serum direct bilirubin, total protein and albumin levels were found in comparison to the STZ group.Conclusion: Asprosin levels were significantly decreased in cases of STZ induced diabetes in comparison with the control, but, increased with oxytocin treatment whether before or after STZ treatment in comparison with STZ group. Also, in STZ group, asprosin was positively correlated with final BMI, serum insulin, serum HDL, serum direct bilirubin, total protein and albumin, but, negatively associated with serum glucose, TC, TG, LDL, VLDL, TNF х, AST, ALT, ALP, total bilirubin, HbA1c and atherogenic index. Thus, changes in circulating asprosin affected glucose homeostasis and subse-quently the pathogenesis and complications of diabetes mellitus and might be a predictor of early diagnosis in diabetes mellitus. Also, in STZ group, liver functions were affected in the form of a significant increase in liver enzymes and total bilirubin but, a significant decrease in direct bilirubin, total protein and albumin. Oxytocin treatment pre or post STZ treatment protected or restored the functional ß-cells, and, improved lipid profile and liver functions.
https://mjcu.journals.ekb.eg/article_63143_3d975dff91016c20c68773c7cb746995.pdf
2018-12-01
4417
4428
10.21608/mjcu.2018.63143
Asprosin – Oxytocin – Streptozotocin – Diabetes Mellitus – Liver Function
KHALED A.A. ABULFADLE, M.D.;
RANIA R.A. ATIA, M.D.
1
The Department of Physiology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
AUTHOR
ORIGINAL_ARTICLE
Role of Diffusion Tensor Imaging (DTI) in Post Traumatic Spinal Cord Injury
AbstractBackground: Traumatic injuries of the spine are potentially catastrophic. If associated with neurologic damage, they lead to overwhelming medical, social, and financial consequences. DTI is an advanced neuroimaging technique that is considered sensitive to cord changes not seen on conventional MR imag-ing.Aim of Study: The aim of this study is to investigate the changes in spinal cord (DTI) parameters in patients with post-traumatic spinal cord injury.Material and Methods: The study was performed in Radiodiagnosis Department. Kasr El-Aini Hospitals in the period of January 2017 to January 2018. 25 patients presented with spinal cord transection after trauma (group 1) and 15 age matched controls (group 2) were included in this study. Conventional MRI and Diffusion tensor imaging (DTI) were performed in both groups. Time of imaging of group 1 varied between 2 to 4 years after trauma. Fraction anisotropy (FA) value was calculated at multiple levels proximal to the level of injury.Results: This study demonstrates that FA values for patients with spinal cord injury are significantly lower than values in healthy individuals. Regional measurements of FA values at 5 cord levels showed significant decrease at the level of cord injury.Conclusion: DTI can be considered sensitive marker of cord injury if compared with conventional MR imaging. It can predict the need for early therapeutic intervention and can be considered as baseline pre-operative study and in follow up post stem cell therapy.
https://mjcu.journals.ekb.eg/article_63144_ba63b17185bd964abbac6604d4da1ed6.pdf
2018-12-01
4429
4433
10.21608/mjcu.2018.63144
MRI – Diffusion tensor imaging – Spinal cord injury – Fractional anisotropy
RANIA Z. HASSEN, M.D.;
SHAIMA F. EL-KHOLY, M.D.
1
The Department of Radiology, Faculty of Medicine, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Transcatheter Atrial Septal Defect Device Closure - A 2.5 Years Single Center Study
AbstractBackground: Atrial septal communications account for approximately 6-10% of congenital heart defects, with an incidence of 1 in 1,500 live births. The atrial septal defect (ASD) is among the most common acyanotic congenital cardiac lesions, occurring in 0.1% of births and accounting for 30-40% of clinically important intracardiac shunts.Transcatheter device closure is advised for all symptomatic patients and also for asymptomatic patients with a Qp: Qs ratio of at least 2:1 or those with right ventricular enlargement. The timing for elective closure is usually after the 1st yr and before entry into school. Closure carried out at open heart surgery is associated with a mortality rate of <1%. Repair is preferred during early childhood because surgical mortality and morbidity are significantly greater in adulthood.Aim of Study: Is to evaluate 2.5 years experience in transcatheter device closure of secundum atrial septal defect at the Pediatric Cardiology Unit, Assiut University Children Hospital.Patients and Methods: The study was conducted on 62 patients [56 (90.4%) children and 6 (9.6%) adults] who underwent transcatheter secundum ASD device closure, at Pediatric Cardiology Unit of Assiut University Children Hospital from March 2014 till September 2016.Results: Transcatheter closure of secundum ASD in chil-dren adolescents and adults has a high success rate (98.3%) regarding the efficacy (successful closure of the defect without residual shunt) and safety (no death or major complications as cerebral embolism, cardiac tamponade, device embolization or dislodgement requiring open cardiac surgery and infectious endocarditis) during procedure, immediate and short to midterm follow-up.Conclusion: Transcatheter closure of secundum ASD in children adolescents and adults has a high success rate (98.3%) regarding the efficacy (successful closure of the defect without residual shunt) and safety (no death or major complications as cerebral embolism, cardiac tamponade, device embolization or dislodgement requiring open cardiac surgery and infectious endocarditis) during procedure, immediate and short to midterm follow-up.
https://mjcu.journals.ekb.eg/article_63145_b304ab0e3b4f5006d013486b65e8c06f.pdf
2018-12-01
4435
4439
10.21608/mjcu.2018.63145
Atrial septal defect – Transcatheter device closure
AHMED M. NAJEB, M.Sc.;
DOAA M. RAAFAT, M.D.
1
AUTHOR
NAJWA A.
MOHAMED, M.D.
2
The Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt
AUTHOR
ORIGINAL_ARTICLE
The Effect of Zinc-Deficient Pregnant Albino Rats on the Retinal Development of their Embryos and Offspring: Light Microscopic and Immunohistochemical Study
AbstractBackground: Zinc is involved in many biochemical func-tions. Over 300 enzymes require zinc for their activation and nearly 2000 transcription factors require zinc for gene expres-sion. Zinc is also an effective antioxidant and anti-inflammatory agent. Nutritional deficiency of zinc may affect nearly 2 billion subjects in the developing world.Aim of Study: Because of the prevalence of malnutrition throughout the world this study was carried out to detect the possible effects of zinc-deficient pregnant albino rats on the retinal development of their embryos and offspring.Material and Methods: Female rats after mating were randomly divided into 2 equal groups: One control group received single intraperitoneal injection of distilled water on day 9 of gestation and one experimental group received intraperitoneal injections of 1.10 phenanthroline (zinc chelator purchased from Sigma Company), in a single dose of 30 mg/kg on day 9 of gestation. From the embryos and offspring of both control and treated mothers (at the following prenatal gestational days: 13, 15, 17, 19 and the following postnatal days: (newborn, 7 days, 15 days and 21 days), retinal specimens were processed for Haematoxylin & Eosin staining technique and immunohistochemical study using caspase-3 antibody was used to detect apoptosis in the postnatal age groups.Results: The light microscopic study of the 13 days zinc deficient embryo retina showed apparent shrinkage of the lens vesicle and the optic cup was well formed but it appeared to be shrunken. The retinal pigment epithelium (RPE) of 15th, 17th and 19th day old zinc-deficient embryos consistently contained apoptotic cells with vacuolated cytoplasm and rarified nuclei. The neuroblastic layer showed apparent de-crease in thickness and less mitotic features. The ganglion cell layer revealed numerous deeply stained pyknotic nuclei in the 19th gestational day. Retinae of the newborn, 7 days, 15 days, 21 days-old zinc deficient albino rats showed that the (RPE) contained some vacuolated cells with pyknotic nuclei. The organization of the retina was altered in zinc deficient rats. In addition, apparent reduction in the total retinal thickness and degenerative changes in some layers were observed. By the immunohistochemical study, there was intense positive caspase-3 reaction in all layers of the treated rat retina.Conclusion: This study revealed that zinc has a role in the developing rat retina and its deficiency causes cytoarchi-tectural and maturational changes in the retina of the albino rats. These histological changes may impair the visual functions of the retina; so it is recommended that further investigations should be carried out to determine the relevancy of deprivation of zinc as an etiologic factor in the development of retinal degeneration.
https://mjcu.journals.ekb.eg/article_63146_faf4d2e9f424853c2ced523862d7e6ad.pdf
2018-12-01
4441
4453
10.21608/mjcu.2018.63146
Retina – Zinc deficiency – Prenatal development – Postnatal development – Albino rat
REFAAT S. MOHAMED, M.D.;
SAYED A. SAYED, M.D.
1
AUTHOR
HEBA K. MOHAMED, M.D.;
NOHA A. RASHED, M.Sc.
2
The Department of Anatomy & Embryology*, Faculty of Medicine, Assiut University, Assiut, Egypt
AUTHOR
ORIGINAL_ARTICLE
Role of Endobronchial Ultrasound (EBUS) in Staging of Lung Cancer
AbstractBackground: EBUS-TBNA represents a new technology in the field of bronchoscopy The primary indications for EBUS-TBNA are staging NSCLC and the diagnostic assess-ment of mediastinal lymphadenopathy. EBUS-TBNA also has a diagnostic role in suspected benign disease, especially sarcoidosis and tuberculosis. It is a minimally invasive option as the first sampling staging procedure in suspected NSCLC with solitary hilar nodes, discrete N2 or N3 or bulky medias-tinal diseaes.Aim of Study: The aim of the work is to estimate role of Endbronchial Ultrasound (EBUS)in staging of lung cancer.Patients and Methods: It is a prospective experimental selected non cohort study that carried out on 20 patients with bronchogenic carcinoma addmited to Tanta University Hos-pitals from April 2016 till November 2016.Results: In the current study, 20 patients (17 males & 3 females) were included to examine subcarinal, hilar and mediastinal lymph nodes (LN) in different stations. Among the 20 patients examined, 7 of them were under 60 years and 13 were above 60 years 17 of them are smokers and 3 patients are non-smokers. According to type of lung cancer 4 patients were adenocarcinoma, 5 patients were large cell carcinoma, 6 patients were small cell carcinomas and 5 patients were squamous cell carcinomas. In the current study the lymph nodes staging of lung cancer were N1 (9 patients), N2 (8 patients) and N3 (3 patients).Conclusions: Endobronchial ultrasound-guided transbron-chial needle aspiration has a high diagnostic yield for the evaluation of mediastinal and hilar lymph node metastasis in lung cancer and has a high impact on patient management.
https://mjcu.journals.ekb.eg/article_63148_f3b0dcd056bb8bbdb5d56455255a1a95.pdf
2018-12-01
4463
4467
10.21608/mjcu.2018.63148
Lung Cancer – Endobronchial Ultrasound – Elastography
EMAD H. HELAL, M.Sc.;
GAMAL A. EL-KHOLY, M.D.
1
AUTHOR
ADEL S. BEDIWY, M.D.;
IBRAHIM S. IBRAHIM, M.D.
2
AUTHOR
MOHAMMED S. HANTERA, M.D.;
AYMAN M. EL-SAKKA, M.D.
3
The Departments of Chest Diseases* and Pathology**, Faculty of Medicine, Tanta University, Tanta, Egypt
AUTHOR
ORIGINAL_ARTICLE
Study of the Vascular Structure of Solid Breast Mass and the Predictive Value of Reversed Diastolic Flow in Predicting Malignancy
AbstractBackground: Breast cancer is considered the most common malignancy in females and the second most common leading cause of cancer death after lung cancer. Color, power and pulsating Doppler ultrasonography are more sensitive in the evaluation of solid breast mass depending on tumor new blood vessels growth that plays an important role in the growth of the malignant lesions.Aim of Work: To study the vascular structure of solid breast mass and to detect the importance of reversed diastolic flow in detection of malignancy.Material and Methods: This study included 114 solid breast mass in 100 female patients. Color Doppler ultrasound was done for all patients. We studied the blood vessels of the mass and we analyzed the wave pattern and detected the value of reversed diastolic flow in detecting malignancy.Results: The vessels in malignant breast mass are of irregular caliber with central penetration while regular periph-eral parallel vessels are suggestive of benignity also we found that reversed diastolic flow is significant sign of malignancy.Conclusion: Color Doppler ultrasound is helpful to detect the vascular pattern of solid breast mass. Hypervascular mass with reversed diastole is suggestive of malignancy especially if the invading vessel is central and of irregular shape while presence of peripheral parallel vessels is suggestive of benignity however color Doppler indices such as high RI alone is not good indicator of malignancy.
https://mjcu.journals.ekb.eg/article_63149_963c3c78ae9cd9609d4310c44c2af5f3.pdf
2018-12-01
4469
4474
10.21608/mjcu.2018.63149
Breast cancer – Solid breast mass – Blood vessel – Color Doppler ultrasound
DINA M. MOHAMED, M.D.;
AL-SHYMAA Z. MAHMOUD, M.D.
1
The Department of Radiodiagnosis and Medical Imaging, Faculty of Medicine, Tanta University, Tanta, Egypt
AUTHOR
ORIGINAL_ARTICLE
Anatomical and Morphomertic Study of the Menisci of the Knee Joint in Egyptians
AbstractBackground: Meniscus injury is common in daily life as well as in sports activities especially football players and runners. Variation of form, thickness and width of the menisci can determine the possibility and type of their injury.Aim of Study: The aim of this work is to study the different measurements of the different parts of both menisci (distance, circumference, thickness and width) in cadaveric specimens and to correlate these measurements with in vivo MRI meas-urements, including sex difference of different meniscal parameters.Materials and Methods: The cadaveric study included fifty menisci of 25 knees of formalin fixed adult human cadavers; Measurements were done with the aid of sliding Vernier caliper and were recorded manually. The MRI study included 76 patients (38 male and 38 female), the caliper used for measurements was inbuilt software. The measurements were performed by the same radiologist in all the scans, to prevent inter-observer error.Results: In the cadaveric study; correlation between the different parameters showed statistically significant positive correlation, while in the MRI study; no significant differences were found in results when comparing male and female subjects, all significant differences were found between medial and lateral menisci, with significant positive correlation between the different parameters.Conclusion: In cadaveric study, the posterior horn is the thickest and widest part of the meniscus in both medial and lateral menisci. There is also a strong positive correlation between the different parameters of the menisci (distance between anterior and posterior horns, the outer and inner circumference of the menisci). Regarding MRI study, it is concluded that, in agreement with the cadaveric study, the posterior horns of the menisci are the thickest and widest parts. There is also a strong positive correlation in thickness between different parts of the same meniscus, and the width between the different parts of the same meniscus. On the other hand, there were no significant differences in these parameters regarding the sex.
https://mjcu.journals.ekb.eg/article_63150_6a0f637906bb632c8d9b742dc1e5ca8a.pdf
2018-12-01
4475
4494
10.21608/mjcu.2018.63150
Anatomy – Menisci – Cadaver – Radiology
HODA MAHMOUD EL-AASAR, M.D.;
MOGEDA M. NASRALLA, M.D.
1
AUTHOR
HEBA AHMED KAMAL, M.D.;
HEND AHMED MOHAMED HUSSEIN, M.Sc.
2
The Departments of Anatomy & Embryology and Diagnostic Radiology*, Faculty of Medicine, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Effect of Preoperative Abdominal Training on Abdominal Muscles Strength Outcomes after Ventral Hernia Repair
AbstractBackground: Hernias are caused by a weakness in the abdominal wall along with increased intra-abdominal pressure and poor wound healing. Ventral (incisional) hernias usually result from a weakness in the abdominal wall after abdominal surgery, especially in the obese patient.Aim of Study: To investigate the effect of pre-operative abdominal training on abdominal muscle strength outcomes after ventral hernia repair by using isokinetic dynamometer as a method of evaluation.Methods: 30 patients their age ranged between 20-45 years with ventral hernia, they were directed to operative hernia repair. The patients were randomly divided into two groups: Group (A) (control group) and Group (B) (study group). Isokinetic dynamometer was used to evaluate abdom-inal muscle strength at 3 occasions, first (initial assessment), second (pre-operative assessment), and third (6 months post-operative assessment). For Group (A) (control group); they were instructed to presume their activities of daily living pre-operatively. For Group (B) (study group); they received selective abdominal training program for 30min. 3 times per week for 6 weeks pre-operatively.Results: The result showed that there was a significant increase in abdominal muscle strength post-operatively in study (abdominal training) group compared to control group.Conclusion: It was concluded that pre operative abdominal muscle training was effective for strengthening abdominal muscles after ventral hernia repair.
https://mjcu.journals.ekb.eg/article_63151_db38b1751b78e9a28e586c02f9ab1b9d.pdf
2018-12-01
4495
4501
10.21608/mjcu.2018.63151
Ventral hernia – Abdominal training – Isokinetic
MOHAMED G. AHMED, M.Sc.;
SALAH A. MOHAMED, M.D.
1
AUTHOR
WALID A. ABOU EL-NAGA, Ph.D.;
MOHAMED M. EL-KABLAWY, Ph.D.
2
The Departments of Physical Therapy for Surgery, Faculty of Physical Therapy* and Surgery, Faculty of Medicine**, Cairo University
AUTHOR
ORIGINAL_ARTICLE
The Interplay between Apelin/APJ System and Renin Angiotensin System in Protection Against Cold Restraint Stress Induced Gastric Ulcers in Adult Male Rats
AbstractBackground: Activation of Renin Angiotensin System (RAS) is one of the main mechanisms involved in the devel-opment of stress induced gastric ulcers.Aim of the Study: This study aimed to examine the effect of inhibitors of RAS in protection against stress-induced gastric ulcers and the interplay between RAS and apelin/APJ system in gastric protection.Material and Methods: Twenty-four adult male rats were divided into 4 groups: Control, Cold Restraint Stress (CRS), Angiotensin Converting Enzyme (ACE) inhibitor + CRS and Angiotensin II receptor type 1 (AT-1) blocker + CRS. Ulcer index, PH, acidity and mucin content of gastric fluid were measured. MDA, NO, PGE2, apelin level, COX-2 and Angi-otensin 1-7 gene expression assessment were done. Gastric tissues were assessed histopathologically.Results: Pre-treatment of rats with either capoten or micardis for 14 days prior to CRS significantly reduced ulcer index, gastric acidity, MDA and COX-2 expression; while PH, gastric acidity, mucin content, NO, PGE2, gastric apelin level and Angiotensin 1-7 gene expression were significantly elevated.Conclusion: Our findings suggest the integration between apelin/APJ system and RAS in protection against gastric ulceration.
https://mjcu.journals.ekb.eg/article_63152_f42f08a452b470e9ea2ac50d3935c830.pdf
2018-12-01
4503
4511
10.21608/mjcu.2018.63152
Renin angiotensin system – Apelin – Angiotensin 1-7 – Gastric stress ulcers
NANCY F. SAMIR, M.D.;
FATMA E. IBRAHIM, M.D.
1
AUTHOR
LAILA A.
RASHED, M.D.
2
The Departments of Physiology* and Biochemistry**, Faculty of Medicine, Cairo University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Posterior Fossa Tumours in Pediatrics; Retrospective Study of the MRI Features
AbstractBackground: Posterior fossa tumours is one of the most common tumours in pediatrics. The most common tumours include juvenile pilocytic astrocytoma. Differential diagnosis of pediatric brain tumours begins with accurate localization of the site of origin the tumours, which is the most important diagnostic features, Conventional MRI with contrast study remains the gold standard for evaluation of brain tumours.Aim of Study: Is to assess role of MRI in evaluation of space occupying lesions seen at the posterior fossa in pediatric age group.Patients and Methods: This retrospective study, including 40 children with their age ranging between 2 and 10 years. All the forty patients were examined by; axial T1 WI, axial T2 WI, coronal and axial FLAIR, post contrast T1WI was done after injection of Magnevist (0.1ml/Kg); DW images and ADC maps were acquired.Results: MRI study revealed 16 cases diagnosed as medul-loblastoma (40%), 8 cases as Ependymoma (20%), 8 cases as juvenile pilocytic astrocytoma (20%), 6 cases as pontine Glioma (15%) and 2 cases as Schwannoma (5%).Conclusion: Conventional MRI with DWI & ADC has high accuracy in the differentiation of posterior fossa tumours in pediatrics.
https://mjcu.journals.ekb.eg/article_63153_197cc2bd6a7378c4cae1e86de62dc2cb.pdf
2018-12-01
4513
4524
10.21608/mjcu.2018.63153
Posterior fossa – Pediatric – MRI – Juvenile pilocytic astrocytoma – Medulloblastoma – Ependymoma – Schwannoma – Brainstem glioma
MAHMOUD A. DAWOOD, M.D.;
NOHA M. ABDEL MABOUD, M.D.
1
AUTHOR
HAYTHAM H. EL-SAEED, M.D.;
MAHA A. SHAWKY, M.D.
2
AUTHOR
EHAB E.
ELGAMAL, M.D.
3
The Department of Radiology & Neurosurgery, College of Medicine, Tanta University, Tanta, Egypt
AUTHOR
ORIGINAL_ARTICLE
Minimally Invasive Percutaneous Nephrolithotomy in Management of Lower Pole Renal Stones 2cm or Less
AbstractBackground: The best management of lower calyceal stones remains debatable. Small lower calyceal stones are usually managed with SWL, RIRS or PNL.Aim of Study: This study aims to assess the safety, efficacy and complications of minimally invasive percutaneous neph-rolithotomy (mini PNL) in lower calyceal stones.Patients and Methods: Patients with lower calyceal radio-opaque unilateral stones £2cm were enrolled and underwent mini PNL between February 2014 and January 2016 using a semi rigid ureteroscope through a 16Fr sheath and holmium laser lithotripsy. Patients were considered stone free when no stones or residuals <3mm were found on plain X-ray UT or non contrast CT.Result: Thirty patients with mean age of 40±9.2 years underwent mini PNL for lower calyceal stones ranging in size from 10-20mm (16.1±1.8). A single tract was used (16Fr). Six patients (20%) had a nephrostomy tube (12F) at the end of the procedure. Mean hospital stay was 2±0.15 days. Twenty-five (83.3%) of our patients had no or mild post-operative pain that required no analgesia. Minor complications occurred in 4 patients (13.3%) in the form of post-operative fever and was treated conservatively.Conclusion: Mini PNL is a safe and effective treatment option for lower calyceal stones 2cm or less. Mini PNL is limited by longer operative time than standard PNL. It has similar safety profile as of standard PNL with the advantage of causing significantly less pain and shorter hospital stay. Stone Free Rate (SFR) is comparable to PNL and is signifi-cantly better than SWL and possibly RIRS.
https://mjcu.journals.ekb.eg/article_63154_0b4689df1d79d77cdfe9873eeef7fabc.pdf
2018-12-01
4525
4529
10.21608/mjcu.2018.63154
Stone – Lower calyx – Minimally invasive – Percutaneous – Nephrolithotomy
MOHAMED ABD EL-WAHED, M.D.;
AHMED M. SHOUMAN, M.D.
1
AUTHOR
ASHRAF MOSHARAFA, M.D.;
AHMED A. MORSY, M.D.
2
The Department of Urology, Faculty of Medicine, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Clinical Audit on Management of Hematemesis in Children Admitted to Pediatric Gastroenterology and Hepatology Unit of Assiut University Children Hospital
AbstractBackground: Hematemesis is an uncommon but potentially serious and life-threatening clinical condition in children. It indicates that the bleeding origin is above the Treitz angle, i.e., that it constitutes an Upper Gastrointestinal Bleeding (UGIB).Aim of Study: To assess for how much the adopted proto-cols of management of children with upper gastrointestinal bleeding were applied at Gastroenterology & Hepatology Unit of Assiut University Children Hospital.Patients and Methods: This study is a an audit on man-agement of children with upper gastrointestinal bleeding admitted to pediatric Gastroenterology and Hepatology Unit, Assiut University Children Hospital during the period from the 1st of March 2016 to the 28th of February 2017 and it included 80 children with hematemesis.Results: Detailed history intake was recorded in most cases except history of drug intake which was not recorded in 30% of cases, history of epigastric pain and food pain relationship were not recorded in 38.7% of cases. Data of examination were recorded in 100% of cases. Basic and mandatory investigations in diagnosis of hematemesis were done in 100% of cases except coagulation profile and liver function tests and upper endoscopy. The standard treatment of hematemesis has been applied in most treatment lines except admission to the Intensive Care Unit. Also intravenous vitamin K was not given to all patients.Conclusion: The international guidelines for the manage-ment of hematemesis have been followed by the Gastroenter-ology and Hepatology Unit of Assiut University Children Hospital in most treatment lineswith some defaults due to poor resources and lack of medication.
https://mjcu.journals.ekb.eg/article_63155_7f76add9a3d701195759ef081d8e68fd.pdf
2018-12-01
4531
4536
10.21608/mjcu.2018.63155
Hematemesis – Pediatrics
ESRAA T. AHMED, M.Sc.;
FATMA A. ALI, M.D.
1
AUTHOR
NAGLA H.
FADDAN, M.D.
2
The Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt
AUTHOR
ORIGINAL_ARTICLE
MRI Evaluation of Hepatic Iron Overload in b-Thalassemic Children
AbstractBackground: b-Thalassaemia major is a hereditary hemo-lytic anemia that have amajor complication iron overload. Assessment of Liver Iron Concentration (LIC) is necessary for detection and quantitative staging of iron overload and monitoring of iron-reducing treatments. MRI represents the most available noninvasive technique to assess LIC.The aim of this study was to assess LIC by MRI in multitransfused b-Thalassemic children.Patients and Methods: Forty multi-transfused b-thalassemic children were subjected to clinical evaluation, appropriate laboratory assessment and assessment of LIC by MRI.T2* weighted gradient echosequence MRI was performed with 1.5T scanner.Results:- Significant reduction in signal intensity ratio of the liver was show in all patients.- Highly significant correlation between MRI parameter (R2* and T2*) and LIC (p<0.001).- Moderate significant correlation between MRI parameters (R2*, T2*) and SF level when serum Ferrittin below 4000 ng/dl and non-significant when SF above 4000ng/dl (p>0.05).- Splenectomizied patients had significant lower SIR of liver (decrease R2* and increase T2*) compared to non splenec-tomized patients (p<0.007).Conclusion: In conclusion based on results of our study MRI is the best noninvasive method for assessment and evaluation of hepatic iron overload and determine its severity in multi-transfused b-thalassemic patients.
https://mjcu.journals.ekb.eg/article_64907_1895dc0245f00df1c5cdcc605a60c508.pdf
2018-12-01
4537
4545
10.21608/mjcu.2018.64907
Thalassemic children – Hepatic iron overload – MRI
ALI E.A. AGALN, M.Sc.;
MOHAMED A. MOHAMED, M.D.
1
AUTHOR
EBRAHIM M. BADRAIA, M.D.;
ABD EL-MONEM N. DARWISH, M.D.
2
The Departments of Diagnostic Radiology* and Pediatrics**, Faculty of Medicine, Tanta University
AUTHOR
ORIGINAL_ARTICLE
Evaluation of Serum Obestatin Level in Rat Model of Diabetic Nephropathy
AbstractBackground: Diabetic nephropathy is characterized by excessive protienuria and progressive irreversible renal dam-age. Various mechanisms were suspected to the development of diabetic nephropathy. However, a few studies have reported associations between obestatin and diabetic complications.Aim of the Work: To evaluate serum OBST in type II diabetic nephropathy rat model and the possible association with the different biochemical and renal parameters.Material and Methods: Twenty male albino rats were included in the study and divided into two groups: Group (I): Control group, group (II) type II diabetic group rats were fed High Fat Diet (HFD) for 5wks, then the HFD was replaced with normal rodent diet and animals received single intraperi-toneal injection of low dose of Streptozotocin (STZ) (35mg/kg). However, rats had been followed up for two weeks (group IIa), four weeks (group IIb) and for eight weeks (group IIc) after induction of diabetes, the following parameters were examined BMI, mean arterial blood pressure, serum OBST, insulin, glucose and calculated insulin resistance, lipids profile, tumor necrosis factor-alpha, angiotensin II levels, urea, cre-atinine and uric acid. Proteinuria, glomerular filtration rate and renal malondialdhyde level, glutathione peroxidase and superoxide dismutase activities. Histopathological examina-tions for kidney tissues were also done at the end of experiment.Results: There were a significant progressive increase in serum levels of OBST, TNF-a and MAP in group II (a, b, c levels) and progressive increase in serum urea, creatinen, UA, ANG II and proteinuria in group IIb and c levels while, group IIa showed insignificant changes. In addition, there were a significant increase in serum glucose, HOMA-IR, total cho-lesterol, TG, LDL, VLDL and renal MDA, with a significant decrease in serum insulin, HDL, GFR and renal GSH-Px, SOD activities in group IIc level. Moreover, there was a progressive significant decrease in BMI in group II (b and c levels). Furthermore, obestatin levels were positively correlated with all the previously affected parameters in group II at all levels, except with insulin, HDL and GFR which showed a significant negative correlation. While no significant correlation had been found with GSH-Px, SOD activities.Conclusion: Serum OBST levels were significantly ele-vated in experimentally induced diabetic nephropathy in rats and positively correlated with most of the measured biochem-ical and renal parameters except for insulin, HDL-C and GFR was negatively correlated. These findings simplify that OBST can be used as a novel biomarker for diabetes induced com-plications. As its increase may play a compensatory role in this metabolic disturbance.
https://mjcu.journals.ekb.eg/article_64908_005f37d46f8ffc0527297eae52a1153d.pdf
2018-12-01
4547
4557
10.21608/mjcu.2018.64908
T2DM – Rats – Nephropathy – Obestatin
SAMA S. KHALIL, M.D.;
NADINE A. RAAFAT, M.D.
1
The Department of Physiology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
AUTHOR
ORIGINAL_ARTICLE
Role of Laparoscopic Sleeve Gastrectomy (LSG) for Management of Obese Patients with Type 2 Diabetes Mellitus-Single Center Study
AbstractBackground: Laparoscopic Sleeve Gastrectomy (LSG) has become one of the commonest bariatric procedures done for management of obese patients. Although Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) has well documented positive clinical influence on type 2 diabetes, the role of LSG in diabetes treatment is still questionable. In this study we want to present our experience in management of diabetes with LSG.Methods: Between September 2014 and June 2016, fifty patients were enrolled in our prospective study at Department of Surgery, Ain Shams University assessing the effect of LSG on morbid obese patients with Type 2 Diabetes Mellitus (T2DM). All patients were monitored for weight loss and improvement of T2DM markers; Fasting Blood Glucose (FBG), Postprandial Plasma Glucose (PPG) and HbA1c at 3, 6 and 12 months follow-up post-operative.Results: There was a highly significant difference between BMI at baseline and at 12 months after operation, resolution of type 2 diabetes mellitus occurred in 70% of patients evident by normalization of HbA1 c (5.6%) and stopping all medica-tions, and improvement occurred in 10% of patients evident by HbA1c value of 6.5% without medication.Conclusion: Laparoscopic sleeve gastrectomy is simple and effective surgical procedure to achieve a significant weight loss and control of type 2 diabetes mellitus which starts in the early post-operative period. There is significant reduction in the diabetes medications hence the cost of diabetes treatment and improvement of the quality of life.
https://mjcu.journals.ekb.eg/article_64909_12c156285accaf7974cd44ae927fe1c2.pdf
2018-12-01
4559
4559
10.21608/mjcu.2018.64909
Sleeve gastrectomy – Morbid obesity – Type 2 diabetes mellitus
MOHAMED ABOUL NAGA, M.D.;
KAMAL MAMDOUH, M.D.
1
The Department of General Surgery, Faculty of Medicine, Ain Shams University, Cairo
AUTHOR
ORIGINAL_ARTICLE
Alterations of Static and Dynamic Balance in Lumbar Radiculopathy
AbstractBackground: Lumbar radiculopathy is a benign, often self-limiting condition. It is characterized by low back pain radiating into one or both lower limbs, combined with one or more positive neurological signs (paresis, sensory impairment, or loss of reflexes) that indicate a nerve root irritation or neurological loss of function. This can be due to mechanical compression of the nerve by a disc herniation which may lead to balance disorders in standing position and to asymmetrical load of lower extremities results from pain radiating to lower extremities and leads to distorted postural stability, as well as to other motor deficits. The consequences are disability, reduced quality of health and reduced working capability.Aim of Study: The purpose of this study was to investigate the alterations of static and dynamic balance in patients with lumbar radiculopathy.Patients and Methods: Twelve patients, both genders with unilateral lumbar radiculopathy were included in the study with a mean age 47.25 (±5.61) years. They were assessed for impairments in static and dynamic balance, compared with twelve normal/healthy subjects. functional reach test” FRT” was used to test static balance by measuring (MAD) maximum anterior reaching distance measured in cm. and Biodex Balance System (BBS) was used to measure dynamic balance. The evaluation of dynamic balance included both Dynamic Balance Test (DBT) and the Dynamic Limits of Stability (DLOS). The (DBT) include the anterior/posterior stability index (APSI), the Medial/Lateral Stability Index (MLSI) and the Overall Stability Index (OASI). The DLOS parameters were expressed as overall Direction Control (DC) and time required for completing the test (T).Results: There was statistically significant differences in all measured variables of static and dynamic balance; between lumbar radiculopathy (A) and control group (B). There was a significant reduction of the mean values of OASI, APSI with (p>0.0001*), T with (p=0.0001*) and MLSI with (p>0.002*) in group (B) and significant increase of the mean values of F.R.T. in group (B). While, there was a signifi-cant increase of the mean values of D.C. with (p=0.0001 *) in group (B).Conclusion: There was a significant differences of all variables of static and dynamic balance between group A and B, which confirms that patients with lumbar radiculopathy due to disc herniation may suffer impaired postural stability, dynamic balance and reduced functional abilities when com-pared to normal subjects.
https://mjcu.journals.ekb.eg/article_64910_7d640029e6d6968eb51a09dfd93f32f7.pdf
2018-12-01
4565
4572
10.21608/mjcu.2018.64910
Lumbar Disc Herniation (LDH) – Lumbar radic-ulopathy – Static balance – Dynamic balance
MARWA A. MOHAMMAD, M.Sc.;
SOHEIR S. RIZKALLAH, Ph.D.
1
AUTHOR
MARY K. NASSIF, Ph.D.;
AMR H. EL-SAYED, M.D.
2
The Department of Basic Sciences, Faculty of Physical Therapy, Horus* and Cairo** Universities and The Department of Neurology, Faculty of Medicine, Cairo University***
AUTHOR
ORIGINAL_ARTICLE
Effectiveness and Safety of Tubeless Minimally Invasive Percutaneous Nephrolithotomy in Management of Lower Pole Renal Stones
AbstractBackground: Placement of a percutaneuos nephrostomy tube for drainage has been an integral part of the standard Percutaneous Nephrolithotomy (PNL) procedure. However, in recent years, the procedure has been modified to what has been called tubeless PNL, in which the nephrostomy tube is replaced with internal drainage by ureteral catheter or double-J stent.Aim of Study: This study aims to assess the safety, efficacy and complications of tubeless minimally invasive percutaneous nephrolithotomy (mini PNL) in lower calyceal stones.Patients and Methods: Patients with lower calyceal stones £2cm were enrolled and underwent tubeless mini PNL between February 2014 and January 2016 using a semi rigid uretero-scope through a 16 Fr sheath and holmium laser lithotripsy. Patients were considered stone free when no stones or residuals <3mm were found on plain X-ray UT or non contrast CT.Result: Twenty four patients with mean age of 39.8±7.1 years underwent mini PNL for lower calyceal stones ranging in size from 10-20mm (15.47±3.04). A single tract was used (16Fr). All patients had a tubeless procedure. Mean hospital stay was 1.5±0.1 days. Twenty patients (83.4%) had no or mild post-operative pain that required no analgesia. Minor complications occurred in two patients (8.3%) in the form of post-operative fever that was treated conservatively.Conclusion: Tubeless PNL can be safe and effective procedure in selected patients (stone burden <2cm, single tract access, no significant residual stones, no significant perforation, minimal bleeding, and no requirement for a secondary procedure), with the potential advantages of de-creased post-operative pain, analgesia requirement, and hospital stay. Stone Free Rate (SFR) is comparable to PNL and is significantly better than SWL and RIRS.
https://mjcu.journals.ekb.eg/article_64911_f399a91b20a1ad61beac945f0133c997.pdf
2018-12-01
4573
4577
10.21608/mjcu.2018.64911
Stone – Tubeless – Lower calyx – Minimally invasive – Percutaneous – Nephrolithotomy
MOHAMED ABD EL-WAHED, M.D.;
AHMED M. SHOUMAN, M.D.
1
AUTHOR
ASHRAF MOSHARAFA, M.D.;
AHMED A. MORSY, M.D.
2
The Department of Urology, Faculty of Medicine, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Preventive Multimodal Analgesia Versus Morphine in Cancer Patients Undergoing Major Abdominal Surgeries
AbstractBackground: Opioids are the corner stone for perioperative analgesia in major surgeries. The aim of this study was to compare the efficacy of preventive multimodal analgesia versus morphine on post-operative pain and total morphine consumption.Aim of Study: To compare the efficacy of preventive multimodal analgesia versus morphine in cancer patients undergoing major abdominal surgeries.Patients and Methods: This prospective randomized study was done from March 2018 to September 2018 after approval of the institutional board review of National Cancer Institute. Forty cancer patients were randomly allocated in the study; patients were divided into 2 groups; multimodal group (n=20) received Ketamine, magnesium, ketorolac, paracetamol, with TAB (transverse abdominis plane) block before surgical incision and morphine group (n=20) received morphine sul-phate 0.1mg/kg before surgical incision.Results: There was statistically significant difference in intraoperative fentanyl consumption p-value (<0.001) and total morphine consumption in the first 24 hours postopera-tively p-value (0.001) between the 2 studied groups being higher in the morphine group.Conclusion: Preventive multimodal analgesia has superior analgesic profile than morphine regarding perioperative analgesia and morphine consumption in the first 24 hours post-operatively.
https://mjcu.journals.ekb.eg/article_64912_3f3aa356f9e410f034aa709b4b03266d.pdf
2018-12-01
4579
4584
10.21608/mjcu.2018.64912
Preventive – Multimodal analgesia – Morphine – Post-operative pain – Cancer patients
WALAA Y.
ELSABEENY, M.D.
1
The Departments of Anesthesia, Pain and Intensive Care, National Cancer Institute, Cairo University
AUTHOR
ORIGINAL_ARTICLE
The Protective Effect of Propolis Compared to Vitamins C and E Antioxidant Mixture in Cyclophosphamide-Induced Lung Toxicity In Mice
AbstractBackground: Pulmonary toxicity could be induced by oxidative stress secondary to use of the anti-cancerous agent cyclophosphamide (CTX).Aim of Study: This study was conducted to examine the ameliorating effects of propolis or Vitamins C +Vitamin E antioxidant mixture (Vit. E-C) on lung tissues in mice exposed to cyclophosphamide.Material and Methods: Forty-eight mice were divided into six groups; the first three groups served as control groups and orally received saline, propolis or antioxidant mixture, respectively; group 4 was intraperitoneally (i.p.) injected with a single dose of CTX (200mg/kg); group 5 was injected with a single dose of CTX (200mg/kg) preceded by propolis (90 mg/kg) and group 6 was injected with a single dose of CTX (200mg/kg) preceded by VitE-C antioxidant mixture (50mg/kg bw each) for 14 consecutive days. One day after CTX injection, mice were sacrificed to analyze oxidative stress biomarkers and to examine the histopathological changes.Results: CTX-treated mice developed elevated malondi-aldehyde and declined antioxidant enzymes. Marked patho-logical changes in the lung architectures were observed. Mice treated with CTX/propolis in group 5 and CTX/antioxidant mixture in group 6 showed improvements in the levels of all oxidative stress markers towards normal. This accompanied by significant restoration of normal lung histology.Conclusions: Propolis and Vit. E-C antioxidant mixture showed a promising ameliorative effect on CTX-induced toxicity in mice.
https://mjcu.journals.ekb.eg/article_64913_315a3f0958a62efc7bbaf0b465d202e8.pdf
2018-12-01
4585
4593
10.21608/mjcu.2018.64913
Cyclophosphamide – Propolis – Lung toxicity – Vitamin C – Vitamin E– Oxidative stress
ABDULRAHMAN HAMDAN ALMAEEN, F.K.S.U.;
MAHROUS ABD EL-BASSET IBRAHIM,
1
AUTHOR
ORIGINAL_ARTICLE
An Analytic Study of Nerve Regeneration between End-to-End and End-to-Side Neurorrhaphy: An Experimental Study in Rats
AbstractBackground: In peripheral nerve injury, end-to-side neu-rorrhaphy involves cooptation of the distal stump of a transect-ed nerve to the trunk of an adjacent donor nerve. It has been proposed as an alternative technique when the proximal stump of an injured nerve is unavailable or the nerve gap is too long to be bridged by a nerve graft. End-to-side neurorrhaphy was first documented in the 19th century [1]. However; the tech-nique has not been a clinical routine for almost a century. In early 1990s, Viterbo et al., [2] demonstrated successful nerve regeneration and muscle re-innervation in a rat end-to-side neurorrhaphy model.Aim of Study: A prospective experimental study was done to study, evaluate, and compere the histological results of neurorrhaphy in rats using end-to-end, end-to-side and end-to-side long contact neurorrhaphy. Thereby presenting a different techniques and for the first time a comparative analytic study for the end-to-side long contact neurorrhaphy.Material and Methods: The experiment carried out on 74 male rats, divided into three groups. After two months all rats were evaluated histologically with immunohistochemistry staining.Results: The repaired grafts from the three groups were obtained from the animals for histological examination.Conclusion: End-to-side neurorraphy presently does not replace a sound primary nerve suture. It should be seen as an excellent, viable option when planning to address difficult peripheral nerve injuries.
https://mjcu.journals.ekb.eg/article_65669_9a6bfc6366f9f6f4d73027194ae7476f.pdf
2018-12-01
4595
4599
10.21608/mjcu.2018.65669
End-to-end neurorrhaphy – End-to-side neuror-rhaphy – Long contact – End-to-side neurorrhaphy – Histological analysis
SHERIF M. AMR, M.D.;
ASHRAF N. MOHARRAM, M.D.
1
AUTHOR
AYMAN M. MANSOUR, M.D.;
MOAMEN S. KHALAF, M.Sc.
2
AUTHOR
MOHAMED H.E. ABORAS, M.Sc.;
BAHAAELDIN S. ABDELWAHED, M.Sc.
3
AUTHOR
OMAR A. SHALABY, M.Sc.;
REDA A. SHETA, M.Sc.
4
The Department of Orthopedic Surgery*, Microsurgery Lab, the Animal House Lab and the Department of Histology**, Faculty of Medicine, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Role of Endobronchial Ultrasound in Diagnosis of Mediastinal and Pulmonary Lesions
AbstractBackground: Lung cancer is one of the most common tumors worldwide. Now it ranks as the leading cause of cancer related death in the world, both in men and women. Pulmonary lesions detected during screening for lung cancer need to be evaluated further and tissue should be obtained. Technical development in last two decades has made it possible for pulmonologists to do endobronchial ultrasound “EBUS”.Aim of Study: The aim of the work is Assessment of the role of endobronchial ultrasound TBNA in diagnosis of me-diastinal lesions as accurate rapid less invasive procedure.Subjects and Methods: This is a Prospective study was conducted on 30 patients presented with chest symptoms (dyspnea, cough, expectoration, chest pain and hemoptysis) diagnosed as mediastinal, hilar and pulmonary lesions as confirmed by CT chest, routine labs and proper history taking and through clinical examination and underwent EBUS-TBNA and the sampled lesion was sent for histopathological exam-ination and reporting at Kobbry Al-Kobba Military Hospital during the period from (November 2015 to October 2016).Results: The mean age of the patients participating in this study was 44.9±15.9 years (ranges 17–73). 56.7% of them were males while 43.3% were femles. Radiological finding showed Hilar & mediastinal lymphadenopathy in 40.0%, mediastinal lymphadenopathy (6.7%), hilar lymphadenopathy (10.0%), pulmonary lesions (33.3%), pulmonary lesions with mediastinal lymphadenopathy (6.7%), pulmonary lesions with mediastinal and hilar lymphadenopathy (3.3%). EBUS findings were 20 patients were having lymph node lesions (85% were benign and 15% were malignant by pathology) and 10 patients were having mass lesions (100% were malignant). No com-plications were detected only minor hemorrhage in 1 patients (3.3%).Conclusion: Endobronchial ultrasound guided transbron-chial fine needle aspiration EBUS-TBNA is the procedure of choice for staging of lung cancers and for the investigation of unexplained mediastinal lymphadenopathy and masses. EBUS guided TBNA is an accurate, cost effective and mini-mally invasive procedure and if successfully performed, TBNA may spare patients additional, more invasive procedures or surgery.
https://mjcu.journals.ekb.eg/article_65668_abad9b5d89039406f4f933e55f4e23e4.pdf
2018-12-01
4455
4461
10.21608/mjcu.2018.65668
Lung Cancer – EBUS – Pulmonary – Mediastinal lesions
GAMAL E.A. EL-SAYED, M.D.;
MOUSA M. EL-SHAMLY, M.D.
1
AUTHOR
ABD ALLAH S. AYOB, M.D.;
KHALED M. ZAMZAM, M.D.
2
AUTHOR
SAAD E.H.
SALAH ELDIN, M.Sc.
3
The Departments of Pathology, Chest Diseases, Faculty of Medicine, Al-Azhar University, Military Chest Department, Kobbry Al-Kobba Hospital and Chest Diseases, El-Abassia Chest Hospital, Cairo
AUTHOR
ORIGINAL_ARTICLE
Pure Endoscopic Endonasal Surgery for Pituitary Adenomas: Technique and Early Results in Banha Neurosurgery Department
AbstractBackground: Surgery for pituitary adenomas passed though several stages of refinement during the past decades. During the past 20 years a major shift has been made by neurosurgeons towards endoscopic pituitary surgery. This has been aided by the great development in technologies of rod lens and high resolution video cameras. The panoramic view offered by the endoscope made the surgery more safe and radical in removing the tumor. Now it is widely accepted in most neurosurgical institutes that the endoscopic endonasal surgery should be the gold standard in pituitary surgery.Aim of Study: In this study we report our early results, challenges we faced and the problems we solved in applying the technique of pure endoscopic endonasal surgery for pituitary adenomas in Banha Neurosurgery Department.Study Design: This is a retrospective study case series of 35 patients with pituitary adenomas. All patients were treated surgically using the pure endoscopic endonasal technique. Patients had been followed after surgery for a period of time ranged from 4 to 36 months during the years from February 2012 to March 2015.Patients and Methods: Thirty five patients were included; twenty with nonfunctioning pituitary adenomas, (nine with suprasellar extension only and 11 with parasellar extension) and fifteen with functioning adenomas including 3 ACTH secreting, 8 GH secreting and 4 prolactinomas. Patients were endocrinologically, ophthalmologically and radiologically evaluated using CT paranasal sinus and MRI pituitary scans. Pre and post-operative scans as well as levels of pituitary hormones have been compared and evaluated for the degree of tumor resection, visual improvement and endocrinological cure.Results: Gross total resection of the tumor has been achieved in 23 patients (65.7%) while 12 patients (34.3%) had incomplete resection. Among 15 patients with pre operative visual deficits, 13 patients (86,6%) showed variable degrees of visual improvement and 2 only (13.3%) did not improve. Endocrinological cure was 75% in GH secreting adenomas, 75% in prolactinomas and 66.7% in ACTH secreting adenomas.The most common complications were transient post-operative DI and inrtaoperative CSF laek. No reported deaths, major vascular injury or worsening of vision.Conclusion: The pure endoscopic endonasal technique, although challenging, it is less traumatic, and associated with good outcome.
https://mjcu.journals.ekb.eg/article_65670_11ec71ff0a342553150cd677a3fb410e.pdf
2018-12-01
4601
4611
10.21608/mjcu.2018.65670
Endoscopic – Endonasal – Pituitary – Adenomas
MOHAMMED H. EL-TANTAWY, M.D.;
AHMED A. ARAB, M.D.
1
AUTHOR
MOHAMED G.
HAMED, M.D.
2
The Department of Neurosurgery, Faculties of Medicine, Benha* and E.N.T., Helwan** Universities
AUTHOR
ORIGINAL_ARTICLE
Does the Portal Pressure Changes have an Effect on Liver Functions of Donor Hepatectomy in Living Donor Transplantation
AbstractBackground: Living donor liver transplantation has now became an alternative for cadaveric liver transplantation. Raised portal pressure and over perfusion can injure the remnant liver and leads to hepatic dysfunction. This prospective study evaluates the portal pressure changes that occurs during donor hepatectomy and its effect on liver functions.Aim of Study: We aimed to study the portal pressure changes during donor hepatectomy and its relation to liver functions.Patients and Methods: This prospective study included 30 adult living donors who underwent right hepatectomy in Liver Transplantation Unit, Faculty of Medicine, Cairo Uni-versity during the period between June 2015 to October 2016. Portal venous pressure was measured intra-operatively using wide gauge cannula preclamping and postclamping of portal vein during donor hepatectomy. Post-operative liver functions in the form of daily ALT, AST, total bilirubin, direct bilirubin, INR and Albumin were done daily till normalization.Results: In this study the mean portal pressure before and after clamping of right portal vein was 9.9mmHg and 15.23 mmHg respectively. The mean changes in portal pressure were significant (p<0.001).The higher the changes in portal pressure the higher were the serum levels of day 1, 3 and 5 ALT, day 3 and 5 AST, day 5 total bilirubin and day 5 albumin. The higher the portal pressure changes gave the longer the duration of normalization of (ALT, AST, bilirubin, and albumin).Conclusion: This study has demonstrated a significant rise in PVP post clamping of right portal vein. The higher the changes in portal pressure the higher serum levels of post-operative day 1, 3 and 5 ALT, day 3 and 5 AST, day 5 total bilirubin and day 5 albumin, the higher the portal pressure changes gave 'the longer the duration of normalization of (ALT, AST, bilirubin, and albumin). However, the delayed functional regeneration did not proceed to liver failure in non of the cases.
https://mjcu.journals.ekb.eg/article_65671_d808c1ab79ba82faa69813ad14d84e8c.pdf
2018-12-01
4619
4623
10.21608/mjcu.2018.65671
Liver transplantation – Living donor – Portal pressure – Liver functions – Liver dysfunction
MOHAMMED KHATTAB, M.Sc.;
AHMED H. KHALIL, M.D., M.R.C.S.,
1
AUTHOR
KAREEM HOSNY, M.D.;
MOSTAFA ELSHAZLY, M.D.
2
AUTHOR
AYMAN SALAH ELDIN, M.D.;
ADEL HOSNY, M.D.
3
The Department of General Surgery, Faculty of Medicine, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Treatment of Subtrochanteric Fractures Using the Proximal Femoral Locked Plate
AbstractBackground: Subtrochanteric femur fractures are one of the most devastating injuries. Most of the fractures in the elderly results from trivial fall while in the younger age group it is mainly due to high energy trauma. Fixing subtrochanteric fractures properly is clinically challenging. Various implants both intramedullary and extramedullary are available for their fixation.Aim of Study: To evaluate the short-term outcomes of proximal femoral locking compression plate (PF-LCP) fixation for subtrochanteric femoral fractures.Material and Methods: 30 patients with subtrochanteric fractures were operated upon with open reduction and internal fixation with proximal femoral locked plate. The Harris Hip score was used to document hip function at final follow-up.Results: 28 patients were available for final follow-up after death of two patients. The mean age was 46.20 years. The mean operative time was 125.6 minutes, mean incision length was 18.33cm, mean blood loss was 360ml and mean follow-up was 9.66 month. Union was achieved in all cases in 18.25 weeks. Complications included three cases of delayed union, five cases of superficial wound infection, two cases of malunion with varus deformity and shortening of 1.5 and 2cm. Final evaluation according to Harris Hip score was excellent in 15 cases (53.6%), good in 11 (39.3%) and fair in 2 (7.1%).Conclusion: The Proximal femoral LCP is a satisfactory and feasible method of treatment in subtrochanteric femur fractures.
https://mjcu.journals.ekb.eg/article_65672_ac80ad1a880e2753b5113edfb51233ff.pdf
2018-12-01
4625
4631
10.21608/mjcu.2018.65672
Subtrochanteric fractures – Proximal femur – Locking compression plate
AMR W. FARAG, M.D.;
HERIF A. OSMAN, M.D.
1
AUTHOR
MOLHAM M. MOHAMMAD, M.D.;
MOHAMED H. EL-AMIR ABORAS, M.Sc.
2
AUTHOR
BAHAALDINE S. ABD EL-WAHAB, M.Sc.;
OMAR A.F. SHALABY, M.Sc.
3
AUTHOR
REDA A.A. SHETA, M.Sc.;
MOHAMED A. ABO KISHK, M.Sc.
4
AUTHOR
MOMEN SEIF
EL-NASR KHALAF, M.Sc.
5
The Department of Orthopedic Surgery, Faculty of Medicine, Cairo University* and Damanhour Teaching Hospital**
AUTHOR
ORIGINAL_ARTICLE
Lateral Supraorbital Approach Versus Classic Pterional Approach In Suprasellar Meningiomas Regarding Accessibility and Safety
AbstractBackground: Minimally invasive Lateral Supraorbital Approach (LSO) is a modified classic pterional approach with advantages of a shorter skin incision and small craniotomy as compared with the pterional approach.Aim of Study: To present our surgical experience in distinguishing between Lateral Supraorbital Approach [LSO] and conventional pterional approach regarding accessibility and safety in suprasellar meningioma.Patients and Methods: This is a retrospective study of 19 cases who were diagnosed with suprasellarmeningiomas and were operated between March 2011 to March 2015 in Cairo University Hospital, and Beni-Sueif University Hospital. The patient was divided into two groups, group A (8 cases) operated via LSO, and group B (11 cases) managed via conventional pterional approach with follow-up period for one year the follow-up images were done immediately post-operative then every six months till 12 months.Results: Complete resection was obtained in 7 cases (75%) in group A, while it was in 8 cases (72.6%) within group B, visual acuity improvement in group A was in 4 cases (50%), in group B it was in 6 cases (54%).Vision unchanged in 3 cases (3 7.5%) group A, and in 4 cases (365%) group B.Vision deteriorated in one case (12,5%) in group A, and in 1 case (9.5%) group B.Transient diabetes insipidus was in only one case (9.5%) group B and no cases in group A.Conclusion: LSO approach is safe, less invasive and provides same accessibility to suprasellarmeningiomas as compared to classic pterional approach.
https://mjcu.journals.ekb.eg/article_65673_e71acc12ad42b0b6e6efdd07875218ba.pdf
2018-12-01
4633
4640
10.21608/mjcu.2018.65673
Lateral supraorbital – Pterional – Suprasellar-meningiomas
AHMED A. ABD EL-KHALEK, M.D.;
MOHAMED SHABAN, M.D.
1
The Department of Neurosurgery, Faculties of Medicine, Cairo* and Beni-Suif** Universities
AUTHOR
ORIGINAL_ARTICLE
Arthroscopic Management of Acute Traumatic Primary Anterior Shoulder Dislocation
AbstractBackground: Glenohumeral joint is the most mobile and most commonly dislocated joint in the human body. The patient's age at the time of injury is inversely related to the incidence of dislocation recurrence rate. Recurrence rate in athletes younger than 20, may be as high as 90%. Arthroscopic stabilization is usually successful in preventing the recurrence of shoulder dislocations leads to reduced recurrence, improved functional outcome.Aim of Study: The aim of this study is to asses the benefits of Bankart repair using suture anchors in treating patient with first time anterior traumatic shoulder instability.Patients and Methods: This prospective study was per-formed on 30 patients having anterior primary shoulder dislocation. All cases were managed by arthroscopic repair of the anterior labral lesion using suture knotted anchors.Results: Patients were assessed pre and post operatively by modified Rowe scale and ASES (American shoulder and Elbow disability system).Conclusion: Primary arthroscopic repair for first-time traumatic anterior shoulder dislocation provided satisfactory functional outcomes and improved quality of life. Primary arthroscopic stabilization can be considered best treatment option in patients younger than 30 years with first time shoulder dislocation.
https://mjcu.journals.ekb.eg/article_65746_99b2af75edf865d85cf452620544c96c.pdf
2018-12-01
4641
4646
10.21608/mjcu.2018.65746
Shoulder dislocation – Bankart lesion – Anchors
KHALID A. SHOHAYEB, M.D.;
NASEF M. NASEF, M.D.
1
AUTHOR
AMR RASHWAN, M.D.;
BAHAAALDINE S. ABD EL-WAHAB, M.Sc.
2
AUTHOR
MOHAMED H.E. ABORAS, M.Sc.;
REDA A.A. SHETA, M.Sc.
3
AUTHOR
MOEMEN SEIF, M.Sc.;
OMAR A. FATHY, M.Sc.
4
The Department of Orthopedic Surgery, Student Hospital* and Faculty of Medicine**, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Role of Irisin Administration in Modulating Testicular Function in Adult Obese Albino Rats
AbstractBackground: Irisin, exercise-induced myokine, is known to improve obesity-induced metabolic disturbances by enhanc-ing thermogenesis and increasing energy expenditure. Recent studies have reported that irisin promoted cell proliferation and protected cells from apoptosis. However, the effects of irisin on testicular function in obese rats is still to be investi-gated.Aim of the Study: This study was designed to explore the probable effects of irisin treatment on modulating the adverse effects of obesity on testicular functions with a trial to clarify some of the possible underlying mechanisms.Material and Methods: Thirty adult male wistar albino rats (200±30g) were divided equally into 3 groups, group (I): Saline-vehicle treated normal fed group, group (II): Saline-vehicle treated rats were fed a High Fat Diet (HFD) for 10 weeks. Group (III): Irisin treated HFD-fed rats for 10 weeks and irisin was injected subcutaneously (150ml daily for 4 weeks). Rats were weighed and serum levels of glucose, insulin, lipid profile, FSH, LH, estradiol & testosterone levels, epididymal sperm count and motility, testicular Malondiald-hyde (MDA) level, Superoxide Dismutase (SOD), Catalase (CAT), Glutathione Peroxidase (GPX) activities, testicular and epidydimal fat weights were estimated. Testicular his-topathological study was done as well.Results: There was a significant increase in the Body Mass Index (BMI) together with deterioration of metabolic, gonadal functions and testicular oxidant/antio-oxidant system in group (II), while exogenous irisin administration in group (III) resulted in: Significant decrease in BMI, insulin resistance with improvement in lipid profile, significant increase in serum FSH, LH & testosterone, sperm count and motility in male rats. Together with marked improvement in the testicular histoarchitecture. Additionally, there was a significant increase in testicular SOD, CAT & GPX activities. However, it signif-icantly decreased testicular MDA level.Conclusions: It could be suggested that irisin has a po-tential positive role against obesity-induced testicular dys-function, which may be due to its role in maintenance of glucose & insulin homeostasis, its antioxidant properties and/ or maintenance of gonadal hormonal function via indirect and/or direct effects on the gonads.
https://mjcu.journals.ekb.eg/article_65747_bd9544335b05432043abf0fdba260e7d.pdf
2018-12-01
4647
4655
10.21608/mjcu.2018.65747
Irisin – Obesity – Testicular function
REHAM H. IBRAHIM, M.D.;
NANEES F. EL-MALKEY, M.D.
1
The Department of Physiology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
AUTHOR
ORIGINAL_ARTICLE
Role of Changes in Some Adipokines with Obesity in Relation to Thyroid Function in Early Diagnosed Patients with Subclinical Hypothyroidism
AbstractBackground: Thyroid hormones can influence energy metabolism. Many patients of obesity have subclinical hy-pothyroidism and vice versa.Aim of Study: To evaluate the relation of changes in the level adipocyte hormones in obesity and in relation to hy-pothyroid state in early diagnosed patients with subclinical hypothyroidism.Material and Methods: This work includes 90 females divided into 3 groups each 30 persons (Group I) normal control, (Group II) obese females and (Group III) obese females with early diagnosed subclinical hypothyroidism: BMI were measured and blood samples were collected from all subjects and subjected to determine fasting blood glucose, triglyceride, High Density Lipoprotein (HDL), Low Density Lipoprotein (LDH), TSH, FT4, FT3, insulin level and Inter-leukin-6 (IL-6). Vaspin, lipocalin 2 and apelin were measured and HOMA IR (homeostatic model assessment) was calculated.Results: In obese patients' body mass index, TSH, fasting blood glucose, fasting insulin, HOMA IR, Interleukin-6, total cholesterol, triglyceride, low-density lipoprotein and apelin, lipocalin 2, vaspin showed a significant increase with a further significant increase in obese with hypothyroidism compared to control group. A significant decrease in high density lipo-protein in obese females with further significant decrease in obese with hypothyroidism, however, the level of FT3 and FT4 are insignificantly reduced in both obese and obese with hypothyroidism compared to control group.Conclusion: It is concluded that obesity released adipok-ines and inflammation may be part of the axis that has a pathogenic role in the development and progression of hy-pothyroidism in obese subjects. This open a new point of view that disruption of thyroid function may be one of sec-ondary effect of obesity and that disruption of adipocyte secretion of vaspin, lipocalin 2 and apelin may be implicated in some of the metabolic changes associated with obesity and aggravated with hypothyroid state.
https://mjcu.journals.ekb.eg/article_65748_e2da1580376fd2ddbda11441a65a3c62.pdf
2018-12-01
4657
4665
10.21608/mjcu.2018.65748
Subclinical hypothyroidism – Obesity – Interleukin 6 – Apelin – Vaspin – Lipocalin 2
ABEER A. ABOZEID, M.D.;
AHMED A. ABD AL-FATTAH, M.D.
1
AUTHOR
YASSER M.
ABD AL-RAOF, M.D.
2
The Departments of Physiology* and Internal Medicine**, Faculty of Medicine, Tanta University, Tanta, Egypt
AUTHOR
ORIGINAL_ARTICLE
Endovascular Management of Central Venous Stenosis in Haemodialysis Patients
AbstractAim of Study: Is to evaluate the patency of the endovascular management for the venous hypertension in haemodialysis access patient having upper limb AVF.Patients and Methods: Fifty patients were recruited in this study, sixty percent of the patients were females, while 40% of patients were males. Mean age of patients was 47.77± 10.49 years. The AVF were native in 38 patients (76%) while synthetic AVFs were reported in 12 cases (24%). Sixty four percent of the patients had left sided AVF & the remaining 36% had right sided AVf. Patency rates of collectively 34 patients are 100%, 97%, 70% at 3, 6, 12 months respectively.Results: Follow-up of a total of 34 successful cases after one year period revealed 24 cases were free of symptoms while 10 cases had recurrent symptoms. One year patency rate of cases with single lesion was 91.6%, and those with multiple lesions was 8.3% and that was statistically significant. One year patency rate for patients with lesions less than 3cm was 66.6% and for those with lesions more than 3cm was 33.3%. This was statistically insignificant with p=0.1.Conclusions: Percutaneous central venous angioplasty could provide symptomatic relief in patients that present with central venous stenosis and upper-extremity edema. Compli-cations from PTA are infrequent. It offers a minimally invasive, first-line approach for a difficult problem in a patient population with significant comorbidities. However the durability of PTA is limited, and in most patients additional interventions are required to extend the symptom free period.
https://mjcu.journals.ekb.eg/article_65749_2260b0633f44df8f6512cf67b3cd3e05.pdf
2018-12-01
4667
4673
10.21608/mjcu.2018.65749
Central venous stenosis and occlusions – Haemo-dialysis – Percuataneous transluminal angioplasty
MOSTAFA S. KHALIL, M.Sc.;
KHALID A.A. ATALLA, M.D.
1
AUTHOR
MOHAMED IBRAHIM, M.D.;
SAHAR H. ALI, M.Sc.
2
The Department of Vascular Surgery, Faculty of Medicine, Assiut University, Assiut, Egypt
LEAD_AUTHOR
ORIGINAL_ARTICLE
Hybrid Management of Critical Limb Ischemia in Assiut University Hospital
AbstractBackground: The alternative of hybrid revascularization surgery combines the well-established patency benefits of open vascular surgery with the advantages of less-invasive endovascular interventions to provide a durable and safe solution for critical limb ischemia.Aim of Study: The aim of this study was to evaluate the feasibility and efficacy of hybrid therapy in patients with complex multifocal steno-obstructive vascular disease and report short and midterm outcomes through assessment of patency and salvage rates.Patients and Methods: This study was conducted prospec-tively on thirty patients who presented to the Department of Vascular Surgery of Assiut University Hospital with critical limb ischemia due to multilevel peripheral arterial disease involving CFA from November 2015 to November 2016. All patients underwent detailed history taking, and data were collected on age, sex and risk factors. Patients were further evaluated using clinical examination, measurement of the Ankle Brachial Index (ABI), duplex ultrasound, and computed tomography angiography if needed.Results: Our study had male predominance (83.3%) with a mean age of 65 years. The most frequent risk factor was smoking in 18/30 (60%). According to Rutherford classifica-tion, the majority of patients (50%) were treated for digital gangrene, followed by minor tissue loss (33.3%) and rest pain (16.7%). Femoral endarterectomy was done in all cases, combined with both proximal and distal endoluminal proce-dures in 40% of patients, with proximal endoluminal proce-dures only in 26.7% and with distal endoluminal procedures in 26.7%. Technical success was achieved in 95.8% of proce-dures. The primary patency rate at 1st, 6th and 12th months were 96.7%, 90% and 80% respectively. Secondary patency rates at 1st, 6th and 12th months were 100%, 83.3% and 67% respectively while limb-salvage rate at 1st, 6th and 12th months were 100%, 100%, and 93.3% respectively. Diabetes has been found to reduce 1-year patency rate with statistically significant difference.Conclusion: Hybrid lower extremity revascularization procedures can be used to treat CLI with low perioperative morbidity and mortality and good immediate and midterm patency and limb salvage.
https://mjcu.journals.ekb.eg/article_65751_720d40206f465ffd5d8280fa2cf694d8.pdf
2018-12-01
4675
4681
10.21608/mjcu.2018.65751
Hybrid – Revascularization – Critical limb ischemia – Peripheral arterial disease
ANDREW F. SEIF, M.Sc.;
MOHAMED A. MUBARAK, M.D.
1
AUTHOR
AHMED H.B. EL-BADAWY, M.D.;
MOHAMED IBRAHIM, M.D.
2
The Department of Vascular Surgery, Faculty of Medicine, Assiut University, Assiut, Egypt
AUTHOR
ORIGINAL_ARTICLE
Study of Some Predictors of Severe Hemolysis in Children with Glucose-6-Phosphate Dehydrogenase Deficiency
AbstractBackground: Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency is one of the most common inherited disorders of mankind; more than 400 million people are affected worldwide, and it is a major health problem in Egypt.Aim of Work: To study some predictors of severe hemolysis in children with glucose-6-phosphate dehydrogenase deficiency and the degree of DNA damage in these patients.Patients and Methods: Seventy-two patients with G6PD deficiency admitted with acute hemolytic attacks to Diarb Negm Central Hospital-Sharkia Governorate, Egypt-over a period of 1 year from 1st May 2014 to 30th April 2015. We collected demographic data, details of signs and symptoms; special attention was given to history of fava bean ingestion, history of drug use or history of recent infection, history of neonatal jaundice, family history of G6PD deficiency disease, abdominal pain, vomiting or fever at admission and the results of tests for hemoglobin, reticulocytic count, hepatic function, G6PD enzyme activity and detection of DNA damage by DNA extraction, purification and agarose gel electrophoresis. We classified patients into mild and severe groups based on hemoglobin levels at admission. The mild cases were consid-ered as the control group.Results: 72 children with G6PD deficiency admitted with acute hemolytic attacks were included in this study, 52 (72%) patients with severe hemolysis and 20 (28%) patients with mild hemolysis (control group). There were no statistically significant differences in many factors between the two groups, but some factors were detected to have statistical significance for severe hemolysis included younger age (p<.0001), male gender (p<.0001), presence of fever at admission (p<.0001), presence of vomiting (p<.0001) and abdominal pain (p<.0001) during the attack, higher Alkaline Phosphatase (ALP) (p <.0001), Aspartate Aminotransferase (AST) (p<.0001), Lactate Dehydrogenase (LDH) (p<.0001) and Total Serum Bilirubin (TSB) (p<.05). DNA damage was significantly higher in the severe cases compared to the mild cases (p<.0001).Conclusion: Severe hemolysis can be predicted during hemolytic episodes in children with G6PD deficiency by young age, male gender, the presence of abdominal pain, vomiting and fever, high levels of ALP, AST, LDH enzymes and elevated TSB. This severe hemolysis predisposes patients to higher degree of DNA damage.
https://mjcu.journals.ekb.eg/article_65754_b33877e5391a6d39ca88a0c2e94f99c2.pdf
2018-12-01
4683
4688
10.21608/mjcu.2018.65754
Predictors of severe hemolysis – G6PD – ALP – LDH – DNA
SEHAM M. RAGAB, M.D.;
MOHAMMAD A. HELWA, M.D.
1
AUTHOR
EMAD A.
MAHDY, M.Sc.
2
The Departments of Pediatrics* and Clinical Pathology**, Faculty of Medicine, Menoufia University, Menoufia, Egypt
AUTHOR
ORIGINAL_ARTICLE
The Relationship between Neck Size of the Cerebral Saccular Aneurysms and Outcome after Endovascular Intervention
AbstractBackground: Intracranial aneurysms are common with a prevalence of 0.2% to 9% in adults. Intracranial aneurysms have high mortality and morbidity, so exclusion of aneurysms from cerebral circulation is aimed with established endovas-cular embolization.Aim of Study: Is to report our experience in managing intracranial aneurysms using coil embolization and to report the relation between neck size of cerebral aneurysms, its relation to dome height which is defined as Aspect Ratio (AR), and clinical, angiographic outcome after endovascular intervention.Patients and Methods: From July 2015 to May 2017, a series of 40 nonrandomized consecutive patients (mean age: 44.2±14.9 years) with 42 intracranial aneurysms underwent endovascular coil embolization in our center. We excluded patients with H & H grade 5 on admission and patients withH & H grade 4 were managed conservatively until improve-ment with better H&H grade. All patients were evaluated by four-vessel angiography to determine the shape, size, number and location of the aneurysms. Degree of aneurysm occlusion were assessed according to modified Raymond Roy classifi-cation. The cases were divided according to neck size, 4mm being the discriminative value for small and wide necks and divided according to aspect ratio into AR >2, AR 1.5-2, AR 1-1.5, AR <1. The post coiling angiogram of each case was analyzed to evaluate the degree of occlusion achieved by the technique, clinical outcome was assessed by Glasgow Outcome Scale (GOS).Results: Immediately after the procedure, Raymond classI with total occlusion was seen in 26 (61.9%), Raymond class II with subtotal occlusion in 10 (23.8%), and incomplete occlusion with Raymond class IIIa in 4 (9.5%) and Raymond class IIIb in 2 (4.8%) aneurysms. There was significant relationship between the aneurysm neck size and aspect ratio with degree of occlusion. In the small necked groupand AR >1.5 with modified Raymond classification are; class I was achieved in 22 (68.8%) aneurysms, class II in 8 (25%) aneu-rysms, class IIIa in one (3.1%) aneurysm, class IIIb in one (3.1%) aneurysm. The wide necked group and AR <1.5 pro-vides different results, class I was achieved in 4 (40%) aneurysms, class II in 2 (20%) patients, class IIIa in 3 (30%) aneurysms and class IIIb in one (10%) aneurysm. Six patients (15%) experienced some complication during the procedure, including two aneurysms perforation, two thromboembolic events and two device induced vasospasm. Thirty four patients with 36 aneurysms who underwent follow-up for 6 months, 29 (80.6%) aneurysms with no change, five (13.8%) had recanalization and two (5.6%) had more thrombosis.Conclusion: Endovascular coiling was an effective and safe technique for treatment of cerebral aneurysms showing a high cure rate as a single treatment modality in aneurysms with small neck size and AR >1.5, but in aneurysms with wide neck and AR <1.5, it is beneficial when assisted with additional forms of endovascular intervention (balloon, stent or flow diverters) for better treatment and improving outcome of the cases. Low aspect ratio plays a more dominant role than neck diameter in predicting the need for adjunctive techniques in the coiling of intracranial aneurysms.
https://mjcu.journals.ekb.eg/article_65757_b502c2dffc52c9f48ef2772fda1653f3.pdf
2018-12-01
4689
4698
10.21608/mjcu.2018.65757
Intracranial aneurysms – Endovascular interven-tion – Aspect ratio – Neck size
AHMED M. DEABES, M.Sc.;
FATHY H. EL-NOSS, M.D.
1
AUTHOR
HOSSAM I. MAATY, M.D.;
AHMED A. ARAB, M.D.
2
AUTHOR
MOHAMED N.
SHADAD, M.D.
3
The Department of Neurosurgery, Faculty of Medicine, Benha University, Benha, Egypt
AUTHOR
ORIGINAL_ARTICLE
Glimepiride as Add-on Therapy in Type 2 Diabetic Patients with Metformin Monotherapy: A Real-Life Study from Egypt
AbstractBackground: Adding glimepiride to metformin mono-therapy was reported to improve the glycemic status of patients with type 2 diabetes mellitus (T2DM), with tolerable safety profile.Aim of Work: The present real-life study aimed to inves-tigate the safety and effectiveness of glimepiride add-on therapy in poorly controlled T2DM patients with metformin monotherapy.Patients and Methods: In the present prospective study, we included 1050 poorly controlled T2DM patients from Egypt, and for whom the investigators decided to prescribe glimepiride in addition to metformin. Glimepiride was added to patients uncontrolled on metformin monotherapy for at least three months despite reaching the maximally tolerated dose. Regimen doses were decided by the investigators to reflect the in-practice approach. We followed the included patients for at three months and safety outcomes were measured throughout the study period.Results: After three months of treatment, the mean HbA1c level decreased by 1.54% (95% CI: –1.61 to –1.46%), with a mean percentage reduction of 16.3% (p<0.001). In addition, 31.7% of the included patients achieved the targeted HbA1c level <7%. The total number of adverse events was 15 adverse events occurred in 11 patients. Ten episodes of non-serious hypoglycemia were recorded.Conclusion: The present real-life study confirms the efficacy of glimepiride add-on therapy to metformin mono-therapy among poorly controlled T2DM patients from Egypt. Moreover, glimepiride/metformin regimen exhibits well-tolerable safety profile.
https://mjcu.journals.ekb.eg/article_65764_dc17295627c8ef4959bf0fb802ba6565.pdf
2018-12-01
4699
4704
10.21608/mjcu.2018.65764
Glimepiride – Metformin – HbA1 c – Hypoglycemia – T2DM
YEHIA
GHANEM, M.D.
1
The Department of Internal Medicine, Unit of Diabetes, Faculty of Medicine, Alexandria University, Alexandria, Egypt
AUTHOR
ORIGINAL_ARTICLE
Penetrating Brain Injuries at Assiut University Hospital: One Year Study
AbstractBackground: Penetrating Brain Injury (PBI) is defined as head traumain which a projectile breaches the cranium and dura matter. It is one of the most fatal forms of trauma and many cases die at the site of trauma. For those who survive till hospitalization, the management of penetrating brain injury represents great challenges to medical and surgical providers. Penetrating brain injuries are classified according to projectile velocity into missile and nonmissile injuries.Aim of Study: Our study discussesclinical-radiological profile and outcome of patients of penetrating brain injuries.Material and Methods: This is a prospective hospital based study includes 30 patients with penetrating head injuries admitted and managed at Department of Neurosurgery and Trauma Units of Assiut University Hospital through one year from March 2015 to March 2016.Results: The mean age was 25 years. 27 patients were males (90%). Brainmatter herniation and Cerebrospinal Fluid (CSF) leak was the most common clinical presentation in 28 (93.3%) patients followed by decreasedlevel of consciousness in 26 (86.6%) patients. Multiple lobe injury was noted in 14 (46.6%) patients followed by parietal lobe in 10 (30%) patients. 12 patients died during the hospital stay. Three patients were discharged in GOS-3, 5 in GOS-4, and 10 in GOS-5. Wound infection occurred in3 (10%) patients, and seizure developed in 7 (23.3%) patients.Conclusion: Penetrating brain injuries are rising issue in our community. It occurs commonly in young adults (20 to 40 year-old agegroup) and occurs more commonly in males. Firearm is the usual mode of injury and carries worse prognosis than other modes of injury. Higher mortality wasobserved among missile injuries compared to non missile injuries. Mostcases presented with brainmatter herniation or CSF leak. Multi lobar injury is themost common finding followed by parietal lobe injury. Aggressive resuscitation is required in cases of PBI. Prognosis of penetrating brain injuries is highly related to post resuscitation GCS.
https://mjcu.journals.ekb.eg/article_65765_ca4a862c6ce7a50c2cb8785e789fa485.pdf
2018-12-01
4705
4712
10.21608/mjcu.2018.65765
Penetrating – Head injury – Assiut University
ABD EL-HAKEEM ABD EL-SATTAR ESSA, M.D.;
AHMED EL-SHANAWANY, M.D.
1
The Department of Neurosurgery, Faculty of Medicine, Assiut University, Assiut, Egypt
AUTHOR
ORIGINAL_ARTICLE
Comparative Study between Results of Bipolar Hemiarthroplasty And Cannulated Screws in Management of Fracture Neck Femur in Old Age Group
AbstractBackground: While the treatment for displaced femoral neck (Garden types I and II) is still the subject of controversy.Aim of Study: The aim of this thesis is to compare the results of internal fixation and bipolar hemiarthroplasty in non-displaced fracture neck of femur in elderly patients.Patients and Methods: The study was performed on 3 patients over 60 years with non-displaced fracture neck of femur, 15 of them treated with internal fixation by cannulated screws, while the other 15 treated by bipolar arthroplasty.Results: All patients were followed up for a mean period of 12 months radiologically by serial X-rays and clinicaly by Harris hip score, where the overall mean Harris Hip score in fixation group was 74, while it was 86.3 for the replacement group.Conclusion: There was a significant relationship between the time of delay of operation and the final outcome in fixation group. There was no significant relationship between the final outcome and age, sex, and garden type of the fracture.
https://mjcu.journals.ekb.eg/article_65780_ea8cb7b6f4a2b70b7e2e13708973f7e2.pdf
2018-12-01
4613
4617
10.21608/mjcu.2018.65780
Non-displaced fracture neck of femur – Elderly-internal fixation – Bipolar arthroplasty
TALAAT T. EL-HADIDI, M.D.;
HISHAM M. SOLIMAN, M.D.
1
AUTHOR
AHMED H. ABD EL-AZEEM, M.D.;
OMAR A. SHALABY, M.Sc.
2
AUTHOR
MOHAMED H.E. ABORAS, M.Sc.;
MOHAMED A. ABOKISHK, M.Sc.
3
AUTHOR
BAHAAALDINE S. ABD EL-WAHAB, M.Sc.;
REDA A.A. SHETA, M.Sc.
4
AUTHOR
MOEMEN
SEIF, M.Sc.
5
The Department of Orthopedic Surgery, Faculty of Medicine, Cairo University* and Damnhour Medical National Inistitute
AUTHOR
ORIGINAL_ARTICLE
Expression of CD10 and CD56 in Benign and Malignant Thyroid Lesions
Abstract Background: Despite its proven benefits, cardiac rehabil-itation (CR) remains markedly underutilized, particularly among eligible women. We sought to demonstrate whether women enrolled in a contemporary CR program derived similar benefits as men. Aim of Study: In this study, we aimed to compare the changes in physical and psychosocial outcomes by sex after CR completion. We hypothesized that after participation in CR, women will demonstrate similar improvements in physical and psychological parameters to men. Patients and Methods: Using a clinical registry of CR participants between January 2015 and February 2020 who completed a standard 12-week CR program, we analyzed changes in physical and psychosocial well-being parameters. Primary endpoint was improvement in 6-minute walking distance (6MWD). Secondary endpoints included change in exercise minutes per week (EMW 150) (only patients with more than 150 minutes per week of reported exercise are included), depression scores (PHQ9), anxiety scores (GAD7), and overall quality of life (COOP) scores (lower scores are better) [1]. Results: There were 617 patients (mean age 64±12 years, 26% women) with complete pre- and post-CR data. At baseline, women had lower 6MWD, lower EMW150, higher GAD7, PHQ9, COOP, heart rate and LV EF. Women were more likely to be referred following a valvular procedure and had fewer CABG. By the end of the CR program, women had similar improvement in their 6MWD as men (women: Median (IQR): 14 [7,20] % (increase from baseline) vs. men: 13 [6,21] % (increase from baseline), p-value=0.87). Women with mild anxiety improved significantly more than men (Table 3). Conclusions: Women who completed a CR program derive similar physical benefits as men and may have greater psy-chosocial well-being improvements. Efforts to increase CR participation should certainly target eligible women. Clinical implications: Physical and psychosocial improve-ments observed in women completing CR are similar to men. Efforts that increase women participation in CR need to be encouraged.
https://mjcu.journals.ekb.eg/article_285364_9d50db8a0b0a9a715b6661357544c039.pdf
2018-12-01
1911
1918
10.21608/mjcu.2018.285364
Cardiac Rehabilitation
sex
Gender
Females
males
men
Women
Coronary Artery Disease
Non-coronary artery disease
Heart failure
myocardial infarction
Stable angina
Heart transplantation
Percutaneous coronary inter-vention
Valvular heart disease
Coronary Artery Bypass Graft
IHAB
YASSIN, M.D.
1
Graduate of the Master of Medical Sciences in Clinical Investigation Program, Harvard Medical School, Boston, MA, USA and The Department of Cardiovascular Medicine, National Heart Institute of Egypt
AUTHOR