The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
The Effect of the Extracorporeal Shock Wave Therapy on Scaphoid Fracture Nonunions
1
6
EN
AMR E. AHMED, M.Sc.;
OMAIMA KATTABEI, Ph.D.
AHMED F. GENEDY, M.D.;
ABER RAMADAN, Ph.D.
The Department of Basic Sciences, Faculty of Physical Therapy, Cairo University* and The Department of Physical Medicine, Military Medical Academy**, Cairo
10.21608/mjcu.2018.54996
Abstract<br />Background: The scaphoid is the most frequently fractured carpal bone, typically as a result of a fall onto an outstretched hand. Nonunion that caused by poor blood supply is an important complication of scaphoid fracture. The purpose of this study was to investigate the effect of the extracorporeal shock wave therapy on the healing of scaphoid fracture nonunion.<br />Subjects: Thirty patients from both genders were diagnosed with scaphoid fracture for more than sex weeks without healing for more than six monthes, aged 20 to 50 years and were divided into two equal groups; fifteen patients each.<br />Method: Subjects were randomly divided into 2 groups; group A (control group) received conservative treatment (immobilization with cast and follow-up). Group B (experi-mental group) received three ESWT sessions followed by immobilization by cast. X-ray radiographs were obtained before and after treatment.<br />Results: There were significant statistical differences between the 2 groups, where the treatment group showed greater improvement in the healing response.<br />Conclusion: ESWT is an effective method in treatment of scaphoid fracture nonunion.
Scaphoid bone,Nonunion fracture,shock wave therapy
https://mjcu.journals.ekb.eg/article_54996.html
https://mjcu.journals.ekb.eg/article_54996_de0ea3c309f155a9e73677af5220d5c5.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Estrogen Iontophoresis Versus Stem Cell Therapy in the Treatment of Chronic Wound in the Lower Limb
7
15
EN
ADEL A. NOSSEIR, Ph.D.;
WAFAA H. BORHAN, Ph.D.
WAEL ABO EL-KHER, M.D.;
ISLAM M. KAMEL, M.Sc.
The Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University*,
The Department of Microbiology & Immunology, Egyptian Military Medical Academy** and The Department of Physical Therapists, El-Maady Military Hospital***
10.21608/mjcu.2018.54998
Abstract<br />Background: Chronic non-healing ulcers present a chal-lenging and demanding scenario to the physical therapists and physician. Over the past decade, new adjuvants for wound healing have been developed that have become readily avail-able to the wound care practitioner.<br />Purpose: To determine and compare between the effec-tiveness of estrogen iontophoresis as physical therapy modality and stem cell therapy in the treatment of diabetic foot ulcers.<br />Methods: Forty-five patients who had diabetic foot ulcers for longer than three months. Their ages were ranged from 40-50 years; with mean value 45.99±4.147 years. The patients were selected from El-Maady Military Hospital (Department of General Surgery)in the period between Jan. 2015 and Dec. 2016. Patients who met the selection criteria were divided randomly into three equal groups, Group (A) received estradiol iontophoresis (–ve ) electrode by intensity 1-5mA for 10min,, 3 sessions per week for 4 weeks and medical treatment. Group (B) received stem cell therapy for wound and estradiol that transmitted through iontophoresis (–ve) electrode for 4 weeks. Group (C) received stem cell therapy (using bone marrow-derived fibrocytes).<br />Measurements: Wound Surface Area (WSA) was assessed by Digital Camera and Image J 1.49. V Computer Software, and wound volume using volumetric method were assessed before treatment and after 4 weeks of treatment.<br />Results: The findings of this study indicated significant decrease in WSA and wound volume after treatment in all groups A, B and C (p<0.0001). There was significant difference between Group B and C after treatment in WSA and wound volume (with favored results in Group B.<br />Conclusion: Results showed that estrogen iontophoresis for 4 weeks in combination with stem cell is an effective adjuvant therapy, better that each method alone, in treatment of diabetic foot ulcers through accelerating wound healing and reducing WSA, wound volume.
Estrogen iontophoresis – Diabetic foot ulcers – Stem cell therapy
https://mjcu.journals.ekb.eg/article_54998.html
https://mjcu.journals.ekb.eg/article_54998_a94191b7d277cbf2a4d2153560983088.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Screening of Oropharyngeal Dysphagia in Patients with Diabetes Mellitus in El-Demerdash Hospital
17
25
EN
MARWA M. SALEH, M.D.;
MERAM M. BEKHET, M.D.
MONA S. KHODEIR, M.D.;
DONIA A. ZAKARIA, M.Sc.
The Departments of Phoniatrics* and Endocrinology**, Faculty of Medicine, Ain Shams University
10.21608/mjcu.2018.55000
Abstract<br />Background: Diabetes mellitus is a systemic endocrinal disease that results either from deficiency of insulin hormone (type 1) or from insulin resistance or both (type 2). Literature is scarce related to dysphagia with diabetes. This complaint is expressed by some patients and needs to be explored. A-EAT-10 is a questionnaire that explores the presence of dysphagia symptoms among patients.<br />Aim: The aim of this work is to screen Egyptian diabetic patients (type 1 and type 2) in El-Demerdash Hospital for oropharyngeal dysphagia using the validated Arabic version of Eating Assessment Tool (A-EAT-10) questionnaire to explore the degree of such symptom among them.<br />Study Design: This was a cross-sectional study conducted to screen the diabetic patients (of both type 1 and type 2) in El-Demerdash Hospital for oropharyngeal dysphagia.<br />Patients and Methods: 200 Egyptian adult diabetic pa-tients, aged 18y.1m.1d-59y.12m.31d, were included in this study. The participants were selected upon certain inclusion and exclusion criteria. The inclusion criteria were diabetic patients of type 1 and/or type 2. The exclusion criteria were any past or present history of disorders that might cause oropharyngeal dysphagia. Patients were asked to complete the Arabic version of the Eating Assessment Tool-10 (A-EAT-10) questionnaire. It is formed of 10 questions, and used to detect the presence of dysphagia complaints among patients and how it affects them.<br />Results: The increase in age and having a female gender were considered of high risk for dysphagia among diabetic patients participating in this study. The commonest symptom among diabetic patients who complained from dysphagia was “I cough when I eat”. There is no relation between the type or duration of diabetes mellitus and the presence of oropha-ryngeal dysphagia.<br />Conclusion: The present study showed that diabetic patients may encounter swallowing problems. The A-EAT 10 is an easy method that can be used for screening of swallowing difficulty.
Oropharyngeal dysphagia – Diabetes mellitus – A-EAT-10
https://mjcu.journals.ekb.eg/article_55000.html
https://mjcu.journals.ekb.eg/article_55000_65e2b0bb8f72e18e0ac31f1ca07e4681.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Effect of Transcutaneous Electrical Nerve Stimulation Versus Transcranial Direct Current Stimulation on Diabetic Peripheral Neuropathy
27
34
EN
AWNY F. RAHMY, Ph.D.;
SHEREEN H. EL-SAID, Ph.D.
ASMAA
YACOUB, M.Sc.
The Department of Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University
10.21608/mjcu.2018.55004
Abstract<br />Background: Diabetic periphral neuropathy is probably the most common form of the diabetic neuropathies. It is seen in both type 1 and type 2 DM with similar frequency, and may occur at time of diagnosis of type 2 DM. Sensory symp-toms are more prominent than motor symptoms and usually involve the lower limbs.<br />Objective: To compare the effect of transcutaneous elec-trical nerve stimulation versus transcranial direct current stimulation on diabetic painful neuropathy.<br />Subjects and Methods: Forty patients of both sex suffering from diabetic peripheral neuropathy with age range from 50 to 60 years old were participated in this study. They were assigned randomly into two equal groups, Group (A) received transcranial direct current stimulation, Group (B) received transcutaneous electrical nerve stimulation. Treatment was applied 3 times per week for 2 months. Pain intensity was assessed by Neuropathy Pain Scale (NPS) before and after treatment.<br />Results: There was significant improvement in both groups after treatment than before treatment but there was no signif-icant difference between transcranial direct current stimulation and transcutaneous electrical nerve stimulation.<br />Conclusion: Both transcutaneous electrical nerve stimu-lation and transcranial direct current stimulation are both effective in pain associated with diabetic painful neuropathy.
Transcranial direct current stimulation – Trans-cutaneous electrical nerve stimulation – Diabetic peripheral neuropathy
https://mjcu.journals.ekb.eg/article_55004.html
https://mjcu.journals.ekb.eg/article_55004_12d8bfba04abdae86d2988cec50ef92d.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Corticosteroids Administration for Enhancement of Fetal Lung Maturity and its Effects on Doppler Indices
35
41
EN
MOUSTAFA H. HEGAB, M.D.;
YAHIA A.S. WAFA, M.D.
HESHAM M.
SWEELAM, M.Sc.
The Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
10.21608/mjcu.2018.55022
Abstract<br />Background: Evaluation the effects of maternal corticos-teroids administration on Doppler indices (RI, PI & S/D ratio) of umblical artery, fetal middle cerebral artery and fetal pulmonary trunk in third trimester and its correlation with pregnancy outcome.<br />Methods: One hundred and fourty (140) women were included in this study, and were divided in two groups, seventy (70) subjects as study group have a risk for preterm labour and seventy (70) subjects as control group with no risk of preterm labour, study group subjects received course of corticosteroids in third trimester. The Doppler examination of the Pulsatility Index (PI), Resistive Index (RI) and Systolic diastolic Ratio (S/D) of the Umbilical Artery (UA), the Middle Cerebral Artery (MCA) and Fetal Pulmonary Trunk (PT) were measured and comparison between values of both groups were done after zero, one, three and five weeks of corticos-teroids administration of study group and same gestational age of control group.<br />Results: No significant change was observed in the mean values of the pulsatility, resistive indices and systolic-diastolic ratios of both groups in umbilical artery, fetal middle cerebral artery and fetal pulmonary trunk after one week after corti-costeroids administration.<br />Conclusions: We demonstrated that dexamethasone ad-ministration did not cause changes in Doppler values and fetal biophysical profile scores after one week of its use.
Corticosteroids – Doppler – Preterm birth – Biophysical profile – Umbilical artery doppler – Middle cerebral artery doppler – Pulmonary trunk doppler
https://mjcu.journals.ekb.eg/article_55022.html
https://mjcu.journals.ekb.eg/article_55022_25dc4ef10af5b8c47c78b5c6ca49c95e.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Study of Management of Retinoblastoma with Vitreous Seeds (Retrospective Study)
43
48
EN
MAGDY M. EL-BARBARY, M.D.;
AZZA M.A. SAID, M.D.
MONA K.
EL-AWADY, M.Sc.
The Department of Ophthalmology, Faculty of Medicine, Ain Shams University
10.21608/mjcu.2018.55027
Abstract<br />Background: The response of retinoblastoma with vitreous seeds to the different modalities of treatment as regards tumor regression, vitreous seeds regression and eye salvage.<br />Aim of the Work: Study of the response of Rb with vitreous seeds to the different modalities of treatment as regards tumor regression, vitreous seeds regression and eye salvage.<br />Patients and methods: This is a retrospective observational study in which we collected the data from medical records of cases of retinoblastoma with vitreous seeds who were managed over ten years at Ocular Oncology Unit, Ophthalmology Department, Ain Shams University Hospitals in the period from January 2004 to June 2015 and followed-up for at least 12 months after the completion of treatment. Our study included 37 patients. Fourty-two eyes affected with retino-blastoma with vitreous seeds were divided into four groups according to the modality of treatment: Group (1): 15 eyes treated with chemoreduction±focal therapy (diode laser ther-motherapy or cryotherapy), Group (2): 8 eyes treated with intravitreal chemotherapy, Group (3): 2 eyes treated with intra-arterial chemotherapy and Group (4): 17 eyes of treated with subTenon's Carboplatin. All eyes had received systemic chemotherapy as a primary treatment before these modalities of treatment.<br />Results: Our study showed that the rate of ocular salvage was the highest in group 4 (52.9%) followed by group 1 (40%), group 2 (20%) and group 3 (0.0%). There was a statistically significant difference between group 1 and group 4 as regards tumor number, tumor location, tumor base diam-eter, number of thermotherapy sessions as primary treatment, mean duration of follow-up and event free interval from last treatment.<br />Conclusion: Subtenon's Carboplatin, chemoreduction plus focal therapy, intravitreal chemotherapy and intra-arterial chemotherapy may be effective supplementary modalities of treatment that help in ocular salvage.
Retinoblastoma – Subtenon's Carboplatin – Chemoreduction plus focal therapy – Intravitreal chemotherapy – Intra-arterial chemotherapy
https://mjcu.journals.ekb.eg/article_55027.html
https://mjcu.journals.ekb.eg/article_55027_efbbc0858cebefca2db9016c60bf569c.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Evaluation of Corneal Endothelial Changes Using Specular Microscope before and after Collagen Cross Linking for the Treatment of Keratoconus
49
53
EN
NEGM E. HELAL, M.D.;
LAMIAA S. ELEWA, M.D.
KHALED M. HAMDY, M.D.;
RANA S. MOHAMED, M.Sc.
The Department of Ophthalmology, Faculty of Medicine, Ain Shams University
10.21608/mjcu.2018.55028
Abstract<br />Background: Keratoconus is a non-inflammatory condition in which the center of the cornea progressively thins and develops a cone-shaped bulge that blurs and distorts vision. A normal cornea is round, with even curvature like that of a sphere. But with keratoconus, the curvature is irregular and too steep, like the narrow end of an egg. Any change in the shape of the cornea changes the way light passes through the eye, and results in a change in vision. When the cornea is too steep, light converges in front of the retina, causing nearsight-edness.<br />Aim of the Work: The purpose of this work is to evaluate the corneal endothelial changes following corneal collagen cross linking (CXL) for the treatment of progressive kerato-conus using corneal specular microscopy.<br />Patient and Methods: This study was a prospective, non-randomised controlled interventional case series. Patients from age 18 to 40 years old diagnosed with progressive keratoconus tested to detect if there is change in corneal endothelium after cross linking or not.<br />Results: Our study was done on 40 eyes in patient age from 18-40 years old. It showed that there were statistically non significant changes in corneal endothelial counts include central corneal thickness (CCT), endothelial cell density (ECD), coefficient of variation (CV%), Hexagonal cells %, after cross linking procedure in keratoconic patients during one month follow-up.<br />Conclusion: Our results demonstrated no changes in human corneal endothelium following UVA/riboflavin CXL.
Keratoconus – Corneal Endothelium – Specular microscopy – Cross-linking– Riboflavin
https://mjcu.journals.ekb.eg/article_55028.html
https://mjcu.journals.ekb.eg/article_55028_5ee8c2b43ac875b3e33f089047000fef.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Cortisol and Quality of Life Responses to Endurance Versus Resistive Exercises in Young Depressed Elderly
55
61
EN
HALA M. EZZ-ELDIN, Ph.D.;
HANY F.E.M. ELSISI, Ph.D.
AHMED S. MOHAMED, M.D.;
ELSHAIMAA E. ALY, M.Sc.
The Department of Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University* and The Department of Psychiatry, Faculty of Medicine, Ain Shams University**
10.21608/mjcu.2018.55030
Abstract<br />Objective: To compare the effect of endurance versus resistive exercise on cortisol and its reflect on quality of life and depression scale in young depressed elderly.<br />Background: Exercise has been suggested to be a viable treatment for depression. This study compared the effect of endurance versus resistive exercise on cortisol and its reflect on quality of life and depression scale in young elderly in order to help elderly to be more active.<br />Subject and Methods: Thirty subjects (13 men, 17 women) were randomly assigned into two groups equal in number. Group (A) Fifteen subjects (7 men, 8 women) received Mod-erate intensity endurance (aerobic) exercise (50 to 70) % of their maximum heart rate. Group (B) Fifteen subjects (6 men, 9 women) received resistance exercise composed of 6 stations of weight lifting with moderate intensity (30% to 40% of 1 RM for upper body exercises and 50% to 60% of 1 RM for lower body exercise). The program duration for both groups was 3 times/week for 12 weeks.<br />Results: Showed that 12 weeks of endurance or resistance exercise for depressed young elderly subjects caused a statis-tical significant improvement in Hamilton Depression Scale (16.86% for Group A and 17.97% for Group B) and Older People Quality of Life Questionnaire (29.94% for Group A and 20.37% for Group B) and a significant decrease in cortisol level (20.81% for Group A and 15.6% for Group B) at the end of rehabilitation program with the favor of aerobic regard-ing cortisol level and quality of life. On the other hand resistive exercise has more effect on Hamilton Depression Scale.<br />Conclusions: Both endurance and resistance exercise are effective non-pharmacological adjuvant treatment for depres-sion and improvement of quality of life in young elderly.
Depression –Young elderly – Aerobic exercise – Resistance exercise – Quality of Life
https://mjcu.journals.ekb.eg/article_55030.html
https://mjcu.journals.ekb.eg/article_55030_24061e26739b32d1f475036b4ce7f2a7.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Effect of Cupping Therapy on Glycemic Control in Type II Diabetic Patients
63
67
EN
SAMAR K. AL-NOUMANY, M.Sc.;
AZZA A. ABD EL-HADY, Ph.D.
BASANT H. EL-REFAY, Ph.D.;
MOHSEN M. HELMY, M.D.
The Departments of Physical Therapy, Zagazig General Hospital*, Physical Therapy for Cardiovascular, Respiratory Disorder & Geriatrics, Faculty of Physical Therapy, Cairo University** and Internal Medicine, Shibin El-Koum Educated Hospital***
10.21608/mjcu.2018.55032
Abstract<br />Background: Diabetes mellitus is a group of metabolic disorders in which there are high blood glucose levels over a prolonged period. If left untreated, diabetes can cause many complications [13]. Acute complications can include diabetic ketoacidosis, hyperosmolar hyperglycemic state, or death [2]. Serious long-term complications include cardiovascular dis-ease, stroke, chronic kidney disease, foot ulcers, and damage to the eyes [12].<br />Purpose: To study the effect of cupping therapy on glyc-emic control in diabetic patients.<br />Methods: Thirty type 2 diabetic patients were selected from Internal Medicine Department of Central Berket El-Sabaa Hospital to determine the effect of cupping therapy on glycemic control in diabetic patients. The practical work was done in the duration between July 2014 till September 2014.<br />They were diagnosed with specialized physician as T2DM patients, their age ranged from (45-55 years) and they were randomly divided into two groups equal in number. Patients were randomly assigned into two groups (A&B); each group consisted of fifteen patients. Parameters measured from both groups were HbA1c, fasting plasma glucose, postprandial plasma glucose level. Group (A) performed aerobic training for three sessions every week for 3 months and cupping therapy one time a month for 3 months while group (B) performed aerobic exercise only. Both groups were under medical treatment.<br />Results: There was a significance decrease in HbA1c, fasting blood glucose, and post prandial blood glucose in group A compared with group B post treatment. The percent of improvement of HbA1 c, fasting blood glucose, post prandial plasma glucose for group (A) was 30.13%, 14.08%, and 23.62% and for group (B) was 18.97%, 13.03%, and 16.26% respectively. The significance decrease in the mean values post treatment (p=0.02), (0.04), (0.3).<br />Conclusion: Using cupping therapy combined with aerobic exercise is superior to aerobic exercises only regarding glyc-emic control in type 2 diabetic patients.
Diabetes –Aerobic exercise – Cupping therapy
https://mjcu.journals.ekb.eg/article_55032.html
https://mjcu.journals.ekb.eg/article_55032_9c342aacddb3991e318e2ad27661ee55.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Her-2 Neu Expression in Endometrial Carcinoma
69
76
EN
AFAF T. ELNASHAR, M.D.;
NOHA ED. HASSAB ELNABY, M.D.
ASMAA A. ABDELLATEF, M.D.;
MOHAMED N. SALEM, M.D.
The Departments of Pathology* and Obstetrics & Gynaecology**, Faculty of Medicine, Sohag University
10.21608/mjcu.2018.55033
Abstract<br />Introduction: Endometrial cancer formed 0.004 of the tumors in Egypt. Detection of high grade tumors from the low-grade ones is mandatory for survival of the patients.<br />Aim of the Work: The use of immunohistochemical tech-nique to detect the expression of Her-2 neu in endometrial carcinomas.<br />Material and Methods: Fifty cases of endometrial carci-noma (37 endometrioid, 10 serous, 1 clear cell and 2 undif-ferentiated carcinomas) were stained with Her-2 neu and its immunoexpression results were evaluated statistically using Chi-square and t-test.<br />Results: Her-2 neu was expressed in (76%) 38/50 cases with statistically significant relation between Her-2 expression and both grade of the tumor p<0.013 and stage p<0.05. Although Her-2 immunostaining was not correlated with tumor histological type p<0.088.<br />Conclusions: Her-2 neu could be used to detect the low-grade, early-stages, endometrial carcinomas from the more aggressive high-grade endometrial carcinomas for therapy modulation.
Her-2 neu – Endometrial carcinoma – Immuno-histochemical expression
https://mjcu.journals.ekb.eg/article_55033.html
https://mjcu.journals.ekb.eg/article_55033_eefea397c7c2721653e4806b1732293a.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Evaluation of Diagnostic Value of Adenosine Deaminase in Diagnosis of Tuberculous Pleural Effusion
77
83
EN
TALAAT A. MOHAMED, M.D.;
AHMED M. TAHOUN, M.D.
MOUSTAFA A. ZEDAN, M.D.;
MOHAMED S. MOHAMED, M.Sc.
The Departments of Chest Disease* and Clinical Pathology**, Faculty of Medicine, Al-Azhar University
10.21608/mjcu.2018.55034
Abstract<br />Background: Many studies suggest that adenosine deam-inase is a marker for tuberculous pleurisy, while controversy exists as to its diagnostic value, accurate diagnosis is essential for tuberculous effusion for initiation of treatment. So evalu-ation of diagnostic value of adenosine deaminase in diagnosis of tuberculous pleural effusion is important.<br />Aim of the Work: To evaluate the diagnostic value of adenosine deaminase in diagnosis of tuberculous pleural effusion from non tuberculous pleural effusion.<br />Subject and Methods: Forty patients with pleural effusion were admitted to Giza chest hospital, Bab El-Sha’eria and Al-Hussein Al- Azhar University Hospital and after taking a written informed consent from the patients during period between April 2014 and May 2016.<br />All patients were subjected to full history and clinical examination, Plain chest X-ray, Sputum examination for Acid Fast Bacilli, ADA in pleural fluid, pleural biopsy and Culture and sensitivity of pleural fluid. Those patients were classified into (2) groups: Group (I): Twenty (20) patients with tuber-culous pleural effusion. Group (2): Twenty (20) patients without tuberculous pleural effusion.<br />Results: Patients with tuberculous pleural effusion had significantly high ADA level in pleural fluid than patients with non-tuberculus effusion (parapneuomonic and malignant effusion) with p<0.001 with cutoff point in pleural fluid was 68.8 IU/l, sensitivity and specificity were 90% and Positive predictive value was 90%.<br />Conclusion: Adenosine deaminase ADA can be used in diagnosis tuberculous pleural effusion with significantly increase ADA level in pleural fluid than those with malignant, parapneumonic effusion. So Adenosine Deaminase ADA is a non invasive, inexpensive and repeatable test provides the results quickly which help to start early treatment.
ADA – Adenosine deaminase – Tuberculous effusion
https://mjcu.journals.ekb.eg/article_55034.html
https://mjcu.journals.ekb.eg/article_55034_7cd14185eb7b3d7985e5d5e764c0eaf2.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Supplemental Versus Permanent Nursing Staffing in Relation to Organizational Commitment
85
90
EN
BADR B. MOHAMED, M.Sc.;
FATMA A. ABED, D.N.Sc.
The Department of Nursing Administration, Faculty of Nursing, Cairo University
10.21608/mjcu.2018.55038
Abstract<br />Background: Nurse Shortages remain of concern because inadequate nurse staffing has been linked to poor quality of care and adverse patient outcomes. During periods of nursing shortage, hospital managers use nurses from temporary em-ployment agencies to fill vacancies and to meet staffing needs. Supplemental nurses are hired with the expectation of main-taining planned staffing levels when scheduled staff is una-vailable or the patient census fluctuates Supplemental registered nurses are similar to permanent RNs on numerous character-istics including education and experience. Because nurses are the main sources for continued success and performance for organization, building organizational commitment is undoubt-edly very important for all organizations.<br />Aim: The current study conducted to compare supplemental versus permanent nursing staffing in relation to organizational commitment.<br />Subjects and Methods: A descriptive comparative 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 sample of 301 convenient nurses was invited to participate in the questionnaire. For the purpose of this study, questionnaire for nurses was developed and utilized that consist of two parts: The first part was related to the nurse personal characteristics, the second part assess the nurses commitment level.<br />Results: The study showed that there was no statistical significance difference among permanent and temporary nurses regarding commitment level as general. The total means of temporary nurse's commitment is moderate (54%). While total mean score of permanent nurse's commitment is moderate (57%).<br />Conclusion: The study concluded that there was no sta-tistical significant difference among permanent and temporary nurses regarding commitment level as supplemental and permanent staffing has moderate level of organizational commitment and the difference among two groups only re-garding affective commitment.<br />Recommendations: The current study recommended that Nursing administrators should gradually increasing the pay and absorbing the temporary employees to permanent employ-ment whenever suitable, should provide temporary nurses with job trainings to equip them with skills so that they could be more productive.
Supplemental nurses – Permanent nurses – Organizational commitment
https://mjcu.journals.ekb.eg/article_55038.html
https://mjcu.journals.ekb.eg/article_55038_0ce00dcde397b0519ac9a64dcbd44fdb.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Correlation between S'-Wave Dispersion of Mitral Annular Tissue Velocity and Severity of Coronary Artery Disease Assessed by SYNTAX Score
91
96
EN
MOHAMMED NAGIB, M.D.;
KAMAL MARGHANY, M.D.
MOHAMMED ABD EL-HADY, M.D.;
AHMAD KHAIRY, M.Sc.
The Department of Cardiology, Faculty of Medicine, Al-Azhar University, Cairo
10.21608/mjcu.2018.55039
Abstract<br />Background: Coronary Artery Disease (CAD) is a para-mount cause of death. Coronary angiography is considered the gold standard for the invasive assessment of obstructive CAD. The SYNTAX score is frequently used to comprehen-sively assess the complexity and burden of CAD. The technique of Tissue Doppler Imaging (TDI) emerged as a unique, easily performed, and reproducible modality for assessing systolic and diastolic LV performance. We aimed to examine the value of the S'-wave dispersion of TDI derived mitral annular velocities for the prediction of severity of coronary artery stenosis.<br />Methods: We included 60 patients with symptoms sug-gesting CAD in the study. We excluded patients with previous myocardial infarction, atrial fibrillation, significant valvular disease, and congestive heart failure. All patients had undergone full history taken and clinical examination; complete 12-leads electrocardiography, echocardiographic with assessment of LV systolic and diastolic dimensions, fraction of shortening, ejection fraction, and Doppler derived mitral valve velocities; TDI with measuring of S'-wave, S'-wave dispersion, S' mean, E'-wave, A'-wave and E'/A' ratio of the septal, lateral, anterior and inferior walls; and coronary angiography.<br />Results: Mean S' was decreased in patients with severe CAD and S'-wave dispersion was high in patients with single or two vessel disease and low in patients with multi vessel disease.<br />Conclusion: S'-wave dispersion in combination with S' mean can predict severity of CAD and number of affected vessel.
Tissue Doppler imaging – Mitral annular velocities,–S'-wave dispersion – Coronary artery disease,–Coronary angiography – Syntax score
https://mjcu.journals.ekb.eg/article_55039.html
https://mjcu.journals.ekb.eg/article_55039_8b0af25c1314b3e8db141a672a16a50d.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Predictive Value of Combining the Ankle-Brachial Index and SYNTAX Score for the Outcome in STEMI Patients Undergoing Primary Percutaneous Coronary Intervention
97
105
EN
KHALED E. HAMADA, M.Sc.;
SEHAM F. BADR, M.D.
YASSER H. EL-BARBARY, M.D.;
SAMEH S. KHALIL, M.D.
The Department of Cardiovascular Medicine, Faculty of Medicine, Tanta University
10.21608/mjcu.2018.55043
Abstract<br />Background: The Synergy between PCI with TAXUS and Cardiac Surgery (SYNTAX) score is effective for prediction of clinical outcome after Percutaneous Coronary Intervention (PCI). However, its predictive ability is low because it reflects only the coronary characterization.<br />Objective: Evaluation of predictive value of combining the Ankle-Brachial Index (ABI) and SYNTAX score for the outcome in STEMI patients undergoing primary percutaneous coronary intervention.<br />Methods: A prospective observational cohort study con-ducted from June 2016 to May 2017 at Cardiovascular Med-icine Department, Tanta University Hospitals in Gharbia Governorate, Egypt. The study enrolled 90 consecutive adult patients of both genders who were diagnosed with definite ST-segment elevation myocardial infarction within 12 hours from the time of symptoms onset, and were treated by primary percutaneous coronary intervention. SYNTAX score was calculated based on its results. ABI-SYNTAX score was calculated by first reclassifying the ABI and SYNTAX scores and then adding them. ABI <0.4 was classified as 2, 0.4 to 0.9 as 1, >0.9 to 1.3 as 0 points; and SYNTAX score <22 was classified as 0, 23 to 32 as 1, and >33 as 2 points. The resulting scores were added. Patients were classified into 3 groups: ABI-SYNTAX score low (0), ABI-SYNTAX score moderate (1 or 2), and ABI-SYNTAX score high (3 or 4).<br />Results: Incidence of MACEs was higher among patients with high ABI-SYNTAX score. From the total incidence of MACEs in the study population (n=17), 12 were present in group III (70.6%), 4 in group II (23.5%) and 1 in group I (5.9%). ABI-SYNATX score was more sensitive than SYNTAX score alone for detection of occurrence of MACEs in patients with high score (group III). Incidence of secondary endpoints, defined as stent thrombosis, in stent restenosis, re-hospitalization with acute coronary syndrome and target lesion revascularization, was higher in group III.<br />Conclusion: ABI- SYNTAX score is an independent prognostic factor for both in-hospital adverse outcomes, as well as, short-term adverse outcomes among STEMI patients who underwent primary PCI. It improved the ability of the SYNTAX score which assesses the angiographic characteristics and complexity of coronary artery lesions by combining the SYNTAX score with ABI. The predictive value of ABI-Syntax score with respect to MACEs was superior to Syntax score alone.
SYNTAX score – Percutaneous coronary interven- tion – ABI-SYNTAX score – MACEs
https://mjcu.journals.ekb.eg/article_55043.html
https://mjcu.journals.ekb.eg/article_55043_7a2c1c6801dce15bdaf5e0a8ba700860.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Sleep Quality in COPD Patients; Incidence and Predictors of Poor Quality
107
115
EN
MOHAMMAD T. ABD EL-FATTAH, M.D.;
ALI O. ABD EL-AZIZ, M.D.
ELHAM A. ABD EL-GAHNY, M.D.;
MAHMOUD H.S. KHEDR, M.D.
The Departments of Chest Diseases* and Internal Medicine**, Faculty of Medicine, Minia University, Egypt
10.21608/mjcu.2018.55045
Abstract<br />Objectives: Evaluation of sleep quality in COPD and relationship of PSQI (Pittsburgh Sleep Quality Index) score with health related quality of life, depression, anxiety and severity of airflow obstruction.<br />Patients and Methods: A prospective study of 124 COPD patients, 42 adult control. All completed PFT, ABG, routine investigation. All were age and gender matched. Quality of sleep measured by Pittsburgh Sleep Quality Index (PSQI). Health related quality of life was measured by diseasespecific (St. George's Respiratory) questionnaires. Anxiety, depression assessed by Hamilton scale and Beck's depression inventory.<br />Results: 53.2% of COPD patients had poor sleep quality, 50% had high risk of OSA with statistically significant differ-ence regarding smoking index, spirometric parameters, 6-min walk test, Berlin questionnaire, PSQI, ESS, BDI and HAM-A. COPD poor sleep quality had statistically higher, number of exacerbations, total SGRQ (St.George respiratory question-naire), ESS (Epworth sleepiness scale), BDI, HAM-A. COPD patients with high risk of OSA had statistically significant number of exacerbations, shorter 6-min walk test and higher total SGRQ, ESS, PSQI, BDI and HAM-A. No relation be-tween disease severity and sleep disturbance, health related quality of life. PSQI was correlated positively with COPD duration, number of exacerbation, PCO2, HAM-A (Hamilton Anxiety Rating Scale), BDI (Beck's Depression Inventory) and SGRQ. PSQI was correlated negatively with FEV1, FVC%, FEF25-75%, use of (long acting muscarinic antago-nists).<br />Conclusion: COPD is associated with poor sleep quality and high risk of OSA. Strong association between poor sleep quality and physical limitation, anxiety, depression and poor health related quality of life.
COPD – Sleep quality – OSA – Health related,quality of life – Depression – Anxiety
https://mjcu.journals.ekb.eg/article_55045.html
https://mjcu.journals.ekb.eg/article_55045_c9704d9d40a5b27f4bb3258e4cc04413.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Impact of Socio-Demographic Characteristics on Attitude of Ever Married Women Towards Gender Based Violence in Egypt: Secondary Analysis of SYPE Data, 2014
117
122
EN
SABRA M. AHMED, M.D.;
FATEN M. RABIE, M.D.
The Department of Public Health and Community Medicine, Faculty of Medicine, Assiut University, Egypt
10.21608/mjcu.2018.55046
Abstract<br />Background: To identify the impact of socio demographic factors on attitude of ever married female toward violence against women in Egypt.<br />Material and Methods: Data from Survey of Young People in Egypt (SYPE), 2014 were used in this study. Attitude towards Gender-Based Violence (GBV) and socio-demographic characteristics of 3,226 ever married females aged 13-35 years were selected for secondary and advanced analysis.<br />Results: Only a small percentage (28.7%) of all ever married female youth rejected gender-based violence. The rejection of GBV was increased with increasing the wealth quintile from the lowest to the richest level (p<0.001). There were no statistical significant differences between respondents who accepted the GBV attitude and those who reject it as regard the employment status (p=0.442). There was more rejection of GBV with increasing educational level of respond-ents and their parents from illiterate to university or higher level (p<0.001). Agreement to GBV increased by increasing the number of brothers and sisters (p=0.021).<br />Conclusion: Sociodemographic characteristics play an important role on the attitude of ever married women towards violence against women.<br />Recommendations: Parents, educational institutions, health care providers (e.g. pre-marital counseling), civil society (mass media), community and religious leaders need to engage in more open dialog with young people to educate them about GBV, enforce positive attitude (multi-sectoral interventions) and support economic and social development.
Sociodemographic – Ever married – Women – Violence
https://mjcu.journals.ekb.eg/article_55046.html
https://mjcu.journals.ekb.eg/article_55046_31c43ac6ebf99c864fe8f62abedea0b9.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Validity of Resistive Index in Intracranial Pressure Monitoring among Questionable Hydrocephalic Infants
123
127
EN
MOHAMED M. EL-MAGHRABI, M.D.;
AHMED A. ARAB, M.D.
MOATAZ A. EL-AWADY, M.D.;
AHMED TURKEY, M.D.
The Departments of Neurosurgery* and Radiology**, Faculty of Medicine, Benha University
10.21608/mjcu.2018.55048
Abstract<br />Background: Resistive Index (RI) measurement by Tran-scranial Doppler sonography was used as a bedside safe, noninvasive technique that helpful for the assessment of vascular hemodynamics in various conditions; such as defect in brain perfusion associated with hydrocephalus.<br />Objective: To evaluate validity of resistive index as reflecting Intracranial Pressure (ICP).<br />Patients and Methods: This is a cross-sectional study which included thirty infants with query hydrocephalus, and they underwent RI measurement of middle cerebral artery at Radiology Department of Benha University Hospital then ICP monitoring at the Neurosurgery Department of Benha University and Benha Children Hospitals through the period from April 2015 to January 2017.<br />Results: This study includes thirty infants with query hydrocephalus, twenty four boys and six girls, with mean age 5.83±3.43 (ranged from 1 to 12 months). There is direct correlation between RI and ICP as RI increase with increasing ICP, which is statistically significant (p<0.05). As regard RI, there is significant difference between infants with high ICP and others with normal ICP (p=0.001). The best detected RI cut off point among infants is 0.7 as it has high sensitivity, specificity and accuracy.<br />Conclusion: RI is valid as a predictor of increased ICP so it can be used as a successful non invasive method instead of invasive technique for evaluating intracranial pressure in diagnosis of hydrocephalus among infants.
Resistive index – Intracranial pressure monitoring
https://mjcu.journals.ekb.eg/article_55048.html
https://mjcu.journals.ekb.eg/article_55048_11fa61097a8e8af026531d0c5e6e8632.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Relationship between Organizational Climate and Occupational Safety and Health for Nurses
129
135
EN
EMAN Y. MOHAMED, M.Sc.;
NEHAD E. FEKRY, D.N.Sc.
The Department of Nursing Administration, Faculty of Nursing, Cairo University
10.21608/mjcu.2018.55049
Abstract<br />Background: Nursing profession is hard and interesting, but unfortunately many nurses are exposed to occupational hazards that may cause them diseases and also reduce their performance in work. The organizational climate of the hospital may be one of the reasons that increase or decrease the exposure to occupational hazards.<br />Aim: The current study assess the relationship between organizational climate and occupational safety and health for nurses.<br />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. A samples of 293 nurses were invited to participate in the questionnaire. For the purpose of this study, questionnaire for nurses was developed 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 organ-izational climate, the third part was related to nurses perception of occupational hazards<br />Results: Half of the study sample were perceived positive hospital climate as, role clarity factor had the mean percentage (54.75%) and the lowest percentage (35.27%) social and (37.25) management. Moreover the study revealed that the study sample perceived psychological hazards was the most type of hazard that they exposed to during their work as (mean = 82.53%).<br />Conclusion: There was strongly positive relation ship between organizational climate and occupational safety and health for nurses as nurse who perceive positive climate reported low exposure to occupational hazards.<br />Recommendations: Hospital should assess organizational climate periodically to use results for creation a positive work atmosphere for productivity. Promoting positive organizational climate by promoting trust and team work 1 and openness through communication. Nurse manager must develop safety climate strategies for hospital, and set training program about protection from occupational hazards for their employee.
Organizational climate – Occupational safety – Health for nurses
https://mjcu.journals.ekb.eg/article_55049.html
https://mjcu.journals.ekb.eg/article_55049_1825a7f79b42e9a6cf6f900f2262b7bd.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Common Health Problems and Risk Behaviors among Adolescent Males in Governmental Secondary Schools, Assuit Governorate
137
144
EN
MOSTAFA M. NABIL, M.Sc.;
MONA SADEK, D.N.Sc.
HEBA
MAGDY, D.N.Sc.
The Department of Community Health Nursing, Faculty of Nursing, Assiut* and Cairo** Universities
10.21608/mjcu.2018.55051
Abstract<br />Background: During adolescence, males have higher rates of morbidity and suffer from various health problems and risk behaviors.<br />Aim of the Study: To assess the most common health problems and risk behavior performed by adolescent males in Governmental Secondary Schools.<br />Subject and Methods: A descriptive cross sectional design was utilized in this study.<br />Setting: Gamal Farghaly Soultan Governmental Secondary School for males Assuit City.<br />Sample: One hundred fifty five students were chosen randomly from 3 different grades.<br />Tools: One questionnaire sheet composed of 3 parts: Part I: Demographic characteristic of the students, part II: Common health problems (physical, social and psychological), part III: Risk health behavior performed by secondary male students.<br />Results: Physically, 23.9% of the students had medical health problems, out of them the most common were respiratory problems (48.6%). Regarding psychological problems frus-tration was common among (25.8%), while the most common social health problem was peer pressure to perform risk behaviors (52.9%). The most common risk behavior was violence at school (27.7%). Smoking was correlated positively with age (p=0.001).<br />Conclusion: The most common physical, psychological and social health problems were as follow, respiratory prob-lems, frustration and peer pressure to perform risk behaviors while the most common risk behavior was violence at school.<br />Recommendation: More health educational programs to raise the awareness of secondary male students about how to avoid being engaged in health risk behaviors.
Male – Adolescents – School – Health problems – Risk behaviors
https://mjcu.journals.ekb.eg/article_55051.html
https://mjcu.journals.ekb.eg/article_55051_85237c07737defdf26169d948a169e79.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Pulmonary Hypertension in Predialysis Chronic Kidney Disease: Frequency and Potential Mechanisms
145
151
EN
MOHAMMED A. SOBH, M.D.;
AMAL M. ABDULAAL, M.D.
SOHEIR M. KASEM, M.D.;
MARWA K. ABDO, M.D.
HANAA M.
RIAD, M.Sc.
The Departments of Internal Medicine* and Clinical Pathology**, Faculty of Medicine, Assiut University
10.21608/mjcu.2018.55052
Abstract<br />Background: Pulmonary arterial hypertension (PH) and Chronic Kidney Disease (CKD) both profoundly affect patient outcomes, whether as primary disease states or as comorbid conditions. PH is a common comorbidity in CKD and vice versa. PH is an independent predictor of mortality in such patients. In a recent review, the prevalence of PHT in ESRD patients was reported to be around 40-50% however, the epidemiological data for this disorder in earlier stages of Chronic Kidney Disease (CKD) and the risk factors associated with its presence are scarce.<br />Aim: To evaluate the frequency of pulmonary hypertension among chronic kidney disease nondialysis dependent patients and to compare clinical and metabolic variables among those patients with the control group to search for possible mecha-nisms.<br />Subjects and Methods: 40 CKD patients (55% men, 45% women; mean age, 42.9±15.13 years) with. According to the magnitude of Glomerular Filtration Rate (GFR) decrease, the CKD patients have divided into 3 groups: (1) 2 patients with a GFR of 89-60ml/min; (2) 6 with a GFR of 59-45ml/min; (3) 32 with a GFR of 44-15ml/min. A control group consisted of 40 individuals with preserved kidney function (a GFR of >90 ml/min). Physical examination and echocardiography were performed in all the patients. The serum concentrations of homocysteine and serum PTH were determined.<br />Results: PH was detected in 20 (50%) of the 40 patients with CKD. As CKD progressed, the frequency of pulmonary hypertension in Groups 1, 2, and 3 increased, amounting to 18.2%, 24.2%, and 35%, respectively.<br />Conclusion: This study demonstrated a high frequency of pulmonary hypertension among patients with CKD without dialysis.<br />The frequency was highest among patients especially those with older age higher, serum creatinine phosphorus c-reactive protein parathyroid hormone and homocysteine; lower hemoglobin, lower EF% which all positively correlated with PASP and may be involved in the pathogenesis of pulmonary hypertension. Early detection of pulmonary hypertension is important in order to avoid the serious consequences of the disease, also managing these potential mechanisms will result in areduction in the occurrence of pulmonary hypertension and thus reducing the incidence of the cardiovascular compli-cations which are considered as one of the most important causes of death in the group of patients.
Pulmonary hypertension – Chronic kidney disease – Urea – Creatinine – Echocardiography – Ho-mocysteine – Parathyroid hormone
https://mjcu.journals.ekb.eg/article_55052.html
https://mjcu.journals.ekb.eg/article_55052_40f2487a16c1083e9e6c9ad5cddaf26d.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Subclinical Right Ventricular Dysfunction in Type 2 Diabetes Mellitus: An Echocardiographic Strain/Strain Rate Study
153
162
EN
YASER R. MOHAMMED, M.D.;
WAEL R. HABLAS, M.D.
ASHRAF M. ANWAR, M.D.;
SAMY H. NOUH, M.D.
ABD EL-HAMID I. ABD EL-HAMID, M.D.;
AYMAN T. EL-DESOUKY, M.Sc.
The Departments of Cardiology* and Clinical Pathology**, Faculties of Medicine, Al-Azhar University and Department of Cardiology, Fowa Central Hospital, Kafr El-Sheikh***, Egypt
10.21608/mjcu.2018.55054
Abstract<br />Background: Type II Diabetes Mellitus (DM) was accom-panied by subclinical impairment of Right Ventricular (RV) systolic dysfunction. Two-Dimensional (2D) Speckle Tracking Echocardiography (STE) allows a precise evaluation of myo-cardial function.<br />Aim of the Study: The aim of this study was to assess the RV systolic function in asymptomatic normotensive subjects with type II DM compared with control subjects, using strain/ strain rate qualification by 2D STE.<br />Subjects and Methods: Prospective study enrolled 100 subjects, they were classified into two groups: Group I included seventy subjects known to have type II DM (36 males and 34 females), mean age 41.37±4.72 years, and group II included thirty healthy subjects (15 males and 15 females) with mean age 39.40±3.14 years. All subjects had normal Left Ventricular (LV) Ejection Fraction (EF), calculated by conventional 2D Trans-Thoracic Echocardiography (TTE). Subjects who had diseases affecting LV and RV systolic functionwere excluded as hypertension, coronary artery disease, valvular diseases, arrhythmias, pulmonary diseases and pulmonary hypertension. All studied population were subjected to informed verbal consent, full history taking. General and cardiac examination were done. Resting standard 12-leads Electrocardiogram (ECG) has been recorded for analysis. HaemoglobinA1c (HbA1c %) level was measured for group I. 2D TTE and 2D STE were done for all subjects. LV global longitudinal strain (LVGLS%), RVGLS%, RV segmental peak Longitudinal Systolic Strains (LSS%) and RV segmental longitudinal systolic strain rates (LSSRs 1/sec) were assessed by 2D STE. Data were collected and statistically analysed.<br />Results: Both groups showed no statistically significant difference regarding LV linear internal dimensions, EF, LV Mass Index (LVMI), RV inflow linear dimensions, Fractional Area Change (FAC) and Tricuspid Annular Post-Systolic Excursion (TAPSE). Mean values of LVGLS and RVGLS were significantly lower in group I than in group II, as mean values for GLS of LV & RV were (–19.93±1.48, –21.49±3.80 for group I respectively versus –22.10±1.21, –26.40±2.86 for group II respectively) with (p-value <0.001). The mean values of RV segmental LSS were lower in group I than in group II as mean values for basal septum, mid septum, apical septum, basal RV free wall and apical RV free wall were lower in group I. (–14.81±4.02, –16.77±3.66, –18.20±3.42, –20.53± 2.14, –24.41±5.72 respectively) versus (21.03±1.35, –22.73± 2.00, –24.60±1.94, –30.37±3.11, –30.23±5.45 respectively) for group II, (p-value <0.001), except for mid RV free wall which showed no statistically significant difference between both groups. No statistically significant difference between both groups was detected regarding mean values of RV seg-mental (LSSRs 1/sec), except for apical RV free wall which were significantly lower in group I (1.18±0.54) than in group II (1.48±0.54), (p-value=0.022). There was a reverse correlation between GLS of LV and RV with the duration of diabetes and the level of HbA1 C.<br />Conclusion: Subjects with type II DM were associated with subclinical LV & RV systolic dysfunction compared with control subjects.
Glycated haemoglobin – Global longitudinal strain – Speckle tracking echocardiography
https://mjcu.journals.ekb.eg/article_55054.html
https://mjcu.journals.ekb.eg/article_55054_868a991ea2da638bccd626bdf391afc0.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Short Term Follow-up in Patients with Stable Chronic Heart Failure on 5-Phosphodiesterase Inhibitor Sildenafil
163
168
EN
MAHMOUD S.
ABD EL-MONEUM, M.D.
The Department of Cardiology, Faculty of Medicine, Benha University
10.21608/mjcu.2018.55067
Abstract<br />Background: The increased Pulmonary Artery (PA) pres-sure is due to disturbances in key vascular mediator pathway including relative deficiencies of vasodilators such as Nitric Oxide (NO) and prostacyclins. Vasodilators such as 5- phosphodiesterase Inhibitor (sildenafil) are a natural initial therapeutic choice.<br />Objectives: The study was designed to investigate whether a 50mg twice daily of sildenafil could improve exercise performance, ventilatory efficiency, oxygen uptake kinetics and pulmonary hypertension in patients with stable Chronic Heart Failure (CHF).<br />Methods: Single center, double-blind, placebo-controlled, parallel-group, randomized clinical trial of one hundred patients with stable CHF, Group (A) including fifty patients who received only the standard therapy of CHF (control group), Group (B) including fifty patients who received Sildenafil in addition to standard CHF therapy (active group) for six months. All patients who met screening criteria under-went baseline studies (history and physical examination, cardiopulmonary exercise tests including [peak exercise (VO2 peak), ventilatory efficiency (VE/VCO2 slope) and Recovery Gas Exchange (T1/2VO2min- T1/2VCO2min)] and echocar-diography for assessment of mean Pulmonary Artery Pressure (mPAP) and LV systolic function) and were then randomly assigned in a 1:1 ratio, to receive either sildenafil or placebo.<br />Results: There was statistically significant difference between Group (A) and Group (B), significant improvement in VO2 peak,VE/VCO2 slope, T-1/2Vo2 (min), T-1/2VCO2 (min) and mean Pulmonary Artery Pressure (mPAP) occurred in Sildenafil group (group B) with p-value <0.05, while in the control group (group A), there was no significant improve-ment in all parameters. After using sildenafil in patient with stable CHF for 6 months the mPAP decreased by 20% in sildenafil group and 2% in the controlled group. There was also improvement in ventilatory efficiency and exercise performance.<br />Conclusion: 5-phosphodiesterase Inhibitor (sildenafil) may be benificial as adjunctive therapy for patients with Chronic Heart Faluire (CHF).
Sildenafil – Heart failure
https://mjcu.journals.ekb.eg/article_55067.html
https://mjcu.journals.ekb.eg/article_55067_8ece579d3cfef33477c9f2ec3f2042ea.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Effects of Administration of Tramadol Hydrochloride on the Histological Structure of the Kidney and the Possible Protective Role of Curcumin in Adult Albino Rat
169
178
EN
DORREIA A.M. ZAGHLOL, M.D.;
SALWA M. OUIES, M.D.
NAGLAA
H. ABBAS, M.Sc.
The Department of Human Anatomy & Embryology, Faculties of Medicine, Assiut* and Sohag** Universities
10.21608/mjcu.2018.55071
Abstract<br />Introduction: Tramadol is a synthetic centrally acting analgesic with effects similar to those of codeine and 10 times less than morphine. Tramadol has a wide range of applications mostly in the treatment of moderate to severe, acute or chronic pain. Curcumin, the active component of Curcuma longa, has antioxidative, anti-fibrotic, anti-inflammatory and anti-proliferative properties.<br />Aim of the Work: The aim of the study was to detect the toxic effects of tramadol on the histological structure of the renal tissue in adult male albino rats and the possible protective role of curcumin against these effects.<br />Material and Methods: 30 adult albino rats were used. The animals were divided into three equal groups: Group I: (control group): Animals were given normal saline orally by intragastric tube in a dose of 25ml/kg every day for one month. Group (II): Animals were given Tramadol Hydrochloride in a dose of 25mg/kg orally by intragastric tube every day for one month. Group (III): Animals were given Tramadol Hy-drochloride in a dose of 25mg/kg and Curcumin solution in a dose of 80mg/kg orally by intragastric every day for one month. At the end of the experiment, the rats were anaesthetized by ether then perfused with saline then with the appropriate fixator, the kidney was obtained and subjected to light and transmission electron microscopic studies.<br />Results: Tramadol caused damage, shrinkage and lobula-tion of renal glomeruli. It also caused dilatation in the distal and proximal convoluted tubules with loss of their brush borders as seen by light and electron microscope. Adminis-tration of curcumin improved the structure of the renal glomer-uli, proximal and distal convoluted tubules.<br />Conclusion: Tramadol caused damage in the renal cortex with dilatation of tubules. The addition of curcumin partially improved these toxic effects.
Kidney – Tramadol – Curcumin
https://mjcu.journals.ekb.eg/article_55071.html
https://mjcu.journals.ekb.eg/article_55071_de80c51b8e8ce8702fa8a672fbb46ed7.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Discharge Needs of Patients after Total Hip Arthroplasty
179
185
EN
EMAN M. HOSNY, M.Sc.;
BASSAMAT O. AHMED, D.N.Sc.
AMEL G.
ABD EL-NABY, D.N.Sc.
The Department of Medical Surgical Nursing, Faculty of Nursing, Cairo University
10.21608/mjcu.2018.55073
Abstract<br />Background: Discharge needs are known to be common problems for total hip arthroplasty (THA) patients due to surgical and technological developments of arthroplasty, treatment procedures, and reducing the duration of hospitali-zation. Hence, nurses play an important role in assessment of discharge needs of patients following THA.<br />Aim of the Study: Is to explore discharge needs of patients after total hip arthroplasty.<br />Material and Methods: Convenient sample of all male and female patients scheduled to undergo THA, above 50 years, performing the surgery for the first time, having hip osteoarthritis. Data was collected using the following two tools: (a) Demographic and Medical Background Information Form, and (b) Arthroplasty Discharge Needs Assessment Tool (ADNA).<br />Results: The majority of sample aged between 51 to 70 years with a mean of 60.6±6.7. Moreover, the majority of participants were females and married with a percentage of 58.3% and 86.7% respectively. Before discharge and two weeks after being discharged, all the participants expressed their unsatisfactory level of information in almost all categories of ADNA with the exception of home setup category. Conse-quently the overall ADNA scores prevail unsatisfactory.<br />Conclusion: The study concluded that, the studied subjects had unmet needs following THA before discharge and two weeks after being discharged.<br />Implications: Significant implication involves the need for further collaboration between health care providers and patients related to the kind and amount of information needed by hip arthroplasty patients especially after being discharged from hospital.<br />Recommendation: Longitudinal study should be designed to determine the long term needs for this group of patients over a long period of time.
Total hip arthroplasty – Osteoarthritis – Discharge needs
https://mjcu.journals.ekb.eg/article_55073.html
https://mjcu.journals.ekb.eg/article_55073_fd579854010a7417b7ad3ecf95d7f8ac.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Sphincter Saving Surgery in Locally Advanced Low Rectal Cancer after Neoadjuvant Chemoradiotherapy
187
193
EN
ISMAIEL A. MOURAD, M.D.;
HISHAM A. EL-HOSSIENY, M.D.
ABDEL-HAMID H. EZZAT, M.D.;
IHAB S. HUSSEIN, M.D.
MOHAMMAD T. FOUAD, M.Sc.;
RASHA M. ALLAM, M.D.
The Departments of Surgical Oncology*, Radiation Therapy** and Biostatistics & Cancer Epidemiology***, National Cancer Institute, Cairo University, Egypt
10.21608/mjcu.2018.55075
Abstract<br />Aim: To evaluate the feasibility of sphincter saving surgery in locally advanced low rectal cancer after neoadjuvant concomitant chemoradiotherapy (CCRT) by assessing the effect of CCRT on downstaging of primary tumor, hence sphincter preservation rate and outcome.<br />Patients and Methods: Patients presenting to the National Cancer Institute-Cairo University from May 2014 to October 2014; with locally advanced low (3-6m from the anal verge) rectal cancer received long-course CCRT and the response was evaluated, then they were subjected to APR or sphincter saving surgery.<br />Results: The study started by 60 patients; 33/60 (55%) underwent APR, 25/60 (41.7%) underwent sphincter saving surgery and 2/60 patients (3.3%) lost follow-up.<br />The clinical response was assessed by the status of the distance from the anal verge: It increasedin 23/60 patients (38.33%), stationary in 17/60 patients (28.33%) and decrea-sedin 20/60 patients. The radiological response showed: downstaging occurred in 27/60 (45%). Pathological response revealed: Down-staging in 28/58 patients (48.3%).<br />Negative distal margin was obtained in all patients had sphincter saving surgery with one case only had positive radial margin.<br />Conclusion: Sphincter saving surgery is an oncologically safe alternative to the standard APR in low rectal cancer, with the added benefit of avoiding a permenant stoma. The use of preoperative concomitant chemoradiotherapy (CCRT) enhances the rate of sphincter saving surgery by downsizing and down-staging of the tumors.
Low rectal cancer – Sphincter saving surgery – Neoadjuvant chemoradiotherapy
https://mjcu.journals.ekb.eg/article_55075.html
https://mjcu.journals.ekb.eg/article_55075_c0c33c29a920b98667b7ac79aa62c235.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Vitamin D Receptor Gene Polymorphisms and Vitamin D Levels in Egyptian Patients with Diabetic Nephropathy and Type 2 Diabetes Mellitusus
195
205
EN
WALEED M. FATHY, M.D.;
GEHAN A. TAWFEEK, M.D.
GEHAN A. TAWFEEK, M.D.;
AZZA M. ABDU ALLAH, M.D.
AHMED R.
TAWFEEK, M.D.
10.21608/mjcu.2018.55077
Abstract<br />Aim: Type 2 diabetes and diabetic nephropathy are asso-ciated with multiple genetic variables. This study aimed to investigate the role of the vitamin D receptor (VDR) BsmI gene polymorphism and the serum level of vitamin D in Egyptian patients with diabetic nephropathy and type 2 dia-betes.<br />Material and Methods: This study involved 80 patients with type 2 diabetes without nephropathy (T2DM), 80 patients with diabetic nephropathy (DN) and 100 healthy individuals as controls. VDR BsmI gene polymorphisms were determined by PCR-RFLP, and vitamin D serum levels were determined by the electrochemiluminescence binding assay.<br />Results: The distribution frequencies of the Bb, bb and Bb+bb genotypes in patients with DN were significantly different from those in the controls (p<0.001) and in those with T2DM (p<0.001). In addition, the b allele frequency was significantly higher in the DN group than the healthy control (OR=6.3, 95% CI, 3.7-10.7, (p<0.001) and T2DM groups (OR=1.91, 95% CI 4.0-13.5, p<0.001). The patients with DN had significantly lower levels of serum vitamin D than both the healthy controls and T2DM patients (p<0.001). Using multivariate regression analysis, diabetes duration, HbA1C, vitamin D deficiency and BsmI genotype were found to be independent risk factors for DN (p=0.019, 0.036, 0.001, 0.035, respectively).<br />Conclusion: The VDR BsmI gene polymorphism and vitamin D deficiency are risk factors for type 2 diabetes and diabetic nephropathy.
Diabetes – Diabetic nephropathy – Egyptian population – Vitamin D deficiency – VDR gene polymorphisms – Risk assessment
https://mjcu.journals.ekb.eg/article_55077.html
https://mjcu.journals.ekb.eg/article_55077_300866155f914ae4db3566a05b2fd076.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Antinucleosome Antibody in Children and Adolescents with Systemic Lupus Erythematosus
207
214
EN
YASMINE A.A. ABUZAID, M.Sc.;
MOHAMAD A. EL-GAMASY, M.D.
AMAL S. EL-BENDARY, M.D.;
HEND ABDEL-NABI, M.D.
MAHER A.
ABDEL-HAFEZ, M.D.
The Departments of Pediatrics* and Clinical Pathology**, Faculty of Medicine, Tanta University, Egypt
10.21608/mjcu.2018.55078
Abstract<br />Background: SLE is an autoimmune disease of unknown etiology characterized by the production of abroad and heter-ogeneous group of autoantibodies. These autoantibodies are directed to nuclear, cytoplasmic, and cellular membrane antigens. Recently, it was proposed that the nucleosome is the principal antigen in the pathophysiology of SLE, and that anti-Nuc antibodies are associated with organic damage.<br />Aim of the Study: The aim of this work was to study the potential utility of serum levels of anti- nucleosome antibodies as a diagnostic tool and a disease activity marker in children and adolescents with systemic lupus erythematosus.<br />Patients and Methods: The study was carried out on forty five patients with SLE who attended to the outpatient clinic and inpatient of Pediatric Nephrology matched age and sex served as a control group. All studied children were subjected to full history, complete physical examination, SLEDAI score, routine laboratory investigations and anti-dsDNA and anti-nucleosome antibody IgG assay. Data was analyzed by using SPSS.<br />Results: The mean serum level of anti-Nuc antibody was significantly higher in patients than controls (p-value <0.001). But there was no significant difference between patients' subgroups. There was a weak correlation between serum anti-Nuc antibody and SLEDAI score (r: 0.213) but strong corre-lation between anti-dsDNA antibody and SLEDAI score (r: 0.711). Anti-Nuc antibody showed higher sensitivity but equal specificity to anti-dsDNA antibody for the diagnosis of SLE.<br />Conclusion: Anti-nucleosome antibodies are superior to anti-dsDNA antibodies in the diagnosis of SLE especially in anti-dsDNA negative patients as they have higher sensitivity but as regard to disease activity antidsDNA antibody is more accurate.
Systemic lupus erythematosus – Antinucleosome antibody IgG assay by ELISA
https://mjcu.journals.ekb.eg/article_55078.html
https://mjcu.journals.ekb.eg/article_55078_e6bb2935c01e3515edcab03d9e5f3546.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Induced Membrane (Masquelet) Technique for Treatment of Long Bone Defects
215
222
EN
AHMED M. LASHIN, M.Sc.;
WEAM F. MOUSA, M.D.
MOHAMED M. HOSNI, M.D.;
EL-SAYED M.E. EL-FORSE, M.D.
The Department of Orthopaedic Surgery, Faculty of Medicine, Tanta University, Egypt
10.21608/mjcu.2018.55079
Abstract<br />Background: Reconstruction of large segmental bone defects following trauma, tumor resection or debridement of an infected segment, is a complicated problem with significant long-term morbidity, both for anatomical and functional results. Treatment of large bone defects represents a great challenge, as bone regeneration is required in large quantity and may be beyond the potential for self-healing. A two-stage technique uses induced biologic membranes with delayed placement of bone graft to manage this clinical challenge. In the first stage, a polymethyl methacrylate spacer is placed in the defect to produce a bioactive membrane. In the second, cancellous autograft is placed within this membrane and, via elution of several growth factors, the membrane appears to prevent graft resorption and promote revascularization and consolidation of new bone. Excellent clinical results have been reported, with successful reconstruction of segmental bone defects >20cm.<br />Objective: The aim of the present study is to evaluate the Masquelet technique in the treatment of post-traumatic seg-mental bone defects.<br />Study Design and Setting: A prospective study.<br />Patients and Methods: This study included twenty patients having segmental bone defects ranging from 4 to 19cm (av-erage 6.35cm) either post-traumatic or following resection of the infected segment in cases of infected un-united fractures. All cases were treated using induced membrane (Masquelet) technique. The mean follow-up period was 11 months.<br />Results: Union was achieved in 17 patients (85%). Satis-factory end results were achieved in fifteen patients (75%) according to the system modified by El-Rosasy from Paley et al., Reconstruction failure with non-union occurred in three patients. Infective complications occurred in two patients (10%). Both of them suffered from non-union.<br />Conclusion: The technique of delayed bone grafting after initial placement of a cement spacer provides a reasonable alternative for the challenging problem of significant bone loss in extremity reconstruction.
Bone defects – Induced membrane – Masquelet
https://mjcu.journals.ekb.eg/article_55079.html
https://mjcu.journals.ekb.eg/article_55079_7386881827353e909153ab7c78ef4c68.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Total Knee Replacement in Genu Valgum
223
229
EN
IBRAHEM MOSTAFA, M.D.;
ABDALLA ABUSENNA, M.D.
TARIK ABD EL-GHAFAR, M.D.;
HANY EL-BARDESY, M.Sc.
The Department of Orthopaedic Surgery, Faculty of Medicine, Al-Azhar University Hospitals
10.21608/mjcu.2018.55081
Abstract<br />Background: The treatment of Genu valgum with grade IV OA is a challenge in TKR. For this reason it is important to correct the deformity during surgery even if it does not completely eliminate the increased risk of failure.<br />Methods: This is a prospective study was conducted on 25 knees (22 patients) suffering from grade IV OA with genu valgum presented to Al-Azhar University Hospitals and Agouza Charity Hospital from October 2013 to November 2016, mean follow-up duration is 24 months no missed patients in the follow-up, three of this patients (12%) had bilateral genu valgum. Only 15 knee (60%) had about 10 degrees valgus deformity (type 1), 5 knees (20%) had about 11-20 degrees valgus deformity (type 2) and 5 knees (20%) had 21-30 degrees valgus deformity (type 3). Patients had a mean age at the time of surgery of 59 years (range from 50 to 68 years), the group of patients included 17 females (77%) and 5 males (23%), 11 patients (50%) had the right knee only replaced (9 females and two males), 8 patients (36%) had left one only (6 females and two males), while 3 patients (12%) had bilateral TKR (2 females and one male).<br />Result: At the last follow-up for all patient's the average Hospital for Special Surgery knee score was 87.82 (ranging from 72 to 94) compared with average preoperative Hospital for special surgery knee score of 66.32 (ranging from 48 to 78), with an average increase of 21.50.<br />Conclusion: In type I valgus deformity we do medial parapetellar approach, release of the posterolateral capsule then we may proceed in our sequence of soft tissue release, we prefer to use PS implant. In type II valgus deformity we do medial parapetellar approach, then we proceed in our sequence of soft tissue release (ITB, POP, LCL, LHG + LCL, POP, ITB + LHG). The choice of the level of constraint was on the operative field, based on the integrity and functionality of the MCL. If there is a medial residual instability do not perform a medial tightening, but switch to a higher constrained implant (CCK) instead of PS implant. In type III valgus deformities we do lateral parapetellar approach ± TTO then we prefer to use a CCK implant.
Knee – Valgus – Valgum – Arthroplasty
https://mjcu.journals.ekb.eg/article_55081.html
https://mjcu.journals.ekb.eg/article_55081_bc88b45aac053c8f7aa5d7b630439170.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Effect of Core Stability Training on Knee Proprioception after Anterior Cruciate Ligament Reconstruction
231
240
EN
ALAA I.M.M. EL-KADY, M.Sc.;
ALAA EL-DIN A. BALBA, Ph.D.
MAHA M. MOHAMMED, Ph.D.;
AHMED H. WALY, M.D.
The Departments of Musculoskeletal Disorders & Their Surgeries, Faculty of Physical Therapy, Cairo University* and Orthopedic Surgery, Faculty of Medicine, Alexandria University**, Egypt
10.21608/mjcu.2018.55091
Abstract<br />Background: Decreased core stability reduce activity participation of athlete. Deficits of core stability is neuromus-cular risk factor for anterior cruciate ligament (ACL) injury.<br />Purpose: This study was conducted to study the effect of core stability training (CST) on knee proprioception and function after ACL reconstruction.<br />Methods: Thirty patients of both gender after ACL reconstruction. Their age ranged from 20-30 years. All patients were referred by the orthopedic surgeon who was responsible for diagnosis and surgery based on clinical and radiological examination. They were randomly assigned into 2 groups group A included 15 patients received standard ACL rehabil-itation protocol and group B included 15 patients received CST in conjugation with standard ACL rehabilitation protocol. Three sessions per week for 8 weeks. The study was conducted in the duration from August 2016 till August 2017 at a private orthopedic and arthroscopic center.<br />Evaluation: The digital inclinometer has been used to assess knee proprioception (joint position sense) after ACL reconstruction.<br />Results: Showed that both standard ACL rehabilitation protocol (group A) and CST in conjugation with standard ACL rehabilitation protocol (group B) were effective in improving the knee proprioception.<br />Conclusion: There was no significant difference in knee proprioception between standard rehabilitation protocol with or without CST, however there was clinical difference and high percent of improvement in adding CST to standard rehabilitation protocol.
Core stability – ACL reconstruction – Rehabili-tation – Proprioception
https://mjcu.journals.ekb.eg/article_55091.html
https://mjcu.journals.ekb.eg/article_55091_f73e0f1bf803791b3263364da08dc26c.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Effect of Neuromuscular Training with Rigid Tape Versus Strength Training on Functional Performance of Knee Osteoarthritis
241
253
EN
AYA A.E.N. NADA, M.Sc.;
ALAA ELDIN A. BALBA, Ph.D.
MAHA M. MOHAMMED, Ph.D.;
AHMED H. WALY, M.D.
The Departments of Musculoskeletal Disorders & Their Surgeries, Faculty of Physical Therapy,
Pharous* & Cairo** Universties and Orthopedic Surgeries, Faculty of Medicine, Alexandria University***, Egypt
10.21608/mjcu.2018.55093
Abstract<br />Background: Osteoarthritis of the knee involving predom-inantly the medial tibiofemoral compartment is common in older people, giving rise to pain and loss of function, Neu-romuscular exercises are typically performed in functional weight-bearing positions emphasizing quality and efficiency of movement, as well as Rigid taping (RT) is an effi-cient way of treatment of pain relief.<br />Purpose: This study was conducted to detect the effect of neuromuscular training with Rigid taping versus strength training on functional mobility in medial compartment knee osteoarthritis.<br />Methods: This study was conducted on thirty patients both gender with mild to moderate OA of medial compartment knee OA . Their age ranged from 45-55 years old. All patients were referred by orthopedic surgeons who are responsible for diagnosis based on clinical and radiological examination. They were randomly assigned into two groups Group (A) received strength training exercises and Group (B) received neuromuscular exercises with rigid tape for three sessions per week for one month. The study was conducted from September 2016 to May 2017 at the department of physical therapy at Abo Keir Hospital, Alexandria, at the out clinic at pharous university and a Private hospital at Alexandria.<br />Methods of Evaluation: Thirty seconds chair stand test (30-CST) test for the assessment of functional performance,<br />Results: Showed that both strength training (group A) and neuromuscular exercises with rigid tape (group B) were effective in improvement of functional performance, but strength training (Group A) were less effective than neuromus-cular exercises with rigid tape.<br />Conclusion: It can be concluded that both strength training and neuromuscular exercises with rigid tape are effective treatment for medial compartment knee OA in terms of func-tional performance.
Strength training – Neuromuscular exercises – Rigid tape and medial compartment knee osteoar-thritis – Functional performance
https://mjcu.journals.ekb.eg/article_55093.html
https://mjcu.journals.ekb.eg/article_55093_de1b7717a8b4983017970f50f4455987.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Biliopancreatic Diversion Versus Gastric Bypass in the Surgical Treatment of Type 2 Diabetes Mellitus in Patients with Body Mass Index Below 35
255
263
EN
MOHAMED SHETIWY, M.D.;
NASHAT ABD EL-RAZEK, M.D.
HOSAM EL-GHADBAN, M.D., M.R.Cs.;
ASHRAF ABBAS, M.D.
AHMED NEGM, M.D.;
MOHAMED SAMIR, M.D., M.R.Cs.
MAGDY BASHEER, M.D.;
ABD EL-RAHMAN EL-BAHY, M.D.
ASHRAF
SHOMA, M.D., F.R.Cs.
The Department of General Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt
10.21608/mjcu.2018.55096
Abstract<br />Background: Type 2 Diabetes Mellitus (T2DM) is an important health problem worldwide with about 23% of patients with morbid obesity have type 2 DM. Bariatric surgery originally developed solely as a weight-reduction therapy, but has been found to improve T2DM and to reduce rates of chronic vascular disease and death. The International Diabetes Federation have recommended consideration of bariatric surgery for control of T2DM.<br />Methods: A total number of 45 patients were randomized into two groups, the first group with 26 patients (n=26) were submitted for Biliopancreatic Diversion (BPD) and the second group with 19 patients (n=19) were planned for Roux-en-Y Gastric Bypass (RYGBP). The main objective was to compare the efficacy of bariatric surgery in inducing clinical remission of T2DM mellitus in patients with body mass index less than 35 in both groups.<br />Results: The operations were performed laparoscopically in all patients. There were no conversions, operative compli-cations or mortality. Data were collected during a two-year follow-up period and were analyzed at the following periods; pre-operatively and post-operatively at 1 months, 4 months, at 8 months, at 1 year and 2 years. The analyzed parameters included the levels of BMI, FBG, HbA1c, Triglycerides and cholesterol. There were no statistical significant difference between the two groups regarding the BMI, mean glucose levels, and HbA1c levels. However the levels of triglycerides were higher in the BPD group, while the levels of cholesterol were higher in the RYGBP group during most of the follow-up periods.<br />Regarding the diabetes outcome, there was significant reduction of patients who showed diabetes remission at one year and those who remains remittent at 2 year, while the number of patients who showed diabetes failure tripled at 2 years follow-up.<br />Conclusions: Although, BPD is known to have a better effect on type 2 DM in the higher BMI group. There was no difference regarding glycemic control between BPD and RYGBP. And both operations failed to maintain glycemic control at long term follow-up periods.
BPD – RYGBP – Metabolic surgery – Surgical treatment of T2DM – Low BMI
https://mjcu.journals.ekb.eg/article_55096.html
https://mjcu.journals.ekb.eg/article_55096_ec58e77bbc8ea251e24d8388f25cbab2.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Knowledge, Attitude and Practice of Health Care Providers at Primary Health Care Setting Regarding Stunting Among Egyptian Under Five Years
265
273
EN
NESREEN M. KAMAL ELDEN, M.D.;
MERVAT EL-RAFIE, M.D.
SHAMAILA M.
ZAMIR UL HASSAN, M.Sc.
The Departments of Public Health and Community Medicine, Faculty of Medicine, Cairo University
10.21608/mjcu.2018.55097
Abstract<br />Background: Children malnutrition constitutes one of the major public health problems in Egypt. Healthcare personnel lack adequate nutrition knowledge and they also lack the competence and skills to provide basic nutrition advice to their clients.<br />Aim: To assess the knowledge, attitude and practice (KAP) of health care providers about chronic malnutrition (stunting) in children under-five in primary health care (PHC) centers and to identify the main items in which health care provides are trained including Integrated Management of Childhood Illness (IMCI) supporting the problem of stunting.<br />Subjects and Methods: This is a cross-sectional descriptive study including all healthcare providers (N=51 doctors and 31 nurses), who were involved in the nutrition care of children under-five at PHC centers in Giza Governorate, at the time of the study. Data were collected using a structured question-naire for KAP of healthcare providers regarding chronic malnutrition (stunting) and training of healthcare providers, and using a checklist to record performance of healthcare providers providing nutrition related services to children under- five.<br />Results: Overall, the mean percent knowledge score of healthcare providers about 'main health problems', 'main nutritional problems' and 'nutritional assessment methods' in children under five was below 50. Healthcare providers had overall positive attitude towards characteristics and manage-ment of stunting in children under-five. The mean percent score for 'Reported Practice related to breast feeding' was higher in nurses, where as reported practice related to com-plementary feeding was higher in doctors. More than 64.5% of healthcare providers reported correct practice regarding recommendation of micronutrient supplementation to children and mothers. Overall healthcare providers' performance re-garding communication and nutrition related services to children under five was suboptimal, but the nurses performing better than doctors. More than 70% of healthcare providers were trained in IMCI but there was a deficiency in nutritional training.<br />Conclusion: The healthcare providers had optimal knowl-edge regarding some aspects of stunting. There was no signif-icant difference between doctors' and nurses' KAP in most of the items. Although they had overall positive attitude towards stunting and the majority were trained in IMCI, they showed suboptimal performance during care of children under five at PHC. The results of the study directed us to some of the recommendations as, preservice, on job and continuous prac-tical training of the health care providers on comprehensive management of malnutrition, improving the quality of health care services in PHCs and prioritizing key 1000 days window concepts in nutrition counseling for future trainings.
Knowledge Attitude and Practice (KAP) – Train-ing,healthcare providers (HCP) – Primary health-care (PHC) – Chronic malnutrition – Stunting
https://mjcu.journals.ekb.eg/article_55097.html
https://mjcu.journals.ekb.eg/article_55097_15181983ad1c4453be872460a6f07eca.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
The Relation between Helicobacter Pylori Infection and Severity of Bronchial Asthma in Children
275
280
EN
MARWA G.A. KHATER, M.Sc.;
NABIL M. EL-ESAWY, M.D.
AHMED M. ABDEL-RAZIK, M.D.;
NAHLA A. NOSAIR, M.D.
The Departments of Pediatrics* and Clinical Pathology**, Faculty of Medicine, Tanta University, Tanta, Egypt
10.21608/mjcu.2018.55099
Abstract<br />Background: Asthma is a chronic lung disease character-ized by wheezy chest, resulting from allergic inflammation and hyperresponsivness of the bronchi to various stimuli. Microbial exposures have been suggested to confer protection from allergic disorders and reduced exposures to gastrointes-tinal microbes have been proposed as an explanation for the increase in asthma prevalence and severity. Since the general prevalence of Helicobacter pylori has been decreasing, we hypothesized that H.pylori status may be inversely related to the severity of asthma.<br />Aim of Study: This study was coducted to evaluate the relation between Helicobacter pylori infection and bronchial asthma in children.<br />Patients and Methods: The study was carried out on sixty children with asthma who attended to the outpatient clinic of Chest and Allergic Diseases, Pediatric Department, Tanta University Hospital. Also, it included thirty apparently healthy children with matched age and sex who served as a control group. All studied children were subjected to full history taking, complete physical examination, pulmonary function test and detection of H.pylori antigen in stool by ELISA. Data was analyzed by using SPSS.<br />Results: There is significant association between severity of asthma and result of H.pylori so with increase severity of asthma there is decrease in percentage of positive H.pylori results. As regard pulmonary function tests (FEV 1 and PEFR), there was statistically significant difference between positive H.pylori asthmatic and negative H.pylori asthmatic children. There was no statistically significant difference between patient's sex or age and results of H.pylori infection test.<br />Conclusion: There is a significant inverse association between severity of asthma and result of H.pylori infection (by H.pylori Ag in stool). This association is not affected by ages and sex of patients.
Bronchial asthma – H.pylori – H.pylori antigen in stool by ELISA
https://mjcu.journals.ekb.eg/article_55099.html
https://mjcu.journals.ekb.eg/article_55099_288e87e50599fd2d42e23c180ec60c08.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Possible Therapeutic Effect of Crocin on Thioacetamide-Induced Liver Injury in Male Albino Rats
281
287
EN
RAMEZ A.E.
BARHOMA, M.D.
The Department of Physiology, Faculty of Medicine, Tanta University, Tanta, Egypt
10.21608/mjcu.2018.55104
Abstract<br />Background: Thioacetamide is an experimentally used hepatotoxic substance. Its hepatotoxicity is mainly due to increased cellular oxidative stress.<br />Aim: To evaluate the possible hepatoprotective effects of crocin on the damage induced by Thioacetamide in liver of male rats.<br />Methods: 50 male Wister rats were divided into 5 groups, 10 rats in each group; control group; given intraperitoneal injection of 1ml normal saline daily, thioacetamide group; received intraperitoneal injection of thioacetamide in a single dose (300mg/kg), and three (Crocin + Thioacetamide) groups, received crocin in doses of 12.5, 25 and 50mg/kg respectively after thioacetamide intoxication, as in group 2. Then the animals were anaesthetized, blood samples were taken by cardiac puncture. Serum levels of aspartate amino transferase (AST), alanine amino transferase (ALT), and alkaline phos-phatase (ALP) were determined. Moreover, the tissue levels of malondialdehyde (MDA), reduced glutathione (GSH) and glutathione peroxidase (GPx) were measured in liver tissue.<br />Results: Compared to control group, thioacetamide group, showed significant increase in serum levels of AST, ALT, ALP, and tissue levels of MDA, with significant decrease in tissue GSH and GPx. Crocin treatment significantly decreased serum levels of AST, ALT, ALP, and tissue levels of MDA and significantly increased tissue GSH and GPx, in a dose dependant manner.<br />Conclusion: Crocin treatment attenuated the liver injury caused by thioacetamide and its clinical application might be a new therapeutic approach in the liver diseases due to its anti-inflammatory and antioxidant properties.
Crocin – Thioacetamide – Antioxidant – Reduced glutathione
https://mjcu.journals.ekb.eg/article_55104.html
https://mjcu.journals.ekb.eg/article_55104_6514a1b8e43f05b2d89177ad63232be2.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Intermittent Exotropia, When to Recommend Glasses and When to Perform Surgery?
289
296
EN
SHAIMAA H.M. SOKEER, M.Sc.;
AHMED L. Aы, M.D.
EL-SAYED S.
ARAFA, M.D.
The Department of Ophthalmology, Faculty of Medicine, Tanta University, Tanta, Egypt
10.21608/mjcu.2018.55106
Abstract<br />Aim of Work: The aim of this study is to determine which type of intermittent exotropia that may be corrected by glasses and which type that is best corrected by surgery and to evaluate the condition of binocular functions both before and after wearing glasses and before and after surgery.<br />Patients and Methods: Fifty patients (3 to 25 years) with intermittent exotropia were evaluated using a new scale to assess the level of control for both distance and near fixation. Near stereoacuity was evaluated with Tetmus Fly test. Diag-nosis of IXT was based on history taking from patients or their parents and clinical examination.<br />Results: The 50 patients with intermittent exotropia had mean age of 9.56-}6.48 with range between (3-25) years. Twenty six patients (52%) were below 10 years and 24 patients (48%) were above 10 years, 34 patients (68%) were males and 16 patients (32%) were females. The mean spherical was –2.88±7.3 1 . The BCVA ranged from 0.40 to 1.0 log MAR (mean 0.69±0.16). Pretreatment distance deviation of exotropia ranged from15 to 80A (mean 3 8.40±16. 14). Twenty four patients (48%) underwent surgery, glasses were prescribed for 8 patients (16%) and over-correcting minus lenses were prescribed for 18 patients (36%).<br />Conclusions: Over correcting minus lenses should be prescribed for IXT patients with the following criteria: high AC/A ratio, moderate to good control of exotropia, a tempo-rizing measure for young patients waiting for surgery and sometimes for patients with undercorrection after surgery. Glasses should be prescribed for IXT patients with the fol-lowing criteria; refractive error either astigmatism or myopia, moderate to good control of exotropia, and small angle of deviation. IXT patients with the following criteria should be corrected by surgery: Gradual loss of fusional control as evidenced by increasing frequency of the manifest phase of the strabismus, an increase in size of the basic deviation, development of suppression and decrease of stereoacuity.
Intermittent exotropia – Glasses – Surgery
https://mjcu.journals.ekb.eg/article_55106.html
https://mjcu.journals.ekb.eg/article_55106_3cca19fd34625d4ea93198691e1e6202.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Fundus Fluorescein Angiography Versus Optical Coherence Tomography Angiography in Evaluation of Retinal Changes in Cases of Retinal Vein Occlusion
297
303
EN
HASHEM H. GHORABA, M.Sc.;
MOSTAFA A. ABO EL-ENIN, M.D.
MAGDY S. MOUSSA, M.D.;
TAMER E. WASFY, M.D.
The Department of Ophthalmology, Faculty of Medicine, Tanta University, Tanta, Egypt
10.21608/mjcu.2018.55109
Abstract<br />Background: Retinal Vein Occlusion (RVO) is the second most common retinal vascular disease and the fifth common cause of visual loss worldwide. Fundus Fluorescein Angiog-raphy (FFA) is the gold standard investigation for its evaluation. However, it has some limitations. Optical Coherence Tomog-raphy Angiography (OCTA) is a novel technique for evaluation of retinal vascular changes. It may overcome some of the limitations of FFA.<br />Objective: Comparison between FFA and OCTA in eval-uation of retinal changes in retinal vein occlusion.<br />Methods: This prospective observational case series study was carried out on 30 eyes of 29 patients attending Ophthal-mology Outpatient Clinic in Tanta University Hospital from July 2016 to May 2017. FFA and OCTA were done to all patients at time of diagnosis. The results of both modalities were compared regarding macular ischemia, macular edema, microaneurysms, collaterals and neovascularizations.<br />Results: OCTA detected macular ischemia in the superficial plexus of 17 cases while it detected ischemia in the deep plexus of 25 cases. FFA detected macular ischemia in 9 cases and couldn't comment on ischemia in 5 cases. FFA detected macular edema in 23 cases while OCTA detected only 20 cases. Both collaterals and neovascularizations were detected in 3 separate cases by both OCTA and FFA. Microaneurysms were detected in 8 cases by FFA and in 4 cases by OCTA.<br />Conclusion: OCTA was superior to FFA in detection of macular ischemia. Both modalities were equal in detection of macular edema, collaterals and neovascularizations. FFA was superior in detection of microaneurysms.
OCTA – FFA – Retinal vein occlusion
https://mjcu.journals.ekb.eg/article_55109.html
https://mjcu.journals.ekb.eg/article_55109_5de953d2b1f1ac1f66aeb2d186e71a2e.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Immunohistochemical Expression of Androgen and Estrogen Receptors and their Prognostic Significance in Urothelial Carcinoma of the Urinary Bladder
305
310
EN
MANAR EL-NADY, M.Sc.;
ALIAA ATEF, M.D.
HANAN EL-SHENAWY, M.D.;
AFAF EL-SHAFEI, M.D.
The Department of Pathology, Faculty of Medicine, Tanta University, Tanta, Egypt
10.21608/mjcu.2018.55113
Abstract<br />Background: Bladder cancer is the most common malig-nancy affecting the urinary tract. It is the fourth most common cancer in men and the ninth most common in women world-wide. It is at least three times more common in males than females suggesting the role of sex hormones in initiation and progression of bladder cancer. The purpose of this study is to detect the immunohistochemical expression of (AR) and (ERb) in urothelial carcinoma and correlate their expression with the known prognostic parameters of urothelial carcinoma to illustrate their prognostic role.<br />Material and Methods: Seventy cases of urothelial carci-noma of the urinary bladder in the form of radical cystectomy (15 specimens) and Transurethral Resection of the Tumour (TURT) (55 specimens) were collected retrospectively. They were stained by H & E, AR and ERb for immunohistochemical study. The relationship between their expression and the available clinicopathological features were evaluated.<br />Results: AR/ERb was positive in (62.9%/52.9% respec-tively) of the studied cases. Significantly lower expression of AR/higher expression of ERb were found in high-grade tumours (52.4%/66.7% respectively) (p-value=0.025, 0.005 respectively) and in muscle invasive tumours (48.4%/71% respectively) (p-value=0.026, 0.007 respectively).<br />Conclusions: AR and ERb expression were significantly correlated with the tumour grade and degree of invasion suggesting the suitability of AR and ERb as prognostic markers of urothelial carcinoma. High AR expression was associated with favorable prognosis of urothelial carcinoma in contrast to high ERb expression which was associated with bad prog-nosis of urothelial carcinoma.
Androgen – Estrogen – Receptor – Bladder cancer – Urothelial – Immunohistochemistry – Prognosis
https://mjcu.journals.ekb.eg/article_55113.html
https://mjcu.journals.ekb.eg/article_55113_3ddb2de3f4ef621c0020be0399e0428e.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Comparative Study between Atropine and Ketamine for Prevention of Oculocardiac Reflex in Children Undergoing Strabismus Surgery
311
317
EN
FATMA E.I. ABOHARGA, M.Sc.;
KAMAL AL-DEN A. HEIKL, M.D.
YASSER M. AMR, M.D.;
MONA R. EL-GHAMRY, M.D.
The Department of Anesthesiology and Surgical Intensive Care, Faculty of Medicine, Tanta University, Tanta, Egypt
10.21608/mjcu.2018.55116
Abstract<br />Background: Oculucardiac Reflex (OCR) is the most common side effect during the strabismus surgeries. OCR is defined as a trigemino-vagal reflex, which may cause brady-cardia, arrhythmias, and cardiac arrest after manipulating orbital structures.<br />Aim: Our aim is to compare the effect of atropine versus ketamine as a protector against oculocardiac reflex during strabismus surgery.<br />Material and Methods: This study was carried out on 111 children, 2-12 years, ASA I-II, scheduled for elective strabis-mus surgery under general anesthesia. Patients were rand-omized into three equal groups (37 patients in each group): Group C: Control Group (CG): Patient received 1mg/kg propofol, 1mic/kg fentanyl and 0.15mg/kg cis-atracurium for induction of anesthesia. Group A: Atropine group (AG): 0.01 mg/kg atropine, 1mg/kg propofol, 1mic/kg fentanyl and 0.15 mg/kg cis-atracurium. Group K: Ketamine Group (kG): 1mg/kg ketamine, 1mic/kg fentanyl and 0.15mg/kg cis-atracurium. The following parameters were compared between the 3 groups: Intraoperative hemodynamics, incidence & severity of Oculocardiac Reflex (OCR), lenght of stay in post anesthesia care unit using modified aldert score, postoperative agitation using behavior score and incidence of Post-Operative Nausea & Vomiting (PONV) using neumeric rank score.<br />Results: Incidence & severity of OCR and behavior score showed a significant decrease in groupK than group A &C, while the mean arterial blood pressure showed insignificant difference at different tybe of operation. Lenght of stay in post Anesthesia Care Unit and post-operative nausea & vom-iting showed a significant increase in groupK than group A & C.<br />Conclusions: In pediatric patients undergoing strabismus surgery, induction of anesthesia using 1mg/kg ketamine showed significant decrease in incidence of OCR owing to its heamo-dynamic stability in comparison with atropine & control groups which showed significant decrease in PONV.<br /><br />
Strabismus – Atropine – Ketamine – Oculocardiac reflex
https://mjcu.journals.ekb.eg/article_55116.html
https://mjcu.journals.ekb.eg/article_55116_17a78ad983a59d2cf6fac7469d7a7f2b.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Upper Deflection Point Versus Lower Inflection Point on Pressure-Volume (P-V) Loop for Determination of Optimum Positive End Expiratory Pressure (PEEP) by Pressure-Volume (P-V) Loop in Acute Respiratory Distress Syndrome (ARDS) Patients: A Prospective Cohort Cross-Over Study
319
324
EN
FADY M.N. ATTALLAH, M.Sc.;
SALAH EL-DIN I. EL-SHERIF, M.D.
GHADA F. EL-BARADEY, M.D.;
MOHAMED S. ABD EL-GHAFAR, M.D.
The Department of Anesthesiology & Surgical ICU, Faculty of Medicine, Tanta University, Tanta, Egypt
10.21608/mjcu.2018.55122
Abstract<br />Background: Lung-protective ventilation has the best outcome in ARDS. Therefore, low tidal volume (6ml/kg of predicted body weight), limitation of plateau pressure (less than 30cmH2O), and optimal PEEP are the key components of the lung protective ventilation. Pressure-Volume (P/V) loop is an important method to set PEEP, while the Lower Inflection Point (LIP) of the inflation limb is traditionally where PEEP is set; evidences suggest that the LIP does not correlate with the pressure at which recruited alveoli will begin to close. Setting PEEP slightly above the deflection point rather than the LIP may be more accurate in determining the optimum PEEP.<br />Aim: The aim is to compare two methods of optimum PEEP determination using Upper Deflection Point (UDP) versus Lower Inflection Point (LIP) on P-V loop in patients with ARDS, as regard lung mechanics, oxygenation and hemodynamics.<br />Patients and Methods: This study was carried out on 30 mechanically ventilated patients within 24 hours of fulfilling Berlin criteria for ARDS. All patients were ventilated with Low Tidal Volume Ventilation (LTVV). Pressure-Volume (P/V) loop was constructed using the quasistatic method with inspiratory flow rate of 3L/min and frequency 5 b/min. After (LIP) and (UDP) were determined on the (P/V) loop, the following parameters were measured before and 30 minutes after setting the optimum PEEP guided by (LIP) and (UDP): Peak airway pressure, mean airway pressure, plateau pressure, PaO2/FIO2 ratio, static compliance, Heart Rate (HR) and Mean Arterial Pressure (MAP).<br />Results: PEEP adjusted according to UDP showed signif-icant increase in static compliance and PaO2/FIO2 ratio and significant decrease in peak airway pressure, plateau pressure and mean airway pressure values in comparison with PEEP adjusted according to LIP.<br />Conclusions: PEEP adjusted according to UDP results in better oxygenation, lung mechanics and hemodynamic stability. So, it is recommended to adjust PEEP according to UDP.
Optimum PEEP – Pressure-Volume (P/V) curve–Lower inflection point – Upper deflection point–Acute respiratory distress syndrome
https://mjcu.journals.ekb.eg/article_55122.html
https://mjcu.journals.ekb.eg/article_55122_98f400f197df2e6fd81847ceef489f5b.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Role of Magnetic Resonance Imaging (MRI) in the Diagnosis of Pediatric Posterior Fossa Tumors
325
331
EN
10.21608/mjcu.2018.55129
Abstract<br />Aim and Objectives: To assess role of MRI in evaluation of space occupying lesions seen at the posterior fossa in pediatric age group.<br />Methodology: This study included 20 patients in pediatric age group suspected to have posterior fossa tumors with neurological symptoms and CT findings, all pateints underwent MRI brain with contrast with diffusion weighted images and ADC values were obtained.<br />Results: A total of 20 patients underwent MRI were: 12 males (60%) and 8 females (40%) their ages ranged from 8 months, according to conventional MRI findings the most common pediatric posterior fossa tumor was medulloblastoma in 8 cases followed by Ependymoma in 4 cases and JPA in 4 cases while pontine glioma was found in 3 cases and one case of schwannoma, based on DWI and ADC map cut off values of 0.9X10–3mm2/s were specific for medulloblastoma while cut off values more than 1.4 X 10–3mm2/s were specific for JPA. In cases of glioma and Schwannoma showed free diffusion with ADC values higher than 1 X 1 0–3mm2/s, cases of Ependymoma showed heterogeneous signal on DWI and ADC map with ADC value ranging from 1.01 and 1.3 X 10–3mm2/s suggesting restricted diffusion more than that seen in JPA cases. By comparing MRI findings with histopathology it was found that conventional MRI combined with DWI and ADC values show sensitivity 94% which is statistically significant positive strong correlation between MRI diagnosis and His-topathological confirmation.<br />Conclusion: Conventional MRI is the primary imaging modality used for the evaluation of posterior fossa tumors in pediatric age. Advance MRI (diffusion weighted images and ADC map) discriminates much better between different types of pediatric brain tumors. The study demonstrated that pilocytic astrocytomas (JPAs) are characterized by significantly higher ADC values than Ependymomas (EPs) and medulloblastomas, while medulloblastoma has the lowest ADC value, which seem to reliably provide the diagnosis which may affect the treatment plan and prognosis.
MRI – Pediatric – Posterior fossa tumors
https://mjcu.journals.ekb.eg/article_55129.html
https://mjcu.journals.ekb.eg/article_55129_e1cc5d9a913be30c9f4d6bafa75952f6.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Evaluation of Results of Calcaneo-Stop Procedure in Treatment of Pediatric Flexible Flatfoot
333
339
EN
ALY M. FAYED, M.Sc.;
AHMED M. SAMY, M.D.
MUHAMMAD A. QUOLQUELA, M.D.;
MAHMOUD A. EL-ROSASY, M.D.
The Department of Orthopaedic Surgery, Faculty of Medicine, Tanta University
10.21608/mjcu.2018.55131
Abstract<br />Background: Flexible flatfoot is a common finding in pediatrics. It is usually amenable to conservative treatment but in less frequent occasions, some cases are not optimally responsive to conservative measures. Calcaneo-stop procedure is minimally invasive and safe resort for this cases after failure of conservative measures.<br />Objective: Evaluate the results of treatment of pediatric flexible flatfoot by Calcaneo-stop procedure only after ex-haustion of six months of supervised conservative management.<br />Study Design and Setting: A prospective randomized clinical trial in a tertiary care center.<br />Patients and Methods: 20 cases of pediatric flexible flatfoot (ten patients) were operated on after failure of six months of conservative treatment. All patients were evaluated pre-operative and post-operative via Kite's angle, Meary's angle and according to American college of Foot and Ankle Society score (ACFAS). A p-value of less than 0.001 was considered statistically significant.<br />Results: There was statistically significant improvement in Meary's, Kite's angle. While ACFAS score measurement was better than preoperative score in all cases but not statis-tically significant.<br />Conclusion: Calcaneo-stop is safe, minimally invasive and effective in treatment of pediatric flexible flatfoot also it doesn't burn bridges for other adjuvant procedures later on.
Calcaneo-stop – Flatfoot – Subtalar arthroeriesis
https://mjcu.journals.ekb.eg/article_55131.html
https://mjcu.journals.ekb.eg/article_55131_e27fa9a8734ec48cb58626b491fb4d59.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
The Correlation between QT Dispersion and Severity of Pulmonary Valve Stenosis
341
347
EN
EMAN A. EL-SETIHA, M.Sc.;
SEHAM F. BADR, M.D.
SAMIA M. SHARAF EL-DEIN, M.D.;
RAGHDA G. EL-SHEIKH, M.D.
The Department of Cardiovascular Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt
10.21608/mjcu.2018.55132
Abstract<br />Background: The heart rate-corrected QT interval (QTc) and QTc dispersion (QTcd) are prolonged and associated with ventricular arrhythmia and an increase in sudden death in a variety of diseases such as coronary heart disease, heart failure, hypertension and diabetes mellitus.<br />Objective: Study of the relation between QTcd, QT interval and QTc and severity of pulmonary stenosis.<br />Methods: A prospective observational cohort single center study in a period of 10 months starting from June 2016 to March 2017 at Cardiovascular Medicine Department, Tanta University Hospitals in Gharbia Governorate, Egypt. The study enrolled 50 subjects of both genders; 40 patients who were diagnosed with pulmonary stenosis & 10 subjects matched in age, sex, weight and body surface area as a control group. Resting 12-lead electrocardiogram was recorded. QT interval was measured manually and corrected using Bazett's formula. Patients were divided into groups with mild, moderate and severe pulmonary valve stenosis and a control group according to peak pressure gradient across pulmonary valve.<br />Results: In all observed cases, mean QTc was higher in severe pulmonary valve stenosis than in controls (448.67±28.0 ms vs. 404.0±19.55ms, p=0.001) and QTcd was higher in mild, moderate (51.75±2.18 & 69.23±6.07ms respectively) and severe pulmonary valve stenosis (79.27±6.73ms) than in controls (46.20±5.49ms) (p=0.001).<br />Conclusion: In patients with pulmonary valve stenosis, mean QTc and QTcd are positively correlated to peak pressure gradient across pulmonary valve and are significantly increased in patients with severe pulmonary valve stenosis.
Pulmonary valve stenosis – QT dispersion – QT interval – Electrocardiogram – Peak pulmonary pressure gradient
https://mjcu.journals.ekb.eg/article_55132.html
https://mjcu.journals.ekb.eg/article_55132_7255075e606cfe4e94b5e83c30640e62.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Comparison of Endoscopic Partial Inferior Turbinectomy, Submucosal Radiofrequency Volume Reduction and Inferior Turbinoplasty in Patients with Hypertrophied Inferior Turbinates
349
356
EN
MOHAMED E.S. EL-KADY, M.Sc.;
EMAD M.K. SHEHATA, M.D.
AHMED S. EL-GUINDY, M.D.;
MAGDY E. SAAFAN, M.D.
The Department of Otolaryngology, Faculty of Medicine, Tanta University
10.21608/mjcu.2018.55133
Abstract<br />Background: Chronic nasal obstruction is a global health problem affecting large number of population all over the world. Hypertrophy of the Inferior Turbinates (HIT) is one of the leading causes of nasal obstruction. There is no con-sensus for best method of inferior turbinate volume reduction.<br />Objective: To compare between the endoscopic Partial Inferior Turbinectomy (PIT), Radiofrequency Assisted Tur-binate volume Reduction (RATR) and submucosal resection (SMR) of the inferior turbinate in success of turbinate size reduction with preservation of the physiological functions of the inferior turbinate.<br />Study Design and Setting: A prospective randomized clinical trial in a tertiary care center.<br />Patients and Methods: 150 patients diagnosed to have (HIT) were randomly selected and allocated into 3 groups for the 3 treatment options. The patients were evaluated pre-operatively and post-operatively by a modified Arabic trans-lation of the Sino-Nasal Outcome Test (MA-SNOT16 test) and rigid nasal endoscopy. A p-value of less than 0.001 was considered statistically significant.<br />Results: There was statistically significant improvement in MA-SNOT16 score post-operatively in all groups which continued to be improved more in SMR group. Least operative time was in RATR group and more crustations. Slightly better long term follow-up was observed in SMR group.<br />Conclusion: There is no consensus on one surgical tech-nique for the inferior turbinate volume reduction. Still there is a need for systematic reviews and meta-analysis to reach the best option.
Inferior turbinate – Turbinectomy – Radiofre-quency – Turbinoplasty
https://mjcu.journals.ekb.eg/article_55133.html
https://mjcu.journals.ekb.eg/article_55133_55378bdbc457f0372d0cdfe52dabaf9b.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Effect of Quercetin on Exercise Tolerance in Experimental Hyperthyroidism in Male Albino Rats
357
366
EN
10.21608/mjcu.2018.55134
Abstract<br />Background: This work was performed to study the effect of Quercetin on exercise tolerance in experimental hyperthy-roidism in male albino rats.<br />The aim of this work is to study the effect of Quercetin on exercise tolerance in experimentally induced hyperthyroid male albino rats.<br />Methods: 40 male rats were divided into 4 groups 10 rats each: (I) Euthyroid sedentary (ES), (normal control) group: Received (0.5ml physiological saline daily Intra-Gastric (IG) for 3 weeks). (II) Thyrotoxic Sedentary (TS), (thyrotoxic control) group: Received exogenous thyroxine (T4), eltroxin (50mg tablet) for induction of thyrotoxicosis in increasing doses (50μg to reach 200μg/kg body weight daily by (IG) administration, for 3 weeks. The rats were given 50μg/kg daily during the first week, 100μg /kg daily during the second week and 200μg/kg daily during third week. (III) Thyrotoxic adapted (TA) group: Received eltroxin in increasing doses (50μg to reach 200μg/kg body weight daily IG) for 3weeks, as (TS) group. (IV) Quercetin Treated Thyrotoxic Adapted (QTTA) group: Received eltroxin (50μg to reach 200μg/kg body weight daily IG) for 3weeks, they received also quercetin at a dose of 25mg/kg, IG on alternate days throughout the experimental period. These animals received the dose of quercetin within 2 hours before submission to the Maximal Swimming Time test (MST). All animals were submitted to MST after induction of thyrotoxicosis. However, the animals of group III, and group IV were submitted to the test after performing swim session adaptation for 2 days before doing the test.<br />Results: At the end of the experimental period all thyro-toxic groups showed significant decrease in total body weight compared to control group, at the same time, TS and TA groups showed significant decrease in relative liver weight, relative thyroid weight, and relative epididymal pad of fat weight compared to control group, while, QTTA group showed insignificant change compared to control group, but it showed significant increase compared to TS and TA groups. All thyrotoxic groups also showed significant increase in serum T3, T4 level, and significant decrease in serum TSH level compared to control group. On the other hand, all thyrotoxic groups showed a significant increase in liver, skeletal muscle MDA, and catalase compared to control group, while TA group showed significant increase in their levels compared to TS group, however it showed significant decrease in their levels after quercetin treatment. It also showed significant decrease in liver and skeletal muscle glycogen in all thyrotoxic groups compared to control group, similarly, it showed sig-nificant decrease in TA group compared to TS group, but, it showed significant increase after quercetin treatment. On the other hand, TS and TA groups showed a significant decrease in MST, while QTTA showed insignificant change compared to control group, TA group also showed significant decrease compared to TS group, while it showed significant increase after quercetin treatment.<br />Conclusion: We concluded that quercetin can improve exercise intolerance that occurs in hyperthyroidism through its antioxidant effect.
https://mjcu.journals.ekb.eg/article_55134.html
https://mjcu.journals.ekb.eg/article_55134_fcdbf6c9aa7108fc9e50beccbed5c990.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
The Oxidant and Antioxidant Status in b-Thalassemia Major Patients
367
374
EN
ALIAA A.F. IBRAHIM, M.Sc.;
TAMER A. EL-BEDEWY, M.D.
EBAA H. EL-SHEIKH, M.D.;
AMAL HELMY ABD EL-HAMEED, M.D.
The Departments of Internal Medicine* and Clinical Pathology**, Faculty of Medicine, Tanta University
10.21608/mjcu.2018.55135
Abstract<br />Background: Thalassemia is associated with anemia and lifelong blood transfusion that lead to oxidant-antioxidant disturbance due to massive iron deposits with generation of labile iron in the red blood cells, which promotes the formation of Reactive Oxygen Species (ROS) with cumulative cell damage.<br />Aim of the Work: Evaluation of Ischemia ModifiEd Albu-min (IMA) as a marker of oxidative stress and Superoxide Dismutase (SOD) as a marker of antioxidant status in patients with b-Thalassemia Major (b-TM).<br />Subjects and Methods: Forty patients with b-TM were divided into 2 groups well chelated (group 1) and poorly chelated (group 2). Twenty healthy participants of matched age and sex were taken as controls (group 3). All patients and controls were subjected to complete history taking, clinical examination. Serum ferritin, IMA and SOD were measured.<br />Results: There were significant higher levels of IMA in thalassemia patients than controls (p-value <0.001*). IMA correlated significantly positive with serum ferritin (r=0.339, p-value 0.032*). There were significant lower levels of SOD in thalassemia patients than controls (p-value <0.001*). SOD correlated significantly negative with serum ferritin (r=–0.718, p-value <0.001*).<br />Conclusion: IMA as a new marker of oxidative stress increased in b-TM patients and SOD as a marker of antioxidant status decreased in b-TM patients.
b-thalassemia major – Oxidant – Antioxidant – Ischemia Modified Albumin (IMA) – Superoxide Dismutase (SOD)
https://mjcu.journals.ekb.eg/article_55135.html
https://mjcu.journals.ekb.eg/article_55135_3efafc5f36761b8bb3e1c7ff4eb947f4.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
The Effect of Crocin on Endocrine Functions of the Testes before and after Testicular Damage in Rats
375
382
EN
NESREN M.M. ABO EDRA, M.Sc.;
ABEER A. AHMED, M.D.
MERVAT H. EL-SAKA, M.D.
SAHAR A. EL-SAWY, M.D.
The Department of Physiology, Faculty of Medicine, Tanta University
10.21608/mjcu.2018.55136
Abstract<br />Aim of the Work: The aim of this work is to study the effect of crocin on endocrine functions of testes before and after testicular damage in rats.<br />Methods: The present work will be carried on 40 male albino rats. The rats will be divided into four groups, (10 rats for each). Control group (group I): Rats received 1ml normal saline intraperitoneally. Cadmium-treated group (group II): Rats received intraperitoneal injection of a single dose of 1 mg/kg cadmium chloride dissolved in saline. Crocin-pretreated group (group III): Rats received crocin in a dose of 50mg/kg intra-peritoneally once daily for 4 weeks, then they received cadmium chloride as in group II. Crocin-treated group (group IV): Rats received cadmium chloride as in group II, then they treated with crocin as in group III. At the end of the experiment, the animals were anesthetized, then the animals were sacrificed by cervical decapitation. The collected blood samples were collected.<br />Results: At the end of the experimental period, the results of the present work revealed that in Cd-treated group, there was significant decrease of serum levels of testosterone, FSH and LH. On the other hand, there was significant increase of testicular caspase-3 and testicular MDA with concomitant significant decrease of testicular GSH level compared to normal control group. In both the crocin-pretreated group and crocin-treated groups, there was significant increase of serum levels of testosterone, FSH and LH, significant decrease of testicular MDA levels associated with significant increase of testicular GSH levels as compared to cadmium-treated group. Testicular caspase-3 significanlty decreased in the crocin-treated group, but insignificanlty changed in crocin-pretreated as compared to cadmium-treated group. Also, all studied parameters significantly improved in crocin-treated group as compared to the crocin-pretreated group.<br />Conclusion: We conclude that crocin can improve testicular toxicity induced by cadmium via its anti-apoptotic and anti-oxidant effects. Moreover, our results showed that the thera-peutic effect of crocin is more effective than its protective effect on testicular toxicity induced by Cd.
Crocin – Cadmium – Testosterone– Caspase-3 – MDA
https://mjcu.journals.ekb.eg/article_55136.html
https://mjcu.journals.ekb.eg/article_55136_209cbff67312cf632df0e6f740730dc0.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Lateral Rotation of the Basal Turn of the Cochlea with its Impact on Cochlear Implant Feasibility
383
387
EN
SHERY MIKHAIL, M.Sc.;
MAHMOUD F. MANDOUR, M.D.
SAAD EL-ZAYAT, M.D.;
MOHAMED HISHAM HAMAD, M.D.
The Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt
10.21608/mjcu.2018.55137
Abstract<br />Purpose: To investigate variation in cochlear orientation, with respect to rotation of basal turn, and its implication to cochlear implantation.<br />Methods: Prospective observational study including 25 patients that underwent cochlear implantation at Tanta Cochlear Implant Centre (TCIC), Otolaryngology, Head & Neck Surgery (ORL-HNS) Department, Faculty of Medicine, Tanta Univer-sity, that had been done from April 2015 to December 2015, with available charts including Computerized Tomography (C.T.) scan of temporal bone. Axial cut with maximum visu-alization of the round window was identified, then angle of axial rotation of the cochlea was measured using two methods: Angle 1 between the midline and line through the long axis of the basal turn and angle 2 between the long axis of the basal turn and the long axis of horizontal segment of Internal Carotid Artery (I.C.A.) at the same axial level. All angles were measured using computer software. All cases had cochlear implantation using standard trans-mastoid technique. Round window visibility through facial recess was assessed after maximal widening of the facial recess to achieve best exposure. Then, cases were assigned into one of two groups according to the degree of round window visibility, Group I: Case with full exposed Round Window (R.W.) membrane. Group II: Cases with partially exposed R.W. membrane or invisible R.W. membrane.<br />Results: Following review of the Computed Tomography (CT) images of the two patients (Group II) in whom cochlear implant was difficult. It appeared that the orientation of the basal turn of the cochlea relative to the midline (angle 1) was more obtuse or more acute than in other patients with p- value =0.007 & 0.002 respectively. It also showed that the orientation of the basal turn of the cochlear in relation to long axis of horizontal part of internal carotid artery (angle 2) was more obtuse relative to other patient with p-value=0.002 & 0.001 respectively.<br />Conclusion: Our work highlights the importance of pre-operative measuring basal turn angel relative to fixed plane, as the mid-sagittal plane in pre-operative CT, instead of other anatomical structure that could be subjected to developmental remodeling and its impact on surgery of cochlear implantation.
Lateral rotation of the basal turn of the cochlea – Cochlear implant – Cochlear implant feasibility
https://mjcu.journals.ekb.eg/article_55137.html
https://mjcu.journals.ekb.eg/article_55137_363bbeb18c2d0eb8cbbf40fe41acc1eb.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Serum Immunoglobulin Paraprotein in Patients with Chronic Lymphocytic Leukemia
389
394
EN
HOSNY B. HAMED, M.D.;
ASMAA M. ZAHRAN, M.D.
MOHAMED Z. ABD EL-RAHMAN, M.D.;
FATMA EL-ZAHRAA A. RASHED, M.Sc.
The Department of Oncological Clinical Pathology, South Egypt Cancer Institute* and The Department of Clinical Pathology, Faculty of Medicine**, Assiut University
10.21608/mjcu.2018.55138
Abstract<br />Background: Chronic Lymphocytic Leukemia (CLL) is the most common chronic lympho-proliferative disorder. This study was done to explore the frequency of serum Immu-noglobulin (Ig) paraprotein in patients with CLL and its correlation with other prognostic factors as expression of CD38 and zeta-chain-associated protein kinase 70 (ZAP70) on malignant lymphocytes.<br />Aim of Study: To study the frequency of serum immu-noglobulin paraprotein in patients with CLL and its correlation with other prognostic factors as expression of CD38 and ZAP70 on malignant lymphocytes.<br />Patients and Methods: Clinico-hematological profiles were done to 30 CLL patients. Serum Protein Electrophoresis (SPE) and Immunofixation Electrophoresis (IFE) were per-formed to measure serum Ig paraprotein. ZAP-70 and CD 38 were tested by flow cytometry.<br />Results: In this study CLL patients were classified accord-ing to modified Rai staging system into: Low risk 10%, intermediate risk 40% and high risk 50%. Four CLL patients (13.4%) had monoclonal gammopathy (M-band), the type of M-band in the 4 patients was IgG-Kappa. One patient (3.3%) had diffuse band (polyclonal gammopathy). ZAP-70 and CD 38 positivity were detected in 7 patients (23.3%) and 15 patients (50%), respectively. There was significant relation between presence of Ig paraprotein in CLL patients and ZAP 70 expression (p=0.034). On the other hand there was no relation between presence of M-band in CLL patients and CD38 expression nor modified Rai staging system.<br />Conclusion: Monoclonal gammopathy was found in 13.4% of CLL patients. The detection of Ig paraprotein might be applied for the assessment of prognosis in patients with CLL.
Chronic lymphocytic leukemia – Immunoglobulin paraprotein – Prognosis – CD38 – ZAP-70
https://mjcu.journals.ekb.eg/article_55138.html
https://mjcu.journals.ekb.eg/article_55138_0088c2077b5f3f6e0f52b1b0cbb1092e.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Possible Prophylactic Role of Querctine on Cisplatin-Induced Myocardial Toxicity in Adult Male Albino Rat: Histological and Immunohistochemical Study
395
403
EN
MOGEDA M.
NASRALLA, M.D.
The Department of Anatomy and Embryology, Faculty of Medicine, Cairo University
10.21608/mjcu.2018.55139
Abstract<br />Background: Cisplatin is an effective chemotherapeutic<br />agent used in treatment of solid tumors. Cardiotoxicity is one<br />of the major side effect frequently observed after administration<br />of cisplatin. Quercetin, an important dietary flavonoid present<br />in several fruits and vegetables, exhibits antioxidant, antiinflammatory<br />and anti-cancer properties.<br />Aim of Work: The present work was designed to study<br />the histological changes in the heart of the adult male albino<br />rat, following administration of cisplatin and the possible<br />prophylactic role of querectine.<br />Material and Methods: Forty adult male albino rats were<br />used in this study. They were divided into four groups, ten<br />rats each; Group I (normal control) received nothing, Group < br />II (sham control): Received a daily oral dose of one ml of<br />normal saline via gastric gavage. Group III (CP): Received<br />intraperitoneal single injection of cisplatin at 15mg/kg dose<br />on the eighth day. Group IV: Querectine has been orally<br />administered at 30mg/kg/day dose for one month beginning<br />seven days prior to single cisplatin injection. At the end of<br />experiments the heart was removed, and prepared for light<br />and electron microscopic studies.<br />Results: Cisplatin treated animals (Group III) showed<br />structural changes in the myocardium in the form of focal<br />lesions in many sections and fragmentation of muscle fibers.<br />By electron microscopic examination, mitochondria revealed<br />variability in size and shape, enlargement (ballooning) with<br />disturbed cristal pattern. Immunohistochemical study of<br />myocardium of Group III animals stained with anti-a-smooth<br />muscle actin antibody showed positive immunoreactivity.<br />Querectine pretreated animals revealed amelioration in histological<br />alterations in the myocardium when compared to<br />cisplatin treated group.<br />Conclusion: This study demonstrated that querectine had<br />a significant effect in protection of the heart against myocardial<br />histological changes induced by cisplatin.
Querectine,Cardio prophylactic,Antioxidant activity,Cisplatin
https://mjcu.journals.ekb.eg/article_55139.html
https://mjcu.journals.ekb.eg/article_55139_b837a9e461dfec53fe84fd3464bed911.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Effect of Short-Term Swim Exercise on Cardiac Dysfunction Induced by Doxorubicin in Rats
405
416
EN
FATEN M.A. DIAB, M.D.;
RAMADAN A. SAAD, M.D.
NOHA A. NASSEF, M.D.;
CHRISTINA M. WADIE, M.Sc.
The Department of Physiology*, Faculty of Medicine, Ain Shams University, Cairo, Egypt* and Fakeeh College of Medical Sciences, KSA**
10.21608/mjcu.2018.55140
Abstract<br />Background: Long-term exercise could confer protection against Doxorubicin-induced cardiotoxicity, yet, the effect of short-term exercise just prior to exposure to Doxorubicin (Dox) is still unclear.<br />Aim: To investigate the effect of short-term exercise on cardiac dysfunction induced by Dox treatment.<br />Material and Methods: Sixty nine female albino rats were assigned into 4 groups: Group 1: Control (sedentary rats, n=17), Group 2: Dox (rats received single intraperitoneal injection of Dox in a dose of 20mg/kg, n=18), Group 3: Exc, (n=16), Group 4: Exc +Dox (n=18). Rats were subjected to recording of the ECG, measurement of arterial blood pressure, echocardiograghy, analysis of serum parameters of SGOT, LDH, CPK-MB, troponin I (cTnI) and evaluation of total antioxidant capacity, Malondialdehyde (MDA) and heat shock protein (Hsp20) in the cardiac tissue.<br />Results: Compared to the control, Dox-treated rats showed significant prolongation of QT interval, with insignificant depression of the R voltage and the elevation of systolic (SBP), diastolic (DBP), mean (MAP) blood pressures were statistically insignificant. These changes were accompanied by significant elevation of serum SGOT and cardiac tissue MDA and Hsp20. Also, compared to the control, rats exposed to 3 days exercise just before Dox injection (Exc + Dox) showed significant prolongation of QT even more than in Dox group. However, the depression of the R voltage and the elevation of the SBP, DBP, and MAP become statistically significant compared to the control. These changes were associated with significant increase in SGOT. However, compared to Dox group, the Exc+Dox demonstrated significant prolongation in QT, significant reduction in the ejection fraction with significant reductions in MDA and Hsp20.<br />Conclusion: Short-term swim exercise training just prior to doxorubicin exposure is risky and makes the heart more predisposed to arrhythmia despite of the relative improvement in cardiac oxidative status.
Doxorubicin – Cardiac dysfunction – Exercise – Hsp20
https://mjcu.journals.ekb.eg/article_55140.html
https://mjcu.journals.ekb.eg/article_55140_a44f6fd9a1006e9d80c725c69811ceda.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Subareolar Dermofibrous Flaps for Correction of Inverted Nipple
417
424
EN
FADY R. HANNA, M.Sc.;
WALEED Y. EL-SHERPINY, M.D.
SALAH El-DIN A. EL-GOHARY, M.D.;
AHMED A. DARWISH, M.D.
The Department of General Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt
10.21608/mjcu.2018.55141
Abstract<br />Background: Inverted nipple is a nipple located on a plane lower than the areola, presents both functional and cosmetic problems. It is a source of repeated irritation and inflammation interferes with nursing and may cause psychologic distress.<br />Many operative modalities are available for correction; they range from suture based methods to the use of areolar or nipple dermal flaps. This variety of available methods amply reflects the difficulty of achieving a satisfactory out-come. In this study a new technique is adopted, based on the use of two triangular subareolar dermofibrous flaps.<br />Aim: The aim of this study was to assess the use of subareolar dermofibrous flaps for correction of inverted nipple in term of shape and recurrence.<br />Methods: The study was carried out on 15 inverted nipples in 10 female patients. Every case was subjected to the follow-ing: Full history taking, clinical examination including general, breast, axilla, nipple and areola examination. The investigations conducted included laboratory work up and breast mammog-raphy with complementary ultrasonography.<br />Results: The follow-up period after removal of distracter ranged from 6 months to 1 year. During the follow-up period, patient satisfaction was assessed. Good aesthetic results were achieved for 80% of patients who were very satisfied with the outcome while 20% were not satisfied because of recur-rence. Infection occurred in only 1 patient in the immediate post-operative period that resolved after antibiotic adminis-tration. No complications such as pain, temporary sensory disturbance, skin pigmentation or nipple necrosis were recorded in this study.<br />Conclusions: The described technique is easy, reliable and does not leave visible scars on areolar skin. In particular, it has been found to be effective for treating grade 2 and 3 inverted nipples.
Inverted nipple – Correction – Subareolar der-mofibrous flaps
https://mjcu.journals.ekb.eg/article_55141.html
https://mjcu.journals.ekb.eg/article_55141_02b137297046a6e03355db111f0c9ede.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Value of Glycated Hemoglobin (HbA1c%) as an Indicator of Severity of Acute Coronary Syndrome in Non-Diabetic Adults
425
432
EN
MOHAMMED S. KASEM, M.Sc.;
EKRAM S. SAEED, M.D.
YASSER H. EL-BARBARY, M.D.;
WAEL A. HASSIB, M.D.
The Department of Cardiovascular Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt
10.21608/mjcu.2018.55142
Abstract<br />Background: Glycated hemoglobin (HbA1c%) is a de-pendable indicator of glycemic status in both diabetic and non-diabetic patients and a good indicator of Coronary Artery Disease (CAD) presence and its severity.<br />Aim of Work: Correlating (HbA1c%) level with the severity of acute coronary syndrome presentation, degree of affection of systolic and diastolic function of the cardiac muscle measured by TTE and degree of coronary vasculature affection as shown by diagnostic coronary angiography, in non-diabetic patients.<br />Methodology: A cross sectional study conducted from May 2016 to April 2017, at Cardiovascular Medicine Depart-ment, Tanta University Hospitals in Gharbia Governorate, Egypt. 123 non-diabetic patients presented to our CCU with Acute Coronary Syndrome (ACS), had Trans-Thoracic Echocardiography (TTE), diagnostic coronary angiography and SYNTAX score was calculated based on its results. HbA1c% level was measured and correlated to previous parameters.<br />Result: Patients was divided into 3 tertiles according to their HbA1c% level, <_5.5, 5.6-5.9 and 6-6.4. Significant relationship was detected between HbA1 c% level and severity of ACS presentation. Moderate positive correlation was found between HbA1c% level and SYNTAX score (r.=0.504, p= 0.001). Also, moderate positive correlation was found between (HbA1c%) level and number of affected coronary vessels as detected by diagnostic coronary angiography (r.=0.397, p= 0.001). Moderate negative correlation was found between (HbA1c%) level and LV systolic function as measured by simpson method through TTE (r.=–0.466, p=0.001).<br />Conclusion: HbA1c% level is a fundamental marker for chronic glycemia and could be utilized as an independent predictor of CAD presence, severity of acute emergent pres-entation and degree of cardiac muscle affection due to CAD even in non-diabetic individuals.
(HbA1 c) Glycated Hemoglobin – (ACS) Acute Coronary Syndrome
https://mjcu.journals.ekb.eg/article_55142.html
https://mjcu.journals.ekb.eg/article_55142_b7eba73228b81c983f595e4a3c0dd1ea.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Left Atrium Volume Index and Aortic Stiffness as Predicting Factors for Severity of Coronary Artery Disease
433
440
EN
MOHAMED M. EL-ZOGHBY, M.Sc.;
MAI M.A. SALAMA, M.D.
SAMIA M. SHARAF AL-DEEN, M.D.;
LAMIAA A. KHEDR, M.D.
The Department of Cardiovascular Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt
10.21608/mjcu.2018.55143
Abstract<br />Background: Recently, it has been demonstrated that left atrial distension and aortic stiffness have a predictive value for cardiovascular outcomes especially in high-risk, elderly, and hypertensive adults.<br />Aim of Study: Evaluation of predictive value of Left Atrium Volume Index (LAVI) and aortic stiffness for severity of angiographic pattern of Coronary Artery Disease (CAD).<br />Methods: A prospective observational cohort single-center study conducted from May 2016 to May 2017, at Cardiovas-cular Medicine Department, Tanta University Hospitals in Gharbia Governorate, Egypt. The study enrolled 100 consec-utive adult patients of both genders who were diagnosed with chronic stable coronary artery disease and were candidates for invasive coronary angiography. Each patient was subjected to echocardiographic assessment for Left Atrium Volume Index (LAVI) and Aortic Stiffness Index (ASI) followed by invasive coronary angiography for assessment of severity of coronary artery disease by Gensini score. Patients were classified into 3 groups by Gensini score: Group I (gensini score equal zero), Group II (Gensini score more than 0 and less than 20) and Group III (Gensini score equal or more than 20).<br />Results: The prevalence of severe CAD was higher among patients with high LAVI (p-value 0.002) and ASI (p-value 0.05). The significant positive relation between LAVI and Gensini score was mainly between Groups II, III (non-severe and severe coronary artery disease). ASI was more sensitive than LAVI for detection of the severity of CAD as ASI showed statistically significant positive strong correlation with the coronary angiographic score (p=0.001) while LAVI showed no significant correlation with the coronary angiographic score (p=0.061). The LAVI carried sensitivity of 67% and specificity of 49.5% in predicting CAD with cutoff value >19.5. While The ASI carried sensitivity of 66.7% and spe-cificity of 21% in predicting CAD with cutoff value >2.88.<br />Conclusion: It was demonstrated that there is significant elevation at aortic stiffness index and left atrium volume index within the group of patient with the higher Gensini score. So ASI and LAVI could be used as promising factors for evalu-ation of the severity of coronary artery disease.<br /><br />
Left atrium volume index – Aortic stiffness-invasive coronary angiography – Gensini score
https://mjcu.journals.ekb.eg/article_55143.html
https://mjcu.journals.ekb.eg/article_55143_83a95bd39e9095a290a6e360b5dc6d29.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Cranial Ultrasonographic Findings in Preterm Infants at Tanta Neonatal Intensive Care Unit (NICU)
441
447
EN
DALIA M. EL-KAMAH, M.Sc.;
RASHA M.G. EL-SHAFIEY, M.D.
MOHAMED A. EL-TOMY, M.D.;
MOHAMED A. ROWISHA, M.D.
The Department of Pediatric, Faculty of Medicine, Tanta University, Tanta, Egypt
10.21608/mjcu.2018.55177
Abstract<br />Background: Premature neonates are at risk for brain injury both hemorrhagic and ischemic injury. Intracranial hemorrhage is the most common abnormal cranial finding followed by PVL and hydrocephalus. Considering that most of the brain lesions are clinically silent during the neonatal period, routine cranial ultrasonography screening may be needed to detect a variety of brain lesions in the preterm infants.<br />Aim: The aim was to detect cranial ultrasonographic findings in preterm infants for initiation of appropriate, protective and therapeutic measures.<br />Methods and Material: This study was carried out on all preterms infants that were admitted in the NICU of Pediatric Department at Tanta University Hospital during the study period over one year using cranial US in the first 3 days of life and on 7th, 14th and 21 st days of life and after any clinical intercurrent events through anterior, posterior and mastoid fontanelle with a single operator, who was unaware of any clinical data of the studied preterms.<br />Results: Most of the preterms were asymptomatic and hypotonia was the main symptom among symptomatic pre-terms. ICH was the most common abnormal CUS finding followed by PVL and hydrocephalus. Hydrocephalus was the main complication of ICH cases. Regarding the grading of ICH, grade III represented the predominant grade. In the studied preterms, those with gestational age £32 weeks, birth weight <_1.5 Kg, Hb £10gm.dL, and mean PCO2 >45 were more likely to have abnormal findings on cranial US exam-ination.<br />Conclusions: Cranial US may be recommended as a routine examination in every preterm infant as most of preterms with abnormal cranial US findings are asymptomatic. The incidence of abnormal CUS findings increases with decreasing gestational age, birth weight, APGAR score, Hb, pH and HCO3 and with increasing HR, RR, CRP, mean PCO2 and length of stay.
Cranial – US – Preterm – Hydrocephalus – PVL
https://mjcu.journals.ekb.eg/article_55177.html
https://mjcu.journals.ekb.eg/article_55177_cf5ce8375bb86e5f8ac615f1199ea5c5.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Outcome of Tendon Transfer Around Shoulder with Erb's Palsy Internal Rotation Deformity
449
455
EN
FAROUK E. FAROUK, M.Sc.;
MUHAMMAD A. ROMEIH, M.D.
ABD EL-HAFEZ A. MEGAHED, M.D.;
MOSTAFA A. AYOUB, M.D.
The Department of Orthopaedic Surgery and Traumatology, Faculty of Medicine, Tanta University, Tanta, Egypt
10.21608/mjcu.2018.55178
Abstract<br />Background: Obstetric Brachial Plexus Palsy (OBPP) is one of the most severe complications at birth with internal rotation deformity that have significant functional disability. There is a many different methods of tendon transfer that have been descried to improve the shoulder Range of Motion (ROM).<br />Aim of Study: Evaluate the outcome of teres major tendon transfer around the shoulder in children with Erb's palsy internal rotation deformity.<br />Methods: This study was Retrospective and prospective randomized clinical study carried out on totally (25) patients admitted to Orthopaedic Department of Tanta University Hospital. Ten children represented the Retrospective portion of the study, and fifteen represented the prospective portion. All cases were operated by Modified Sever-L'Episcopo tech-nique. The external rotation, according to Mallet score, was recorded pre-and post-operatively.<br />Results: The mean follow-up period was twelve months (range 6-18). The Mallet score for the shoulder external rotation, at the end of follow-up periods, was graded as Grade II in two patients (8%), Grade III in nine patients (36%), and Grade IV in fourteen patients (56%). There was a highly significant improvement (p=0.00001) of the external rotation range as the mean pre-operative score was 2.04±0.02, and the mean post-operative score was 3.48±0.65.<br />Conclusion: The Modified Sever L'Episcopo procedure that compromises of anterior release, then teres major tendon transfer to the tendon of infraspinatus shows a high incidence of good outcome with a promising subjective and objective improvement in almost cases.
Tendon transfer – OBBP – Erb's palsy – Modified sever L'Episcopo procedure
https://mjcu.journals.ekb.eg/article_55178.html
https://mjcu.journals.ekb.eg/article_55178_6e1153e9bc2a926d569fedb5bd1c7958.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Effect of Fistula in Ano Surgery on Anorectal Manometric Study
457
460
EN
USAMA S. MOHAMED, M.D.;
KHALIL EL-GENDY M.Sc.
AHMED
FARAG, M.D.
The Department of General Surgery, Faculty of Medicine, Cairo University
10.21608/mjcu.2018.55179
Abstract<br />Background: Surgical treatment of anal fistula is associated with a significant risk of impaired continence. Anorectal manometry is the most widely available tool for investigating anorectal function.<br />Patients and Methods: Twenty patients of age ranging from twenty to sixty years old underwent treatment of anal fistula. They did anorectal manometry before and two months after management.<br />Results: Significant decrease noted in the resting and squeezes pressure and maximal tolerable volume in the rectum.<br />Conclusion: Anorectal manometry is a valuable tool in detecting the effect of anal fistula surgery on anorectal function even in subclinical conditions that may be helpful in opening the way for studies predicting high risk patient after anal fistula surgery to start treatment before reaching the clinical condition.
FISTULA – Ano surgery – Anorectal manometric
https://mjcu.journals.ekb.eg/article_55179.html
https://mjcu.journals.ekb.eg/article_55179_e15f90c08596e760b44d5d740a0c8004.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
The Role of Epidural Steroids in the Outcome of Postoperative Lumbar Discectomy
461
463
EN
MOHAMED MOHAMED, M.D.;
MOHAMED A. HEWEDY, M.D.
10.21608/mjcu.2018.55181
Abstract<br />Background: Many surgeons prefer using intra-operative steroids directly over the durra and nerve root claiming that it decrease the post-operative pain, this study was made to determine if there is real role of steroids on the post-operative pain after lumbar discectomy.<br />Patients and Methods: This is a prospective study in which we collected the data of 104 patients who underwent single level laminectomy and discectomy from March 2013 to March 2016 in Faculty of Medicine, Bani-Seuf University. Recurrent disc and multiple disc affection were excluded from these study. We divided the patients into 2 groups, Group (A) which receive steroids intra operatively on the dura and included 50 patients and Group (B) without usage of steroids and included 54 patients, the patients in the 2 groups were compared in the post-operative pain by consumption of pain killer, the timing of hospital stay also the duration to return to normal daily activity.<br />Results: Considering the drug use after surgery the mean rate in Group (A) was about 10mg of narcotics vs. 10.4mg in Group (B) the duration of hospital stay in both groups was 3 days patients of both groups were able to walk on the operation night, the mean interval duration before returning to normal daily activity was 18 day in Group (A) and 20 days in Group (B) the results of these parameters did not show any significant difference between the 2 groups.<br />Conclusion: Intra-operative steroid usage by direct apply on dura does not affect the severity of post-operative pain after lumbar disc removal it does not shorten the hospital stay or time needed to return to work.
Discectomy – Post-operative – Steroid – Epidural
https://mjcu.journals.ekb.eg/article_55181.html
https://mjcu.journals.ekb.eg/article_55181_75f897cc8194e203d12698f2c48bc187.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
The Role of Fascia Lata Graft in Treatment and Camouflage of Nasal Dorsum Irregularities
465
471
EN
AHMED S. ABD EL-HAMID, M.Sc.;
OSAMA AL-BIRMAWY, M.D.
YASSER AGLAN, M.D.;
MOHAMED AMER, M.D.
AHMED
YOUNES, M.D.
The Department of Otorhinolaryngology, Faculty of Medicine, Tanta University, Tanta, Egypt
10.21608/mjcu.2018.55182
Abstract<br />Background: Nasal dorsal irregularities after rhinoplasty are troublesome for both patient and surgeon, especially in patients with thin dorsal skin, which may be seen after improper hump reduction and multiple surgeries. Many types of grafts have been used for nasal contouring, augmentation and cam-ouflage as diced cartilage, fascia, dermal grafts, alloderm and banked allograft.<br />Methods: We report the use of Fascia Lata (FL) graft for dorsalcontouring and camouflage in 20 patients who underwent rhinoplasty between May 2015 to September 2016. There were 12 male and 8 female patients, with ages ranging from 18 to 43 years (mean age: 30.35). Of the 20 patients, 12 underwent primary rhinoplasty, while 8 were secondary cases. An informed consent was obtained from all patients for the use of FL graft. The graft was harvested from the right lateral thigh. A simple method was used to placethe graft over the nasal dorsum. Post-operative follow-up period was 16 months. Clinical evaluation was made by inspection, palpation and photographic documentation.<br />In addition, a questionnaire related to patient satisfaction and donor-site morbidity.<br />Results: All patients had satisfactory aesthetic results, andno apparent irregularities were observed over the nasal dorsum. The questionnaire resultsshowed that all patients, but one, were satisfied with surgery, and were not concerned aboutdonor-site scar; however, one patient had donor-site morbidity.<br />Conclusions: This study conclusively shows that it is a reliable, simple method for camouflaging any post-operative dorsalirregularities, particularly in patients with thin nasal skin.
Rhinoplasty – Fascia lata – Camouflage – Nasal dorsum
https://mjcu.journals.ekb.eg/article_55182.html
https://mjcu.journals.ekb.eg/article_55182_22f98f1faf669e7372ca9e5775b44caa.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Role of Ultrasound and Magnetic Resonance Imaging in Diagnosis of the Etiology of Chronic Ankle Pain
473
482
EN
EMAN K. SULTAN, M.Sc.;
MOHAMMED FOUAD SHERIEF, M.D.
EMAD M.
MASHALY, M.D.
The Department of Radio-Diagnosis & Medical Imaging, Faculty of Medicine, Tanta University, Tanta, Egypt
10.21608/mjcu.2018.55184
Abstract<br />Background: In patients with ankle and foot pain, it is crucial to detect the lesion responsible for the pain for deter-mining adequate treatment. MRI in combination with other radiologic images is currently regarded as the most appropriate diagnostic imaging of benign bone and soft tissue lesions in chronic ankle pain.<br />Aim of Work: To evaluate the role of ultrasound and magnetic resonance imaging in diagnosis of the etiology of chronic ankle pain.<br />Material and Methods: This study included ninety patients with chronic ankle pain. All patients were subjected to clinical evaluation, ultrasound examination and MRI.<br />Results: Both ultrasound and MRI revealed nearly the same results in evaluation of tendon abnormalities. Ultra-sonography couldn't detect injuries of the posterior talo-fibular ligament as well as posterior tibio-fibular ligament while MRI could clearly detect them. Regarding other ligaments (anterior talo-fibular, anterior lower tibio-fibular and deltoid ligaments), MRI was slightly superior to ultrasound in evaluation of injuries of these ligaments. Ultrasonography could detect some cases of postero-medial impingement syndromes (caused by deltoid ligament injury), however it couldn't detect cases of posterior or anterior impingement (usually caused by bony abnormalities), these cases were better assessed by MRI examination. Cases of osteochondritis dessicans and bony tumors could be assessed by MRI examination however; ultrasonography was negative in detecting these lesions.<br />Conclusion: Ultrasound and MRI showed similar results in evaluation of tendon and ligament injuries as well as entrapment neuropathy, MRI was superior to ultrasound in evaluation of impingement syndromes and osseous pathologies.
Tendons – Ligaments – Impingement – Osteo-chondritis dessicans – Ultrasound – MRI
https://mjcu.journals.ekb.eg/article_55184.html
https://mjcu.journals.ekb.eg/article_55184_392504af1635db61824221062d5ef0d7.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Study of Serum Level of IL10, CD4, CD8 and Acute Phase Reactants in Thalassemic Children with Effect of Splenectomy
483
489
EN
MARWA M.A. KHATTAB, M.Sc.;
SHEBL S. SHEBL, M.D.
IBRAHIM M. BADRAIA, M.D.;
MAALY M. MABROUK, M.D.
YASMINE SH.
SAID, M.D.*
The Departments of Pediatrics* and Clinical Pathology**, Faculty of Medicine, Tanta University, Tanta, Egypt
10.21608/mjcu.2018.55185
Abstract<br />Background: Thalassemia is one of the most common single gene disorders and widely distributed in the Mediter-ranean region and inherited as autosomal recessive disorders. Beta-thalassemia major has an increased risk for systemic infections, suggesting that a basic defect in the host defense is present.<br />Aim of Study: It was to study the level of (interleukin 10, CD4, CD8 subsets) in thalassemic patients and correlation with certain acute phase reactants and as well as effect of splenectomy.<br />Patients and Methods: The study was carried out on 40 children with thalassemia who attended to Hematology Unit, Pediatrics Department, Tanta University Hospital at the period from June 2016 to February 2017. Also it included 20 healthy children with matched age and sex served as a control group. All patients and controls were subjected to full history taking, clinical examination, routine laboratory investigations, CD4, CD8, CD4/CD8 ratio and interleukin 10 measurements.<br />Results: This study found that CD4 and CD8 are signifi-cantly higher in post splenectomised thalassemic patients compared with non splenectomised thalassemic patients and control group (p-value >0.05). While interleukin 10 was significantly lower in post splenectomised thalassemic patients compared with non splenectomised thalassemic patients and control group (p-value >0.05).<br />Conclusion: There are significant differences in immune responses among post-splenectomy and non-splenectomy thalassemic patients. There were significant higher level of CD4, CD8 and lower IL10 in the splenectomised thalassemic patients than non splenectomised thalassemic patients and controls. There were significant negative correlation between CD4/CD8 ratio and interleukin 10 (IL10). While there were no significant correlation between CD4, CD8 and interleukin 10 (IL10). There was statistically significant correlation between CD4, CD8 and serum ferritin.
Thalassemia – Immune response – Splenectomy
https://mjcu.journals.ekb.eg/article_55185.html
https://mjcu.journals.ekb.eg/article_55185_9bbf0b5079e2afca68b6fc1744c6d681.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
The Prognostic Significance of the Metastatic Lymph Node Ratio versus the Number of Affected Lymph Nodes in Patients with Colorectal Cancer Stage III Undergoing Potentially Curative Surgery
491
496
EN
AHMED S.A. ABDUL-SAMAD, M.Sc.;
MOSTAFA A. SOLIMAN, M.D.
MAMDOH H. HAGGAG, M.D.;
TAREK O. HEGAZY, M.D.
The Department of General Surgery, Faculty of Medicine, Cairo University
10.21608/mjcu.2018.55187
Abstract<br />Background: Many investigators have questioned the prognostic power of the TNM system in the prognosis of colorectal cancer because of the possibility of stage migration, and have proposed alternative prognostic methods; one of those is the lymph node ratio.<br />Aim of Work: The objective of this study is to compare the prognostic significance of the LNR with the absolute number of affected lymph nodes for resected colorectal ade-nocarcinoma stage III regarding overall and disease specific survival.<br />Patients and Methods: 55 patients with colorectal cancer stage III who underwent curative surgery were enrolled in a retrospective cohort study reviewing their medical charts from Medical Oncology Department between January 2005 and December 2006, and their five years follow-up period regarding local recurrence, metastasis and survival.<br />Results: The mean follow-up time was 55.1±18 months (range 6-72, median 60 months). During this time period, 12 (21.8%) patients died of disease, 20 (36.4%) patients developed local recurrence or metastasis. Overall Survival (OS) was 90.9%, 85.5%, 78.2% at 1.5, 3, 5 years respectively. Disease Specific Survival (DSS) was 90.9%, 74.5%, 63.6% at 1.5, 3, 5 years respectively.<br />Five year overall survival rates was significantly worse in colorectal cancers with LNR >40% (p-value <0.01, hazard ratio 0.022, 95% CI 0.003-0.17) and also worse 5 year disease specific survival (p-value <0.01, hazard ratio 0.182, 95% CI 0.075-0.44). Total LN £ 11 and positive number of LNs >4 showed significant worsening in the 5 year DSS only (p-value <0.05, hazard ratio 2.8, 95% CI 1.025-7.7) vs. (p-value <0.05, hazard ratio 0.32, 95% CI 0.13-0.8) respectively.<br />Conclusion: LNR was a robust prognostic indicator for node-positive colon cancers undergoing curative surgery. Because this ratio-based staging was demonstrated to reduce stage migration and to aid in identifying high-risk patients, application of the pLNR improved patient stratification in colorectal cancer and may be considered in future staging systems, it could be proposed as a standard tool for colon cancer staging.
Lymph node ratio – Colorectal cancer
https://mjcu.journals.ekb.eg/article_55187.html
https://mjcu.journals.ekb.eg/article_55187_3a8f15d5b7264f88327b479b352e26b5.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Diffusion Weighted Magnetic Resonance Imaging in Diffuse and Focal Vertebral Bone Marrow Lesions Using Apparent Diffusion Coefficient (ADC) Mapping as a Quantitative Assessment Tool
497
506
EN
NARDINE N. HELMY, M.Sc.;
MOHAMED A. HASSAAN, M.D.
AMR Y. SAKR, M.D.;
MOHAMED T. ALI, M.D.
The Departments of Radiology* and Radiotherapy**, Faculty of Medicine, Cairo University
10.21608/mjcu.2018.55189
Abstract<br />Background: Routine magnetic resonance imaging MRI is highly sensitive in detecting bone marrow alterations; however, it is of limited specificity in the evaluation of the causes of these alterations. Diffusion Weighted Imaging (DWI) is an imaging technique which probes the structure of a biologic tissue. The contrast achieved with this technique together with measurement of the apparent diffusion coefficient ADC values are useful complementary MRI tools and can be used for non-invasive tissue characterization and therefore reaching a more specific diagnosis.<br />Aim of Work: The aim of this study is to determine the value of both qualitative and quantitative assessment of DWI in differentiation between different vertebral lesions and to determine cut off ADC value between benign and malignant lesions.<br />Patients and Methods: This is a prospective study carried out in Radio-Diagnosis Department, Faculty of Medicine, Cairo University between August 2014 and February 2016 for patients diagnosed with or suspected to have vertebral lesion of any etiology. A total number of 40 patients (22 males and 18 females) with age range 2-88 (average 49).<br />The MRI sequences obtained were sagittal T1WI, T2WI, STIR and axial T1WI, T2WI & DWI (± post contrast images in some patients). Bone marrow signal intensity was qualita-tively analyzed by visually comparing its signal intensity with the signal intensity of the intervertebral disc, fat and muscle tissue on T1-weighted images. Hyperintense lesions on the DWI were identified and ADC values were automatically calculated using the software provided by the MR scanner manufacturer (Diffusion Calculation: Philips Medical Systems) and the ADC quantitative parameter was expressed in: 1 0–3mm2/s.<br />Results: Our study included 40 patients who were diag-nosed with or suspected to have vertebral lesion of any etiology. Qualitative evaluation of the lesion contrast in diffusion-weighted MRI of the vertebral column has been shown to be valuable for the differentiation of lesion etiology; however, visual assessment of high signal intensity was not specific for malignancy.<br />On the other hand the quantitative assessment by meas-uring the ADC value was able to distinguish benign from malignant high signal intensity on DWI.<br />In our study, infiltrated neoplastic marrow as well as hypercellular red marrow had higher ADC values than normal marrow while inflammatory lesions and hemangiomas had the highest ADC values.<br />Conclusion: Diffusion weighted MRI is a reliable tool in characterization of different vertebral bone marrow abnormal-ities. The routine MRI protocol of spine examinations could be modified to include DWI as a cost effective substitute for the gadolinium enhanced scan especially in patients with contraindication for contrast administration.
DWI – Vertebral lesions – Bone marrow – ADC – Malignant lesions
https://mjcu.journals.ekb.eg/article_55189.html
https://mjcu.journals.ekb.eg/article_55189_9dffcc7c23dede22b82f4f1c83270b31.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Impact of Renal Impairment on Coronary Vasculature among Patients Undergoing Primary Percutaneous Coronary Intervention and its Effect on Hospital Stay Outcome
507
516
EN
MAHMOUD M. KHALIL, M.Sc.;
MEDHAT M. ASHMAWY, M.D.
MOHAMED W. EL-SETIHA, M.D.;
MAHMOUD A. ABOUOMAR, M.D.
The Department of Cardiovascular Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt
10.21608/mjcu.2018.55191
Abstract<br />Background: The decrease in glomerular filtration rate is independently associated with increase of cardiovascular disease and cardiovascular death. Cardiovascular causes, mainly myocardial infraction are responsible for half of deaths in Chronic Kidney Disease (CKD) patients.<br />Aim of Study: To study impact of renal impairment on coronary vasculature among patients undergoing primary PCI and its effect on hospital stay outcome.<br />Methods: A prospective observational study conducted from June 2016 to November 2016, at Cardiovascular Medicine Department, Tanta University Hospitals in Gharbia Governo-rate, Egypt. The study enrolled 138 consecutive adultpatients of both genders who were diagnosed with definite ST-segmentelevation myocardial infarction within 12 hours from the time ofsymptoms onset and were treated by primary percutaneous coronaryintervention. EGFR was calculated and the patient were divided into four groups according to the severity of the renal impairment.<br />Results: The current study showed that reduced renal function either estimated by eGFR was associated with sig-nificantly lower rates of suboptimal perfusion assessed by angiographic and by electrocardiographic criteria.Both the epicardial coronary artery flow and the myocardial perfusion were both reduced with reduced renal function when compared to the group with normal kidney functions.<br />Conclusion: CKD is not uncommon finding among pa-tients with STEMI and the rate of no reflow showed significant increment with worsening of renal function. Both epicardial coronary flow and myocardial perfusion are reduced in CKD patients with STEMI and CKD was independently and in-versely associated with the rate of procedural success.
Chronic kidney disease – Percutaneous coronary intervention – ST elevation myocardial infarction – Primary percutaneous coronary intervention
https://mjcu.journals.ekb.eg/article_55191.html
https://mjcu.journals.ekb.eg/article_55191_12fae1f66d4fa0333cec0237d77682c1.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Tissue Doppler Assessment of Systolic Right Ventricular Function before and after Balloon Pulmonary Vulvuloplasty
517
523
EN
LAMIAA A. EL-BATANONY, M.Sc.;
SEHAM F. BADR, M.D.
SAHAR A. EL-SHEDODY, M.D.;
SAMEH S. KHALIL, M.D.
The Department of Cardiovascular Medicine, Faculty of Medicine, Tanta University
10.21608/mjcu.2018.55192
Abstract<br />Background: The incidence of valvular pulmonary stenosis has been reported to be 0.6 to 0.8 per 1000 live births, and when associated with other congenital heart diseases as many as 50% of all patient with congenital heart diseases. The magnitude of right ventricular pressure and the pressure across the pulmonary valve are generally proportional to the degree of obstruction. Under usual circumstances, proportional right ventricular hypertrophy maintains normal pulmonary flow. If the normal output isn't maintained, right sided heart failure ensues. This occur in neonates with critical pulmonary stenosis and in patient with severe obstruction that occur in childhood or adulthood.<br />Aim of Study: To assess the right ventricular systolic function by tissue Doppler in patients with critical valvular pulmonary stenosis before, immediately and three months after successful Balloon Pulmonary Valvuloplasty (BPV).<br />Methods: This study is a prospective study, it included 20 patients with critical stenosis who attended to the Cardiology Department in Tanta University Hospital and subjected to balloon pulmonary valvuloplastyfrom August 2016 to March 2017. The patients are subjected to balloon valvuloplasty and full echocardiography assessment and tissue Doppler to the right ventricle.<br />Results: The transcutaneous BPV showed high efficacy in reducing the pressure gradient across the pulmonary valve denoting successful and effective dilatation, where the max-imum pulmonary PG ranged from 68-120mmHg. With a mean ± SD value of 82.47±16.3 at base line, and 12-30mmHg with a mean value of 20.26±5.43 immediately after intervention, and 15-35mmHg, with a mean ± SD value of 22.37±5.05 mmHg three months after intervention. There was statistically significant decrease in maximum pulmonary PG immediately after BPV (p=0.001), but there was no statistically significant difference in the maximum pulmonary PG immediately after intervention and after three months. TAPSE ranged from 11- 16mm with a mean ± SD value of 13.48±1.43 at base line, and 13-17mm with a mean ± SD value of 15.87±1.08 imme-diately after intervention.and 20-24mm with a mean ± SD value of 21.74±1.163 three months after intervention. There was statistically significance increase in TAPSE immediately after intervention and also three months after intervention. Right Ventricular Systolic wave (RVs) ranged from 8-11cm/s with a mean ± SD value of 9.24±0.77 at base line, and 8-11 cm/s with a mean ± SD value of 9.24±0.67 immediately after intervention and ranged from 11-14cm/s with a mean ± SD value of 12.41±0.67 three months after intervention. There was no statistically difference in RVs before intervention and immediately after intervention but RVs was statistically significance increased after three months from both before intervention and immediately after intervention.<br />Conclusion: BPV is safe and effective to relieve critical pulmonary stenosis. The balloon promotes advantageous changes in both, pulmonary annulus and pressure gradient across the RVOT, in addition, the Doppler gradient observation during the follow-up support the expectation that BPV is a curative therapy. The right ventricular systolic function changed favorably in children with moderately-severe pulmonary stenosis after successful balloon valvuloplasty. These changes provide a good insight for early intervention in the children with pulmonary stenosis to avoid progression to permanent cardiac deformation and heart failure.
Pulmonary stenosis – Tissue Doppler – Balloon valvuloplasty
https://mjcu.journals.ekb.eg/article_55192.html
https://mjcu.journals.ekb.eg/article_55192_82ac63d0c639247b1974696a2e4fe441.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Prediction of Acute Kidney Injury among ST- Elevation Myocardial Infarction Patients Treated with Primary Percutaneous Intervention by Hemoglobin Level and Left Ventricular Function
525
534
EN
SALMA M. EL-SHOKAFY, M.Sc.;
MAGDY M. EL-MASRY, M.D.
EHAB A. HAMDY, M.D.;
AYMAN A. EL-SHEIKH, M.D.
The Department of Cardiovascular Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt
10.21608/mjcu.2018.55194
Abstract<br />Background: Among patients with ST-segment Elevation Myocardial Infarction (STEMI) undergoing primary Percuta-neous Coronary Intervention (PCI), worsening of renal function resulting in Acute Kidney Injury (AKI) is a frequent compli-cation known to be associated with adverse outcomes. Also, anemia on admission is associated with an increased risk for (AKI). The relation between echocardiographic parameters of Left Ventricular (LV) function and the risk of AKI among patients with STEMI undergoing PCI is still controversial.<br />Aim of the Study: Detection of the relationship between hemoglobin level and LV systolic and diastolic function as a predictors for developing AKI after primary PCI in patients with STEMI.<br />Methods: A prospective observational cohort study con-ducted from June 2016 to June 2017, at Cardiovascular Medicine Department, Tanta University Hospitals in Gharbia Governorate, Egypt. The study enrolled 38 consecutive adult patients of both genders who were diagnosed with definite STEMI within 12 hours from the time of symptoms onset and were treated by PCI who developed AKI after the procedure. The study population (38 patients) was then subdivided according to severity of renal impairment according to creat-inine clearance (Cr cl ) into two groups:<br />Group I: Those who developed severe renal impairment with Cr.cl £30ml/min (17 patients).<br />Group II: Those who developed mild to moderate renal impairment with Cr.cl ³30ml/min (21 patients).<br />They were subjected to full clinical examination, labora-tory investigation including serum creatinine (sCr) level that was determined on hospital admission, before primary PCI, and at least once a day during the cardiac Intensive Care Unit stay, complete blood count with special attention to Hemo-globin (Hb) level at hospital admission before primary PCI. All patients underwent a screening echocardiography within three days of admission, measurement of LV systolic function was performed using the commercially available machine (Vivid 7, GE Medical System, Horten, Norway) with a 3.5- MHz transducer. LV systolic function was assessed using M-mode in parasternal long axis view.<br />Results: Group I patients were older (70.65±10.36 years vs 57.43±12.09 years, p=0.001), but there was no statistacillay significant difference between both groups for risk factors, smoking, dyslipidemia, diabetes, time to reperfusion, addiction, site of infarction or Killip's classification; but there was more prevelance of prior MI in Group I than Group II. There was a statistically significant difference between both groups as regard Hb level (10.65±0.996gm/dl vs 11.62±1.396gm/dl, p= 0.017), EF (40.18±7.40% vs 48.67±8.05%, p=0.002), Cr cl ( 26.35±2.18ml/min vs 39. 10±5.61ml/min, p=0.001), sCr on admission (1.36±0.21ml/dl vs 1.06±0.20ml/dl, p=0.001), peak sCr (2.08±0.32ml/dl vs 1.79±0.32ml/dl, p=0.010) and s.Cr level at discharge (1.55±0.21ml/dl vs 1.36±0.18ml/dl, p= 0.004).<br />Conclusion: Older ages, previous history of myocardial infarction, TIMI flow after PCI, anemia on admission, level of serum creatinine on admission, creatinine clearance and impaired systolic function of left ventricle were strongly statistically different with developing AKI and related to its severity, while no significant statistical difference could be found as regard gender, smoking, addiction, diabetes, dyslip-idemia, Killip classification, time to reperfusion, or site of infarction with incidence of developing AKI.
Acute kidney injury – Percutaneous coronary intervention – Ejection fraction percentage – Hb level
https://mjcu.journals.ekb.eg/article_55194.html
https://mjcu.journals.ekb.eg/article_55194_5b303948b0160b74994802c65dc71921.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Evaluation of the Prognostic Value of BNP in Prediction of Sudden Cardiac Death in Patients with Left Ventricular Dysfunction after an Acute MI
535
541
EN
AHMED YASSIN, M.Sc.;
MOHAMED ABO HAMILA, M.D.
AHMED BATTAH, M.D.;
AMAL RIZK, M.D.
SHERIEF
MOKHTAR, M.D.
The Department of Critical Care, Faculty of Medicine, Cairo University
10.21608/mjcu.2018.55196
Abstract<br />Background: Sudden Cardiac Death (SCD) is still a challenge despite advances in diagnostic and therapeutic and inspite of effectiveness of Implantable Cardioverter Defibril-lators (ICDs), a better identification of patients with depressed ventricular function who could benefit from an ICD or, perhaps more importantly, those who are unlikely to benefit would helpin their management.<br />Aim of Study: Was To assess the prognostic value of B-type Natriuretic Peptide (BNP), in predicting sudden cardiac death within 90 days from the onset of MI in pts who developed LV dysfunction in this period.<br />Methods: We measured NT pro BNP in 60 consecutive post-STEMI patients with LV systolic dysfunction (<EF 50%), (45 men, represents 75% with mean age 57.6±8.4 years old), 3 to 5 days after onset chest pain.<br />Results: Mean age of studied patients was 57.6±8.4 years old (range 35-80). Males constituted 73.3% of our study population (44 males), we found mean NYHA 2.8, mean Killip class of 2.9 and mean TIMI risk score of 8.3. Follow-up was done at 90 days. Forty eight patients survived (80%), of whom life-threatening arrhythmias was documented in seven patients (11.7%), 12 pts had SCD (20%). Pro-BNP as evidenced as a useful marker in predicting SCD by plotting the ROC curve that revealed AUC for 0.775 for prediction of sudden cardiac death, while AUC was 69.6% of ROC curve of same neuropeptide in evaluating accuracy in prediction VT, by. Kaplan Meier analysis shows that rise of pro-BNP above 3.2ng/ml has a significant predictive impact upon SCD, [OR 0.748 (CI 95%: 0.07-0.932), p-value .039].<br />Conclusion: BNP levels are a strong, independent predictor of sudden death in patients with ischemic cardiomyopathy after an acute MI.
AUC: Area Uner the Curve – BNP: Beta Natru-iretic Peptide – MI: Myocardial Infarction – SCD: Sudden Cardiac Death – VT: Ventricular Tachy-cardia – STEMI: ST Elevated Myocardial Infarc-tion
https://mjcu.journals.ekb.eg/article_55196.html
https://mjcu.journals.ekb.eg/article_55196_b614691ffda4b97994902b9751acd46c.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Role of I-Scan in the Diagnosis of Patients with Portal Hypertensive Gastropathy
543
546
EN
AYMAN YOUSY, M.D.;
HANY SHEHAB, M.D.
KHALED RAGAB, M.Sc.;
MAGED EL-GHANAM, M.D.
MOHAMED GODA, M.D.;
HAYTHAM ABDALLA, M.D.
TAREK ABOUSHOUSHA, M.D.;
NOHA HELAL, M.D.
The Departments of Endemic Medicine, Hepatology & Gastroenterology*, Faculty of Medicine, Cairo University, Hepatology & Gastroenterology** and Clinical Pathology***, Theodor Bilharz Research Institute
10.21608/mjcu.2018.55199
Abstract<br />Background: Portal Hypertensive Gastropathy (PHG) occurs as a complication of cirrhotic or non-cirrhotic portal hypertension. PHG is clinically important because it might cause acute or chronic blood loss. The aim of the current study was to test the value of I-scan to predict gastric histologic diagnosis especially in cases with portal hypertensive gastrop-athy.<br />Subject and Methods: 113 subjects involved into this study and divided into two groups; Group (1) Consisted of twelve normal subjects while Group (2) Consisted of 101 HP negative PHG. Upper endoscopy was performed for all cases, first by WLE then we shifted to I-scan technology, two biopsies were taken (one from greater curvature of the body of stomach and the other from antrum). Also full clinical assessment, biochemical profile, viral markers and ultrasound were per-formed for all the patients.<br />Results: PHG group showed a congested SECN and CV of the body and antrum with high specificity and sensitivity above 90%.<br />Conclusion: I-scan has good sensitivity and specificity regarding diagnosis of PHG and poor specificity in the diag-nosis of HP gastritis.
Portal hypertensive gastropathy – I-scan
https://mjcu.journals.ekb.eg/article_55199.html
https://mjcu.journals.ekb.eg/article_55199_ce045172d5d3e56b140ff91f226b801a.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Role of Cardiac Magnetic Resonance Imaging in the Assessment of Myocardial Viability in Patients with Coronary Artery Disease
547
559
EN
AALAA Y. MOHAMMED, M.Sc.;
OMAR A. HASSANIEN, M.D.
AHMED S. IBRAHIM, M.D.;
NAGLAA L. DABEES, M.D.
The Department of Diagnostic Radiology and Medical Imaging, Faculty of Medicine, Tanta University, Tanta, Egypt
10.21608/mjcu.2018.55201
Abstract<br />Background: The principal goal of the assessment of myocardial viability is to identify patients whose symptoms, exercise capacity, and long-term prognosis may improve after revascularization. Contrast enhanced cardiac MRI has devel-oped as a promising imaging modality for the assessment of myocardial viability which provides direct imaging of necrotic tissue with high contrast and high spatial resolution. Aim of the work was to assess role of cardiac MRI as a non-invasive tool in the evaluation of myocardial viability in patients with coronary artery disease.<br />Aim of Study: To assess the role of cardiac MRI as a non-invasive tool in the evaluation of myocardial viability in patients with coronary artery disease.<br />Material and Methods: The study included 25 patients diagnosed as having Coronary Artery Disease (CAD), (age range, 28-68 years ±11.29). All selected patients were subjected to cardiac MRI examination using 1.5-T MR system for studying myocardial function and viability. Comparison was made between echocardiography and cardiac MRI regarding segmental wall motion using the 17-segment model of the American Heart Association for assessment of myocardial function. Delayed-enhancement MRI was performed to deter-mine myocardial viability and scarring while black blood T2W sequence with fat suppression was done to detect cases with acute infarction. Microvascular occlusion was diagnosed using early Gadolinium enhancement sequence.<br />Results: Good agreement between cardiac MRI and echocardiography regarding segmental wall motion with p-value of 0.065. Sensitivity and specificity of cardiac MRI for detecting SWMA were 93.6%, and 44.4% respectively. Myo-cardial viability was evaluated by cardiac MRI with the use of end-diastolic wall thickness, imaging of early and late enhancement after contrast administration. Late gadolinium enhancement allowed assessing state of myocardium and visualizing myocardial scar with its quantification. Two segments showed 1-25% transmural extent of myocardial wall infarction, while 120 segments showed 71-100% extent and 261 segments showed no enhancing scar.<br />Conclusion: Cardiac MR imaging is an effective and reliable method for the evaluation of myocardial function as compared to echocardiography. Also it is effective and reliable method for the evaluation of myocardial viability being able to assess both the infarct size and trans-murality and accord-ingly helps to predict functional recovery after revasculariza-tion.
Ischemic Heart Disease (IHD) – Segmental Wall Motion Abnormality (SWMA) – Cardiac Magnetic Resonance (CMR) – Myocardial viability – Late gadolinium enhancement
https://mjcu.journals.ekb.eg/article_55201.html
https://mjcu.journals.ekb.eg/article_55201_911a71f7d2f2bb3a802ceb27593de293.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Efficacy of Whole Body Vibration on Post Thyroidectomy Osteoporosis
561
565
EN
ZAKARIA M.E. MOAFY, Ph.D.;
ERENY S. WAHBA, Ph.D.
AMIR A.
ABOUTAHOUN, M.Sc.
The Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University* and Physical Therapy Department, 6th October Hospital**, Giza
10.21608/mjcu.2018.55207
Abstract<br />Purpose: This study was conducted to investigate effect whole body vibration on post thyroidectomy osteoporosis.<br />Subjects and Methods: Thirty patients with osteoporosis following thyroidectomy were conducted in the present study. All patients with age ranged from 40 to 60 years. They were selected from El-Kasr El-Ainy Hospital and El-Safwa Hospital in Cairo, Egypt.<br />Patients assigned randomly into two Groups (A and B) equal in number: Group (A) fifteen patients received the routine medical treatment (Bisphosphonates, Calcium and Vitamin D) plus whole body vibration for 12 weeks (3 sessions/ week). Group (B) fifteen patients received the recommended routine medical treatment (Bisphosphonates, Calcium and Vitamin D) for 12 weeks.<br />Evaluations of both groups (A and B) were done before starting the treatment and at the end of study by Dual Energy X-rays (DEXA).<br />Results: This study showed a statistically significant increase of bone density with percentage of improvement (23.44) in Group (A), compared with Group (B) with percent-age of improvement (13.2).<br />Conclusion: Whole body vibration is an effective modality for improving bone density.
Thyroidectomy – Osteoporosis – DEXA – Whole body vibration
https://mjcu.journals.ekb.eg/article_55207.html
https://mjcu.journals.ekb.eg/article_55207_40efb6376fa7e5d9af9f7649bd45bd5b.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Pulmonary Functions after Mitral Valve Replacement
567
573
EN
AMR A.S.A. ATTIA, M.Sc.;
MOHAMMED Sh. MOHRAN, M.D.
AYMAN A. SALLAM, M.D.;
ABD EL-HADY M. TAHA, M.D.
The Department of Cardiothoracic Surgery, Faculty of Medicine, Tanta University
10.21608/mjcu.2018.55208
Abstract<br />Background: Mitral valve replacement surgery has a great impact on pulmonary functions specially in patients with preoperative pulmonary hypertenstion. Spirometry test can be used to measure the changes in pulmonary function after mitral valve replacement surgery of cases with pulmonary hypertension.<br />Aim: To clarify pulmonary function changes after mitral valve replacement of cases.<br />Methods and Material: This study was carried out on forty-two patients subjected to mitral valve replacement surgery due to rheumatic mitral affection. Those patients divided into two groups, Group 1 included twelve patients subjected to mitral valve replacement having no preoperative pulmonary hypertension and Group 2 included thirty patients subjected to mitral valve replacement having pre-operative various degree of pulmonary hypertension. Group 2 are furtherly subdivided into three subgroups according to Systolic Pulmonary Artery Pressure (SPAP) during rest. Pulmonary functions evaluated two days pre-operatively, at discharge of patients, three and six months post-operatively.<br />Results: Pulmonary function tests impaired pre-operatively in association with severity of pulmonary hypertension and more impairment early after mirtal valve repacement was noticed and recovers gradually along six months later post-operatively with statistically significant among the severe pulmonary hypertension group.<br />Conclusions: There is no correlation between the reduction of pulmonary hypertension and the improvement of pulmonary functions, so we can’t depend on pulmonary function as a predictor of reduction in pulmonary hypertension after mitral valve replacement surgery due to small sample size. Patients with severe pulmonary hypertension pre-operatively, showed statistically significant improvement in the pulmonary functions during the six months post-operatively.
Pulmonary function – Pulmonary hypertension – Mitral valve replacement
https://mjcu.journals.ekb.eg/article_55208.html
https://mjcu.journals.ekb.eg/article_55208_c15c3cc501f7750bd0124a3796a8fbbb.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Efficacy of Intravenous 3% Hypertonic Saline Compared to Mannitol 20% for Lowering Intraocular Pressure in Glaucoma Patients
575
579
EN
MOHAMMED H.E. HAFEZ, M.D.;
GIHAN M. OBAYAH, M.D.
MAHA M.I. YOUSSEF, M.D.;
MOHAMMED S. MOHAMMED, M.D.
OMNIA A.
MANDOR, M.Sc.
The Departments of Anesthesia & ICU* and Ophthalmology**, Faculty of Medicine, Cairo University
10.21608/mjcu.2018.55209
Abstract<br />Background: It is essential to reduce acutely raised in-traocular pressure before surgery and mannitol has been effectively used for this purpose. Also, intraocular pressure can be decreased by hypertonic saline by pulling fluid osmot-ically from tissues to the intravascular space.<br />Aim of Work: To evaluate efficacy of IV infusion of HTS 3% compared to mannitol 20% for decreasing IOP in glaucoma patients.<br />Material and Methods: 30 patients undergoing glaucoma surgery under general anesthesia were randomly allocated into 2 groups. One group recieved hypertonic saline 3% (3 ml/kg) and the other group received mannitol (0.5gm/kg). Baseline IOP was measured just before infusion then measured 5, 10, 20, 30, 60, 120min after end of infusion.<br />Results: There was statistical significant decrease in the IOP in both groups at 1 and 2 hours after infusion when collected data were compared to baseline.<br />Conclusion: This study concluded that IV infusion of HTS 3% seemed to be effective in decreasing IOP in glaucoma patients. It might be considered as a good alternative to mannitol for this purpose.
Hypertonic saline – Mannitol – IOP – Glaucoma
https://mjcu.journals.ekb.eg/article_55209.html
https://mjcu.journals.ekb.eg/article_55209_bef71b5ff626a784f00cf6e64a8d0306.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Role of Laparoscopy in Appendicular Mass among Pediatric Age Group With or Without Perforation: Early Outcome
581
588
EN
SAMIR M. ABO EL-SOOD, M.Sc.;
SHERIF M. SHEHATA, M.D.
HOSSAM F. HASSAN, M.D.;
HISHAM AL-ALMETAHER, M.D.
The Department of General Surgery, Faculty of Medicine, Tanta University
10.21608/mjcu.2018.55210
Abstract<br />Background: Laparoscopic appendectomy is a safe, fea-sible and effective technique for complicated appendicitis such as mass, abscess and perforation in pediatric patients. Laparoscopic approach had several advantages over open appendectomy in that, it allow proper and wide visualization of the abdominal cavity.<br />Aim: Our aim is to evaluate the feasibility and safety of laparoscopy in cases of appendicular mass among pediatric age group with or without perforation.<br />Material and Methods: This study was carried out on fourty children presented by complicated appendicitis (perfo-ration, mass or abscess) with history less than 72 hours, aged between 4 and 18 years and scheduled for laparoscopic ap-pendectomy. Antibiotic regimen consisted of daily intravenous administration of (cefotiam, 80mgkg/24h) for 5 days intrave-nously and metronidazole (20mg/kg/24h) for 5 days intrave-nously, oral antibiotics (cefuroxime + metronidazole) were continued for another 1 week.<br />Results: Intraoperative findings were 17 cases acute perforated appendicitis, 13 cases appendicular mass, two patients were converted to open appendectomy. Analysis revealed presence of gangrenous appendicitis in 75% and suppurative (Phlegmonous) appendicitis in 25% of all appen-dices. Post-operative complications were encountered in form of intraperitoneal collection in one, fever in five, umbilical port site infection in two cases.<br />Conclusions: Laparoscopic appendectomy is a safe, fea-sible and effective technique for complicated appendicitis such as mass, abscess and perforation in pediatric patients. Laparoscopic approach had several advantages over open appendectomy in that, it allow proper and wide visualization of the abdominal cavity, moreover, it is very useful in reaching an exact diagnosis in complicated cases with experience and gentle handling.
Laparoscopic appendectomy – Complicated appendicitis – Pediatrics
https://mjcu.journals.ekb.eg/article_55210.html
https://mjcu.journals.ekb.eg/article_55210_18dba124fbc6f06d0191b89bc6c498d5.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Role of Quantitative Fecal Immunochemical Test in Assessment of Mucosal Healing in Patients with Ulcerative Colitis
589
595
EN
AHMAD F. ABO EL-EZZ AHMED, M.Sc.;
MOHAMED M. EL-BEDEWY, M.D.
MOHAMED A.S. ATTIA, M.D.;
MAHMOUD F. SELIM, M.D.
The Departments of Internal Medicine* and Clinical Pathology**, Faculty of Medicine Tanta University, Egypt
10.21608/mjcu.2018.55211
Abstract<br />Background: Ulcerative Colitis (UC) is a chronic inflam-matory disorder of the colorectum that is characterized by a remission and relapse course. Mucosal healing has been considered the goal of treatment in UC because it reduces the risk of relapse and colectomy. Fecal biomarkers have emerged as an important easy, rapid and non-invasive tool for assessing and monitoring mucosal healing in patients with UC.<br />Aim of the Study: To determine if the q-FIT can evaluate the mucosal healing in UC patients.<br />Patients and Methods: The study was conducted on 60 UC patients who underwent colonoscopy in the Endoscopy Unit, Internal Medicine Department in Tanta University Hospital. FIT was examined in stool samples from all the patients. Mucosal status was assessed using the Mayo Endo-scopic Subscore (MES).<br />Data were collected from all study patients including; clinical, demographic and laboratory data. Statistical analysis was carried out for all collected data and statistical significance was determined at a p-value <0.05.<br />Results: A total of 60 UC patients were evaluated with FIT results in conjunction with colonoscopies. The sensitivity and specificity of the FIT values (<100ng/ml) for predicting MH (MES 0 alone) were 0.93 and 0.80, respectively. The sensitivity and specificity when MH was defined as (MES 0 or 1) were 0.75 and 0.91, respectively. A significant correlations between FIT levels and the MES was observed (r=0.858, p-value=0.001 *).<br />Conclusion: Quantitative FIT can be a non-invasive and effectivebiomarker for evaluation of mucosal healing in UC.
Ulcerative colitis – Mucosal healing – Quantitative faecal immunochemical test
https://mjcu.journals.ekb.eg/article_55211.html
https://mjcu.journals.ekb.eg/article_55211_ee6ad2909f0decaae5f4d5978d056a72.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Evaluation of Vaginal Fluid b-Human Chorionic Gonadotropin for Diagnosis of Premature Rupture of Membranes
597
603
EN
AHMED M. ABBAS, M.Sc.;
SHAHINAZ H. EL-SHORBAGY, M.D.
AMAL S. EL-BANDARY, M.D.;
AHMED M. EL-ATTAR, M.D.
The Departments of Obstetrics & Gynecology* and Clinical Pathology**, Faculty of Medicine, Tanta University
10.21608/mjcu.2018.55212
Abstract<br />Background: Premature rupture of membranes is a com-mon obstetric problem, and assessment of the woman with possible membranes rupture is management issued faced in every day practice. When the fetal membranes rupture occurs, the fetus loses the protection afforded within the amniotic cavity, the chance of fetal infection increases.<br />Aim of the Work: To detect the reliability of Beta-Human Chorionic Gonadotropin (b-HCG) in vaginal washings of pregnant women for diagnosis of premature rupture of mem-branes.<br />Methods: A prospective case-study includes 90 pregnant women subdividing into three equal groups (Group A: 30 pregnant women with confirmed premature rupture of mem-branes, Group B: 30 pregnant women with suspected premature rupture of membranes, Group C: 30 apparently healthy preg-nant women without any complaint) for whom sterilized speculum examination for amniotic fluid pooling, nitrazine paper test and measurement of vaginal washing fluid b-HCG were performed.<br />Results: There was significant differences in mean vaginal washing fluid b-HCG concentration among the three groups, being higher in Group A than the other two groups and the time interval between sampling and delivery was significantly shorter among the other two groups and the optimal cut off value for vaginal washing b-HCG was 68mIU/mL using ROC curve with a sensitivity of 95%, a specificity of 88%, positive and negative predictive values of 93% and 84% respectively. Diagnostic accuracy was 90%.<br />Conclusion: Detection of vaginal fluid b-HCG is simple, reliable and rapid test for the diagnosis of premature rupture of membranes.
HCG – Vaginal washing – Premature rupture of membranes
https://mjcu.journals.ekb.eg/article_55212.html
https://mjcu.journals.ekb.eg/article_55212_5885174d7a32f2e0ed7bea253e2b68c4.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Study Risk of Hepatic Encephalopathy in Diabetic Patients with Decompensated Cirrhosis
605
610
EN
KHALED M. DARWISH, M.D.;
ABEER A. SHAHBA, M.D.
AMAL A. SELIM, M.D.;
MARIAM N. EL-MAHALAWY, M.Sc.
The Department of Internal Medicine, Faculty of Medicine, Tanta University
10.21608/mjcu.2018.55213
Abstract<br />Background: Hepatic Encephalopathy (HE) is a serious complication in patients with cirrhotic liver disease. Diabetic patients with decompensated cirrhosis are suffering more than non-diabetic patients.<br />Patients and Methods: This study included 100 patients with decompensated cirrhosis and they were classified into 2 main groups:<br />Group (A): Diabetic with decompensated cirrhosis. They were further classified into diabetic patients and patients with Impaired Glucose Tolerance (IGT).<br />Group (B): Non-diabetic with decompensated cirrhosis.<br />Then we compared the risk of hepatic encephalopathy between the 2 groups.<br />Results: Diabetic patients are at higher risk for HE than patients with IGT and both are at higher risk than non-diabetic patients.<br />Conclusion: Patients with cirrhosis should be screened for IGT and diabetes at frequent intervals so that early inter-vention can be initiated when required.
Decompensated cirrhosis – Hepatic encephalop-athy – Diabetes mellitus
https://mjcu.journals.ekb.eg/article_55213.html
https://mjcu.journals.ekb.eg/article_55213_089cd0003597815c3aee0bcb589b2f99.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
The Correlation between the Duration of Fetal Extraction during Cesarean Section and Development of Transient Tachypnea of the Newborn
611
615
EN
MOHAMAD M.I. EL-BOKL, M.D.;
DOAA Sh. ABO ZAHER, M.D.
ABD EL-RAHMAN A. ABD EL-RAZEK, M.D.;
MONA M. SEDIEK KHALIL, M.D.
HEBA M.
MARIE, M.D.
The Departments of Obstetrics & Gynecology* and Pediatrics**, Faculty of Medicine, Cairo University
10.21608/mjcu.2018.55214
Abstract<br />Background: Opted to assess the relation between each of the induction delivery time and the uterine incision delivery time during CD with the incidence of TTN.<br />Study Design: A prospective cohort study.<br />Patients and Methods: We included 100 pregnant women who were delivered by CS under spinal anesthesia, (completed 37 weeks), having singleton, non-anomalous fetus, at Kasr El-Aini Hospital, Cairo University, from May 2014 to Decem-ber 2014. Two time intervals (in seconds) were recorded: A) The induction delivery interval (from the start of induction of anesthesia till cord clamping=I-C interval), B) The uterine incision delivery interval (from the time of uterine incision till cord clamping=U-C interval). Neonatal parameters as regard; gender, weight, & 5 minute Apgar score were reportedas well as the development of TTN.<br />Results: The reported I-C interval & U-C interval ranged between 335-999sec (mean ± SD; 696±129.7) & 23-66sec (mean ± SD; 48.7±14.32) respectively. The 5 minute Apgar score range was between 6 to 10 (median; 9) & the neonatal respiratory rate range was from 39/min to 66/min (median; 44). The 5 minute Apgar score did not show any correlation, neither with the different variables of the study, nor with the I-C & U-C intervals. Out of the 100 delivered neonates, 8 neonates (8%) developed TTN & were admitted to the NICU for further management. TTN development showed a signif-icant correlation with the Gestational Age (GA), otherwise, there had been no statistical correlation between the develop-ment of TTN and the duration of fetal extraction during CS.<br />Conclusion: According to our finding TTN is not related to the length of the operative procedure till fetal delivery in cases under spinal anesthesia. We recommend the need of carrying on studies with larger populations, to offer the optimal time limit safe for fetal delivery and other possible risks for the development of TTN.
Cesarean delivery – Spinal anesthesia – I-C interval – U-C interval – TTN
https://mjcu.journals.ekb.eg/article_55214.html
https://mjcu.journals.ekb.eg/article_55214_e858b29eb1d32adbf58eab39b6d4fd07.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Efficacy of Adding Atracurium to Percaruncular Block for High Myopes (A Randomized Controlled Trial)
617
622
EN
MAHA M.A. MOSTAFA, M.D.*;
NAZMY E. SEIF, M.D.
MAHA M.I. YOUSSE, M.D.;
MAHMOUD M. SOLIMAN, M.D.
ASHRAF M.
AMIN, M.D.
The Departments of Anesthesia, Pain Management & Surgical ICU* and Ophthalmology**, Faculty of Medicine, Cairo University
10.21608/mjcu.2018.55215
Abstract<br />Background: In the current study, it was hypothesized that adding low dose atracurium to Local Anesthetic (LA) mixture would provide an early onset of akinesia and favorable surgical condition in percaruncular peribulbar anesthesia for high myopes undergoing phacoemulsification.<br />Methods: 91 ASA-PS I-III high myopes scheduled for phacoemulsification were enrolled in this randomized con-trolled trial. The enrolled patients were randomly allocated to one of two groups. Group C (n=46) received 2.5ml of lidocaine 2%, 2.5ml of bupivacaine 0.5% with hyaluronidase 15IU/ml and 1ml normal saline, while patients in Group A (n=45) received the same mixture with 5mg atracurium. The onset of globe and eyelid akinesia and duration of akinesia were recorded. The need for supplementation, total LA volume and surgeons' satisfaction were recorded.<br />Results: Eighty-two patients were analyzed with 41 patient in each group. The onset of globe akinesia was earlier in Group A than Group C [4 (2-9), 4 (4-15) min. respectively, p<0.001]. Furthermore, fewer patients in Group A required supplementation compared to Group C, 27% versus 62% respectively, p=0.002. The onset of eyelid akinesia, duration of akinesia and the total volume of LA were comparative between the 2 groups.<br />Conclusion: Adding 5mg atracurium to LA solution re-duced the time to onset of globe akinesia and the need for supplementation in the percaruncular block in myopic patients with no effect on duration of akinesia or quality of analgesia.
Atracurium – Percaruncular – Medial canthal – Peribulbar anesthesia – High myopes
https://mjcu.journals.ekb.eg/article_55215.html
https://mjcu.journals.ekb.eg/article_55215_fe11af92ef4e987807f4851657f1cced.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Correlation of Fundus Autofluorescence of the Macula with Visual Outcome after Successful Repair of Rhegmatogenous Retinal Detachment
623
628
EN
MARIAM R. FADEL, M.Sc.;
SHERIF SHETA, M.D.
ALI M. TAHA, M.D.;
; HATEM A. SAEED, M.D.
NAHLA B. ABOU HUSSEIN, M.D.;
AHMED E. HABIB, M.D.
The Department of Ophthalmology, Faculty of Medicine, Cairo University
10.21608/mjcu.2018.55375
Abstract <br /> Background: Successful reattachment of the macula after <br /> RD is often associated with incomplete visual recovery. Even <br /> with a normal-appearing macula on examination, patients <br /> often experience visual impairment. Fundus autfluorescence <br /> has been used to investigate the morphological and functional changes occurring after RD repair following vitrectomy. <br /> Aim of the Work: To investigate the structure-function <br /> relationship of the macula, by correlating fundus autofluorescence and visual acuity following successful repair of rhegmatogenous retinal detachment. <br /> Material and Methods: Forty-five eyes underwent surgical <br /> repair of RRD followed by FAF imaging one and three months post-operative. FAF findings were correlated with postoperative BCVA. <br /> Results: Forty-five eyes achieved complete post-operative <br /> reattachment with 95.6% SOSR. Mean preoperative logMAR <br /> visual acuity showed significant difference with mean postoperative logMAR BCVA (p 0.001). The values of BCVA <br /> showed significant difference between eyes showing hyperautofluorescence on FAF imaging and eyes not showing hyperautofluorescence (p=0.015). <br /> Conclusion: Fundus autofluorescence is a recent noninvasive imaging modality that evaluates the function and <br /> health of the photoreceptor and the RPE layers showing great <br /> advantage in analyzing the macular function abnormality.
FAF – Rhegmatogenous retinal detachment – Microstructural changes – Macula – Visual outcome
https://mjcu.journals.ekb.eg/article_55375.html
https://mjcu.journals.ekb.eg/article_55375_ba5575d4fd5cafeed8172e05e44af1ed.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Serum Cystatin C Level for Evaluation of Renal Functions in Women with Severe Preeclamptic Toxemia
629
633
EN
MOHAMED R. MONTASER, M.Sc.;
AHMED M. OSMAN, M.D.
WESSAM S. MOHAMED, M.D.;
AHMED H. ABOU FREIKHA, M.D.
The Departments of Obstetrics & Gynecology* and Clinical Pathology**, Faculty of Medicine, Tanta University
10.21608/mjcu.2018.55376
Abstract <br /> Background: Preeclampsia is a complex and serious multisystem disorder of pregnancy with a worldwide incidence of 5-7% and contributes significantly to maternal and perinatal morbidity and mortality. Altered renal function is an essential component of the pathophysiological process in PE, so close monitoring of renal function is important to ensure a timely delivery before serious renal damage occurs. <br /> Aim of the Work: To evaluate diagnostic value of cystatin C serum levels as an alternative marker of renal function in women with severe preeclamptic toxemia versus matching cases of normal pregnancy and compare it with the traditional markers of renal function, Creatinine, urea and serum uric acid. <br /> Patients and Methods: A case-control study includes 80 Primigravidae with singleton pregnancy and gestation ≥28 weeks and were divided into two groups, Group 1: (40 patients) with severe preeclampsia and Group 2: (40 patients) as a control group (normotensive and nonproteinuric). Markers of kidney function were investigated in two groups of pregnant women and comparison between both groups as regards to cystatin C serum levels, creatinine, blood urea and serum uric acid was done. <br /> Results: The difference in the mean serum uric acid level (5.10±0.96 versus 4.70±0.63mg/dl) was significantly higher in preeclampsia (p=0.027), the specificity was 100% and sensitivity of the test was 87.5%, the difference in the mean serum concentration of creatinine (0.94±0.16 versus 0.86± 0.12mg/dl) was significantly higher in preeclampsia (p=0.028), the specificity of the test was 100% and the sensitivity was <br /> 82.5%. Serum cystatin C level has a mean (1.26±0.21 versus 0.75±0.05mg/l) which was significantly higher in preeclampsia (p=0.001) with a specificity 100% and sensitivity 96%. Conclusion: It is concluded that among serum creatinine, blood urea, serum uric acid & serum cystatin C, Serum cystatin C is the earliest & a better marker of renal dysfunction in preeclampsia. <br />
Cystatin C – Renal function – Preeclampsia
https://mjcu.journals.ekb.eg/article_55376.html
https://mjcu.journals.ekb.eg/article_55376_c9579fb31c3f9a25ac5d359833b62464.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Case Report: Trans-Vaginal Excision of Anterior Rectal Duplication Cyst in an Adult
635
638
EN
DAFER M. AL-SHEHRI, M.D.,
S.B.-SURG.
HALA F. ALI, M.S.,
M.R.Cs.
WALID M.
ABD EL-MAKSOUD, M.D., Ph.D., M.R.Cs.
The Department of General Surgery, Aseer Central Hospital* and Faculty of Medicine, King Khalid University**, Abha, Saudi Arabia
10.21608/mjcu.2018.55377
Abstract<br />Case Report: We present an extremely rare case of anterior rectal duplication cyst in a 36-year old female patient. The patient presented with deep perineal pain, constipation, and severe dyspareunia. Pelvic examination showed a mass in the rectovaginal space. The condition has been diagnosed by MRI. The cyst was completely excised through transvaginal approach due to its lower anterior location. The transvaginal approach was safe, easy and was followed by well-preserved anal functions. Post-operative histopathological examination confirmed the diagnosis of rectal duplication cyst. The patient was followed for one year and she reported complete disap-pearance of her pre-operative symptoms.<br />Conclusions: Although anterior rectal duplication is an extremely rare condition, it should be put into consideration in managing patients with pararectal cysts. MRI is an efficient radiological investigation that accurately describes the cyst and its relation to surrounding structures. Transvaginal ap-proach is a safe and easy approach to excise these lesions, especially when they have a low anterior location.
Rectal duplication cyst – Trans-vaginal approach – MRI – Dyspareunia
https://mjcu.journals.ekb.eg/article_55377.html
https://mjcu.journals.ekb.eg/article_55377_4729e431d535fd5faca8ecb5f52aeaf2.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
The Value of MRI Brain DWI (ADC) in the Management of Ventriculomegaly in Pediatric Age Group
639
643
EN
MONA M.M. FATOUH, M.Sc.;
HASSAN A.H. EL-KIKI, M.D.
MERVAT Sh. EL-SAHRAGTY, M.D.;
HASSAN I. EL-SHAFEI, M.D.
TALAAT A.
HASSAN, M.D.
The Departments of Radiology* and Neurosurgery**, Faculty of Medicine, Cairo University, Egypt
10.21608/mjcu.2018.55378
Abstract<br />Background: Neurosurgeons need to answer the question: Which infant with an enlarged ventricular system needs neurosurgical intervention (progressive pressure hydroceph-alus) and which one needs to be left alone and diagnosis of compensated pressure hydrocephalus is established using MRI brain DWI (ADC) as well as a useful follow-up tool for the treatment success.<br />Aim of the Work: Investigate the role of ADC's value in children with hydrocephalus to differentiate between compen-sated and progressive hydrocephalus and follow-up after neurosurgical interventions.<br />Patients and Methods: This prospective study included (40 participants) 10 controls (5 males and 5 females) and 30 patients (18 males and 12 females). All the patients underwent routine MRI brain and DWI (ADC) examinations.<br />Results: In our study, we found that DWI (ADC) is a useful non invasive tool in diagnosis and follow-up the treatment success in hydrocephalic children, providing us the mean ADC cut off value (1.0817) for differentiation (compen-sated from progressive pressure).<br />Conclusion: Elevated ADC values in children with pro-gressive hydrocephalus and normalization of the previously high mean ADC value associated with successful neurosurgical intervention, however some patients can present with borderline ADC values and diagnosis of PPH based on the clinical background of the patient and follow-ups. The patients with compensated pressure hydrocephalus, there is no significant decrease of the calculated mean ADC value with follow-ups.
Compensated pressure hydrocephalus – Progres-sive pressure hydrocephalus – MRI – DWI – ADC
https://mjcu.journals.ekb.eg/article_55378.html
https://mjcu.journals.ekb.eg/article_55378_c31897926d8ceca4410587d9e09a10df.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
The Effect of Intratympanic Injection of Dexamethasone for the Treatment of Sudden Sensorineural Hearing Loss
645
650
EN
MOSTAFA R.A. LOTFY, M.Sc.;
AMANI M.N. EL-GHARIB, M.D.
ABO-BAKR S. BEHERY, M.D.;
MOHAMED A.A. KHALEFA, M.D.
The Departments of Otorhinolaryngology*, Audiology** and Otolaryngology***, Faculty of Medicine, Tanta University
10.21608/mjcu.2018.55379
Abstract<br />Background: Steroids remain the treatment of choice for sudden hearing loss regardless the cause. With the adverse effects of systemic corticosteroids, Intratympanic injection of steroids appears to be an attractive method of management of Idiopathic Sudden Sensorineural Hearing Loss (ISSHL) in patients with contraindication for systemic steroids.<br />Patients and Methods: 40 patients, presented with mod-erate to severe and severe SSNHL were enrolled in the study. Patients were randomly allocated in one of two groups: (Group I) received intratympanic injection of dexamethasone 4mg for 5 times over 4 weeks and (Group II) received systemic steroid 1mg/kg for one week and tapering the dose for two weeks. Pure Tone Audiogram (PTA) and Speech Discrimina-tion (SD) were used for assessment pre and post-treatment in the two groups.<br />Results: Group I treated with intratympanic injection of dexamethasone showed hearing improvement in 45% of patients (9 patients) and no improvement in 55% of patients (11 patients), while Group II treated with systemic corticos-teroids showed hearing improvement in 60% of patients (12 patients) and no improvement in 40% of patients (8 patients). The degree of improvement showed no statistically difference between both groups.<br />Conclusions: The intratympanic injection of dexametha-sone is an effective alternative to systemic steroids in treatment of ISSNHL as a primary therapy.
Intratympanic dexamethasone injection – Sudden deafness – Steroid
https://mjcu.journals.ekb.eg/article_55379.html
https://mjcu.journals.ekb.eg/article_55379_cbaaf156c2d214921c957acfc488643b.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Vitamin E Improves Doxorubicin Induced Nephrotoxicity; Possible Underlying Mechanisms
651
657
EN
HEBA S. SHOUKRY, M.D.'
RADWA T. HASSANIEN, M.D.
RABAB A. RASHEED, M.D.;
MOATAZ M. KAMEL, M.D.
EHAB R. IBRAHIM, M.D.;
HALA S. IBRAHIM, M.Sc.
10.21608/mjcu.2018.55380
Abstract<br />Background: Doxorubicin (Dox) nowadays is a widely used chemotherapy, however using it has a lot of side effects on different body organs. Unfortunately Nephrotoxcisty is one of its common side effects.<br />Aim of Work: In this article we tried to seek for the effect of Vitamin E (Vit E) as a commonly used vitamin to reduce Dox induced nephrotoxisty.<br />Material and Methods: 40 albino rats were involved, they were divided into 4 groups: Control group, Dox group in which Dox was given in a dose of 2.5mg/kg, 3 times/week, Vit E group in this group rats were given Vitamin E alone for 250mg/kg/day daily via intramuscular injection, Dox + Vit E rats in this group received both medications in the previously mentioned doses. At the end of the experimental period blood samples were collected for biochemical analysis of serum Urea, Creatinin and 8-Hydroxy-2´-deoxyguanosine (OHdG). Renal tissues were collected for analysis of tissue OHdG, histological examination (H & E) and immunohistochemical analysis of renal tissue caspase 3 levels.<br />Results: Our results showed deterioration of all parameters and increased immunohistochemical expression of caspase 3 in Dox treated group. On the other hand administration of Dox with Vit E significantly improved all measured parameters and lowers the expression caspase 3 levels.<br />Conclusion: Combined treatment of Dox with Vitamin E decreases risk of Dox induced nephrotoxcisty. Protective effects of Vitamin E can be due its antioxidant and its antia-poptotic actions.
Doxorubicin – Vitamin E – 8-Hydroxy-2´-deo-xyguanosine – Caspase 3
https://mjcu.journals.ekb.eg/article_55380.html
https://mjcu.journals.ekb.eg/article_55380_de5b2744f4ad1c90109c31b2406890da.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Effect of Caudal Dexmedetomidine on Prevention of Postoperative Agitation after Sevoflurane Anesthesia in Children: A Prospective Randomized Study
659
665
EN
ZINB T. RAGAB, M.Sc.;
AMR A. MAGDY, M.D.
AHMED A. EL-DABA, M.D.;
SOHEIR M. SOLIMAN, M.D.
The Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Tanta University
10.21608/mjcu.2018.55381
Abstract<br />Background: Sevoflurane commonly used in pediatric anesthesia for inhalational induction and maintenance, however Emergence Agitation (EA) in children after sevoflurane anesthesia is common, with reported incidence up to 80%. Dexmedetomidine is a selective alpha 2 receptor agonist and has sympatholytic, analgesic and sedative properties with minimal respiratory effects.<br />Aim: The aim of this study is to evaluate the effect of caudal dexmedetomidine on prevention of agitation after sevoflurane anesthesia as a primary outcome measure. Also post-operative analgesia will be studied as secondary outcome measures.<br />Material and Methods: This study was carried out on 120 children, 1-6 years, ASA I, scheduled for elective lower abdominal surgery. Patients were randomized into 3 equal groups (40 patients in each group): Group I: Dexmedetomidine group (DEX): Received caudal anesthesia with dexmedeto-midine 1ug/kg and 1ml/kg bupivacaine 0.25%, Group II: Received caudal anesthesia with1ml/kg bupivacaine 0.25%. Group III: Received general anesthesia without caudal block. Hemodynamics: (HR & MAP) and SpO2 before induction and every 10 minutes for 1st 2 hours andat 15-min intervals for 1h. post-operatively, depth of anesthesia, incidence of emergence agitation after extubation and for 10min in the PACU by Aono's four-point scale. at 15-min intervals for 1h. Post-operative pain was assisted by CHIPPS.<br />Results: Hemodynamics (HR & MAP) only significant decrease in MAP and HR in DEX group. EA was significantly lower in DEX group, CHIPPS was significantly lower in Group I, BIS value was low in DEX group, fentanyl require-ment was lower in Group 1.<br />Conclusions: The use of dexmedetomidine (1μg/kg) added to bupivacaine in caudal block in sevoflurane-anaesthetized children significantly decreased the occurrence of EA and prolonged duration of post-operative analgesia.
Caudal block – Bupivacaine – Dexmedetomidine – Emergence agitation – Sevoflurane
https://mjcu.journals.ekb.eg/article_55381.html
https://mjcu.journals.ekb.eg/article_55381_04a881c7406fa2480c5f46a76a69a439.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Comparative Study between Adductor Canal Block and Femoral Nerve Block for Postoperative Analgesia in Knee Arthroscopy
667
673
EN
MAI K. ABDALLAH, M.Sc.;
MOHAMAD G. EL-MAWY, M.D.
AHMED A. ABD EL-HAFEZ, M.D.;
SOHAIR M. SOLIMAN, M.D.
The Department of Anesthesiology & Surgical Intensive Care, Faculty of Medicine, Tanta University
10.21608/mjcu.2018.55382
Abstract<br />Background: Femoral Nerve Block (FNB) is one of the easiest peripheral nerve blocks. However, prolonged motor blockade is associated with a clinically important risk of fall. With the advent of ultrasonography, the adductor canal can be easily visualized at the mid-thigh level, allowing perform-ance of Adductor Canal Block (ACB) with a high success rate.<br />Aim: To compare the safety and efficacy of ultrasound guided adductor canal block versus ultrasound guided femoral nerve block as post-operative analgesic in patients undergoing knee arthroscopy.<br />Patients and Methods: This study was carried out in Tanta University Hospitals from September 2015 till March 2016 on 105 adult patients of both sexes with ASA physical status I/II scheduled for knee arthroscopy. Patients divided into three equal groups (Group I) received basic analgesia in the form of paracetamol and diclofenac, (Group II) received ultrasound guided FNB and (Group III) received ultrasound guided ACB.<br />Results: There were no significant differences among the three studied groups according to demographic data. Compar-ison of the mean value of NPS score showed no significant difference between FNB and ACB, but there were significant increase in control group in comparison to both FNB and ACB. The first time to introduce morphine and total morphine consumption showed no significant difference between FNB and ACB. There was significant decrease of BBS score in FNB till 6-8h postoperative in comparison with control group and ACB.<br />Conclusion: Ultrasound guided adductor canal block is efficient as ultrasound guided femoral nerve block in control post-operative pain in patients undergoing knee arthroscopy. Also ACB result in early mobilization with no risk of fall that renders ACB preferred.
Post-operative analgesia – Adductor canal block – Femoral nerve block – Knee arthroscopy
https://mjcu.journals.ekb.eg/article_55382.html
https://mjcu.journals.ekb.eg/article_55382_24be4fe8c12b7790ed2f8c4f744be4c4.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Role of Diffusion Tensor Imaging of the Median Nerve in Carpal Tunnel Syndrome: A Case Control Comparative Study with Electrophysiological Tests and Clinical Assessment
675
683
EN
AHMAD M. WAFAIE, M.D.;
KAREEM M. MOUSSA, M.D.
HODA M. ABBAAS, M.Sc.;
LAMIA M. AFIFI, M.D.
AYMAN M.
MANSOUR, M.D.
The Departments of Radiology*, Neurophysiology** and Musculoskeletal Surgery***, Faculty of Medicine, Cairo University, Egypt
10.21608/mjcu.2018.55383
Abstract<br />Background: Carpal Tunnel Syndrome (CTS) is the most common peripheral neuropathy of an upper extremity. The diagnosis of CTS is commonly based on findings from the medical history, physical examination, and provocative tests. To confirm the diagnosis, some clinician accepts Electrophys-iological Studies (EPS) as the reference standard. Diffusion-Tensor Imaging (DTI) is a subtype of diffusion-weighted imaging based on measurement of molecular diffusion along multiple directions in space. Directional anisotropy of water diffusibility can be quantified by imaging indices such as Apparent Diffusion Coefficient (ADC) and Fractional Anisot-ropy (FA) used to characterize the degree of diffusion anisot-ropy.<br />Aim of Work: The aim of this study is to study the efficacy of diffusion tensor imaging in the diagnosis of carpal tunnel syndrome.<br />Material and Methods: Twenty-three wrists of 15 healthy subjects and 47 wrists of 31 CTS patients were evaluated with DTI and EPS. FA and ADC of the median nerve were calculated at four locations: Distal radioulnar joint, pisiform bone, hamate bone and hamate hook, and also determined from the whole median nerve. Electrophysiological test, including nerve conduction velocity was also performed for comparison with clinical assessment as a standard of reference.<br />Results: There was a significant difference between healthy individuals and patients with carpal tunnel syndrome (p<0.01 for both FA and ADC). FA value less than 0.54 and ADC value more than 1.19 X 1 0–3mm2/sec might be used in the diagnosis of carpal tunnel syndrome. As regards the DTI results, the sensitivity, specificity, negative predictive value, positive predictive value and accuracy were 97.8%, 95.6%, 95.6%, 97.8% and 97.1% respectively.<br />Conclusion: DTI scan contribute to carpal tunnel syndrome diagnosis on the basis of FA and ADC measurements.
Diffusion tensor imaging – Electrophysiological studies – Carpal tunnel syndrome
https://mjcu.journals.ekb.eg/article_55383.html
https://mjcu.journals.ekb.eg/article_55383_774f38a811e566fd4b9f95af21994987.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Tympanomeatal Degloving Technique Versus Ring Graft Underlay Technique in Tympanoplasty Type I for Subtotal Perforations
685
693
EN
AHMED M.M. HESHMAT, M.S.c.;
MAHMOUD A.E. HAGRASS, M.D.
MOHAMED N.A. EL-SHEIKH, M.D.;
HASSAN M. HEGAZI, M.D.
The Department of Otorhinolaryngology, Faculty of Medicine, Tanta University, Tanta, Egypt
10.21608/mjcu.2018.55384
Abstract<br />Background: Tympanoplasty is an operative procedure used in the reconstruction of a perforation of the tympanic membrane (TM). Two classic methods for reconstruction of a TM perforation have been used: The underlay or overlay graft techniques. Each of these approaches and techniques has its advantages and disadvantages [1,2,3].<br />Objectives: The aim of this study was to evaluate the outcomes of tympanoplasty type I performed with overlay temporalis fascia using tympanomeatal degloving technique and to compare them with results of tympanoplasty type I performed with underlay ring graft [modified cartilage peri-chondrium composite graft, CPCG].<br />Patients and Methods: This study is a comperative pro-spective study carried out in ORL-HNS Department in Tanta University Hospital, operative procedures was done in the period from October 2015 to February 2016 Study followed by 3 month follow-up for each case, population was forty-eight consecutive cases of subtotal TM perforation undergoing type one tympanoplasty.<br />The patients were divided into 2 surgical groups [I&II], 24 ears each. Group (I) is treated by using tympanomeatal degloving technique & overlay temporalis fascia. While Group (II) is treated by using ring graft underlay technique.<br />Results: Fascia group showed better hearing results [the change in ABG was (mean: 12.6±5.2) dB] than the Ring group [the change of ABG was (mean: 11.6±3.9) dB] but the differ-ence between both groups is statistically insignificant.<br />The graft success rate in (group 1) was 83.3%. Only 4 cases (16.7%) developed post operative perforations. In (group II) the success rate was 95.8%. Only one case (4.2%) developed post operative perforation. The difference in the graft success rates between the 2 groups is statistically insignificant (p>0.05)<br />Conclusion: Both techniques we used in this study were very effective in closing subtotal large perforations of TM. Ring group showed better healing results but the difference between both groups is statistically insignificant (p>0.05).<br />Fascia group showed better hearing results but the differ-ence between both groups is statistically insignificant.
Tympanoplasty – Overlay graft – Temporalis fascia graft – Cartilage perichondrium and ring graft
https://mjcu.journals.ekb.eg/article_55384.html
https://mjcu.journals.ekb.eg/article_55384_7f0d7eede3e89eebb867bb6826ea3a52.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Immunohistochemical Expression of Debiquitinating Enzyme OTUB1 in Colorectal Carcinoma
695
702
EN
NEDAL A. HEGAZY, M.D.;
RIHAM M. ABU ZEID, M.D.
EMAN A. IBRAHIM, M.D.;
DIANA Z. SAAD, M.Sc.
The Department of Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
10.21608/mjcu.2018.55385
Abstract<br />Background and Objective: Colorectal Carcinoma (CRC) is the most common malignancy of the gastrointestinal tract. The overall five-year survival for colon cancer and rectal cancer are 65% and 68%, respectively with liver metastasis being the leading cause of death. Despite the use of active targeted drugs for treatment of metastatic CRC in the past decade, cure rates remain low. Therefore, research on novel markers for earlier diagnosis and target therapy of CRC is of a great concern. OTUB1 (OTU deubiquitinase, ubiquitin aldehyde binding 1) is a deubiquitinating enzyme (DUB) that belongs to the OTU (ovarian tumor) superfamily. The aim of this work is to study the immunohistochemical expression of OTUB1 in CRC and its correlation with the available clinico-pathological variables.<br />Material and Methods: This retrospective study was conducted on a total number of 45 cases of CRC. All cases were retrieved from the archival files of the pathology labs of Ain Shams University Hospitals (from 2012-2016). Immu-nohistochemistry using rabbit polyclonal anti OTUB 1 antibody was performed.<br />Results: OTUB 1 was overexpressed in CRC tissues, and the expression level of OTUB1 was correlated significantly with histologic grade (p<0.001), depth of invasion (pathological T) (p=0.03) and location of CRC (p=0.002). On the other hand, no significant correlation was found with age, gender, metastasis whether nodal or distant, TNM stage and size of tumor.<br />Conclusion: OTUB1 may have a possible role in tumor differentiation as well as local tumor invasion, thus could be useful in identification of biologically aggressive tumors in colonoscopic biopsies in addition to providing a basis for targeted therapy which could play a major role in the treatment of CRC.
OTUB1 – Colorectal carcinoma – Immunohisto-chemistry
https://mjcu.journals.ekb.eg/article_55385.html
https://mjcu.journals.ekb.eg/article_55385_0afb2cf29aa90ece0cf437a4120d08bb.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
The Role of Concomitant Mastoidectomy in Improving Outcomes Following Tympanic Membrane Perforation Repair: A Systematic Review
703
708
EN
EMAN A. EBRAHIM, M.Sc.;
HOSSAM S. EL-SHERIF, M.D.
SHAABAN B. MOHAMMED, M.D.;
FATTHE A. ERFAN, M.D.
The Department of Otorhinolaryngology, Faculty of Medicine, Tanta University, Tanta, Egypt
10.21608/mjcu.2018.55386
Abstract<br />Background: The role of mastoidectomy performed with tympanoplasty for tympanic membrane perforations in the absence of cholesteatoma remains controversial. Many otolaryngologists continue to routinely perform mastoidectomy with tympanoplasty, others argue that performing mastoidec-tomy in these patients is unnecessary, does not improve surgical outcomes, and subjects patients to increased surgical risks.<br />Aim of the Work: To assess the effectiveness and safety of performing routine cortical mastoidectomy in addition to tympanoplasty in treatment of tympanic membrane perforation in cases of chronic suppurative otitis media in the absence of cholesteatoma.<br />Patients and Methods: Five randomized controlled trials with total of 610 participents were included of any age with chronic suppurative non cholestaetomatous otitis media, divided into two groups: Group A (received Tympanoplasty alone), Group B (Tymanplasty with cortical mastoidectomy).<br />Five outcomes measured namely (healing rate,hearing rate, tympanometric evaluation, rate if otorrhea, need for subsequent procedure).<br />Results: Articles reporting results of concomitant mas-toidectomy with tympanoplasty were identified. Five articles satisfied our eligibility criteria, there was no significant heterogeneity. Compared to the conventional method tympan-oplasty with cortical mastoidectomy was found to have a significantly higher rate of healing (odds ratio of 1.762 with a 95% CI of –1.115 to 2.787, no significant difference in post-operative air bone gap (SMD of .056 with 95% CI of –0.110 to 0.222), no significant difference in rate of otorrhea (odds ratio of 1.949 with a 95% CI of 0.528 to 7.192, no significant difference in post-operative tympanometry (odds ratio of type A, Astympanometry was 0.777 and a 95% CI of 0.278 to 2.179, no significant difference in rate of revision surgery (odds ratio 2.069 and a 95% CI of 0.178 to 24.075.<br />Conclusions: From the result s of our systematic review we advise for the use of tympanoplasty alone for treatment of non cholesteatomatous chronic otitis media.
Tympanoplasty or myringoplasty and mastoidec- tomy or tympa – Nomastoidectomy
https://mjcu.journals.ekb.eg/article_55386.html
https://mjcu.journals.ekb.eg/article_55386_61853661bb63bf2d2c367c0b4a88b01a.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
MR Arthrography with Radial Planes in Diagnosis of Acetabular Labral Tear and Articular Cartilage Lesion of the Hip
709
715
EN
MUHAMMAD AZMY EL-KAMEL, M.Sc.;
OSAMA H. ABDEL LATIF, M.D.
HATEM G. SAID, M.D.;
EHAB M. MOHAMMAD, M.D.
The Departments of Radio-Diagnosis* and Orthopedics**, Faculty of Medicine, Assiut University, Egypt
10.21608/mjcu.2018.55387
Abstract<br />Background: The target of this study was to compare between MR arthrography with parallel planes and MR ar-thrography with radial planes in the diagnosis of acetabular labral tear and chondral lesion of the hip joint.<br />Patients and Methods: 28 hips of 27 patients with sus-pected labral tear and/or FAI were enrolled in this prospective study. All hips were examined by direct MR arthrography. The acetabular labrum and articular cartilage were assessed at parallel planes (axial and coronal) and compared to radial planes.<br />Results: Parallel planes detected 14 labral tear and 13 chondral lesion of the 28 examined hips while radial planes detected 22 labral tear and 22 chondral lesion.<br />Conclusion: Radial planes have higher sensitivity than parallel planes in diagnosis of acetabular labral tear and chondral lesion of the hip.
Radial MRI – Arthrography –FAI – Hip joint– Labrum
https://mjcu.journals.ekb.eg/article_55387.html
https://mjcu.journals.ekb.eg/article_55387_9fda16b332033c213f334282a082c72c.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Prevalence of Obesity and its Relation with Eating Habits and Lifestyle among Male Primary Schoolchildren in Al-Madinah City, Saudi Arabia
717
723
EN
AWAD MOHAMMED AL-QAHTANI, M.D.,
S.B.F.M., A.B.F.M.
The Department of Family & Community Medicine, College of Medicine, Najran University, Saudi Arabia
10.21608/mjcu.2018.55388
Abstract<br />Objective: To investigate lifestyle and dietary habits associated with development of obesity among male primary school children in Al-Madinah City, Saudi Arabia.<br />Methods: A cross sectional study was conducted in Al-Madinah City that included 201 male primary school students aged above 8 years. The researcher used a study questionnaire that comprised socio-demographic variables and the HABITS questionnaire. Anthropometric measurements were also re-corded to calculate the Body Mass Index (BMI).<br />Results: The mean age of participants (SD) was 11.22 (±1.1) years. Prevalence of obesity among participants was 19.4%, 59.7% of male primary schoolchildren ate three meals daily. Only 16.9% ate fruits daily, 17.9% ate vegetables daily, while 88.1% ate snacks between meals and 20.4% consumed soft and energy drinks once daily, while 10.4% consumed soft and energy drinks twice or several times daily. One third of male primary schoolchildren watched TV for 3 hours or more, while during weekends, 66.2% watched TV for 3 hours or more. Regarding outdoor activity, 29.9% practiced it once a day, while 18.9% practiced it more than once a day.<br />Consumption of soft and energy drinks was significantly higher among obese participants than non-obese ones (p= 0.035), and outdoor activity was significantly higher among non-obese participants than obese ones (p=0.027).<br />Conclusions: Bad nutritional habits are common among male primary schoolchildren. Prevalence of obesity among male primary school children is high and increases with their age. Consumption of soft and energy drinks and lack of physical activity are associated with obesity among children. Therefore, there is a pressing need for the development of effective obesity prevention programs for schoolchildren.
Obesity – Schoolchildren – Food habits – Body mass index – Physical activity
https://mjcu.journals.ekb.eg/article_55388.html
https://mjcu.journals.ekb.eg/article_55388_344b8859446b1606726c6f245ba265af.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Case Report: Left Lung Hypoplasia with Left-Sided Pulmonary Artery Agenesis and Right-Sided Aortic Arch in A Toddler Girl in Aseer Region, Saudi Arabia
725
729
EN
ZEINH H. FARDAN, M.D.;
HESSA M. GILBAN, M.D.
RUBA E. ABO ESSA, M.D.;
ZEINAB A. ASIRI, M.B.B.S.
The Department of Child Health, King Khalid University* and The Department of Pediatrics, Maternity and Children's Hospital**, Abha, Saudi Arabia
10.21608/mjcu.2018.55550
Abstract<br />Background: Pulmonary hypoplasia is an uncommon congenital aberration which is often interconnected with other abnormalities.<br />Objective: To report a rare condition of left pulmonary hypoplasia associated with some great vessels anomalies.<br />Case Report: A 4-year-old Saudi girl with recurrent chest infections was shown to have left lung hypoplasia along with left sided pulmonary artery agenesis and right sided aortic arch. Her condition improved after medical treatment then she was referred for surgical management.<br />Conclusions: Lung hypoplasia is a rare disease. However, it should be suspected when children present with recurrent chest infections. Our case had a classical presentation since her infancy period. Early diagnosis of such cases is essential for subsequent management and achieving a good outcome.
Pulmonary hypoplasia – Pulmonary artery agen-esis – Congenital anomaly – Recurrent pneumonia
https://mjcu.journals.ekb.eg/article_55550.html
https://mjcu.journals.ekb.eg/article_55550_7b576f997262ae408651db37e966cf02.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
The Role of Diffusion Tensor Imaging (DTI) in Developmental Brain Anomalies in Pediatric Age Group
731
731
EN
DINA H. FAWZY, M.Sc.;
HADEEL M. SEIF EL-DIEN, M.D.
RANIA Z.
HASSEN, M.D.
The Department of Radiology, Faculty of Medicine, Cairo University
10.21608/mjcu.2018.55552
Abstract<br />Background: Neurodevelopmental disorders are complex processes with underlying abnormalities of white matter tracts. DTI is an advanced neuroimaging technique that can delineate the underlying abnormal white matter tracts in these disorders.<br />Purpose: To demonstrate the role of diffusion tensor imaging and the tarctography techniques in the diagnosis of brain developmental anomalies in pediatric age group.<br />Patients and Methods: This is a prospective study carried out in Radio-Diagnosis Department, Faculty of Medicine, Cairo University between March 2014 and October 2015. It included eleven patients (1 day-15 years) having neurological dysfunctional symptoms and ten control subjects of the same age group. Conventional MRI images and tractography maps were used. The examined tracts were Corpus Callosum (CC), corticospinal tract (Cst), superior and inferior longitudinal fasciculi (SLF, ILF). Fractional Anisotropy (FA) was measured at bilateral frontal, parietal and occipital white matters regions.<br />Results: Nine cases out of eleven cases with positive conventional MRI findings showed additional DTI findings. e.g tract disruption, absent or attenuated fibers Altered FA values in the white matter tracts were also found.<br />Conclusion: This study emphasis the feasibility of applying DTI technique in the evaluation of developmental brain anomalies to demonstrate additional findings not clearly visualized in conventional MR images to increase the diag-nostic accuracy.
Diffusion tractography – Echo-Planar Imaging (EPI) – Nervous system malformations – Meta-bolic – Neurodevelopmental disorders
https://mjcu.journals.ekb.eg/article_55552.html
https://mjcu.journals.ekb.eg/article_55552_1140109088091ee3e601d859b748d91b.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
The Implications of Complete Mesocolic Excision in the Treatment of Patients with Potentially Curable Colorectal Cancer Stage III
737
741
EN
AHMED S.A. ABDUL SAMAD, M.Sc.;
MOSTAFA A. SOLIMAN, M.D.
MAMDOH H. HAGGAG, M.D.;
TAREK O. HEGAZY, M.D.
The Department of General Surgery, Faculty of Medicine, Cairo University
10.21608/mjcu.2018.55554
Abstract<br />Background: Complete mesocolic excision and central vascular ligation remove more mesocolon and are best able to completely remove lymph node metastases in the draining area raising a question, does it really improve the outcome compared to an incomplete or damaged excision of the me-sentery.<br />Aim of the Work: To determine the drawbacks of total mesocolic excision on the number of total LNs harvested, overall survival and disease specific survival of Patients with Potentially Curable Colorectal Cancer Stage III.<br />Patients and Methods: It is a randomized control study and it's managed and followed-up in the police authority hospital between January 2014 and August 2015 (20 months), comparing it with a retrospective cohort (control) study of 55 patients that was analyzed in the previous study.<br />Twenty five patients with colon cancer stage III were included in the study with complete open resection of the primary tumour with lymphovascular resection as much as possible (complete mesocolic excision) to see its reflection on prognosis and follow-up of these patients for 18 months regarding survival rate, local recurrences, metastasis.<br />Results: The total number of harvested nodes was (505) LNs mean was 20.2±6.6 (range 12-35, median 19 nodes). The total number of the positive LN was 129; its mean was 5.1±2 (range 1-9, median 5). The number of patients with N1 was 6 (24%), with N2a was 13 (52%) and with N2b was 6 (24%). The lymph node ratio ranged from 8.3% to 53.3% (mean 27.3±13.2, median 25).<br />Comparing the 1.5 year overall and disease specific survival in colon cancer in both retrospective(control group) and prospective group revealed a better outcome in the pro-spective group in both OS and DSS (96%) vs. (OS of 93.1%, DSS of 90.9%) in retrospective group, but it didn't reach a significance (p=0.61) in OS and (p=0.43) in DSS.<br />Conclusion: Extended lymphadenectomy in colon cancer is important and should be applied universally for several reasons as Tumor staging would be more precise and con-founding stage migration is avoided.
Complete mesocolic excision – Colorectal cancer
https://mjcu.journals.ekb.eg/article_55554.html
https://mjcu.journals.ekb.eg/article_55554_f775611631307dbc3e7bf54ff62c1233.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Incidence of Ventricular Arrhythmias in Association with Left Ventricular Dyssynchrony in Chronic Ischemic Patients
743
749
EN
AHMED GAMAL, M.Sc.;
AHMED DAWOOD, M.D.
AHMED AL-HABAA, M.D.;
TAREK BASSIONY, M.D.
MOHAMED ABD EL-HADY, M.D.;
YOUSSEF NOSIR, M.D.
The Departments of Cardiology, National Heart Institute* and Faculty of Medicine, Al-Azhar University**, Cairo, Egypt
10.21608/mjcu.2018.55555
Abstract<br />Background: Intra ventricular mechanical dyssynchrony may play an important role in ventricular arrhythmogenesis in chronic ischemic patients.<br />Aim of the Study: To detect the prevalence of ventricular arrhythmia in chronic ischemic patients in association with left ventricular dyssynchrony assessed by left ventricular longitudinal strain.<br />Methods: The study included 50 patients with ischemic heart disease confirmed by coronary angiography. Speckle tracking echocardiography was performed. Patients were divided into 2 groups according to presence or absence of left ventricular mechanical dyssynchrony, considering difference in time to peak ³130ms by longitudinal strain between any two opposing segment at basal and mid level in LV 12 segments positive for mechanical dyssynchrony. Every patient in both groups underwent 24 hours holter monitoring for detection of ventricular arrhythmia.<br />Results: The study results showed that there were 45 males and 5 females. Mean age ±SD was 51.00±7.06 years. Mean heart rate was 76.92±13.29 beat/minute. Patients were divided into 2 groups. Group I included 40 patients with left ventricular dyssynchrony and mean time to peak SD was 102.5±34.16m sec and Group II included 10 patients without left ventricular dyssynchrony and mean time to peak SD was 82.3±45.1msec. 24 hours ECG Holter monitoring data showed that there was higher incidence of ventricular runs in Group I with positive dyssynchrony patients (47.5%) than those in Group II with negative dyssynchrony patients (20%).<br />Conclusion: Left ventricular dyssynchrony assessed by left ventricular longitudinal strain could be a predictor for increased risk of ventricular arrhythmia.
Ventricular arrhythmia – Left ventricular dyssyn-chrony – Longitudinal strain – Speckle tracking echocardiography
https://mjcu.journals.ekb.eg/article_55555.html
https://mjcu.journals.ekb.eg/article_55555_a055f5caf2f8da3d1b31590892385c65.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Effect of Aerobic Exercise Versus Calcium Supplementation on Serum Calcium Level in Hypocalcemic Children
751
757
EN
SALWA FOUAD, M.Sc.;
ELHAM E. SALEM, Ph.D.
SHOROUK E. BAYOMY, Ph.D.;
SAHAR A. MOHAMED, M.D.
The Department of Physical Therapy for Paediatrics, Faculty of Physical Therapy* and Paediatrics Department, Faculty of Medicine**, Cairo University
10.21608/mjcu.2018.55557
Abstract<br />Background: Hypocalcemic child is the presence of low serum calcium levels in the blood. Normal blood calcium level is between 8.5 to 10.5mg/dLin children. Calcium is the most important abundant mineral in the body which is impor-tant for growth bons, teeth and their skeleton.<br />Purpose: To investigate the effect of aerobic exercise versus calcium supplementation on serum calcium level in hypocalcemic children.<br />Subjects and Methods: This study was carried out on 36 hypocalcemic children of both sexes, subdivided into two groups, eighteen in each group. Their ages ranged from 24- 42 months old.<br />Results: Serum free total calcium, gross motor function measure 88score of standing and walking domain measured for all children before and after 12 weeks of intervention. Group (A): Were participated in aerobic exercise program in the form of bicycle ergometer training program 3 time/week for 12 weeks in addition to balanced daily diet calcium supplement. Group (B): Children were be treated by calcium supplementation in form of calcium carbonate (lactose) which was given once daily.<br />Non significant difference in gross motor function measure 88 scoreing of standing and serum calcium level but there was significant increase in gross motor function measure 88 scoreing of walking in Group (A) compared with Group (B).<br />Conclusion: This study concluded that aerobic exercise has benifical effect on walking ability and serum calcium level in children with hypocalcemia.
Calcium – Aerobic exercise – Calcium supple-mentation – Hypocalcemia
https://mjcu.journals.ekb.eg/article_55557.html
https://mjcu.journals.ekb.eg/article_55557_87300be018ced9262e7ccee609e8dd59.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Impact of Glycated Haemoglobin Level on Severity of Coronary Artery Disease in Non-Diabetic Patients
759
767
EN
MOUSTAFA I. MOKARRAB, M.D.;
MANSOUR M. MOUSTAFA, M.D.
WAEL R. HBLAS, M.D.;
AHMED M. SABRY, M.D.
ABD EL-HAMID I. ABD EL-HAMID, M.D.;
AHMED M. HAMED, M.Sc.
The Departments of Cardiology* and Clinical Pathology**, Faculty of Medicine, Al-Azher University and Cardiology Department, Maadi Military Hospital***, Cairo
10.21608/mjcu.2018.55559
Abstract<br />Background: Diabetes Mellitus (DM) is a major and well established risk factor for macrovascular diseases. Glycated haemoglobin (HbA1c) was more strongly associated with the risks of Atherosclerotic Coronary Vascular Disease (ASCVD).<br />Aim of the Study: This study was designed to assess the relationship between the level of HbA1c and the severity of Coronary Artery Disease (CAD) which was assessed by Gensini score and Syntax score among non-diabetic patients who were referred to elective coronary angiography.<br />Patient and Methods: A total number of 104 non diabetic patients who were referred to elective coronary angiography at Maadi Military Hospital within the period from June 2015 to June 2016 were included in this study. All patients were subjected to history taking, full clinical examination, venous samples were withdrawn for glycated haemoglobin, haemo-globin, serum creatinine, high density lipoprotien, low density lipoprotien, total cholesterol, triglycerides, and creatinine clearance was calculated. Electrocardiogram was done, and coronary angiography was recorded, and Syntax and Gensini scores were calculated.<br />Result: In high risk group, male gender represented 52.1% (n=25) of the patients, and most of this group were old age with mean age ± SD (56.83±7.18) years, and they were over weighted with mean body mass index ± SD (29.02±5.07), and hypertensive patients represented 50.0% (n=24) of this group and smokers represented 18.8% (n=9). In low risk group, male gender represented 55.4% (n=3 1) of the patients, and most of this group were old age with mean age ± SD (55.02± 7.64) years, and they were over weighted with mean body mass index ± SD (29.29±4.14), and hypertensive patients represented 58.9% (n=33) and smokers represented 37.5% of this group (n=21).<br />There was a high statistically significant difference be-tween the two groups as regard right coronary artery lesion, left circumflex artery lesion, Gensini score and Syntax score as p<0.001, and there was a statistically significant difference between the two groups as regard left main lesion as p<0.05, and there was a positive correlation between HbA1c with Gensini score and Syntax score as r=0.74 and 0,77 respectively.<br />The accuracy of Gensini score equals 85% by 81.2% sensitivity and 83.9% specificity at cut off predictive value <59 to discriminate between the two groups. The accuracy of Syntax score equals 88% by 87,5% sensitivity and 91.1% specificity at cut off predictive value <12 to discriminate between the two groups.<br />Conclusion and Recommendation: There was a positive correlation between level of glycated haemoglobin and severity of coronary artery disease which was assessed by Syntax score and Gensini score in non-diabetics who were referred to elective coronary angiography, and after this study we recommend to use HbA1c as a complimentary parameter to traditional risk factors to predict the severity of CAD.
Glycated haemoglobin – Syntax score – Gensini score – Coronary artery disease – Non-diabetic
https://mjcu.journals.ekb.eg/article_55559.html
https://mjcu.journals.ekb.eg/article_55559_effa2f1684d03071ac0cba5b74b37f86.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Early Neuromuscular Training after Anterior Cruciate Ligament Reconstruction
769
782
EN
AL-HASSAN M.M. MOHAMED, M.Sc.;
ALAA EL-DIN A. BALBA, Ph.D.
MAHA M. MOHAMMED, Ph.D.;
MOHIE EL-DIN M. FADEL, M.D.
The Department of Musculoskeletal Disorder and their Surgeries, Faculty of Physical Therapy, Pharous* and Cairo** Universities and The Department of Orthopedic Surgery, Faculty of Medicine, Alexandria University***, Egypt
10.21608/mjcu.2018.55560
Abstract<br />Background: Rupture of anterior cruciate ligament is one of the most common knee injuries, Anterior Cruciate Ligament Reconstruction (ACLR) remains the standard approach for athletes who aim to return to high level sporting activities, neuromuscular training is a main part of the rehabilitation program after ACLR.<br />Aim of the Study: This study was conducted to detect the effect of early neuromuscular training on knee propioception after ACLR.<br />Methods: Thirty patients of both gender after ACLR with age ranged from 20-30 years were included in the study. All patients were referred by orthopedic surgeon who was respon-sible for diagnosis and surgery based on clinical and radio-logical examination. They were randomly assigned into 2 Groups A included 15 patients who received standard ACL rehabilitation protocol and Group B included 15 patients who received standard ACL rehabilitation protocol in addition to neuromuscular training for three sessions per week for 6 weeks. The study was conducted at a private clinic in Alex-andria in the duration from November 2016 to August 2017.<br />Methods of Evaluation: The digital inclinometer used to assess knee proprioception (joint position sense) after ACLR.<br />Results: Showed that both standard ACL rehabilitation protocol (Group A) and standard ACL rehabilitation protocol adding early neuromuscular training (Group B) were effective in improvement of the knee proprioception with no statistical difference between the two groups.<br />Conclusion: There was no significant difference in knee proprioception between standard rehabilitation protocol with or without adding early neuromuscular training, however there was clinical difference and high percent of improvement in adding adding early neuromuscular training to standard rehabilitation protocol.
ACL reconstruction – Rehabilitation – Neuromus- cular training and propioception
https://mjcu.journals.ekb.eg/article_55560.html
https://mjcu.journals.ekb.eg/article_55560_43e038c3d75b588931cd3a95ad4157d0.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Relation between Findings of Nerve Conduction Study and Hand Function in Carpal Tunnel Syndrome
783
789
EN
NAWAL A. ABU SHADY, Ph.D.;
MYE A. BASHEER, M.D.
AHMED A. SHEHAB EL-DEIN, M.Sc.;
EMAN YASEN, Ph.D.
The Department of Neuromuscular Disorders & its Surgery, Faculty of Physical Therapy*, The Department of Special Medicine, Faculty of Medicine**, Cairo University and Physical Therapist, Human Performance in Health and Disability,
Cairo University Hospitals***
10.21608/mjcu.2018.55561
Abstract<br />Background: Functional problems occur in carpal tunnel syndrome patients affecting their daily living activities.<br />Aim of the Study: The purpose of this study was to inves-tigate the relation between nerve conduction study and hand function findings in carpal tunnel syndrome.<br />Patients and Methods: The study included 40 female patients diagnosed with carpal tunnel syndrome. They were assessed by nerve conduction study, pinch dynamometer for pinch strength and Boston questionnaire for assessing the symptoms severity and functional status of patients with CTS.<br />Results: This study revealed that there was no correlation between motor latency and symptoms subscale (r=0.113, p=0.489), functional subscale (r=0.212, p=0.189). Total hand function scale (r=0.177, p=0.274), tip pinch (r=–0.093, p= 0.567), and key pinch (r=–0.025, p=0.88) and palmar pinch (r=0.001, p=0.995).<br />There was no correlation between motor amplitude and symptoms subscale (r=0.018, p=0.911), functional subscale (r=–0.075, p=0.645), total hand function scale (r=–0.03, p=0.855), key pinch (r=0.196, p=0.225) and palmar pinch (r=0.062, p=0.705). While, there was weak positive significant correlation between motor amplitude and tip pinch (r=0.351, p=0.027*).<br />There was no correlation between velocity of motor nerve and symptoms subscale (r=0.199, p=0.217), functional subscale (r=0.245, p=0.127), total hand function scale (r=0.247, p=0.125), tip pinch (r=0.174, p=0.282), between, key pinch (r=0.049, p=0.764), and palmar pinch (r=–0.013, p=0.936).<br />There was no correlation between onset sensory latency and symptoms subscale (r=0.01, p=0.951), functional subscale (r=–0.036, p=0.826), total hand function scale (r=–0.013, p=0.935), tip pinch (r=–0.095, p=0.56), key pinch (r=–0.212, p=0.19) and palmar pinch (r=–0.188, p=0.245).<br />There was no correlation between sensory amplitude and symptoms subscale (r=0.033, p=0.841), functional subscale (r=0.143, p=0.379), total hand function scale (r=0.096, p= 0.555), tip pinch (r=0.178, p=0.273), key pinch (r=0.099, p=0.543) and palmar pinch (r=–0.019, p=0.909).<br />Conclusion: Hand function assessment should be done separately from nerve conduction study when assessing carpal tunnel syndrome patients. Psychological factors should be considered.
Carpal tunnel syndrome – Nerve conduction study – Handfunction findings
https://mjcu.journals.ekb.eg/article_55561.html
https://mjcu.journals.ekb.eg/article_55561_2785c8d7e344131d5a906776e91660f9.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Effect of Continuous Therapeutic Ultrasound and Stretching Exercise on Calf Muscle Cramp during Pregnancy
791
797
EN
PETER B. MELAD, M.Sc.;
HALA M. HANAFY, Ph.D.
MARWA A.E. MOHAMED, Ph.D.;
AMIR A. GBR, M.D.
The Department of Physical Therapy, El-Sahel Teaching Hospital*, The Department of Physical Therapy, Women Health, Faculty of Physical Therapy** and The Department of Obstetrics & Gynecology, Faculty of Medicine***, Cairo University
10.21608/mjcu.2018.55563
Abstract<br />Background: This study aimed to investigate the effect of continuous ultrasound and stretching exercise on calf muscle cramp during pregnancy.<br />Design: Randomized clinical trial.<br />Subjects and Methods: Thirty volunteers' pregnant women suffering from calf muscle cramp assigned into two equal groups. Their ages were ranged from 20-35 years.<br />This study conducted at Nahea Family Medical Center, Giza, Egypt.<br />Intervention: Group (A) received continuous ultrasound with frequency 1MHz, intensity 1.5w/cm2, 5 minutes in each session and stretching exercise of calf muscle by 15 seconds of passive stretch to the calf muscle followed by 30 seconds of rest with repetition 6 times per session with instructions about dealing with cramp by self slow sustained stretch. Group (B): Received the same instructions about dealing with cramp with self slow sustained stretch for calf muscle. Treatment sessions were applied 3 times/week for 4 weeks for two groups.<br />Outcome Measures: Cramp questionnaire with description of muscle cramps with visual analogue scale was used to assess severity of pain. Evaluation was performed before and after treatment.<br />Results: There was no significant difference between control and study group in pre and post treatment in exagger-ating factors, localization, and duration of cramp. There was significant difference between study group and control group in frequency, time of having cramp and quality of life deteri-oration.<br />Conclusion: Stretching exercise is effective in treating calf cramp during pregnancy and adding ultrasound to stretch is making significant difference than stretching alone in decreasing the frequency of cramps, time of having cramps and in decreasing the deterioration of life quality.
US – Stretching exercise – Calf – Cramp – Pregnancy
https://mjcu.journals.ekb.eg/article_55563.html
https://mjcu.journals.ekb.eg/article_55563_4a38f5a64a276a7c2d4dca12ffe3b486.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Effects of Administration of Tramadol Hydrochloride on the Histological Structure of the Liver and the Possible Protective Role of Curcumin in Adult Albino Rat
799
807
EN
DORREIA A.M. ZAGHLOL, M.D.;
SALWA M. OUIES, M.D.
NAGLAA H.
ABBAS, M.Sc.
The Department of Human Anatomy & Embryology, Faculty of Medicine, Assiut* and Sohag** Universities
10.21608/mjcu.2018.55565
Abstract<br />Background: Tramadol hydrochloride is a synthetic opioid. It is a centrally acting analgesic drug widely used in the treatment of pain. Curcumin is a medicinal plant extensively used as a home remedy for various diseases. It is shown to have anti-inflammatory and antioxidant properties.<br />Aim of the Work: To detect the toxic effects of the tramadol on the histological structure of the liver tissue and to study the possible protective role of curcumin against its toxic effects.<br />Material and Methods: 30 adult albino rats were used. The animals were divided into three groups each of them consists of 10 rats: Group I: (Control group): Animals were given normal saline orally by intragastric tube in a dose of 25ml/kg every day for one month. Group (II): Animals were given Tramadol Hydrochloride in a dose of 25mg/kg body weight orally by intragastric tube every day for one month. Group (III): Animals were given Tramadol Hydrochloride in a dose of 25mg/kg body weight and curcumin solution in a dose of 80mg/kg body weight orally by intragastric tube every day for one month. At the end of the experiment, the rats were anaesthetized by ether then perfused with saline then with the appropriate fixator, the liver was obtained and subjected to light and transmission electron microscopic studies.<br />Results: Tramadol caused dilatation in the central vein, blood sinusoids and degeneration of hepatocytes at light and electron microscopic examination and statistical studies. Administration of curcumin could improve these effects.<br />Conclusion: Tramadol caused loss of normal pattern of hepatic tissue with degeneration of some hepatocytes. Curcu-min improved the picture of the liver tissue and decreased degeneration in hepatocytes.
Liver – Tramadol – Curcumin
https://mjcu.journals.ekb.eg/article_55565.html
https://mjcu.journals.ekb.eg/article_55565_0cab79b11a1f87cb24f6b955584388e3.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
The Relationship between Daily Sedative Interruption and Selected Patients' Outcomes among Mechanically Ventilated Patients
809
817
EN
ASMAA K. HARAS, M.Sc.;
MANAL S. ISMAEL, D.N.Sc.
FATMA S.
ALI, D.N.Sc.
The Department of Critical Care and Emergency Nursing, Faculty of Nursing, Cairo University
10.21608/mjcu.2018.55568
Abstract<br />Background: Mechanically ventilated patients are a risk group whose outcomes are negatively affected by many factors. Among these factors is sedation because it is a cornerstone therapy for critically ill patients.<br />Aim of the Study: To investigate the relationship between daily sedation interruption and selected outcomes of critically ill mechanically ventilated patients.<br />Research Design: A descriptive correlational research design was utilized.<br />Research Questions: What is the relationship between daily sedation interruption and (frequency of organ dysfunction, length of ICU stay, and weaning from mechanical ventilation) among adult critically ill mechanically ventilated patients?<br />Setting: Different intensive care units of Cairo University Hospitals.<br />Sample: A purposive sample of 80 critically ill patients connected to mechanical ventilators for at least 12 hours.<br />Tools of Data Collection: Four tools were utilized to collect data pertinent to the current study:<br />Tool 1: Personnel characteristics & medical data sheet,<br />Tool 2: Daily sedative interruption outcomes assessment tool, Tool 3: Richmond Agitation Sedation Scale (RASS),<br />Tool 4: Sequential Organ Failure Assessment (SOFA score) tool.<br />Results: The majority (72.5%) of the studied sample was males, and 43.8% were in the age group of 50-£60. More than one third received fentanyl as sedation. A significant statistical relationship was found between sedation name and ICU length of stay, sedation dose and ICU length of stay, RASS score and mechanical ventilator days (c2=24.72, p-value <0.002), (c2=32.18, p£0.008), (c2=10.63, p£0.031) respectively. No significant statistical relationship was found between sedation name and the weaning type from mechanical ventilation (c2= 7.190.15, p<0.126). No significant statistical relationship was found between sedation name and the occurrence of organ failure (c2=3.29, p<0.192). <br />Conclusion: The current study revealed a significant statistical relationship between sedative agents, doses and ICU length of stay. However, no significant relationship between sedative agents and weaning type and occurrence of organ failure.<br />Recommendations: Avialability of evidence base guidelines for management of pain and sedation in ICU. Enhance the work of the multidisciplinary team who can provide the optimum care for the mechanically ventilated patients.
Mechanical ventilation – Sedation – Outcomes of mechanically ventilated patient
https://mjcu.journals.ekb.eg/article_55568.html
https://mjcu.journals.ekb.eg/article_55568_ad20777f232ecef3c891cdd6541cf348.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Short-Term Assessment of Intersphincteric Resection in Low Rectal Cancer
819
825
EN
ISMAIEL A. MOURAD, M.D.;
HISHAM A. EL-HOSSIENY, M.D.
ABD EL-HAMID H. EZZAT, M.D.;
IHAB S. HUSSEIN, M.D.
MOHAMMAD TAHER FOUAD, M.D.;
RASHA MAHMOUD ALLAM, M.D.
The Departments of Surgical Oncology*, Radiation Therapy** and Biostatistics & Cancer Epidemiology***, National Cancer Institute, Cairo University, Egypt
10.21608/mjcu.2018.55569
Abstract<br />Background: Correlation analysis between functional outcomes and different factors (pouch, stoma, ISR type, age and sex) revealed: Pouch formation and type of ISR had significant correlations with some functional aspects.<br />Aim of the Study: To evaluate the oncologic safety and functional outcomes of Intersphincteric Resection (ISR) as an alternative to Abdominoperineal Resection (APR) in low rectal cancer.<br />Patients and Methods: Patients presenting to the National Cancer Institute, Cairo University from May 2014 to October 2014; with locally advanced low (3-6m from the anal verge) rectal cancer and ended their long-course neoadjuvant chem-oradiotherapy were subjected to ISR if eligible. These patients were assessed and followed for the short-term outcomes of ISR.<br />Results: Twenty one patients underwent ISR. There was no mortality. Ten patients had postoperative complications.<br />All cases had free distal margin and one patient had +ve radial margin. The Improvement of all functional aspects occurred with time. Kirwan's grade of continence by the 15th month was: I: 5/16 (31.3%), II: 8 (50%) and III: 3 (18.8%). This is very clear comparing it with 3rd month results: II: 3/19 (15.8%), III: 13 (68.4%) and IV: 3 (15.8%).<br />Conclusion: Intersphincteric resection is an oncologically safe alternative to the standard APR in low rectal cancer, with the added benefit of improving the quality of life by avoiding a permenant stoma, together with acceptable functional out-comes.
Low rectal cancer – Intersphincteric resection – Neoadjuvantchemoradiotherapy – Coloplasty pouch
https://mjcu.journals.ekb.eg/article_55569.html
https://mjcu.journals.ekb.eg/article_55569_478cfc0df4fad4bb92869496868993dc.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
The Utility the Platelet-to-Lymphocyte Ratio in Predicting Angiographic Reflow after Primary Percutaneous Coronary Intervention in Patients with Acute ST- Segment Elevation Myocardial Infarction
827
836
EN
SAFWAT A.H. EL-HAWARY, M.D.;
MAMDOUH A.M. MAHMOUD, M.D.
ALI A. RAMZY, M.D.;
MOHAMED S. EL-SAYED, M.D.
AHMED M.A.
IBRAHIM, M.Sc.
The Departments of Cardiology* and Clinical Pathology**, Faculty of Medicine, Al-Azhar University
10.21608/mjcu.2018.55570
Abstract<br />Background: Impaired coronary flow after Primary Per-cutaneous Coronary Intervention (PPCI) is associated with long term morbidity and mortality in patients with acute ST-segment Elevation Myocardial Infarction (STEMI). Recent studies have demonstrated that Platelet-to-Lymphocyte Ratio (PLR) is associated with adverse cardiovascular outcomes. We want to determine the relation between admission (PLR) and angiographic reflow following PPCI.<br />Material and Methods: A total of 72 patients with STEMI-(age 55±10 years; 91% men) occurring within 12 hours of the onset of symptoms who underwent PPCI were enrolled. The PLR and other laboratory parameters (CKMB, creatinine, heamoglobin) were measured before Primary Percutaneous Coronary Intervention (PPCI). The patients were divided into 2 groups based on the post-intervention Thrombolysis In Myocardial Infarction (TIMI) flow grade: Normal reflow group (defined as post-intervention TIMI grade 3 flow) and no-reflow group (consisted of both patients with angiographic no-reflow defined as post-intervention TIMI grade 0-1 flow and slow flow defined as post-intervention TIMI grade 2 flow).<br />Results: There were 31 patients (22.5%) in no-reflow group (age 54±10 years and 93.5% male) and 41 patients in normal reflow group (age 55±11 years and 37% male). No-reflow group had significantly higher PLR compared to normal reflow group (196-262) versus (139-180), p=0.009). In logistic regression analysis, PLR (Odds Ratio (OR): 1.008, 95% Confidence Interval (CI):1.002-1.014, p<0.001) and were independent predictors of no-reflow after PPCI.<br />Conclusion: Pre-intervention PLR is a strong and inde-pendent predictor of slow flow/no-reflow following PPCI in patients with acute STEMI.
Platelet-to-lymphocyte ratio – Post-intervention angiographic reflow – ST-segment elevation my-ocardial infarction
https://mjcu.journals.ekb.eg/article_55570.html
https://mjcu.journals.ekb.eg/article_55570_db12896357cc0688296dd1b1038277da.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Comparison between Hypertonic Saline 3% and Mannitol, the Most Commonly Used Osmotic Agents, Regarding Effect on Blood Pressure, Electrolytes Level and Acid Base Balance
837
842
EN
MOHAMMED H.E. HAFEZ, M.D.;
GIHAN M. OBAYAH, M.D.
MAHA M.I. YOUSSEF, M.D.;
MOHAMMED S. MOHAMMED, M.D.
OMNIA A.
MANDOR, M.Sc.
The Departments of Anesthesia & ICU* and Ophthalmology**, Faculty of Medicine, Cairo University
10.21608/mjcu.2018.55571
Abstract<br />Background: Increased ICP following neurological injury can decrease CBF and may also lead to brain herniation and death so it should be lowered. Mannitol and HTS are the most commonly used osmotic agents for management of intracranial hypertension to improve the outcome.<br />Aim of Work: The aim of this study was to assess compli-cations of HTS and mannitol as they are commonly used for osmotherapy regarding effect on blood pressure, electrolytes level and acid base balance.<br />Material and Methods: 30 patients undergoing glaucoma surgery under general anesthesia were randomly allocated to 2 groups. One group recieved hypertonic saline 3% and the other group received mannitol. Mean arterial blood pressure was measured before infusion and then measured 5, 10, 20, 30, 60, 120min after end of infusion. Arterial blood gases (pH), and Na, k levels were measured at baseline (before infusion) and 60min after end of infusion.<br />Results: As regards MAP, both groups showed statistically significant increase in MAP initially followed by statistically significant decrease at 20min, 30min and 1h when collected data were compared to baseline.<br />Regarding Na level, there was statistically significant increase in Na level in HTS group in comparison to mannitol group despite being within normal range of Na level.<br />As to K level, both groups showed statistically significant decrease in K level. As regards PH, there was no statistically significant difference between both groups at baseline and after infusion.<br />Conclusion: Both HTS and mannitol had the same effect on MAP, K level and PH. Regarding Na level, it was increased slightly in HTS group while decreased in mannitol group.
Hypertonic saline – Mannitol – Mean arterial blood pressure – Na – K– PH
https://mjcu.journals.ekb.eg/article_55571.html
https://mjcu.journals.ekb.eg/article_55571_27a4d6f00766ca17094356f04ea8675e.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Phenotypic Detection of Metallo (3-Lactamase in Carbapenem Resistant Gram Negative Bacilli Isolates
843
849
EN
SHAABAN R. HELAL, M.D.;
HEBAT-ALLAH G. RASHED, M.D.
TAGHREED M. KAMAL EL-DIN, M.D.;
MOHAMMED Z. ABD EL-RAHMAN, M.D.
EBTISAM S.HASSANIN, M.Sc.;
SUGANO S., M.D.
The Department of Clinical Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt*, The Department of Medical Genomics, Tokyo University, Minato-Ku, Tokyo, Japan** and Assiut General Hospital, Ministry of Health, Assiut, Egypt***
10.21608/mjcu.2018.55573
Abstract<br />Background: A rising threat of the rapid spread of acquired metallo (3-lactamases (MBLs) among Gram Negative Bacilli (GNB) is a matter of public health concern worldwide. Hence, detection of MBLs producing clinical isolates via an accurate and cost effective technique is necessary to prevent their dissemination as well as regulation of antimicrobial steward-ship policy. This study aimed to detect MBLs in Carbapenem Resistant Gram Negative Bacilli (CRGNB) using two pheno-typic tests; Combined Disc Test (CDT) and Double Disc Synergy Test (DDST).<br />Methods: We conducted a prospective study on 130 GNB isolates recovered from different clinical specimens collected from different patients. Isolates were identified then antibiotic susceptibility profile was determined by VITEK® 2 compact system. GNB which showed resistance to meropenem were screened for MBLs production by CDT and DDST.<br />Results: Out of 36 CRGNB isolates, 23 isolates (63.9%) were MBLs positive by CDT, and 20 (55.6%) by DDST. With almost perfect agreement between CDT and DDST.<br />Conclusion: Our study validates two phenotypic methods (CDT and DDST) for the detection of MBLs production, making them highly applicable to routine clinical laboratories.
MBLs – Combined disc test – Double disc synergy test – CRGNB
https://mjcu.journals.ekb.eg/article_55573.html
https://mjcu.journals.ekb.eg/article_55573_b32c123890718b6c09c87cf567d24a66.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Predisposing Factors for Dural Tear during Lumbar Spine Surgery
851
853
EN
MOHAMED MOHAMED, M.D.;
MOHAMED A. HEWEDY, M.D.
The Department of Neurosurgery, Faculty of Medicine, Beni-Suef University, Egypt
10.21608/mjcu.2018.55575
Abstract<br />Background: Dural tear is a common complication of lumbar spine surgery. The aim of this prospective study was to identify the predisposing factors for dural tear in lumbar spine surgery.<br />Patients and Methods: We prospectively recorded data of 174 patients with lumbar spine surgery from 2013 to 2016 in Faculty of Medicine, Bani seuf University. We compared result obtain from the patients in which a dural tear occurred (Group A) and those in which a dural tear did not occur (Group B) excluded criteria are recurrent procedures, and intradural procedures.<br />All the patient data like age, sex clinical examination, and scheduled procedure, and intra-operative data (surgeon experience. Type and time of surgery) were record and com-pared between the two groups.<br />Results: 104 patients underwent discectomy, 50 patients underwent laminectomy. And 20 patients underwent lumber fixation. Among the 104 patients who underwent discectomy 5 patients had a dural tear. Among the 50 patients who under-went laminectomy 3 patients had dural tear. Amongthe 20 patient underwent lumber fixation 2 patients had dural tear. Patients with incidental durotomy were older (mean 60±5 vs 50±5 years), and had longer surgery (180±30 vs 120±30 minutes), compared with the patients without dural tear. The incidence was significantly higher with lumber fixation (pro-longed surgery) when physician training was examined; residents were responsible for 50% of all dural tear.<br />Conclusion: Predisposing factors for dural tear were, older age, prolonged surgery, and the years of physician training or resident experience appear to be a major risk.
Dural tear – Lumbar surgery – Predisposing factors – CSF
https://mjcu.journals.ekb.eg/article_55575.html
https://mjcu.journals.ekb.eg/article_55575_e48023ac25730e407d144e21a69cc1c4.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Safety of Low Dose Atracurium Added to Lidocaine, Bupivacaine and Hyaluronidase Mixture in Percaruncular Peribulbar Anesthesia for High Myopes Undergoing Phacoemulsification (A Randomized Controlled Trial)
855
859
EN
MAHA M.A. MOSTAFA, M.Sc.;
NAZMY E. SEIF, M.D.
MAHA M.I. YOUSSE, M.D.;
MAHMOUD M. SOLIMAN, M.D.
ASHRAF M.
AMIN, M.D.*
The Departments of Anesthesia, Pain Management & Surgical ICU* and Ophthalmology**, Faculty of Medicine, Cairo University
10.21608/mjcu.2018.55576
Abstract<br />Background: The current study explored the safety of adding low dose atracurium to lidocaine, bupivacaine and hyaluronidase mixture in percaruncular peribulbar anesthesia for high myopes undergoing phacoemulsification.<br />Methods: 82 ASA-PS I-III patients scheduled for phacoe-mulsification with high myopia were enrolled in this rand-omized controlled double-blinded trial. The enrolled patients were randomly allocated to one of two groups. Group C (n=41) received 2.5ml of lidocaine 2%, 2.5ml of bupivacaine 0.5% with hyaluronidase 15IU/ml and 1ml normal saline, while patients in Group A (n=41) received the same mixture with 5mg atracurium. Patients' hemodynamics, peripheral O2 saturation, occurrence of intraoperative pain and incidence of were recorded.<br />Results: There were no major complications in any of the 82 cases. The incidence of minor complications between both groups were comparative. Chemosis occurred in 12.2% of Group A and in 24.3% of Group C. Sub-conjunctival hemor-rhage occurred in 4.9% of patients of both groups. Local hyperemia were only observed in Group A (7.3%) with no statistical significance.<br />Conclusion: Adding 5mg atracurium to LA solution did not increase the incidence of complications in percaruncular block in high myopes.
Lidocaine – Atracurium – Bupivacaine – Hyaluro-nidase – High myopes – Phacoemulsification
https://mjcu.journals.ekb.eg/article_55576.html
https://mjcu.journals.ekb.eg/article_55576_0f4bb9e74a45a90c2b27fa3bd5555e7e.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Totally Laparoscopic Strategies for the Management of Colorectal Cancer with Synchronous Liver Metastasis
861
866
EN
AMR F. EL-ALFY, M.Sc.;
ADEL DENEWER, M.D.Ph.D.
NAZEM SHAMS, M.D., Ph.D.;
WALEED EL-NAHAS, M.D., Ph.D.
OMAR
FAROUK, M.D., Ph.D.
The Department of Surgery, Surgical Oncology Unit, Oncology Center, Mansoura University (OCMU)
10.21608/mjcu.2018.55577
Abstract<br />Background: The purpose of this study is to compare the laparoscopic techniques for the management of colorectal cancer with synchronous liver metastases:<br />Simultaneous laparoscopic liver and colon cancer resec-tion.<br />Simultaneous colon resection and Radiofrequency Ablation (RFA) of liver metastases.<br />Methods: Convenient sample of about 30 patients expected to attend the Oncology Center, Mansoura University (OCMU) Gastro-Enterology Center (GEC) during study period of 3 years (2014-2017) with adenocarcinoma of the colon and rectum with Synchronous Colorectal Liver Metastases (SCRLM) will be considered.<br />Results: Mean operative time was 205 minutes for LLR, in comparison with the resection group, mean operative time for RFA was 185 minutes. Though shorter in time, this did not appear to be statistically significant (p-value=4.41). Mean blood loss for the resection group was 350ml, and mean blood transfusion was 0.89L. On the other hand, mean blood loss for the RFA group was 90ml and mean blood transfusion was 0.76L. This difference between the two groups appeared to be statistically different (p-value=0.01). For the LLA group mean hospital stay 8.4 days and mean recovery time per case was 4.1 days. This was a bit shorter for the RFA group were mean hospital was 8.3 days while mean recovery time per case was 3.6 days. Although shorter, this difference appear to be insignificant statistically. (p-value=0.95/p-value=0.79 respectively).<br />Conclusions: Treatment of hepatic metastasis especially in colorectal hepatic lesion could prolong survival in selected cases, all the results of the systemic reviews and meta-analysis suggested an inferior outcome of non resectional treatment compared to hepatic resection.<br />Minimal invasive approach for treatment of CRLM offers more advantages such as early recovery, less pain, better cosmosis, less blood loss, and reduced morbidity and mortality with equal oncological outcome compared to classic open surgery.
CRLM – RFA – Laparoscopic liver resection – Laparoscopic colorectal surgery
https://mjcu.journals.ekb.eg/article_55577.html
https://mjcu.journals.ekb.eg/article_55577_e46f093c9ffda0d37b7f291c30824077.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Role of Diffusion Weighted Magnetic Resonance Imaging in Differentiation between Benign and Malignant Vertebral Body Collapse
867
873
EN
NARDINE N. HELMY, M.Sc.;
MOHAMED A. HASSAAN, M.D.
AMR Y. SAKR, M.D.;
MOHAMED T. ALI, M.D.
The Departments of Radiology* and Radiotherapy**, Faculty of Medicine, Cairo University
10.21608/mjcu.2018.55578
Abstract<br />Background: In recent years, MRI has increasingly become the modality of choice for imaging of musculoskeletal disor-ders. Diffusion weighted MR sequences provide microscopic information to supplement the macroscopic information pro-vided by conventional sequences. It is a non invasive imaging technique which is suitable for probing the physical structure of a biologic tissue at a microscopic level and it exploits the random, translational motion of water protons in a biologic tissue, which reflects the tissue specific diffusion capacity and can be used for tissue characterization.<br />Aim of Work: The aim of this study is to determine the value of Diffusion Weighted Imaging (DWI) in differentiation between different causes of vertebral collapse.<br />Patients and Methods: This is a prospective study carried out in Radio-Diagnosis Department, Faculty of Medicine, Cairo University between August 2014 and February 2016 for patients diagnosed with vertebral body collapse. A total number of 35 patients (20 males and 15 females) with age range 18-74 (average 52).<br />The MRI sequences obtained were sagittal T1WI, T2WI, STIR and axial T1WI, T2WI & DWI (± post contrast images in some patients). Bone marrow signal intensity of the collapsed vertebra was analyzed by comparing its signal intensity with the signal intensity of the intervertebral disc, fat and muscle tissue on T1-weighted images, the signal intensity of the affected veteba was also inspected on DWI then ADC values were automatically calculated using the software provided by the MR scanner manufacturer (Diffusion Calculation: Philips Medical Systems) and the ADC quantitative parameter was expressed in: 10–3mm2/s.<br />Results: Our study included 35 patients who were diag-nosed with vertebral body collapse. Qualitative evaluation of the lesion contrast in diffusion-weighted MRI of the vertebral column has been shown to be valuable for the differentiation of lesion etiology; however, visual assessment of high signal intensity was not specific for malignancy.<br />On the other hand the quantitative assessment by meas-uring the ADC value was able to distinguish different types of vertebral collapse.<br />In our study, there was statistically Highly Significant (HS) difference between malignant and the following benign causes of vertebral collapse; acute fracture, chronic osteoporot-ic collapse and pyogenic spondylodiscitis. There is also statistically significant difference (S) between malignant and TB spondylodiscitis lesions according to ADC values.<br />Conclusion: Diffusion weighted MRI can be used as a reliable tool in differentiation between different causes of vertebral body collapse. DWI could be applied as a cost effective substitute for the gadolinium enhanced scan especially in patients with contraindication for contrast administration.
DWI – Osteoporotic collapse – Compression fracture – ADC – Malignant collapse
https://mjcu.journals.ekb.eg/article_55578.html
https://mjcu.journals.ekb.eg/article_55578_7cbfdde68f3b3125b1a26ff0d7242064.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Comparative Study between Intramuscular and Intra-Arterial Autologous Transplantation of Bone Marrow Derived Mononuclear Cells in Treatment of Non Reconstructable Critical Limb Ischemia
875
886
EN
HESHAM M.I. EL-ASHRY, M.Sc.;
HASSAN A.H. ALI, M.D.
SAIED M.H. ABDOU, M.D.;
AHMED M.I. TAWFIK, M.D.
The Departments of General Surgery*, Vascular Surgery** and Clinical Pathology***, Faculty of Medicine, Tanta University
10.21608/mjcu.2018.55579
Abstract<br />Background: Critical limb ischemia is a limb threatening condition characterized by ischemic rest pain, non-healing wounds, or tissue gangrene related to the peripheral arterial occlusive disease. Treatment of non-reconstructable critical limb ischemia is a challenge despite advances in surgical and endovascular techniques.<br />Aim: The aim is to compare the efficacy and safety of intramuscular and intra-arterial autologous transplantation of bone marrow derived mononuclear cells in treatment of non-reconstructable critical limb ischemia.<br />Material and Methods: This study was conducted on forty-five patients with non-reconstructable critical limb ischemia stages III or IV (Fontaine's classification) with ABI below 0.5 and the arteriogram showed no distal run-off and no option for revascularization. All patients were subjected to the best medical treatment according to (TASC II) then randomized (closed envelop) into three equal groups (15 patients in each group). Group I, II: Subjected to intra-arterial and intra-muscular autologous transplantation of bone marrow derived cells respectively while Group III only subjected to the best medical treatment as a control group. The primary outcomes were amputation free-survival and absence of therapy related major complication while secondary outcomes were improvement of ischemic rest pain assessed by Visual Ana-logue Scale (VAS), improvement of ischemic tissue perfusion assessed by Ankle Brachial Index (ABI), improvement of pain free walking distance, improvement of ischemic wound healing, detection of new collaterals in the angiogram and presence of neo-angiogenesis in calf muscle tru-cut needle biopsy.<br />Results: There were no significant differences between both Group I, II as regards the primary outcomes (limb salvage rates were 81.8%, 72.7% respectively, without therapy related major complication or mortality) and secondary outcomes during the follow-up period. When compared with the control group there were significant differences in both primary (limb salvage rate was 27.7%) and secondary outcomes.<br />Conclusions: No difference between autologous trans-plantation of bone marrow derived mononuclear cells either by intra-arterial or intra-muscular administration. Both routes are simple, safe and effective.
Non-reconstructable – Critical limb ischemia – Bone marrow stem cells – Autologous transplan-tation
https://mjcu.journals.ekb.eg/article_55579.html
https://mjcu.journals.ekb.eg/article_55579_44532446e1eacd4e93804d7c8d73a119.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Evaluation of Red Cell Alloimmunization in Thalassemic Patients with Repeated Blood Transfusion
887
892
EN
MARWA M.S. AL-HADAD, M.B.B.Ch.;
MANAL A. EID, M.D.
MAALY M. MABROUK, M.D.;
IBRAHEEM M. BEDRIA, M.D.
The Departments Clinical Pathology* and Pediatrics**, Faculty of Medicine, Tanta University
10.21608/mjcu.2018.55580
Abstract<br />Background: Thalassemia is a group of inherited disorders that arise as a result of certain mutations in hemoglobin (Hb) genes, affecting the synthesis of globin chain (a, (3), which leads to certain pathophysiological disorders as chronic hemolytic anemia and ineffective erythropoiesis. Patients who suffered from thalassemia receive blood transfusion regularly every month or even less than month according to the severity of hemolysis. Repeated blood transfusion results in many complications including formation of alloantibodies or au-toantibodies against transfused RBCs.<br />Aim of the Study: To evaluate alloantibodies and autoan-tibodies formation in thalassemic patients with repeated blood transfusion and try to avoid hemolytic transfusion reaction which may occur during future blood transfusion.<br />Patients and Methods: The present study was carried on a hundred (100) pediatric thalassemic patients. All included subjects were submitted to full history taking, clinical exam-ination and laboratory investigations. Screening gel tests for allo and autoantibodies.<br />Results: We found that the frequency of development of red cell alloimmunization in thalassemic patients receiving multiple blood transfusions is 26% and autoantibodies 0%. The most frequently occurring alloantibodies was anti k (13%), anti Jsb (13%), anti Lub (13%), anti D (5%), anti Jka (5%), anti M (5%), anti S (5%), anti Kpa (4%), anti N (4%), anti C (3%), anti Lea (3%), anti c (1%), anti Fyb (1%), anti Lea (1%) and anti p1 (1%).<br />Conclusion: Thalassemic patients with repeated blood transfusion develop a significant rate of alloantibodies. Some of these antibodies are clinically significant and may affect the safety of further blood transfusion and cause hemolytic transfusion reaction. So antibody screening test should be performed to patients with chronic transfusion to avoid the hazardous of future transfusion.
Alloantibodies – Autoantibodies – Hemolytic transfusion reaction
https://mjcu.journals.ekb.eg/article_55580.html
https://mjcu.journals.ekb.eg/article_55580_be5ab62bb07545dcde5f622a05af7622.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Effect of Shock Wave Therapy on Postpartum Low Back Pain
893
901
EN
DOAA Sh. AHMED, M.Sc.;
ENGY M. NAHAS, Ph.D.
FAYIZ F. EL-SHAMY, Ph.D.;
MAGDA S. MORSY, Ph.D.
The Department of Physical Therapy for Women Health, Faculty of Physical Therapy, Cairo University
10.21608/mjcu.2018.55581
Abstract<br />Background: Almost 50 percent of women suffer from lower back pain in the first few months after having baby; Shock Wave Therapy (SWT) is effective in numerous types of musculoskeletal disorders.<br />Aim of the Study: This study was conducted to determine the effect of shock wave therapy in treating postpartum low back pain.<br />Patients and Methods: Thirty volunteers multiparous women suffering from postpartum low back pain for at least 3 months following delivery were participated in this study. They were referred from the Outpatient Clinic of Orthopedic and Outpatient Clinic of Gynecology in Al-Agouza Police Authority Hospital. Their age ranged from 25-35 years old with a mean value 29.3±2.4 years. Parity ranged from (2-3) and their body mass index not exceed 30kg/m2 with a mean value (26.11±1.76)kg/m2. The patients were divided randomly into two equal Groups (A & B). Patients in Group A (study group) were treated by shock wave on the lumber region in addition to abdominal and back exercise together with postural correction training, 2 times per week for 8 sessions. All patients in both Groups (A & B) were evaluated by Visual Analogue Scale (VAS) and plasma serotonin level before starting and after the end of treatment program.<br />Results: Showed a highly significant (p=0.000) decrease in VAS and increase in plasma serotonin level after the treatment program in both groups, yet this decrease in VAS and increase in serotonin plasma level was more pronounced and statistically significant (p=0.000) in the study group when compared to the control group.<br />Conclusion: Shock wave therapy is an effective modality in alleviating postpartum low back pain.
Postnatal – Shock wave – Low back pain – Visual analogue scale – Plasma serotonin level
https://mjcu.journals.ekb.eg/article_55581.html
https://mjcu.journals.ekb.eg/article_55581_4d673e2d176c2d6f88ab2bf644a5b71e.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Efficacy of Moderate Aerobic Training on Insulin Like Growth Factor and Functional Capacity in Elderly
903
908
EN
SHYMAA Y. ABO ZAID, M.Sc.;
SAMAH M. ISMAIL, Ph.D.
MARIAM E. MOHAMED, Ph.D.;
FARAG A. ALY, Ph.D.
The Department of Physical Therapy for Cardiovascular/Respiratory Disorder & Geriatrics, Faculty of Physical Therapy, South Valley*, Cairo** and Horus*** Universities
10.21608/mjcu.2018.55582
Abstract<br />Background: The Insulin like Growth Factor-1 (IGF-1) decrease with aging, which lead to several disorders and disabilities in elderly.<br />Objective: The purpose of this study was to find out the effect of moderate aerobic training on insulin like growth factor and functional capacity in elderly.<br />Subjects and Methods: The study was conducted on thirty elderly subjects, their age ranged from 65 to 75 years old with mean value of 64.81 years, they were selected randomly based on the inclusion criteria. All the subjects had participated in moderate aerobic training calculated as 60% to 70% of their predetermined maximum heart rate. This program was applied three times per week for eight weeks.<br />Results: Statistical analysis showed a significant increase of insulin like growth factor by 32% and functional capacity by 18.5%.<br />Conclusion: It was concluded that moderate aerobic training improve insulin like growth factor and functional capacity in elderly.
Elderly – Aerobic training – Insulin like growth factor – Functional capacity
https://mjcu.journals.ekb.eg/article_55582.html
https://mjcu.journals.ekb.eg/article_55582_b34b187faa38553facbf03b9f3ea2d05.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Kinesiotaping versus Mcconnell Taping in Management of Knee Osteoarthritis
909
917
EN
AHMED R. OMAR, M.Sc.;
RAGIA M. KAMEL, Ph.D.
SALAH EL-DIN B. EL-SAYED, Ph.D.;
ASHRAF N. MOHARAM, M.D.
The Department of Physical Therapist, El-Khazndara General Hospital, Cairo*,
The Department of Physical Therapy for Basic Science, Faculty of Physical Therapy** and The Department of Orthopedic Surgery, Faculty of Medicine***, Cairo University
10.21608/mjcu.2018.55583
Abstract<br />Background: Knee Osteoarthritis (OA) is the most com-mon chronic degenerative joint disorder; it is characterized by increasing joint pain, stiffness and limitations in Range of Motion (ROM). Taping is a physiotherapy treatment strategy recommended in the management of knee OA.<br />Aim of the Study: This study was designed to determine the effect of Kinesio taping and McConnell taping on Knee Osteoarthritis Outcome Score (KOOS) and Active Range of Motion (AROM) of patients with knee OA.<br />Subjects and Methods: Fourty five subjects suffering from unilateral primary knee OA (according to X-ray and Kellgren and Lawrence classification). Their ages were from 40 to 50 years and body mass index was from 25 to 29.9kg/m2. They were randomly divided into three equal groups, Group A received conventional physical therapy management program for knee OA (ultrasound therapy, transcutaneous electrical neuromuscular stimulation and quadriceps set exercise) plus Kinesio taping, Group B received the same conventional physical therapy management program plus McConnell taping, Group C (control group) received only the same conventional physical therapy management program. All patients received treatment three times per week for four weeks. Health-related quality of life was measured using KOOS and AROM was measured using universal goniometer pre and post-treatment.<br />Results: There was a significance difference between Group A and B in symptoms, pain and Quality of Life (QOL) parts of KOOS (p=0.003, 0.012 and 0.031 respectively) and active ROM of knee flexion (p=0.008). There was a signifi-cance difference between Group A and C in pain severity, Activities of Daily Living (ADL), sport/recreation and QOL parts of KOOS (p=0.0001, 0.004, 0.002, 0.0001 respectively) and active ROM of knee flexion (p=0.019).<br />Conclusions: Kinesio taping is more effective than Mc-Connell taping as nonsurgical intervention method for symtoms relief, pain relief, improving ADL and improving AROM of knee flexion in patients with knee OA.
Knee osteoarthritis – Kinesio taping – McConnell taping
https://mjcu.journals.ekb.eg/article_55583.html
https://mjcu.journals.ekb.eg/article_55583_31e6c7cd549b2e65b45da84f41eaaca0.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Neutrophil-Lymphocyte Ratio as a Reliable Predictive Marker in Systemic Lupus Erythematosus
919
925
EN
HEBATU ALLAH A. EL-HABIBY, M.Sc.;
NOHA E. ESHEBA, M.D.
ENAAM S. ABD EL-BAR, M.D.;
GEHAN M. SHEIRA, M.D.
The Departments of Internal Medicine* and Clinical Pathology**, Faculty of Medicine, Tanta University
10.21608/mjcu.2018.55585
Abstract<br />Background: SLE is a complex autoimmune disease with heterogenous clinical manifestations and disease course, Nephritis is a major cause of morbidity and mortality in patients with lupus. Many clinical parameters and laboratory markers can be used to evaluate disease activity. NLR is positively associated with inflammatory disorders.<br />Objectives: Is to evaluate the Neutrophil Lymphocytic ratio (NLR) as a reliable predictive and prognostic marker in systemic lupus erythematosus.<br />Methods: The present study was carried out on 60 patients and 20 healthy individuals as controls. Patients were classified into: Group I: 40 SLE patients with active disease, which was sub divided into two subgroups: Group IA included thirty SLE patients with LN and Group IB included ten SLE patients with active disease without nephritis. Group II: 20 SLE patients with inactive disease. Group III: 20 apparently healthy vol-unteers as controls. CBC, serum creatinine, ESR, CRP, ANA, Anti-ds DNA, C3, C4, 24-hour protein in urine and urine analysis were done to all participants.<br />Results: The NLR of SLE patients was significantly higher compared to that of the controls. Furthermore, SLE patients with nephritis had higher NLR levels than those without nephritis.<br />Conclusion: NLR is a useful, simple and bed side inflam-matory marker for assessment of disease activity in patients with SLE. Also, NLR is a promising predictor of lupus ne-phritis.
Neutrophil Lymphocytic Ratio (NLR) – Systemic lupus erythematosus – Lupus nephritis
https://mjcu.journals.ekb.eg/article_55585.html
https://mjcu.journals.ekb.eg/article_55585_13ba60b13eb9aec2d54b81a2da14335a.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Role of MR Defecography in the Assessment of Obstructed Defecation Syndrome
927
931
EN
MOHAMED F. OSMAN, M.D.;
AHMED F. AHMED, M.D.
The Departments of Diagnostic & Interventional Radiology* and General Surgery**, Faculty of Medicine, Cairo University
10.21608/mjcu.2018.55586
Abstract<br />Background: Obstructed Defecation Syndrome (ODS) is characterized by the urge to defecate but an impaired ability to expel the fecal bolus. Symptoms include unsuccessful fecal evacuation attempts, excessive straining, pain, bleeding after defecation, and a sense of incomplete fecal evacuation. ODS has been linked to anatomic abnormalities of rectocele, rec-toanal or recto-rectal intussusception, paradoxical puborectalis contraction, pelvic organ prolapse, descending perineum syndrome, solitary rectal ulcer syndrome, sigmoidocele, and enterocele. A functional abnormality such as pelvic floor dyssynergia, decreased rectal compliance and decreased rectal sensation has also been shown to contribute to symptoms of ODS.<br />Objective: To assess the role of MR defecography in finding functional abnormalities in patients with obstructed defecation syndrome.<br />Patients and Methods: A prospective study was carried out on 30 patients (20 females and 10 males) with clinical symptoms of obstructed defecation syndrome for a period longer than 6 months. Patients were assessed statically using T2 weighted images and dynamically by MR defecography using fast imaging via steady-state acquisition sequences. All patients had symptoms of obstructed defecation syndrome as unsuccessful fecal evacuation attempts, excessive straining, pain during defecation, a sense of incomplete fecal evacuation and digital rectal evacuation.<br />Results: A total of 30 patients with a mean age of 40.2 with 20 (66.7%) females and 10 (33.3%) males. MR defecog-raphy revealed rectocele in 19 (63.3%) of all patients and cystocele in 17 (56.7%) patients. Four patients (13.3%) had rectal intussusception. Spastic pelvic floor syndrome was found in 2 patients (6.75%). Multicompartmental dysfunction was observed in 18 (60%) of the female patients.<br />Conclusion: MR defecography was proven to be highly valuable in assessing patients with obstructed defecation syndrome, particularly females as it depicts multicompart-mental dysfunction in females with a seemingly single com-partment symptom ultimately changing the treatment approach.
Obstructed defecation syndrome – MR defecog-raphy – Rectal prolapse – Pelvic organ prolapse
https://mjcu.journals.ekb.eg/article_55586.html
https://mjcu.journals.ekb.eg/article_55586_f2d43214854455ca917c657922f35621.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Maternal Serum Copeptin for Early Prediction of Preeclampsia
933
937
EN
LOBNA A. ABOELMAGD, M.Sc.;
AHMED M. HAGRAS, M.D.
MORAD A. MORAD, M.D.;
HESHAM M. EL-TOKHY, M.D.
The Departments of Obstetrics & Gynecology* and Clinical Pathology **, Faculty of Medicine, Tanta University
10.21608/mjcu.2018.55757
Abstract<br />Background: Pre-eclampsia is a serious complication of pregnancy however there is no single predictor of pre-eclampsia among women at either low or increased risk of pre-eclampsia. The increased maternal levels of copeptin may be involved in the pathogenesis of pre-eclmapsia and may be useful in the assessment of the severity of the disease.<br />Aim of the Work: The aim of this work is to study the value of maternal serum copeptin level measured during the first trimester of pregnancy in the prediction of preeclampsia.<br />Patients and Methods: An observational prospective study includes 80 primigravidae with singleton pregnancy and gestation 11-13 weeks and Copeptin was measured using the BRAHMS Immunoluminometric Assay (Thermo Scientific). Copeptin, a surrogate marker of vasopressin, has been asso-ciated with a decline in renal function and may be a useful alternative biomarker for Preeclampsia (PE).<br />Results: The maternal Serum copeptin was significantly higher in cases who later developed preeclampsia and is more higher in severe cases (13.64±3.02) than mild cases of preec-lampsia. (7.27±1.40) compared to the normal group (4.66±1.24) (p-value=<0.001). The specificity was 92% and sensitivity of the test was 88%.<br />Conclusion: Serum copeptin is higher as early as 13 weeks gestation in women who later developed pre-eclampsia than in cases who remained normotensive till full term and delivery, and is more higher in severe cases than mild cases of preec-lampsia.
Copeptin – Prediction – Preeclampsia
https://mjcu.journals.ekb.eg/article_55757.html
https://mjcu.journals.ekb.eg/article_55757_4479b2f48bb6cc6a60d9b2d83b7cf32e.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Comparative Study between Multislice Computed Tomography Coronary Angiography and Invasive Coronary Angiography in Diagnosis of Mid and Distal Segment Coronary Artery Stenosis
939
946
EN
SALAH EL-DIN I. AGAMY, M.Sc.;
MAI M. SALAMA, M.D.
AYMAN M. EL-SAEED, M.D.;
AMR A. MUBARAK, M.D.
The Department of Cardiovascular Medicine, Faculty of Medicine, Tanta University
10.21608/mjcu.2018.55759
Abstract<br />Background: Computed Tomography Coronary Angiog-raphy (CCTA) is a promising method for detection and exclu-sion of obstructive coronary artery stenosis. Mid and distal segments of coronary arteries were chosen because they are usually small in caliber especially distal segment (usually less than 1.5mm) and they are affected by cardiac motion on the contrary, the proximal segment is always away from the myocardium and usually larger in diameter so that it can be easily diagnosed by CCTA.<br />Objective: The purpose of this study was to evaluate the added value of CT coronary angiography for detecting Coro-nary Artery Disease (CAD) in mid and distal segment lesions using invasive coronary angiography as a reference standard.<br />Methods: We prospectively evaluated 20 patients who suspected to have CAD and underwent CTA. we assessed mid and distal segment lesions using invasive coronary angiography as a reference standard. We excluded proximal segment lesion, high calcium score (800), arrhythmias, post percutaneous coronary intervention and post coronary artery bypass graft.<br />Results: A total of 20 subjects underwent both CCTA and ICA (60% were females with mean age: 58.1 years). On a patient based model, the sensitivity, specificity, and positive and negative predictive values to detect mid segment lesions were 88.9%, 95.2%, 88.9%, and 95.2% respectively and for distal lesions were 85%, 100%, 100%, 98.1%, respectively. Diagnosis of mid and distal segment lesions by both CT and coronary angiography showed statistically significant strong positive correlation.<br />Conclusion: CT angiography is a reliable tool and has high accuracy for detection of CAD in both mid and distal segment lesions. Importantly, the high NPV (97%) firmly establishes CCTA as an effective noninvasive method to rule out obstructive coronary artery stenosis in patient with mod-erate pre-test probability.
CT coronary angiography – Invasive coronary angiography – Calcium score
https://mjcu.journals.ekb.eg/article_55759.html
https://mjcu.journals.ekb.eg/article_55759_ab462b92653f542c7bd4ff72292dfe35.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
The Relation between Anemia and Microvascular Complications in Patients with Type 2 Diabetes Mellitus
947
954
EN
SAMAR M. YOUSSEF, M.Sc.;
NASRAT M. AYAD, M.D.
MOHAMMED H. ELBRADEY, M.D.;
NOHA E. ESHEBA, M.D.
The Departments of Internal Medicine* and Ophthalmology**, Faculty of Medicine, Tanta University
10.21608/mjcu.2018.55761
Abstract<br />Background: Recently, it has been demonstrated that anemia may be an etiological factor in development of micro-vascular complication in type 2 D.M. patients.<br />Objective: Evaluation of the relation between anemia and microvascular complications in patients with type 2 diabetes mellitus.<br />Methods: 100 patients were included in the study. They were selected from wards of Internal Medicine Department and Outpatient Endocrinology Clinic in Tanta University Hospital during the period from February 2016 to August 2016. They divided into two groups, Group (I): 50 patients DM type 2 without anemia. Group (II): 50 patients DM type 2 with anemia (Hb level >10gm/dl). Inclusion criteria: Patients diagnosed to have type 2DM, anemia with (Hb level >10gm/dl) in Group (II). Exclusion criteria: Type 1 DM or other types of diabetes, patients with obvious cause of anemia e.g. hemo-lytic anemia, aplastic anemia, acute blood loss, severe infection, collagen disease. Chronic illness e.g. severely impaired liver functions (AST or ALT more than 2 upper limit of normal), end stage renal disease. All patients were subjected to: History taking after providing a written informed consent. Full clinical examination including; anthropometric parameters {weight, height, Body Mass Index (BMI)}. Upon recruitment, all patients underwent comprehensive assessment of diabetes-related microvascular complications as following: Diabetic Retinopathy (DR) was assessed by professional ophthalmol-ogists, diabetic nephropathy was assessed according to 24hr albumin collection in urine. Diabetic peripheral neuropathy was diagnosed by: The presence of typical symptoms and compatible finding from neurological examination or. History of treatment for neuropathy. Laboratory investigations includ-ing: Fasting and 2 hour post prandial blood glucose. HbA1C, complete blood count, blood urea, serum creatinine and estimated glomerular filtration rate. 24 hour collection of urine albumin liver function tests. Erythrocyte Sedimentation rate (ESR). C Reactive Protein (CRP) complete iron profile and abdomino-pelvic ultrasound.<br />Results: Comparison between the 2 studied groups showed that 24% of Group I (DM without anemia) had neuropat hy while 100% of Group II (DM with anemia) had neuropathy with statistical significance (p-value <0.001). Also comparison between the 2 studied groups showed that 26% of Group I had retinopathy while 100% of Group II had retinopathy with statistical significance (p-value <0.001). The mean of 24hr ALB which represent diabetic nephropathy in Group I was (25.10±4.10mg/24hr) while the mean of it in Group II was (349.26±87.67mg/24hr). The mean 24hr ALB in Group II was higher than Group I with statistical significance (p-value <0.001).<br />Conclusion: Our finding suggests that microvascular complications (diabetic neuropathy, diabetic nephropathy and diabetic retinopathy) were common with anemic patients than the non anemic patients. So we can conclude that anemia may be an etiological factor in development of microvascular complication in type 2 D.M. patients.
Anemia – Microvascular complications – Type 2 Diabetes mellitus
https://mjcu.journals.ekb.eg/article_55761.html
https://mjcu.journals.ekb.eg/article_55761_2d108d71c2a37a2d4188c101ff7e6c1f.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Original Article: Hypertonic Saline Versus Mannitol Therapy in Traumatic Brain Injured Patients Guiding by Transcranial Doppler Pulsatile Index in Zagazig University Hospital
955
964
EN
ABDEL-MONEM A. SALEM, M.Sc.;
HOWAYDAH A. OTHMAN, M.D.
GHADA M. ABDEL-RAZEK, M.D.,
ISLAM A. ELEWA, M.D.
MANSOUR A.
MAKIA, M.D.
The Departments of Anesthesia & Surgical Intensive Care* and Neurosurgery**, Faculty of Medicine, Zagazig University, Egypt
10.21608/mjcu.2018.55763
Abstract<br />Background: Hyperosmolar therapy is the primary medical management strategy for brain edema and raised intracranial pressure. The role of osmotic therapy with either mannitol or hypertonic saline is based on the principle that these agents will help to remove water from brain tissue across an intact blood brain barrier. There is a debatation regarding the efficacy of hypertonic saline (HTS) versus mannitol in traumatic brain injury when are given in equiosmolar doses.<br />Patients and Methods: An interventional study carried out at trauma and surgical critical care units in Zagazig University Hospital during the period from march 2016 to march 2017. It included ninety patients with different ages, sexes and Glasgow coma scale. The patients were randomly selected from the trauma and surgical critical care units, provided that the patients not received hyperosmolar drug before admission The patients were classified into three groups (thirty patients for each group) as the following: Group A: Included those who are treated with 20% mannitol. Group B: Included those who are treated with 3% hypertonic saline. Group C: Included those who are treated with 3% hypertonic saline alternating with 20% mannitol. Transcranial Doppler parameters especially pulsatility index were observed in the patients before every drug dose and 30 min after giving. Then we observed the change in value of cranial Doppler pulsatility index with subsequently interpretation of values.<br />Results: There was no significant difference in equiosmolar dose (2ml/kg/6h) between mannitol 20% and hypertonic saline 3% in reducing noninvasive intracranial pressure (nICP) and pulsatility index (PI). Also, there were no significant differences in GCS at the end of treatment and GOS at one month from admission and decrease nICP between the two agents.<br />Conclusion: This study recommends that in absence of contraindications, no superiority of hypertonic saline 3% over mannitol 20% as hyperosmolar therapy in TBI patients as the both are equally effective in reducing ICP and neurological outcome.
Traumatic brain injury – Transcranial doppler – Pulsatility index and Hyperosmolar Therapy
https://mjcu.journals.ekb.eg/article_55763.html
https://mjcu.journals.ekb.eg/article_55763_a6db79afe246f27ce31c8240a9c712f0.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Relationship between Job Satisfaction, Professional Image and Nurses Marketing of the Nursing Profession
965
973
EN
HANY S. HUSSIEN, M.Sc.;
NEHAD E. FEKRY, D.N.Sc.
The Department Nursing Administration, Faculty of Nursing, Cairo University
10.21608/mjcu.2018.55765
Abstract<br />Background: A global shortage of healthcare professionals calls for effective recruitment and retention strategies. One approach that has received increasing interest is the use of internal marketing to reduce occupational and organizational turnover among practicing nurses. The model links nurses' job satisfaction and organizational commitment to internal marketing programs based on principles of relationship mar-keting to build work environments that are more likely to lead to the engagement and retention of nursing staff. As is the case with the internal marketing of nursing, external marketing of nursing integrates marketing theory with related concepts from other areas in business. In the case of internal marketing, these concepts come from organizational psychology and include employee turnover, job satisfaction, and professional image.<br />Aim: The current study assess the relationship between job satisfaction, professional image and marketing of the nursing profession.<br />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. A samples of 293 nurses were invited to participate in the questionnaire. For the purpose of this study, questionnaire for nurses was developed and utilized that consist of four parts: The first part was related to the nurse personal characteristics, the second part assess the nurses job satisfaction, the third part was related to nurses perception of professional image, the fourth part was about nurses participation in marketing activities.<br />Results: The study showed that the study sample has low job satisfaction with mean percentage of about 59%. This may be due to work overload and inadequate salary. The study sample have moderate professional image with mean percent-age of 68%. This may be due to experience and about half of the sample holding academic degrees that make their profes-sional image quite good. The study sample have very low promotional activities with mean percentage of about 36%.<br />Conclusion: The present study concluded that there was a relationship between study sample job satisfaction & pro-fessional image and promotional & marketing activities. As highly satisfied nurses with high professional image perception having high level of promotional and marking activities.<br />Recommendations: Measure 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 developing strategies to improve nurses image throughout the nursing curriculum and implementing nursing profession marketing plan.
Job satisfaction – Professional image– Marketing nursing profession
https://mjcu.journals.ekb.eg/article_55765.html
https://mjcu.journals.ekb.eg/article_55765_513248866d44329942d8709fb030f00c.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
New Technique: Paravertebral Muscle Refashioning in Meningiomyelocele Repair
975
980
EN
MOHAMED M. EL-MAGHRABI, M.D.;
MOATAZ A ELAWADY, M.D.
AHMED A.
ARAB, M.D.
The Department of Neurosurgery, Faculty of Medicine, Benha University, Benta, Egypt
10.21608/mjcu.2018.55767
Abstract<br />Background: One of the most complications of meningi-omyelocele surgical repair is early postoperative Cerebrospinal fluid (CSF) leakage. Cystic back swelling due to prolonged sitting of children is an annoying symptom of their parents.<br />Aim of the Study: To assess the technique of paravertebral muscle refashioning in meningiomyelocele repair as a protec-tive layer of opened spinal canal.<br />Study Design: A prospective clinical trial study of 46 infants, 25 boys and 21 girls, with meningiomyelocele which was repaired surgically using paravertebral muscle refashioning technique in 18 infants (group I) while 28 infants without this technique (group II) at Benha University and Benha children Hospitals through the period from May 2013 to April 2017. The mean period of follow-up was (18.27±2.78 months).<br />Patients and Methods: Comparison was performed be-tween two groups by analysis of early postoperative CSF subcutaneous swelling and late pulsatile cystic swelling of repaired defect.<br />Results: Forty six infants were studied, 25 boys (54.3%) and 21 girls (45.7%) with mean age 29.7±15.39 days (ranging from 1 to 90 days), and they were followed up with a mean of 18.27±2.78 months (ranging from 12 to 24 months). Early postoperative CSF leakage was absent in 72.8% of group I and 71.4% of group II which was statistically non significant between two techniques while late cystic back swelling was not detected in 88.9% of group I and only 32.1% of group II which was statistically significant (p<0.001).<br />Conclusion: Paravertebral muscle refashioning in menin-giomyelocele repair is an effective technique for prevention of late cystic back swelling.
Paravertebral muscle refashioning – Meningi-omyelocele repair
https://mjcu.journals.ekb.eg/article_55767.html
https://mjcu.journals.ekb.eg/article_55767_393394c4e0b688bdd80dc10e5d1c5137.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
The Weaning Practices from the Mechanical Ventilation in the Pediatric Intensive Care Unit at Assiut University Children Hospital
981
987
EN
EKRAM A. HASHEM, M.D.;
MOHAMMAD A. FATHY, M.D.
RANDA H.
MOHAMMAD, M.Sc.
The Department of Pediatrics, Faculty of Medicine, Assiut University Children Hospital, Assiut, Egypt
10.21608/mjcu.2018.55769
Abstract<br />Background: Mechanical ventilation for children and neonates is different from that for adults. While basic principles of physics and gas flow apply to all age groups, anatomical and physiological differences play a significant role in selecting the type of ventilator as well as the ventilatory modes and settings.<br />Upper airway in children is cephalad funnel-shaped with narrowest area being subglottic (at the level of cricoid ring), as compared to adults where the upper airway is tubular with narrowest part at the vocal cords. Airway resistance increases inversely by 4th power of radius, i.e. in an already small airway, even one mm of edema or secretions will increase the airway resistance and turbulent flow markedly, necessitating treatment of airway edema, suctioning of secretions, measures to control secretions. Low functional residual capacity (FRC: volume of air in the lungs at end of expiration) reduces the oxygen reserve and reduces the time that apnea can be allowed in a child.<br />Material and Methods: Medical records of children whom were connected to mechanical ventilation in the Pediatric ICU, Assiut University Children Hospital during the period from June 1, 2015 to May 30, 2016 were collected and re-viewed to choose the cases which fulfilled the inclusion criteria of the study.<br />Results: During the period from 1st of June, 2015 to the 30th of May, 2016, 325 patients were admitted to the pediatric ICU, 116 (35.7%) of them were critically ill intubated patients receiving mechanical ventilation and subjected to weaning process.<br />Conclusions: Nearly, half of the studied cases (49.1%) were successfully weaned, while weaning failure occurred in 31.1% out of the studied cases. Rest of the cases (19.8%) showed extubation failure.
Mechanical ventilation – Weaning from mechanical ventilation
https://mjcu.journals.ekb.eg/article_55769.html
https://mjcu.journals.ekb.eg/article_55769_785e97a388f58f706a95a09a0eee6b86.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Prevalence of Red Cell Blood Group Antigens Among Egyptian Population in Comparison with Other Ethnic Groups
989
994
EN
RANDA M. ABOU EL-FETOUH, M.D.;
TAREK M.A. EL-GEMMEZI, E.F.B.T.M.
MERHAN A. FOUDA, M.D.;
FATEN M. MOFTAH, C.T.M-R.C.P.S. of Edinburgh
10.21608/mjcu.2018.55771
Abstract<br />Background: Blood group antigens differ in their distri-bution among different ethnic populations, knowledge of the different blood antigen frequency in a population is important for safe blood transfusion, as cases of multi-transfused patients with multiple allo-antibodies, where antigen-negative blood should be provided.<br />Aim of the Work: Is to detect the prevalence of red cell blood group antigens among Egyptian population and compare it with other ethnic groups. This information can be used to establish the correlation between blood group genotype and phenotype, and to help managing cases of alloimmunization in multiply transfused patients.<br />Methodology: A total number of 3219 regular blood donors in NBTC and the blood bank of the National Cancer Institute, Cairo University, were subjected to extended Rh system phenotyping (D, C, E, c and e), and to phenotyping for other blood group systems. Colum Agglutination Technique was used to test the red cells of the blood donors.<br />Results: Our study showed that in the Rh system, the D+(84%), e+(97.4%), C+(67.5%) prevalence was close to Caucasians. The K antigen (8.23%) was also almost close to Caucasian, while the k antigen (99%) was equal to other ethnic population. The S and s antigens (56.77%, 86.1% respectively) were almost the same as that of Caucasian and Indian population. Duffy blood group was different as Fya (26.66%) and Fyb (48.87%) antigens results were unique to our studied population. The Lea (26.26%) antigen was almost the same as both Caucasians and African population. While the Jka (83.88%) antigen was close to the Indians population, the Jkb (58.75%), the Leb (46.49%) and the N (40.1%) antigens were unique to our studied group. The M antigen (78.99%) result was almost the same as Caucasian and Asian population.<br />Conclusion: The distribution of the blood group antigens among different races shows different findings. Knowledge of the prevalence of different blood group antigens in any given population is helpful in managing cases of alloimmuni-zation in multiply transfused patients.
Red cell – Blood group antigens – Egyptians – Ethnic groups – Prevalance
https://mjcu.journals.ekb.eg/article_55771.html
https://mjcu.journals.ekb.eg/article_55771_b44d1e55e1ffdc9fbd4a034d89c5685a.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Structural Correlation of Spectral Domain OCT and Fundus Autofluorescence (FAF) of the Macula, Following Successful Surgical Repair of Rhegmatogenous Retinal Detachment
995
1002
EN
MARIAM R. FADEL, M.Sc.;
SHERIF SHETA, M.D.
ALI M. TAHA, M.D.;
HATEM A. SAEED, M.D.
NAHLA B. ABOU HUSSEIN, M.D.;
AHMED E. HABIB, M.D.
The Department of Ophthalmology, Faculty of Medicine, Cairo University
10.21608/mjcu.2018.55773
Abstract<br />Background: Macular recovery after surgery for retinal detachment depends on pre-operative and post-operative predictive factors. Pre-operative factors, which influence macular recovery negatively, include duration of macular detachment, height of macular detachment and vitreomacular traction. Post-operative factors, which influence macular recovery negatively, include cystoid macular edema, epiretinal membranes, retinal folds, subretinal Retinal Pigment Epithe-lium (RPE) migration and persistent subretinal fluid.<br />OCT has elucidated several postoperative factors corre-lating with poor vision. These features include persistent SRF and increased foveal thickness ,demonstrating as well the submacular fluid that couldn't be detected clinically. OCT can detect persistent foveal detachment, distortion and disruption of Outer Retinal Layers (ORLs) and macular folds following successful surgery for RD. FAF has been used to investigate the morphological and functional changes occurring after RD repair.<br />Objective: The aim of our study is to correlate the struc-ture-function relationship of the macula following successful repair of rhegmatogenous retinal detachment, by correlating the SD-OCT and FAF macular images with BCVA.<br />Study Design: Prospective observational case series study.<br />Patients and Methods: Forty-five eyes underwent surgical repair of RRD followed by SD-OCT and FAF imaging one to three months post-operative. SD-OCT and FAF findings were correlated with post-operative BCVA.<br />Results: Forty-five eyes achieved complete post-operative reattachment with 95.6% SOSR. The values of BCVA showed significant difference between eyes with the following OCT findings: Macular edema, persistent SRF, RPE-choriocapillaries complex, IS/OS junction disruption and neurosensory detach-ment and eyes not showing the same OCT changes (p 0.05).<br />The values of BCVA showed significant difference be-tween eyes showing hyper-autofluorescence on FAF imaging and eyes not showing hyper-autofluorescence (p=0.015).<br />We found significant association between fundus hyper-autofluorescence and the following OCT findings: Macular edema, RPE-choriocapillaries complex irregularity, IS/OS junction disruption and neurosensory detachment.<br />Conclusion: SD-OCT is considered a valuable tool for evaluating the microstructural changes at the macula. The IS/OS junction disruption, persistent SRF, macular edema, neurosensory detachment and RPE-choriocapillaries complex irregularity are considered vital measures affecting the structure and function of the macula and can explain the incomplete visual recovery despite an anatomical successful RD surgery. Fundus autofluorescence is a non-invasive imaging modality that evaluates the function and health of the photoreceptor and the RPE layers showing great advantage in analyzing the macular function abnormality.
SD-OCT – FAF – Rhegmatogenous retinal de-tachment – Microstructural changes – Macula – visual outcome – Macular edema – IS/OS junction – RPE-choriocapillaries complex – Neurosensory detachment
https://mjcu.journals.ekb.eg/article_55773.html
https://mjcu.journals.ekb.eg/article_55773_7f5143f721dac4cebece20ceabaa07b5.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
The Value of MRA Versus MRI Brain DWI (ADC) in the Management of Ventriculomegaly in Pediatric Age Group
1003
1007
EN
MONA M.M. FATOUH, M.Sc.;
HASSAN A.H. EL-KIKI, M.D.
MERVAT Sh. EL-SAHRAGTY, M.D.;
HASSAN I. EL-SHAFEI, M.D.
TALAAT A.
HASSAN, M.D.
The Departments of Radiology* and Neurosurgery**, Faculty of Medicine, Cairo University, Egypt
10.21608/mjcu.2018.55775
Abstract<br />Background: Neurosurgeons may find difficulties in differentiation between progressive and compensated hydro-cephalus since signs and symptoms of raised intracranial pressure can be subtle or completely absent in children with progressive hydrocephalus. The CBF and ADC values can help to differentiate between compensated and progressive hydrocephalus thus facilitating the decision to withhold CSF diversion in an infant with a compensated hydrocephalus.<br />Material and Methods: This prospective study included (40 participants) 10 control (5 males and 5 females) and 30 patients (18 males and 12 females). Patients were divided according to their clinical presentation into two groups, suspected to have Progressive Pressure Hydro cephalous (PPH) and Compensated Pressure hydro cephalous (CPH). All the patients underwent routine MRI brain, DWI (ADC) and MRA examinations.<br />Results: In our study, we found that each patient has his own CBF as base line for follow-up in hydrocephalic children with mean ADC value (1,018) as a cut off value below which compensated pressure hydrocephalus is diagnosed and above which progressive pressure hydrocephalus is diagnosed.<br />Conclusion: MRA is helpful as a complementary non invasive tool and each patient has his own CBF as base line for follow-up in hydrocephalic children due to great variations in the measured CBF with clear mean ADC cut off value for differentiation between compensated from progressive pressure and follow-up.
Compensated Pressure Hydrocephalus (CPH) – Progressive Pressure Hydrocephalus (PPH) – MRI – MRA – CBF
https://mjcu.journals.ekb.eg/article_55775.html
https://mjcu.journals.ekb.eg/article_55775_038cc5d075df80a2cf4af5371b589d21.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Role of Conventional MR Imaging of the Median Nerve in Carpal Tunnel Syndrome: A Case Control Comparative Study with Electrophysiological Tests and Clinical Assessment
1009
1018
EN
AHMAD M. WAFAIE, M.D.;
KAREEM M. MOUSSA, M.D.
HODA M. ABBAAS, M.Sc.;
LAMIA M. AFIFI, M.D.
AYMAN M.
MANSOUR, M.D.
The Departments of Radiology*, Neurophysiology** and Musculoskeletal Surgery***, Faculty of Medicine, Cairo University, Egypt
10.21608/mjcu.2018.55776
Abstract<br />Background: Carpal Tunnel Syndrome (CTS) is the most common peripheral neuropathy of an upper extremity. The diagnosis of CTS is commonly based on findings from the medical history, physical examination, provocative tests and Electrophysiological Studies (EPS) as the reference standard, but in some cases the results may be equivocal due to discrep-ancies in the different measured clinical parameters. Imaging has the potential to resolve these discrepancies. Fat-saturated, T2-weighted Magnetic Resonance Imaging (MRI) can reveal morphological changes in CTS patients, such as nerve enlarge-ment, nerve flattening, increased nerve signal intensity, and bowing of the flexor retinaculum.<br />Aim of Work: The aim of this study is to study the role of conventional MRI in the diagnosis of Carpal Tunnel Syn-drome (CTS).<br />Patients and Methods: Twenty-three wrists in 15 healthy subjects and 47 wrists in 31 CTS patients were evaluated with MRI and Electrophysiological Studies (EPS). The qualitative and quantitative analysis of MRI include: (1) The high signal intensity of the Median Nerve (MN) on the T2W and PD fat suppressed weighted images, (2) Flexor Retinaculum (FR) bowing and measurements of its height and area, (3) Flattening ratio of the MN, (4) MN CSA. EPS; including nerve conduction velocity was also performed for comparison with clinical assessment as a standard of reference.<br />Results: There was a significant difference between healthy individuals and patients with CTS for all qualitative and quantitative MRI interpretation. This includes, the higher SI of the MN on both T2 and PD WIs, the greater FR bowing area and height, the higher flattening ratio of the MN at CT and the greater value of MN CSA. As regards the MRI results, the sensitivity, specificity, negative predictive value, positive predictive value and accuracy were 97.8%, 95.6%, 95.6%, 97.8% and 97.1% respectively.<br />Conclusion: MRI can contribute to carpal tunnel syndrome diagnosis on the basis of its qualitative and quantitative measurements.
MRI imaging – Electrophysiological studies – Carpal tunnel syndrome
https://mjcu.journals.ekb.eg/article_55776.html
https://mjcu.journals.ekb.eg/article_55776_651d4b09260858a480963e04dcac7ee5.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Role of Endoscopic Imaging (I Scan) in the Diagnosis of Gastritis
1019
1023
EN
AYMAN YOUSY, M.D.;
HANY SHEHAB, M.D.
KHALED RAGAB, M.Sc.;
MAGED EL-GHANAM, M.D.
MOHAMED GODA, M.D.;
HAYTHAM ABDALLA, M.D.
TAREK ABOUSHOUSHA, M.D.;
NOHA HELAL, M.D.
The Department of Endemic Medicine, Hepatology & Gastroenterology, Faculty of Medicine, Cairo University*,
The Departments of Hepatology & Gastroenterology** and Clinical Pathology***, Theodor Bilharz Research Institute
10.21608/mjcu.2018.55777
Abstract<br />Background: Gastritis: Defines any (histologically con-firmed) inflammation of the gastric mucosa. Worldwide, the epidemiology of gastritis overlaps that of Helicobacter pylori infection, which affects approximately 50% of the world's population. The aim of the current study was to investigate the value of I-scan in diagnosis gastritis whether HP positive or negative.<br />Subjects and Methods: This study included 164 patients divided into three groups. Group (1) included 12 normal subjects, Group (2) 101 helicobacter pylori positive subjects with gastritis and Group (3) 51 helicobacter pylori negative subjects gastritis. Upper endoscopy was performed for all cases, first by WLE then we shifted to I scan technology. Two biopsies were taken, one from greater curvature of the body of stomach and the other from antrum). All patients were assessed clinically, biochemically, viral markers and by ultrasound.<br />Results: In the helicobacter pylori positive gastritis we found that absence of collecting venule and Subepithelial Capillary Net Work (SECN) had good sensitivity 93% and poor specificity 32%.<br />Conclusion: I scan has poor specificity in diagnosis of HP gastritis.
I scan – Helicobacter pylori – Gastritis
https://mjcu.journals.ekb.eg/article_55777.html
https://mjcu.journals.ekb.eg/article_55777_0fe7379cc42746a9990e17eb37c301c4.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Soluble CD14 Subtype (Presepsin) Assay for Early Diagnosis of Sepsis in Egyptian Patients
1025
1032
EN
MALAKA Z. AMER, M.D.;
SALLY M. SABER, M.D.
MARWA A. EL-ASHRY, M.D.;
HAYAM A. HEBAH, M.D.
The Departments of Clinical Pathology* and Internal Medicine & Nephrology**, Faculty of Medicine, Ain Shams University, Cairo, Egypt
10.21608/mjcu.2018.55778
Abstract<br />Background: Despite advances in therapy, sepsis is the leading cause of death in critical care settings. The early recognition of sepsis as well as the speed and appropriateness of therapy in the initial hours after presentation are likely to influence the outcomes of septic patients. This study was conducted to investigate the early diagnostic and differentiating value of pathfast presepsin assay (soluble CD14 subtype) compared to other biomarkers in patients presenting at emer-gency department with systemic inflammatory response syn-drome and suspected sepsis.<br />Methods: The current study included seventy suspected septic patients (patient group) and thirty apparently healthy individuals (control group). All subjects were subjected at first presentation to determination of plasma presepsin, quan-titative C-reactive protein and total leucocytic count values, while patient group were subjected to blood culture as a gold standard method.<br />Results: Presepsin levels showed a statistically significant increase between septic and systemic inflammatory response patients. The cut off value that gave the best sensitivity and specificity for presepsin was 395pg/ml.<br />Conclusions: Presepsin can be a very useful promising biomarker not only for the early diagnosis of sepsis (15min) with discrimination between sepsis and systemic inflammatory response syndrome in patient presented in ED, but also for assessment of its severity and prognosis. Higher level was correlated with poor patient outcome. Future studies on large scale are needed to monitoring of prespsin level in response to antibiotic treatment.
CRP – Presepsi – Procalcitonin – Sepsis – SIRS
https://mjcu.journals.ekb.eg/article_55778.html
https://mjcu.journals.ekb.eg/article_55778_79dabd8080cb364cbce1fa2e56f818e1.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Unilateral Versus Bilateral Wrist Band in Alleviating Nausea and Vomiting in Post Cesarean Section
1033
1039
EN
HALA M. HANAFY, Ph.D.;
GHADA E. EL-REFAYE, Ph.D.
SHOKRY A. EL-SHERSHABY, M.D.;
BOUSY A. EBRAHIM, M.Sc.
10.21608/mjcu.2018.55780
Abstract<br />Background: Postoperative nausea and vomiting (PONV) is nausea and vomiting occurring within 24 hours after surgery. Acupressure by using wrist bands are used to decrease post-operative nausea and vomiting by stimulation of P6 acupoint.<br />Aim: This study designed to analyze the effect of unilateral wrist band versus bilateral wrist bands in decreasing postop-erative nausea and vomiting.<br />Methods: Forty volunteers, women had cesarean section, were randomly sent to two equal groups in the number of (A&B). Group (A) had unilateral wrist band before induction of anesthesia and removed 24 hours after operation, group (B) had bilateral wrist bands before induction of anesthesia and removed 24 hours after operation.<br />Main Measures: Assessment for all subjects in both groups (A&B) was carried out by using Rhodes Index, immediately after operation and at 6 and 24 hours after operation.<br />Results: Both groups exhibited a reduction in PONV after the end of treatment program, when both groups (A&B) were compared together, there is favoring of group B. These results indicate that using of unilateral wrist band and bilateral wrist bands were effective methods in decreasing post cesarean section nausea and vomiting, but bilateral is more effective.
Nausea – Vomiting – Wrist band – Cesarean section
https://mjcu.journals.ekb.eg/article_55780.html
https://mjcu.journals.ekb.eg/article_55780_f3acd0b81aebffce42476a2f8cfdffbf.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Effect of Aerobic Treadmill Training on Level of Testosterone Hormone and Obesity in Male Children
1041
1047
EN
MAYADA F. MOHAMED, M.Sc.;
EMAN I. EL-HADIDY, Ph.D.
ZEINAB A. HUSSIEN, Ph.D.;
SAHAR A. KHAIRY, M.D.
The Departments of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University* and National Institute of Nutrition**, Egypt
10.21608/mjcu.2018.55781
Abstract<br />Background: Childhood obesity becomes a major health concern in recent decades, the relationship between obesity and testosterone level is one of the longest running controver-sies in medical field.<br />Aim of the Study: was to determine the effect of aerobic exercise on obesity and testosterone level in boys.<br />Patients and Methods: Thirty boys participated in this study, their ages ranged from 8 to 12 years old and their body mass index percentile equal to or greater than 95%. The participated children were assigned randomly in two equal groups control group A and study group B. Group A received a balanced diet regimen for 12 weeks while Group B received the same balanced diet regimen in addition to aerobic exercise in the form of treadmill training for 50min, 3 days/week for 12 weeks. Weight, height, waist circumference, total and free testosterone were evaluated before and after 12 weeks of treatment for both groups.<br />Results: Non significant differences were found between both groups before treatment in all measuring variables (p>0.05). Post treatment results revealed no statistically significant differences between groups regarding body mass index, and total testosterone (p>0.05), while Significant differences (p<0.05) were observed in waist circumference and free testosterone between both groups in favor of the study group B.<br />Conclusion: Aerobic exercise in form of treadmill training with balanced diet increase free testosterone level and decrease waist circumference after 12 weeks in obese boys.
Testosterone– Male children – Body mass index percentile – Waist circumference – Aerobic exer-cise
https://mjcu.journals.ekb.eg/article_55781.html
https://mjcu.journals.ekb.eg/article_55781_28e7e0e09fdc1c3238643d6d87f768e8.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
miRNA Expression Profiling in Pediatric B-Cell Acute Lymphoblastic Leukemia by Microarray Technology
1049
1053
EN
EMAN EL-SHARAWY, M.Sc.;
MOHAMED EL-SHANSHORY, M.D.
SAID ABDOU, M.D.;
LAILA M. SHREIF, M.D.
ABDEL-AZIZ A. ZIDAN, Ph.D.;
ENAS A.A. BAKI, Ph.D.
10.21608/mjcu.2018.55782
Abstract<br />Background: MicroRNAs (miRNAs) are endogenous non-coding RNAs, which play an essential role in the regulation of gene expression.<br />Aim of the work: To analyze miRNA expression profile in the childhood B acute lymphoblastic leukemia (B-ALL). To understand the functional regulatory effects of differential miRNAs on their targets and its clinical significance and novel analytical method to combine their expression profiles.<br />Patients and Methods: In this study, we determined the relative expression analysis of miRNA and mRNA profiles in 20 childrenB-ALL patients. Through the use of miRNA microarray technology and according to their miRNA pro-file.The best characterized non-coding RNA family consists in humans of about 1400 microRNAs for which abundant evidence have demonstrated fundamental importance in normal development, differentiation, growth control and inhuman diseases such as cancer.<br />Results: miR-100, miR-146a, miR-128a, miR-128b, miR-181a, miR-34, miR-193a, miR-193b, miR-151, miR-130b, and miR-125b were found to be the most consistently upreg-ulated miRNAs in B-acute lymphoblastic leukemia patients as compared with healthy control.<br />Conclusion: To analyze miRNA in B-ALL children patients before and after induction of chemotherapy and measure the correlation of these results using microarray technique.
miRNA – B-ALL – Microarray – Expression profile – Children ALL
https://mjcu.journals.ekb.eg/article_55782.html
https://mjcu.journals.ekb.eg/article_55782_e7c69b873f59e6c69ba4199e96642573.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
The Beneficial Effects of Silymarin in Treatment of Experimentally Induced Non-Alcoholic Fatty Liver Disease in Rats
1055
1064
EN
HEBAT ALLAH M. MAHMOUD, M.Sc.;
FATMA A. MAHMOUD, M.D.
GHADA HASHEM, M.D.;
HANAN H. AHMED, M.D.
HESHAM M.
MAHMOUD, M.D.
The Departments of Medical Pharmacology* and Biochemistry**, Faculty of Medicine, Cairo University
10.21608/mjcu.2018.55784
Abstract<br />Background: Non alcoholic fatty liver disease (NAFLD) is one of the most common diseases worldwide, which is commonly associated with diabetes hyperlipidemia and insulin resistance with oxidative stress and inflammatory reaction. Silymarin offers good protection in various toxic models of experimental liver diseases in laboratory animals. It acts by antioxidative, anti-lipid peroxidative, antifibrotic, anti-inflammatory, membrane stabilizing, immunomodulatory and liver regenerating mechanisms<br />Aim of the Study: The present work was designed to study the beneficial effects of silymarin on a dietary model of NAFLD.<br />Material and Methods: 30 male albino rats were allocated in 3 groups. Groups. Group I represents the normal control, Group II represents the HFD induced NAFLD model, the effects of silymarin, was assessed in groups III. Body weight and blood pressure were recorded and blood samples were tested for total cholesterol, triglycerides and liver transami-nases. Livers were removed and weighed, parts were used for GSH, MDA,TGF-B and other parts were kept for histopatholg-ical examination. Aortae were removed for in vitro vascular reactivity studies.<br />Results: Induction of NAFLD model by HFD for 20 weeks resulted in significant increase in body weight, blood pressure, liver index and epididymal weight, serum and liver different biochemical parameters with significant improvement of these indices in silymarin treated group. HFD model groups showed notable steatosis, lobular inflammation and fibrosis which was improved with silymarin use. Also NAFLD rats developed endothelial dysfunction which was significantly ameliorated in silymarin treated group.<br />Conclusion: The results of the present work showed that silymarin have the potential to favorably influence the course of NAFLD process and its complications. silymarin has many beneficial effects including scavenging of free radicals, or by enhancing the activity of antioxidant effects.
Non alcoholic fatty liver disease – HFD – Sily-marin
https://mjcu.journals.ekb.eg/article_55784.html
https://mjcu.journals.ekb.eg/article_55784_feaf75f77ac18718e5b9d2504f9b0da6.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
The Beneficial Effects of Sitagliptin, a Dipeptedyl Peptidase-4 (DPP-4) Inhibitor on Experimentally Induced Non-Alcoholic Fatty Liver Disease in Rats
1065
1076
EN
HEBAT ALLAH M. MAHMOUD, M.Sc.;
FATMA A. MAHMOUD, M.D.
GHADA HASHEM, M.D.;
HANAN H. AHMED, M.D.
HESHAM M.
MAHMOUD, M.D.
The Departments of Medical Pharmacology* and Biochemistry**, Faculty of Medicine, Cairo University
10.21608/mjcu.2018.55786
Abstract<br />Background: Non alcoholic fatty liver disease (NAFLD) is an increasing health problem which affects about 1/3 of the population worldwide, it is strongly associated with metabolic syndrome with oxidative stress and insulin resistance are the mechanisms mostly involved in its pathogenesis. Dipeptidyl peptidase-4 inhibitors are antidiabetic agents expected to have beneficial effects beyond their glycemic control.<br />Aim of the Study: The present work was designed to study the beneficial effects of sitagliptin (a DPP-4I) on a dietary model of NAFLD.<br />Material and Methods: 30 male albino rats were allocated in 3 groups. The effects of sitagliptin, was assessed in groups III. Body weight and blood pressure were recorded and blood samples were tested for total cholesterol, triglycerides and liver transaminases, glucose and insulin levels. Livers for GSH, MDA, TGF-B and DPP-4 activity and for histopatholg-ical examination. Aortae were removed for in vitro vascular reactivity studies.<br />Results: Induction of NAFLD model by HFD for 20 weeks resulted in significant increase in body weight, blood pressure, liver index and epididymal weight. Significant reduction of these parameters was observed with 4 week treatment with sitagliptin. There was significant increase in all biochemical parametres in HFD fed rats compared to that of normal with significant improvement in sitagliptin treated group. HFD model groups showed notable steatosis, lobular inflammation and fibrosis which was improved with sitagliptin use. Also NAFLD rats developed endothelial dysfunction which was significantly ameliorated in sitagliptin treated group.<br />Conclusion: The results of the present work showed that the DPP4Is have the potential to favorably influence the course of NAFLD process and its complications. DPP4I (sitagliptin) has many beneficial effects including scavenging of free radicals, and enhancing the activity of antioxidant effects. Large clinical trials are needed to determine the effectiveness of DPP-4 inhibitors for the prevention and treatment of NAFLD
Non alcoholic fatty liver disease – HFD – DPP-4Is – Sitagliptin
https://mjcu.journals.ekb.eg/article_55786.html
https://mjcu.journals.ekb.eg/article_55786_9206f1f6d62d35b99b5249d78e64d36d.pdf
The Clinical Society of Cairo University
The Medical Journal of Cairo University
0045-3803
2536-9806
86
March
2018
03
01
Ketamine Plus Nitroglycerin Versus Ketamine as Adjuncts to Lidocaine for Intravenous Regional Anesthesia in Adult Patients Undergoing Hand Surgery
1077
1081
EN
ISLAM A.
ELIWA, M.D.
The Department of Anesthesiology, Faculty of Medicine, Zagazig University, Egypt
10.21608/mjcu.2018.55787
Abstract<br />Background: Different agents have been used as adjutants to lidocaine for intravenous regional anesthesia (IVRA) to improve the quality of analgesia.<br />Aim of the Study: The aim of this double blinded rand-omized controlled trial is to evaluate if adding nitroglycerin to ketamine is more effective than using ketamine alone as an adjuvant to lidocaine for IVRA.<br />Patients and Methods: Fifty adult ASA I-II patients undergoing hand surgery using IVRA were divided into two equal groups: ketamine/nitroglycerin (K/N) group received lidocaine 3mg/kg (maximum 200mg) with ketamine 0.1mg/kg (maximum 10mg) plus nitroglycerin 2mcg/kg (maximum 200mcg) and ketamine (K) group received lidocaine 3 mg/kg (maximum 200 mg) with ketamine 0.1mg/kg (maximum 10mg). Statistical analysis was done using Student's t test or Chi square analysis whenever appropriate.<br />Results: The two groups were similar in demographic data and patients characteristics. The onset times of sensory and motor blockades were significantly shorter in K/N group. Although the preoperative visual analogue scale for pain intensity (VAS) was comparable, the intra-operative and postoperative VAS, were significantly less in K/N group. The intra-operative fentanyl consumption as an intra-operative analgesia was significantly less in K/N group. Also, the time to call for the first postoperative analgesia was significantly longer in K/N group than K group. However the postoperative analgesics consumption showed no significant difference between the two groups.<br />Conclusion: In comparison to ketamine, adding a combi-nation of ketamine and nitroglycerin to lidocaine for IVRA improved the quality of anesthesia without inducing significant clinical side effects.
Nitroglycerin – Ketamine – Intravenous – Regional – Anesthesia
https://mjcu.journals.ekb.eg/article_55787.html
https://mjcu.journals.ekb.eg/article_55787_26784018a57d006af9b881bd7c370008.pdf