e- Learning
Raouf
Salem
General Surgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
text
article
2021
eng
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
1
2
https://amj.journals.ekb.eg/article_197515_39e0b0377e786ae4cc668071168b3d08.pdf
dx.doi.org/10.21608/amj.2021.197515
SURGICAL MANAGEMENT OF SPASTIC DIPARESIS IN SELECTED CASES OF CEREBRAL PALSY BY "SELECTIVE DORSAL RHIZOTOMY" OPERATION
Ahmed
Nasser Abdul-Hamid Al-Sayed
Department of Neurosurgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
Ma'moun
Abo-Shousha
Department of Neurosurgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
Mohammed
Ahmed El-Labbad
Department of Neurosurgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
Alaa
Rashad Ibrahim
Department of Neurosurgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
text
article
2021
eng
Background: Spasticity affects a large number of children, mainly in the setting of cerebral palsy, however, only a few paediatric neurosurgeons deal with this problem. This is mainly due to the fact that until 1979, when Fasano has published the first series of selective dorsal rhizotomy (SDR), neurosurgeons were able to provide such children only a modest help.
Objectives: This work aims to study the effect of performing selective dorsal rhizotomy operation on patients suffering from spastic diparesis due to cerebral palsy, and the aim of surgery is to relieve the present spasticity, which is predominantly seen in the lower limbs, and to improve motor function.
Patients and methods: This study was done on 30 patients with ages (4-12) years old, with mean age 8 years old, included patients from both sexes (16 males, 14 females), on Al-Azhar University Hospital and Dar El-shefa Hospital, in the period from January 2019 to August 2020.
Results: In our study, we achieved significant results in our patients with sectioning 30-60% of rootlets, with preservation of motor power and no sensory loss. According to our results, an important factor that may improve outcome and prognosis of patients is the pre-operative mental state, as patients with acceptable mental ability has the potential to participate in more active physiotherapy programs that improve outcome greatly. However, even with decreased mentality there is post-operative decrease in muscle tone and reflexes, which may aid in making patient's decubitus less prone to pressure sores, and make the patient easier to handle, so, the proper care can be achieved. Also according to our study, the higher the grade of Aschworth's score is a good prognostic factor of achieving faster improvement of spasticity and gait.
Conclusion: selective dorsal rhizotomy is not a cure for cerebral palsy. The procedure offers spastic CP children improved motor capabilities and increased levels of functioning. Achieving maximal benefits depends on how much and which of the posterior rootlets are cut.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2363
2378
https://amj.journals.ekb.eg/article_196375_ee493c7bf165b3fb2cc4b828de146db1.pdf
dx.doi.org/10.21608/amj.2021.196375
PREGNANCY OUTCOMES IN WOMEN WITH GESTATIONAL DIABETES COMPARED WITH THE GENERAL OBSTETRIC POPULATION
Abdalla
M. El-Shikh
Obstetrics and Gynecology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
Mostafa
H. Hegab
Obstetrics and Gynecology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
Fahd
A. Al-Omda
Obstetrics and Gynecology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
Wael
R. Hablas
Obstetrics and Gynecology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
text
article
2021
eng
Background: Gestational diabetes mellitus (GDM) is the most prevalent metabolic disorder during pregnancy. It is described as the vulnerability to impaired glucose tolerance of multiple severities, usually during pregnancy.
Objective: To compare pregnancy outcome in pregnant women with gestational diabetes mellitus and pregnant women in general population.
Patients and Methods: A prospective non-intervention observational study was conducted in Obstetrics and Gynecology Department, Faculty of Medicine, Al-Azhar University, Samanoud General Hospital and Private Clinics during the period from October 2017 to October 2020. This study included 200 primigravida singleton pregnant women between 24 weeks and 28 weeks of gestation divided into two equal groups: case group included pregnant women attended for their routine antenatal care and discovered to have gestational diabetes and control group included normal healthy pregnant women attended for their routine antenatal care.
Results: Fetal weight was significantly higher among study group than controls. Fetal complications in the form of Large for Gestational Age (LGA), premature, shoulder dystocia, hypoglycemia and hyperbilirubinemia were significantly higher among study group than controls. Neonatal Intensive Care Unit (NICU) admission was significantly higher among study group was (14%) than controls (3%).
Conclusion: Increased maternal and fetal morbidity is linked with maternity gestational diabetes. Early screening, diagnosis, closer monitoring, and intervention were also important to minimize short and long-term maternal and fetal adverse effects, in particular in populations that are high-risk.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2379
2390
https://amj.journals.ekb.eg/article_196376_36666e6544870484dfe470ec586666a8.pdf
dx.doi.org/10.21608/amj.2021.196376
COMPARISON OF INTRAOCULAR LENS IMPLANTATION WITH AND WITHOUT VISCOELASTIC SUBSTANCES IN PHACOEMULSIFICATION
Hossam
Mohamed Khalil Mohamed
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University
author
Mohamed
Zakaria Eid
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University
author
Sayed
Mustafa El-Sayed
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: Life expectancy of the population may increase and cataract development may affect all the people with aging. Intraocular lens implantation surgery, a worldwide performed procedure, evolves and progresses. However, different techniques exist, which could be selected for different cases. Any ideal technique should be safe, simple, fast, and easy to learn with good clinical outcome.
Objective: The aim of this work was to compare the efficacy and safety of intraocular lens implantation with and without ophthalmic viscoelastic device after phacoemulsification as well as surgery duration and post-operative intraocular pressure and central corneal thickness.
Patients and methods: This was a prospective, randomized controlled trial conducted on 40 eyes with cataract; to compare the efficacy and safety of intraocular lens implantation with and without ophthalmic viscoelastic device after phacoemulsification of the lens as regard to surgery duration, post-operative intraocular pressure and central corneal thickness. Patients were evaluated 1 day, 1 week, and 1 month postoperatively. Patients were divided into two groups after the completion of lens cortex removal: Group A (n=20, hydro-implantation): One-piece acrylic intraocular lens implantation was performed with normal saline solution (0.9 solution) irrigation. Group B (n=20, visco-implantation): using Hydroxy-propyl-methyl-cellulose 2% implantation.
Results: Highly significant increase in phaco operative time in visco-implantation group; compared to hydro-implantation group (p < 0.0001), Non-Significant increase in post-operative IOP, in visco-implantation group; compared to hydro-implantation group (p > 0.05 respectively). Non-significant difference as regards post-operative Central corneal thickness (CCT) (p > 0.05). Non-significant increase in post-operative CCT measurements in visco-implantation group (p > 0.05). Non-significant difference in post-operative IOP measurements in visco-implantation group (p > 0.05). Non-significant decrease in post-operative IOP and CCT measurements in hydro-implantation group (p > 0.05). Non-significant decrease in post-operative IOP in hydro-implantation group; compared to visco-implantation group; during the serial 1st and 2nd measurements. Non-significant increase in post-operative CCT in Visco-implantation group; compared to hydro-implantation group; during the serial 1st and 2nd measurements.
Conclusion: The hydro-implantation had similar clinical outcome to visco-implantation with advantage of reduced surgical time and cost, and no ophthalmic viscosurgical devices (OVD) induced intraocular pressure elevation postoperatively.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2391
2400
https://amj.journals.ekb.eg/article_196377_93116f67ec6a538cbeb8881c276807ab.pdf
dx.doi.org/10.21608/amj.2021.196377
MANAGEMENT OF THYROTOXICOSIS IN PREGNANCY
Waleed
Abd El-Monem Mansour
Departments of General Surgery, Faculty of Medicine, Al-Azhar University
author
Mohamed
Sobhy Teamma
Departments of General Surgery, Faculty of Medicine, Al-Azhar University
author
Osama
Fathy Ibrahim Al-Mezaien
Departments of General Surgery, Faculty of Medicine, Al-Azhar University
author
Ahmed
Mohamed Mohamed Saeed
Departments of Gynaecology & Obstetrics, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: Autoimmune GD (Graves' Disease) is the most common cause of hyperthyroidism in women of childbearing age. To prevent maternal and fetal complications, thyrotoxicosis during pregnancy should be adequately managed and controlled. The physiological adaptations associated with pregnancy challenge the assessment of thyroid function in pregnant women, and the treatment with antithyroid drugs (ATD) raises concerns for the pregnant woman and the fetus. Our aim of this study was to discuss the effect of hyperthyroidism on pregnancy, different methods of diagnosis of hyperthyroidism and treatment of hyperthyroidism during pregnancy for a favorable maternal health and fetal outcome.
Objective: To discuss thyrotoxicosis this affects the pregnant woman and the effect of hyperthyroidism on pregnancy. It is to discuss different methods of diagnosis of hyperthyroidism during pregnancy. Also it is to study the treatment of hyperthyroidism and thyrotoxicosis during pregnancy for a favorable maternal health and fetal outcome.
Patients and Methods: A prospective randomized clinical study that was conducted on 20 pregnant female patients with thyrotoxicosis in different stages of pregnancy attending Bab-El Shaaria and El-Hussein University Hospitals through the period from April (2020) to December (2020). The selected patients received one of the two main medications which are propyl-thiouracil (PTU) and methimazole (MMI). Propylthiouracil was given in the 1st trimester and Methimazole was given in 2nd and 3rd trimester.
Results: There was statistically significant difference found between pretreatment and post treatment groups regarding Heat Intolerance, Palpitations, Tremors, and Irritability, while there was no statistically significant difference found between Pretreatment and Post treatment regarding Exophthalmos. Methimazole (MMI) is preferred to propyl-thiouracil (PTU) after the first trimester because PTU has an association with hepatotoxicity. However, PTU is recommended for the first trimester of pregnancy because its teratogenic effects are considered less severe than those of MMI.
Conclusion: Management of hyperthyroidism during pregnancy and lactation requires special considerations and should be meticulously implemented to provide best care to pregnant woman and prevent any adverse effects. Thyrotoxicosis of pregnancy can present unique diagnostic challenges and, if untreated, is associated with increased risks of adverse maternal, fetal, and neonatal complications. The clinical presentation, serum thyroid function test results, and serum TRAb titers can help differentiate the etiology of thyrotoxicosis. However, assessment and monitoring with serum thyroid function tests can be difficult, as there is significant overlap between test results arising from normal pregnancy physiology and intrinsic hyperthyroidism.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2401
2412
https://amj.journals.ekb.eg/article_196378_1783eccde3005a2af6599fbabd0d0d43.pdf
dx.doi.org/10.21608/amj.2021.196378
OUTCOME OF POLYTETRAFLUOROETHYLENE VERSUS DACRON GRAFTS FOR SUPRAGENICULAR FEMOROPOPLITEAL ARTERIAL BYPASSES
Abd El-Aziz
Ahmed Abd El-Hafez
Departments of Vascular Surgery, Faculty of Medicine, Al-Azhar University
author
Hany
Abd El-Momein
Departments of Vascular Surgery, Faculty of Medicine, Al-Azhar University
author
Mohammad
Abol-Wafa Amin
Departments of Radiology, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: Long saphenous vein (LSV) is used usually as the graft of the choice in the treatment of critical limb ischemia (CLI). LSV graft in femoropopliteal and femrodistal bypasses is more durable and also associated with reduced surgical mortality ratios and good success rates in preserving the ischemic limb. Synthetic graft, i.e. Dacron /Polytetrafluoroethylene (PTFE) is a good alternative if the saphenous vein is not available. PTFE has been the most popular choice. However, the preference for PTFE over Dacron is not evidence-based. The optimum graft configuration for the above-knee femoropopliteal bypass, whether PTFE or Dacron, remains a subject of controversy.
Objective: To outcome whether Dacron versus PTFE Grafts as optimum in supragenicular femoropopliteal revascularization.
Patients and Methods: Fifty patients with critical limb ischemia referred to Vascular Surgery Department, Al-Azhar University, Sednawy and El-Araby Hospitals were included during the period from July 2018 to April 2020. They had foot lesions as ulcer, wound or tissue loss associated with non-palpable distal pulses, and long occlusion of superficial femoral artery (SFA) defined as TransAtlantic Inter-Society Consensus (TASC) II C or D lesions. End points were healed, healing, nonhealing wounds or amputation. Patients were divided into two groups: group A included 25 patients who underwent Dacron graft bypass “DB”, and group B included 25 patients who underwent PTFE bypass “PB”.
Results: Twenty- two patients (44%) reached the end point of complete healing (10 patients did “DB” and 12 did “PB”), whereas twenty-six patients (52%) had no or inadequate healing lesions. The limb salvage after one year was 40 patients (80%): 21 of them with ‘DB’ technique, and 19 with ‘PB’ technique. The remaining 8 patients (16%) underwent major amputation (5 with ‘DB’ technique and 3 with ‘PB’ technique) and two patients (4%) died. The early patency rate at 1 and 3 months was 92.43 % in the group with ‘DB’, and 94.39% in the group with ‘PB’. The late patency rate at one year post-operatively was 63.63 % in the ‘DB’ group and 68.63 % in the ‘PB’ group.
Conclusion: Both Dacron and PTFE grafts were effective regarding wound healing and limb salvage as well as patency rate in supragenicular femoropopliteal revascularization.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2413
2422
https://amj.journals.ekb.eg/article_196379_593b066ef04b2ed1ec3fbfbe9ae72c88.pdf
dx.doi.org/10.21608/amj.2021.196379
EVALUATION OF INSULIN- LIKE GROWTH FACTOR BINDING PROTEIN-1 IN DIAGNOSIS OF PRETERM PREMATURE RUPTURE OF FETAL MEMBRANES
Ahmed
Salah Bakr
Departments of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University
author
Mohamed
Ali Mohamed
Departments of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University
author
Adel
Aly El-Boghdady
Departments of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University
author
Mohamed
Sad El-Deen Radwan
Departments of Clinical Pathology, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: Premature rupture of membranes (PROM) is preterm (PPROM) when it occurs before 37 weeks gestation. It is a complication of 2% to 20% of all deliveries and is a known important contributor to maternal and perinatal morbidity and perinatal mortality.
Objective: To assess the accuracy of the uses of insulin-like growth factor binding protein-1 (IGFBP-1) in prediction of preterm premature rupture of membranes.
Patients and Methods: This comparative cross sectional study included 90 pregnant women between 28-36 weeks of gestation complaining of watery vaginal discharge, carried out at Sayed Galal hospital, Al-Azhar University between August, 2018 and August, 2020.
Results: This study showed no statistically significant differences regarding maternal age, parity and gestational age at recruitment.IGFBP-1 (Actim PROM test) was more sensitive and specific in diagnosing rupture of membranes than Nitrazine test. The sensitivity and the specificity of IGFBP-1 (Actim PROM test) in diagnosing PROM was 89.7% and 86.9% respectively as compared to Nitrazine test which was 75.9% and 82.0%. The PPV and NPV of IGFBP-1 were 76.5% and 94.6% as compared to Nitrazinet test which were 66.7% and 87.7%.
Conclusion: One step cervicovaginal IGFBP-1 (Actim PROM) dipstick was a rapid reliable, non-invasive, easy and accurate diagnostic test for PROM.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2423
2432
https://amj.journals.ekb.eg/article_196380_bab04d0b39ef5fa157869cee9050d17e.pdf
dx.doi.org/10.21608/amj.2021.196380
EVALUATION OF PATIENTS’ SATISFACTION AFTER RHINOPLASTY: A PROSPECTIVE STUDY
Abd El-Rahman
Awadeen
Department of Plastic & Reconstructive Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
text
article
2021
eng
Background: Rhinoplasty is a technically demanding procedure, requiring a comprehensive understanding of the nasal and facial anatomy and carrying out the nasofacial analysis. These factors are critical in determining the operative plan and the most effective technique that manipulates cartilage, bone, and soft tissue. The ultimate aim of rhinoplasty is to satisfy the patients with post-operative aesthetic and functional outcomes.
Objective: To assess the long-term functional and aesthetic satisfaction among a sample of Egyptian patients subjected to rhinoplasty.
Patients and Methods: This was a prospective cohort study conducted at Al-Azhar University Hospitals from May 2014 to May 2019. Patients aged more than 22 years of both sexes subjected to rhinoplasty, and presented in the outpatient clinics for follow-up were included. Post-operative counseling with the patients about the pre-operative conditions and deformities was done. Patients’ satisfaction was assessed using the rhinoplasty outcome evaluation questionnaire.
Results: This study included a total of 30 patients. Of them, there was 3 (10%) male and 27 (90%) females with a mean age of 38.1±6.91years. The mean level of Rhinoplasty outcome evaluation questionnaire was 77.1±6.91. Out of the included patients, 17 (56.66%) patients were satisfied with their aesthetic and functional rhinoplasty outcomes and were presented only for follow-up. Of the remaining 13 (43.33%) cases, four (13.3%) cases required secondary correction due to functional problems and complained of headache and difficulty breathing. Two patients were dissatisfied due to partner dissatisfaction that developed significant psychological impact.
Conclusion: A considerable proportion of patients were dissatisfied after rhinoplasty. The major contributing factors are related to functional and aesthetic problems, as well as psychological morbidities. Therefore, patients seeking rhinoplasty should be subjected to thoroughly functional and psychological evaluation preoperatively to achieve the desired functional and aesthetic outcomes.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2433
2442
https://amj.journals.ekb.eg/article_196382_5e8d855f8ce914c7d08a3c95bc379b7f.pdf
dx.doi.org/10.21608/amj.2021.196382
ONCOPLASTIC BREAST SURGERY FOR EARLY BREAST CANCER
Ahmed
Mahmoud Eid Mahmoud
General Surgery Department, Faculty of Medicine, Al-Azhar University
author
Abdoh
Salem
General Surgery Department, Faculty of Medicine, Al-Azhar University
author
Mahmoud
Mohamed Ibrahim Mohamed
General Surgery Department, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: Breast cancer is the most commonly diagnosed cancer worldwide, and is the second most common cause of cancer-related deaths between females, with about 18000 new cases diagnosed among female in 2014 in Egypt.
Objective: To evaluate the oncological outcomes and patient satisfaction on the esthetical side with oncoplastic surgery for patients with early stage breast cancer.
Patients and Methods: The present study was enrolled from January 2019 to January 2020 at Al- Azhar University Hospitals and Nasser's Institute Hospital for Research and Treatment. This were a descriptive study done on 30 participants with breast cancer who met inclusion criteria underwent various level II, III Oncoplastic breast surgery. The oncological and aesthetic satisfaction was evaluated.
Results: Our study results showed statistically significant difference between surgeons score on cosmetic outcome as regards wound dehiscence and fat necrosis.
Conclusion: Oncoplastic breast surgery techniques are effective and results in improved patient-reported outcomes in early breast cancer.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2443
2458
https://amj.journals.ekb.eg/article_196385_c4a1687c2f649f950e01ecdd9a56b14b.pdf
dx.doi.org/10.21608/amj.2021.196385
RADIOLOGICAL AND CLINICAL ANALYSIS OF BIPLANE OPENING WEDGE HIGH TIBIAL OSTEOTOMY FOR MEDIALLY ARTHRITIC VARUS KNEES FIXED BY LOCKING PLATE
Mahmoud
Gamal Mahmoud
Department of Orthopedic Surgery and Traumatology, Faculty of Medicine, AL-Azhar University, Cairo, Egypt
author
Mohammed
Abd El-Monem Negm
Department of Orthopedic Surgery and Traumatology, Faculty of Medicine, AL-Azhar University, Cairo, Egypt
author
Amr
Abd El-Halim Amr
Department of Orthopedic Surgery and Traumatology, Faculty of Medicine, AL-Azhar University, Cairo, Egypt
author
text
article
2021
eng
Background: High tibial osteotomy is an established and helpful treatment for unicompartmental osteoarthritis associated with varus deformity. However, asupratubercle high tibial osteotomy leads to a decrease in patellar height making the technique not suitable in the case of concomitant patella Baja. Moreover, this kind of osteotomy can change in situ forces at the patellofemoral joint and the lateral patellar tilt. To widen the indication of high tibial osteotomy was proposed a biplane opening wedge high tibial osteotomy with a distal tuberosity osteotomy (B-OWHTO).
Objective: To assess the clinical and radiological outcome of biplane open wedge high tibial osteotomy in the treatment of medially arthritic varus knees.
Patient and Methods: Twenty varus knees (20) patients, with MCOA, were operated upon from 2019 to 2020 at Al-Azhar University Hospital (Assiut). They all had Medially Opening Wedge High Tibial (MOWHTO) using the biplanar technique and fixed by locking plates. We compared the data fetched preoperatively (at day 0 = D0) with data one year or more after surgery with a mean of 14.5 months (at year 1=Y1). The mean age was 49.39 ± 8.15 years old, 13 were females, while others were males. Eleven were right knees, and 7 were left. Types of occupation were; 9 employed, 7 unemployed. Sixteen were no sportive, and 2 were recreational athletes. Seven patients were normal weight, while 11 were overweight. Two patients were diabetic, and 2 were perceived as treated HCV infection. According to the MCOA K-L scale; 5 were grade 3, 9 were grade 2 and 4 were grade 1.
Results: The mean western Ontario and Macmaster universities osteoarthritis index (WOMAC), value was 51.44 ± 26.8 and then dropped to 24. 39 ± 17.41. The difference was statistically significant (p-value was <0.001). The mean Cincinnati score was 40.36 ± 19.28 at D0, then 81.88 ± 14.45 at Y1. The rising pattern from D0 to Y1 was significant statistically (p-value was <0.001). For radiological results, the mean amount of correction was 10.56º ± 2.97º. The mean TS for the18 patients was 10.78º ± 2.92º and changed to 10.49º ± 2.51º, and this was statistically insignificant. Regarding the patellar height (PH), there was a statistically significant decreasing tendency from a mean of 1.02 ± 0.16 to 0.97 ± 0.15. LPT showed a statistically significant decrease, although quite small, from 10.48 º ± 6.18 º to 9.43º ± 4.27º. MOWHTO using biplanar technique and fixed by the locking plate without BG filling was a very efficient modality of treatment for adult patients suffering from medially arthritic varus knees in terms of clinical and radiological aspects.
Conclusion: Medial Open Wedge High Tibial Osteotomy (MOWHTO) using biplanar technique and fixed by the locked plate without bone graft filling was a very efficient modality of treatment for adult patients suffering from medially arthritic varus knees in terms of clinical and radiological aspects.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2459
2472
https://amj.journals.ekb.eg/article_196387_b99ebc26b98881c4dc014d4f62cf82e9.pdf
dx.doi.org/10.21608/amj.2021.196387
CORNEAL ENDOTHELIAL CELL CHANGES AFTER TRABECULECTOMY WITH MITOMYCIN-C IN GLAUCOMA PATIENTS
Mohamed
Abd El-Aziz Mohamed Salah
Department of Ophthalmology, Faculty of Medicine, Al Azhar University, Cairo, Egypt
author
Hassan
El-Sayed El-Baz
Department of Ophthalmology, Faculty of Medicine, Al Azhar University, Cairo, Egypt
author
Sayed
Mostafa El-Sayed
Department of Ophthalmology, Faculty of Medicine, Al Azhar University, Cairo, Egypt
author
text
article
2021
eng
Background: Mitomycin C is an antimetabolite and affects corneal endothelial cells as measured by noncontact specular microscopy after trabeculectomy with mitomycin-C (MMC).
Objective: To evaluate the corneal endothelial cells changes after trabeculectomy with MMC.
Patients and methods: Patients were categorized into 2 groups, group A(25 eyes) were managed by trabeculectomy with mitomycin-C injection, group B (25 eyes) were managed by trabeculectomy with mitomycin-C sponge-applied technique which was carried out on patients attending at Ophthalmology Department of Al-Azhar University Hospitals from March 2019 to February 2021. Follow-up by specular microscopy preoperatively and 1 month and 6 months postoperatively to evaluate corneal endothelial cells density and morphological changes.
Results: There was a significant reduction in the endothelial cell density and percentage of hexagonal cells and increased variation in cell size in the two studied groups after 1 month and 6 months compared with preoperative values. With no differences between the two studied groups.
Conclusion: Trabeculectomy with both MMC injection and sponge applied caused a significant loss of the corneal endothelial cells intraoperatively or at the early postoperative period. Progressive cell losses due to MMC were not a major concern.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2473
2484
https://amj.journals.ekb.eg/article_196388_a12c89b0e96ba91e14d1737f652dee2d.pdf
dx.doi.org/10.21608/amj.2021.196388
CORRELATION BETWEEN CORPUS LUTEUM VOLUME USING 2D ULTRASOUND AND COLOR-DOPPLER STUDY OF CORPUS LUTEUM VASCULATURE WITH MATERNAL SERUM CA-125 LEVEL IN PROGNOSIS OF FIRST TRIMESTER THREATENED ABORTION
Ayman
Aly Abd El-Rahman Nafea
Departments of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
author
Yahia
Abd El-Salam Wafa
Departments of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
author
Osama
El-Saeed Ali
Departments of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
author
Wael
Refaat Hablas
Departments of Clinical Pathology, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: Threatened miscarriage is a common complication in the first trimester of pregnancy and is often associated with anxiety regarding pregnancy outcome. Approximately, 20% of pregnant women have symptoms of threatened abortion in the first trimester of pregnancy. A single serum cancer antigen 125 (CA-125) level determination is valuable in women with imminent abortion presenting with abdominal pain, vaginal bleeding or both rather than serial measurements.
Objective: To evaluate the prognostic value of correlating the corpus luteum volume measured by two-dimensional ultrasound, and color doppler blood flow changes in the corpus luteum together with the results of serum CA-125 at the time of initial presentation with pregnancy outcome in patients with first trimesteric threatened abortion.
Patients and methods: This prospective controlled study was held during the period from May 2015 to May 2018 on 100 women on their first trimester of pregnancy, 50 women having normal uncomplicated pregnancy and 50 women with clinical diagnosis of threatened abortion. The latter group was further subdivided into: group of patients who aborted (14 patients), and another group who continued their pregnancy and proceeded into the second trimester (36 patients).
Results: It was found that the mean corpus luteum peak systolic velocity (CL PSV) for the threatened abortion (aborted) group was 30.68 ± 18.9 cm/sec, while for the threatened abortion (continued) group was 22.03 ± 12.9 cm/sec, and for the control group was 21.58 ± 13.77 cm/sec. The difference was statistically significant between threatened abortion (aborted) group and each of the threatened abortion (continued) group and the control group. The difference was statistically non-significant between the threatened abortion (continued) group, and the control group. The cut-off value of CL PSV at which there was a high probability of termination of pregnancy in threatened abortion cases, reached 17.785 cm/sec with a sensitivity of 63.6% and specificity of 54.4%.
Conclusion: Serum CA-125 level determination was valuable in the women with symptoms of threatened abortion with a cut-off limit of 31.85 IU/ml of CA-125 level which carried a sensitivity of 86.4% and specificity of 80.7%. The study suggested that CA- 125 may be a cheap, sensitive and specific method in prediction of the cases of threatened abortion.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2485
2498
https://amj.journals.ekb.eg/article_196390_15c99afe9f8bab02b37f39b621a0bbc2.pdf
dx.doi.org/10.21608/amj.2021.196390
MODIFIED MUSTARDÉ TECHNIQUE FOR CORRECTION OF PROTRUDING EAR ( BAT EAR ) IN CHILDREN
Abd El-Rahman
Salah Beltagy El-Beltagy
Department of Pediatric Surgery, Faculty of Medicine, Al-Azhar University
author
El-Sayed
Hassan Mohamed Abdallah
Department of Pediatric Surgery, Faculty of Medicine, Al-Azhar University
author
Ibrahim
Ahmed Ismail Gamaan
Department of Pediatric Surgery, Faculty of Medicine, Al-Azhar University
author
Abd El-Rahman
Safwat Yossef El-Kady
Department of General Surgery, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: The auricle constitutes an important part of the face which is a focus of attention and personal interaction. A malformed auricle especially in young school age may result in some kind of psychosocial disturbance. Congenital abnormalities of the auricle have been estimated to occur in 5% of the population.
Objective: to demonstrate and evaluate the results of modified mustarde technique used for correction of prominent ear deformity in pediatric.
Patients and Methods: The present study included the results of operations in 30 ears concerning 16patients because there were 14 bilateral and 2 unilateral patients with prominent ear deformities, at age between 4-14 years of sexes, (11 males and 5 females). The patients were admitted to Al-azhar University hospitals in Cairo.
Results: Our results were discussed in view of one technique, modified mustarde technique for all cases. The aesthetic results were evaluated,during the first 6 months postoperatively, by inspection and continuous measurements of auriculo-mastoid distance. For that purpose, photographs and measurements data taken in the pre- and post-operative periods was compared. In addition, the opinions of the patients and their care givers were taken into consideration.
Conclusion: The use of modified mustarde technique not only hides the suture material but also provides a primary otoplasty technique that supports the repair with plication and scoring which gives the opportunity for the new shape to remain consistent in the postoperative period, a natural-looking antihelical fold, no sharp edges was formed and Long-lasting permanent results were aimed We believe that the modified mustarde technique was simple, safe and easy applicable method for protruding ear correction with excellent results.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2499
2510
https://amj.journals.ekb.eg/article_196392_91a85832631b65974d3d760142a227fc.pdf
dx.doi.org/10.21608/amj.2021.196392
KIRSCHNER WIRES VERSUS HERBERT SCREW FIXATION WITH BONE GRAFT IN CASE OF NONUNITED SCAPHOID WAIST FRACTURE
Ammar
Ahmed
Department of Orthopedic Surgery, Faculty of Medicine, Al-Azhar University
author
Ahmed
Badawy
Department of Orthopedic Surgery, Faculty of Medicine, Al-Azhar University
author
Galal
Hegazy
Department of Orthopedic Surgery, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: Scaphoid nonunion is challenging to manage because of the geometry of the scaphoid, the direction and type of fracture, and the vascular pattern of the blood supply to the scaphoid. Fracture proximal to the perforating vessels on the dorso-radial surface of the scaphoid can cause significant bone ischemia of the proximal pole.
Objective: To compare the impact of the Kirschner wires versus Herbert screw fixation with iliac bone graft on the rate of union, time to union, correction of deformity, and clinical outcome in adults with nonunited scaphoid waist fracture without avascular necrosis.
Patients and Methods: We prospectively randomized 40 patients to undergo corticocancellous iliac bone grafting and internal fixation either with multiple Kirschner wires or Herbert screw. This study was conducted in the Department of Orthopedic surgery at Al-Hussien University Hospital, Faculty of Medicine, Al-Azhar University during the period from February 2018 to April 2020. Radiographs, clinical outcome measures (pain, range of motion, and grip strength) were done pre- and post-operatively.
Results: No significant difference detected between the two groups with respect to the time to union, rate of union, deformity correction, pain analysis, range of motion, grip strength, and complications.
Conclusion: Combination of impaction of iliac bone graft, and internal fixation with k-wire or Herbert’s screw provided a good option for treatment of scaphoid nonunion. However, because of kirschner wires has a shorter operative time, lower cost and easy application as compared with the Herbert screw, so k wire may be a good alternative to Herbert screw.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2511
2520
https://amj.journals.ekb.eg/article_196393_95ac220d567e214b9e77597b4b9bb5b2.pdf
dx.doi.org/10.21608/amj.2021.196393
EFFECT OF LAG-SCREW POSITIONS ON FIXATION FAILURE IN PATIENTS WITH INTERTROCHANTERIC FRACTURES OF THE FEMUR
Mahmoud
Mohammed
Orthopedic department faculty of medicine Al-Azhar University Cairo Egypt
author
Kamal
Abd Al-Rhman Abd El-Hafez
Department of orthopedic surgery, Faculty of Medicine, Al-Azhar University
author
Mohammed
Moawad Abd El-Motlb
Department of orthopedic surgery, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: The dynamic hip screw (DHS) is widely used in treating the intertrochanteric fractures of the femur in old patients. The positions of the lag screw in the femoral neck and the distance between the tip of the lag screw and the apex of the femoral head are very important for the procedure success.
Objective: To assess lag-screw positions rule on failure of fixation intertrochanteric femur fractures.
Patients and Methods: This was a case presentation study contained twenty patients aged ≥50 with unstable types of intertrochanteric fractures, and had been subjected to dynamic hip screws.
Results: This study included (13) females and (7) males whose ages ranged between (58) to (86) years, Failure of fixation seen in 15 cases (75%) of all cases and union seen only in 5 cases (25%). The mean tip apex distance (TAD) was significantly longer when with fixation failure (p= 0.002). Relation of Location of Lag Screw to fixation failure had no statistically significant difference. Tip apex distance(TAD)was significantly longer among the studied cases with inferior-centeral (I-C) location of lag screw as compared with centeral-centeral (C-C) location of lag screw (p= 0.006).
Conclusion: The Tip apex distance (TAD) wasan easy effective way which was very important to determine the location of the screw. Regardless place of the guide-pin was placed as long as the aimed position results in a tip-apex distance of greater than twenty-five millimeters. So, it was recommended to reconsider the guide pin reduction and redirection.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2521
2530
https://amj.journals.ekb.eg/article_196394_fab9262725e64dd7335c45cfb196b027.pdf
dx.doi.org/10.21608/amj.2021.196394
EVALUATION OF BLUNT ABDOMINAL TRAUMA SEVERITY SCORE (BATSS) IN PREDICTING THE NECESSITY OF LAPAROTOMY FOR ADMITTED CASES WITH BLUNT ABDOMINAL TRAUMA
Ismael
Ragab El-Said Beltagy
Department of General Surgery, Faculty of Medicine, Al-Azhar University
author
Mahmoud
Mohammed Abo Al-Yazid
Department of General Surgery, Faculty of Medicine, Al-Azhar University
author
Eslam
Taha Ghalwash
Department of General Surgery, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: Abdominal trauma is the third leading cause of death in trauma patients and can be found in about 7-10% of the total number of trauma cases. The Blunt Abdominal Trauma Scoring System (BATSS) provides a high-accuracy score system for diagnosing injury to intra-abdominal organs in blunt abdominal trauma patients based on clinical features, such as patient history, physical examination.
Objectives: To determine Blunt Abdominal Trauma patients ‘signs, as well as clinical data, and to clarify the accuracy, sensitivity, specificity, positive and negative predictive value of Blunt Abdominal Trauma Severity Score (BATSS).
Patients and methods: This was a cross sectional study that was conducted on 100 cases admitted with bunt abdominal trauma in Al-Hussein Hospital, Al- Azhar University from March 2020 to October 2020, which included 50 males (50%) and 50 females (50%), their ages ranged from 18.0 to 60.0 years (mean ±SD 38.53 ± 12.11); included majority of cases from 20 to 40 year (54%), after initial resuscitation and achieving hemodynamic stability, All patients were subjected to careful examination, and all patients underwent the FAST ultra sound and plain radiograph of chest and abdomen scan and blunt abdominal trauma severity score was calculated, decision was taken for further investigations and CT scan if the patient was stable. If patient was hemodynamic unstable, the patient was resuscitated and planned for emergency surgery if indicated.
Results: 64% were High risk (≥12) according to blunt abdominal trauma severity score, 26% was of medium risk (8 – 11), and only 10% was of low risk (< 8) 19% had perforated gut, 32% had spleen hematoma, 13% had liver tear, only 1% had kidney hematoma, and 1% had shattered spleen. There was non-statistical significant difference between presence or absence of mortality/morbidity and blunt abdominal trauma severity score, and there was statistical significant difference between procedure done and blunt abdominal trauma severity score.
Conclusion: BATSS can be a tool of early identification and stratification of patients blunt abdominal trauma, and it is a new scoring system based on clinical signs, can be used in predicting whether a blunt abdominal trauma patient needs laparotomy or not.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2531
2542
https://amj.journals.ekb.eg/article_196395_31274c0b88793cb92641c2f6b92c8386.pdf
dx.doi.org/10.21608/amj.2021.196395
COMPARATIVE STUDY BETWEEN BALLOON ANGIOPLASTY AND BYPASS SURGERY IN LONG SUPERFICIAL FEMORAL ARTERY LESIONS
Mohamed
Hamdy Hassan
Department of Vascular Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
Hany
Abd El-Moamen Abd El-Fatah
Department of Vascular Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
Omar
Mokhtar Ibrahim
Department of Vascular Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
text
article
2021
eng
Background: Critical limb ischemia is the most advanced stage of peripheral arterial occlusive disease. The prognosis is poor, with amputation rates up to 30 % and mortality up to 25% after 1 year.
Objective: To compare using of balloon angioplasty versus bypass surgery in management of long superficial femoral artery (SFA) lesions.
Patients and methods: A prospective comparative study conducted at the Vascular Surgery Department at Al-Azhar University Hospitals starting from November 2019 to November 2020. The study included (30) patients (15 patients were treated by angioplasty and 15 patients were treated by autogenous femoro popliteal bypass) suffering from long SFA lesions.
Results: No statistical difference was found regarding age and sex distribution and associated comorbidities. Technical success rate after endovascular intervention (group A) reached 93.3% compared to 86.7% in femoropopliteal bypass (group B). Procedure duration was 1.1±0.85 compared to 2.8±1.7 in Group B. This was statistically lower in endovascular group (P=0.032). Mean hospital stay was 0.6±0.35 compared to 3.1±2.6 in Group B. This was statistically lower in endovascular group (P=0.013). We achieved a limb salvage rate of 14 (93.3%) in group A and 13 patients (86.7%) for group B and a major amputation rate of 6.7% (1 patients) in group A and 13.3% (2 patients) in group B over 1-year follow-up period. No difference was found between both interventions.
Patency rate at 12 months was higher in group B than in group A (66.7% vs. 46.7%). P=0.27. Postoperative improvement of ankle brachial pressure index (ABPI) was statistically non-different (P=0.07, 0.89). Superficial infection, Deep infection and Seroma were all confined to bypass group. Other complications were not statistically different in both groups. There was no significant difference in the mortality rate which was 6.7% and 13.3% in group A and B respectively.
Conclusion: Both balloon angioplasty and bypass surgery were safe and effective method for treatment of long SFA lesions. Bypass group showed better patency rates at final follow up.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2543
2554
https://amj.journals.ekb.eg/article_196396_083591b92b73f4ac5015778833760a30.pdf
dx.doi.org/10.21608/amj.2021.196396
COMPARATIVE STUDY BETWEEN SINGLE LAYER VERSUS DOUBLE LAYER ANASTOMOTIC TECHNIQUE FOR SMALL INTESTINAL ANASTOMOSIS IN ADULTS
Ahmed
Abd El-Aal Sultan
Department of General Surgery, Faculty of Medicine, Al-Azhar University
author
Mohamed
Kamal Soliman
Department of General Surgery, Faculty of Medicine, Al-Azhar University
author
Mohamed
Ibrahim El-Anany
Department of General Surgery, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: Anastomosis of gastrointestinal tract more commonly used in most of abdominal operations including esophagus, stomach, small intestine, large intestine, and biliary system. However single layer versus double layer anastomotic technique is still a matter of discussion as regard safety and efficacy.
Objective: To study efficacy and safety of single layer intestinal anastomosis against double layer anastomosis as regard leakage, cost effectiveness, and the time of the procedure.
Patients and methods: This prospective randomized study included 40 patients requiring small intestinal resection and anastomosis at Al- Hussein University Hospital and Damanhur Medical National Institute (Al-Behira) during the period between May 2019 and October 2020. The cases of this study were subjected to full history taking, full clinical examination, along with routine laboratory and radiological investigations. The cases of this study were divided into two equal groups randomly; Group A was subjected to one-layer anastomosis, and group B underwent double layered anastomosis. All cases were subjected to the standard post-operative care. Oral intake and hospital stay were recorded. In addition, post-operative complications including leakage, ileus, and mortality were recorded.
Results: Mean time of operation in the single layer intestinal anastomosis was statistically significantly shorter as compared with double layered intestinal anastomosis (28.29 ± 8.15 minutes and 35.19 ± 9.96 minutes) respectively. The early postoperative findings and late postoperative complications were comparable in both groups with no statistically significant difference.
Conclusion: Single layer intestinal anastomosis was less time consuming, less utilization of packing material, in addition to equal efficacy and safety as compared with double layer intestinal anastomosis.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2555
2564
https://amj.journals.ekb.eg/article_196397_36cff25c655cb636f33a8778f48d893d.pdf
dx.doi.org/10.21608/amj.2021.196397
DECOMPRESSIVE CRANIOTOMY IN MANAGEMENT OF ACUTE CEREBRAL ISCHEMIA
Nayef
Mohamed Maher
Departments of Neurosurgery, Faculty of Medicine, Al-Azhar University
author
Maamoun
Abou Shosha
Departments of Neurosurgery, Faculty of Medicine, Al-Azhar University
author
Ahmed
Mahmoud El-Sherif
Departments of Neurosurgery, Faculty of Medicine, Al-Azhar University
author
Mohamed
Abou El-Naga
Departments of Radiodiagnosis, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: Ischemic stroke is a medical emergency and the most common affection of the central nervous system (CNS). This is the second-leading cause of death worldwide and the first causes of morbidity. Ischemic stroke correspond to 85% of all strokes with a mortality of 10-50%. Large space-occupying infarction accounts for 1-10% of all supratentorial infarction with signs of elevated intracranial pressure (ICP) and brain herniation usually in the second to the fifth day leading to a mortality rate of 53% to 89%.
Objective: To evaluate the clinical and radiological outcome of decompressive surgery in the setting of cerebral infarctions, and to study its effect in reducing the overall mortality rates of this fatal condition.
Patients and methods: This study is descriptive and analytic clinical trial study for evaluating the clinical and functional outcomes of surgical cases with massive cerebral infarction. Over one year, Between January 2018 and January 2019, at Dar Alshifa Hospital, and Al-Azhar University Hospitals in Cairo.
Results: Twenty cases with cerebral infarctions were included in this. In our study, there was 12 males (60%) and 8 females (40%) male: female ratio 1.5:1.The age of the cases ranged from 37 to 77 years. The mean age was 57.65 years. Four cases were less than 50 years (20%), 6 cases between 50 and 60 years (30%), 8 cases between 60 and 70 years (40%), and 2 cases above 70 years (10%). Eighteen cases had middle cerebral artery (MCA) infarctions (90/%), while 2 cases had both MCA and anterior cerebral artery (ACA) infarctions. eleven cases were right sided while 9 cases were having left-sided infarctions.
Conclusion: The preoperative clinical condition , higher GCS score at presentation were strongly related to a favorable clinical outcome .Some ICU related complications such as contra lateral infarction, hemorrhagic infarction, pulmonary embolism, pneumonia can worse the patient outcome .Other complication related to the surgery such as CSF leak, wound infection did not effect on patient prognosis. Factors like patients’ age, sex, site of infarction, and preoperative midline shift did not affect the final outcome. A study with larger sample size and longer follow-up is recommended for better confirmation of these facts.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2565
2574
https://amj.journals.ekb.eg/article_196399_0b002d2916e12e6283ccd9815cffa54c.pdf
dx.doi.org/10.21608/amj.2021.196399
PREOPERATIVE EVALUATION OF THE COMMON BILE DUCT IN GALLSTONE PATIENTS USING ULTRASOUND ALONE VERSUS ADDED LAPAROSCOPIC CHOLANGIOGRAPHY DURING CHOLECYSTECTOMY
Mustafa
Lotfy Abdul-Baky
Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
Ahmed
Shehata Kawashti
Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
Abd El-Rahman
Safwat El-Kady
Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
text
article
2021
eng
Background: Intraoperative cholangiography (IOC) is one of the surgical advances that aim to evaluate the billary system and reduce the risk of laparoscopic cholecystectomy (LC) complications.
Objective: To evaluate the Common bile duct (CBD) preoperatively in gallstone patients using ultrasound alone versus added laparoscopic cholangiography during cholecystectomy.
Patients and Methods: This prospective randomized study at the Department of Surgery, Faculty of Medicine, Al-Azhar University from November 2019 till September 2020 ,were 40 patients randomized divided into two equal groups: Group I received laparoscopic cholecystectomy and Group II received laparoscopic cholecystectomy with intra operative trans-cystic cholangiography. Adult patients with good general condition were enrolled if they were diagnosed with symptomatic gall stones. Our protocol was approved by the institutional review board at Faculty of Medicine, Al-Azhar University and all participants signed an informed written consent before the procedure.
Results: IOC scored the highest visualization rate, sensitivity and specificity rate (100%). Success rate was also high reaching 95%.
Conclusion: IOC during LC was associated with a low morbidity rate and no mortalities. This confirmed the effectiveness of IOC in reducing the postoperative complications of LC.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2575
2586
https://amj.journals.ekb.eg/article_196400_160e3b0f1bab847065f1bfe6fec08bd1.pdf
dx.doi.org/10.21608/amj.2021.196400
GASTRO-ESOPHAGEAL REFLUX DISEASE BEFORE AND AFTER BARIATRIC SURGERIES
Said
El-Seayd Ahmed El-Didamony Ahmed
Department of General Surgery, Faculty of Medicine, Al-Azhar University, Egypt
author
Ahmed
Ibrahim Shehata Kawashti
Department of General Surgery, Faculty of Medicine, Al-Azhar University, Egypt
author
Ahmed
Abd El Fattah Ahmed Mustafa
Department of General Surgery, Faculty of Medicine, Al-Azhar University, Egypt
author
text
article
2021
eng
Background: The relationship between obesity and gastro esophageal reflux disease (GERD) risk has been well established. Many authors suggest performing esophagogastroduodenoscopy (OGD) in all patients before bariatric procedures. On the other hand, many other investigators advocate a selective approach for asymptomatic patients. Laparoscopic Roux-en-Y gastric bypass (LRYGB) is considered by most experts the procedure of choice for the management of GERD in obese patients; however, the effect of LSG on GERD is still unclear.
Objective: To identify presences or absences of GERD in patients undergoing different types of bariatric surgery and the effect of this surgery on GERD status post operatively.
Patients and Methods: This study included forty successive morbidly obese patients who present to Surgery Department of Al-Azhar University Hospitals seeking for bariatric surgery, during the period from January 2018 to April 2020. Seventeen (42.5%) of the patients were males, while twenty-three (57.5%) were females. Upper endoscopy was performed preoperatively in all cases. Full history, physical examination and special investigations were taking, Patients was classified into laparoscopic sleeve gastrostomy (LSG) group (14 cases), laparoscopic greater curvature gastric plication (LGCGP) group, (3 cases), LRYGB group, (19 cases), and laparoscopic mini gastric bypass (LMGB) group, (4 case). OGD was done preoperatively in all patient and yearly postoperatively for two successive year.
Result: In LSG group (14 cases), post-operatively with follow up by OGD, there was five cases (35.7%) have GERD sings and the rest of cases, nine cases (64.3%) have normal esophageal mucosa. In LRYGB group, all patients have normal esophageal mucosa after operation. In LGCGP group, three cases, post-operatively with follow up by OGD, there was one case (33.3%) have GERD signs, and the rest of cases, two cases (66.7%) have normal esophageal mucosa. In LMGB group, two case 50% improved in the 2nd year, one (25%) improved from the 1st year, and one case (25%) has increased GERD symptoms, signs, and biliary reflux.
Conclusion: OGD should be done before bariatric procedures routinely or selectively, Laparoscopic Roux-en-Y gastric bypass (LRYGB) was considered the procedure of choice for the management of GERD in obese patients, However LSG still unclear on obese patient with GERD.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2587
2598
https://amj.journals.ekb.eg/article_196401_2f7229d0a81909211ac63188f5f8de49.pdf
dx.doi.org/10.21608/amj.2021.196401
FOAM SCLEROTHERAPY VERSUS MICRO STAB PHLEBECTOMY IN THE TREATMENT OF RECURRENT LEG VARICOSE VEINS
Yousef
Abd El-Kareem Mohammed Younus
Department of Vascular Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
Ahmed
Said Ahmed Daha
Department of Vascular Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
Hisham
Wefky Anwar Hassan
Department of Vascular Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
text
article
2021
eng
Background: Varicose veins are common in the adult population and about one in four develops the condition throughout life.
Objective: To compare micro stab phlebectomy and foam sclerotherapy in the treatment of recurrent leg varicose veins regarding results of treatment, incidence of complications, and recurrence.
Patients and methods: This was a prospective observational cohort study included fifty patients with recurrent varicose veins divided in two equal comparative groups: Group A underwent stab phlebectomy and group B underwent foam sclerotherapy. The study duration was between January 2020 and November 2020 at the Department of Vascular Surgery, Al-Azhar University Hospitals (Al-Hussein and Bab Al-Shaareia University Hospitals).
Results: Thirty males and twenty females were included. Mean age (years) was 35 and 34 in phlebectomy and foam sclerotherapy groups, respectively. No significant difference between the two groups according to age and sex. The prevalence of recurrent lower limb varicose vein was found to be more common in males than in females in the vicinity of this study.
Dilated veins were the most common involving in 60 % (n = 30/50) of the patients. The primary symptom of the patients relieved in 80 % and 56% in phlebectomy and foam sclerotherapy groups, respectively. Time taken in procedures was significantly different between the two groups.
During the follow-up with duplex at 6 months, treated veins showed 92 % (n =23/25) removal of treated veins in the phlebectomy group, while only 72% (n=18/25) of the patients in the foam group showed evidence of complete occlusion. Recurrent varicose veins were found in 4 % (n = 1/25) of the patients in the phlebectomy group, while 16 % (n =4/25) of the patients in the foam sclerotherapy group had recurrence.
Conclusion: Both micro stab phlebectomy and foam sclerotherapy were safe effective in treating recurrent varicose veins with advantage of micro stab phlebectomy regarding to lower recurrence, primary symptom relief and better post procedural outcomes.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2599
2608
https://amj.journals.ekb.eg/article_196402_311b097cca5533af5971b2949204b02b.pdf
dx.doi.org/10.21608/amj.2021.196402
EVALUATION OF OUTCOMES OF ENHANCED RECOVERY AFTER SURGERY PROGRAMME IN SLEEVE GASTRECTOMY
Ahmed
Mohammed Abd El-Ghany Shrery
Department of General Surgery, Faculty of Medicine, Al-Azhar University
author
Ahmed
Shwky Abd El-Azez
Department of General Surgery, Faculty of Medicine, Al-Azhar University
author
Walid
Raafat Abd El-Atey
Department of General Surgery, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: Strategic multidisciplinary protocols for enhanced recovery after surgery (ERAS) have demonstrated reductions in length of hospital stay (LOS), morbidity, and costs in conjunction with bariatric procedures, Although enhanced recovery after surgery has made great progress in the field of surgery, the guidelines point to the lack of high-quality evidence in upper gastrointestinal surgery.
Objectives: To evaluate the outcomes of ERAS program in sleeve gastrectomy.
Patients and methods: This was a randomized clinical trial that was carried out at Al-Hussein Hospital, Al-Azhar University. The study was conducted on 50 patients. All patients underwent sleeve gastrectomy during the study period. The patients in the group A received conventional perioperative care plan, and ERAS perioperative care plan was given to the patients in the group B.
Results: There was a significant difference between the two studied groups regarding complications which were more frequent in group A. There was a significant difference between the two studied groups regarding early oral intake, drain from components compliance, and overall compliance.
Conclusion: The enhanced recovery after surgery protocol in the setting of bariatric surgery shortened hospital stay and was cost-effective. There was no increase in perioperative morbidity. Enhanced recovery after surgery was safe, effective in laparoscopic bariatric surgery, and can be further clinically popularized.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2609
2618
https://amj.journals.ekb.eg/article_196403_f31ec1f106852d16d3b7f0e5e0f206db.pdf
dx.doi.org/10.21608/amj.2021.196403
RAFTING SCREWS VERSUS BONE GRAFTS IN DEPRESSED TIBIAL PLATEAU FRACTURES
Muhammad
Ahmed Abd El-Samad
Department of Orthopedic Surgery, Faculty of Medicine, Al-Azhar University
author
Ali
Al-Gioushy
Department of Orthopedic Surgery, Faculty of Medicine, Al-Azhar University
author
Ehab
El-Zahed
Department of Orthopedic Surgery, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: Tibial plateau fractures involve a major weight-bearing joint. They occur due to a combination of axial loading and varus/valgus applied forces leading to articular depression, malalignment and an increased risk of post-traumatic osteoarthritis.
Objective: To evaluate the clinical, radiographic and functional results in a cohort of patients who sustained open reduction and internal fixation by rafting screws 3.5- 6.5mm cortical screws.
Patients and methods: A total number of 30 cases were included in this study and divided into 2 equel groups: Group (A) and group (B). The demographic data showed sex distribution as 22 males & 8 females with closed lateral tibial plateau fractures (18 type II & 12 type III). As regard to radiological outcome, there was no significant difference between both groups during the period between December 2019 and November 2020 at Al-Hussein University Hospital.
Results: Functional and radiological results without using graft were slightly lesser than when graft was used, but it avoided possible donor site complications of the graft, decreased blood loss and minimized operative time.
Conclusion: Treating depressed tibial plateau fractures type II and type III with mild or moderate depression (<1.5cm) by open reduction and internal fixation using large set buttress plate and screws or screws alone without using bone graft or bone graft substitute represented a viable option.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2619
2628
https://amj.journals.ekb.eg/article_196404_4dc3d6e6b1e7e6d03c1fe8b922753d8e.pdf
dx.doi.org/10.21608/amj.2021.196404
SPECULAR MICROSCOPY OF CORNEAL ENDOTHELIUM IN PATIENTS WITH TYPE I DIABETES MELLITUS VERSUS NORMAL PERSONS
Abd El-Mohimen
Mohammed Basiony
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University
author
Abd El-Moez
Haddad Ahmed
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University
author
Ahmed
Gomaa El-Mahdy
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: Diabetes mellitus is a general disorder that changes the main metabolic processes that distressing the functions of systems in the body. Type 1 diabetes is the generally common metabolic disorder of adulthood. Around one in each 400–600 juveniles and adults has type 1 diabetes. Its incidence has risen over new years.
Objective: To evaluate corneal endothelial alterations in type I diabetic patients with or without diabetic retinopathy.
Patients and Methods: A prospective comparative study of 60 subjects divided into two equal groups: Group A: with type I DM with or without diabetic retinopathy and Group B: normal persons matched with age and sex. All patients were subjected to full history and ophthalmic examination including Uncorrected / best corrected visual acuity (UCVA/BCVA) expressed in LogMar scoring, refraction using automated refractometer (Topcon KR-800 Auto refractometer), intraocular pressure (IOP) measurement by Goldman Applanation tonometer, Slit lamp biomicroscopy to assess corneal clarity, depth of anterior chamber, state of pupil dilatation, lens morphology, state of diabetic retinopathy in dilated pupil fundus examination and non-contact specular microscope (Topcon sp-1p, Topcon Medical Inc., Japan) to assess the corneal endothelium and patients were compared to normal persons as regard: endothelial cell density (ECD), coefficient of variation in cell size (CV), changes in percentage of hexagonal cells (HEX) and central corneal thickness (CCT). The study was done at Department of ophthalmology, Sayed Galal University Hospital, Cairo, Egypt and it was carried out from May 1ˢͭ, 2019 to April 30ͭ ͪ 2020.
Results: Among patient group, twenty one (70%) patients were females while nine (30%) patients were males. Ten persons (20 eyes) in study group were diabetics with diabetic retinopathy. There was a significant decrease in ECD, and a significant increase in CCT, also there was a significant change in CV, and HEX an increase in CV (polymegathism) and decrease in hexagonality (pleomorphism) in type I diabetic patients. Diabetic retinopathy and duration of diabetes were factors that affect central corneal thickness.
Conclusion: Cornea of a diabetic patient has lower ECD compared to normal and thicker cornea than non-diabetics also with higher coefficient of variation and lower hexagonality.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2629
2642
https://amj.journals.ekb.eg/article_196405_5b9ee90e9db36ed57ac488a4f9647779.pdf
dx.doi.org/10.21608/amj.2021.196405
PREVALENCE OF KERATOCONUS IN EGYPTIAN ASTIGMATIC PATIENTS
Mohammed
El-Sayed Fawzy Abd El-Hafez
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
Ahmed
Salah Abd El-Rehim
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
Nour El-Din
Abd El-Hamid Abd El-Halim
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
text
article
2021
eng
Background: Keratoconus is a corneal ectatic disease characterized by progressive, non-inflammatory corneal disorder, which is characterized by thinning, protrusion of central or paracentral portion of the cornea resulting in irregular astigmatism, myopia, corneal scarring and reduction in visual acuity. The onset of the keratoconus usually occurs at puberty with the progression until the third to fourth decade of the life in most of the cases.
Objective: To estimate the prevalence of keratoconus in Egyptian people who have corneal astigmatism using pentacam as an imaging device.
Patients and Methods: A retrospective study was done at Al-Sayed Galal University Hospital in Ophthalmology outpatient clinics. The retrieved data revealed 80 eyes of 40 patients photographed during the period from June 2019 to December 2019 by using Scheimpflug imaging device (pentacam) as screening device for keratoconus. All such cases underwent a complete ophthalmic examination that includes visual acuity measurement, refraction, slit lamp biomicroscopy, retinoscopy, fundus examination and corneal topography (pentacam).
Results: Mean age of our study cases was 26.55 ± 8 years, which included 22 (55%) males and 18 (45%) females. Cases with KC have higher keratometric corneal values (k1, k2, kmax) and thinner pachymetric values than normal astigmatic eyes.
Conclusion: The higher the astigmatism was the higher risk to have keratoconus. Cases with astigmatism ≥ 1.5D who present to outpatient clinics, should undergo corneal topography screening for early diagnosis of KC even if visual acuity is not affected. Pentacam may provide more accurate information about anterior and posterior corneal anatomy especially in suspected eyes.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2643
2654
https://amj.journals.ekb.eg/article_196406_5cd5d07611feedb58a6163ac08d97c54.pdf
dx.doi.org/10.21608/amj.2021.196406
MEASUREMENT OF FETAL OCCIPUT-SPINE ANGLE DURING THE FIRST STAGE OF LABOR IN PRIMIGRAVIDA AS A PREDICTOR OF THE MODE OF LABOR
Nour
Gamal Abd El-Nasser
Department of Obstetrics& Gynecology, Faculty of Medicine, Al-Azhar University
author
Ismael
Mohamed Abd El-Azem Mira
Department of Obstetrics& Gynecology, Faculty of Medicine, Al-Azhar University
author
Abd El-Monsef
Abd El-Hamed Sedek
Department of Obstetrics& Gynecology, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: Fetal head “attitude” (relationship of fetal head to spine) in the first stage of labor may have a substantial impact on labor outcome. The diagnosis of fetal head deflexion traditionally is based on digital examination in labor.
Objectives: To quantify the degree of fetal head deflection via the use of Ultrasound during the first stage of labor, and the relationship with the course and outcome of labor.
Patients and methods: This was a prospective study conducted at Sayed Galal Hospital, Al-Azhar University from June 2019 to December 2019. Nonconsecutive series of women with uncomplicated singleton pregnancies at term gestation (37 weeks or more) were submitted to trans-abdominal ultrasound during the first stage of labor. Fetal position was occipito-anterior, and the angle between the fetal occiput and the cervical spine (the occiput-spine angle) was sonographically obtained on the sagittal plane. The measurements of the occipito-spine-angle were performed offline by an operator who was blinded to the labor outcome. The intra- and inter observer reproducibility and the correlation between the occipito-spine angle and the mode of delivery were evaluated.
Results: A total of 400 pregnant women were recruited, 350 of which underwent a spontaneous vaginal delivery, and 50 were submitted to cesarean delivery. The mean value of the occipito-spine angle measured in the active phase of the first stage was 126° ± 2.79° (SD). The occipito-spine angle was significantly narrower in women who underwent CS delivery due to labor arrest. A larger occipito-spine angle (i.e. >126°) showed to be significantly associated with a shorter duration of labor.
Conclusion: Fetuses with smaller occipito-spine angle (<126°) were at increased risk for operative delivery.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2655
2666
https://amj.journals.ekb.eg/article_196407_717f56fb763ff9e03386447a3631686a.pdf
dx.doi.org/10.21608/amj.2021.196407
LAPAROSCOPIC MANAGEMENT OF SUSPICIOS ADENEXAL MASS
Ibrahim
Safwat Ibrahim
Department Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University
author
Esmail
T. El-Garhy
Department Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University
author
Maged
M. Labib
Department Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
ABSTRACT
Background: Different tools have been used for prediction of malignancy in ovarian masses; such as tumor markers, ultrasound findings, or other malignancy indices combining more than one variable. Cancer antigen 125 (CA-125) is the most frequently used biomarker for ovarian cancer detection.
Objective: To investigate whether laparoscopy could replace safe and effective surgical management of adnexal masses.
Patients and Methods: This was a prospective study. It was conducted over 2 years in Al-Maadi Military Hospital and Air force General Hospital. The study was conducted on 100 patients from October 2018 till September 2020. Histopathology was done by Histopathology team at Maadi Military hospital.
Results: All 93 patients managed laparoscopically had a benign and malignant diagnosis, whereas 7 of the 19 patients who underwent laparotomy were diagnosed with malignancy. The indications for conversion to laparotomy were malignancies, dense adhesions and small bowel enterotomies.
Conclusion: Laparoscopic surgery seemed to offer significant advantages such as reduced hospital stay, less adverse effects, and better quality of life, laparoscopic surgery became a corner stone in management of adenexal masses either benign or malignant especially if the facility of Frozen Section Biopsy can be offered.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2667
2678
https://amj.journals.ekb.eg/article_196408_18d4ebb2ef253b08eadc2137ef7afa7a.pdf
dx.doi.org/10.21608/amj.2021.196408
ASSESSMENT OF PERINATAL OUTCOME AFTER USING NIFEDIPINE VERSUS PLACEBO IN THE TREATMENT OF PRETERM PRELABOR RUPTURE OF MEMBRANES (Randomized controlled study)
Mohamed
Gamal El-Din Ahmed Shafey
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
author
Farid
Ibrahim Hassan
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
author
Mofeed
Fawzy Mohamed
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
author
Dalia
Moneer El-Lahouny
Department of Pediatrics, Faculty of Medicine, Al-Menoufia University
author
text
article
2021
eng
Background: Preterm birth is the most common cause of neonatal morbidity and mortality worldwide and accounts for approximately 75% of all neonatal deaths and 50% of childhood neurological morbidities. Around one-third of preterm deliveries start with preterm pre-labor rupture of membranes (PPROM).
Objective: To assess the value of Nifedipine to change the perinatal outcome in cases of preterm pre-labor rupture of membranes.
Patients and methods: This was a randomized, controlled study that included and followed 200 pregnant women. One hundred pregnant women were recruited in the Nifedipine group in addition to 100 pregnant women were recruited as a control group from Obstetric Department of Shebin El Kom Teaching Hospital during the period form to 2017-2019.
Results: In this randomized clinical trial among women with PPROM without contractions, we found no significant differences between treatment with nifedipine or placebo in terms of perinatal outcomes and prolongation of pregnancy.
Conclusion: On perinatal outcomes or prolongation of pregnancy in women with PPROM without contractions.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2679
2690
https://amj.journals.ekb.eg/article_196409_4b37cdffbb81f174ef979da09f7d6913.pdf
dx.doi.org/10.21608/amj.2021.196409
SURGICAL SAFETY AND ADVERSE EVENTS IN THE OPERATING ROOMS OF OBSTETRIC DEPARTMENT AT AL-AZHAR UNIVERSITY HOSPITAL
Ahmed
Abd El-Ghafour El-Basuony Abou Zid
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
author
Ismail
Talaat El-Garhy
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
author
Adel
Aly El-Boghdady
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: Most surgical safety interventions have focused on the operating room. Since more than half of all surgical errors occur outside the operating room. It is likely that a more substantial improvement in outcomes can be achieved by targeting the entire surgical pathway. Evidence-based elements in patients who undergo Cesarean delivery (CD) may decrease the incidence of this major complication.
Objective: To improve the health and well-being of pregnant women undergoing obstetric surgery in Al-Azhar University Hospital through making a relation between cesarean section in full term pregnant women and surgical site infection postoperatively.
Patients and methods: This was a cross sectional study, completed at working rooms of obstetric office at Al-Hussein Hospital, Al-Azhar University, from October 2019 till July 2020. Test size was determined utilizing Open EPI program. Test size was 150.
Results: There were 29 (19.33%) with diabetes, 38 (25.33%) with hypertension, 10 (6.67%) with cardiac diseases, 6 (4%) with HCV positive, 30 (20%) with anemia, 5 (3.33%) with thrombocytopenia and 75 (50%) with previous CS, 15 (10%) with previous D&C and 2 (1.33%) with other past activities. There were 133 (88.6%) cases utilizing spinal sedation, 12 (8%) utilizing general sedation, and 5 (3.33%) utilizing general sedation. The biggest level of patient went through activities in which things of careful wellbeing agenda sign in were satisfied aside from that patients had affirmed site and checked it. The biggest level of patient went through activities in which things of careful security agenda Time out were not satisfied aside from that Surgeon, sedation expert and medical caretaker verbally affirm system. Anti-toxin prophylaxis been given inside the last 60 mins before cut. Anesthesia group audits and Nursing group affirmed sanitization.
Conclusion: There was a strong connection between applying careful security agenda and result of medical procedure.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2691
2702
https://amj.journals.ekb.eg/article_196410_650c3c39d2a6e0614c0cc9afd4cebe8e.pdf
dx.doi.org/10.21608/amj.2021.196410
USE OF SILDENAFIL CITRATE IN TREATMENT OF INTRA UTERINE GROWTH RESTRICTION (IUGR)
Moslem
Fayez Ali Korayem
Department of Obstetrics and Gynecology, Faculty of Medicine Al- Azhar University
author
Mofeed
Fawzy Mohamed
Department of Obstetrics and Gynecology, Faculty of Medicine Al- Azhar University
author
Noha
Mohamed Sabry
Department of Obstetrics and Gynecology, Faculty of Medicine Al- Azhar University
author
text
article
2021
eng
Background: Sildenafil citrate is a phosphor-diestrase enzyme 5 inhibitor that leads to increasing the cyclic guanosine monophosphate and so enhancing the vasodilator effect of nitric oxide through which it may increase placental perfusion. So, it is used to treat pre-eclampsia.
Objective: To evaluate the efficacy of low dose sildenafil in the treatment of intra uterine growth restriction by estimating fetal biometry and fetal Doppler parameters using trans-abdominal ultrasound.
Patients and methods: This was a case control study carried on 40 pregnant female, at outpatient clinic of Department of Obstetrics and Gynecology at Zagazig General Hospital with intrauterine growth restriction singleton pregnancy. IUGR was diagnosed with ultrasound and fetal Doppler and gestational age ranged from 26 week of gestation to 31 week of gestation according to first day of last menstrual period in regular cycle patients or first trimestric visit ultrasound.
Results: Umbilical artery Pulsitility Index (PI) in study and control groups before and after therapy showing statistically significant decrease in PI in study group compared to control group after therapy. Improvement in cerebroplacental ratio in study group compared to control group after therapy. There was no statistically significant difference between both groups regarding gestational age at delivery. There was a statistically significant difference regarding changes in Amniotic Fluid Index (AFI) in both groups after therapy.
Conclusion: The administration of oral sildenafil tablets (20 mg twice a day) for 6 weeks improved Doppler indices in umbilical artery and cerebroplacental ratio, yet it had no effect on gestational age at neither birth nor birth weight.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2703
2714
https://amj.journals.ekb.eg/article_196412_e3826e5cd1b73fd11cc9f6d15a13a46f.pdf
dx.doi.org/10.21608/amj.2021.196412
PROPHYLACTIC USE OF PROGESTERONE VAGINAL SUPPOSITORY IN PREVENTION OF RECURRENT PRETERM LABOR
Mohamed
M. Lotfy
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
author
Ahmed
S. Amer
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
author
Adel
A. El-Boghdady
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: Prematurity is the leading cause of neonatal morbidity and mortality. Although perinatal care advanced in the last few decades, preterm labor did not decrease but even is increasing and creating a great social and economic problem.
Objective: To test the effectiveness of progesterone vaginal suppository in prevention of preterm labor in patients with previous history of preterm labor.
Patients and Methods: This was a randomized , prospective, single blind study after approval of the medical ethical committee at Al-Azhar university Hospitals, Department of Obstetrics and Gynecology, and after patients giving written consents, during the period from February 2020 to October 2020 . We enrolled 168 women for the study at high risk for preterm labor who were randomly divided into two groups (progesterone group and placebo group). Two hundred mg of vaginal progesterone pessary or placebo were used by the patient from 24 to 36 weeks of gestation. Uterine contractions were recorded by external tocodynamometer every other week from 28 to 36 weeks of gestations.
Results: There was a statistically significant reduction in the incidence of preterm delivery between the two groups from 38.5% in placebo group, compared with 21% in progesterone group. There was also a statistically significant reduction in the incidence of early preterm delivery (<34 week) between the two groups from 21.2% in placebo group, compared with 5.7% in progesterone group. There was a significant prolongation of the mean gestational age at delivery from 36.36 ± 2.83 weeks in placebo group compared to 37.57 ± 1.72 weeks in progesterone group. There was no statistically significant difference in the average gestational age for those who had preterm birth between both groups. There were fewer women in progesterone group who reported symptoms of preterm labor of 52.4%, compared with 75% in placebo group. There was a significant more frequent uterine contraction in placebo group of 48.1% compared to progesterone group of 24.8%.
Conclusion: Prophylactic vaginal progesterone reduces the rate of preterm labor, prolongs gestational age at delivery, reduces the frequency of uterine contractions, and improves the symptoms of preterm labor in women at high risk of preterm labor.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2715
2724
https://amj.journals.ekb.eg/article_196413_0b4600ab5eed6e8547cdc0e306350bbd.pdf
dx.doi.org/10.21608/amj.2021.196413
ROLE OF LOCAL HEMOSTATIC AGENTS AS ADJUVANT IN CONTROL OF PRIMARY POSTPARTUM HEMORRHAGE
Mohamed
El-Saghier El-Hofey
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
author
Hossam
Al-Din Hussein Kamel
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
author
Adel
Aly El-Boghdady
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: Hemostasis is an integral and very important aspect of surgical practice. In the developing world, about 1.2% of deliveries are associated with PPH and when PPH occurred about 3% of women died. Causes of postpartum hemorrhage are uterine atony, trauma, retained placenta or placental abnormalities, and coagulopathy, commonly referred to as the "four Ts".
Objective: To study the effect of gelfoam in hemostasis as adjuvant in control of primary postpartum hemorrhage.
Patients and Methods: This was a Cohort study conducted at Sayed Galal University Hospital, Al-Azhar University Faculty of Medicine during the period from May 2019 to May 2020. A number of 60 cases of postpartum hemorrhage and role of gel foam in hemostasis as adjuvant in control of primary postpartum hemorrhage.
Results: The findings of the present study indicate that local hemostatic agent “gel foam” was useful as adjuvant in control of primary postpartum hemorrhage in cesarean section. Local hemostats reduce the use of systemic hemostats, shorten the time required to achieve hemostasis. The delay in the recovery of bowel motility was due to the local hypersensitivity reaction caused by gelatin sponge and/or dislocation of this local hemostat.
Conclusion: Local hemostatic agent “gel foam” was useful in adjuvant in control of primary postpartum hemorrhage in cesarean section.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2725
2732
https://amj.journals.ekb.eg/article_196414_fa056bf63c7961f3c45a0700492d8a4a.pdf
dx.doi.org/10.21608/amj.2021.196414
The Effect of Laparoscopic Tubal Disconnection or Laparoscopic Salpingectomy on Ovarian Reserve.
Mohamed
Ata Ahmed Emara
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
author
Ehab
Hassanin Mohamad Hassanin
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
author
Farid
Ahmed Sayed Kassab
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: Fertility of a woman is the most important job in her life, thus preserving the elements of this fertility is much important. The biological age and ovarian reserve are of the most agonizing issues for women, especially in their late thirties and forties. The uterine tubal disconnection versus uterine tubal excision is usually indicated in subfertile patient suffering from tubal disease or indicated in surgical management of ectopic tubal pregnancy.
Objective: To study the effect of laparoscopic tubal disconnection or laparoscopic salpingectomy on ovarian reserve.
Patients and methods: This study is a prospective cohort study that was conducted at the Endoscopy Unit, Obstetrics and Gynecology Department, Al-Azhar University Hospitals, throughout the period from Oct. 2019 to Sep. 2020. It included 44 patients of the outpatient clinic with a diagnosis of tubal factor infertility or tubal ectopic pregnancy. 22 patients underwent laparoscopic proximal tubal disconnection, and 22 patients underwent laparoscopic salpingectomy. In both groups, basal antral follicle count (AFC) and mean ovarian volume (OVVOL) were evaluated by transvaginal sonography (TVS) before and 3 months after surgery.
Results: The mean of the basal AFC and mean OVVOL before and after laparoscopic tubal disconnection were the same suggesting no effect on ovarian reserve, while the mean AFC and OVVOL before and after laparoscopic salpingectomy were different. Both decreased, suggesting negative effect. It was insignificant negative difference in basal AFC and hardly significant negative difference in mean OVVOL.
Conclusion: Laparoscopic tubal disconnection does not affect ovarian reserve, while salpingectomy has a negative effect on ovarian reserve estimated by OVVOL three months after the surgical intervention.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2733
2742
https://amj.journals.ekb.eg/article_196417_b3da98fceef10716715c71bd49149fbe.pdf
dx.doi.org/10.21608/amj.2021.196417
TRANSOLECRANON AND LATERAL KIRSCHNER WIRE FIXATION FOR DISPLACED SUPRACONDYLAR HUMERAL FRACTURE IN CHILDREN
Abdul-Azim
Ahmed Abdul-Azim
Department of Orthopedic Surgery, Faculty of Medicine, Al-Azhar University
author
Ahmed
Abd El-Hamid Shamma
Department of Orthopedic Surgery, Faculty of Medicine, Al-Azhar University
author
Mohamed
Mosa Mohamed
Department of Orthopedic Surgery, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: Supracondylar fractures in children are common, accounting for 65% of all elbow fractures in children. In types II and III displaced supracondylar humeral fractures, closed reduction is difficult to achieve because of the thin bone between the coronoid and olecranon fossae as well as stripping of the periosteum. In addition, hyperflexion for maintenance of fracture reduction leads to swelling, compartment syndrome, and neurovascular compromise.
Objective: To evaluate the clinical and radiological outcome after closed reduction and pinning using a Kirschner wire inserted vertically through the olecranon and another inserted laterally for displaced supracondylar humeral fractures.
Patients and methods: A prospective case series, single Centre study conducted at Al-Azhar University Hospitals from June 2020 to May 2021. It included 20 patients with Gartland type III fracture who undergone for closed reduction and percutaneous pin fixation using two Kirschner wires, the first one was inserted vertically through the olecranon across the fracture into the metaphysis of the humerus and the second wire was inserted from the lateral column across the fracture at 30-40 degree to the opposite cortex of the humerus.
Results: Operative time ranged from 15- 30 minutes with a mean of 19.25 minutes. We counted the operative time after induction of anesthesia (including draping, reduction, wires insertion and splint application). Results were within normal range for all patients. The mean Baumann angle in the patients was 70.57 degree, and standard deviation was 3.01. Postoperatively, anteroposterior and lateral views were done, and wires were removed by 3 weeks if clinical and radiological evidence of early bone union was present and, if not, wires removal was postponded one week later. Thirteen patients (65%) had the wires removed by 3rd week, and 7 patients (35%), the wires were removed by 4th week with a mean of 3.35 week, and standard deviation of 0.49. Few complications occurred and all were tolerable with no effect on final outcome, and these were pin tract infection in 2 patients and loss of reduction.
Conclusion: Transolecranon and lateral Kirschner wires fixation was an effective option for displaced supracondylar humeral fractures in children.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2743
2758
https://amj.journals.ekb.eg/article_196418_f49ce30ca9065f48b1e59d7de43f2cac.pdf
dx.doi.org/10.21608/amj.2021.196418
ROLE OF COLOR DOPPLER U/S AND MRI FOR DIAGNOSIS OF PLACENTA ACCRETA
Ahmed
M. Siddik
Department of Obstetrics and Gynecology, Faculty of Medicine, AL-Azhar University
author
Mostafa
H. Hegab
Department of Obstetrics and Gynecology, Faculty of Medicine, AL-Azhar University
author
Abd El-Rahman
M. Anbar
Department of Obstetrics and Gynecology, Faculty of Medicine, AL-Azhar University
author
text
article
2021
eng
Background: The worldwide incidence of placenta accreta (PA) is rapidly rising, following the trend of increasing cesarean delivery. Antenatal diagnosis is highly desirable because outcomes are optimized when delivery occurs at a level III or IV maternal care facility before the onset of labor and with avoidance of placental disruption. The primary diagnostic modality for antenatal diagnosis is obstetric color Doppler ultrasonography (CDUS). Magnetic Resonance Imaging (MRI), although widely employed, has yet to clearly demonstrate a significant improvement in management, but it is expensive and requires expertise that is rarely available in most low-income countries and many medium income countries.
Objective: To evaluate and compare the accuracy of CDUS and MRI in the diagnosis of PA and to define the most relevant specific features that may predict placental invasion.
Patients and methods: A case control study was conducted at AL- Azhar University Hospitals during the interval between November 2017 and November 2020, total set of 50 patients in the third trimester of pregnancy with diagnosis of placenta accreta and at least one previous caesarean section (CS). Patients were equally divided into 2 groups; Group I: Control group diagnosed as PA by CDUS. Group II: Study group diagnosed as placenta accreta by CDUS and subjected to MRI. With inclusion and exclusion criteria, all included women was subjected to; history taking, physical examination, obstetric CDUS and MRI scan was added for Group II only to pick up features suggestive of PA.
Results: The sensitivity and specificity of CDUS were 100% and 72%, whereas the sensitivity and specificity of MRI were 76% and 52%, respectively, in their ability to diagnose PA. The highest sensitivity of individual CDUS and MRI markers in predicting PA were obliteration of the retroplacental clear space (63.6%) and focal interruption in the myometrial wall (73.7%), respectively.
Conclusion: Ultrasound imaging is the mainstay of screening for placenta accreta. MRI appears to be complementary to ultrasonography, especially when there are few ultrasound signs or if there is a suspicion for invasion into surrounding organs.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2759
2768
https://amj.journals.ekb.eg/article_196419_65ac711d810f76b2d87b2b677b4e385b.pdf
dx.doi.org/10.21608/amj.2021.196419
EFFECT OF MODERN VERSUS STANDARD OF CARE ANTI-FAILURE MEDICATIONS ON LEFT VENTRICULAR FUNCTION IN HEART FAILURE PATIENTS WITH REDUCED EJECTION FRACTION AS DETECTED BY2D SPECKLE TRACKING ECHOCARDIOGRAPHY
Ahmed
Mamdouh Abdin
Department of Cardiology, Faculty of Medicine, Al-Azhar University
author
Wael
Mohamed Attia
Department of Cardiology, Faculty of Medicine, Al-Azhar University
author
Yasser
Abd El-Galel Omar
Department of Cardiology, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: Heart failure (HF) is a major and growing public health problem, as 21 million adults worldwide are living with heart failure and this number is expected to rise due to aging population, increasing prevalence of risk factors and improved post myocardial infarction (MI) survival.
Objective: This study was discuss the effect of modern versus standard of care anti failure medications on LV function in heart failure patients with reduced ejection fraction using 2D speckle tracking echocardiography.
Patients and methods: The study population includes 100 heart failure patients with reduced ejection fraction 50 on modern anti-failure medications including angiotensin receptor neprilysin inhibitor (ARNI) and 50 controls on standard anti-failure medications including angiotensin I-converting enzyme inhibitor (ACEI) or angiotensin II receptor blockers (ARBs). All patients attended the outpatient clinic of the Cardiology Department at Al-Azhar University Hospital (Cairo) from March 2020 to March 2021.
Results: There was no significant statistical difference between groups also regard sex distribution there was no significant difference between groups and male were majority in both groups. There was no significant difference between the two studied groups regarding levels of serum creatinine and serum K. Results of comparison of end systolic, end diastolic diameters of left ventricle and diameter of left atrium showed no significant difference between both groups at pre medication assessment but there was a highly significant after medications in both groups (p= 0.00, 0.038 and 0.035 respectively) also in group A there was a significant decrease from pre to post assessment (p=0.003, 0.012 and 0.004 respectively). There was a statistically significant improve in mitral regurgitation after medication in group A than in group B (p=0.00) but was of no significant in pre medication assessment (p=0.48).
Conclusion: In HFrEF patients, sacubitril/valsartan significantly improves the mitral regurgitation LV remodeling and with a significant effect on LV diastolic and systolic echo parameters. Accordingly, sacubitril/valsartan could be used at an earlier time in HFrEF patients in order to further limit LV remodeling.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2769
2782
https://amj.journals.ekb.eg/article_196420_18ebb11b943ae8720dd8309a1f88f18b.pdf
dx.doi.org/10.21608/amj.2021.196420
IMPACT OF TRANSCATHETER CLOSURE OF ATRIAL SEPTAL DEFECT ON RIGHT VENTRICULAR SIZE AND FUNCTION BY ECHOCARDIOGRAPHY
Hatem
Al-Samman Mohammed
Departments of Cardiology, Faculty of Medicine, Al-Azhar University
author
Sameh
Refat Hassan Allam
Departments of Cardiology, Faculty of Medicine, Al-Azhar University
author
Ahmed
Meawad Al-Emam
Department of Cardiology, National Heart Institute
author
Mohammad
Ismail Al-Deftar
Departments of Cardiology, Faculty of Medicine, Al-Azhar University
author
Ashraf
Abd-Almonem Sayed Ahmed
Departments of Clinical Pathology, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: Percutaneous atrial septal defect (ASD) device closure is a safe and effective means of reducing or eliminating interatrial shunting. The response of the right heart to device closure is incompletely understood.
Objective: To evaluate the effects of transcatheter closure of secundum ASD on right ventricle size and function, that is, both systolic and diastolic by transthoracic echocardiography (TTE) over a 6 month period.
Patients and Methods: One hundred patients had 100 device implantations. The patients were assessed with echocardiography before, at 1 and 6 months after procedure, at Bab Al-Shaareya Hospital of Al-Azhar University, and National Heart Institute, Egypt during the period from April 2017 to October 2019.
Results: Mean age was (12.62±11.39 years). Maximum ASD size indexed to body surface area (BSA) was (Mean±SD=17.88±5.08 mm/m2). The device size ranged from 11 mm to 31 mm. There was significant decrease from baseline to 1 month and baseline to 6 months after closure In the following indexed parameters: RV basal, mid, longitudinal diameters I, RV end diastolic area I, RV/LV end diastolic dimension ratio, RA end systolic area I and Estimated systolic pulmonary artery pressure (ESPAP), Also parameters of RV systolic functions such as; tricuspid annular plane systolic excursion (TAPSE), tricuspid annular systolic velocity (TASV or S/) and fractional area change (FAC%), and diastolic dysfunction parameters; E/A and E/e/, (p=0.001). while RV index of myocardial performance (RIMP) showed significant reduction at one month (0.39±0.03 vs. 0.35±0.02; p=0.001) and non-significant change at six months in comparison to baseline (p=0.083).
Conclusion: RV volumes decreased significantly in the first month after ASD device closure and continued up to 6 months. There was no change in global right ventricular systolic function but a high basal RV systolic function decreased after closure. Some patients had impaired diastolic function before closure of defect, which reversed to normal within 6 months after closure.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2783
2798
https://amj.journals.ekb.eg/article_196421_3a97037c0c42bd0a291c1267fcb87ace.pdf
dx.doi.org/10.21608/amj.2021.196421
COMPARISON OF R WAVE AMPLITUDE CHANGES VERSUS ST-SEGMENT DEPRESSION IN STRESS TESTING ELECTROCARDIOGRAM AMONG ISCHEMIC HEART DISEASE PATIENTS
Muhamad
Abd Al-Hamied Muhamad Abou-Zeid
Department of Cardiovascular Medicine, Faculty of Medicine, Al-Azhar University, Egypt
author
Ahmed
M. Kamal Motawh
Department of Cardiovascular Medicine, Faculty of Medicine, Al-Azhar University, Egypt
author
Attia
Morsy Shokr
Department of Cardiovascular Medicine, Faculty of Medicine, Al-Azhar University, Egypt
author
text
article
2021
eng
Background: R-wave changes might be helpful in accurate diagnosis of coronary artery disease with exercise testing in combination with ST segment changes as ∆RST index and might be superior to the traditional ST segment depression only.
Objective: To further clarify R-wave amplitude (RWA) changes during exercise stress test (EST) among established IHD patients.
Patients and methods: The study enrolled 50 subjects - aged from above 35 to below 65 years old of both sexes, known to be ischemic by a previous angiography, divided into two main groups: Group I (control group): 15 subjects with normal coronaries (lesion < 30 % stenosis), and Group II (IHD group): 35 patients with stable ischemic heart disease which were subdivided according to previous coronary angiography results (lesion >70 % stenosis).The study was conducted at the Department of Cardiovascular Medicine and its Out-patient Clinic, Al-Hussein University Hospital during the period from September 2019 to March 2021.
∆RST index was formed from algebraic summation of RWA difference between (rest and immediate recovery) plus ST segment depression in mile meters.
Results: ∆RST index was more useful in detection of coronary artery disease with higher sensitivity and specify among chronic ischemic patients than RWA difference or ST segment depression alone. When cutoff ≥ -1.65 cardiac ischemia could be predicted with a sensitivity rate of 98.93%, a specificity rate of 96.00%, a positive predictive value of 96.3 %, and a negative predictive value of 98%. RWA at a cut-off point of -1.2 was sensitive 95.02% and specific 94.0 % , a positive predictive value of 95.7%, and a negative predictive value of 96.6%. ST segment depression at a cut-off point of ≥ 0.45 was sensitive 77.1% and specific 80%, a positive predictive value of 78.4%, and a negative predictive value of 60.3%.
Conclusion: ∆RST index was more useful in detection of coronary artery disease with higher sensitivity and specify among chronic ischemic patients than RWA difference or ST segment depression alone.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2799
2810
https://amj.journals.ekb.eg/article_196422_52fbc4db0fc852befab4a6ebb7d17f65.pdf
dx.doi.org/10.21608/amj.2021.196422
COMPARISON BETWEEN DIFFERENT PARAMETERS IN EARLY DETECTION OF LV SYSTOLIC DYSFUNCTION IN PATIENTS WITH CHRONIC STABLE ANGINA
Taghreed
Abd El-Rahman Ahmed
Cardiology Department, Faculty of medicine (Girls), Al-Azhar University, Cairo, Egypt
author
Mona
Naiem Ali Hassan
Cardiology Department, Faculty of medicine (Girls), Al-Azhar University, Cairo, Egypt
author
text
article
2021
eng
Background: Ischemia plays a pivotal role in the development and progression of both types of HF (HFrEF & HFpEF). Strain echocardiography, performed by using the speckle tracking technique, can identify subclinical left ventricular dysfunction before left ventricular ejection fraction declines.
Objective: To assess left ventricular systolic function by different noninvasive imaging modalities in patients with chronic ischemic heart disease.
Patients and methods: This study was done at Al Zahra University Hospital from November 2017 till January 2020. It included 80 patients (group I) with chronic ischemic heart disease (IHD), they were 60 males (75%) and 20 females (25%) with mean age 53.5±8.08, and 15 apparently healthy age and sex matched subjects as a control group (group II), they were 11(73.3%) females and 4(26.7%) males with mean age 53.2±7.7. Group I was further sub-classified to impaired and preserved according to their LVEF assessed by 2D echo, speckle tracking echo global longitudinal strain (STE-GLS), tissue Doppler imaging (TDI) strain, TDI Sa and gated SPECT LVEF.
Results: The ischemic (group I) showed a statistically significant decrease in the average Sa 5.45±1.69 VS group II 8.7± 0.73 (P value < 0.001), lower LVEF 2D echo in group I 46.3±9.68 compared to group II 58.9±4.68 (P value < 0.001), decrease in gated SPECT LVEF in group I 56.4±13.98 VS group II 67.067±5.66 (P value < 0.001), statistically significant reduction in left ventricular global longitudinal strain (LV-GLS) (-13.89±18.99) in group I vs -21.24±1.23 in group II (P value <0.05). The highest percentage of patients with impaired LV systolic function were those who assessed by STE-GLS (74 patients 92%), 72 patients (90%) impaired LVEF by TDI Sa, 60 patients (75%) impaired LVEF by 2D echo, and by TDI strain, and 22 patients (27.5%) impaired LVEF by gated SPECT.
Conclusion: STE is considered the most sensitive method in assessment of subclinical LV systolic dysfunction and is considered superior to other methods.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2811
2828
https://amj.journals.ekb.eg/article_196423_626baddd5f5c8e4ecff4d7ff740fa1fc.pdf
dx.doi.org/10.21608/amj.2021.196423
3D-Speckle Tracking Echocardiography for Assessment of Coronary Artery Disease Severity in Stable Angina Pectoris
Ahmed
Yehia Mohamed
Department of Cardiology, Faculty of Medicine, Al-Azhar University
author
Sameh
Refaat Allam
Department of Cardiology, Faculty of Medicine, Al-Azhar University
author
Ibrahim
Faragallah Abdelhady
Department of Cardiology, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: Stable angina pectoris is a common disease that may cause disability. Echocardiography is the leading and feasible cardiac imaging in patients with cardiac disease. An early evaluation of patients with complex coronary lesions plays an important role in the prognosis and selection of treatment strategy.
Objective: To evaluate the feasibility and accuracy of 3D-speckle tracking echocardiography in assessment of coronary artery disease severity in stable angina pectoris.
Patients and methods: The study was across sectional study include 90 patients with chronic coronary syndrome(stable angina) come to Islamic cardiac center at Al-Azhar University for coronary angiography on clinical basis indications between period from April 2019 to May 2020.The patients were classified into two groups after according to the results of coronary angiography. Group (I): Case group include 60 patients with different coronary lesions in angiography, and Group (II): control group include 30 patients with normal coronary angiography. The group (I) subsequently divided into two subclasses after coronary angiography according to the Gensini score. Group (IA) non-critical stenosis ( 0-19) , group (IB) critical stenosis (≥ 20).
Results: There was no statistically significant difference between patients and control groups as regard demographic data and risk factors( age , gender, diabetes mellitus, hypertension, smoking ,family history and dyslipidemia) .There was no statistically significant difference between group (I) &group(II) as regard their Echo parameters left atrial diameter ( LAD) , left ventricular end diastolic diameter (LV EDD), left ventricular end systolic diameter (LV ESD) , left ventricular end systolic volume (LV ESV )and left ventricular ejection fraction (LV EF%) . There was statistically significant decrease in group(I) compared to group(II) as regard their 3D speckle parameters global longitudinal strain ( GLS%)( -12.35% ± 2.7% versus -20.2% ±1.19%) , global circumferential strain( GCS%)(-19.23% ± 4.18% versus -26.57% ± 1.3%), global radial strain (GRS% )(23.48 ± 3.32% versus 53.67% ± 2.99%) and global area strain (GAS%)(-23.98% ± 4.14% versus -31.93 ± 1.28%) . Also there was significant decrease in critical stenosis group (IB) as regard 3D speckle parameters in comparison with non-critical stenosis group (IA).
Conclusion: 3D-STE is a noninvasive and handy parameter that has the potential to improve the value of echocardiography in the detection of the coronary artery disease (CAD) and to provide more information for clinical physicians. It could be expected to identify severe coronary stenosis in chronic coronary syndrome (CCS) patients even when resting wall motion and left ventricular ejection fraction were normal. It shows good sensitivity and specificity with best values for global area strain (GAS).
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2829
2844
https://amj.journals.ekb.eg/article_196424_31a45b4bbe48120e8cf9d7d439382c7a.pdf
dx.doi.org/10.21608/amj.2021.196424
ECHOCARDIOGRAPHIC ASSESSMENT OF RIGHT VENTRICULAR FUNCTION AFTER SUCCESSFUL REVASCULARIZATION FOR ACUTE ANTERIOR MYOCARDIAL INFARCTION WITHOUT RIGHT VENTRICULAR INFARCTION
Mohamed
El-Sayed Hammad
Department of Cardiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
Mohamed
Sami Abd El-Samea
Department of Cardiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
Abd El-Mohsen
Mostfa
Department of Cardiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
text
article
2021
eng
Background: Right ventricular (RV) affection in acute left ventricular (LV) myocardial infarction (MI) is frequently underestimated in the clinical setting as the diagnostic limitations of the electrocardiogram and echocardiography.
Objective: To assess RV function in patients presented with first acute anterior ST elevation myocardial infarction (STEMI) who underwent successful primary percutaneous coronary intervention (PCI) and factors affecting it.
Patients and Methods: Forty consecutive patients with anterior STEMI who underwent successful primary PCI in the Cathetrization (cath) labs of Al-Azhar University Hospitals, Cairo, Egypt from March 2019 to April 2020 for first acute anterior STEMI without RV were enrolled in the study. Presence of a coexisting clinical condition that might affect RV function, patients with RV infarction or those having significant stenosis (>50%) affecting RV branch or right coronary artery proximal to RV branch were excluded. Echocardiography was performed during the hospital stay to assess the LV and RV systolic and diastolic functions with special focus on tricuspid annular plane systolic excursion, mid RV end-diastolic dimension, right atrial area, RV fractional area change, and tissue Doppler-derived myocardial performance index.
Results: RV dysfunction, according to our definition in the first anterior MI, occurred in (55%) of the study population. Independent predictors for abnormal RV function were left circumflex artery mid or proximal affection, eventful procedure, occurrence of no reflow, glucose level, LV end-systolic dimension, LV end-diastolic dimension, and LV ejection fraction.
Conclusion: RV dysfunction is detected in anterior myocardial infarction after successful revascularization. Several echocardiographic parameters may be possible measures for RV dysfunction including RVFAC, TAPSI, MPI and S’.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2845
2856
https://amj.journals.ekb.eg/article_196425_f5361e0ee0238892643daf62fc1112ba.pdf
dx.doi.org/10.21608/amj.2021.196425
EVALUATION OF LEFT ATRIAL FUNCTION BY 2D SPECKLE TRACKING ECHOCARDIOGRAPHY IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS
Abd El-Kawy
Abd El-Halem Ahmed
Departments of Cardiology, Faculty of Medicine, Al-Azhar University
author
Mamdouh
Helmy El-Tahan
Departments of Cardiology, Faculty of Medicine, Al-Azhar University
author
Abdul-Hameed
Abdul-Hareth Ghazaly
Departments of Physical medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Al-Azhar University
author
Al-Sayed
Ali Abdou Al-Marghany
Departments of Cardiology, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: Left atrial (LA) speckle tracking echocardiography (STE) is a newer echocardiographic technique for strain and strain rate analyses that tracks ‘speckles’ or natural acoustic markers in the two-dimensional (2D) ultrasound image. STE has been described for assessment of regional and global LA function. Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease that is characterized by inflammation and damage to multiple organ systems. Cardiac involvement can be seen in over 50% of lupus patients.
Objective: To evaluate LA function and volume by STE-derived strain and strain rate in SLE patients compared to controls and assess the relationship of LA function and varying grades of Left ventricular diastolic dysfunction (LVDD) in SLE patients.
Patients and Methods: Sixty SLE patients aged 20 to 40 with normal LV systolic function (LVEF > 50%). SLE patients met the 2012 ACR revised criteria for SLE, were enrolled in this study. Age and sex matched apparently healthy forty subjects were included in this study as controls. Both of patients and control groups were selected from the attendants of Rheumatology Department and Cardiology Department of Al-Azhar University hospitals.
Results: No statistically significant difference between patients and control groups as regarding age, gender, body surface area (BSA), systolic blood pressure (SBP) and Diastolic blood pressure (DBP). The Left atrial volume index (LAVI) was significantly larger in the SLE patients group than that in control group. Diastolic function was normal in 31.66%, impaired relaxation in 26.7%, pseudo normal in 38.33% and restrictive in 3.34%. Global strain, derived as an average of all segments, was 25.80±6.33 in SLE group vs. 33.12±8.71 in control group. Septal, lateral and apical longitudinal strains reduced in SLE patients with significantly differences between both groups.LA SRa increased in SLE group compared with that in control group (1.97±0.47 vs 1.57±0.60). There were significant differences in LAVI, SRs, SRe and SRa among normal and abnormal diastolic function in patients of the SLE group. The correlation between LVDD and left atrial SRs, SRe and, SRa showed that there were significant correlations with SRs, SRe but not significant with SRa.
Conclusion: LA function impaired in SLE patients. Left atrial remodeling and impaired LA mechanical functions can be detected accurately with speckle tracking echocardiography. Assessment of LA strain represents a simple, accurate and reproducible technique to evaluate LA function.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2857
2870
https://amj.journals.ekb.eg/article_196426_0f21902a3f6308dbe816948a50bcc7d9.pdf
dx.doi.org/10.21608/amj.2021.196426
IMPACT OF ADENOTONSILLECTOMY ON BRONCHIAL ASTHMA IN CHILDREN
Mahmoud
Mohammed Ramadan Khaleel
Departments of Otorhinolaryngology, Faculty of Medicine, Al-Azhar University
author
Mostafa
Mohammed El-Sayed
Departments of Otorhinolaryngology, Faculty of Medicine, Al-Azhar University
author
Yahia
Mohammed Dawood
Departments of Otorhinolaryngology, Faculty of Medicine, Al-Azhar University
author
Abd El-Sattar
Abdullah El-Sayeh
Departments of Pediatrics, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation. It is defined by the history of respiratory symptoms such as wheeze, shortness of breath, chest tightness and cough that vary over time and in intensity, together with variable expiratory airflow limitation.
Objective: To detect the impact of adenotonsillectomy operation on control of bronchial asthma in pediatric population based on clinical assessment of preoperative and postoperative asthma symptoms control.
Patients and Methods: This was a prospective case series study of 40 patients with chronic adenotonsillitis and bronchial asthma. The patients to be studied were recruited from the outpatient clinic of Otorhinolaryngology Department, Al-Hussein University Hospital during the period from January 2020 till April 2020. The patients were evaluated pre-operatively regarding asthma status using Childhood Asthma Control Test, and measuring peak expiratory flow rate. Adenotonsillectomy operation was done for them, and 3 months post-operatively, asthma was re-evaluated using the same previous methods.
Results: There was a highly significant difference between preoperative and postoperative condition regarding Childhood Asthma Control Test results and peak expiratory flow rate which was in favor of overall improvement of asthma control.
Conclusion: Adenotonsillectomy in asthmatic patients with chronic adenotonsillitis led to significant improvement in asthma symptoms control and most of the patients were able to improve their life style.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2871
2878
https://amj.journals.ekb.eg/article_196427_997c71a7b9314931d3c986b55dff05c8.pdf
dx.doi.org/10.21608/amj.2021.196427
EFFICACY OF COMBINATION OF ASPIRIN WITH PHOSPHODIESTERASE TYPE 5 INHIBITORS IN PHOSPHODIESTERASE TYPE 5 INHIBITORS NON-RESPONDERS ERECTILE DYSFUNCTION PATIENTS
Ahmed
Abd El-Monem Ali Al-Ashkar
Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Al-Azhar University
author
Abd El-Raouf
Mohamed Al-Mohsen
Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Al-Azhar University
author
Mohamed
Ismail M. Kamel
Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: Erectile dysfunction (ED) is a worldwide health problem causing significant impact on the quality of life of men and their partners. The etiology of ED may be organic, psychogenic or mixed. There were many treatment options for ED, but oral phosphodiesterase type 5 inhibitors are considered the first line of treatment with considerable therapeutic failure rate. Phosphodiesterase type 5 inhibitors therapeutic failure is considered a treatment challenge. Many modalities to overcome phosphodiesterase inhibitors failure or no response had been developed.
Objective: To evaluate the efficacy of aspirin when combined with phosphodiesterase inhibitors in erectile dysfunction phosphodiesterase non-responders patients.
Patients and methods: The current study was carried out on 40 patients with ED that did not respond to on demand phosphodiesterase inhibitors. Patients were recruited from outpatient clinic of Dermatology, Venerology and Andrology Department, Faculty of Medicine, Al-Azhar University Hospitals from December 2019 to October 2020. A regimen of sildenafil on demand and tadalafil daily for 6 weeks to overcome the phosphodiesterase inhibitors type 5 non response. All the studied patients received 100 mg aspirin daily combined with sildenafil and tadalafil for another 6 weeks to evaluate the effect of adding aspirin on the ED status of the patients. The patients were evaluated using a 5-items version of the International Index of Erectile Function (IIEF-5).
Results: The results revealed non-significant improvement after added aspirin to sildenafil and tadalafil in comparison to the same studied group taking sildenafil and tadalafil only. The evaluation was done using a 5-items version of the International Index of Erectile Function (IIEF-5).
Conclusion: aspirin combination with PDE5i added no more efficacy than PDE5i alone in ED PDE5i non-responders patients.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2879
2886
https://amj.journals.ekb.eg/article_196428_dd50c554374d6039e786c600fa511bd6.pdf
dx.doi.org/10.21608/amj.2021.196428
EFFICACY OF INTRALESIONAL VERAPAMIL HYDROCHLORIDE VERSUS INTRALESIONAL TRIAMCINOLONE ACETONIDE IN HYPERTROPHIC SCARS AND KELOIDS
Radwa
O. Mohamed
Department of Dermatology and Venereology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
author
Abeer
M. Kamel
Department of Dermatology and Venereology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
author
Osama
M. Mostafa
Department of Pathology, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt
author
Nehal
A. Gadallah
Department of Dermatology and Venereology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
author
text
article
2021
eng
Background: Keloids and hypertrophic scars are dermal fibro-proliferative disorders lead to disfigurement, pain and pruritus. Their management is still challenging as there is no universally accepted treatment regimen. Corticosteroid injections, most commonly triamcinolone acetonide, continue to play a major role in the management of keloids. Verapamil is a phenylalkylamine calcium channel blocker antiarrhythmic agent that has antifibrotic effect.
Objective: To compare efficacy of intralesional verapamil hydrochloride and triamcinolone acetonide in hypertrophic scars and keloids.
Patients and methods: Forty Egyptian patients with keloids or hypertrophic scars were divided into two equal groups. The patients were recruited from the Dermatology outpatient clinics of Al-Zahraa University Hospital during the period from May 2016 to May 2017. Informed written consents were obtained from all patients.
Group A: Intralesional Verapamil Hydrochloride.
Group B: Intralesional Triamcinolone Acetonide.
The efficacy of treatment was evaluated by Digital photography and Vancouver scar scale before and after treatment. Two- fine millimeter punch biopsies were taken from 5 patients of the verapamil group before and after treatment to demonstrate the histopathological changes induced by verapamil.
Results: Both drugs improved total Vancouver scar scale, vascularity score and pliability score of keloid or hypertrophic scar nearly equally with no statistical significant difference. Both drugs improved height of keloid or hypertrophic scar significantly, but triamcinolone showed better improvement. Verapamil highly improved pigmentation score of keloids and hypertrophic scars, but triamcinolone showed non- significant improvement. Side effects were reported in 4 patients of triamcinolone group with no side effects in verapamil group.
The histopathological examination after treatment with verapamil injection showed marked reduction of collagen deposition and alteration of the fibroblast shape (from elongated to spherical), and these changes are similar to histopathological changes which occur after corticosteroids injection.
Conclusion: Verapamil was among the several therapeutic modalities, have an option for keloids and hypertrophic scars with an extremely low cost and fewer adverse effects.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2887
2900
https://amj.journals.ekb.eg/article_196429_a1df738934e63a738d50cb167402728f.pdf
dx.doi.org/10.21608/amj.2021.196429
HISTOPATHOLOGICAL AND HISTOCHEMICAL STUDY OF THE EFFECTS OF VITAMIN C ON BISPHENOL A TOXICITY IN ALBINO RATS
Mohamed
Nafea Al-Sayed
Departments of Forensic Medicine & Clinical Toxicology, Faculty of Medicine, Al-Azhar University
author
Magdy
Mohamed Sherif
Departments of Forensic Medicine & Clinical Toxicology, Faculty of Medicine, Al-Azhar University
author
Nagy
Mohamed Al-Fadaly
Departments of Forensic Medicine & Clinical Toxicology, Faculty of Medicine, Al-Azhar University
author
Ashraf
Ibrahim Hasan
Departments of Forensic Medicine & Clinical Toxicology, Faculty of Medicine, Al-Azhar University
author
Sayed
Abd El-Rehiem Sayed
Departments of Pathology, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: The harmful effect of a phenolic type of environmental toxicant, known as bisphenol A (BPA), has achieved great relevance. The interest in this compound is increasing owing to its possible adverse effects on several organs, which has led several organizations to recommend the prohibition or at least use reduction. BPA has also aroused interest in the nephrological community, as it has been linked to kidney and endocrine disorders. Since BPA is cleared by the kidneys, plasma and tissue levels of BPA are markedly increased in patients with impaired renal function. Objective: The present work was designed to Study Histopathological and histochemical changes caused by Bisphenol A in the kidney and testis of albino rats and to identify the potential protective role of vitamin C on Bisphenol A toxicity. Materials and Methods: One hundred (100) adult healthy male albino rats Weigh ting 180 – 220 gm were obtained from the animal house, Faculty of Medicine, Assiut University, Egypt and housed in a clean capacious macro-lane cages (5 per cage) under standard laboratory conditions including good aerated room with suitable temperature, relative humidity, maintained at good light with alternating 12 hours light/dark cycles. All rats were given normal rat diet during the experimental period with free access to water. Results: Bisphenol A has deleterious effects on the histological structure of the testis and kidney of albino rats. Testis and kidney of rat administrated vitamin C in combination with Bisphenol A showed marked amelioration of the degenerative changes that were observed in rats administrated Bisphenol A alone. Effects of Bisphenol A on Testis and kidney of rat after recovery for two weeks were still as in group II while other effects worse. The only effects which disappear were hemorrhage and inflammatory infiltrate. Conclusion: BPA has many toxic adverse health effects including reproductive and renal toxicity.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2901
2914
https://amj.journals.ekb.eg/article_196430_3e37291dc54a30b3c5c6080a9fd2fc64.pdf
dx.doi.org/10.21608/amj.2021.196430
EFFECTS OF ROSMARINUS OFFICINALIS AND/OR OCIMUM BASILICUM SUPPLEMENTATION ON INDUCED DIABETES IN ADULT MALE ALBINO RATS
Saied
Sharaf Mohamed
Medical Physiology Department, Faculty of Medicine, Al-Azhar University, Cairo
author
text
article
2021
eng
Background: Diabetes mellitus (DM) is a metabolic syndrome that is rising in prevalence worldwide in both humans and animals. It is characterized by persistent hyperglycemia and is caused either by inadequate insulin secretion from pancreatic beta cells, impaired insulin signaling, or both. Objective: To evaluate the possible protective effects of rosmarinus officinalis and/or ocimum Basilicum on induced diabetes in adult male albino rats. Material and methods: The present work was carried out form 15th of June to 30th of July 2021. Fifty adult male albino rats of local strain weighing 135 - 150 g were chosen to be the model of the present study and kept in suitable cages (45 x 30 x 30 cm, 5 rats per cage). They were divided into five equal groups: Group I (Control group) received no treatment; Group II (Diabetic group) was subjected to induction of diabetes by intraperitoneal alloxan injection (120mg/kg BW for two days), Group III (Rosemary group) subjected to induction of diabetes and received Rosemary fortified diet (at 0.05%) for four weeks, Group IV (Basil group) subjected to induction of diabetes and received Basil fortified diet (at 0.05%) for four weeks, and Group V (combined group) subjected to induction of diabetes and received Rosemary and Basil fortified (0.025% each) diet for four weeks. Checking of blood glucose was done, rats with high blood glucose (250 mg/dl or more) were considered diabetic. At the end of the study, blood samples were withdrawn and serum was separated for determination of serum fasting glucose, insulin, glutathione (GSH), catalase (CAT), superoxide dismutase (SOD), lactate dehydrogenase (LDH) and malondialdehyde (MDA). Results: Rats of groups III, IV and V showed significant decreases in serum glucose levels in comparison to the control group. In addition, dietary fortification with Rosemary and/or Basil significantly increased glutathione, superoxide dismutase, and catalase levels, while values for malondialdehyde and lactate dehydrogenase were decreased. Conclusion: Dietary fortification with Rosemary and/or Basil leaves powder at 0.05% separately or 0.025% in combination might be used as promising modulators of blood glucose levels as well as nutritional management tools for the prevention and control of diabetes mellitus.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2915
2926
https://amj.journals.ekb.eg/article_201565_04cea4ec9d07d36769253aac8d67bd26.pdf
dx.doi.org/10.21608/amj.2021.201565
ASSESSMENT OF LIVER FIBROSIS BEFORE AND AFTER DIRECT ACTING ANTIVIRAL THERAPY IN COMPENSATED HCV RELATED LIVER DISEASE
Ahmed
Fathalla Khattab
Department of liver, GIT and Infectious Diseases, Faculty of Medicine, Al-Azhar University
author
Islam
Ammar
Department of liver, GIT and Infectious Diseases, Faculty of Medicine, Al-Azhar University
author
Ahmed
Mohamed Massoud
Department of liver, GIT and Infectious Diseases, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: Hepatitis C virus (HCV) is a major health problem worldwide. Its long-term impact ranges from minimal damage to extensive fibrosis and cirrhosis, which is sometimes, accompanied by hepatocellular carcinoma (HCC).
Objective: To evaluate early changes of hepatic fibrosis-related parameters in patients with chronic HCV patients using sonography-based real time elastography (RTE) and serum parameters as APRI, FIB4 before and after sofosbuvir-based antiviral therapy.
Patients and methods: This study were conducted on 75 Egyptian patients with chronic hepatitis C who were collected from September 2019 and March 2020 at the National Hepatology and Tropical Medicine Research Institute Outpatient Clinics, Cairo, Egypt.
Results: The mean age of the studied patients was 49.6±11.34years, 33 (44%)of them were males while 42 (56%) were females. A history of diabetes was reported in 9 (12%) patients, while 6 (8%) of our patients were hypertensive. A total of 75 HCV-infected patients treated with sofosbuvir based therapy for 12 weeks were identified, 62 (82.7%) were treated with sofosbuvir (400 mg/day) and daclatasvir( 60 mg/day) , 13(17.3%)were treated with sofosbuvir( 400 mg/day )and daclatasvir( 60 mg/day) with weight-based ribavirin.
Conclusion: Sofosbuvir-based treatment regimens for chronic hepatitis C resulted in significant reduction in liver stiffness measurements (LSM) by pSWE with significant changes in the distribution of patients receiving triple therapy among the fibrosis stages and significant improvement in fibrosis scores (FIB4 and APRI) 12 weeks post treatment.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2927
2936
https://amj.journals.ekb.eg/article_196431_b890212086c21a37f96a8fe491e8a79b.pdf
dx.doi.org/10.21608/amj.2021.196431
ASSESSMENT OF SUBCLINICAL ATHEROSCLEROSIS IN PATIENTS WITH HIDRADENITIS SUPPURATIVA AND ITS RELATION TO C-REACTIVE PROTEIN
Sara
Ahmed Galal
Department of Dermatology & Venereology, Faculty of Medicine for (Girls), Cairo, Al–Azhar University, Egypt
author
Eslam
Mahmoud Mohammed
Department of Dermatology & Venereology, Faculty of Medicine for (Girls), Cairo, Al–Azhar University, Egypt
author
Abeer
Mostafa Kamel
Department of Dermatology & Venereology, Faculty of Medicine for (Girls), Cairo, Al–Azhar University, Egypt
author
Hala
Maghraby Maghraby
Department of Radiodiagnosis, Faculty of Medicine for (Girls), Cairo, Al–Azhar University, Egypt
author
text
article
2021
eng
Background: Hidradenitis suppurativa (HS) is a chronic, inflammatory, recurring dermatosis of the hair follicle. Some studies have revealed relation between HS and other diseases as metabolic syndrome, multifaceted disorder associated with increased risk for subclinical atherosclerosis and cardiovascular disease (CVD).
Objective: To measure carotid artery intima-media thickness (CIMT) as predictors of cardiovascular risk in HS patients and its relation to inflammatory serum marker especially C-reactive protein (CRP).
Patients and Method: This was a prospective case-control performed on 20 patients with HS and compared to 20 healthy volunteers matched in sex, mean of the age and BMI. Participants were recruited from Outpatient clinic of Al-Zahra’a University Hospital during the period from March 2017 to December 2018. The following investigations were done to all the participants including CRP, ESR, neutrophils count, HDL, total cholesterol, triglycerides and glucose. Carotid intima media thickness with B-mode ultrasound.
Conclusion: CIMT measurement was not significantly different between patients and controls but differed significantly according to stage of the disease, so HS potentially increased the risk of cardiovascular. The thickness of CIMT related directly to inflammatory serum markers especially CRP, so CRP was considered marker of disease severity and can be used for monitoring the response of treatment.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2937
2950
https://amj.journals.ekb.eg/article_196432_a207242dc0fc5612f073210440fe9c09.pdf
dx.doi.org/10.21608/amj.2021.196432
PREVALENCE OF PERIPHERAL ARTERIAL DISEASE AMONG HEMODIALYSIS PATIENTS
Tarek
Ebrahim Ahmed Abo Al-Fadl
Departments of Internal Medicine, Faculty of Medicine, Al-Azhar University
author
Mohamed
Salah El-Feshawy
Departments of Diagnostic Radiology, Faculty of Medicine, Al-Azhar University
author
Hany
Ismail Hamed
Departments of Internal Medicine, Faculty of Medicine, Al-Azhar University
author
Ahmed
Alaa El-Din Ahmed M. Saad
Departments of Internal Medicine, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: Peripheral arterial disease (PAD) is common in patients with end-stage renal disease on hemodialysis, but is frequently underdiagnosed. The risk factors for PAD are well known within the general population, but they differ somewhat in hemodialysis patients. This study aimed to determine the prevalence of PAD and its risk factors in patients on hemodialysis.
Objective: To assess the prevalence of peripheral arterial disease in end stage renal disease patients on hemodialysis.
Patients and Methods: This was across-sectional study carried out at Hemodialysis Unit of Al-Hussein University Hospital over a period of six month; from September 2019 to April 2020, and conducted on 80 hemodialysis patients. Demographic data and clinical information were recorded. Laboratory data including CBC, calcium, phosphate, total cholesterol, triglyceride, high-density lipoprotein, and iron profile were evaluated. The ankle-brachial index was measured in all patients. PAD was diagnosed if ankle-brachial index < 0.9. Duplex ultrasound for arterial system of both lower limb was done for patient with ankle / brachial index>0.9.
Results: As regard description of demographic data, the mean age of all studied patients was 45.3 ± 8.8 years with minimum age of 24 years and maximum age of 62 years. There were 43 males (53.8%) and 37 females (46.3%). Thirty-five patients (43.7%) were diabetic, and 48 patients (60%) were hypertensive. According to laboratory profile, the mean of WBCs, Hb, platelets, serum calcium, PO4, and iPTH were 6.5 x10³/ul, 10.4 g/dl, 228.2 x10³/ul, 8.3 mg/dl, 9.4 mg/dl and 477.2 ug/ml respectively. Regarding lipid profile, the mean of total cholesterol, HDL and triglyceride were 214.7 mg/dL, 41.9 mg/dL,and 172.2 mg/dL, respectively. Regarding to iron profile, the mean of iron serum, ferritin and TIBC were 62.7 mg/dl, 603.3 ng/ml and 236.7 mg/dl, respectively. According to ABI, there were 22 patients (27.5%) ≤ 0.9, while there were 58 patients (72.5%) > 0.9. The prevalence of peripheral arterial disease among HD patients was 27.5%.
Conclusions: High prevalence of peripheral arterial disease in CKD patients on hemodialysis and Ankle –brachial index was clearly more sensitive than physical examination in detecting of peripheral arterial disease in CKD patients on hemodialysis.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2951
2958
https://amj.journals.ekb.eg/article_196433_a484b8462a6978d152d3e13e4cbc2fd6.pdf
dx.doi.org/10.21608/amj.2021.196433
ROLE OF ULTRASOUND IN THE EVALUATION OF PAINFUL KNEE A COMPARATIVE STUDY TO MRI
Muhammad
Reda Abdullah Ali
Department of Radio diagnosis, Faculty of Medicine, Al-Azhar University
author
Ahmed
Abdul Fatah Mahmoud Abo-Rashed
Department of Radio diagnosis, Faculty of Medicine, Al-Azhar University
author
Ahmed
Muhammad Moustafa
Department of Radio diagnosis, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: One of the frequent musculoskeletal problems is knee pain. The trend of increasing of knee pain among the populations is noted. Therefore, choosing a reliable screening tool with reasonable cost is mandatory. Although magnetic resonance imaging (MRI) is the gold standard imaging modality for knee soft tissue structures, it has been widely abused with its high cost. Ultrasound is an established modality to image the soft tissue structures of the knee.
Objective: To show the role of ultrasound (US) in evaluating of knee pain and comparing the results with magnetic resonance imaging (MRI).
Patients and methods: This study included 40 patients (18 males and 22 females) with an age ranging from 15-69 years. This study was carried out at the Radiology Department of Al-Azhar University Hospitals for ultrasonography and MRI examination during the period from October 2019 to November 2020.
Results: Regarding meniscal horn tear, ultrasound detected tear in 2 cases, while MRI detected tear in 5 cases. Regarding meniscal horn degeneration, Ultrasound detected degeneration in 1 case, while magnetic resonance imaging detected degeneration in 6 cases. These results indicated that sonography was not accurate enough to be used as the only modality for diagnosing lesions of the knee menisci. Regarding medial collateral ligament (MCL) injury, ultrasound detected medial collateral ligament injury in 3 cases, while magnetic resonance imaging detected medial collateral ligament injury in 4 cases. The majority of the knees with osteoarthritis (OA) had effusion using ultrasound (100%) and magnetic resonance imaging (100%). Synovial thickening observed on ultrasound and magnetic resonance imaging. This study confirmed that there was a significant correlation between the magnetic resonance imaging and ultrasound techniques for evaluating the cartilage and soft tissue changes in the patients with knee osteoarthritis.
Conclusion: Ultrasound is an effective imaging modality that can be suitable as a screening tool for patients having knee pain. Knee US has reasonable accuracy in detecting collateral ligament and meniscal pathology. US with the advantages of being widely available lower in cost and with no contraindications should be the first modality of choice in evaluating knee pain. MRI can be reserved for equivocal US results.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2959
2970
https://amj.journals.ekb.eg/article_196434_49988dc6a2018e4581d32de0464d95f3.pdf
dx.doi.org/10.21608/amj.2021.196434
TISSUE FACTOR IN CIRRHOTIC AND HEPATOCELLULAR CARCINOMA PATIENTS
Mohamed
Mohamed Abd El-Rehim El-Hawawshy
Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University
author
Maged
Abd El-Fattah Esmael Shalaby
Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University
author
Ahmed
Ali Ali Assem
Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: The liver is the primary site of synthesis of nearly all coagulation factors, along with several proteins involved in fibrinolysis and anticoagulation, The acute and chronic inflammation in the liver is associated with a bleeding diathesis due to deficiency in the synthesis of coagulation factors as well as a pro-coagulant state due to the defects in the synthesis of anticoagulant factors by the liver.
Objective: To assess the tissue factor in cirrhotic and hepatocellular carcinoma (HCC) patients and their coagulation profile.
Patients and methods: This was a case control study carried on Al-Mahala General Hospital, and conducted on 80 subjects. They were categorized into in to main two groups: Group A (60 patients) and Group B (20 control persons) from March 2019 till September 2019.
Results: There was a statistical significant difference between tissue factor expression and other laboratory parameters among the studied group. There was a significant positive correlation between tissue factor and alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatinine, total bilirubin, α-fetoprotein (AFP), international normalized ratio (INR) and activated partial thromboplastin time (APTT). Also there was a significant negative correlation between tissue factor and hemoglobin, albumin and platelets.
Conclusion: Tissue factor (TF) enhances the inflammatory process within the liver parenchyma as it induces release of pro-inflammatory cytokines. This raises the possibility of a potential role for anti-inflammatory substances as a potential therapeutic option that can ameliorate liver damage in those patients.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2971
2982
https://amj.journals.ekb.eg/article_196435_49999d81d1360aecc6a5418a75bb6c52.pdf
dx.doi.org/10.21608/amj.2021.196435
COMPARATIVE STUDY BETWEEN DEXMEDETOMIDINE AND MAGNESIUM SULPHATE AS SEDATIVES IN AWAKE FIBEROPTIC INTUBATION IN CONTROLLED HYPERTENSIVE ADULT PATIENTS
Mohamed
Ali Mohamed Abd El-Aal
Anesthesiology and Intensive Care Department, Faculty of Medicine, Al-Azhar University
author
Gamal
Farouk Mohamed
Anesthesiology and Intensive Care Department, Faculty of Medicine, Al-Azhar University
author
Amr
Soliman Hamrosh
Anesthesiology and Intensive Care Department, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: Flexible bronchoscopy has become the “gold standard” for managing the expected and unexpected difficult airway. Several drugs have been used to provide adequate sedation to optimize adequate fiberoptic intubation.
Objective: To compare the sedative effects of dexmedetomidine and magnesium sulphate during awake fiberoptic nasal intubation in controlled hypertensive adults undergoing elective surgeries.
Patients and methods: Sixty controlled hypertensive patients intubated using awake fiberoptic. They were divided into 2 equal groups: Patients received dexmedetomidine infusion at dose of 1ug/kg, and the other patients received magnesium sulphate at dose of 30mg/kg. Topicalization of airway was done using lidocaine “spray as you go technique”. After completing the loading dose, Ramsay score was assessed before intubation. The 2 groups were compared according to Ramsay score, cough score, facial grimace and hemodynamic changes. This study was done at Al-Azhar University Hospitals after approval of the medical ethical committee, from May 2019 till November 2020.
Results: Ramsay score, cough score and facial grimace were favorable with less hemodynamic effects in dexmedetomidine group than magnesium group.
Conclusion: Dexmedetomidine was effective sedative agent for awake fiberoptic intubation in controlled hypertensive patients in comparison with magnesium sulphate.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2983
2994
https://amj.journals.ekb.eg/article_196436_2e2bb12cee4a67b309ddec84e98edd23.pdf
dx.doi.org/10.21608/amj.2021.196436
THE ROLE OF CEREBROSPINAL FLUID DYNAMICS USING PHASE-CONTRAST MAGNETIC RESONANCE IMAGING IN ASSESSMENT OF MULTIPLE SCLEROSIS ACTIVITY
Emad
Abd El-Galil
Department of Radiodiagnosis, Faculty of Medicine, Al-Azhar University, (Damietta), Egypt
author
Mostafa
Mohamed Mostafa Shakweer
Department of Radiodiagnosis, Faculty of Medicine, Al-Azhar University, (Damietta), Egypt
author
Ahmed
Yahia Ahmed Ashour
Department of Radiodiagnosis, Faculty of Medicine, Al-Azhar University, (Damietta), Egypt
author
text
article
2021
eng
Background: Multiple sclerosis (MS) is a chronic complex neurodegenerative disease, targeting the central nervous system (CNS) and widely believed to be autoimmune in nature. Alterations to the normal flow of Cerebrospinal fluid (CSF) in the brain could be a contributing factor to the accumulation of toxic substances in the brain interstitium and may be related to the pathogenesis of neurological disorders such as Alzheimer’s disease and MS.
Objective: To evaluate the CSF dynamics and its relation to MS activity using phase-contrast magnetic resonance imaging (PC-MRI).
Patients and methods: This prospective study was performed between April 2020 and October 2020. A total of 45 cases were enrolled in this study divided into three equal groups: MS patients with active plaques-enhanced on MRI (group 1), MS patients with chronic plaques (group 2), and healthy controls (group 3). Quantitatively evaluation of the CSF flow was performed at the level of the cerebral aqueduct by PC-MRI.
Results: Regarding to peak velocity, average velocity, net volume and average flow, there were no statistically significant differences between the three studied groups. Regarding to forward volume, reverse volume and aqueductal area, there were statistically significant differences between the three studied groups.
Conclusion: The forward and reverse CSF flow volumes and aqueductal area were significantly higher in the MS patients. These findings may support the venous theory in MS patients, but may also be explained by atrophy-dependent ventricular dilatation independent of the venous theory in MS patients.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
2995
3006
https://amj.journals.ekb.eg/article_196437_7cce677d372f907eede490efc4b4749d.pdf
dx.doi.org/10.21608/amj.2021.196437
THE STUDY OF INFLUENCE OF PLATELET DYSFUNCTION ON CLINICAL PHENOTYPE OF HEMOPHILIA
Mohammed
Khalil Mohammed Abdalla
Departments of Internal Medicine, Faculty of Medicine, Al-Azhar University
author
Mahmoud
Mohammed Mousa Bazeed
Departments of Internal Medicine, Faculty of Medicine, Al-Azhar University
author
Mahmoud
Abdeirashed Abdelkhalek
Departments of Clinical Pathology, Faculty of Medicine, Al-Azhar University
author
Ahmed
Ali Ali Assem
Departments of Clinical Pathology, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: Hemophilia is an X-linked heritable coagulopathy with an overall prevalence of approximately 1 in 10,000 individuals. Hemophilias are rare X linked hereditary bleeding disorders. Platelets may be among the determinants of variability in bleeding phenotype.
Objective: To evaluate the platelet function tests in patients with hemophilia, and to explore the influence of platelet dysfunction on hemophilia bleeding score.
Patients and Methods: The study was conducted on 40 hemophilic patients and 20 normal persons as a control in outpatient clinics at Kafr El-Sheikh Governorate Hospitals and Al-Azhar University Hospitals (Al-Hussein and Sayed Galal) to evaluate the platelet function tests in patients with hemophilia, and to explore the influence of platelet dysfunction on hemophilia bleeding score.
Results: The majority of cases (35 patients 87.5%) were type A and (5 patients 12.5%) were type B. As regard to hemophilia scoring system (HSS), 3 patients (7.5%) were type 1, 19 patients (47.5%) were type 2 and 18 patients (45%) were type 3. Bleeding from the knee occurred in the majority of patients (77.5%), from the elbow occurred in 32.5%, from the ankle occurred in 5%, from the vagina occurred in 15% and from the nose and the gum occurred in 7.5%. Platelets and maual platelet count showed insignificant difference between both groups. Platelets aggregation tests (ADP) test, collagen and restocetin agonists test) were significantly lower in cases group than control group. Prothrombin time (PT), international normalized ratio (INR), bleeding time (BT) showed insignificant differences between both group. On the other hands, activated partial thromboplastin time (APTT) significantly prolonged cases group than control group. No hemophilia C cases were detected in our study.
Conclusion: There was a statistical significant relationship between bleeding phenotype in hemophilia B and platelet function. Diagnosis of hemophilia was confirmed by factor VIII assay for hemophilia A and factor IX assay for hemophilia B.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
3007
3018
https://amj.journals.ekb.eg/article_196438_01d57756dd3ed340303a262db0499701.pdf
dx.doi.org/10.21608/amj.2021.196438
HISTOPATHOLOGICAL AND BIOCHEMICAL STUDY ABOUT THE CHRONIC ADMINISTRATION OF BISPHENOL A ON THE GENITAL TRACT OF ADULT FEMALE ALBINO RATS
Mohamed
Mahmoud Hussein
Departments of Forensic Medicine & Clinical Toxicology, Faculty of Medicine, Al-Azhar University
author
Fouad
Helmy El-Dabah
Departments of Forensic Medicine & Clinical Toxicology, Faculty of Medicine, Al-Azhar University
author
Mohammed
Fathy Assasa
Departments of Forensic Medicine & Clinical Toxicology, Faculty of Medicine, Al-Azhar University
author
Al-Sayed
Mohammed Ibrahim Tealeb
Departments of Pathology, Faculty of Medicine, Al-Azhar University
author
Mohammed
Ali Abd El-Hamed
Departments of Forensic Medicine & Clinical Toxicology, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
ABSTRACT
Background: Bisphenol A (BPA) is an industrial chemical synthesized by condensation of two phenol groups and one acetone molecule. Sources of exposure to bisphenol A including food especially canned food, dust, papers especially thermal because it comes with food or due to recycling with other types of paper, dental materials, medical devices and healthcare applications. In rodents and primates, as well as humans, orally administered bisphenol A is rapidly and efficiently (95% of dose) absorbed from the gastrointestinal tract and undergoes extensive first-pass metabolism in the gut wall and in the liver. During this first-pass metabolism, biotransformation of bisphenol A to bishenol A – glucuronide is the major pathway of BPA metabolism.
Objective: To demonstrate the possible chronic toxic effect (biochemical & histopathological) of Bisphenol A on ovaries, uterus and vagina of adult female albino rats.
Materials and methods: The present study was conducted at the Animal House (Assiut University), and Departments of Forensic Medicine & Clinical Toxicology and Pathology, Faculty of Medicine, Al-Azhar University, Egypt. The study followed the research ethics and standard protocol of dealing with animal. This research has been conducted on one hundred adult healthy female albino rats of a local strain weighing 100 – 120, during the period from April 2018 to May 2019.
Results: The chronic BPA exposure affected the pituitary gland, ovaries uterus and vagina of adult female albino rats. This effect appeared as significant statistical decrease in the total body weight of the rats. Biochemical examination revealed significant statistical decrease in serum levels of Follicular Stimulating Hormone (FSH), Luteinizing hormone (LH) and Estrogen. In addition, histopathological examination showed changes in the pituitary gland (cells showed disturbance in their architecture, hemorrhage and necrosis), ovary (disruption of the Graafian follicles, atretic follicles, dilated congested blood vessels and hemorrhage), uterus (severe degeneration and necrosis of the surface epithelium, leukocytic infiltration in the interstitial tissue, cystic dilation of endometrial glands, hyperplasia of endometrial epithelium and leukocytic infiltration with vacuolar degeneration in endometrial epithelium), and vagina (severe keratinization, epithelial atrophy, in addition to focal patches of decreasing of epithelial lining) when stained by hematoxylin and eosin stain then examined by light microscope.
Conclusion: The previous results proved the chronic toxic effects of BPA on the female reproductive system. So, the exposure to BPA that present in plastic containers and other products produces toxic effect on the reproductive health of females.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
3019
3038
https://amj.journals.ekb.eg/article_196445_23df348607deff351c4207eaa762721e.pdf
dx.doi.org/10.21608/amj.2021.196445
ENDOSCOPIC VERSUS HISTOPATHOLOGICAL DIAGNOSIS OF PAN-GASTRITIS IN PATIENTS WITH CHRONIC GASTRIC DYSPEPSIA
Mahmoud
Kamel Abdo Metawae
Departments of Hepto- Gastroenterology & Infectious diseases, Faculty of Medicine, Al-Azhar University
author
Nasser
Kamal El-Hamshary
Departments of Hepto- Gastroenterology & Infectious diseases, Faculty of Medicine, Al-Azhar University
author
Diaa
Mohammad El-Teby
Departments of Hepto- Gastroenterology & Infectious diseases, Faculty of Medicine, Al-Azhar University
author
Sayed
Abd El-Raheem Sayed Ali
Departments of Pathology, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: Dyspepsia is a clinical syndrome including manifestations related to the upper gastrointestinal tract. Options for evaluating dyspeptic patients include therapeutic trials, testing for Helicobacter pylori, upper gastrointestinal (UGI) radiography, and endoscopy.
Objective: To compare the endoscopic and histopathologic diagnosis of gastritis in patients presented with chronic gastric dyspepsia to evaluate the relative frequency and pattern of different types of gastritis in patients presented with chronic gastric dyspepsia.
Patient and method: Prospective cross-sectional study on 120 patients with chronic dyspepsia more than 8 weeks. All patients underwent gastroscopy. The findings of gastric inspection were recorded for all patients. Biopsy specimens were taken. Two from the anterior and posterior antrum, two from the anterior and posterior body, and two from any additional area of abnormality. Diagnostic criteria were applied to histological features and each histopathological parameter (chronic inflammation, activity, atrophy, intestinal metaplasia and H. pylori density) were graded for assessment of their severity as 0= absent, 1= mild, 2=moderate or 3= severe in the corpus and antrum.
Results: Endoscope revealed normal gastric mucosa in 33 patients (27.5%), gastritis in 64 patients (53.3%) and other lesions in 23 patients (19.2%). As regard gastritis, there was edema in 61 patients (95.3%), erythema in 45 patients (70.3%), atrophy in 10 patients (15.6%) and mucosal nodularity in 10 patients (15.6%). As regard location of gastritis, it was pan-gastritis in 44 patients (68.8%), Antrum predominant gastritis in 10 patients (15.6%) & corpus predominant gastritis in 10 patients (15.6%).As regard other lesions, there was Duodenal ulcer in 7 patients (30.4%), peptic ulcer in 3 patients (13%), esophagitis in 2 patients (8.7%), erosive gastritis in 4 patients (17.4%), upper GIT suspecting malignancy in 2 patients (8.7%) and hiatal hernia in 5 patients (21.7%). Histopathology results were Normal in 18 (18.6%), Chronic inflammation in 79 (81.4%), Neutrophilic infiltration in 60 (61.7%), Glandular atrophy in 10 (10.3%), Intestinal metaplasia in 3 (3.1%) and H. pylori density in 47 (48.5%). Gastritis was detected by Endoscopy in 64 (53.3%) and in 79 (81.4%) by histopathology. This difference was statistically significant (p-value: 0.014).
Conclusion: The prevalence of gastritis among the dyspeptic patients is very high since we observed endoscopically gastritis in 64 patients (53.3%) and other lesions in 23 patients (19.2%). The concordance between endoscopic findings and histopathological diagnosis of gastritis was (81%). High prevalence of H.Pylori among the dyspeptic patients (48.5%). Gastritis was better detected by histopathology.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
3039
3050
https://amj.journals.ekb.eg/article_196446_7ae4a5cc96ead4fc1508cb9545ac52b6.pdf
dx.doi.org/10.21608/amj.2021.196446
THE POSSIBLE EFFECT OF FLAXSEED EXTRACT ON LETROZOLE-INDUCED POLYCYSTIC OVARY RAT MODEL: CORRELATIVE HISTOLOGICAL AND FUNCTIONAL STUDY
Mona
Mohamed Abd El-Galil
Histology Department, Faculty of Medicine (Girls), Al-Azhar University, Cairo, Egypt
author
Shaymaa
Fathy Mohammed
Physiology Department, Faculty of Medicine (Girls), Al-Azhar University, Cairo, Egypt
author
text
article
2021
eng
Background: Polycystic Ovary Syndrome (PCOS) is one of the most common metabolic disorders affecting women in the reproductive age leading to infertility/subfertility. It may occur as a complication of Letrozole (LTZ) therapy in breast cancer patients. Objective: This was a preliminary study to assess the possible protective and/or curative effect of flaxseed extract in a letrozole-induced PCO rat model. Material and Methods: Thirty-six adult female albino rats were divided into five main groups: Group I kept as the control group, Group II (Letrozole-induced PCO group), received letrozole solution (3 mg/kg) orally once daily by gastric tube for 21 days. Group III (combined flaxseed and letrozole group), received aqueous flaxseed extract (500 mg /kg/day) orally one hour before letrozole in the same dose and duration as group II, Group IV (recovery group), received letrozole in the same dose and duration as group II and then left without treatment for the next 4 weeks after PCO induction, Group V (flaxseed-treated group), treated with aqueous flaxseed extract orally once daily for the next 4 weeks after PCO induction. At the end of the experiment, final body weight, ovarian weight, blood glucose, serum antioxidants assay, and sex hormones levels were measured. Also, specimens of ovaries were processed for light and electron microscopic studies. Histomorphometric and statistical analyses were done. Results: letrozole-induced PCO resulted in a significant increase in final body weight, ovarian weight as well as abnormal blood glucose, sex steroids hormone levels, and antioxidant assays. Moreover, numerous ovarian cystic follicles, widespread cytoplasmic vacuolation in the granulosa lutein cells, congested blood capillaries, and increased fibrosis within the ovarian medulla were evident in the PCO group in concomitant with a significant increase in area percentage of collagen fibers. The ultrastructural assessment confirmed these distortions. The protective and curative potential of flaxseed is mostly comparable revealed improvement in the final body weight, biochemical markers and histological changes, with the protective effect was more pronounced than the curative one. Conclusion and Recommendation: Flaxseed succeeded in ameliorating letrozole-induced polycystic ovary owing to its phytochemicals, antioxidant and anti-inflammatory properties with folliculogenesis potentials. So, it is recommended to use flaxseed as a co-therapy with letrozole to reduce its hyperandrogenic effects.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
3051
3096
https://amj.journals.ekb.eg/article_196448_050e76526975b94d4261f7db9b246898.pdf
dx.doi.org/10.21608/amj.2021.196448
ROLE OF 3D DIGITAL MAMMOGRAPHY IN STUDYING BREAST LESIONS IN ADULT FEMALES OF DENSE BREAST
Ahmed
Rabie Ewis El-Sayed
Department of Radio diagnosis, Faculty of Medicine, Al-Azhar University
author
Mostafa
Ali Motawe
Department of Radio diagnosis, Faculty of Medicine, Al-Azhar University
author
Yousef
Mohammed Faheem
Department of Radio diagnosis, Faculty of Medicine, Al-Azhar University
author
Mohammed
Abo El-Naga Mohammed
Department of Radio diagnosis, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: Digital breast tomosynthesis (quasi three-dimensional [3D] mammography) is a relatively novel technique. It creates thin-slice reconstructions of the breast from low-dose digital mammographic images acquired at multiple angles. This evolution of mammography improves lesion visibility by reducing overlapping tissue. Hence, it has the potential to increase BC detection and to reduce false-positive (FP) findings.
Objective: To review the role of 3D Digital Mammography in Studying of dense breast Lesions in adult female.
Patients and methods: This was a retrospective study conducted on 40 patients who were eligible for examination by 3D Digital Mammography referred to WAFI center (women and fetal imaging center). The study was conducted during 12 months from January 2019 till January 2020 and was carried at Al-Azhar University Hospitals and WAFI Center (Woman and fetal imaging center).
Results: There was no statistically significant difference between ultrasound (US) and tomosynthesis (TOMO) as regarding mass detection. There was a statistically significant increase as regarding calcification detection in TOMO than US. There was a statistically significant increase as regarding asymmetry detection in TOMO than US. There was no statistically significant difference between US & TOMO as regards Arch. Distortion detection. There was no statistically significant difference between US & TOMO as regards inflammatory reactions detection. There was statistically significant increase as regarding cyst detection in US than TOMO. There was a statistically significant increase as regarding dilated ducts detection in US than TOMO. There was a statistically significant increase as regarding added value detection in US than TOMO. There was no statistically significant difference between US & TOMO as regarding Breast Imaging-Reporting and Data System (BI-RADS).
Conclusion: Both modalities were not similar in the ability to identify malignant lesions. Wide-angle digital breast tomosynthesis (DBT) was able to initially identify two more lesions <1cm in size; one more malignant focus in a patient with a multi-focal disease, and a small malignant lesion, a case with multiple benign lesions. Both lesions presented as small area of architectural distortion on DBT images (statistically, no significance despite the difference between the two modalities, p=0.07), also DBT has higher detection rate than US as regard calcification and focal asymmetry.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
3097
3112
https://amj.journals.ekb.eg/article_196449_ffed80c39b6e5b7bfaef5a10b3e9d3b9.pdf
dx.doi.org/10.21608/amj.2021.196449
INTEGRATED USE OF BEDSIDE LUNG ULTRASOUND AND ECHOCARDIOGRAPHY AS AIDING PREDICTORS IN SUCCESSFUL WEANING PROCESS
Ahmed
Mohamed Abdalla Beshir
Departments of Chest disease, Faculty of Medicine, Al-Azhar University
author
Ismael
Abd El-Menem Attia
Departments of Chest disease, Faculty of Medicine, Al-Azhar University
author
Mahmoud
El-Saeed Ahmed
Departments of Chest disease, Faculty of Medicine, Al-Azhar University
author
Ebrahim
Faragallah Saeed
Departments of Cardiology, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: We hypothesized that bedside lung ultrasound (LUS) and echocardiography could be a predictor of postextubation distress by detecting a high lung aeration defect immediately before weaning by evidencing significant lung derecruitment during the spontaneous breathing trial (SBT).
Objective: To evaluate the effectiveness of Lung Ultrasound (LUS) and Transthoracic Echocardiography (TTE) in predicting successful weaning of mechanically ventilated patients.
Patients and Methods: This study was performed on 50 mechanically ventilated patients in general and respiratory ICU during the period from August 2019 to January 2021, at Bab-Al-Sha'reia University Hospital. Lung ultrasound and echocardiography were determined before and at the end of a 60-min spontaneous breathing trial (SBT) and 4 hrs. after extubation. To quantify lung aeration, a lung ultrasound score was calculated.
Results: Forty-five patients had SBT success (90%) and 5 patients experienced SBT failure (10%), From those patients with SBT success, there were 16 patients (35.56%) had post extubation distress, and 29 patients (64.44%) had post extubation success. In patients who successfully passed the SBT, a lung ultrasound score ≤10 at the end of the SBT was highly predictive of postextubation success with a statistically significant difference (p value < 0.001). On the other hand, lung ultrasound score ≥18 at the end of the SBT was highly predictive of postextubation distress with a statistically significant difference (p value < 0.001). We found significant differences in E/A ratio 1.08 ± 0.2 in patients with spontaneous breathing trial success, and 1.6 ± 0.1 in patients with SBT failure with a statistical significant (p-value < 0.001).
Conclusion: LUS and TTE during spontaneous breathing trial may accurately predict postextubation distress.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
3113
3122
https://amj.journals.ekb.eg/article_196450_bec6667240c230a47f87b5572656901b.pdf
dx.doi.org/10.21608/amj.2021.196450
BODY MASS INDEX AS A PREDICTOR FOR OBSTRUCTIVE SLEEP APNEA IN SNORING PATIENTS
Khalid
M. Halima
Department of Chest Diseases, Al Azhar Faculty of Medicine, Egypt
author
Safwat
A. M. El-Daboosy
Department of Chest Diseases, Al Azhar Faculty of Medicine, Egypt
author
Amgad
Awad
Department of Internal Medicine, Al Azhar Faculty of Medicine, Egypt
author
Saber
Abo Al-Hassan
Department of Neurology, Assiut Faculty of Medicine, Egypt
author
Mohamed
O. Nour
Department of Public Health and Community Medicine, Al Azhar Faculty of Medicine, Damietta, Egypt
author
text
article
2021
eng
Background: Obstructive sleep apnea (OSA) is a very common disease in the general population that can cause deterioration in the quality of life, chronic diseases, road traffic accidents and excessive mortality in itself. The condition is characterized by repeated episodes of upper airway obstruction, accompanied by nocturnal oxygen desaturation, fragmented sleep and excessive daytime sleepiness.
Objective: To evaluate body mass index (BMI) correlated to apnea-hypopnea index (AHI) and minimum O2 saturation (Nadir SaO2).
Patients and Methods: A retrospective database analysis of medical records of One hundred fifty patients with OSA that performed at Almoosa Hospital, Saudi Arabia during the period from August 2016 to August 2019.BMI was calculated for each patient, as well as AHI and Nadir SaO2 recorded during polysomnography. AHI was used to evaluate the severity of OSA and to assess if there is correlation to BMI values.
Results: The severity of OSA had significant positive correlation with BMI (ρ =0.13, P=0.005) and significant negative correlation with Nadir SaO2 (ρ = -0.27, P=0.001). BMI had significant negative correlation with Nadir SaO2 (ρ = -0.18, P=0.027).
Conclusion: Higher BMI values were correlated with lower Nadir SaO2 during overnight polysomnography. Since hypoxia stress is a risk factor for cardiovascular diseases and alters the lipid metabolism, dietary consulting should be recommended in association with other treatment modalities for OSA.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
3123
3136
https://amj.journals.ekb.eg/article_196451_7d084996f2b882d21770725b2a490ab6.pdf
dx.doi.org/10.21608/amj.2021.196451
AGGRESSIVE BEHAVIOR AND SUICIDE PROBABILITY IN ADOLESCENT MALES
Mohammed
Mohammed Abd El-Khalik El-Deeb
Department of Psychiatry, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: Aggressive behavior and probability of suicide in adolescents are increased in last decades this affects most communities in our world increasing and socio-economic burden and stress health care facilities. Objective: To compare suicide probability and aggressive behavior in rural and urban areas and relation between probability of suicide and aggressive behavior in adolescents. Patients and Methods: Total sample of this study was 295 male student,105 student from Zorkan secondary school at Zorkan Village, Tala Center, El-Menofeya Governorate and 190 students from Khalil Agha secondary school in Bab El-Sheria Cairo Governorate selected in random manner. All participants were subjected to suicide probability scale, semi-structured clinical psychiatric interview and socioeconomic standard form during the period from December 2019 to April 2020. Results: This study revealed that there was a high suicide risk in the sample divided into three groups: group of mild risk (46.1%), group of moderate risk (25.1%) and group of sever risk (11.9%), Suicide risk increased in urban sample than rural sample in statistical significant degree, There was a positive correlation between suicide risk and aggressive behavior in statistical significant degree, Prevalence of psychiatric disorders was(11.53%) in the total sample, (11.58%) in urban sample and (11.435%) in rural sample, Prevalence of depression in rural sample was (8.57%) and (7.89%) in urban sample while prevalence of generalized anxiety disorder in rural sample was (2.86%) and in urban sample was (2.635%), Prevalence of obsessive- compulsive disorder in urban sample was (1.05%) and no cases in rural sample, there was a positive correlation between suicide probability, aggressive behavior and psychiatric morbidity in a significant degree in the sample as a whole. Conclusion: Suicide probability and aggression in adolescents was increased in urban areas in Egypt than in rural areas also the increasing rate of aggressive behavior increased the rate of probability of suicide in adolescents.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
3137
3144
https://amj.journals.ekb.eg/article_196452_65574820ae2d0ee88e1a7f04b0cc2a2c.pdf
dx.doi.org/10.21608/amj.2021.196452
LIVER IMPAIRMENT AS A PREDICTIVE FACTOR FOR MORTALITY RATE OF COVID-19 PATIENTS
Ashraf
Abd El-Aty El-Shenawy Emara
Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Department of Medical Physiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
author
Amin
Mahmoud Amin Hegazy
Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
Ahmed
Mohamed Abu Hassan
Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
Ahmed
Mohamed El-Deeb
Department of Diagnostic Radiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
author
text
article
2021
eng
Background: In the current COVID-19 pandemic, which is caused by severe acute respiratory syndrome- coronavirus-2 (SARS-CoV2), disease diagnosis is essential for optimal management, timely isolation of infected cases in order to prevent further spread and is associated with significant morbidity and mortality burden.
Objective: To assess the liver impairment as a predictive factor for mortality rate of COVID -19 patients.
Patients and Methods: The prospective study included 100 patients with Covid-19 infection who were admitted to Al-Hussein and Bab Al-Sha׳aria University Hospitals. The study was during the period from 1st of February 2021 to 31th of May 2021 and divided in to five groups according to liver functions tests. Presenting clinical manifestations, laboratory findings, radiological findings and mortality rate were recorded from electronic medical records. Diagnoses of COVID-19 patient were done according to criteria of ministry of health and population- Egypt.
Results: The results revealed that the mean of platelets reaching to a minimum mean value at group E and the mean of the neutrophil /lymphocyte ratio reaching to a maximum mean value at Group E, while the lymphocyte /monocyte ratio reaching to a minimum mean value at Group E. There were significant difference among all groups regarding ALT, AST, total bilirubin, direct bilirubin and serum Albumin with P value =0.001 in all parameters. Also there were significant decreases of serum albumin in groups C, D and E when compared with group A, and there were significant increases of total bilirubin, direct bilirubin mean values in group E when compared with group A. There were significant increase of prothrombin time (PT) and INR in groups E when compared with group A. The results showed a significant difference (p-value <0.05) between recovered and died cases for each group with higher mortality rate at group D (7 cases with a percent of 30.4%), then at group E (3 cases with a percent of 25%), and there were 88% recovered and 12% died in all studied COVID-19 patients. The results revealed that the higher mortality rates at group D and E between patients having chest CT scoring 4 and 5.
Conclusion: Patients with accompanying chronic liver diseases are predisposed to developing a more severe course of COVID-19 and increase the mortality rate, but on the other hand, a more complicated presentation of SARS-CoV-2 infection increases the risk of liver failure.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
3145
3162
https://amj.journals.ekb.eg/article_196453_7155e1cde9d4b2fe63a84148f94bc745.pdf
dx.doi.org/10.21608/amj.2021.196453
Role of Ultrasound and Transient Elastography in Diagnosis of Occult Cirrhosis in Chronic Liver Disease
Mohamed
Fikry Mohamed Ali
Department of Radiodiagnosis, Faculty of Medicine, Al-Azhar University
author
Abdallah
Mohamed El Kheshen
Department of Radiodiagnosis, Faculty of Medicine, Al-Azhar University
author
Mohamad
Abo Al Naga
Department of Radiodiagnosis, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: Hepatic cirrhosis represents the most advanced stage of any chronic liver disease characterized by progressive fibrosis. Complications including decompensation, spontaneous bacterial peritonitis, variceal bleeding, and hepatocellular carcinoma, carry significant morbidity and mortality. Early identification of patients with cirrhosis is of paramount importance to initiate surveillance protocols for prevention, early diagnosis, and specific therapies for such devastating complications.
Objective: To investigate prevalence of preclinical cirrhosis diagnosed by transient elastography (TE) that we defined as occult cirrhosis (OC) and to evaluate the pattern of surveillance that patients with OC received in current clinical practice.
Patients and methods: Our study included 60 chronic liver disease patients recruited from National Hepatology and Tropical Medicine Research Institute (NHTMRI) outpatient clinics to assess prevalence of occult cirrhosis among patients who have not any clinical or definite sonographic signs of liver cirrhosis, the study was divided into two groups: 1) Occult cirrhosis, defined as TE ≥13kPa and F4 on METAVIR scoring system. 2) non-cirrhotic chronic liver disease (CLD) (TE<13kPa). We found that the prevalence of OC is considerable, representing 15% of all CLD patients. This proportion suggests up to 1 in 7 individuals with CLD may have their OC missed.
Results: Concerning the etiology of the chronic liver disease in our study, among the occult cirrhosis group there were 8 patients diagnosed as hepatitis C virus positive representing (89%) and one patient diagnosed as hepatitis B virus positive representing (11%) and among the non-cirrhotic group there were 42 patients diagnosed as hepatitis C virus positive representing (82%) and 4 patients diagnosed as hepatitis B virus positive representing (8%) and 5 patients diagnosed as non-alcoholic fatty liver disease (NAFLD) representing (10%). In our study among the occult cirrhosis group there were 5 male patients (55%) and 4 females (45%) with their age ranged between 33-55 years with the mean age 44 years and among the non-cirrhotic group there were 32 male patients (62.7%) and 19 female patients (37.3%) their age ranged between 19-58 years with the mean age 38.5 years.
Conclusion: This study suggests that occult cirrhosis is a frequent finding. Clinicians should be aware that the absence of definite sonographic signs cannot rule out the possibility of compensated cirrhosis in its preclinical stage. Patients with occult cirrhosis can exhibit rapid development of hepatocellular carcinoma, variceal bleeding, and ascites.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
3163
3180
https://amj.journals.ekb.eg/article_196455_94849acd6149e8d443cae2d5af3c97f7.pdf
dx.doi.org/10.21608/amj.2021.196455
PREVALENCE OF PSYCHIATRIC DISORDERS IN MALE ADOLESCENTS IN URBAN AREAS IN EGYPT
Mohammed
Mohammed Abd El-Khalik El-Deeb
Department of Psychiatry, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background:Knowledge about the epidemiology of mental disorders in children and adolescents is essential for research and planning of health services. Surveys can provide prevalence rates, whereas population-based registers are instrumental to obtain precise estimates of incidence rates and risks. Objective:To study the morbidity and the outbreak rate of the psychiatric illnesses among adolescents in Egyptian urban areas. Patients and Methods: This study was conducted during the period from December 2017 to April 2018, this study was conducted on 1014 students: 500 students from Khalil Agha school and 514 from Ismail Al-Kabbany school in Cairo, Egypt. All participants were subjected to Socioeconomic standard application, General health questionnaire (GHQ), Semi-structured clinical interview according to DSM5, Eysenck personality questionnaire for those given positive results by GHQ and Investigations included CT brain and EEG, as per the clinical interview, in order to exclude organic cases. Results: The sample age was 12-19 years and averaged at (14.99), with a standard deviation of (1.53). The number of those who had psychiatric disorders was(154) and (15.2%), while the number of those who didn't have any psychiatric disorders was 860 and (84.8%), Anxiety disorders were the most common in the sample with a percentage of (6.8%), including Generalized Anxiety Disorder (GAD) (2.2%), Social Phobia (2.1%), Obsessive Compulsive Disorder (OCD)(0.8%), Specific Phobia (0.7%), Panic Disorder (0.7%), Single Panic Attack (0.2%), Anxiety Disorder Not Otherwise Specified (0.2%), Depressive Disorders (4.9%), which included Major Depression (2.2%), Minor Depression (1.7%), Dysthymia (1.3%); Adjustment Disorders (2.4%), Conduct Disorder (0.4%), Nightmares Disorder (0.2%) and Teeth-Grinding Disorder (0.2%), The GHQ results average value were 28.68%, with a standard deviation of (12.87). Positive results reached (91.3%), while negative ones reached (8.7%). There was an indicative increase in the GHQ results average value among the ill group, compared to the normal one, The Average value of the socioeconomic standard results was (65.14%), with a standard deviation of (16.88), The results average of Eysenck personality questionnaire hit (46.47), with a standard deviation of (6.26). The average results of the branch scales were: Lie: (14.7), with a standard deviation of (14.4), Neurosis: (13.65), with a standard deviation of (4.5), Extroversion: (12.24), with a standard deviation of (3.12), Psychosis: (5.8), with a standard deviation of (3.21). Conclusion: Rate of psychiatricdisorders increased in Egyptian male adolescents in urban areas.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
3181
3192
https://amj.journals.ekb.eg/article_198398_0fc1169b974b9c6f2ed0c0aafd23d3cf.pdf
dx.doi.org/10.21608/amj.2021.198398
CORRELATION BETWEEN HELICOBACTER PYLORI INFECTION AND RISK OF ESOPHAGOGASTRIC VARICEAL BLEEDING IN LIVER CIRRHOSIS
Mohammed
Ismael Abdallah
Department of Internal Medicine , Faculty of Medicine, Al-Azhar University
author
Fathy
Ghamry Abd El-Razek
Department of Internal Medicine , Faculty of Medicine, Al-Azhar University
author
El-Sayed
El-Meghawry El-Sayed
Department of Internal Medicine , Faculty of Medicine, Al-Azhar University
author
Tarek
Mustafa Emran
Department of Clinical Pathology , Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: Bleeding from esophageal and gastric varices is a fatal event in patients with liver cirrhosis and portal hypertension. Objective: Evaluation the correlation between Helicobacter Pylori infection and risk of esophagogastric variceal bleeding in liver cirrhosis. Patients and Methods: This study was carried out on one hundred (100) patients, suffering from post hepatitic cirrhosis and portal hypertension: fifty (50) of them presented with esophageogastric varices without bleeding selected from patients coming for screening of esophagogastric varices for anti-hepatitis c virus treatment, and the other fifty (50) presented with acute variceal bleeding. All patients attending to Internal Medicine outpatient’s clinic and Internal Medicine Department of Al-Azhar University Hospital at new Damietta during the period from September 2018, to April 2020. All patients were subjected to complete history, clinical assessment, abdominal ultrasonography, upper GIT endoscope and laboratory investigations. Results: There was a significant relation between H.Pylori infection and the presence of esophagogastric variceal hemorrhage and H. Pylori infection was positive in 92% of the patients in group II, and 24% patients was grade II oseophageal varices, 70% grade III oseophagogastric varices, and 6% grade IV oseophagogastric varices, There was a statistically significant correlation of increased esophageal varices (grade three) in positive H pylori in group II, while in group I detection of H.pylori showed 24% patients were positive, and 76% patients were negative. Endoscopic examination showed 40 patients without esophagogastric varices (80%), 8% patients grade I, 4% patients grade II, 6% patients grade III, 2% patients grade IV, and there was a statistically significant increase on esophageal varices (grade zero) in negative H pylori in group I. Conclusion: Helicobacter Pylori infection helped in the development of portal hypertensive gastropathy as well as its severity, and increased risk of esophagogastric variceal bleeding in patients with liver cirrhosis. So, eradication and treatment of Helicobacter Pylori in all patients with liver cirrhosis helped to decrease risk of esophagogastric variceal bleeding in these patients.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
3193
3202
https://amj.journals.ekb.eg/article_198538_dc7f20683f7457359051e0d3f67c2cd6.pdf
dx.doi.org/10.21608/amj.2021.198538
RELATIONSHIP BETWEEN C-REACTIVE PROTEIN TO ALBUMIN RATIO AND THE EXTENT OF CORONARY ARTERY DISEASE SEVERITY IN PATIENTS WITH NON ST ELEVATED MYOCARDIAL INFARCTION
Hamdy
Saleh Abd El-Moaty
Department of Cardiology, Faculty of Medicine, Al-Azhar University
author
Mohammed
Hesham Hassan Ezzat
Department of Cardiology, Faculty of Medicine, Al-Azhar University
author
Abd El-Aleem
Abd El-Aleem Ali El-Guindy
Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University
author
Ahmed
Abd El-Raouf Mahdy
Department of Cardiology, Faculty of Medicine, Al-Azhar University
author
text
article
2021
eng
Background: Coronary artery diseases (CAD) are as atherosclerotic heart disease, atherosclerotic cardiovascular diseases, coronary heart diseases (CHD), or ischemic heart disease (IHD). CAD is the largest contributor of cardiovascular diseases (CVDs), and mortality rate is due in prevalence to atherosclerosis, a chronic inflammatory condition of the arterial wall. Objective: To assess the relationship between C reactive protein /albumin ratio and the extent of coronary coronary disease assessed by the syntax score I in patients with non ST elevated myocardial infarction. Patients and methods: This was a prospective cohort study carried out at Cardiology Department of Al-Azhar University, and Al-Agouza Cardiology Department, and enrolled 100 patients admitted with non ST- elevation myocardial infarction and underwent coronary intervention during the period from January 2019 to February 2020. Results: There was a non-statistically significant relation regarding gender and age. There was statistically significant relation regarding diabetes mellitus (DM) and dyslipidemia (cholesterol and LDL). There was also a statistically significant relation regarding syntax score, CRP and also CRP/Alb ratio. Conclusion: There was a correlation between CRP/ Albumin ratio and the severity of coronary artery disease assessed by syntax score I.
Al-Azhar Medical Journal
Al-Azhar Scientific Medical Society
1110-0400
50
v.
4
no.
2021
3203
3214
https://amj.journals.ekb.eg/article_203953_2cab62663e4f4d416eda1a201413a1d9.pdf
dx.doi.org/10.21608/amj.2021.203953