@article { author = {}, title = {THE GOOD IS THE ENEMY OF THE ADEQUATE}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {2}, pages = {1-1}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0038253}, abstract = {}, keywords = {}, url = {https://amj.journals.ekb.eg/article_56412.html}, eprint = {https://amj.journals.ekb.eg/article_56412_be0e563195ff43e39a61cd9df4255613.pdf} } @article { author = {Abdel-Rahman Eletreby, Ezzat and Ahmed Massoud, Waleed and Abd EL-Ghany Mohamed, Hany}, title = {EFFECT OF TOTAL PARATHYROIDECTOMY WITHOUT AUTOIMPLANTATION ON PARATHYROID HORMONE LEVEL IN HEMODIALYSIS PATIENTS WITH SECONDARY HYPERPARATHYROIDISM}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {2}, pages = {315-322}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0038254}, abstract = {Background: Secondary hyperparathyroidism is a major problem in chronic kidney disease patients, resulting in skeletal complications including enhanced osteoclast activity with accelerated bone turnover and osteitis fibrosa cystica. Objective: Studying the effect of total parathyroidectomy without autoimplantation on PTH level, and state of parathormone activity in hemodialysis patients. Patients and Methods: Thirty four hemodialysis patients with secondary hyperparathyroidism were subjected for follow up as regard calcium, phosphorus, parathormone (PTH) level, post total parathyroidec-tomy without auto implantation between July 2013 and December 2015 after failure of medical treatment. Results: The studied patients had a mean age of 52.3 ±5.6 years. They were 15 males (44.1 %) and 19 females (55.8%). Mean of hemodialysis duration was 12.4 ±3.8 years.There was a significant decline of the postoperative parathyroid hormone levels when compared with their preoperative assessments. After 6 months 67.6 % had PTH levels of 3-8 folds more than upper normal of assay, while 5.9% had PTH level below 100 pg-ml, and 26.5 % have PTH level more than 8 folds the upper normal of assay,and symptoms of recurrent hyperparathyroidism. Conclusion: Total parathyroidectomy without autoimplantation was associated with a low rate of hypopara-thyroism in hemodialysis patients.}, keywords = {Parathyroidectomy,Hyperparathyroidism,Hemodialysis}, url = {https://amj.journals.ekb.eg/article_56612.html}, eprint = {https://amj.journals.ekb.eg/article_56612_3d1367d96777bfcc6c3ad81f9b4b5c9f.pdf} } @article { author = {Mohamed Ibrahim Farahat, Mohamed and Samir Fouad Khalaf, Mohamed and Abd Al-Galel EL-Sheikh, Waleed and Fawzy Mohamed, Mofeed and Fares Mohamed, Tamer and Hassan Ahmed, Ahmed}, title = {COMPARISON BETWEEN HAPTOGLOBIN AND CA125 TO PREDICT NATURE OF OVARIAN MASS}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {2}, pages = {323-330}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0038255}, abstract = {Background: Ovarian cancer has been named "the silent killer" because it frequently causes non-specific symptoms which contribute to diagnostic delay. Despite of the improved surgical techniques and effective chemotherapeutic regimens available for management of ovarian cancer, there is no improvement in its early detection. Thus, ovarian cancer remains a leading cause of death from gynecological malignancies with an overall poor prognosis. The identification of novel cancer biomarker opens the possibility for early detection, and better monitoring of tumor progression. Haptoglobin is a novel biomarker which was used in diagnosis in ovarian cancer. Objectives: To assess the performance of haptoglobin and CA125 to increase the sensitivity and specificity in diagnosis of nature of ovarian mass.    Patients and Methods: This study was carried out on 90 women attending at Al-Hussein and Bab El-Sha'aria University Hospitals. A prospective study was held on patients with ovarian mass prepared for surgery. It was a case control study. It incorporated on 60 patients with ovarian masses (30 women with benign ovarian masses and 30 women with malignant ovarian masses), and 30 women without masses (control group). Those patients were subjected to careful history taking, clinical examination, ultrasound examination and preoperative assessment of serum levels of Haptoglobin and CA125. Results: the prediction of CA-125 was better than that of haptoglobin but the combination of both markers was better than the prediction of one of them in diagnosis of ovarian cancer. Conclusion: Haptoglobin has an important role in the prediction of ovarian cancer. It increased significantly in malignant ovarian tumors than in benign ovarian tumors. So, it can be used as a diagnostic tumor marker in cases of ovarian neoplasia.}, keywords = {Haptoglobin,CA125,Ovarian mass}, url = {https://amj.journals.ekb.eg/article_56616.html}, eprint = {https://amj.journals.ekb.eg/article_56616_d3a8c456a4b85291d04fc3434eda8018.pdf} } @article { author = {Allam, Emad and Shaheen, Hussin and Hamed, Fawzy and M Rashed, Alsayed and S Alshorbagy, Mohamed and M Rashed, Ahmed}, title = {URINARY CONNECTIVE TISSUE GROWTH FACTOR LEVEL AS AN EARLY NON-INVASIVE BIOMARKER OF CHRONIC ALLOGRAFT NEPHROPATHY}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {2}, pages = {331-344}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0038256}, abstract = {Background: Chronic allograft nephropathy (CAN) is a major cause of renal graft loss. Connective tissue growth factor (CTGF) expression is increased in fibrotic renal diseases including diabetic nephropathy and CAN. Objective: Assessing urinary CTGF as a non-invasive marker of CAN. Patients and method: Urinary CTGF was measured in samples collected from all the study candidates which included transplanted patients with normal kidney functions tests and estimated glomerular filtration rate(e GFR) more than 60 ml/minute as a control, transplanted patients with biopsy-proven diagnosis of IF/TA indicating presence of CAN, and e GFR between 30 -59 ml/minute and transplanted patients with biopsy-proven diagnosis of interstitial fibrosis (IF/TA), indicating presence of CAN, and e GFR less than 30 ml/minute. To assess the effect of the native kidneys, hemodialysis patients were recruited and their urine samples were collected and to measure CTGF. To adjust for decreasing GFR and urine output, urinary creatinine was measured in all samples, and CTGF/creatinine ratio was calculated. Results: The mean urinary CTGFin patients with CAN was significantly higher than the mean level in transplant candidates with normal kidney function.The mean urinary CTGF in patients with CAN and marked graft dysfunction was significantly higher than the mean level in those with milder graft dysfunction. The mean urinary CTGF was found to be significantly higher in patients with history of acute rejection than in those without history of acute rejection. There was a significant positive correlation between urinary CTGF level and both of serum creatinine and duration of transplantation, and a negative correlation between urinary CTGF level and e GFR. The CTGF/creatinine ratio showed similar results. Conclusion: Urinary CTGF level and CTGF/creatinine ratio could be used as an early non-invasive marker of chronic allograft nephropathy.}, keywords = {Kidney transplantation,chronic allograft nephropathy,connective tissue growth factor}, url = {https://amj.journals.ekb.eg/article_56627.html}, eprint = {https://amj.journals.ekb.eg/article_56627_222d4c634a0d0d5219fb2d68a9919348.pdf} } @article { author = {Abdalhameed Shamma, Ahmad and Saleh Abusenna, Abdalla and Abdalmonem Negm, Mohammad and Abdalbaset Hegazy, Mohammad}, title = {THE MANAGEMENT OF CERVICAL DISC DISEASE BY USING AN ANTERIOR CERVICAL INTERBODY CAGE WITH INTEGRATED SCREWS}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {2}, pages = {345-350}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0038257}, abstract = {Background: Stand-alone anchored spacers aim at reducing complications associated with traditional plating while maintaining the functionality of interbody spacer and plating. Objective: We prospectively followed up patients who underwent anterior cervical discectomy and fusion (ACDF) in single or multiple levels using the polyetheretherketone (PEEK) prevail cervical interbody device. Patients and Method: Prospective study of 24 patients suffering from single or multiple level degenerative cervical disc diseases from C3-C4 to C7-T1, operated at Al-Agouza spine hospital, between September 2013 to August 2015. All patients underwent surgery using PEEK prevail device. Patients were evaluated using visual analogue score (VAS) for neck pain, VAS for arm pain, and neck disability index (NDI) scores. Clinical improvement was also graded by Odom's criteria at final follow up. Result: The study showed a statistically significant difference between pre and post-operative as regard VAS for neck pain and arm pain of the study group. Also, there was a statistically significant difference between pre- and post-operative as regard neck disability index of the study group.   Conclusion: The use of stand-alone cages in anterior cervical decompression and fusion provided short time clinical improvement with minimal complication rates.}, keywords = {VAS score,stand-alone cages,Odom's criteria}, url = {https://amj.journals.ekb.eg/article_56630.html}, eprint = {https://amj.journals.ekb.eg/article_56630_b150ed57887c5b997e702642454a234f.pdf} } @article { author = {Mohamed Abd Al-Aziz, Abd El-Hamid and Mahmoud Attia, Shady and Mahmoud Mohamed Abdo, Adel and Ibrahim El-Hossiny, Hossam}, title = {THE EFFECT OF AUTOLOGOUS PLATELET RICH PLASMA (PRP) ON PATIENTS WITH ALOPECIA AREATA}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {2}, pages = {351-362}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0038258}, abstract = {Background: Alopecia areata (AA) is a non-scarring, autoimmune hair loss condition. Despite available therapeutic options, searching for new and more effective treatment is continuous. Objective:Evaluation of  the efficacy of autologous platelet-rich plasma (PRP) for the treatment of localized AA. Patients and methods: This was a prospective study that conducted at Al-Azhar University Hospital  in which 30 patients who attended the outpatient clinic were enrolled. All the patients had age range from 14 to 50 years  with localized AA "patchy AA", normal laboratory parameters for CBC, and thyroid functions. None of them had hematological disorders, thyroid dysfunction, low pain threshold, malnutrition, cicatricial alopecia, alopecia total is, alopecia universal is or other dermatological disorders contributing to hair loss. Results: Eighteen patients (60.0%) were responders and twelve patients (40.0%) were non-responders. From 18 responders, 16 (88.9%) were good responders,  and 2 (11.1%) were partial responders. Conclusion: PRP has emerged as a new treatment modality in AA, and showed effective results and safety in treatment of alopecia areata.}, keywords = {Platelet rich plasma (PRP),Alopecia areata (AA)}, url = {https://amj.journals.ekb.eg/article_56632.html}, eprint = {https://amj.journals.ekb.eg/article_56632_c11e2ff9188f7da993aed6bd6ff1e1ab.pdf} } @article { author = {M. El-Sayaad, Ibrahim and M. Shahin, Mohammed and A. E. Abdelmonem, Sayed and T. Mahrous Ahmed El-Shamy, Amgad and H. Gouda, Samir and Mahran, Zakria}, title = {COMPARATIVE STUDY BETWEEN SYSTEMIC AND TOPICAL PROPRANOLOL IN TREATMENT OF INFANTILE HEMANGIOMAS}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {2}, pages = {363-372}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0038259}, abstract = {Background: Hemangioma is one of the most common benign infantile vascular tumors. Corticosteroids were used for a long time for treatment. However, it was associated with many complications. Thus, propranolol was introduced and become the first line of treatment. Initially, it was used orally, and then the topical use gained a wide acceptance. However, no study compared the effectiveness and safety profile of topical when compared to systemic propranolol therapy. Objective: Comparison between systemic and topical propranolol in treatment of infantile hemangioma (IHs). Patients and Methods: The study was carried out at Al-Azhar University Hospitals (Pediatric Surgery Unit) during the period from May 2015 to February 2016. Forty infants with hemangioma were included, and divided into two equal groups: The first group received systemic propranolol therapy; while the second group received topical propranolol therapy. Patients were evaluated before starting the treatment by full history taking and clinical examination. The treatment started in systemic group by 1mg/kg/day divided into three doses; then increased and maintained on 2mg/kg/day till the fifth month, then gradually withdrawn by the end of the sixth month. In topical group, 1mg/kg/day was prepared in an oily base received in daily two divided doses till the end of the sixth month. Outcome was compared between both groups. Results: Topical propranolol therapy was effective as the systemic therapy with low side effects and even better effectiveness. However, the difference was statistically non-significant. In addition, both groups were comparable as regards patient demographics and hemangioma characteristics. Conclusion: Topical propranolol was effective and safe as that or even better than systemic propranolol therapy. However, the small number of the studied subjects prevented the globalization of our results.}, keywords = {Hemangioma,Propranolol,infantile,systemic,topical}, url = {https://amj.journals.ekb.eg/article_56633.html}, eprint = {https://amj.journals.ekb.eg/article_56633_daf07a33621c78bdc8bfb4f4cb898f0c.pdf} } @article { author = {Ramadan Samaha, Shebl}, title = {EFFECTS OF ROSEMARY EXTRACT SUPPLEMENTATION ON ETHANOL INDUCED LIVER INJURY IN ADULT MALE ALBINO RAT}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {2}, pages = {373-382}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0038260}, abstract = {Background: Rosemary is a native Mediterranean small green herb. Its leaves contain many active constituents providing defense against oxidative stress from oxidizing agents and free radicals. The liver has a central role in the metabolism of many drugs. Chronic alcohol intake is associated with increasedoxidative stress and decreased antioxidant enzymes. Objective: Evaluation of the effects of Rosemary extract  supplementation on ethanol induced liver injury in adult male albino rats. Material and methods: Thirty adult male albino rats of local strain weighing 140 - 155 g were chosen to be the model of the present study.Theywere divided into three equal groups: Group I (Control group) received no treatment, Group II (Ethanol group) were subjected to induction of hepatotoxicity by daily administration of  45% liquid ethanol for six weeks, and Group III (Rosemary-treated group) were subjected to induction of hepatotoxicity and Rosemary supplementationfor six weeks. Blood samples were withdrawn, serum was separated for determination of ALT, AST, ALP, SOD and MDA serum levels. Rats were killed and pelvi-abdominal cavities were opened. Livers were excised for studying histopathological changes. Results: Ethanol administration was associated with significant changes in the  liver functions indicated by elevated serum liver enzymes and distorted liver morphology associated with disturbed oxidant-antioxidant status as indicated by elevated serum MDA and decreased SOD levels. These changes were improved by Rosemary administration but however, these improvements did not reach the basal level. Conclusion: Ethanol administration markedly disturbed the liver functions. Rosemary administration has a hepatoprotective effects against these changes.}, keywords = {rosemary,alcoholic liver disease,oxidants-antioxidants}, url = {https://amj.journals.ekb.eg/article_56634.html}, eprint = {https://amj.journals.ekb.eg/article_56634_e75a71e85f6b50cb24e4354d41d79286.pdf} } @article { author = {M Abdelraouf, Samy and M Enite, Ashraf and I Saleh, Ola}, title = {PRIMARY EXPERIENCE WITH CT GUIDED MANDIBULAR NERVE BLOCK IN PATIENTS WITH TRIGEMINAL NEURALGIA}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {2}, pages = {383-390}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0038261}, abstract = {Background: Trigeminal neuralgia (TN) is a well-known facial pain syndrome characterized by excruciating paroxysmal shock pain attacks located in somato-sensensory distribution of trigeminal nerve.  Mandibular affection is a common presentation of TN. Objectives: Studying the effect of injection of mandibular nerve with neurolytic solutions in trigeminal neuralgia that was unresponsive to pharmacotherapy. Patients and Method: This prospective study included 21 patients treated for mandibular neuralgia by percutaneous injection of absolute alcohol under guidance of CT image. Their ages ranged from 35-60 years and male to female was 3:4. All patients suffered from moderate to severe TN, and did not respond to medical treatment. Entry and trajectory of needle was planned by CT and after local anesthesia. Alcohol was injected at the exit of mandibular nerve from foramen ovale.            Results: 85.7% of patients improved (71.4% became pain free and severity of pain decreased in 19%), while 9.6% of patients has no response after injection. The pain free patients became 61.9% after two years of follow up.  Conclusion: CT guided mandibular nerve block by neurolytic agent as absolute alcohol and showed its effectiveness as minimal invasive treatment option for intractable trigeminal neuralgia. CT guidance provided a clear view to secure the safety, accuracy and selectivity of nerve block.}, keywords = {trigeminal neuralgia,computed tomography guided,nerve block}, url = {https://amj.journals.ekb.eg/article_56636.html}, eprint = {https://amj.journals.ekb.eg/article_56636_3a7eece84bb3c3a0d75a16faf14d454f.pdf} } @article { author = {F. Al-Saeed, Hanan and M. M. Salah Eldin, Ghada and E. Ibrahim, Samah and B. Kholoussy, Adel}, title = {EFFECTS OF OXYTOCIN ON CYCLOPHOSPHAMIDE-INDUCED NEPHROTOXICITY IN ADULT MALE ALBINO RATS}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {2}, pages = {391-404}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0038262}, abstract = {Background: Cyclophosphamide (CP) is commonly used as anti-cancer drug which causes tissue toxicity by its reactive metabolites. Oxytocin (OT) is a peptide hormone secreted by the hypothalamic paraventricular and supraoptic nuclei. It modulates the immune and inflammatory processes. Objective: Investigating the effects of oxytocin on CP induced-acute renal toxicity in adult male albino rats. Materials and Methods: Seventy adult male albino rats were divided into 5 groups:  0 group served as normal control (20 rats were subdivided into A&B; 10 rats each), group I served as positive control (20 rats injected with single intraperitoneal dose of CP and were subdivided into A&B; 10 rats each), Group-II (10 rats treated with OT for 7 days before CP injection then sacrificed 24 hours later with 0-A and I-A groups), Group III (10 rats treated with OT after CP injection for 10 days then sacrificed with 0-B, I-B & IV groups), and Group IV(10 rats treated with OT for 7 days before and for 10 days after CP injection).  By the end of the experimental period, blood samples were collected to measure serum creatinine and urea. Both kidneys of each rat were dissected out carefully. The right kidney was used for measurement of malondialdehyde (MDA), glutathione (GSH) and tumor necrosis factor alpha (TNF-α), while the left kidney was preserved for histological examination. Results: Administration of oxytocin alleviated CP-induced renal toxicity as evident from the decreased levels of kidney toxicity markers (urea, creatinine, MDA and TNF-α) and elevation of GSH levels. No significant differences were found between the groups treated with OT. Administration of oxytocin caused a significant improvement in kidney histopathology with alleviation of tissue inflammation and tissue recovery especially in rats treated with OT pre- and post-CP injection. Conclusion: Oxytocin has a protective and therapeutic role from CP-induced renal toxicity by modulating levels of MAD, GSH and TNF-α.}, keywords = {cyclophosphamide,oxytocin,renal histology,Kidney function,cytokines and oxidative stress}, url = {https://amj.journals.ekb.eg/article_56638.html}, eprint = {https://amj.journals.ekb.eg/article_56638_b412f8ba664cb66fe338220dd3f4db1c.pdf} } @article { author = {I. Mohamed, Hala and Hassan, Ahmed and Swar, Shreif}, title = {EFFECT OF RENAL HEMODIALYSIS IN END STAGE RENAL DISEASES ON THE LEVEL OF HEPATITIS SURFACE ANTIBODIES AFTER VACCINATION}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {2}, pages = {405-412}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0038263}, abstract = {Background: The prevalence of viral hepatitis is higher in end stage renal diseases(ESRD) patients with dialysis than in general population, because of the opportunity for exposure during dialysis to blood products, and shared hemodialysis equipments.  The impaired efficacy of HBV vaccine has been attributed to numerous factors such as immune compromised state because of uraemia, age.  Immunization is the most effective way to prevent transmission of HBV. Objective: To evaluate the effect of chronic renal hemodialysis on the level of hepatitis B surface antibodies after vaccination and to compare between immunogenic seroconversion response to HBV vaccine in hemodialysed patients and healthy individuals. Patients and Methods: One hundred eighty cases were included in the study (60 controls and 120 hemodialysed patients) at national institute of urology and nephrology (NIUN).  The patients were subdivided into 2 subgroups: 1) Sixty hemodialysed diseased patients due to immunological disease. 2) Sixty hemodialysed diseased patients due to other causes of renal diseases including diabetes mellitus (D.M.) and hypertension (HT).  All subjects received 3 doses of HBV vaccine starting from 11/2013 till 5/2014 (0,1, 6 months). Patients have double the dose (2 ml) of the controls.  After one year of complete vaccination, all subjects were investigated for Hepatitis B surface antibodies titer (HBs Abs titer) in their sera. RESULTS: There was a statistically significant difference between patient and control groups as regards urea, creatinine, uric acid, sodium, and potassium.  No statistically difference between male and female patients as regards HBs Abtiter, and statistically significant difference of HBs Ab seroconversion when comparing between patients and controls.  There was a statistically significant difference between subgroup 1and subgroup 2. No significant correlation between age, adequacy of dialysis, and HBsAb titer in groups of patients. Conclusion: The study reported a high response rate to hepatitis-B vaccination among hemodialysed patients. Gender and efficiency of dialysis have no association with response to HBV vaccine. Young age was associated with good response to hepatitis B vaccine, while diabetes mellitus has a poor response to hepatitis B vaccine.}, keywords = {ESRD,HBs Ab,immunological causes,Diabetes mellitus,Hypertension}, url = {https://amj.journals.ekb.eg/article_56639.html}, eprint = {https://amj.journals.ekb.eg/article_56639_7176e7712cd37bff4f6cdda223d416bc.pdf} } @article { author = {Mohamed Khloussy, Hemmat and Samy Shoukry, Heba and Desoky Badawy, Ahmed and El –Sonbaty, Sameh and Ibrahim El-Sherbini, Abd El-Hamied}, title = {ALTERATION OF SCIATIC NERVE CONDUCTION VELOCITY IN RATS SUBJECTED TO IMMOBILIZED STRESS}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {2}, pages = {413-424}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0038265}, abstract = {Background: Limb immobilization is one of treatments for managing musculoskeletal injury. Although immobilization often benefit the affected part of the body, when prolonged, it often harms the rest of body. Objective: Studying the morphological and functional changes in the nerves of immobilized muscles. Materials and Methods: Thirty four adult male albino rats weighing from 140 –160 g were included in the study. The rats were classified into two  equal groups: control group included rats not exposed to immobilization, and experimental group included rats exposed to immobilization. After 14 days of immobilization, the rats were sacrificed and the sciatic nerve was dissected and placed in moist nerve chamber, then stimulated by power lab 4/25 stimulator for measuring the nerve conduction velocity (NCV), and the amplitude of action potential. Results: Immobilized group showed a significant decrease in both the NCV, and amplitude of action potential of sciatic nerve in comparison to the control group. In addition, there were  histological findings suggesting degeneration of myelin sheath and nerve axons. Conclusion: Limb immobilization altered the physiological parameters and histological characters of sciatic nerve.}, keywords = {Limb immobilization,sciatic nerve,conduction velocity,action potential amplitude}, url = {https://amj.journals.ekb.eg/article_56641.html}, eprint = {https://amj.journals.ekb.eg/article_56641_f4243071c8353d8ac5f2a9891157f44a.pdf} } @article { author = {G Montasser, Mahmoud}, title = {DECREASING THE INCIDENCE OF VENTILATOR ASSOCIATED PNEUMONIA WITH COMPLETE ADHERENCE TO ITS PREVENTION BUNDLE}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {2}, pages = {425-432}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0038264}, abstract = {Background: Ventilator-associated pneumonia (VAP) is a very common nosocomial infection in intensive care units (ICU) with subsequent increase in morbidity, mortality and cost. Objective: Toestimate the effect of strict compliance of VAP bundle on decreasing VAP rate per 1,000 ventilator days. Methodology: A prospective study was done in adult ICU at Al–Hayat Hospital, Jeddah, KSA; between January 2013 and April 2015. During the period of January to March 2013, ICU staff nurses were educated and made aware about the use of ventilator bundle in helping to prevent this infection. One hundred sixty four patients with age ranged between 33-60 years old were intubated and ventilated for more than two days were suspected to have VAP. Cases were divided into two groups; the first group (84 patients) included all patients admitted to ICU, intubated and ventilated for more than two days with incomplete compliance with VAP bundle (missed one or more components of VAP bundle), the second group included 80 patients with strict compliance of VAP prevention bundle. Patient (s) who are expired within 48 hrs of admission, transferred to tertiary care unit within 48hrs, diagnosed with pulmonary embolism or had gastrointestinal bleeding prior to admission were excluded from this study. Results: There was no significant difference between cases with incomplete application or strict application of VAP bundle as regard age, sex distribution or cause (s) of ICU. On the other hand, there was a significant decreased VAP% in cases with strict application of VAP bundle (1.3%) when compared to patients with incomplete VAP bundle application (9.5%). In addition, the rate of VAP cases /1000 ventilator days significantly decreased from 13.6/1000 (in cases with incomplete VAP bundle application) to 3.1/1000 (in cases with strict application of VAP bundle). Also, there was significant decrease as regard the mean duration of ventilation; from 7±091dayes in cases with incomplete VAP bundle application to 4±0.75 days in cases with strict application of VAP bundle. In addition, the mean length of ICU stay was significantly shortened from 10.42±1.71 days in cases with incomplete application of VAP bundle to 7.25±1.08 days in cases with strict application of VAP bundle. Finally ICU mortality was significantly reduced from 23.8% in cases with incomplete VAP bundle application to 7.5% in cases with strict application of VAP bundle. Conclusion: Theresults of the study revealed efficacy of strict implementation of VAP prevention bundle in reducing incidence of VAP/1000 ventilator days, decreasing duration of ventilation, shortening length of stay and decreasing ICU mortality rate related to VAP. Thus, it is advocated to continue strict adherence to these bundle.}, keywords = {Ventilator Associated Pneumonia,bundle,prevention}, url = {https://amj.journals.ekb.eg/article_56643.html}, eprint = {https://amj.journals.ekb.eg/article_56643_bd7d7fef5159e2212d130ebec3e6e1fa.pdf} } @article { author = {Sobhy Teama, Mohammed and Yahia Zakaria Mohamed, Mohamed and Mohamed Mostafa Abd Elwahab, Khaled}, title = {EVALUATION OF NEW ORAL ANTICOAGULENTS IN MANAGEMENT OF DEEP VEIN THROMBOSIS}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {2}, pages = {433-442}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0038266}, abstract = {Background: Low molecular weight heparin (LMWH) and vitamin K antagonists (VKAs) have been considered the first line option for the prevention and treatment of venous thromboembolism (VTE) for several yearsafter decades during which warfarin was the only oral anticoagulation option; newer anticoagulants have the potential to change the management of coagulation disorders. The new oral anticoagulants (NOACs) differ from VKAs in their action mechanism because of direct inhibition of proteins of the coagulation cascade. They have more predictable pharmacokinetics leading to fixed and convenient dosing regimens and no need for routine monitoring, as well as in a rapid onset of action, and importantly, high efficacy and low risk of bleeding. Some of their limitations are the higher cost, limited monitoring (if needed, as only qualitative measures available) and the lack of a specific antidote. Objectives: To evaluate the efficacy and side effects of the new groups of oral anticoagulants in comparison to traditional oral anticoagulants in management of deep vein thrombosis. Patient and methods: This work was done over 50 patients, divided into 2 equal groups: Group I received oral rivaroxaban for 3 months, and group II received warfarin guided with INR measurement for 3 months. The following was done for all patients: Complete blood count, coagulation profile, liverfunction tests, kidney function tests and duplex scan. Results: Rivaroxaban (group I) included 9 males and 16 females with a mean age of 37.6 (27-60), and a mean body weight of 83.7± 16.3. Warfarin group II included 7 males and 18 females with a mean age of 37.9 (27-52), and a mean body weight of 84.2± 13.  The main symptoms of our patients were leg pain in 86%, leg swelling in 78%, tenderness in 74%, redness/warmth in the leg in 34%, the main risk factors for DVT were hormonal contraceptive in 44%, immobilizations in 34%, hypercoagulability in 30%, operative history in 24%, history of orthopedic surgery in 22%, old age in 8%, with no statistical significant differences between the 2 arms of the study. Conclusion: Rivaroxaban have the advantage of more predictable anticoagulation, fewer drug interactions, and vascular outcomes compared with warfarin. New oral anticoagulants have shown to have a favorable balance between efficacy and safety compared with warfarin because recanalization occurred, with high percentage in new oral anticoagulants more than warfarin. Rivaroxaban has a rapid onset of anticoagulant that can be given in fixed doses without routine monitoring.}, keywords = {New oral anticoagulants,vitamin K antagonists,Venous Thromboembolism}, url = {https://amj.journals.ekb.eg/article_56644.html}, eprint = {https://amj.journals.ekb.eg/article_56644_c655d7ac5bd024b7f276de013e4d47fa.pdf} } @article { author = {M. Kenawy, Eglal and Abd El-Hafeez, Hafez and Abd El-Ghaffar Mohamed, Nagwa and M.A. Naeem, Mahmoud}, title = {INTERLEUKIN (IL)-17 AS A BIOMARKER IN ASSESSMENT OF BRONCHIAL ASTHMA SEVERITY}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {2}, pages = {443-454}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0038267}, abstract = {Background: Asthma is a serious global health problem affecting all age groups. Cytokines from T-helper 2 cells are believed to be critical contributors of asthma. Objective: Measuring the serum levels of IL-17 as non-invasive biomarkers to assess asthma severity. Patients and Method: A prospective case controlled study included forty patients were recruited from the outpatient clinic and inpatient of Internal Medicine Department, Al-Hussein University Hospital, Al-Azhar University divided into two equal groups (mild asthma and severe asthma) compared with twenty healthy non-smoker subjects. Total serum level of IL 17 and serum IgE was measured by ELISA technique. Complete blood count (CBC), pulmonary function tests (spirometry) and skin peak test were done for all patients. Results: A significant increase in body mass index (BMI) and age were found in patients with severe asthma compared with those with mild asthma and normal control. Also, patients with severe asthma have more airflow limitation, with a higher serum level of IL-17, IgE, and the number of eosinophils than patients with mild asthma. Significant increase was found in the serum level of IL-17, IgE, the total count of WBCS the number of eosinophils and the number of platelets in asthmatic patients compared with normal control. IL17 has positively correlated with the serum level of IgE, the number of eosinophils, BMI, the age of patients, and negatively correlated with pulmonary function tests. By ROC analysis, a cutoff point for IL – 17 >51.5 Pg/ml, IgE >60IU/ml and the number of eosinophils >2.8% in the mild form of asthma, while the cutoff values for IL17>92.9Pg/ml, IgE>162.0IU/ml and the number of eosinophils >4.1%) in the severer form of asthma. Sensitivity, specificity and positive predictive value for IgE level in mild asthma were 85%, 80% and 77.8% respectively, while in severe asthma 65%, 85% and 83% respectively. Moreover, sensitivity, specificity, positive predictive values for IL17 in mild asthma were 97.5%, 100% and 100% respectively, while in severe asthma were 100%, 100% and 100% respectively. Conclusion: Simple spirometric parameters (bedside test) were a good predictive tool for assessment asthma severity. Among laboratory tests, IL17 was the best biomarker for diagnosis and prediction of asthma severity in asthmatic patients than IgE.}, keywords = {Asthma,IL17,IgE,Eosinophils,Obesity}, url = {https://amj.journals.ekb.eg/article_56645.html}, eprint = {https://amj.journals.ekb.eg/article_56645_4eea620b49afda0e7bd99b7f7f2b75b0.pdf} } @article { author = {Yehya Ismail, Nadia and Mohamed Rabie, Moftah and AL-Awadi, Ibrahim and Gamil Twfeeq, Hussein}, title = {FREQUENCY OF ASTHMA IN CHILDREN BORN BY CESAREAN SECTION COMPARED TO THOSE DELIVERED VAGINALLY}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {2}, pages = {455-462}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0038268}, abstract = {Background: Cesarean sections (CS) have been reported to increase the risk of asthma in offsprings. This may be due to that infants delivered by CS are unexposed to vaginal flora, according to the ‘hygiene hypothesis’ Objective: Investigating the risk effects of CS on inducing childhood asthma. Patients and Methods: A case-control study was performed on 400 (case = 200, control = 200) children aged 3-12 years referred to outpatient clinics of Al-Hussein University Hospital, the study was conducted from May  2015 to May  2016 . A questionnaire was administered to obtain a demographic, environmental, and clinical history. Sex, mode of delivery, birth weight, age, parental smoking and exclusive breast feeding matching with cases were carried out during sampling for controlling of possible cofounding effects of these factors for asthma. Logistic regression models were fitted to compute odds ratios (ORs), and 95% confidence intervals (CI). Results: Risk of being diagnosed with bronchial asthma was significantly higher in children born by Cesarean section (OR=1.8), children in urban areas (OR=1.73), children with history of parental smoking (OR=1.64), low birth weight (OR=2.01) and non exclusive breast feeding (OR=2.12).   On performing multiple stepwise logistic regression analysis,CS delivery was the most significant risk factor followed by urban residence followed by non exclusive breast feeding. Conclusion: Birth by cesarean section increased the risk for asthma in childhood}, keywords = {Asthma,cesarean section,children,vaginal delivery}, url = {https://amj.journals.ekb.eg/article_56646.html}, eprint = {https://amj.journals.ekb.eg/article_56646_de5fe3be6e05ca45b4cde8a514a57b45.pdf} } @article { author = {A. Shoman, Abeer and Desoky, Ahmed}, title = {THE ROLE OF GHRELIN AND PANCREATIC POLYPEPTIDES IN DEVELOPMENT OF HIGH FAT DIET (HFD) - INDUCED OBESITY IN ADULT ALBINO RATS}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {2}, pages = {463-478}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0038269}, abstract = {Background: Sex difference in eating behavior is well documented. Development of diet-induced obesity in males and females is mediated by distinct mechanisms. Therefore, understanding the key molecular mechanisms involved in the pathogenesis of obesity could be beneficial for the development of a therapeutic approach. Objective:  Assessing whether high fat diet (HFD) induced obesity is sex-specific and the possible effect of pancreatic polypeptide (PYY) and ghrelin on the HFD induced obesity in albino rats. Material and Methods: Sixty four rats of a local strain were divided into 4 equal groups. Each group was divided into male and female subgroups: group I(control group), group II (HFD received rats), group III (HFD- PYY treated rats at a dose of 50 µg⁄ kg twice daily by i.p injection), and group IV( HFD- ghrelin treated rats at a dose of 10 nmol/ day by intraperitoneal injection). Results: There were extensive differences between the sexes in the development of obesity by using high fat diet at the end of 4th and 5th weeks. Body weight was significantly lower in females as compared to males. Administration of PYY caused significant decrease in body weight compared to HFD, whereas ghrelin administration caused significant increase in body weight compared to HFD in all groups. Conclusion: Despite extensive similarities in the brain responses to hunger and satiety between male and female, there were sex- differences in the development of obesity and body weight gain. PYY administration reduced HFD induced obesity, while a ghrelin administration exaggerated the degree of obesity.}, keywords = {High fat diet,Obesity,ghrelin,pancreatic polypeptide PYY,albino rats}, url = {https://amj.journals.ekb.eg/article_56647.html}, eprint = {https://amj.journals.ekb.eg/article_56647_2934beaff24be8f52be35cecae3e7687.pdf} } @article { author = {Abd Al-Shakour, Maher}, title = {EFFECT OF REPEATED BLOOD TRANSFUSION ON SOME BLOOD PARAMETERS}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {2}, pages = {479-486}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0038270}, abstract = {Background: Repeated blood transfusion causes a lot of complications in the body specially iron deposition in different organs in the body. Objective: Investigating the changes which occurred in the human body blood parameters on repeated blood transfusion. Subjects and methods: This study was performed at outpatient clinic, Faculty of Medicine, Al-Azhar University Hospital (Assiut). The patients were forty patients already diagnosed as thalassemic major and exposed to repeated blood transfusion and the following parameters were measured (oral glucose tolerance, plasma glucose level, plasma insulin level, C- peptide level, lipase level, serum iron, total iron binding capacity and serum Ferritin). Results: The study showed that hemosidtherosis affected the level of serum lipase which decreased in thalassemic patients as a model of hyperplastic anemia. Also, C-peptide level decreased in those patients more than control. This indicated that the pancreatic functions were affected by iron deposition. Also, serum iron and serum ferritin increased which led to decrease in the level of total iron binding capacity which caused by decrease in Hb level. Conclusion: Blood glucose level increased significantly in thalassemic patients while insulin level decreased in them. Serum Ferritin level was increased in thalassemic patients where the hemoglobin decreased. Serum lipase and C-lipase decreased in thalassemic patient}, keywords = {thalassemia,repeated blood transfusion}, url = {https://amj.journals.ekb.eg/article_56648.html}, eprint = {https://amj.journals.ekb.eg/article_56648_112751f03c61575d180217a1fb9cae18.pdf} } @article { author = {Abd Al-Shakour, Maher and Soltan, Sameh and Gad Allah, Ahmed}, title = {ARACHIDONIC ACID CORRELATION WITH SUSPENDED AND ATTACHED NEUTROPHILS}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {2}, pages = {487-494}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0038271}, abstract = {Background: Neutrophils are the blood cells for which adhesion is one of the main functions. Neutrophils adhered to biological surfaces show different characteristics of activation compared with neutrophils in suspension. The respiratory burst in suspended neutrophils in response to a chemotactic factor is lower when compared with the cells attached to the surface. Objectives: This study aimed to study the role of arachidonic acid release in suspended and attached neutrophils following stimulation of human neutrophils with LPS and PAF. Materials and methods: The suspended and attached neutrophils were primed by LPS and PAF, and inhibited by Anti-CD 14 (MY4). Results: The arachidonic acid release in attached cells is more than in suspended cells. This release is rapid with the increase of incubation time and dose-depended. The Fmet-Leu-Phe (FMLP) potentiates arachidonic acid release in attached cells pretreated with LPS and serum. Arachidonic acid release was less in suspended cells in comparison to attached cells where the addition of low concentration of LPS in presence of serum or platelet activating factor (PAF) to suspended cells produce increase in arachidonic acid release. On the other hand LPS in combination with PAF produce a large and significant increase in arachidonic acid release. The potentiative effect of LPS is mediated via CD14 receptors. The monoclonal antibodies against CD14 had no effect on arachidonic acid release in PAF treated cells where it inhibited greatly the potentiation by LPS or LPS-serum complex with PAF. Conclusion: LPS or PAF alone produced small increase in arachidonic acid release in both suspended and attached human neutrophils, where LPS in combination with PAF induced significant arachidonic acid release in suspended and attached human neutrophils.}, keywords = {Arachidonic acid,Neutrophils,LPS,PAF,CD14}, url = {https://amj.journals.ekb.eg/article_56649.html}, eprint = {https://amj.journals.ekb.eg/article_56649_1371087d593ab10a5e99e6423378c75f.pdf} } @article { author = {El-Mokhtar Ibrahim, Omar and Abdelhamied Goma, Mohamed and Alaa Sharaby, Sherif}, title = {DUPLEX GUIDED VERSUS CONTRAST VENOGRAPHY FOR LANDING OF INFERIOR VENA CAVA FILTER (COMPARATIVE STUDY)}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {2}, pages = {495-506}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0038272}, abstract = {Background: Vena cava filters are an important alternative when anticoagulation is contraindicated. Techniques for placement of inferior vena cava (IVC) filters have undergone continued evolution from open surgical exposure of the venous insertion site to percutaneous insertion in most cases .Today, all of the commonly used filters can be placed via a peripheral vein by using percutaneous puncture. Increased experience with color flow duplex scanning for routine IVC imaging and portability of ultrasound equipment have suggested the usefulness of duplex-guided IVC filter insertion (DGFI). Objective: Comparing bedside trans-abdominal duplex ultrasound versus contrast venography for inferior vena cava filter placement as regard to safety, efficacy , results and possible complications. Patients and Methods: This was a comparative study which included 30 patients divided into two groups: Group A which contained 15 patients by which filter placement was done by contrast venography in Al-Hussein Hospital, and Group B which contained 15 patients by which filter placement was done by duplex ultrasound in Al- Zahraa Hospital. History, complete examination and investigations were done to all the patients. Results:  There was a difference between both groups according to the age, gender, pulmonary embolism attack , indications for IVC filter deployment and the venous access aproach but insignificant, All filters were permenant and most common indication was recurrent tromboembolism insbite of adequate anticoagulation. Two patients in Group A suffered from hematoma and echymosis at access site, and filter deployment failed for the first time in two patients of Group B, but succeeded for the second time with no mortality detected. Conclusion: Inferior vena cava filter insertion was safe and effective in preventing pulmonary embolism. Fluroscopy has traditionally been the golden standard procedure for IVC filter deployment. Duplex guidance can replace fluoroscopy to guide the procedure in patients whose conditions can not tolerate the contrast material or exposure to X-ray.  The current study suggested that duplex guided filter insertion was safe, reliable, and accurate as the fluoroscopy guided procedure. Duplex guided method has proved to be cost effective as it can be done as a bedside procedure.  Obesity constituted the major technical limitation of duplex guided procedure.}, keywords = {Duplex,Venography,Inferior vena cava}, url = {https://amj.journals.ekb.eg/article_56650.html}, eprint = {https://amj.journals.ekb.eg/article_56650_2499657bbe933ef0fabdbeacb4ceb5c4.pdf} } @article { author = {M. Farawela, Hala and M. Zawam, Hamdy and A. Al-Wakeel, Hanan and H. El-Nagdy, Mona and A. El-Refaey, Fatma and A. Abdel-Rahman, Hala}, title = {THE EXPRESSION PATTERN OF BMI-1 GENE IN ACUTE MYELOID LEUKEMIA}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {2}, pages = {507-514}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0038273}, abstract = {Objectives: B-cell specific moloney murine leukemia virus integration site-1 (BMI-1) gene is a stem cell gene that modulates stem cell pluripotency and is also implicated in the regulation and accumulation of leukemic stem cells (LSCs). The current study aimed at characterizing BMI-1 gene expression in de novo AML patients before the start of chemotherapy and in those who achieved complete remission (CR). Methods: Real-time polymerase chain reaction was used to assess the gene expression in 54 de novo AML patients: 43 AML and 11 in CR as well as in 21 non malignant bone marrow samples. Results: AML patients showed a higher BMI-1 median fold change in expression (median=0.157) as compared to AML-CR patients (median=0.000) but this difference was not statistically significant.  A higher median fold change was observed in patients with intermediate/unfavourable risk groups (2.381) than with favourable risk (0.000). BMI-1 expression levels were not seen to be influenced by clinicopatholoical factors of the disease or to affect response to first induction, overall and disease-free survival. Conclusion: The role of BMI-1 in myeloid leukemogenesis needs further delineation to determine its significance in acute leukemia pathogenesis. Our results point to its possible role in AML risk stratification but further studies are needed.}, keywords = {BMI-1,Haematopoietic stem cells,Acute Myeloid Leukemia}, url = {https://amj.journals.ekb.eg/article_56651.html}, eprint = {https://amj.journals.ekb.eg/article_56651_3e78ad028538487201d71589241119f5.pdf} } @article { author = {O. Nour, Mohamed and Mohamed, Khalil and AL Bishi, Amel and Amir, Maysa}, title = {INFECTION CONTROL AMONG HEALTHCARE PROVIDERS AT UMM AL QURA UNIVERSITY MEDICAL CENTER, MAKKAH, SAUDI ARABIA. A CROSS-SECTIONAL STUDY}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {2}, pages = {515-530}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0038274}, abstract = {Background: Healthcare associated infections (HCAI) are one of the most serious and complex worldwide health problems. Committment to standard precautions (SPs) and infection control (IC) measures are important to all healthcare providers (HCP) to prevent occupational exposure to hazardous materials. Objectives: This study aimed at evaluating the knowledge, attitude and practices (KAP) towards IC measures amongst HCP at Umm AL Qura University Medical Center, Makkah, Saudi Arabia. Subjects and methods: A cross-sectional descriptive study was conducted by using a pretested self-administered questionnaire. Convenience sampling was used, and the KAP scores of HCP towards IC measures were evaluated and correlated with their characteristics. Results: The study included 54 HCP with mean age 32.4±7.8 years, half of them were female and 42.6 % of them received previous training/orientation on IC and SPs in different forms. Participants' good KAP scores concerning the various aspects of IC measures were slightly below average (46-48%). No significant differences between the overall mean KAP scores and different characteristics of participants, but significant correlations were observed between knowledge and both attitude and practices scores. Conclusion: There was a gap between the actual and desired KAP of HCP regarding IC. Continuing education programs are needed to improve their KAP scores towards SPs and IC measures in order to reduce HCAI.}, keywords = {Knowledge,Attitude,Practices,Standard Precautions,Infection control,healthcare providers}, url = {https://amj.journals.ekb.eg/article_56652.html}, eprint = {https://amj.journals.ekb.eg/article_56652_dd3791cc32da1e9daff478bc0023feef.pdf} } @article { author = {Soltan, Sameh}, title = {COMPARATIVE STUDY OF ERYTHROPOIETIN AND EXTENDIN-4 ON ADULT MALE DIABETIC ALBINO RATS}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {2}, pages = {531-540}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0038275}, abstract = {Background: Erythropoietin (EPO) and exendin-4 are widely used intreatment of type 2 diabetes and enhance the general and metabolic conditions in diabetic patients. Objective: Assessing the effect of erythropoietin and exendin-4 administration on experimental diabetic adult male albino rats. Design: experimental design. Materials and Methods: Forty adult male albino rats of local strain were housed in 8 suitable metal cages (20 ×32× 20 cm for every 5 rats). They were divided into five equal groups: Group I served as a control group, group II was diabetic control, group III was diabetic group-treated with erythropoietin subcutaneously in a dose of 300 uint/kg 3 times a week for 4 weeks, group IV was diabetic group received exendin-4 intraperitonealy in a dose of 1 microgram /kg once daily for one week  period, and groupV was diabetic-treated with both drugs. Blood samples were collected for measuring fasting glucose, fasting insulin , cholesterol(CHO), triglycerides (TG), low density lipoprotein cholesterol (LDL-c), high density lipoproteins cholesterol (HDL-c), and hematological parametres: hematocrite value , hemoglobin content, red blood cells (RBCs) and white blood cells (WBCs) .      After induction of diabetes by alloxan, the first diabetic  group was kept diabetic without any treatment (diabetic control G II) , the second diabetic group was treated with erythropoietin subcutaneously in a dose of 300 uint/kg 3 times a week for 4 weeks (G III), the third diabetic group was treated with exendin-4 intraperitonealy in a dose of 1 microgram /kg once daily for one week (G IV), and the fourth diabetic group of rats was treated with both drugs (G V). Results: Alloxan-induced diabetes mellitus was associated with significant higher levels of blood glucose, total cholesterol, triglycerides and  LDL, and significantly lower levels of, insulin, , HDL and hematological parameters (HV,HB%,RBCs,WBCs)  as compared with normal control group. Erythropoietin injection in diabetic rats  produced significant lower levels of blood glucose, total cholesterol,  triglycerides and LDL, with significantly higher  levels of insulin, HDL and hematological parameters  as compared with control diabetic group. Exendin-4 showed significant lower levels of  blood glucose, total cholesterol and TG, and significant higher levels of HDL, and insignificant results on insulin and  hematological parameters  as compared with the control diabetic rats. Treatment of rats with erythropoeitin and exendin-4 resulted in significant lower levels of blood glucose, total cholesterol and  LDL, and significant high levels of insulin, HDL and hematological parameters as compared with control and other groups . Conclusion: Erythropoietin and exendin-4 were more potent in reducing hyperglycemia than the effect of each one separately. Erythropoietin improved the general condition of  diabetic rats due to its hematopoitic  effect.}, keywords = {EPO,exendin-4,alloxan,experimental diabetes}, url = {https://amj.journals.ekb.eg/article_56653.html}, eprint = {https://amj.journals.ekb.eg/article_56653_dd7ee52d588a40fe0e6193fc9be98ade.pdf} } @article { author = {Gad Alla, Ahmad and M Gad Alla, Ahmad and H Haredy, Haredy}, title = {COMPARATIVE STUDY BETWEEN BERBERINE AND EXENDINE 4 ON ADULT MALE DIABETIC ALBINO RATS}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {2}, pages = {541-556}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0038276}, abstract = {Background: Exendin-4 is a similar peptide to glucagon - like peptide-1, and can interfere with various receptors of glucagon  like peptide-1and is evaluated for the regulation of blood glucose in diabetes mellitus. Berberine  (BBR) is demonstrated to have a hypoglycemic effect in vitro and in vivo.  Objective: Comparing between the effects of berberine and exendine 4 on adult male diabetic albino rats. Materials and Methods: Thirty two adult male albino rats of local strain were housed in 8 suitable metal cages (20 × 32 × 20 cm for every 4 rats). They were divided into four equal groups: Group I served as a control group, group II was diabetic control, group III was diabetic group   treated with berberine, and group IV was diabetic group received exendin-4. Body weight was measured daily till the end of  the experimental period .Blood samples were collected for measuring fasting glucose, fasting insulin, homeostasis model assessment  insulin resistance ( HOMA –IR), C-peptide, glycosylated hemoglobin (Hb A1c), cholesterol(CHO), triglycerides (TG), low density lipoprotein cholesterol (LDL-c), and high density lipoproteins cholesterol (HDL-c). The pancreas of the sacrificed rats were excised and randomly processed for histological staining and biochemical assays for superoxide dismutase (SOD) and malondialdehyde (MDA).               Results: Alloxan-induced diabetes mellitus was associated with significant higher levels of blood glucose, HOMA –IR, Hb A1c, total cholesterol, triglycerides, LDL-c and pancreatic MDA with significantly lower levels of body weight, insulin, C-peptide, HDL-c and pancreatic SOD as compared with normal control group. Berberine in diabetic rats  produced significant lower levels of body weight, blood glucose, HOMA –IR,  Hb A1c,  total cholesterol,  triglycerides, LDL and pancreatic MDA with significantly higher  levels of insulin , C-peptide , HDL and pancreatic SOD as compared with control diabetic group. Exendin-4 showed significant lower levels of  blood glucose, HOMA –IR, total cholesterol, TG, LDL-c and pancreatic MDA levels, and significant higher levels of insulin , HDL-c, C-peptide and pancreatic SOD as compared with the control diabetic rats. Results of the present study showed that the effects of exendin-4 produced insignificant changes of body weight as compared with control diabetic group. Conclusion: Exendin-4 was more potent in reducing hyperglycemia than berberine, while berberine has a better body weight reduction. Furthermore, berberine treatment significantly increased pancreatic antioxidant enzymes activities as well as exendin-4. Berberine and exendin-4 treatment protected and preserved pancreatic β-cell architecture and integrity.}, keywords = {alloxan,berberine,exendin-4,Diabetes mellitus}, url = {https://amj.journals.ekb.eg/article_56654.html}, eprint = {https://amj.journals.ekb.eg/article_56654_f3aa36187224b1cdba64768a11e5026e.pdf} } @article { author = {Adel Attia, Mohammed and Ahmed Dabash, Tarek and Mohammed Mostafa, Ahmed and Ali Ramzi, Ali and Mustafa Emran, Tarek and Ali Hammad, Mohammed}, title = {CORRELATION BETWEEN LEFT VENTRICULAR FUNCTION AND MYOCARDIAL BLUSH GRADING IN PATIENTS WITH ISCHEMIC HEART DISEASE}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {2}, pages = {557-569}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0038277}, abstract = {Background: Myocardial blush is a simple, widely available, and virtually costless technique for the immediate diagnosis of microvascular impairment, and confirms myocardial tissue-level perfusion at time of coronary angiography. Objective: Emphasizing the correlation between left ventricular functions and angiographic evidence of myocardial blush grade (MBG) in patients with ischemic heart disease (IHD). Patients and Methods: The present study included fifty patients who had been admitted to AL-Azhar University Hospital (Damietta) between February 2015 and October 2015 by IHD, and eligible to coronary angiography. Patients in the study were subjected to full history with special emphasis on age, sex, other risk factors for coronary artery disease (CAD), and analysis of anginal pain. Echocardiography to assess LV functions was done immediately before coronary angiography and assessment of MBG. Results: The mean age of studied cases was 56.5 years. Most of our cases were males (68%), and the most frequent risk factor was hypertension (54%). Ejection fraction was within normal limits in 54% of cases. Mild, moderate and severe impairment of LV systolic functions were found to be 24, 10 and 12 % respectively. Most of the patients (47 for right coronary, 43 for left circumflex and 44 for left anterior descending arteries) had thrombolysis in myocardial infarction (TIMI) grade III. Myocardial blush grading was assessed for both right and left coronary arteries. The most frequent finding was grade III for both left (50%) and right (62%) systems, and the least was grade I for left (16%) and right (10%) systems. Impaired MBG of the left coronary system was associated with old age, male sex and low blood pressure, while right coronary system had no such association. Impaired MBG of both right and left coronaries was related to impairment of left ventricular systolic function, but not related to diastolic function. Also, degree of MBG was related to degree of TIMI on both right and left coronaries. In contrast, degree of systolic function by echocardiographic assessment was not related to TIMI of right coronary system or TIMI left circumflex (LCX) artery. Finally, MBG was related to degree of stenosis of all coronary arteries except LCX artery. Conclusion: Myocardial blush grade was correlated with left ventricular systolic function. Impaired myocardial blush grade was related to TIMI and degree of coronary stenosis. Impaired MBG of left system was associated with old age, male sex and low blood pressure.}, keywords = {Myocardial blush grades,Ischemic heart disease,Left Ventricular Function}, url = {https://amj.journals.ekb.eg/article_56655.html}, eprint = {https://amj.journals.ekb.eg/article_56655_5ffe7e82f2beb09a53e679a22cff236a.pdf} }