@article { author = {Salem, Raouf}, title = {DEFENSIVE MEDICINE AND THE PROTECTIVE EXTRAS}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {4}, pages = {1-1}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0045164}, abstract = {}, keywords = {}, url = {https://amj.journals.ekb.eg/article_57330.html}, eprint = {https://amj.journals.ekb.eg/article_57330_829fa5572f3b52e652ad4d8faa51224b.pdf} } @article { author = {Sonbol, Mostafa and Ibrahim, Wafik and Ghunaimi, Mohammed}, title = {ROLE OF ULTRASONOGRAPHY IN THE DIAGNOSIS OF CARPAL TUNNEL SYNDROME}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {4}, pages = {765-780}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0045165}, abstract = {Background: Carpal tunnel syndrome (CTS) is the most common form of peripheral entrapment neuropathy. The use of sonography for investigation and diagnosis of musculoskeletal conditions has been rapidly increasing over the past few decades. Recent studies have demonstrated advantages of sonographic techniques in the diagnosis of carpal tunnel syndrome (CTS). Objective: Assessing the utility of ultrasonography in the diagnosis of carpal tunnel syndrome (CTS) and grading its severity. Patients and Methods : Sixty hands in 46 patients with clinically and electro-physiologically confirmed carpal tunnel syndrome,  and sixty asymptomatic hands in 34 healthy individuals as control group were included in the study and underwent high-resolution ultrasonography of the wrists. In ultrasonographic assessment the cross-sectional area (CSA) of the median nerve at the distal crease of the wrist and flattening ratio (FR) of the median nerve in the carpal tunnel as well as palmar bowing (PB) of the flexor retinaculum were measured. Ultrasonographic Data from the patients group and control group were compared to determine the statistical significance. The accuracy of the ultrasonographic diagnostic criteria for carpal tunnel syndrome was evaluated using receiver-operating characteristic (ROC) curve analysis. Sensitivity and specificity of ultrasonographic measurements were evaluated. Ultrasonographic measurements were correlated with severity of CTS according to nerve conduction studies (NCS).    Results: The CSA of the median nerve and PB of the flexor retinaculum were significantly larger in the CTS hands compared to the normal control hands. However, FR of the median nerve showed no significant difference between both groups. Increased cross-sectional area of the median nerve was the most predictive measurement of carpal tunnel syndrome. Using the ROC curve, a CSA cut-off value of 10 mm² provided a diagnostic sensitivity of 93.3 % and specificity of 98.3 % and PB cut-off value of 3.3 mm provided a diagnostic sensitivity of 90 % and specificity of 85 %. No significant differences in CSA and PB were found among patients with mild, moderate and severe carpal tunnel syndrome so that CSA and PB did not reflect the severity of the condition. Conclusion: Ultrasonography is a useful non-invasive method for the diagnosis of carpal tunnel syndrome but not assessing its severity.}, keywords = {Carpal tunnel syndrome,Ultrasonography,Median nerve,Diagnosis}, url = {https://amj.journals.ekb.eg/article_57937.html}, eprint = {https://amj.journals.ekb.eg/article_57937_e3bed12257f89929823854c0b447502a.pdf} } @article { author = {M. B. Gamil, Nehal and M.Y. Mohamed, Soha and A. Abou-Bakr, Doaa and S. M. Elsaid, Basant}, title = {EFFECT OF VITAMIN E ON THE PROGRESSION OF RENAL ISCHEMIA REPERFUSION INJURY IN FEMALE RATS}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {4}, pages = {781-792}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0045166}, abstract = {Background: Acute kidney injury (AKI) is a common worldwide disorder that is associated with high morbidity and mortality. Its pathophysiology is complex including a triad of oxidative tissue damage, inflammation and activation of clotting cascade. Objective: Investigating the outcome of vitamin E acetate administration immediately after the induction of renal ischemia/reperfusion injury on its progression. Materials and Methods:  The present study was carried out on 48 adult female Wister rats, weighing 185-250 grams, randomly allocated into the following 3 groups: Sham-operated group (SHAM; nₒ=18), renal ischemia/reperfusion injury group (RIR; nₒ=20), and renal ischemia/reperfusion injury group treated with Vitamin E Acetate (RIRttt; nₒ=10).  Rats were subjected to measurement of initial and final body weights (IBW, FBW), absolute and relative kidney weights (AKW, RKW), serum level of urea and creatinine as renal function tests, prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrin degradation products (FDPs) as markers of blood coagulation, C-reactive protein (CRP) as an inflammatory marker, as well as plasma and renal tissue malondiadehyde (MDAp, MDAt) as oxidative stress markers, in addition to histopathological study of the kidney tissue. * The majority of preclinical studies in AKI were performed in males (Skrypnyk et al., 2016), so we focused to study the effect of RIR in female rats independent of estrus cycle. Results: RIR rat group showed significant increase in AKW, RKW, as well as serum levels of urea and creatinine compared to sham operated group, but there was no significant change in their PT, APTT, FDPs, CRP, MDAp, and MDAt compared to the sham operated group. RIRttt rat group exhibited insignificant changes in their AKW, RKW, serum urea, creatinine, PT, APTT, FDPs, CRP, MDAp, and MDAt compared to RIR. Histopathological study of RIR rat kidneys showed glomerular congestion with periglomerular edema and atrophy of some glomeruli as well as cystic tubular dilation with esinophilic cast with tubular epithelial necrobiosis, and these changes were not improved by vitamin E treatment in RIRttt rat kidneys. Conclusion: Vitamin E acetate administration in a single dose of 1000 mg/kg B.W. immediately after induction of RIR could not interfere with the progression of AKI as proved by the non significant changes in kidney function tests and histopathological picture.}, keywords = {AKI,RIR,Blood Coagulation,Oxidative Stress,inflammation and Vitamin E}, url = {https://amj.journals.ekb.eg/article_57939.html}, eprint = {https://amj.journals.ekb.eg/article_57939_944a75c99e95ad31db97705bc5c6ac06.pdf} } @article { author = {El–Ghamry, Fathy and Shalaby, Helmy and Al-Wassief, Ahmed and Zaema, Reda and El-Shorbagi, Mohammad}, title = {IMPACT OF SUSTAINED VIROLOGICAL RESPONSE OF VIRUS C OUTCOME ON TYPE II DIABETIC PATIENTS INSULIN RESISTANCE AND METABOLIC STATE}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {4}, pages = {793-806}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0045167}, abstract = {Background: Diabetes is one of the most prevalent non-communicable diseases throughout the world, affecting 415 million people in 2015.  Hepatitis C virus (HCV) infection is widespread, affecting up to 185 million people worldwide.  Interestingly, a systematic review has also shown a significant association between the presence of type 2 diabetes mellitus T2D and the risk of HCV infection.  Chronic HCV is associated with hepatic and peripheral insulin resistance (IR) . Objective: Investigating the impact of SVR12 following combination of Sofosbuvir and Daclatasvir on IR  and metabolic state in type 2 D.M. Patients and Methods: The study  was conducted on100 patients. Patients were divided in two groups; group I, that included 30 patients who have  both T2D  and HCV and did not receive  any anti viral drugs,  and they served as a control group. Group II, which included 70 patients as a case group who have  type 2 DM and HCV and received treatment for 12 weeks according to the Egyptian guidelines using Sofosbuvir and Daclatasvir, and achieved  SVR12. All patients were included in the final analysis investigated by fasting and postprandial blood sugar, full lipid profil, HbA1c and microalbuminuria,  HOMA- IR , fibroscan  and liver enzymes . Serum HCV-RNA was tested at baseline, after 4 weeks, end of treatment, and 12 weeks after the end of treatment. Results showed that cirrhotic patients showed worse metabolic profile as FBS, PPBS, HbA1c, and Homa - IR, serum cholesterol and serum triglycerides  compared to non cirrhotic ones at the start of the therapy.  Following the achievement of SVR, Group II patients showed a decrease in its mean fasting blood sugar, postprandial blood sugar, HbA1c, albuminuria , Homa - IR score, cholesterol,  triglycerides. Group I showed only improvement of cholesterol level. Normalization of  SGOT, SGPT, serum bilirubin and serum albumin was recorded only in group II patients, while INR level showed no change from its pretreatment level in  both groups. Additionally, fibroscan result improved in group II , while it increased in group I . So, the achievement of SVR in diabetic  patients with CHC have a favorable outcome on IR which was more pronounced in non cirrhotic patients. Conclusion: The achievement of SVR in patients with HCV and diabetes mellitus is associated with improvement in Insulin resistance and metabolic markers. This improvement can lead to stopping of anti-diabetic treatment with additional improvement of albuminuria which reflect improvement of vascular complications of IR.}, keywords = {}, url = {https://amj.journals.ekb.eg/article_57940.html}, eprint = {https://amj.journals.ekb.eg/article_57940_46a9d7ae1363b7aad65b10988880c3dc.pdf} } @article { author = {Mohammed Ibrahim, Ebtesam and F. El-Malkey, Nanees}, title = {EFFECTS OF -3 POLYUNSATURATED FATTY ACIDS SUPPLEMENTATION ON LIVER FUNCTION AND SERUM APELIN-13 IN TYPE II DIABETIC RATS}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {4}, pages = {807-824}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0045168}, abstract = {Background: Nonalcoholic fatty liver disease (NAFLD) is a chronic liver condition complicating type II diabetes. Insulin resistance (IR) plays a vital role in the pathogenesis of fatty liver in diabetes mellitus. Interestingly, both w-3 polyunsaturated fatty acids (w-3 PUFA) and apelin-13 have controversial relationship to IR and liver function. Objective: To demonstrate the effect of w-3 PUFA on serum apelin-13 and its association to liver function in type II diabetic rats. Material and methods: This study was conducted on 40 of  adult male albino rats divided into 3 groups: Control group (A) in which rats fed normal chow, type II diabetic group (B) in which type-II diabetes was induced by feeding the rats HFD for 2 weeks followed by a single intraperitoneal injection of streptozotocin (35 mg/kg BW), and type II diabetic treated group (C) in which rats treated with ω-3 PUFA (500mg/kg/day; orally) for 4 weeks after induction of diabetes. Results: There was a significant elevation in serum apelin-13, glucose, HOMA-IR, ALT, AST, plasma prothrombin and fibrinogen accompanied by significant decrease in serum insulin and albumin in group (B) when compared with control group. Treatment with PUFA in group (C) improved gluco-lipid metabolic parameters with significant reduction in serum apelin-13, ALT and AST. Linear regression analysis test showed that apelin-13 has no predictive value to the histological changes of liver injury in group B. Conclusion: Treatment of diabetic rats with w-3 PUFA improved insulin resistance, liver enzymes and decreased serum apelin-13 level. However, apelin-13 cannot be used as a non invasive laboratory marker to distinguish the severity of liver injury in type II diabetic rats.}, keywords = {Apelin,Insulin Resistance,Fatty Liver}, url = {https://amj.journals.ekb.eg/article_57951.html}, eprint = {https://amj.journals.ekb.eg/article_57951_a96941742f3ed54d207fbb293476bb1e.pdf} } @article { author = {A Habib, Marwa and S. Khalil, Sama}, title = {SERUM NESFATIN-1 LEVELS IN RAT MODEL OF NON-ALCOHOLIC FATTY LIVER DISEASE}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {4}, pages = {825-838}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0045169}, abstract = {Background: Non-alcoholic fatty liver disease (NAFLD) is a frequent progressive disorder manifested by fat accumulation in the liver and usually related to obesity and insulin resistance, but its pathogenesis is still uncertain. Nesfatin-1 is a polypeptide derived from nucleobindin-2 and involved in regulation of food intake and glucose homeostasis. The relationship between nesfatin-1 and NAFLD is still controversial. Objective: To evaluate serum levels of nesfatin-1 in NAFLD model induced by high fat diet (HFD) in male albino rats. Material and methods: Forty eight male adult albino rats were divided into four equal groups: 2 control groups that were fed ordinary diet for 4 weeks (group IA) and 12 weeks (group IB), and 2 HFD groups that were fed HFD for 4 weeks (group IIA) and 12 weeks (group IIB). In all groups, abdominal circumference, body weight, serum levels of nesfatin-1, insulin, glucose, C-reactive protein (CRP), lipid profile parameters, and liver enzymes (ALT & AST) were measured. BMI and HOMA-IR were calculated, and isolated liver tissues were examined histopathologically. Results: After 4-week and 12-week-HFD feeding, the rats developed simple steatosis and steatohepatitis, respectively. These were proved by the progressive rise of liver enzymes and the histopathological findings. Besides, there was a significant progressive rise in BMI, HOMA-IR, serum levels of nesfatin-1, glucose, insulin, CRP, and all lipid profile parameters except high density lipoprotein that significantly decreased in HFD groups in comparison to control groups. Moreover, nesfatin-1 correlated positively with all measured parameters in HFD groups except for HDL that showed negative correlation with nesfatin-1. Conclusion: Serum levels of nesfatin-1 increased in NAFLD rat model induced by HFD. This rise may be attributed to feeding rats with HFD, hyperglycemia or may compensate for the inflammation and disturbed metabolism.}, keywords = {NAFLD,Nesfatin-1,Lipid profile,HOMA-IR}, url = {https://amj.journals.ekb.eg/article_57952.html}, eprint = {https://amj.journals.ekb.eg/article_57952_bff42772f87a13f21b0d2e6a529621ce.pdf} } @article { author = {S Khalil, Sama and A Habib, Marwa}, title = {SERUM VASPIN LEVELS IN NORMAL PREGNANT AND GESTATIONAL DIABETIC ALBINO RAT MODEL}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {4}, pages = {839-850}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0045170}, abstract = {Background:Gestational diabetes mellitus (GDM) is a major pregnancy complication with increased blood glucose levels and insulin resistance. Vaspin is a visceral adipokine that is synthesized and secreted by abdominal fat tissue and one of the superfamily of serine protease inhibitors. Data proposed vaspin levels in normal pregnancy and GDM are still controversial. Objective : To assess serum vaspin levels in both of late pregnancy and experimentally-induced GDM in relation to certain metabolic parameters in albino rats. Material and methods: Thirty six virgin female albino rats of a local strain weighing 100-150 g were divided randomly into three equals groups. Group I (Control); virgin rats were fed normal diet. Group II (normal pregnant); rats were fed normal diet for five weeks before induction of pregnancy. Group III (experimentally-induced GDM); rats were fed fatty-sucrose diet (FSD) for five weeks before induction of pregnancy, then injected intraperitoneally with streptozotocin (25 mg/kg) on the 7th day of gestation. In all groups, serum vaspin, body mass index (BMI), serum estradiol, progesterone, total triglycerides (TG), total cholesterol (TC), low density lipoproteins-cholesterol (LDL-c), high density lipoproteins-cholesterol (HDL-c), glucose, insulin levels and calculated homeostatic model assessment of insulin resistance index (HOMA-IR) were estimated. Results: Normal pregnant rats showed a significant increase in BMI, serum vaspin, TG, TC, LDL-c, insulin levels and HOMA-IR compared to controls. Additionally, serum vaspin levels were significantly and positively correlated with BMI, serum glucose, TG levels and HOMA-IR. GDM-induced rats had significantly increased levels of serum vaspin, TC, TG, LDL-c, glucose, BMI and HOMA-IR, while decreased insulin and HDL-c levels compared to normal pregnant and control rats. Moreover, serum vaspin levels showed significant positive correlations with BMI, HOMA-IR, glucose, TG, TC levels, and an inverse correlation with HDL-c levels in GDM-induced group. Conclusion: Serum vaspin levels increased in both of late pregnancy and experimentally-induced GDM, but more in the later possibly for compensating GDM-induced insulin resistance and dyslipidemia. }, keywords = {Gestational diabetes mellitus,vaspin,Pregnancy,Insulin Resistance}, url = {https://amj.journals.ekb.eg/article_57954.html}, eprint = {https://amj.journals.ekb.eg/article_57954_82f34342636bc3ed6888bc4437a9cd3a.pdf} } @article { author = {Hosam Eldien Abou Shahba, Mohamed and Mohamed Hassan Hindam, Hedaya and Farouk El-Faresy, Mohamed}, title = {SURGICAL VENTRAL REDUCTION OF TRAUMATIC SUBAXIAL CERVICAL LOCKED FACET JOINT}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {4}, pages = {851-868}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0045171}, abstract = {Background: Locked cervical spine facets accounting more than 50% of cervical spine injuries. It is a highly unstable condition in need of realignment, decompression, reduction and fixation. Objective: Aprospective clinical case study to evaluate the effectiveness and safety of surgical anterior cervical decompression, reduction, and fixation approach for management of traumatic sub-axial cervical locked facets. Patients and Methods: We studied 30 patients with traumatic cervical sub axial locked facets managed surgically through anterior cervical decompression, reduction and anterior plate fixation. All patients were subjected to full general and neurological clinical assessment, routine laboratory work and neuroimaging by plain X-ray, CT scan and MRI cervical spine. All patients were assessed post-operatively, clinically and radiologically with regular follow up for one year. Results: This study included 30 patients (21 males and 9 females), with main age 39.3 years. The most common mode of trauma was road traffic accident in 23 patients. All patients presented by neck pain and cervical spine tenderness, and 23 patients presented by neurological deficits, mostly with bilateral facets cases 19 (82.6%). The most common affected level was C6-7, in 10 patients (33.3%). Traumatic disc herniation was presented in all cases with bilateral facets dislocation (23 cases -76.7%), and 4 cases with unilateral facet dislocation. All patients treated through anterior cervical approach, with main operative time 150 minutes, median operative blood loss 100 cc. One patient has intra-operative CSF leak, and no other intra-operative complications. Conclusion: Open ventral reduction, decompression and fixation was considered the initial choice for treatment and stabilization of cervical locked facets, with less complication and several advantages to the patients.}, keywords = {Cervical anterior approach,locked cervical facets,spinal cord injury,anterior plate}, url = {https://amj.journals.ekb.eg/article_57955.html}, eprint = {https://amj.journals.ekb.eg/article_57955_d5393b994b6e5cc867a5042f701445f0.pdf} } @article { author = {Abdelmokhles Abdelmottaleb, Neazy}, title = {ULTRASOUND-GUIDED VERSUS CONVENTIONAL INTERSCALENE BRACHIAL PLEXUS BLOCK}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {4}, pages = {869-878}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0045172}, abstract = {Background: Regional anesthesia can provide superior pain management and perhaps improve patient outcomes. Ultrasound guidance may be associated with better results of regional anesthesia block. Objective: Detection of the important differences between conventional and ultrasound guided interscalene block. Patients and methods: Following approval to enter the study and obtaining informed consents from the patients, sixty patients who scheduled for upper limb surgery were randomized into two equal groups: ● Group A: conventional interscalene brachial plexus block (ISBPB) using conventional landmark-guided interscalene block. ● Group B: Ultrasound-guided interscalene brachial plexus blockguided by two dimensional ultrasonic images. Results: Both groups were comparable as regard to patient demographics, surgical intervention and premedication. Ultrasound guided group had shorter time to detect the plexus, injection of local anesthesia, and shorter time of sensory blockage. However, the difference was statistically non-significant. On the other hand, ultrasound guided group had the advantages of significantly shorter time to reach motor blockade, and significant longer duration of both sensory and motor block. Finally, success rate was high in ultrasound guided group, but the difference was statistically non-significant. Conclusion: Conventional and Ultrasound-guided guidance provided comparable sensory block onset times, complications, and success rates in patients undergoing interscalene block. Ultrasound guided block showed significantly shorter time to reach motor blockade and significant longer duration of both sensory and motor block.}, keywords = {Interscalene,brachial plexus,Ultrasound}, url = {https://amj.journals.ekb.eg/article_58572.html}, eprint = {https://amj.journals.ekb.eg/article_58572_458b82a287e8d458e31c243d5ab8cdb6.pdf} } @article { author = {Hosam Eldin Abo Shahba, Mohammed and Mohamed Hendam, Hedaya and Mohamed Taha, Ahmed and Mohamed Abd-Alwahab Slama, Abd-Allah}, title = {UPDATES IN LAMINOPLASTY TECHNIQUES FOR TREATMENT OF MULTILEVEL CERVICAL STENOSIS}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {4}, pages = {879-892}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0045173}, abstract = {Background: The main goal of laminoplasty is to provide decompression of the spinal cord by widening the spinal canal, and used to gain wide access to the spinal canal to perform additional procedures, e.g. adequate dissection around the dural tube, duraplasty, and removal of spinal cord tumor. Objective: Across sectional cohort study to assess effectiveness and safety of laminoplasty in treatment of multilevel cervical canal stenosis and comparison of different techniques. Patients and Methods: We studied 20 patients with multilevel cervical canal stenosis undergoing cervical laminoplasty. All patients were subjected pre-operatively to full general and neurological clinical assessment, routine laboratory work and neuroimaging by plain X-ray, CT scan and MRI cervical spine. Results: This study included 20 patients (14 males and 6 females) and the mean age was 48.9 years. There were 7 patients with history of HTN and 5 patients with history of DM.There was a significant improvement post-operatively ofNurick grade score, Japanese Orthopedic Association scores and neck pain visual analog scale score. Conclusions: Laminoplasty is becoming an increasingly popular treatment for multilevel cervical stenosis due to cervical spondylotic myelopathy. Laminoplasty minimizes the risk of certain complications associated with other surgical options, such as graft and fusion-related complications.}, keywords = {Multilevel cervical stenosis,Laminoplasty}, url = {https://amj.journals.ekb.eg/article_58574.html}, eprint = {https://amj.journals.ekb.eg/article_58574_32c9fae4905013afc76282d99237727d.pdf} } @article { author = {K. Ramadan, Basma and A. A. Salama, Abeer and M. Meselhy, K}, title = {THE POSSIBLE EFFECTS OF OLEUROPEIN ON ADIPOSE TISSUE BROWNING IN TREADMILL EXERCISED OBESE RATS}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {4}, pages = {893-910}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0045174}, abstract = {Background: Obesity is considered to be a pandemic that has increased during the last decades. The energy burning capacity of brown adipose tissue (BAT) makes it an attractive target in anti obesity therapies. Several strategies are being examined to activate and recruit BAT with no side effects. Objective: To use olive tree waste (leaves) as a source of medicinally important phenolic compound oleuropein and to evaluate the possible effects of oleuropein on browning of white adipose tissue in exercised obese Rats.  Material and methods: Sixty adult male Wister albino rats were divided into six equal groups. Group I: Normal control, group II: Oleuropein treated group, group III: High fat diet (HFD), group IV: HFD plus oleuropein, group V: HFD plus exercise training, group VI: HFD plus exercise training and oleuropein. At the end of the experiment, the body weight and the serum levels of lipid profile, GSH, MDA, IL-6 and irisin hormone were determined. The abdominal adipose tissues were excised for the measurement of gene expression of adipose tissue uncoupling protein 1 (UCP1), and CD137. Results: Oleuropein treatment significantly decreased body weight. Serum cholesterol, triglycerides and LDL significantly decreased, while HDL significantly increased. Furthermore, oleuropein suppressed the increase in serum IL-6 significantly. Conclusion: Oleuropein supplementation may provide an effective therapeutic option for combating obesity as it possessed antioxidant and anti-inflammatory activities, as well as increased expression UCP1 and CD137 which promoted additional browning in BAT}, keywords = {Oleuropein,HFD,exercise,Browning of adipose tissue}, url = {https://amj.journals.ekb.eg/article_58579.html}, eprint = {https://amj.journals.ekb.eg/article_58579_0530ca7c334f18c6c5a28d73ea8990b8.pdf} } @article { author = {Ahmed Shawer, Gamal and Mahmoud Hewedi, Kamel and Ramadan Samaha, Shebl and Frag Ibrahim, Ahmad and Ahmed Mohamed, Mahmoud}, title = {STUDY OF NORMAL ADULT EEG AND PATTERNS OF UNCERTAIN CLINICAL SIGNIFICANCE}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {4}, pages = {911-918}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0045175}, abstract = {Background: Electroencephalogram (EEG) is a mean of investigation of cortical and subcortical brain functional activity. Certain benign patterns may be epileptiform, yet can occur in healthy individuals without clinical epilepsy. Objective: Study of normal adult EEG and patterns of uncertain clinical significance. Subjects and Method: The present study was conducted on 100 adult Egyptian subjects (64 males and 36 females). All were subjected to history taking, examination and EEG evaluation. Results: Fifteen percent of participants have benign variants in their recorded EEG including Mu Rhythm (4%), OIRDA (5%), and FIRDA (6%). OIRDA and Mu Rhythm were more predominant in females, unlike FIRDA which was more predominant in males. The prevalence of artifacts in recorded EEG was 97% among participants. Among participants, there was epileptic activity recorded in 11 % of them. The prevalence of benign variants in EEG in participants was 15 %. Conclusion: Recording EEG pattern in normal adults help in minimizing over-interpretation and over-treatment of patients.}, keywords = {}, url = {https://amj.journals.ekb.eg/article_58583.html}, eprint = {https://amj.journals.ekb.eg/article_58583_9139ee89033f9baab2e303b3eace7a70.pdf} } @article { author = {Abdelhamid Fathy, Maha}, title = {EFFECT OF CHRONIC AEROBIC EXERCISE TRAINING ON SERUM IRISIN LEVEL IN TYPE 2 DIABETIC RATS}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {4}, pages = {919-938}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0045176}, abstract = {Background: Exercise and diet play a key role in management of type 2 diabetes.  Skeletal muscles secrete a variety of substances named myokines that are believed to mediate the beneficial effect of exercise. Irisin is a peptide secreted by skeletal muscles in response to exercise and also by adipocytes. So, it can be considered as myokine and adipokine. Irisin was reported to have an influence on glucose homeostasis and lipid metabolism.     Objective: To study the effect of chronic aerobic swimming exercise on serum irisin levels in type 2 diabetic rats, and clarify the possible association between these levels and some metabolic parameters. Material and Methods: The present study was carried out on a total number of 40 adult male albino rats divided into four equal groups: group I (standard diet sedentary group): animals were fed normal laboratory chow diet with no exercise training; group II (standard diet exercised group):  the rats were assigned  to chronic swimming exercise protocol of moderate intensity (1 h /day, 5 days/week for 8 weeks); group III (type 2 diabetic sedentary group): type 2 diabetes was induced using high-fat diet and a single intra-peritoneal injection of streptozotocin (35 mg/kg) then rats remained sedentary in their cages throughout the experimental period, and group IV (type 2 diabetic exercised group): the rats were trained by the same swimming exercise protocol after induction of type 2 diabetes. Results: Serum irisin level significantly increased in group II compared to group I. In group III, irisin level decreased significantly compared to group I and II. A significant increase in irisin level was found in group IV compared to group III but still significantly lower than group I and II. The results also revealed a non-significant change in blood glucose, serum insulin, HOMA-IR and HOMA-β between group I and II. Blood glucose level and HOMA-IR increased significantly in group III in comparison with group I and II. However, they showed a significant decrease in group IV versus group III, but these levels remain significantly higher than those of group I and II. A non-significant change was found in serum free T3 levels among groups, while a significant decrease in serum free T4 was noticed in group III compared to group I, II and IV. Conclusion: Type 2 diabetes was associated with a significant decrease in serum irisin level, while chronic swimming exercise training induced a significant increase in serum irisin in both healthy and type 2 diabetic rats.}, keywords = {Irisin,Obesity,exercise,HOMA-IR}, url = {https://amj.journals.ekb.eg/article_58591.html}, eprint = {https://amj.journals.ekb.eg/article_58591_ab93a2c200d0d2552482b724fdcf2f4e.pdf} } @article { author = {F Mohammed, Mostafa}, title = {CHANGES OF PERIPAPILLARY NERVE FIBER LAYER AND FOVEAL THICKNESS MEASUREMENTS BY OPTICAL COHERENCE TOMOGRAPHY AFTER PHACOEMULSIFICATION IN NON-DIABETIC NON-GLAUCOMATOUS PATIENTS WITH SENILE GRADE 1+ CATARACT}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {4}, pages = {939-952}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0045177}, abstract = {Background: Optical coherence tomography (OCT) is widely used by ophthalmologists for diagnosing and following retinal diseases such as diabetic retinopathy (DR), and OCT measurement of peripapillary nerve fiber layer (NFL) thickness is valuable for glaucoma screening and detection of progression. Previous studies reported that the presence of visually significant cataract can affect the quality and accuracy of NFL and foveal thickness measurements by OCT because cataract increases light scattering and absorption. The effect of age related low grade cataract on OCT measurements has not been widely investigated. Objective: Studying the changes of peripapillary NFL and foveal thickness measurements by OCT after phacoimulsification and intraocular lens (IOL) implantation in non diabetic non glaucomatous patients with grade 1+ senile cataract.     Patients and methods: This prospective study included 20 eyes of 20 patients (12 females and 8 males) with grade 1+ senile cataract [according to world health organization (WHO) criteria for cataract grading] which permits OCT imaging with reliable signal strength (SS). Patients with chronic systemic diseases such as diabetes mellitus (DM) and uncontrolled hypertension were excluded. Patients with dense or posterior subcapsular (PSC) cataract, patients with high myopia and patients with signs or OCT findings of glaucoma or maculopathy were also excluded. Detailed personal history, medical history, and ophthalmic history were taken at base-line for all patients, and full ophthalmologic examination including refraction, best corrected visual acuity (BCVA), slit lamp examination of the anterior segment, applanation tonometry, and dilated fundus examination of the macula, disc, retinal blood vessels and retinal periphery by slit lamp biomicroscopy were done at base line examination. OCT images for peripapillary NFL and macula were taken for all participants preoperatively and after 5 weeks postoperatively at Al-Hussein University hospital using spectral OCT SLO combination imaging system (OPKO/OTI, USA). Results: The mean (M) age was 56.65±1.9 years. The M preoperative BCVA was 0.3±0.1. The M postoperative BCVA was 0.6±0.1. All preoperative and postoperative OCT images were reliable with SS ≥ 6. The M values of participants` minimum, average and maximum NFL measurements were increased significantly after phacoemulsification. The average NFL measurement increased significantly by 9.8 µm (11%) from 89.80±6.69 µm preoperatively to 99.6±3.82 µm postoperatively. By analyzing the NFL quadrants thickness scales, there was an increase in the peripapillary NFL M measurements in all quadrants postoperatively. This increase was statistically significant in the superior, nasal and inferior quadrants, while this increase was not statistically significant in the temporal quadrant. As regard macular OCT, the M foveal thickness increased significantly by 26.15 µm (15%) from 172.10 ± 50.05 µm preoperatively to 198.25 ± 27.95 µm postoperatively.          Conclusion:Peripapillary NFL and foveal thickness parameters may increase significantly after uncomplicated phacoemulsification and posterior chamber bag foldable IOL implantation. The optical effect of media opacity caused by cataract should be taken into consideration during follow up of cases by OCT such as glaucomatous and diabetic patients. Detailed general and ophthalmologic history, full ophthalmologic examination and previous investigations should be taken into consideration when patients were followed up using OCT, and any changes just as incidence of early cataract should be written in the OCT report.}, keywords = {Ocular coherence tomography,nerve fiber layer,foveal thickness,Cataract,signal strength}, url = {https://amj.journals.ekb.eg/article_58599.html}, eprint = {https://amj.journals.ekb.eg/article_58599_3df1e2948529c9cd88cb6b954bd73252.pdf} } @article { author = {A. Nassef, Noha}, title = {POTENTIAL ANTIDEPRESSANT EFFECT OF OLIVE OIL IN ADULT MALE RATS EXPOSED TO RESTRAINT STRESS: ROLE OF BRAIN STEM SEROTONIN}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {4}, pages = {953-964}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0045178}, abstract = {Background: Olive oil (OO) has neuroprotective effects and is inversely associated with depression risk. However, the role of neurotransmitter systems in the pathophysiology of depression is still unclear. Objectives: In the present study, the antidepressant effect of olive oil and the underlying neurochemical mechanism were investigated. Materials and methods: Twenty eight male albino rats were allocated into four equal groups: Control group, OO-supplemented group (OO was given in a daily dose of 300 μl/kg by gavage 5 days a week for 2 consecutive weeks, restraint stress (RS) group, and OO+RS group. Forced swim test was performed and immobility time was measured. Serotonin, malondialdehyde (MDA) and glutathione peroxidase (GPx) in the brain stem homogenate, and cortisol level in the serum were measured. Results: Restraint stress group showed significant decrease in immobility time during forced swimming test, along with significant increase in serum cortisol, serotonin and MDA, and significant decrease in GPx. In the OO+RS group, immobility time was significantly reduced compared to restraint stress group and compared to control group. Cortisol, serotonin and MDA decreased and GPx increased. Conclusion: Olive oil has antidepressant potential which could be mediated via its antioxidant not its neurochemical effects.}, keywords = {olive oil,Antidepressant,glutathione peroxidase,serotonin}, url = {https://amj.journals.ekb.eg/article_58606.html}, eprint = {https://amj.journals.ekb.eg/article_58606_ab84f2ebfb2e18e548af46bb823859bd.pdf} } @article { author = {Mabrouk Gabr, Nageh}, title = {EFFECTS OF POMEGRANATE (PUNICA GRANATUM L.) FRESH JUICE AND PEEL EXTRACT ON DIABETIC MALE ALBINO RATS}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {4}, pages = {965-980}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0045179}, abstract = {Background: Pomegranate is used in traditional medicine for its therapeutic properties. Objective: Evaluation of the effectiveness of pomegranate fresh juice and peel extract on diabetes mellitus. Material and Methods: Sixty adult male albino rats of local strain were distributed randomly into 6 equal groups: normal control group, control group received Pomegranate fresh juice (500 mg/kg body weight per rat orally), control group received Pomegranate peel extract (500 mg/kg body weight per rat orally), diabetic group received alloxan (140 mg/kg body weight intraperitoneally), diabetic group received Pomegranate fresh juice (500 mg/kg body weight per rat orally), and diabetic group received Pomegranate peel extract (500 mg /kg body weight per rat orally). Results: Oral administration of Pomegranate juice and peel extract to diabetic rats for 4 weeks significantly decreased serum levels of TC, TG, low density lipoproteins cholesterol (LDL-c), and liver enzymes when compared to the control group. Levels of high density lipoprotein cholesterol (HDL-c) and antioxidant enzymes significantly increased as compared to the control group. Histopathological examination of liver and pancreas of Pomegranate juice-treated groups showed amelioration of histological changes caused by high level of cholesterol in diabetic group. These results were more prominent by Pomegranate fresh juice than peel extract. Conclusion: Pomegranate has antioxidant and lipid lowering effects and improves the health of pancreatic islets of Langerhans in diabetic rats.}, keywords = {pomegranate,alloxan,diabetogenic,antiatherogenic,antioxidants,dyslipidemia}, url = {https://amj.journals.ekb.eg/article_58608.html}, eprint = {https://amj.journals.ekb.eg/article_58608_cbd09acb06991c0a6c6bab1b4a23a109.pdf} } @article { author = {F. El-Deek, Ahmed and M. El-Sayaad, Ibrahim}, title = {ULTRASONOGRAPHY VERSUS COMPUTED TOMOGRAPHY IN DIAGNOSIS OF ACUTE APPENDICITIS}, journal = {Al-Azhar Medical Journal}, volume = {46}, number = {4}, pages = {981-994}, year = {2017}, publisher = {Al-Azhar Scientific Medical Society}, issn = {1110-0400}, eissn = {}, doi = {10.12816/0045180}, abstract = {Background: Acute appendicitis (AA) is among the most common cause of acute abdominal pain. Imaging methods, such as ultrasonography (US) and computed tomography (CT), aimed at avoiding a misdiagnosis and facilitating earlier surgery, when necessary, have become increasingly important for decreasing the morbidity of the disease. Objective: This study aimed to compare the accuracy of US and CT in the diagnosis of AA. Patients and Methods: After local ethical approval and written consent taken, 107 patients with signs and symptoms suggesting AA, selected from emergency department of Al-Azhar University Hospital, New Damietta during the period from March, 2016 to April 2017. They were 63 males and 44 females, mean age was 17.09±3.02 years. 90 (84.11%) underwent surgery, and 17 patients (15.9%) were hospitalized for clinical observation after imaging (12 patients (11.2%) were dismissed from the hospital while 5 cases (4.7%) presented with positive CT findings underwent surgery). After history taking, full clinical examination and laboratory investigations, all patients were subjected to US and CT examination. All patients were reevaluated clinically, and a correlation was made between both sets of results. Accordingly, final decision was made. Accuracy was ascertained intra-operatively for those underwent appendectomy, and the results were compared with those found by radiological examination. The results were correlated with surgical and histopathologic findings. Results: Males affected more than females, and abdominal pain was present in 100%. The sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of US in diagnosis of AA in our study were found to be 91.7 %, 77.8 %, 94.3%, 70.0% and 88.9 % respectively.The sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of CT in diagnosis of AA were 98.8 %, 88.9 %, 98.8%, 88.9% and 97.8 % respectively. Conclusion: US should be the first-line imaging modality. As US sensitivity is limited, and non-confirmed US examinations, diagnostic strategies and algorithms should focus on clinical reassessment and CT examination.}, keywords = {acute appendicitis,Computed tomography,Ultrasound}, url = {https://amj.journals.ekb.eg/article_58612.html}, eprint = {https://amj.journals.ekb.eg/article_58612_63da9ed27686c42f96c2340cf4d580cb.pdf} }