ORIGINAL_ARTICLE
COMBINED REGIONAL NASAL BLOCK AND GENERAL ANESTHESIA VERSUS GENERAL ANESTHESIA WITH INDUCED HYPOTENSION TECHNIQUE DURING ENDOSCOPIC SINUS SURGERY
Background: Since the early development of functional endoscopic sinus surgery (FESS) in the 1970s, this technique has gained increasing popularity. Objective: To compare the efficacy of combined regional nasal anesthesia and general anesthesia -in a group of patients undergoing FESS versus the efficacy of general anesthesia. Patients and Methods: A double blinded study was carried out, in Al-Azhar University Hospitals on 40 adult patients undergoing endoscopic sinus surgery, Physical status (ASA I&II), after approval of the ethical committee of Al-Azhar University. Written consent was obtained from all patients. Every patient received an explanation to the purpose of the study and given a code number. The SPSS program was used for data handling. Results: After analysis of the data, the results have shown that the regional anesthesia in Group B could achieve better surgical fields, less blood loss, a stable hemodynamic profile with no need for the use of risky multimodal drugs, less anesthesia time, and better postoperative analgesia. Conclusion: Regional anesthesia of the nose after induction of general anesthesia in patients undergoing FESS is an effective method that can provide better surgical field visualization with fewer bleeding, more stable hemodynamic profile without the use of multimodal drugs, less anesthesia time, and better postoperative analgesia when compared to the induced hypotension technique.
https://amj.journals.ekb.eg/article_67533_72b3f28b239b8ae1f999f427ae3c4884.pdf
2020-01-01
1
14
10.21608/amj.2020.67533
Regional Nasal Block – Induced Hypotension
Surgical Field Visualization – FESS
Ismail
Owais Amin
1
Anesthesiology and Intensive Care Department, Faculty of Medicine, Al Azhar University
AUTHOR
Abdalla
Mohammad Abdalla
2
Anesthesiology and Intensive Care Department, Faculty of Medicine, Al Azhar University
AUTHOR
Ali
Abdalla Al-Kumity
3
Anesthesiology and Intensive Care Department, Faculty of Medicine, Al Azhar University
AUTHOR
Amr
Mohammad Al-Mowafy
a.mowafy@hotmail.com
4
Anesthesiology and Intensive Care Department, Faculty of Medicine, Al Azhar University
LEAD_AUTHOR
REFERENCES
1
Alan RA, David JR and Graham S (2001): Hypotensive anesthesia, Textbook of anesthesia. Pbl: Churchil Livingston, London, 4th edition, pp: 682-688.
2
Amorocho, M. C. and Fat, I. (2016): Anesthetic techniques in endoscopic sinus and skull base surgery. Otolaryngologic Clinics of North America, 49(3): 531-547.
3
Atighechi, S., Azimi, M. R., Mirvakili, S. A., Baradaranfar, M. H. and Dadgarnia, M. H. (2013): Evaluation of intraoperative bleeding during an endoscopic surgery of nasal polyposis after a pre-operative single dose versus a 5-day course of corticosteroid. European Archives of Oto-Rhino-Laryngology, 270(9), 2451-2454.
4
Boberg-Ans J, and Barner SS (1980): Neural blockade for ophthalmologic surgery. In: Cousins MJ, Bridenbaugh PO, eds, Neural Blockade in clinical Anesthesia and management of pain. Pbl: JB Lippincott, Philadelphia, pp: 443-462.
5
DeMaria S, Govindaraj S, Chinosorvatana N, Stanley Kang, and Adam Levine (2012): Bilateral sphenopalatine ganglion blockade improves postoperative analgesia after endoscopic sinus surgery. American Journal of Rhinology & Allergy, 26(1): e23-7.
6
Douglas R and Wormald PJ (2006): Pterygopalatine fossa infiltration through the greater palatine foramen: where to bend the needle. Laryngoscope, 116(7):1255-7.
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Dyomina, E. N., Kastyro, I. V. and Drozdova, G. A. (2015): Evaluation of autonomic nervous system in patients with chronic rhinosinusitis and olfactory disorder. RUDN Journal of Medicine, 3: 40-45.
8
Ghanem MT and Elmalt A (2017): Local anesthesia with sedation versus local anesthesia after general anesthesia for sinus surgery: a randomized trial. Research and Opinion in Anesthesia and Intensive Care, 4(4): 188-194.
9
Govindaraj, S., Adappa, N. D. and Kennedy, D. W. (2010): Endoscopic sinus surgery: evolution and technical innovations. The Journal of Laryngology & Otology, 124(3): 242-250.
10
Ismail, S. A. and Anwar, H. M. (2005): Bilateral sphenopalatine ganglion block in functional endoscopic sinus surgery under general anaesthesia. AJAIC, 8(4): 45-53.
11
Kastl, K. G., Betz, C. S., Siedek, V. and Leunig, A. (2009): Control of bleeding following functional endoscopic sinus surgery using carboxy-methylated cellulose packing. European Archives of Oto-Rhino-Laryngology, 266(8): 1239-1243.
12
Kesimci, E., Öztürk, L., Bercin, S., Kırış, M., Eldem, A. and Kanbak, O. (2012): Role of sphenopalatine ganglion block for postoperative analgesia after functional endoscopic sinus surgery. European Archives of Oto-Rhino-Laryngology, 269(1): 165-169.
13
Ma’somi A and Abshirini H (2013): Comparison of local anesthetic effect of bupivacaine versus bupivacaine plus dexamethasone in nasal surgery. Iranian Journal of Otorhinolaryngology, 25(70): 7-10
14
Miłoński, J., Zielińska-Bliźniewska, H., Golusiński, W., Urbaniak, J., Sobański, R. and Olszewski, J. (2013): Effects of three different types of anaesthesia on perioperative bleeding control in functional endoscopic sinus surgery. European Archives of Oto-Rhino-Laryngology, 270(7): 2045-2050.
15
Mohseni, M. and Ebneshahidi, A. (2011): The effect of oral clonidine premedication on blood loss and the quality of the surgical field during endoscopic sinus surgery: a placebo-controlled clinical trial. Journal of Anesthesia, 25(4): 614-618
16
Park, S. S., Yoon, B. N., Cho, K. S. and Roh, H. J. (2010): Pneumatization pattern of the frontal recess: relationship of the anterior-to-posterior length of frontal isthmus and/or frontal recess with the volume of agger nasi cell. Clinical and Experimental Otorhinolaryngology, 3(2): 76-83.
17
Rayan AA (2016): Controlled hypotensive anesthesia for functional endoscopic sinus surgery: a new protocol for dexmedetomidine administration. Ain-Shams Journal of Anaesthesiology, 9(1): 57-65.
18
Rezaeian A, Hashemi SM and Dokhanchi ZS (2019): Effect of Sphenopalatine Ganglion Block With Bupivacaine on Postoperative Pain in Patients Undergoing Endoscopic Sinus Surgery. Allergy & Rhinology, 10: 2152656718821282.
19
Scott, J. R., Sowerby, L. J. and Rotenberg, B. W. (2017): Office-based rhinologic surgery: a modern experience with operative techniques under local anesthetic. American Journal of Rhinology & Allergy, 31(2): 135-138.
20
Takahashi Y, Kakizaki H, and Nakano T (2011): Infraorbital foramen: horizontal location in relation to ala nasi. Ophthal Plast Reconstr Surg., 27(4): 295-7.
21
Turk D C and Melzack R (2001): Self report scales and procedures for assessing pain in adults, Handbook of pain assessment, Pbl: The Gulford press, New York, 2nd edition, pp: 20, 21.
22
Zide BM and Swift R (1998): How to block and tackle the face [published correction in plast Reconstr. Surg., 101: 840-851.
23
ORIGINAL_ARTICLE
A COMPARATIVE STUDY OF CANAGLIFLOZIN (INVOKANA) ON TYPE-I AND TYPE-II DIABETES MELLITUS ON ADULT MALE ALBINO RAT
Background: Glycemic control is important in diabetes mellitus to minimize the progression of the disease and the risk of potentially devastating complications. Inhibition of the sodium glucose cotransporter (SGLT2-inhibitor) induces glucosuria and has been established as a new anti-hyperglycemic strategy. Canagliflozin is approved as sodium glucose co-transporter 2 inhibitors (SGLT2-inhibitor), plays a distinct and complementing role in glucose homeostasis.
Objective: Comparing the effects of Canagliflozin on streptozotocin-induced type-I and type- II- diabetes in adult male albino rat.
Materials and Methods: Sixty male albino rats were randomly categorized into 6 equal groups; Group I (Normal control group): Rats received 2 ml/100 g Na citrate buffer by intraperitoneal injection, Group II (Normal-Canagliflozin-treated-group): Rats received Canagliflozin (10 mg/kg/day, orally), Group III (Streptozotocin-induced type-I diabetic group): Rats were subjected to induction of diabetes by a high single intraperitoneal injection of streptozotocin 65 mg/kg body weight in citrate buffer, Group IV (Streptozotocin- nicotinamide- induced type-II diabetic group): The overnight fasted rats were subjected to induction of diabetes by a small single intraperitoneal injection of streptozotocin 40 mg/kg body weight (2 ml/100 gram) in citrate buffer and nicotinamide in a dose of 110 mg/kg boy weight 15 minutes before streptozotocin injection, Group V (Streptozotocin + Canagliflozin): Received a high dose of streptozotocin (65 mg/kg body weight) and Canagliflozin (10 mg/kg/day, orally), and Group VI (Streptozotocin + nicotinamide + Canagliflozin): Received a small dose of streptozotocin (40 mg/kg body weight), nicotinamide (110 mg/kg body weight), and Canagliflozin (10 mg/kg/day, orally). At the end of the experimental period, blood samples were collected for measuring of fasting serum glucose level, insulin level, C-peptide level, total cholesterol, triglycerides (TG), cholesterol- low density lipoproteins (LDL-C), cholesterol-high density lipoproteins (HDL-C), aspartate transaminase (AST), and alanine transaminase (ALT). Histopathological studies of the pancreas were done.
Results: Streptozotocin-induced diabetes mellitus was associated with significant higher levels of serum blood glucose, total cholesterol, TG and cholesterol- LDL-C, AST, and ALT, with significant lower levels of insulin, C-peptide, and HDL-C as compared to the control normal group. Canagliflozin showed significant lower levels of blood glucose, total cholesterol, TG, LDL-C, AST, and ALT, and significant higher levels of insulin, C-peptide, and HDL-C as compared with the diabetic rats. There were insignificant changes also between groups V and VI in all parameters.
Conclusion: Canagliflozin improved glycemic, lipidemic disturbances, liver enzymes, and have a potent tissue protective and regenerative effects for the pancreas.
https://amj.journals.ekb.eg/article_67534_8d2d043f17c4568db116c8829fc19645.pdf
2020-01-01
15
32
10.21608/amj.2020.67534
Canagliflozin
Invokana
streptozotocin
Diabetes mellitus
hyperlipidemia
Nageh
Mabrouk Gabr
gabrnageh@yahoo.com
1
Departments of Medical Physiology, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Ibrahim
Hassan Mohammed
2
Departments of Medical Biochemistry, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Abdul-Ghani, M.A., Norton, L. and Defronzo, R.A. (2011): Role of sodium-glucose cotransporter 2 (SGLT 2) inhibitors in the treatment of type 2 diabetes. Endocr. Rev., 32(4):515–31.
2
Adeyemi, D.O., Komolafa, O.A., Adewole, O.S., Obuotor, E.M., Abiodun, A.A. and Adenowo, T.K. (2015): Histomorphological and morphometric studies of the pancreatic islet cells of diabetic rats treated with extract of Annonamuricata. Folia Morphol., 69(2): 92–100 .
3
Adeyi, A., Idowu, B., Mafiana, C., Oluwalana, S., Ajayi, O. and Akinloye, O. (2012): Rat model of food-induced non-obese-type 2 diabetes mellitus: comparative pathophysiology and histopathol-ogy. Intl J Physiol Pathophysiol Pharmacol., 1:51–8.
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American Diabetes Association (2018): Diagnosis and classification of diabetes mellitus. Diabetes Care, 39(1): 81-90.
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Berhan, A. and Barker, A. (2013): Sodium glucose co-transports 2 inhibitors in the treatment of type 2 diabetes mellitus: a meta-analysis of randomized double-blind controlled trials. BMC Endocr. Disord., 13(1):58-59.
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Chaudhury, A., Duvoor, C., Dendi, V.R., Kraleti, S., Chada, A., Ravilla, R., Marco, A., Shekhawat, N.S., Montales, M.T., Kuriakose, K., Sasapu, A. , Beebe, A., Patil, N., Musham, C.K., Lohani, G.P. and Mirza, W. (2017): Clinical Review of Antidiabetic Drugs: Implications for Type 2 Diabetes Mellitus Management. Front. Endocrinol., 8 (6): 1-12.
7
Gautam, A., Agrawal, P.K., Doneria, J. and Nigam, A. (2018): Effects of Canagliflozin on Abnormal Liver Function Tests in Patients of Type 2 Diabetes with Non-Alcoholic Fatty Liver Disease. Journal of the Association of Physicians of India, 66(1): 62-65.
8
Gokhan, Tahir, S.O., Humyra, B., Ozlem, B. and Sebahat, O. (2017): C-peptide Measurement may not be Necessary for Choosing a Treatment Modality in Type 2 Diabetes Mellitus: A Retrospective Analysis C-peptid. Turk. J. Endocrinol. Metab., 21:68-71.
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Gurbet, C., Asij, S., Serdar, K., Sevki A., Orhan, A. and Alaattin, S. (2013): A Comparative Study for the evaluation of two doses of ellagic acid on hepatic drug metabolizing and antioxidant. Bio. Med. Research International, 9: 358945-55.
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Hadi, A., Pourmasoumi, M., Najafgholizadeh, A., Kafeshani, M. and Sahebkar, A. (2018): Effect of purslane on blood lipids and glucose: A systematic review and meta‐analysis of randomized controlled trials. Phytotherapy Research, 18: 1–10.
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Iranshahy, M., Javadi, B., Iranshahi, M., Jahanbakhsh, S.P., Mahyari, S., Hassani, F.V. and Karimi, G. (2017): A review of traditional uses, phytochemistry and pharmacology of Portulaca oleracea L. J Ethnopharmacol., 9(205):158-172.
12
Jabbour, S.A., Hardy, E., Sugg, J. and Parikh, S. (2014): Dapagliflozin is effective as add-on therapy to sitagliptin with or without metformin: a 24-week, multicenter, randomized, double-blind, placebo-controlled study. Diabetes Care, 37: 740-50.
13
Kaveh, M., Eidi, A., Nemati, A. and Boskabady, M.H. (2017): Modulation of lung inflammation and immune markers in asthmatic rats treated by Portulaca Oleracea. A.J.P., 7(5): 409-16.
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Kim, S.Y., Johnson, M.A., McLeod, D.S., Alexander, T., Hansen, B.C., Lutty, GA. (2015): Neutrophils are associated with capillary closure in spontaneously diabetic monkey retinas. Diabetes; 54: 1534-42
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Krishna, V.R., Amuthalakshmi, S. and Nalini, C.N. (2018): Validation of a stability-indicating reverse phase method for determination of canagliflozin API. World Journal of Pharmaceutical Research, 7(3): 459-468.
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Leiter, L.A., Forst, T., Polidori, D., Balis, D.A., Xie, J. and Sha, S. (2018): Effect of canagliflozin on liver function tests in patients with type 2 diabetes. Diabetes Metab., 42 (1): 25-32.
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Madkor, H.R., Mansour, S.W. and Ramadan, G. (2011): Modulatory effects of garlic, ginger, turmeric and their mixture on hyperglycaemia, dyslipidaemia and oxidative stress in streptozotocin – nicotinamide diabetic rats. British Journal of Nutrition, 105: 1210-1217.
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Marcelo, S., Pinheiro, 1., luhara, S,. rodrigues, 1., Eila, S., Neto,1., Rafaianne, Q., Moraes, 1., Thaigra, S,. Soares, 1., MadilEine, f., Americo, 1., Kieber, E., Campos, 1., Debora, c., Dama, S. and Gustavo, T. (2017): Effect of Bauhinia holophylla treatment in Streptozotocin-induced diabetic rats. Anais da Academia Brasileira de Ciências, 89 (1): 263-272.
19
Mikhail, N. (2014): Safety of canagliflozin in patients with type 2 diabetes. Curr .Drug Saf., 9:127–32.
20
Mori, K., Saito, R., Nakamaru, Y., Shimizu, M., Yamazaki, H. (2016): Physiologically based pharmacokinetic-pharmacodynamic modeling to predict concentrations and actions of sodium-dependent glucose transporter2 inhibitor canagliflozin in human intestines and renal tubules. Drug Dispos., 37(8):491-506.
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Nazeam, J.A., El-Hefnawy, H.M., Omran, G. and Singab, A. (2018): Chemical profile and antihyperlipidemic effect of Portulaca oleracea L. seeds in streptozotocininduced diabetic rats. Natural Product Research, 32(12): 1484–1488.
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Olga, M., Kerenaftali, K., Sudhesh, K., Kamlesh, K. and Sanjoy, K. P. (2018): Addition of or switch to insulin therapy in people treated with glucagon like peptide-1 receptor agonists: A real-world study in 66583 patients. American Diabetes Association J., 8:103-116.
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Omolaoye, T., Stefan, S., Du, Pl. and Bonelike, S. (2017): Diabetes mellitus- induction: Effect of different streptozotocin doses on male reproductive parameters. Acta Histochemica, 120: 103-109
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Park, J.E., Lee, J.S., Lee, H.A. and Han, J.S. (2018): Portulaca oleracea L. Extract Enhances Glucose Uptake by Stimulating GLUT4 Translocation to the Plasma Membrane in 3T3-L1 Adipocytes. J. Med. Food, 18: 1–7.
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Parveen, R., Agarwal, N.B., Kaushal, N., Mali, G. and Raisuddin, S. (2019): Efficacy and safety of canagliflozin in type 2 diabetes mellitus: systematic review of randomized controlled trials. Expert Opin Pharmacother., 9:1-11.
26
Ranjan, D., Sharma, A. and Babu, R. (2018): Saxagliptin and Dapagliflozin for type 2 Diabetes mellitus: A Review. International Journal of Drug Regulatory Affairs, 6(3):24-30.
27
Seyedeh, Z., Moklesur, R., Asmah, R., Saad, A. and Fauziah, O. (2017): The effect of pomegranate fresh juice versus pomegranate seed powder on metabolic indices, lipid profile, inflammatory biomarkers, and the histopathology of pancreatic islets of Langerhans in streptozotocin-nicotinamide-i induced type 2 diabetic Sprague–Dawley rats. BMC Complementary and Alternative Medicine, 17:156-166.
28
Sindhuja, M., muthiah, N.S. and Rajeswari, R. (2017): Comparative efficacy of canagliflozin versus empagliflozin on oxidative stress – in-vitro method. Int J Pharma Bio Sci., 8(4): (P) 232-236.
29
Sloan, J.H., Siegel, R.W. and Ivanova, Y.T. (2012): A novel high-sensitivity electrochemiluminescence (ECL) sandwich immunoassay for the specific quantitative measurement of plasma glucagon. Clin. Biochem., 45: 1640-1644.
30
Takebayashi, K., Hara, K., Terasawa, T., Naruse, R., Suetsugu, M., Tsuchiya, T. and Inukai, T. (2017): Effect of canagliflozin on circulating active GLP-1 levels in patients with type 2 diabetes: a randomized trial. Endocr. J.., 64(9):923-931.
31
Tatiana, Y., Lulu, C., Weifeng, T., Peter, J., Greasley, K., Helena, P., Susanne, J., Kirill, P., Gabriel, H., David, W., Boulton,Y. and Robert, C. P. (2019): Comparison of the urinary glucose excretion contributions of SGLT2 and SGLT1: A quantitative systems pharmacology analysis in healthy individuals and patients with type 2 diabetes treated with SGLT2 inhibitors. Diabetes Obes. Metab., 1–10.
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Vagula, M.C., Mastro, M. and Caputo, J. (2014): Cognitive impairment and dementia in Type 2 diabetes mellitus. US Pharm., 39(10): 33-37.
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Vivian, A.F., Merri, P. and Roberta, H.M. (2014): Complications of Diabetes in Clinical Practice. Pbl. Springer-Verlag London, limited, (5): 41-43.
34
Wang, N., Zhang, P., Xiao, Y. X., Zhao, Y., Zhang, B., Xin, W. and Wen, Y. (2017): Associations between changes in glucagon-like peptide-1 and body weight reduction in patients receiving acarbose or metformin treatment. Journal of Diabetes, 9: 728–737.
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Yin, L., Kenji, A., Kiichiro, U., Matsushita, Y., Kuriyama, C., Martin, T., Du, F., Liu, Y., Xu, J., Conway, B., Conway, J., Polidori, D., Ways, K. and Demarest, K. (2012): Effect of Canagliflozin on Renal Threshold for Glucose, Glycemia, and Body Weight in Normal and Diabetic Animal Models. Plos. One, 7 (2): 1-7.
36
Zurek, A.M., Yendapally, R. and Urteaga, E. M. (2017): A Review of the Efficacy and Safety of Sodium–Glucose Cotransporter 2 Inhibitors: A Focus on Diabetic Ketoacidosis. Diabetes Spectr., 30(2): 137–142.
37
ORIGINAL_ARTICLE
PREVALENCE AND RISK FACTORS FOR HEPATITIS C VIRUS INFECTION AMONG GENERAL POPULATION IN LUXOR GOVERNORATE, EGYPT
Background: Hepatitis C virus (HCV) is one of the hepatitis viruses that transmitted through blood or blood products. HCV has been implicated as a major reason of chronic liver disease and hepatocellular carcinoma worldwide. Objective: This study aimed to determine the seroprevalence of HCV antibodies among community in Luxor governorate, Egypt. Moreover to assess if there is any association with the population group, sex, age and other different risk factors. Patients and methods: We randomly selected 745 blood samples; from males and females of different ages (20-65 years). Samples were collected from Luxor governorate, Egypt. Seras from all subjects were tested for hepatitis C virus antibodies using rapid test method and confirmed by the enzyme linked immunosorbent assay (ELISA third generation). Results: Our results showed that 584 (78.40 %) of the community were males and most of them aged between 31 and 50 years. Thirty two (5.48%) from blood samples of males were anti-HCV seropositive, and the highest prevalence of anti-HCV (7.22%) of age groups from 41-50 years. One hundred and sixty one (21.60%) from the community were female and most of them aged between 41 - 65 years. Six (3.73%) of female subjects tested positive for anti-HCV and the highest prevalence of anti-HCV (4.87%) was with age groups from 31-40 years. Four risk factors reflecting high mechanisms of HCV transmission have been associated with HCV infection including residing in rural areas, no education, blood transfusion, and dental treatment. Exposures to surgery and history of schistosomiasis showed low association with Anti-HCV. Among the community exposures, were blood donation and alcohol consumption but these associations were not important. Conclusion: This study has been conducted to determine the prevalence rate of anti-HCV among community in Luxor governorate, Egypt.
https://amj.journals.ekb.eg/article_67535_5f3878dc55735870728d83371b5c913e.pdf
2020-01-01
33
44
10.21608/amj.2020.67535
HCV
Hepatitis
anti-HCV
Ahmed
M. El-Adly
ahmedeladly.ast@azhar.edu.eg
1
Botany and Microbiology Department, Faculty of Science, Al-Azhar University, (Assiut)
LEAD_AUTHOR
Ahmed
Wardany
2
Botany and Microbiology Department, Faculty of Science, Al-Azhar University, (Assiut)
AUTHOR
Mohamed
F. M. Morsy
3
Hepatology and gastroenterology and infectious diseases Department, Faculty of Medicine, Al-Azhar University, (Assiut)
AUTHOR
REFERENCES
1
Abdel-Aziz F, Habib M, Mohamed MK, Abdel-Hamid M and Gamil F (2000): Hepatitis C virus (HCV) infection in a community in the Nile Delta: population description and HCV prevalence. Hepatology, 32(1): 111-115.
2
Abo-Amer YE, Abd-Elsalam S, Eldosoky H, ELShenawy AK, Awny S, Elagawy W, El Abgeegy M, Elsergany HF, Elashry H and Negm MS (2018): Declining prevalence of hepatitis C virus among university students in one of the main governorates in Egypt. Infect. and Drug Resist,11: 2435–2441.
3
Amer FA, Gohar M and Yousef M (2015): Epidemiology of Hepatitis C Virus Infection in Egypt. International Journal of Tropical Disease & Health 7(3): 119-131.
4
Ayele AG and Gebre Selassie S (2013): Prevalence and risk factors of hepatitis B and hepatitis C virus infections among patients with chronic liver diseases in public hospitals in Addis Adaba, Ethiopia. ISRN Tropical Medicine, 1-7.
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7
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El-Ghitany EM (2019): Hepatitis C Virus Infection in Egypt: Current Situation and Future Perspective. J of High Institute of Public Health, 49(1):1-9.
11
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13
Frank C, Mohamed MK, Strickland GT, Lavanchy D and Arthur RR (2000): The role of parenteral antischistosomal therapy in the spread of hepatitis C virus in Egypt. Lancet, 355(9207): 887-891.
14
Gitto S, Micco L, Conti F, Andreone P and Bernardi M, (2009): Alcohol and viral hepatitis: A minireview. Dig Liver Dis, 41(1): 67-70.
15
Habib M, Mohamed MK, Abdel-Aziz F, Magder LS and Abdel-Hamid M (2001): Hepatitis C virus infection in a community in the Nile Delta: risk factors for seropositivity. Hepatology, 33(1): 248-253.
16
Kalil KA, Farghally HS, Hassanein KM, Abd-Elsayed AA and Hassanein FE (2010): Hepatitis C virus infection among paediatric patients attending University of Assiut Hospital, Egypt. East Mediterr Health Journal, 16(4): 356-361.
17
Mastoi AA, Devrajani BR, Shah SZ, Rohopoto Q and Memon SA (2010): Metabolic investigations in patients with hepatitis B and C. World Journal Gastroenterol, 16(5): 603-607.
18
Mazen N, Serag E, Hamdy A, Rasha MA, Ahmed H and Yehia MN (2019): Clinical Characteristics of HCV in Egyptian Patients. EC Gastroenterol. and Diges Sys, 6(2): 168-179.
19
Miller FD and Abu-Raddad LJ (2010): Evidence of intense ongoing endemic transmission of hepatitis C virus in Egypt. Proc Natl Acad Sci USA, 107 (33): 14757-14762.
20
Mohamed MK, Abdel-Hamid M, Mikhail NN, Abdel-Aziz F and Medhat A (2005): Intrafamilial transmission of hepatitis C in Egypt. Hepatology, 42(3): 683-687.
21
Mohlman MK, Saleh DA, Ezzat S, Abdel-Hamid M and Korba B (2015): Viral transmission risk factors in an Egyptian population with high hepatitis C prevalence. BMC Public Health, 15: 1030.
22
Mousa SM, El-Ghamrawy MK, Gouda H, Khorshied M and Ahmed DA (2016): Prevalence of Hepatitis C among Egyptian Children with Sickle Cell Disease and the Role of IL28b Gene Polymorphisms in Spontaneous Viral Clearance. Mediterr. Journal Hematol. Infect. Dis, 8(1): e201600.
23
Pawlowska M, Domagalski K, Pniewska A, Smok B and Halota W (2015): What’s new in hepatitis C virus infections in children? World Journal Gastroenterol, 21(38): 10783-10789.
24
Ramarokoto CE, Rakotomanana F, Ratsitorahina M, Raharimanga V and Razafindratsimandresy R (2008): Seroprevalence of hepatitis C and associated risk factors in urban areas of Antananarivo, Madagascar. BMC Infect Dis, 8: 25.
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Sharma S, Carballo M, Feld JJ and Janssen HL (2015): Immigration and viral hepatitis. Journal Hepatol, 63(2): 515-522.
26
Shepard CW, Finelli L and Alter MJ (2005): Global epidemiology of hepatitis C virus infection. Lancet Infect Dis 5(9): 558-567.
27
Siddiqui FA, Akhtar K, Sherwani RK, Rehman K and Alam F (2009): Prevalence of Hepatitis C virus in Aligarh: A seven year experience. Indian Journal Community Med, 34(3): 264-265.
28
Stoszek SK, Abdel-Hamid M, Narooz S, El Daly M and Saleh DA (2006). Prevalence of and risk factors for hepatitis C in rural pregnant Egyptian women. Trans. R. Soc. Trop. Med. Hyg, 100(2): 102-107.
29
Svirtlih N, Jevtovic D, Simonovic J, Delic D and Dokic L (2007): Older age at the time of liver biopsy is the important risk factor for advanced fibrosis in patients with chronic hepatitis C. Hepatogastroenterology, 54(80): 2324-2327.
30
Vallab GB, Vazhavandal, A. Uma and Chitra Rajalakshmi (2014): Seroprevalence of Hepatitis C Virus Infection among Patients attending a rural teaching hospital in South India: A Three Year Study. Int. Journal Curr. Microbiol. App. Sci, 3(2): 123-127.
31
Verma R, Behera BK, Jain RB, Arora V and Chayal V (2014): Hepatitis C: A silent threat to community of Haryana, India: A community based study. Australas Med. Journal, 7(1): 11-16.
32
Wasley A and Alter M (2000): Epidemiology of hepatitis C: geographic differences and temporal trends. Semin Liver Dis, 20(1): 1-16.
33
WHO, World Health Organization (2016): GAR-WHO Hepatitis C. Fact sheet, Geneva, Switzerland.
34
WHO, World Health Organization (2015): Hepatitis C. Fact sheet, Geneva, Switzerland.
35
Yuan JM, Govindarajan S, Arakawa K and Yu MC (2004): Synergism of alcohol, diabetes, and viral hepatitis on the risk of hepatocellular carcinoma in blacks and whites in the U.S.A. Cancer, 101(5): 1009- 1017.
36
ORIGINAL_ARTICLE
EVALUATION OF THE POSSIBLE PROTECTIVE EFFECT OF METFORMIN IN CISPLATIN - INDUCED NEPHROTOXICITY IN ADULT MALE ALBINO RATS
Backgrounds: Clinical use of cisplatin is limited by its nephrotoxicity as cisplatin -induced oxidative stress which leads ultimately to kidney dysfunction. Objective: Evaluation of the nephron-protective effect of metformin against nephrotoxicity induced by cisplatin in adult albino rats. Materials and Methods: Sixty adult male albino rats were divided randomly into 6 equal groups: Group I (control group) was injected with 1 ml isotonic saline solution intraperitoneally (I.P). Group 2 was injected with single dose of cisplatin I.P 3.5mg/kg. Group 3 was injected with single dose of cisplatin I.P 7.5 mg/kg. Group 4 was given an oral dose of metformin (350 mg/kg /day for 10 days). Group 5 was given 100 mg kg/day metformin for 3 days before cisplatin injection I.P at a dose of 7.5 mg/kg on day four, and metformin continued for 7days after. Group 6 was given 350 mg kg/day metformin for 3 days before cisplatin injection I.P at a dose of 7.5 mg/kg on day four, and metformin continued for 7days after. Body weight of each rat was recorded on day 1, 4, 7 and 10 and average weight for each group was calculated. At the end of specified duration (10 days), rats were sacrificed and both kidneys were excised, processed and stained with Hematoxylin and Eosin for histopathological study and with Periodic Acid-Schiff (PAS) and Mallory’s stain stains for histochemical study. Results: Rats injected with high dose of cisplatin (7.5 mg/kg) showed more loss of average body weight and higher blood urea nitrogen (BUN) and serum creatinine (Cr) levels than those rats injected with 3.5 mg/kg cisplatin. Rat group injected with high dose of cisplatin (7.5 mg/kg) and given low dose metformin (100 mg/kg/day) showed less loss of average body weight and improved renal functions than rat group given high dose of cisplatin (7.5 mg/kg) and high dose of metformin (350 mg/kg/ day). Histopathological examination with H&E and histochemical examination with PAS and Mallory stains revealed mild glomerular, tubular and interstitial changes in cisplatin low dose group compared to cisplatin high dose group which showed more renal damages. Group given metformin low dose + cisplatin high dose showed less renal damage than those given high dose of cisplatin+ high dose metformin. Conclusion: Metformin has protective effects against cisplatin -induced nephrotoxicity in adult male albino rats.
https://amj.journals.ekb.eg/article_67536_a3d2f5b19e136afb760e87cecbdc0aa4.pdf
2020-01-01
45
58
10.21608/amj.2020.67536
Cisplatin
nephrotoxity
Metformin
Mohammed
Assasa
1
Departments of Forensic Medicine, Faculty of Medicine, Al Azhar University, Cairo
AUTHOR
Sayed
Abd El-Raheem
2
Departments of Pathology, Faculty of Medicine, Al Azhar University, Cairo
AUTHOR
Abd El-Lateef
Said
3
Departments of Pharmacology, Faculty of Medicine, Al Azhar University, Cairo
AUTHOR
Ashraf
I. Hassan
4
Departments of Forensic Medicine, Faculty of Medicine, Al Azhar University, Cairo
AUTHOR
REFERENCES
1
Abdel-Daim M. M., El-Sayed Y. S., Abd Eldaim M. and Ibrahim A. (2017): Nephro-protective efficacy of ceftriaxone against cisplatin-induced subchronic renal fibrosis in rats., Arch Pharmacol., 390:301–309.
2
Akunna G.G., Obikili E.N., Anyawu G.E. and Esom E.A. (2018): Histochemical and morphometric evidences of the curative role of aqueous zest extract of Citrus sinensis on anti-neoplastic drug-induced testicular degeneration in animal models., Eur. J. Anat. 22 (6): 497-507.
3
Alhaider A.A., Korashy H.M., Sayed-Ahmed M.M., Mobark M., Kfoury H. and Mansour M.A. (2011): Metformin attenuates streptozotocin-induced diabetic nephropathy in rats through modulation of oxidative stress genes expression., Chem Biol Interact., 192(3):233-42.
4
Alhoshani A. R., Hafez M. M., Husain S., Al-sheikh A. M., Alotaibi M. R., Al Rejaie S. S., Alshammari M. A., Almutairi M. M. and Al-Shabanah O. A. (2017): Protective effect of rutin supplementation against cisplatin-induced Nephrotoxicity in rats., BMC Nephrology, 18:194- 204.
5
Amini F.G., Rafieian-Kopaei M., Nematbakhsh M., Baradaran A. and Nasri H. (2012): Ameliorative effects of metformin on renal histologic and biochemical alterations of gentamicin-induced renal toxicity in Wistar rats., J Res Med Sci., 17:621–5.
6
Chirino Y. and Pedraza-Chaverri J. (2009): Role of oxidative and nitrosative stress in cisplatin-induced nephrotoxicity., xp Toxicol Pathol., 61:223242.
7
Dasari S. and Tchounwou P.B. (2014): Cisplatin in cancer therapy: molecular mechanisms of action., Eur J Pharmacol., 740:364-78
8
Dehkordi A. H., Abbaszadeh A., Mir S. and Hasanvand A (2019): Metformin and its anti-inflammatory and anti-oxidative effects; new concepts, J Renal Inj Prev., 8(1):54-61.
9
Fatemeh H., Mehran H., Shokouh S., Abedi-Gheshlaghi Z. and Seyed S. B. M. (2016): Prevention of cisplatin nephrotoxicity, J Nephropharmacol., 5 (1): 57–60.
10
Florea A.M. and Büsselberg D. (2011): Cisplatin as an anti-tumor drug: cellular mechanisms of activity, drug resistance and induced side effects. Cancers, 3:1351-1371.
11
Gabbiani C., Magherini F., Modesti A. and Messori L. (2010): Proteomic and metallomic strategies for understanding the mode of action of anticancer metallodrugs. Anticancer Agents. Med Chem., 10: 324–37
12
Kim J., Shon E., Kim C.S. and Kim J.S. (2012): Renal Podocyte Injury in a Rat Model of Type 2 Diabetes Is Prevented by Metformin. Exp. Diabetes Res., 2012:1-9.
13
Kundan G. I., Thakurdesai P.A. and Vyawahare N. S. (2013): Protective effect of Hygrophila spinosa against cisplatin induced nephrotoxicity in rats. Indian J Pharmacol., 45(3): 232–236.
14
Li J., Gui Y., Ren J., Liu X., Feng Y., Zeng Z., He W., Yang J. and Dai C. (2016): Metformin Protects Against Cisplatin-Induced Tubular Cell Apoptosis and Acute Kidney Injury via AMPKα-regulated Autophagy Induction., Sci Rep. 6: 1-15.
15
Nasri H. (2013): Reno-protective effects of metformin, Daru J. of Pharmaceutical Sciences, 21(1): 1-3.
16
Peres LA and da Cunha A. D J. (2013): Acute Nephrotoxicity of Cisplatin: Molecular mechanisms, J. Bras. Nefrol; 35(4):332-340.
17
Pezeshki Z., Khosravi1 A., Nekuei1 M., Khoshnood S., Zandi E., Eslamian M., Talebi1 A., r Emami S. N. and Nematbakhsh M. (2017): Time course of cisplatin-induced nephrotoxicity and hepatotoxicity. Nephropathol. 6(3):163-167
18
Rafieian-Kopaei M., Baradaran A., Merrikhi A., Nematbakhsh M., Madihi Y. and Nasri H. (2013): Efficacy of Co-administration of Garlic Extract and Metformin for Prevention of Gentamicin–Renal Toxicity in Wistar Rats: A Biochemical Study., Int J Prev Med, 4(3): 258–264.
19
Rafieian-Kopaei M and Nasri H. ( 2013): Ginger and diabetic nephropathy., J Ren Inj Prev., 2(1): 9–10.
20
Sahu B.D., Kuncha M., Putcha U.K. and Sistla R. (2013): Effect of metformin against cisplatin induced acute renal injury in rats: A biochemical and histo-architectural evaluation, Experimental and Toxicologic Pathology, 65 (6): 933-940.
21
Taheri N., Azarmi Y., Neshat M., Garjani A. and Doustar Y. (2012): Study the effects of metformin on renal function and structure after unilateral ischemia-reperfusion in rat. Res Pharm Sci., 18(7): 62-8.
22
Zsuzsanna K. Z., Ellezian L., Brown D., Horváth B., Mukhopadhyay P, Kalyanaraman B., Parikh S. M., Karumanch S. A., Stillman I. E. and Pacher P. (2012): Cisplatin Nephrotoxicity Involves Mitochondrial Injury with Impaired Tubular Mitochondrial Enzyme Activity. J Histochem Cytochem., 60(7): 521–529.
23
ORIGINAL_ARTICLE
PREDICTIVE VALUE OF SERUM CA-125 VERSUS SERUM PROGESTERONE IN PREDICTING RISK OF PREGNANCY LOSS IN CASES OF FIRST TRIMESTERIC THREATENED ABORTION
Background: Pregnancy misfortune happens in 0.5-1% of ladies. The etiology is frequently vague and might be multifactorial, with much debate in regards to determination and treatment. Objective: Investigating the relationship between serum progesterone and CA-125 distinguishing successful from unsuccessful pregnancy outcome during the first trimestic cases of threatened abortion. Patients and Methods: This clinical trial included 80 cases of confirmed intrauterine pregnancies between 6-12 weeks with demonstrable embryonic pulsation 40 asymptomatic patients and 40 cases complicated with vaginal bleeding. All cases were selected from Obstetrics and Gynecology Department, Al-Hussein and Sayed Galal Hospitals, Al-Azhar University, from December, 2018 to August, 2019. All patients showed an evidence of embryonic cardiac activity. CA-125 serum levels ware measured and compared with progesterone levels. Results: The mean level of CA.125 was 42.3±19.1 in threatened group and was 30.1±21.6 in normal group respectively. There was a statistically difference between the two groups regarding serum CA125. On the other hand, there was no statistically difference between the two groups regarding progesterone. ROC curve analysis showed 80.55% sensitivity and 100% specificity of CA125, and 78.65% sensitivity and 98.04% specificity of progesterone for prediction of the occurrence of miscarriage. Conclusion: Serum CA-125 seemed to be a promising biomarker for the early prediction of miscarriage
https://amj.journals.ekb.eg/article_67537_541efcb464794c64bbaff860e2da5140.pdf
2020-01-01
59
68
10.21608/amj.2020.67537
Normal pregnancy
serum CA 125
progesterone
threatened miscarriage
Abd El-Moneim
M. Zakaria
1
Department of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University, Egypt
AUTHOR
Fahd
A. Al-Omda
2
Department of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University, Egypt
AUTHOR
Mekky
Abd El-Moneim
3
Department of Clinical and Chemical Pathology, Faculty of Medicine, Al-Azhar University, Egypt. Hepatology and gastroenterology and infectious diseases Department, Faculty of Medicine, Al-Azhar University, (Assiut)
AUTHOR
Bahgat
S. Mohamed
drbahgat87@gmail.com
4
Department of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University, Egypt
AUTHOR
REFERENCES
1
Abdul-Hussein, M. M., Abdul-Rasheed, O. F. and Al-Moayed, H. A. Q. (2012): The values of CA-125, progesterone, ss-HCG and estradiol in the early prediction of ectopic pregnancy. Oman Medical Journal, 27(2): 124.
2
Adeku, M. A., Adegbola, O. and Ajayi, G. O. (2019): The predictive value of serum cancer antigen 125 (CA125) levels on pregnancy outcome in threatened miscarriages. Journal of Perinatal Medicine, 47(7): 704-709.
3
Al Mohamady, M., Fattah, G. A., Elkattan, E., Bayoumy, R. and Hamed, D. A. (2016): Correlation of serum CA-125 and progesterone levels with ultrasound markers in the prediction of pregnancy outcome in threatened miscarriage. International Journal of Fertility & Sterility, 9(4): 506-5011.
4
Di Renzo, G. C., Giardina E. and Gerli, S. (2016): Progesterone in normal and pathological pregnancy. Hormone Molecular Biology and Clinical Investigation, 27(1): 35–48.
5
Haas DM and Ramsey PS. (2008): Progestogen for preventing miscarriage. Cochrane Database of Systematic Reviews, 2: CD003511.
6
Han, S. N., Lotgerink, A., Gziri, M. M., Van Calsteren, K., Hanssens, M. and Amant, F. (2012): Physiologic variations of serum tumor markers in gynecological malignancies during pregnancy: a systematic review. BMC Medicine, 10(1): 86.
7
Li, X., Ouyang, Y. and Yi, Y. (2017): Correlation analysis between ultrasound findings and abnormal karyotypes in the embryos from early pregnancy loss after in vitro fertilization-embryo transfer. Journal of Assisted Reproduction and Genetics, 34(1): 43–50.
8
Maggio, L. and Rouse, D. J. (2014): Progesterone. Clinical Obstetrics and Gynecology, 57(3): 547-556.
9
Mahdi BM. (2010): Estimation of CA-125 level in first trimester threatened abortion. Internet J Gynecol Obstet., 12:1–5.
10
Osmanagaoglu MA, Karajan SC Aran T, Güven S, Turgut E, Mentese A. and Mentees A. (2014): The Diagnostic Value of β Human Chorionic Gonadotropin, Progesterone, and Ischemia-Modified Albumin and Their Combined Use in the Prediction of First Trimester Abortions. Int Scholarly Research Notices.
11
Pillai RN, Konje JC, Tincello DG and Potdar N. (2015): Role of serum biomarkers in the prediction of outcome in women with threatened miscarriage: a systematic review and diagnostic accuracy meta-analysis. Hum Reprod Update, 22(2):228-239.
12
Revankar, V. M., Aggarwal, A., and Revankar, M. G. (2015): Comparison of ca-125 levels in threatened abortion and normal pregnancies. World Journal of Pharmacy and Pharmaceutical Sciences, 4(7): 1357-1364.
13
Saraswat, L., Bhattacharya, S., Maheshwari, A. and Bhattacharya, S. (2010): Maternal and perinatal outcome in women with threatened miscarriage in the first trimester: a systematic review. BJOG : An International Journal of Obstetrics and Gynaecology, 117(3), 245–257.
14
Seong, W. J. (2016): Amniotic fluid CA-125 as amarker of intra-amniotic inflammation associated with preterm delivery: a preliminary single center study. Archives of Gynecology and Obstetrics, 293(1):55-59.
15
Sweed, M. S., Sammour, H. M. and Bakr, A. A. (2016): Serum CA-125 for Early Prediction of Miscarriage. Med J Obstet Gynecol , 4(1): 1077.
16
ORIGINAL_ARTICLE
STUDY OF MEAN PLATELET VOLUME VERSUS LEUCOCYTE ESTERASE AS A MARKER IN DIAGNOSIS OF SPONTANEOUS BACTERIAL PERITONITIS
Background: Spontaneous bacterial peritonitis (SBP) is a severe and frequent complication of cirrhosis with a high mortality rate. Early diagnosis and treatment of SBP is necessary for survival.
Objective: To study the mean platelet volume (MPV) versus leucocyte esterase as a marker in diagnosis of decompensated cirrhotic patients with spontaneous bacterial peritonitis.
Patients and methods: A total of 200 patients with decompensated liver cirrhosis and ascites, were admitted to the Department of Gastroenterology and Hepatology in Nasser Institute, and were enrolled in this study between January 2016 and October 2017. Patients were divided into two equal groups; group (I) was diagnosed non SBP and group (II) was diagnosed SBP. All patients underwent abdominal paracentesis, and the ascitic fluid was processed for cell count, leukocyte esterase reagent strip test (LERS) (URIT 10V) and culture. All patients underwent assessment of MPV in CBC.
Results: Diagnostic performance of mean platelet volume showed that we can use MPV as a good diagnostic marker for SBP with sensitivity 75 %, specificity 99% and accuracy 93.2 %. The best cut off value for discriminating patients with SBP from patients without SBP was 9.2 fl. The test of ascetic fluid by leukocyte esterase reagent strips showed that specificity = 93% , sensitivity = 80%, positive predictive value (PPV) = 92%, negative predictive value (NPV) =82.3% and accuracy = 86.5%.
Conclusion: MPV and LERS can be used as a good marker in diagnosis of SBP in cirrhotic patients with ascites.
https://amj.journals.ekb.eg/article_67538_a5486b1a17d454ebd658142c1a86f969.pdf
2020-01-01
69
82
10.21608/amj.2020.67538
Cirrhosis
ascites
Spontaneous Bacterial Peritonitis
Mean platelet volume
leucocyte esterase
Amer
Abd EL-Hamid Gomaa
1
Gastroenterology and Hepatology, Faculty of Medicine, Al-Azhar University
AUTHOR
Ali
Ibrahim Ali Soliman
2
Gastroenterology and Hepatology, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Ahmad
Hasan Muhammad Salim
3
Gastroenterology and Hepatology department in Nasser Institute
AUTHOR
Mahmoud
Bastawy Ismaeil
4
Clinical Pathology, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Abdel-Razik A, Eldars W and Rizk E, (2014): Platelet indices and inflammatory markers as diagnostic predictors for ascitic fluid infection. Eur J Gastroenterol Hepatol., 26:1342–1347.
2
Bafandeh, Y. and Khodaei, M. (2012): Evaluation of leukocyte esterase reagent strip test to detect spontaneous bacterial peritonitis in cirrhotic patients. Gastroenterology Insights, 4(1): e13-e13.
3
Cai, Q., Liu, W., Zhu, M. and Sheng, J. (2019): Microbial Infections as a Trigger for Acute-on-Chronic Liver Failure: A Review. Medical Science Monitor, 25: 4773-4783.
4
Cekin, Y., Cekin, A. H., Duman, A., Yilmaz, U., Yesil, B. and Yolcular, B. O. (2013): The role of serum procalcitonin levels in predicting ascitic fluid infection in hospitalized cirrhotic and non-cirrhotic patients. International Journal of Medical Sciences, 10(10): 1367– 1374.
5
Chouhan, P., Dubey, R., Upmanyu, N. and Shrivastava, A. (2018): Update Review Article: Spontaneous Bacterial Peritonitis. Journal of Drug Delivery and Therapeutics, 8(6-s): 384-393.
6
Chugh, K., Agrawal, Y., Goyal, V., Khatri, V. and Kumar, P. (2015): Diagnosing bacterial peritonitis made easy by use of leukocyte esterase dipsticks. International Journal of Critical Illness and Injury Science, 5(1): 32-7
7
Dever, J. B. and Sheikh, M. Y. (2015): spontaneous bacterial peritonitis–bacteriology, diagnosis, treatment, risk factors and prevention. Alimentary Pharmacology & Therapeutics, 41(11): 1116-1131.
8
Doddamani, G. B., Pujar, S. and Kora, S. A. (2010): Spontaneous Bacterial Peritonitis in Ascites: A prospective study in a tertiary care hospital. J Clin Diagn Res., 4: 2737-41.
9
Fernandez, J. and Gustot, T. (2012): Management of bacterial infections in cirrhosis. Journal of Hepatology, 56: S1-S12.
10
Hadhoud, K. M., Ashour, M. A., Basha, O. M., El-Messallamy, F. A., Anwar, A. and Ellatif Hafez, R. A. (2012): Study of Leucocyte Esterase Reagent Strips as a screening test for Spontaneous Bacterial Peritonitis. Life Science Journal-Acta Zhengzhou University Overseas edition, 9(4): 5369-5375.
11
Honar, N., Geramizadeh, B., Dehghani, S. M., Kalvandi, G., Shahramian, I., Rahmani, A. and Javaherizadeh, H. (2015): Evaluation of leukocyte esterase reagent strips test in the diagnosis of spontaneous bacterial peritonitis in children with cirrhosis. Arquivos de gastroenterologia, 52(3): 195-199.
12
Jafri, S., Awan, R. H., Nayab, S. E. E. M. A. and Awan, K. H. (2019): Spontaneous bacterial peritonitis. The Professional Medical Journal, 26(03): 404-408.
13
Khan, Z., Khan, I., Din, J. U., Subhan, F., Khan, B. and Khan, H. (2009): Frequency of spontaneous bacterial peritonitis in cirrhotic patients with ascites due to hepatitis C virus and efficacy of ciprofloxacin in its treatment. Gomal J Med Sci, 7(2): 149-54.
14
Koulaouzidis, A. (2011): Diagnosis of spontaneous bacterial peritonitis: an update on leucocyte esterase reagent strips. World Journal of Gastroenterology: WJG, 17(9): 1091- 1094.
15
Lippi, G., Danese, E., Cervellin, G. and Montagnana, M. (2014): Laboratory diagnostics of spontaneous bacterial peritonitis. Clinica Chimica Acta, 430: 164-170.
16
Mendler, M. H., Agarwal, A., Trimzi, M., Madrigal, E., Tsushima, M., Joo, E. and Runyon, B. (2010): A new highly sensitive point of care screen for spontaneous bacterial peritonitis using the leukocyte esterase method. Journal of Hepatology, 53(3): 477-483.
17
Oey, R. C., Kuiper, J. J., Van Buuren, H. R. and De Man, R. A. (2016): Reagent strips are efficient to rule out spontaneous bacterial peritonitis in cirrhotics. Neth J Med, 74: 257-61.
18
Parvizi, J., Jacovides, C., Antoci, V. and Ghanem, E. (2011): Diagnosis of periprosthetic joint infection: the utility of a simple yet unappreciated enzyme. JBJS, 93(24): 2242-2248.
19
Pathak, R., Harsh, S., Adhikari, A., and Khadga, P. K. (2014): Clinical Spectrum of Spontaneous Bacterial Peritonitis in Tertiary Care Centre. Journal of Institute of Medicine, 36(2): 28-32
20
Ponziani, F. R., Zocco, M. A., Cerrito, L., Gasbarrini, A. and Pompili, M. (2018): Bacterial translocation in patients with liver cirrhosis: physiology, clinical consequences, and practical implications. Expert Review of Gastroenterology & Hepatology, 12(7): 641-656.
21
Riggio, O. and Angeloni, S. (2009): Ascitic fluid analysis for diagnosis and monitoring of spontaneous bacterial peritonitis. World Journal of Gastroenterology: WJG, 15(31): 3845- 3850.
22
Runyon, B. A. (2009): Management of adult patients with ascites due to cirrhosis: an update. Hepatology, 49(6): 2087-2107.
23
Sánchez, E., Soriano, G., Mirelis, B., Gonzalez, B., Nieto, J. C., Vidal, S. and Guarner, C. (2015): Effect of long-term acid gastric inhibition on bacterial translocation in cirrhotic rats. European Journal of Gastroenterology & Hepatology, 27(5): 570-576.
24
Saqib, A., Khan, R. R., Masood, Z. and ul Haque, I. (2012): Frequency of spontaneous bacterial peritonitis (SBP) in cirrhotic patients with ascites due to hepatitis B and C. J Uni Med Dent Coll, 3(1): 22-26.
25
Shizuma, T. (2018): Spontaneous bacterial and fungal peritonitis in patients with liver cirrhosis: A literature review. World Journal of Hepatology, 10(2): 254-66.
26
Sithara K., Thomas V. and Sainu, A. (2010): Evaluation of leucocyte esterase reagent strip test for the rapid bedside diagnosis of spontaneous bacterial peritonitis. Indian J Gastroenterol (March-April), 29(2):74-77.
27
Suvak, B., Torun, S., Yildiz, H., Sayilir, A., Yesil, Y., Tas, A. and Kayaçetin, E. (2015): Mean platelet volume is a useful indicator of systemic inflammation in cirrhotic patients with ascitic fluid infection. Annals of Hepatology, 12(2): 294-300.
28
Thévenot T, Briot C, Macé V, Lison H, Elkrief L, Heurgué-Berlot A, Bureau C, Jézéquel C, Riachi G, and Louvet, A. (2016): The Periscreen Strip Is Highly Efficient for the Exclusion of Spontaneous Bacterial Peritonitis in Cirrhotic Outpatients. Am J Gastroenterol. (111):1402–1409.
29
ORIGINAL_ARTICLE
COMPARATIVE STUDY BETWEEN ENDOSCOPIC AND MICROSCOPIC TYMPANOPLASTY THROUGH TRANSCANAL APPROACH
Background: Since the introduction of tympanoplasty in the 1950s, variety of surgical techniques has been developed for closure of tympanic membrane perforation. Tympanoplasty and myringoplasty are commonly used procedures for the treatment of chronic otitis media. Objective: The aim of the present work was to compare the success rate between endoscopic and microscopic tympanoplasty through transcanal approach as regard improvement of hearing, closure of tympanic membrane perforation and the time of operation. Patients and Methods: This prospective study was carried out on thirty patients who attended to outpatient clinic of Al-Hussien University Hospital from November 2018 to June 2019. All patients with the complaint of discharging ear and decreased hearing were screened. They were divided randomly into two equal groups; group A was treated by transcanal endoscopic tympanoplasty, and group B was treated by transcanal microscopic tympanoplasty. All operations were done at AL-Azhar University Hospitals (Al-Hussein University Hospital). Results: The graft success rate was 80 % in group A, and 73.3 % in group B. There was significant improvement in hearing in both groups pre- and post – operatively, but the difference between both groups was not statistically significant. Microscopic tympanoplasty was shorter than endoscopic with no significant difference between both groups. Conclusion: Tympanoplasty is an effective technique for recovering hearing thresholds secondary to a tympanic membrane perforation. In transcanal approach, postoperative cares were easy as the technique is minimally invasive in surgical approach, scar, bleeding and pain. The telescopic wide angle magnified view of the endoscope overcame most of the disadvantages of the microscope. Endoscopes provided good exposure of the tympanic membrane, usually without canaloplasty.
https://amj.journals.ekb.eg/article_67539_a19bf06b54eda36b7a49bd11667c7429.pdf
2020-01-01
83
90
10.21608/amj.2020.67539
Endoscopic
Microscopic Tympanoplasty
Transcanal Approach
Mostafa
Shams El-Din Khafagy
1
Otorhinolaryngology Department, Faculty of Medicine, Al-Azhar University
AUTHOR
Hatem
Salah El-Din El-Habashy
2
Otorhinolaryngology Department, Faculty of Medicine, Al-Azhar University
AUTHOR
Mahmoud
Tarek Mohie El-Din El-Hamshary
mhmodelhamshary@gmail.com
3
Otorhinolaryngology Department, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
REFERENCES
1
Ayache, S. (2013): Cartilaginous myringoplasty: the endoscopic transcanal procedure. European Archives of Oto-Rhino-Laryngology, 270(3): 853-860.
2
Cavaliere, M., Mottola, G., Rondinelli, M. and Iemma, M. (2009): Tragal cartilage in tympanoplasty: anatomic and functional results in 306 cases. Acta Otorhinolaryngologica Italica, 29(1): 27-32.
3
Choi, N., Noh, Y., Park, W., Lee, J. J., Yook, S., Choi, J. E. and Moon, I. J. (2017): Comparison of endoscopic tympanoplasty to microscopic tympanoplasty. Clinical and experimental otorhinolaryngology, 10(1),: 44-49.
4
Friedman, A. B., Gluth, M. B., Moore, P. C. and Dornhoffer, J. L. (2013): Outcomes of cartilage tympanoplasty in the pediatric population. Otolaryngology--Head and Neck Surgery, 148(2): 297-301.
5
Furukawa, T., Watanabe, T., Ito, T., Kubota, T. and Kakehata, S. (2014): Feasibility and advantages of transcanal endoscopic myringoplasty. Otology & Neurotology, 35(4): e140-e145.
6
Halim, A. and Borgstein, J. (2009): Pediatric myringoplasty: postaural versus transmeatal approach. International journal of pediatric otorhinolaryngology, 73(11): 1580-1583.
7
Huang, T. Y., Ho, K. Y., Wang, L. F., Chien, C. Y. and Wang, H. M. (2016): A comparative study of endoscopic and microscopic approach type 1 tympanoplasty for simple chronic otitis media. J Int Adv Otol, 12(1): 28-31.
8
Lade, H., Choudhary, S. R. and Vashishth, A. (2014): Endoscopic vs microscopic myringoplasty: a different perspective. European Archives of Oto-Rhino-Laryngology, 271(7): 1897-1902.
9
Marchioni, D., Alicandri‐Ciufelli, M., Piccinini, A., Genovese, E. and Presutti, L. (2010): Inferior retrotympanum revisited: an endoscopic anatomic study. The Laryngoscope, 120(9): 1880-1886.
10
Migirov, L. and Wolf, M. (2015): Transcanal microscope-assisted endoscopic myringoplasty in children. BMC Pediatrics, 15(1): 32-49.
11
Migirov, L., Shapira, Y., Horowitz, Z. and Wolf, M. (2011): Exclusive endoscopic ear surgery for acquired cholesteatoma: preliminary results. Otology & Neurotology, 32(3): 433-436.
12
Onal, K., Arslanoglu, S., Songu, M., Demiray, U. and Demirpehlivan, I. A. (2012): Functional results of temporalis fascia versus cartilage tympanoplasty in patients with bilateral chronic otitis media. The Journal of Laryngology & Otology, 126(1): 22-25.
13
Özgür, A., Dursun, E., Erdivanli, Ö. Ç., Coşkun, Z. Ö., Terzi, S., Emiroğlu, G. Ö. K. H. A. N. and Demirci, M. (2015): Endoscopic cartilage tympanoplasty in chronic otitis media. The Journal of Laryngology & Otology, 129(11): 1073-1077.
14
Patel, J., Aiyer, R. G., Gajjar, Y., Gupta, R., Raval, J. and Suthar, P. P. (2015): Endoscopic tympanoplasty vs microscopic tympanoplasty in tubotympanic CSOM: a comparative study of 44 cases. Int J Res Med Sci, 3(8): 1953-1957.
15
Salam RTA, Nambiar SS and Anusha V. (2018): Comparative Study of the Outcomes of Tympanoplasty by the Conventional Microscopic and Endoscopic Techniques. Int J Sci Stud.,6(9) :81-86
16
Sinha, M., Hirani, N. and Khilnani, A. K. (2017): Comparison of endoscopic underlay and microscopic underlay tympanoplasty: a prospective research at a tertiary care centre in Gujarat. International Journal of Otorhinolaryngology and Head and Neck Surgery, 3(4): 874.
17
Tan, H. E., Santa Maria, P. L., Eikelboom, R. H., Anandacoomaraswamy, K. S. and Atlas, M. D. (2016): Type I tympanoplasty meta-analysis: a single variable analysis. Otology & Neurotology, 37(7): 838-846.
18
Wick, C. C., Arnaoutakis, D., Barnett, S. L., Rivas, A. and Isaacson, B. (2017): Endoscopic transcanal transpromontorial approach for vestibular schwannoma resection: a case series. Otology & Neurotology, 38(10): e490-e494.
19
Yadav, S. P., Aggarwal, N., Julaha, M. and Goel, A. (2009): Endoscope-assisted myringoplasty. Singapore medical journal, 50(5): 510-512.
20
Yilmaz, M. S., Guven, M., Kayabasoglu, G. and Varli, A. F. (2015): Comparison of the anatomic and hearing outcomes of cartilage type 1 tympanoplasty in pediatric and adult patients. European Archives of Oto-Rhino-Laryngology, 272(3): 557-562.
21
ORIGINAL_ARTICLE
ASSESSMENT OF THE MICROSCOPIC– OBSERVATION- DRUG - SUSCEPTIBLITY ASSAY (MODS) AND GENEXPERT ASSAY FOR DIAGNOSIS OF PULMONARY TUBERCULOSIS
Background: Tuberculosis (TB) is considered the most common and highly contagious disease worldwide. Early and accurate diagnosis of TB with detection of multidrug-resistant Mycobacterium tuberculosis (M.TB) is of primary importance for both patient management and infection control.
Objectives: To evaluate the performance of Microscopic-Observation Drug-Susceptibility (MODS) assay and GeneXpert MTB/RIF( GeneXpert ) assay in diagnosis of TB and detection of MDR-TB directly from sputum specimens in comparison to the convential diagnostic methods (direct Ziehl-Neelsen "Z-N" stained smear and culture on Lowenstein-Jenson media "LJ").
Patients and Methods: After approval of institutional ethical committee a total of 120 suspected pulmonary TB patients admitted to chest hospitals and dispensaries in Egypt (Giza, Cairo, Alexandria, Dakahlia, Suez, Beheira, Monufia, Qena). Their age was more than 16 years; all of them did not receive any anti tubercular drugs. Sputum samples were collected from each patient and subjected to direct ZN smear, culture and sensitivity of M.TB on LJ and Middlebrook 7H9 medium for MODS assay. Finally Genexpert M.TB/RIF assay was done directly for all sputum samples.
Results: Infection rate among males was higher than female (81.7% & 18.7%). Also, it was observed that 56.7% of sputum samples gave positive direct Z-N smear, while 64.2% were positive for both LJ culture &MODS assay. On the other hand, by Genexpert, 68% of cases were positive. The sensitivity and specificity of the various diagnostic methods were studied in relation to LJ culture (gold standard). It was found that MODS assay was rapid that results were obtained in a median of 8 days ranged from (7– 21 days), while median time of LJ was 21dayes ranged from (21– 60). MODS had 100% sensitivity and specificity. Direct smear was less sensitive (88.3%), and GeneXpert was less specific (88.4%), but more rapid results were obtained in 2 hours. Finally, detection of MDR-TB using various methods for 77 isolated M.TB strains ranged from 16.9-19.5% to isoniazid (INH) and 9.8%-18.2% to rifampicin (RMP) by various diagnostic methods with statistically insignificant difference between them.
Conclusion: MODS was an optimal alternative rapid diagnostic technique for TB and detection of M.TB and MDR-TB in resource limited settings, results were obtained in a median of 8 days. On the other hand, Gene Xpert was a novel integrated diagnostic PCR analysis in a single hand free step for rapid diagnosis of TB and detection of RMP resistance in clinical specimens in 2 hours but it was expensive.
https://amj.journals.ekb.eg/article_67540_e794f49669278105d954b5616bbab474.pdf
2020-01-01
91
102
10.21608/amj.2020.67540
MODS
GeneXpert
M.TB
MDR-TB
TB
and PCR
Eman
Hosny Mohamad
emanhosny22@yahoo.com
1
Department of Microbiology, Al-Azher Faculty of Medicine (Girls)
AUTHOR
Effat
Mostafa Hasan
2
Department of Microbiology, Al-Azher Faculty of Medicine (Girls)
AUTHOR
Faten
Aly Shoukry
3
Department of Microbiology, Al-Azher Faculty of Medicine (Girls) and National TB Program*
AUTHOR
Omnia
Ahmed El-Dydamoni
4
Department of Microbiology, Al-Azher Faculty of Medicine (Girls)
AUTHOR
REFERENCES
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Blakemore R, Story E, Helb D, Kop J, Banada P, Owens MR, Chakravorty S, Jones M and Alland D. (2010): Evaluation of the analytical performance of the Gene Xpert MTB/RIF assay. Clin. Micro. J., 48: 2495–2501.
2
Bodmer T and Ströhle A. (2012): Diagnosing Pulmonary Tuberculosis with the Gene Xpert MTB/RIF assay. Journal of Vis. Exp. j., 62: 3547 -3553.
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Boehme C C and Nabeta P. (2014): Rapid molecular detection of tuberculosis and rifampin resistance. N. Engl. Med. J., 363: 1005 –1015.
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Bunsow E, Ruiz-Serrano MJ, Lopez Roa P, Kestler M, ViedmaDG and Bouza E. (2014): Evaluation of GeneXpert MTB/RIF for the detection of MT.B and resistance to rifampin in clinical specimens.Infect. J., 68: 338 -343.
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Canetti G. Fox W, Khousenko A. Mahler H T, Menon N K, Mitchison D A, Rist N and Surden NA. (1969): Advances in techniques of testing mycobacterial drug sensitivity, and the use of sensitivity tests in tuberculosis control programmes. Bull. W. H. O., 41: 21– 43.
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Caviedes L, Lee TS, Gilman RH, Sheen P, Spellman E, Lee EH, Berg DE and Montenegro James S. (2000): Rapid, efficient detection and drug susceptibility testing of M.TB in sputum by microscopic observation of broth cultures.Clin. Micro. J., 38 (3):1203 –1208.
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Heba M A. (2014): Quality of life among pulmonary tuberculosis patients, Thesis Submitted For Partial Fulfillment of M.D Degree in Microbiology, pp 138-140.
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Helb D, Jones M, Story E, Boehme C, Wallace E, Ho K, Kop J, Owens MR, Rodgers R, Banada P, Safi H and Blakemore R. (2010): Rapid detection of M.TB and rifampin resistance by use of ondemand, near-patient technology. Clin. Micro. J., 48: 229 –237.
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Huang Z, QinC, Jinghui D, Qing L, Yaoxing W, Wang Z, ZhangX, Guoliang X,Jie C, Xiaomeng X, Weiting L and Junming L. (2015) : Evaluation of the MODS for the rapid detection of MDR-TB and XDR-TB in China: aprospective multicentre study. Antimicrob. Chemother. J., 70 (2):456 – 462.
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Mohamed A , Hossam M and Masoud M E. (2019): Evaluation of GeneXpert as a new diagnostic tool for detection of pulmonary tuberculosis,The Egyptian Journal of Chest Diseases and Tuberculosis, 68: 270 –273.
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Lawn SD and Nicol MP. (2011): Xpert (R) MTB/RIF assay: development, evaluation and implementation of a new rapid molecular diagnostic for tuberculosis and rifampicin resistance. Future Microbiol. J., 6 (9):1067–1082.
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Lawn SD, Mwaba P, Bates M, Piatek A, Alexander H, Marais BJ, Cuevas LE, McHugh TD, Zijenah L, Kapata N, Abubakar I, McNerney R, Hoelscher M, Memish ZA, Migliori GB, Kim P, Maeurer M, Schito M and Zumla A. (2013): Advances in tuberculosis diagnostics: the Xpert MTB/RIF assay and future prospects for a point-of-care test. Lancet Infect. Dis., 13(4): 349- 61.
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Monika A, Ashish B, Vinay B and Sarjana D. (2016): Comparative Study of GeneXpert with ZN Stain and Culture in Samples of Suspected Pulmonary Tuberculosis,Clin.and Diag. Research J., 10 (5): DC09-DC12.
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Pai M, Minion J, Sohn H, Zwerling A and Perkins MD. (2009): Novel and improved technologies for tuberculosis diagnosis: progress and challenges. J., Clin Chest Med., 30: 701–716.
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Rasslan O, Hafez S F, Hashem M, Ahmed OI, Faramawy MA S, Khater W S, Saleh D A, Mohamed MI, Khalifa M A M, Shoukry F A and El-Moghazy E H. (2012): MODS assay in the diagnosis of multidrug-resistant tuberculosis.Int. J. Tuberc. Lung Dis., 16 (7): 941– 6.
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Sanogo M, Kone B, Diarra B, Maiga M, Baya B, Somboro AM, Sarro YS, Togo ACG, Dembele BPP, Goita D, Kone A, M'Baye O, Coulibaly N, Diabate S, Traore B, Diallo MH, Coulibaly YI, Saleeb P, Belson M, Orsega S, Siddiqui S, Polis MA, Dao S, Murphy RL and Diallo S. (2017): Performance of Microscopic Observation Drug Susceptibility for the Rapid Diagnosis of Tuberculosis and Detection of Drug Resistance in Bamako, Mali, Clin. Micro. Infect J., 3 (6): 408.e1– 408.e6.
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Sanchez PE, Merker M, Beckert P, Jochims F, Dlamini T, Kahn P, Bonnet M and Niemann S. (2015): Detection of drug-resistant tuberculosis by Xpert MTB/RIF in Swaziland. N Engl, Med J., 372:1181 -1182.
21
Sharma S K, Mikashmi K, Raj N Y , Jigyasa C , Dinkar B , Vishnubhatla S , Rohini S and Binit K. (2015): Evaluating the Diagnostic Accuracy of Xpert MTB/RIF Assay in Pulmonary Tuberculosis. Pone. J., 10:1371-1380.
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Wilson M L. (2014): Recent advances in the laboratory detection of M.TB complex and drug Resistance,J. of Clin. Infect. Dis., 52 1350 –1355.
25
ORIGINAL_ARTICLE
FACILITATORS ABD BARRIERS OF ACTIVE AGING AMONG EGYPTIANS: A COMMUNITY BASED STUDY IN CAIRO GOVERNORATE, EGYPT
Background: Active aging can be achieved, when people are free of diseases, have intellectual capabilities, possess high physical fitness and can actively be engaged with others. In developing countries, most of which do not have comprehensive policies on aging, big challenges are faced including double burden of disease, increased risk of disability and feminization of aging. It is important to promote the concept of active aging in the population.
Objective: To understand the Egyptians perception and attitudes towards the elderly, the contribution of older people in their workplaces, societies and determine the most important actions required to ensure an actively aged Egyptian population.
Subjects and methods: A community based study was conducted in eastern Cairo by applying simple random sample to select between 4 main divisions, a sample of 1000 participants yielded a power of approximately 99%. All age groups above 18 years old were included. Subjects were divided into two groups: below 60 years and those equal to or above 60years. Data was collected using interview questionnaire, which was adopted from the special Active Aging questionnaire EUROBAROMETER 378 questionnaire.
Results: The majority of the participants feel that a person is considered old at the age of 66, and 51% of participants less than 60 years assured that elderly play a big role towards their family. Workplace age discrimination was highly reported, being unable to adapt to modern workplaces is found to be the main obstacle stopping people aged 60 years and over from working.
Conclusion: Flexibility at work and financial rewards for elderly are recommended. More attention must be given to institutions as older people’s organizations and religious organizations that have a positive role in tackling the challenges of aging in population.
https://amj.journals.ekb.eg/article_67542_d28d44bee841dfc689fb4d88cd014d7e.pdf
2020-01-01
103
116
10.21608/amj.2020.67542
Active aging– barriers– community based study- elderly
Hoda
Ibrahim Fahim
daliagabesos@gmail.com
1
Department of Community Medicine, Faculty of Medicine, Ain Shams University, Egypt
LEAD_AUTHOR
Dalia
Gaber Sos
2
Department of Community Medicine, Faculty of Medicine, Ain Shams University, Egypt
AUTHOR
Sally
Adel Hakim
3
Department of Community Medicine, Faculty of Medicine, Ain Shams University, Egypt
AUTHOR
Sarah
Ahmed Hamza
4
Department of Geriatrics, Faculty of Medicine, Ain Shams University, Egypt
AUTHOR
REFERENCES
1
Active aging report (2012): Special Eurobarometer 378/Wave EB76.2 – TNS opinion & social. European Commission; 2012:1
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Age pension (2014): Budget fact sheet. Department of social services. Australian Government.
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Antoine Ph., ET Golaz V. and Au Sud V. (2010): Une Grande Variété De Situations. Autrepart, 53: 3-15.
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Depp CA, Harmell A and Vahia IV. (2012): Successful cognitive aging. Curr Topics Behav Neurosci, 10:35–50.
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Illario M., Vollenbroek-Hutten M. M. R., Molloy D. W., Menditto E., Iaccarino G. and Eklund P. (2016): Active and healthy ageing and independent living 2016. Journal of Aging Research. 2016:3pages,Id 8062079.
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Irving J. (2017): researches older workers, retirement and ageism at the University of South Australia. Originally published in The Conversation Age discrimination in the workplace happening to people as young as 45.
7
Kirkwood TBL (2005). the biological science of human aging. In: Johnson ML, editor. Age and Ageing. Cambridge, Mass, USA: Cambridge University Press.
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Kusumastuti S, Derks MG, Tellier S, Di Nucci E, Lund R, Mortensen EL and Westendorp RG. (2016): Successful ageing: a study of the literature using citation network analysis. Maturitas, 93:4–12.
9
Punyakaew A., Lersilp S. and Putthinoi S (2019): Active Ageing Level and Time Use of Elderly Persons in a Thai Suburban Community. Occup Ther., 1-8.
10
Rantanen T., Saajanaho M., Karavirta L., Siltanen S., Rantakokko M., Viljanen A., Pynnönen K., Karvonen A., Lisko I., Palmberg L., Eronen J., Palonen E., Hinrichs T., Kauppinen M., Katja K and Portegijs E. (2018): Active aging – resilience and external support as modifiers of the disablement outcome: AGNES cohort study protocol. BMC Public Health, 18:565.
11
Saleh Y. (2016): Egypt: Egyptian Labor Law. Mondaq Connecting knowledge and people; 2016.
12
State Council Circular on Issuing State Council Temporary Measures on Providing for Old, Weak, Sick, and Handicapped Cadres, and State Council Temporary Measures on Workers' Retirement, Resignation" (Chinese Text)". Archived from the original on 15 March 2016.
13
Vidovićová, L., Galčanová, L. and Petrová Kafková, M (2015): The meaning and performance of the grandparental role in Czech young-olds. Czech Sociological Review; 51(5): 761–782.
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World Health Organization (2011): Global Health and Ageing report. Geneva, Switzerland: WHO Library Cataloguing-in-Publication Data.
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World Health Organization (2015), World report on ageing and health. Geneva, Switzerland: WHO Library Cataloguing-in-Publication Data.
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Wongkeenee W., Chintanawat R. and Sucamvang K. (2013): Factors predicting active ageing among population of Mueang District, Chiang Mai Province. Nursing Journal, 40(4):91–99.
17
Wu C, Odden MC and Fisher GG. (2014): Association of retirement age with mortality: a population-based longitudinal study among older adults in the USAJ Epidemiol Community Health Published Online First: 21 March 2016.
18
ORIGINAL_ARTICLE
CHANGES IN MACULAR THICKNESS AFTER PART TIME OCCLUSION IN CHILDREN WITH AMBLYOPIA USING OPTICAL COHERENCE TOMOGRAPHY (OCT)
Background: Amblyopia is the commonest childhood vision disorder, most children with amblyopia require refractive correction as well as patching; Evidences for direct retinal changes in amblyopic eyes are still inconclusive and controversial.
Objectives: To detect changes in the macula by macular Optical Coherence Tomography (OCT) after part time occlusion in children with amblyopia.
Patients and Methods: Arandomised non controlled study included forty child suffering amblyopia in this study. Best corrected visual acuity (BCVA: 0.1- 0.5) were recruited and treated with refractive correction, and part time occlusion (6 hours/day) for one week per year. BCVA and macular thickness were measured by OCT before and after treatment. Factorial repeated-measures analysis of variance was performed to determine the macular thickness in amblyopic eyes changed after amblyopia treatment.
Results: The mean age of children was 8.57±2.52 years. There was a statistically significant difference in the central macular thickness pre & post amblyopia treatment. There was no statistically significant difference for the other macular thickness parameters except for superior quadrant of parapovea where the difference was significantly significant.
Conclusion: The mean of central macular thickness and superior quadrant of parapovea increased after part time occlusion treatment compared to pretreatment. No significant difference in average macular thickness, (nasal, temporal, inferior) parapovea, perifovea, retinal nerve fiber layer (RNFL) thickness and ganglion cell layer (GCL) before and after treatment.
https://amj.journals.ekb.eg/article_67543_52c672e7d0690810978f9c2321c590a0.pdf
2020-01-01
117
124
10.21608/amj.2020.67543
Amblyopia
occlusion therapy
macular changes
Mohamed
Zakaria Eid
1
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Ahmed
Mahmoud Amin
2
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Mahmoud
El-Sayed Mohamed
mahmoudsalem3330@gmail.com
3
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
REFERENCES
1
Bowling B (2016): Kanski's clinical ophthalmology 8th edition, pbl Elsevier USA, chapter 18, strabismus, pp. 737-743.
2
Chen W, Chen J, Huang J, Xu J, Zhang F and Lu F (2013): Comparison of macular and retinal nerve fiber layer thickness in untreated and treated binocular amblyopia. Curr Eye Res., 38:1248–1254.
3
Chun-Hsiu L, Sherine JO, Chung-Ying H, Wei-Chi W, Ling-Yuh K and Meng-Ling Y (2018): Macular Thickness, Foveal Volume, and Choroidal Thickness in Amblyopic Eyes and Their Relationships to the Treatment Outcome. J Ophthalmol.; 2018: 1967621.
4
Huynh SC, Samarawickrama C and Wang XY (2009): Macular and nerve fiber layer thickness in amblyopia: the Sydney Childhood Eye Study. Ophthalmology, 116:1604–1609.
5
Hwang DJ, Kim YJ and Lee JY (2010): Effect and sustainability of part-time occlusion therapy for patients with anisometropic amblyopia aged ≥8 years; British Journal of Ophthalmology, 94:1160-1164.
6
Kavitha V, Heralgi MM, Harishkumar PD, Harogoppa S, Shivaswamy H M and Geetha H (2019): Analysis of macular, foveal, and retinal nerve fiber layer thickness in children with unilateral anisometropic amblyopia and their changes following occlusion therapy. Indian J Ophthalmol, 67:1016-22.
7
Liu H, Zhong L and Zhou X (2010): Macular abnormality observed by OCT in children with amblyopia failing to achieve normal visual acuity after long-term treatment. J Pediatr Ophthalmol Strabismus, 47: 17—23.
8
Pang Y, Frantz KA, Block S, Goodfellow GW and Allison C (2015): Effect of amblyopia treatment on macular thickness in eyes with myopic anisometropic amblyopia. Invest Ophthalmol Vis Sci., 56:2677–2683.
9
Sapkota C, Alves S and Pina S (2014): Comparison of macular thickness and volume in amblyopic children using time domain optical coherence tomography. Ophthalmologia, 36:231—236.
10
Tugcu B, Araz-Ersan B and Erdogan ET (2014): Structural and functional comparison of the persistent and resolved amblyopia. Doc Ophthalmol., 128:101–109.
11
ORIGINAL_ARTICLE
COGNITIVE ASSESSMENT IN A SAMPLE OF EGYPTIAN PATIENTS WITH GENERALIZED ONSET EPILEPSY
Background: Cognitive brain functions constitute the ability to work with information in a meaningful way, apply gained information, perform preferential changes, and someone ability to change opinions about that information. Individuals with epilepsy have a higher prevalence of impaired cognitive performance compared to healthy individuals who are matched for age and education. Numerous factors can have a deleterious impact on cognition in patients, including age at onset of epilepsy, seizure frequency, duration of seizures, structural cerebral damage as a consequence of repetitive or prolonged seizures and medications used for treating seizures. Objective: Assessing the cognitive functions in patients with generalized onset epilepsy. Patients and Methods: Our study was conducted, in the neurology department of Sohag general hospital upon 75 individuals divided into 3 equal groups presented with epilepsy selected from the inpatient and outpatient clinics. Patients were divided into three groups: I. Group A: patients diagnosed with generalized onset epilepsy with medication (anti-epileptic drugs). II. Group B: patients diagnosed with generalized onset epilepsy without medication (anti-epileptic drugs). III. Group C: healthy subjects will be included in the study as the control group. All of the participants were be subjected to the following: *Full history (demographic data and personal history, detailed history of general health condition and chronic or current diseases) and general and neurological examination *Special tests including: PEBL Wisconsin (Berg) Card Sort test, PEBL The Conners’ continuous performance test, Montreal cognitive assessment (MoCa) *Brain imaging: MRI brain (to exclude organic cause). *EEG. Results: The mean Correct Responses Wisconison card sorting test of study groups was around 76.7±5.65 in group 1, around 78±2.88 in group 2 and 81.8±2.38 in group 3; with significant difference between group 1 and group 3 and significant difference between group 2 and group 3. The mean Target Acc Rate continuous performance test was around 0.956±0.03 in group 1, around 0.970±0.015 in group 2 and 0.974±0.015 in group 3; with significant difference between group 1 and group 2 and significant difference between group 1 and group 3. The mean MoCa of study groups was around 24.1 in epileptic with medication group, 23.96 in epileptic without medication group and 25 in control group with no significant difference between all groups. With high significant difference between Group 1 versus Group 3, and Group 2 versus Group 3. The normal MoCa was around 3 in epileptic with medication group, 2 in epileptic without medication group and 22 in control group with high significant difference between all groups. Conclusion: All patients with epilepsy reported significant impairment in all cognitive measures such as working memory, inhibitory control, goal maintenance, and mental flexibility. We observed attentional deficits in processes such as alertness and attention span and those requiring sustained and divided attention compared with controls. Attentional and executive impairment was correlated with higher frequency of seizures.
https://amj.journals.ekb.eg/article_67544_893b53ddb7ca1abc21d608978533d167.pdf
2020-01-01
125
136
10.21608/amj.2020.67544
Cognitive brain functions
cognition assessment and generalized onset epilepsy
Ahmed
El-Sayed Ismail
drahmedelsayed110@gmail.com
1
Department of Neurology, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Hassan
Kawashti Gad
2
Department of Neurology, Faculty of Medicine, Al-Azhar University
AUTHOR
Mohamed
Hamed Rashad
3
Department of Neurology, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Parente A., Manfredi V., Villani F., Franceschetti S. and Giovagnoli A.R. (2013): Investigating higher-order cognitive functions in temporal lobe epilepsy: Cognitive estimation, Biol Psychiatry. 28(10): 1276-1128.
2
Desoky T. and Gabra R.H. (2019): Executive dysfunction in an Egyptian sample of adult participants with epilepsy: a case–control study. Egyptian Journal of Psychiatry. 14: 31-34.
3
Fisher R.S., Cross J.H., French J.A., Higurashi N., Hirsch E., Jansen E., Lagae L., Moshe S.L., Peltola J., Perez E.R., Scheffer I.E. and Zuberi S.M. (2017): Operational classification of seizure types by the International League Against Epilepsy: Position Paper of the ILAE Commission for Classification and Terminology. Epilepsia. 58(4): 522-530.
4
Julayanont P., Brousseau M., Chertkow H., Phillips N. and Nasreddine Z.S. (2014): Montreal Cognitive Assessment Memory Index Score (MoCA-MIS) as a predictor of conversion from mild cognitive impairment to Alzheimer's disease. J Am Geriatr Soc. 62(4): 679-684.
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Luton L.M., Burns T.G. and DeFilippis N. (2010): Frontal lobe epilepsy in children and adolescents: a preliminary neuropsychological assessment of executive function. Arch Clin Neuropsychol. 25(8): 762-770.
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Megiddo I., Colson A., Chisholm D., Dua T., Nandi A. and Laxminarayan R. (2016): Health and economic benefits of public financing of epilepsy treatment in India: An agent-based simulation model. Epilepsia. 57(3): 464-474.
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Morita T., Asada M. and Naito E. (2016): Contribution of Neuroimaging Studies to Understanding Development of Human Cognitive Brain Functions. Front Hum Neurosci. 10: 464-469.
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Mueller S.T. and Piper B.J. (2014): The Psychology Experiment Building Language (PEBL) and PEBL Test Battery. J Neurosci Methods. 222: 250-259.
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Phabphal K. and Kanjanasatien J. (2011): Montreal Cognitive Assessment in cryptogenic epilepsy patients with normal Mini-Mental State Examination scores. Epileptic Disord. 13(4): 375-381.
10
Realmuto S., Zummo L., Cerami C., Agro L., Dodich A., Canessa N., Zizzo A., Fierro B. and Daniele O. (2015): Social cognition dysfunctions in patients with epilepsy: Evidence from patients with temporal lobe and idiopathic generalized epilepsies. Epilepsy Behav. 47: 98-103.
11
Sadr S.S., Javanbakht J., Javidan A.N., Ghaffarpour M., Khamse S. and Naghshband Z. (2018): Descriptive epidemiology: preva-lence, incidence, sociodemographic factors, socioeconomic domains, and quality of life of epilepsy: an update and systematic review. Arch Med Sci. 14(4): 717-724.
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Sunmonu T.A., Komolafe M.A., Ogunrin A.O. and Ogunniyi A. (2009): Cognitive assessment in patients with epilepsy using the Community Screening Interview for Dementia. Epilepsy Behav. 14(3): 535-539.
13
Zhang C., Yang H., Qin W., Liu C., Qi Z., Chen N. and Li K. (2017): Characteristics of Resting-State Functional Connectivity in Intractable Unilateral Temporal Lobe Epilepsy Patients with Impaired Executive Control Function. Front Hum Neurosci. 11: 609-612.
14
ORIGINAL_ARTICLE
ASSESSMENT OF EARLY RETINAL ANATOMICAL AND FUNCTIONAL CHANGES IN HYDROXYCHLOROQUINE TREATED PATIENTS BY MULTIFOCAL ELECTRORETINOGRAM AND OPTICAL COHERENCE TOMOGRAPHY
Background: Patients having treated with hydroxychloroquine (HCQ) can have retinal function and morphological changes with no evident retinal abnormalities on ophthalmoscopy this can be detected by various imaging Tanique’s. Objective: We aimed to evaluate the early changes of retinal function by multifocal electroretinogram (MF-ERG) and morphology by spectral domain optical coherence tomography (SD-OCT) that may eventually occur in a population of subjects having Rheumatoid Arthritis treated with hydroxychloroquine with no evident retinal abnormalities on ophthalmoscopy. Patients and methods: A prospective study on 30 eyes of patients treated with HCQ (Patient group) and another 30 healthy eyes (control group). SD-OCT and MF-ERG was done in both groups. All patients underwent full medical and ophthalmic history including onset and duration of disease and HCQ therapy, history of ocular surgeries. All patients underwent complete ophthalmic examination including visual acuity: uncorrected VA (UCVA) and best corrected VA (BCVA), anterior segment examination using slit-lamp biomicroscopy, intraocular pressure (IOP) measurement by applanation tonometry, fundus examination, OCT imaging using SD-OCT, and MF-ERG imaging. Results: In patients treated with HCQ, there was a significant reduction in the pri-foveal macular thickness by SD-OCT in comparison to control group. There were also significant MF-ERG changes in the form on decreased P1-wave amplitude and increased P1-wave latency. Conclusion: MF-ERG and SD-OCT were very sensitive tests for the early detection of HCQ-related retinal toxicity. Using either MF-ERG or SD-OCT, or combination of them may be recommended in order to detect retinal changes earlier and also in follow up.
https://amj.journals.ekb.eg/article_67545_ce62baa1fd5604426f105ebf510f1fbe.pdf
2020-01-01
137
148
10.21608/amj.2020.67545
Hydroxychloroquine Retinopathy
Multifocal Electroretinogram
Spectral Domain Optical Coherence Tomography
Chloroquine toxicity
El-Sayed
Mostafa Eliwa
1
Departments of Ophthalmology, Faculty of Medicine, Al-Azhar University
AUTHOR
Mostafa
Mahmoud Mostafa
2
Departments of Ophthalmology, Faculty of Medicine, Al-Azhar University
AUTHOR
Ahmed
Ragab
ahmedomardr@gmail.com
3
Departments of Ophthalmology, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
REFERENCES
1
Korah, S., and Kuriakose, T. (2008): Optical coherence tomography in a patient with chloroquine-induced maculopathy. Indian journal of ophthalmology, 56(6), 511.
2
Lung, J. C., Swann, P. G., and Chan, H. H. (2012): Early local functional changes in the human diabetic retina: a global flash multifocal electroretinogram study. Graefe's archive for clinical and experimental ophthalmology, 250(12): 1745-1754.
3
Lyons, J. S., and Severns, M. L. (2009): Using multifocal ERG ring ratios to detect and follow Plaquenil retinal toxicity: a review. Documenta ophthalmologica, 118(1): 29-36.
4
Marmor, M. F., Kellner, U., Lai, T. Y., Lyons, J. S., and Mieler, W. F. (2011): Revised recommendations on screening for chloroquine and hydroxychloroquine retinopathy. Ophthalmology, 118(2): 415-422.
5
Melles, R. B., and Marmor, M. F. (2014): The risk of toxic retinopathy in patients on long-term hydroxychloroquine therapy. JAMA ophthalmology, 132(12): 1453-1460.
6
Moschos, M. M., Nitoda, E., Chatziralli, I. P., Gatzioufas, Z., Koutsandrea, C., and Kitsos, G. (2015): Assessment of hydroxychloroquine maculopathy after cessation of treatment: an optical coherence tomography and multifocal electroretinography study. Drug design, development and therapy, 9: 2993.
7
Pasadhika, S., and Fishman, G. A. (2010): Effects of chronic exposure to hydroxychloroquine or chloroquine on inner retinal structures. Eye, 24(2): 340-346.
8
Shao, L., Xu, L., Chen, C. X., Yang, L. H., Du, K. F., Wang, S., ... and Wei, W. B. (2013): Reproducibility of subfoveal choroidal thickness measurements with enhanced depth imaging by spectral-domain optical coherence tomography. Investigative ophthalmology & visual science, 54(1): 230-233.
9
Stepien, K. E., Han, D. P., Schell, J., Godara, P., Rha, J. and Carroll, J. (2009): Spectral-domain optical coherence tomography and adaptive optics may detect hydroxychloroquine retinal toxicity before symptomatic vision loss. Transactions of the American Ophthalmological Society, 107: 28-33.
10
Ulviye, Y., Betul, T., Nur, T. H., and Selda, C. (2013): Spectral domain optical coherence tomography for early detection of retinal alterations in patients using hydroxychloroquine. Indian journal of ophthalmology, 61(4): 168-171.
11
ORIGINAL_ARTICLE
IMPACT OF DIABETES MELLITUS ON MICROVASCULAR MYOCARDIAL PERFUSION AND LEFT VENTRICULAR REMODELING IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION TREATED WITH PRIMARY CORONARY INTERVENTION
Background: Diabetes mellitus (DM) is associated with a greater risk of cardiovascular disease and almost one third of patients with acute myocardial infarction (AMI) may have undiagnosed DM on admission. DM is associated with abnormal endothelial function, increased inflammatory response, increased platelets and leukocytes plugging and seems to be an important factor deteriorating microvascular reperfusion in acute phase of MI. Objective: The purpose of this study was to evaluate the impact of diabetes mellitus on: (1) Myocardial microvascular reperfusion after primary PCI in patients with acute myocardial infarction utilizing two well validated measures of myocardial reperfusion, resolution of ST- segment elevation and myocardial blush grade (MBG) and (2) Left ventricular systolic function recovery and incidence of remodeling after primary PCI in patients with acute myocardial infarction. Patients and Methods: The study population consisted of 100 patients with STEMI (50 diabetic and 50 non-diabetic) conducted at coronary care unit of El-Zyton specialized hospital .All patients underwent Primary percutaneous coronary intervention (1ry PCI), ECG (pre and post PPCI) to assess ST segment resolution and Conventional 2D echocardiography to asses left ventricular ejection fraction ( LVEF) (by M-Mode and Simpson rule), end diastolic volume (EDV) and end systolic volume (ESV) and wall motion score index(WMSI) was done within 72hr of admission and after 3 months later and patients with LV remodeling, i.e. an increase >20% in LV end-diastolic volume (LVEDV), were identified. Results: No significant difference was found regarding baseline demographic, clinical and lab data except in dyslipidemic number of patients (92% in diabetic group vs. 36% in non-diabetic group. There was a statistically significant difference between both studied groups as regard ECG post PPCI finding, no significant difference between 2 groups as regard baseline ECHO (EF by M-Mode, EF by Simpsons rule, LVEDV, LVESV, E/A ratio, deceleration time (DT) and wall motion score index). As regard coronary angiography and 1ry PCI data there was a significant difference between diabetic and non-diabetic group as regard number of diseased vessel and myocardial blush grade (MBG): MBG(0) was 1 % in diabetic group and was 1% in non-diabetic group, MBG (1) was 12 % in diabetic group and was 4% in non-diabetic group ,MBG(2) was 48 % in diabetic group and was 14% in non-diabetic group and MBG(3) was 38 % in diabetic group and was 80% in non-diabetic group . Conclusion: The microvascular reperfusion in STEMI patients with diabetes was worse than STEMI patients without diabetes. The incidence of remodeling was more in STEMI patients with diabetes than STEMI patients without diabetes.
https://amj.journals.ekb.eg/article_67546_e0d9346e2e8571186bb9e97afc5ec7de.pdf
2020-01-01
149
160
10.21608/amj.2020.67546
Acute coronary syndromes
Acute myocardial infarction
Antithrombotic therapy
Fibrinolysis
Ischemic heart disease
Primary percutaneous coronary intervention
Reperfusion therapy
ST-segment elevation
Sameh
Refaat Allam
1
Cardiology Department, Al-Azhar Faculty of Medicine
AUTHOR
El-Sayed
Ali Abdo El-Marghany
2
Cardiology Department, Al-Azhar Faculty of Medicine
AUTHOR
Omar
Ahmed Helmi
d.omarhelmy@gmail.com
3
Cardiology Department, Al-Azhar Faculty of Medicine
LEAD_AUTHOR
REFERENCES
1
Amira M, Samy w and Randa A (2016): Speckle Tracking Echocardiography in Diabetic Patients with STEMI. Med. J. Cairo Univ,. 1579-1585.
2
Andrade P, Rinaldi F and Bergonso M (2013):.ST-Segment Resolution after Primary Percutaneous Coronary Intervention: Characteristics, Predictors of Failure, and Impact on Mortality. Rev Bras CardiolInvasiva, 21(3):227-33.
3
Antoniucci D, Valenti R and Migliorini A(2004): Impact of Insulin-Requiring diabetes mellitus on effectiveness of reperfusion and outcome of patients undergoing primary percutaneous coronary intervention for acute myocardial infarction; American Journal of Cardiology, 93( 9):1170-1172.
4
Araszkiewicz A, Janus M and Prech M (2014): Relations of diabetes mellitus, microvascular reperfusion and left ventricular remodelling in patients with acute myocardial infarction treated with primary coronary intervention. Kardiol Pol., 72, 1: 20–26.
5
Brener SJ, Mehran R and Dressler O (2012): Diabetes mellitus, myocardial reperfusion, and outcome in patients with acute ST-elevation myocardial infarction treated with primary angioplasty (from HORIZONS AMI). Am J Cardiology, 109(8):1111-6.
6
Choe J, Cha K and Yun EY (2017): Reverse Left Ventricular Remodelling in ST-Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention: Incidence, Predictors, and Impact on Outcome.Heart Lung Circ., 27(2):154-164.
7
Farag E and Al-Daydamony M (2017): Symptom-to-balloon time and myocardial blush grade are predictors of left ventricular remodelling after successful primary percutaneous coronary intervention. Cardiovasc J, 28: 186–190.
8
Gargiulo G (2016): 6- or 24-month dual-antiplatelet therapy duration: Insights from the PROlonging Dual-antiplatelet treatment after grading stent-induced Intimal hyperplasia studY trial. Am Heart J, 174:95–102.
9
Georgette E, Rachid A and Joyce E (2015): Comparison of Changes in Global Longitudinal Peak Systolic Strain after ST-Segment Elevation Myocardial Infarction in Patients with Versus Without Diabetes Mellitus. Am J Cardiol., 116:1334–9.
10
Lamblin N, Fertin M and de Groote P (2012): Cardiac remodeling and heart failure after a first anterior myocardial infarction in patients with diabetes mellitus. J Cardiovasc Med (Hagerstown), 13: 353-359.
11
Preis S, Hwang S and Coady Sa (2009): Trends in all-cause and cardiovascular disease mortality among women and men with and without diabetes mellitus in the Framingham Heart Study, 1950 to 2005. Circulation, 119(13): 1728-35.
12
Shah AM, Hung CL and Shin SH (2011): Cardiac structure and function, remodeling, and clinical outcomes among patients with diabetes after myocardial infarction complicated by left ventricular systolic dysfunction, heart failure, or both. Am Heart J., 162:685–91.
13
Verouden NJ, Haeck JD and Kuijt WJ (2010): Clinical and angiographic predictors of ST-segment recovery after primary percutaneous coronary intervention, American Journal of Cardiology, 105(12):1692-1697
14
ORIGINAL_ARTICLE
EVALUATION OF OX-LDL AND EXTRACELLULAR SUPEROXIDE DISMUTASE IN HEPATITIS C VIRUS PATIENTS BEFORE AND AFTER DIRECT-ACTING ANTIVIRAL THERAPY
Background: Hepatitis C virus (HCV) lifecycle is closely connected to host cell lipid metabolism, from cell entry, through viral RNA replication to viral particle production and formation/assembly. Objective: To determine the serum levels of ox-LDL, total antioxidant capacity and superoxide dismutase, and evaluate their role in HCV hepatitis patients. In addition, the effect of direct-acting antiviral therapy on their levels was evaluated. Patients and Methods: This study included forty chronic hepatitis C (genotype 4) patients. Blood samples were taken from the patients before and after taking sofosbuvir (400 mg) and daclatsvir 60 mg; one time daily orally for 24 weeks. Forty apparently healthy personnel were used as control group. Results: Serum TAC in chronic HCV hepatitis patients were significantly low before treatment as compared to the control group. Serum levels of ox-LDL were significantly high in patients before treatment and after treatment as compared to control group. Antioxidants supplementations and direct antiviral drugs did not affect the levels of ox-LDL significantly. Serum levels of extracellular SOD were significantly higher in control group, than levels in HCV patients before treatment and after treatment. Treatment did not restore the levels of serum SOD in patients. Direct-acting antiviral agents had a sustained virological response in the chosen group of patients. Conclusions: Direct-acting antiviral agents did not normalize serum levels of ox-LDL and extracellular SOD. In addition, the currently used antioxidants did not decrease the oxidative changes in LDL.
https://amj.journals.ekb.eg/article_67547_bdb1e147a24910e11211eeb10007f774.pdf
2020-01-01
161
174
10.21608/amj.2020.67547
Ox-LDL
Total Antioxidant Capacity
superoxide dismutase
HCV hepatitis
direct antiviral therapy
Sofosbuvir
daclatsvir
Mahmoud
Mohamed Abou El-Makarem
1
Department of Medical Biochemistry, Faculty of Medicine, Al -Azhar University, Cairo, Egypt
AUTHOR
Abd El-Aziz
Abd El-Rahman El-Nokaly
2
Department of Medical Biochemistry, Faculty of Medicine, Al -Azhar University, Cairo, Egypt
AUTHOR
Sayed
Farouk Mohamed
sayed.faroukma@azhar.edu.eg
3
Department of Tropical Medicine, Faculty of Medicine, Al -Azhar University, Cairo, Egypt
AUTHOR
Ibrahim
Hassan Mohammed
4
Department of Medical Biochemistry, Faculty of Medicine, Al -Azhar University, Cairo, Egypt
AUTHOR
Ahmed
Mahrous Ahmed Ibrahim
5
Department of Medical Biochemistry, Faculty of Medicine, Al -Azhar University, Cairo, Egypt
AUTHOR
REFERENCES
1
Abhilash PA, HarikrishnanR and Indira M (2013): Ascorbic acid is superiortosilymarin in the recovery of ethanol-induced inflammatory reactions inhepatocytes of guinea pigs. J Physiol Biochem., 69: 785-798.
2
Abou-El-Makarem MM, Moustafa MM, Fahmy MA, Abdel-Hamed AM, El-Fayomi KN and Darwish MA (2014): Evaluation of Carbonylated Proteins in Hepatitis C Virus Patients. Mod Chem Appl., 2:130-137.
3
Choi J (2012): Oxidative stress, endogenous antioxidants, alcohol, and hepatitis C: pathogenic interactions and therapeutic considerations. Free Radic Biol Med., 52(7): 1135-1150.
4
Freitas MCP, Fernandez DGE, Cohen D, Figueiredo-Neto AM, Maranhão RC and Damasceno NRT (2018): Oxidized and electronegative low-density lipoprotein as potential biomarkers of cardiovascular risk in obese adolescents. Clinics (Sao Paulo)., 73:e189.
5
Fryar CD, Quipping G and Ogden CL (2010): Anthropometric Reference Data for Children and Adults: United States, 2007–2010. Vital and health statistics, Series 11, Number 252.
6
Ganini D and Mason RP (2014): Absence of an effect of vitamin E on protein and lipid radical formation during lipoperoxidation of LDL by lipoxygenase. Free Radic Biol Med., 76:661-668.
7
González-Aldaco K, Torres-Reyes LA, Ojeda-Granados C, José-Ábrego A, Fierro NA and Román S (2018): Immunometabolic Effect of Cholesterol in Hepatitis C Infection: Implications in Clinical Management and Antiviral Therapy. Ann Hepatol., 17(6):908-919.
8
Gottfredsen RH, Goldstrohm DA, Hartney JM, Larsen UG, Bowler RP and Petersen SV (2014): The cellular distribution of extracellular superoxide dismutase in macrophages is altered by cellular activation but unaffected by the naturally occurring R213G substitution. Free Radic Biol Med., 69:348-56.
9
Ho CM, Ho SLJeng YM, Lai YS, Chen YH, Lu SC, Chen HL, Chang PO, Hu RH and Lee PH (2019): Accumulation of free cholesterol and oxidized low-density lipoprotein is associated with portal inflammation and fibrosis in nonalcoholic fatty liver disease. J Inflamm (Lond)., 16:Aricle 7.
10
Holley AK, Bakthavatchalu V, Velez-Roman JM and St. Clair DK (2011): Manganese Superoxide Dismutase: Guardian of the Powerhouse. Int J Mol Sci., 12: 7114-7162.
11
Holvoet P, Mertens A, Verhamme P, Bogaerts K, Beyens G, Verhaeghe R, Collen D, Muls E and Van de Werf F (2001): Circulating oxidized LDL is a useful marker for identifying patients with coronary artery disease. Arterioscler Thromb Vasc Biol., 21(5):844-848.
12
Janardhan SV and Reau NS (2015): Should NS5A inhibitors serve as the scaffold for all-oral anti-HCV combination therapies. Hepat Med., 7:11-20.
13
Karadeniz G, Acikgoz S, Tekin IO, Tascýlar O, Gun BD and Cömert M (2008): Oxidized low-density-lipoprotein accumulation is associated with liver fibrosis in experimental cholestasis. Clinics (Sao Paulo)., 63:531–540.
14
Khedr MA, El-Araby HA, Konsowa HA, Sokar SS, Mahmoud MF, Adawy NM and Zakaria HM (2019): Glutathione peroxidase and malondialdehyde in children with chronic hepatitis C. Clin Exp Hepatol. 2019 Mar;5(1):81-87.
15
Koracevic D, Koracevic G, Djordjevic V, Andrejevic S and Cosic V (2001): Method for the measurement of antioxidant activity in human fluids. J Clin Pathol., 54: 356-361.
16
Li H, Huang MH, Jiang JD and Peng ZG (2018): Hepatitis C: from inflammatory, pathogenesis, to anti-anflammatory/hepatoprotective therapy. World J Gastroenterol., 24(47):5297-5311.
17
Lin SJ, Shyue SK, Shih MC, Chu TH, Chen YH, Ku HH, Chen JW, Tam KB and Chen YL (2007): Superoxide dismutase and catalase inhibit oxidized low-density lipoprotein-induced human aortic smooth muscle cell proliferation: role of cell-cycle regulation, mitogen-activated protein kinases, and transcription factors. Atherosclerosis, 190(1): 124-134.
18
Lozano-Sepulveda SA, Bryan-Marrugo OL, Cordova-Fletes C, Gutierrez-Ruiz MC and Rivas-Estilla AM (2015): Oxidative stress modulation in hepatitis C virus infected cells. World J Hepatol., 7(29): 2880–2889.
19
Makino J, Asai R, Hashimoto M, Kamiya T, Hara H, Ninomiya M, Koketsu M and Adachi T (2016): Suppression of EC-SOD by oxLDL During Vascular Smooth Muscle Cell Proliferation. J Cell Biochem., 117(11):2496-2505.
20
Nishikimi M, RaoNA andYagi K (1972): The occurrence of superoxide anion in the reaction of reduced phenazinemethosulphate and molecular oxygen. Biochem. Biophys Res Co., 46: 849–864.
21
Pol S, Corouge M and Vallet-Pichard A (2016): Daclatasvir-sofosbuvir combination therapy with or without ribavirin for hepatitis C virus infection: from the clinical trials to real life. Hepat Med., 8:21-26.
22
Robbins D and Zhao Y (2011): The role of manganese superoxide dismutase in skin cancer. Enzyme Res., 2011:492-95.
23
Russ KB, Stevens TM and Ashwani KS (2015): Acute Kidney Injury in Patients with Cirrhosis. J ClinTranslHepatol; 3(3): 195–204.
24
ORIGINAL_ARTICLE
EFFECT OF PLATELET RICH PLASMA-ENRICHED GELFOAM ON CHRONIC TYMPANIC MEMBRANE PERFORATION
Background: Tympanic Membrane (TM) perforation is one of the common reasons of patients’ attending Otolaryngology clinics. Repair of tympanic membrane perforations with most accepted techniques reaches a success rate of over 90%. Platelet-Rich Plasma (PRP) can be defined as an autologous concentration of human platelets in a small volume of plasma. Objective: The aim of this study was to evaluate the effect of PRP-enriched gel foam on the healing of chronic TM perforation in comparison with gel foam alone after myringoplasty. Patients and Methods: In this double-blind randomized clinical trial, 40 patients with chronic tympanic membrane perforations, attending the ENT outpatient clinics of Al-Azhar university hospitals between September, 2017 and May, 2019, they were randomly allocated to two groups; intervention group, underwent myringoplasty with platelet rich plasma (PRP)-enriched gel foams and control group, underwent myringoplasty operation with conventional gel foams alone. Patients were seen 1 month, 3 months and 6 months after surgery. Results: Forty patients, 21 males (52.5%) and 19 females (47.5%) with a mean age of 45.3 ± 11.9 years in intervention, and 43.98 ± 10.8 years in control group underwent analysis. Complete TM healing was seen in 19 (95%) patients in intervention group, and 14 (70%) patients in control group three months after intervention. No complications were seen in intervention group, while three otorrhea cases were recorded for control group in the first follow up after intervention which was resolved by medication. Conclusion: Addition of PRP to conventional gel foams used in TM perforation repair increased the complete healing rate of TM perforation to a significant extent.
https://amj.journals.ekb.eg/article_67548_b4bba6bf3b9b5993d6f4801a7757e2cc.pdf
2020-01-01
175
182
10.21608/amj.2020.67548
platelet-rich plasma
gel foam
tympanic membrane perforation
Ahmed
Seddik Abd El-Gelil
dr_ahmedseddik@yahoo.com
1
Otorhinolaryngology Department, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Yahia
Mohamed Dawod
2
Otorhinolaryngology Department, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Ahmed R., Yasser A., Magdy B. and Saeed A. (2018): Myringoplasty Of Central Tympanic Membrane Perforation With A Fat Graft From The Ear Lobule And Platelet Rich Plasma. Z.U.M.J., 24: (2): 188-192.
2
Akbar Z. and Saif O. (2019): Myringoplasty using temporalis fascia and its clinical outcome. Int J Otorhinolaryngol Head Neck Surg., 5:1539-42.
3
Cervelli V., Gentile P., Scioli M. and Grimaldi M. (2009): Application of platelet-rich plasma in plastic surgery: clinical and in vitro evaluation. Tissue Eng Part C Methods, 15:625-34.
4
Dhafer A. (2016): Use of PRP in Rhinoplasty. Otolaryngol (Sunnyvale), 6(6):280-282.
5
El-Anwar M., El-ahl M., Zidan A. and Yacoup M. (2015): Topical use of autologous Platelet rich plasma in myringolplasty. Arius Nasus Larynx, 42(5):365-8.
6
Erkilet E., Koyuncu M., Atmaca S. and Yarim M. (2009): Platelet rich plasma improves healing of tympanic membrane perforations: Expermental study. J Laryngol Otol., 123(5):482-7.
7
Fawzy T., Hussein M., Eid S. and Guindi S. (2018): Effect of adding platelet-rich plasma to fat grafts in myringoplasty. Egypt J Otolaryngol, 34;224-8.
8
Garin P., Peerbaccus Y., Mardyla N., Mullier F., Gheldof D. and Dogne J. (2014): Platelet-Rich plasma (PRP): an autologous packing material for middle ear microsurgery. B-ENT, 10:27-34.
9
Habesoglu M., Oysu C., Yilmaz A. and Tosun A. (2014): Platelet rich fibrin for repair of tympanic membrane. J Craniofac Surg., 25(6):2056-8.
10
Maria L., Ortiz L., Rodriguez R. and Boemo J. (2011): Research Article on Pilot Study on the Efficiency of the Biostimulation with Autologous Plasma Rich in Platelet Growth Factors in Otorhinolaryngology: Otologic Surgery (Tympanoplasty Type I). ISRN Surgery, 7(4):213-220.
11
Mohammad A., Wail F. and Samir S. (2018): Platelet-Rich Plasma in Reconstruction of Posterior Meatal Wall after Canal Wall Down Mastoidectomy. Arch Otorhinolaryngol., 22(2):103-107.
12
Mohebbi S., Daneshi A. and Ebrahimnijad S. (2018): Evaluation of Locally Administered Autologous Platelet Rich Plasma in Reducing Symptoms of Recurrent Sinonasal Polyposis Following Endoscopic Sinus Surgery. RJMS, 25(8):24-32.
13
Panayiota M., Angelos K., Stephanie M., Samir M., Magdolna K. and Agnes S. (2016): Anosmia treatment by platelet rich plasma injection.The International Tinnitus Journal, 20(2):102-105.
14
Ruta S., Yoganathan G. and Vellavedu U. (2018): Myringoplasty with Autologous Platelet Rich Plasma -A Prospective Study. JMSCR, 10(6): 1170-1173.
15
Saeedi M., Ajalloueian M., Zare E., Taheri A., Yousefi J. and Mirlohi S. (2017): The effect of PRP-enriched gel foam on chronic tympanic membrane perforation: A double-blind randomized clinical trial. International Tinnitus Journal, 21(2):108-111.
16
Scala M., Mereu P. and Spagnolo F. (2014): The use of platelet-rich plasma gel in patients with mixed tumor undergoing superficial parotidectomy: a randomized study. In vivo. Acta Otorhinolaryngologica Italica, 28: 121-4.
17
Serap B., Selcuk D., Hasan E., Tahsin M., Mustafa C. and Cagdas E. (2014): Treatment of Acute Vocal Fold Injury with Platelet-Rich Plasma. Journal of Voice, 30(6): 731-735.
18
Sommeling C., Heyneman A. and Hoeksema A. (2013): The use of platelet rich plasma in plastic surgery; a systematic review. An international journal of surgical reconstruction. JPRAS, 66(3):301-311.
19
Tamer F., Hussein M., Eid S. and Guindi S. (2018): Effect of adding platelet-rich plasma to fat grafts in myringoplasty. Egypt J Otolaryngol. 34:224-8.
20
Tang X., Dong P., Wang J., Zhou H., Zhang H. and Wang S. (2015): Effect of autologous platelet-rich plasma on the chondrogenic differentiation of rabbit adipose-derived stem cells in vitro. Exp Ther Med., 10(2):477-83.
21
Tate K. and Crane D. (2010): Platelet rich plasma grafts in musculoskeletal medicine. J Prolother., 2:371–6.
22
Yadav S., Malik J., Malik P. and Sehgal P. (2018): Studying the result of underlay myringoplasty using platelet-rich plasma. Journal of Laryngology & Otology, 132(11):990-994.
23
ORIGINAL_ARTICLE
CLINICAL AND RADIOLOGICAL EVALUATION OF PATIENTS WITH SUBARACHNOID HAEMORRHAGE SUBJECTED TO DIGITAL SUBTRACTION ANGIOGRAPHY IN AL-HUSSEIN NEURO-INTERVENTION UNIT
Background: Subarachnoid hemorrhage (SAH) refers to bleeding that occurs primarily within the subarachnoid space, in between cases of spontaneous SAH and rupture of an intracranial saccular aneurysm accounts for approximately 85%. Objectives: The aim of this study was to assess clinical presentation, risk factors and the etiology of subarachnoid hemorrhage in a sample of Egyptian patients, and also assess the outcome of endovascular management and complications. Patients and Methods: The study was carried out on patients with SAH who were subjected to endovascular neuro-intervention unit in AL-Hussein University Hospital, including patients with SAH retrospectively from 2006 to 2018, and the newly diagnosed patients during 2019. Results: During the period from May 2006 to May 2019, 560 patients with SAH has been admitted. 136 patients (24.2%) were excluded from the study as they were critically ill. Their Hunt and Hess score were 4 to 5. Also, another 51 has been excluded due to missed files or discharge against medical advice. The remaining 373 patients. 145 patients were angiographically free, Patients with aneurysm were 228 patients, 77 patients died before therapeutic endovascular treatment as they delayed due to financial troubles, The remaining patients were 151, The most common type of aneurysm between those patients was anterior communicating aneurysm (27.8%), then MCA aneurysm (17.8%), posterior communicating artery aneurysm (13.9%), para-ophthalmic artery aneurysm (6.6 %), basilar artery aneurysm (5.9%), posterior inferior cerebellar artery aneurysm (6.4%), supraclinoid carotid artery aneurysm (3.1%), peri callossal artery aneurysm (3.3%), T carotid artery aneurysm (7.2%), superior cerebellar artery aneurysm (1.9%), inferior cerebellar artery aneurysm (2.6%) and multiple aneurysms (6.6%). The complications of endovascular treatment in studied patients occurred in 13 patients (3.4%) in the form of aneurysmal rupture, coil displacement, hydrocephalus and vessel rupture. Conclusion: Cerebral catheter angiography is a safe, feasible and efficacious procedure. The new technique in the endovascular management of the cerebral aneurysm as balloon or stent assisted technique and flow diverter stent is greatly reducing the complication rate and making the outcome is very promising.
https://amj.journals.ekb.eg/article_67549_8bc7dc399b972c26bc5f83acea12bb83.pdf
2020-01-01
183
196
10.21608/amj.2020.67549
Subarachnoid Hemorrhage
Digital Subtraction Angiography
Khaled
Muhammad Sobh
1
Neurology Department, Faculty of Medicine, Al-Azhar University
AUTHOR
Muhammad
Salah Al Fishawy
2
Radiology Department, Faculty of Medicine, Al-Azhar University
AUTHOR
Mahmoud
Galal
3
Neurology Department, Faculty of Medicine, Al-Azhar University
AUTHOR
Muhammad
Fadel Muhammad
m_fadel1991@yahoo.com
4
Neurology Department, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
REFERENCES
1
Ahmed, A. Z., Zohdi, A. M., Zaghloul, M. S and ElSamman, A. K. (2013): Endovascular coiling versus surgical clipping in the treatment of ruptured anterior communicating artery aneurysm in Cairo University Hospitals. The Egyptian Journal of Radiology and Nuclear Medicine, 44(3): 523-530.
2
Ahmed, M., Nasir, H., Khan, A and Anwar, K. (2015): To Compare Aneurysmal Findings of CTA with Surgical Findings in Patients of Aneurysmal Subarachnoid Haemorrhage. Pakistan Journal of Neurological Surgery, 19(4): 241-245.
3
Ayling, O. G., Ibrahim, G. M., Alotaibi, N. M., Gooderham, P. A and Macdonald, R. L. (2016): Dissociation of early and delayed cerebral infarction after aneurysmal subarachnoid hemorrhage. Stroke, 47(12): 2945-2951.
4
Badry, A., Elshafey, R and Khalil, M. (2014): Detection, characterization and endovascular therapy planning of intracranial aneurysms with 16-channel multidetector row CT angiography. The Egyptian Journal of Radiology and Nuclear Medicine, 45(1): 151-158.
5
Chen, G., Fang, Q., Zhang, J., Zhou, D and Wang, Z. (2011): Role of the Nrf2‐ARE pathway in early brain injury after experimental subarachnoid hemorrhage. Journal of Neuroscience Research, 89(4): 515-523.
6
Coelho, L. G. B. S. A., Costa, J. M. D and Silva, E. I. P. A. (2016): Non-aneurysmal spontaneous subarachnoid hemorrhage: peri mesencephalic versus non-peri mesencephalic. Revista Brasileira de Terapia Intensiva, 28(2): 141.
7
Fattahian, R., Shahsavari, N and Sadeghi, M. (2018): Epidemiological Factors of Non-traumatic Subarachnoid Hemorrhage and Complications during Hospitalization in Kermanshah’s Educational Hospitals. Journal of Research in Medical and Dental Science, 6(2): 327-331.
8
Gunia, D. D., Ekvtimishvili, E. T and Basiladze, G. Z. (2016): Using of modern endovascular methods and techniques in treatment of complex aneurysms. Journal of Endovascular Neuroradiology, 2: 22-28.
9
Hanak, B. W., Zada, G., Nayar, V. V., Thiex, R., Du, R., Day, A. L and Laws, E. R. (2012): Cerebral aneurysms with intrasellar extension: a systematic review of clinical, anatomical, and treatment characteristics: A review. Journal of neurosurgery, 116(1): 164-178.
10
Jeon, S. B., Parikh, G., Choi, H. A., Badjatia, N., Lee, K., Schmidt, J. M and Claassen, J. (2013): Cerebral microbleeds in patients with acute subarachnoid hemorrhage. Neurosurgery, 74(2): 176-181.
11
Kang, J., Kang, C. H., Roh, J., Yeom, J. A., Shim, D. H., Kim, Y. S and Kim, S. K. (2018): Feasibility, Safety, and Follow-up Angiographic Results of Endovascular Treatment for Non-Selected Ruptured Intracranial Aneurysms Under Local Anesthesia with Conscious Sedation. Journal of Neurocritical Care, 11(2): 93-101.
12
Kranthi, S., Sahu, B. P and Aniruddh, P. (2016): Factors affecting outcome in poor grade subarachnoid haemorrhage: An institutional study. Asian Journal of Neurosurgery, 11(4): 365.
13
Kumar, S., Goddeau, R. P., Selim, M. H., Thomas, A., Schlaug, G., Alhazzani, A and Caplan, L. R. (2010): Atraumatic convexal subarachnoid hemorrhage: clinical presentation, imaging patterns, and etiologies. Neurology, 74(11): 893-899.
14
Mac Grory, B., Vu, L., Cutting, S., Marcolini, E., Gottschalk, C and Greer, D. (2018): Distinguishing characteristics of headache in nontraumatic subarachnoid hemorrhage. Headache: The Journal of Head and Face Pain, 58(3): 364-370.
15
Song, J. P., Ni, W., Gu, Y. X., Zhu, W., Chen, L., Xu, B and Mao, Y. (2017): Epidemiological Features of Nontraumatic Spontaneous Subarachnoid Hemorrhage in China: A Nationwide Hospital-based Multicenter Study. Chinese Medical Journal, 130(7): 776.
16
Wiebers, D. O. (2006): Unruptured intracranial aneurysms: natural history and clinical management. Update on the international study of unruptured intracranial aneurysms. Neuroimaging Clinics, 16(3): 383-390.
17
ORIGINAL_ARTICLE
COMPARATIVE STUDY BETWEEN CONTINUOUS SPINAL ANESTHESIA AND COMBINED SPINAL EPIDURAL ANESTHESIA IN KNEE ARTHROPLASTY
Background: Continuous spinal anesthesia (CSA) and combined spinal epidural anesthesia (CSE) are safe and reliable anesthesia methods in knee arthroplasties. Objectives: This study aimed at comparing the efficacy and hemodynamic changes of CSA technique versus single interspace CSE technique in knee arthroplasties intra & postoperatively, and the potential adverse effects for both techniques. Patients and Methods: After approval of Institutional ethical committee and obtaining written informed consents, forty patients aged 18 to 55 years of both sexes and American Society of Anesthesiologists (ASA) class I, II, were scheduled for elective knee arthroplasties. All Patients were assigned randomly by using a computerized program to one of the two equal groups: Group CSA: Patients undergoing elective knee arthroplasty received continuous spinal anesthesia. Group CSE: Patients undergoing elective knee arthroplasty received single interspace combined spinal epidural anesthesia. The following parameters were assessed: Hemodynamics: including heart rate and systolic (SBP) and diastolic arterial blood pressures (DBP), and percentage of oxygen saturation (SpO2) were obtained then recorded at 5th, 15th, 30 minutes, and at 1st, 2nd, 4th hours intra-operatively till the end of surgery. Postoperatively, they were obtained at 0, 1 hour and every four hours for first 24 hours. Anesthetic complications: PDPH, urine retention, and Postoperative nausea and vomiting (PONV). Postoperative pain was evaluated at rest using a 10-cm Visual analogue scale (VAS) (0 cm=no pain; 10 cm=worst pain possible) and pain scores were recorded at 30 min and 1st, 2nd, 4th, 6th, 12th and 24th hours post-operatively. This prospective randomized clinical trial study was conducted at Al- Azhar University Hospitals (Al- Hussein and Bab-Al-Shaarya) at the orthopedics operating theatre from March 2019 till September 2019. Results: No significant difference between the two groups regarding the length of surgery, hypoxia, post-operative nausea and vomiting (PONV), post-operative pain score. The application time of the anesthetic technique was significantly shorter in the CSA group than CSE group. The heart rate was significantly higher in the CSE group at 1st minutes while SBP and DBP were significantly lower in the CSE group at 1st minutes than the CSA group. Post dural puncture headache (PDPH), and urine retention was significantly higher in the CSA group than the CSE group. PDPH occurred in 35% of the CSA group compared to 10 %. Urine retention occurred in 25% of the CSA group compared to 5% of the CSE group. The total dose of bupivacaine (0.5%) collectively given intra-operatively and morphine postoperatively were significantly lower in the CSA group than the CSE group. Conclusion: The study revealed that CSA and CSE were both effective and safe techniques for knee arthroplasties with superiority of CSA in hemodynamic stability intraoperative at 1st minutes of surgery. CSA offered many advantages over epidural anesthesia by using smaller anesthetic dose with rapid onset and recovery of motor and sensory blockade with better cardiovascular stability than CSE.
https://amj.journals.ekb.eg/article_67550_ce1f99b098a8e3911a9ef1af352c30ab.pdf
2020-01-01
197
208
10.21608/amj.2020.67550
Anesthesia
spinal
epidural
Knee arthroplasties
Sayed
Ahmed Abd El-Ali
1
Department of Anesthesiology and Intensive Care, Faculty of Medicine, Al-Azhar University
AUTHOR
Amr
Soliman Abd El-Magid
2
Department of Anesthesiology and Intensive Care, Faculty of Medicine, Al-Azhar University
AUTHOR
Abd Allah
Ahmed Abd El-Sadek Sayed
doctorxp2000@gmail.com
3
Department of Anesthesiology and Intensive Care, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
REFERENCES
1
Alonso, E., Gilsanz, F., Gredilla, E., Martinez, B., Canser, E., and Alsina, E. (2009): Observational study of continuous spinal anesthesia with the catheter-over-needle technique for cesarean delivery. International Journal of Obstetric Anesthesia, 18(2): 137-141.
2
Bujedo, B. M. (2014): Spinal opioid bioavailability in postoperative pain. Pain Practice, 14(4): 350-364.
3
Imbelloni, L. E., Gouveia, M. A. and Cordeiro, J. A. (2009): Continuous spinal anesthesia versus combined spinal epidural block for major orthopedic surgery: prospective randomized study. Sao Paulo Medical Journal, 127(1): 7-11.
4
Jaitly, V. K., and Kumar, C. M. (2009): Continuous spinal anaesthesia for laparotomy. Current Anaesthesia and Critical Care, 20(2): 60-64.
5
Lux EA (2012): Continuous spinal anesthesia for lower limb surgery: a retrospective analysis of 1212 cases. Local and Regional Anesthesia, 5:63–67.
6
Milbrandt, T. A., Singhal, M., Minter, C., McClung, A., Talwalkar, V. R., Iwinski, H. J. and Sucato, D. J. (2009): A comparison of three methods of pain control for posterior spinal fusions in adolescent idiopathic scoliosis. Spine, 34(14): 1499-1503.
7
Moore, J. M. (2009): Continuous spinal anesthesia. American Journal of therapeutics, 16(4): 289-294.
8
Palmer CM (2010): Continuous Spinal Anesthesia and Analgesia in Obstetrics. Anesthesia and Analgesia, 111(6): 1476-1479.
9
Radke K, Radke OC (2013): Post-dural puncture headache. Anaesthesist, 62:149-161
10
Stamenkovic, D. and Karanikolas, M. (2012): Combined spinal epidural anesthesia and analgesia. Epidural Analgesia-Current Views and Approaches. Croatian: In Tech: 115-134.
11
Tao, W., Grant, E. N., Craig, M. G., McIntire, D. D. and Leveno, K. J. (2015): Continuous spinal analgesia for labor and delivery: an observational study with a 23-gauge spinal catheter. Anesthesia and Analgesia, 121(5): 1290-1294.
12
ORIGINAL_ARTICLE
LETROZOLE VERSUS CLOMIPHENE CITRATE FOR OVULATION INDUCTION IN WOMEN WITH POLYCYSTIC OVARY SYNDROME
Backround: Ovulation is the central event in the reproduction cycle. Anovulatory dysfunction is a common problem and is responsible for about 40% of female infertility. Polycystic ovarian syndrome (PCOS) with abnormalities in the metabolism of androgens and estrogen and in the control of androgen production remains one of its leading causes .Polycystic ovary syndrome (PCOS) is a common multisystem endocrine disorder in women, with long-term health consequences Objectives: Comparing the efficacy of Letrozole and Clomiphene citrate, as a first line treatment for induction of ovulation in cases of polycystic ovary syndrome. Patients and Methods: This study was randomized comparative study involving 100 Egyptian women having polycystic ovary syndrome attending Al-Azhar University Maternity hospital (Sayed Galal/ Infertility outpatient clinic, And 6th October Health Insurance Hospital). During the initial visit, anthropometric measurements and baseline investigations were performed. Patients were randomized to 5.0 mg Letrozole daily (50 Patients) or 100 mg Clomiphene citrate (50 Patients) from the third until the eighth day of menstruation. Serial transvaginal scans were performed to see the dominant follicles, endometrial thickness and number of follicles. Transvaginal scans were performed serially to look for evidence of ovulation. Results: The difference between Letrozole and Clomiphene citrate for ovulation rate was 44 (88%) versus 30 (60%) respectively. Patients taking Letrozole exhibited a mean endometrial thickness (ET) at mid cycle of menses (Day 11-D14) of 9.2 mm (SD 2.37) versus 8.4 mm (SD 1.61) for patients taking Clomiphene citrate, and these differences were statistically significant. In terms of pregnancy rate, Letrozole facilitated pregnancy induction in 19 patients (38%) versus 8 patients (16%) for Clomiphene citrate, which was statistically significant. More dominant follicles exhibiting a mono-follicular morphology were observed in patients treated with Letrozole compared to patients treated with Clomiphene citrate, with a mono-follicular dominant follicle observed in 23 (46%) versus 14 (28%) patients respectively. Conclusion: Letrozole provided a more efficient stimulation compared to Clomiphene citrate in terms of ovulation induction, thickening of the endometrial lining and achievement of a successful pregnancy.
https://amj.journals.ekb.eg/article_67551_33897db69260e2212b32ffde965df024.pdf
2020-01-01
209
218
10.21608/amj.2020.67551
Polycystic Ovarian Syndrome
Ovulation Induction
Clomiphene citrate
Letrozole
Sameh
Al-Shoraky Mohamed
drsamehalshoraky@gmail.com
1
Department of Obstetrics & Gynecology, Faculty of Medicine-Al-Azhar University
LEAD_AUTHOR
Hossam
El-Din Hussien
2
Department of Obstetrics & Gynecology, Faculty of Medicine-Al-Azhar University
AUTHOR
El-Sayed
Ahmed El-Desouky
3
Department of Obstetrics & Gynecology, Faculty of Medicine-Al-Azhar University
AUTHOR
REFERENCES
1
Abu Hashim, H., Shokeir, T. and Badawy, A. (2010): Letrozole versus combined metformin and clomiphene citrate for ovulation induction in clomiphene-resistant women with polycystic ovary syndrome: A randomized controlled trial. Fertility and Sterility, 94: 1405-1409.
2
Badawy, A., Abdel-Aal, I. and Abulatta, M. (2009-a): Clomiphene citrate or letrozole for ovulation induction in women with polycystic ovarian syndrome: A prospective randomized trial. Fertility and Sterility, 92: 849-852.
3
Badawy, A., Mosbah, A., Tharwat, A. and Eid, M. (2009-b): Extended letrozole therapy for ovulation induction in clomiphene-resistant women with polycystic ovary syndrome: A novel protocol. Fertility and Sterility, 92: 236- 239.
4
Banerjee Ray, P., Ray, A. and Chakraborti, P.S. (2012): Comparison of efficacy of letrozole and clomiphene cit-rate in ovulation induction in Indian women with poly-cystic ovarian syndrome. Archives of Gynecology and Obstetrics, 285: 873-877.
5
Begum, M.R., Ferdous, J., Begum, A. and Quadir, E. (2009): Comparison of efficacy of aromatase inhibitor and clomiphene citrate in induction of ovulation in polycystic ovarian syndrome. Fertility and Sterility, 92: 853-857.
6
Behnoud N, Farzaneh F and Ershadi S (2019): The effect of clomiphene citrate versus letrozole on pregnancyrate in women with polycystic ovary syndrome: a randomized clinical trial. Crescent Journal of Medical and Biological Sciences, 6(3):335-340.
7
Franik S, Eltrop SM and Kremer JA (2018): Aromatase inhibitors (letrozole) for subfertile women with polycystic ovary syndrome. Cochrane Database Syst Rev., 5: CD010287.
8
Franik S, Kremer JA, Nelen WL, and Farquhar C, Marjoribanks J (2015): Aromatase inhibitors for subfertile women with polycystic ovary syndrome: summary of a Cochrane review. Fertil Steril., 103:353–355.
9
Joham AE1, Teede HJ, Ranasinha S, Zoungas S and Boyle J. (2015): Prevalence of Infertility and Use of Fertility Treatment in Women with Polycystic Ovary Syndrome: Data from a Large Community- Based Cohort Study, 20(1):37-42.
10
Kar, S. (2012) Clomiphene citrate or letrozole as first-line ovulation induction drug in infertile PCOS women: A prospective randomized trial. Journal of Human Repro-ductive Sciences, 5: 262-265.
11
Legro RS, Brzyski RG, Diamond MP and kim B (2014): Letrozole versus clomiphene for infertility in the polycystic ovary syndrome. N Engl J Med., 371:119_132
12
Mejia, R.B., Summers, K.M., Kresowik, J.D., and van Voorhis, B.J (2019): A randomized controlled trial of combination letrozole and clomiphene citrate or letrozole alone for ovulation induction in women with polycystic ovary syndrome. Fertil Steril., 111: 571–578.
13
Nahid L and Sirous K. (2012): Comparison of the effects of letrozole and clomiphene citrate for ovulation induction in infertile women with polycystic ovary syndrome. Minerva Gynecol., 64(3):253–258.
14
Roque M, Tostes AC, Valle M, Sampaio M and Geber S (2015): Letrozole versus clomiphene citrate in polycystic ovary syndrome: systematic review and meta-analysis. Gynecol Endocrinol., 31:917–921.
15
Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group (2014): Revised 2013 consensus on di-agnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertility and Sterility, 81: 19-25.
16
Sharief M, Nafee NR (2015): Comparison of letrozole and clomiphene citrate in women with polycystic ovaries undergoing ovarian stimulation. J Pak Med Assoc., 65:1149–1152.
17
Teede, H.J., Misso, M.L., Costello, M.F., Dokras, A., Laven, J., Moran (2018): and International PCOS Network. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Fertil Steril., 110: 364–379.
18
ORIGINAL_ARTICLE
SERUM LIPID PROFILE IN MIDDLE AGED FEMALE PATIENTS WITH CARPAL TUNNEL SYNDROME
Background: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. It is a combination of symptoms and signs caused by the compression of the median nerve as it passes in the carpal tunnel at the wrist. It is an important cause of functional disability, and is the commonest cause of referral to the Electro diagnostic laboratory. CTS is studied extensively. However, its pathophysiology still unclear and most of the cases still idiopathic especially in middle aged women. Objective: To correlate between severity of CTS and abnormality of lipid profile, and to establish the relationship between severity of CTS and age, Body mass index (BMI), in Egyptian middle aged women. Patients and Methods: This study included 155 female cases and controls recruited from the Neurology outpatient clinics of Al-Hussein University Hospital and Al Sahel Teaching Hospital during the period from November 2018 to September 2019, 103 cases with the clinical and neurophysiological diagnosis of idiopathic carpal tunnel syndrome. The study demonstrated the relation between age, lipid profile, BMI and severity of carpal tunnel syndrome in this group of females in comparison to the 52 females as a controls. Results: Age, high BMI, higher cholesterol and LDL levels, were correlated with severity of CTS, while Cholesterol and LDL were much higher among the cases compared to controls. HDL was less in the patients. Conclusion: Abnormal lipid profile, higher BMI, obesity and poor living circumstances could influence the incidence and severity of CTS among middle aged Egyptian women.
https://amj.journals.ekb.eg/article_67552_d31f2fc5d4e26b05e14f1f07755f488f.pdf
2020-01-01
219
228
10.21608/amj.2020.67552
Idiopathic carpal tunnel syndrome
CTS
Lipid profile
middle aged females – BMI – Cholesterol
Hussein
Awad El Gharieb
1
Neurology Department, Faculty of Medicine, Al-Azhar University
AUTHOR
Abd El Aleem
Abd El Aleem El Gendy
2
Clinical pathology department, Faculty of Medicine, Al-Azhar University
AUTHOR
Mohammad
Hamed Rashad
3
Neurology Department, Faculty of Medicine, Al-Azhar University
AUTHOR
Omar
Mohammad Al Bazza
omar.albazza@gmail.com
4
Neurology Department, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
REFERENCES
1
Alanazy M (2017): Clinical and electrophysiological evaluation of carpal tunnel syndrome: approach and pitfalls Neurosciences, 22 (3): 169-180.
2
De Krom MC, de Krom CJ and Spaans F (2009): Carpal tunnel syndrome: diagnosis, treatment, prevention and its relevance to dentistry. Ned Tijdschr Tandheelkd., 116(2):97-101.
3
Duncan S and Kakinoki R (2017): Carpal Tunnel Syndrome and Related Median Neuropathies Challenges and Complications. Springer International Publishing, USA Chapters 4&5, pages 31-51.
4
Ibrahim I, Khan WS, Goddard N and Smitham P (2012): Carpal tunnel syndrome: a review of the recent literature. Open Orthop J., 6(1):69–76.
5
Iftikhar S, Javed MA and Kasuri MN (2016): Frequency of Metabolic Syndrome and Its Components in Patients with Carpal Tunnel Syndrome Journal of the College of Physicians and Surgeons Pakistan, 26 (5): 380-383.
6
Komurcu FH, Kilic S and Anlar O (2014): Relation of age, body mass index and wrist waist circumference to carpal tunnel syndrome severity. Neurol Med Chir (Tokyo), 54:394–400.
7
Malibary HM, Al-Najjar A, Yassen DM, Abuhussain HA, Radhwi O and Al Fares ZR (2013): Clinical Profile of Carpal Tunnel Syndrome in a Teaching Hospital. Pak J Med Sci., 29(1): 119–121.
8
Mansoor S, Siddiqui M , Mateen F , Saadat S , Khan ZH , Zahid M , Khan H, Malik S H and Assad S (2017): Prevalence of Obesity in Carpal Tunnel Syndrome Patients: A Cross-Sectional Survey. Cureus, 9(7): e1519-1523.
9
Mohammadi A, Naseri M, Ashraf M and Ashraf A (2016): Correlation between Female Sex Hormones and Electrodiagnostic Parameters and Clinical Function in Post-menopausal Women with Idiopathic Carpal Tunnel Syndrome. J Menopausal Med., (2): 80–86.
10
Nageeb R., Shehta N, Nageeb GS and Omran AA (2018): Body mass index and vitamin D level in carpal tunnel syndrome patients. The Egyptian Journal of Neurology, Psychiatry and Neurosurgery, 54:14-22.
11
Naik BM, Pal P, Pal GK, Balakumar B and Dutta TK (2014): Assessment of motor nerve conduction in healthy obese Indian population. Int J Clin Exp Physiol., 1: 277-82.
12
Nawar S, Alotaibi S, Saad S and Alqahtani M (2018): The Prevalence and Patterns of Carpal Tunnel Syndrome and Their Associated Risk Factors Among Diabetic Population In South-West of Kingdom of Saudi Arabia . The Egyptian Journal of Hospital Medicine, 70 (7): 1152-1158.
13
Shakir E and Nazar Z (2017): Obesity increases the risk of carpal tunnel syndrome.International Journal of Scientific Research and Education 5 (4): 6309-6312.
14
Shiri R, Pourmemari MH, Falah-Hassani K and Viikari-Juntura E. (2015): The effect of excess body mass on the risk of carpal tunnel syndrome: a meta-analysis of 58 studies. Obes Rev., 16(12):1094–104.
15
Uchiyama S, Itsubo T, Nakamura K, Kat H, Yasutomi T and Momose T. (2010): Current concepts of carpal tunnel syndrome: pathophysiology, treatment, and evaluation. J Orthop Sci., 15: 1-13.
16
Wang L. (2013): Electrodiagnosis of carpal tunnel syndrome. Phys Med Rehabil Clin N Am., 24:67–77.
17
Watson JC. (2012): Electrodiagnostic approach to carpal tunnel syndrome. Neurol Clin., 30:457–78.
18
Yeo S.H. and Joo I.S. (2009): Correlation between serum cholesterol level and electrophysiologic findings in patients with carpal tunnel syndrome. Journal of the Neurological Sciences, 285 S155–S339.
19
Yi-Chuan C, Jen-Huai Chiang, Ing-Shiow Lay and Yu-Chen Lee (2019): Increased Risk of Coronary Artery Disease in People with a Previous Diagnosis of Carpal Tunnel Syndrome: A Nationwide Retrospective Population-Based Case-Control Study Hindawi BioMed Research International Volume 2019, Article ID 3171925, 8 pages
20
Yurdakul F, Bodur H, Öztop Çakmak Ö, Ateş C, Sivas F, Eser F and Yılmaz Taşdelen Ö. (2015): On the Severity of Carpal Tunnel Syndrome: Diabetes or Metabolic Syndrome. J Clin Neurol., 11(3): 234–240.
21
Zyluk A, Dabal L and Szlosser Z (2011): Association of anthropometric factors and predisposition to carpal tunnel syndrome. Chir Narzadow Ruchu Ortop Pol., 76:193-19.
22
ORIGINAL_ARTICLE
Anti-chalmydial antibody as a predictive test for tubal factor infertility
Background: Infertility is a common gynaecological problem that has a multi factorial aetiology. Conception and pregnancy depend on complex physiological, anatomic and immunological factors. Objective: to evaluate the prevalence of chlamydial infection, especially subclinical cases, in a population of Egyptian tubal infertile women and to relate it to history, symptoms, clinical, and laparoscopy findings. Finally, to find any advantage of detecting antichlamydial antibodies in serum of these patients and evaluate its importance in prediction of tubal factor of infertility. Patients and Methods: This study includes 50 primary or secondary infertile females (patients group) their age between 20-30 years, and 50 random fertile females (control group) and Blood sample for IgG, Chlamydia trachomatis antibodies were drawn from all cases of the study for ELISA test. Results: The prevalence rate of Chlamydia trachomatis IgG antibodies was significantly higher in infertile group than that of control group. There was significant higher rate and ratio of positive results in infertile group than that of control group concerning anti-chlamydial IgG. There was a strong correlation between serum levels of anti-chlamydial IgG in the infertility patients. There was a significant correlation between serum anti-chlamydial IgG levels and the duration of infertility. There was no relation between the serum level of anti-chlamydial IgG and the age of the patients of the type of infertility. The results of this study are matched with most of the previous published studies yet there are some differences in the positive and negative ratios. Conclusion: Chlamydia trachomatis plays a major role in the occurrence of tubal factor of infertility. Subclinical chlamydial salpinigits was an important cause of tubal infertility. Serological test for Chlamydia trachomatis namely anti-chlamydial antibodies IgG are sensitive, simple, and inexpensive tests even if compared by using direct methods for detection and should be done as a routine part of infertility investigations. The serological test could be an accurate non-invasive predictor of tubal status especially if combined with other methods as HSG, good history taking and examination.
https://amj.journals.ekb.eg/article_67131_9fee4e904b0784412a0ea10df97f4941.pdf
2020-01-01
229
240
10.21608/amj.2020.67131
Anti-chlamydial antibody
tubal factor
Infertility
Emad
A. El-Tamamy
1
Departments of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University, Cairo
AUTHOR
Ashraf
H. Mohamed
2
Departments of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University, Cairo
AUTHOR
Wael
R. Hablas
3
Departments of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo
AUTHOR
Shaban
H. Abd El-Rahman
shaban.abdalrahman2018@gamail.com
4
Departments of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University, Cairo
LEAD_AUTHOR
REFERENCES
1
Amadi L, Onwudiegwu U, Adeyemi A, Nwachukwu C and Abiodun A. (2019): Usefulness of Chlamydia serology in prediction of tubal factor infertility among infertile patients at Federal Medical Centre, Bida, North Central Nigeria. Int J Reprod Contracept Obstet Gynecol.; 8(2): 412-419.
2
Bastidas RJ, Elwell CA, Engel JN and Valdivia RH. (2013): Chlamydial intracellular survival strategies. Cold Spring Harbor perspectives in medicine; 3(5): a010256.
3
Budrys NM, Gong S, Rodgers AK, Wang J, Louden C, Shain R, Schenken RS and Zhong G. (2012): Chlamydia trachomatis antigens recognized by women with tubal factor infertility, normal fertility, and acute Infection. Obstetrics and Gynecology; 119(5): 1009.
4
Cárcamo CP, Campos PE, García PJ, Hughes JP, Garnett GP, Holmes KK, and Peru PREVEN Study Team (2012): Prevalences of sexually transmitted infections in young adults and female sex workers in Peru: a national population-based survey. The Lancet Infectious Diseases. 12(10): 765-73.
5
Claude M, Nathalie D, Rita V, Marleen T, Geert C and Elizaveta P. (2011): Chlamydia trachomatis infection in fertile and subfertile women in Rwanda: prevalence and diagnostic significance of IgG and IgA antibodies testing; Human Reproduction; 26(12): 3319–3326.
6
Gorwitz RJ, Wiesenfeld HC, Chen PL, Hammond KR, Sereday KA, Haggerty CL, Johnson RE, Papp JR, Kissin DM, Henning TC and Hook III EW. (2017): Population-attributable fraction of tubal factor infertility associated with chlamydia. American Journal of Obstetrics and Gynecology; 217(3):336-e1.
7
Hjelholt A, Christiansan G, Johansson TG, Ingerslev HJ and Birkelund S. (2011): Tubal factor infertility is associated with antibodies against Chlamydia trachomatis heat shock protein 60 (HSP60) but not human HSP60. Human Reprod: 26: 2069- 2076.
8
Israel J, Ola O and Chris A. (2011): The Prevalence of Serum Immunoglobulin G Antibody to Chlamydia Trachomatis in Subfertile Women Presenting at the University of Port Harcourt Teaching Hospital, Nigeria, Int J Biomed Sci.; 7 (2): 120-124.
9
Jeremiah I, Okike O and Akani C. (2011): The prevalence of serum immunoglobulin G antibody to Chlamydia trachomatis in subfertile women presenting at the University of Port Harcourt teaching hospital, Nigeria. International journal of biomedical science: IJBS; 7(2):120.
10
Joolayi F, Navidifar T, Jaafari RM and Amin M. (2017): Comparison of Chlamydia trachomatis infection among infertile and fertile women in Ahvaz, Iran: A case-control study. International Journal of Reproductive Biomedicine; 15(11):713.
11
Jorn S, Oliver T, Yaw L, Peter A, Danso K, Rolf K and Andreas E. (2008): Chlamydia trachomatis Infection as a Risk Factor for Infertility among Women in Ghana, West Africa, Am J Trop Med Hyg., 78(2): 323- 327.
12
Keltz MD, Gera PS and Moustakis M. (2006): Chlamydia serology screening in infertility patients. Fertility and Sterility, 85(3):752-4.
13
May K and Amer S. (2012): Evaluation of Chlamydia Trachomatis Antibodies In Women with Infertility; Al- Mustansiriya J. Sci., 23(3): 273-281.
14
O’Connell CM and Ferone ME. (2016): Chlamydia trachomatis genital infections. Microbial cell, 3(9):390.
15
Peivandi S, Moslemizadeh N, Gharajeh S and Ajami A. (2009): The role of the Chlamydia trachomatis IgG antibody testing in predicting the tubal factor infertility in northern Iran. International Journal of Fertility and Sterility, 3 (3): 143-148.
16
Seth-Smith HM, Harris SR, Skilton RJ, Radebe FM, Golparian D, Shipitsyna E, Duy PT, Scott P, Cutcliffe LT and O’Neill C, Parmar S. (2013): Whole-genome sequences of Chlamydia trachomatis directly from clinical samples without culture. Genome Research; 23(5),855-66.
17
Singh S, Bhandari S, Agarwal P, Chittawar P and Thakur R. (2016): Chlamydia antibody testing helps in identifying females with possible tubal factor infertility. International Journal of Reproductive BioMedicine; 14(3),187.
18
Surana A, Rastogi V and Nirwan PS. (2012): Association of the serum anti-Chlamydial antibodies with tubal infertility. Journal of Clinical and Diagnostic Research: JCDR, 6(10): 1692.
19
Tabong PT and Adongo PB. (2013): Infertility and childlessness: a qualitative study of the experiences of infertile couples in Northern Ghana. BMC pregnancy and childbirth, 13(1):72.
20
Tsevat DG, Wiesenfeld HC, Parks C and Peipert JF. (2017): Sexually transmitted diseases and infertility. American journal of Obstetrics and Gynecology. 216(1),1-9.
21
ORIGINAL_ARTICLE
HISTOLOGICAL AND IMMUNOHISTOCHEMICAL STUDY OF HEPATIC STELLATE CELLS PRE AND POST-TRANSPLANTED HUMAN LIVER
Background: Hepatic stellate cells (HSCs) regulate vitamin A metabolism and play a vital role during the activation of the immune response. During liver damage, HSCs transform to myofibroblast-like cells, leading to loss of their lipid content and synthesis of extracellular matrix (ECM) inducing liver fibrosis. Objective: The present study aimed to establish the correlation between HSCs activity within different areas of hepatic tissue and the degree of liver fibrosis in individuals with normal liver, hepatitis C virus infected patients and post-transplanted liver. Patients and methods: The study involved thirty four cases from the international medical center classified into three groups: group 1 included ten healthy individuals as control, group 2 included twelve patients with chronic hepatitis C virus and liver cirrhosis and group 3 included twelve patients with post-transplanted liver due to liver previous hepatitis C virus infection and hepatic cirrhosis subdivided into group 3a five patients who received antihepatitis C treatment, and group 3b seven patients who didn’t receive antihepatitis C treatment. We used H&E and Masson trichrome stains, immunohistochemical detection of á-smooth muscle actin (á-SMA), Glial Fibrillary acidic protein (GFAP) and transmission electron microscopy (TEM). Results: H&E stain revealed hepatic tissue with preserved architecture in group 1, disrupted architecture and areas of feathery degeneration in group 2, normal tissue histology in group 3a and moderate cellular infiltration in group 3b. Masson trichrome stain revealed normal collagen fibers distribution in group1, advanced fibrosis in group 2, no fibrotic changes in group 3a and few foci of bridging fibrosis in group 3b. Immunohistochemical analysis revealed increased expression of α-SMA in group 2 and group 3b in comparison to group 1 and group 3a. Immunohistochemical analysis revealed increased expression of GFAP in group 3b in comparison to group 3a, group 2 and group 1. TEM showed increase in the fibrous tissue and degeneration in the ultrastructure of the hepatocyte with few lipid droplets in HSCs of group 2 compared to group 1. Conclusion: The hepatic stellate cells play an important role in the fibrosis of the liver damaged by hepatitis C virus and in the post-transplanted liver which not treated from HCV.
https://amj.journals.ekb.eg/article_67553_02fc68e861157ed81d1cd6fb8fc12a5a.pdf
2020-01-01
241
256
10.21608/amj.2020.67553
HSCs – HCV – fibrosis – post-transplanted liver
Mahmoud
A.A. Masoud
1
Department of Medical Histology and Cell Biology, Al-Azhar Faculty of Medicine in Cairo
AUTHOR
Mohammad
A. Kasem
2
Department of Medical Histology and Cell Biology, Al-Azhar Faculty of Medicine in Assiut
AUTHOR
Ayman
F. El-Sharwy
3
Department of Medical Histology and Cell Biology, Al-Azhar Faculty of Medicine in Cairo
AUTHOR
Amr
F. El-Sebaey
4
Department of Pathology, Military Medical Academy
AUTHOR
Tamer
I. Abd El-Rahman
tamer23101982@gmail.com
5
Department of Medical Histology and Cell Biology, Al-Azhar Faculty of Medicine in Assiut
LEAD_AUTHOR
REFERENCES
1
Bakiera KK, Gawda EW, Kwiatkowska BC and Jedrych BJ. (2016): Hepatic stellate cells activation and liver fibrosis after chronic administration of ethanol. Curr. Issues Pharm. Med. Sci; 29(2): 66-70.
2
Barakat EM, El Wakeel LM and Hagag RS. (2013): Effects of Nigella sativa on outcome of hepatitis C in Egypt. World J Gastroenterol; 19(16): 2529–2536.
3
Bhatia HK, Singh H, Grewal N and Natt NK. (2014): Sofosbuvir A novel treatment option for chronic hepatitis C infection. Molecules of the Millennium; 5(4): 278-284.
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Busletta C, Novo E, Cannito S, Paternostro C and Parola M. (2011): Hepatic myofibroblasts in liver fibrogenesis. Trends in Alcoholic Liver Disease Research - Clinical and Scientific Aspects.
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Curry MP, Forns X, Chung RT, Terrault NA, Brown R and Fenkel JM. (2015): Sofosbuvir and ribavirin prevent recurrence of HCV infection after liver transplantation: an open-label study. Gastroenterology; 148:100 –107.
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DeLemos AS, Schmeltzer PA and Russo MW. (2014): Recurrent hepatitis C after liver transplant. World J Gastroenterol; 20(31):10668–10681.
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Ferrarese A, Germani G, Gambato M, Russo FP, Senzolo M, Zanetto A, Shalaby S, Cillo U, Zanus G, Angeli P and Patrizia Burra P. (2018): Hepatitis C virus related cirrhosis decreased as indication to liver transplantation since the introduction of direct-acting antivirals: A single-center study. World J Gastroenterol24 (38): 4403–4411.
8
Friedman SL and Lee UE. (2011): Mechanisms of Hepatic Fibrogenesis. Best Pract Res Clin Gastroenterol; 25(2): 195–206.
9
Hassan S, Syed S, and Imdad Kehar S. (2014): Glial Fibrillary Acidic Protein (GFAP) as a Mesenchymal marker of Early Hepatic Stellate Cells Activation in Liver Fibrosis in Chronic Hepatitis C Infection. Pak J Med Sci; 30(5): 1027-1032.
10
Hirabaru M, Mochizuki K, Takatsuki M, Soyama A, Kosaka T, Kuroki T, Shimokawa I and Eguchi S. (2014): Expression of alpha smooth muscle actin in living donor liver transplant recipients. World J Gastroenterol; 14: 20(22): 7067–7074.
11
Ionescu AG, Letitia AMS, Vere CC, Ciurea ME, Streba CT, Ionescu M, Comanescu M , Irimia E and Rogoveanu O. (2013): Histopathological and immunohistochemical study of hepatic stellate cells in patients with viral C chronic liver disease. Rom J Morphol Embryol; 54(4):983–991.
12
Iwaisako K, Jiang C, Zhang M, Cong M, Moore-Morris TJ, Park TJ, Liu X, Xu J, Wang P, Paik YH, Meng F, Asagiri M, Murray LA, Hofmann AF, Iida T, Glass CK, Brenner DA and Kisseleva T. (2014): Origin of myofibroblasts in the fibrotic liver in mice. Proc Natl Acad Sci U S A; 111:3297-3305
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16
Kisseleva T, Cong M, Paik Y, Scholten D, Jiang C and Benner C. (2012): Myofibroblasts revert to an inactive phenotype during regression of liver fibrosis. Proc Natl Acad Sci U S A; 109: 9448–9453.
17
Lin Ji, Jian-Feng Wu, Zhang Qi, Hong-Wei Zhang, and Guang-Wen Cao. (2014): Virus-related liver cirrhosis: Molecular basis and therapeutic options. World J Gastroenterol; 20 (21): 6457–6469.
18
Nafady AM, Ahmed OB, Ghafeer HH. (2017): Scanning and transmission electron microscopy of the cells forming the hepatic sinusoidal wall of rat in acetaminophen- and Escherichia coli endotoxin-induced hepatotoxicity. Journal of Microscopy and Ultrastructure; 5 (1): 21-27.
19
Olsen AL, Bloomer SA, Chan EP, Gaça MD, Georges PC and Sackey B. (2011): Hepatic stellate cells require a stiff environment for myofibroblastic differentiation. Am J Physiol Gastrointest Liver Physiol; 301(1):110–118.
20
Pellicoro A, Ramachandran P and Iredale JP. (2014): Liver fibrosis and repair: immune regulation of wound healing in a solid organ. Nat Rev Immunol; 14:181–194.
21
Salas-Villalobos TB. Lozano-Sepúlveda SA. Rincón-Sánchez AR. Govea-Salas MG and Rivas-Estilla AM. (2017): Mechanisms involved in liver damage resolution after hepatitis C virus clearance. Medicina Universitaria; 19(75): 100-107.
22
Săndulescu L, Rogoveanu I, Ciurea T, Comănescu MV, Streba CT, Ionescu AG, Oproaica A and Ene M. (2011): Immunohistochemical study of stellate cells in patients with chronic viral hepatitis C genotype 1. Rom J Morphol Embryol; 52(1):137-43.
23
Terrault N. (2012): Liver transplantation in the setting of chronic HCV. Best Pract Res Clin Gastroenterol ., 26:531–548.
24
Troeger JS., Mederacke I, Gwak GY, Dapito DH, Mu X and Hsu CC. (2012): Deactivation of hepatic stellate cells during liver fibrosis resolution in mice. Gastroenterology; 143: e1022.
25
Zakaria S, Youssef M, Moussa M, Akl M, El-Ahwany E, El-Raziky M, Mostafa O, Helmy A.H, and El-Hindawi A. (2010): Value of α-smooth muscle actin and glial fibrillary acidic protein in predicting early hepatic fibrosis in chronic hepatitis C virus infection. Arch Med Sci; 30: 6(3): 356–365.
26
ORIGINAL_ARTICLE
SEROLOGICAL AND MOLECULAR DIAGNOSIS OF HBV INFECTION AND ITS CLINICAL IMPLICATIONS AMONG PATIENTS OF ASSIUT GOVERNORATE, EGYPT
Background: Hepatitis B virus (HBV) infection is an important health problem and the major cause of chronic hepatitis, cirrhosis and hepatocellular carcinoma (HCC) in Egypt, and especially in Upper Egypt. Objectives: The aim of this study was to estimate the prevalence of hepatitis B virus among Assiut Governorate patients. Patients and method: Our study focused on screened of all patients by ELISA tests for blood-borne viral infections. Seropositive patients were inquired about the exposure to possible risk associations for acquiring these infections. Biochemical, HBV markers by ELIZA, DNA-PCR, were done to classify patients to groups (Low viremia, High viremia, and occult). Results: We examined 1085 patients for HBsAg at Assiut Governorate, Egypt. Out of the 1085 population tested for HBs-Ag, 623 (57.5%) were males, whereas 462 (42.5%) were females. A total of 165 out 1085 were seropositive for HBsAg (15.2%). The highest seropositive of HBsAg were recorded in 106 males (17.1%) compared to 59 females (12.8%). HBsAg seropositive decreased with grassing age, The highest seroprevalence of HBsAg recorded in age ranged between 21-30 years 62 (37.5%). All patients were divided into four groups according to HBV-DNA. Seroprevalence of HBsAg increased with group 2 (Low titer of HBV-DNA < 2000 IU/ml - 46.1%), where highest prevalence of HBsAg was recorded in males (37.6%) compared to females (8.5%). The lowest seroprevalence of HBsAg were recoded with group 3 (high titer of HBV-DNA > 2000 IU/ml -14.5%). HBV was common in rural versus urban community areas (78.2% versus 21.8 % respectively). We did not find abnormal levels of biochemical indicators of liver and kidney functions in HBV infected patients. Conclusion: Screening of HBV infection to monitor liver disease progression in HBV carriers by using molecular, biochemical and serological markers, stated that effective treatment can be initiated early before the development of advanced liver diseases.
https://amj.journals.ekb.eg/article_67554_dbf15f76aa289d9dceba89bc2b803514.pdf
2020-01-01
257
270
10.21608/amj.2020.67554
Ahmed
M. El-Adly
ahmedeladly.ast@azhar.edu.eg
1
Botany and Microbiology Department, Faculty of Science, Al-Azhar University, (Assiut)
LEAD_AUTHOR
Ahmed
Wardany Abd El-Rady
2
Botany and Microbiology Department, Faculty of Science, Al-Azhar University, 71524 Assiut, Egypt
AUTHOR
Ahmed
Khalifa Meshaal
3
Botany and Microbiology Department, Faculty of Science, Al-Azhar University, 71524 Assiut, Egypt
AUTHOR
Helal
Foud Heta
4
Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut
AUTHOR
REFERENCES
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Ali H, Zafar F, Korai O, Siddiqui S, Naveed S, Baloch SA, Asad S and Fatima R (2015): Hepatitis: Prevalence, Risk Factors and Associated Co-morbidities in Local Population of Karachi, Pakistan. Bioequivalence & Bioavailability Journal,7(1): 51-55.
3
Allain JP, Stramer SL, Carneiro-Proietti AB, Martins ML, Lopes da Silva SN, Ribeiro M, Proietti FA and Reesink HW (2009): Transfusion-transmitted infectious diseases. Biological Journal, 37(2): 71-77.
4
Bisceglie AM, AS L, Martin P, Terrault N, Perrillo RP, Hoofnagle JH (2015): Recent US Food and Drug Administration warnings on hepatitis B reactivation with immune-suppressing and anticancer drugs: just the tip of the iceberg? Hepatology Journal,. 61(2): 703-11.
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Borenstein M, Rothstein H and Cohen J (1997): Sample power 1.0. Chicago: SPSS. Inc.
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Buti M, Rodríguez Frías Fand Esteban R (2012): Quantification of hepatitis B virus HBsAg: clinical implications. Med. Clin. (Barc.) Journal, 138(11): 483-488.
7
Candotti D and Laperche S (2018): Hepatitis B Virus Blood Screening: Need for Reappraisal of Blood Safety Measures. Frontier in Medicin Journal,. 5(29): 1-10.
8
Dandri M and Petersen J (2016): Mechanism of Hepatitis B Virus Persistence in Hepatocytes and Its Carcinogenic Potential. Clinical Infectious Diseases Journal, 1: S281-S288.
9
Elbedewy AT, Elshweikh AS, Baiomy N (2016): Prevalence and significance of hepatitis-B core antibodies among hepatitis B surface antigen-negative Egyptian patients on hemodialysis in Al-Gharbia governorate. Tanta Med. Journal,. 44 (2): 33-38.
10
Elrashidy H, El-Didamony G, Elbahrawy A, Hashim A, Alashker A and Hanafy MM (2014): Absence of occult hepatitis B virus infection in sera of diabetic children and adolescents following hepatitis B vaccination. Hum. Vaccin Immunother Journal, 10(8): 2336-2341.
11
El-Zayadi AR, Badran HM, Saied A, Shawky S, Attia M and Zalata K (2009): Evaluation of liver biopsy in Egyptian HBeAg-negative chronic hepatitis B patients at initial presentation: implications for therapy. Gastroenterol. Journal, 104(4): 906-11.
12
Guirgis BS, Abbas RO and Azzazy HM (2010): Hepatitis B virus genotyping: current methods and clinical implications. Infect. Dis. Journal, 14(11): e941-e953.
13
Gutiérrez-García ML, Fernandez-Rodriguez CM, Lledo-Navarro JL and Buhigas-Garcia I (2011): Prevalence of occult hepatitis B virus infection. World Journal Gastroenterol., 17(12): 1538.
14
Hahne SJ, Veldhuijzen IK, Smits LJ, Nagelkerke N and Van De Laar MJ (2008): Hepatitis B virus transmission in The Netherlands: a population-based, hierarchical case-control study in a very low-incidence country. Epidemiol. Infect. Journal, 136(2): 184-195.
15
Ismail AM, Sivakumar J, Anantharam R, Dayalan S, Samuel P, Fletcher GJ, Gnanamony M and Abraham P (2011): Performance characteristics and comparison of Abbott and artus real-time system for hepatitis B virus DNA quantification. Clin. Microbiol. Journal, 49(9): 3215-3221.
16
Jayasuriya DGD, F, Noordeen F and Pitchai NN (2015): Genotypes of hepatitis B virus identified in patients tested prior to endoscopy from a Teaching Hospital in the Central Province of Sri Lanka. Ceylon Medical Journal, 60(2): 62-64.
17
Kafi-abad SA, Rezvan H, Abolghasemi H and Talebian A (2009): Prevalence and trends of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus among blood donors in Iran, 2004 through 2007 Transfusion Journal, 49(10): 2214-2220.
18
Kao J (2008): Diagnosis of hepatitis B virus infection through serological and virological markers. Expert. Rev. Gastroenterol. Hepatol. Journal, 2(4): 553-562.
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Kleinman SH, Kuhns MC, Todd DS, Glynn SA, McNamara A, DiMarco A and Busch MP (2003): Frequency of HBV DNA detection in US blood donors testing positive for the presence of anti-HBc: implications for transfusion transmission and donor screening. Transfusion. Journal, 43(6): 696-704.
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Kondo Y, Ninomiya M, Kakazu E, Kimura O and Shimosegawa T (2013): Hepatitis B surface antigen could contribute to the immunopathogenesis of hepatitis B virus infection. ISRN Gastroenterology Journal, 13:8.
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Levrero M, Pollicino T, Petersen J, Belloni L, Raimondo G and Dandri M (2009): Control of cccDNA function in hepatitis B virus infection. Hepatol. Journal, 51(3): 581-592.
22
Liu Y, Li P. P, Li C, Zhou J, Wu C. and Zhou Y (2010): Detection of hepatitis B virus DNA among accepted blood donors in Nanjing, China. Virology Journal, 7 (1): 193-199.
23
Luo Z, Li L and Ruan L (2012): Impact of the implementation of a vaccination strategy on hepatitis B virus infections in China over a 20-year period. Infectious Diseases Journal,16 (2): e82-e88.
24
Mahboobi N, Porter RS, Karayiannis P and Alavian S (2013): Dental Treatment as a Risk Factor for Hepatitis B and C Viral Infection. A Review of the Recent Literature. Gastrointestinal and Liver Diseases Journal,22 (1): 12-15.
25
Mekky MA (2014): To treat or not to treat the "Immunotolerant Phase" of Hepatitis B Infection: A tunnel of Controversy. World Journal Hepatol, 6(4): 226-229.
26
Morikawa K, Shimazaki T, Takeda R, Izumi T, Umumura M, and Sakamoto N (2016): Hepatitis B: progress in understanding chronicity, the innate immune response, and cccDNA protection, Ann Transl Med. Journal, 4(18): 337-384.
27
Morsica G, Ancarani F, Bagaglio S, Maracci M, Cicconi P and Cozzi Lepri A (2009): Occult hepatitis B virus infection in a cohort of HIV-positive patients: correlation with hepatitis C virus coinfection, virological and immunological features. Infection Journal, 37(5): 445-449.
28
Narayanasamy K, Annasamy C, Ramalingam S and Elumalai S (2015): Study of Hepatitis B and C Virus Infection in Urban and rural Population of Tamil Nadu, India. Current Microbiology and Applied Sciences Journal, 4(6): 443-451.
29
Ndako JA, Nwankiti OO, Echeonwu GO, Junaid SA, Anaele O and Anthony TJ (2011): Studies on prevalence and risk factors for Hepatitis B Surface Antigen among secondary school students in north-central, Nigeria. Biomedical Research Journal, 3(3): 163-168.
30
Ozer A, Yakupogullari Y, Beytur A, Beytur L, Koroglu M, Salman F and Aydogan F (2011): Risk factors of hepatitis B virus infection in Turkey: A population-based, case-control study: Risk Factors for HBV Infection. Hepat. Mon. Journal, 11(4): 263-268.
31
Peters MG (2019): Hepatitis B Virus Infection: What Is Current and New. Top Antivir Med. Journal, Vol. 26(4): 112-116.
32
Shalaby S, Kabbash IA, Saleet GE, Mansour N, Omar A and El Nawawy A (2010): Hepatitis B and C viral infection: prevalence, knowledge, attitude and practice among barbers and clients in Gharbia governorate, Egypt. Eastern Mediterranean Health. Journal, 16(1): 10-17.
33
Shamsuddin K and Marmuji LJ (2010): Weighted analysis of prevalence and risk factors of hepatitis B infection among antenatal mothers in Ipoh. Singapore Med. Journal, 51(10): 800-805.
34
Tessema B, Yismaw G, Kassu A, Amsalu A, Mulu A, Emmrich F and Sack U (2010): Seroprevalence of HIV, HBV, HCV and syphilis infections among blood donors at Gondar University Teaching Hospital, Northwest Ethiopia: declining trends over a period of five years. BMC Infect Dis. Journal, 10(1): 111-118.
35
ORIGINAL_ARTICLE
Lactoferrin versus Ferrous Sulphate for the Treatment of Iron Deficiency Anemia during Pregnancy (A Randomized Clinical Trial)
Background: Iron deficiency anemia (IDA) is the condition in which there is decrease in the number of red blood cells or the amount of hemoglobin in the blood. It is caused by insufficient dietary intake and absorption of iron, or iron loss from bleeding. Bleeding can be from a range of sources such as the intestinal, uterine or urinary tract. IDA develops when available iron is insufficient to support normal red cell production and is the most common type of anemia. Objective: Comparing the efficacy and the safety of Lactoferrin versus ferrous sulphate for the treatment of iron deficiency anemia during pregnancy. Patients and Methods: This study was done in outpatient clinic of El-Monera General Hospital, from January 2019 to March 2019, between two groups of pregnant women ranging from 20-40 years and gestational age 24-32 weeks with microcytic hypochromic anemia, mild anemia and moderate anemia for 2 months that were selected in a randomized method by the computer. Results: Oral lactoferrin was better tolerated and more acceptable with higher increase in mean hemoglobin when compared to oral iron therapy over two months treatment. Conclusion: Oral lactoferrin was better tolerated and more acceptable with higher increase in mean hemoglobin when compared to oral iron therapy over two months treatment.
https://amj.journals.ekb.eg/article_67107_e8a842ab21d7b49a8b010d3df49777a2.pdf
2020-01-01
271
282
10.21608/amj.2020.67107
Lactoferrin
Ferrous Sulphate
iron deficiency anemia
Mofeed
Fawzy Mohamed
1
Obstetrics and Gynecology Department, Faculty of Medicine, Al Azhar University, Cairo, Egypt
AUTHOR
Wael
Soliman Taha
2
Obstetrics and Gynecology Department, Faculty of Medicine, Al Azhar University, Cairo, Egypt
AUTHOR
Mohamed
Farrag Ismaeil Farag
mohammad.farrag.mf@gmail.com
3
Obstetrics and Gynecology Department, Faculty of Medicine, Al Azhar University, Cairo, Egypt
LEAD_AUTHOR
REFERENCES
1
Baker HM and Baker EN (2012): A structural perspective on lac- toferrin function. Biochem Cell Biol., 90: 320–328.
2
Duck KA and Connor JR (2016): Iron uptake and transport across physiological barriers. Biometals; 29(4):573-91.
3
Hutter D, Jaeggi E (2010): Causes and mechanisms of intrauterine hypoxia and its impact on the fetal cardiovascular system: a review. International Journal of Pediatrics; Vol. 2010. published online 2010 Oct 19.
4
Kochhar PK, Kaundal A and Ghosh P (2013): Oral iron in treatment of iron deficiency anemia in pregnancy: A randomized clinical trial. J Obstet Gynaeco. Res., 39: 504-510.
5
Nappi C, Tommaselli GA, Morra I (2009): Efficacy and tolerability of oral bovine lactoferrin compared to ferrous sulfate in pregnant women with iron deficiency anemia: a prospective controlled randomized study. Acta Obstetricia et Gynecologica Scandinavica, 88(9): 1031-1035.
6
Nocerino N, Fulgione A, Iannaccone M, Tomasetta L, Ianniello F, Martora F, Lelli M, Roveri N, Capuano F and Capparelli R (2014): Biological activity of lactoferrin-funtionalized biomimetic hydroxyapatite nanocrystals. International Journal of Nanomedicine; 9: 1175.
7
Paesano R, Berlutti F, Pietropaoli M, Pantanella F, Pacifici E, Goolsbee W and Valenti P (2010): Lactoferrin efficacy versus ferrous sulfate in curing iron deficiency and iron deficiency anemia inpregnant women. Biometals, 23: 411–417.
8
Rezk M, Kandil M, Dawood R, Shaheen AE, Allam A (2015): Oral lactoferrin versus ferrous sulphate and ferrous fumerate for the treatment of iron deficiency anemia during pregnancy. Journal of Advanced Nutrition and Human Metabolism. 1:1-5.
9
Sharma JB and Meenakshi S (2014): Anemia in Pregnancy. JIMSA., 23(4): 253-260.
10
Stedman's Medical Dictionary (28th ed) (2006): Philadelphia: Lippincott Williams & Wilkins. p. Anemia. ISBN 9780781733908.
11
Tolkien Z, Stecher L, Mander AP, Pereira DI and Powell JJ (2015): Ferrous sulphate supplementation causes significant gastrointestinal side-effects in adults: a systematic review and meta-analysis. PIoS One; 10(2): e0117383.
12
ORIGINAL_ARTICLE
EFFECT OF SALT LOADING ON METABOLIC CHANGES IN OVARIECTOMIZED RATS
Background: Menopause, a natural step in woman`s life aging process, is associated with increased risk of metabolic diseases. Salt, is an essential micronutrient, commonly added to food. However, studies addressing the metabolic effects of high salt intake are controversial and limited. Objective: The present study was designed to determine the changes imposed by increased salt consumption on glucose and lipid homeostasis in ovariectomized rats that mimics the estrogen-deprived condition in postmenopausal women. Material and Methods: Thirty six adult female albino Wister rats were allocated into 3 equal groups: Control group, ovariectomized group, and high salt ovariectomized group which received high salt (2%NaCl) solution for 2 months. Rats were subjected to estimation of body weight (BW), body mass index (BMI), waist circumference (WC), and visceral fat weight. Glucose uptake by diaphragm and glucose output by kidneys were determined. Also, levels of glucose, lipid profile, malondialdehyde, catalase, insulin, estradiol and tumor necrosis factor-α were measured. Pancreatic and hepatic tissues were examined histopathologically. Also, caspase-3 was assessed in pancreas by immunohistochemistry. Results: High salt ovariectomized group showed significant decrease in final WC, and significant increase in serum insulin, HOMA-IR, serum levels of MDA and TNF-α compared to the ovariectomized group. There were significant increases in plasma levels of glucose, triglycerides, total cholesterol, LDL-C, catalase, and AI, and significant decrease in glucose uptake by diaphragm, and plasma HDL-C in high salt group compared to control group. As compared to ovariectomized group, the pancreas in salt loaded group showed decreased number of islets of Langerhans and fatty degeneration together with increased caspase-3. Liver histology was also worsened, and hepatocytes showed ballooning, steatosis and inflammatory infiltration together with massive amounts of collagen fibers around portal tract. Conclusion: High salt intake exacerbated the hyperglycemia and insulin resistance, intensified pancreatic apoptosis and hepatic fatty, and degenerative changes. These effects could be explained by salt loading-induced exacerbation and exaggeration of oxidative and inflammatory influences of ovariectomy.
https://amj.journals.ekb.eg/article_67555_5f90531df48718d39fef9517e778b21e.pdf
2020-01-01
283
304
10.21608/amj.2020.67555
Ovariectomy
Menopause
estradiol
salt loading
Oxidative Stress
Inflammation
hyperglycemia
hyperlipidemia
metabolic derangement
Howida
A. Saleh
howidaahmed@med.asu.edu.eg
1
Department of Medical Physiology, Faculty of Medicine, Ain Shams University, Egypt
LEAD_AUTHOR
Dalia
A. Saad
2
Department of Medical Physiology, Faculty of Medicine, Ain Shams University, Egypt
AUTHOR
Doaa
A. Abou-Bakr
3
Department of Medical Physiology, Faculty of Medicine, Ain Shams University, Egypt
AUTHOR
Lobna
El-Khateb
4
Departments of Histology, Faculty of Medicine, Ain Shams University, Egypt
AUTHOR
Mona
A. Ahmed
5
Department of Medical Physiology, Faculty of Medicine, Ain Shams University, Egypt
AUTHOR
REFERENCES
1
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63
ORIGINAL_ARTICLE
CHILD MARRIAGE: A MAJOR RISKY BEHAVIOR IN DEVELOPING EGYPTIAN GOVERNORATES
Background: Marriage timing is one of the important determinants of birth rates and health profile of both the mothers and infants. Child marriage is recognized as a major development issue that affects girls in many developing countries. The practice has been linked to a number of health risks, higher fertility, and lower education attainment. Objective: To estimate the rate of child marriage in some underdeveloped Egyptian governorates and identify its correlates. Subjects and Methods: The study was part of a large survey, which was conducted in six purposefully selected Egyptian governorates and defined as developing; three from upper Egypt (Sohag, Assuit and Menia) and three from lower Egypt (Sharkia, Behira and Ismalia) aiming to measure the prevalence of child marriage and assess the impact of the different social and economic factors that affect the occurrence of the phenomena. Data were collected from 15279 females using an interview questionnaire targeting households’ members (sampling unit) in the selected governorates. Results: Prevalence of early age of marriage was significantly high among governorates of upper Egypt than in lower Egypt (reaching 39.75 in rural areas in El Menia) especially in rural residency. Lower educational level (less than secondary School) and consanguinity were found to have significant association with early age of marriage. Results revealed that early age of marriage has its effect on birth rate with mean number of children of 3.59 per women who married at age less than 18 years. Conclusion: Early age of marriage is an important public health challenge. Hence, a national multi-sectorial approach must be targeted to reduce this phenomenon.
https://amj.journals.ekb.eg/article_67556_84196373d8500bd9614bc49354b0e2cd.pdf
2020-01-01
305
318
10.21608/amj.2020.67556
child marriage
rural – upper Egypt- socio-economic impact
Dalia
G. Sos
daliagabesos@gmail.com
1
Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University
LEAD_AUTHOR
Maha
M. El-Gaafary
2
Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University
AUTHOR
Maha
M. Wahdan
3
Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University
AUTHOR
Ghada
O. Wassif
4
Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University
AUTHOR
Sally
A. Hakim
5
Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University
AUTHOR
Wafaa
M. Hussein
6
Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University
AUTHOR
Amr
Hassan
7
Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University and *the National Population Council
AUTHOR
Mohammed
Y. El-Awady
8
Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University
AUTHOR
Mervat
H. Rady
9
Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University
AUTHOR
Wagida
A
10
Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University
AUTHOR
REFERENCES
1
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2
Egypt Demographic and Health Survey 2014 (EDHS 2014): Ministry of Health and Population/Egypt, El-Zanaty and Associates/Egypt, and ICF International.
3
Elden NM and Mosleh H (2015): Impact of Change in Law on Child Marriage in Egypt A Study in Two Egyptian Governorates. The Egyptian Journal of Community Medicine 33: 4.
4
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5
Gold KJ, Sen A and Hayward RA (2010): Marriage and cohabitation outcomes after pregnancy loss. Pediatrics 125: e1202-e1207.
6
Malé C. and Wodon Q. (2016): B asic profile of child marriage in Egypt. HNPGP Knowledge Brief , March 2016.
7
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8
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Roudi-Fahimi F and Ibrahim S (2014): Ending child marriage in the Arab region Population Reference Bureau 2013.
10
Shawkya R.M. El-Awady M.Y., Elsayed S. M and Hamadan G.E. (2011): Consanguineous matings among Egyptian population. Egyptian Journal of Medical Human Genetics. 12(2), 157-163.
11
The National council for Childhood and Motherhood (2008): Law no 12 of 1996 formulating the child law (amended by law no 126 of 2008).
12
United Nations Population Fund. Marriage and the family [cited 2006 Aug 8].
13
United Nations Population Fund. (2012): Marrying Too Young, End Child Marriage New York: UNFPA.
14
UNFPA. State of world population. (2005). Child marriage fact sheet.
15
United Nations Children's Fund (UNICEF 2005). Early Marriage: A Harmful Traditional Practice: A Statistical Exploration. UNICEF: New York,
16
UNICEF. Early marriage, child spouses (2001): Innocent Digest no 7 March 2001.
17
Women and Children Legal Research Foundation WCLRF (2008): Early Marriage in Afghanistan. Women and Children Legal Research Foundation (WCLRF 2008).
18
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19
ORIGINAL_ARTICLE
Effect of Cyclic Loading on the Strength of Flexor Tendon Repair in Vitro Study
Background: The initial strength of the repair depends on the material properties and knot security of the sutures as well as on the holding capacity of the suture grip of the tendon. Objective: Detecting the effect of cyclic loading on the strength of flexor tendon repair using 6 strand Tang suture experimentally. Materials and Methods: In the present ex vivo study of 50 sheep flexor tendons, six strand Tang suture technique was used: Twenty five repairs were subjected to cyclic tensile testing, and twenty five repairs were subjected to static tensile testing using 4/0 polypropylene simple suture material + epitendinous continuous running sutures using 5/0 polypropylene suture material. Results: The results of the study showed that 44 % survival at 41.7 N cyclic testing, without evidence of significant gap formation or rupture and the breaking force on continuous loading mean 55.95 N. The Tang suture method provided much more sufficient gap resistance and tensile strength able to withstand early active mobilization after primary flexor tendon repair. Conclusion: The Tang suture method provided sufficient gap resistance and tensile strength able to withstand early active mobilization after primary flexor tendon repair. There were some disadvantages regarding to time consuming during surgery and difficult to use in pediatrics and small tendons.
https://amj.journals.ekb.eg/article_67557_eb3262512687a0431174aded064a0ac0.pdf
2020-01-01
319
328
10.21608/amj.2020.67557
Flexor tendon repair
six strand Tang suture
yield force
Abd Elhakim
Abd Allah Massoud
1
Hand and Microsurgery Unite, Department of Orthopaedic Surgery, Faculty of Medicine - Al Azhar University
AUTHOR
Amro
A. Fouaad
elbiady2020@gmail.com
2
Hand and Microsurgery Unite, Department of Orthopaedic Surgery, Faculty of Medicine - Al Azhar University
LEAD_AUTHOR
Mahmoud
Saad Mohammed
3
Hand and Microsurgery Unite, Department of Orthopaedic Surgery, Faculty of Medicine - Al Azhar University
AUTHOR
REFERENCES
1
Al-Qattan MM and Al-Turaiki TM (2009): Flexor Tendon Repair In Zone 2 Using A Six-Strand ‘Figure Of Eight’ Suture. The Journal of Hand Surgery European, 34(3) 322–328.
2
Aoki M, Manske PR, Pruitt DL and Larson BJ. (1994): Tendon repair using flexor tendon splints: an experimental study. J Hand Surg. , 19A: 984-991.
3
Barrie KA, Tomak SL, Cholewicki J, Merrell GA and Wolfe SW (2001):: Effect of suture locking and suture caliber on fatigue strength of flexor tendon repairs. J Hand Surg. , 26A:340–346.
4
Gelberman RH and Manske PR. (1985): Factors influencing flexor tendon adhesions. Hand Clin. ; 1:35-42.
5
Hatanaka H and Manske PR (2000): Effect of suture size on locking and grasping flexor tendon repair techniques. Clin Orthop. , 375:267–274.
6
Kubota H, Aoki M, Pruitt DL and Manske PR (1996): Mechanical properties of various circumferential tendon suture techniques. J Hand Surg. , 21B:474–480.
7
Latendresse K, Dona E, Scougall PJ, Schreuder FB, Puchert E and Walsh WR (2005): Cyclic testing of pullout sutures and micro-mitek suture anchors in flexor digitorum profundus tendon distal fixation. J. Hand. Surg. [Am.]. , 30 (3): 471–478.
8
Linnanmaki L, Goransson H, Havulinna J, Sippola P, Karjalainen T and Leppanen OV (2016): Validity of parameters in static linear testing of flexor tendon repair. J. Biomech. , 49 (13): 2785–2790.
9
Manske PR (2005): History of Flexor Tendon Repair. Hand Clin. , 21:123–127.
10
Matheson G, Nicklin S, Gianoutsous MP and Walsh WR (2005): Comparison of zone II flexor tendon repairs using an in vitro linear cyclic testing protocol. Clin. Biomech. (Bristol, Avon). , 20 (7): 718–722.
11
McDowell CL, Marqueen TJ, Yager D, Owen JR and Wayne JS (2002): Characterization of the tensile properties and histologic/biochemical changes in normal chicken tendon at the site of suture insertion. J Hand Surg. , 27A:605–614
12
Piskin A, Yuceturk A, Tomak Y, Ozer M, Gulman B, Ataman A, Kangal M, Sahin Y, Desteli E and Alic T (2007): Tendon repair with the strengthened modified Kessler, modified Kessler, and Savage suture techniques: a biomechanical comparison. Acta Orthop Traumatol Turc. , 41(3):238-243.
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Pruitt DL, Manske PR and Fink B. (1994): Cyclic stress analysis of lfexor tendon repair. J Hand Surg. , 19A:701-707.
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Pruitt DL, Manske PR and Fink B (1991): Cyclic stress analysis of flexor tendon repair. J Hand Surg Am. , 16(4):701-707.
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Sanders DW, Milne AD, Dobravec A, MacDermid J, Johnson JA and King GJ. (1997): Cyclic testing of flexor tendon repairs: an in vitro biomechanical study. The Journal of Hand Surgery. , 22(6):1004-10.
16
Taras JS, Raphael JS, Marczyk SC and Bauerle WB (2001): Evaluation of suture caliber in flexor tendon repair. J Hand Surg. , 26A:1100–1104.
17
Wang B, Xie RG and Tang JB. (2003): Biomechanical analysis of a modification of Tang method of tendon repair. Journal of Hand Surg. , 28(4): 347-50.
18
Xie RG and Tang JB (2005): Investigation of locking configurations for tendon repair. J Hand Surg. , 30A:461– 465.
19
Xie Rg, Xue HG and Gu JH (2005): Effects of locking area on strength of 2- and 4-strand locking tendon repairs. J Hand Surg. , 30A:455–460.
20
ORIGINAL_ARTICLE
Assessment Of Active Shoulder Rotation After Tendon Transfer Around The Shoulder In Cases Of Residual Brachial Plexus Injury
Background: Active range of motion were analyzed as the outcomes of tendon transfer around the shoulder in children who had internal rotation contracture deformities secondary to obstetric brachial plexus palsy (OBPP) to improve the shoulder external rotation. Regarding to importance of external rotation there was some limitation of internal rotation which can affect patient’s daily activities. Methods: 50 patients with brachial plexus injury who underwent tendon transfer (teres major or latissimus dorsi) with or without anterior shoulder release in two separate incisions. Coracohumeral ligament release and Subscapularis release were done for all patients through anterior incision. A separate second incision in the posterior axillary fold was carried out to perform rerouting of the teres major or latissimus dorsi tendon. Results: The average active external rotation in abduction increased from 23.5º preoperatively to 76.4º postoperatively. The average active external rotation in adduction increased from 9.6º to 77.5º. The average shoulder abduction increased from 74.5º to 142.6º. Active internal rotation was analyzed just after operation, 6 month after and one year after. There was limited active IR in adduction from 10º to 50º with mean average 28.21º and improvement gradually with physiotherapy. Conclusions: Anterior shoulder release combined with latissimus dorsi or teres major rerouting significantly improved global shoulder function, but with limitations of active internal rotation which improving significally with physiotherapy.
https://amj.journals.ekb.eg/article_68429_22bc09090baf76c0176395d199e5c068.pdf
2020-01-01
329
340
10.21608/amj.2020.68429
Brachial Plexus Injury
Birth Palsy
Tendon Transfer
Abd El-Hakim
Abd Allah Massoud
1
Hand & Microsurgery Unit, Department of Orthopaedic Surgery, Faculty of Medicine, Al-Azhar University
AUTHOR
Amro
A. Fouaad
elbiady2020@gmail.com
2
Hand & Microsurgery Unit, Department of Orthopaedic Surgery, Faculty of Medicine, Al-Azhar University
AUTHOR
Ahmed
Mohammed Rashad Donia
ahmeddonia5@gmail.com
3
Hand & Microsurgery Unit, Department of Orthopaedic Surgery, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
REFERENCES
1
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Andrés-Cano, P., Toledo, M. A., Farrington, D. M. and Gil, J. J. (2015): Arthroscopic treatment for internal contracture of the shoulder secondary to brachial plexus birth palsy: report of a case series and review of the literature. European Journal of Orthopaedic Surgery & Traumatology, 25(7): 1121-1129.
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Ozben, H., Atalar, A. C., Bilsel, K. and Demirhan, M. (2011): Transfer of latissmus dorsi and teres major tendons without subscapularis release for the treatment of obstetrical brachial plexus palsy sequela. Journal of Shoulder and Elbow Surgery, 20(8): 1265-1274.
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20
Shah, M. and Ganjwala, D. (2018): Current Concept in the Management of Brachial Plexus Birth Palsy, Treatment of Brachial Plexus Injuries, Vicente Vanaclocha and Nieves Sáiz-Sapena, 5(11): 1-16.
21
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23
ORIGINAL_ARTICLE
CHANGES IN GANGLION CELL AND INNER PLEXIFORM LAYERS THICKNESS AND RETINAL MICROVASCULATURE IN DIFFERENT STAGES OF GLAUCOMA
Background: Primary open angle glaucoma (POAG) is an optic neuropathy characterized by progressive degeneration of retinal ganglion cells (RGC) and their axons, which results in characteristic excavation of the neuroretinal rim with corresponding visual field (VF) deficits. Optical coherence tomography angiography (OCTA) is a novel imaging modality that can detect vascular flow of the retina and choroid in great detail. The ability to segment OCT angiograms into the different vascular layers may improve understanding of disease pathogenesis. Objective: To evaluate the correlation between Ganglion Cell and Inner Plexiform Layers thickness using optical coherence tomography (OCT) and the macular microvasculature density in different stages of primary open angle glaucoma using optical coherence tomography angiography (OCTA). Subjects and Methods: The study was performed on 80 eyes of 48 subjects including 20 eyes of 11 controls, and 60 eyes of 37 POAG cases which were divided into 3 groups according to Hodapp,Parish,Anderson (H-P-A) classification; Group1: mild glaucoma (20 eyes), Group 2: moderate glaucoma (20 eyes),Group 3: severe glaucoma (20 eyes). Results: In our study, we found that there was a significant reduction in Ganglion Cell - Inner Plexiform Layer (GCIPL) thickness and macular VD in patients with POAG which increased with increasing glaucoma severity, also we found that OCT and OCTA parametrs were significantly differentiate between normal and POAG cases and also between different stages of POAG. Also we found that an OCTA was an important diagnostic tool in diagnosing mild cases of POAG and to differentiate between mild and moderate cases of POAG,in contrast to OCT in which there was no significant differance between mild and moderate cases of POAG. OCTA seems to be a good candidate for diagnosis and follow-up of glaucoma, complementing the results provided by OCT and visual field testing. Conclusion: Significant differences between eyes with POAG and normal eyes in terms of the macular GCIPL thickness and microvasculature density (VD) suggest that the macular GCIPL thickness and the retinal capillary vessel area density may be reliable indicators of glaucoma severity.
https://amj.journals.ekb.eg/article_68430_dd1b614056ec84e50e68e0b5080ca7fe.pdf
2020-01-01
341
356
10.21608/amj.2020.68430
Primary Open angle glaucoma
Ganglion Cell - Inner Plexiform Layer
optical coherence tomography (OCT)
optical coherence tomography angiography (OCTA)
vessel density (VD)
Mohamed
Abd El-Monem Mahdy
1
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University
AUTHOR
Mohamed
Abd El-Badiea Rashed
2
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University
AUTHOR
Mahmoud
Ali Metwaly Omran
drmahmoudali426@gmail.com
3
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
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20