ORIGINAL_ARTICLE
EVALUATION OF HERNIORRHAPHY FOR PARA - UMBILICAL HERNIA ASSOCIATED WITH LAPAROSCOPIC CHOLECYSTECTOMY
Background: Para-umbilical hernia repair (PUHR) combined with LC result in longer operating time, longer anesthesia, and risk of increased blood loss. But it has the advantages of single hospital stay, single anesthesia exposure, less post-operative pain and morbidity, early return to work, better cosmesis and more convenient , efficacy and cost effective for the patient. Objective: To evaluate the selected repair methods for para-umbilical hernias that already exist or are encountered incidentally and to present data regarding potential problems that may occur during laparoscopic cholecystectomy. Patients and Methods: During period of January 2017 to January 2019, laparoscopic cholecystectomy was attempted in 25 patients suffering from chronic calcular cholecystitis accompanied by para-umbilical hernia, patients were assigned to two groups according to occurrence of recurrence. A retrospective analysis of parameters, including patient demographics, laboratory values, radiologic data, and intraoperative findings, was performed. Results: The operating time, postoperative pain, length of hospital stay, wound infection and the time needed for return to work were less in patients without recurrence than patients with recurrence. Recurrence occurred in cases with BMI 35.5±8.08, patient with comorbidities (DM and hypertension) and size of the defect 2.4±.07 cm. Cases with recurrence have longer operational time and hospital stay than cases without recurrence and take more days to return to work. Cases with recurrence have also other complication such as hematoma and wound infection. There was a moderate positive correlation between BMI and both operating time and length of hospital stay. There was strong positive correlation between size of hernia and both operating time and length of hospital stay. There was a strong positive correlation between comorbidity and both operating time and length of hospital stay. Conclusion: Para-umbilical hernia repair combined with laparoscopic cholecystectomy resulted in longer operating time, longer anesthesia, and risk of increased blood loss. But it has the advantages of single hospital stay, single anesthesia exposure, less postoperative pain and morbidity, early return to work, better cosmesis and more convenient, efficacy and cost effective for the patient. However, the outcomes of the para-umbilical defect repair with mesh after laparoscopic surgeries appeared to be better for either obese or non-obese patients than primary suture techniques in recurrence rates.
https://amj.journals.ekb.eg/article_158228_2dddb307038f3b50abd83eea704acd8c.pdf
2021-04-01
821
830
10.21608/amj.2021.158228
hernia repair
Laparoscopic cholecystectomy
Para-umbilical hernia
Ahmed
Radwan Ali Ahmed
ahmed_radwan55@gmail.com
1
Department of General Surgery, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Selim
Saied Abd El-Rahman El-Nemr
2
Department of General Surgery, Faculty of Medicine, Al-Azhar University
AUTHOR
Mahmoud
Abd El-Hady Abd El-Aziz
3
Department of General Surgery, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Aslani N and Brown CJ (2010): Does mesh offer an advantage over tissue in the open repair of umbilical hernias? A systematic review and meta-analysis. Hernia, 14(5):455–462.
2
Bozkırlı OP, Gundogdu RK, Basically H, Ersoy P, Turgay M and Vulture S (2012): The Significance of the Coexistence of Cholelithiasis and UmbilicalHernia in Laparoscopy Era. Gazi Med J., 23: 59 - 61.
3
Farquharson M, Hollingshead J and Brendan M (2014): Farquharson's Textbook of Operative General Surgery. Pbl. CRC Press., p. 222.
4
Kulaçoğlu H (2015): Current options in umbilical hernia repair in adult patients. Turk. J. Surg., 31(3):157-162.
5
Lanaya S and Manvi PN (2018): A clinical study and different modalities of management of ventral hernias. Int Surg J., 5(11):3589-3593.
6
Malik AM (2011): General Surgery Procedures, Advances in Laparoscopic Surgery part 1 Pp. 1-55.
7
Martis JJ, Rajeshwara KV, Shridhar MK, Janardhanan D and Sudarshan S (2011): Strangulated Richter's umbilical hernia-a case report. Indian J Surg., 73(6):455–457. 2011.
8
Savita KS, Khedkar I and Bhartia VK. (2010): Combined Procedures with Laparoscopic Cholecystectomy. Indian J Surg., 72(5): 377 –380.
9
Zoricic I, Vukusic D, Rasic Z, Schwarz D and Sever M. (2013): Therapy of Umbilical Hernia during Laparoscopic Cholecystectomy. Coll Antropol., 37(3): 1003–1005.
10
ORIGINAL_ARTICLE
OUTCOME OF SURGICAL EXCISION OF ACCESSORY BREAST TISSUE IN THE AXILLA
Background: The axilla is the most common site for accessory breasts. Although they may be asymptomatic, axillary accessory breasts can cause cosmetic concerns, pain, or restriction in arm movements. The radiological methods used for diagnosis include ultrasonography and MRI. The main concerns about the surgical treatment of accessory breasts are leaving any breast tissue unresected and cosmetic problems resulting from a bad scar or contour deformities. Objective: To evaluate the surgical outcome after excision of prominent accessory breast in the axilla. Patients and Methods: The current study included 50 female patients, presented to Al-Azhar University Hospitals, in Cairo, for elective excision of uncomplicated axillary accessory breast, in which an axillary swelling was noticed by themselves following pregnancy and lactation, during the period from May 2019 till April 2020. Their ages ranged from ranged between 18-40 years with a mean of 28.76 ± 5.7 years. Results: The local examination of the axillary breast revealed that its size ranged between 4-10 cm with a mean of 6.8 ± 2.3 cm. Consistency was firm in 40% of patients, hard in 40% of patients and soft in 20% of patients, fixed in 40% of patients and mobile in 60% of them, with an extension beyond the axilla in 40% of cases, whereas no extension was found in 60% of cases. Ultrasound examination of the axillary breast revealed that the mass was hyper-echoic in 60% of patients and hypo-echoic in 40% of them. Size ranged between 5-12 cm with a mean of 8 ± 2.6 cm. Wound healing was good in 82% of patients and was delayed in 18% of them. It was affected by hemoglobin level, but not with albumin level. Postoperative complications ranged from mild scar hypertrophy in 3 patients (6%), medial arm pain in 2 patients (4%), allergy to sticking plaster in 2 patients (4%), and hematoma in 1 patient (2%). Conclusion: Proper surgical excision provided numerous advantages as an option in treating an accessory axillary breast with virtually no postoperative complications.
https://amj.journals.ekb.eg/article_158229_c8dfa931a6c880c615655fd180bec5ca.pdf
2021-04-01
831
842
10.21608/amj.2021.158229
Surgical Excision
Accessory Breast Tissue
Axilla
Mohammed
Refaat Hasan El-Bermawy
mohammedrefaat@gmail.com
1
Department of General Surgery, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Adel
Mohammad Abdul-Haleem Lasheen
2
Department of General Surgery, Faculty of Medicine, Al-Azhar University
AUTHOR
Walid
Raafat Abd El-Atey
3
Department of General Surgery, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Arenberger P, Engels P, Arenbergerova M, Gkalpakiotis S, García Luna Martínez FJ, Villarreal Anaya A and Fernandez L. (2011): Clinical results of the application of a hemoglobin spray to promote healing of chronic wounds. GMS Krankenhhyg Interdiszip., 6(1): 1-9.
2
Arora BK, Arora R and Aora A. (2016): Axillary accessory breast: presentation and treatment. International Surgery Journal, 3: 2050-2053.
3
Aydogan F, Baghaki S, Celik V, Kocael A, Gokcal F, Cetinkale O and Unal H (2010): Surgical treatment of axillary accessory breasts. Am Surg., 76(3):270–272.
4
Bartsich SA, Ofodile FA and Sachan P. (2011): Accessory breast tissue in the axilla: Classification and treatment. Plastic and Reconstructive Surgery, 128(1):35-36.
5
Bhave MA. (2016): Axillary Breast: Contouring the Axilla. Intech Open, 14: 196-206.
6
Down S, Barr L, Baildam AD and Bundred N. (2013): Management of accessory breast tissue in the axilla. Br J Surg., 90(10):1213–1214.
7
Guo SD and DiPietro LA. (2010): Factors Affecting Wound Healing. Journal of Dental Research, 89(3):219-29.
8
Iizaka S, Sanada H, Matsui Y, Furue M, Tachibana T, Nakayama T and Sugama J. (2011): Serum albumin level is a limited nutritional marker for predicting wound healing in patients with pressure ulcer: two multicenter prospective cohort studies. Clin Nutr., 30(6):738-45.
9
Jahromi MK, Sobhanian S, Hojat M and Taheri L. (2015): Correlation between hemoglobin levels with wound infections in orthopedic patients: a case-control study. Jokull Journal, 65:187-195.
10
Loukas M, Clarke P and Tubbs RS. (2017): Accessory breasts: a historical and current prospective. Am Surg., 73(5):525-8.
11
Ortega-Andreu M, Pérez-Chrzanowska H, Figueredo R and Gómez-Barrena E. (2011): Blood loss control with two doses of tranexamic acid in a multimodal protocol for total knee arthroplasty. The Open Orthopaedics Journal, 5:44-46.
12
Sahu S, Hussain M and Sachan P. (2017): Bilateral accessory breast. Internet J Surg., 17(2):1-4.
13
Shultz D, Templeman C and Hertweck SP. (2018): Breast disorders in the pediatric and adolescent patient. Obstet Gynecol Clin North Am., 27:19-26.
14
Solanki R, Choksi DB and Duttaroy DD. (2018): Accessory breast tissue presenting as a large pendulous mass in the axilla: a diagnostic dilemma. N Z Med J., 121(1277):76-8.
15
Sørensen LT. (2012): Wound healing and infection in surgery: the pathophysiological impact of smoking, smoking cessation, and nicotine replacement therapy: a systematic review. Annals of Surgery, 255(6):1069-79.
16
Velanovich V, Ward E, Brawley O and Jemal A. (2012): Ectopic breast tissue, supernumerary breasts, and supernumerary nipples. South Med J., 88:903–906.
17
ORIGINAL_ARTICLE
BLOOD TRANSFUSION REQUIREMENTS IN CARDIAC SURGERY
Background: The effect of restrictive blood transfusion in comparison to liberal red cell transfusion strategy on clinical outcome in cardiac surgery remains undetermined. Objectives: The aim of this work is to evaluate the restrictive blood transfusion strategy versus the liberal strategy in open heart surgery in terms of vital organ functions (heart, brain, lung, and kidney) and mortality. Patients and Methods: After approval of Institutional ethical committee and obtaining written informed consent from the patient, in this multicenter randomized prospective study, we assigned 100 adult cardiac surgery patients with Euro score I of 6 or more to a restrictive red cell transfusion trigger (transfuse if hemoglobin level was <7.5g/dl starting from the induction of anesthesia) and liberal red cell transfusion trigger (transfuse if hemoglobin level was <9.5g/dl in the operative room or intensive care unit or <8.5g/dl in the ward). The primary outcome was composite of any cause death, myocardial infarction, stroke, or new onset renal failure with dialysis by discharge from hospital or by day28 whichever came first. Results: There was a significant decrease in RBC transfusion in the restrictive group intraoperative, in the postoperative day (1), and in the ward stay. There was significantly less fresh frozen plasma transfused in the restrictive group during the ward stay only. There were a significant decrease in ventilator time, ICU stay, chest tube drainage, and rapid AF occurrence in the restrictive. Conclusion: The restrictive transfusion strategy showed efficacy and safety in decreasing transfusion requirements in cardiac surgery, thus decreasing morbidities and mortality associated with blood transfusion. It also showed cost effectiveness.
https://amj.journals.ekb.eg/article_158230_6d7123a40449e99dac811dd7ce54b260.pdf
2021-04-01
843
854
10.21608/amj.2021.158230
Blood transfusion requirements
cardiac surgery
Cardiopulmonary bypass
Preoperative anemia
Amr
Abd El Aal
amribrahim288@yahoo.com
1
department of cardiothoracic surgery, Faculty of medicine, Alexandria university
LEAD_AUTHOR
El-Husseiny
El-Husseiny Gamil
2
Department of Cardiothoracic Surgery, Faculty of Medicine, Al-Azhar University
AUTHOR
Hossam
Fouad Fawzy
3
Department of Cardiothoracic Surgery, Faculty of Medicine, Tanta University
AUTHOR
Yousry
Zaki Al-Zohairy
4
Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Carson, J. L., Stanworth, S. J., Roubinian, N., Fergusson, D. A., Triulzi, D., Doree, C. and Hebert, P. C. (2016): Transfusion thresholds and other strategies for guiding allogeneic red blood cell transfusion. Cochrane database of systematic reviews, 10: CD002042.
2
Delaney, M., Wendel, S., Bercovitz, R. S., Cid, J., Cohn, C., Dunbar, N. M., Apelseth, T. O., Popovsky, M., Stanworth, S. J., Tinmouth, A., Van De Watering, L., Waters, J. H., Yazer, M. and Ziman, A. (2016): Transfusion reactions: prevention, diagnosis, and treatment. The Lancet, 388(10061): 2825-2836.
3
Docherty, A. B., O'Donnell, R., Brunskill, S., Trivella, M., Doree, C., Holst, L., Parker, M., Gregersen, M., Pinheiro de Almeida, J., Walsh, T. S. and Stanworth, S. J. (2016): Effect of restrictive versus liberal transfusion strategies on outcomes in patients with cardiovascular disease in a non-cardiac surgery setting: systematic review and meta-analysis. British medical journal, 352: i1351.
4
El-Hilali, F., El-Hilali, H., Dheeb, B., Traore, B. and Messouak, M. (2016): Blood Transfusion Utility during Cardiopulmonary Bypass and Correlation with Key-Biochemical Laboratory Findings: A New Approach to Identify Preventive and Risk Factors (1-Year Practice at University Hospital Hassan-II of Fez). Biochemistry and Analytical Biochemistry, 5: 290-295.
5
Ferraris, V. A. (2015): Blood transfusion in cardiac surgery: who should get transfused? The Lancet. Haematology, 2(12): e510-e511.
6
Garg, A. X., Badner, N., Bagshaw, S. M. and Cuerden, M. S. (2019): Safety of a Restrictive versus Liberal Approach to Red Blood Cell Transfusion on the Outcome of AKI in Patients Undergoing Cardiac Surgery: A Randomized Clinical Trial. Journal of the American Society of Nephrology, 30(7): 1294-1304.
7
Mazer, C. D., Whitlock, R. P., Fergusson, D. A., Belley-Cote, E., Connolly, K., Khanykin, B., Gregory, A. J., de Medicis, E. and Carrier, F. M. (2018): Six-Month Outcomes after Restrictive or Liberal Transfusion for Cardiac Surgery. The New England Journal of Medicine, 379(13): 1224-1233.
8
Murphy, G. J., Pike, K., Rogers, C. A., Wordsworth, S., Stokes, E. A., Angelini, G. D. and Reeves, B. C. (2015): Liberal or restrictive transfusion after cardiac surgery. The New England Journal of Medicine, 372(11): 997-1008.
9
Tagliari, A. P., da Silveira, L. M., Kochi, A. N., Souza, A. C. d., Gib, M. C., Freitas, T. M. d., Martins, C. B., Cavazzola, L. T. and Wender, O. C. B. (2019): Adverse Events and Risk Factors of Blood Transfusion in Cardiovascular Surgery: A Prospective Cohort Study. International Journal of Cardiovascular Sciences, 32(6): 565-572.
10
10. Tempe, D. K. and Khurana, P. (2018): Optimal Blood Transfusion Practice in Cardiac Surgery. Journal of Cardiothoracic and Vascular Anesthesia, 32(6): 2743-2745.
11
11. Van Boven, W. J., Hermanns, H. and Juffermans, N. P. (2015): New insights for transfusion triggers in cardiac surgery. Netherlands Journal of Critical Care, 21(3): 4-5.
12
12. Vlot, E. A., Verwijmeren, L., van de Garde, E. M. W., Kloppenburg, G. T. L., van Dongen, E. P. A. and Noordzij, P. G. (2019): Intra-operative red blood cell transfusion and mortality after cardiac surgery. BMC Anesthesiology, 19(1): 65-71.
13
ORIGINAL_ARTICLE
EVALUATION OF THE DISTAL RESECTION MARGIN VASCULARITY IN THE SUPERIOR RECTAL ARTERY PRESERVATION IN SIGMOIDECTOMY FOR SIGMOID COLON CANCER
Background: Colorectal surgery has gained wide acceptance, especially in the treatment of cancer colon. Several techniques and modifications have been proposed to improve morbidity and mortality associated with left hemicolectomy. Objective: To evaluate the technique of superior rectal artery preservation in sigmoidectomy for sigmoid colon cancer, as regard impact on both radicality and vascularization in the remaining rectum. Patients and Methods: A prospective study had been conducted on Bab El Sharia University Hospital and El-Sahel Teaching Hospital from March 2019 to March 2020. Thirty patients who are posted for sigmoidectomy with preservation of superior rectal artery had been included in the study. Results: That mean of intraoperative blood loss was 35.64 ml and 6.7% of patients have intraoperative bleeding. The mean of harvested lymph nodes was 19.27. One patient needed conversion to open surgery. As regard mean of operation time, it was 190.73 min. Conclusion: Superior rectal artery preservation sigmoidectomy for colon cancer was a beneficial technique guarding against post-operative anastomosing leakage, important oncologic principles as lymph node (LN) metastasis and recurrence should be taken in consideration should be kept in mind before performing that procedure.
https://amj.journals.ekb.eg/article_158231_f75035f552205486d54014a7b8df8c3f.pdf
2021-04-01
855
862
10.21608/amj.2021.158231
Sigmoid Cancer
Superior Rectal Artery
sigmoidectomy
Colon cancer
Mohammed
L. Abd El-Mawgod
dr_mlotfy2017@gmail.com
1
Department of General Surgery, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Saeed
H. El-Bendary
2
Department of General Surgery, Faculty of Medicine, Al-Azhar University
AUTHOR
Mohammed
M. Ahmed
3
Department of General Surgery, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Dobrowolski S, Hai S, Kobiela J and Sledzii Z. (2010): Should we preserve the inferior mesenteric artery during sigmoid colectomy? Neurogastroenterol Motil., 21(12): 1288-e123.
2
Doryane MRL, João PB, Gustavo K and Univaldo ES. (2017): Importance of Superior Rectal Artery Preservation in Videolaparoscopic Rectosigmoidectomy 004 for Benign Disease. Adv Res Gastroentero Hepatol., 4(3): 58-61.
3
Ge L, Wang HJ, Wang QS, Zhao ZL and Lei C. (2017): The surgical technique of laparoscopic lymph node dissection around the inferior mesenteric artery with preservation of superior rectal artery and vein for treatment of the sigmoid and rectal cancer. Journal of Laparoendoscopic & Advanced Surgical Techniques, 27(2):175-80.
4
Guraya SY. (2016): Optimum level of inferior mesenteric artery ligation for the left-sided colorectal cancer. Systematic review for high and low ligation continuum. Saudi Med J., 37:731–6.
5
Lehmann RK, Brounts LR, Johnson EK, Rizzo JA and Steele SR. (2011): Does sacrifice of the inferior mesenteric artery or superior rectal artery affect anastomotic leak following sigmoidectomy for diverticulitis? A retrospective review. Am J Surg., 201(5): 623-627.
6
Masoni L, Mari FS, Nigri G, Favi F and Gasparrini M. (2012): Preservation of the inferior mesenteric artery via laparoscopic sigmoid colectomy performed for diverticular disease: real benefit or technical challenge: a randomized controlled clinical trial. Surg Endosc., 27(1): 199-6.
7
Sekimoto M, Takemasa I, Mizushima T, Ikeda M and Yamamoto H. (2011): Laparoscopic lymph node dissection around the inferior mesenteric arterywith preservation of the left colic artery. Surg Endosc., 25(3): 861-866.
8
Shi D, Liang L, MaY, Li Q and Li X. (2018): Laparoscopic radical treatment with preservation of left colon artery and superior rectal artery for sigmoid colon cancer. Translational Cancer Research, 7(3):738-743.
9
Singh D, Luo J, Liu XT, Ma Z, Cheng H and Yu Y. (2017): The long-term survival benefits of high and low ligation of inferior mesenteric artery in colorectal cancer surgery: a review and meta-analysis. Medicine, 96(47):124-9.
10
10. Wakahara T, Toyokawa A, Ashitani H, Tsuchida S and Hasegawa Y. (2015): Comparison of laparoscopic sigmoidectomy with and without preservation of the superior rectal artery: A single-institution retrospective study. Asian Journal of Endoscopic Surgery, 8(1):29-33.
11
11. Wakahara T, Toyokawa A, Awadu M, Takahashi T, Tsuchida S and Hasegawa Y. (2014): Laparoscopic sigmoidectomy with preservation of the superior rectal artery: usefulness of bipolar scissors. Journal of Japanese College of Surgeons, 39(2):155-9.
12
ORIGINAL_ARTICLE
STUDY OF THE EFFECT OF LACTOBACILLUS ACID FAST AS A PROPHYLAXIS FOR ENTER-COLITIS FOLLOWING SURGERY FOR HIRSCHSPRUNG’S DISEASE IN CHILDREN
Background: Hirschsprung’s associated enterocolitis (HAEC) after surgery is a common problem. The exact pathogenesis of HAEC still remains unclear. Considering the complex interrelation between the epithelium, the immune system, and the micro biome of the intestine, disturbances of the intestinal microbial composition may predispose a patient to develop HAEC. Surgery reduces, but does not eliminate the risk of enterocolitis, as up to 40% of the patients continue to suffer from HAEC despite correct surgical treatment. Objective: To evaluate use of the lactobacillus acid fast (probiotic) as a prophylactic treatment for enter-colitis following surgery for Hirschsprung’s disease (HD) . Patients and Methods: This numerical randomized control study was done on fifty patients. Their ages ranged from 0 day up to 10 years. All of them had undergone surgical treatment for Hirschsprung’s disease in Al-Azhar University Hospitals, Al Sheikh Zayed specialized Hospital and Al haram Hospital, during the period from January 2017 to December 2019. They were classified into 2 equal groups; Group A received lactobacillus acid fast (probiotic) as a prophylactic treatment for two years post-operative compared to group B did not. Results: Treatment with probiotics did not only significantly diminish the incidence, but also decreased the severity of HAEC. Conclusion: The use of probiotics as a prophylactic treatment following surgery for Hirschsprung’s disease did not only significantly diminish the incidence, but also decreased the severity of Hirschsprung-Associated Enter-colitis (HAEC).
https://amj.journals.ekb.eg/article_158281_9c2f0ac721f221f84d562a57424a2989.pdf
2021-04-01
863
874
10.21608/amj.2021.158281
Hirschsprung
Associated Enter
colitis (HAEC)
Hussein
Ahmed Mohamed Abd El-Lattif
hussienadam77@gmail.com
1
Department of Pediatric Surgery, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Maged
Mohamed Mohamed Ismail
2
Department of Pediatric Surgery, Faculty of Medicine, Al-Azhar University
AUTHOR
Samir
Hamed Gouda
3
Department of Pediatric Surgery, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Austin KM (2012): The pathogenesis of Hirschsprung’s disease-associated enterocolitis. In: Seminars in Pediatric Surgery, 21(4): 319-327.
2
Burkardt DD, Graham JM, Short SS and Frykman PK (2014): Advances in Hirschsprung disease genetics and treatment strategies: an update for the primary care physician. Clin Pediatr, 53:71-81.
3
Demehri FR, Halaweish IF, Coran AG and Teitelbaum DH (2013): Hirschsprung-associated enterocolitis: pathogenesis, treatment and prevention. Pediatr Surg Int, 29:873-881.
4
Georg S, Karl K, Christoph C, Holger T (2018): Department of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria Volume 2018, Article ID 3292309, 6 pages.
5
McLaughlin D and Puri P (2015): Familial Hirschsprung’s disease: a systemic review. Pediatr Surg Int, 31:695-700.
6
Poenaru D, Borgstein E, Numanoglu A and Azzie G (2010): Caring for children with colorectal disease in the context of limited resources. Semin Pediatr Surg, 19:118–127
7
Ralls MW, Coran AG and Teitelbaum DH (2012): Reoperative surgery for Hirschsprung disease. Semin Pediatr Surg, 21:354-363.
8
ST. Louis (2016): Children's hospital, all rights reserved St. Louis Children's Hospital • One Children's Place • St. Louis, MO, 63110. 314.454.6000
9
Temple SJ, Shawyer A and Langer JC (2012): Is daily dilatation by parents necessary after surgery for Hirschsprung disease and anorectal malformations? Journal of Pediatric Surgery, 47(1):209-12.
10
10. Wang Q, Dong J and Zhu Y (2012): Probiotic supplement reduces risk of necrotizing enterocolitis and mortality in preterm very low-birth weight infants: an updated meta-analysis of 20 randomized, controlled trials. J Pediatr Surg, 47(1):241–8.
11
11. Wilkins T and Sequoia J (2017): Probiotics for Gastrointestinal Conditions: A Summary of the Evidence. American Family Physician, 96(3):170-8.
12
12. World Gastroenterology Organisation Global Guidelines (2011): Allen SJ, Martinez EG, Gregorio GV, Dans LF. Probiotics for treating acute infectious diarrhoea. Cochrane Database of Systematic Reviews 2010, Issue 11. Art. No.: CD003048.
13
ORIGINAL_ARTICLE
PREOPERATIVE EVALUATION OF THE SCORING SYSTEM DEVELOPED BY ATEMA TO DISTINGUISH COMPLICATED FROM UNCOMPLICATED ACUTE APPENDICITIS
Background: The diagnosis of acute appendicitis is purely based on history, clinical examination and some laboratory investigations (e.g. WBC count). Certain diagnosis can only be obtained at surgery and after pathological examination of surgical specimen. The Atema scoring system can distinguish complicated from non-complicated appendicitis preoperatively. Objective: To evaluate the validity and diagnostic accuracy of the Atema scoring system in differentiating complicated from non- complicated appendicitis before surgery. Patients and Methods: A prospective study was carried out on 60 patients complaining of acute abdominal pain, diagnosed as acute appendicitis using the Alvarado score and undergoing open appendectomy operation in the Emergency Department, Faculty of Medicine, Al-Azhar University from December 2019 to July 2020. Routine clinical and laboratory work up were done, the Atema Score was calculated to every patient in the study preoperatively. The decision to operate was made by a senior surgeon (consultant). The intraoperative finding whether the acute appendicitis was complicated or not was recorded. Post operatively, the histo-pathological examination results were recorded for each patient. The ROC curve was done, the cut-off point of the Atema scoring system was detected based on the ROC curve. The area under the ROC curve and the p-value were calculated. The sensitivity, specificity, positive predictive value and negative predictive value of the Atema scoring system above the level of the cut-off point were calculated. Results: In total of 60 patients, 37 patients (61.7%) had complicated appendicitis and 23 patients (38.3%) had non-complicated appendicitis. The sensitivity of the Atema score has a diagnostic accuracy of 0.944 (Area under the curve) with sensitivity 86.96% and specificity 89.19% with positive predictive value 83.3% and negative predictive value 91.7%. Conclusion: The Atema score can significantly differentiate between complicated and non-complicated acute appendicitis. A higher score denotes increased probability of the presence of complications as perforation and gangrene.
https://amj.journals.ekb.eg/article_158284_6166676e2c4498900ea46f20aee71fb3.pdf
2021-04-01
875
884
10.21608/amj.2021.158284
Atema scoring system
complicated acute appendicitis
uncomplicated acute appendicitis
Appendectomy
Abd El-Kader
Hamdy Mohammed Abd El-Kader
dr.surgeon100100@gmail.com
1
Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
LEAD_AUTHOR
Mohammed
Hafez Mahmoud
2
Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Mahmoud
Abd El-Hady Abd El-Aziz
3
Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
REFERENCES
1
Abbasi AS, Niaz S and Ashfaq U (2017): Acute Appendicitis: Relationship of Total Leucocyte Count with Per-Operative Stage. Journal of Islamabad Medical & Dental College; 6(4):255-8.
2
Abbas PI, Zamora IJ, Elder SC, Brandt ML, Lopez ME and Orth RC (2016): How Long Does it Take to Diagnose Appendicitis? Time Point Process Mapping in the Emergency Department. Pediatr Emerg Care, 9: 4-5.
3
Alnjadat I and Abdallah B (2013): Alvarado versus RIPASA score in diagnosing acute appendicitis. Rawal Medical Journal; 38(2):147-51.
4
Ansaloni L, Catena F, Coccolini F, Ercolani G, Gazzotti F, Pasqualini E and Pinna AD (2011): Surgery versus conservative antibiotic treatment in acute appendicitis: a systematic review and meta-analysis of randomized controlled trials. Dig Surg; 28:210–221
5
Antoniou SA, Koch OO, Antoniou GA, Lasithiotakis K, Chalkiadakis GE, Pointner R and Granderath FA (2014): Metaanalysis of randomized trials on single-incision laparoscopic versus conventional laparoscopic appendectomy. Am J Surg; 207:613–622.
6
Atema JJ, Van Rossem CC, Leeuwenburgh MM, Stoker J and Boermeester MA (2015): Scoring system to distinguish complicated from non-complicated acute appendicitis. BJS, 102(8):979-980.
7
D’Souza N and Nugent K (2016): Appendicitis. Am Fam Physician; 93: 142- 143.
8
Glass CC, Saito JM, Sidhwa F, Cameron DB, Feng C, Karki M, Abdullah F, Arca MJ, Goldin AB, Barnhart DC and Zurakowski D (2016): Diagnostic imaging practices for children with suspected appendicitis evaluated at definitive care hospitals and their ssociated referral centers. J Pediatr Surg, 7: 8-10.
9
Liu K and Fogg L (2011): Use of antibiotics alone for treatment of uncomplicated acute appendicitis: a systematic review and meta-analysis. Surgery, 150(4):673-83.
10
Nanjundaiah N, Mohammed A, Shanbhag V, Ashfaque K and Priya SA (2014): A comparative study of RIPASA score and ALVARADO score in the diagnosis of acute appendicitis. Journal of clinical and diagnostic research: JCDR, 8(11):NC03.
11
Norman SW, O’Connell P and Andrew W (2018): McCaskie. Baily and Love’s Short practice of surgery, 27th edition. HK Lewis, Great Britain; 11(72):1299.
12
Raja MH, Elshaikh E, Williams L and Ahmed MH (2017): The value of CRP in enhancing the diagnosis of acute appendicitis. Journal of Current Surgery 15 (7): 50-61.
13
Siddiqui J, Oliphant R and Suen M (2018): Appendicitis: A Traumatic Etiology. Journal of Case Reports, 8(3):176-8.
14
Xu AM, Huang L and Li TJ (2015): Single-incision versus three-port laparoscopic appendectomy for acute appendicitis: systematic review and meta-analysis of randomized controlled trials. Surg Endosc, 29:822–843.
15
ORIGINAL_ARTICLE
COMPARATIVE STUDY BETWEEN TRANSBRACHIAL VS TRANSFEMORAL ANGIOPLASTY OF CHRONIC COMPLETE ILIAC ARTERY OCCLUSION
Background: Critical limb ischemia (CLI) is the most advanced stage of peripheral arterial occlusive disease; the prognosis is poor, with amputation rates up to 30 % and mortality up to 25% after 1 year. Objective: To compare between transbrachial approach and ipsilateral transfemoral approach either ultrasound guided or road map technique in common iliac artery occlusion angioplasty. Patients and Methods: A retrospective study conducted at the Department of Vascular Surgery, Faculty of Medicine, Al-Azhar University Hospitals from January 2019 till October 2020. The 88 patients who are candidates for study were subdivided into to three groups: Group A: Including 31 patients for whom transbrachial iliac angioplasty, Group B: Including 30 patients for whom transfemoral ultrasound guided iliac angioplasty and Group C: Including 27 patients for whom transfemoral road map guided iliac angioplasty. All lesions were categorized according to the Trans-Atlantic Inter-Society Consensus II (TASC) classification. Results: Transbrachial success rate was 90.32% compared with 96.6 in transfemoral access. No statistical difference was found. Patency rate reached 90.3%, 90.0% and 85.2% in transbrachial, transfemoral ultrasound and transfemoral road map guided groups respectively (X2:0.462; P=0.794). Peri-procedural complication rate reached 16.1%, 6.7% and 74.1% in Tran brachial, transfemoral ultrasound and transfemoral road map guided groups, respectively. Complications were statistically higher significantly in transfemoral road map guided group (X2:0.462; P=0.794). Thirty days mortality rate reached 11.1%, 23.8% and 17.4% in Tran brachial, transfemoral ultrasound and transfemoral road map guided groups, respectively. This was not statistically different among the three access groups (X2: 1.362; P=0.506). Amputation rate reached 9.7%, 6.7% and 3.7% in transbrachial, transfemoral ultrasound and transfemoral road map guided groups, respectively. No statistically significant difference was found (X2: 6.207; P=0.145). Conclusion: The technical success of all approaches is high, with higher success rate in transfemoral access. While we found more bleeding complications with transfemoral access.
https://amj.journals.ekb.eg/article_158285_d2ddeb7cce675528f46984fc30733217.pdf
2021-04-01
885
896
10.21608/amj.2021.158285
Transbrachial
ipsilateral
Transfemoral
Iliac
Angioplasty
Haytham
Yousef Ali
hysamali4@gmail.com
1
Department of Vascular Surgery, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Alaa
El-Dein Sharaby
2
Department of Vascular Surgery, Faculty of Medicine, Al-Azhar University
AUTHOR
Mohamed
Hamza
3
Department of Vascular Surgery, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Aboyans V, Ricco JB, Bartelink MEL, Björck M, Brodmann M, Cohnert T, Collet JP, Czerny M, De Carlo M, Debus S, Espinola-Klein C, Kahan T, Kownator S, Mazzolai L, Naylor AR, Roffi M, Röther J and Sprynger M. (2017): ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS) Vascular Surgery (ESVS). European Heart Journal, 39(9): 763-816.
2
Aho PS and Venermo M. (2017): Hybrid Procedures as a Novel Technique in the Treatment of Critical Limb Ischemia. Scandinavian Journal of Surgery, 101(2): 107-113.
3
Alvarez-Tostado JA, Moise MA, James F and Bena F. (2019): The brachial artery: A critical access for endovascular procedures. Journal of Vascular Surgery, 49(2): 378-385.
4
Basche S, Eger C and Aschenbach R (2019): The brachial artery as approach for catheter interventions – indications, results, complications. Vasa, 33(4): 235-238.
5
Coroleu SF, Burzotta F and Fernández-Gómez C. (2018): Feasibility of complex coronary and peripheral interventions by trans-radial approach using large sheaths. Catheter Cardiovasc Interv., 79(4):597-600.
6
Cortese B, Peretti E, Troisi N, Siquilberti E, Setti M and Pitì A. (2017): Transradial percutaneous iliac intervention, a feasible alternative to the transfemoral route. Cardiovascular Revascularization Medicine, 13(6): 331-334.
7
Hamon M, Mehta S, Steg PG, Faxon D, Kerkar P, Rupprecht HJ, Tanguay JF, Afzal R and Yusuf S. (2018): Impact of transradial and transfemoral coronary interventions on bleeding and net adverse clinical events in acute coronary syndromes. EuroIntervention, 7(1): 91-97.
8
Ichihashi S, Higashiura W, Itoh H, Sakaguchi S, Nishimine K and Kichikawa K. (2017): Long-term outcomes for systematic primary stent placement in complex iliac artery occlusive disease classified according to Trans-Atlantic Inter-Society Consensus (TASC)-II. Journal of Vascular Surgery, 53(4): 992-999.
9
Joyal D, Bertrand OF, Rinfret S, Shimony A and Eisenberg MJ. (2018): Meta-Analysis of Ten Trials on the Effectiveness of the Radial Versus the Femoral Approach in Primary Percutaneous Coronary Intervention. The American Journal of Cardiology, 109(6): 813-818.
10
Mirza AK, Steerman SN and Ahanchi S. (2014): Analysis of vas-cular closure devices after transbrachial artery access. Vasc Endovascular Surg., 48:466–469.
11
Moreira RW, Costa PV and Carrilho DDR. (2018): Treatment of critical lower limb ischemia using a hybrid technique. Jornal Vascular Brasileiro, 13(3): 257-261.
12
Muluk SC, Muluk VS and Kelley ME (2011): Outcome events in patients with claudication: a 15-year study in 2777 patients. J Vasc Surg., 33:251–257.
13
Norgren L, Hiatt W, Dormandy J, Nehler M, Harris K and Fowkes F (2014): Inter Society Consensus for the Management of Peripheral Arterial Disease (TASC II). Eur J Vasc Endovasc Surg., 33:1-75.
14
Novo S, Coppola G and Milio G. (2018): Critical Limb Ischemia: Definition and Natural History. Current Drug Target -Cardiovascular & Hematological Disorders, 4(3): 219-225.
15
Sanghvi K, Kurian D and Coppola J. (2018): Transradial Intervention of Iliac and Superficial Femoral Artery Disease is Feasible. Journal of Interventional Cardiology, 21(5): 385-387.
16
Stavroulakis K, Usai MV, Torsello G, Schwindt A, Stachmann A, Beropoulis E and Bisdas T. (2016): Efficacy and safety of transbrachial access for iliac endovascular interventions. Journal of Endovascular Therapy, 23(3): 454-460.
17
Treitl KM, König C and Reiser MF. (2015): Complications of transbrachial arterial access for peripheral endovascular interventions. J Endovasc Ther., 22:63–70.
18
Turner S, Sacrinty M, Manogue M, Little W, Gandhi S and Kutcher M. (2017): Transitioning to the radial artery as the preferred access site for cardiac catheterization: an academic medical center experience. Catheter Cardiovasc Interv., 80(2):247-57.
19
ORIGINAL_ARTICLE
PREDICTIVE FACTORS FOR CONSERVATIVE TREATMENT OF LIVER TRAUMA
Background: Injuries are a major public health problem. The liver is the most commonly injured intra-abdominal organ. Conservative treatment thereby not only decreases the number of non-therapeutic laparotomies but also achieves a reduction in morbidity and mortality. Objective: To evaluate the management of patients with liver injury and the possible predictive factors for conservative treatment. Patients and methods: Prospective outcome analysis was done for 30 patients who were candidates for conservative management of liver trauma at Al-Azhar University Hospitals and Damanhur TeachingHospital from December2019 till October2020. Patients information’s had been collected from the hospital data and connection with them had been through phone calling and hospital follow up visits. Patients had been subjected to clinical and radiological examination. Results: The mean age of the included cases in the study group was 33.63 years (range, 6 – 75), The group included 8 females (26.7%) and 22 males (55%)ss regard type of hepatic injuries of the studied group, 8(26.7%) were isolated hepatic injuries and 22(73.3%) were combined hepatic and other organs, The success rate of the studied group showed that 21(70%) were successful and 9(30%) were unsuccessful. Conclusion: Conservative management of traumatic liver injuries is safe when the decision is based on careful initial evaluation.
https://amj.journals.ekb.eg/article_158291_2ad294bab5dccb1a2db6c4d41678a16c.pdf
2021-04-01
897
904
10.21608/amj.2021.158291
Conservative
hepatic
Liver
Trauma
Peritoneal Inflammatory Syndrome
Predictive factors
Ahmed
Masoud Abd El-Wahab Mohammed
drahmedmasoudmido1988@gmail.com
1
Department of General Surgery Faculty of Medicine, Al-Azhar University, Egypt
LEAD_AUTHOR
AL-Sayed
Ahmed Mustafa
2
Department of General Surgery Faculty of Medicine, Al-Azhar University, Egypt
AUTHOR
Basma
Ahmed Mohamed
3
Department of General Surgery Faculty of Medicine, Al-Azhar University, Egypt
AUTHOR
REFERENCES
1
Asfar S, Khoursheed M, Al-Saleh M, Alfawaz AA, Farghaly MM and Nur AM. (2014): Liver Trauma Registry Group. Management of liver trauma in Kuwait. Med PrincPract., 23:160—6.
2
Baldoni F, DiSaverio S, Antonacci N, Coniglio C, Giugni A and Montanari N. (2011): Refinement in the technique of perihepatic packing: a safe and effective surgical hemostasis and multidisciplinary approach can improve the outcome in severe liver trauma. Am J Surg., 201: 5-14.
3
Behboodi F, Amiri ZM, Masjedi N, Shojaie R and Sadri P. (2016): Outcome of Blunt Abdominal Traumas with Stable Hemodynamic and Positive FAST Findings. Emergency, 4(3): 136-139.
4
Bennett S, Amath A, Knight H and Lampron J. (2016): Conservative versus operative management in stable patients with penetrating abdominal trauma: the experience of a Canadian level 1 trauma centre. Can J Surg., 59(5): 317-321.
5
Buci S, Torba M, Gjata A, Kajo I, Bushi G and Kagjini K. (2017): The rate of success of the conservative management of liver trauma in a developing country. World Journal of Emergency Surgery, 18: 19-23.
6
ElhattabiK, Bachar A, Bensardi F, Mourid K and Fadil A. (2020): Serious Liver Trauma: Predictive Factors Of Therapeutic Choice And Prognostic Factors (About 65 Cases). EJMED, 2(3):136-139.
7
Kaptanoglu L, Kurt N and Sikar HE (2017): Current approach to liver traumas. International Journal of Surgery, 39:255-9.
8
Saleh AF, Sageer EA and Elheny A, (2016): Management of Liver Trauma in Minia University Hospital, Egypt. Ind J Surg., 78(6): 442-7.
9
Winata AA and Rudiman R. (2017): Predictors of failure in non-operative management of blunt liver trauma. IntSurg J., 4: 2913-9.
10
ORIGINAL_ARTICLE
TEMPORARY VESICOSTOMY IN CHILDREN WITH VOIDING DYSFUNCTION: POSSIBLE PREDICTORS OF MORPHOLOGICAL AND FUNCTIONAL IMPROVEMENT OF UPPER URINARY TRACT
Background: Chronic retention in infancy and childhood is induced secondary to lower urinary tract obstruction or dysfunction. Objectives: To evaluate the outcomes of temporary vesicostomy in children with voiding dysfunction, and to assess the possible predictors of morphological and functional improvement of upper urinary tract. Patients and Methods: This retrospective study included 69 patients who underwent cutaneous vesicostomy during the period from January 2014 to December 2019 at Al-Azhar University hospitals (Al-Hussein and Sayed Galal) Cairo; Egypt. Patients were evaluated by clinical history, examination, urine analysis, s.creatinine, ultrasonography, voiding cystourethrogram, magnetic resonance urography and renal scan before and 12 months after vesicostomy. Results: There was significant clinical, morphological and functional improvement. The mean serum creatinine before vesicostomy was 1.75±1.12mg/dl and improved gradually to 0.97 ±0.63 mg/dl after 12 months. Number of pus cells decreased gradually from 44.35±33.23 cell/ HPF to 2.65±1.74 cell/ HPF. The mean glomerular filtration rate (GFR) was 25.0±11.5 and 50.8±21.7ml/ minute pre and 12 months after vesicostomy respectively. Forty four (63.8%) cases were not complicated, 7 (10.1%) cases (5 male and 2 females) were complicated with prolapse, 8 (11.6%) cases complicated with stenosis and all of them were males, and 10 (14.5%) cases complicated with peristomal dermatitis and all of them were males. Conclusion: Vesicostomy is a simple urinary diversion, showing encouraging results towards safeguard of kidney function and morphology. Furthermore, the procedure has received rave reviews from the caregivers, and therefore, it has become a viable choice for children with neurological or other voiding dysfunctions or those that do not respond to conservative treatment.
https://amj.journals.ekb.eg/article_158294_26211bc3e89b2638e08fe7576be63e8b.pdf
2021-04-01
905
914
10.21608/amj.2021.158294
Temporary Vesicostomy
children
voiding dysfunction
morphological
Functional Improvement
upper urinary tract
Ahmed
H. Okasha
aokasha2016@gmail.com
1
Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
LEAD_AUTHOR
Hussein
A. Galal
2
Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
El-Sayed
M. Salih
3
Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
REFERENCES
1
Coran, A. G., A. Caldamone, N. S. Adzick, T. M. Krummel, J.-M. Laberge and R. Shamberger (2012): Pediatric surgery E-book, Elsevier Health Sciences.
2
Howe, A., Kozel, Z., & Palmer, L. (2017): Robotic surgery in pediatric urology. Asian Journal of Urology, 4(1), 55-67.
3
Hutcheson, J. C., C. S. Cooper, D. A. Canning, S. A. Zderic and H. M. Snyder (2010): "The use of vesicostomy as permanent urinary diversion in the child with myelomeningocele." The Journal of urology 166(6): 2351-2353.
4
Lopez Pereira, P., E. Jaureguizar, M. Martinez Urrutia, C. Meseguer and M. J. P. t. Navarro (2000): "Does treatment of bladder dysfunction prior to renal transplant improve outcome in patients with posterior urethral valves?" 4(2): 118-122.
5
Lukong, C. S., Ameh, E. A., Mshelbwala, P. M., Jabo, B. A., Gomna, A., Anumah, M. A.,... & Mfuh, A. Y. (2014): Role of vesicostomy in the management of posterior urethral valve in Sub-Saharan Africa. Journal of Pediatric Urology, 10(1), 62-66.
6
Prudente, A., L. O. Reis, R. de Paula França and M. J. U. J. Miranda (2009): "Vesicostomy as a protector of upper urinary tract in long-term follow-up." 6(2): 96-100.
7
Rouzrokh, M., A. Mirshemirani, A. Khaleghnejad-Tabari, N. Sadeghian, L. Mohajerzadeh and M. J. I. J. o. P. Mohkam (2013): "Protective temporary vesicostomy for upper urinary tract problems in children: a five-year experience." 23(6): 648.
8
Westney, O. L. J. U. C. (2010): "The neurogenic bladder and incontinent urinary diversion." 37(4): 581-592.
9
ORIGINAL_ARTICLE
EVALUATION OF POSTERIOR LUMBER INTERBODY FUSION WITHOUT INSTRUMENTATION IN LUMBER DEGENERATIVE DISC DISEASES
Background: Degenerative disc disease represents a common cause of chronic low back pain that makes some disabling and requires surgical intervention. Posterior lumbar interbody fusion (PLIF) represents one of the techniques used to deal with this disabling. Objective: To assess the results of the posterior lumbar interbody fusion (PLIF) without instrumentation in cases of degenerative disc diseases without instability. Patient and method: This was a prospective study of twenty patients who underwent surgical lumbar laminectomy and discectomy with interbody fusion and graft for degenerative lumbar diseases that not responsive to medical treatment for 6 months at Sayed Galal Hospital, Al-Azhar Faculty of Medicine. Result: There was a highly statistically significant decrease in the level of pain (VAS score) one week postoperatively compared to preoperative level with p-value < 0.001, and a statistically significant difference was found between preoperative pain (VAS score) level ,and post 6 months level with p-value < 0.001. Conclusion: Posterior lumbar interbody fusion technique without instrumentation showed several potential benefits in the treatment of degenerative disc disease (DDD).
https://amj.journals.ekb.eg/article_158295_312fec989484ad6cb66e4ee425804436.pdf
2021-04-01
915
922
10.21608/amj.2021.158295
PLIF
degenerative disc diseases
without instrumentation
Ahmed
Ismael Mohamed Ismael Khattab
ahmedkhattab423@yahoo.com
1
Department of Orthopedic Surgery, Faculty of Medicine of Al-Azhar University, Cairo, Egypt
LEAD_AUTHOR
Eissa
Ragheb
2
Department of Orthopedic Surgery, Faculty of Medicine of Al-Azhar University, Cairo, Egypt
AUTHOR
Mohamed
Negm
3
Department of Orthopedic Surgery, Faculty of Medicine of Al-Azhar University, Cairo, Egypt
AUTHOR
REFERENCES
1
Alijani, B., Emamhadi, M., Behzadnia, H., Aramnia, A., Chabok, S. Y., Ramtinfar, S., ... and Golmohamadi, S. (2015): Posterior lumbar interbody fusion and posterolateral fusion: Analogous procedures in decreasing the index of disability in patients with spondylolisthesis. Asian Journal of Neurosurgery, 10(1), 51.
2
Aygün H, Cakar A, Hüseyinoğlu N, Hüseyinoğlu U and Celik R. (2014): Clinical and ra- diological comparison of posterolateral fusion and posterior interbody fusion techniques for multilevel lumbar spinal stabilization in manual workers. Asian Spine, 8:571-580.
3
El-Fiky T and Allam Y. (2016): Posterior lumbar interbody fusion using single polyetheretherketone transforaminal lumbar interbody fusion cage: a single- surgeon experience. Egypt Orthop J, 51:8-12.
4
Elghait HA, Akar A and Awad HA (2019): Posterior lumbar interbody fusion (PLIF) in lumbar spine infection: a retrospective study. Sci J Al-Azhar Med Fac Girls , 3:252-60.
5
Galgiani, J. N., Ampel, N. M., Blair, J. E., Catanzaro, A., Geertsma, F., Hoover, S. E., ... and Meyerson, S. L. (2016): 2016 Infectious Diseases Society of America (IDSA) clinical practice guideline for the treatment of coccidioidomycosis. Clinical Infectious Diseases, 63(6), e112-e146.
6
Lee, L. Y., Idris, Z., Beng, T. B., Young, T. Y., Chek, W. C., Abdullah, J. M., and Hieng, W. S. (2017): Outcomes of minimally invasive surgery compared to open posterior lumbar instrumentation and fusion. Asian Journal of Neurosurgery, 12(4), 620.
7
Lykissas MG and Aichmair A. (2013): Current concepts on spinal arthrodesis in degenerative disorders of the lumbar spine. World J Clin Cases. 1(1):4–12.
8
Mobbs RJ, Li JXJ and Phan K. (2017): Anterior Longitudinal Ligament Reconstruction to Reduce Hypermobility of Cervical and Lumbar Disc Arthroplasty. Asian Spine J., 11(6):943–950.
9
Tropiano, P., Giorgi, H., Faure, A., and Blondel, B. (2017): Surgical techniques for lumbo-sacral fusion. Orthopaedics& Traumatology: Surgery & Research, 103(1):S151–S159.
10
ORIGINAL_ARTICLE
PREVALENCE OF LIGAMENTOUS INJURY ASSOCIATED WITH EXTRA ARTICULAR DISTAL RADIUS FRACTURE
Background: The radius is the most commonly broken bone in the arm. Distal radius fractures are very common and are commonly associated with ligament injuries and chondral damage. Objective: To report the incidence of ligaments and cartilage lesions associated with extra-articular distal radius fracture. Patients and methods: Fifty consecutive patients with extra-articular distal radius fractures, who attended at Al-Azhar University Hospital during the study period, were included in the study. 42.0% of the patients were males, 58.0% of them were females, and their mean age was 45.5 ± 5.24 years. Results: The affected wrist was the right wrist in 56% of cases and on plain radiographs. 46% of cases had A2 fractures, and 54% of them had A3 fractures. Ligament and cartilage lesions were found in 88% of cases. No significant statistical association was found between the intracarpal soft tissue injury and the different types of fractures. Conclusion: Using arthroscopy is recommended in distal radius fractures for verification of the degree of associated injuries and larger studies are needed to confirm our results.
https://amj.journals.ekb.eg/article_158296_a78c9dc3ef0079c24d5c5cd368502358.pdf
2021-04-01
923
930
10.21608/amj.2021.158296
Extra-articular radius fractures
Ligamentous injuries
Intracarpal soft tissue injury
Ahmed
Abdallah Mohamed
dr.mansy3890@gmail.com
1
Department of Orthopedic Surgery, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Aly
Mohamed El-Geoushy
2
Department of Orthopedic Surgery, Faculty of Medicine, Al-Azhar University
AUTHOR
Galal
Mohamed Mansour
3
Department of Orthopedic Surgery, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Araf M and Mattar R. (2014): Arthroscopic study of injuries in articular fractures of distal radius extremity. Acta Ortop Bras., 22(3):144–50.
2
Brogren E, Petranek M and Atroshi I. (2010): Incidence and characteristics of distal radius fractures in a southern Swedish region. BMC Musculoskelet Disord., 8:48-52.
3
Caldwell RA, Shorten PL and Morrell NT. (2019): Common Upper Extremity Fracture Eponyms: A Look Into What They Really Mean. J Hand Surg Am., 44(4):331-334.
4
Meena S, Sharma P, Sambharia AK and Dawar A. (2014): Fractures of distal radius: An overview. J Family Med Prim Care, 3(4):325-32.
5
Nellans KW, Kowalski E and Chung KC. (2012): The epidemiology of distal radius fractures. Hand Clin., 28(2):113–25.
6
Ogawa T, Tanaka T, Yanai T, Kumagai H and Ochiai N. (2013): Analysis of soft tissue injuries associated with distal radius fractures. BMC Sports Science, Medicine and Rehabilitation, 5:19-23.
7
Shkolnikova J and Harvey J. (2018): Wrist arthroscopy in the management of distal radius fractures. Annals of Joint, 3: 1-13.
8
Smith D. (2018): Treating intra-articular distal radius fractures. BCMJ., 60(1):17-21.
9
Swart E and Tang P. (2017): The effect of ligament injuries on outcomes of operatively treated distal radius fractures. Am J Orthop., 46(1):41-46.
10
ORIGINAL_ARTICLE
MINIMALLY INVASIVE TREATMENT OF INTRA-ARTICULAR CALCANEAL FRACTURES
Background: Calcaneal fractures have considerable debate of the appropriate methods of management and how to lessen potential complications. Objective: Evaluation of intra-articular calcaneal fractures that treated by minimally invasive methods. Patients and Methods: A prospective study has been conducted on twenty patients having intra-articular calcaneal fractures and were managed by minimally invasive methods of fixation at Al Azhar university hospitals, Cairo, Egypt, after that they have been followed up for 6 months. Results: According to the American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hind foot Score. There was: excellent (5 feet (25%), good (11 feet (55%), fair (2 feet (10%) and poor (2 feet (10%). The average score was 83 with a range of 68 to 95. No patient in this series experienced any failure of hard-ware, or developed deep infections. Complications included: superficial pin tract infection, varus heel deformity, flexion deformity of the big toe, reflex sympathetic dystrophy, subtalar arthritis and painful heel. Conclusion: Management of calcaneal, intra-articular, fractures by minimally invasive techniques is a viable surgical alternate as it provides shorter time of surgery, nominal invasiveness, less serious wound problems, and no residual hardware (in case of pinning). Their drawbacks include technical issues and inadequate reduction fracture fragment.
https://amj.journals.ekb.eg/article_158300_47dc0ab42c0402399994e47694c856b6.pdf
2021-04-01
931
942
10.21608/amj.2021.158300
Keywords: Intra-articular calcaneal fractures
minimally invasive techniques
sinus tarsi approach
K. wires
cannulated screws
Ahmed
Mohamed Ahmed Selim
drshahmedselim@gmail.com
1
Orthopedic Department, Faculty of Medicine, Al-Azhar University, Egypt
LEAD_AUTHOR
Mohamed
Ibrahim Abulsoud
2
Orthopedic Department, Faculty of Medicine, Al-Azhar University, Egypt
AUTHOR
Mahmoud
Seddik Hassan
3
Orthopedic Department, Faculty of Medicine, Al-Azhar University, Egypt
AUTHOR
REFERENCES
1
Chen, M., Deng, K., Zeng, W. H., Zeng, J. J., Zhong, Q. S. and Han, Z. M. (2017): Minimally invasive tarsal sinus incision combined with manipulative reduction and internal fixation for calcaneal fractures of Sanders type Ⅱ and Ⅲ. Zhonghua wai ke za zhi, 55(3): 220-223.
2
Dong, F., Lu, C., Zhu, J., Li, Y. and Mi, K. (2017): Minimally invasive treatment of calcaneal fractures by subtalar arthroscopy with posterior approach. Zhongguo xiu fu chong jian wai ke za zhi, 31(1): 36-41.
3
El Khalifa, T., El Bagali, M., Yousif, W. and Hashem, F. (2011): Limited Open Reduction and Percutaneous Screw Fixation of Displaced Intra-Articular Fracture of Calcaneus: A Review of 48 Fractures. Bahrain Med Bull, 158(685): 1-6.
4
Gomaa, M. A., El Naggar, A. and Anbar, A. S. (2014): A new minimally invasive technique for the treatment of intra-articular fractures of the calcaneus preliminary results. Egypt Orthop J, 49(3): 225-231.
5
Gusic, N., Fedel, I., Darabos, N., Lovric, Z., Bukvic, N., Bakota, B. and Lemac, D. (2015): Operative treatment of intraarticular calcaneal fractures: Anatomical and functional outcome of three different operative techniques. Injury, 46 Suppl 6: S130-133.
6
Kumar, V. S., Sharma, V., Farooque, K. and P. K. (2012): Minimally invasive fixation of calcaneal fractures. OrthopJ, 13: 16-21.
7
Li, Y., Bao, R. H., Jiang, Z. Q. and Wu and H. Y. (2016): Complications in operative fixation of calcaneal fractures. Pakistan Journal of Medical Sciences, 32(4): 857-862.
8
Luo, X., Li, Q., He, S. and He, S. (2016): Operative versus Nonoperative Treatment for Displaced Intra-Articular Calcaneal Fractures: A Meta-Analysis of Randomized Controlled Trials. The Journal of Foot and Ankle Surgery, 55(4): 821-828.
9
Meraj, A., Zahid, M. and Ahmad, S. (2012): Management of intraarticular calcaneal fractures by minimally invasive sinus tarsi approach-early results. Malaysian Orthopaedic Journal, 6(1): 13-17.
10
Prod'homme, M., Pour Jafar, S., Zogakis, P. and Stutz, P. (2018): A Novel Minimally Invasive Reduction Technique by Balloon and Distractor for Intra-Articular Calcaneal Fractures: A Report of 2 Cases. Case Reports in Orthopedics, 790-9184.
11
Rammelt S, Amlang M, Barthel S, Gavlik JM, Zwipp H. (2010): Percutaneous treatment of less severe intraarticular calcaneal fractures. Clin Orthop Relat Res., 2010; 468(4):983-90.
12
Spierings, K. E., Min, M., Nooijen, L. E., Swords, M. P. and Schepers, T. (2019): Managing the open calcaneal fracture: A systematic review. Foot and Ankle Surgery, 25(6): 707-713.
13
Su, Y., Chen, W., Zhang, T., Wu, X., Wu, Z. and Zhang, Y. (2013): Bohler's angle's role in assessing the injury severity and functional outcome of internal fixation for displaced intra-articular calcaneal fractures: a retrospective study. BMC Surgery 13: 40-49.
14
Wang, J., Qin, S. and Ma, J. (2019): Calcaneal reduction forceps for minimally invasive treatment of calcaneal fractures: literature review and techniques. International Journal of Clinical and Experimental Medicine, 12(8): 9582-9589.
15
Wei, N., Yuwen, P., Liu, W., Zhu, Y., Chang, W., Feng, C. and Chen, W. (2017): Operative versus no operative treatment of displaced intra-articular calcaneal fractures: A meta-analysis of current evidence base. Medicine, 96(49): e9027-e9033.
16
Zhang, Z., Wang, Z., Zhang, Y., Qiu, X. and Chen, Y. (2018): Risk factors for increased postoperative drainage of calcaneal fractures after open reduction and internal fixation: An observational study. Medicine, 97(32): e11818-e11822.
17
ORIGINAL_ARTICLE
MICRO-ALBUMINURIA AT MID PREGNANCY IN THE PREDICTION OF PREECLAMPSIA
Background: Proteinuria has classically been an important finding in the diagnosis of preeclampsia and eclampsia, so in our study we use measearing microalbuminuria as a predictor of preeclampsia. Objective: To evaluate microalbuminuria at mid pregnancy, as a predictor of preeclampsia. Patients and Methods: This prospective observational study was carried out on 200 normotensive women, aged 18-35years, and live singleton pregnancy between 24-28 weeks at Embaba General Hospital during the period between April 2019 and February 2020. Microalbuminuria was measured in urine samples of the first micturition of the day. All were followed till delivery. Results: Negative microalbuminuria was present in 154 patients, 6 (3.89%) developed preeclampsia. Forty six women had positive microalbuminuria and 12 (26%) of them developed preeclampsia. The sensitivity was 66.7%, specificity 81.3%, the positive predictive value was 26.1%, and the negative predictive value was 96.1%. Conclusion: Microalbuminuria at mid pregnancy could be a significant predictor of preeclampsia.
https://amj.journals.ekb.eg/article_158303_c41c6aed9a90668b9ccee6eff3679bcc.pdf
2021-04-01
943
950
10.21608/amj.2021.158303
Microalbuminuria
prediction of preeclampsia
Mahmoud
A. Fawaz
mafawaz89@gmail.com
1
Department of Obstetrics & Gynecology, Faculty of Medicine - Al-Azhar University
LEAD_AUTHOR
Tamer
Fares
2
Department of Obstetrics & Gynecology, Faculty of Medicine - Al-Azhar University
AUTHOR
Ahmed
El-Tabakh
3
Department of Obstetrics & Gynecology, Faculty of Medicine - Al-Azhar University
AUTHOR
REFERENCES
1
Chawla R and Malik S. (2018): Microalbuminuria detected at midterm as a marker for adverse pregnancy outcome. International Journal of Health Sciences and Research 8: 41-52.
2
Conde-Agudelo A, Romero R and Roberts JM. (2015): Tests to predict preeclampsia. Chesley's hypertensive disorders in pregnancy. Elsevier, 221-251.
3
Divya B. (2017): Urine Calcium-Creatinine Ratio and Microalbuminuria in Prediction of Preeclampsia. Tirunelveli Medical College, Tirunelveli.53-86.
4
Gathiram P., and Moodley J., (2016): Pre-eclampsia: its pathogenesis and pathophysiolgy, Cardiovasc J Afr, 27(2): 71–78.
5
Jayaballa M, Sood S, Alahakoon I, Padmanabhan S, Cheung NW and Lee V (2015): Microalbuminuria is a predictor of adverse pregnancy outcomes. Pregnancy Hypertens, 5(4):303-307.
6
Jensen, D.M., Damm, P. and Gvesen, P. (2010): Microalbuminuria, preeclampsia and preterm delivery in pregnant women with type I diabetes. Diabetes Care, 33: 90-94.
7
Jillian T. Henderson, Jamie H. Thompson and Brittany U. Burda (2017): Preeclampsia Screening Evidence Report and Systematic Review for the US Preventive Services Task Force, 317(16):1668-1683.
8
Kattah AG, Asad R, Scantlebury DC, et al. (2013): Hypertension in pregnancy is a risk factor for microalbuminuria later in life. The Journal of Clinical Hypertension 15: 617-623.
9
Oliveira, L.G., Karumanchi, A. and Saas, N. (2010): Pré-eclâmpsia estresse oxidativo, inflamação e disfunção endotelial. Rev Bras Ginecol Obstet, 32(12):609-616.
10
Parving H-H and Rossing P. (2020): The History of Prevention and Treatment of Diabetic Nephropathy. Unveiling Diabetes-Historical Milestones in Diabetology. Karger Publishers, 242-256.
11
Pontius E and Vieth JT. (2019): Complications in early pregnancy. Emergency Medicine Clinics 37: 219-237.
12
Rafi T, Batool A and Samar S. (2019): urinary albumin to creatinine ratio as a predictor of preclampsia among pregnant women at a tertiary care hospital.Journal of Medicine, Physiology and Biophysics. 62:50-54.
13
Sandvik MK, Hallan S, Svarstad E, et al. (2013): Preeclampsia and prevalence of microalbuminuria 10 years later. Clinical Journal of the American Society of Nephrology 8: 1126-1134.
14
Senna A and Abonar E. (2017): Early Pregnancy Microalbuminuria as a Predictor of Pre-Eclampsia. JFIV Reprod Med Genet 5: 4-6.
15
Singh R, Tandon I, Deo S, et al. (2013): Does microalbuminuria at mid pregnancy predict development of subsequent pre eclampsia? Journal of Obstetrics and Gynaecology Research 39: 478-483.
16
Sobh SM, Sanad SA, Abdelazeem HM, et al. (2016): Microalbuminuria during midpregnancy in the prediction of preeclampsia. Evidence Based Women's Health Journal 6: 47-50.
17
ORIGINAL_ARTICLE
ROLE OF MIDDLE CEREBRAL ARTERY DOPPLER AND AMNIOTIC FLUID INDEX IN PREDICTING PERINATAL OUTCOME IN POSTDATED PREGNANCIES
Background: Post-date pregnancy carries many fold problems for both pregnancy and fetal outcome. Abnormal middle cerebral artery Dopplers are strongly associated with preterm delivery and antenatal steroid administration. Objective: To identify the relationship between middle cerebral artery Doppler, Amniotic fluid index and perinatal outcomes in postdated pregnancies. Patients and Methods: This study was performed on 50 pregnant women whose gestational age was 40–42 weeks’ gestation attending the antenatal clinic of Zefta General Hospital. The study was done during the period between December 2017 and August 2019.Inclusion criteria included singleton living fetuses with vertex presentation in postdated pregnancies (40 – 42) week gestation. Exclusion criteria included cases with premature rupture of membranes, antepartum hemorrhage and maternal medical disorders as hypertension, diabetes mellitus, hepatic, cardiac, renal or anemia with pregnancy, patients with uterine scar. All patients were subjected to detailed history taking, physical examination and routine investigations including complete blood picture, Rh typing, fasting blood sugar, liver functions, kidney functions and urine analysis. Ultrasound and Doppler study were done twice weekly till the onset of labor or termination of pregnancy in order to assess GA, estimated fetal weight (EFW), placental site and grading, amniotic fluid volume (AFV) (oligohydramnios was diagnosed if the largest vertical pocket less than 2 cm), Doppler study of the MCA. The study population was divided into two groups based on the presence or absence of adverse perinatal outcome. Results: Expected fetal weight (EFW), resistive Index of middle cerebral artery (MCA) and resistive Index of umbilical artery (UA) were not significantly predicting perinatal outcome of postdated pregnancies among the studied pregnant women. Amniotic fluid index (AFI) and biophysical profile (BPP) were significant predictors for perinatal outcome of postdated pregnancies. Conclusion: Resistive Index of (MCA) was not significant predictor for perinatal outcome of postdated pregnancies. Amniotic fluid index was significant predictor for perinatal outcome of postdated pregnancies.
https://amj.journals.ekb.eg/article_158305_4bb5454e384295bb90742d3e0c5d9698.pdf
2021-04-01
951
962
10.21608/amj.2021.158305
Middle cerebral artery Doppler - Amniotic fluid index
predictors
postdated pregnancies
Ahmed
Ali El-Sebahy
drrahmedelsebahy@gmail.com
1
Department of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Mohammed
Taher Ismail
2
Department of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University
AUTHOR
Mohammed
Salah El-Din Hassanien
3
Department of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University
AUTHOR
Ahmed
Shaaban Mohammed
4
Department of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Abdelhak AM. and Abd El-Razek AA. (2011): Fetal Middle Cerebral and Umbilical Arteries Doppler Velocimetry and Amniotic Fluid Volume in the Surveillance of Post term Pregnancy. Med. J. Cairo Univ., 79(2): 107-111.
2
Chauhan MB and Malik R. (2020): Post term Pregnancy. In: Labour Room Emergencies. Pbl. Springer, Singapore. pp. 173-181.
3
Cunningham FG and Leveno KJ. (2010): Post-term pregnancy. In: Cunningham FG, Williams JW, eds. William’s obstetrics. 23rd ed. Pbl. New York (NY): McGraw-Hill, Chapter 37:535–45.
4
EL-Gharib, MN and El-Bohoty SB. (2020): Lack of Importance of Studying Middle Cerebral Artery Doppler and Amniotic Fluid Index in Prediction of Perinatal Outcome of Prolonged Pregnancies. J Nurs Midwifery, 1(1), 005-008.
5
Galal M, Symonds I, Murray H, Petraglia F and Smith R. (2012): Post term pregnancy. Facts, views & vision in ObGyn, 4(3): pp.175- 187.
6
Lindqvist PG, Pettersson, K, Morén A, Kublickas M and Nordström L. (2014): Routine ultrasound examination at 41 weeks of gestation and risk of post-term severe adverse fetal outcome: a retrospective evaluation of two units, within the same hospital, with different guidelines. BJOG, International Journal of Obstetrics &Gynaecology, 121(9): 1108-1116.
7
Liston R, Sawchuck D and Young D. (2018): No. 197b-fetal health surveillance: intrapartum consensus guideline. Pbl. Journal of Obstetrics and Gynaecology Canada, 40(4): e298-e322.
8
Maged AM, Abdelhafez A, Mostafa WA and Elsherbiny W. (2014): Fetal middle cerebral and umbilical artery Doppler after 40 weeks gestational age. The Journal of Maternal-Fetal & Neonatal Medicine, 27(18): 1880-1885.
9
Monem MA, Nazeer AE, Abd-Elhamed AE and Hassan AB. (2016): Doppler Velocimetry of the fetal middle cerebral artery, umbilical and uterine arteries in the prediction of prolonged pregnancy and their effect on neonatal outcome. Al-Azhar Medical Journal, 45(4): 735-752.
10
Nomura RY, Niigaki JI, Horigome FT, Francisco RV and Zugaib M. (2013): Doppler velocimetry of the fetal middle cerebral artery and other parameters of fetal well-being in neonatal survival during pregnancies with placental insufficiency. Revista da AssociaçãoMédicaBrasileira, 59(4): 392-399.
11
Sayan K, Sayan CD and Kokanalı M. K. (2014): The Relationship between Doppler Parameters and Perinatal Outcomes in Postterm Pregnancies. Journal of TurgutOzal Medical Center, 21(4): 264-269.
12
Vahanian S, Kinzler WL, Chen A, Saleh I, Chavez M and Vintzileos AM. (2016): 745: Fetal surveillance using middle cerebral artery (MCA) Dopplers in pregnancies complicated by diabetes. Pbl. American Journal of Obstetrics & Gynecology, 214(1): S390-S391.
13
ORIGINAL_ARTICLE
EFFECT OF SURGICAL OPERATION FOR BENIGN OVARIAN TUMORS ON ANTI MULLERIAN HORMONE
Background: Surgical operation for benign ovarian tumors creates a potential risk for the ovarian reserve. Ovarian procedures including excision of cysts (cystectomy) are very commonly performed worldwide for various disorders. Objective: To study the long term effect of ovarian surgery on blood level of anti mullerian hormone. Patients and Methods: The present study was a prospective cohort study of patients who have benign ovarian tumor which carried on Patients from December 2019 to October 2020 at Obstetrics and Gynecology Department, Faculty of Medicine, Al-Azhar University. Results: There was a significant decrease in Anti mullerian hormone ( AMH ) post operatively by 25.79%. There was a significant relation between level of AMH and age of the patients. The old age had a low level of AMH. Also, the bilateral lesion showed a low level of AMH less than the unilateral lesions. The cyst size more than 5 cm showed a negative relation with level of AMH. The log duration of surgery had a negative effect on the level of AMH. The endometeriotic type showed a significant decrease in AMH level more than the other histopathological findings. Conclusion: Serum AMH levels could be preferred in determining the indication and selection of operative methods for benign gynecologic conditions, especially endometriomas.
https://amj.journals.ekb.eg/article_158443_b4074b44b6862d7513a675395ce4e78c.pdf
2021-04-01
963
974
10.21608/amj.2021.158443
Surgical Operation for Benign Ovarian tumors
Anti Mullerian Hormone
Mohammed
Aboul-Fotouh Abd El-Mageed
moooyadak90@gmail.com
1
Obstetrics and Gynecology Dept., Faculty of Medicine, Al-Azhar University, Cairo, Egypt
LEAD_AUTHOR
Mahmoud
S. Zaki
2
Obstetrics and Gynecology Dept., Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Ahmed
A. El-Tabaakh
3
Obstetrics and Gynecology Dept., Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
REFERENCES
1
Alborzi S, Keramati P, Younesi M, Samsami A and Dadras N. (2014): The impact of laparoscopic cystectomy on ovarian reserve in patients with unilateral and bilateral endometriomas. Fertil Steril., 101:427-34.
2
Amooee S, Gharib M and Ravanfar P. (2015): Comparison of anti-mullerian hormone level in non-endometriotic benign ovarian cyst before and after laparoscopic cystectomy. Iranian Journal of Reproductive Medicine., 13(3), 149–154.
3
Celik HG, Dogan E, Okyay E, Ulukus C, Saatli B, Uysal S and Koyuncuoglu M. (2012): Effect of laparoscopic excision of endometriomas on ovarian reserve: serial changes in the serum antimullerian hormone levels. Fertil Steril., 97:1472–1478.
4
Elsemary YM, Mostafa WFG, El Taher OS, Mahmoud HE and Aly RH. (2018): Serum antimullerian hormone before and after laparoscopic excision of ovarian endometrioma. J Med Sci Res., 1: 30-4.
5
Ercan CM, Sakinci M, Duru NK, Alanbay I, Karasahin KE and Baser I. (2010): AntiMüllerian hormone levels after laparoscopic endometrioma stripping surgery. Gynecol Endocrinol., 26: 468-72.
6
Hirokawa W, Iwase A, Goto M, Takikawa S, Nagatomo Y, Nakahara T, Bayasula B., Nakamura T, Manabe S and Kikkawa F. (2011): The post‑operative decline in serum antimullerian hormone correlates with the bilaterality and severity of endometriosis. Hum Reprod., 26: 904–910.
7
Hwu YM, Wu FS, Li SH, Sun FJ, Lin MH and Lee RK. (2011): The impact of endometrioma and laparoscopic cystectomy on serum antimullerian hormone levels. Reprod Biol Endocrinol., 9: 1-8.
8
Iwase A, Nakamura T, Osuka S, Takikawa S, Goto M and Kikkawa F. (2015): Anti-Müllerian hormone as a marker of ovarian reserve: What have we learned, and what should we know?. Reprod Med Biol., 15(3):127-136.
9
Jang TG, Lee A, Kim YJ, Lee KY, Rhee JH and Park JC. (2012): Age-related normal serum concentrations of anti-Müllerian hormone and comparison of ovarian reserve tests in a cohort of healthy Korean women. Fertil Steril., 98: 85-97.
10
10. Jeon JH, Park SY, Lee SR, Jeong K and Chung HW. (2015): Serum Anti-Müllerian Hormone Levels before Surgery in Patients with Ovarian Endometriomas Compared to Other Benign Ovarian Cysts. Journal of menopausal medicine., 21(3): 142–148.
11
11. Kelsey TW, Wright P, Nelson SM, Anderson RA and Wallace WH. (2011): A validated model of serum anti-mullerian hormone from conception to menopause. PLoS One., 6 (7): 1-7.
12
12. Kovačević VM, Anđelić LM and Jovanović AM. (2018): Changes in serum antimüllerian hormone levels in patients 6 and 12 months after endometrioma stripping surgery. Fertility and Sterility, 110 (6): 1173-1180.
13
13. La Marca A, Sighinolfi G, Radi D, Argento C, Baraldi E, Artenisio AC, Stabile G and Volpe A. (2010): Anti-Mullerian hormone (AMH) as a predictive marker in assisted reproductive technology (ART). Hum Reprod Update, 16:113–130.
14
14. Lee DY, Young Kim N, Jae Kim M, Yoon BK and Chos D. (2011): Effects of laparoscopic surgery on serum antimullerian hormone levels in reproductive-aged women with endometrioma. Gynecol Endocrinol., 27:733–736.
15
15. Litta P, D'Agostino G, Conte L, Saccardi C, Cela V, Angioni S and Plebani M. (2013): Anti-mullerian hormone trend after laparoscopic surgery in women with ovarian endometrioma. Gynecol Endocrinol., 29: 452-454.
16
16. Meczekalski B, Czyzyk A, Kunicki M, Podfigurna-Stopa A, Plociennik L, Jakiel G, Maciejewska-Jeske M and Lukaszuk K. (2016): Fertility in women of late reproductive age: the role of serum anti-Müllerian hormone (AMH) levels in its assessment. J Endocrinol Invest., 39: 1259–1265.
17
17. Raffi F, Metwally M and Amer S. (2012): The impact of excision of ovarian endometrioma on ovarian reserve: a systematic review and meta-analysis. J Clin Endocrinol Metab., 97:3146-54.
18
18. Stilley JA, Birt JA and Sharpe-Timms KL. (2012): Cellular and molecular basis for endometriosis-associated infertility. Cell Tissue Res., 349: 849-62.
19
19. Streuli I, de Ziegler D, Gayet V, Santulli P, Bijaoui G, de Mouzon J and Chapron C. (2012): In women with endometriosis anti-Mullerian hormone levels are decreased only in those with previous endometrioma surgery. Hum Reprod., 27:3294-303.
20
ORIGINAL_ARTICLE
COMPARATIVE STUDY BETWEEN DIFFERENT TYPES OF VAGINAL PROGESTERONE IN LUTEAL PHASE SUPPORT IN ICSI CYCLES
Background: Assisted reproductive techniques (ART) include all fertility treatments in which the gametes (egg and sperm) are handled outside the human body with the aim of achieving a healthy conception. Common ART procedures include in vitro fertilization (IVF) with or without intracytoplasmic sperm injection (ICSI), fresh or frozen embryo transfer, and IVF with donor oocytes. Luteal phase support through pharmaceutical drugs has been universally agreed. Objective: To compare the effectiveness of different types of vaginal progesterone preparations for luteal support in patients undergoing Intracytoplasmic Sperm Injection. Patients and Methods: The current randomized controlled clinical trial study was conducted on 300 patients who were following at the Assisted Reproductive Technology (ART) unit of the International Islamic Center for Population Studies and Research (IICPSR) of Al-Azhar University over the period from May 2016 to January 2018 after being approved by the ethical committee. The patients were divided into 3 equal groups received Prontogest vaginal suppositories 400 mg once per day, Group B received Crinone 8% (90 mg) vaginal gel once per day and Group C received Endometrin vaginal suppositories once per day. Results: Comparison between studied group A (Prontogest), group B (Crinone) and group C (Endometrin) as regards demographic characteristics revealed no statistically significant differences. As regards the cause of infertility, a statistically significant increase in the number of patients with male and tubal factors in group B (Crinone) than group A (Prontogest). Concerning the laboratory hormonal profile of the studied groups before ICSI, there was a statistically significant increase in FSH and LH levels in group A (Prontogest) than group B (Crinone) and group C (Endometrin). On the other hand, there was a difference between the studied groups as regards prolactin and estrogen levels, but did not reach statistical significance. Comparison between studied groups, as regards Endometrial thickness, number of retrieved oocytes and number of transferred embryos revealed no statistically significant difference. Comparison between the studied groups, as regards pregnancy rates, revealed a statistically significant increase in pregnancy rates in group C than group A. Conclusion: The use of Endometrin vaginal suppositories in patients undergoing ICSI had a statistically significant higher clinical pregnancy rates in comparison to Prontogest vaginal suppositories. On the other hand, Crinone vaginal gel had a higher clinical pregnancy rate than Prontogest.
https://amj.journals.ekb.eg/article_158445_fa80848cc5612d4b46adc5f41f9dc0b3.pdf
2021-04-01
975
988
10.21608/amj.2021.158445
ICSI
Luteal phase
Vaginal Progesterone
Ali
S.A. Ahmed
aliobs_005@yahoo.com
1
Departments of Obstetrics and Gynecology, Faculty of Medicine, Al- Azhar University
LEAD_AUTHOR
REFERENCES
1
Cozzolino M, Vitagliano A, Di Giovanni MV, Laganà AS, Vitale SG, Blaganje M, Starič KD, Borut K, Patrelli TS and Noventa M (2018): Ultrasound-guided embryo transfer: summary of the evidence and new perspectives. A systematic reviewand meta-analysis. Reproductive Biomedicine Online, 36 (5): 524-42.
2
De Ziegler D, Ayoubi JM, Frydman R and Fanchin R (2018): Luteal phase support in assisted reproductive technologies: from here to there. Fertility and Sterility, 109 (1): 57-8.
3
Garcia-Velasco JA, Motta L and López A (2010): Low-dose human chorionic gonadotropin versus estradiol/progesterone luteal phase support in gonadotropinreleasing hormone agonist–triggered assisted reproductive technique cycles: understanding a new approach. Fertility and Sterility; 94 (7): 2820-2823.
4
Ghanem ME and Al-Boghdady LA (2012): Luteal phase support in ART: An update. Enhancing success of assisted reproduction, IntechOpen, ed, Darwish AM; 2nd ed (chap 7): 156-167.
5
Lawrenz B, Coughlan C and Fatemi HM (2019): Individualized luteal phase support. Current Opinion in Obstetrics and Gynecology, 31(3):177-82.
6
Nastri CO, Polanski LT, Raine- Fenning N and Martins WP (2014): Endometrial scratching for women with repeated implantation failure. Human Reproduction, 29 (12): 2855– 2856.
7
Panaino TR, da Silva J, Tamm M, Lira P, Arêas PC, Mancebo AC, Souza MM, Antunes RA and Souza MD (2016): Prediction of metaphase II oocytes according to different serum Anti-Müllerian hormone (AMH) levels in antagonist ICSI cycles. JBRA Assist Reprod, 20 (4): 222-226.
8
Polyzos NP, Christina I, Messini CI, Mauri D, Tzioras S, Badawy A and Messinis IE (2010): Vaginal progesterone gel for luteal phase support in IVF/ICSI cycles. Fertility and Sterility, 94 (6): 2083-2087.
9
Practice Committee of the American Society for Reproductive Medicine (2017): Performing the embryo transfer: a guideline. Fertility and Sterility, 107(4):882-96.
10
Ray LK (2012): Definitions of infertility and recurrent pregnancy loss. Fertility and Sterility, 99 (1):60- 63.
11
Roque M, Lattes K, Serra S, Sola I, Geber S, Carreras R and Checa MA (2013): Fresh embryo transfer versus frozen embryo transfer in in vitro fertilization cycles: a systematic review and metaanalysis. Fertility and Sterility, 88 (7): 145-147.
12
Talaulikar VS and Arulkumaran S (2013): Maternal, perinatal and long-term outcomes after assisted reproductive techniques (ART): implications for clinical practice. European Journal of Obstetrics & Gynecology and Reproductive Biology, 170 (1): 13-19.
13
Tokgoz VY, Sipahi M, Aydin Y and Tekin AB (2019): Does multifollicular development and number of intermediate follicles contribute to the effect of luteal phase support with vaginal progesterone gel in intrauterine insemination cycles?. Gynecological Endocrinology, 65 (8): 112-117.
14
Wiltshire A, Ghidie L and Brayboy L (2020): Infertility and assisted reproductive technology outcomes in Afro-Caribbean women. Assisted Reproduction Technologies, 89: 1-18.
15
Yanushpolsky E (2015): Luteal Phase Support in In Vitro Fertilization. Seminars in Reproductive Medicin; 33: 118–124.
16
Zarutskie PW and Phillips JA (2009): A meta-analysis of the route of administration of luteal phase support in assisted reproductive technology: vaginal versus intramuscular progesterone. Fertil. Steril, 92(1): 163-169.
17
ORIGINAL_ARTICLE
COMPARATIVE STUDY BETWEEN TOTAL DOSE OF IRON INFUSION AND INTRAMUSCULAR IRON ADMINISTRATION IN TREATMENT OF IRON DEFICIENCY ANEMIA IN PREGNANT WOMEN
Background: Iron deficiency anemia (IDA) is the most common problem of nutritional deficiency in pregnant women worldwide. There is a concern about the high prevalence of iron and other micronutrient deficiencies among women during pregnancy in developing countries, and maternal anemia continues to cause significant perinatal morbidity and mortality. Objective: To compare between total dose of iron infusion and intramuscular iron administration from 12-32 weeks in pregnant women with moderate iron deficiency anemia. Patients and Methods: The study was held on 100 patients in the Obstetrics and Gynecology Department at Al-Hussien University Hospital Al- Azhar University on pregnant women at 12-32 weeks gestation attending the antenatal care unit from September 2019 to March 2020. Results: Group A was received I.V iron, Hb (pretherapy) ranged from 7.1-9 g%, elevated to 10.1-12 g%, the ferritin ranged from 15-30 ng/ml, elevated to 32-49 ng/ml. Group B was received I.M-iron, Hb (pretherapy) ranged from 7-9 g%, elevated to 8.5-10.9 g%, and ferritin ranged from 16-29ng/ml, elevated to 24-35ng/ml. Conclusion: Intravenous iron showed high effectiveness in the treatment of iron deficiency anemia during pregnancy. No side effects were detected and thus, it can be considered as a useful and alternative formulation for the treatment of iron deficiency.
https://amj.journals.ekb.eg/article_158448_7dd5aac45331a430f141ea071125cfc4.pdf
2021-04-01
989
998
10.21608/amj.2021.158448
Iron infusion
Intramuscular iron
iron deficiency anemia
Pregnant women
Mohamed
El-Shahat El-Saied Abd El-Khalek
dktwr638@gmail.com
1
Departments of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Abdalla
Khalil Ahmed
2
Departments of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University
AUTHOR
Abd El-Raouf
Abd El-Raouf Abo-Nar
3
Departments of Clinical Pathology, Faculty of Medicine, Al-Azhar University
AUTHOR
Samir
Khamis Galal
4
Departments of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Ahmad MS, Farooq H, Maham SN and Qayyum Z. (2018): Iron deficiency and cognitive achievement among school-aged children and adolescents in the United States. Pediatrics, 107(6):1381–1386.
2
Baradwan S, Alyousef A and Turkistani A. (2018): Associations between iron deficiency anemia and clinical features among pregnant women: a prospective cohort study. J Blood Med., 9: 163–169.
3
Bridwell RE, Carius BM and Long BJ. (2019): Serial study of factors influencing changes in cardiac output during human pregnancy. Am J Physiol., 256(4 Pt 2):1060–1065.
4
El Aal Al-Omda FA, El Sayed Al Naggar W and Al Sayed Al-Morsi MA. (2019): Comparative study-efficacy, safe and compliance of intravenous iron sucrose and intramuscular of sorbitol in iron deficiency anemia of pregnancy. The Egyptian Journal of Hospital Medicine; 74 (4): 905-913.
5
Gaikwad HS, Sindhu A and Sarda N. (2017): Comparison of efficacy and safety of intravenous iron sucrose and intramuscular iron sorbitol therapy in patients with anemia during pregnancy in a developing country. Asian Journal of Medical Sciences; 8(5): 31-35.
6
Hamm RF, Blauvelt C and Wang EY. (2019): Intravenous versus oral iron for treatment of anemia in pregnancy: a randomized trial. Obstet Gynecol., 106(6):1335–1340.
7
Hoffman R, Benz EJ, Silberstein LE, Heslop H, Jeffrey I and Sebastian M. (2018): Hematology: Basic Principles and Practice. 7th ed.Pbl New York: Churchill Livingstone, Inc,; p. 2374.
8
Khan M. (2011): Effect of maternal anaemia on fetal parameters. J Ayu Med Coll Abbottabad., 13(2):38–41.
9
Muñoz M, Stensballe J, Ducloy-Bouthors AS, Bonnet MP, De Robertis E and Sara G. (2019): Impact of parturition on iron status in non anaemic iron deficiency. Eur J Clin Invest.; 33: 919-23.
10
Qassim A, Gergis RG, Jeffries B, Grivell RM and Grzeskowiak LE. (2018): Use of intravenous iron polymaltose in the management of iron deficiency in pregnancy: A retrospective cohort study. Australian and New Zealand Journal of Obstetrics and Gynaecology; 58(2): 163-169.
11
Singh S, Singh S and Singh PK. (2013): Efficacy and safety of intravenous iron sucrose and intramuscular iron sorbitol therapy for anemia during pregnancy. J Obstet Gynaecol India; 63(1): 18-21.
12
Von Wowern E, Källén K and Olofsson P. (2019): Early pregnancy changes in hemodynamics and volume homeostasis are consecutive adjustments triggered by a primary fall in systemic vascular tone. Am J Obstet Gynecol., 169(6):1382–1392.
13
Wali A and Mushtaq A. (2010): Comparative study--efficacy, safety and compliance of intravenous iron sucrose and intramuscular iron sorbitol in iron deficiency anemia of pregnancy. Journal of Pakistan Medical Association; 52(9): 392.
14
ORIGINAL_ARTICLE
COMPARISON OF OBSTETRICAL OUTCOME WITH LABOR INDUCTION AGENTS USED AT TERM
Background: Induction of labour has risen gradually in modern obstetrics all over the world. It is more predominant in developed countries (around 20%) than developing countries. Objectives: To evaluate the outcome of induction of labor in primiparous, multiparous women and the risk of cesarean delivery associated with induction. Patients and methods: This study included 200 patients attending to Obstetrics and Gynecological Department at Al-Hussein University Hospital for delivery and Al-Sinblawein General Hospital from September 2019 to April 2020. The patients were classified into two equal groups according to success of induction: Group 1 was given misoprostol vaginally after rupture of membrane, group 2 patients was give oxytocin by slow infusion after rupture of membrane. Patients with gestational age less than 37 weeks, previous cesarean delivery, with breech presentation and age above 40 years were excluded. Results: There was a statistically significant difference between group 1(misoprostol) and group 2 (oxytocin) regarding induction of labor with mean interval between hours was higher in group 2. Conclusion: Vaginal misoprostol was effective, easy to administer, safe method and superior to oxytocin for induction of labor.
https://amj.journals.ekb.eg/article_158449_ac7efc6d4587478596ddd6cd53e0da86.pdf
2021-04-01
999
1006
10.21608/amj.2021.158449
Labor
misoprostol
oxytocin
Mohamed
El-Sebaey El-Awdy
m_elsebaey@gmail.com
1
Obstetrics and Gynecology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
LEAD_AUTHOR
Ahmed
Mohamed Al-Sadek
2
Obstetrics and Gynecology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Mofeed
Fawzy Mohamed
3
Obstetrics and Gynecology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
REFERENCES
1
Acharya, T., Devkota, R., Bhattarai, B. and Acharya, R. (2017): Outcome of misoprostol and oxytocin in induction of labour. SAGE Open Medicine, 5, 2050312117700809.
2
Alfirevic Z., Keeney E., Dowswell, T., Welton N. J., Medley N., Dias S. and Caldwell M. (2016): Which method is best for the induction of labour? A systematic review, network meta-analysis and cost-effectiveness analysis. Health technology assessment. Last accessed 14 Sep. 2020.
3
Chitrakar NS. (2012): Comparison of misoprostol versus dinoprostone for pre-induction cervical ripening at-term. J Nepal Health Res Counc., 10: 10–15.
4
Dongol A, Shakya S, Chawla C. (2010): Safety and efficacy of misoprostol for induction of labour. J Nepal Health Res Counc., 8(1): 27–30.
5
Girault A. (2020): Rupture des membranes à terme avant travail. Recommandations pour la pratique clinique du CNGOF—Méthodes de déclenchement. Gynécologie Obstétrique Fertilité & Sénologie, 48(1): 48-58
6
Gülmezoglu, A. M., Crowther, C. A., Middleton, P. and Heatley, E. (2012): Induction of labour for improving birth outcomes for women at or beyond term. Cochrane database of systematic reviews. Last accessed 16 Aug. 2020.
7
Jamali, M., Bakhtiyari, M., Arab F. and Mirzamoradi M. (2020): Misoprostol complications in second-trimester termination of pregnancy among women with a history of more than one cesarean section. Obstetrics & Gynecology Science, 63(3), 323-338.
8
Jenitha B. and Subbiah M. (2013): A comparative study of low dose Misoprostol (PGE1) with intercervical Dinoprostone (PGE2) gel for cervical ripening and labour induction, Journal of Evolution of Medical and Dental Sciences, 10.14260.
9
Kamel, R., Montaguti, E., Nicolaides, K. H., Soliman, M., Dodaro, M. G., Negm, S. and Youssef, A. (2019): Contraction of the levator ani muscle during Valsalva maneuver (coactivation) is associated with a longer active second stage of labor in nulliparous women undergoing induction of labor. American journal of obstetrics and gynecology, 220(2): 189-e1.
10
10. Kavita G, Jaya K, and Disha A (2014): Induction of Labor: A Review Indian Journal of Clinical Practice, 24(2):400-406
11
11. Osman B. Alaa S. Mahmoud A., Ali A. and Mehmet C. (2011): Comparison of induction of labor with vaginal misoprostol plus oxytocin versus oxytocin alone in term primigravidae, The Journal of Maternal-Fetal & Neonatal Medicine, 24(9): 1084-1087.
12
12. Shabana AA, El Kilani OA, El Khouly NI. and Tayel SM (2015): Comparison of oral misoprostol and oxytocin for labor induction in prelabor rupture of membranes at term. Menoufia Med J., 28:239-44
13
13. Shakya R, Shrestha J. and Thapa P. (2010): Safety and efficacy of misoprostol and dinoprostone as cervical ripening agents. JNMA J Nepal Med Assoc., 49(177): 33–37.
14
14. Tsakiridis I., Mamopoulos A., Athanasiadis, A. and Dagklis T. (2020): Induction of Labor: An Overview of Guidelines. Obstetrical & Gynecological Survey, 75(1): 61-72.
15
15. WHO recommendations for induction of labour. (2011): World Health Organization: Geneva; https://www.who.int/reproductivehealth/publications/maternal_perinatal_health/9789241501156/en/ last accessed 22 September 2020.
16
16. World Health Organization (2014): Preparations WECoSfP – quality assurance of pharmaceuticals: meeting a major public health challenge. https://www.who.int/reproductivehealth/publications/maternal_perinatal_health/38292412546/en/ last accessed 22 September 2020.
17
17. Wing DA. Induction of labor. In: Queenan JT, Hobbins JC. and Spong CY. (2010): Protocols for high-risk pregnancies. Hoboken, NJ: Wiley-Blackwell. 140–147.
18
18. Winikoff, B., Dabash, R., Durocher, J., Darwish, E., Ngoc, N. T. N., León, W. and Blum, J. (2010): Treatment of post-partum haemorrhage with sublingual misoprostol versus oxytocin in women not exposed to oxytocin during labour: a double-blind, randomised, non-inferiority trial. The Lancet, 375(9710): 210-216.
19
ORIGINAL_ARTICLE
BODY MASS INDEX IN PATIENTS WITH POLYCYSTIC OVARIAN SYNDROME AND ITS RELATION TO DOSE AND DURATION OF HMG, OVULATION RATE AND PREGNANCY RATE
Background: Polycystic ovary syndrome (PCOS) is one of the most common causes of endocrinological disorders affecting 5-10% of women in reproductive age. It is the most important cause of anovulation and infertility. Objective: To examine the relation of body mass index in PCOS patients with dose and duration of Human Menopausal Gonadotropin (HMG), ovulation rate and pregnancy rate. Patients and Methods: The study was retrospectively conducted on 150 women selected from patients attending the infertility clinic of Al-Azhar hospitals, Faculty of Medicine, Al-Azhar University during the period from August 2018 till July 2020, and we revised and collected that data from the records. All cases were selected after fulfilling inclusion and exclusion criteria. The patients were divided into three equal groups according to their body mass index, Group A: patients with normal body mass index (BMI 19-24.9), Group B: patients with overweight (BMI 25-29.9) and group C: patients with obesity (BMI equals or more than 30). Results: There was a statistical significance as regards pregnancy rates between studied groups. In the current study there was a statistical significant difference between three groups as regards the mean age. There was no statistical significant difference between three groups as regards the mean Follicular Stimulating Hormone (FSH), Luteinizing Hormone (LH), Estradiol (E2), Prolactin (PRL) and Thyroid stimulating Hormone (TSH). According to the days of stimulation, group C showed a significant increase than group A and B. The dose of HMG used in the three studied groups, showed a significantly higher dose used in group C than group A and B. The ovulation rate was 68% in group A, 56% in group B and 28% in group C. The results were compared with other studies of similar scope and most of them were recent ones. In our study, obesity had negative impact on ovulatory functions. It seemed that obesity was a negative prognostic factor for women referred to vitro fertilization (IVF) treatment. They should be encouraged to change lifestyle habits in order to lose weight before starting fertility treatment. Although our findings did not support a policy of excluding obese and overweight women from IVF treatment on the grounds of likely failure of ovulation induction or IVF, Beyond the IVF results, obesity increased morbidity for both mother and fetus. There was an increased risk in pregnancy hypertension, toxemia, gestational diabetes, Cesarean section, increased hospitalization, and the risk to their offspring of their abnormality in BMI. Conclusion: Programs of weight loss are recommended for obese women undergoing in vitro fertilization, and the institution of a process of weight loss where appropriate, HMG can be given to patients with PCO adjusting dose according to their BMI and response with expecting satisfactory ovulation, and pregnancy rate.
https://amj.journals.ekb.eg/article_158450_aa360b54fe127a84d33e929cb29efc66.pdf
2021-04-01
1007
1016
10.21608/amj.2021.158450
Body Mass Index
Polycystic Ovarian Syndrome
dose/duration
HMG
ovulation rate
pregnancy rate
Abdallah
G. Mohammad
elansaryabdo88@gmail.com
1
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Ismail
T. El-Garhy
2
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
AUTHOR
Noha
M. Sabry
3
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Anjali S, Balasubramanyam S, Gupta S and Verma T. (2010): Effect of body mass index on in vitro fertilization outcomes in women, J Hum Reprod Sci., 3(3): 135–138.
2
Bellver J, Rodríguez-Tabernero L, Robles A, Muñoz E, Martínez F, Landeras J, García-Velasco J, Fontes J, Álvarez M, Álvarez C and Acevedo B. (2018): Polycystic ovary syndrome throughout a woman’s life. Journal of Assisted Reproduction and Genetics. 35(1):25-39.
3
Cheng J and Li CY. (2010): Clinical outcomes of ovulation induction with metformin, clomiphene citrate and human menopausal gonadotrophin in polycystic ovary syndrome. J Int Med Res., 36: 1250-8.
4
Dağ ZÖ and Dilbaz B. (2015): Impact of obesity on infertility in women. Journal of the Turkish German Gynecological Association., 16(2):111-117.
5
Dağ ZO and Dilbaz B (2017): Impact of obesity on infertility in women,. Journal of the Turkish German Gynecological Association. 16(2):111-115.
6
Diamanti-Kandarakis E, Piperi C, Argyrakopoulou G, Spina J, Papanastasiou L, Bergiele A and Panidis D (2012): Polycystic Ovary Syndrome: The influence of environmental and genetic factors. Hormones 27,17-34.
7
Erin K. Barthelmess H and Rajesh K. (2014): Polycystic ovary syndrome: current status and future perspective, Front Biosci (Elite Ed)., 6: 104–119.
8
Frattarelli JL and Kodama CL. (2014): Impact of body mass index on in vitro fertilization outcomes. J Assist Reprod Genet. 21, 211–215.
9
Makrakis E. (2010): The impact of female obesity on in vitro fertilization outcomes, Journal of Minimally Invasive Gynecology, 230-237.
10
10. Petanovski Z, Dimitrov G, Ajdin B, Hadzi-Lega M, Sotirovska V, Matevski V, Stojkovska S, Saltirovski S, Suslevski D and Petanovska E. (2011): Impact of body mass index (BMI) and age on the outcome of the IVF process, 17:155-71.
11
11. Sarais V, Pagliardini L, Rebonato G, Papaleo E and Candiani M. (2016): A Comprehensive Analysis of Body Mass Index Effect on in Vitro Fertilization Outcomes Nutrients, 8(3): 109-112.
12
12. Susan M, Sirmans T and Kristen A and Pate Y. (2014): Epidemiology, diagnosis, and management of polycystic ovary syndrome Clin Epidemiol., 6: 1–13.
13
13. Vilarino FL, Bianco B, Christofolini DM and Barbosa CP. (2010): Impact of body mass index on in vitro fertilization outcomes. Rev. Bras. Gynecol. Obstet., 32: 536–540.
14
14. World Health Organization (2015): Obesity and overweight Fact sheet N°311.Geneva, Switzerland: World Health Organization Lancet., 363:157-163.
15
15. Zhang D, Zhu Y, Gao H, Zhou B, Zhang R, Wang T, Ding G, Qu F, Huang H and Lu X. (2010): Overweight and obesity negatively affect the outcomes of ovarian stimulation and in-vitro fertilization: A cohort study of 2628 Chinese women. Gynecological Endocrinology, 26: 325–32.
16
ORIGINAL_ARTICLE
A COMPARATIVE STUDY BETWEEN GENERAL AND SPINAL ANESTHESIA REGARDING MATERNAL BLOOD INDICES CHANGES AFTER LOW RISKY ELECTIVE CEASAREAN SECTION (A PROSPECTIVE CONTROLLED RANDOMIZED STUDY)
ABSTRACT Background: Delivery by ceasarean section is one of the most common surgical procedures nowadays. However, Choosing of anesthesia is a matter of controversy among obstetrician. Objective: To study the effect of two types of anesthesia on maternal hemoglobin and hematocrit level after elective cesarean section. Patients and methods: This was a randomized controlled study done at Sayed Galal University hospital and private centers (Tbarak Private Hospital Group) including 100 pregnant women underwent elective first time ceasarean section for variables causes. Changes in maternal hemoglobin and hematocrit indices were measured. Result: There was statistically significant difference between both groups after 48th hour post ceasarean section. Mean 48 hours postoperative hemoglobin and hematocrit parameter differences were significantly lower in the group with spinal anesthesia. Conclusion: Spinal anesthesia was better and has a greater advantage for maternal condition than general anesthesia as regard post-operative blood indices changes. So, whenever it is not contraindicated, spinal anesthesia should be recommended for elective ceasarean section.
https://amj.journals.ekb.eg/article_158451_210108c5beb8d03b0fafa99782d64dd5.pdf
2021-04-01
1017
1026
10.21608/amj.2021.158451
worpsi general and sbinal anesthesia
blood inpices
cesarean
El-Sayed
El-Desouky
elsayedeldesouky@yahoo.com
1
Department Of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Osama
Kamal Raslan
2
Department Of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
AUTHOR
Ibrahim
Abo El-Magd
3
Department Of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
AUTHOR
Shady
M. Hassan
4
Department Of anesthesia and ICU, Faculty of Medicine, Zagazig University
AUTHOR
REFERENCES
1
Abdalla MA and Abdel-Rahman MA (2015): The effect of general compared to spinal anesthesia on blood loss in cesarean section a randomized controlled study vol 13 , no 2 , suppl 2:111-116.
2
Abdallah MW, Elzayyat NS, Ahmed MA, and Gado AM. (2014): Comparative study of general anesthesia versus combined spinal-epidural anesthesia on the fetus in cesarean section. Egypt J Anaesth; 30:155–160.
3
Afolabi BB, and Lesi FE. (2012): Regional versus general anesthesia for caesarean section. Cochrane Database Syst Rev; 10:CD004350.
4
Bourke DL, and Smith TC. (1974): Estimating allowable hemodilution. Anesthesiology; 41:609–611.
5
Curtin SC, Gregory KD, Korst LM, and Uddin SF. (2015): Maternal morbidity for vaginal and cesarean deliveries, according to previous cesarean history: New data from the birth certificate, Natl Vital Stat Rep; 64:1‑13.
6
Ezzatalsadat J, Shamsi N, Aamir J, and Omid M (2013): Comparison of hematocrit concentration after cesarean section between two methods: general anesthesia Vs spinal anesthesia. Life Science Journal, 9(4):1258-60.
7
Incerpi MH. (2013): Operative delivery. In: Decherney AH, NathanL, Laufer N, Roman A, editors. Diagnosis and Treatment, Obstetricsand Gynecology 11th ed. New York, USA: McGraw‑Hill, Company Incorporated; p. 334‑48.
8
Jeong K, Hyang L, Eun K, and Myung W. (2012): The effect of type of anesthesia on intra and postoperative blood loss at elective cesarean section Korean Journal of anesthesiol., 62(2): 125-129.
9
Martin TC, Bell P, and Ogunbiyi O (2014): Comparison of general anesthesia and spinal anesthesia for caesarean section in Antigua and Barbuda. West Indian Medical Journal, 56:4.
10
10. Ogboli‑Nwasor E, Yunus AA. (2014): Anesthesia for cesarean deliveryin a low‑resource setting, an initial review. Open J Anesthesiol; 4: 217‑22.
11
11. Practice guidelines for obstetric anesthesia (2016): An updated reportby the American Society of Anesthesiologists Task Force on Obstetric Anesthesia and the society for obstetric anesthesia and perinatology. Anesthesiology; 124:270‑300.
12
12. Reynolds F (2010): General anesthesia is unacceptable for elective cesarean section. Int J Obstet Anesth; 19:212–217.
13
13. Saygı Aİ, Özdamar Ö, Gün İ, Emirkadı H, Müngen E, and Akpak YK (2015): Comparison of maternal and fetal outcomes among patients undergoing cesarean section under general and spinal anesthesia. Sao Paulo Med J; 133:227–234.
14
14. Wong CA. (2010): General anesthesia is unacceptable for elective cesarean section. Int J Obstet Anesth; 19: 209–212.
15
15. Yeoh SB, Leong SB, and Heng AS. (2010): Anaesthesia for lower‑segment caesarean section: Changing perspectives. Indian J Anaesth 54:409‑14.
16
ORIGINAL_ARTICLE
COLOPOSCOPY AND OFFICE HYSTEROSCOPY FOR CERVICAL ASSESSMENT FOR EVALUATION OF SUSPICIOUS CERVIX
Background: Cervical cancer is the second most common cancer among women in developing countries. Cervical cancer is a deadly disease once it reaches the invasive stages but out of all the female genital tract cancers. It is the only preventable cancer if detected in its early stages, and the disease is almost 100% curable with accurate screening and early detection. Objective: To evaluate efficacy of both office cervicoscopy and colposcopy directed biopsy in evaluation of clinically suspicious cervix. Patients and methods: Prospective cohort study on 200 patients with clinically suspicious cervix attending the outpatient Department of Obstetrics and Gynecology, at the Hospital of Al-Azher Assiut University. Results: Colposcopy had a sensitivity of 60% and a specificity of 91.1%. Office cervicoscopy showed a sensitivity of 75% and a specificity of 89.3%. Conclusions: Office cervicoscopy is more sensitive than stationary colposcopy for detection of cervical lesions in cases with suspicious cervix as an example of high risk group for cervical cancer. Its small caliber allows easy, simple and fast diagnostic out-patient evaluation of the cervix.
https://amj.journals.ekb.eg/article_158452_77cd983b19e1ccf5f9a62701be05dc40.pdf
2021-04-01
1027
1036
10.21608/amj.2021.158452
Screening of suspicious cervix
Coloposcopy and office hysteroscopy
punch biopsy
cervical histopathology
Mohammed
Mamdouh Sayed
m_mamdouh91@yahoo.com
1
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University (Assiut)
LEAD_AUTHOR
Faisal
Ali Mustafa
2
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University (Assiut)
AUTHOR
Hussein
A.H. Gadallah
3
Department of Pathology, Faculty of Medicine, Al-Azhar University (Assiut)
AUTHOR
Abd El-Halim
Mohammed Abd El-Halim
4
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University (Assiut)
AUTHOR
REFERENCES
1
American College of Obstetricians and Gynecologists ACOG (2016): Cervical cancer screening and prevention. Practice Bulletin No. 168. Obstet Gynecol., 128: e111-30.
2
Casey PM, Long ME and Marnach ML (2011): Abnormal Cervical Appearance What To Do, When to Worry? Mayo Clin Proc., 86:147e50.
3
Centini G, Troia L, Lazzeri L, Petraglia F and Luisi S (2016): Modern operative hysteroscopy. Minerva Ginecologica, 86(2):126-32.
4
Darwish AM, Abdulla Sa,Zahran Am and Abdel-Fattah NA (2013): Cervicoscopy and microcolposcopy in the evaluation of squamo columnar junction and cervical canal in LSIL patients with inadequate or negative colposcopy. International journal of biomedical science 9(3):148-152.
5
Dhakal R, Makaju R Sharma S, Bhandari S, Shrestha S, and Bastakoti R (2016): Correlation of cervical pap smear with biopsy in the lesion of cervix. Kathmandu University Medical Journal, 14:254-257.
6
Ferlay J, Soerjomataram I, Ervik M, Dikshit R and Eser S (2017): GLOBOKAN 2012. Cancer incidence and mortality worldwide. Lyon: International agency for Research on cancer. France, 73(8): 648-51.
7
Quaas J, Reich O and Kuppers V (2011): Explanation and use of the RIO 2011 colposcopy nomenclature of the IFCPC (International Federation For Cervical Pathology and Colposcopy) Realiability of unided naked-eye examination as a screening test for cervical lesions in a developing country setup. Journal of Lower Genital Tract Disease, 17(2): 182 -186.
8
Valli E, Fabbri G, Centozone C, Bompianei A, Baiocco F, Larciprete G and Ghinassi A (2013): Cervicoscopy and microcolposcopy in the evaluation of squamo columnar junction and cervical canal in LSIL patients with inadequate or negative colposcopy. International Journal of Biomedical Sciences, 9(3):148-152.
9
Walzer P, Dexeus S, De Palo G, Barrasso R, Campion M and Girardi F (2013): International terminology of colposcopy: An update report from international federation for cervical pathology and colposcopy. Obstet Gynecol., 101:175-7.
10
Wentzensen N, Schiffman M and Silver M, (2017): ASCCP Colposcopy Standards: risk-based colposcopy practice. J Low Genit Tract Dis., 21:230–4.
11
ORIGINAL_ARTICLE
EFFECT OF MAGNESIUM SULFATE ON DOPPLER INDICES AND FETAL CIRCULATION IN CASES OF SEVERE PRE-ECLAMPSIA
Background: In women with severe PE, the use of magnesium sulfate (MgSO4) is indicated for prevention and control of acute convulsions. Several randomized trials have compared the efficacy of MgSO4 with other anticonvulsants in women with eclampsia, and the rates of recurrent seizures and maternal death significantly reduced with MgSO4 as compared with other anticonvulsants. Objective: To assess the effect of magnesium sulfate injection on Doppler indices and fetal circulation in cases of severe pre-eclampsia. Patients And Methods: This was a prospective study that conducted on one hundred pregnant women suffering from pre-eclampsia, selected from the Obstetrics and Gynecology Department of Al-Hussein University Hospital from January 2018 to December 2018, evaluated before and after administration of magnesium sulfate, Doppler ultrasound was carried out to measure umbilical artery blood flow. Results: The results showed that a significant improvement in Doppler measurements and out come with treated groups (MgSO4) group more than the control group. Conclusion: MgSO4 proved to cause many hemodynamic changes as it has a vasodilator effect on maternal and fetal blood vessels. Doppler indices in the umbilical arteries significantly changed after administration of MgSO4 in patients with severe preeclampsia.
https://amj.journals.ekb.eg/article_158454_e6c432b8af5115d2064e3ded3298e2eb.pdf
2021-04-01
1037
1046
10.21608/amj.2021.158454
magnesium sulfate
Doppler indices
Pre-eclamsia
fetal circulation
Ahmed
A. Moussa
ahmedmoussa3387@gmail.com
1
Obstetrics and Gynecology Department, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Abd El-Moneim
M. Zakarya
2
Obstetrics and Gynecology Department, Faculty of Medicine, Al-Azhar University
AUTHOR
Ahmed
O. Abd El-Motaal
3
Obstetrics and Gynecology Department, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Abdelrahman TN, Youssry MA, Radwan AM and Ahmed A (2019): Impact of intravenous infusion of labetalol combined with magnesium sulfate versus hydralazine combined with magnesium sulfate on fetomaternal hemodynamics in severe preeclampsia. Ain-Shams J Anesthesiol., 11: 5-13.
2
Adekanmi AJ, Roberts A, Akinmoladun JA, and Adeyinka AO (2019): Uterine and umbilical artery doppler in women with pre-eclampsia and their pregnancy outcomes. Niger Postgrad Med., J 26: 106-12.
3
Belfort MA, Anthony J, Saade GR, Allen JC and Group NS (2013): A comparison of magnesium sulfate and nimodipine for the prevention of eclampsia. N Engl J Med.; 348: 304–311.
4
Bellomo G (2018): Hypertensive disorders of pregnancy. In: "Disorders of Blood Pressure Regulation; Phenotypes, Mechanisms, and Therapeutic Options; Berbari AE and Mancia G eds", pbl. Springer Intl Publishing, Switzerland, Part IX, Chapt 44, pp 763-796.
5
Dasgupta S, Ghosh D, Seal SL, Kamilya G, Karmakar M and Saha D (2012): Randomized controlled study comparing effect of magnesium sulfate with placebo on fetal umbilical artery and middle cerebral artery blood flow in mild preeclampsia at ≥34 weeks gestational age. J Obstet Gynaecol Res., 38: 763-771.
6
Dennis AT, Chambers E and Serang K (2015): Blood pressure assessment and frst-line pharmacological agents in women with eclampsia. Int J Obstet Anesth., 24: 247-251.
7
Ekun OA, Olawumi OM, Makwe CC and Ogidi NO (2018): Biochemical Assessment of Renal and Liver Function among Preeclamptics in Lagos Metropolis. Intl J Reprod Med 2018(ID 1594182): 6 pages.
8
Maged AM, Hashem AMT, Gad Allah SH, El-Mahy M, Mostafa WAI and Kotb A (2016): The effect of loading dose of magnesium sulfate on uterine, umbilical, and fetal middle cerebral arteries Doppler in women with severe preeclampsia: A case control study. J Hyperten Preg., 35(1): 91-99.
9
Magee LE, Pels A, Helewa MD, Rey E, von Dadelszen P; Canadian Hypertensive Disorders of Pregnancy (HDP) Working Group and Canadian Hypertensive Disorders of Pregnancy HDP Working Group (2015): The hypertensive disorders of pregnancy (29.3). Best Pract Res Clin Obstet Gynecol., 29(5): 643-657
10
Oliveira CA, de Sa RAM, Zamprogno KV, da Matta FG and Araújo F (2017): Magnesium sulfate and ophthalmic artery Doppler velocimetry in patients with severe preeclampsia: a case series. Journal of Medical Case Reports, 11: 326-331.
11
Patil S, Jyothi A, Babu A and Goud VGK (2016): A study on Liver function tests and Renal function tests in Preeclampsia. Intl J Biomed Res., 7(10): 713-717.
12
Peralta Pedro ML, Basavilvazo R, Cruz Avalar A, Sanchez Ambroz S, Guzman A and Martinez G (2014): Clinical significance of the laboratory determinations of preeclamptic patients. Gynecologia y Obstetriciade, 72:57–62.
13
Rantonen T, Kääpä P, Grönlund J, Ekblad U, Helenius H, Kero P and Välimäki I (2001): Maternal magnesium sulfate treatment is associated with reduced brain-blood flow perfusion in preterm infants. Crit Care Med., 29(7): 1460-5.
14
Rezavan N, Farshchian N, Gaviri A, Veisi F and Jallilian N (2016): Evaluation of the effect of magnesium sulfate on the parameters of Doppler flow velocity or the uterine arteries and fetal outcomes in severe preeclampsia. Acta Med Mediter 32: 1959-1963.
15
Sakae C, Sato Y, Kanbayashi S, Taga A, Emoto I, Maruyama S, Mise H and Kim T (2017): Introduction of management protocol for early-onset severe pre-eclampsia. J Obstet Gynecol Res., 43(4): 644-652.
16
Sedek AA (2015): Effect of the loading dose of magnesium sulfate on the Doppler velocimetry parameters in the uterine, umbilical and fetal middle cerebral arteries in severe pre-eclampsia. Al-Azhar Assuit Med J., 13(4): 56-62.
17
Shah D and Khalil RA (2015): Bioactive factors in uteroplacental and systemic circulation link placental ischemia to generalized vascular dysfunction in hypertensive pregnancy and preeclampsia. Biochem Pharmacol., 95: 211-226.
18
Souza AS, Amorim MM and Coutinho IC (2010): Effect of the loading dose of magnesium sulfate (MgSO4) on the parameters of Doppler flow velocity in the uterine, umbilical and middle cerebral arteries in severe preeclampsia. Hypertens Pregnancy, 29(2): 123-34.
19
Takenaka S, Matsuoka R, Maruyama D, Kawashima A, Koide K, and Sekizawa A (2016): Magnesium sulfate has an antihypertensive effect on severe pregnancy induced hypertension. Hypertens Res Pregnancy, 4: 11–15.
20
Too G and Hill JB (2013): Hypertensive crisis during pregnancy and postpartum period. Semin Perinatol., 37: 280-287.
21
Vieira JSP and Khalil RA, (2016): Mechanisms of Endothelial Dysfunction in Hypertensive Pregnancy and Preeclampsia. Adv Pharmacol., 77: 361-431.
22
ORIGINAL_ARTICLE
ROLE OF MIDDLE CEREBRAL ARTERY AND DUCTUSVENOSUS DOPPLER IN EVALUATION OF INTRAUTERINE GROWTH RESTRICTION
Background: World over, intrauterine growth restriction (IUGR) is observed in about 24% of newborns. Approximately, 30 million infants suffer from IUGR every year. IUGR is associated with stillbirth, neonatal death, and perinatal morbidity as well as delayed effects including cerebral palsy (CP) and adult diseases. Objective: To assess the role of umbilical artery, middle cerebral artery and ductus venosus doppler in evaluating the neonatal outcome of growth restricted fetuses. Patients and methods: Our study was conducted on 100 pregnant women attended at the department of Obstetrics and Gynecology, Al-Azhr University Hospitals from January 2019 to December 2019. The cases were allocated into 2 main groups: Group I: thirty two pregnant women with intrauterine growth restriction (IUGR), Group II: sixty eight normal pregnant women without IUGR. Results: The presence of high statistical significance correlation between neonatal outcome and Doppler indices of umbilical artery, middle cerebral artery (PSV, PI, RI) in IUGR group. There were also high statistical significance correlation between neonatal outcome and Ductus venosus Doppler with high specificity and sensitivity of A wave RI, PI in IUGR group. Conclusion: The umbilical artery Doppler indices (RI, PI) were abnormally high in IUGR, in addition with S/D ratio have significant relation with poor neonatal outcome in IUGR fetuses. Middle cerebral artery Doppler indices (PSV, S/D ratio, RI and PI) are abnormally high in IUGR and have high significant relation with poor neonatal outcome in IUGR group.
https://amj.journals.ekb.eg/article_158455_4204e9397e9a3731a7ec66c8d164d54a.pdf
2021-04-01
1047
1058
10.21608/amj.2021.158455
Middle Cerebral Artery & Ductus
Doppler
IUGR
Ahmed
Abd El-Sattar Al-Sayed Yakout
ahmed.yakout89@gmail.com
1
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
LEAD_AUTHOR
Abd El-Monaem
Mohamed Zakaria
2
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Ahmed
Mohammed Saeed
3
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
REFERENCES
1
Alfirevic Z, Stampalija T and Gyte GM. (2010): Fetal and umbilical Doppler ultrasound in high risk pregnancies. Cochrane Database Syst Rev., (1):CD007529.
2
Al Qahtani N. (2011): Doppler Ultrasound in the assessment of suspected intra-uterine growth restriction. Ann Afr Med., 10(4):266-271.
3
Axt-Fliedner R, Diler S and George T. (2010): Reference values of ductusvenosus blood flow velocities and waveform indicies. Arch Gynecol Obestet., 269:199-204.
4
Bano S, Chaudhary V and Pande S. (2010): Color doppler evaluation of cerebral-umbilical pulsatility ratio and its usefulness in the diagnosis of intrauterine growth retardation and prediction of adverse perinatal outcome. Indian J Radiol Imaging, 20(1):20–25.
5
Banu AA. (2011): Doppler velocimetry in the umbilical and middle cerebral arteries in fetuses with intrauterine growth retardation or fetal distress. FukokaIgaku Zasshi., 99(5):133–144.
6
Baschat AA, Cosmi E and Bilardo CM. (2011): Predictors of neonatal outcome in early-onset placental dysfunction. American Journal of Obstetrics and Gynecology, 109:253–61.
7
Cosmi E, Saccardi C, Bogana G, Funai E, Berghella V and Mari G. (2011): Doppler and BPP as predictors of outcome in severe IUGR fetuses. American Journal of Obstetrics and Gynecology, 6: 197-209.
8
Figueras F and Gratacos E (2014): Stage-based approach to the management of fetal growth restriction. Prenat Diagn, 34:655–9.
9
Gluckman PD, Hanson MA, Cooper C and Thornburg KL. (2010): Effect of in-utero and early life conditions on adult health and disease.N Engl J Med., 359(1):61-73.
10
10. Hung JH, Fu CY and Hung J. (2010): Combination of fetal Doppler velocimetric resistance values predict academic growth-restricted neonates. J Ultrasound Med., 25(8): 957-962.
11
11. Jurisić A, Jurisić Z and Pazin V. (2010): Fetal cerebral-umbilical Doppler ratio in prediction of fetal distress in patients with preeclampsia. Vojnosanit Pregl., 67(6):487–492.
12
12. Kaponis A, Harada T, Makrydimas G, Kiyama T and Adonakis G. (2011): The importance of venous Doppler velocimetry for evaluation of intrauterine growth restriction. J Ultrasound Med., 30(4):529-45.
13
13. Mari G, Brocato B, Donepudi RV and Preedy VR. (2012): Cardiovascular changes in IUGR. In: Handbook of growth and growth monitoring in health and disease. Pbl. New York, LLC, Pp. 275-97.
14
14. Mari G, Hanif F, Kruger M, Cosmi E and Treadwell MC. (2010): Middle cerebral artery peak systolic velocity: a new Doppler parameter in the assessment of growth-restricted fetuses. American Journal of Obstetrics and Gynecology, 29(3):310-6.
15
15. Neilson JP and Alfirevic Z. (2010): Doppler ultrasound for fetal assessment in high risk pregnancies. Cochrane Database Syst Rev., (2):CD000073.
16
16. Petraglia F, Boni C, Severi FM, Norman J. Buonocore G, Bracci R and Weindling M. (2012): Neonatology: a practical approach to neonatal diseases. Pbl. Milan: Springer, Pp. 55-66.
17
17. Picconi JL, Kruger M and Mari G.(2010): Ductusvenosus S-wave/isovolumetric A-wave (SIA) index and A-wave reversed flow in severely premature growth-restricted fetuses. J Ultrasound Med., 27(9):1283-1289.
18
18. Pokharel P and Alam AM. (2017): Fetal ductusvenosuspulsatility index and diameter during second and third trimester of gestation. Nepal Med Assoc., 56(205):124-131.
19
19. Schild RL. (2013): Obstetrical aspects In Caring for Children Born Small for Gestational Age. Pbl. Springer Healthcare, Pp. 77-81.
20
20. Spinillo A, Montanari L, Roccio M, Zanchi S, Tzialla C and Stronati M. (2011): Prognostic significance of the interaction between abnormal umbilical and middle cerebral artery Doppler velocimetry in pregnancies complicated by fetal growth restriction. Acta Obstet Gynecol Scand., 88(2):159-66.
21
21. Turan OM, Turan S, Gungor S, Berg C, Moyano D and Gembruch U. (2010): Progression of Doppler abnormalities in intrauterine growth restriction. American Journal of Obstetrics and Gynecology, 32:160–167.
22
ORIGINAL_ARTICLE
FIRST-TRIMESTER NEUTROPHIL-TO-LYMPHOCYTE AND PLATELET-TO-LYMPHOCYTE RATIOS AS INDICATORS FOR EARLY DIAGNOSIS OF PREECLAMPSIA
Background: Preeclampsia is a popular obstetric complication. Neutrophil to lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have gained notable attention as systemic inflammatory response indicators in diverse clinical settings. Objective: To evaluate the diagnostic worth NLR and PLR during the first trimester of gestation to forecast the subsequent occurrence of preeclampsia. Patients and methods: The present study was a prospective cohort study that enrolled 300 pregnant ladies. Initial CBC was done for all eligible cases at 7-14 weeks of gestation then cases were followed up till delivery. Results: The results showed progressively statistically increase in the mean NLR in PE cases compared to control cases and a statistically significant difference between the control and PE cases s regard PLR. Cut off value 1.7538 NLR can differentiate normotensive pregnant women from preeclampsia women with sensitivity of 86.5 %, specificity of 91.6% %, PPV of 64 %, and NPV of 97.5 %. However, PLR can differentiate normotensive pregnant women from preeclampsia women at a cut off value 80.70 with sensitivity of 81.1 %, specificity of 95.1 %, PPV of 28.6 %, and NPV of 64.6 %. Conclusion: Neutrophil to lymphocyte ratio and platelet to lymphocyte ratios is cheap, simple, rapid, and readily accessible marker that may be beneficial to predict preeclampsia in early pregnancy. Hence, these easy applicable parameters can be applied as low-cost predictive factors for the development of PE.
https://amj.journals.ekb.eg/article_158456_7a0137e70492ccb4ca8cf7649a2668f2.pdf
2021-04-01
1059
1074
10.21608/amj.2021.158456
preeclampsia
Neutrophil-to-lymphocyte ratio (NLR)
platelet-to-lymphocyte Ratio (PLR)
Ahmed
Gamal El-Din Mahmoud
1
Departments of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
LEAD_AUTHOR
Mohamed
Ali Mohamed
2
Departments of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
El-Sayed
Ahmed El-Desouky
3
Departments of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Mohamed
Saad El-Din Radwan
4
Departments of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
REFERENCES
1
Ali E (2016): Early Pregnancy Hemoglobin Levels as Prediction of Preeclampsia. International Journal of Advanced Research, 4(10):16-19.
2
Alkholy EA, Farag EA, Behery MA and Ibrahim MM (2013): The Significance of Platelet Count, Mean Platelet Volume And Platelet Width Distribution In preeclampsia. Al-Azhar Assiut Medical Journal, 11(1):200-214.
3
Alkredes A and Zaherra S (2018): The Significance of Blood Parameters in Womenwith Preeclampsia. International Journal of Scientific & Engineering Research, 9(1):714-718.
4
AlSheeha MA, Alaboudi RS, Alghasham MA, Iqbal J and Adam I (2016): Platelet count and platelet indices in women with preeclampsia. Vascular Health and Risk Management, 12:477-480.
5
American College of Obstetricians and Gynecologists (2013): Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ task force on hypertension in pregnancy. Obstetrics and Gynecology, 122(5):1122-13.
6
Canzoneri BJ, Lewis DF, Groome L and Wang Y (2010): Increased neutrophil numbers account for leukocytosis in women with preeclampsia. American Journal of Perinatology, 26:729–732.
7
Cordina M, Bhatti S, Fernandez M, Syngelaki A, Nicolaides KH and Kametas NA (2015): Maternal hemoglobin at 27–29 weeks’ gestation and severity of pre-eclampsia. The Journal of Maternal-Fetal & Neonatal Medicine, 28(13):1575-1580.
8
de Siqueira Guida JP, Surita FG, Parpinelli MA and Costa ML (2017): Preterm Preeclampsia and Timing of Delivery: A Systematic Literature Review. Revista Brasileira de Ginecologia e Obstetrícia/RBGO Gynecology and Obstetrics, 39(11):622-631.
9
Gezer C, Ekin A, Ertas IE, Ozeren M, Solmaz U, Mat E and Taner CE (2016): High first-trimester neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios are indicators for early diagnosis of preeclampsia. Ginekologia Polska, 87(6):431-435.
10
10. Habas E, Rayani A and Ganterie R (2013): Thrombocytopenia in hypertensive disease of pregnancy. The Journal of Obstetrics and Gynecology of India, 63(2):96-100.
11
11. Hassan B, Almushait M, Mubashar H and Zia S (2016): The Role of Risk Assessment at Antenatal Care Clinics in the Prediction of Pre-Eclampsia in a High Altitude Area. International Journal of Clinical Medicine, 7(1):10-15.
12
12. Khoigani MG, Goli S and Hasan Zadeh A (2012): The relationship of hemoglobin and hematocrit in the first and second half of pregnancy with pregnancy outcome. Iranian Journal of Nursing and Midwifery Research, 2(l1):165-170.
13
13. Kholief A, Swilam R, Elhabashy A and Elsherief R (2019): Neutrophil/ lymphocyte ratio, platelet/lymphocyte ratio, and c-reactive protein as markers for severity of pre-eclampsia. Research and Opinion in Anesthesia and Intensive Care, 6(1):1-8.
14
14. Kim MA, Han GH, Kwon JY and Kim YH (2018): Clinical significance of platelet-to-lymphocyte ratio in women with preeclampsia. American Journal of Reproductive Immunology, 80(1):1-6.
15
15. Kirbas A, Ersoy AO, Daglar K, Dikici T, Biberoglu EH, Kirbas O and Danisman N (2015): Prediction of preeclampsia by first trimester combined test and simple complete blood count parameters. Journal of Clinical and Diagnostic Research, 9(11):C20–C23.
16
16. Kurt RK, Aras Z, Silfeler DB, Kunt C, Islimye M and Kosar O (2015): Relationship of red cell distribution width with the presence and severity of preeclampsia. Clinical and Applied Thrombosis/Hemostasis, 21(2):128-131.
17
17. Kurtoglu E, Kokcu A, Celik H, Tosun M and Malatyalioglu E (2015): May ratio of neutrophil to lymphocyte be useful in predicting the risk of developing preeclampsia? A pilot study. The Journal of Maternal-Fetal & Neonatal Medicine, 28(1):97-99.
18
18. Mannaerts D, Heyvaert S, De Cordt C, Macken C, Loos C and Jacquemyn Y (2019): Are neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and/or mean platelet volume (MPV) clinically useful as predictive parameters for preeclampsia?. The Journal of Maternal-Fetal & Neonatal Medicine, 32(9):1412-1419.
19
19. Melchiorre K, Sharma R and Thilaganathan B. (2014): Cardiovascular implications in preeclampsia: an overview. Circulation, 130(8):703-714.
20
20. Monteiro G, Subbalakshmi NK and Pai SR (2014): Relevance of measurement of hematological parameters in subjects with pregnancy induced hypertension. Nitte University Journal of Health Science, 4(1):15-20.
21
21. Nasiri M, Faghihzadeh S, Majd HA, Zayeri F, Kariman N and Ardebili NS (2015): Longitudinal discriminant analysis of hemoglobin level for predicting preeclampsia. Iranian Red Crescent Medical Journal, 17(3):1-7.
22
22. Örgül G, Haklı DA, Özten G, Fadiloğlu E, Tanacan A and Beksaç MS (2019): First trimester complete blood cell indices in early and late onset preeclampsia. Turkish Journal of Obstetrics and Gynecology, 16(2):112-117.
23
23. Oylumlu M, Ozler A, Yildiz A, Oylumlu M, Acet H, Polat N, Soydinc HE, Yuksel M and Ertas F (2014): New inflammatory markers in pre-eclampsia: echocardiographic epicardial fat thickness and neutrophil to lymphocyte ratio. Clinical and Experimental Hypertension, 36(7):503-507.
24
24. Phaloprakarn C, Tangjitgamol S and Manusirivithaya S (2018): Total White Blood Cell Count and Its Subtypes in Early Pregnancy and Later Development of Preeclampsia. Journal of the Medical Association of Thailand, 101(8):1-10.
25
25. Qin B, Ma N, Tang Q, Wei T, Yang M, Fu H, Hu Z, Liang Y, Yang Z and Zhong R (2016): Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were useful markers in assessment of inflammatory response and disease activity in SLE patients. Modern Rheumatology, 26(3):372-376.
26
26. Sachan R, Patel ML, Sachan P and Shyam R (2017): Diagnostic accuracy of neutrophil to lymphocyte ratio in prediction of nonsevere preeclampsia and severe preeclampsia. Journal of Current Research in Scientific Medicine, 3(2):79-83.
27
27. Toptas M, Asik H, Kalyoncuoglu M, Can E and Can MM (2016): Are neutrophil/ lymphocyte ratio and platelet/lymphocyte ratio predictors for severity of preeclampsia?. Journal of Clinical Gynecology and Obstetrics, 5(1):27-31.
28
28. Tzur T, Weintraub AY, Sergienko R and Sheiner E (2013): Can leukocyte count during the first trimester of pregnancy predict later gestational complications?. Archives of Gynecology and Obstetrics, 287(3):421-427.
29
29. Vilchez G, Lagos M, Kumar K and Argoti P (2017): Is mean platelet volume a better biomarker in pre-eclampsia?. Journal of Obstetrics and Gynaecology Research, 43(6):982-990.
30
30. Yıldız Ç, Karakuş S, Akkar ÖB, Topbaş T, Çetin M, Yanık A and Çetin A (2016): The significance of neutrophil-lymphocyte ratio and mean corpuscular volume in diagnosis of preeclampsia. Gynecology Obstetrics & Reproductive Medicine, 22(2):75-79.
31
31. Yücel B and Ustun B (2017): Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, mean platelet volume, red cell distribution width and plateletcrit in preeclampsia. Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health, 7:29-32.
32
ORIGINAL_ARTICLE
CARBETOCIN VERSUS COMBINED OXYTOCIN AND METHERGINE FOR PREVENTION OF POSTPARTUM HEMORRHAGE AFTER VAGINAL DELIVERY IN HIGH RISK PREGNANCY
Background: Around the world, one woman every minute dies as a result of postpartum hemorrhage (PPH) and it remains the single major cause of maternal mortality and morbidity. The early identification of risk factors and effective prevention and management of PPH are critical to minimize the impact of PPH. Carbetocin, a new drug for the prevention of uterine atony, is a synthetic analogue of oxytocin with a half-life of up to 4 to 10 times longer than that of oxytocin. In comparison with oxytocin, it is used as a single-dose injection instead of an infusion and can be given intravenously or intramuscularly. Objective: To evaluate the effect of carbetocin in preventing postpartum hemorrhage after vaginal delivery in comparison with combined oxytocin and methergine. Patients and methods: This study was conducted at Al-Galaa Maternity Hospital during the period from 1 June to 1 December 2020. The study included 100 candidates between 37 to 40 weeks with a risk factor to develop PPH divided randomly into two equal groups: Group A received a single 100 mg IM dose of carbetocin (Pabal®) and Group B received 5 IU IM oxytocin (Syntocinon®) combined with 1 mL, 0.2 mg IM methylergonovine maleate (Methergine®). Results: Carbetocin was more effective, with significant difference, in reducing the time of 3rd stage of labor, reducing amount of blood loss and drop of both HB% and hematocrit levels with significant decreased incidence of side effects. Conclusion: A single 100 mg IM dose of carbetocin (Pabal®) may be more effective as compared to 5 IU IM oxytocin (Syntocinon®) combined with 1 mL, 0.2 mg IM methylergonovine maleate (Methergine®) in reducing postpartum blood loss with a smaller drop in hemoglobin levels.
https://amj.journals.ekb.eg/article_158457_86f82454a777fa7172f91e9b194f7160.pdf
2021-04-01
1075
1088
10.21608/amj.2021.158457
carbetocin
Combined Oxytocin and Methergine
Postpartum Hemorrhage
vaginal delivery
Mohamed
Gamal Nasr El-Shennawy
mohamedgamal5545@gmail.com
1
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Mohamed
Mohamed Gebreel
2
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
AUTHOR
Alrefaai
Abd El-Fattah Marai
3
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Askar AA, Ismail MT, El-Ezz AA and Rabie NH. (2011): Carbetocin versus syntometrine in the management of third stage of labor following vaginal delivery. Archives of Gynecology and Obstetrics, 284(6):1359–65.
2
Edhi MM, Aslam H, Naqvi Z and HashmiH. (2013): Postpartum hemorrhage: causes andmanagement. BMC Research Notes, 6:236-42.
3
El Behery MM, El Sayed GA, Abd El Hameed AA, Soliman BS, Abdelsalam WA and Bahaa A. (2016): Carbetocin versus oxytocin for prevention of postpartum hemorrhage in obese nulliparous women undergoing emergency cesarean delivery. J Matern Fetal Neonatal Med., 29:1257–1260.
4
Grotegut CA, Paglia MJ, Johnson LN, Thames B and James AH. (2011): Oxytocin exposure during labor among women with postpartum hemorrhage secondary to uterine atony. Am J Obstet Gynecol., 204:e51–e56.
5
Kansouh AM and El Naggar MA. (2019): Carbetocin versus oxytocin in prevention of postpartum hemorrhage in late preterm twin pregnancy following cesarean section: a prospective clinical study. Journal of Medicine in Scientific Research, 2(1):54-58.
6
Maged AM, Hassan AM and Shehata NA. (2016): Carbetocin versus oxytocin for prevention ofpostpartum hemorrhage after vaginal delivery inhigh risk women.J Matern Fetal Neonatal Med., 4:532-6.
7
Reyes OA and Gonzalez GM. (2011): Carbetocin versus oxytocin for prevention of postpartum hemorrhage in patients with severe preeclampsia: a double-blind randomized controlled trial. J Obstet Gynaecol Can., 33:1099–104.
8
Su LL, Chong YS, Samuel M. (2012): Carbetocin for preventing postpartum haemorrhage. Cochrane Database Syst Rev., 2: 5457-63.
9
Westhoff G, Cotter AM and Tolosa JE. (2013): Prophylactic oxytocin for the third stage oflabour to prevent postpartum haemorrhage.Cochrane Database of Systematic Reviews, 10: 1808-13.
10
Zein El Abdeen E. (2018): Carbetocin versus oxytocin and ergometrine for prevention of postpartum hemorrhage following caesarean section. Evidence Based Women's Health Journal, 8(1):138-43.
11
ORIGINAL_ARTICLE
COMPARISON OF RECURRENCE INCIDENCE AFTER PTERYGIUM EXCISION BY USING PEROPRATIVE SUBCONJUNCTIVAL BEVACIZUMAB INJECTION VERSUS CONJUNCTIVAL AUTO GRAFT
Background: A pterygium is a fleshy, wing-shaped growth from the conjunctiva, crossing over the limbus onto the cornea. The tissue is fibrovascular and can occur over the nasal or temporal cornea. It can be a bilateral process and asymmetric with one eye affected by a larger pterygium than the other. Objectives: To compare between Subconjunctival injection of bevacizumab (Avastin) and conjunctival autograft in the treatment of primary pterygium. Patients and Methods: This study was performed on 40eyes of 40 patients with primary pterygia of variable durations. The eyes were randomly classified into two equal groups: group A patients to be treated by Subconjunctival Bevacizumab (avastin) 0.2 ml (5 mg) for Primary Pterygium Excision, group B patients treated by conjunctival auto graft. Best corrected visual acuity, occurrence of recurrence, IOP and postoperative complications were compared. Patients were evaluated preoperatively then 1 day, 1 week, 1 month, 3 months after surgery. Eye photography was done before surgery and during the follow up period. This study was conducted at Department of Ophthalmology Al-Azhar University Hospital and Kobry El Kobba Military Hospital, from August 2018 to July 2020. Results: When the two groups were compared together, we found no statistically significant differences among them in multiple compared items, but the recurrence rate in group A (bevacizumab group) occurred in (10%), while in group B conjunctival auto graft no recurrence occurred and this was statistically insignificant difference among the 2 groups. There were no statistically significant differences regarding improvement in visual acuity, intraocular pressure change and postoperative complications among the two groups. Conclusion: A single preoperative subconjunctival injection of bevacizumab had decreased the recurrence rate befor primary pterygium excision, but did not give a more desirable recurrence rate. On the other hand conjunctival autograft was more effective than bevacizumab in reducing the recurrence rate of primary pterygium after surgical excision.
https://amj.journals.ekb.eg/article_158458_b17cafdd01e05cad1fb09d19fffb5fd9.pdf
2021-04-01
1089
1102
10.21608/amj.2021.158458
Recurrence Incidence
Pterygium Excision
Peroprative Subconjunctival Bevacizumab Injection
Conjunctival Auto Graft
Mohamed
El-Sayed Mohamed Abd El-Wahab
m.deghesh@yahoo.com
1
Ophthalmology Department, Faculty of Medicine, Al-Azhar University Cairo, Egypt
LEAD_AUTHOR
Hisham
Fawzy Khalel
2
Ophthalmology Department, Faculty of Medicine, Al-Azhar University Cairo, Egypt
AUTHOR
Abd Al-Magid
Mohamed Tag Al-Din
3
Ophthalmology Department, Faculty of Medicine, Al-Azhar University Cairo, Egypt
AUTHOR
REFERENCES
1
Ahmed M, Ahmed AM and Mirza GK (2019): Role of Topical Cyclosporine in Prevention of Pterygium Recurrence, after Primary Excision. Pakistan Journal of Ophthalmology, 35(3):188-192
2
Bunga T and Kotipalli L (2016): Mitomycin C, Recurrence, Surgical Management, 5-Fluorouracil, Pterygium. A study of management of pterygium: a comparative study, 3(67): 3617-3621.
3
Chui J, Coroneo MT, Tat LT, Crouch R, Wakefield D and Di Girolamo N (2011): Ophthalmic pterygium: a stem cell disorder with premalignant features. The American Journal of Pathology; 178(2):817-27.
4
Clearfield E, Muthappan V, Wang X and Kuo IC (2016): Conjunctival autograft for pterygium. Cochrane Database of Systematic Reviews;2, Issue .Feb. 2016 Art. No.: CD 011349.
5
Dos Santos Martins TG, de Azevedo Costa AL, Alves MR, Chammas R and Schor P (2016): Mitomycin C in pterygium treatment. International Journal of Ophthalmology, 9(3):465-468.
6
Genidy MM, Abdelghany AA and Alio JL (2017): Tailored corneo-conjunctival autografting in primary and secondary pterygium surgery. European Journal of Ophthalmology, 27(4):407-10.
7
Han SB, Jeon HS, Kim M, Lee SJ, Yang HK, Hwang JM, Kim KG, Hyon JY, and Wee WR (2016): Quantification of astigmatism induced by pterygium using automated image analysis. Cornea, 35(3):370-6.
8
Hovanesian JA, Starr CE, Vroman DT, Mah FS, Gomes JA, Farid M, Shamie N, Davidson RS, John T, Holland EJ and Kim T (2017): Surgical techniques and adjuvants for the management of primary and recurrent pterygia. Journal of Cataract and Refractive Surgery, 43(3):405-19.
9
Huang X, Zhu B, Lin L and Jin X (2018): Clinical results for combination of fibrin glue and nasal margin suture fixation for attaching conjunctival autografts after pterygium excision in Chinese pterygium patients. Medicine, 97(44): Issue .Nov.2018 Art. No.:13050.
10
Hussain SA, Shaheen KH, Ullah MS and Furqan A (2020): Recurrence of Pterygium after Pterygium Excision with Stem Cell Graft and Amniotic Membrane Graft: A Comparison. Cureus Journal, 12(1): Art. No.: 6535.
11
Kinast RM, Akula KK, DeBarber AE, Barker GT, Gardiner SK, Whitson E and Mansberger SL (2016): The degradation of mitomycin C under various storage methods. Journal of Glaucoma, 25(6):477-81.
12
Kocabora SM, Fazil K, Ozsutcu M, Doyduk-Kocabora A and Gulkilik G (2013): Subconjunctival bevacizumab injection in the surgery of primary pterygium: comparison with intraoperative mitomycin-C. Bull Soc. Belge. Ophthalmol, 322: 7-12.
13
Kuo IC, Muthappan V and Wang X (2014): Conjunctival autograft for pterygium. Cochrane Database of Systematic Reviews, Issue 10. Art. No: CD011349.
14
Mak RK, Chan TCY, Marcet MM, Choy BNK, Shum JWH, Shih KC and Ng ALK (2017): Use of anti‐ vascular endothelial growth factor in the management of pterygium. Acta Ophthalmologicam 95(1): 20-27.
15
Rashid O, Rimsha S, Waseem R, Arshad R, Shahzada BS and Assif SI (2012): Role of subconjunctival bevacizumab in treatment of pterygium. Pakistan Journal of Ophthalmology, 28(3): 132 -135.
16
Razeghinejad MR, Hosseini H, Ahmadi F, Rahat F and Eghbal H (2010): Preliminary Results of Subconjunctival Bevacizumab in Primary Pterygium Excision. Ophthalmic Res, 43(3): 134-138.
17
Rosenfeld PJ, Fung A, Andrew M and Michels S (2016): Optical coherence tomography and the development of antiangiogenic therapies in neovascular age-related macular degeneration. Investigative Ophthalmology and Visual Science, 57(9):OCT14-26.
18
Said DG, Faraj LA, Elalfy MS, Yeung A, Miri A, Fares U, Otri AM, Rahman I, Maharajan S and Dua HS (2013): Intra-lesional 5 fluorouracil for the management of recurrent pterygium. Eye, 27(10):1123-9.
19
Shenasi A, Mousavi F, Shoa-Ahari S, Rahimi-Ardabili B, and Fouladi RF (2011): Subconjunctival bevacizumab immediately after excision of primary pterygium: the first clinical trial. Cornea, 30(11): 1219-1222.
20
Sun YC, Hsiao CH, Chen WL and Hu FR (2011): Overexpression of matrix metalloproteinase-1 (MMP-1) and MMP-3 in superior limbic keratoconjunctivitis. Investigative Ophthalmology and Visual Science, 52(6):3701-5.
21
ORIGINAL_ARTICLE
MACULAR THICKNESS CHANGES IN DIABETIC VERSUS NON DIABETIC PATIENTS AFTER UNCOMPLICATED PHACOEMULSIFICATION
Background: In recent years, there has seen great progress in cataract surgery, both in the surgical technique as well as with modern phacoemulsifiers. Optical Coherence Tomography (OCT) is a noninvasive and noncontact diagnostic tool with high resolution to assess macular changes.
Purpose: To assess the impact of uncomplicated phacoemulsification on the changes of central macular thickness (CMT) values in diabetic and non-diabetic patients.
Methods: Thirty eyes of 30 subjects who underwent uneventful phacoemulsification were divided into 3 equal groups: Group I: Non diabetic patients, Group II: Diabetic patients without retinal changes and Group III: Diabetic patients with mild to moderate non-proliferative diabetic retinopathy (NPDR). Each patient was subjected to routine examination, best corrected visual acuity and CMT was assessed by OCT one day before operation, one week, one month and six months after the operation.
Results: According to CMT, significant difference was reported after one month and six months between all groups. This study showed statistically significant differences between groups one week, one month and six months postoperatively according to BCVA. Also there were statistically significant differences over the periods through BCVA in the each group, negative significant correlations between CME and BCVA after 1 month and 6 months. The mean BCVA improved progressively in the postoperative period, and it was non-significant correlated with duration of DM one week postoperatively. However, the correlations were significant after one month and six months. The CMT increased progressively in the postoperative periods and it significantly correlated with the duration of DM after one month and six months.
Conclusion: Diabetes influenced the central macular thickness in diabetic patients, who were more liable to changes in central macular thickness after cataract surgery even with uncomplicated cataract surgery.
https://amj.journals.ekb.eg/article_158459_b9d14072fdf606a594f1a262197d35bb.pdf
2021-04-01
1103
1118
10.21608/amj.2021.158459
Macular thickness changes
diabetic
non-diabetic
Uncomplicated Phacoemulsification
Mahmoud
Mohammed Madeeh Hassanin
mahmoudmadeeh0110@gmail.com
1
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Mohamed
Khedr Mohamed
2
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University
AUTHOR
Mohamed
Mohamed-Aly Ibrahim
3
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Bannale SG, Pundarikaksha H and Sowbhagya H. (2012): A prospective, open-label study to compare the efficacy and the safety of topical loteprednol etabonate and topical flurbiprofen sodium in patients with post-operative inflammation after cataract extraction. Journal of clinical and diagnostic research: JCDR, 6: 1499-.1514
2
Bressler SB, Qin H, Beck RW, Chalam KV, Kim JE, Melia M and Wells JA 3rd (2012): Factors associated with changes in visual acuity and central subfield thickness at 1 year after treatment for diabetic macular edema with ranibizumab. Archives of Ophthalmology, 130: 1153-1161.
3
Day AC, Gore DM, Bunce C and Evans JR. (2016): Laser-assisted cataract surgery versus standard ultrasound phacoemulsification cataract surgery. Cochrane Database of Systematic Reviews, 21: 379-392.
4
El-Saadani AE-K, Mandour S and Laymouna M. (2018): Evaluation of macular changes after uncomplicated phacoemulsification surgery in diabetic patients using optical coherence tomography. Menoufia Medical Journal, 31: 289-292.
5
Eriksson U, Alm A, Bjärnhall G, Granstam E and Matsson AW. (2011): Macular edema and visual outcome following cataract surgery in patients with diabetic retinopathy and controls. Graefe's Archive for Clinical and Experimental Ophthalmology 249: 349-359.
6
Fujimoto JG, Schmitt J, Swanson E,Aguirre AD and Jang Ik. (2020): The Development of Optical Coherence Tomography. Cardio-vascular OCT Imaging. pbl. Springer, 1-23.
7
Ghosh S, Bansal P, Shejao H, Hegde R, Roy D and Biswas S. (2015): Correlation of morphological pattern of optical coherence tomography in diabetic macular edema with systemic risk factors in middle aged males. International Ophthalmology, 35: 3-10.
8
Islam F, Ashraf M, Zafar S and Masood H. (2016): Retinal thickness and visual acuity in diabetic macular edema: An optical coherence tomography-based study. Journal of the College of Physicians and Surgeons Pakistan, 26: 598-601.
9
Liu J, Jones RE, Zhao J, ZHANG J and ZHANG F. (2015): Influence of uncomplicated phacoemulsification on central macular thickness in diabetic patients: a meta-analysis. PloS one, 10: 121-143.
10
10. Musat O, Cernat C, Labib M, Gheorghe A, Toma O, Zamfir M and Boureanu AM. (2015): diabetic Macular Edema. Rom J Ophthalmol., 59: 133-136.
11
11. Oh J-H, Chuck RS, Do JR and Park CY. (2014): Vitreous hyper-reflective dots in optical coherence tomography and cystoid macular edema after uneventful phacoemulsification surgery. PloS one, 9: 950-966.
12
12. Romero-Aroca P. (2010): Targeting the pathophysiology of diabetic macular edema. Am Diabetes Assoc., 33(11): 2484–2485.
13
13. Silpa-Archa S and Sukhawarn R. (2012): Prevalence and associated factors of diabetic retinopathy in Chandrubeksa Hospital, Directorate of Medical services, Royal Thai Air Force. J Med Assoc Thai., 95: S43-S49.
14
14. Song E, Sun H, Xu Y, Ma Y, Zhu H and Pan CW. (2014): Age-related cataract, cataract surgery and subsequent mortality: a systematic review and meta-analysis. PloS one, 9: 112-154.
15
15. Srinivasan S, Raman R, Swaminathan G,Ganesan S Kulothungan V and Sharma T. (2017): Incidence, progression, and risk factors for cataract in type 2 diabetes. Investigative Ophthalmology & Visual Science, 58: 5921-5929.
16
16. Tsilimbaris M, Diakonis VF, Kymionis GD, Eleftheriadou MI, Fragkiskou S, Moschandreas J, Frueh BE, Epstein D and Pallikaris AI. (2012): Prospective study of foveal thickness alterations after cataract surgery assessed by optical coherence tomography. Ophthalmologica, 228: 53-58.
17
17. Wang K-Y and Cheng C-K. (2014): Central retinal thickness changes and visual outcomes following uncomplicated small-incision phacoemulsification cataract surgery in diabetic without retinopathy patients and nondiabetic patients. Taiwan Journal of Ophthalmology, 4: 33-39.
18
18. Yassin SA, SM AL, Alromaih AZ and Alrushood AA. (2019): Optical coherence tomography patterns of diabetic macular edema in a Saudi population. Clin Ophthalmol., 13: 707-714.
19
19. Zhao C, Wang W, Xu D, Li H, Li M and Wang F. (2014): Insulin and risk of diabetic retinopathy in patients with type 2 diabetes mellitus: data from a meta-analysis of seven cohort studies. Diagn Pathol., 9: 130-147.
20
20. Zhu X-f, Zou H-d, Yu Y-f, Sun Q and Zhao N-Q. (2012): Comparison of blue light-filtering IOLs and UV light-filtering IOLs for cataract surgery: a meta-analysis. PloS one, 7: 33-53.
21
ORIGINAL_ARTICLE
CORNEAL TOPOGRAPHIC CHANGES AFTER EYELID PTOSIS SURGERIES MEASURED BY CORNEAL TOPOGRAPHY
Background: The cornea is a complex structure which has a protective role, and responsible for about three-quarters of the optical power of the eye. Pressure from the eyelids has been implicated in a range of short- and long-term corneal topographical changes. Objective: To evaluate corneal topographic changes after eyelid ptosis surgeries measured by corneal topography by the Sirius system (CSO, Florence, Italy). Patients and Methods: A total of 50 eyes of patients were enrolled in the study to be examined before and 6 weeks after ptosis surgeries using corneal topography device at Al-Azhar University Hospitals in the period extending from December 2018 to December 2019. A complete ophthalmological examination included uncorrected visual acuity, best corrected visual acuity, full slit lamp examination and evaluation of eyelid. Examination was done by the Sirius system to evaluate corneal topographic changes. Results: Apical keratometry front (AKF) was changed from (44.63 ± 1.34D) to (44.06 ± 1.47D) with statistically significant (P value=0.002). Changes in central corneal thickness (CCT), corneal astigmatism (CYL), average simulated keratometry (average K), and symmetry index front (SIF) obtained from Sirius were not statistically significant. Conclusion: The pressure of upper eyelid in patients with ptosis appeared to inducing steepening of the superior cornea along this axis. The surgical correction of ptosis induces flattening of superior cornea as shown by significant decrease in AKF value postoperatively restoring corneal topography to a more regular state.
https://amj.journals.ekb.eg/article_158461_186409e70b004eb73d33e14f1a5bac17.pdf
2021-04-01
1119
1126
10.21608/amj.2021.158461
Eyelid ptosis
Corneal topography
corneal steepening
Zakariya
Abd El-Ghany Mohammed
d.rzakariya1988@gmail.com
1
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Mohamed
Amin Anwar El-Masry
2
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University
AUTHOR
Ehab
Abd El-Samie El-Shiekh
3
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
AGRAWAL, G. and RAVANI, S. (2016): Astigmatic changes following ptosis correction surgery in 30 consecutive children seen in a regional institute of ophthalmology. International Journal of Current Research and Review, 8, 1.
2
BYARD, S. D., SOOD, V. and JONES, C. A. (2014): Long-term refractive changes in children following ptosis surgery: a case series and a review of the literature. International Ophthalmology, 34, 1303-1307.
3
CRUZ, A. A. V. and AKAISHI, A. (2018): Frontalis-Orbicularis Muscle Advancement for Correction of Upper Eyelid Ptosis: A Systematic Literature Review. Ophthalmic Plast Reconstr Surg, 34, 510-515.
4
KARABULUT, G. O. and FAZIL, K. (2019): Corneal Topographical Changes after Müller’s Muscle-conjunctival Resection Surgery. Ophthalmic Plastic & Reconstructive Surgery, 35, 177-181.
5
MASEEDUPALLY, V., GIFFORD, P. and SWARBRICK, H. (2015): Variation in normal corneal shape and the influence of eyelid morphometry. Optometry and Vision Science, 92, 286-300.
6
NEIMKIN, M. G. and HOLDS, J. B. (2016): Evaluation of eyelid function and aesthetics. Facial Plastic Surgery Clinics, 24, 97-106.
7
READ, S. A., VINCENT, S. J. and COLLINS, M. J. (2014): The visual and functional impacts of astigmatism and its clinical management. Ophthalmic and Physiological Optics, 34, 267-294.
8
RUBERTI, J. W., SINHA ROY, A. and ROBERTS, C. J. (2011): Corneal biomechanics and biomaterials. Annual review of biomedical engineering, 13, 269-295.
9
SAVINO, G., BATTENDIERI, R., RISO, M., TRAINA, S., POSCIA, A., D'AMICO, G. and CAPOROSSI, A. (2016): Corneal topographic changes after eyelid ptosis surgery. Cornea, 35, 501-505.
10
10. ZOUMALAN, C. I. and LISMAN, R. D. (2010): Evaluation and management of unilateral ptosis and avoiding contralateral ptosis. Aesthetic surgery journal, 30, 320-328.
11
ORIGINAL_ARTICLE
DIABETIC MACULAR ISCHEMIA DIAGNOSIS: COMPARISON BETWEEN OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY AND FLUORESCEIN ANGIOGRAPHY
Background: Diabetic retinopathy (DR) is a common complication of diabetes mellitus and is a leading cause of blindness worldwide. Diabetic macular ischemia is recognized as an important cause of visual disability. DMI is characterized by enlargement of the physiological capillary-free zone (FAZ). Objective: To compare fluorescein angiography (FA) and optical coherence tomography angiography (OCTA) of foveal avascular zone (FAZ) in patients with diabetic retinopathy (DR) with and without diabetic macular ischemia (DMI). Patients and methods: Our study included 60 patients with diabetic retinopathy, divided into 2 groups: Group I: 80 eyes of diabetic patients with diabetic retinopathy and DMI and Group II: 40 eyes of diabetic patients with. Diabetic retinopathy and no DMI (diagnosed clinically and FA). All of them underwent full history taking, complete ophthalmological examination including FFA & OCTA during the period from October 2017 to December 2018. Results: Regarding the comparison of OCTA with FA in diagnosis of DMI according to ETDRS DMI grading. The present study found that moderate agreement between both devices (Kappa agreement k = 0.560 FAZ area was measured in DMI group and non DMI group. Group I Mean FAZ area ± SD was (0.57 ± 0.29 mm2) in OCTA6x6, (0.61 ± 0.28mm2) in FFA. Statistically, the difference in FAZ area between the OCTA and FFA was insignificant. The horizontal and vertical diameter was (650 ± 0.32Mm & 490 ±0.26) in OCTA6x6, (690 ± 0.25Mm & 530 ± 0.31Mm) in FFA. Statistically, the difference in horizontal and vertical diameter between the OCTA and FFA was insignificant. Conclusion: OCT angiography was a valid, reliable and easy-to-use method to detect and quantify DMI changes without use of dye .with a moderate degree of agreement between FFA and OCTA in evaluating DMI.
https://amj.journals.ekb.eg/article_158462_4eac5f267febac776559bcab40d32278.pdf
2021-04-01
1127
1138
10.21608/amj.2021.158462
DMI
FAZ
OCTA
Sara
Hammam Mohamed
sarahammam1987@gmail.com
1
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Ahmed
Shafeq Abdallah
2
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University
AUTHOR
Zeinab
Sayed Hasan
3
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University
AUTHOR
Mohamed
Mohamed-Aly Ibrahim
4
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Bradley PD, Sim DA, Keane PA, Cardoso J, Agrawal R, Tufail A and Egan CA. (2016): The Evaluation of Diabetic Macular Ischemia Using Optical Coherence Tomography Angiography. Investigative Opthalmology & Visual Science, 57: (2): 626-31.
2
Cennamo G, Romano MR, Nicoletti G and de Crecchio G. (2017): Optical coherence tomography angiography versus fluorescein angiography in the diagnosis of ischaemic diabetic maculopathy. Acta Ophthalmologica, 95: (1): 36-42.
3
de Carlo TE, Romano A and Waheed NK. (2015): A review of optical coherence tomography angiography (OCTA). International Journal of Retina and Vitreous, 1: (1): 134-138.
4
Fadzil MA, Izhar LI and Nugroho HAJC. (2010): Determination of foveal avascular zone in diabetic retinopathy digital fundus images. Comput Biol Med., 40(7):657-64.
5
Freiberg FJ, Pfau M, Wons J, Wirth MA, Becker MD and Michels S. (2015): Optical coherence tomography angiography of the foveal avascular zone in diabetic retinopathy. Graefe's Archive for Clinical and Experimental Ophthalmology, 254: (6): 1051-1058.
6
Garcia JMB, Lima TT, Louzada RN and Avila M (2016): Diabetic Macular Ischemia Diagnosis: Comparison between Optical Coherence Tomography Angiography and Fluorescein Angiography. Journal of Ophthalmology, 2016: 1-6.
7
La Mantia A, Kurt RA, Mejor S, Egan CA, Tufail A, Keane PA and Sim DA. (2019): Comparing fundus fluorescein angiography and swept-source optical coherence tomography angiography in the evaluation of diabetic macular perfusion. Retina, 39: (5): 926-937.
8
Liew G, Sim DA, Keane PA, Tan AG, Mitchell P, Wang JJ, Wong TY, Fruttiger M, Tufail A and Egan CA. (2015): Diabetic macular ischaemia is associated with narrower retinal arterioles in patients with type 2 diabetes. Acta Ophthalmologica, 93: (1): 45-51.
9
Mansouri K, Medeiros FA, Marchase N, Tatham AJ, Auerbach D and Weinreb RN. (2013): Assessment of Choroidal Thickness and Volume during the Water Drinking Test by Swept-Source Optical Coherence Tomography. Ophthalmology, 120: (12): 2508-2516.
10
10. Miwa Y, Murakami T, Suzuma K, Uji A, Yoshitake S, Fujimoto M, Yoshitake T, Tamura Y and Yoshimura N. (2016): Relationship between Functional and Structural Changes in Diabetic Vessels in Optical Coherence Tomography Angiography. Scientific Reports, 148(1):4–6.
11
11. Nagiel, A., Sadda, S. R., & Sarraf, D. (2015): A promising future for optical coherence tomography angiography. JAMA ophthalmology, 133(6), 629-630.
12
12. Sim DA, Keane PA, Zarranz-Ventura J, Tufail A and Egan CA (2013): The Effects of Macular Ischemia on Visual Acuity in Diabetic Retinopathy. Investigative Ophthalmology & Visual Science, 54: (3): 2353-2360.
13
13. Spaide RF, Klancnik JM and Cooney MJ. (2015): Retinal Vascular Layers Imaged by Fluorescein Angiography and Optical Coherence Tomography Angiography. JAMA Ophthalmology, 133: (1): 45-50.
14
14. Wilkinson CP, Ferris FL 3rd, Klein RE, Lee PP, Agardh CD, Davis M, Dills D, Kampik A and Pararajasegaram R. (2003): Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Ophthalmology, 110: (9): 1677-1682.
15
ORIGINAL_ARTICLE
EFFECT OF MITOMYCIN C VERSUS BEVACIZUMAB ON CORNEAL ENDOTHELIAL CELLS FOLLOWING TRABECULECTOMY IN PRIMARY OPEN ANGLE GLAUCOMA
Background: Trabeculectomy is the standard treatment for patients with primary open angle glaucoma who had failed maximal tolerated medical therapy. The use of Mitomycin C (MMC) or Bevacizumab as adjuvant during trabeculectomy reduces fibrosis which in turn increases the possibility of success in filtrating surgery. However, MMC or Bevacizumab can lead to adverse effects, such as corneal toxicity especially on corneal endothelium, hypotony, formation of avascular cystic blebs, leaks, blebitis, and endophthalmitis. Objective: To evaluate and compare corneal endothelial cell changes before and after trabeculectomy with subconjunctival Mitomycin C versus trabeculectomy with sub conjunctival Bevacizumab in primary open angle glaucoma patients (1 month and 6 months postoperatively). Patients and methods: In this study, 20 patients (with 20 eyes) were divided into two equal groups: (Group A) included patients who underwent subscleral trabeculectomy with adjuvant intraoperative use of 0.2mg/ml MMC for 2 min, and (Group B) included patients who underwent subscleral trabeculectomy with subconjunctival injection of 1.25 mg/0.1 ml Bevacizumab. Non-contact specular microscope (Topcon sp-1p, Topcon Medical Inc., Japan) was done preoperatively, one month postoperatively and six months post-operatively to assess the corneal endothelium as regard ECD (cells/mm²), CV in cell size, HEX and CCT. This prospective comparative study was done at Department of ophthalmology, Sayed Galal University Hospital, Cairo, Egypt, and it was carried out from February 1ˢͭ 2019 to October 30ͭ ͪ 2020. Results: Six males (60%) and four females (40%) in group A while five males (50%) and five females (50%) in group B. The patients’ ages ranged from {25 to 47 years} (mean age35.70±6.70) in group A, and ranged from {20 to 45 years} (mean age 31.20±8.70) in group B. MMC and Bevacizumab did not have the same effect on corneal endothelium. There was a significant decrease in endothelial cell density (ECD) after six months post-operatively in both groups with significant difference between the two groups, and insignificant increase in central corneal thickness (CCT) after six months post-operatively in both groups, Also there was a significant changes in coefficient of variation (CV), and percentage of hexagonal cells (HEX), an increase in CV (polymegathism), and decrease in hexagonality (pleomorphism) in both groups, with significant difference between the two groups. Conclusion: MMC affected all parameters of endothelial cells more than Bevacizumab.
https://amj.journals.ekb.eg/article_158463_c8c0468e9b7b6469edba355517efc149.pdf
2021-04-01
1139
1152
10.21608/amj.2021.158463
Bevacizumab
mitomycin c
Specular microscopy (SP)
endothelial cell density (ECD)
Coefficient of variation (CV)
percentage of hexagonal cells (HEX) and central corneal thickness (CCT)
Mahmoud
Samir Ali El-Rifai
mahmoudsamir028@gmail.com
1
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Hassan
Mohamed Hegazy
2
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University
AUTHOR
Mahmoud
Hamed Allam
3
Department of Ophthalmology, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Anbar M, Ammar H and Mahmoud RA. (2016): Corneal Endothelial Morphology in Children with Type 1 Diabetes. Journal of Diabetes Research, 1-8.
2
Benetz B. (2011): Specular microscope. In: Krachmer J, Mannis M, Holland E. Cornea, 3rd ed. Pbl. Philadelphia: Elsevier Mosby, pp. 178- 198.
3
Charnock-Jones DS. (2015): vascular endothelial growth factors their receptors and their inhibition. Cell TransmNewslett Cell Signal Neurosci Res., 21:1–5.
4
Coppens G and Maudgal P. (2010): corneal complications of intraoperative MMC in glaucoma surgery. Bull Soc Ophthalmol., 314:19–23.
5
Gasser L, Reinhard T andBöhringer D. (2015): Comparison of corneal endothelial cell measurements by two non-contact specular microscopes. BMC Ophthalmol, 15: 87-91.
6
Higashide, T., Nishino, T., Sakaguchi, K., Yamada, Y., & Sugiyama, K. (2019): Determinants of corneal endothelial cell loss after trabeculectomy with mitomycin C. Journal of Glaucoma, 28(1), 61-67.
7
Jagani SN, Lune AA, MagdumRM, and et al., (2015): Comparison of Endothelial cell loss by specular Microscopy between phacoemulsification and small- incision cataract surgery.Nigerian J ophthalmol; 23(2):54-59.
8
Joyce NC and Harris DL. (2010): Decreasing expresson of the G1- phase inhibitors, p21Cip1 and p16ink4a, promotes division of corneal endothelial cells from older donors. Molecular Vision, 16: 897–906.
9
Khaw PT, Occleston NL, Schultz G, Grierson I, Sherwood MB and Larkin G. (2010): Activation and suppression of fibroblast function. Eye, 8:188–195.
10
Lama PJ and Fechtner RD. (2013): Antifibrotics and wound healing in glaucoma surgery. Surv Ophthalmol., 48:314–346.
11
McCarey B, Edelhauser H and Lynn M. (2010): Review of Corneal Endothelial Specular Microscopy for FDA Clinical Trials of Refractive Procedures, Surgical Devices, and New Intraocular Drugs and Solutions. Cornea, 27:1-16.
12
Nilforushan N, Yadgari M, Kish SK and Nassiri N. (2012): Subconjunctival bevacizumab versus mitomycin C adjunctive to trabeculectomy. Am J Ophthalmol. 153(2):352-7el.
13
Saeed AM and AboulNas TT. (2014): Subconjunctival bevacizumab to augment trabeculectomy with MMC in the management of failed glaucoma surgery. Clin Ophthalmol., 1745–1755.
14
Van Bergen T, Van de veire S, Vandewalle E, Moons L, Dewerchin M, Stassen JM, et al., (2014): The role of different VEGF iso forms in scar formation after glaucoma filtration surgery. Exp Eye Res, 93(5):689-99.
15
Van Schaick WB, Van Dooren and Mulder PG et al., (2015): Validity of endothelial cell analysis methods and recommendations for calibration in Topcon SP-2000P specular microscopy. Cornea, 24(5); 538-44.
16
ORIGINAL_ARTICLE
OCT ASSESSMENT OF MACULAR THICKNESS IN NON-PROLIFERATIVE DIABETIC RETINOPATHY IN RELATION TO GLYCOSYLATED HEMOGLOBIN
Background: Diabetic retinopathy (DR), also known as diabetic eye disease, is a retinal damage that occurs due to diabetes. Blindness can be the end result of diabetic retinopathy. Objective: To evaluate the relation of macular thickness to glycosylated hemoglobin in patients with non-proliferative diabetic retinopathy. Patients and Methods: This study included 100 eyes of 100 patients with a diagnosis of type 2 DM. This was designed as an observational, cross-sectional and non-cohort study during the period from 6/2019 to 3/2020. One hundred eyes were divided into two equal groups: one group included diabetic patients with no diabetic retinopathy and the other group included diabetic patients with non-proliferative diabetic retinopathy. Patients were recruited from Retinal clinic in Al-Azhar University Hospital and asked to participate in this study. Results: The results showed that non-proliferative diabetic retinopathy (NPDR) group and group of no DR were comparable as regard age, sex and best corrected visual acuity (BCVA). There was a statistically insignificant difference between group of no DR and NPDR group, but group of no DR had shorter duration of DM, lower HbA1c level, lower macular thickness in all of the 9 standard early treatment diabetic retinopathy study (ETDRS) subfields, lower total macular volume (TMV) than NPDR Group. The results showed that central subfield macular thickness (CST) is positively and significantly related to glycosylated hemoglobin (HbA1c) level in each group of no DR and NPDR, and that severity of DR stage was significantly increased with increased HbA1c levels. The results also showed that there’s significant positive association between severity of DR stage and macular thickness in all of the nine standard ETDRS subfields. There was a positive significant relation between duration of DM and HbA1c level in type 2 diabetic patients, while there was no significant relation between duration of DM and macular thickness. The results also showed significant inverse relation between insulin use and HbA1c level, and significant inverse relation between insulin use and prevalence of DR in type 2 diabetic patients. Conclusion: Increased incidence of DR, increased macular thickness and increased incidence of diabetic macular edema were associated with increased level of glycosylated hemoglobin in type II diabetic patients.
https://amj.journals.ekb.eg/article_158464_145a39273600cb175b91baaab7f18afb.pdf
2021-04-01
1153
1168
10.21608/amj.2021.158464
Macular Thickness
Non-Proliferative Diabetic Retinopathy
Glycosylated Hemoglobin
Amr
Muhammad Badr Salah El-Deen
dramrbadrsalah@gmail.com
1
Ophthalmology Department, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Hany
Mahmoud Baiomy Sammor
2
Ophthalmology Department, Faculty of Medicine, Al-Azhar University
AUTHOR
Mohammed
Al Taher Abd El-Wahab
3
Ophthalmology Department, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Alabdulwahhab K. (2019): Relationship between Diabetic Retinopathy and HbA1c in Type 2 Diabetics, Kingdom of Saudi Arabia. Journal of Research in Medical and Dental Science, 7: 1-5.
2
Al-Sarraf A, Al-Bannai S, Al-Furaih S and El-Shazly M (2010): Prevalence And Factors Associated With Diabetic Retinopathy, A Multi-Centric Study In Kuwait. Alexandria Journal of Medicine, 46: 99–108.
3
Altintas AG, Gulpamuk B, Cankurtaran V, Ilhan C and Citirik M (2018): The Correlation between Changes in Biochemical Parameters and Central Macular Thickness in Patients with Non-Proliferative Diabetic Retinopathy. Medical Hypothesis, Discovery and Innovation in Ophthalmology, 7(1):10-16.
4
Asefzadeh B, Fisch BM, Parenteau CE and Cavallerano AA (2012): Macular thickness and systemic markers for diabetes in individuals with no or mild diabetic retinopathy. Clinical & Experimental Ophthalmology, 36(5):455-63.
5
Browning DJ and Fraser CM (2010): Regional patterns of sight-threatening diabetic macular edema. Am. J. Ophthalmol., 140: 117-124.
6
Cho A, Park HC, Lee YK, Shin YJ, Bae SH and Kim H (2020): Progression of Diabetic Retinopathy and Declining Renal Function in Patients with Type 2 Diabetes. Journal of Diabetes Research, 20: 36-45.
7
De Waard EA, de Jong JJ, Koster A, Savelberg HH, van Geel TA, Houben AJ, Schram MT, Dagnelie PC, van der Kallen CJ, Sep SJ and Stehouwer CD (2018): The association between diabetes status, HbA1c, diabetes duration, microvascular disease, and bone quality of the distal radius and tibia as measured with high-resolution peripheral quantitative computed tomography—The Maastricht Study. Osteoporosis International, 29(12):2725-38.
8
Hee MR, Puliafito CA, Wong C, Duker JS, Reichel E and Rutledge B. (2010): Quantitative assessment of macular edema with optical coherence tomography. Arch Ophthalmol., 113: 1019–1029.
9
Hooper P, Boucher MC, Cruess A, Dawson KG, Delpero W, Greve M, Kozousek V, Lam WC and Maberley DA (2012): Canadian Ophthalmological Society evidence-based clinical practice guidelines for the management of diabetic retinopathy. Canadian Journal of Ophthalmology, 47 (2): 1–30.
10
10. Jiang S, Franco YL, Zhou Y and Chen J (2018): Nanotechnology in retinal drug delivery. International Journal of Ophthalmology, 11(6):1038-43.
11
11. Kajiwara A, Miyagawaa H, Saruwatari J, Kita A, Sakata M and Kawata Y. (2014): Gender differences in the incidence and progression of diabetic retinopathy among Japanese patients with type 2 diabetes mellitus. Diabetes Res Clin Pract., 103: 7–10.
12
12. Klein R, Klein BE, Moss SE and Cruickshanks KJ (2010): The Wisconsin epidemiologic study of diabetic retinopathy XV. The long term incidence of macular edema. Ophthalmology, 102: 7-16.
13
13. Meena N, Meena HS and Meena MM (2019): Correlation of blood sugar and HBA1C levels in different stages of diabetic retinopathy at our tertiary care center in AJMER. International Journal of Scientific Research, 8: 216-222.
14
14. Moon SW, Kim HY, Kim SW, Oh J, Huh K and Oh IK (2011): The change of macular thickness measured by optical coherence tomography in relation to glycemic control in diabetic patients. Graefe's Arch Clin Exp Ophthalmol., 249(6): 839–848.
15
15. Moreira RO, Trujillo FR, Meirelles RM, Ellinger VC and Zagury L (2010): Use of optical coherence tomography (OCT) and indirect ophthalmoscopy in the diagnosis of macular edema in diabetic patients. Int Ophthalmol., 24: 331–336.
16
16. Pierro L, Giatsidis SM, Mantovani E and Gagliardi M (2010): Macular thickness interoperator and intraoperator reproducibility in healthy eyes using 7 optical coherence tomography instruments. Am J Ophthalmol., 150: 199–204.
17
17. Raman R, Gupta A, Krishna S, Kulothungan V and Sharma T (2012): Prevalence and risk factors for diabetic microvascular complications in newly diagnosed type II diabetes mellitus. Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetic Study (SN-DREAMS, report 27). Journal of Diabetes and its Complications, 26: 123–128.
18
18. Raman R, Vaitheeswaran K, Vinita K and Sharma T (2011): Is prevalence of retinopathy related to the age of onset of diabetes? Ophthlamic Res., 45: 36–41.
19
19. Sakata K, Funatsu H, Harino S, Noma H and Hori S (2011): Relationship of Macular Microcirculation and Retinal Thickness with Visual Acuity in Diabetic Macular Edema. Ophthalmology, 114: 2061–2069.
20
20. Shrote AP and DiAgAvAne S (2015): Clinical evaluation of correlation between diabetic retinopathy with modifiable, non-modifiable and other independent risk factors in tertiary set-up in central rural India. Journal of Clinical and Diagnostic Research, 9(10):10-16.
21
21. Sohn EH, van Dijk HW, Jiao C, Kok PHB, Jeong W, Demirkaya N, Garmager A, Wit F, Kucukevcilioglu M, van Velthoven MEJ, DeVries JH, Mullins RF, Kuehn MH, Schlingemann RO, Sonka M, Verbraak FD and Abràmoff MD (2016): Retinal neurodegeneration may precede microvascular changes characteristic of diabetic retinopathy in diabetes mellitus. Proc Natl Acad Sci USA., 113: 2655-2664.
22
22. Subrayan V, Chang KM, Loo AV and Loke MF (2015): Proteomic Analysis of Saliva From Diabetic Patients in Different Stages of Diabetic Retinopathy. Investigative Ophthalmology & Visual Science, 56(7):5202-6.
23
23. Verma R (2010): Diabetic retinopathy: challenges and future directions. American Journal of Ophthalmology, 141(3):539-41.
24
24. Wani JS, Nasti AR, Ashai M, Keng M, Qureshi T and Rashid S (2010): Incidence of maculopathy in non-proliferative and proliferative diabetic retinopathy. JK-Practitioner, 10: 275-278.
25
25. Weitzman S, Maislos M, Bodner-Fishman B and Rosen S (2010): Association of diabetic retinopathy, ischemic heart disease, and albuminuria with diabetic treatment in type 2 diabetic patients. Acta Diabetologica., 34(4):275-9.
26
26. Yang JY, Kim NK, Lee YJ, Noh JH, Kim DJ and Ko KS. (2013): Prevalence and factors associated with diabetic retinopathy in a Korean adult population. Diabetes Res Clin Pract., 102(3): 218–24.
27
27. Yeung L, Sun CC, Ku WC, Chuang LH, Chen CH and Huang BY. (2010): Associations between chronic glycosylated haemoglogin (HbA1c) level and macular volume in diabetes patients without macular oedema. Acta Ophthalmol., 88: 753-758.
28
ORIGINAL_ARTICLE
OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY CHANGES IN MYOPIC CHOROIDAL NEOVASCULARIZATION BEFORE AND AFTER INTRAVITREAL RANIBIZUMAB INJECTION
Background: Progressive and excessive elongation of the globe may lead to many complication one of them is myopic choroidal neovascularization which can be diagnosed with FFA, OCT and OCTA and treated with intravitreal injection of Ranibizumab. Objective: To investigate morphological changes in myopic choroidal neovascularization (mCNV) using optical coherence tomography-angiography (OCT-A) after treatment with ranibizumab. Patients and methods: This study is prospective cross sectional interventional study on 50 high myopic eyes with naive mCNV. All patients were imaged at baseline with color pictures, FFA, OCT and OCT-A at baseline and after treatment. Results: There was a significant improvement of best corrected visual acuity and decrease in central foveal thickness after intravitreal injection of Ranibizumab. Optical coherence tomography angiography can detect myopic choroidal neovascularization with high sensitivity with different patterns (sea-fan, medusa and tree-in-bud) but after treatment this abnormal vascularization may not be detected in some cases and lower number of injection needed in tree-in-bud pattern. Conclusion: OCTA can be used in diagnosis of mCNV with high sensitivity (88 %) with three patterns tree-in-bud, medusa and sea-fan with tree-in-bud represents the most common pattern of mCNV. Ranibizumab intravitreal injection is an effective treatment in mCNV using 1+PRN protocol with significant improvement of BCVA and decrease in CFT. Unlike CNV due to AMD mCNV may regress with single or double injection with improvement of BCVA and larger number of injection is usually needed in older age patients and with mature patterns (medusa and sea-fan) of mCNV.
https://amj.journals.ekb.eg/article_158465_585e90b68e93883c66d2910752bace51.pdf
2021-04-01
1169
1186
10.21608/amj.2021.158465
Intravitreal Ranibizumab Injection
Optical coherence tomography angiography
Myopia
Mohamed
Medhat Sakhsoukh
knight_2210@yahoo.com
1
Ophthalmology Department, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Ahmed
M. Youssef
2
Ophthalmology Department, Faculty of Medicine, Al-Azhar University
AUTHOR
Abd El-Ghany
Ibrahim Abd El-Ghany
3
Ophthalmology Department, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Augsburger M, Sarra G and Imesch P (2019): Treat and extend versus pro re nata regimens of ranibizumab and aflibercept in neovascular age-related macular degeneration: a comparative study. Graefes Arch Clin Exp Ophthalmol., 257: 1889–95.
2
Bagchi A, Schwartz R, Hykin P and Sivaprasad S (2019): Diagnostic algorithm utilizing multimodal imaging including optical coherence tomography angiography for the detection of myopic choroidal neovascularization. Eye, 33:1111–8.
3
Bruyère E, Miere A, Cohen SY, Martiano D, Sikorav A, Popeanga A, Semoun O, Querques G and Souied EH (2017): Neovascularization secondary to high myopia imaged by optical coherence tomography angiography. Retina, 37:2095–101.
4
Cennamo G, Amoroso F, Schiemer S, Velotti N, Alfieri M and de Crecchio G (2019): Optical coherence tomography angiography in myopic choroidal neovascularization after intravitreal ranibizumab. Eur J Ophthalmol., 29(2):239-43.
5
Cha DM, Kim TW, Heo JW, Woo SJ, Park KH, Yu HG and Chung H (2014): Comparison of 1-year therapeutic effect of ranibizumab and bevacizumab for myopic choroidal neovascularization: a retrospective, multicenter, comparative study. BMC Ophthalmol., 21(4);14:69.
6
Cheng Y, Li Y, Huang X and Qu Y (2019): Application of optical coherence tomography angiography to assess anti-vascular endothelial growth factor therapy in myopic choroidal neovascularization. Retina, 39(4):712-8.
7
Cohen SY, Tabary S, El Ameen A, Mrejen S, Quentel G and Giocanti-Auregan A (2019): Vascular remodeling of choroidal neovascularization in older myopic patients treated with ranibizumab. Graefes Arch Clin Exp Ophthalmol., 257: 485–93.
8
Fedra K, Leila E and Ahmed C (2015): Current and emerging treatment options for myopic choroidal neovascularization. Clinical Ophthalmology, 9:733–44.
9
Giorno P, Iacono P, Scarinci F, Di Renzo A, Varano M and Parravano M (2020): Microvasculature Changes of Myopic Choroidal Neovascularization and the Predictive Value of Feeder Vessel Disappearance after Ranibizumab Treatment Revealed Using Optical Coherence Tomography Angiography. Ophthalmologica, 243:263-70.
10
10. Guichard MM, Peters G, Tuerksever C, Pruente C and Hatz K (2020): Outcome Predictors of SD-OCT-Driven Intravitreal Ranibizumab in Choroidal Neovascularization due to Myopia. Ophthalmologica, 243(2):154-62
11
11. Introini U, Casalino G, Querques G, Gimeno AT, Scotti F and Bandello F (2012): Spectral-domain OCT in anti-VEGF treatment of myopic choroidal neovascularization. Eye (Lond), 26(7):976-82.
12
12. Karagiannis D, Kontadakis GA, Kaprinis K, Giarmoukakis A, Georgalas I, Parikakis EA and Tsilimbaris MK (2017): Treatment of myopic choroidal neovascularization with intravitreal ranibizumab injections: the role of age. Clin Ophthalmol.,11:1197-201.
13
13. Korol A, Kustryn T, Zadorozhnyy O, Pasyechnikova N and Kozak I (2020): Comparison of Efficacy of Intravitreal Ranibizumab and Aflibercept in Eyes with Myopic Choroidal Neovascularization: 24-Month Follow-Up. Journal of Ocular Pharmacology and Therapeutics: the Official Journal of the Association for Ocular Pharmacology and Therapeutics, 36(2), 122-5.
14
14. Lee DH, Kang HG, Lee SC and Kim M (2018): Features of optical coherence tomography predictive of choroidal neovascularisation treatment response in pathological myopia in association with fluorescein angiography. Br J Ophthalmol., 102(2):238-42.
15
15. Leveziel N, Caillaux V, Bastuji-Garin S, Zmuda M and Souied EH (2013): Angiographic and optical coherence tomography characteristics of recent myopic choroidal neovascularization. Am J Ophthalmol., 155(5):913–9.
16
16. Miyata M, Ooto S, Hata M, Yamashiro K, Tamura H, Akagi-Kurashige Y, Nakanishi H, Ueda-Arakawa N, Takahashi A, Kuroda Y, Wakazono T, Yoshikawa M and Yoshimura N (2016): Detection of myopic choroidal neovascularization using optical coherence tomography angiography. Am J Ophthalmol., 165:108–14.
17
17. Mohsen TA and Kishk HM (2019): Optical coherence tomography angiography in the diagnosis of choroidal neovascular membrane. J Egypt Ophthalmol Soc., 112:108-118.
18
18. Ohno-Matsui K, Lai TY, Lai CC and Cheung CM (2016): Updates of pathologic myopia. Prog Retin Eye Res., 2016;52:156–87.
19
19. Pasyechnikova NV, Naumenko VO, Korol AR, Zadorozhnyy OS, Kustryn TB and Henrich PB (2015): Intravitreal ranibizumab for the treatment of choroidal neovascularizations associated with pathologic myopia: a prospective study. Ophthalmologica, 233(1):2-7.
20
20. Querques L, Giuffrè C, Corvi F, Zucchiatti I, Carnevali A, De Vitis LA, Querques G and Bandello F (2017): Optical coherence tomography angiography of myopic choroidal neovascularisation. Br J Ophthalmol., 101(5):609–15.
21
21. Schwartz DM, Fingler J, Kim DY, Zawadzki RJ, Morse LS, Park SS, Fraser SE and Werner JS (2014): Phase-variance optical coherence tomography: a technique for noninvasive angiography. Ophthalmology, 121:180–7.
22
22. Tan CS and Sadda SR (2017): Anti-vascular endothelial growth factor therapy for the treatment of myopic choroidal neovascularization. Clin Ophthalmol., 11:1741-6.
23
23. Wang R, Liang Z and Liu X (2019): Diagnostic accuracy of optical coherence tomography angiography for choroidal neovascularization: a systematic review and meta-analysis. BMC Ophthalmol; 19(1):162-71.
24
24. Zhang Y, Han Q, Ru Y, Bo Q and Wei RH (2015): Anti-VEGF treatment for myopic choroid neovascularization: from molecular characterization to update on clinical application. Drug Des Devel Ther., 9:3413-21.
25
ORIGINAL_ARTICLE
SUBFOVEAL CHOROIDAL THICKNESS CHANGES IN DIABETIC MACULAR EDEMA WITH CYSTIC CHANGES BY USING SPECTRAL DOMAIN-OPTICAL COHERENCE TOMOGRAPHY
Background: Diabetic macular edema (DME) results from breakdown of retinal vasculature integrity and hemodynamic abnormalities. Choroidal thickness is an important metric for the blood flow and choroidal health. Objective: To correlate Subfoveal Choroidal Thickness (SFCT) with central macular thickness (CMT) in DME with and without cystic changes by using spectral domain optical coherence tomography (SD-OCT). Patients and Methods: A prospective study was conducted on 120 eyes of 68 diabetic patients, divided according to OCT macula into three equal groups: Group A: Diabetic patients with normal CMT, Group B: Have non-cystic diabetic macular edema and Group C: Have cystic diabetic macular edema. Measurements of CMT and SFCT by using spectral domain optical coherence tomography (SD-OCT). This study was conducted at Ophthalmology Department, Bahteem hospital for specialized surgery, Health Insurance, during the period from August 2018 to February 2020. Results: Sixty-eight patients had a mean age of 54.96 ± 8.36 years. The mean SFCT have insignificant correlation could be demonstrated between SFCT and CMT (r= –0.323, P= 0.45), in group B, a positive correlation was observed (r= 0.614, P=0.027), while in group C a negative correlation with CMT (r= –0.875, P=0.02). There was insignificant correlation could be demonstrated between SFCT and BCVA (LogMAR) in all groups: in group A (r= –0.251, P= 0.35), in the group B (r= –0.318, P=0.15), and in group C (r= –0.735, P=0.23). Conclusion: Mean SFCT decrease with cystic changes in DME patients.
https://amj.journals.ekb.eg/article_158466_fb44ed243e2bad0d754665f476ba691b.pdf
2021-04-01
1187
1198
10.21608/amj.2021.158466
subfoveal choroidal thickness
central macular thickness
diabetic macular edema and spectral domain optical coherence tomography
abdelghany
abdelghany
abdelghanyahmed936@gmail.com
1
AL-azhar university
LEAD_AUTHOR
REFERENCES
1
Al-Nashar H (2017): Changes in subfoveal choroidal thickness in diabetic macular edema. Egypt Retina J, 41:235–243.
2
Barteselli G, Chhablani J and El-Emam S (2012): Choroidal volume variations with age, axial length, and sex in healthy subjects: a three-dimensional analysis. Ophthalmology, 119: 2572–2578.
3
Dalia M, Adel N, Amr A and Moataz H (2018): Correlation between choroidal thickness and central macular thickness measured by optical coherence tomography in non-proliferative diabetic retinopathy. Delta Journal of Ophthalmology, 19:201–204.
4
Esmaeelpour M, Brunner S, Ansari-Shahrezaei S, Nemetz S, Povazay B, Kajic V, Drexler W and Binder S (2012): Choroidal thinning in diabetes type 1 detected by 3-dimensional 1060nm optical coherence tomography. Invest Ophthalmol Vis Sci, 53:6803–6809.
5
Falcao M, Gonçalvez N and Freitas-Costa P (2014): Choroidal and macular thickness changes induced by cataract surgery. Clin Ophthalmol, 8: 55–60.
6
Fong A, Li K and Wong D (2011): Choroidal evaluation using enhanced depth imaging spectral-domain optical coherence tomography in Vogt-Koyanagi-Harada disease. Retina, 31:502–509.
7
Kase S, Endo H, Yokoi M, Kotani M, Katous S and Takasi M (2016): Choroidal thickness in diabetic retinopathy in relation to long-term systemic treatments for diabetes mellitus. Eur J Ophthalmol, 26(2): 158–162.
8
Kim J, Lee D, Joe S, Kim J and Yoon H. (2013): Changes in choroidal thickness in relation to the severity of retinopathy and macular edema in type 2 diabetic patients. Invest Ophthalmol Vis Sci, 54(5): 3378-3384.
9
Lee H, Lim J and Shin M (2013): Comparison of choroidal Thickness in Patients with Diabetes by Spectral-domain Optical Coherence Tomography. Korean J Ophthalmol, 27(6):433-439.
10
Mansour M and Hegazy H (2018): Choroidal Thickness in Patients with Diabetic Macular Edema and its Correlation to Macular Thickness and Vision. The EJHM, 73 (8), 7293-7299.
11
Querques G, Querques G, Lattanzio R, Querques L, Del Turco C, Forte R and Pierro L (2012): Enhanced depth imaging optical coherence tomography in type 2 diabetes. Investigative Ophthalmology and Visual Science, 53.10: 6017-6024.
12
Shahzad R, Rehman S, Zafar S and Kausar F and Masroor F (2018): Choroidal thickness changes following cataract surgery using swept source optical coherence tomography. Can. J Ophthalmol, 53(1):60-64.
13
Ünsal E, Eltutar K, Zirtiloğlu S, Dinçer N, Özdoğan Erkul S and Güngel H. (2014): Choroidal thickness in patients with diabetic retinopathy. Clin Ophthalmol, 8: 637-642.
14
Vujosevic S, Martini F, Cavarzeran F, Pilotto E and Midena E (2012): Macular and peripapillary choroidal thickness in diabetic patients. Retina, 32.9: 1781-1790.
15
Xu J, Du K, Shao L, Chen C and Zhou J (2013): Subfoveal choroidal thickness in diabetes and diabetic retinopathy. Ophthalmology, 120: 2023-2028.
16
ORIGINAL_ARTICLE
CONSERVATIVE MANAGEMENT OF EXTRA DURAL HEMORRHAGE
Background: Extra Dural hematoma (EDH) is a blood clot that develops between the dura mater and the skull, found in 2.5% to 5% of head injured patients. Patient with small EDH may be treated conservatively through close observation is advised, yet sudden neurological deterioration may occur. Objective: To review the literature and to evaluate safety and efficacy of conservative management of extradural hematoma (EDH) in trauma patients with selected criteria. Patients and methods: This was a hospital based study which was done at the Department of neurosurgery at Al-Azhar University Hospitals and Luxor International Hospital during the period from September 2017 to September 2019. It was conducted on 15 patients with extradural hemorrhage who fulfilling the criteria (volume<30ml, thickness8), with exclusion of patients with extradural hematoma who needs surgical evacuation, patients with bleeding tendency and patients with temporal or occipital extradural hematoma. All cases records were reviewed and the pertinent data (clinical history, age, sex, mode of injury) analyzed. The patients were subjected to conservative treatment through Neurosurgery ICU admission and follow up CT Brain done at 6 hours, 12 hours, 24 hours and 48 hour after admission. Patients were given Analgesics, Antibiotics and Anti epleptics if needed .All patients stayed at ICU for 3 days until they had good conscious level then transferred to Neurosurgery ward for one day then discharged to home. Final CT Brain was done for all patients before discharge to ensure resolution of hemorrhage. Follow up of Patients continued for one month after discharge at clinic. Results: In our study of 15 patients, the conservative management of extradural hematoma continued in all patients (100%). This means that conservative management increased, and the mentioned protocol of conservative management gives successful results in the treatment of EDH. Conclusion: The conservative management gives successful results so we can avoid surgical evacuation in patients with selected criteria.
https://amj.journals.ekb.eg/article_160385_964f186897a17b17db65d73346dd0d10.pdf
2021-04-01
1199
1208
10.21608/amj.2021.160385
Extradural
Conservative
Hematoma
Amr
Ali El-Saghir Zedan
amr.elsaghir2014@gmail.com
1
Department of Neurosurgery, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
El-Sayed
Abd El-Rahman El-Mor
2
Department of Neurosurgery, Faculty of Medicine, Al-Azhar University
AUTHOR
Alaa
Rashad Ibrahim Hassan
3
Department of Neurosurgery, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Bhau K, Bhau S, Dhar S and Kachroo S. (2012): Traumatic extradural hematoma – Role of non-surgical management and reasons for conversion. Indian Journal of Surgery, 72(2):124-9
2
Chen TY, Wong CW, Chang CN, Lui TN, Cheng WC, Tsai MD and Lin TK. (2010): The expectant treatment of "asymptomatic" supratentorial epidural hematomas. Neurosurgery, 32(2):176-9.
3
Dolgun H, Türkoğlu E and Kertmen H. (2011): Rapid resolution of acute epidural hematoma: case report and review of the literature. Ulus Travma Acil Cerrahi Derg., 17(3):283–85.
4
Dubey A, Pillai SV and Sastry KV. (2011): Does volume of extradural hematoma influence management strategy outcome? Neurology India, 52:443-445.
5
Hamilton M and Wallace C. (2010): Nonoperative management of acute epidural hematoma diagnosed by CT. The neuroradiologist's role. AJNR Am J Neuroradiol., 13:853-859.
6
Huang AP, Huang SJ and Hong WC. (2012): Minimally invasive surgery for acute noncomplicated epidural hematoma: an innovative endoscopic-assisted method. J Trauma Acute Care Surg., 73(3):774–77.
7
Marshall LF, Marshall SB, Klauber MR. and Clark MV. (2011): A new classification of head injury based on computed tomography. J Neurosurg., 75:S14–S20.
8
Maugeri R, Anderson DG, Graziano F, Meccio F, Visocchi M and Iacopino DG. (2015): Conservative vs. Surgical Management of Post-Traumatic Epidural Hematoma: A Case and Review of Literature. Am J Case Rep., 16:811-817.
9
Miller JD and Statham PF. (2012): Surgical management of traumatic intracranial hematomas. In: Schmidek HH, Sweet WH, eds. Operative neurosurgical techniques, 3rd edn., Philadelphia: WB Saunders Company, Pp. 73-80.
10
Pang D, Horton JA and Herron JM. (2010): Nonsurgical management of extradural hematomas in children. J Neurosurg, 59(6):958–71.
11
Skadorwa T, Zygańska E, Eibl M and Ciszek B. (2013): Distinct strategies in the treatment of epidural hematoma in children: clinical considerations. Pediatr Neurosurg., 49(3):166–71.
12
Tascu A, Pascal C, Iencean SM and Gorgan MR (2014): Aggressive or conservative management in extradural hematomas in children: A challenging neurosurgical choice. Roneuro, 21: 384-393.
13
Tuncer R, Kazan S and Uçar T. (2010): Conservative management of epidural haematomas: prospective study of 15 cases. Acta Neurochir (Wien)., 121:48–52.
14
ORIGINAL_ARTICLE
TYMPANOMETRIC CHANGES IN GASTRO ESOPHAGEAL REFLUX DISEASE PATIENTS
Background: Gastroesophageal reflux (GERD), in particular extra-esophageal reflux, has been associated with a variety of upper aerodigestive tract symptoms or diseases, such as sinusitis and otitis. Many studies showed the role of reflux in chronic otitis media in children. Objective: To survey tympanometric changes in gastro esophageal reflux disease patients by tympanometry. Patients and methods: Prospective cross-sectional study included 40 cases with GERD and 20 persons without GERD as a control group. All cases were subjected to history taking and ENT examination. Moreover, tympanometry was performed for all cases. Results: The mean age of the included cases were 32.7 years. Patients were 25 females (62.5%) and 15 males (37.5%). The mean value of GERD score was 11.18 (range, 10 – 12). The four tympanogram types did not differ in age and gender, all the cases with type B and C tympanometry in the right ear was with GERD score of 11 and 12. Conclusion: GERD may induce type B and C tympanometric changes, suggestive of eustachian tube dysfunction.
https://amj.journals.ekb.eg/article_158467_8ba67e253145cad47d5046b4a7112bbf.pdf
2021-04-01
1209
1216
10.21608/amj.2021.158467
Tympanomety
Gastroesophageal reflux disease
Ahmed
Mostafa Abd El-Moniem Ali
ahmed_mostafa19883@yahoo.com
1
Department of Otorhinolaryngology Faculty of Medicine, Al-Azhar University, Egypt
LEAD_AUTHOR
Ahmed
Mohamed Ahmed
2
Department of Otorhinolaryngology Faculty of Medicine, Al-Azhar University, Egypt
AUTHOR
Mostafa
Shams El-Din Abd El-Haliem
3
Department of Otorhinolaryngology Faculty of Medicine, Al-Azhar University, Egypt
AUTHOR
REFERENCES
1
Brunworth JD, Mahboubi H, Garg R, Johnson B, Brandon B and Djalilian HR. (2014): Nasopharyngeal acid reflux and Eustachian tube dysfunction in adults. Annals of Otology, Rhinology & Laryngology, 123(6): 415-419.
2
Chuang TW, Chen SC and Chen KT. (2017): Current status of gastroesophageal reflux disease: diagnosis and treatment. Acta gastro-enterologica Belgica, 80(3): 396-404.
3
Dent J, Vakil N, Jones R, Bytzer P, Schöning U, Halling K, Junghard O and Lind T. (2010): Accuracy of the diagnosis of GORD by questionnaire, physicians and a trial of proton pump inhibitor treatment: the Diamond Study. Gut, 59(6): 714–721.
4
Doğru M, Kuran G, Haytoğlu S, Dengiz R and Arıkan OK. (2015): Role of laryngopharyngeal reflux in the pathogenesis of otitis media with effusion. J Int Adv Otol., 11(1): 66-71.
5
Górecka-Tuteja A, Jastrzębska I, Składzień J and Fyderek K. (2016): Laryngopharyngeal reflux in children with chronic otitis media with effusion. Journal of Neurogastroenterology and Motility, 22(3): 452–458.
6
Gyawali CP and Fass R. (2018): Management of gastroesophageal reflux disease. Gastroenterology, 154(2): 302-318.
7
Kataoka Y, Maeda Y, Fujisawa I, Sugaya A, Kariya S and Nishizaki K (2019): Clinical evaluation of 1,000-Hz tympanometry for the diagnosis of exudative otitis media in Japanese infants. Journal of Otolaryngology of Japan, 112(7): 960-968.
8
Katz J, Chasin M, English K, Hood LJ, Tillery KL (2015): Handbook of clinical audiology. 7th ed. Pbl. Philadelphia: Wolters Kluwer Health. p.137.
9
Kavitt RT, Lal P, Yuksel ES, Ates F, Slaughter JC, Garrett CG, Higginbotham T and Vaezi MF. (2017): Esophageal mucosal impedance pattern is distinct in patients with extraesophageal reflux symptoms and pathologic acid reflux. Journal of Voice, 31(3): 347-351.
10
10. Libwea JN, Kobela M, Ndombo PK, Syrjänen RK, Huhtala H, Fointama N, Koulla-Shiro S, Nohynek H, Nuorti JP and Palmu AA. (2018): The prevalence of otitis media in 2–3 year old Cameroonian children estimated by tympanometry. International Journal of Pediatric Otorhinolaryngology, 115: 181-187.
11
11. Sandhu DS and Fass R (2018): Current trends in the management of gastroesophageal reflux disease. Gut and Liver, 12(1): 7-12.
12
12. Sone M, Kato T and Nakashima T (2013): Current concepts of otitis media in adults as a reflux-related disease. Otology & Neurotology, 34(6): 1013-1017.
13
13. Yüksel F, Doğan M, Karataş D, Yüce S, Şentürk M and Külahli I. (2013): Clinical presentation of gastroesophageal reflux disease in children with chronic otitis media with effusion. The Journal of Craniofacial Surgery, 24(2): 380–383.
14
14. Zerbib F and Dulery C (2017): Facts and Fantasies on Extraesophageal Reflux. Journal of Clinical Gastroenterology, 51(9): 769-776.
15
ORIGINAL_ARTICLE
EVALUATION OF TRANS-NASAL ENDOSCOPIC CROSS-OVER FLAP TECHNIQUE IN THE REPAIR OF CHOANAL ATRESIA
Background: Choanal atresia (CA) is a widely recognized craniofacial disorder characterized by the obliteration of the posterior nasal opening, due to the imperforation of the oronasal membrane and overgrowth of the horizontal and vertical process of the palatine bone during weeks 4-11 of the gestation process. Objective: To evaluate the efficacy of trans-nasal endoscopic cross-over flap technique in the repair of choanal atresia with long-term follow-up. Patients and methods: This study was conducted on 20 choanal atresia cases that were managed by the endoscopic transnasal approach using cross-over flap technique at the Department of Otorhinolaryngology, Bab EL-Sharia and AL-Hussein Hospitals, Faculty of Medicine, AL-Azhar University from December 2018 to January 2020. Results: The study included 20 cases: 13 females and 7 males, 5 cases were bilateral, 15 cases were unilateral. Four cases were bony atretic plate, and 16 cases were mixed atretic plate. Four cases (20%) needed post-operative revision repair due to restenosis of the choana. Revision was more common in bilateral cases than unilateral cases and in bony type than mixed type. Also, revision was common in patients with associated malformations, and in patients done before 10 days. Conclusion: Transnasal endoscopic surgery using cross-over flap technique is one of the best choices in the management of the choanal atresia. Endoscopy and CT are the methods of choice for diagnosis.
https://amj.journals.ekb.eg/article_158468_8c3bc00922a3155fadfa211a146e42ed.pdf
2021-04-01
1217
1230
10.21608/amj.2021.158468
Trans-nasal endoscopic
Cross-over flap technique
Repair of choanal atresia
Mohamed
Ahmed El-Saeed Ali
moha.mg160@gmail.com
1
Department of Otorhinolaryngology, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Wafaey
Abdul Rasol Mohamed
2
Department of Otorhinolaryngology, Faculty of Medicine, Al-Azhar University
AUTHOR
Marwan
Ahmed Ibrahim
3
Department of Otorhinolaryngology, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
El-Ahl MA and El-Anwar MW. (2012): Stentless endoscopic transnasal repair of bilateral choanal atresia starting with resection of vomer. Int J Pediatric Otorhinolaryngology, 76:1002-6.
2
Flint PW, Haughey BH, Lund VJ, Niparko JK and Richardson MA. (2010): Cummings Otolaryngology Head and Neck Surgery. 5th. 1-2. Pbl. Philadelphia: Elsevier, Pp. 2694-2695.
3
Hengerer AS, Brickman TM and Jeyakumar A. (2012): Choanal atresia: embryologic analysis and evolution of treatment, a 30-year experience. Laryngoscope, 118(5):862–866.
4
Ibrahim AA, EA Magdy and MH Hassab. (2010): Endoscopic Choanoplasty without Stenting for Congenital Choanal Atresia Repair. Internation Journal of Pediatric Otorhinolaryngology, 74: 144-150.
5
Kim H, Park JH, Chung H, Han DH, Kim DY and Lee CH. (2012): Clinical features and surgical outcomes of congenital choanal atresia: factors influencing success from 20-year review in an institute. Am J Otolaryngol., 33:308-12.
6
Newman JR, Harmon P, Shirley WP, Hill JS, Woolley AL and Wiatrak BJ. (2013): Operative management of choanal atresia: a 15-year experience. JAMA Otolaryngol Head Neck Surg., 139:71-5.
7
Ramsden JD, Campisi P and Forte V. (2011): Choanal atresia and choanal stenosis. Otolaryngol Clin North Am., 42: 339---52.
8
Saafan ME. (2013): Endoscopic management of congenital bilateral Posterior choanal atresia: value of using stents. Eur Arch Otorhinolaryngol., 270:129-34.
9
Saleem AF, Ariff S, Aslam N and Ikram M. (2010): Congenital bilateral choanal atresia. J Pak Med Assoc., 60: 869-72.
10
10. Velegrakis S, Mantsopoulos K, Iro H and Zenk J. (2013): Long-term outcomes of endonasal surgery for choanal atresia: 28 years’ experience in an academic medical centre. Eur Arch Otorhinolaryngology, 270:113-6.
11
11. Yantis M, Mukerji S and Mukerji SD. (2014): Diagnosis, Management, and Association with CHARGE Syndrome. J Pak Med Assoc., 13: 53-58.
12
12. Zanetta A, Rodriguez H, Quiroga V, Cuestas G and Tiscornia C. (2012): Congenital nasal obstruction due to choanal atresia. Arch Argent Pediatr., 110:152---5.
13
13. Zuckerman JD, Zapata S and Sobol SE. (2010): Single-stage choanal atresia repair in the neonate. Arch Otolaryngol Head Neck Surg., 134: 1090–1093.
14
ORIGINAL_ARTICLE
ASSESSMENT OF MYOCARDIAL LEFT VENTRICULAR FUNCTIONS USING 2D SPECKLE TRACKING IN NORMAL PREGNANT FEMALES IN COMPARISON TO NORMAL NON-PREGNANT FEMALES
Background: While the hemodynamic changes occurring during pregnancy have been reasonably well characterized, the impact of pregnancy on cardiac contractile function has not been fully elucidated. Objective: To assess myocardial left ventricular functions in normal pregnant females using 2D speckle tracking echocardiography in comparison to non-pregnant adult females. Patient and methods: The study was a prospective observational study that was carried out at Cardiology Department, Al-Azhar University Hospitals throughout the period between August 2016 and July 2019. The study involved 15 healthy control unpregnant women in addition to 45 pregnant ladies (15 in each trimester). All the included subjects underwent thorough clinical examination, routine laboratory investigations, resting electrocardiogram (ECG), resting conventional trans-thoracic echocardiography, and speckle tracking echocardiography. Results: The two groups showed no-significant difference between them in accordance with age, systolic, and diastolic blood pressure. Left ventricular (LV) internal dimensions at end diastole (LVEDD) had significantly higher values in the third trimester cases. Moreover, the control group had the lowest value among the study groups. No significant changes were detected in LVESD. LVEDV and LVESV showed a significant increase during pregnancy. All readings were significantly higher than controls. The two groups showed no significant difference between them in accordance with ejection fraction. Global longitudinal strain was significantly different between the study groups. It decreases from 20.73% in the first trimester down to 18.33 and 16.67% in the second and third trimesters respectively. Besides, two-, three-, and four-chamber strain showed the same changes as well. Conclusion: Cardiac adaptation throughout normal pregnancy is characterized by LV longitudinal thickening reduction.
https://amj.journals.ekb.eg/article_158469_44f11465a6f27ae5b8133ddc692ceff0.pdf
2021-04-01
1231
1242
10.21608/amj.2021.158469
Speckle tracking echocardiography
Left Ventricular Changes
Pregnancy
LV Longitudinal strain
Mohammad
El-Sayed Nofal
mohammad_nofal33@gmail.com
1
Department of Cardiology, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Mohey
El-Din Mansour Al-Abbady
2
Department of Cardiology, Faculty of Medicine, Al-Azhar University
AUTHOR
Saad
Ebrahim Deef-Allah EL-Zoghby
3
Department of Cardiology, Faculty of Medicine, Al-Azhar University
AUTHOR
Ahmed
Mohammed Salah El-Din Ahmed
4
Department of Cardiology, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Collier P, Phelan D and Klein A. (2017): A test in context: myocardial strain measured by speckle-tracking echocardiography. Journal of the American College of Cardiology, 69(8):1043-56.
2
Cong J, Fan T, Yang X, Squires JW, Cheng G and Zhang L. (2015): Structural and functional changes in maternal left ventricle during pregnancy: a three-dimensional speckle-tracking echocardiography study. Cardiovascular Ultrasound, 13(1): 6-11.
3
D’Ascenzi F, Caselli S, Solari M, Pelliccia A, Cameli M and Focardi M. (2016): Novel echocardiographic techniques for the evaluation of athletes’ heart: A focus on speckle-tracking echocardiography. European Journal of Preventive Cardiology, 23(4):437-46.
4
Estensen M, Beitnes J, Grindheim G, Aaberge L, Smiseth O and Henriksen T. (2013): Altered maternal left ventricular contractility and function during normal pregnancy. Ultrasound in Obstetrics & Gynecology, 41(6):659-66.
5
Geyer H, Caracciolo G, Abe H, Wilansky S, Carerj S and Gentile F. (2010): Assessment of myocardial mechanics using speckle tracking echocardiography: fundamentals and clinical applications. Journal of the American Society of Echocardiography, 23(4):351-69.
6
Hall ME, George EM and Grangerb JP. (2011): The Heart during Pregnancy. Rev Esp Cardiol., 64(11): 1045–1050.
7
Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A and Ernande L. (2015): Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. European Heart Journal-Cardiovascular Imaging, 16(3):233-71.
8
Longobardo L, Suma V, Jain R, Carerj S, Zito C and Zwicke DL. (2017): Role of two-dimensional speckle-tracking echocardiography strain in the assessment of right ventricular systolic function and comparison with conventional parameters. Journal of the American Society of Echocardiography, 30(10):937-46.
9
Mirea O, Duchenne J and Voigt JU. (2016): Recent advances in echocardiography: strain and strain rate imaging. F1000Research, 5: 787-91.
10
Mor-Avi V, Lang RM, Badano LP, Belohlavek M, Cardim NM and Derumeaux G. (2011): Current and evolving echocardiographic techniques for the quantitative evaluation of cardiac mechanics: ASE/EAE consensus statement on methodology and indications endorsed by the Japanese Society of Echocardiography. European Journal of Echocardiography, 12(3):167-205.
11
Pfeffer MA, Shah AM and Borlaug BA. (2019): Heart Failure with Preserved Ejection Fraction in Perspective. Circulation Research, 124:1598–1617
12
Savu O, Jurcuţ R, Giuşcă S, Van Mieghem T, Gussi I and Popescu BA. (2012): Morphological and functional adaptation of the maternal heart during pregnancy. Circulation: Cardiovascular Imaging, 5(3):289-97.
13
Sengupta SP, Bansal M, Hofstra L, Sengupta PP and Narula J. (2017): Gestational changes in left ventricular myocardial contractile function: new insights from two-dimensional speckle tracking echocardiography. The International Journal of Cardiovascular Imaging, 33(1):69-82.
14
Sengupta SP, Caracciolo G, Thompson C, Abe H and Sengupta PP. (2013): Early impairment of left ventricular function in patients with systemic hypertension: new insights with 2-dimensional speckle tracking echocardiography. Indian Heart Journal, 65(1):48-52.
15
Sengupta SP, Jaju R, Nugurwar A, Caracciolo G and Sengupta PP. (2012): Left ventricular myocardial performance assessed by 2-dimensional speckle tracking echocardiography in patients with sickle cell crisis. Indian Heart Journal, 64(6):553-8.
16
Zacher J, Blome I, Schenk A and Gorr E. (2020): Cardiac adaptations in elite female football-and volleyball-athletes do not impact left ventricular global strain values: a speckle tracking echocardiography study. The International Journal of Cardiovascular Imaging, 2020:1-12.
17
ORIGINAL_ARTICLE
PREDICTING UNSUCCESSFUL ELECTRICAL CARDIOVERSION FOR ACUTE ATRIAL FIBRILLATION (FROM THE AF-CVS SCORE)
Background: Despite good progress in the management of patients with atrial fibrillation, this arrhythmia remains one of the major causes of stroke, heart failure, sudden death, and cardiovascular morbidity in the world. Furthermore, the number of patients with AF is predicted to rise steeply in the coming years. Objective: To validate a clinical risk stratification tool (AF-CVS score) for identifying patients at high risk for unsuccessful outcome after electrical cardio-version for acute AF. Patients and Methods: The present study was a cohort study conducted between March 2018 and March 2019. We enrolled 100 consecutive patients admitted at Al-Hussain University, Al-Azhar University, presented with acute onset atrial fibrillation (AF) requiring direct current electro-version (DC electro-version). An informed consent obtained from every patient after full explanation of the research objectives and the purpose of this study. Results: A binary logistic regression was run to evaluate AFCVS score as a predictor for the recurrence among the patients in the study population. There was homoscedasticity and normality of the residuals. The binary logistic regression model was statistically significant (χ2= 28.01, df 1, p= < 0.001) with insignificant Hosmer and Lemeshow test (p 0.114). AFCVS score was a significant predictor for the AF recurrence in the studied population (p < 0.001). The diagnostic efficacy and cut off point of AFCVS for prediction of AF recurrence in the studied sample was determined using a receiver operating characteristic curve (ROC) and the AFCVS score cut off point was 5 . The score showed 83.8% sensitivity, 68.3% Specificity, 87.8% negative predictive value, 60.8% positive predictive value and 74% accuracy. Conclusion: Atrial fibrillation provokes important economic burden along with significant morbidity and mortality. Our study showed that the risk of unsuccessful outcome of ECV can be predicted using five simple clinical variables: A-- Age. F-- not First time AF. C-- Cardiac failure. V-- Vascular disease. S-- Short duration from previous AF (within 1 month before electrical cardio-version (ECV)).
https://amj.journals.ekb.eg/article_158471_2fff79f45c707f0e3a98828e1a55a78e.pdf
2021-04-01
1243
1256
10.21608/amj.2021.158471
Electrical Cardioversion
Acute Atrial Fibrillation
AF-CVS score
Hamdi
Sobhi Ramadan El-Adawi
hamdiramadan_99@gmail.com
1
Department of Cardiology, Faculty of Medicine Al-Azhar University
LEAD_AUTHOR
Abd El-Halem
Mohamed Abo El-Magd
2
Department of Cardiology, Faculty of Medicine Al-Azhar University
AUTHOR
Mansour
Mohamed Sallam
3
Department of Cardiology, Faculty of Medicine Al-Azhar University
AUTHOR
REFERENCES
1
Amin A, Houmsse A, Ishola A, Tyler J and Houmsse M. (2016): The current approach of atrial fibrillation management. Avicenna Journal of Medicine, 6(1):8-16.
2
Berruezo A, Tamborero D, Mont L, Benito B and Tolosana JM. (2011): Pre-procedural predictors of atrial fibrillation recurrence after circumferential pulmonary vein ablation. European Heart Journal, 28(7): 836-841.
3
Camm AJ, Kirchhof P, Lip GY, Schotten U, Savelieva I, Ernst S and Van Gelder IC (2011): Guidelines for the management of atrial fibrillation The Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J., 32(9): 1172-76.
4
Frost L and Vestergaard P (2010): Alcohol and risk of atrial fibrillation or flutter: a cohort study. Archives of Internal Medicine, 164(18): 1993-1998.
5
Heeringa J, Kors JA, Hofman A, van Rooij FJ and Witteman JC. (2010): Cigarette smoking and risk of atrial fibrillation: the Rotterdam Study. American Heart Journal, 156(6): 1163-1169.
6
Jaakkola S, Lip GY, Biancari F, Nuotio I, Hartikainen JE, Ylitalo A and Airaksinen KJ. (2017): Predicting unsuccessful electrical cardioversion for acute atrial fibrillation (from the AF-CVS Score). American Journal of Cardiology, 119(5): 749-752.
7
January CT, Wann LS, Calkins H, Chen LY and Cigarroa JE. (2019): 2019 AHA/ACC/HRS focused update of the 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Journal of the American College of Cardiology, 74(1): 104-132.
8
Kannel WB, Wolf PA, Benjamin EJ and Levy D. (2010): Prevalence, incidence, prognosis, and predisposing conditions for atrial fibrillation: population-based estimates. American Journal of Cardiology, 82(7): 2-9.
9
Kinoshita M, Herges RM, Hodge DO, Friedman L, Ammash NM, Bruce CJ, Somers V, Malouf JF, Askelin J, Gilles JA and Gersh BJ. (2010): Role of smoking in the recurrence of atrial arrhythmias after cardioversion. American Journal of Cardiology, 104(5): 678-682.
10
10. Kirchhof P, Andresen D, Bosch R, Borggrefe M, Meinertz T, Parade U, Ravens U, Samol A, Steinbeck G, Treszl A and Wegscheider K. (2012): Short-term versus long-term antiarrhythmic drug treatment after cardioversion of atrial fibrillation (Flec-SL): a prospective, randomised, open-label, blinded endpoint assessment trial. The Lancet, 380(9838): 238-246.
11
11. Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B and Castella M. (2016): 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. European Journal of Cardio-Thoracic Surgery, 50(5): 1-88.
12
12. Kishore A, Vail A, Majid A, Dawson J, Lees KR, Tyrrell PJ and Smith CJ. (2014): Detection of atrial fibrillation after ischemic stroke or transient ischemic attack: a systematic review and meta-analysis. Stroke, 45(2): 520-526.
13
13. Kotecha D, Holmes J, Krum H, Altman DG and Manzano L. (2014): Efficacy of β blockers in patients with heart failure plus atrial fibrillation: an individual-patient data meta-analysis. The Lancet, 384(9961): 2235-2243.
14
14. Lee SH, Kim JB, Cho WC, Chung CH, Jung SH, Choo SJ and Lee JW (2011): The influence of age on atrial fibrillation recurrence after the maze procedure in patients with giant left atrium. The Journal of Thoracic and Cardiovascular Surgery, 141(4): 1015-1019.
15
15. Ma X, Zhang X and Guo W. (2011): Factors to predict recurrence of atrial fibrillation in patients with hypertension. Clinical Cardiology: An International Indexed and Peer-Reviewed Journal for Advances in the Treatment of Cardiovascular Disease, 32(5): 264-268.
16
16. Movahed MR, Hashemzadeh M and Jamal MM. (2011): Diabetes mellitus is a strong, independent risk for atrial fibrillation and flutter in addition to other cardiovascular disease. International Journal of Cardiology, 105(3): 315-318.
17
17. Stewart S, Hart CL, Hole DJ and McMurray JJ. (2012): A population-based study of the long-term risks associated with atrial fibrillation: 20-year follow-up of the Renfrew/Paisley study. The American Journal of Medicine, 113(5): 359-364.
18
ORIGINAL_ARTICLE
CORRELATION BETWEEN MYOCARDIAL PERFUSION IMAGING AND CAROTID ULTRA-SONOGRAPHY IN PATIENTS WITH CHEST PAIN
Background: Atherosclerosis is a major risk factor for coronary artery disease (CAD). Carotid ultrasound (U/S) may be a useful method for prediction of CAD through measurement of intimio-media thickness (IMT) of right and left common carotic arteries. Objective: To emphasize the correlation between myocardial perfusion imaging using single photon emission computed tomography (SPECT) and carotid ultrasound through measuring IMT in early prediction and diagnosis of CAD. Patients and methods: The study included 80 patients complaining from chest pain. Single photon emission computed tomography (SPECT) and carotid U/S were done to each of them. All Patients were recruited from El-Hussein university hospital outpatient clinic and Kobry El-Koba military hospital outpatient clinic between February 2020 and November 2020. Results: The study included 80 patients, 57 of them were males while 23 of them were females. 52 patients were hypertension (HTN), 31 patients were diabetes mellitus (DM), 33 patients were smokers, 15 patients of them had positive family history. 52 patients had positive SPECT stress test revealing CAD “ischemic group”, while 28 of them had negative SPECT stress test “Non-ischemic group”. For the ischemic group, 43 patients (82.7%) had increased intimio-media thickness IMT. Right IMT mean ± SD “0.69±0.10”, t-test “7.771”, weighted Kappa test 0.655 substantial agreement and P-value “p <0.001”. Lefy IMT mean ± SD “0.77±0.12”, t-test “5.122” , weighted Kappa test 0.614 substantial agreement and p-value “p <0.001”. Only 9 patients (17.3%) from the ischemic group had below 75th percentile IMT. For Non-ischemic group, only 9 patients (32.1%) had abnormal IMT while the other 19 patients (67.9%) had normal IMT. Conclusion: Carotid ultrasound and intimio-media thickness are good predictors and highly correlated to coronary artery disease.
https://amj.journals.ekb.eg/article_158473_9f4537478ab3f483db052d47e99c5f1a.pdf
2021-04-01
1257
1270
10.21608/amj.2021.158473
SPECT
Carotid U/S
Intimio-media thickness
CAD
Ahmed
Abd El-Aziz Hassan Abd El-Aziz
ahmedabdelaziz1516@yahoo.com
1
Departments of Cardiology, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Abd El-Halim
Mohammed Abo El-Magd
2
Departments of Cardiology, Faculty of Medicine, Al-Azhar University
AUTHOR
Ayman
El-Saeid Sadek
3
Departments of Cardiology, Faculty of Medicine, Al-Azhar University
AUTHOR
Mohamed
Talaat Mohamed
4
Departments of Radiology, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Boucher B, Cerisier A, Bouchou K, Brulport-Cerisier V, Charmion S, Estour B and Cathébras, P. (2010): Silent myocardial ischemia in type 2 diabetes. Predictive value of intima-media thickness. Presse Med., 31(5): 218-222.
2
Djaberi R, Schuijf JD, Jukema JW, Rabelink TJ and Bax JJ. (2010): Increased carotid intima-media thickness as a predictor of the presence and extent of abnormal myocardial perfusion in type 2 diabetes. Diabetes Care, 33(2): 372-374.
3
Fihn SD, Gardin JM, Abrams J, Berra K and Williams SV. (2012): 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol., 60(24): 44-164.
4
Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD Borden WB and Turner MB. (2013): Heart disease and stroke statistics--2013 update: a report from the American Heart Association. Circulation, 127(1): 6-245.
5
McPherson R and Tybjaerg-Hansen A. (2016): Genetics of Coronary Artery Disease. Circ Res., 118(4): 564-578.
6
Mitevska IP, Baneva N, Bosevski M and Kostovska ES. (2017): Prevalence of risk factors and asymptomatic carotid atherosclerosis in diabetic patients screened for silent myocardial ischemia by SPECT myocardial imaging. Nucl Med Rev Cent East Eur., 20(1): 3-9.
7
Ruigómez A, Rodríguez LA, Wallander MA, Johansson S and Jones R. (2010): Chest pain in general practice: incidence, comorbidity and mortality. Fam Pract., 23(2): 167-174.
8
Rusnak J, Fastner C, Behnes M, Mashayekhi K, Borggrefe M and Akin I. (2017): Biomarkers in Stable Coronary Artery Disease. Curr Pharm Biotechnol., 18(6): 456-471.
9
Staub D. (2018): Duplex ultrasound in cerebrovascular disease - asymptomatic carotid stenosis. Ther Umsch., 75(8): 489-495.
10
Yano M, Miura S, Shiga Y, Miyase Y, Suematsu Y, Norimatsu K and Saku K. (2016): Association between smoking habits and severity of coronary stenosis as assessed by coronary computed tomography angiography. Heart Vessels, 31(7): 1061-1068.
11
ORIGINAL_ARTICLE
EFFECT OF COLLOID VS CRYSTALLOID PRELOAD ON HEMODYNAMIC STABILITY IN ELDERLY PATIENTS UNDERGOING LOWER LIMB ORTHOPEDIC SURGERY UNDER SPINAL ANESTHESIA
Background: Hypotension is commonly occurred with Spinal anesthesia. Colloids and Crystalloids are used preoperatively to prevent hypotension. Objective: To examine the effect of fluid (crystalloid vs. colloid) preloading on hemodynamic stability in old patients planned for lower limb orthopedic operations with spinal anesthesia. Patients and methods: Eighty patients undergoing orthopedic surgery under spinal anesthesia were included in this work. Their age ranged between 60-80 years. Patients were allocated randomly to either Crystalloid (Ringer solution RS group) or Colloid (hydroxyethyl starch solution HES group). Intravenous preload of 10 mL/kg of either lactated Ringer's solution in the RS group or hydroxyethyl starch solution (6% HES 130/0.4; Voluven) in the HES group was infused over 20 min before spinal anesthesia.. Hemodynamic parameters were recorded, and all results were compared. Results: More than 20% drop in systolic blood pressure occurred in 45% patients in the crystalloid group compared to 15% patients in the colloid group. This difference was significant statistically (p < 0.01). Regarding requirement of ephedrine to treat hypotension, (45% of patients in crystalloid group required Ephedrine compared to 15% patients in colloid group). This was also statistically significant (p < 0.01). Conclusion: Colloid solution was better than crystalloid solution in controlling blood pressure, ephedrine requirements and heart rate changes.
https://amj.journals.ekb.eg/article_158299_76350cdb740e1e95f8b8a84633436218.pdf
2021-04-01
1271
1280
10.21608/amj.2021.158299
colloid
preload
Elderly
Spinal anesthesia
Ahmed
Sultan
dr.sultan14@gmail.com
1
Department of Anesthesia, Nasser Institute Hospital
LEAD_AUTHOR
Hassanin
Abd Al-Karem
2
Department of Anesthesia and Intensive Care, Faculty of Medicine, Al Azhar University
AUTHOR
Ahmed
Said
3
Department of Anesthesia and Intensive Care, Faculty of Medicine, Al Azhar University
AUTHOR
Ahmed
M. El-Garhy
4
Department of Anesthesia and Intensive Care, Faculty of Medicine, Al Azhar University
AUTHOR
REFERENCES
1
Alimian M, Mohseni M, Safaeian R, Faiz SH and Majedi MA (2014): Comparison of hydroxyethyl starch 6% and crystalloids for preloading in elective caesarean section under spinal anesthesia. Med Arch, 68(4):279-281.
2
Bishop DG, Cairns C, Grobbelaar M and Rodseth RN (2017): Heart rate variability as a predictor of hypotension following spinal for elective caesarean section: a prospective observational study. Anaesthesia, 72(5):603–608.
3
Buggy D, Higgins P, Ciaran M and Maire M (2013): Prevention of spinal anesthesia-induced hypotension in the elderly: comparison between preanesthetic administration of crystalloids, colloids, and no prehydration. Anesthesia and Analgesia, 84 (1) : 106-110.
4
Fathi M, Imani F, Joudi M and Goodarzi V (2013): Comparison between the effects of Ringer`s lactate and hydroxyethyl starch on hemodynamic parameters after spinal anesthesia: A randomized clinical trial. Anesth Pain Med.; 2(3):127–133.
5
Madhusudan U, Bhat S and Paul S (2016): Six percent hetastarch versus lactated Ringer's solution – for preloading before spinal anesthesia for cesarean section. Anesth Essays Res 2016; 10:33-37.
6
Mehdi F, Farnad I, Marjan J and Vahid G (2013): Comparison Between the Effects of Ringer`s Lactate and Hydroxyethyl Starch on Hemodynamic Parameters After Spinal Anesthesia: A Randomized Clinical Trial. Anesth Pain Med; 2(3): 127–133.
7
Memtsoudis S, Sun X, Chiu Y, Stundner O, Liu S, Banerjee S, Mazumdar M and Sharrock N (2013): Perioperative comparative effectiveness of anesthetic technique in orthopedic patients. Anesthesiology 2013; 118: 1046–1058.
8
Mohammad G, Reza A, Hamid A, Alireza O and Mahbobe R (2018): The Effects of Pre-Spinal Anesthesia Administration of Crystalloid and Colloid Solutions on Hypotension in Elective Cesarean Section. Anesthesiology and pain medicine vol. 8,4 e69446.
9
Mohanchandra M, Subhrajyoti C, Teesta B and Sumit C (2016): Comparison of crystalloid and colloid preload on maternal hemodynamics in elective caesarean section under spinal anaesthesia. Int J Res Med Sci; 4(6):2428-2435.
10
10. Ripolles M, Espinosa A, Martinez E, Casans R, Navarro R and Abad A (2015): Colloids versus crystalloids in the prevention of hypotension induced by spinal anesthesia in elective cesarean section. A systematic review and meta-analysis. Minerva Anestesiol., 81(9):1019–1030.
11
11. Tawfik M, Hayes S, Jacoub F, Badran B, Gohar F, Shabana A, Abdelkhalek M and Emara M (2014): Comparison between colloid preload and crystalloid co-load in cesarean section under spinal anesthesia: a randomized controlled trial.Int J Obstet Anesth, 23(4):317-323.
12
ORIGINAL_ARTICLE
RENAL HISTOPATHOLOGICAL PROFILE IN PATIENTS WITH SILENT LUPUS NEPHRITIS
Background: Silent lupus nephritis (SLN) is a life menacing consequence of systemic lupus erythematous (SLE). This condition is characterized by pathological impairment of the kidney in the obscurity of clinical or laboratory manifestations. Objective: To reveal the existence of SLN along with the potential differences between overt lupus nephritis (OLN) and SLN among a sample of Egyptian patients based on histopathological assessment. Patients and Methods: It is a prospective case-control study which was performed at nephrology units, internal medicine department, Elhussein and Sayed Galal university hospitals, faculty of medicine, Al-Azhar University, Cairo, Egypt, throughout the entire period April 2016 to November 2019. Patients aged more than 18 years (216 months) and fulfilled at least 4 of the American College of Rheumatology criteria for the classification of systemic lupus erythematosus (SLE) were enrolled in the current study. Patients were further assorted into two groups; patients with SLN and those with OLN. Patients were subjected to the following investigations: 1.Complete blood count, using Coulter counter Max-M (Coulter Cooperation, Florida, USA) 2.Erythrocyte sedimentation rate, (Wester green method) (Ref: < 20mm/hr) 3.S. Albumin, S. Creatinine. Albumin/Creatinine ratio. Creatinine clearanc & eGFR using the Modification of Diet in Renal Disease (MDRD) formula. 4. Liver function tests. 5. Coagulation profile. 6. Urine analysis (Fresh morning midstream urine) to exclude infection. 7. Quantitative assessment of proteinuria by Pr/creat. Ratio (Ref. <0.2). Assessment of auto-antibodies and complement system: Autoantibodies to ds-DNA, RNP. SSA, SSB, Sm and Scl-70, C4 and C3 serum levels were assessed in all of the included patients. In particular, the titer of anti-dsDNA antibodies was evaluated by enzyme- Radiological evaluation: Patients were subjected to pelvi-abdominal ultrasound in order to obtain valuable data about the morphological appearance of the kidney and to detect any urological abnormality. Renal biopsy: Percutaneous renal biopsy was carried out under local anesthesia. Results: An overall 40 patients with SLE who developed lupus nephritis were enrolled in the current study. Among them, 20 patients had OLN, whereas 20 patients were SLN. Based on ISN/RPS Classification, stage II was the predominant stage, 13 patients, among patients with SLN, whilst stage V was the predominant stage among the OLN patients. Additionally, five and three patients were stage III among the SLN and OLN groups, respectively. Furthermore, the presence of RBCs Cast (r=0.479, P=0.032) in urine and decreased levels of complement (r=0.676, P=0.001) showed a statistically significant positive correlation with the high grades of lupus nephritis among SLN group. Conclusion: Patients with SLE should be subjected to close follow up evaluation and renal biopsy for early detection of SLN to determine the activity, severity, and chronicity of LN.
https://amj.journals.ekb.eg/article_158472_72f88c7ee9d506564bffc19c172f46b0.pdf
2021-04-01
1281
1292
10.21608/amj.2021.158472
Silent
lupus-nephritis
silent lupus erythematosus and overt lupus nephritis
Kazem
Mohamed El-Sayed
1
Departments of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
LEAD_AUTHOR
Emad
Allam Mohamed
2
Departments of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Al-Sayed
Mohamed Rashed
3
Departments of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Mohamed
Said Abd El-Aziz Shehata
4
Departments of Radiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Essam
Mohamed Ragab Mandour
5
Departments of General Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
REFERENCES
1
Almaani, S., Meara, A. and Rovin, B. H. (2017): Update on lupus nephritis. Clinical Journal of the American Society of Nephrology, 12(5): 825-835.
2
Davidson, A., Aranow, C. and Mackay, M. (2019): Lupus nephritis: challenges and progress. Current Opinion in rheumatology. 31(6): 682-688.
3
Duli, M., Dika, Q., Duli, X. and Hankollari, J. (2017): Prevalence of Terminal Renal Disease in Lupus Nephritis Patients.UBT International Conference, 89 (2): 43-47.
4
Fibbe, W. E. and Rabelink, T. J. (2017): Lupus nephritis: mesenchymal stromal cells in lupus nephritis. Nature Reviews Nephrology, 13(8): 452.
5
Fu, S. M., Sung, S.-S. J., Wang, H. and Gaskin, F. (2019): Pathogenesis of lupus nephritis Dubois' Lupus Erythematosus and Related Syndromes (pp. 269-293): Elsevier.
6
Haładyj, E. and Cervera, R. (2016): Do we still need renal biopsy in lupus nephritis? Reumatologia, 54(2): 61.
7
Hoover, P. J. and Costenbader, K. H. (2016): Insights into the epidemiology and management of lupus nephritis from the US rheumatologist's perspective. Kidney Int, 90 (3): 487-492.
8
Houssiau, F. A. and Lauwerys, B. R. (2013): Current management of lupus nephritis. Best Practice & Research Clinical Rheumatology, 27(3): 319-328.
9
Hsieh, Y. P., Wen, Y. K. and Chen, M. L. (2012): The value of early renal biopsy in systemic lupus erythematosus patients presenting with renal involvement. Clinical Nephrology, 77(1): 18-24.
10
Ishizaki, J., Saito, K. Nawata, M., Mizuno, Y., Tokunaga, M., Sawamukai, N., Tanaka, Y. (2015): Low complements and high titre of anti-Sm antibody as predictors of histopathologically proven silent lupus nephritis without abnormal urinalysis in patients with systemic lupus erythematosus. Rheumatology (Oxford), 54(3): 405-412.
11
Moroni, G., Depetri, F. and Ponticelli, C. (2016): Lupus nephritis: When and how often to biopsy and what does it mean? J Autoimmun, 74: 27-40.
12
Mubarak, M. and Nasri, H. (2014): ISN/RPS 2003 classification of lupus nephritis: time to take a look on the achievements and limitations of the schema. Journal of Nephropathology, 3(3): 87-90.
13
Stillman, I. E. (2016): The Pathology of Lupus Nephritis Systemic Lupus Erythematosus (pp. 351-371): Elsevier.
14
Tang, Y., Zhang, W., Zhu, M., Zheng, L., Xie, L., Yao, Z. and Lu, B. (2018): Lupus nephritis pathology prediction with clinical indices. Sci Rep, 8(1): 10231.
15
Touma, Z., Gladman, D. D., Ibañez, D. and Urowitz, M. B. (2011): Development and initial validation of the systemic lupus erythematosus disease activity index 2000 responder index 50. J Rheumatol, 38(2): 275-284.
16
Wang, H., Ren, Y. L., Chang, J., Gu, L. and Sun, L. Y. (2018): A Systematic Review and Meta-analysis of Prevalence of Biopsy-Proven Lupus Nephritis. Arch Rheumatol, 33(1): 17-25. doi: 10.5606/ArchRheumatol.2017.6127.
17
Wen, Y.-K. (2011): Renal biopsy findings in new-onset systemic lupus erythematosus with clinical renal disease. International urology and nephrology, 43(3): 801-806.
18
Xu, S., Liu, Z., Chen, H., Zeng, C., Zhang, H. and Hu, W. (2014): Diffuse segmental and pure diffuse global proliferative glomerulonephritis: different patterns of class IV lupus nephritis. Clin Nephrology, 81(6): 411-418.
19
ORIGINAL_ARTICLE
STUDY OF CORRELATION BETWEEN SEVERITY OF ISCHEMIC MITRAL VALVE REGURGITATION BY ECHO DOPPLER AND ECG CHANGES IN ACUTE MYOCARDIAL INFARCTION
Background: Myocardial infarction (MI) accompanies with different mechanical complications including ischemic mitral regurgitation (IMR) which is correlated with increased risk of mortality and heart failure. IMR existence and its severity had significant prognostic effect on patients’ mortality following acute myocardial infarction (AMI). Echocardiography is the choice imaging modality for the diagnosis and assessment of IMR and establishing its etiology. IMR usually results from papillary muscle displacement, ventricular dilation and remodeling with reduced closing forces. Objective: Assessment of the correlation between echocardiographic severity of ischemic mitral valve regurgitation following acute myocardial infarction and its electrocardiographic location. Patients and methods: This was a prospective study that included 100 patients admitted to CCU OF Beni-Suief General Hospital in the period from October 2019 to May 2020 . Those patients were divided on two equal groups: Group I: patients with STEMI and no, trivial or mild MR and Group II: patients with STEMI and moderate or severe MR. Results: Mean age of group I involved in the study was 55.44 ± 7.23 years and 70% of them were males. Mean age of group II was 58.38 ± 7.8 and 56% were males. 70 % of the group II had inferolateral STEMI compared to group I who had more anterior STEMI. Group II were more smokers with hyperlipidemia. Group II was with higher previous stable and unstable angina, with less streptokinase treatment, with higher abnormal chest radiogrgh and higher killip class. Group II had significantly lower EF and higher LVEDD, LVESD, LA diameter, RV diameter, MV A velocity, tricuspid valve excursion TAPSI and pulmonary artery pressure and more diastolic dysfunction. Mechanism of IMR in case group was mono leaflet tethering in 43 cases, both leaflet tethering in 7 cases and ring dilation in 30 cases. MR jet direction was medial commissure posterior in 31 (62%), lateral commissure anterior in 12 (24%), and both commissures central in 7 (14%) cases. Conclusion: Mitral regurgitation is common after acute myocardial infarction, especially in cases with inferior mitral regurgitation. The echocardiographic findings are indicative of left ventricular remodeling and abnormality of mitral valve apparatus.
https://amj.journals.ekb.eg/article_158470_329405c19ae8fbefe025722771b92234.pdf
2021-04-01
1293
1304
10.21608/amj.2021.158470
Ischemic Mitral Valve Regurgitation
Echo Doppler
eCG
Myocardial Infection
Mohamed
Gamal Abd El-Azeem
mohamed_gamal@gmail.com
1
Department of Cardiology, Faculty of Medicine Al-Azhar University
LEAD_AUTHOR
Yasser
Radwan Mohammed
2
Department of Cardiology, Faculty of Medicine Al-Azhar University
AUTHOR
Yasser
Al-Sayed Mohammed
3
Department of Cardiology, Faculty of Medicine Al-Azhar University
AUTHOR
REFERENCES
1
Boyd JH. (2013): Ischemic mitral regurgitation, where do we stand? Circ J., 77(8):1952-6.
2
Carrabba N, Parodi G, Valenti R, Shehu M, Migliorini A, Memisha G, Santoro GM and Antoniucci D. (2010): Clinical implications of early mitral regurgitation in patients with reperfused acute myocardial infarction. J Card Fail., 14:48-54.
3
Chua S, Hung J and Chung SY. (2011): Primary Percutaneous Coronary Intervention Lowers the Incidence of Ischemic Mitral Regurgitation in Patients With Acute ST-Elevated Myocardial Infarction. Circulation, 123:1529-1536.
4
Fazlinezhad A, Dorri M, Azari A and Bigdelu L. (2014): Frequency of Ischemic Mitral Regurgitation after First-Time Acute Myocardial Infarction and its Relation to Infarct Location and In-Hospital Mortality. J Teh Univ Heart Ctr., 9(4):160-165.
5
Lancellotti P, Troisfontaines P, Toussaint A and Pierard LA. (2013): Prognostic Importance of Exercise-Induced Changes in Mitral Regurgitation in Patients with Chronic Ischemic Left Ventricular Dysfunction. Circulation, 108(14):1713-7.
6
MacHaalany J, Bertrand OF, O’Connor K, Abdelaal E, Voisine P and Larose É. (2014): Predictors and prognosis of early ischemic mitral regurgitation in the era of primary percutaneous coronary revascularisation. Cardiovascular Ultrasound, 12:14-18.
7
Mehrnoush T, Sakineh H and Afshin H. (2018): Correlation between echocardiographic severity of ischemic mitral valve regurgitation following acute myocardial infarction and its electrocardiographic location. J Cardiovasc Thorac Res., 10(3): 169-173.
8
Mentias A, Raza MQ, Barakat AF, Hill E, Youssef D and Krishnaswamy A. (2016): Outcomes of ischaemic mitral regurgitation in anterior versus inferior ST elevation myocardial infarction. Open Heart, 3(2):88-93.
9
Meris A, Amigoni M, Verma A, Thune J and Køber L. (2012): Mechanisms and Predictors of Mitral Regurgitation after High-Risk Myocardial Infarction. J Am Soc Echocardiogr., 25(5): 535–542.
10
10. Nishimura RA, Otto CM, Bonow R, Carabello BA, Erwin JP, Guyton RA, O’Gara PT, Ruiz CE, Skubas NJ, Sorajja P, Sundt TM and Thomas JD. (2014): AHA/ACC Guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. Circulation, 129:521–643.
11
11. Pant S, Neupane P, Pant OB, Paudel R, Kavin Kumar MP and Vijayashankar CS. (2011): Mild Functional Ischemic Mitral Regurgitation Following Acute Coronary Syndrome: A Retrospective Study. Heart Views, 12:93-8.
12
12. Poh KK, Lee GK and Lee LC. (2012): Reperfusion therapies reduce ischemic mitral regurgitation following inferoposterior ST-segment elevation myocardial infarction. Coronary Artery Disease., 23: 555-559.
13
13. Thomas H Marwick, Patrizio Lancellotti and Luc Pierard. (2010): Ischaemic mitral regurgitation: Mechanisms and diagnosis. Heart, 95: 1711-8.
14
14. Uddin AM, Henry TD and Hodges JS. (2012): The prognostic role of mitral regurgitation after primary percutaneous coronary intervention for acute ST-elevation myocardial infarction. Catheter Cardiovasc Interv., 80:779-86.
15
15. Valuckienė Ž, Urbonaitė D and Jurkevičius R. (2015): Functional (ischemic) mitral regurgitation in acute phase of myocardial infarction: Associated clinical factors and in hospital outcomes. Medicina (Kaunas), 51(2):92-9.
16
ORIGINAL_ARTICLE
ADMISSION HYPERGLYCEMIA IN CRITICALLY ILL PATIENTS WITH SEPSIS; HIGH IL6 AND ITS RELATION WITH OUTCOME
Background: Hyperglycemia has long been recognized as a common occurrence in critically ill patient, even without history of diabetes mellitus (D.M). Although there are few studies investigating the prevalence of stress hyperglycemia, one study reported that 38% of patients admitted to general hospitals had hyperglycemia episodes, 16% of which had no previous history of D.M. Objective: To investigate the role of high IL6 in patients with sepsis admitted to medical I.C.U with acute hyperglycemia and its relation to 30 days outcome. Patients and Methods: This study was conducted on 100 adult septic patients who were admitted to medical I.C.U at Al-Hussein University Hospital, the study was carried in the period between January 2018 and June 2019. 80 patients with evidence of hyperglycemia and 20 patients with euglycemic state. Results: non-significant difference was found according to mean values of Na+, K+, creat, TLC, HB%, PLT, ALT, AST. On the other hand, the hyperglycemic group showed a significant increase regarding mean value of HbA1c compared to control group. The comparative study between the 2 groups revealed a significant increase of mean value of CRP in the hyperglycemic group compared to the control group. As regards the vital signs, the hyperglycemic group showed a significant increase in mean values of systolic blood pressure, diastolic blood pressure, MAP & HR compared to the control group. While there was no significant difference between the 2 groups regarding temperature and RR. This study showed statistically significant decrease in mean values of GCS in hyperglycemic group compared to control group, while APACHE II and qSOFA showed a significant increase in hyperglycemic group compared to control group. The mean values of ABG parameters revealed no statistically significant difference between the 2 groups. On the other hand, mean values of RBS and IL6 showed a statistically significant increase in hyperglycemic group compared to control group. The comparative study between the 2 groups showed a significant increase in mean values of hyperglycemic group compared to control group according to duration of ICU stay (days), Insulin therapy, AKI and Outcome and non-significant difference according to ILD, CLD, CKD, stroke, pneumonia, IHD, COPD & HF. Conclusion: Stress hyperglycemia with high IL6 is strongly associated with adverse outcomes in patients with sepsis who were admitted to the medical ICU. Sepsis patients with hyperglycemia showed increased incidence of mortality and AKI.
https://amj.journals.ekb.eg/article_158476_b967ab8cd10f991db81bd6c5541b9eeb.pdf
2021-04-01
1305
1316
10.21608/amj.2021.158476
hyperglycemia
Sepsis
ICU
IL6
Diaa
A. Abd El-Monem
1
Departments of Internal Medicine, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Gamal
A. Badr
2
Departments of Internal Medicine, Faculty of Medicine, Al-Azhar University
AUTHOR
Farag
k. Farag
3
Departments of Internal Medicine, Faculty of Medicine, Al-Azhar University
AUTHOR
Ashraf
A. Ahmed
4
Departments of Clinical Pathology, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Dellinger RP, Levy MM and Rhodes A (2013): Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock. Crit Care Med., 41: 580-637.
2
Fayed AM, El-sawy MM, Mahrous AA-E and Soliman ME (2015): IL-6 and ITS correlation to stress hyperglycemia in diabetic and non-diabetic critically ill septic patients intensive care mwdicine. Experimental, 3(1):304-307.
3
Ganesh K, Sharma RN, Varghese J and Pillai MG. (2016): A profile of metabolic acidosis in patients with sepsis in an Intensive Care Unit setting. Int J Crit Illn Inj Sci., 6(4):178-181.
4
James AR (2010): Management of Sepsis. N Engl J Med., 355:1699-1713.
5
John X W and Bryan Y (2011): Sepsis-associated encephalopathy: Evolving concepts. Neurol J Southeast Asia, 8: 65–76.
6
Jozwiak M, Persichini R and Monnet X. (2011): Management of Myocardial Dysfunction in Severe Sepsis. Semin Respir Crit Care Med., 32(2):206-214.
7
Knaus WA, Draper EA and Wagner DP. (2010): APACHE II: a severity of disease classification system. Crit Care Med., 13(10):818-29.
8
Marik PE and Bellomo R. (2013): Stress hyperglycemia: an essential survival response. Crit Care Med., 41(6): 93-4.
9
Nakamura M, Oda S, sadhir T, Watanabe E, Abe R, Nakada T, Morita and Hirasawa H (2012): Correlation between high blood IL6 level, hyperglycemia and glucose control in sebtic patients. Critical Care, 16(58):1-9.
10
10. Pakhetra LCR, Grag CMK and Suryanarawana AMKM (2016): Management of hyperglycemia in critical illness: review of targets strategies. Med J Armed Forces India, 67(1): 53–57.
11
11. Park, S. K., Chun, H. J., Kim, D. W., Im, T. H., Hong, H. J., and Yi, H. J. (2010): Acute Physiology and Chronic Health Evaluation II and Simplified Acute Physiology Score II in predicting hospital mortality of neurosurgical intensive care unit patients. Journal of Korean medical science, 24(3), 420-426.
12
12. Raith, E. P., Udy, A. A., Bailey, M., McGloughlin, S., MacIsaac, C., Bellomo, R., and Pilcher, D. V. (2017): Prognostic accuracy of the SOFA score, SIRS criteria, and qSOFA score for in-hospital mortality among adults with suspected infection admitted to the intensive care unit. Jama, 317(3), 290-300.
13
13. RIEDEL, F., ZAISS, I., HERZOG, D., GÖTTE, K., NAIM, R., and HÖRMANN, K. (2005): Serum levels of interleukin-6 in patients with primary head and neck squamous cell carcinoma. Anticancer research, 25(4), 2761-2765.
14
14. Robba C and Bilotta F (2016): Admission hyperglycemia and outcome in ICU patients with sepsis. J thorac Dis., 8(7):581-583.
15
15. Schmitz D, Kobbe P and Lendemanns S. (2012): Survival and cellular immune functions in septic mice treated with growth hormone (GH) and insulin-like growth factor-I (IGF-I). Growth Horm IGF Res., 18(3):245-52.
16
16. Shigeki K, Satoshi G and Daizoh S (2013): The impact of body temperature abnormalities on the disease severity and outcome in patients with severe sepsis: an analysis from a multicenter, prospective survey of severe sepsis. Critical Care, 17:271-75.
17
17. Sourris KC, Lyons JG and de Courten MP. (2012): c-Jun NH2-terminal kinase activity in subcutaneous adipose tissue but not nuclear factor-kappaB activity in peripheral blood mononuclear cells is an independent determinant of insulin resistance in healthy individuals. Diabetes, 58(6):1259-65.
18
18. Spindler MP, HO AM, Tridgell D, McCulloch-Oslon M, Gersuk V, NI C, Greenbaum C and Sanda S (2016): Acute hyperglycemia, IL6 expression in humans. Immunity, Inflammation and Disease, 4(1):91-97.
19
19. Venot M, Weis L, Clec'h C, Darmon M, Allaouchiche B, Goldgran-Tolédano D, Garrouste-Orgeas M, Adrie C, Timsit JF and Azoulay E. (2015): Acute kidney injury in severe sepsis and septic shock in patients with and without diabetes mellitus: A multicenter study. PLoS One, 10(5): 127-133.
20
20. Wang Z, Ren J, Wang G, Liu Q, Guo K and Li J (2017): Association Between Diabetes Mellitus and Outcomes of Patients with Sepsis: A Meta-Analysis. Med Sci Monit., 23: 3546-3555.
21
ORIGINAL_ARTICLE
ASSESSMENT OF THE SERUM LEVEL OF COMPLEMENT C3 AND C4 IN CHRONIC VIRAL HEPATITIS C INFECTION AND THEIR CORRELATION WITH RESPONSE TO DIRECT ACTING ANTI-VIRAL AGENTS
Background: The interactions between hepatitis C Virus (HCV) and the host immune system have a major role in HCV pathogenesis. Objective: To estimate complement C3 and C4 serum levels in patients with chronic HCV patients and to correlate its levels with response to directly acting anti-viral agents (DAAs) in those patients. Patients and methods: The study included 80 individuals classified into two groups: Group (I): 40 patients with chronic HCV infection, Group (II): Control group which included 40 healthy individuals. Measurement of the level of complement C3 and C4 has done by nephelometry immunoassay before and after treatment with DAAs. Results: All patients with chronic HCV infection in group (I) showed significant reduction in serum levels of complement C3 and C4 compared to the control group (II). Moreover, those patients who treated with DAAs showed significantly higher levels of C3 and C4 when compared to chronic HCV patients before treatment with DAAs. Conclusion: Serum levels of complement C3 and C4 serum may be used in the follow up of the course of the disease and may be used as a predictor for the response to treatment with DAAs.
https://amj.journals.ekb.eg/article_158477_2a5c16ed5a719560a2e22ed14184a3a1.pdf
2021-04-01
1317
1326
10.21608/amj.2021.158477
hepatitis C
complement
Response
Antivirals
Viral load
Mohamed
Abd El-wahed Ramadan
dr.mohamedabdelwahed92@gmail.com
1
Department of Clinical Pathology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
LEAD_AUTHOR
Sabah
Ibrahim Abd El-Rehiem
2
Department of Clinical Pathology, Faculty of Medicine for Girls, Al-Azhar University, Egypt
AUTHOR
Ahmad
Al-Saeed Al-Sehrawy
3
Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Egypt
AUTHOR
Mohamed
Hieza
4
Department of Hepatology, Gastroenterology and Infectious diseases, Damietta Faculty of Medicine, Al-Azhar University, Egypt
AUTHOR
REFERENCES
1
Asselah T and Marcellin P (2012): Direct acting antivirals for the treatment of chronic hepatitis C: one pill a day for tomorrow. Liver Int., 32: 88-102.
2
Banerjee A, Mazumdar B, Meyer K, Di Bisceglie AM, Ray RB and Ray R (2011): Transcriptional repression of C4 complement by hepatitis C virus proteins. J Virol., 85(9):4157-66.
3
Buğdaci MS, Karaca C, Alkim C, Kesıcı B, Bayraktar B and Sökmen M (2012): Serum complements C4 in chronic hepatitis C: correlation with histopathologic findings and disease activity. Turk J Gastroenterol., 23(1):33-7.
4
Bunchorntavakul C, Mitrani R and Reddy KR (2018): Advances in HCV and Cryoglobulinemic Vasculitis in the Era of DAAs: Are We at the End of the Road? J Clin Exp Hepatol., 8(1):81-94.
5
Chi CT, Chen CY, Su CW, Chen PY, Chu CJ, Lan KH, Lee IC and Hou MC (2019): Direct-acting antivirals for patients with chronic hepatitis C and hepatocellular carcinoma in Taiwan. J Microbiol Immunol Infect., 14:1182-1186.
6
Crespo J, Cuadrado A, Perelló C, Cabezas J, Llerena S, Llorca J, Cedillo S and Llop E (2020): Epidemiology of hepatitis C virus infection in a country with universal access to direct-acting antiviral agents: Data for designing a cost-effective elimination policy in Spain. J Viral Hepat., 27(4):360-370.
7
Dunkelberger JR and Song WC. (2011): Complement and its role in innate and adaptive immune responses. Cell Res., 20(1):34-50.
8
El-Fatah Fahmy Hanno A, Mohiedeen KM, Deghedy A and Sayed R (2014): Serum complements C3 and C4 in chronic HCV infection and their correlation with response to pegylated interferon and ribavirin treatment. Arab J Gastroenterol., 15(2):58-62.
9
Essa M, Sabry A, Abdelsameea E, Tharwa ES and Salama M (2019): Impact of new direct-acting antiviral drugs on hepatitis C virus-related decompensated liver cirrhosis. Eur J Gastroenterol Hepatol., 31(1):53-58.
10
10. Hakobyan S, Harding K, Aiyaz M, Hye A, Dobson R, Baird A, Liu B and Harris CL (2016): Complement Biomarkers as Predictors of Disease Progression in Alzheimer's Disease. J Alzheimers Dis., 54(2):707-16.
11
11. Hassan AM, Osman HA, Mahmoud HS, Hassan MH, Hashim AA and Ameen HH (2018): Sofosbuvir-daclatasvir improves hepatitis C virus-induced mixed cryoglobulinemia: Upper Egypt experience. Infect Drug Resist., 11:895-901.
12
12. Honma Y, Shibata M, Hayashi T, Kusanaga M, Ogino N, Minami S, Kumei S and Oe S (2019): Effect of direct-acting antivirals on platelet-associated immunoglobulin G and thrombocytopenia in hepatitis C virus-related chronic liver disease. Liver Int., 39(9):1641-1651.
13
13. Iliescu EL, Mercan-Stanciu A and Toma L (2020): Safety and efficacy of direct-acting antivirals for chronic hepatitis C in patients with chronic kidney disease. BMC Nephrol., 21(1):21-26.
14
14. Mazumdar B, Kim H, Meyer K, Bose SK, Di Bisceglie AM, Ray RB and Ray R.(2012): Hepatitis C virus proteins inhibit C3 complement production. J Virol., 86(4):2221-8.
15
15. Ruane PJ, Ain D, Stryker R, Meshrekey R, Soliman M, Wolfe PR, Riad J and Mikhail S (2015): Sofosbuvir plus ribavirin for the treatment of chronic genotype 4 hepatitis C virus infection in patients of Egyptian ancestry. J Hepatol., 62(5):1040-6.
16
16. Van der Meer AJ, Veldt BJ, Feld JJ, Wedemeyer H, Dufour JF, Lammert F, Duarte-Rojo A and Heathcote EJ (2012): Association between sustained virological response and all-cause mortality among patients with chronic hepatitis C and advanced hepatic fibrosis. JAMA., 308(24):2584-93.
17
17. Vanni E, Bugianesi E and Saracco G (2015): Treatment of type 2 diabetes mellitus by viral eradication in chronic hepatitis C: Myth or reality? Dig Liver Dis., 48(2):105-11.
18
18. Webster DP, Klenerman P and Dusheiko GM (2015): Hepatitis C. Lancet, 385(9973):1124-35.
19
ORIGINAL_ARTICLE
EFFICACY OFPLATELET RICH PLASMA VERSUS AUTOLOGOUS EMULSIFIED FAT IN THE TREATMENT OF INFRAORBITAL DARK CIRCLES
Background: Periorbital hyperpigmentation, generally called dark circles, is a condition characterized by relatively dark coloration of the periorbital eyelids. It is a common worldwide problem which makes a person appear tired, sad, and aged. Although this condition does not cause physical morbidity, it can pose a substantial cosmetic problem and, eventually, affect the quality of the effected individual. Objective: To evaluate the efficacy of platelet rich plasma versus autologous emulsified fat in the treatment of infraorbital dark circle. Patients and methods: Our study was carried out on 30 patients presenting with infraorbital dark circles of different etiological factors divided into A and B from December 2019 to July 2020.All patients were recruited from the Dermatology outpatient clinic of Al-Azhar University Hospitals. Patients were divided into two equal groups: Group A treated with platelet rich plasma (PRP) and Group B treated by autologous fat injection. Results: The present study showed excellent response of 3 patients (20%) in group A, and 7 patients (46.7%) in group B. Moderate response occurred in 2 patients (13.3%) in group A, and 4 patients (26.7%) in group B. Mild response occurred in 2 patients (13.3%) in group A, and 3 patients (20%) in group B. No response occurred in 8 patients (53.3%) in group A and 1 patient (6.7%) in group B. Conclusion: Both PRP and emulsified fat were effective in treatment of infraorbital dark circles with statistically significant difference as regard the improvement, patient satisfaction and postoperative complications at the end of treatment period and follow up for six months.
https://amj.journals.ekb.eg/article_158479_f9954b7bf8e5358ab7ada4ad69553bd8.pdf
2021-04-01
1327
1334
10.21608/amj.2021.158479
platelet rich plasma
Autologous Fat
Infraorbital Dark Circles
Ahmed
Kadry Nabih Attia
ahmedkadry420@gmail.com
1
Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Abd El-Raouf
Mohammed Al-Mohsen
2
Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Al-Azhar University
AUTHOR
Shady
Mahmoud Attia
3
Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Alsaad SMS and Mikhail M (2013): Periocular hyperpigmentation: A review of etiology and current treatment options. JDD, 12: 154-157.
2
Al-Shami SH (2014): Treatment of periorbital hyperpigmentation using platelet-rich plasma injections. Am J Dermatol Venereol, 3(5):87-94.
3
Anitua E, Alonso R, Girbau C, Aguirre JJ, Muruzabal F and Orive G (2012): Antibacterial effect of plasma rich in growth factors (PRGF-Endoret) against Staphylococcus aureus and Staphylococcus epidermidis strains. Clin Exp Dermatol, 37:652-7.
4
Mehryan P, Zartab H, Rajabi A, Pazhoohi N and Firooz A (2014): Assessment of efficacy of platelet-rich plasma (PRP) on infraorbital dark circles and crow’s feet wrinkles. J Cosmet Dermatol, 13(1):72-8.
5
Nofal E, Elkot R, Nofal A, Eldesoky F, Shehata S and Sami M (2018): Evaluation of carboxytherapy and platelet-rich plasma in treatment of periorbital hyperpigmentation: A comparative clinical trial. J Cosmet Dermatol, 17(6):1000-7.
6
Oh D, Kim D, Roh T, Yun I and Kim Y (2014): Correction of Dark Coloration of the Lower Eyelid Skin with Nanofat Grafting. Archives of Aesthetic Plastic Surgery, 20(2):92.
7
Ranu H, Thng S, Goh BK, Perio, Burger A and Goh CL (2011): Periorbital hyperpigmentation in Asians: an epidemiologic study and a proposed classification DermatolSurg, 37(9):1297–1303.
8
Roberts WE (2014): Periorbital hyperpigmentation: Review of etiology, medical evaluation, and aesthetic treatment. JDD, 13: 472-482.
9
Taskin B (2015): Periocular Pigmentation: Overcoming the Difficulties. Journal of Pigmentary Disorders, 02(01): 159–174.
10
10. Uyulmaz S, Macedo NS, Rezaeian F, Giovanoli P and Lindenblatt N (2018): Nanofat Grafting for Scar Treatment and Skin Quality Improvement, Aesthetic Surgery Journal, 38(4): 421–428.
11
11. Zzam E, Khlosy H and Abouarab M. (2020): The Efficacy of Autologous Nanofat Injection in the Treatment of Infraorbital Dark Colouration. The Egyptian Journal of Plastic and Reconstructive Surgery, 43(3):445-452.
12
ORIGINAL_ARTICLE
HEPATOTOXIC AND CARDIOTOXIC EFFECTS OF TESTOSTERONE ENANTHATE ABUSE ON ADULT MALE ALBINO RATS
Background: Anabolic androgenic steroids (AASs) represent a group of synthetic derivatives of testosterone created to maximize anabolic effects and minimize the androgenic ones. Athletes use anabolic androgenic steroids (AAS) to enhance performance regardless of the health risk they may impact in some persons. Objective: To study the histopathological and biochemical changes that could occur on liver and cardiac muscle after administration of doping dose (supraphysiological dose) of testosterone enanthate (one of AAS). Materials and Methods: One hundred (100) male albino rats were included in the present study and divided into six groups. Group (1a); negative control group, Group (1b) positive control group treated with therapeutic dose of testosterone Enanthate (10 mg /Kg body weight intramuscular / I.M weekly for 12 weeks), group (2) was treated with doping dose of testosterone enanthate (60 mg /Kg body weight/ I.M for 4 weeks), group (3) was treated with treated with doping dose of testosterone enanthate (60 mg /Kg body weight / I.M weekly for 8 weeks), group (4) treated with doping dose of testosterone enanthate (60 mg /Kg body weight / I.M weekly for 12 weeks), group (5a) treated with doping dose of testosterone enanthate (60 mg /Kg body weight/ I.M/ weekly for 12 weeks followed by 2 weeks of treatment discontinuation) , group (5b) treated with doping dose of testosterone enanthate (60 mg /Kg body weight/ I.M weekly for 12 weeks followed by 4 weeks of treatment discontinuation). Blood samples were collected at the start and at the end of study. Liver and cardiac enzymes were measured by usual methods. At the end of study for each group, animals were sacrificed and deeply anesthetized by diethyl ether then specimens from the heart and liver were processed for histological study using light microscope. Results: There was no statistical significant difference in the body weight between negative and positive control group. In contrast, animals administering doping dose of testosterone enanthate for 8 and 12 weeks (group III-IV) showed a significant decrease in the body weight compared with animals of control group and group II (P < 0.05). There was a significant decrease in the body weight of recovery group (group Va and group Vb) when compared with control group (p value < 0.05). In the current study as regard the level of liver biomarkers (ALT-AST) had gradual significant increase all through the experimental periods. There was a significant increase in the level of creatinine kinase (CK) and CK-MB in treated groups versus control in most of experimental groups at P Conclusion: Chronic use of testosterone enanthate in supraphysiological dose (doping dose) has a toxic effect on rat cardiac muscle and liver in the form of alteration of normal histology, hypertrophy and fibrosis at both histological and biochemical levels which may lead to loss of their functions. This effect was partially reversible after cessation of the treatment.
https://amj.journals.ekb.eg/article_158480_61d003d92840e20206ccfa77f3d7d183.pdf
2021-04-01
1335
1348
10.21608/amj.2021.158480
Testosterone enanthate
supraphysiological dose of anabolic agents
Hepatotoxicity
Mohamed
Abd El-Aziz El-Gendy
dr.gendy2210@gmail.com
1
Departments of Forensic Medicine & Clinical Toxicology, Al-Azhar Faculty of Medicine, Egypt
LEAD_AUTHOR
Fouad
Helmy El-Dabbah
2
Departments of Forensic Medicine & Clinical Toxicology, Al-Azhar Faculty of Medicine, Egypt
AUTHOR
Ashraf
Ibrahim Hassan
3
Departments of Forensic Medicine & Clinical Toxicology, Al-Azhar Faculty of Medicine, Egypt
AUTHOR
Naser
Abd El-Naby Awad
4
Departments of Pathology, Al-Azhar Faculty of Medicine, Egypt
AUTHOR
REFERENCES
1
Abdelhafez, H. M. (2014): Histological, histochemical and ultrastructural studies on the effect of Deca-Durabolin and whey protein isolate on cardiac muscle in adult male albino rats. International Journal, 2(10): 164-187.
2
Abd Hamza, E and Rashid, K. H. (2017): Some hepatic and renal histological and physiological effects of the artificial testosterone (Sustanon) on female rats. Pak. J. Biotechnol. Vol, 14(3): 369-372.
3
Ahmadiasl N, Najafipour H, Soufi FG and Jafari A. (2012): Effect of short- and long-term strength exercise on cardiac oxidative stress and performance in rat. J Physiol Biochem, 68(1):121–8.
4
Al-Aubody, N. M and AL-Diwan, M. A. (2018): Histopathological changes of liver, kidneys and heart of male rats caused by abusing of sustanon 250. Basrah Journal of Veterinary Research, 17(3).
5
Althobiti SD, Alqurashi NM, Alotaibi AS, Alharthi TF, and Alswat KA. (2018): Prevalence, Attitude, Knowledge, and Practice of Anabolic Androgenic Steroid (AAS) Use among Gym Participants. Materia Socio-Medica, 30(1): 49.
6
Doumas, B. T., Watson, W. A. and Biggs, H. G. (1971): Albumin standards and the measurement of serum albumin with bromcresol green. Clinica chimica acta, 31(1): 87-96.
7
El-Halwagy, M. E., Abd-Alrahman, S. H., Mahmoud, R. H., Khalifa, F. K., Darwish, N. S., Attia, A. A and Mohamed, A. S. (2016): Impact of chronic androgenic steroid exposure on liver toxicity. International Journal of Clinical and Experimental Pathology, 9(2): 2652-2659.
8
Fontana K, Campos GER, Staron RS and da Cruz-Höfling MA. (2013): Effects of Anabolic Steroids and High-Intensity Aerobic Exercise on Skeletal Muscle of Transgenic Mice. PLoS ONE; 8 (11): e80909.
9
Frati P, Busardò FP, Cipolloni L, De Dominicis E and Fineschi V. (2015): Anabolic androgenic steroid (AAS) related deaths: autoptic, histopathological and toxicological findings, Curr., Neuropharmacol. 13 146–159.
10
10. Golestani, R., Slart, R.H., Dullaart , R.P., Glaudemans, A. W., Zeebregts, C.J. and Boersma, H.H.(2012): Adverse cardiovascular effects of anabolic steroids: pathophysiology imaging. Eur. J. Clin. Invest. 42(7):795-803.
11
11. Houglum, J. E. and Harrelson, G. L. (2011): Principles of pharmacology for athletic trainers (2nd ed.). SLACK Incorporated. p. 345.
12
12. Kahal, A., Allem, R., Zahzeh, T., Oulmane, S and Tafroukhte, Z. (2020): Abuse of androgenic anabolic drugs with “Cycling” induces hepatic steatosis in adult male mice. Steroids, 155: 108574.
13
13. Karbasi, S., Zaeemi, M., Mohri, M., Rashidlamir, A and Moosavi, Z. (2018): Effects of testosterone enanthate and resistance training on myocardium in Wistar rats; clinical and anatomical pathology. Andrologia, 50(3): e12908.
14
14. Lee, D. M., Min, T., Choi, I., Cheon, Y. P., Chun, T., Park, C. S and Lee, K. H. (2010): Feeding effect of an anabolic steroid, nandrolone, on the male rat testis. Asian-Australasian Journal of Animal Sciences, 23 (12): 1566-1577.
15
15. Lok, S., Tasgin, E., Demir, N and Ozdemir, M. (2010): Long term used testosterone may cause heart and liver damage. Journal of Animal and Veterinary Advances, 9(18): 2343–2345.
16
16. Lopes, R. A. M., Neves, K. B., Pestana, C. R., Queiroz, A. L., Zanotto, C. Z., Chignalia, A. Z and Tostes, R. C. (2014): Testosterone induces apoptosis in vascular smooth muscle cells via extrinsic apoptotic pathway with mitochondria-generated reactive oxygen species involvement. American Journal of Physiology-Heart and Circulatory Physiology, 306(11): H1485-H1494.
17
17. Nascimento, HM and Medei, E. (2011): Cardiac effects of anabolic steroids: hypertrophy, ischemia and electrical remodelling as potential triggers of sudden death. Mini reviews in medicinal chemistry, 11(5): 425-429.
18
18. Oberlander, J. G., Porter, D. M., Penatti, C. A and Henderson, L. P. (2012): Anabolic androgenic steroid abuse: multiple mechanisms of regulation of GABAergic synapses in neuroendocrine control regions of the rodent forebrain. Journal of neuroendocrinology, 24(1): 202-214.
19
19. Pope, H. G., Khalsa, J. H and Bhasin, S. (2017): Body image disorders and abuse of anabolic-androgenic steroids among men. Jama, 317(1): 23-24.
20
20. Riezzo I, De Carlo D, Neri M, Nieddu A, Turillazzi E and Fineschi V. (2011): Heart disease induced by AAS abuse, using experimental mice/rats models and the role of physical exercise. Mini Rev Med Chem, 11(5):409–424.
21
21. Young, D. S., Pestaner, L. C. and Gibberman, V. A. L. (1975): Effects of drugs on clinical laboratory tests. Clinical chemistry, 21(5): 1D.
22
ORIGINAL_ARTICLE
A STUDY OF THE EFFECT OF MUSCULAR EXERCISE WITH CINNAMON EXTRACT AND/OR FLAXSEEDS EXTRACT ON DIABETIC ADULT MALE ALBINO RATS
Background: Diabetes is one of the most common endocrine disorders. Muscular exercise possesses antioxidant property and can be a candidate in the treatment and prevention of diabetes complications. Cinnamon is a plant which displays antioxidant and glucose lowering effects. Flaxseeds are a promising alternative to reduce the risk of diseases associated with increased body weight as diabetes mellitus. Objective: To study the effect of muscular exercise with cinnamon extract and/or flaxseeds extract on diabetic adult male albino rats. Materials and Method: The present study was conducted on 72 adult male albino rats of a local strain divided into 9 equal groups: Group I: Control received distilled water only. Group II: Treated with flaxseeds extract (400 mg/kg orally). Group III: Treated with cinnamon extract (200 mg/kg orally). Group IV: Control practiced swimming program. Group V: Diabetic control rats. Group VI: Diabetic rats practiced swimming program. Group VII: Diabetic practiced swimming program and received flaxseeds extract. Group VIII: Diabetic practiced swimming program and received cinnamon extract. Group IX: Diabetic practiced swimming program and received both flaxseeds and cinnamon extract. Rats submitted to swimming program, received flaxseeds and cinnamon extracts after induction of diabetes according to the study groups, and submitted to body weight and food consumption assessment. At the end of the study, fasting plasma glucose level, blood insulin level, HbA1c, lipid profile, reduced glutathione (GSH) and malondialdehyde (MDA) were measured. Results: In diabetic rat’s submitted to swimming and received flaxseeds and cinnamon extracts, body weight relative to food consumption decreased. Fasting plasma glucose level and blood insulin level improved. No change in HBA1c. Lipid profile improved, reduced glutathione (GSH) increased in flaxseeds and cinnamon diabetic groups. Malondialdehyde (MDA) decreased in swimmed, flaxseeds and cinnamon diabetic groups. Histo-pathological architecture improved. The effect of combination of swimming, flaxseeds and cinnamon improved all parameters. Conclusion: Exercise with receiving flaxseeds extract or cinnamon extract in adult male diabetic rats improve body weight, glucose and insulin level, lipid profile, oxidative stress markers and tissue pathology, and the combination was more potent than each one alone.
https://amj.journals.ekb.eg/article_158482_553d2ebcef7c96e610c9e0b79bbb427a.pdf
2021-04-01
1349
1364
10.21608/amj.2021.158482
Exercise - Cinnamon - Flaxseeds
Diabetes mellitus
Mahmoud
Ahmed Mohamed
1
Department of Medical Physiology, Al-Azhar Faculty of Medicine
LEAD_AUTHOR
Gamal
Ahmed Shawer
2
Department of Medical Physiology, Al-Azhar Faculty of Medicine
AUTHOR
Al-Bayoumi
Ali Fouda
3
Department of Medical Physiology, Al-Azhar Faculty of Medicine
AUTHOR
REFERENCES
1
Afzal, U., Butt, M., Ashfaq, F., Bilal, A. and Suleria, H. (2020): Bioassessment of flaxseed powder and extract against hyperglycemia. Biomed. Res. Int., 12: 20-50.
2
Ahmad, A., Khan, A., Batool, Z., Hassan, M. and Khaliq, S. (2020): Medicinal effects of saffron and chamomile on diabetes mellitus and associated hyperlipidemia and memory impairment. Pak. J. Pharm. Sci., 33(3): 1191-1198.
3
Asano, R., Sales, M., Browne, R. and Moraes, R. (2014): Acute effects of physical exercise in type 2 diabetes; A review. World J. Diabetes, 5 (5): 659-665.
4
Bastuga, M. and Ficicilara, H. (2019): Effects of exercise training on anxiety in diabetic rats. Behavioral Brain Research, 376:11- 84.
5
Cronin, O., Keohane, D., Molloy, M. and Shanahan, F. (2017): The effect of exercise interventions on inflammatory biomarkers in healthy, physically inactive subjects. A systematic review. QJM, 7: 1-12.
6
Dou, L., Yahong, Z., Li, L., Gui, X. and Chen, Y. (2018): The effect of cinnamon on polycystic ovary syndrome in a mouse model. Reprod. Biol. Endocrinol., 6: 2–10.
7
El-Beeh, M., Fouda, Y., El-badry, D. and El-Sayyad, H. (2019): Anti-apoptic activity of cinnamon on some organs of 18 days rat fetuses of diabetic mother. Biosciences Biotechnology Research Asia, 16 (3): 637-648.
8
El-Ghawet, H., El-Sayyad, H., Ghanem, N. and Mkhemar, S. (2019): Cinnamon and ginger combined extract in improving diabetes. Iranian J. of Dia. and Obesity, 9 (3): 101-106.
9
Frigero, M., Santos, S., Serra1, A., et al., (2017): Effect of photobiomodulation therapy on oxidative stress markers of gastrocnemius muscle of diabetic rats subjected to high-intensity exercise. Lasers in Medical Science, original article, 3: 12-13.
10
10. Harriss, D., Macsween, A. and Atkinson, G. (2018): Standards for ethics in sport and exercise science research. International Journal of Sports Medicine, 38:1126–1131.
11
11. Hasaniani , N., Rahimlou, M., Ahmadi , A., Khalifani , A. and Alizadeh, M. (2019): The effect of flaxseed enriched yogurt on the glycemic status and cardiovascular risk factors in patients with type 2 diabetes mellitus: Randomized, Open-labeled, Controlled Study. Clin. Nutr. Res., 8 (4): 284-295.
12
12. Hassanpour, G., Hosseini, S., Keikhosravi, F. and Noura, M. (2017): The effect of swimming training with cinnamon extract on hematological factors in diabetic rats. Iranian J. of Dia. and Obesity, 9 (3): 101-106.
13
13. Hosni, A., Moneim, A., Abdel-Reheim, E. and Mohamed, M. (2017): Cinnamaldehyde potentially attenuates gestational hyperglycemia in rats through modulation of PPARgamma, pro inflammatory cytokines and oxidative stress. Biomed Pharmacotherapy, 88: 52-60.
14
14. Iqubal, A., Ali, A, Singh, A. and Kumar, A. (2019): Comparative nephroprotective effect of cinnamomum cassia and zingiber officinal on diabetic rat. Clinical Nutrition, 9 (12): 224 – 555.
15
15. Jáuregui, K., Aranda, C. and Herrera, A. (2017): Utricular hypofunction in patients with type 2 diabetes mellitus. Acta Otorhinolaryngol. Ital., 37: 430-435.
16
16. Kassaee, S., Goodarzi, M. and Oshaghi, E. (2017): Reno-protective effects of trigonella foenum and cinnamon on type 2 diabetic rats. Avicenna Journal of Medical Biochemistry, 5 (1): 17-21.
17
17. Kassaee, S., Goodarzi, M. and Oshaghi, E. (2017): Reno-protective effects of trigonella foenum and cinnamon on type 2 diabetic rats. Avicenna Journal of Medical Biochemistry, 5 (1): 17-21.
18
18. Kaur, G., Invally, M., Khan, M. and Jadhav, P. (2018): A nutraceutical combination of cinnamomum cassia and nigella sativa for type 1 diabetes mellitus. J. Ayurveda Integr. Med., 9: 27-37.
19
19. Kaviarasan, S., Naik, G. and Gangabhagirathi, R. (2015): In vitro studies on anti-radical and anti-oxidant activities of fenugreek (Trigonellafoenumgraecum) seeds. Food Chem., 103 (1): 3-7.
20
20. Loren, D., Roscoe, R. and Shack, A. (2018): Complementary and alternative medicine for diabetes. Canadian Journal of Diabetes, 42: 154-161.
21
21. Mora, A., Kayacanb, Y., Ipekoglua, G. and Arslanoglua, E. (2018): Effect of carbohydrate–electrolyte consumption on insulin, cortisol hormones and blood glucose after high-intensity exercise. The Journal of Metabolic Diseases, Archives of Physiology and Biochemistry, 1: 2-30.
22
22. Rajabi, G., Mohaddes, F., Farajdokht, S., Nayebi, M. and Mesgari, S. (2018): Impact of loganin on pro-inflammatory cytokines and depression- and anxiety-like behaviorsin male diabetic rats. Physiol. Int., 3: 199–209.
23
23. Rezaei, S., Sasani, M., Akhlaghi1, M. and Kohanmoo, A. (2020): Flaxseed oil in the context of a weight loss program ameliorates fatty liver grade in patients with non-alcoholic fatty liver disease: a randomized double-blind controlled trial. The British Journal of Nutrition, 3: 34-89.
24
24. Saed, L., Deihim, Z., Naghshbandi, M., Rajabnia, M. and Naleini, S. (2019): Cardiovascular events in patients with over 10 year's history of type 2 diabetes mellitus. Diabetes Metab. Syndr., 13: 68-72.
25
25. Salima, B., Saidb, G., Noureddine, M. and Allali H. (2018): Molecular modeling interaction between enzyme diabetes type 2 dipeptidyl-Peptidase (DPP-4) and main compound of cinnamon current enzyme inhibition. Clinical Nutrition, 14: 61-66.
26
26. Soltanian, N. and Janghorbani, M. (2018): A randomized trial of the effects of flaxseed to manage constipation, weight, glycemia, and lipids in constipated patients with type II diabetes. Nutrition & Metabolism, 2: 15-36.
27
27. Talaei, B., Amouzegar, A., Sahranavard, S., Hedayati, M., Mirmiran, P. and Azizi, F. (2017): Effects of cinnamon consumption on glycemic indicators, Advanced J. of Met., 4: 12-18.
28
28. Tzimou, A., Taitzoglou, I., Galazoulas, C. and Mougios, V. (2019): Effects of physical exercise and social isolation on anxiety related behaviors in two inbred rat strains. Behavioural Processes J., 142: 70–78.
29
ORIGINAL_ARTICLE
PREDICTORS OF RESPONSE TO PLASMAPHERESIS IN AUTOIMMUNE NEUROPATHIES
Background: Immune-mediated neuropathies represent a significant portion of cases encountered by neurologists. The scope of responsive neuropathies, the extent of response to plasmapheresis and its predictors varies widely. Objective: To recognize predictors of response to plasmapheresis in autoimmune-neuropathies. Patients and Methods: Seventy-six subjects; 61 Guillain-Barre syndrome (GBS) patients and 15 chronic inflammatory demyelinating polyneuropathy (CIDP) patients were recruited and evaluated using Medical Research Council sum score (MRCSS) and Modified Neuropathy Disability Score (NDS); on admission, 2 weeks and 3 months after six session of plasmapheresis. Different clinical, laboratory and neurophysiological variables were evaluated as possible predictors of response. Results: Of 61GBS patients, after 3 months, 41% (n=25) of them were poor-responders to plasmapheresis (<50% increase in MRCSS), and 59% (n=36) were good-responders. Older age, higher MRCSS on admission, lower NDS on admission, cyto-albuminous dissociation, electro-physiological evidence of axonal nerve affection and low NLR were predictors for poor response to plasmapheresis in GBS patients. Of 15 CIDP patients, after 3 months, 53.3% (n=8) of them were poor-responders to plasmapheresis (< 30% increase in MRCSS), and 46.7% (n=7) were good-responders. Higher MRCSS on admission, low CMAP amplitude, low MCV and long time between onset of the health problem and start of plasmapheresis were predictors for poor response to plasmapheresis in CIDP patients. Conclusion: Response to plasmapheresis in autoimmune neuropathies is variables and depends on several factors that can predict it.
https://amj.journals.ekb.eg/article_158484_b9def69c41c5d964a0bd7cf720422f50.pdf
2021-04-01
1365
1374
10.21608/amj.2021.158484
Guillain–Barré
Demyelinating Polyneuropathy
prognosis
Plasmapheresis
Yasser
El-Sayed Mukhtar
yassermukhtar1@gmail.com
1
Neurology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
LEAD_AUTHOR
Tarek
Ibrahim Mnecie
2
Neurology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Hassan
Kawashti Gad
3
Neurology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Mohammed
Ahmed Zaki
4
Neurology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
REFERENCES
1
Chevret S, Hughes RAC and Annane D (2017): Plasma exchange for Guillain-Barré syndrome. Cochrane Database of Systematic Reviews, Issue 2. Art. No.: CD001798.
2
Dyck PJB and Tracy JA (2018): History, Diagnosis, and Management of Chronic Inflammatory Demyelinating Polyradiculoneuropathy. Mayo Clin Proc, 93:777- 785.
3
Hashim NA, Samir WM and Mohammed EE (2020): Neutrophil–lymphocyte ratio and response to plasmapheresis in Guillain–Barré syndrome: a prospective observational study. The Egyptian Journal of Neurology, Psychiatry and Neurosurgery, 56:17-38.
4
Hugh J Willison, Bart C Jacobs, Pieter A and Van Doorn (2016): Guillain-Barré syndrome. Lancet; 388: 717-727.
5
Hughes RA, Swan AV and van Doorn PA (2014): Intravenous immunoglobulin for Guillain- Barré syndrome. Cochrane Database Syst. Rev, 9: CD002063.
6
Jeffrey A. A (2020): The Misdiagnosis of CIDP: A Review. Neurol Ther, 9:43–54.
7
Kuwabara S (2011): Does Campylobacter jejuni infection elicit axonal or demyelinating Guillain-Barre syndrome, or both? J Neurol Neurosurg Psychiatry. 82(3):238-312.
8
Lehmann HC, Burke D and Kuwabara S (2019): Chronic inflammatory demyelinating polyneuropathy: update on diagnosis, immunopathogenesis and treatment J Neurol Neurosurg Psychiatry, 90:981–987.
9
Lehmann HC, Burke D and Kuwabara S (2019): Chronic inflammatory demyelinating polyneuropathy: update on diagnosis, immunopathogenesis and treatment J Neurol Neurosurg Psychiatry, 90:981–987.
10
10. Prasad HB, Borse RT, Avate AN and Neelesh P (2017): Prognostic Indicators of Response to Plasmapheresis in Patients of Guillain Barre Syndrome. Journal of the Association of Physicians of India, 65: 119-167.
11
11. Rajabally Y and Narasimhan M (2011): Distribution, clinical correlates and significance of axonal loss and demyelination in chronic inflammatory demyelinating polyneuropathy. Eur J Neurol; 18:293-299.
12
12. Sahin S, Cinar N and Karsidag S (2017): Are cerebrospinal fluid protein levels and plasma neutrophil/ lymphocyte ratio associated with prognosis of Guillain– Barré syndrome. Neurol Int., 9:7032–6.
13
13. Shimizu F, Oishi M, Sawai S, Beppu M, Misawa S, Matsui N, Miyashiro A, Maeda T, Takeshita Y, Nishihara H, Sano Y, Sato R, Kaji R, Kuwabara S and Kanda T (2019): Increased IP-10 production by blood-nerve barrier in multifocal acquired demyelinating sensory and motor neuropathy and multifocal motor neuropathy. J Neurol Neurosurg Psychiatry, 90(4):444–450.
14
14. Van den Berg B, Walgaard C, Drenthen J, Fokke C, Jacobs BC and van Doorn PA (2014): Guillain-Barre syndrome: pathogenesis, diagnosis, treatment and prognosis. Nat Rev Neurol; 10: 469–82.
15
15. Van Doorn PA (2013): Diagnosis, treatment and prognosis of Guillain-Barre syndrome (GBS), 42: e193–201.
16
16. Verboon C, van Doorn PA and Jacobs BC (2017): Treatment dilemmas in Guillain- Barré syndrome. J. Neurol. Neurosurg. Psychiatry, 88: 346–352.
17
17. Willison HJ, Jacobs BC and van Doorn PA (2016): Guillain- Barré syndrome. Lancet, 388: 717–727.
18
18. Wu X, Li C, Zhang B, Shen D, Li T and Liu K (2015): Predictors for mechanical ventilation and short-term prognosis in patients with Guillain-Barre syndrome. Crit Care, 19:310-346.
19
19. Zhang Y, Zhao Y and Wang Y (2018): Prognostic factors of Guillain-Barré syndrome: a 111-case retrospective review. Chinese Neurosurgical Journal, 4:14-52.
20
ORIGINAL_ARTICLE
`COMPARISON BETWEEN LINEZOLID VERSUS VANCOMYCIN IN TREATMENT OF DIABETIC PATIENTS WITH NOSOCOMIAL PNEUMONIA CAUSED BY METHICILLIN RESISTANT STAPH AUREUS
Background: The optimal antibiotic therapy for the treatment of hospital acquired pneumonia (HAP) caused by Methicillin-resistant Staphylococcus aureus (MARSA) is controversial especially in diabetes mellitus patients. However, certain researches recommended that linezolid is superior to vancomycin in management of HAP. Objective: To assess the effect of treatment outcomes in patients with nosocomial pneumonia caused by methicillin- resistant staph aureus in diabetic patients and non-diabetic patients. Patients and Methods: This study was conducted on 120 patients at Mansoura Chest Diseases Hospital, Mansoura, Egypt, in the period between December 2019 and August 2020 among patients whose age more than 18 years old. Group A (n=60): Diabetic cases which further subdivided into two subgroups: Group A1 (n=30): Diabetic patients with nosocomial pneumonia receiving linezolid. Group A2 (n=30): Diabetic patients with nosocomial pneumonia receiving vancomycin. Group B (n=60): Non- diabetic cases, which further subdivided into two subgroups: Group B1 (n=30): Non-diabetic patients with nosocomial pneumonia receiving linezolid. Group B2 (n=30): Non-diabetic patients with nosocomial pneumonia receiving vancomycin. Results: APACHE score and duration of hospital admission were higher in diabetic cases in comparison with non-diabetic cases with statistically significant differences. Diabetic cases were more liable for complications with a subsequent high mortality rates in comparison with non-diabetic ones irrespective of the current usage of antibiotics (weather linezolid or vancomycin). Treatment outcomes were comparable among Linezolid and vancomycin used groups. The need for mechanical ventilation was comparable among all groups with no statistically significant difference. Conclusion: Diabetic comorbidity remains the main factor that affects the outcomes and prognosis of HAP cases. Higher complications and mortality rates were more in diabetic cases owing to their renal condition and uncontrolled diabetic status. Linezolid and vancomycin have similar efficacy and safety profiles in management of HAP cases.
https://amj.journals.ekb.eg/article_158485_1db5dccefb5a93fb8564bbbcb21b91bf.pdf
2021-04-01
1375
1394
10.21608/amj.2021.158485
HAP
Vancomycin
Linezolid
nosocomial pneumonia
Diabetic cases
APACHE score
Islam
Nomeir Mohamed El-Morsy
islam.nomeir@outlook.com
1
Department of Chest diseases Faculty of medicine, Al-Azhar University
LEAD_AUTHOR
Abu Bakr
Helal El-Asmar
2
Department of Chest diseases Faculty of medicine, Al-Azhar University
AUTHOR
Abdallah
Soliman Ayoob
3
Department of Chest diseases Faculty of medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Beibei L, Yun C and Mengli C (2010): Linezolid versus vancomycin for the treatment of gram-positive bacterial infections: meta-analysis of randomised controlled trials. International journal of antimicrobial agents, 35(1): 3-12.
2
Di Yacovo, S., Garcia-Vidal, C., Viasus, D., Adamuz, J., Oriol, I., Gili, F., ... & Carratala, J. (2013): Clinical features, etiology, and outcomes of community-acquired pneumonia in patients with diabetes mellitus. Medicine, 92(1):15.
3
Djahmi, N., Messad, N., Nedjai, S., Moussaoui, A., Mazouz, D., Richard, J. L., ... & Lavigne, J. P. (2013): Molecular epidemiology of Staphylococcus aureus strains isolated from inpatients with infected diabetic foot ulcers in an Algerian University Hospital. Clinical Microbiology and Infection, 19(9): E398-E404.
4
Equils O, da Costa C and Wible M (2016): The effect of diabetes mellitus on outcomes of patients with nosocomial pneumonia caused by methicillin-resistant Staphylococcus aureus: data from a prospective double-blind clinical trial comparing treatment with linezolid versus vancomycin. BMC infectious diseases, 16(1): 476 (1-10).
5
García MS, De la Torre MÁ and Morales G (2010): Clinical outbreak of linezolid-resistant Staphylococcus aureus in an intensive care unit. JAMA, 303(22): 2260-2264.
6
Giuliano KK, Baker D and Quinn B (2018): The epidemiology of nonventilator hospital-acquired pneumonia in the United States. American journal of infection control, 46(3): 322-327.
7
Kalil AC, Klompas M and Haynatzki G (2013): Treatment of hospital- acquired pneumonia with linezolid or vancomycin: a systematic review and meta-analysis. BMJ open, 3(10): e003912.
8
Kalil AC, Murthy MH and Hermsen ED (2010): Linezolid versus vancomycin or teicoplanin for nosocomial pneumonia: a systematic review and meta-analysis. Critical care medicine, 38(9): 1802-1808.
9
Kalil, A. C., Metersky, M. L., Klompas, M., Muscedere, J., Sweeney, D. A., Palmer, L. B., ... & El Solh, A. A. (2016): Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 clinical practice guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clinical Infectious Diseases, 63(5), e61-e111.
10
10. Korol E, Johnston K and Waser N (2013): A systematic review of risk factors associated with surgical site infections among surgical patients. PloS one, 8(12): e83743.
11
11. Kullar R, Davis SL and Levine DP (2011): Impact of vancomycin exposure on outcomes in patients with methicillin-resistant Staphylococcus aureus bacteremia: support for consensus guidelines suggested targets. Clinical Infectious Diseases, 52(8): 975-981.
12
12. Lipsky BA, Itani KM and Weigelt JA (2011): The role of diabetes mellitus in the treatment of skin and skin structure infections caused by methicillin-resistant Staphylococcus aureus: results from three randomized controlled trials. International Journal of Infectious Diseases, 15(2): e140-e146.
13
13. Meyer E, Schwab F and Gastmeier P (2010): Nosocomial methicillin resistant Staphylococcus aureus pneumonia-epidemiology and trends based on data of a network of 586 German ICUs (2005-2009): European Journal of Medical Research, 15(12): 514.
14
14. Walkey AJ, O'Donnell MR and Wiener RS (2011): Linezolid vs glycopeptide antibiotics for the treatment of suspected methicillin- resistant Staphylococcus aureus nosocomial pneumonia: a meta- analysis of randomized controlled trials. Chest, 139(5): 1148-1155.
15
15. Wunderink RG, Niederman MS and Kollef MH (2012): Linezolid in methicillin-resistant Staphylococcus aureus nosocomial pneumonia: a randomized, controlled study. Clinical Infectious Diseases, 54(5): 621- 629.
16
ORIGINAL_ARTICLE
RELATIONSHIP BETWEEN SERUM MAGNESIUM AND ERYTHROPOIETIN RESPONSIVENESS IN HEMODIALYSIS PATIENTS
Background: Serum magnesium is associated with anemia. But the roles of magnesium in anemia and erythropoietin (EPO) responsiveness remain not well knwon in maintenance hemodialysis (MHD) patients. Objective: to study the level of serum magnesium and its relationship with EPO responsiveness in MHD patients. Patients and methods: This study was done in hemodialysis unit at Bab El-Shaareya University Hospital, during the period of January 2020 to June 2020. A total of 60 regular hemodialysis (RHD) patients were recruited for this survey. Their anthropometrics and laboratory data were collected. EPO responsiveness was evaluated by the erythropoietin resistance index (ERI). The patients were divided into 2 groups according to EPO resistance Index (ERI) Group A, the patients with higher ERI than 1.52, and group B with lower ERI than 1.52. Multivariate logistic regressions were conducted to evaluate the factors that may be associated with EPO responsiveness. Results: The mean serum magnesium level was higher than normal levels in RHD patients, while nearly no hypomagnesemia was observed. A multivariate logistic regression model revealed that lower serum magnesium levels were correlated with a high ERI. The OR of a high ERI was found to be 2.89 (93% CI 1.197–4.715, p = 0.005) for group A and 1.57 (94% CI 0.779––2.941, p > 0.05) for group. Conclusion: Serum magnesium levels were found to be higher than normal levels in RHD patients. A high serum magnesium level was shown to be correlated with good EPO responsiveness and it has a protective role from EPO hyporesponsiveness.
https://amj.journals.ekb.eg/article_158475_bd4f14f24f312c0bf72582e9cccb3387.pdf
2021-04-01
1395
1404
10.21608/amj.2021.158475
Hemodialysis
Serum magnesium
erythropoietin responsiveness
erythropoietin resistance index
Khalid
Gamal El-Hady
khaledd88@yahoo.com
1
Departments of Internal Medicine, Faculty of Medicine in Cairo, Al-Azhar University
LEAD_AUTHOR
Fawzy
Hamid Hassan
2
Departments of Internal Medicine, Faculty of Medicine in Cairo, Al-Azhar University
AUTHOR
Mohammed
Ahmed Al-Sayed
3
Departments of Internal Medicine, Faculty of Medicine in Cairo, Al-Azhar University
AUTHOR
Ahmed
Ali Ali Assem
4
Departments of Clinical Pathology, Faculty of Medicine in Cairo, Al-Azhar University
AUTHOR
REFERENCES
1
Abe M, Okada K, Soma M and Matsumoto K (2011): Relationship between insulin resistance and erythropoietin responsiveness in hemodialysis patients. Clin Nephrol. 75(1): 49–58.
2
Bellinghieri G, Condemi CG, Saitta S, Trifirò G, Gangemi S and Savica V (2015): Erythropoiesis-stimulating agents: dose and mortality risk. J Ren Nutr. 25(2): 164–8.
3
Blaine J, Chonchol M and Levi M (2015): Renal control of calcium, phosphate, and magnesium homeostasis. Clin J Am Soc Nephrol. 10(7): 1257–72.
4
Chait, Horowitz J and Nichols B (2014): Control-relevant erythropoiesis modeling in end-stage renal disease. IEEE Trans Biomedical Eng. 61:658–664.
5
Chang JH, Jung JY, Lee HH, Chung W, Joo KW and Kim S (2011): Serum resistin as a novel marker of erythropoietin resistance in nondiabetic patients on hemodialysis. Tohoku J Exp Med. 224(4): 281–5.
6
GBD (2013): Global Burden of Diseases, Injuries, and Risk Factors prevention and control of noncommunicable diseases 2013-2020. Geneva, Switzerland: World Health Organization; 2013.
7
Kanbay M, Perazella MA, Kasapoglu B, Koroglu M and Covic A (2010): Erythropoiesis stimulatory agent- resistant anemia in dialysis patients: review of causes and management. Blood Purif, 29(1): 1–12.
8
Khalil SK, Amer HA, El Behairy AM and Warda M (2016): Oxidative stress during erythropoietin hyporesponsiveness anemia at end stage renal disease: molecular and biochemical studies. J Adv Res. 7(3): 348–58.
9
Lau JH, Gangji AS, Rabbat CG and Brimble KS (2015): Impact of haemoglobin and erythropoietin dose changes on mortality: a secondary analysis of results from a randomized anaemia management trial. Nephrol Dial Transplant. 25(12): 4002–9.
10
10. Locatelli F, Martin-Malo A, Hannedouche T, Loureiro A, Papadimitriou M,Wizemann V, Jacobson S.H, Czekalski S, Ronco C,Vanholder R and Membrane Permeability Outcome (MPO) Study Group (2009) Effect of Membrane Permeability on Survival of Hemodialysis Patients. J Am Soc Nephrol. 20: 645–654.
11
11. Mallick S, Rafiroiu A, Kanthety R, Iqbal S, Malik R, Rahman M (2012) Factors predicting erythropoietin resistance among maintenance hemodialysis patients. Blood Purif. 33(4): 238–44.
12
12. Locatelli F, Martin-Malo A, Hannedouche T, Loureiro A, Papadimitriou M,Wizemann V, Jacobson S.H, Czekalski S, Ronco C,Vanholder R and Membrane Permeability Outcome (MPO) Study Group (2009): Effect of Membrane Permeability on Survival of Hemodialysis Patients. J Am Soc Nephrol. 20: 645–654.
13
13. Mallick S, Rafiroiu A, Kanthety R, Iqbal S, Malik R, Rahman M (2012): Factors predicting erythropoietin resistance among maintenance hemodialysis patients. Blood Purif. 33(4): 238–44.
14
14. Ogawa T, Shimizu H, Kyono A, Sato M, Yamashita T and Otsuka K (2014): Relationship between responsiveness to erythropoiesis-stimulating agent and long-term outcomes in chronic hemodialysis patients: a single-center cohort study. Int Urol Nephrol. 46(1): 151–9.
15
15. Okazaki M, Komatsu M, Kawaguchi H, Tsuchiya K and Nitta K (2014): Erythropoietin resistance index and the all-cause mortality of chronic hemodialysis patients. Blood Purif., 37(2): 106–12.
16
16. Sakaguchi Y, Fujii N, Shoji T, Hayashi T, Rakugi H and Iseki K (2014): Committee Renal Data Registry of the Japanese Society for Dialysis Therapy. Magnesium modifies the cardiovascular mortality risk associated with hyperphosphatemia in patients undergoing hemodialysis: a cohort study. PLoS One, 9(12):e116273.
17
17. Toprak O, Kurt H, Sarı Y, Şarkış C, Us H and Kırık A (2017): Magnesium Replacement Improves the Metabolic Profile in Obese and Pre-Diabetic Patients with Mild-to-Moderate Chronic Kidney Disease: A 3-Month, Randomised, Double-Blind, Placebo-Controlled Study. Kidney Blood Press Res, 42(1): 33–42.
18
18. Xiong J, He T, Wang M, Nie L, Zhang Y and Wang Y (2019): Serum magnesium, mortality, and cardiovascular disease in chronic kidney disease and end-stage renal disease patients: a systematic review and meta-analysis. Journal of Nephrology, 32(5):791-802.
19
19. Yoon HE, Kim YW, Ha KS, Sim EH, Go SW and Shin SJ (2013): Hypermagnesemia accompanied with colonic perforation in a hemodialysis patient. Yonsei Med J, 54(3): 797–800.
20
20. Yu L, Li H and Wang SX (2017): Serum Magnesium and Mortality in Maintenance Hemodialysis Patients. Blood Purif, 43(1–3): 31–6.
21
21. Ling Yu , Jinghong Song, Xiangxue Lu, Yuan Zu, Han Li, Shixiang Wang (2019): Association between Serum Magnesium and EPO Responsiveness in Hemodialysis Patients: A Cross-Sectional Study Kidney Blood Press Res., 44:354–361.
22
22. Zhan Y, Chen R, Zheng W, Guo C, Lu L and Ji X (2014): Association between serum magnesium and anemia: china health and nutrition survey. Biol Trace Elem Res. 159(1-3): 39–45.
23
ORIGINAL_ARTICLE
EFFECT OF HELICOBACTER PYLORI INFECTION ON NON VARICEAL BLEEDING IN PATIENTS WITH LIVER CIRRHOSIS
Background: Variceal bleeding in chronic liver disease has been studied extensively. However, 30-40% of upper digestive hemorrhages in cirrhotic patients are non variceal (NVUGIB). Clinical features and endoscopic findings of this population have rarely been reported. Objective: To determine the prevalence of H. pylori infection in cirrhotic patients with non variceal upper gastrointestinal bleeding. Patients and methods: This was carried out at Hepatology, Gastroenterology and Infectious Diseases Department of Al-Azhar University Hospitals, and conducted on 150 patients infected by H. pylori From May 2019 till November 2019. Pateints were selected and divided into three equal groups: Group A: Patients with recent active bleeding (maximum within two days) of non variceal origin diagnosed endoscopically. Group B Matched cirrhotic patients without history of upper gastrointestinal bleeding, and group C Non-cirrhotic patients without history of upper gastrointestinal bleeding. Upper GI Endoscopy was done for all patients of the studied groups. Multiple biopsies were taken and H.pylori infection was determined by Histopathology. Results: The mean age of participants was 54.3 years. Males were 79 (52.6%) while females were 71 (47.3%). 58 of 150 patients (38.6%) were positive for H. pylori. there was no significant relation between H. pylori positivity and cause of cirrhosis. there was significant relation between H. pylori positivity and Sex of the studied cases. And there was high significant difference between the studied groups as regard H. pylori distribution. Conclusion: There was significant association between H. pylori infection and non variceal upper gastrointestinal bleeding. Eradication therapy has a role in reducing the incidence of NVUGIB in cirrhotic patients.
https://amj.journals.ekb.eg/article_158619_15b64cd1a714e4541d4f1aa8898d0137.pdf
2021-04-01
1405
1414
10.21608/amj.2021.158619
Cirrhosis
H. pylori
Non Variceal
Hepatology
Gastroenterology and Infectious diseases
Samy
Mohamed El-Sayed
n.eraa7666@yahoo.com
1
Department of Hepatology, Gastroenterology and Infectious Diseases, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Nader
Farid Mostafa
2
Department of Hepatology, Gastroenterology and Infectious Diseases, Faculty of Medicine, Al-Azhar University
AUTHOR
Abdallah
Hendawi El-Shahat
3
Department of Hepatology, Gastroenterology and Infectious Diseases, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Abbas, Z., Yakoob, J. and Usman, MW. (2014): Effect of Helicobacter pylori and its virulence factors on portal hypertensive gastropathy and interleukin (IL)‑8, IL‑10,and tumor necrosis factor‑alpha levels. Saudi Journal of Gastroenterology, 20: 120‑7.
2
Eid, KAA., Shawky, MAE. and Hassan, AM. (2016): Prevalence of Helicobacter pylori infection in patients with portal hypertensive gastropathy owing to liver cirrhosis in Upper Egypt. Al-Azhar Assiut Medical Journal, 14(3): 109-111.
3
Elsebaey, MA., Tawfik, MA. and Elshweikh, SA. (2019): Impact of Helicobacter pylori Infection on Gastric Variceal Bleeding among Patients with Liver Cirrhosis. Gastroenterol Res Pract., 6:529-532.
4
Hanafy, AS., El Hawary, AT. and Hamed EF. (2016): Impact of Helicobacter pylori eradication on refractory thrombocytopenia in patients with chronic HCV awaiting antiviral therapy. European Jourrnal of Clinical Microbiology Infectious Diseases, 7:1171–1176.
5
Hassan, A., Afaf, T., Hanaa, M. and Ashraf, A. (2018): Association of Helicobacter pylori infection and Potal Hypertensive Gastropathy in Liver Cirrhosis. The Medical Journal of Cairo University, 86:1281-1286.
6
Holland-Bill, L., Christiansen, C., Gammelager, H. and Mortensen, R. (2015): Chronic liver disease and 90-day mortality in 21 359 patients following peptic ulcer bleeding − a Nationwide Cohort Study. Alimentary Pharmacology and Therapeutics, 41(6):564-72.
7
Huang, J. and Cui, J. (2017): Evaluation of Helicobacter pylori in patients with chronic hepatic disease. Chinese medical journal, 130(2):149‑156.
8
Kitano, S. and Dolgor, B. (2012): Does portal hypertension contribute to the pathogenesis of gastric ulcer associated with liver cirrhosis? J Gastroenterol., 35:79-86.
9
Narayanan, M., Reddy, K., Mrasicano, E. and Kavya, M. (2018): Peptic Ulcer Diseas and Helicobacter pylori infection. Missouri medicine, 115(3):219-222.
10
10. Pogorzelska, J., Łapińska, M., Kalinowska, A., Lapinski, T. and Flisiak, R. (2017): Helicobacter pylori infection among patients with liver cirrhosis. European Journal of Gastroenterology & Hepatology, 29(10): 1161-1164.
11
11. Puri, S., Jain, M. and Narayan, KS. (2017): Helicobacter pylori infection in patients with portal hypertensive gastropathy owing to liver cirrhosis: Prevalence and relation with severity of gastropathy. Journal of Digestive Endoscopy, 8(03): 123-128.
12
12. Safwat, E., Hussein, HA. and Hakim, SA. (2015): Helicobacter pylori in Egyptian patients with HCV‑related liver cirrhosis and portal hypertensive gastropathy: Prevalence and relation to disease severity. Life Sci J., 12:168‑73.
13
13. Sakamoto, Y., Oho, K. and Toyonaga, A. (2013): Effect of Helicobacter pylori infection on esophagogastric variceal bleeding in patients with liver cirrhosis and portal hypertension. Journal of Gastroenterology and Hepatology, 28(9): 1444-1449.
14
14. Sathar, SA., Kunnathuparambil, SG. and Sreesh, S. (2013): Helicobacter pylori infection in patients with liver cirrhosis: Prevalence and association with portal hypertensive gastropathy. Annals of Gastroenterology, 26(4):48‑52.
15
15. Toyonaga, A. and Iwao, T. (2013): Portal hypertensive gastropathy. J Gastroenterol Hepatol., 13:865-877.
16
16. Voulgaris, t., karagiannakis, D., Siakavellas, S., Kalogera, D., Angelopoulos, T., Chloupi, E.and Vlachogiannakos, j. (2019): High prevelance of asymptomatic peptic ulcers diagnosed during screening endoscopy in pateints with cirrhosis. Annals of Gastroenterology, 32(5):451-453.
17
17. Wang, J., Li, WT. and Zheng, YX. (2016): The association between Helicobacter pylori infection and chronic hepatitis C: a meta-analysis and trial sequential analysis. Gastroenterol Res Pract., 8:780-795.
18
ORIGINAL_ARTICLE
EVALUATION OF EFFICACY AND SAFETY OF TOPICAL NICOTINAMIDE FOR TREATMENT OF PSORIASIS VERSUS CALCIPOTRIOL-BETAMETHASONE: COMPARATIVE STUDY
Background: Psoriasis is a chronic skin disorder typically characterized by symmetrical erythematous papules and plaques with a silver scale. Objective: To compare the efficacy and safety of topical nicotinamide for the treatment of mild to moderate psoriasis in Interventional Clinical Trial study compared with calcipotriol-betamethasone. Patients and methods: Our study was carried out on sixty patients from November 2019 to March 2020, complaining of psoriasis thirty patients treated by topical nicotinamide 4% weekly and thirty patients treated by topical calcipotriol-betamethasone weekly. Patients were selected from out-patient clinic of Dermatology, Venereology and Andrology Department of Al-Azhar University Hospitals. Results: The present study using topical nicotinamide 4% weekly versus calcipotriol –betamethasone weekly showed lesions on both sides were similar regarding baseline Psoriasis Area and Severity Index (PASI) score (P = 0.148), while at 1 month and 3 months after therapy, PASI scores were significantly lower with calcipotriol betamethasone in the second group as compared with nicotinamide alone in first group (P < 0.001). At the end of the trial, PASI scores were reduced by 17.9± 7.8 points before treatment to 12.2± 5.08 after 12 weeks with nicotinamide as compared to 16.2 ± 5.5 before treatment to 9.1± 3.2 points with calcipotriol betamethasone (P < 0.001). Conclusion: Nicotinamide can be used for topical psoriasis treatment and may be a good adjuvant to be added to the treatment regimens of psoriasis and it was less effective than calcipotriol betamethasone regarding clinical response and patient's satisfaction.
https://amj.journals.ekb.eg/article_158621_26a7ec702e6e4a7aaf4c6118eb1cdddc.pdf
2021-04-01
1415
1424
10.21608/amj.2021.158621
Nicotinamide 4%
Calcipotriol-betamethasone
Psoriasis
Ahmed
Saeed Mostafa Anbar
anbarman2020@gmail.com
1
Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Mohammed
Ahmed El-Khalawany
2
Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Al-Azhar University
AUTHOR
Ahmed
Hassan Nouh
3
Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Alvarez AC, Rodríguez-Nevado I and De Argila D (2011): Recalcitrant pustular psoriasis successfully treated with adalimumab. Pediatr Dermatol., 28: 195–197.
2
Bailey EE, Ference EH, Alikhan A, Hession MT and Armstrong AW (2012): Combination treatments for psoriasis: A systematic review and meta-analysis. Arch Dermatol., 148:511–22.
3
Chen AC and Damian DL (2014): Nicotinamide and the skin. Australas J Dermatol., 55: 169– 75.
4
Drago F, Ciccarese G and Parodi (2016): Nicotinamide for skin‐cancer chemoprevention. N Engl J Med., 374: 789– 90.
5
Elman SA, Weinblatt M and Merola JF (2018): Targeted therapies for psoriatic arthritis: an update for the dermatologist. Semin Cutan Med Surg., 37(3):173-181.
6
Kuchekar AB, Pujari RR, Kuchekar SB, Dhole SN and Mule PM (2011): Psoriasis: A comprehensive review. Int. J. of Pharm. & Life Sci., 2:857-877.
7
Levine D, Even-Chen Z, Lipets I, Pritulo OA, Svyatenko TV and Andrashko Y (2010): Pilot, multicenter, double-blind, randomized placebo-controlled bilateral comparative study of a combination of calcipotriene and nicotinamide for the treatment of psoriasis. J Am Acad Dermatol., 63:775–81.
8
Morganti P, Berardesca E, Guarneri B, Guarneri F, Fabrizi G and Palombo P (2011): Topical clindamycin 1% vs. linoleic acid-rich phosphatidylcholine and nicotinamide 4% in the treatment of acne: A multicentre-randomized trial. Int J CosmetSci., 33:467–76.
9
Nguyen CT, Bloch Y, Składanowska K, Savvides SN and Adamopoulos IE (2019): Pathophysiology and inhibition of IL-23 signaling in psoriatic arthritis: A molecular insight. Clin. Immunol., 206:15-22.
10
10. Parisi R, Symmons DP, Griffiths CE and Ashcroft DM (2013): Impact project team Global epidemiology of psoriasis: A systematic review of incidence and prevalence. J. Invest. Dermatol., 133:377–385.
11
11. Park J, Halliday GM and Surjana D (2010): Nicotinamide prevents ultraviolet radiation‐induced cellular energy loss. Photochem Photobiol., 86: 942– 8.
12
12. Rovito H and Oblong J (2013): Nicotinamide preferentially protects glycolysis in dermal fibroblasts under oxidative stress conditions. Br J Dermatol., 169: 15– 24.
13
13. Siadat AH, Iraji F, Khodadadi M and Jary MK (2013): Topical nicotinamide in combination with calcipotriol for the treatment of mild to moderate psoriasis: A double-blind, randomized, comparative study. J Res Med Sci., 18(2): 115–117.
14
ORIGINAL_ARTICLE
EVALUATION OF THE EFFICACY OF TOPICAL PIPERINE OIL COMBINED WITH EXCIMER LIGHT PHOTOTHERAPY IN THE TREATMENT OF NON-SEGMENTAL VITILIGO: COMPARATIVE INTRA INDIVIDUAL STUDY
Background: Vitiligo is an acquired idiopathic disease that appears as skin depigmented patches due to a loss of melanocytes that are responsible for producing melanin pigment in the skin, hair, mucous membranes and retina. Objective: To evaluate the efficacy of topical piperine oil combined with excimer light phototherapy in the treatment of non-segmental vitiligo: comparative intra individual study. Patients and methods: Our study was carried out on 30 patients complaining of vitiligo from December 2019 to September 2020. Thirty subjects with two comparable patches were treated by excimer light phototherapy; one of them was randomly selected and treated with daily topical piperine oil at home. Patients were selected from out-patient clinic of Dermatology, Venereology and Andrology Department of Al-Azhar University Hospitals. Results: The present study showed improvement in patches treated with piperine plus excimer light phototherapy as excellent response in 60% of patients, good response in 6.6% of patients, fair response in 26.6% of patients and poor response in 6.6% of patients. Improvement in patches treated with excimer light phototherapy only as excellent response in 6.6% of patients, good response in 46.6% of patients, fair response in 26.6% of patients and poor response in 20% of patients. Conclusion: Using piperine combined with Excimer light phototherapy was a promising method for vitiligo treatment.
https://amj.journals.ekb.eg/article_158624_13dd15f952e5f8baaa0a606569285fca.pdf
2021-04-01
1425
1432
10.21608/amj.2021.158624
Piperine oil
Excimer light phototherapy
Vitiligo
Mahmoud
Abd El-Ghany El-Dyasty
mahmoudddyasty2013@gmail.com
1
Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Mohamed
Ahmed Abd El-Rahman El-Khalawany
2
Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Al-Azhar University
AUTHOR
Ibrahim
Mohamed Abd El-Salam Abd El-Kareem
3
Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Hedayat, K., Karbakhsh, M, Ghiasi M, Goodarzi A, Fakour Y, Akbari Z (2016): Quality of life in patients with vitiligo and vitiligo hypotheses: A cross‐ sectional study based on Vitiligo Quality of Life index (VitiQoL). Health and Quality of Life Outcomes, 14(1): 86–98.
2
Hossan, Piccinno R, Caccialanza M and Forti S (2012): Narrowband ultraviolet B phototherapy and immunological interventions in the treatment of vitiligo: Evaluation of results in 28 patients. Pediatric Dermatology, 29(2): 160–165.
3
Khaitan B, Kathuria S and Ramam M (2012): A descriptive study to characterize segmenta and non-segmental vitiligo prevelance. Indian Journal of Dermatology, Venereology and Leprology, 78(6): 715–734.
4
Lee D, Patel R, Chaudhary B, Mehta A and Pilani A (2010): tacrolimus (Protopic) has been applied to treat vitiligo that may develop skin cancer or lymphoma, 39(3): 143–146.
5
Mahajan V, Khatri G, Singh R, Chauhan P and Mehta K (2015): Bier spots: An uncommon cause of mottled skin. Indian Dermatol Online J, 6(2): 128–129.
6
Meghwal M and Goswami T (2013): Piper nigrum and piperine: An update. Phytotherapy Research, 27(8): 1121–1130.
7
Nordal E, Guleng G and Rönnevig J (2011): Treatment of vitiligo with narrowband-UVB (TL01) combined with tacrolimus ointment (0.1%) vs. placebo ointment, a randomized right/left double-blind comparative study. Journal of the European Academy of Dermatology and Venereology, 25(12): 1440–1443.
8
Sarveswari K (2010): Cosmetic camouflage in vitiligo and response to treatment. Indian Journal of Dermatology, 55(3): 211–214.
9
Shafiee B, Sun Y, Chen H, and Gao, X (2018): Treatment of vitiligo with NB-UVB: A systematic review. Journal of Dermatological Treatment, 26(4): 340–346.
10
Speeckaert R and van N (2017): Vitiligo: An update on pathophysiology and treatment options. American Journal of Clinical Dermatology, 18(6): 733–744.
11
Whitton, Toossi P, Shahidi-Dadras M, Mahmoudi M and Fesharaki R (2011): Effect of vitiligo on the quality of life. Journal of the European Academy of Dermatology and Venereology, 25(10): 1182–1186.
12
Yaghoobi R, Omidian M and Bagherani N (2011): Vitiligo: A review of the published work. The Journal of Dermatology, 38(5): 419–431.
13
ORIGINAL_ARTICLE
ROLE OF MICRO RNA-21 IN EGYPTIAN PATIENTS WITH ISCHEMIC HEART DISEASE
Background: Ischemic heart diseases are major sources of morbidity and mortality worldwide. Several biomarkers have been suggested to aid in the diagnosis of myocardial infarction and unstable angina. Multiple micro-RNAs, a class of regulatory ribonucleic acids, have been studied in ischemic heart disease patients for a potential role in diagnosis. Objective: To study the role of micro RNA-21(miRNA21 or miR21) in Egyptian patients with ischemic heart diseases(IHD), myocardial infarction (MI) and unstable angina (UA) to evaluate its diagnostic value in IHDs. Patients and Methods: This prospective case-control study included 50 subjects, divided into two groups: Patient group including 30 subjects, and control group including 20 subjects. Subjects were subjected to full history taking and clinical assessment, routine lab investigations, cardiac markers assay, and determination of serum expression of Micro RNA-21 using real-time polymerase chain reaction (PCR). This study was conducted on patients attending at cardiology department, Al-Hussein University Hospital. Study started in March 2018, and ended in October 2018. Results: Micro-RNA expression profile showed that miR-21 was up-regulated in MI and UA patients in general, with a statistically extremely highly significant difference (p=<0.001). Its diagnostic performance was marvelous, but couldn’t distinguish between UA and MI. Conclusions: In conclusion, we found that Micro RNA-21 showed a statistically extremely high significant up regulation in MI and UA patients, with strong diagnostic performance, but couldn't distinguish between UA and MI. Micro RNA-21 might be biomarker for ischemic heart disease.
https://amj.journals.ekb.eg/article_158629_4132c4a629b7b9c984e4e1a6574fe48a.pdf
2021-04-01
1433
1446
10.21608/amj.2021.158629
: Micro-RNA
Cardiac
Fold-changes
biomarker
Mohammed
Abd El-Fattah Mokhtar Khalaf
mak_3turbo@yahoo.com
1
Departments of Clinical Pathology, Faculty of Medicine- Al-Azhar University
LEAD_AUTHOR
Hassan
Abd El-Aziz Gaber
2
Departments of Clinical Pathology, Faculty of Medicine- Al-Azhar University
AUTHOR
Tarek
Abd El-Kareim El-Dahshan
3
Departments of Clinical Pathology, Faculty of Medicine- Al-Azhar University
AUTHOR
Ahmad
Fathey Abd El-Aziz
4
Departments of Clinical Pathology, Faculty of Medicine- Al-Azhar University
AUTHOR
Ahmed
Kamal Harfoush
5
Departments of Cardiology, Faculty of Medicine- Al-Azhar University
AUTHOR
REFERENCES
1
Backus BE, Six AJ and Kelder JC. (2013): Prospective validations of the HEART score for chest pain patients at the emergency department.Int J Cardiol., 168: 2153-8.
2
Bonauer A, Carmona G, Iwasaki M, Mione M and Koyanagi M. (2010): MicroRNA-92a controls angiogenesis and functional recovery of ischemic tissues in mice. Science, 324: 1710–1713.
3
Darabi F, Aghaei M and Movahedian A. (2017): Association of serum microRNA‑21 levels with Visfatin, inflammation, and acute coronary syndromes. Heart Vessels, 32:549–557.
4
Deddens JC, Colijn JM and Oerlemans MIFJ. (2013): Circulating MicroRNAs as Novel Biomarkers for the Early Diagnosis of Acute Coronary Syndrome. J of Cardiovasc Trans Res., 6: 884–898.
5
Desjardins P and Conklin D (2010): NanoDrop microvolume quantitation of nucleic acids. J Vis Exp., (45):2565-67.
6
Fiedler J, Jazbutyte V and Kirchmaier BC. (2011): MicroRNA-24 regulatesvascularity after myocardial infarction. Circulation, 124:720–730.
7
Gao C, Zhao D and Wang J. (2019): Clinical significance and correlation of microRNA-21 expression and the neutrophil-lymphocyte ratio in patients with acute myocardial infarction. Clinics, 74:e1237.
8
Han H, Qu G, Han C, Sun T, Li F, Wang J and Luo S (2015): MiR-34a, miR-21 and miR-23a as potential biomarkers for coronary artery disease: a pilot microarray study and confirmation in a 32 patient cohort. Experimental & Molecular Medicine, 47: 138-142.
9
Kukreja RC, Yin C and Salloum FN. (2011): MicroRNAs: new players in cardiac injury and protection. Mol Pharmacol., 80: 558-564.
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10. Ling H, Guo Z, Shi Y, Zhang L and Song C. (2020): Serum Exosomal MicroRNA-21, MicroRNA-126, and PTEN Are Novel Biomarkers for Diagnosis of Acute Coronary Syndrome. Front Physiol., 11:654-57.
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11. Livak K and Schmittgen T (2001): Analysis of relative gene expression data using real time quantitative PCR and the 2^-CT method. Methods, 25: 402-8.
12
12. Long G, Wang F and Duan Q (2012): Human circulating microRNA-1 and microRNA-126 as potential novel indicators for acute myocardial infarction. Int J Biol Sci., 8:811–818.
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13. Mythili S and Malathi N. (2015): Diagnostic markers of acute myocardial infarction. J Nucl Cardiol., 3: 1-6.
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14. Oerlemans MI, Mosterd A and Dekker MS. (2012): Early assessment of acute coronary syndromes in the emergency department: the potential diagnostic value of circulating microRNAs. EMBO Mol Med., 4:1176–85.
15
15. Olivieri F, Antonicelli R, Lorenzi M, Lisa R, La Sala L and Galeazzi R. (2013): Diagnostic potential of circulating miR-499-5p in elderly patients with acute non ST-elevation myocardial infarction. Int J Cardiol., 31:531–536.
16
16. Paul P, Chakraborty A and Sarkar D. (2017): Interplay between miRNAs and Human Diseases: A Review. Journal of Cellular Physiology, 233(3):2007-2018.
17
17. Porwal V, Khandelwal S, Jain D and Gupta S. (2016): Histological Classification of Atherosclerosis and Correlation with Ischemic Heart Disease. A Autopsy Based Study Annals of Pathology and Laboratory Medicine, 3(2):103-104.
18
18. Robinson S, Follo M and Haenel D. (2018): Droplet digital PCR as a novel detection method for quantifying microRNAs in acute myocardial infarction. Int J Cardiol., 257: 247–254.
19
19. Samani OS and Meder B (2016): microRNA assays for acute coronary syndromes. De Gruyter J., 3(4): 183–188.
20
20. Tawfik NA, El-Dydamoni OA, Abozaid SY, Ebrahem EE and Abd EL Rahim MMMA. (2019): Serum miRNA-146a and miRNA-155 as Novel Biomarkers in Lupus Nephritis Activity with Systemic Lupus Erythematosus. American Journal of Biochemistry, 9: 21-34.
21
21. Van Rooij E, Sutherland LB and Thatcher JE. (2010): Dysregulation of microRNAs after myocardial infarction reveals a role of miR-29 in cardiac fibrosis. Proc Natl Acad Sci USA., 105: 13027–13032.
22
22. Xu F, Xu L, Wang M and Feng G. (2015): The accuracy of circulating microRNA-21 in the diagnosis of colorectal cancer: a systematic review and meta-analysis. Colorectal Dis., 17: 100-107.
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23. Yates LA, Norbury CJ, and Gilbert RJ. (2013): The long and short of microRNA. Cell, 153(3): 516–9.
24
24. Zhang Y, Liu YJ, Liu T and Yang J. (2016): Plasma microRNA-21 is a potential diagnostic biomarker of acute myocardial infarction. Eur Rev Med Pharmacol Sci., 20(2):323-9.
25
25. Zile MR, Mehurg SM and Arroyo JE. (2011): Relationship between the temporal profile of plasma microRNA and left ventricular remodeling in patients after myocardial infarction. Circulation Cardiovascular Genetics, 4: 614–619.
26
ORIGINAL_ARTICLE
ANALGESIC EFFICACY OF BILATERAL ULTRASOUND GUIDED ERECTOR SPINAE PLANE BLOCK IN LUMBAR SPINE SURGERIES
Background: Pain after lumbar spine surgery is often difficult to control in the postoperative period. Traditionally, opioids have been the mainstay of treatment but are associated with many unwanted side effects and prolonged hospital stay. The ultrasound-guided erector spinae plane block (ESPB) is a relatively safe, simple technique. However, there are few controlled studies evaluating its efficacy. Objective: To evaluate the analgesic efficacy of bilateral ultrasound-guided erector spinae plane block in lumbar spine surgeries. Patients and Methods: This study included 50 patients of both sexes admitted for lumbar surgery at the Al-Hussein University Hospital from December 2019 to August 2020. They were randomly allocated into two groups: Control group (general anesthesia without ESPBP), and ESPB Group: included general anesthesia and bilateral ultrasound-guided erector spinae plane block. The following parameters were assessed in the two studied groups: Heart rate, mean arterial blood pressure, arterial oxygen saturation, end-tidal CO2, recovery profile, time of patient ambulation, visual analog score pain scores (VAS), Ramsay Sedation Scale scores, first request for postoperative analgesia, adverse events, the level of the patient satisfaction, and total dose of postoperative nalbuphine consumption. Results: This study showed a significant statistical difference regarding the postoperative VAS pain scores between the two groups. Patients who received ESPB had improved post-operative analgesia, better patients’ satisfaction, and earlier patient ambulation. Conclusion: Bilateral ultrasound-guided erector spinae plane block in lumbar spine surgeries is one of the most advantageous adjuvant blocks for improving post-operative pain relief and reducing opioid use and subsequently side effects.
https://amj.journals.ekb.eg/article_158630_4e335f792cb690df57391c874c9d426a.pdf
2021-04-01
1447
1458
10.21608/amj.2021.158630
Erector Spinae
Postoperative Nalbuphine Consumption
Lumbar Surgery
Abd El-Rahman
Mohammed Abd El-Fattah El-Maghraby
drabdelrahmanelmaghraby@gmail.com
1
Department of Anesthesiology and Intensive Care, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Ayman
Hussein Fahmy Mohammed Kahla
2
Department of Anesthesiology and Intensive Care, Faculty of Medicine, Al-Azhar University
AUTHOR
Othman
Saad El-Deen Yahia Mousa
3
Department of Anesthesiology and Intensive Care, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Aksu C, Kuş A, Yörükoğlu H, Kılıç L and Gürkan Y (2019): The Effect of Erector Spinae Plane Block on Postoperative Pain Following Laparoscopic Cholecystectomy. Journal of Anaesthology and Reanimation Specialists’ Society, 27(1): 9-14.
2
Altiparmak B, Toker MK, Uysal Aİ, Kuşçu Y and Demirbilek SG (2019): Efficacy of ultrasound-guided erector spinae plane block for analgesia after laparoscopic cholecystectomy: a randomized controlled trial. Rev Bras Anestesiol., 69(6): 561-568.
3
Calandese F and Adduci A (2019): Erector spinae plane block for acute post-operative pain management after anterior thoracolumbar spine surgery. J Clin Anesth.; 52: 55–56.
4
Devin CJ and McGirt MJ (2015): The best evidence in multimodal pain management in spine surgery and means of assessing post-operative pain and functional outcomes. Journal of Clinical Neuroscience, 22(6): 930-938.
5
Ding X, Jin S, Niu X, Wang T, Zhao X, Ren H, Tong Y and Li Q (2014): Morphine with adjuvant ketamine versus higher dose of morphine alone for acute pain: a meta-analysis. International Journal of Clinical and Experimental Medicine, 7(9): 2504-11.
6
Forero M, Adhikary SD, Lopez H, Tsui C and Chin KJ (2016): The erector spinae plane block: a novel analgesic technique in thoracic neuropathic pain. Regional Anesthesia and Pain Medicine, 41(5): 621–627.
7
Karaca O and Pınar H (2020): The Efficacy of Ultrasound-Guided Erector Spinae Plane Block for Postoperative Analgesia in Laparoscopic Cholecystectomy. A Retrospective Cohort Study, Journal of Anesthesiology and Reanimation Specialists’ Society (JARSS), 28(3): 179–187.
8
Singh S, Choudhary NK, Lalin D and Verma VK (2020): Bilateral ultrasound-guided erector spinae plane block for postoperative analgesia in lumbar spine surgery: a randomized control trial. Journal of neurosurgical anesthesiology, 32(4): 330-334.
9
Ueshima H, Inagaki M, Toyone T and Otake H (2019): Efficacy of the erector spinae plane block for lumbar spinal surgery: a retrospective study. Asian spine journal; 13(2): 254–264.
10
10. Ueshima H and Otake H (2017): Clinical experiences of ultrasound-guided erector spinae plane block for thoracic vertebra surgery. J Clin Anesth.; 38: 137–150.
11
ORIGINAL_ARTICLE
COMPARATIVE STUDY OF DIFFERENT FORMULAE OF ULTRASONOGRAPHIC QUANTIFICATION OF THE AMOUNT OF PLEURAL EFFUSION
Background: Pleural effusion may be a result of a primary pulmonary illness. It also can be the pleural manifestation of numerous of diseases that primarily affect other organs. Quantification of pleural effusion is of great value in clinical practice, as it usually guides the plan of management. Chest ultrasound (U/S) is one of the helpful non-invasive means in estimating pleural fluid volume. Objective: To correlate the U/S estimated volumes of pleural fluid calculated by studied formulae, with the actual effusion volume, and to identify the most accurate formula in quantifying the pleural fluid volume. Patients and Methods: This prospective cross-sectional study was carried out in the department of Chest, Bab Al-sha'reia University Hospital, during the period from October 2019 to September 2020, and included forty patients with clinical and radiological diagnosis of pleural effusion. Ultrasound estimation of the amount of pleural effusion was done using 4 different formulae, followed by full pleural drainage through either simple aspiration or tube thoracostomy. Lastly, the ultrasonographically estimated fluid volumes were then compared to the actually drained fluid volume. Results: The supine formulae showed excellent correlation with the drained pleural fluid volume, with Pearson correlation coefficient(r) = 0.9607 and 0.9602 for Eibenberger and Balik formulae respectively (p-value <0.0001). On the other side, the erect formulae were found to have reasonable correlations with the drained volume, with r= 0.4017 (p-value= 0.0102) and 0.5729 (p-value <0.0001) for Goecke1 and Goecke 2 respectively. All studied formulae failed to quantify the pleural effusion volume accurately when comparing its estimated volume to the actually drained fluid volume. Conclusion: The 4 studied formulae had good correlations with the actually drained volume. However, supine formulae were better than erect formulae.
https://amj.journals.ekb.eg/article_158632_84a962d0be41cc85dc72bd8850113f8d.pdf
2021-04-01
1459
1466
10.21608/amj.2021.158632
Pleural effusion
ultrasonographic
quantification
Mohamed
Sabri Ahmed Amin
mohamed.sabri.1992@gmail.com
1
Department of Chest, Faculty of medicine, Al-Azhar University, Cairo, Egypt
LEAD_AUTHOR
Abo-Bakr
Helal Al-Asmar
2
Department of Chest, Faculty of medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Houssam
El-Din Hassanin Abd El-Naby
3
Department of Chest, Faculty of medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
REFERENCES
1
Brockelsby C, Ahmed M and Gautam M (2016): Pleural disease assessment and outcome (Pleural effusion size estimation: U/S, CXR or CT? Thorax; 3: A1-A288.
2
Cerquitella M, Saccomandi P, Schena E, Silvestri S, Scarlata S and Giua R (2016): Ultrasound estimation of pleural effusion in geriatric patients. In: IEEE International Symposium on Medical Measurements and Applications (MeMeA), 15-18.
3
Hassan M, Rizk R, Essam H and Abouelnour A (2017): Validation of equations for pleural effusion volume estimation by ultrasonography. J Ultrasound, 20: 267-271.
4
Ibitoye BO, IdowuBM, Ogunrombi AB and Afolabi BI (2018): Ultrasonographic quantification of pleural effusion: comparison of four formulae. Ultrasonography; 37(3): 254-260.
5
Lichtenstein D (2017): Novel approaches to ultrasonography of the lung and pleural space: where are we now? Breathe; 13: 100-111.
6
Light RW (2013): Pleural diseases. 6th ed.Pbl.Philadelphia, PA: Lippincott Williams &Wilkins., 126-129.
7
Mathis G (2011): Pleura. In: Mathis G, ed. Chest sonography. 3rd ed. Pbl.Heidelberg: Springer-Verlag., 30-32.
8
Mercer RM, Psallidas I and Rahman NM (2017): Ultrasound in the management of pleural disease. Expert Rev Respir Med.; 11: 323-331.
9
Müller MC,Arbous MS and Spoelstra-de Man (2015): Transfusion of fresh-frozen plasma in critically ill patients with a coagulopathy before invasive procedures: a randomized clinical trial (CME). Transfusion, 55(1): 26-35.
10
10. Teichgräber UK and Hackbarth J (2018): Sonographic bedside quantification of pleural effusion compared to compute tomography volumetry in ICU patients. Ultrasound Int Open, 4(4): E131-E135.
11
11. Usta E, Mustafi M and Ziemer G (2010): Ultrasound estimation of volume of postoperative pleural effusion in cardiac surgery patients. Interact CariovascThorac Surg.; 10: 204-207.
12
12. Vetrugno L and Bove T (2018): Lung ultrasound estimation of pleural effusion fluid and the importance of patient position. Ann. Intensive Care; 8: 125.
13
ORIGINAL_ARTICLE
CLINICAL COMPARATIVE STUDY BETWEEN INTRATHECAL DEXMEDETOMIDINE AND DEXAMETHASONE ON PROLONGING THE DURATION OF INTRATHECAL BLOCKADE IN LOWER LIMB ORTHOPEDIC SURGERY
Background: Spinal anesthesia is safer than general anesthesia during lower limb operations; many studies have been concerned about prolonging the duration of spinal anesthesia by adding different adjuvants. Objective: To compare the efficacy of intrathecal dexmedetomidine versus intrathecal dexamethasone in prolonging duration of spinal anesthesia, and postoperative analgesia, safety and hemodynamic stability. Patients and methods: Our study was carried out on 60 patients of American Society of Anesthesiologists (ASA) physical status I or II, scheduled for orthopedic operation under spinal anesthesiadivided into A, B and C from March 2020 to November 2020. They were divided into 3 equal groups: Group A received 2ml bupivacaine (0.5%) and 10μg dexmedetomidine in 1ml normal saline intrathecal, Group B received 2ml bupivacaine (0.5%) and 4 mg dexamethasone in 1 ml normal saline intrathecal and Group Creceived 2ml bupivacaine (o.5%) and 1ml normal saline Intrathecal. The study was carried out at Al-Azhar University Hospitals (Al- Hussein and Sayed Galal Hospitals). Results: The present study showed statistically significant difference (P-value <0.001) between the three groups according to time of motor and sensory regression. The regression time of block (both sensory and motor) were prolonged in A (sensory 359.50±20.32, motor 319.00±21.06) and B (sensory 199.75±18.22, motor 170.00±20.00) when compared to the C group (sensory 149.55±10.83, motor 141.00±22.09). However, the duration was longest in A group among the three groups. According to amount of analgesic consumption postoperatively, there was significant decrease in amount in A group in comparison to B and C groups. The amount is insignificantly decreased in B group in comparison to C group. Regarding safety and hemodynamic stability there was no statistically significant difference between the three groups. Conclusion: Dexmedetomidine had prolonging the duration of spinal anesthesia more than dexamethasone and control group with statistically significant difference between the three groups and provided prolonged postoperative analgesia compared to dexamethasone and control group.
https://amj.journals.ekb.eg/article_158633_7b27b55cb9466cb085b4c7186b59b474.pdf
2021-04-01
1467
1478
10.21608/amj.2021.158633
Intrathecal dexmedetomidine
intrathecal dexamethasone
Spinal anesthesia
Ahmed
Abd El-Hamed Hassan
ahmedabdelhamed@azhar.edu.eg
1
Department of Anesthesia and Intensive Care, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Ali
Abd-Allah Al-Kumity
2
Department of Anesthesia and Intensive Care, Faculty of Medicine, Al-Azhar University
AUTHOR
Alaa
El-Deen Mahmoud Sayed Ahmed
3
Department of Anesthesia and Intensive Care, Faculty of Medicine, Al-Azhar University
AUTHOR
Ismaeil
Abd El-Latif Shabaiek
4
Department of Anesthesia and Intensive Care, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Al-Mustafa M. M., Badran I. Z., Abu-Ali H. M., Al-Barazangi B. A., Mossad I. M. and Al-Ghanem S. M. (2013): Intravenous dexmedetomidine prolongs bupivacainespinal analgesia. Middle East J Anesthesiology: 20: 225–231.
2
Bajwa S. J., Bajwa S. K., Kaur J., Singh G. and Arora V. (2011): Dexmedetomidine and clonidine in epidural anaesthesia: a comparative evaluation. Indian J Anesthesia: 55:116–1 21.
3
Bani-Hashem N., Hassan-Nasab B., Pour E. A., Maleh P. A., Nabavi A. andJabbari A. (2011): Addition of intrathecal dexamethasone to bupivacaine for spinal anesthesia in orthopedic surgery. Saudi J Anesthesia: 5:382– 386.
4
Ganesh M. and Krishnamurthy D. (2018): A comparative study of dexmedetomidine and clonidine as an adjuvant to intrathecal bupivacaine in lower abdominal surgeries. Anesthesia. Essays and Researches: 12: 539– 545.
5
Gupta R., Bogra J., Verma R., Kohli M., Kushwaha J.K. and Kumar S. (2011): Dexmedetomidine as an intrathecal adjuvant for postoperative analgesia. Indian J Anesthesia: 55:347– 351.
6
Kaya F. N., Yavascaoglu B., Turker G., Yildirim A., Gurbet A., Mogol E. B. andOzcan B. (2010): Intravenous dexmedetomidine, but not midazolam, prolongs bupivacaine spinal anesthesia. Can J Anesthesia: 57:39– 45.
7
Nashwa E., Heba I. N. andKarim G. (2014): The effect of adding dexmedetomidine versus dexamethasone on prolonging the duration of intrathecal bupivacaine in lower abdominal operations.Ain-Shams Journal of Anesthesiology: 07:388–392.
8
Nethra S. S., Sathesha M., Aanchel D., Pradeep A. D., Harsoor S. and Devikarani D. (2015): Intrathecal dexmedetomidine as adjuvant for spinal anesthesia for perianal ambulatory surgeries. Indian J. of Anesthesia: 51:177–181.
9
Rajesh M., Suvarana K., Indu S., Taznim M. and Priyanka P. (2015): Difficult air way management and alternative from regional anesthesia. Indian Journal of Anesthesia: 59: 801–806.
10
Reddy V. S., Shaik N. A., Donthu B. and Jangam V. (2013): Intravenous dexmedetomidine versus clonidine for prolongation of bupivacaine spinal anesthesia and analgesia: A randomized double-blind study. J Anesthesiology Clin Pharmacology: 29: 342–347.
11
Routary S., Rabinarayan D. and Bidhubhusan M. (2017): Comparison of intraarticulerlevobupivacaine and dexmedetomidine with ropivacaine and dexmedetomidine for postoperative pain management. AIMDR: 13: 120–131.
12
Shalu P. S. and Ghodki P. S. (2017): Dexamethasone efficacy in prolonging spinal anesthesia in elective CS. Anesth. Essays and researches: 11: 321– 325.
13
Shukla D., Verma A. and Agarwal A. (2011): Comparative study of intrathecal dexmedetomidine with intrathecal magnesium sulfate used as adjuvants to bupivacaine. J Anesthesiology Clin Pharmacology: 27: 495–502.
14
Solanki S. L., Bharti N., Batra Y. K., Jain A., Kumar P. and Nikhar S.A. (2013): The analgesic effect of intrathecal dexmedetomidine or clonidine, with bupivacaine, in trauma patients undergoing lower limb surgery: a double-blind study. Anaesth.S Intensive Care: 41:51– 56.
15
ORIGINAL_ARTICLE
ROLE OF IMAGING IN ACUTE ABDOMEN IN ADULT
Background: Acute abdominal pain is a common complaint of patients presenting at the Emergency Department. Approximately, 10% of presentations at the Emergency Department are because of acute abdominal pain which can be caused by a variety of diseases ranging from mild and self-limiting to life-threatening diseases. Objective: The purpose of this study was to collect data for constructing an optimal diagnostic algorithm for the wide spectrum of patients with acute abdominal pain at the Emergency Department (ED). Patients and methods: The study was carried out at the Department of Radiology, Al-Azhar University Hospitals, Cairo. The study was carried during the period between April 2019 and April 2020 a total of 30 patients were selected from those were referred to Radiology Department of Al-Azhar University Hospitals. All patients were subjected to conventional radiography, US and CT scan. Results: Out of 30 patients, there were 15 (50%) male patients, 15 (50%) female patients. The spectrum of diseases included in the study were bowel obstruction (23.3%), obstetric related causes (20.0%), urinary cause (20.0%), acute appendicitis (13.3%), abdominal malignancy (3.3%), acute cholecystitis (3.3%), Chron’s disease (3.3%), hepatic abscess (3.3%), pancreatitis (3.3%), perforated viscus (3.3%) and splenic abscess (3.3%). Conclusion: Radiological assessment has a main role in diagnosis and treatment of acute abdomen. CT proved to be a better imaging modality with high sensitivity and specificity in diagnosis than conventional imaging especially in acute appendicitis, Chron’s disease, hepatic abscess, pancreatitis and splenic abscess. X-ray was the standard in diagnosis of intestinal obstruction or viscus perforation.
https://amj.journals.ekb.eg/article_158637_602c3b31154fd367f9685398183d3032.pdf
2021-04-01
1479
1488
10.21608/amj.2021.158637
abdominal pain
ED
CT
X-ray
Ahmed
Mahmoud Helmy Mohammed
ahmed_helmy@gmail.com
1
Department of Radio diagnosis, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Abd El-Monem
Sayed Ragheb
2
Department of Radio diagnosis, Faculty of Medicine, Al-Azhar University
AUTHOR
Mahmoud
Kadry El-Gendy
3
Department of Radio diagnosis, Faculty of Medicine, Al-Azhar University
AUTHOR
Mohamed
Abu El-Naga Mohamed
4
Department of Radio diagnosis, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Al-Ajerami Y. (2012): Sensitivity and specificity of ultrasound in the diagnosis of acute appendicitis. East Mediterr Health J., 18(1):66-9.
2
Allemann F, Cassina P, Rothlin M and Largiader F. (2010): Ultrasound scans done by surgeons for patients with acute abdominal pain: a prospective study. Eur J Surg., 165(10): 966-70.
3
Ashindoitiang JA, Atoyebi AO and Arogundade RA. (2012): The value of plain abdominal radiographs in management of abdominal emergencies. Luth Nig Q J Hosp Med., 18(3): 170-174.
4
Caterino S, Meli C, Capotondi C, Cavallini M, Zerilli M, Schiffino L, Murante G, Alessi G and Cavallaro A. (2011): Role of ultrasonography in emergency surgery. Ann ItalChir., 66(1):87-97.
5
Fagerstroem A, Paajanen P and Saarelainen H. (2017): Non-specific abdominal pain remains as the most common reason for acute abdomen: 26-year retrospective audlt in one emergency unit. Scandinavian Journal of Gastroenterology, 52(10):1-6.
6
Gans SL, Pols MA and Stoker J. (2015): Guideline for the Diagnostic Pathway in Patients with Acute Abdominal Pain. Dig Surg., 32:23–31.
7
Gans SL, Stoker J and Boermeester MA. (2016): Plain abdominal radiography in acute abdominal pain; past, present, and future. International Journal of General Medicine, 5: 525–533.
8
Laméris W, RandenAV and Boermeester MA. (2017): Optimization of diagnostic imaging use in patients with acute abdominal pain (OPTIMA): Design and rationale. BMC Emergency Medicine, 7:9-12.
9
Manfredi R, Brizi MG, Canade A, Vecchioli A and Marano P. (2011): Imaging of acute pancreatitis. Rays, 26(2):135-42.
10
10. Mayumi T, Yoshida M and Furukawa A. (2015): The Practice Guidelines for Primary Care of Acute Abdomen 2015. Japanese Journal of Radiology, 23(1): 80-115.
11
11. McGrath FP and Keeling F. (2011): The role of early sonography in the management of the acute abdomen. ClinRadiol., 44(3):172-4.
12
12. Postma GN, Seybt MW, Rees CJ, Snow JB and Wackym PA. (2011): Ballinger’s otolaryngology Head & neck surgery. 22thedition. Pbl. Shelton, Conn: BC Decker Inc, Pp. 975-95.
13
13. Rai V, Mishra M, Pandey Y, Singh P and Tripathi A. (2017): Diagnostic role of ultrasonography for diagnosis of acute abdomen. JMSCR., 5(8): 26609-26613.
14
14. Van Randen A, Laméris W, van Es HW, van Heesewijk HP, van Ramshorst B, ten Hove W and Stoker J. (2011): A comparison of the accuracy of ultrasound and computed tomography in common diagnoses causing acute abdominal pain. European Radiology, 21(7): 1535-1545.
15
15. Velissaris D, Karanikolas M and Gogos C. (2017): Acute Abdominal Pain Assessment in the Emergency Department: The Experience of a Greek University Hospital. J Clin Med Res., 9(12):987-993.
16
16. Zoller WG, Kellner H and Schwerk WB. (2010): Value of ultrasound in diagnosis of acute appendicitis. Bildgebung, 63(2):78-82.
17
ORIGINAL_ARTICLE
ROLE OF TRANSBRONCHIAL LUNG BIOPSY AND BRONCHOALVEOLAR LAVAGE IN DIAGNOSIS OF DIFFUSE PARENCHYMAL LUNG DISEASE
Background: Diffuse parenchymal lung diseases (DPLD) constitute a group of over 200 diverse etiologic entities which present with respiratory symptoms and diffuse lung infiltrates and account for 15% of patients seen by a pulmonary physician. Objective: To evaluate the role of transbronchial lung biopsy and bronchoalveolar lavage in diagnosis of diffuse parenchymal lung disease. Patients and Methods: This prospective cross-sectional study was carried out at the Department of Chest, Al-Hussein University Hospital, during the period from October 2019 to October 2020, and included sixty patients admitted in the inpatient wards with undiagnosed DPLD, after detailed history taking, physical examinations, routine labs, chest X-ray PA view, HRCT chest, pulmonary function tests (PFTs) as simple spirometry, ECG, echocardiography and Arterial blood gases evaluation. All of them were subjected to fibrooptic bronchoscope, transbronchial lung biopsy and bronchoalveolar lavage. Results: As regard comparison between bronchoalveolar lavage (BAL) and transbronchial lung biopsy (TBLB) diagnostic yield there was a statistical significant difference between TBLB positive and negative patients, as regard BAL predominant cells and BAL microbiology. the comparison of histopathology as regard TBLB diagnostic yield showed a statistical significant difference between TBLB positive and TBLB negative patients. Conclusion: Bronchoalveolar lavage was a minimally invasive procedure performed during flexible bronchoscopy. BAL cellular analysis alone was insufficient to diagnose the specific type of DPLD, except in malignancies and some rare interstitial lung diseases (ILDs), and the yield of bronchoscopic lung biopsy was high in diseases where the lesions were peri bronchial in distribution such as in sarcoidosis, hypersensitivity pneumonitis and organizing pneumonias.
https://amj.journals.ekb.eg/article_158639_30112d57e69fe44f38d6bf9b93fef103.pdf
2021-04-01
1489
1496
10.21608/amj.2021.158639
Diffuse Parenchymal Lung Disease
Bronchoalveolar lavage
Transbronchial Lung Biopsy
Ahmed
Rady Abd El-Azeem Erfan
kedomedo8@gmail.com
1
Department of Chest, Faculty of medicine, Al-Azhar University, Cairo, Egypt
LEAD_AUTHOR
Hamdy
Mohamed Zoair
2
Department of Chest, Faculty of medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Ibraheem
Hassan Mohamed
3
Department of Chest, Faculty of medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
Khalid
Mohamed Halima
4
Department of Chest, Faculty of medicine, Al-Azhar University, Cairo, Egypt
AUTHOR
REFERENCES
1
Andersen HA and Fontana RS. (2012): Transbronchoscopic lung biopsy for diffuse pulmonary diseases: technique and results in 450 cases. Chest., 62:125-8.
2
Cantrell ET, Martin RR, Warr GA, Busbee DL. (2013): Induction of aryl hydrocarbon hydroxylase in human pulmonary alveolar macrophages by cigarette smoking. Trans Assoc Am Physicians., 86:121-30.
3
F Fend, G Mikuz, G Ott and J Rothmund. (2012): Combined transbronchial lung biopsy and bronchoalveolar lavage in diffuse parenchymal lung disease,Pathol Res Pract. Mar; 184(3):312-7.
4
Jindal SK, Gupta D and Aggarwal AN. (2010): Sarcoidosis in developing countries. Current Opinion in Pulmonary Medicine, 6:448–454.
5
Kebbe J and Tony A. (2017): the diagnostic role of bronchoscope in interstitial lung disease, 10:2103-37.
6
Leslie KO. (2016): My approach to interstitial lung disease using clinical, radiological and histopathological patterns. J Clin Pathol 62:387-401.
7
Meyer KC, Raghu G, Baughman RP and Brown K (2012): An official American Thoracic Society clinical practice guideline: the clinical utility of bronchoalveolar lavage cellular analysis in interstitial lung disease. Am J Respir Crit Care Med., 185: 1004-14. 10.1164/rccm.201202-0320ST.
8
Poletti V, Chilosi M and Olivieri D. (2014): Diagnostic invasive procedures in diffuse infiltrative lung diseases. Respiration., 71:107-19.
9
Quin H, Qun Lo, Xiaobo C, Jiaxing X, Lulu Wu and Rongchang Chen (2017): Transbronchial lung biopsy and bronchoalveolar lavage in diffuse parenchymal lung disease Clin Respir J,; 11(2):168-175.
10
Reynolds HY. (2017): Bronchoalveolar Lavage 1, 2. American Review of Respiratory Disease. Am Thoracic Soc., 135:250-63.
11
Wollin L, Wex E, Pautsch A and Schnapp G. (2015): Mode of action of Nintedanib in the treatment of idiopathic pulmonary fibrosis. Eur Respir J., 45:1434–1445.
12
ORIGINAL_ARTICLE
THE EFFECT OF ALPHA LIPOIC ACID ON IDIOPATHIC ASTHENOZOOSPERMIC PATIENTS
Background: Many infertile men have disorders correctable with the use of medication, and if diagnosed and treated properly, natural fertilization can be attained.
Objective: To evaluate the effect of ALA on semen parameters in idiopathic asthenozoospermia.
Patients and methods: This was a case-control study, including 80 patients presenting with primary infertility enrolled from outpatient Andrology Clinic Units of Al-Azhar University Hospitals. Patients were divided into two equal groups. One group was given oral ALA tablets at a dose of 300 mg twice/day, whereas the other group was given a placebo twice daily. The duration of the study ranged from March 2020 till September 2020.
Results: There was a significant difference between 2 groups as regard total motility after treatment progressive motility after treatment, and % vitality after treatment.
Conclusion: Medical therapy of asthenoteratospermia with ALA supplement could improve quality of semen parameters.
https://amj.journals.ekb.eg/article_158490_4cc5b717a81f94f82559bdf0c4c07e55.pdf
2021-04-01
1497
1506
10.21608/amj.2021.158490
: Reproductive
Infertility
ALA
Semen
and Asthenozoospermia
Ahmed
N. M. Abd El-Hamid
zayed3_6@hotmail.com
1
Departments of Dermatology & Andrology, Faculty of Medicine, Al-Azhar University, Egypt
AUTHOR
Yahya
M. I. Hodeeb
2
Departments of Dermatology & Andrology, Faculty of Medicine, Al-Azhar University, Egypt
AUTHOR
Emad
M. El-Rewiny
3
Departments of Dermatology & Andrology, Faculty of Medicine, Al-Azhar University, Egypt
AUTHOR
Abdullah
M. Gaafar
4
Departments of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Egypt
AUTHOR
REFERENCES
1
Bidmeshkipour A, Hosseinzadeh A, Gholinezhad M and Biparva P. (2010): Seminal plasma total antioxidant capacity and vitamin-C levels in asthenozoospermia: a case-control study. Tehran Univ Med J., 67: 835–42.
2
Borowczyk K, Krawczyk M, Kubalczyk P and Chwatko G. (2015): Determination of lipoic acid in biological samples. Bioanalysis, 7(14): 1785–1798.
3
Buanayuda GW, Lunardhi H and Mansur IG. (2019): Effect of In-Vitro Alpha Lipoic Acid Addition on Spermatozoa Motility in Sperm Preparation Process. Folia Medica Indonesiana, 55(4): 246-250.
4
Canepa P, Dal Lago A, De Leo C, Gallo M, Rizzo C and Licata E. (2018): Combined treatment with myo-inositol, alpha-lipoic acid, folic acid and vitamins significantly improves sperm parameters of sub-fertile men: A multi-centric study. Eur Rev Med Pharmacol Sci., 22: 7078-7085.
5
Eslamian G, Amirjannati N, Rashidkhani B, Sadeghi MR, Baghestani AR and Hekmatdoost A. (2015): Dietary fatty acid intakes and asthenozoospermia: a case-control study. Fertility and Sterility, 103(1): 190-198.
6
Haghighian HK, Haidari F, Mohammadi-Asl J and Dadfar M. (2015): Randomized, triple-blind, placebo-controlled clinical trial examining the effects of alpha-lipoic acid supplement on the spermatogram and seminal oxidative stress in infertile men. Fertility and Sterility, 104(2): 318-324.
7
Ibrahim SF, Jaffar FHF, Osman K and Syed SF. (2011): Bull spermatozoa motility: optimization of coenzyme q10 and alpha-lipoic acid concentration. IIOAB J., 2: 8-13.
8
Ibrahim SF, Osman K, Das S, Othman AM, Majid NA and Rahman MP. (2012): A study of the antioxidant effect of alpha lipoic acids on sperm quality. Clinics, 63: 545-550.
9
Khosrowbeygi A, Zarghami N and Deldar Y. (2012): Correlation between sperm quality parameters and seminal plasma antioxidants status. Iran J Reprod Med., 2:58–64.
10
10. Lu J, Huang Y and Lü N. (2010): WHO Laboratory Manual for the Examination and Processing of Human Semen: its applicability to andrology laboratories in China. Zhonghua Nan Ke Xue., 16(10):867-71.
11
11. Manda K, Ueno M, Moritake T and Anzai K. (2011): K.a-Lipoic acid attenuates x-irradiation-induced oxidative stress in mice. Cell Biol Toxicol., 23:129–137.
12
12. Raaia MF, Atyeah AA, Elkhiat YI and Elenany HG. (2012): Treatment of idiopathic asthenozoospermia, either isolated or oligoasthenozoospermia, with α-lipoic acid: a placebo-controlled, double-blind study. Human Andrology, 2(4): 94-98.
13
13. Tremellen K. (2012): Oxidative stress and male infertility—a clinical perspective. Hum Reprod Update, 14:243–58.
14
14. Yeni D, Fidan AF, Ciğerci Ih, Konuk M, Avdatek F and Gündoğan M. (2012): Effect of α-lipoic acid on sperm quality, reproductive tract measures in thinner exposed rats. Andrologia., 44: 74-80.
15
ORIGINAL_ARTICLE
EVALUATION OF CD82/ (KAI-1) IMMUNOHISTOCHEMICAL EXPRESSION IN COLORECTAL CARCINOMA
Background: Colorectal carcinoma (CRC) is one of the most common human cancers. It is the fourth most common cause of death from cancer. Colorectal cancer is the third most common cancer in men and the second in women worldwide. Objective: To evaluate the immunohistochemical expression of KAI-1/CD82 in different stages of colorectal carcinoma and to evaluate the biological behavior of tumor and target therapy. Patients and Methods: Thirty formalin-fixed, paraffin-embedded tissue of colorectal carcinoma (obtained from archive of Al-Azhar University Hospital Labs and some private labs). Clinicopathological and histological features were taken from files and confirmed by H&E examination. Immunohistochemical study was done by using CD82/ (KAI-1) marker. Results: CD82 showed an insignificant relation with age, sex, site of tumor and degree of differentiation. A significant inverse relationship was detected between CD82 expression in tumor cells and tumor stage according to modified Duke's staging. Insignificant relation between age, sex, site and grade. Conclusion: The decreased membranous and/or cytoplasmic expression of CD82 might be used as a prognostic marker to monitor patient with colorectal cancer.
https://amj.journals.ekb.eg/article_158642_38f62b3947b978d4abc2c268fa76772a.pdf
2021-04-01
1507
1516
10.21608/amj.2021.158642
CD82
KAI1
Colorectal carcinoma
Anass
Fathi Shafiq Al-Gazzar
doctoranass88@gmail.com
1
Department of Pathology, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Sayed
Abd El-Raheem Sayed Ali
2
Department of Pathology, Faculty of Medicine, Al-Azhar University
AUTHOR
Al-Sayed
Mohammed Ibrahim Tealeb
3
Department of Pathology, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Akkoca AN, Yanık S, Özdemir ZT, Cihan FG, Sayar S, Cincin TG and Özer C. (2014): TNM and Modified Dukes staging along with the demographic characteristics of patients with colorectal carcinoma. International Journal of Clinical and Experimental Medicine, 7(9): 2828-35.
2
Doger K, Meteoglu I and Tuncyurek P (2012): The EGFR & VEGF expression predicts the prognosis in colon cancer. Eur Surg Res., 38: 540-544.
3
Ferlay J, Shin HR, Bray F, Forman D, Mathers C and Parkin DM (2010): Cancer Incidence and Mortality Worldwide Int J Cancer, 136(5):E359-86.
4
Ganji S, Saligheh A, Shafiepour S, Ashrafi F and Pornour M. (2018): Decreased expression of KAI1 in colorectal cancer significantly associates with the cancer metastasis. Journal of Research in Medical and Dental Science, 6(3): 78-84.
5
Lee MS, Lee J, Kim YM and Lee H. (2019): The metastasis suppressor CD82/KAI1 represses the TGF-β1 and Wnt signalings inducing epithelial-to-mesenchymal transition linked to invasiveness of prostate cancer cells. Prostate, 79(12):1400-1411.
6
Liu L, Wu DH, Li ZG, Yang GZ and Ding YQ (2014): Effects of KAI1/CD82 on biological behavior of human colorectal carcinoma cell line. World Journal of Gastroenterology, 9(6): 1231-37.
7
Petrelli F, Tomasello G, Borgonovo K, Ghidini M, Turati L, Dallera P, Passalacqua R, Sgroi G and Barni S. (2016): Prognostic Survival Associated With Left-Sided vs Right-Sided Colon Cancer: A Systematic Review and Meta-analysis. JAMA Oncol., 400-410.
8
Zavarhei MD, Bidgoli SA, Zryarani MM, Shariatpanahi M and Ardalan FA (2014): Progesterone receptor positive colorectal tumors have lower thymidine phosphory lase expression: An immunohistochemical study. Pak J Boil Sci., 10: 4485-4489.
9
Zhu B, Zhou L, Yu L, Song W, Gong X and Wang D. (2017): Evaluation of the correlation of vasculogenic mimicry, ALDH1, KAI1 and microvessel density in the prediction of metastasis and prognosis in colorectal carcinoma. BMC Surg., 17(1):47-54.
10
ORIGINAL_ARTICLE
EFFECT OF ONLINE HEMODIAFILTRATION ON PATIENTS WITH SEPSIS AND ACUTE KIDNEY INJURY IN INTENSIVE CARE UNIT
Background: Acute kidney injury is a common occurrence in critically ill patients, with incidence rates of occurrence varying from 5 to 60% and a trend towards higher rates (30 to 60%) when using the risk, injury, failure, loss of kidney function, end stage renal failure (RIFLE) or Acute Kidney Injury (AKI) Network (AKIN) classification. Objective: To compare between effect of online hemodiafiltration and conventional hemodialysis in patients with sepsis and acute kidney injury in intensive care unit. Patients and Methods: This study included forty (age and sex matched) patients with acute kidney injury (AKI) who were critically ill they were selected from the Nephrology Unit Ahmed Maher Teaching Hospital. The included patients were divided into two equal groups: Group (A) that included patients on online hemodiafiltration (OLHDF) and Group (B) that included patients on conventional hemodialysis. Results: There was a statistically significant difference found between two groups after dialysis regarding HB, WBCs, platelet, Na and albumin. Also, there was high statistically significant difference between two groups regarding urea, creat, K and PCT, and there was no statistically significant difference between the two groups regarding CRP. Conclusion: OL-HDF showed to be better than IHD-LI in many aspects but there was no statistically significant difference in mortality.
https://amj.journals.ekb.eg/article_158645_5d94e005287de31846728097730b6687.pdf
2021-04-01
1517
1530
10.21608/amj.2021.158645
Online Hemodiafiltration
Acute kidney injury
Intensive Care Unit
Mahmoud
Mohammed Kasem Ibrahem
drmkasem2014@gmail.com
1
Departments of Internal Medicine, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Mostafa
Abd El-Fattah El-Ballat
2
Departments of Internal Medicine, Faculty of Medicine, Al-Azhar University
AUTHOR
Nagah
Mohamed Abo Mohamed
3
Departments of Internal Medicine, Faculty of Medicine, Al-Azhar University
AUTHOR
Mohamed
Ahmed El-Sayed
4
Departments of Clinical Pathology, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Ahrenholz PG, Winkler RE, Michelsen A, Lang DA and Bowry SK. (2010): Dialysis membrane-dependent removal of middle molecules during hemodiafiltration: the beta2-microglobulin/albumin relationship. Clin Nephrol., 62(1):21–8.
2
Azkarate I, Choperena G and Salas E. (2015): Epidemiology and prognostic factors of severe sepsis / septic shock. Six years of evolution. Medicina Intensiva., 40: 18-25.
3
Canaud B, Vienken J, Ash S and Ward RA. (2018): Hemodiafiltration to Address Unmet Medical Needs ESKD Patients. Clin J Am Soc Nephrol., 13(9):1435-1443.
4
Combarnous F, Tetta C, Cellier CC, Wratten ML, Custaud and De Catheu T. (2010): Albumin loss in on-line hemodiafiltration. Int J Artif Organs, 25(3):203–9.
5
Darío J, Manuel G and Ana A. (2017): Intermittent Hemodialysis Low Intensity vs. on Line HemodiafiltrationinCritically Ill Patients with Sepsis and Acute Kidney Injury. Choosing the Best Treatment in a Developing Country. J Nephrol Ther., 7: 299-304.
6
Den Hoedt CH, Bots ML, Grooteman MP, van der Weerd NC, Mazairac AH and Penne EL. (2014): Online hemodiafiltration reduces systemic inflammation compared to low-flux hemodialysis. Kidney Int., 86(2):423–32.
7
Eloot S, Schneditz D and Cornelis T. (2016): Protein-Bound Uremic Toxin Profiling as a Tool to Optimize Hemodialysis. PLoS One, 11 (1): 147-153.
8
Herget Rosenthal S, Marggraf G, Pietruck F, Hüsing J, Strupat M and Philipp T. (2010): Procalcitonin for accurate detection of infection in haemodialysis. Nephrol Dial Transplant, 16(5):975-979.
9
Jean G, Hurot JM, Deleaval P, Mayor B and Lorriaux C. (2015): Online-haemodiafiltration vs. conventional haemodialysis: a cross-over study. BMC Nephrol., 16:70-75.
10
Jimenez DM, Guanuna A, Aguilar M, Morales F, Jimenez A, Duenas M, Castillo R, Gonzalez G, Paredes E and Pazos F. (2017): Intermittent Hemodialysis Low Intensity vs. on Line Hemodiafiltration in Critically Ill Patients with Sepsis and Acute Kidney Injury. Choosing the Best Treatment in a Developing Country. Journal of Nephrology & Therapeutics, 17: 7-14.
11
Kaukonen K, Bailey M, Suzuki S, Pilcher D and Bellomo R. (2014): Mortality related to severe sepsis and septic shock among critically ill patients in Australia and New Zealand. JAMA, 311: 1308-1316.
12
Kullaya T, Paweena S and Somchai E. (2018): Hemodiafiltration in Acute Kidney Injury, Aspects in Continuous Renal Replacement Therapy. Annals of Intensive Care, 10: 32-38.
13
Kumar V, Abbas AK and Aster JC. (2015): Robbins and Cotran pathologic basis of disease (Ninth edition.). Pbl. Philadelphia, Elsievier, Pp. 1408.
14
Locatelli F, Altieri P, Andrulli S, Bolasco P, Sau G and Pedrini LA. (2010): Hemofiltration and hemodiafiltration reduce intradialytic hypotension in ESRD. J Am Soc Nephrol., 21(10):1798–807.
15
Lombardi R, Rosa-Diez G and Ferreiro A. (2014): AcuteKidney Injury in Latin America: A view on renal replacement therapyresources. Nephrol Dial Transplant., 29: 1369-1376.
16
Maduell F, Moreso F and Mora-Macia J. (2015): Reanalysis of the ESHOL study: All-cause mortality considering competition and time-dependent risks for renal transplantation. Nefrologia., 36: 156-163.
17
Maduell F, Moreso F, Pons M, Ramos R, Mora-Macia J and Carreras J. (2013): High-efficiency postdilution online hemodiafiltration reduces all-cause mortality in hemodialysis patients. J Am Soc Nephrol., 24 (3): 487–97.
18
Masakane I, Kan K and Hideki K. (2017): Evidence for the clinical advantages of predilution on-line hemodiafiltration. Scientific Aspects of Dialysis Therapy, 189: 17-23.
19
Mora-Bravo FG, De-La-Cruz G, Rivera S, Ramirez AM, Raimann JG and Perez-Grovas H. (2012): Association of intradialytic hypotension and convective volume in hemodiafiltration: results from a retrospective cohort study. BMC Nephrol., 13:106-111.
20
Movilli E, Camerini C, Gaggia P, Poiatti P, Pola A and Viola BF. (2011): Effect of post-dilutional on-line haemodiafiltration on serum calcium, phosphate and parathyroid hormone concentrations in uraemic patients. Nephrol Dial Transplant, 26(12):4032–7.
21
Nakamura Y, Murai A, Mizunuma M, Ohta D, Kawano Y and Matsumoto N. (2015): Potential use of procalcitonin as biomarker for bacterial sepsis in patients with or without acute kidney injury. J Infect Chem other, 21(4):257-63.
22
Ok E, Asci G, Toz H, Ok ES, Kircelli F and Yilmaz M. (2013): Mortality and cardiovascular events in online haemodiafiltration (OL-HDF) compared with high-flux dialysis: results from the Turkish OL-HDF Study. Nephrol Dial Transplant, 28(1):192–202.
23
Peerapornratana S, Manrique-Caballero CL, Gómez H and Kellum JA. (2019): Acute kidney injury from sepsis: current concepts, epidemiology, pathophysiology, prevention and treatment. Kidney Int., 96(5):1083-1099.
24
Poukkanen M, Vaara ST and Reinikainen M. (2015): Predicting one-year mortality of critically ill patients with early acute kidney injury: data from the prospective multicenter FINNAKI study. Crit Care, 125: 19-24.
25
Premuzic V, Basic-Jukic N, Jelakovic B and Kes P. (2017): Differences in CVVH vs. CVVHDF in the management of sepsis-induced acute kidney injury in critically ill patients. Journal of Artificial Organs, 20:326-334.
26
Rama I, Llaudó I and Fontova P. (2016): Onlinehemodia-filtration improves inflammatory state in dialysis patients: Alongitudinal study. 2016. PLOS ONE, 11: 164-69.
27
Schiffl H, Lang SM and Fischer R. (2013): Effects of high efficiency post-dilution on-line hemodiafiltration or conventional hemodialysis on residual renal function and left ventricular hypertrophy. Int Urol Nephrol., 45(5): 1389–96.
28
Steinbach G, Bölke E, Grünert A, Storck M and Orth K. (2010): Procalcitonin in patients with acute and chronic renal insufficiency. Wien Klin Wochenschr., 116 (24):849-853.
29
Zhang Z. (2015): Biomarkers, diagnosis and management of sepsis-induced acute kidney injury: a narrative review. Heart Lung Vessel, 7:64-73.
30
ORIGINAL_ARTICLE
CHILD-TURCOTTE-PUGH /ALBUMINURIA AS A PREDICTOR OF ACUTE KIDNEY INJURY AMONG HOSPITALIZED PATIENTS WITH LIVER CIRRHOSIS
Background: The incidence of acute kidney injury (AKI) in cirrhotic patients about fifteen percent of hospitalized cirrhotic patient, Prediction of AKI indicated in all patients with liver cirrhosis. Albuminuria in cirrhotic patient can predict AKI. Objective: To assess the role of Child-Turcotte Pugh/Albuminuria (CTP-Alb), in prediction of AKI among hospitalized patients with liver cirrhosis. Patients and Methods: After departmental ethics committee approval and patient consents were obtained, 60 patients with liver cirrhosis screened for AKI during hospital admission at hepatogastroenterology unit, Department of Internal Medicine in Al-Hussein Hospital, Al-Azhar University, and The study was carried out during the period from September 2019 and September 2020, The diagnosis of liver cirrhosis based on clinical, biochemical and ultrasonography findings. Patients with Fib-4 ≥ 3.5 in the absence of liver decomposition were categorized as compensated liver cirrhosis. Severity of liver disease was assessed using the CTP score, model for end stage liver disease (MELD) score and CTP-Alb score. Diagnosis of acute kidney injury was based on the changes in serum creatinine. The baseline renal assessment at first day of hospital admission was included serum creatinine, estimated glomerular filtration rate (eGFR), albumin/creatinine ratio, and abdominal ultrasonography. AKI was categorized as hepatorenal syndrome (HRS), pre-renal azotemia, post-renal azotemia or intrinsic acute kidney injury. Results: A total of 60 patients included. They were 40 (66.66%) males and 20 (33.34%) females. Their mean age was 50 ± 33 years, of them 8 (13.33%) patients developed AKI during hospital admission with their mean age was 60.6 ± 10.9 years. They were 5 (62.5%) males and 3 (37.5%) females, Hypoalbuminemia, Child score at admission and Child-albuminuria score at admission were identified as independent risk factors for AKI by multivariate analysis (p < 0.05). Conclusion: Thirteen percent of cirrhotic patients developed AKI during hospital admission according to our results. The majority of patients were child C in our series; CTP/Albuminuria score, Hypoalbuminemia and ACLF has promising sensitivity, specificity and accuracy in prediction of AKI in hospitalized cirrhotic patient.
https://amj.journals.ekb.eg/article_158646_69b7c2f53bde50a95539b4b1f6f74439.pdf
2021-04-01
1531
1538
10.21608/amj.2021.158646
AKI
CTP/Albuminuria score
Hypoalbuminemia and ACLF
Othman
Mohammed Ahmed Othman
doctorosmanmahmedosman@gmail.com
1
Departments of Internal Medicine, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Mohammad
Sad Al-Den Radwan
2
Departments of Clinical Pathology, Faculty of Medicine, Al-Azhar University
AUTHOR
Sadek
Mostafa Sadek
3
Departments of Internal Medicine, Faculty of Medicine, Al-Azhar University
AUTHOR
Ashraf
Mohammed El-Bahrawy
4
Departments of Internal Medicine, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Amathieu R, Al-khafaji A, Sileanu FE and Foldes E. (2017): Significance of Oliguria in Critically Ill Patients with Chronic Liver Disease. Hepatology, 66(5):1592-1600.
2
Belcher JM, Garcia-Tsao G, Sanyal AJ, Bhogal H, Lim JK, Ansari N, Coca GS and Parikh CR. (2013): Association of AKI with mortality and complications in hospitalized patients with cirrhosis. Hepatology, 57:753–762.
3
Belcher JM, Sanyal AJ, Peixoto AJ, Perazella MA, Lim J, Thiessen-Philbrook H, Ansari N, Coca SG, Garcia-Taso G and Parikh CR. (2014): Kidney biomarkers and differential diagnosis of patients with cirrhosis and acute kidney injury. Hepatology, 60(2):622–32.
4
Cholongitas E, Arsos G, Goulis J, Birtsou C, Haidich AB, Nakouti T, Chalevas P, Ioannidou M, Karakatsanis K and Akriviadis E. (2014): Glomerular filtration rate is an independent factor of mortality in patients with decompensated cirrhosis. Hepatol Res, 44(10):E145–55.
5
Moreau R, Jalan R, Gines P, Pavesi M, Angeli P, Cordoba J, Durand F, Gustot T, Saliba F, Domenicali M, Gerbes A, Wendon J, Alessandria C, Laleman W, Zeuzem S and Arroyo V. (2013): Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis. Gastroenterology,144:1426–1437.
6
Slack AJ, McPhail MJ, Ostermann M, Bruce M, Sherwood R, Musto R, Dew T, Auzinger G, Bernal W, O’Grady J, Heneghan MA, Moore K and Wendon JA. (2013): Predicting the development of acute Kidney injury in liver cirrhosis—an analysis of glomerular filtration rate, proteinuria and kidney injury biomarkers. Aliment Pharmacol Ther., 37: 989–997.
7
Wiedermann CJ, Wiedermann W and Joannidis M. (2010): Hypoalbuminemia and acute kidney injury. Intensive care Med., 36: 1657-1665.
8
Wong F. (2012): Recent advances in our understanding of hepatorenal syndrome. Nat Rev Gastroenterol Hepatol., 9: 382-391.
9
Wong F. (2016): Acute kidney injury in liver cirrhosis: new definition and application. Clinical and Molecular Hepatology, 22:415-422.
10
Yo M, Lee SW, Baek SH, Na KY, Chae DW, Chin HJ and Kim S. (2017): Hypoalbuminemia at admission predicts the development of AKI in hospitalized patients: a retrospective cohort study. PLOS 12(7), e 0180750.
11
ORIGINAL_ARTICLE
VALUE OF BREAST ELASTOGRAPHY IN EVALUATION OF BREAST MASSES DETECTED ON SCREENING ULTRASOUND
Background: Breast cancer remains one of the leading causes of death in women over the age of 40 years. Breast cancer screening is used to identify women with asymptomatic cancer with the goal of enabling women to undergo less invasive treatments that lead to better outcomes, ideally at earlier stages, and before the cancer progresses. Objective: To evaluate the additional value of Elastography as complementary to conventional US in breast masses found on screening US. Patients and methods: The study was performed prospectively between April 2020 and October 2020 at Elsayed Galal University Hospital in 35 consecutive female patients with 39 breast lesions who met all inclusion criteria and no exclusion criteria. Results: This study included 35 female patients (with 39 breast lesions). Their ages ranged from 16 to 68 years old with mean age 46 ± 12.7 (mean ± SD). In this study, 8 /39 (20.5 %) cases were almost fatty (ACR “a”) in which 6/6 cases were malignant & 24/39 (61.5%) with scattered area of fibro-glandular tissue (ACR “b”) in which 8/24 cases were malignant and 7/39 (17.9 %) cases were heterogeneously dense breasts (ACR “c”) in which 3/7 cases were malignant. Lesions that scored 1, 2, and 3 were considered benign 24/39(61.5 %) cases, whereas lesions that scored 4 and 5 15/39 (38.5%) cases, were considered malignant. When considering lesions with strain ratio less than 3.0 as benign and lesions with strain ratio more than or equal 3.0 as malignant, 15/39 (38.5) lesions were benign, 24/39 (61.5 %) were malignant by strain ratio. Conclusion: US Elastography provides useful information about distinguishing benign and malignant lesions. Thus, consideration of lesion stiffness could increase positive predictive values and reduce unnecessary benign biopsies.
https://amj.journals.ekb.eg/article_158640_8962ae84ca40f69bc9b9771319a5ca34.pdf
2021-04-01
1539
1552
10.21608/amj.2021.158640
Breast elastography
Breast Masses
screening ultrasound
Waleed
Rabiey Mohammed
waleedmohammed88@gmail.com
1
Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Amr
Mahmoud Zied
2
Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Al-Azhar University
AUTHOR
Hussein
Montaser Roshdy
3
Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
1
Athanasiou A, Tardivon A, Tanter M, Sigal-Zafrani B, Bercoff J and Deffieux T. (2010): Breast lesions: quantitative elastography with supersonic shear imaging—preliminary results. Radiology, 256: 297–303.
2
Berg WA, Cosgrove DO and Dore CJ. (2012): Shear-wave elastography improves the specificity of breast US: the BE1 multinational study of 939 masses. Radiology, 262(2):435–449.
3
Comstock C. (2011): Ultrasound elastography of breast lesions. Ultrasound Clin., 6: 407–415.
4
Costantini M, Belli P and Lombardi R. (2010): Characterization of solid breast masses use of the sonographic BI-RADS lexicon. J Ultrasound Med., 25:649–59.
5
D’Orsi CJ, Sickles EA and Mendelson EB. (2013): ACR BI-RADS® Atlas, Breast Imaging Reporting and Data System. Reston VA. American College of Radiology, 15: 36-42.
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Drukteinis JS, Mooney BP, Flowers CI and Gatenby RA. (2013): Beyond mammography: new frontiers in breast cancer screening. Am J Med., 126(6):472-9.
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Elkharbotly A and Farouk H. (2015): Ultrasound elastography improves differentiation between benign and malignant breast lumps using B-mode ultrasound and color Doppler. The Egyptian Journal of Radiology and Nuclear Medicine, 46: 1231–1239.
8
Itoh A, Ueno E and Tohno E. (2010): Breast disease: Clinical application of US elastography for diagnosis. Radiology, 239:341–50.
9
Ko KH, Jung HK, Kim SJ, Kim H and Yoon JH. (2013): Clinical Application of the BI-RADS Final Assessment to Breast Sonography in Conjunction with Mammography. European Society of Radiology, 15: 1209-12-15.
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Lee BE, Chung J, Cha E, Eun J and Kim H. (2015): Role of shear-wave elastography (SWE) in complex cystic and solid breast lesions in comparison with conventional ultrasound. European Journal of Radiology, 7: 1236-1241.
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Mahoney MC, Gatsonis C and Hanna L. (2012): Positive predictive value of BI-RADS MR imaging. Radiology, 264:51–58.
12
Ricci P, Maggini E, Mancuso E, Maldur V, Medvedyva O, Ursu S and Pediconi F. (2017): Comparison of Ultrasound Elastography, Mammography, and Sonography in the Diagnosis of Solid Breast Lesions. Acta Radiology Journal, 10: 1189-1197.
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Scheel JR, Lee JM and Sprague BL. (2015): Screening ultrasound as an adjunct to mammography in women with mammographically dense breasts. Am J Obstet Gynecol., 212:9.
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Yang T, Liang H, Chouc C Huang J and Pan H. (2013): The adjunctive digital breast tomosynthesis in diagnosis of breast cancer. Biomed Res Int., 13: 59-63.
15
ORIGINAL_ARTICLE
OCCULT HEPATITIS B INFECTION IN HEMODIALYSIS PATIENTS INFECTED WITH HEPATITIS C VIRUS
Background: Occult hepatitis B infection (OBI) is defined as the existence of low-level HBV DNA in the serum ( Objective: To evaluate the prevalence of occult hepatitis B infection among hemodialysis patients infected with Hepatitis C Virus. Patients and Methods: Our study was conducted on 100 patients with end-stage renal disease who were positive Hepatitis C Virus undergoing regular hemodialysis from the dialysis unit related to the department of nephrology, Nasser Institute, Egypt, during the period from July to January 2018. Female ratio was |39%|, while male ratio was |61%|, age ranged from (18-60) with mean efficient |39.20±11.98|.HbcIgG was checked to all patients, and HBV PCR to positive HBcIgG patients. Results: The results of our study showed that 8% of the whole samples were Positive, and 92% were negative HbCIgG patients. From these 8% positive HBcIgG patients, HBV PCR was positive in only 2% patients. Conclusion: OBI was prevalent among chronic HCV patients on regular hemodialysis. However, more precise assessment of this infection requires regular patient follow up using HBV DNA detection methods.
https://amj.journals.ekb.eg/article_160386_39f2201d339cc0ab2c2bacbcff2f2068.pdf
2021-04-01
1553
1562
10.21608/amj.2021.160386
occult heeahtis
henodialysis
Abd El-Aziz
Mamdouh Mohamed Abd El-Aziz Mohamed
abdelaziz.berbesh@yahoo.com
1
Department of Internal Medicine –Faculty of Medicine, Al-Azhar University, Cairo, Egypt
LEAD_AUTHOR
REFERENCES
1
Abu El Makarem MA, Abdel Hamid M, Abdel Aleem A, Ali A, Shatat M and Sayed D (2012): Prevalence of occult hepatitis B virus infection in hemodialysis patients from egypt with or without hepatitis C virus infection. Hepat Mon., 12:253–8.
2
Aghakhani A, Banifazl M, Kalantar E, Eslamifar A, Ahmadi F and Razeghi E (2010): Occult hepatitis B virus infection in hemodialysis patients with isolated hepatitis B core antibody: a multicenter study. TherApher Dial., 14(3):349–53.
3
Albuquerque AC, Coelho MR, Lemos MF and Moreira RC (2012): Occult hepatitis B virus infection in hemodialysis patients in Recife, State of Pernambuco, Brazil. Rev Soc Bras Med Trop., 45: 558-562.
4
Amer FA, Gohar M and Yousef M (2015): Epidemiology of hepatitis C virus infection in Egypt. Int J Trop Dis Health., 7(7):119–31.
5
Belperio PS, Shahoumian TA, Mole LA and Backus LI (2017): Evaluation of hepatitis B reactivation among 62,920 veterans treated with oral hepatitis C anti-virals. Hepatology, 66: 27-36.
6
Datta S, Chatterjee S, Veer V andChakravarty R (2012): Molecular biology of the hepatitis Bvirus for clinicians. J. Clin. Exp. Hepatol., 2(4):353-65.
7
Inoue T, Tanaka Y (2016): Hepatitis B virus and its sexually transmitted infection-an update. Microbial Cell., 3(9):420-45.
8
Kang SY, Kim MH and Lee WI (2014): Occult hepatitis B virus infection in Korean patients with isolated anti-HBc. Arch Virol., 159:227-233.
9
Kwak M-S and Kim YJ (2014): Occult hepatitis B virus infection. World J.Hepatol., 6 (12):860-476.
10
10. Mina P, Georgiadou SP, Rizos C, Dalekos GN andRigopoulou EI (2010): Prevalence of occult hepatitis B virus infection in haemodialysis patients from central Greece. World J. Gastroenterol., 16:225–31.
11
11. Motta JS, Mello FC, Lago BV, Perez RM, Gomes SA and Figueiredo FF (2010): Occult hepatitis B virus infection and lamivudine-resistant mutations in isolates from renal patients undergoing hemodialysis. J. Gastroenterol Hepatol., 25:101–6.
12
12. Ocana S, Casas ML, Buhigas I and Lledo JL (2011): Diagnostic strategy for occult hepatitis B virus infection. World J.Gastroenterol., 17: 1553-1557.
13
13. Panigrahi R, Biswas A, De BK, Chakrabarti S and Chakravarty R (2013): Characterization of antiviral resistance mutations among the Eastern Indian Hepatitis B virus infected population. Virol J., 10: 56-70.
14
14. Pondé RA, Cardoso DD and Ferro MO (2010): The underlying mechanisms for the ‘anti-HBc alone’ serological profile. Arch Virol., 155:149–58.
15
15. Raimondo G, Allain JP, Brunetto MR, Buendia MA, Chen DS and Colombo M (2019): Statements from the Taormina expert meeting on occult hepatitis B virus infection. Updated Journal of Hepatology., 71 : 397-408.
16
16. Raimondo G and Pollicino T (2016): Occult HBV infection. Hepatitis B virus in human diseases. Springer USA., 277-301.
17
17. Squadrito G, Spinella R andRaimondo G (2014): The clinical significance of occult HBV infection. Ann Gastroenterol., 27(1):15-4.
18
18. Sun S, Zhou H, Zhou B, Hu Z, Hou J and Sun J (2012): Sensitivity and specificity of nested PCR pyro sequencing in hepatitis B virus drug resistance gene testing. Nan Fang Yi Ke Da Xue Xue Bao., 32: 610-613.
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19. Urbani S, Fagnoni F, Missale G and Franchini M (2010): The role of anti-core antibody response in the detection of occult hepatitis B virus infection. Clin Chem Lab Med., 48: 23-29.
20
ORIGINAL_ARTICLE
STUDY OF THORACIC COMPLICATIONS IN PATIENTS WITH LIVER CIRRHOSIS
Background: Liver cirrhosis and its complications are a leading cause of death among adults. The diseased liver leads to many deleterious effects on multiple organ systems, including the pulmonary system. Objective: To determine the types and frequency of pulmonary complications in patients with liver cirrhosis and to assess the relation between the incidence of pulmonary complications and severity of liver cirrhosis according to Child-Pugh Score. Patients and Methods: This was a prospective cohort study that conducted on 100 cirrhotic patients. The study was carried in the period from January 2018 till February 2019, Patients included in this study were classified according to their Pugh score into class A with 71 patients, class B with 15 patients and class C with 14 patients. This study was conducted in Dekernes general hospital and Dekernes chest hospital/ Dakahlia Governorate. Results: 58% of the included patients were females and 42% of them were males. Their ages ranged from 38 to 77 years with a mean age of 56.24 ±9.39 years. The main findings of this study were that 65% of the liver cirrhosis patients had associated co-morbidities. Pulmonary complications in these patients were presented as cough, dyspnea, fever and dyspnea with wheezes. Hospitalization was needed in 12% of them for management of pneumonia, bronchitis, bronchial asthma and pleural effusion. 100% of the patients were HCV positive and by the end of the study 100% of the patients survived. When patients were classified based on Pugh score, those groups showed statistically significant differences as regards associated co-morbidities, incidence of jaundice at presentation, degree of ascites, results of investigations as well as incidence of different types of pulmonary complications. Conclusion: Liver cirrhosis was associated with unique pulmonary complications, which differ in incidence with progression of the disease.
https://amj.journals.ekb.eg/article_160387_b6554fa1b2f65ecc80407fb45e99c34b.pdf
2021-04-01
1563
1574
10.21608/amj.2021.160387
Liver cirrhosis
Complications
pulmonary
Pugh classification
El-Moataz
Bellah Mohamed Mohamed El-Desoqy
el-moatazbellah_mohamed@gmail.com
1
Departments of Chest Diseases, Faculty of Medicine, Al-Azhar University
LEAD_AUTHOR
Taalat
Abd El-Aziz Arafa
2
Departments of Chest Diseases, Faculty of Medicine, Al-Azhar University
AUTHOR
Mousa
Mohamed Mousa El-Shamly
3
Departments of Chest Diseases, Faculty of Medicine, Al-Azhar University
AUTHOR
Anwar
Gomaa Mohamed
4
Departments of Tropical Diseases, Faculty of Medicine, Al-Azhar University
AUTHOR
REFERENCES
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Albillos A, Lario M and Alvarez-Mon M. (2014): Cirrhosis-associated immune dysfunction: Distinctive features and clinical relevance. J Hepatol., 61(6):1385–96.
2
Aliannejad R and Ghanei M. (2011): Hepatitis C and pulmonary fibrosis: Hepatitis C and pulmonary fibrosis. Hepat Mon., 11(2):71-3.
3
Badillo R and Rockey DC. (2014): Hepatic hydrothorax: Clinical features, management and outcomes in 77 patients and review of the literature. Medicine (Baltimore): 93(3):135-138.
4
Banerjee A. (2017): Respiratory Emergencies. Emergency Clinical Diagnosis, 12: 45-68.
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Cardenas A, Kelleher TB and Chopra S. (2018): Hepatic hydrothorax. Semin Respir Crit Care Med., 33: 3-10.
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Dam MK, Flensborg-Madsen T, Eliasen M, Becker U and Tolstrup JS. (2013): Smoking and risk of liver cirrhosis: A population-based cohort study. Scand J Gastroenterol., 48(5):585-91.
7
Elkrief L, Rautou PE, Sarin S, Valla D and Paradis V. (2016): Diabetes mellitus in patients with cirrhosis: Clinical implications and management. Liver Int., 36(7):936-48.
8
Fargo MV, Grogan SP and Saguil A. (2017): Evaluation of jaundice in adults. Am Fam Physician, 95(3):164-8.
9
Frothingham S. (2018): Child-Pugh Score. Health Line, 23: 212-215.
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10. Galal G, Alkhayat K, Zaghloul A and Abd El Mobdy A. (2017): Pulmonary Dysfunction in Patients with Liver Cirrhosis. Sohag Medical Journal, 21(2): 1-9.
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13. Grancini V, Trombetta M, Lunati ME, Zimbalatti D and Boselli ML. (2015): Contribution of β-cell dysfunction and insulin resistance to cirrhosis-associated diabetes: Role of severity of liver disease. J Hepatol., 63(6):1484-90.
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14. Guy J and Peters MG. (2013): Liver disease in women: The influence of gender on epidemiology, natural history and patient outcomes. Gastroenterol Hepatol., 9(10):633–9.
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15. Helmy AM and Awadallah MF. (2014): Study of pulmonary dysfunctions in liver cirrhosis. Egyptian Journal of Chest Diseases and Tuberculosis, 63(4):1079-85.
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16. Jalan R, Fernandez J, Wiest R, Schnabl B and Moreau R. (2014): Bacterial infections in cirrhosis: A position statement based on the EASL special conference 2013. J Hepatol., 60(6):1310–24.
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17. Kumar R. (2018): Hepatogenous diabetes: An underestimated problem of liver cirrhosis. Indian J Endocr Metab., 22:552-9.
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