2024-03-29T00:26:19Z
https://amj.journals.ekb.eg/?_action=export&rf=summon&issue=9390
Al-Azhar Medical Journal
1110-0400
1110-0400
2015
44
4
SCIENCE, ANTISCIENCE AND PROTOSCIENCE
Raouf
Salem
2015
10
01
1
1
https://amj.journals.ekb.eg/article_64667_fe4281cb6d9cebf37e12d06fade1c3eb.pdf
Al-Azhar Medical Journal
1110-0400
1110-0400
2015
44
4
ROLE OF ADIPOSE DERIVED MESENCHYMAL STEM CELLS IN IMPROVING STREPTOZOTOCIN-INDUCED DIABETES MELLITUS IN RATS
Shereen
M. Morsy
Angie
M. Ameen
Maha
M. Atwa
Magda
I. Mohamed
Background: Diabetes mellitus (DM) is one of the most recognizable endocrine metabolic disorders characterized by chronic hyperglycemia.Mesenchymalstem cells (MSCs) are promising toolto treatDM type I (DM 1). They can be isolated from many sources including adipose tissue because of its easy availability. Objective: Evaluation of the effect of adipose derived MSCs (ADMSCs) on streptozotocin (STZ)-induced DM in rats. Materials and Methods: Forty eight adult male albino rats were included and divided into 4 equal groups. Group I: control untreated, group II: diabetic group, group III: insulin-treated group, and group IV: ADMSCs-treated group. After 21 days from treatment, animals were sacrificed and pancreas was obtained for histological assessments. Stem cell homing was detected by polymerase chain reaction for human specific Alu gene. Results: ADMSCs caused lowering of blood glucose levels starting at the 14th day of treatment and increased blood insulin levels accompanied by reversal of the histopathological changes that were found in the diabetic group and increase insulin secreting cells. Conclusion: ADMSCs improved blood glucose levels and reversed the histopathological changes of the pancreas in experimentally induced DM I.
adipose derived stem cells
Mesenchymal Stem Cells
type I diabetes
2015
10
01
279
293
https://amj.journals.ekb.eg/article_64673_196f2cf94fcdaadf0e7d56392587c8c7.pdf
Al-Azhar Medical Journal
1110-0400
1110-0400
2015
44
4
THE ANTIOXIDANT METABOLIC PROTECTIVE EFFECT OF EXERCISE ON D-GALACTOSE INDUCED SPATIAL MEMORY IMPAIRMENT; POSSIBLE ROLE OF HIPPOCAMPAL ASTROCYTES
Suzy
F. Ewida
Magda
A. Mansour
BACKGROUND: Aging is a complex biological phenomenon distinguished by accumulation of deleterious changes with time including memory impairment. Physical exercise positively affects the brain both during aging and neurodegenerative diseases.
OBJECTIVE: Studying the role of hippocampal astrocytes in the protective effect of exercise in D-galactose induced memory impairment.
MATERIALS AND METHODS: Eighteen rats were divided into 3 equal groups; group I (control) was given saline i.p. for 10 weeks, group II was treated with D-galactose(D-gal 100 mg/kg i.p. for 10 weeks) as it induces memory impairment and group III was co-treated with D-gal and swimming exercise for 10 weeks. Memory and learning performance in Barnes maze test were analyzed. Brain tissue was dissected and processed for histological and immunohistochemical study using glialfibrillary acidic protein (GFAP) and induced nitric oxide synthase (iNOS) markers. Brain homogenate was prepared for estimation of malondialdehyde (MDA), superoxide dismutase (SOD), lactate and pyruvate.
RESULTS: Exercise significantly improved D-gal rats' performance during acquisition and probe phases of Barnes maze test, reduced MDA and increased SOD, lactate and pyruvate levels with reduction of lactate\pyruvate ratio in brain homogenate. Neural cell count increased in hippocampus with decrease of apoptotic cells, GFAP and iNOS expression.
CONCLUSION: Exercise was significantly effective in improving oxidative stress in brain and restoring hippocampal neural and astrocyte metabolic functions with resultant improvement in spatial memory performance.
swimming
Hippocampus
spatial memory
astrocytes
2015
10
01
295
316
https://amj.journals.ekb.eg/article_64718_16d9d397433d0142b64fc64f906e3d40.pdf
Al-Azhar Medical Journal
1110-0400
1110-0400
2015
44
4
VALUE OF LARYNGEAL ULTRASOUND IN COMPARISON TO VOCAL CORD VIDEO STROPOSCOPY IN DIAGNOSIS OF VARIOUS LARYNGEAL LESIONS
Hala
Maghraby
Hala
Abd El-Haseeb
Background: Video stroposcopy is useful in diagnosis of various laryngeal lesion. Laryngeal ultrasound is also used as a beneficial tool in this diagnosis. Objectives: The main aim of this study was to evaluate the value of laryngeal ultrasound in comparison to vocal cord stroposcopy in diagnosis of different laryngeal lesions. Patients and Methods: This study which was carried out between August 2014 and April 2015 in Radio diagnosis and Otorhinolaryngology Departments, Al-Zahraa University Hospital, Egypt. The study included groups of thirty patients who had complaints related to the larynx as hoarseness of voice, stridor, chronic cough, chocking attacks or neck swelling. These patients were referred from the ENT outpatient clinic. All the patients of the study group were subjected to both laryngeal ultrasound and vocal cord stroposcopy. Results: Twelve patients (40%) were normal, two patients (6.6%) had vocal fold palsy, four patients (13,3 %) had vocal fold nodules, three (10%) had vocal fold polyp, two (6.6%) had vocal fold hypertrophy, two (6.6%) had intrarytenoid edema, one (3.3%) had anterior commissure mass enchroaching upon the right vocal cord, one (3.3%) had submandibular swelling and three (10%) had multinodular goitre. Conclusion: Laryngeal ultrasound can be used in diagnosis in different vocal cord lesions. It can be used as a complementary tool to vocal cord stroposcopy in diagnosis of vocal cord lesions.
2015
10
01
317
326
https://amj.journals.ekb.eg/article_64738_6a292c203c092fa8c7a90c70101b6849.pdf
Al-Azhar Medical Journal
1110-0400
1110-0400
2015
44
4
NESFATIN-1 TREATMENT ALLEVIATES INDOMETHACIN-INDUCED GASTRIC ULCER IN RATS
Dalia
I. Abd Al-Aleem
Dalia
M. Abd- Al-Mottaleb
Background: Indomethacin is a non-steroidal anti-inflammatory drug which is known to produce serious adverse effects including ulcerative lesions. Nesfatin-1, is an identified anorexigenic peptide to have antioxidant effects.
Objective: This study aimed to investigate the possible ameliorative effect of nesfatin-1 against indomethacin induced gastric ulcer in rats, with exploration of the possible mechanisms underlying this effect.
Materials and methods: Twenty four adult male albino rats were the animal model of this study. Ulcers were induced using oral indomethacin (20mg/kg) daily for 7 days. The rats were randomly assigned to vehicle-treated control group (I), indomethacin-treated (II), and indomethacin-treated for 7 days followed by nesfatin-1 (1ug/kg i.p) daily for 10 days. Assessment of gastric juice parameters (total acid output, pepsin activity and mucin content),gastric mucosal levels of malondialdehyde (MDA) , tumor necrosis factor –alpha (TNF-alpha) , nitrite and prostaglandin E2 (PGE2) levels were also determined. This in addition to assessment of gastric lesions and histopathologic examination of the gastric mucosa in each group.
Results: Nesfatin-1 displayed a significant ameliorative effect in gastric lesions induced by indomethacin as indicated by a significant decrease in ulcer index and improved histopathology, along with a significant reduction in measured gastric juice parameters .It also reduced both gastric mucosal MDA and TNF-alpha significantly and increased nitrite and PGE2 levels in this ulcer model.
Conclusion: Nesfatin-1 attenuates indomethacin- induced gastric ulcer and potentiates ulcer healing in the stomach of rats exposed to chronic administration of indomethacin. This effect depended upon decrease in gastric secretion, increase in nitric oxide and PGE2, besides an antioxidant anti-inflammatory role.
Nesfatin-1
Indomethacin
Gastric ulcer
MDA
TNF-alpha
Nitric oxide
Rats
2015
10
01
327
338
https://amj.journals.ekb.eg/article_64753_15557173ac98edca813d620e5eaed092.pdf
Al-Azhar Medical Journal
1110-0400
1110-0400
2015
44
4
RENOPROTECTIVE EFFECTS OF THYMOQUINONE AGAINST CISPLATIN-INDUCED NEPHROTOXICITY IN RATS
Mohamed
Hassan Abdelsattar
Background: Cisplatin (CIS) is one of the most effective chemotherapeutic agents and is used to treat various types of tumors. However its optimal clinical benefit is limited by its serious nephrotoxicity. Objective: Investigating the possible effects of thymoquinone (TQ), a compound derived from Nigella sativa with strong anti-oxidant properties, against CIS-induced nephrotoxicity. Materials and Methods: Forty adult male albino rats were divided into four equal groups: Rats in the first group were injected daily with normal saline, rats in the second group received TQ, rats in the third group were injected with CIS on the sixth day of experiment, whereas rats in the fourth group received TQ in drinking water for 11 consecutive days in addition to CIS injection (7.5 mg/kg, i.p.) on the sixth day of experiment. The animal were sacrificed at day 12 and following parameters were evaluated: (i) the levels of serum creatinine (Cr) and the blood urea nitrogen (BUN) as biomarkers of renal function, (ii) the renal content of thiobarbituric acid reactive substances (TBARS) as an index of lipid perioxidation and oxidative stress, (iii) total glutathione (GSH) content and glutathione S-transferase (GST) activity in renal tissues as indices of antioxidant mechanisms, and (iv) the histopathological hallmarks of kidney specimens. Results: CIS administration induced nephrotoxicity associated with significant higher in the levels of serum Cr, BUN, and renal TBARS and significant reductions in the renal GSH and GST. The histopathological findings supported the presence of seriously injured kidney. However, administration of TQ efficiently reduced the development of CIS nephrotoxicity and its associated biochemical and histopathological features. Conclusion: TQ mediates via, at least in part its antioxidant property, a marked renoprotective effect against CIS-induced nephrotoxicity.
Thymoquinone
Nephrotoxicity
Oxidative Stress
Cisplatin
antioxidant
2015
10
01
339
350
https://amj.journals.ekb.eg/article_64755_12876e7aa2fc3b596a2eba39fda274a7.pdf
Al-Azhar Medical Journal
1110-0400
1110-0400
2015
44
4
EVALUATION OF DIRECT FLUORESCENT ANTIBODY AND ENZYME LINKED IMMUNOSORBENT ASSAY VERSUS COPROMICROSCOPY IN DIAGNOSIS OF CRYPTOSPORIDIOSIS
Ahmed
Abd El-Aziz Ezz El-Din El-Bhairy
Background: Cryptosporidium oocysts detection methods include alternate bright-field stains and negative stains. These methods show high sensitivities but it may leave some oocysts unstained.
Objective: Evaluation of the direct fluorescence antibody (DFA) and coproantigens by ELISA versus modified Ziehl–Neelsen (MZN) stained smears in detection of Cryptosporidium.
Material and Methods: Eighty two immunocompromised patients having acute/ chronic diarrhea, were selected from the attendants of the pediatrics, oncology and nephrology clinics in Al-Azhar University Hospitals, during the period from August 2013 to May 2014. All cases were subjected to history taking and clinical examination, laboratoryexaminationof their fecal smears by microscopic examination of MZN stained smears, detection of coproantigens by ELISA and DFA for diagnosis of Cryptosporidium.
Results: Fifteen (18.29%) of the individuals were positive for Cryptosporidium infection using modified Ziehl–Neelsen stain, and 17 (20.73%) were positive by direct fluorescent antibody, while ELISA detect crypto-coproantigen in 18 (21.95%). Statistically, there were highly significant relations between ELISA, DFA, and MZN. The sensitivity, specificity, and positive and negative predictive values of DFA test were 100, 97, 88.2 and 100 %, respectively, and for ELISA test were 100, 95.5, 83.3 and 100%, respectively, compared with MZN method as the gold standard test for detection of the Cryptosporidium .
Conclusion: Modified Ziehl-Neelsen staining remained the gold standard for the detection of Cryptosporidium spp., but it may leave some oocysts unstained. So, the immunofluorescence assays were the methods of choice for greatest sensitivity and specificity especially when oocyst numbers in stool specimens were low.
2015
10
01
351
362
https://amj.journals.ekb.eg/article_64758_f320166067459259c187ea71f8b97faa.pdf
Al-Azhar Medical Journal
1110-0400
1110-0400
2015
44
4
CORRELATION BETWEEN MICROALBUMINURIA AND SEVERITY OF CORONARY ARTERY STENOSIS IN PATIENTS WITH TYPE II DIABETES MELLITUS
Khaled
I. Nageuib
Mohammed
A. Attia
Mohammed
S. Bashandy
Hammouda
Abdul-Khalik
Mohamed
A. Omar
Khaled
A. Aboualmagd
Background: Cardiovascular disease is the major cause of death in patients with diabetes mellitus. Microalbuminuria (MAU) is defined as persistent subclinical elevation of urinary albumin excretion rate (UAER), which is insufficient to be demonstrated by reagent strips.
Objective: to determine the correlation between microalbuminuria and the severity of coronary artery stenosis assessed by Gensini score in patients with type II diabetes mellitus
Patients and methods: This study included sixty-one patients with type II diabetes mellitus and suspected coronary artery disease that underwent elective coronary angiography in Al-Azhar University Hospital, New Damietta, during the period between October 2013 and October 2014. Patients were classified into two groups based on the level of urinary albumin: creatinine ratio (UACR): Group I included 32 patients (52.5 %) with microalbuminuria (UACR level ranging from 30 to less than 300 mg/g), and Group II included 29 patients (47.5 %) with normoalbuminuria (UACR level less than 30 mg/g). All patients were subjected to full history taking,clinical assessment, standard 12-lead surface electrocardiogram (ECG), echocardiography,laboratory investigations, andcoronary angiography.
Results: This study showed that UACR and Gensini score increased with age. There was a significant positive correlation between UACR and total cholesterol, triglycerides, LDL-C and glycosylated hemoglobin (HgbA1c), while there was a significant negative correlation with HDL-C and smoking. There was a significant positive correlation between Gensini score and urinary albumin level. The Gensini score was correlated with LDL- C and no correlation with total cholesterol, triglycerides, HDL-C and glycosylated hemoglobin (HgbA1c) or smoking. In the present study, the number of coronary vessels affected was higher in patients with microalbuminuria than those without microalbuminuria. The severity of coronary artery disease assessed by Gensini score was significantly higher in patients with microalbuminuria than those without microalbuminuria, and there was a correlation between UACR and Gensini score as a measurement of severity of coronary artery stenosis.
Conclusion: In patients with type II DM, microalbuminuria can be used as a predictor for coronary artery disease severity.
Gensini Score, Diabetes Mellitus, microalbuminuria
coronary artery stenosis
2015
10
01
363
372
https://amj.journals.ekb.eg/article_64770_ee76114460c0b8c4c4476db49d595fe1.pdf
Al-Azhar Medical Journal
1110-0400
1110-0400
2015
44
4
EFFECTIVENESS OF THROMBOLYTIC THERAPY FOR MASSIVE PULMONARY EMBOLISM
Mousa
Elshamly
Ahmad
Shawky Sherif
Mohamed
O. Nour
Background: Pulmonary embolism (PE) is a common disorder that is associated with significant morbidity and mortality. The primary cause of death in fatal PE is right-sided heart failure. Several randomized, controlled trials comparing thrombolytic therapy with heparin in patients with an acute PE have demonstrated more rapid clot resolution in those treated with thrombolysis.
Objective: Study the effectiveness and complications of thrombolytic therapy for massive pulmonary embolism.
Patients and Methods: Sixty patients with objectively confirmed massive pulmonary embolism were divided into two equal groups. First group with no contraindication for thrombolytic therapy was treated by (streptokinase or recombinant tissue plasminogen activator) and second group with absolute contraindication for thrombolytic therapy was treated by unfractionated heparin (UFH).
Results: CT pulmonary angiography showed that main pulmonary artery embolism was 25%, bilateral saddle shape pulmonary embolism 41.6%, left pulmonary artery embolism 15% and right pulmonary artery embolism 11.6% , and CT was not done in 4 patients because they were unstable. Mortality was high in patients with main pulmonary embolism 13.3%. Mortality was 20% in thrombolytic therapy treated group compared to 50% in heparin treated group and result was statistically significant . Moderate bleeding occurred into left knee in one patient of thrombolytic therapy treated group and mild Hematemesis occurred in one patient of heparin treated group but no mortality occurred due to bleeding.
Conclusion: Thrombolytic treatment reduced overall mortality of patients with acute massive PE, and was not associated with major bleeding.
2015
10
01
373
384
https://amj.journals.ekb.eg/article_64778_7b3a11ee4313a29c1bd153ae6d80e3e7.pdf
Al-Azhar Medical Journal
1110-0400
1110-0400
2015
44
4
CLINICAL FEATURES AND RISK FACTORS OF ACUTE STROKE IN WOMEN
Yousry
A. Abd-Elhamid
Taha
K.T. Aloush
Yasmin
M. Hanafy
Background: There is growing recognition of the clinical and public health importance of stroke in women. Moreover, stroke-related outcomes, including disability and quality of life are consistently poorer in women than in men. Yet the reasons for this are not well understood. Objectives: The aim of this study was to identify risk factors, clinical severity, type, site and size of stroke among sample of Egyptian women patients with acute stroke. Subjects and Methods: The study evaluated 103 female patients with acute stroke admitted within 48 hours of stroke onset. All patients were subjected to full history and neurological examination. The stroke severity was assessed on presentation using National Institutes of Health Stroke Scale (NIHSS). Also, computer topography and magnetic resonance imaging brain, bilateral carotid duplex study and trans-thoracic echocardiography study were done to all patients. Results:The mean age of the patients was 62.16 ± 13.5 years. Hypertension was the highest family (48.5%) and past history (78.6%) among the study patients. The mean of NIHSS score of our study patients on admission was 6.5 ± 3.76. The past history of previous cerebral stroke insult, high erythrocyte sedimentation rate and abnormal glycosylated hemoglobin were significantly associated with more severe stroke. Large artery atherosclerosis was the most common ischemic etiology in our sample (38.3%). Parietal lesions was the most common stroke site affected in our study patients (26 patients = 25.2%) followed by frontal lesions (18 patients =17.5%). Conclusion: Understanding acute stroke among females will help neurologist to develop sex-specific interventions that improve post-stroke recovery for women and reduce their excess burden of disability.
risk factors
Outcome
Acute stroke
Women
2015
10
01
385
396
https://amj.journals.ekb.eg/article_64796_53671e1c5ce5cfe79c5e6cbaa7bc40a1.pdf
Al-Azhar Medical Journal
1110-0400
1110-0400
2015
44
4
OROPHARYNGEAL PROLONGED DYSPHAGIA AFTER ACUTE STROKE: DIAGNOSIS AND CLINICAL PREDICTORS
Yousry
A. Abd-Elhamid
Ahmed
A.I. Elbassiouni
Taha
K.T. Aloush
Background: Dysphagia following acute stroke can be a serious threat to one's health because of the risk of aspiration pneumonia, malnutrition, dehydration, weight loss, and airway obstruction. There is an evidence that early enteral feeding via percutaneous endoscopic gastrostomy (PEG) is both beneficial and safe. Objectives: To predict risk factors ofprolonged dysphagia following acute stroke and proper management of similar cases. Subjects and Methods: This study was a prospective cohort study conducted on 113 patients with acute stroke admitted within 24 hours. Clinical findings and imaging results were prospectively collected, and subsequent progress was recorded. Subjects were divided into 3 groups for analysis: no dysphagia; transient dysphagia (≥14 days); or prolonged dysphagia (>14 days). Particular attention was paid to bulbar function. Stroke severity was assessed using the National Institutes of Health Stroke Scale on admission and on discharge. The water swallow test was performed to all patients who were able to attend sufficiently to follow the instructions. Modified Barium Swallow or Video-fluoroscopy test was done for some patients to detect the oropharyngeal dysphagia. Results: Significant associations for prolonged dysphagia were seen with large stroke, increased stroke severity, dysphasia and lesions of the frontal and insular cortex and presence of old vascular insult on brain imaging. Conclusion: These results indicated that it is potentially possible to identify those patients who have prolonged significant dysphagia following acute stroke at an early time point. This would allow the judicious use of early PEG to avoid aspiration pneumonia and for better nutrition.
Acute stroke
Dysphagia
risk factors
percutaneous endoscopic gastrostomy
aspiration pneumonia
2015
10
01
397
406
https://amj.journals.ekb.eg/article_64797_706b81c51051cbb73787f8016342d6ad.pdf
Al-Azhar Medical Journal
1110-0400
1110-0400
2015
44
4
THE EFFICACY OF HYOIDOTHYROPEXY IN MANAGEMENT OF MODERATE AND SEVERE OBSTRUCTIVE SLEEP APNEA
Mohamed
Abd-Elrahman Shams Al-Deen
Background: Snoring and obstructive sleep apnea (OSA) are major and important health problems with increasing rate of recording and achieving more attention. The wide spread availability of polysomnography and sleep lab makes the diagnosis of OSA easier and straight forward. Hyoidothyropexy is a type of skeletal surgeries which considered a part of phase I surgery targeted to the hypopharyngeal area
Objective: Evaluation of the efficacy of hyoidothyropexy in patients with moderate and severe Obstructive Sleep Apnea (OSA)
Material and methods: Nineteen patients were included in the study after taking their consent. They all underwent full history taking, and clinical examination with measurement of body mass index (BMI). Daytime sleepiness was measured using the Epworth Sleepiness Scale (ESS). The site of obstruction was determined via the upper airway endoscopy and Mueller maneuver and sleep endoscopy. The diagnosis and severity were assessed by overnight sleep study, i.e polysomnography (PSG). Patients were divided into moderate OSA (group A - 8 patients), and severe OSA (group B - 11 patients). Post-operative revaluation after 6 months was done by ESS and PSG. Preoperative and postoperative data were compared regarding ESS, and overnight sleep study PSG findings; (AHI), (SI), average SpO2 (%). Also demographic date and BMI were reviewed.
Results: The difference between the pre- and postoperative means of AHI, SI, ESS and average Spo2 % was of statistically significance in both groups. The cure rate in group A and B after hyoidothyropexy was 71.4 % and 61.4% respectively, but the main postoperative AHI was < 10 in group (B).
Conclusion: Hyoidothyropexy was an effective method in surgical treatment of moderate OSA with cure rate of 71.4% and significant reduction of AHI. While, in severe OSA it was better to be combined in multilevel surgery because the main AHI remained above 10 in most of the cases.
Obstructive sleep apnea
hyoidothyropexy
hyoid suspension
2015
10
01
407
414
https://amj.journals.ekb.eg/article_64798_ab4beecae5ae24c4313f5726231d54a4.pdf
Al-Azhar Medical Journal
1110-0400
1110-0400
2015
44
4
COMPARATIVE STUDY BETWEEN SELECTIVE NECK DISSECTION AND RADIOTHERAPY IN THE MANAGEMENT OF CLINICALLY NODE NEGATIVE NECK IN CASES OF HEAD AND NECK CANCERS
Mohammed
Abd El Rahman Shams El Deen
Eid
Rizk Al Gammal
Said
Hosny Al Bendary
Ahmed
Youssef Abdulhakeem
Ramadan
Hassan Alfar
Lobna
Rashed Ezz Al Arab
Background: The management of clinically node negative neck (cN0) remains a matter of controversy. The used methods of treatment are observation and follow up and treating the neck when clinical metastasis developed, prophylactic radiotherapy, or elective neck dissection. Many surgeons prefer the elective surgical intervention because of the increasing incidence of clinically node negative neck having occult metastatic lymph nodes.
Objective: The aim of this study was to compare between the efficacy of both elective neck dissection and elective neck irradiation in the management of clinically node negative neck (cN0) of patients with squamous cell carcinoma of head and neck, and to determine which type of treatment improves the 2- year survival, disease-free survival and loco-regional control rates.
Patients and Methods: During the period from 2012-2015, this prospective study was done at Al- Azhar University hospitals (Otorhinolaryngology Department, and Surgical Oncology Unit) on 50 patients diagnosed to have clinically node negative neck (cN0) of squamous cell carcinoma of head and neck randomized into two groups, 25 of them managed by selective neck dissection (Group I) and 25 managed by elective radiotherapy (Group II). They were followed up for a period ranged from 6 months to 24 months with a mean period of 15months. All patients were subjected for full history taking, general and local examination, (assessment of the primary site and state of nodes of the neck), neck ultrasound, computed tomography (CT) and chest X-ray. Patients of Group (I) were evaluated postoperatively for surgical complications. Patients of Group II received 50 Gy using conventional fractionation (2 Gy per fraction with 2 days rest) to a total duration of 5 weeks. The incidences of local and regional recurrences were recorded. Survival times were calculated starting from the date of the surgery.
Results: Nineteen female (38%) and 31 male patients (62%) were included in this study. 38% of patients have their primary lesion in the tongue and 30% of patients with primary laryngeal lesion. The check, lower lip, hypopharynx, alveolar margin, and nasopharynx were affected by primary lesion in 14%, 6%, 4%, 2% and 4% respectively. Moderately differentiated tumors (G2) were the most prevalent grade among the study groups. 26% of patients were presented with T1 lesion. T2, T3 and T4 were diagnosed in 50%, 14% and 12% of the studied patients respectively. Pathologically, positive nodes were observed in 4 cases of the dissected specimens ranging from 1-2 LN with the mean positive LN 1.3 nodes. Extra capsular extension was present in 3 patients (12%); positive LN without extra capsular spread was present in one patient (4%). Nine patients (18%) had a recurrence. In group I, 4 patients had recurrence, (2 local recurrences and 2 regional recurrences). In group II, 5 patients had a recurrence, (3 local recurrences, 1 regional recurrence and 1 loco-regional recurrence). The loco-regional control rate (LRC) for group I was 84% and for group II was 80%. Two years disease free survival rate in group (I) was 64% while that for group (II) was 56%. The overall survival rate (OSR) for group (I) was 80%, while that of group II was 76%. The differences between study groups as regard recurrence, loco-regional control rate, disease free survival rate, and survival time were statistically insignificant.
Conclusion: Patients with clinically node negative neck of cases of squamus cell carcinoma of head and neck, elective neck dissection and elective radiotherapy were both suitable in terms of survival and locoregional control rates. Patients receiving both modalities of therapy can get nearly the same outcome. They were nearly equally effective in controlling the cN0 neck. The choice of the type of treatment modality depended mainly on the surgical experience of the treating oncologist, how the primary site is managed, the surgeon and patient choices.
Clinically Node Negative Neck
Squamus Cell Carcinoma of Head and Neck
Neck Dissection
Elective Neck Radiation
2015
10
01
415
426
https://amj.journals.ekb.eg/article_66963_0c754af10ca0578ff9a10802c8a46dbb.pdf