Al-Azhar Scientific Medical SocietyAl-Azhar Medical Journal1110-040048320190701STUDY OF THE EFFECT OF MIDAZOLAM PRIOR TO ELECTIVE CESAREAN SECTION ON MOTHER AND NEONATE UNDER SPINAL ANESTHESIA1771865667310.21608/amj.2019.56673ENEmadAbd El-Hamid ShaabanAnesthesiology and Intensive Care Department, Faculty of Medicine, Al-Azhar UniversityMohamedAbd El-Gawad Abd El-Halim Abu El-SeoudAnesthesiology and Intensive Care Department, Faculty of Medicine, Al-Azhar UniversityMahmoudEmad El-Din Sabra Abd El-GhaniAnesthesiology and Intensive Care Department, Faculty of Medicine, Al-Azhar UniversityJournal Article20190701<strong>Background:</strong> Spinal anesthesia is the most popular form of regional anesthesia used for Cesarean delivery. Like all surgical patients, obstetric patients also feel operative stress and anxiety. The pharmacological sedation in spinal anesthesia is not commonly applied.
<strong>Objectives:</strong> This work aimed to determine the effect of premedication with midazolam on preoperative maternal anxiety, neonatal outcome regarding respiratory depressant effect and muscle tone, and also postoperative satisfaction of parturients scheduled for elective cesarean delivery under spinal anesthesia.
<strong>Patients and Methods:</strong> After approval of Institutional ethical committee and obtaining written informed consent from eligible parturient women, 80 full term pregnant patients aged between 18 and 40 years were classified according to American Society of Anesthesiologist I and II and scheduled for elective cesarean section. The study was conducted in the Obstetrics Department of Al-Azhar University Hospitals (Al-Hussein and Bab-Al-Shaarya), from December 2018 till June 2019.
<strong>Results:</strong> Midazolam intravenously at a dose of 0.035 mg/kg before spinal anesthesia for patients undergoing cesarean section were effective in relieving maternal anxiety with no adverse effect on neonates or maternal hemodynamic instability.
<strong>Conclusion:</strong> Preoperative sedation 30 mins pre anesthetichally was found to be associated with improved preoperative anxiety, postoperative satisfaction, and maternal hemodynamics in parturients scheduled for elective cesarean delivery.https://amj.journals.ekb.eg/article_56673_ed792f2dbf712c21d7df85c42b6e8758.pdfAl-Azhar Scientific Medical SocietyAl-Azhar Medical Journal1110-040048320190701PHENOTYPIC AND GENOTYPIC DETECTION OF CARBAPENEM RESISTANT ACINETOBACTER BAUMANNII IN SURGICAL AND INTENSIVE CARE UNITS IN AL AZHAR UNIVERSITY HOSPITAL – NEW DAMIETTA1872065667410.21608/amj.2019.56674ENMohammedGohar Mohammed ElsherbenyDepartment of Microbiology, Faculty of Medicine, Al-Azhar University, Cairo, EgyptMoustafaAbdelnasser AlyDepartment of Microbiology, Faculty of Medicine, Al-Azhar University, Cairo, EgyptEl SayedAhmed GoudaDepartment of Microbiology, Faculty of Medicine, Al-Azhar University, Cairo, EgyptMohammedMoustafa BalboulaDepartment of Surgery, Faculty of Medicine, Al-Azhar University, New Damietta, EgyptMohammedMohammed Ahmed SalehDepartment of Microbiology, Faculty of Medicine, Al-Azhar University, Cairo, EgyptJournal Article20190701<strong>Background: </strong>Acinetobacter baumannii (A. baumannii) has emerged as a healthcare-associated pathogen worldwide. Several epidemiological studies have reported the occurrence of multi-drug resistant A. baumannii infections in different regions of the world. The spread of carbapenem-resistant A. baumannii is of a global concern.<br /> <strong>Objectives:</strong> This work was carried out to detect carbapenem-resistant A. baumannii in Surgical Departments and intensive care units (ICUs), Al-Azhar University hospital, New Damietta. It was also aimed to determine the occurrence of bla OXA -51-like and bla OXA-23 like genes among the isolated strains.<br /> <strong>Patients and methods:</strong> The current study was conducted on 500 patients attending the Surgical Departments and ICUs during the period between May 2016 and September 2018. The choice of samples differs according to the clinical manifestations.<br /> The isolates were obtained from various clinical specimens, i.e. sputum, endotracheal aspirate (ETA), pus, urine and blood samples. All clinical specimens were collected under complete aseptic conditions. The clinical specimens were traced to the species level using API 20NE system followed by an assesment of the different phenotypic assays for detection of carbapenemase production using multiplex polymerase chain reaction (PCR).<br /> <strong>Results:</strong> Post-operative infections were detected in 217 (43.4%) out of 500 of patients. A. baumannii was considered the third common isolated Gram-negative organisms (27, 12.3 %). A. baumannii isolates were predominant in ICUs (14, 51.9%). Carbapenemase production was detected in A. baumannii isolates using the modified Carbapenem Inactivation Method (mCIM), the modified Hodge test (MHT) and the Carba NP test. Using multiplex PCR analysis, most isolates (12; 44.4%) carried bla OXA-51-like gene, followed by ten (37%) isolates that carried both bla OXA-51-like and bla OXA-23-like genes. Only one (3.7%) isolate carried bla OXA-23-like gene.<br /> <strong>Conclusion: </strong>The current study suggested that A. baumannii is one of the most commonly detected isolates in our hospital. The mCIM is the most useful phenotypic method for detection of carbapenemase production. Detection of carbapenem resistance genes is alarming a serious healthcare problem in our hospital.https://amj.journals.ekb.eg/article_56674_992a8acdecd11ec95255fbdaf65253fc.pdfAl-Azhar Scientific Medical SocietyAl-Azhar Medical Journal1110-040048320190701IRISIN: A POTENTIAL PROMISING AGENT AGAINST NON-ALCOHOLIC FATTY LIVER DISEASE IN TYPE 2 DIABETIC RATS2072265667510.21608/amj.2019.56675ENHanyA. El-KattawyPhysiology Department, Zagazig Obesity Management & Research Unit Faculty of Medicine; Zagazig University; Egypt and College of Medicineو Al maarefa University; Saudi ArabiaWesamM. R. AshourPhysiology Department, Faculty of Medicine, Zagazig University, EgyptJournal Article20190701<strong>Background</strong>: Non-alcoholic fatty liver disease (NAFLD) is strongly related to obesity, insulin resistance and type 2 diabetes.Irisin is an exercise-induced myokine which improves glucose profile and insulin resistance.
<strong>Objective: </strong>To evaluate the potential effects of irisin on liver function in type 2 diabetic rats with NAFLD and elucidate the underlying mechanisms.
<strong>Material and methods: </strong>Thirty adult male albino rats were divided into 3equal groups: control rats, type 2 diabetic with NAFLD rats, and type II diabetic rats with NAFLD received irisin (0.5 μg/g body weight once daily for 8 weeks). Diabetes was induced by high fat diet for 12 weeks followed by injection of small dose of streptozotocin (35 mg/kg body weight). Eight weeks after establishment of diabetes, body mass index and abdominal circumference were estimated. Serum was analysed for glucolipid metabolic parameters, liver enzymes, C-reactive protein, tumour necrosis facror-α. Liver homogenate was assayed for malondialdehyde, superoxide dismutase, and glutathione s-transferase activities. Liver sections were stained with Hematoxlyin & eosin.
<strong>Results:</strong> Irisin treatment significantly improved glucolipid metabolic parameters, liver enzymes, antioxidante enzymes accompanied by significant decrease in inflammatory mediators and malondialdehyde levels, with improvement of the histopathological findings.
<strong>Conclusion: </strong>Irisin may be used as a promising agent against NAFLD in type 2 diabetic rats possibly through controlling glucose and lipid metabolism and via its beneficial anti-inflammatory and anti-oxidant effects as well.https://amj.journals.ekb.eg/article_56675_b37dce12300de23a90bed81eccd61513.pdfAl-Azhar Scientific Medical SocietyAl-Azhar Medical Journal1110-040048320190701COMPARISON BETWEEN SUPERFICIAL CERVICAL BLOCK AND MORPHINE TO REDUCE ANALGESIC REQUIREMENTS DURING AND AFTER TOTAL THYROIDECTOMY OPERATIONOPERATION2272425667610.21608/amj.2019.56676ENEssamIbrahem SaberAnesthesia & Intensive Care Department, Al-Azhar faculty of medicineWaelMohamed El Mahdi IbrahimAnesthesia & Intensive Care Department, Al-Azhar faculty of medicineMostafaMohamed Abd El-HakeamCorresponding author: Mostafa Mohamed Abd El-HakeamJournal Article20191103<strong>Background:</strong> More than 230 million people undergo surgery each year worldwide, and the number is increasing annually. Surgery causes commonly postoperative pain that should be alleviated as soon as possible to reduce suffering, and to promote the healing process and rehabilitation, and to prevent complications. Pain after thyroid surgery is regarded as being of moderate intensity and short duration. However, during the first 24 h after surgery, some patients require opioid and non-opioid analgesics.
<strong>Objectives:</strong> The aim of this work was to compare the effect of superficial cervical block combined with general anesthesia, intravenous morphine in patients undergo thyroidectomy operation as regard as the heamodynamics intraoperative and post-operative analgesia.
<strong>Patients and Methods:</strong> After obtaining the approval of the Al-Azhar University Ethical Committee, eighty patients of American Society of Anethesiologists (ASA) physical status I or II, scheduled for thyroidectomy operation under general anesthesia were enrolled in this randomized, prospective, clinical trial study. Information about the study were given comprehensively both orally and in written forms to the patients. All patients gave their written informed consents prior to their inclusion in the study. The study was carried out in Al-Azhar University Hospitals (AL- Hussein &Sayed Galal Hospitals). Eighty patients were randomly divided into two equal groups: Group {A} received a bilateral superficial cervical block (15ml per side) with bupivacaine 0.25% after induction of general anesthesia, and Group {B} recived morphine (0.1 mg\ kg body weight) 15 minutes before induction of general anesthesia.
<strong>Results:</strong> The results of the present study revealed that mean arterial pressure (MAP) and heart rate (HR) were significantly lower in Group (A) compared with group (B). Pethidine requirements during the first 24 h after thyroidectomy were significantly reduced in Group (A) compared with Group (B). At post-operative care unit (PACU) admission, pain scores were significantly lower in Group (A) than in Group (B). Pain scores decreased in the two groups during the 24 h after surgery. Thirty-four patients (42.2%) developed post-operative nausea and vomiting (PONV) in the post-operative care unit (PACU), 8 patients in Group (A), 26 patients in Group (B).
<strong>Conclusion:</strong> Bilateral superficial cervical plexus block (BSCPB) was an effective technique to reduce analgesic requirements during and after thyroid surgery and improved the anethetic outcome more than intravenous injection of morphine.https://amj.journals.ekb.eg/article_56676_ee409ac51d87c367289dbaebd00b65c5.pdfAl-Azhar Scientific Medical SocietyAl-Azhar Medical Journal1110-040048320190701ASSESSMENT OF 14-3-3 PROTEIN ETA AND ANTI-CYCLIC CITRULLINATED PEPTIDE (ANTI-CCP) IN JUVENILE IDIOPATHIC ARTHRITIS VERSUS ADULT ONSET RHEUMATOID ARTHRITIS2432565667710.21608/amj.2019.56677ENMohammedA. HassanDepartments of Pediatrics, Faculty of Medicine (Girls and Boys), Al-Azhar UniversityRashaM. GoudaDepartments of Pediatrics, Faculty of Medicine (Girls and Boys), Al-Azhar UniversityWagenatE. AlsayedDepartments of Internal medicine, Faculty of Medicine (Girls and Boys), Al-Azhar UniversityImanA.KassemDepartments of Clinical Pathology, Faculty of Medicine (Girls and Boys), Al-Azhar UniversityJournal Article20190703<strong>Background:</strong> 14-3-3(eta) protein, is an intracellular chaperone (cellular adapter) protein, which released to the extra cellular space during the early stages of the rheumatoid arthritis (RA), and acts as an inducer of innate immune system. Many inflammatory mediators and pathways that involved in the pathogenesis and progression of RA have been upregulated through 14-3-3 eta protein. So, this marker in addition to existing biomarkers can augment the lab efficacy in the early identification and progression assessment of the RA.
<strong>Objective:</strong> Investigating the existence of anti-CCP antibodies and 14-3-3 protein eta in juvenile idiopathic arthritis (JIA) and RA patients, comparing that with healthy controls and correlated their levels with Disease Activity Score (DAS 28).
<strong>Patients and Methods:</strong> Serum levels of 14-3-3 eta protein and anti-CCP were measured using enzyme-linked immunosorbent assay (ELISA) in 40 patients including 20 JIA cases (group I), 20 RA cases (group II), and 40 apparently healthy controls.
<strong>Results:</strong> There were highly significant statistical increases in RF, and anti-CCP antibodies in JIA patients as compared with their controls, while there was insignificant statistical difference between both groups regarding 14-3-3 protein eta. There were significant statistical increases in14-3-3 protein eta and anti-CCP antibodies in adult RA patients as compared with their controls. In JIA patients, there was significant increase in disease activity score 28 (DAS 28) among patients with +ve RF and +ve anti-CPP, meanwhile there were non-significant relation between DAS 28 and CRP results. Among cases with RA, there was non-significant relation between DAS 28 and the 3 markers (CRP, RF, and anti-CCP antibodies). At cutoff point of 0.19 ng/ml (which was used in many previous studies as the best for 14-3-3 eta protein), our results showed sensitivity and specificity for this marker in JIA (15% and 100%) . In RA, we found 90% sensitivity and 90% specificity for this marker at the same cutoff point. Our study revealed that serum 14-3-3 eta protein level was significantly correlated to disease severity score 28 (DAS 28) for JIA (r = 0.49 / P = 0.0288), while for RA (r = 0.8502 / P= 0.0001).
<strong>Conclusion:</strong> anti-CCP antibodies were prevalent among polyarticular onset JIA patients compared to other subtypes of the disease. 14-3-3 protein had +ve correlation with disease severity in both groups and needs further evaluation on larger samples.https://amj.journals.ekb.eg/article_56677_e2b02e039438b6dd244380de36b63e7f.pdfAl-Azhar Scientific Medical SocietyAl-Azhar Medical Journal1110-040048320190701COMPARATIVE STUDY BETWEEN MEPERIDINE, KETAMINE, AND ONDASETRON FOR PROPHYLACTIC MANAGEMENT OF POST-SPINAL SHIVERING IN PATIENTS UNDERGOING LOWER ABDOMINAL SURGERIES2572665667910.21608/amj.2019.56679ENTawfikM. Noor EL-DinDepartments of Anesthesia and Intensive care, Faculty of Medicine, Al-Azhar University, CairoMohamedS. SharafDepartments of Anesthesia and Intensive care, Faculty of Medicine, Al-Azhar University, DamiettaAhmedMahmoud M. AlgarhyDepartments of Anesthesia and Intensive care, Faculty of Medicine, Al-Azhar University, CairoMahmoudS. EisaDepartments of Anesthesia and Intensive care, Faculty of Medicine, Al-Azhar University, CairoJournal Article20191103<strong>Background:</strong> Shivering can be very unpleasant and physiologically stressful for the patient. It can be detrimental to patients with low cardio-respiratory reserve.
<strong>Objective:</strong> The study was done to compare the effect of Meperidine, Ketamine, and Ondansetron in prevention of post-spinal shivering.
<strong>Patients and Methods:</strong> This prospective randomized single blinded controlled clinical study was conducted on 120 patients under spinal anesthesia ASA I, II, undergoing lower abdominal and lower limb surgical procedures not exceeding 60 minutes. Patients were randomized into three equal groups. Group (A) received meperidine in a dose of 0.5 mg/kg.i.v, Group(B) received ketamine in a dose of 0.25 mg/kg.iv, and Group (C) received ondansetron in a dose of 4 mg. iv . All these drugs were given after subarachnoid block. Patients were evaluated by measuring shivering grade, HR, Systolic BP every 5 minutes for 60 minutes after interthecal injection. Shivering during spinal anesthesia was determindeded using a scale validated by Tsai and Chu. Blood pressure, heart rate and side effects were recorded.
<strong>Results:</strong> There were statistical significant differences between Meperidine, Ketamine, and Ondansetron as Meperidine has a superior effect in prevention of shivering. No changes in systolic BP and HR.
<strong>Conclusion:</strong> Meperidine and low dose ketamine (0.25mg/kg) were significantly more effective than ondansetron for prevention of post-spinal shivering in patients undergoing lower abdominal surgeries.https://amj.journals.ekb.eg/article_56679_483f872a7a776c7fef82926aa0e5e2ef.pdfAl-Azhar Scientific Medical SocietyAl-Azhar Medical Journal1110-040048320190701PERIPHERAL NEUROPATHY IN BEHÇET'S DISEASE: CLINICAL AND NEUROPHYSIOLOGICAL STUDY2672785668010.21608/amj.2019.56680ENHossamMohamed EmamDepartments of Neurology, Faculty of Medicine, Al-Azhar University, Cairo, EgyptMohieEl Din Tharwat MohamedDepartments of Neurology, Faculty of Medicine, Al-Azhar University, Cairo, EgyptHatemGalal AbdallahDepartments of Rheumatology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt0000-0002-2906-9162ELSayedMaher ArafatDepartments of Neurology, Faculty of Medicine, Al-Azhar University, Cairo, EgyptJournal Article20190703<strong>Background:</strong> Behçet’s disease (BD) is a chronic idiopathic relapsing condition, whereas multiple organs are affected as a sequential effect of the vascular and inflammatory process. Based on the neurophysiological studies, 20-40% of BD patients may have silent neurological involvement (SNI) with no or very mild clinical manifestations.<br /> <strong>Objectives:</strong> Assessing clinically and electro physiologically the prevalence of symptomatic and asymptomatic peripheral neuropathy (PN) among BD patients along with the potential predictors of PN among BD patients.<br /> <strong>Patients and Methods:</strong> All patients with clinically established BD according to the International Criteria for Behçet's Disease (ICBD) were involved in the current study. All patients were submitted to clinical evaluation, neuropathy symptom score (NSS) along with electrophysiological nerve conduction studies including sensory and motor nerve conduction assessment.<br /> <strong>Results: </strong> An overall 30 participants who fulfilled the inclusion criteria were enrolled in the study. There were 22 (73.3%) males and 8 (26.7%) females with a mean age of 37.9±8.31 years. Based on the electrophysiological studies, 16 (53.3%) patients had the evidence of peripheral neuropathy in the terms of mixed (23.3%), motor (6.6%), and sensory (23.3%) nerve affection. The most affected peripheral nerve was sural nerve (46.6%) succeeded by peroneal (43.3%) and ulnar (20%) nerves. The univariate regression model showed that the age of the patients and the duration of the disease were independent predictors of peripheral neuropathy.<br /> <strong>Conclusion:</strong> PN is a considerable complication of BD, whereby health care providers should employ a routine follow up protocol for early detection of even the subclinical PN.https://amj.journals.ekb.eg/article_56680_1500136ec563f90dbdc0bcf65c6422e0.pdfAl-Azhar Scientific Medical SocietyAl-Azhar Medical Journal1110-040048320190701ROLE OF COLONOSCOPY IN DIAGNOSING ORGANIC DISEASES IN PATIENTS WITH COLONIC SYMPTOMS COMPATIBLE WITH ROME IV CRITERIA2792885668110.21608/amj.2019.56681ENAliIbrahim AliDepartments of Hepatogastroenterology& infectious diseases, Faculty of Medicine, Al-Azhar University, Cairo, EgyptAl-SayedMohammed IbrahimDepartments of Histopathology, Faculty of Medicine, Al-Azhar University, Cairo, EgyptGalalAbd-Elhamid Abo FarragDepartments of Hepatogastroenterology& infectious diseases, Faculty of Medicine, Al-Azhar University, Cairo, EgyptAhmedAbd-Allah AliDepartments of Hepatogastroenterology& infectious diseases, Faculty of Medicine, Al-Azhar University, Cairo, EgyptJournal Article20190703<strong>Background:</strong> Irritable bowel syndrome is a symptom-based condition defined by the presence of abdominal pain or discomfort, with altered bowel habits, the diagnosis could be reached using symptom-based diagnostic criteria without the need for exhaustive investigation; however interest in the potential for a missed organic GI disease in patients diagnosed IBS has increased over the last years.
<strong>Objective: </strong>This study aimed to evaluate the role of colonoscopy in diagnosing organic diseases in patients with colonic symptoms compatible with Rome IV criteria of Irritable bowel syndrome as well as studying the effect of the presence or absence of alarm features on detecting organic lesions
<strong>Patients and methods:</strong> A cross sectional study was carried out on 50 patients fulfilling the Rome IV criteria for IBS. The study was conducted in in the department of Hepatogastroenterology, Al-Azhar university Hospitals from December 2018 to May 2019.
Patients were selected and divided into two equal groups: Group A: fulfilled Rome IV criteria for IBS without alarm features, and Group B: included 25 patients fulfilled Rome IV criteria for IBS with alarm features. All patients underwent full colonoscopy along with biopsy from colon was taken for histopathological examination.
<strong>Results:</strong> The mean age of participants was 40.12 years. Males were 27 (54%) while females were 23 (46%), Eleven of 50 patients (22%) fulfilling Rome IV criteria of IBS had organic colonic diseases. There was higher prevalence of organic GI lesions in patients who reported alarm features. Microscopic colitis was the predominant organic disease among studied patients. IBS-D has the highest contribution to the total number of organic diseases.
<strong>Conclusion:</strong> Up to one in six patients meeting criteria for IBS without alarm features in routine clinical practice may have underlying organic GI lesions, and this increased to one in four patients if alarm features were present .https://amj.journals.ekb.eg/article_56681_0542d9e6d4bf07f1bbbdb2674d462680.pdfAl-Azhar Scientific Medical SocietyAl-Azhar Medical Journal1110-040048320190701CERVICOVAGINAL FLUID CYTOKINES' LEVELS IN PRETERM BIRTH HIGH-RISK WOMEN COULD BE USED AS EARLY PREDICTORS FOR RECURRENT PRETERM BIRTH2893005668210.21608/amj.2019.56682ENSamehSaidDepartments of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University, CairoEl-SayedEl-DesoukyDepartments of Obstetrics & Gynecology, Faculty of Medicine, Al-Azhar University, CairoMahmoudHashishDepartments of Clinical Pathology,
Faculty of Medicine, Al-Azhar University, CairoJournal Article20190703<strong>Background:</strong> Differences in cytokine distribution across different biological fluids; maternal plasma, cervicovaginal fluid (CVF), and amniotic fluid are evident throughout normal pregnancy, but profiles of numerous cytokines varied across trimesters in women delivering term versus preterm in both CVF and serum.
<strong>Objective:</strong> To evaluate cytokine profile in cervicovaginal fluid (CVF) of women had previous preterm birth (PTB) and the effect imposed by cerclage on these levels.
<strong>Patients and Methods:</strong> Seventy study women with previous PTB and currently had cercical length (CL) of <25 mm and 20 control women with no history of PTB and had CL of >25 mm were studied. At the 24<sup>th</sup> gestational week (GW; T1), all women had CL estimation and CVF sampling. At time of labor or removal of the suture (T2), study women had CL re-estimation and CVF re-sampling. CVF levels of monocyte chemoattractant protein-1 (MCP-1), tumor necrosis factor-α (TNF-α), interleukin (IL)-1β and IL-6 were ELISA estimated. Shirodkar cervical cerclage (CC) was performed within 4 days after T1 sampling. Outcomes included difference in T1-CVF cytokines' levels between study and control women, effect of cerclage on CL and CVF cytokines' levels and the value of T1-CVF cytokines' levels as predictors of pregnancy duration.
<strong>Results:</strong> T1-CVF levels were significantly higher in study than control women and to their T2- levels. T1- and T2-CL in study women was significantly shorter than T1-CL in controls with significant difference between T1- and T2-CL. Percentage of T2-CL decrease was negatively correlated with the percentage of decrease of T2-CVF levels. Duration of pregnancy of study women was negatively correlated with percentage of CL shortening, while was positively correlated with percentage of decrease of T2-CVF levels of MCP-1 and TNF-α. Statistical analyses defined high T1-CVF levels of MCP-1, IL-β and TNF-α as significant early predictor for PTB.
<strong>Conclusion:</strong> High CVF cytokines' levels were associated with increased risk of PTB. Cerclage worked beyond its mechanical action through reduction of CVF cytokines' levels. High CVF cytokines' levels at 24th GW, especially high levels of MCP-1 and TNF-α, may help to predict PTB.https://amj.journals.ekb.eg/article_56682_c51b5f8e0e0be99f6d08cd9b78a45728.pdfAl-Azhar Scientific Medical SocietyAl-Azhar Medical Journal1110-040048320190701EVALUATION OF SERUM ADENOSINE DEAMINASE LEVEL IN CORRELATION TO THE ACTIVITY OF ULCERATIVE COLITIS3013125668310.21608/amj.2019.56683ENAbdoMabrouk El-ShafaeDepartments of Hepatology,gastroenterology & infectious diseases, Faculty of Medicine, Al-Azhar University-Cairo, EgyptSherifAli Abd El-AzizDepartments of Hepatology,gastroenterology & infectious diseases, Faculty of Medicine, Al-Azhar University-Cairo, EgyptNagahMohamed Abu MohamedDepartment of Clinical Pathology, Faculty of Medicine, Al-Azhar University-Cairo, EgyptMostafaMostafaDepartments of Hepatology,gastroenterology & infectious diseases, Faculty of Medicine, Al-Azhar University-Cairo, EgyptJournal Article20190703<strong>Background:</strong> Ulcerative colitis (UC) is a chronic inflammatory disease characterized by recurrent inflammation and ulcerations of colonic mucosa causing frequent episodes of bleeding per rectum.
The diagnosis of UC is best made with colonoscopy and mucosal biopsy for histopathology. Noninvasive tests, including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cells (WBC), fecal calprotectin are being widely recognized , both for initial diagnosis and for accurately monitoring disease activity in UC.
<strong>Objective:</strong> Evaluation of the level of serum adenosine deaminase in correlation to the activity of Ulcerative colitis.
<strong>Patient and Methods:</strong> In this Prospective study evaluation the level of serum adenosine deaminase in correlation to the activity of UC was done in 80 patients. They were divided into 3 groups, Group I: 30 patients confirmed and well known cases of ulcerative colitis (by colonoscopy and histopathological examination), during remission state. Group II: 30 patients confirmed and well known cases of ulcerative colitis (by colonoscopy and histopathological examination), during exacerbation state (activity state). Group III: 20 patients with colonic manifestations other than ulcerative colitis.
<strong>Results:</strong> The current study showed that ADA, the cut-off was 9.32 U/L to differentiate between exacerbation and remission states with sensitivity of 82.3%, specificity of 84.5%.
<strong>Conclusion:</strong> Serum ADA is more accurate than CRP, WBCs and ESR to differentiate between exacerbation and remission states of UC.https://amj.journals.ekb.eg/article_56683_42acd6af91735c0ba34fad72fad16c8a.pdf