bluuebunny/crossref_metadata_2025 huggingface dataset:
A comparison between Sevoflurane Volatile Induction/Maintenance Anesthesia and Propofol Total Intra-venous Anesthesia for Rigid Bronchoscopy under Spontaneous Breathing for Tracheal/Bronchial Foreign Body Removal in Children
Authors: Al-Safty O M T , Youssef O R , Kamaleldin D M , Youssef M K M
Published: May 2020

Background

Foreign body aspiration is a life-threatening condition. Asphyxiation from inhaled foreign bodies is a leading cause of accidental death among children younger than 4 years. While early clinicians used topical anesthesia, general anesthesia became common place for the removal of aspirated objects with increased experience with the rigid bronchoscope and advances in anesthetic delivery. Inhaled anesthesia and total intravenous anesthesia are widely used for rigid bronchoscopy in children.

Objective

In this study, we compared sevoflurane VIMA and propofol TIVA, when used for both induction and maintenance of anesthesia in children undergoing rigid bronchoscopy for tracheal or bronchial foreign body removal.

Methods

This is a prospective double – blinded, randomized controlled Trial, After Approval is obtained from the research ethics committee of anaesthesia and intensive care department, Ain Shams University. Patients were randomly divided into two groups (n = 30 each). In Group VIMA, anesthesia was induced with inhalation of sevoflurane. Before induction, a closed circuit with a 1-l reservoir bag was overflowed by 8 vol % sevoflurane with 0.3 l/min fresh oxygen flow for 3 min. In Group TIVA, a bolus of 2.5 mg/kg propofol was administered over 30 seconds. Additional propofol 0.5–1 mg/kg was given as needed to deepen anesthesia.

Results

Our results demonstrate that compared with propofol TIVA, sevoflurane VIMA provides more stable haemo-dynamics and respiration, faster induction and recovery and higher incidence of excitement in paediatric patients undergoing tracheal/bronchial foreign body removal.

Conclusion

Foreign body aspiration is a life-threatening condition. Anesthetic management can be challenging, as the airway is shared with the surgeon and adequate ventilation must be maintained despite airway manipulation.
A Comparison of the Analgesic Effect between Magnesium Sulphate and Fentanyl as Adjuvants to Epidural Levobupivacaine in Patients Undergoing Open Reduction and Internal Fixation of Pott's Fracture
Authors: Ibrahim S F , Samir G M , Alawady D S M , Kodous M A A H
Published: May 2020

Background

The use of opioids in epidural anesthesia has become popular to optimize postoperative analgesia. The present study was designed to compare the analgesic efficiency of epidural infusion of (magnesium sulfate added to levobupivacaine) compared to (fentanyl added to levobupivacaine) and (levobupivacaine) alone.

Objective

The aim of this study was to assess the post-operative analgesic efficiency of Magnesium Sulphate as an additive to Levobupivacaine in comparison with either Levobupivacaine alone or the combination of Levobupivacaine and Fentanyl.

Patients and Methods

Ain Shams university hospitals. After obtaining an informed consent; 45 patients admitted for open reduction and internal fixation of Pott's fracture, were blindly randomized into three groups; group N, group M or group F. Group N receive levobupivacaine, group M receive levobupivacaine and magnesium, and group F receive levobupivacaine and fentanyl.

Results

The study showed that the onset of both sensory and motor blocks was significantly faster in the group receiving magnesium and levobupivacaine in comparison with the other two groups. In addition, heart rate was significantly lower in the 2 groups receiving magnesium and fentanyl as adjuvant to levobupivacaine compared to the third group.

Conclusion

It was concluded that using magnesium sulphate as an additive to epidural levobupivacaine infusion produces good analgesia without side effects; it proved to fasten the epidural block in comparison to both the levobupivacaine and the levobupivacaine and fentanyl groups, besides it increased the duration of post operative analgesia in comparison with levobupivacaine group.
Evaluating the effect of calcium chloride in combination with neostagmine and atropine against residual neuromuscular blockade at the end of general anesthesia
Authors: Marzouk M M , Shoukry R A , Refaat S A , Fathi A M
Published: May 2020

Background

Muscle relaxants used in general anesthesia during the insertion of an endotracheal tube (ETT) to relax the muscles of the neck and throat, which reduces the risk of injury. They also are used to relax the chest muscles when an endotracheal tube is used to aid mechanical ventilation.

Objective

The aim of this study has been to evaluate the effect of calcium chloride coadministered with neostigmine and atropine on neuromuscular blockade recovery time at the end of general anesthesia. And compare it’s effect against usual neuromuscular reverse of neostigmine and atropine.

Patients and Methods

In this present study we use Double blind prospective randomized Clinical trial study, 30 patients were enrolled. They were divided in two groups each of which contains 15 patients: Group (A): received 5 mg/kg of calcium chloride coadministered with 25 μg/kg of neostigmine and 15 μg/kg of atropine at the end of surgery. Group (B): received the same volume of normal saline coadministered with 25 μg kg of neostigmine and 15 μg / kg of atropine at the end of surgery.

Results

Comparison between calcium and neostigmine groups according TOF at 5 minutes and 10 minutes using Independent t-test, P- value was less than 0.01 which means that there is high significant difference between 2 groups. On the other hand, TOF at 20 minutes in calcium and neostigmine groups shows no difference at all.

Conclusion

So Calcium chloride elevate serum calcium level, calcium has antineuromuscular blockade effect, therefore calcium chloride increase TOF and enhance neuromuscular recovery and decrease the PORC after neostigmine administration.
Impact of Thyroid Dysfunction in Correlation to Mortality Rate of the Critically ILL ICU Patients (Prospective Observational Study)
Authors: Mohammed A E , Saied A M , Selima W Z , Ibrahim W S
Published: May 2020

Background

during critical illness, changes in circulating hormonal levels are a common phenomenon. These alterations are correlated with the severity and outcome of patients in intensive care unit (ICU). Thyroid hormone stays a key role in the maintenance of the body growth. Modulating metabolism and the immune system.

Aim of the Work

is to access the relation between thyroid dysfunction and mortality in critically ill patients and to access the strength of thyroid dysfunction as a predictor of mortality against APACHE II score and CRP, also to assess the additive effect of low FT3 and high APACHE II score as a predictor of mortality.

Patients and Methods

the study population (n = 40) included 21 males (52.2%) and 19 females (47.5). their age range from (21 years) to (91 years) were selected from critically ill patients admitted to El Demerdash hospital general ICU in the period from March 2017 to March 2018. Patients were divided into 2 groups according to 7th day thyroid profile:

Group 1

Normal thyroid function group (24 patients).

Group 2

thyroid dysfunction group (16 patients).

Results

the most significant abnormality between the 2 groups was TT3 and FT3. The patients in thyroid dysfunction group showed significantly higher APACHE II score and CRP but lower GCS. They also needed more mechanical ventilation with longer duration. There was no significant difference between the 2 study groups as regard cardiovascular complication.

Conclusion

our study also showed highly significant correlation between thyroid dysfunction and mortality. FT3 appeared to be better predictor of mortality among critically ill patients with AUC 83% and p value < 0.001 with sensitivity 99% and specificity 61%. The predictive value of FT3 for mortality increased by the addition of APACHE II score > 25.
Prevalence of Peripheral Arterial Disease among End Stage Renal Disease Patients
Authors: Morkos R R W , Shahan A M , Elserafy A S , Hanna H F
Published: May 2020

Background

Patients with End Stage Renal Disease are more susceptible to develop Peripheral Arterial Disease. So, screening is helpful for early diagnosis.

Objectives

The aim of this study is to screen and calculate the prevalence of asymptomatic patients on regular hemodialysis for presence of PAD.

Methods

The study included 100 asymptomatic patients on regular hemodialysis and below 60 years old to be screened for presence of PAD. All selected patients have been subjected to ABI assessment using the Doppler. It was found that the prevalence of PAD among ESRD patients is 26% of which 80.8% had bilateral PAD and 19.2% had unilateral disease. The results showed that females had statistically significant higher risk of developing PAD than males. The study showed also that A1C level in patients who have no diabetes carries statistically significant results. The mean A1C level for the study group was 5.56 ± 0.70 and the control group was 4.92 ± 0.73. The p value was 0.000. The A1C level cut off value was > 5.3.

Conclusion

Renal impairment is an important risk factor for developing PAD in absence of traditional risk factors such as DM, hypertension, or dyslipidemia. Prevalence of PAD was 26% in our study. ABI is a simple non-invasive modality of screening for PAD. Females are at higher risk to develop PAD than males by ∼ 2.7 fold. Although diabetes is absent, A1C level > 5.3 is significantly correlating with the risk of PAD.
Right Ventricular Function Assessment in patients with chronic stable angina with Type II DM Versus Non Diabetic Patients by TAPSE and TDI Echocardiography
Authors: Kamal M , Shabana A , Thabet S , Wadie B
Published: May 2020

Background

In patients with documented right coronary artery (RCA) lesions, right ventricular function could be affected. In addition, the presence of diabetes mellitus is found to be a risk factor for cardiomyopathy.

Objective

The aim of the study is to assess the effect of type II DM on RV function in patients with chronic stable angina who have significant RCA lesion, using TAPSE and TDI by echocardiography

Patients and Methods

One hundred patients who underwent elective coronary angiography for suspected coronary artery disease and were found to have significant RCA lesion were divided into two groups according to presence of Type II DM. Echocardiography was done for all patients and RV function assessment by TAPSE and TDI was done.

Results

In our study 100 patients were included; 73 of patients were males and 27 were females with mean age of 56.70 ± 8.51 years. almost one fourth of the candidates were smokers, 23% were ex-smokers and about half of the candidates were non-smokers (51%).About half of the patients were known hypertensive (48%) while the rest were not. As regarding LVEF it ranged between 35-73% with a Mean ± SD of 54.10 ± 8.94, TAPSE ranged between 17-30 mm with a mean ± SD of 22.81 ± 3.08 and S ‘was ranged between 9-19cm/s with a mean ± SD of 13.50 ± 2.24. Comparison between both groups showed that control group (Group I) had a mean age of (57.34 ± 8.74) and 86% were males . All Diabetic patients (Group II) had a mean age of (56.06 ± 8.30) years, (60%) were males. There was no significant difference between the two groups with respect to age and gender. As regarding smoking status in Group II (20%) were smokers and for Group I (32%) . As regarding hypertension, in Group II (72%) were hypertensive and for the Group I (32%) were hypertensive which was significantly different in both groups.The presence of associated significant LAD lesions was found in 52% of Group II and only 32% in Group I, which was significantly differenct between 2 groups. (p = 0.043).As regarding Echocardiographic data, there was no significant difference in both groups regarding TAPSE (P value .629) and S’(P value .247).

Conclusions

The results of this study shows that TAPSE and S’ showed normal values in patients with chronic stable angina and there was no additional effect for type II D.M.
Knowledge, Attitude and Practice towards vitamin D importance and supplementation among mothers of under five children in a primary health care center in Cairo
Authors: Selim N S S , Wahdan M M , Aboulezz N F , Sabbour S M
Published: May 2020

Background

The world is currently facing a pandemic of vitamin D deficiency especially women in child bearing age, during pregnancy and nursing mothers. One of the major reasons for the worldwide spread of this nutritional disorder has been lack of awareness about the importance of vitamin D and prevention of deficient states across populations.

Objectives

To assess the knowledge and attitude of mothers attending primary health care center in Cairo towards vitamin D importance, to identify mothers' practices towards vitamin D, its supplementation & sun light exposure.

Subjects & Methods

A cross sectional study was conducted among mothers attending “100 meters” primary health care center in El-Sherouk city in Cairo. A sample of 195 mothers were interviewed using structured questionnaire to collect data including socio-demographic characteristics, mother’s knowledge about the importance of Vitamin D, mother’s attitude and practices towards taking vitamin D, its supplementation and sun light exposure for herself and her child. Scoring system was designed for knowledge, attitude and practice of mothers. A short targeted health education message was given to the participating mothers about vitamin D importance in the form of flyers.

Results

Less than one quarter of the mothers (22.6%) had a good knowledge towards vitamin D and its supplementation (total knowledge score percentage > 50%) . The highest knowledge about benefits of vitamin D was “bone health” and the least knowledge recalled by mothers were “prevention of depression and obesity”. Thirty six percent of mothers had a positive attitude towards vitamin D and its supplementation (total attitude score percentage ≥75%) & forty six percent of mothers had a good practice towards vitamin D and its supplementation ( total practice score percentage ≥75%) . More than half of mothers (53.5%) were exposed to the sun from 10 am to 3 pm. The majority of mothers (91.1%) were exposed to the sun more than one hour per week. Only (48.7%) of the mothers gave their children vitamin D supplementation & about half of them (52%) started giving vitamin D supplement to her children since birth. Highly educated mothers had better knowledge and practice score than others (P value < 0.05).

Conclusion & Recommendation

Less than one quarter of the mothers had a good knowledge towards vitamin D and its supplementation while about three fifths of the mothers had a positive attitude regarding vitamin D and its supplementation & less than half of the mothers had a good practice towards vitamin D and its supplementation. Implementing awareness campaigns and future health education programs may help in building more awareness about the vitamin D importance.
Evaluation of Superficial Electrocautery in the Treatment of Localized Vitiligo
Authors: Rasheed A I , Abdelfattah N S , Abdallah A G M
Published: May 2020

Background

Vitiligo is a disease that causes the loss of skin color. The extent and rate of color loss from vitiligo is unpredictable. It can affect the skin on any part of your body. It may also affect hair and the inside of the mouth.

Aim of the Work

Aiming for treating localized stable vitiligo by a simple, old technique. This study was based on a minimal burn, insufficient to develop scar, might activate the repairing processes which would enhance in the same time the MCs proliferation.

Patients and Methods

The study was done on 30 patients presented with localized stable vitiligo. Superficial electrocautery was done every month for 4 months with application of daily closed wound care using combined fusidic acid and betamethasone valerate cream followed by herbal β sitosterol containing cream then occlusion with Vasline gauze for 10 days or till complete wound healing. Other patch in the same patient is treated only by the above mentioned topical treatment as a control.

Results

In our study of total 30 patients, 8 patients (27%) showed marked repigmentation after treatment, 16 patients (53%) showed moderate response and the remaining 6 patients (20%) showed mild or no response to treatment.

Conclusion

No significant side effects were noticed during the course of treatment. Just mild, transient erythema and burning sensation were detected.
Assessment of Plasma Malondialdehyde in Acne Patients on Isotretinoin Therapy
Authors: Saleh H M A , Alzawahry K M A , Gad R E M
Published: May 2020

Background

Acne vulgaris is a chronic inflammatory disorder of the pilosebaceous unit that affects predominantly adolescents and young adults. Oral isotretinoin is a highly effective treatment agent for patients with nodulocystic acne and moderate to severe acne resistant to conventional therapy, isotretinoin might have side effects of oxidative stress and lipid peroxidation. . Malondialdehyde is the end product of lipid peroxidation and is a good marker of free radical-mediated damage and oxidative stress.

Objective

The purpose of this study to estimate malondialdehyde level in patients on Isotretinoin treatment for moderate to severe acne and compare them with healthy control group.

Patients and Methods

The case-control study was conducted at Ain. Shams University Faculty of Medicine, Egypt, from October 2017 to April 2017, and comprised male or non-pregnant female patients more than 18 years of age. 88 participants were included in the study; 44 cases, categorized by the Global Evaluation Acne (GEA) into 22 patients with moderate acne vulgaris and 22 patients with severe acne in comparison to equal healthy matching group. Isotretinoin was started in a dosage of 0.5mg/kg/day, and1.0mg/kg/day in patients with moderate and severe acne vulgaris respectively. Malondialdehyde, liver function tests, lipid profile and CBC were tested at the baseline for all participants and after 3 months for the patients who started isotretnoin therapy.

Results

In the current study, the mean baseline level malondialdehyde among all cases was 141.39 µmo1/m1±88.90, (range: 34.5 -360) and in controls it was 40 [µmo1/m1 ±11.3, (range: 9.5-90.4) this difference was statistically highly significant (P = 0.001). There was highly significant difference in malondialdehyde serum level (p = 0.0001) among all cases after 3 months of isotretnoin therapy, also there was a significant increase in MDA serum level among moderate cases (p = 0.021) and highly significant increase of MDA in severe cases (p=.001).ALP, ALT, serum cholesterol and triglyceride significant increases were seen in all cases.

Conclusion

low dose isotretinoin seems to have less side effects on basic laboratory data such as CBC, liver function tests, lipid profile and Malondialdehyde serum levels than high dose.
Comparative Study Between Medical Treatment and Intervention in Acute Iliofemoral DVT
Authors: Hussein K , Mohamed M M , Mohamed M I , Elanany S H S
Published: May 2020

Background

The cornerstone of current management of deep vein thrombosis (DVT) are the routine use of anticoagulant therapy, graduated elastic compression stockings (ECS), and early ambulation. Thrombolytic therapy was previously reserved only for patients with life-, limb-, or organ-threatening complications. However, the Post-Thrombotic Syndrome (PTS) has been increasingly recognized as a frequent and serious long-term complication of DVT. In this study I will use systematic review techniques to compare between the medical and intervention management outcome and possible complications and I will try to find out if although of high expenses of the new techniques especially catheter directed thrombolysis CDT it worth it as regarding the post-operative care and complications.

Objective

To review the literature comparing between medical treatment of acute iliofemoral DVT and intervention in the form of endovenous or surgical management of acute iliofemoral DVT as regards short and long term benefits.

Methodology

A systematic Review of published English literature from their date of inception till 2018. Only published English literature will be included in the study. All studies from their inception date till 2018 will be included.

Results

The literature search from the specified electronic databases identified 179 articles. After application of the inclusion and exclusion criteria, 7 comparative studies were finally included in this systematic review. There were 5 randomized trials and 2 observational studies. 1 prospective and 1 was retrospective. Various other approaches were used in combination with conservative/pharmacological thrombolysis according to the underlying pathology A total of 631 patients underwent CDT compared to 675 patients who underwent conservative strategy for management of acute iliofemoral DVT

Conclusion

Pharmacological and pharmacomechanical thrombolysis offers significant benefits to proximal dvt patients in the long term period. However, it does not show an advantage over conservative management in short -term outcome. Furthermore, CDT carries more risk of bleeding and recurrent VTE in the shortterm. More randomized control studies focused on quality of life after conservative and endovasculat intervention in proximal dvt patients as well as on studies on newer generation devices is needed to provide more information for clinical decisions.
Study of Pregnancy related AKI in Egyptian patients: Incidence, Risk factors and Outcome
Authors: Elshinnawy H A , Aref H M , Rezk K M , Elkotb A M , Mohamed A Y
Published: May 2020

Background

Acute kidney injury (AKI) is a serious problem during pregnancy. Once occurred, it causes devastating maternal and fetal outcomes. In developed nations, the trend of pregnancy-related AKI (PRAKI) is on a decline due to the advances in obstetrics care and the legality of abortion. On the contrary, this situation remains a major health problem in the developing countries.

Aim of the work

in the present study, we determine the incidence, etiology and outcome of PRAKI in a sample of Egyptian patients.

Methods

Prospective observational study to determine the incidence, etiology and outcome of PRAKI was conducted over a period of one year from January to December 2017 at Ain Shams university obstetrics & gynecology hospital. Patients were enrolled in this study once PRAKI at antepartum as well as postpartum period was diagnosed according to the definition of KDIGO AKI guidelines diagnostic criteria

Results

During the period of the study a total of 13050 obstetric patients were admitted in Ain Shams university obstetrics & gynecology hospital. In total, 78 patients met the diagnostic criteria of PRAKI representing an incidence of 0.59% (78/13050). Pre-eclampsia & sepsis were the two most common causes of PRAKI, others were dehydration, postpartum hge, antepartum hge, UTI, proteinuria for investigation, SLE activity, DIC, TTP, Acute fatty liver of pregnancy, eclampsia, eclampsia complicated with HELLP syndrome, eclampsia with acute fatty liver of pregnancy, HUS, hyperemesis gravidarum, hypertensive emergency. Fifty five patients (70.5%) received conservative management. Hemodialysis was initiated in twelve patients (15.3%) based on standard indication (azotemia, oliguria volume overload, hyperkalemia and/or metabolic acidosis). Hemodialysis and plasma exchange was used for four patients (5.1%). Plasma exchange was indicated for seven patients. None of the patients received peritoneal dialysis or continuous renal replacement therapy. The ultimate evolution was good in 47 (60%) patients with complete recovery of the kidney function.14 women (17.9%) had an increased serum creatinine level at discharge for follow up at outpatient clinic. 6 patients (7.6%) had kept with advanced renal failure requiring hemodialysis. There were 11 cases of death, mortality rate was 14%.

Conclusion

AKI during pregnancy poses a challenge for physicians. In view of the multifaceted problems that potentially complicate pregnancy in women with AKI. Fortunately, with ongoing improvements in obstetrical care, multidisciplinary approaches comprising nephrologists, obstetricians and neonatologists maternal and perinatal mortality in this setting are largely avoidable. Therefore early recognition of signs and symptoms, close monitoring in high risk cases, early referral and a multidisciplinary team management could potentially prevent progression to higher stages of PRAKI and reduce morbidity and mortality.
Urinary Claudin-1 Level as a Marker of Podocyte Injury in Patients with Proteinuria
Authors: Nasser M E , Shawky S M , Sanad E A M
Published: May 2020

Background

The biology of claudins is a rapidly evolving field, and many intriguing questions remain unanswered. Although it had been assumed that the reason there are ≥24 isoforms of claudin is that each one has distinct permeability properties. The nephron displays a wide spectrum of claudins, whose distribution varies in each tubular segment. In diabetic nephropathy and glomerulonephritis the gene expression of claudin-1, is markedly upregulated in the podocyte, accompanied by a tighter filtration slit diaphragm (cell-cell junction made by the glomerular podocytes) and the appearance of TJ-like structures between the foot processes causing further podocytes injury and proteinuria.

Aim of the work

to assess urinary claudin -1 level as a marker of podocyte injury in patients with proteinuria.

Patients and Methods

it is a case control study which was conducted upon 90 subjects who were divided into three groups: group I included 30 patients with type II DM, group II included 30 patients with glomerulonephritis and group III had 30 healthy subjects as controls. Urinary claudin-1 level was measured by Enzyme linked Immunosorbent Assay (ELISA)

Results

In this study, we found that urinary claudin-1 level was significantly higher in diabetics group and GN group than in control group. In comparison between GN group and diabetic group, we found that urinary claudin-1 level was higher in GN group than in diabetics group but with no statistically significant difference between the two groups.

Conclusion

urinary claudin-1 level was significantly higher in diabetics and GN group and has positive correlation with uACR. So it can be used as marker of podocytes injury and proteinuria
HCV Core Antigen as an alternative test to Quantitative HCV RNA for assessment of SVR in Chronic HCV infected patients treated with Direct Acting Antiviral agents
Authors: Mohamed S M , Musa N I , Ghait R S , Abdelrhiem B M
Published: May 2020

Background and aims

Widespread use of direct-acting antiviral (DAA) agents to treat patients with hepatitis C virus (HCV) infection has reduced the need for monitoring of HCV-RNA levels, because viral kinetics do not predict sustained virologic response (SVR) to these drugs. However, the performance of cheaper tests, such as the assay to quantify HCV core antigen (HCV Ag), has not been determined. This study was aimed at investigating the accuracy of the HCV Ag test in predicting which patients receiving DAAs will achieve SVR at week 12 (SVR12).

Methods

We performed a prospective study on 90 patients, chronically infected with HCV, receiving DAAs therapy from different NCCVH centers in Cairo during the period from August 2017 to June 2018. We collected blood samples and measured the levels of HCV core Ag and HCV-RNA at baseline and 12 weeks after end of treatment. We compared the ability of these assays to predict which patients would have SVR12.

Results

The median baseline level of HCV-RNA was 1688529.6 ± 994697.3 IU/ml (range, 312700 IU/ml to 3491100 IU/ml) and HCV Ag was 179.2 ± 83.5 pg/ml (range, 33.5 pg/ml to 315.6 pg/ml). HCV Ag became undetectable in 92.2% 12 weeks after the end of treatment. HCV-RNA became undetectable in 87.8% at the end of treatment (P<.0001). 79 out of 90 patients (87.8%) achieved an SVR12; the test for HCV Ag identified 63.6% of these patients.

Conclusions

Tests that measure HCV Ag monitor efficacy of DAA therapy for HCV infection as well as assays that measure HCV-RNA, and hence could be recommended for clinical practice.
IgA Deficiency in type 1 Diabetes Mellitus patients
Authors: Abouali F H , Sheha D S , Elsayed H M , Ibrahim N A , Kamal S T , Sharawy Y S
Published: May 2020

Background

Selective IgA deficiency (SIgAD) in Type 1 diabetes mellitus patients (T1DM) has been reported, but the exact prevalence of SIgAD in Egyptian adults with T1DM is not known.

Aim of the Work

The aim of this work was to measure serum IgA level in patients with T1DM as compared to healthy controls.

Patients and Methods

Our study was a case control study conducted on 50 adult patients with T1DM recruited from the outpatient diabetes clinic of Ain Shams University Hospitals, with 50 healthy participants of comparable age and sex included as controls. All patients enrolled in the study were subjected to detailed history taking, serum levels of IgA, IgG and IgM levels were measured by Nephlometry. Patients with low sIgG or sIgM were excluded.

Results

The mean age of patients’ group was 24.5 ± 5.3 years. We report that 30 out of 50 patients (60%) with T1DM had associated SIgAD with a female predominance (20 females (66.7%) had SIgAD compared to 10 males (33.3%)). We also found a statistically significant relationship between SIgAD and diabetic ketoacidosis (DKA) (P-value<0.001). Moreover, 6 out of 50 (12%) of T1DM patients had associated autoimmune diseases but their sIgA level was normal.

Conclusion

The current study displays 60% prevalence of SIgAD among Egyptian patients with T1DM, which is higher than reported in other populations. Moreover, our data show a higher prevalence of SIgAD in female gender.
Paracetamol versus Nalbuphine in Relieving Pain in the First Stage of Labour in Primigravida: Double-Blinded Randomized Controlled Trial
Authors: Nadim A A , Elghareeb N A M , Eid S H M
Published: May 2020

Background

First stage of labor begins with regular uterine contractions and ends with complete cervical dilatation at 10 cm. It is divided into a latent phase and an active phase. The latent phase begins with mild, irregular uterine contractions that soften and shorten the cervix.

Objectives

To compare between intravenous nalbuphine and paracetamol in relieving pain in first stage of labour.

Patients and Methods

This double-blinded randomized controlled trial was conducted on 120 women primigravida with term and viable pregnancy, presenting with the vertex attending the labor ward for delivery in Ain Shams Maternity Hospital.

Results

Our study showed remarkably noticeable change on comparing the pre-injection and post-injection SPADI Scoring system at 4,8,12 and 24 weeks. There is highly statistically significant pain and disability score and percentage improvement, yet on the other hand the radiological improvement shows no statistically significant difference found between baseline tendon thickness and its follow up at 4, 8 and 12 weeks while only there was statistically significant decrease in tendon thickness found at 24 weeks with p-value = 0.043.

Conclusion

The ultrasound-guided PRP injection for supraspinatus tendinopathy cases is a safe, cheap, and easily prepared outpatient procedure which showed competitive, promising, and well-proved results when compared to other modalities outcomes such as conventional surgeries, arthroscopic procedures, and physiotherapy. It deserves our attention to its value and efficacy for the sake of the patient as a minimally invasive procedure providing better quality of life.
Addition of azithromycin to cefazolin pre elective CS reduces post operative infections
Authors: Mohamed M E , Allam H A , Abdelgaber M A
Published: May 2020

Introduction

The results of the Cesarean Section Optimal Antibiotic Prophylaxis(C/SOAP) trial describe an absolute reduction of 5.9 percentage points in the rate of the primary composite outcome of endometritis, wound infection,or other infection occurring within 6 weeks after non elective cesarean section with the use of adjuvant azithromycin prophylaxis. The absolute reduction in maternal postpartum use of antibiotics was 4.3 percentage points. The study drug was administered after the first incision in 12.4%of the patients who received azithromycin and in12.3% of those who received placebo. The authors did not indicate when the standard prophylaxis(mainly cefazolin) was delivered.

Objective

The aim of our study is to evaluate the efficacy of addition of azithromycin to cefazolin pre-operative in reducing the risk of postoperative infection after elective CS.

Methods

Four hundred patients were randomized to two groups. Control Group included 200 women undergoing elective CS. Patients received standard antibiotic prophylaxis cefazolin (at a dose of 1 gm) and azithromycin (at a dose of 1 gm) 2 hours preoperatively. Study Group included 200 women undergoing elective CS. Patients received only standard prophylaxis antibiotic (cefazolin).

Results

Our study showed that majority of the mothers were housewives (70% in cefazolin-azithromycin group and 85.5% in cefazolin group), with a statistically high significant difference between the two groups regarding occupation (p < 0.001). But, there was no statistically significant difference regarding residence (p > 0.05) between both studied groups. Regarding demographic characteristics, majority of the mothers had similar mean age/years; 25.5 years in cefazolin-azithromycin group and 24.7 years in cefazolin group, with no statistically significant difference between both studied groups (p > 0.05) but body mass index illustrated statistically a significant difference (p < 0.05). On the other hand, preoperative hemoglobin showed no statistically significant difference between both studied groups (p > 0.05). Regarding obstetric history, there were statistically significnat differences between both studied groups regarding parity and previous cesarean sections (p < 0.05) and a high significant difference regarding previous abortions (p < 0.001).

Conclusion

At the end of this study, we observed that, with regards to postoperative fever, wound healing duration, infection post-surgery and per-vaginal discharge, addition of azithromycin to cefazolin (Zinol) is effective than cefazolin only in reducing the risk of postoperative infection after elective CS and maternal use of healthcare resources.
Association between Preeclampsia and vitamin D Deficiency
Authors: Elhoussieny A S , Ibrahim M E , Gad H F , Mahdi E H
Published: May 2020

Background

Preeclampsia is a pregnancy-specific disorder that affects 3–5% of pregnant women worldwide and is one of the most frequently encountered medical complications of pregnancy. Recent research has pointed towards some role of vitamin D deficiency in pathogenesis of preeclampsia. Vitamin D deficiency in pregnant women and their children is a major health problem, with potential adverse consequences for overall health.

Aim of the Study

The aim of this study is to investigate the serum vitamin D levels in preeclampsia and healthy normotensive pregnant women.

Patients and Methods

This case control study was conducted at Ain Shams University Maternity Hospital from November 2017. The study included pregnant women 20-35years this study will be carried out on pregnant women recruited at pre labour room (preeclamptic group) and (non preeclamptic group) at Ain Shams University Maternity Hospital, 50 women in each group.

Results

All samples were screened by DRG® 25-OH Vitamin D (total) ELISA (EIA-5396) and it was found that mean 25 hydroxy vitamin D levels were lower in preeclamptic group than normotensive control group. Mean level of 25 hydroxy vitamin D between preeclamptic cases was 13.98 ±4.98 ng/ml and between normotensive controls was15.62± 3.51 ng/ml.

Conclusion

This study has shown no association between vitamin D deficiency and pre-eclampsia, supporting no role for vitamin D as a preventative agent against preeclampsia.
Role of Ki67 in predicting response to adjuvant tamoxifen in postmenopausal hormonal positive breast cancer patient
Authors: Abdelaziz H M , Naguib K , Moussa D , Mohammad N
Published: May 2020

Background

Breast cancer (BC) is a major health problem in Egypt and worldwide. Its prognosis depends not only on tumor stage but also on tumor biology.

Aim of the Work

To correlate the percentage of expression of Ki67 with the clinical outcomes of early hormone-receptor positive for postmenopausal breast cancer patients who are receiving adjuvant tamoxifen

Material and Methods

we retrospectively reviewed 52 patients treated for non-metastatic postmenopausal breast cancer with adjuvant tamoxifen at Ain-Shams University hospital, Clinical Oncology department between January 2010 and December 2015. Ki67 value and other clinicopathological data were retrieved.

Results

Out of 52 patients fulfilling research criteria, the age rannged from 45 to 71 years.All patients were stage0-ΙΙΙ. Stage II was the most common represented 38.5 %, while Stage 0 was the least common presents 3.8%. Using a ki67cut-off value of 20, patients were stratified into two risk groups; the low risk group had ki67 <20 % and represented (67.3%) of cases and the high risk group were ≥ 20% and represented 32.7%. The median Ki67 value was 12.00 (IQR 5 – 20).Median DFS was 42.5 months (IQR 31.2 – 57). Median of OS was 49 moths (IQR 34 – 58).Among multiple prognostic factors Stage, luminal A subtype was significantly related to better OS and DFS In our study, there was no difference regarding OS and DFS between low and high ki67 group’s results ρ = 0.308 and ρ = 0.064 respectively.

Conclusion

Ki67 is not a predictive factor for resistance to adjuvant tamoxifen in post-menopausal female breast cancer patients.
Assessment of Epithelial Thickness in Keratoconic Patients Before and After Intracorneal Ring Segment Implantation Using Anterior Segment Optical Coherence Tomography
Authors: Mohamed R F , Elghazawy R M F , Fawzy S M , Badran T A
Published: May 2020

Background

Keratoconus, the most common primary corneal ectasia, is a bilateral asymmetric corneal degeneration accompanied with local corneal thinning and occurs mostly in the inferior and central part of the cornea, it usually causes high myopia and irregular astigmatism which results in poor quality of vision. Based on disease severity, many treatment modalities exist including glasses and contact lenses for mild to moderate disease, while corneal graft preserved for more advanced disease. In advent of alternative treatments, intrastromal ring implantation have been introduced which improves visual acuity and optical aberrations and also corrects refractive errors and mean keratometric data, anterior segment Optical cohehernce Tomography epithelial mapping is anew modality to assess epithelial thickness. Objective: To investigate epithelial thickness changes in keratoconic patients before and after intracorneal ring segment implantation using AS OCT. Methods: Thirty eyes with early to moderate keratoconus were included in this prospective interventional case series study which has been conducted at patients from Ain shams university hospitals, after the approval of the research ethical committee in the Faculty of Medicine, Ain Shams University between March to October. All cases underwent a Complete ophthalmological examination before surgery. the examination included Visual acuity assessment and Best corrected visual acuity. Slit Lamp Biomicroscopy examination with fundus examination through dilated pupil using D lens & Corneal Topography, Anterior segment Optical cohehernce Tomography Epithelial mapping(zeiss). Results: we found that epithelial thickness showing statistically significant change comparing pre and post operative epithelial mapping especially in certain areas in the map,area ( _ ),( _ )  mm. Conclusion: There is increase in epithelium thickness in keratoconic corneas after intracorneal ring segment implantation to compensate for stromal irregularities in patients with keratoconus.
Effect of BMI on complications rate, reoperation and functional outcome after Total Knee Arthroplasty, A Systematic Review of Literature
Authors: Abdelmegied W S , Sallam A M , Ahmed M M
Published: May 2020

Purpose The body mass index (BMI) is widely recognized as a prognostic factor in multiple operations; however, the relationship between the BMI and outcomes following total knee arthroplasty (TKA) is extensively debated. We aimed to evaluate the effect of the BMI at different cutoff values on the outcomes following primary TKA.

Methods Electronic databases (PubMed/Medline, Embase and Web of Science) were systematically searched for studies investigating the association between the BMI and outcomes following primary TKA. Two investigators independently reviewed studies for eligibility. A meta-analysis was performed using Review Manager 5.2 software from the Cochrane Collaboration.

Results Thirteen articles were identified. The postoperative Knee Society Score appeared to trend lower in obese (BMI ≥ 30 kg/ m2) patients than in non-obese (BMI < 30 kg/m2) patients. The meta-analysis showed that revision with follow-up ≥2 years, any infection, superficial infection and deep vein thrombosis occurred statistically more frequently in obese patients.

Conclusion Patients with a BMI ≥ 30 kg/m2 are at a higher risk of lower functional scores and developing complications following primary TKA. It appears reasonable to encourage obese patients to lose weight before selective TKA.
Transgenic snail approach for the control of schistosomiasis
Authors: Tawfeek G M
Published: May 2020

Schistosomiasis remains the most important tropical snail-borne trematodiasis that threatens many millions of human lives. In achieving schistosomiasis elimination targets, sustainable control of the snail vectors represents a logical approach. Nonetheless, the ineffectiveness of the present snail control interventions emphasizes the need to develop new complementary strategies to ensure more effective control outcomes. Accordingly, the use of genetic techniques aimed at driving resistance traits into natural vector populations has been put forward as a promising tool for integrated snail control. The use of CRISPR/Cas9 based snail modification strategy appears fascinating and potentially effective. However, this approach is currently still underdeveloped in snail molecular research. This review provides knowledge related to this genetic technique without neglecting the current existing gaps and trying to identify ways to bypass potential future challenges, all are requisites for achieving this promising snail control strategy.
Nanotechnology and Its Applications to Medicine: an over view
Authors: Ibrahim H
Published: May 2020

Nowadays there are more interesting with nanotechnology and its applications in several sectors specially in medicine for diagnoses, therapeutic and research biomedical tools. It can be defined as any process or technique used to produce material in nano-scale structure with particle size ranged from 1-100 nm. The utilization of nanotechnology in human health benefits known as nano medicine. So that nanotechnology has firmly entered the drug delivery realm to maximize drug therapeutic activity and minimize its undesirable side effects. Herein we deal with both nanoparticles and nano-fibers and their applications in medical field. Nano-particles have unique properties from its small size with high surface area therefore it provides larger than particle numbers from that prepared with convention methods. In addition, nanoparticles can be used to improve various drug bio-availability from its biodegradability and bio-compatibility. Nano-fibers have huge surface area to volume ratio which increase its performance in several applications. Nano-fiber produced via electrospinning process (simple and have high production rate). It can be used in many applications such as water filtration, tissue engineering scaffold, wounds, fiber composites, drug release and protective clothes.
Is there a benefit of vitamin D supplementation in deficient children and adolescents suffering from obesity? A meta-analysis
Authors: Nassar M F , Emam E K , Allam M F
Published: May 2020

Background and objectives

Both childhood obesity and vitamin D deficiency are common in the Middle East. This systematic review/meta-analysis aims to highlight the effect of vitamin D supplementation in deficient children suffering from obesity.

Methods

Published clinical studies on vitamin D supplementation in obese children and adolescents with vitamin D deficiency were identified through a comprehensive MEDLINE/PubMed search (from July 1966 to November 2017). Outcomes intended after vitamin D supplementation were improvements in vitamin D status, BMI alterations and appetite changes. The inclusion criteria were children aged 2 to 18 years of both sexes in clinical trials that specified the oral and/or intramuscular dose of vitamin D supplementation.

Results

Ten studies were retrieved, but only six were relevant. First, supplemented obese children and adolescents were compared to non-obese controls; thereafter, supplemented obese children and adolescents were compared to matching obese peers given placebo. Pooled risks from the two studies that evaluated the number of obese and non-obese children and adolescents who improved upon vitamin D supplementation revealed that obesity poses a risk for not benefiting from the vitamin D supplementation regardless of the dose and the duration of supplementation. Pooled results from the six retrieved studies that compared supplemented obese children and adolescents to matching non-obese or obese peers given placebo revealed significantly lower vitamin D levels in obese participants than in non-obese peers.

Conclusion

Vitamin D levels are significantly lower in obese children and adolescents with obesity, posing a risk for not benefiting from vitamin D supplementation regardless of the dose and duration of supplementation. Our results suggest that only with simultaneous weight adjustment strategies, vitamin D sufficiency would be achieved more effectively.

Vitamin D supplementation in deficient children suffering from obesity.
A Typical Features of Fibroadenoma, Correlation between Ultrasound and Pathology
Authors: Hanafy H M , Naser H M , Ahmed N A
Published: May 2020

Background

Fibroadenomas (FAD) are benign tumors composed of stromal and epithelial elements. These tumors are commonly seen in young women. Multiple or complex fibroadenomas may indicate a slightly increased risk for breast cancer.

Aim of the Work

To assess the diagnostic accuracy of ultrasound in atypical fibroadenoma.

Materials and Methods

This retrospective study was approved by Ain Shams radiology department. On the basis of results of core needle or excisional surgical biopsy, we retrospectively identified 40 consecutive patients between October 2017 and October 2018 with the diagnosis of fibroadenoma.

Results

In our study, we found that The mean age in the simple fibroadenoma group was 29 years (range 18-49), and in the complex fibroadenoma group, it was 38 years (range 17-62) which represents statistically significant difference between the two groups (P =.021).

Conclusion

Complex fibroadenomas showed some characteristics that could help in differentiating them from their simple counterparts, namely, an irregular shape, noncircumscribed contours, a complex echo structure. The awareness of these distinguishing features could help radiologists decide which fibroadenomas should be sampled.