bluuebunny/crossref_metadata_2025 huggingface dataset:
Immediate versus deferred PCI in patients presenting with acute ST Segment elevation myocardial infarction with moderate to high thrombus burden
Authors: Mohammed M Y , Alfiqy E , Said K , Rifaie O
Published: May 2020

Background

Primary PCI is considered the standard of care treatment for STEMI when timely done. However, the proper management of the culprit artery with moderate to high thrombus burden is still unclear.

Objective

We sought to compare the outcome of deferred primary PCI in patients presenting with STEMI with moderate to high thrombus burden after a course of intensive dual anti-platelet and IV Glycoprotein IIb/IIIa receptor blockers with immediate PCI.

Methods

We analyzed the data of 100 patients with STEMI and high or moderate thrombus burden who underwent primary PCI in a prospective nonrandomized case control study. Patients were divided into 2 groups, 50 in each group. The first group(A) included patients who underwent coronary angiography with immediate PCI. While the second group(B) included the patients who were deferred and received dual antiplatelet and Glycoprotein IIb/IIIa receptor blockers .After 24-48 hours, coronary angiogram was repeated and PCI was done when needed. All patients had a pre-discharge echo for assessment and followed up for 4 weeks after discharge for major adverse cardiac events (MACE)

Results

The baseline data were similar in both groups.There was no statistical difference between both groups as regards the TIMI flow of the culprit artery at the end of the procedure TIMI III was 84% in the groupA and was 86% in group B (P. value = 0.114)). There was a significant difference between both groups for the need of PCI being lower in the deferral group 50 patients had PCI in the group A (100.0%) and 29 patients only had PCI in group B (58.0%), P value = 0.000). Thrombuss aspiration decreased the need for PCI (22 patients out of 35 had PCI from the aspiration group while 58 patients out of 63 had PCI, (P value = 0.001).There was no statistical difference between the immediate and the deferral group as regards the in-hospital morbidity and mortality nor left ventricular functions.At follow up, there was no statistical difference between both groups as regards MACE.

Conclusion

Deferring PCI in patients with STEMI and high or moderate thrombus burden, did not affect neither the TIMI flow at the end of the procedure nor the in-hospital morbidity or mortality. After 4 weeks.MACE was similar in the deferral and immediate PCI groups.However, deferral carries an advantage of reducing the need for PCI. Thrombus aspiration may enhance the flow in the culprit artery and reduce the need for PCI.
Comparison of Short Term Outcomes of De Vega Repair versus Ring Annuloplasty in Cases of Functional Tricuspid Regurgitation
Authors: Ibrahim M A , Saber W A , Abdelhamid H A , Mansour S A , Mostafa M G
Published: May 2020

Background

functional tricuspid valve regurgitation (FTR) is a common problem accompanying left-sided heart lesions e.g. mitral stenosis. FTR is a serious disease which affects survival and quality of life if left untreated. Many techniques can be used to repair the tricuspid valve (TV), but the optimal method for repair is still controversial. The aim of our study is to compare ring annuloplasty and De Vega repair of TV as regard effectiveness and durability.

Patients and Methods

sixty patients who are candidate for mitral valve (MV) replacement and TV repair were randomized into two groups, 30 patients each. Group (A) underwent ring annuloplasty, and group (B) underwent De Vega repair of TV. Patients from both groups were followed up after the operation for one year.

Results

Ring annuloplasty was more effective as the mean grade of TR in this group (1.6 ± 1.2) was significantly lower than that in De Vega group (2.2 ± 1.0), p value 0.041. After one year of follow up, no significant increase was present in the mean grade of TR in the ring annuloplasty group. However, grade of TR increased significantly in the De Vega group from 2.2 to 2.6, p value < 0.001.

Conclusion

Ring annuloplasty provides more effective and durable reduction of FTR compared to De Vega repair of TV.
Early Outcomes of Custodiol versus Blood Cardioplegia in Coronary Artery Bypass Graft Surgery at Ain Shams University Hospitals
Authors: Sayed G S , Ismail I A , Khorshid R M R , Mohamed A H
Published: May 2020

Background

Inadequate myocardial protection in long ischemic periods followed by reperfusion is an issue of concern in cardiac surgery. Cardioplegic solutions improve the tolerance to ischemia and reperfusion by preserving myocardial energy reserves, preventing osmotic and electrolyte imbalances and buffering acidosis. The aim of the study was to compare early outcomes of Histidine–tryptophan–ketoglutarate (HTK) solution versus blood cardioplegia in coronary artery bypass graft surgery at Ain Shams University Hospitals.

Methodology

This was a retrospective study conducted on patients who underwent isolated elective CABG at the department of cardiothoracic surgery at Ain Shams University Hospitals from the 1stof January, 2017 to the 1st of August, 2018.

Results

the analysis between these two groups divided as the following: first group who received Histidine–tryptophan–ketoglutarate (HTK) and the second who received conventional blood cardioplegia , There was no statistically significant difference between the two groups of myocardial protection in terms of morbidity and mortality with a p-value >0.05. With a stastically significant increase in Total bypass time with a p value <0.05 and a highly significant difference in terms of post operative Ventilation time and ICU stay which was higher in HTK group with a p-value of < 0.01 between the two groups.

Conclusion

Conventional blood cardioplegia showed superiority in terms of metabolic recovery based on the incidence of spontaneous defibrillation, ventilation time and ICU stay on the other hand Histidine–tryptophan–ketoglutarate (HTK) cardioplegia is a much more easily administered cardiolplegia technique without the need of preparation or repeated administration. Both Solutions showed efficacy in different areas that could be owed to the small sample size we used which cannot asses the ultimum superiority of one solution over the other .
Developing of a Simple Screening Tool for Opportunistic COPD Case Finding
Authors: Mohamed Y M , Sharkawy S H , Darwish D I
Published: May 2020

Background

Under diagnosis of COPD is serious problem in many countries world-wide because there are no generally detection tools available to detect high-risk patients for spirometry, and patients will not go for COPD check-up until a serious issue happens like exacerbation.

Objective

The aim of the work is trying to assess a new screening tool for early diagnosis of COPD.

Patients and Methods

The present study was conducted upon 500 subjects during the period from march 2018 to august 2018 who admitted to our chest department or visit our outpatient clinic, employees and visitors to Ain Sham hospitals.All subjects >40yrs who smoker or ex-smoker(≥10pack-years) applied a six variants(age,sex,packed years smoked during life ,dyspnea,chronic phlegmand chronic cohgh)questionnaire modified from PUMA questionnaire Subjects with score ≥5 did spirometry

Results

500 subjects shared in the study 497 of them were males ( 99.4% )and 3 were females (.6%). 152of them(30.4%) had score <5 and 348 of them (69.6%)had score ≥5 who did spirometry.152 subjects did not perform spirometry. By spirometry we diagnosed 81(23.3) case COPD (fev1-fvc <.7) out of 348 subjects under gone spirometry and 16.2% of total subjects(500) .

Conclusion

Modified puma score is a simple and easy screening questionnaire for early detection of COPD cases and spirometry should be done to confirm the diagnosis or rule out.COPD is prevalent in many healthy apparent persons.
Retrospective Study of the Outcome of Mitral Valve Replacement with or without Tricuspid Valve Repair in Ain Shams University
Authors: Elfeky A M A , Fadala M M A , Abdelhameed O A , Khorshid R M R
Published: May 2020

Background

Rheumatic mitral valvular disease is more common than degenerative mitral valve disease. Mitral valve repair is not possible in large number of patients because of rheumatic cicatrized subvalvular mitral valve disease. The prosthetic mitral valve replacement is commonly performed in our center.

Objective

The aim of the study was to evaluate and assess the short outcome of Mitral Valve Replacement with or without Tricuspid Valve Repair.

Patients and Methods

This study was done in department of Cardiothoracic surgery, Faculty of Medicine at Ain Shams university, after approval of the local ethical committee from 2015 to 2016.The inclusion criteria includes All gender, All age, Primary Mitral valve replacement for severe Mitral valve disease of Rheumatic origin with or without Tricuspid Valve Repair and Primary Mitral valve replacement for severe Mitral valve disease of Degenerative origin with or without Tricuspid Valve Repair and the exclusion criteria includes concomitant coronary artery bypass graft surgery or other cardiac operations or infective endocarditis and Patients with chronic liver, kidney and parenchymal pulmonary disease.

Results

This study included one hundred and seventy- seven (177) patients; One hundred and thirty one (131) patients did Mitral Valve Replacement without Tricuspid valve Repair, Fourty six (46) patients did Mitral valve Replacement with Tricuspid valve Repair and the outcome was Mortality (3.9%), Reoperaion (5.08%), Stroke (0. 56%), Re-Intubation (1.13%) and Re-Admission to ICU (1.69%)

Conclusion

The Reoperation has a direct relation and effect on the Mortality,Prolonged bypass time independently predicts postoperative morbidity and mortality and Prolonged aortic cross-clamp time significantly correlates with major post-operative morbidity and mortality.
The Effect of Glycosylated Hemoglobin Oil Post-Operative Coronay Artery Bypass Graft Surgery Outcomes
Authors: Elsaka A B B B , Abdelkarim M , Mourad F , Elkilany I
Published: May 2020

Background

type 2 diabetes mellitus (T2DM) is a known risk factor of coronary artery disease (CAD). Cardiovascular disease is the leading cause of death in T2DM patients. Antecedent to and associated with epicardial coronary artery stenosis, T2DM patients develop abnormal microvascular function in systemic circulatory beds. Glycosylated hemoglobin (HgbA1c) has been established as a risk factor for T2DM patients developing microvascular atherosclerosis.

Aim of the Work

the Effect of Glycosylated Hemoglobin Control on Post-Operative Coronary Artery Bypass Graft Surgery Outcomes this is widely across studies and patient populations, and this heterogeneity must be controlled when using the literature to indicate safety.

Patients and Methods

this study was performed on 60 patients, who underwent CABG at Cardiothoracic Academy from January 2018 to August 2018. Retrospective Descriptive Observational Study. Cardiothoracic Academy, Ain Shams University Hospitals. Study Period: 6 Months. This study included all patients operated upon for CABG in our hospital and who fulfilled our inclusion and exclusion criteria.

Results

preoperative HbA1c is not the only predictor of surgical site infection after cardiac surgery in diabetic patients and in patients with previously undiagnosed diabetes. Baseline HbA1c 8.6 was associated with the higher risk of chest wound infection. Interestingly, in this series.

Conclusion

this study shows that the incidence of chest and leg wound infections are significantly related to the value of the glycosylated hemoglobin and rate of infection increases with poor control of diabetes and from this study we recommend measurement of glycosylated hemoglobin value for all patient undergoing cardiac surgery.
Nadir oxygen delivery to the brain as a risk factor for postoperative neurocognitive impairment in patients undergoing coronary artery bypass grafting: A myth or fact
Authors: Abdaljawad M N , Taha S
Published: May 2020

Background

There are many factors that determine the best neurocognitive outcome following cardiac surgery. Optimum oxygen delivery to the tissues has always been the goal to optimum perfusion. Some patients may exhibit neurocognitive impairments in the early postoperative period; that could be easily missed clinically as they are not associated with radiographic evidence of structural brain damage. At this study we aimed to correlate the lowest oxygen delivery levels with incidence of neurocognitive impairment in the early postoperative period by Folstein test.

Methods

A non-randomized, prospective pilot study was designed to correlate the nadir oxygen delivery (DO2) during CPB with post-operative cognitive impairment. The study included 271 patients of both sexes, an age group of 50e60 years with university level of education, scheduled for elective, isolated CABG for three vessel disease. All patients underwent pre-and post-operative neurocognitive test by a specialized neuropsychiatric doctor.

Results

with a mean nadir DO2 of 291 mL/min/m2, the majority of the patients exhibited “normal” results, with a mean nadir DO2 of 266 mL/min/m2 92 patients showed mild impairment in their cognitive behavior, while the worst results “moderate” and “severe” were associated with means of 244,200 mL/min/m2 successively.

Conclusions

The nadir oxygen delivery is a risk factor for development of post-operative neurocognitive impairment. A level below 260 mL/min/m2 is generally associated with higher risk while a level below 220 mL/min/m2 carries the worst prognosis.
Study of Chronic Obstructive Pulmonary Disease patients in Gamal Abd El-Nasser Hospital in 2017
Authors: Ahmed M M , Ali T M , Khalafallah K H
Published: May 2020

Background

COPD is characterized by non-remitting airflow limitation and persistent respiratory symptoms which is an enhanced inflammatory response to prolonged exposure to smoking or noxious gases or particles and manifested through chronic cough, effort dyspnea, expectoration and wheezing, symptoms that appears in context of airways hyper-responsiveness and may be partially reversible.

Objective

Assessment of COPD patients in Gamal Abd El Nasser Hospital during period from January 2017 to June 2017.

Subjects and Methods

This study was a cross sectional study that included 290 COPD patients recommended for spirometric assessment. The patients were classified into 2 groups: Outpatients and inpatients in the period from January 2017 to June 2017, they were subjected to full medical history, general and local examination, Pre and post bronchodilator spirometric study according to (GOLD,2017) and each patient will be subjected to the following questionnaire [Serial number, Name, Age, Sex, Occupation, Residence, Level of education, Smoking, Smoking index, Family history of COPD, Symptoms, Number and severity of exacerbation attacks in the last year, Number of Hospitalization during the last year, Vaccination status, Spirometry, Treatment prescribed by, Treatment, Inhalation therapy, Regulation of treatment, Non pharmacological therapy, Satisfaction of treatment, co morbidities, Complications, Outcome for inpatient]

Results

The study included 290 patients, 259 males and 31 females with age range of 29 _ 83 years, the majority of the studied cases were Current smoking but only 22.5% was ex-smoker. Mean FEV1% pred. Post-bronchodilator was 75.9± 16.9 in outpatients and mean FEV1% pred. Post – bronchodilator was 52.9 ± 13.4 in inpatient. The most common co morbidities in COPD patients were hypertension in 25% of cases. More than half of all studied cases had complications and the most frequent complication was Cor-pulmonale and respiratory Failure. In this study, Severity of COPD according to GOLD 2017 was 27.8% in mild stage, 34.2% in moderate stage, 35.8% in severe stage and 2.5% in very severe stage.

Conclusion

Spirometry had a great role in diagnosis of COPD and its differential diagnosis from asthma. Smoking is the major risk factors in developing COPD and this reflects on the disease occurrence and severity. Some of COPD patients refuse to use inhalers due to fear of addiction and incorrect method in using it. Inhaler steroids were preferred due to fear of systemic complications of steroids. There is great defect in vaccination and trials of quitting smoking as a non-pharmacological treatment for COPD patients.
Detection of Antibiotic Susceptibility by Colorimetric Minimum Inhibitory Concentration in Staphylococcal Isolates
Authors: Mahmoud B S , ElMasry S A , Fahim N A , Shaker O A , Abdelsattar M A
Published: May 2020

Background

Staphylococcus species are implicated in a wide range of community and hospital-acquired infections, which necessitates rapid provision of antibiotic susceptibility results for patients at risk. The current study evaluated the usefulness of applying broth microdilution (BMD) and agar dilution methods for antimicrobial susceptibility testing of Staphylococci using tetrazolium salts as redox indicators.

Methods

Minimum inhibitory concentration (MICs) of eight antimicrobials representing different antibiotic classes as recommended by CLSI; vancomycin (VA), linezolid (LZD), oxacillin (OX), gentamicin (CN), tetracycline (TE), ciprofloxacin (CIP), erythromycin (E) and clindamycin (DA) was investigated for 80 isolates of Staphylococci by a modified BMD with the addition of dimethyl thiazole diphenyl tetrazolium bromide (MTT). As well as agar dilution with the addition of MTT & triphenyl tetrazolium chloride (TTC) at the standard bacterial concentration together with addition of MTT at an experimental bacterial concentration.

Results

BMD (MTT) showed the highest agreement regarding most antibiotics among different isolates in comparison with the standard BMD. All performed methods showed significant agreement except agar dilution (TTC) using TE, DA, E, and agar dilution (MTT 108) using DA as well as agar dilution (MTT 104) using E among S. aureus.

Conclusions

Colorimetric BMD was rapid, easy to interpret and showed the highest agreement with the standard BMD. Colorimetric agar dilution (MTT) was less tedious than BMD. The colorimetric MIC method using MTT may be a useful surrogate of antimicrobial susceptibility testing among Staphylococcus isolates.
Value of E-test in the Determination of Synergistic Antimicrobial Combinations Active Against Multi-Drug Resistant Enterobacteriacae
Authors: Kassem N N , Ismail G A , Hafez H M , Gomaa F A M , Fahim N A , Mohamed M R
Published: May 2020

Background

A number of methods have been used to study the in-vitro synergy between antibiotics with the checker board titration and E-test being the most widely described.

Aim of the Study

The aim of the present study is to determine the prevelence of Multi-Drug Resistance (MDR) among Enterobacteriacae and to compare between the E-test and the checkerboard titration method as rapid in-vitro diagnostic tests that can help to determine the synergy between selected antimicrobial combinations thought to be active against multi-drug resistant Enterobacteriacae.

Materials and Methods

The present study was conducted during the period between May 2017 and December 2017. A total number of 34 MDR Enterobacteriacae isolates were recovered from different clinical specimens submitted to the Main Microbiology Laboratory, Ain Shams University Hospitals. The isolates were tested using checkerboard titration method and E-test to determine the synergistic activity of selected antimicrobial combinations thought to be active against the MDR organisms.

Results

Out of 46 Enterobacteriacae isolates 34(74%) were MDR. According to antibiotic combination the combinations of Amikacin/Ceftazidime, Amikacin/Meropenem and Amikacin/Ampicillin+Sulbactam have synergistic effect against MDR Enterobacteriacae by E-test and checkerboard method. A statistically poor agreement was observed between the checkerboard BMD method and the E-test method regarding the results of the studied antibiotic combinations

Conclusion

The Checkerboard method, being the reference method for assessing antimicrobial synery, showed that the highest synergic activity belongs to Meropenem and Amikacin (40%).
Assessment of serum visfatin level in beta thalassemia patients
Authors: Abdelwahab S E , Habashy D M M , Shams M A , Amin A H M
Published: May 2020

Background

Thalassemias are monogenetic hematologic disorders which are caused by faulty synthesis of one or more of the Hb chains which leads to imbalance in globin chains resulting in hemolysis and impaired erythropoiesis and chronic inflammatory condition. Visfatin is a pro-inflammatory adipocytokine which is mostly expressed in visceral adipose tissue and its testing may help in assessment of severity of the disease.

Aim of the work

This study aims at measuring serum visfatin level in Beta thalassemia patients and its possible correlation to disease severity (major andintermedia).

Patients and methods

Forty-one patients diagnosed as β-thalassemia (major, intermedia) and twenty age and sex-matched healthy individuals as the control group were tested for serum visfatin levels by enzyme-linked immunosorbent assay.

Results

Serum visfatin was higher in theß-thalassemia major(ß-TM) group than in the control group (P<0.001). Serum visfatinand serum ferritin were higher inß-TM group than in ß-thalassemia intermediagroup (ß-TI)(p < 0.001).Serum visfatin was found positively correlated with platelet count (P< 0.001) in the ß-TM group.As per ROC curve analysis, measured serum visfatin level was found to discriminate ß-TM group from β-TI group and control group.

Conclusion

There is an association between serum visfatin and the degree of severity of β thalassemia disease.

Recommendations

Testing of the relationship between serum visfatin level and other vascular inflammatory markers in β-thalassemia disease (asadiponectin, resistin, intracellular adhesion molecule (ICAM)) to clarify the exact mechanism of the inflammatory process in the disease and its complications to alter the course of the disease.Also to study serum visfatin in complicated β-thalassemia patients to establish its possible role in cardiac, vascular, endocrine or any other complications and comparing it with non-complicated patients.
Usefulness of Eosin-5’-Maleimide (EMA) Dye for the Diagnosis of Hereditary Spherocytosis
Authors: Eldanasoury A S , Habashy D M M , Ragab I A , Hassaballah D M S
Published: May 2020

Background

the normal biconcave discoid shape of the red blood cell (RBC) is maintained by cytoskeletal proteins underneath the membrane. This protein network and its link with the lipid bilayer are essential for RBCs to remain flexible and carry out their physiological functions. A number of disorders including hereditary spherocytosis (HS) and hereditary elliptocytosis (HE) are caused by decreased expression or mutation of cytoskeletal proteins.

Aim of the Work

to evaluate the usefulness eosin-5-maleamide (EMA) dye binding flow cytometric test in the diagnosis of HS and assess the sensitivity and specificity of this test to distinguish HS patients from patients having anemia due to other causes.

Subjects and Methods

this study was conducted on 52 patients with chronic anemia, 21 diagnosed as HS (group I) and 31 patients with anemia due to other causes (group II). The patients were 28 males and 23 females with a male to female ratio 1.2:1, their ages ranged between 3 to 12.5 years old attending at the Pediatric Hematology Clinics, Ain Shams University Hospitals. Normal control group (group III) was included in the study.

Results

median fluorescence intensity (MFI) had shown significantly lower values in HS patients (group I) (3.78±0.48) than (iron deficiency anemia) IDA patients (group IIa) (5.56±0.35), auto immune hemolytic anemia (AIHA) patients (group IIb) (5.7±0.27), beta thalassemia intermedia (BTI) patients (group IIc) (6.01±0.63) and control group (group III) (5.3±0.43). The % reduction in EMA fluorescence proved to be significantly higher in HS patient (group I) (29.88±8.27) than in IDA patients (group IIa) (1.13±6.18), AIHA patients (-6.14±10.44) and BTI patients (group IIc) (-5.1±10.07). Multi regression analysis had been used to check the most sensitive predictors for diagnosis of HS, both EMA MFI and the % reduction in EMA fluorescence proved to be the best sensitive predictive values for discriminating HS patients, however the higher F-ratio in EMA MFI (F = 25.222) than in % reduction in EMA fluorescence intensity (F = 19.866) showed that the MFI is even better than % reduction in fluorescence in diagnosis of HS.

Conclusion

the present study highlighted the role of flow cytometric EMA binding test in differentiating HS patients from patients having anemia due to other causes.
Procollagen III amino terminal propeptide (PIIINP): A non invasive marker of methotrexate induced liver fibrosis in Rheumatoid arthritis patients
Authors: Amer H , Ghareeb H , Mohamed N L , El-Azizi N O , Mansour A M
Published: May 2020

Background

Rheumatoid Arthritis (RA) is a common autoimmune disease with a complex pathogenesis involving multiple genetic and environmental factors. The management of RA rests on several principles. Drug treatment, which comprises disease-modifying antirheumatic drugs (DMARDs), non-steroidal anti-inflammatory drugs and glucocorticoids (GCs), as well as non-pharmacological measures, such as physical, occupational and psychological therapeutic approaches, together may lead to therapeutic success. However, the mainstay of RA treatment is the application of DMARDs. Methotrexate is an antifolate and antimetabolite; it’s one of the DMARDs. Long term therapy with methotrexate has been associated with development of fatty liver and hepatic fibrosis. Liver biopsy is the standard method for diagnosing liver fibrosis, but it may be associated with significant morbidity and mortality of up to 0.33% thereby limiting its use. So the use of noninvasive markers of hepatic fibrosis such as serial platelet counts, FIB 4 score, ALT/AST ratio and recently serum PIIINP become mandatory.

Objectives

to evaluate the reliability of PIIINP in the screening for hepatic fibrosis induced by long term methotrexate therapy in rheumatoid arthritis patients compared with FIB 4 score and ALT/AST ratio.

Patients and Methods

This case study included 90 RA patients categorized into 60 RA patients on MTX therapy (group I), 30 RA patients on other medications (group II). All participants were subjected to full history taking, thorough rheumatological examination and lab investigations including complete blood count (CBC), ESR, CRP, AST, ALT, RF and measurement of serum PIINP levels, DAS and FIB-4 score were calculated.

Results

Patients in group I showed significant increase in serum PIIINP compared to patients in group II. There was significant negative correlation between disease duration, Platelets count and serum PIIINP levels in patients of both groups. There was significant negative correlation between folic acid intake and serum PIIINP levels of group I. There was significant positive correlation between Mean Corpuscular Volume, AST, ALT, AST/ALT ratio, FIB-4 score and serum PIIINP levels in patients of both groups. There was significant positive correlation between MTX dose and duration and levels of serum PIIINP in patients of group I.

Conclusion

Serum PIIINP levels could be used as non invasive marker for screening for hepatic fibrosis induced by long term MTX therapy in RA patients.
Assessment of Implementation of Occupational Infection Prevention of The Employee Wellness Program among a Group Of Healthcare Workers in Pediatrics Hospital of Ain Shams University, Cairo, Egypt
Authors: Hemida E A , Mo’men M A T , Boulos D N K , Aboalfotouh A M
Published: May 2020

Background

Healthcare workers (HCWs) are exposed every day to multiple occupational hazards, the most common being the risk of exposure to occupational infections. Occupational infection prevention of the healthcare workers is a substantial issue not only to protect them, but also to protect their patients. If the risk posed by infection in health care workers is not recognized and addressed, there is the potential for large outbreaks of infection among staff and patients.

Aim of Study

Assessment of implementation of occupational infection prevention of the employee wellness program among healthcare workers in pediatrics hospital of Ain Shams University, Cairo, Egypt.

Subjects and Methods

A descriptive study was conducted and a structured self-administered aided questionnaire was used to collect data from 110 healthcare workers in the pediatrics hospital at Ain Shams University in Cairo to assess the pre-employment procedures, investigations, infection control training provided by the hospital and post exposure management procedure.

Results

Around half of the participants (48.2%) reported that they had undergone the pre-employment screening procedures. The majority of participants (85.4%) received infection control training at the hospital. Most of the participants didn’t receive the appropriate management after needle stick injury.

Conclusion and Recommendations

the current system followed in the Pediatrics hospital does not adequately implement all of the essential elements of the employee wellness program and needs to be improved. Co-ordination between the occupational health unit and infection control department should be done to improve the implementation of other elements of the employee wellness program to protect healthcare workers from occupational infections.
Environmental safety assessment of a printing plant in cairo, egypt
Authors: Ibrahim A A , Elgewely M S , Hakim S A , Wassif G O
Published: May 2020

Background

The workplace environment impacts workers health, morale, productivity and engagement - both positively and negatively. The workplace environment in most of industry is unsafe and unhealthy. During the past ten years, the printing services have met a large development. Technological changes and the introduction of new work processes in the matter of printing have had a deep impact on labor, security and health.

Objectives

to describe the environmental features of a printing press in Cairo.

Methods

A descriptive observational study was carried out in a big printing press in Cairo, Egypt. Assessment of the work environment (prepress department, printing department, bookbinding section & office) was done using checklist modified from that of occupational safety team, 2012.

Results

The majority of the study participants (79.5%) in the printing press were working in the printing and bookbinding department. which complains from poor ventilation, poor housekeeping, presence of spills & tripping hazards, lack of personal protective equipments, presence of noisy machines, significant manual handling & awkward body positions, lack of first aid kit & hazardous containers (ink containers in the printing department & adhesives in the bookbinding department) were left open. By comparing the departmental total score of the items in the environmental checklist; the prepress department were the highest in fulfilling the positive items with score (86.66%) and the printing & bookbinding department were the least with total score (40.09%).

Conclusion

The study concluded that some areas of the printing press (printing & bookbinding department) need urgent attention to the work environment and recommend periodic environmental examination, good housekeeping, training, health education & provision of protective measures. Further work to confirm these findings in other study settings & population is also needed.
Mild cognitive impairment among type 2 diabetic patients attending Zagazig University outpatient clinics
Authors: Elshamy N H , Salama I I , Gabal M S , Hassan A M , Abdellatif G A
Published: May 2020

Objective

The incidence of mild cognitive impairment increases with age, so this study is conducted to assess the relation between mild cognitive impairment and type 2 diabetes.

Methods

100 type 2 diabetic patients attending Zagazig University outpatient clinics with age range from 40-60 years old was included in the study. These patients were matched with 100 non-diabetic controls regarding age, sex and educational class. Patients with important risk factors for cognitive disorders (cerebro-vascular stroke, organ failure, mental disorders, etc.) were not included in the study. Montreal cognitive assessment (MoCA) was done for all participants by an expert examiner using MoCA tool.

Results

Mild cognitive impairment was confirmed in 22% of diabetic patients and in 9% of control group (p < 0.05) with total MoCA score lower in diabetic group than control one (p < 0.01).

Conclusion

Type 2 diabetes may be associated with lower levels of cognitive function.
Evaluation of Subclinical Nail changes in Patients with Chronic Plaque Psoriasis using Dermoscopy
Authors: Sallam M A , Elzawahry K M A , Attia R O M
Published: May 2020

Background

Dermoscopy is a non-invasive technique that allows the visualization of subtle clinical features of the skin surface and appendages details not visible to the naked eye, allowing magnifications of up to 200x. It is widely used for evaluating and diagnosing all nail diseases, as it provides important information. As any other examination, nail dermoscopy (onychoscopy) requires a good knowledge of nail anatomy & physiology and the pathogenesis of the nail diseases, and it is helpful for the diagnosis of numerous nail diseases and tumors. Nail disorders are defined according to their appearance and the part of the nail affected (from distal to proximal): hyponychium, onychodermal band (ODB), nail bed, nail plate, lateral nail folds (perionychium), lunula (distal part of the matrix), cuticle, nail matrix and proximal nail fold.

Objective

To study the dermoscopic findings of subtle nail changes in patients with chronic plaque psoriasis and compare it with that nail changes in healthy controls by both polarized and non polarized mode of dermoscope, aiming to assist clinicians in correctly evaluating and diagnosing nail changes with the help of dermoscopy.

Methods

We conducted a comparative descriptive study on 50 patients having chronic plaque psoriasis, 26 were males (52.0%) and 24 were females (48.0%), as well as 50 normal healthy control subjects, 31 were males (62.0%) and 19 were females (38.0%). Patients and controls were randomly recruited from the outpatient clinic of dermatology department at Ain Shams University Hospitals, during the period from February 2018 till September 2018. And the age of both groups ranged from 14 to 70 years.

Results

Our study revealed that the most common fingernail changes found in psoriatic patients were nail plate thickening and crumbling followed by Dilated nailbed capillaries at the onychodermal band, Oncholysis, Subungual hyperkeratosis, Pitting, Longitudinal ridges, Scales, Salmon patch, Leukonychia, Splinter hemorrhage, Lunula red spot and Trachyonychia. And the most common toenail changes found in psoriatic patients were Subungual hyperkeratosis followed by Nail Plate Thickening &Crumbling, Oncholysis, Pitting, Longitudinal ridges, Scales, Salmon patch, Trachyonychia, Dilated nailbed capillaries at the onychodermal band, Splinter hemorrhage, Leukonychia and Lunula red spot. We found there was no difference between polarized and non polarized mode of dermoscope in examination of fingernails and toenails except that the non polarized mode showed the changes of the Dilated capillaries at the onychodermal band more obviously. And also, there was no difference between wet and dry method of polarized mode of dermoscope.

Conclusion

This study confirms that a handheld dermoscope is a very efficient and simple tool for detection of any nail abnormality.
Prevelance and Causes of Facial Hyperpigmentation in Egypt: Dermoscopic and Histopathological Study
Authors: Abdallah M A , Sultan M Y , Abdallah A H
Published: May 2020

Background

One of the most common dermatological complaints from patients with skin of color is dyspigmentation, particularly hyperpigmentation. The challenge for clinicians is to establish correct diagnoses along with successful treatments to meet the needs of the increasingly diverse population.

Aim of the Work

To identify the prevalence and the causes of facial hyperpigmented lesions in Egyptian people by using dermoscope and histopathological examination.

Patients and Methods

This study is a prospective cross-sectional non-controlled study that included 125 patients with facial hyperpigmentary lesions on the face. The patients were randomly recruited from the outpatient clinic of Dermatology at Ain Shams University Hospitals, during the period from July 2017 till December 2018.

Results

In our study, 67 patients (44%) had melasma; 25patient (16%) PIH and 23 (15%) patients showed freckles. In addition, SK was diagnosed in 10 patients (6%), phototoxicity in 4 patients (2.5%), 11(7.5%) patient was diagnosed with LPP, riehls melanosis was also diagnosed in 3 patients (2%), 2 patient presented with epidermal naevi (1.8%) and one patient presented with naevus of ota (0.5%) and one with solar lentigo (0.5%).

Conclusion

Dermoscopic examination can be dignostec in some diseases like SK and it can be helpful the determine the level of pigmentation and to expect the treatment results. And correlation between histopathology and dermoscopy can be helpful to reach the final diagnosis ant to determine the best treatment choice.
Whole Area versus Focal Acne Scar Treatment (FAST) of Post Acne-Scars by Fractional CO2 Laser: A Comparative Study
Authors: Abdallah M A , Gobrial C K T , Gomah S G H
Published: May 2020

Background

Acne scarring is often the primary concern of a patient with acne. Acne scarring can cause depression and is a risk factor for suicide. Patients feel their appearance interferes with their relationships and chances of future employment. Acne scars can be classified into 3 different types: atrophic, hypertrophic, or keloidal. Atrophic acne scars are the most common type. Atrophic acne scars are divided into three main types: ice pick, rolling and boxcar scars.

Aim of the Work

To compare the results of whole facial area versus Focal Acne Scar Treatment (FAST) by factional CO2 laser in a split face study.

Patients and Methods

The present study is a split face comparative study which included 20 adult patients with atrophic acne scars ranged from 18 to 44 years old of both sex. The study was approved by the Research Ethical Committee, Faculty of Medicine, Ain Shams University and fulfilled all the ethical aspects required in human research. All patients received full information about description of the procedure of treatment, possible side effects, photo documentation and they all provided written consent.

Results

Patients were asked to compare the pain, peeling and complications between the right and left sides post CO2 fractional treatment: pain was more at right side in 35% of cases and more at left side in 30% of cases and equal in the rest of cases, peeling was faster at the right side in 60% of cases, faster at the left side in 20% of cases and equal at the rest of cases, 4 of the patients had post inflammatory hyperpigmentation (1 patient at right side, 2 patients at left side and 1 patient at both sides), no other complications were recorded as secondary infection, scaring keloid and prolonged erythema.

Conclusion

We compared the results of whole facial area treatment in the right side of the face versus Focal Acne Scar Treatment (FAST) in the left side by factional CO2 laser. We discovered that there is a statistically highly significant relationship between the improvement of acne scars and treatment with fractional CO2 laser by the either techniques. Both techniques are preferable in treating acne scars in equal degree.
Effect of Local versus Systemic Steroids in Treatment of Children with Otitis Media with Effusion
Authors: Shafik A G , Hassabalah M S , Maarouf A M , Elghobashy M K
Published: May 2020

Background

otitis media with effusion (OME) or glue ear is the collection of fluid behind the tympanic membrane without inflammatory signs present for 6 weeks.

Aim of the Work

comparing the effect of intra nasal versus systemic steroids in treatment of children with Otitis media with effusion as regard: Improvement of clinical symptoms and Audiological findings.

Subjects and Methods

this study is a prospective, case control study on the effects of intranasal versus systemic steroids on children with otitis media with effusion. This thesis study was conducted on 30 patients diagnosed according to clinical and audiological assessment recruited from otorhinolaryngology outpatient clinic Ain Shams university hospital from October 2017 to July 2018. An informed consent was obtained from each patient or control or their legal guardians before enrolment in the study.

Results

however, statistically there is no significant relation between the occurrence of complete resolution of OME and the route of administration of steroid (either intranasal or systemic), whatever the cause either allergic rhinitis or adenoid hypertrophy. So we can use either intranasal or systemic steroids in management of otitis media with effusion in children with either allergic rhinitis or adenoid hypertrophy or both.

Conclusion

both topical intranasal and oral steroids are effective adjunctive treatment for OME in children in the short term, without significant difference between the two methods, and thus oral steroid complications could be avoided using local steroid spray.
The Impact Of Chronic Rhinosinusitis On Olfaction: Immunohistochemical Study
Authors: Elbeltagy Y F , Elhalabi H S , Ahmed N S , Maarouf A M , Saleeb M F
Published: May 2020

Background

Chronic rhinosinusitis (CRS) is one of the leading causes of olfactory. Olfactory impairments in CRS can be classified into two broad mechanisms of impairment: conductive losses from obstruction of the nasal passages, or sensorineural causes from damage to the olfactory neuroepithelium. Nestin is one type of intermediate filament protein, was a specific marker for OE stem cells. It was found that nestin is actually expressed in the axonal ends and inferior processes of OE sustentacular cells in the basal compartment of the epithelium. Nestin immunoreactivity, which is clearly present in the sustentacular cell layer of normosmic patients, was slightly reduced in the OE of subjects suffering from hyposmia. In contrast, in the OE of anosmics, nestin expression was found to be noticeably reduced. This indicates that expression of nestin protein is related to olfactory function and is down regulated with loss of olfactory function.

Methods

This study included 60 patients (20 chronic rhinosinusitis with polyps patients (CRSwp), 20 chronic rhinosinusitis without polyps patients (CRSsp), and 20 controls). Biopsies taken from olfactory mucosa during surgery. Immunohistochemical examination was done using nestin protein marker, a marker directly related to function in olfactory mucosa, to examine the etiology of olfactory dysfunction in CRS.

Results

There was a significant difference between the three study groups was found regarding olfaction. While there was a highly statistically significant difference between the three groups regarding nestin staining pattern, however, when comparing the two cases groups, the difference was not significant. Nestin staining decreased in both cases groups and patients with CRSwp have more olfactory dysfunction than patients with CRSsp. This means that while the inflammatory process is strongly present in both groups, the presence of polyps increases olfactory function loss.

Conclusion

Olfactory dysfunction in patients with CRS is multifactorial where both obstructive and inflammatory causes contribute in the pathogenesis.
A comparative study between the effect of radio-chemotherapy versus surgery with or without postoperative radiotherapy on advanced stage hypopharyngeal carcinoma (stage III and IV)
Authors: Hamid O , Ahmed S , Elrashedy M F
Published: May 2020

Background

The improvement of clinical outcomes for patients with hypopharyngeal SCC has been particularly challenging for head and neck surgeons and oncologists. CRT has been used for patients with advanced hypopharyngeal cancer with the aim of preserving the larynx. The reasons for the un-favorable prognosis of hypopharyngeal cancers are the strong tendency for extensive sub-mucosal spread, the early occurrence of regional lymphatic involvement, and the relatively high rate of distant spread.

Aim

This study was conducted to collect the recent data about the different modalities of management of advanced stage hypopharyngeal carcinoma (stage III and IV), and systematically review the outcomes of each modality either alone or in combination and compare the efficacy of them.

Method

I- Target determination II- Identification and location of articles III- Screening and evaluation of articles IV- Data collection V- Reporting and interpretation VI- Discussion and consultation

Results

We found 650 record; of them 160 unique records identified (duplicate removed) by the database searches; 490 were excluded based on title and abstract review; 160 article are searched for eligibility by full text review; 119 articles cannot be accessed or obtain full text; 10 studies were reviews and case reports; 3 were not describing functional outcome, overall survival, regarding surgery group was reported in 8 studies with total 1657 patients achieved overall survival (46.23%); While in CRT group, it was reported in 18 studies with total 2995patients achieved overall survival (43%).Comparative study between the 2 groups revealed decrease in overall survival rate; in CRT group; compared to surgery group; with significant statistical difference (p = 0.019).

Conclusion

The treatment approach had a significant impact on OS and RR, as described in other series. Given the equivalence between these two strategies suggested in several series, definitive CRT seems to be an advantageous option as it improves organ preservation and, consequently, the functional outcome.

Recent developments in chemo-radiation treatment techniques could hopefully increase tumor management and survival rates.